Burnout among nursing staff in accident and emergency and acute medicine: a comparative study.
Gillespie, Mark; Melby, Vidar
2003-11-01
This study was designed to identify the prevalence of burnout among nurses working in Accident and Emergency (A & E) and acute medicine, to establish factors that contribute to stress and burnout, to determine the experiences of nurses affected by it and highlight its effects on patient care and to determine if stress and burnout have any effects on individuals outside the clinical setting. A triangulated research design was used incorporating quantitative and qualitative methods. Maslach Burnout Inventory was used. Nurses working in acute medicine experienced higher levels of emotional exhaustion than their A & E counterparts. The overall level of depersonalization was low. High levels of personal accomplishment were experienced less by junior members of staff. Stress and burnout have far reaching effects both for nurses in their clinical practice and personal lives. If nurses continue to work in their current environment without issues being tackled, then burnout will result. The science of nursing does not have to be painful, but by recognition of the existence of stress and burnout we can take the first steps towards their prevention.
Accident and emergency management
International Nuclear Information System (INIS)
Andersen, V.; Moellenbach, K.; Heinonen, R.; Jakobsson, S.; Kukko, T.; Berg, Oe.; Larsen, J.S.; Westgaard, T.; Magnusson, B.; Andersson, H.; Holmstroem, C.; Brehmer, B.; Allard, R.
1988-06-01
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)
Radiological accidents balance in medicine
International Nuclear Information System (INIS)
Nenot, J.C.
1995-01-01
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
Further studies into the emergency medical care of radiation accidents
International Nuclear Information System (INIS)
Nakao, Isamu
1989-01-01
The emergency medical care of radiation accidents constitute a peculier characteristics of radiation protection including the works of the administrative management, environmental radiological monitoring and health physics around the clinical medicine. It is thought to be an interdisciplinary medical field which is designated as a comprehensive medicine for radiation hazard. Moreover, it will be thought that the radiological medicine is not only the medical science which deals with the use of radiant energy in the diagnosis and treatment of disease, but also the art and science of maintenance of health and cure for radiation injuries, just as the two wheels of a cart. It should reward the needs of today. We would like to expect that this symposium will be a clue to the theoretical systematization of the comprehensive medicine of radiation accidents. (author)
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.
Accident knowledge and emergency management
International Nuclear Information System (INIS)
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
All-Russian service of disaster medicine organizes response of radiative accidents
International Nuclear Information System (INIS)
Avetisov, G.M.; Goncharov, S.F.; Grachev, M.I.
1996-01-01
Theoretical base to establish the All-Russian service for disaster medicine (ARSDM) is elaborated. The arrangement system for medical aid for the population of the Chernobyl NPP (including the aspects of planning and management) is proved in action. COnclusion is made about the necessity to introduce special structure of measures aimed at provision of medical aid of accident victims, of their evacuation and treatment under elimination of radiation accidents. This structure requires to unify all abilities and means of health service into the single system for Medical Provision of population under the emergencies. 4 figs., 2 tabs
Akgül Karadana, Gökçe; Metin Aksu, Nalan; Akkaş, Meltem; Akman, Canan; Üzümcügil, Akın; Özmen, M Mahir
2013-12-09
Traffic accidents are ranked first as the cause of personal injury throughout the world. The high number of traffic accidents yielding injuries and fatalities makes them of great importance to Emergency Departments. Patients admitted to Hacettepe University Faculty of Medicine Adult Emergency Department due to traffic accidents were investigated epidemiologically. Differences between groups were evaluated by Kruskall-Wallis, Mann-Whitney, and Wilcoxon tests. A value of paccidents were the most common. In 2004 the rate of traffic accidents (15.3%) was higher than the other years, the most common month was May (10.8%), and the most common time period was 6 pm to 12 am (midnight). About half of the patients (51.5%) were admitted in the first 30 minutes. Life-threatening condition was present in 9.6% of the patients. Head trauma was the most common type of trauma, with the rate of 18.3%. Mortality rate was 81.8%. The average length of hospital stay was 403 minutes (6.7 hours) and the average cost per patient was 983 ± 4364 TL. Further studies are needed to compare the cost found in this study with the mean cost for Turkey. However, the most important step to reduce the direct and indirect costs due to traffic accidents is the prevention of these accidents.
Reconstruction of the Chernobyl emergency and accident management
International Nuclear Information System (INIS)
Schinner, F.; Andreev, I.; Andreeva, I.; Fritsche, F.; Hofer, P.; Lettner, E.; Seidelberger, E.; Kromp-Kolb, H.; Kromp, W.
1998-01-01
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)
Emergency Response to Radioactive Material Transport Accidents
International Nuclear Information System (INIS)
EL-shinawy, R.M.K.
2009-01-01
Although transport regulations issued by IAEA is providing a high degree of safety during transport opertions,transport accidents involving packages containing radioactive material have occurred and will occur at any time. Whenever a transport accident involving radioactive material accurs, and many will pose no radiation safety problems, emergency respnose actioms are meeded to ensure that radiation safety is maintained. In case of transport accident that result in a significant relesae of radioactive material , loss of shielding or loss of criticality control , that consequences should be controlled or mitigated by proper emergency response actions safety guide, Emergency Response Plamming and Prepardness for transport accidents involving radioactive material, was published by IAEA. This guide reflected all requirememts of IAEA, regulations for safe transport of radioactive material this guide provide guidance to the publicauthorites and other interested organziation who are responsible for establishing such emergency arrangements
International Nuclear Information System (INIS)
1989-01-01
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
National emergency plan for nuclear accidents
International Nuclear Information System (INIS)
1992-10-01
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
[Diving accidents. Emergency treatment of serious diving accidents].
Schröder, S; Lier, H; Wiese, S
2004-11-01
Decompression injuries are potentially life-threatening incidents mainly due to a rapid decline in ambient pressure. Decompression illness (DCI) results from the presence of gas bubbles in the blood and tissue. DCI may be classified as decompression sickness (DCS) generated from the liberation of gas bubbles following an oversaturation of tissues with inert gas and arterial gas embolism (AGE) mainly due to pulmonary barotrauma. People working under hyperbaric pressure, e.g. in a caisson for general construction under water, and scuba divers are exposed to certain risks. Diving accidents can be fatal and are often characterized by organ dysfunction, especially neurological deficits. They have become comparatively rare among professional divers and workers. However, since recreational scuba diving is gaining more and more popularity there is an increasing likelihood of severe diving accidents. Thus, emergency staff working close to areas with a high scuba diving activity, e.g. lakes or rivers, may be called more frequently to a scuba diving accident. The correct and professional emergency treatment on site, especially the immediate and continuous administration of normobaric oxygen, is decisive for the outcome of the accident victim. The definitive treatment includes rapid recompression with hyperbaric oxygen. The value of adjunctive medication, however, remains controversial.
International Nuclear Information System (INIS)
Yang Ling
2011-01-01
Nuclear accident assessment is one of the bases for emergency decision-making in the situation of nuclear accident in NPP. Usually, the assessment includes accident status and consequence assessment. It is accident status assessment, and its application in emergency decision-making is introduced here. (author)
International Nuclear Information System (INIS)
Berger, M.E.
1982-01-01
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
Explanation of procedure on site medical emergency response for nuclear accident
International Nuclear Information System (INIS)
Liu Yulong; Jiang Zhong
2012-01-01
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)
International Nuclear Information System (INIS)
2000-01-01
The purpose of the Nuclear Accident/Radiological Emergency Assistance Plan (NAREAP) is to describe the framework for systematic, integrated, co-ordinated, and effective preparedness and response for a nuclear accident or radiological emergency involving facilities or practices that may give rise to a threat to health, the environment or property. The purpose of the NAREAP is: to define the emergency response objectives of the Agency's staff in a nuclear accident or a radiological emergency; to assign responsibilities for performing the tasks and authorities for making the decisions that comprise the Agency staff's response to a nuclear accident or radiological emergency; to guide the Agency managers who must ensure that all necessary tasks are given the necessary support in discharging the Agency staff responsibilities and fulfilling its obligations in response to an emergency; to ensure that the development and maintenance of detailed and coherent response procedures are well founded; to act as a point of reference for individual Agency staff members on their responsibilities (as an individual or a team member) throughout a response; to identify interrelationships with other international intergovernmental Organizations; and to serve as a training aid to maintain readiness of personnel. The NAREAP refers to the arrangements of the International Atomic Energy Agency and of the United Nations Security and Safety Section at the Vienna International Centre (UNSSS-VIC) that may be necessary for the IAEA to respond to a nuclear accident or radiological emergency, as defined in the Early Notification and Assistance Conventions. It covers response arrangements for any situation that may have actual, potential or perceived radiological consequences and that could require a response from the IAEA, as well as the arrangements for developing, maintaining and exercising preparedness. The implementing procedures themselves are not included in the NAREAP, but they are required
Emergency planning and preparedness for a nuclear accident
International Nuclear Information System (INIS)
Rahe, E.P.
1985-01-01
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
Bibliography for nuclear criticality accident experience, alarm systems, and emergency management
International Nuclear Information System (INIS)
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
Reevaluation of nasal swab method for dose estimation at nuclear emergency accident
International Nuclear Information System (INIS)
Yamada, Yuji; Fukutsu, Kumiko; Kurihara, Osamu; Akashi, Makoto
2008-01-01
ICRP Publication 66 human respiratory tract model has been used extensively over in exposure dose assessment. It is well known that respiratory deposition efficiency of inhaled aerosol and its deposition region strongly depend on the particle size. In most of exposure accidents, however, nobody knows a size of inhaled aerosol. And thus two default aerosol sizes of 5μ in AMAD for the workers and 1μ in AMAD for the public are given as being representative in the ICRP model, but both sizes are not linked directly to the maximum dose. In this study, the most hazardous size to our health effects and how to estimate an intake activity was discussed from a viewpoint of emergency medicine. In exposure accident of alpha emitter such as Pu-239, lung monitor and bioassay measurements are not the best methods for rapid estimation with high sensitivity, so that an applicability of nasal swab method has been investigated. A computer software, LUDEP, was used in the calculation of respiratory deposition. It showed that the effective dose per unit intake activity strongly depended on the inhaled aerosol size. In case of Pu-239 dioxide aerosols, it was confirmed that the maximum of dose conversion factor was observed around 0.01μ. It means that this 0.01μ is the most hazardous size at exposure accident of Pu-239. From analysis of the relationship between AI and ET l deposition, it was found that the dose conversion factor from the activity deposited in ET l region also was affected by the aerosol size. The usage of the ICRP's default size in nasal swab method might cause obvious underestimation of the intake activity. Dose estimation based on nasal swab method is possible from safety side at nuclear emergency, and the availability in quantity should be reevaluated for emergency medicine considering of chelating agent administration. (author)
International Nuclear Information System (INIS)
Li Wei; Ding Qihua; Wu Haosong
2014-01-01
On March 11, 2011, the Fukushima Dai-ichi Nuclear Power Station of the Tokyo Electric Power Company ('TEPCO') was hit and damaged by a magnitude 9 earthquake and accompanying tsunami. The accident is determined to be of the highest rating on the International Nuclear Event Scale. The Government of Japan and TEPCO have taken emergency response actions on-site and off-site at the accident. It became clear through the investigation that the accident had been initiated on the occasion of a natural disaster of an earthquake and tsunami, but there have been various complex problems behind this very serious and large scale accident. For an example, the then-available accident preventive measures and disaster preparedness of TEPCO were insufficient against tsunami and severe accidents; inadequate TEPCO emergency responses to the accident at the site were also identified. The accident rang the alarm for the nuclear safety of nuclear power plants. It also taught us a great of lessons in nuclear emergency management. (authors)
Proposal optimization in nuclear accident emergency decision based on IAHP
International Nuclear Information System (INIS)
Xin Jing
2007-01-01
On the basis of establishing the multi-layer structure of nuclear accident emergency decision, several decision objectives are synthetically analyzed, and an optimization model of decision proposals for nuclear accident emergency based on interval analytic hierarchy process is proposed in the paper. The model makes comparisons among several emergency decision proposals quantified, and the optimum proposal is selected out, which solved the uncertain and fuzzy decision problem of judgments by experts' experiences in nuclear accidents emergency decision. Case study shows that the optimization result is much more reasonable, objective and reliable than subjective judgments, and it could be decision references for nuclear accident emergency. (authors)
Multi-objective evolutionary emergency response optimization for major accidents
International Nuclear Information System (INIS)
Georgiadou, Paraskevi S.; Papazoglou, Ioannis A.; Kiranoudis, Chris T.; Markatos, Nikolaos C.
2010-01-01
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.
Individual feature identification method for nuclear accident emergency decision-making
International Nuclear Information System (INIS)
Chen Yingfeng; Wang Jianlong; Lin Xiaoling; Yang Yongxin; Lu Xincheng
2014-01-01
According to the individual feature identification method and combining with the characteristics of nuclear accident emergency decision-making, the evaluation index system of the nuclear accident emergency decision-making was determined on the basis of investigation and analysis. The effectiveness of the nuclear accident emergency decision-making was evaluated based on the individual standards by solving the individual features of the individual standard identification decisions. The case study shows that the optimization result is reasonable, objective and reliable, and it can provide an effective analysis method and decision-making support for optimization of nuclear accident emergency protective measures. (authors)
System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals
International Nuclear Information System (INIS)
Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio
2011-01-01
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
Accident assessment under emergency situation in Daya Bay nuclear power station
International Nuclear Information System (INIS)
Yang Ling; Chen Degan; Lin Shumou; Fu Guohui
2004-01-01
The accident assessment under emergency situation includes the accident status evaluation and its consequence estimation. This paper introduces evaluation methods for accident status and its assistant computer system (SESAME-GNP) utilized during the emergency situation in Guangdong Daya Bay Nuclear Power Station (GNPS) in detail. At the same time, an improved accident consequence estimation system in GNPS (RACAS-GNP) is briefly described. With the improvement of the accident assessment systems, the capability of emergency response in GNPS is strengthened
Research on sever accident emergency simulation system for CPR1000
International Nuclear Information System (INIS)
Yang Zhifei; Liao Yehong; Liang Manchun; Li Ke; Yang Jie; Chen Yali
2015-01-01
The enhanced capability to nuclear power plant (NPP) severe accident management and emergency response depends heavily on exercises. Since the exercise scene is usually monotonous and not realistic, and conduct of exercise has a high cost, the effect of enhancing the capability is limited. Thus, the development of a Sever Accident Emergency Simulation System (SAESS) is necessary. SAESS is able to connect NPP simulator, and simulates the process of severe accident management, personnel evacuation, the dispersion of radioactive plume, and emergency response of emergency organizations. The system helps to design several of exercise scenes and optimize the disposal strategy in different severe accidents. In addition, the system reduces the cost of emergency exercise by computer simulation, benefits the research of exercise, increases the efficiency of exercise and enhances the emergency decision-making capability. This paper introduces the design and application of SAESS. (author)
Experience and lessons learned from emergency disposal of Fukushima nuclear power station accident
International Nuclear Information System (INIS)
Xu Xiegu; Zhen Bei; Yang Xiaoming; Chen Xiaohua
2012-01-01
After Fukushima nuclear accident, we visited the related medical aid agencies for nuclear accidents and conducted investigations in disaster-affected areas in Japan. This article summarizes the problems with emergency disposal of Fukushima nuclear accident while disclosing problems should be solved during the emergency force construction for nuclear accidents. (authors)
Cooke, M. W.; Allan, T. F.; Wilson, S.
1999-01-01
AIM: To determine whether there were any changes in attendance at accident and emergency departments that could be related to international football matches (Euro96 tournament). METHOD: Fourteen accident and emergency departments (seven adjacent to and seven distant from a Euro96 venue) provided their daily attendance figures for a nine week period: three weeks before, during, and after the tournament. The relation between daily attendance rates and Euro96 football matches was assessed ...
Transport accident emergency response plan
International Nuclear Information System (INIS)
Vallette-Fontaine, M.; Frantz, P.
1998-01-01
To comply with the IAEA recommendations for the implementation of an Emergency Response Plan as described in Safety Series 87, Transnucleaire, a company deeply involved in the road and rail transports of the fuel cycle, masters means of Emergency Response in the event of a transport accident. This paper aims at analyzing the solutions adopted for the implementation of an Emergency Response Plan and the development of a technical support and adapted means for the recovery of heavy packagings. (authors)
International Nuclear Information System (INIS)
McLaughlin, Thomas P.
2003-01-01
This paper presents analyses and applications of data from reactor and critical experiment research on the dynamics of nuclear excursions in solution media. Available criticality accident information is also discussed and shown to provide strong evidence of the overwhelming likelihood of accidents in liquid media over other forms and to support the measured data. These analyses are shown to provide valuable insights into key parameters important to understanding solution excursion dynamics in general and in evaluating practical upper bounds on criticality accident magnitudes. This understanding and these upper bounds are directly applicable to the evaluation of the consequences of postulated criticality accidents. These bounds are also essential in order to comply with national and international consensus standards and regulatory requirements for emergency planning. (author)
Emergency medicine and general practice
Abela, Gunther
2005-01-01
Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneu...
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...
Emergency preparedness and response: compensating victims of a nuclear accident
International Nuclear Information System (INIS)
Schwartz, Julia
2004-01-01
The 1986 tragedy at the Chernobyl Nuclear Power Plant in Ukraine motivated the entire international nuclear community to ensure that countries would, in the future, be well prepared to manage the physical, psychological and financial consequences of a serious nuclear accident. Since that event, numerous nuclear emergency preparedness and post-emergency management programmes have been established at national and international levels to ensure that appropriate mechanisms will respond to the threat, and the aftermath, of a nuclear accident. The INEX 2000 Workshop on the Indemnification of Nuclear Damage, jointly organised by the OECD/Nuclear Energy Agency and the French Government, was the first ever international programme to address the manner in which victims of a nuclear accident with trans-boundary consequences would be compensated for damage suffered before, during and after the accident. The Workshop results revealed striking differences in the compensation principles and practices implemented in the 30 participating countries, in the co-ordination measures between different public authorities within an affected state, and in the co-operative procedures between the accident state and its neighbours. All participants agreed on the need for improvement in these areas, particularly for maintaining public confidence in governments' ability to properly manage nuclear emergencies
International Nuclear Information System (INIS)
2009-01-01
This Safety Guide provides guidance on various aspects of emergency planning and preparedness for dealing effectively and safely with transport accidents involving radioactive material, including the assignment of responsibilities. It reflects the requirements specified in Safety Standards Series No. TS-R-1, Regulations for the Safe Transport of Radioactive Material, and those of Safety Series No. 115, International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. Contents: 1. Introduction; 2. Framework for planning and preparing for response to accidents in the transport of radioactive material; 3. Responsibilities for planning and preparing for response to accidents in the transport of radioactive material; 4. Planning for response to accidents in the transport of radioactive material; 5. Preparing for response to accidents in the transport of radioactive material; Appendix I: Features of the transport regulations influencing emergency response to transport accidents; Appendix II: Preliminary emergency response reference matrix; Appendix III: Guide to suitable instrumentation; Appendix IV: Overview of emergency management for a transport accident involving radioactive material; Appendix V: Examples of response to transport accidents; Appendix VI: Example equipment kit for a radiation protection team; Annex I: Example of guidance on emergency response to carriers; Annex II: Emergency response guide.
Local emergency arrangements for radiation accidents
International Nuclear Information System (INIS)
Jones, A.
1989-01-01
This paper describes the local and national framework for public protection during peacetime emergencies with particular reference to major accidents or events with radiological consequences. The basis for the development of emergency plans will be described together with the inter-relationship between the responsibilities of individual organisations. (author)
The Fukushima Daiichi Accident. Technical Volume 3/5. Emergency Preparedness and Response
International Nuclear Information System (INIS)
2015-08-01
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
Considerations on radiation protection and accidents in nuclear medicine
International Nuclear Information System (INIS)
Lima, Carla Flavia de; Avelar, Artur Canella; Campos, Tarcisio P.R.
2001-01-01
The present study presents the radiation protection in the services of nuclear medicine in relation to the design of the services, manipulation of sources, cares with the patient, accomplishment of procedures and definition of accidents and incidents; besides approaching the CNEN requirements
Emergency handling of radiation accident cases: firemen
International Nuclear Information System (INIS)
Procedures for the emergency handling of persons exposed to radiation or radioactive contamination are presented, with emphasis on information needed by firemen. The types of radiation accident patients that may be encountered are described and procedures for first aid, for preventing the spread of radioactive contamination, and for reporting the accident are outlined
Radiological emergency: road map for radiation accident victim transport
International Nuclear Information System (INIS)
Costa, V.S.G.; Alcantara, Y.P.; Lima, C.M.A.; Silva, F. C. A. da
2017-01-01
During a radiological or nuclear emergency, a number of necessary actions are taken, both within the radiation protection of individuals and the environment, involving many institutions and highly specialized personnel. Among them it is possible to emphasize the air transportation of radiation accident victims.The procedures and measures for the safe transport of these radiation accident victims are generally the responsibility of the armed forces, specifically the Aeronautics, with the action denominated 'Aeromedical Military Evacuation of Radiation Accident Victims'. The experience with the Radiological Accident of Goiânia demonstrated the importance of adequate preparation and response during a radiological emergency and the need for procedures and measures with regard to the transport of radiation victims are clearly defined and clearly presented for the effectiveness of the actions. This work presents the necessary actions for the transport of radiation accident victim during a radiological emergency, through the road map technique, which has been widely used in scientific technical area to facilitate understanding and show the way to be followed to reach the proposed objectives
Medical emergency and first aid for radiation accident
International Nuclear Information System (INIS)
Suzuki-Yasumoto, Masashi
1980-01-01
The thinkings concerning the injuries to human beings in nuclear accidents differ somewhat between Japan and the U.S.A. and other European countries. In accordance with the historical evolution of nuclear power and the characteristics of medical system in respective countries, there are more or less modified measures in the scheme of three phases; i.e. first aid stations on the sites of nuclear facilities, support hospitals, and radiation injury centers, in order. So far, easy reliance on such as the National Institute of Radiological Sciences was large, but with the Three Mile Island nuclear plant accident as the turning point, the emergency and first aid systems are being studied intensively both in the Government and private nuclear power enterprises. The following matters are described: the differences in thinkings between Japan and other countries; fundamentals in the medical emergency scheme in radiation accidents; the systems in U.S.A., U.K., France and West Germany; and the problems and measures in the scheme of Japan. (J.P.N.)
Emergency response planning and preparedness for transport accidents involving radioactive material
International Nuclear Information System (INIS)
1988-01-01
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
Female authorship in emergency medicine parallels women practicing academic emergency medicine.
Tinjum, Banu E; Getto, Leila; Tiedemann, Juliah; Marri, Maaya; Brodowy, Michelle; Bollinger, Melissa; O'Connor, Robert E; Breyer, Michael J
2011-12-01
Studies have shown that women in emergency medicine (EM) lag behind their male counterparts in academic productivity. We compared the proportion of female attending physicians from EM academic programs to the proportion of female first or second authors of original scientific manuscripts and case reports from four major EM journals in a single year. We used a retrospective cross-sectional design. Original scientific manuscripts and case reports from four major EM journals published in 2005: Academic Emergency Medicine, Annals of Emergency Medicine, American Journal of Emergency Medicine, and Journal of Emergency Medicine were reviewed to determine genders of first and second authors. The proportion of female first or second authorship was then compared to the proportion of female EM attending physicians from 134 academic EM programs in the United States. Data were analyzed using Pearson's chi-squared and Clopper-Pearson binomial confidence intervals as appropriate. A p-value of ≤ 0.05 was considered significant. The percentage of female faculty; 940/3571 (26.32%, 95% confidence interval [CI] 24.9-27.8%) vs. the percentage of female first or second authorship 289/1123 (25.73%, 95% CI 23.3-28.4%) was not statistically significant (p = 0.562). There was no difference in the proportion of male and female authors with multiple manuscripts (p = 0.889). As measured by first and second authorship, there was no discrepancy between the proportion of female EM faculty and the proportion of female authorship in EM literature from 2005. Copyright © 2011 Elsevier Inc. All rights reserved.
Populations protection and territories management in nuclear emergency and post-accident situation
International Nuclear Information System (INIS)
Bourrel, M.; Calmon, Ph.; Calvez, M.; Chambrette, V.; Champion, D.; Devin, P.; Godino, O.; Lombard, J.; Rzepka, J.P.; Schneider, Th.; Verhaeghe, B.; Cogez, E.; Kayser, O.; Guenon, C.; Jourdain, J.R.; Bouchot, E.; Murith, Ch.; Lochard, J.; Cluchier, A.; Vandecasteele, Ch.; Pectorin, X.; Dubiau, Ph.; Gerphagnon, O.; Roche, H.; Cessac, B.; Cochard, A.; Machenaud, G.; Jourdain, J.R.; Pirard, Ph.; Leger, M.; Bouchot, E.; Demet, M.; Charre, J.P.; Poumadere, M.; Cogez, E.
2010-01-01
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
ANS-8.23: Criticality accident emergency planning and response
International Nuclear Information System (INIS)
Pruvost, N.L.
1991-01-01
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
Overcrowding of accident & emergency units: is it a growing concern ...
African Journals Online (AJOL)
Overcrowding of accident & emergency units: is it a growing concern in Nigeria? ... of the Nigeria's Accident and Emergency Departments (AED) to meet current ... The data supporting perceptions of insufficient capacity are limited. ... better organized and diligent discharge planning, and reducing access block should be a ...
State of emergency medicine in Azerbaijan
Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam
2008-01-01
Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...
Directory of Open Access Journals (Sweden)
Sricharoen P
2015-02-01
Full Text Available Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010 at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74% were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001. The top three highest average satisfaction scores in the new EM curriculum group were trauma
International Nuclear Information System (INIS)
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
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.
Accidents and emergency conditions: Legal aspects
International Nuclear Information System (INIS)
Peinsipp, N.
1985-01-01
The currently valid versions of the Federal German Atomic Energy Act, the Radiation Protection Ordinance, and the X-Ray Ordinance show differences with regard to the use of the terms 'accident' or 'emergency', respectively, preferring either one or the other term, or using both terms. The author comments on this lack of harmonization in terminology and goes into details on aspects such as legislation and application of law. (DG) [de
[Diagnosis and treatment of diving accidents. New German guidelines for diving accidents 2014-2017].
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.
Emergency department discharge prescription interventions by emergency medicine pharmacists.
Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G
2013-02-01
We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.
International Nuclear Information System (INIS)
Ho Van Cu; Nguyen Huu Nghia
2011-01-01
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)
International Nuclear Information System (INIS)
Belyi, D. A.; Khomenko, V. I.; Bebeshko, V. G.
2009-01-01
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)
Risk analysis of emergent water pollution accidents based on a Bayesian Network.
Tang, Caihong; Yi, Yujun; Yang, Zhifeng; Sun, Jie
2016-01-01
To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.
International Nuclear Information System (INIS)
Aleksanin, S.
2016-01-01
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. (authors)
ANSI/ANS-8.23-1997: nuclear criticality accident emergency planning and response
International Nuclear Information System (INIS)
Baker, J.S.
2004-01-01
American National Standard ANSUANS-8.23 was developed to expand upon the basic emergency response guidance given in American National Standard, 'Administrative Practices for Nuclear Criticality Safety' ANSI/ANS-8.19-1996 (Ref. 1). This standard provides guidance for minimizing risks to personnel during emergency response to a nuclear criticality accident outside reactors. This standard is intended to apply to those facilities for which a criticality accident alarm system, as specified in American National Standard, 'Criticality Accident Alarm System', ANSI/ANS-8.3-1997 (Ref. 2) is in use. The Working Group was established in 1990, with Norman L. Pruvost as chairman. The Working Group had up to twenty-three members representing a broad range of the nuclear industry, and has included members from Canada, Japan and the United Kingdom. The initial edition of ANSI/ANS-8.23 was approved by the American National Standards Institute on December 30, 1997. It provides guidance for the following topics: (1) Management and technical staff responsibilities; (2) Evaluation of a potential criticality accident; (3) Emergency plan provisions; (4) Evacuation; (5) Re-entry, rescue and stabilization; and (6) Classroom training, exercises and evacuation drills. This guidance is not for generic emergency planning issues, but is specific to nuclear criticality accidents. For example, it assumes that an Emergency Plan is already established at facilities that implement the standard. During the development of the initial edition of ANSI/ANS-8.23, each Working Group member evaluated potential use of the standard at a facility with which the member was familiar. This revealed areas where a facility could have difficulty complying with the standard. These reviews helped identify and eliminate many potential problems and ambiguities with the guidance. The Working Group has received very limited feedback from the user community since the first edition of the standard was published. Suggestions
International Nuclear Information System (INIS)
Kato, Hideki; Suzuki, Shoichi; Koga, Sukehiko; Mukoyama, Takashi; Tomatsu, Hirotaka; Suzuki, Yusuke
2009-01-01
Radionuclide contamination is one of the accidents that might occur while carrying out a periodical inspection of nuclear power stations during normal reactor operation. When such an accident occurs, rescue and medical personnel, involved in transporting and treating affected workers run the risk of exposure to secondary radiation. In this study, the ambient dose equivalent rate at a certain distance from the surface of the human body contaminated with typical radioactive corrosion products was calculated. Further, the relationships among the adhesion area, contamination density, and secondary exposure dose were clarified. The secondary exposure dose and permissible working hours in a radiation emergency medicine were estimated by presenting these relationships in the form of a chart and by specifying the contamination levels. (author)
Study on the offsite emergency planning against an accident in NPP
International Nuclear Information System (INIS)
Khang, Byung Oui; Lee, Goan Yup; Wu, Jong Sup; Kim, Joo Hag; Lee, Jong Tai; Lee, Jae Eun; Ahn, Chul Hyun; Ahn, Jae Hyun; Park, Dae Woo
2009-12-01
- Proposing effective local nuclear emergency preparedness system against nuclear/radiological accidents. - Proposing improved preparation/operation scheme on emergency response facilities, installations and equipment. - Establishing protection scheme on the general public against nuclear/radiological accidents. - Proposing effective preparation/operation scheme on local radioactive monitoring system. - Establishing effective training/drill scheme on the nuclear emergency preparedness. - Proposing effective technical administrative system of the local government (Busan metropolitan city)
Emergency response and nuclear risk governance. Nuclear safety at nuclear power plant accidents
International Nuclear Information System (INIS)
Kuhlen, Johannes
2014-01-01
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
International Nuclear Information System (INIS)
Adler, V.; Sorensen, J.H.; Rogers, G.O.
1989-01-01
Because the goal of emergency preparedness for both chemical and nuclear hazards is to reduce human exposure to hazardous materials, this paper examines the interchange of lessons learned from emergency planning and accident experience in both industries. While the concerns are slightly different, sufficient similarity is found for each to draw implications from the others experience. Principally the chemical industry can learn from the dominant planning experience associated with nuclear power plants, while the nuclear industry can chiefly learn from the chemical industry's accident experience. 23 refs
International Nuclear Information System (INIS)
Odano, N.; Matsuoka, T.; Suzuki, H.
2004-01-01
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
Guidelines for attendance and registration for radiological emergencies of nuclear accidents
International Nuclear Information System (INIS)
1994-01-01
Today in Brazil the use of nuclear energy is becoming an usual practice in various activities. Thus, must be a matter of great weight, directions for attendance and registration for radiological emergencies or nuclear accidents. This work shows the planning elaborated by the Comissao Nacional de Energia Nuclear (Brazilian CNEN) for nuclear plants, aiming avoid the injurious effects from the ionizing radiation exposure, radionuclides release or the direct or indirect exposure of ionizing radiation, that proceeding from a radiological emergencies or a nuclear accidents. (J.A.M.M.)
Optimization of emergency response to major nuclear accidents
International Nuclear Information System (INIS)
Papazoglou, I.A.; Christou, M.D.
1991-01-01
A methodology for the optimization of the short-term emergency response in the event of a nuclear accident has been developed. The method aims at an optimum combination of protective actions in the presence of a multitude of conflicting objectives and under uncertainty. Conflicting objectives arise when the minimization of the potential adverse effects of an accident and the simultaneous minimization of the associated socioeconomic impacts is attempted. Additional conflicting objectives appear whenever an emergency plan tends to decrease a particular health effect (e.g. acute deaths) while at the same time it increases another (e.g. latent deaths). The uncertainty is due to the multitude of the possible accident scenarios and their respective probability of occurrence, the stochastic variability in the weather conditions and in the variability and/or lack of knowledge in the parameters of the risk assessment models. A multiobjective optimization approach is adopted in a dynamic programming scheme. An emergency protective plan consists of defining a protective action (e.g. evacuation, sheltering) at each spatial cell around the plant. Three criteria (evaluators) are used as the objective functions of the problem, namely, acute fatalities, latent effects and socioeconomic cost. The optimization procedure defines the efficient frontier, i.e. all emergency plans that are not dominated by another in all three criteria. No value trade-offs are necessary up to this point
[Accidents and violence among women attended in Sentinel Emergency Services--Brazil, 2009].
Rodrigues, Celeste de Souza; Malta, Deborah Carvalho; Godinho, Tatau; Mascarenhas, Márcio Dênis Medeiros; da Silva, Marta Maria Alves; Silva, Rurany Ester
2012-09-01
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 important that services are able to provide comprehensive and humanized care to the victims of this important public health problem.
Severe accident management at nuclear power plants - emergency preparedness and response actions
International Nuclear Information System (INIS)
Pawar, S.K.; Krishnamurthy, P.R.
2015-01-01
This paper describes the current level of emergency planning and preparedness and also improvement in the emergency management programme over the years including lessons learned from Fukushima accident, hazard analysis and categorization of nuclear facilities into hazard category for establishing the emergency preparedness class, classification of emergencies based on the Emergency Action Levels (EAL), development of EAL’s for PHWR, Generic Criteria in terms of projected dose for initiating protective actions (precautionary urgent protective actions, urgent protective actions, early protective actions), operational intervention levels (OIL), Emergency planning zones and distances, protection strategy and reference levels, use of residual dose for establishing reference levels for optimization of protection strategy, criteria for termination of emergency, transition of emergency exposure situation to existing exposure situation or planned exposure situation, criteria for medical managements of exposed persons and guidance for controlling the dose of emergency workers. This paper also highlights the EALs for typical PHWR type reactors for all types of emergencies (plant, site and offsite), transition from emergency operating procedures (EOP) to accident management guidelines (AMG) to emergency response actions and proposed implementation of guidelines
Analysis in nuclear power accident emergency based on random network and particle swarm optimization
International Nuclear Information System (INIS)
Gong Dichen; Fang Fang; Ding Weicheng; Chen Zhi
2014-01-01
The GERT random network model of nuclear power accident emergency was built in this paper, and the intelligent computation was combined with the random network based on the analysis of Fukushima nuclear accident in Japan. The emergency process was divided into the series link and parallel link, and the parallel link was the part of series link. The overall allocation of resources was firstly optimized, and then the parallel link was analyzed. The effect of the resources for emergency used in different links was analyzed, and it was put forward that the corresponding particle velocity vector was limited under the condition of limited emergency resources. The resource-constrained particle swarm optimization was obtained by using velocity projection matrix to correct the motion of particles. The optimized allocation of resources in emergency process was obtained and the time consumption of nuclear power accident emergency was reduced. (authors)
NPP accident scenario. Which emergency measures are planned in Switzerland?
International Nuclear Information System (INIS)
Flury, Christoph
2016-01-01
As a consequence of the reactor accident in Fukushima the Swiss government has ordered an extensive analysis of emergency planning in case of a NPP accident Switzerland. A special working group has analyzed the possible improvements of Swiss emergency planning based on the experiences in Japan. Under the special direction of the Bundesamt fuer Bevoelkerungsschutz (BABS) the agreed improvements were integrated into the emergency concept. The reference scenarios have been re-assessed and the zone concept adapted. The emergency measures include shelter-type rooms (basement or window-less rooms), the preventive distribution of iodine pills, measures concerning agriculture, aquatic systems, preventive evacuation, traffic regulations, and delayed evacuation.
International Nuclear Information System (INIS)
Barat, J.L.; Ducassou, D.; Lesgourgues, P.; Zamaron, S.; Boulard, G.
2006-01-01
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)
Emergency medicine in Dubai, UAE.
Partridge, Robert; Abbo, Michael; Virk, Alamjit
2009-08-18
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.
Emergency medicine in Dubai, UAE
Partridge, Robert; Abbo, Michael; Virk, Alamjit
2009-01-01
Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.
Directory of Open Access Journals (Sweden)
M. S. Khubutiya
2016-01-01
Full Text Available The occurrence of large-scale emergencies with great human losses and the absence of a unified authority of the country health system which would manage its medical and sanitary consequences required the creation of special units to provide emergency health services (EHS in mass injuries. The disaster medicine became attractive for the N.V. Sklifosovsky Research Institute for Emergency Medicine in the 70s of the last century. Originally, the Department for Disaster Medicine was established at the Institute in 1987. At the Department, the extensive work was performed to shorten a time gap between the delivery of medical care and the beginning of a disaster as much as possible. It was based on a created concept for organization of medical assistance and evacuation, methods of its expertise and the development of technical means for phased medical and evacuatiol support of victims. The organizational and medical-diagnostic specificity of EHS in emergencies and its delivery were analyzed in order to reduce the severity of consequences. The health care experience in emergencies has been enriched by the staff of the Institute (who were not employees of the Department actively involved in the management of mass injuries and poisonings via air ambulance at the accident site and in the treatment of victims admitted to the Institute from sites of emergencies. Consequently, the N.V. Sklifosovsky Research Institute for Emergency Medicine developed and offered the scientific and organizational basis for EHS in emergencies which made a significant practical contribution to the creation of public services for disaster medicine in the country.
International Nuclear Information System (INIS)
1987-03-01
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
The criticality accident in Tokaimura and medical aspects of radiation emergency
International Nuclear Information System (INIS)
Chen Xiaohua; Mao Bingzhi
2003-01-01
A criticality accident occurred on September 30, 1999 at the uranium processing plant in Tokaimura Japan, which is the most severe accident since Chernobyl catastrophe. 213 people were exposed to radiation, among them 2 workers were exposed to 16-23 Gy and 6-10 Gy individually, one worker was 2 Gy, 2 people was 10 mSv and 208 person was 0-5 mSv. Author was invited to attend an international symposium on 'The Criticality Accident in Tokaimura Medical Aspects of Radiation Emergency' in Chiba Japan on December 2000. An overview of the accident, dose estimation and neutron relative biological effects are discussed in this article
Emergency Medicine Gender-specific Education.
Ashurst, John V; McGregor, Alyson J; Safdar, Basmah; Weaver, Kevin R; Quinn, Shawn M; Rosenau, Alex M; Goyke, Terrence E; Roth, Kevin R; Greenberg, Marna R
2014-12-01
The 2014 Academic Emergency Medicine consensus conference has taken the first step in identifying gender-specific care as an area of importance to both emergency medicine (EM) and research. To improve patient care, we need to address educational gaps in this area concurrent with research gaps. In this article, the authors highlight the need for sex- and gender-specific education in EM and propose guidelines for medical student, resident, and faculty education. Specific examples of incorporating this content into grand rounds, simulation, bedside teaching, and journal club sessions are reviewed. Future challenges and strategies to fill the gaps in the current education model are also described. © 2014 by the Society for Academic Emergency Medicine.
National radiological emergency response to the Fukushima Daiichi Nuclear Power Plant accident
International Nuclear Information System (INIS)
Dela Rosa, Alumanda M.
2011-01-01
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)
Radioactivity measurement for emergency or post-accident situations
International Nuclear Information System (INIS)
Champion, D.
2010-01-01
Specific objectives have to be achieved by radioactivity measurements during emergency or post-accident situations, which are different from those in normal situation. At the beginning of a nuclear emergency, few radioactivity data will be available, mainly from automatic monitoring systems implemented on the site or in its surrounding. Progressively, measurement programmes will be performed, in priority to get information on dose rate, atmospheric radionuclides and surface activities. In order to avoid excessive exposure of the measure teams, these programmes should be optimized. During early post-accident phase, different types of measurements will be done, following two main objectives: 1) to improve the assessment of the environmental contamination and people exposure; 2) for control purpose, to check the contamination of urban places, foodstuff and other products, compared to specific reference levels. The samples measurement in laboratories would be a challenge: usually, the laboratories involved in routine monitoring have to deal with very low level of radioactivity and a poor diversity of artificial radionuclides; after a reactor accident, the environmental samples to be measured would be more active and with a mixture of radionuclides (mainly with short or middle half-life) difficult to be characterized. So theses laboratories have to be trained and organised before any severe accident. (author)
Brazilian emergency planning for radiological accidents
International Nuclear Information System (INIS)
Mendonca, A.H.
1986-01-01
Brazilian emergency planning for radiological accidents is organized to respond promptly to any emergency at nuclear power plants or other installations utilizing nuclear fuel. It consists of several committees: a general coordination committee with representatives from several federal departments, with final decision with the Brazilian Nuclear Energy Commission (CNEN), and the Federal Environmental Protection Agency (SEMA). Some committees conduct support activities. For example, the Operational Coordination Committee supervises the tasks undertaken by the Army, Navy, and Air Force in response to the needs and decisions of the general coordination committee
International Nuclear Information System (INIS)
Brown, G.S.; Cashwell, J.W.; Apple, M.L.
1993-01-01
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.)
Mutual emergency assistance for radiation accidents
International Nuclear Information System (INIS)
1971-01-01
This document presents the result of a questionnaire survey conducted in order to assess what type of emergency assistance IAEA member states could provide in the event of radiation accidents. The survey covers resources like skilled personnel in collection, analysis and interpretation of data, surveying and radiation protection equipment, radiochemical analysis facilities, and medical assistance capacities
Baskin, Sean M; Lin, Christina; Carlson, Jestin N
2014-11-01
Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.
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.
International Nuclear Information System (INIS)
Wang Yuexing
1999-01-01
The characteristics of emergency rescue and the measures for preventing and decreasing accidents in nuclear-powered submarine have been presented. The breakdown of equipment and human factors are the main reasons which lead to accidents. Four preventive measures are suggested: enhancing capabilities to take precautions against fire, seriously controlling the environmental factors which affect the health of the submariners, reinforcing the constitutions of the submariners, and working out emergency planning against serious accidents in advance
Emergency Evacuation of Hazardous Chemical Accidents Based on Diffusion Simulation
Jiang-Hua Zhang; Hai-Yue Liu; Rui Zhu; Yang Liu
2017-01-01
The recent rapid development of information technology, such as sensing technology, communications technology, and database, allows us to use simulation experiments for analyzing serious accidents caused by hazardous chemicals. Due to the toxicity and diffusion of hazardous chemicals, these accidents often lead to not only severe consequences and economic losses, but also traffic jams at the same time. Emergency evacuation after hazardous chemical accidents is an effective means to reduce the...
Emergency preparedness and response to 'Not-in-a-Facility' radiological accidents
International Nuclear Information System (INIS)
Grlicarev, Igor
2008-01-01
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)
The future of emergency medicine.
Schneider, Sandra M; Gardner, Angela F; Weiss, Larry D; Wood, Joseph P; Ybarra, Michael; Beck, Dennis M; Stauffer, Arlen R; Wilkerson, Dean; Brabson, Thomas; Jennings, Anthony; Mitchell, Mark; McGrath, Roland B; Christopher, Theodore A; King, Brent; Muelleman, Robert L; Wagner, Mary J; Char, Douglas M; McGee, Douglas L; Pilgrim, Randy L; Moskovitz, Joshua B; Zinkel, Andrew R; Byers, Michelle; Briggs, William T; Hobgood, Cherri D; Kupas, Douglas F; Krueger, Jennifer; Stratford, Cary J; Jouriles, Nicholas J
2010-08-01
The specialty of emergency medicine (EM) continues to experience a significant workforce shortage in the face of increasing demand for emergency care. In July 2009, representatives of the leading EM organizations met in Dallas for the Future of Emergency Medicine Summit. Attendees at the Future of Emergency Medicine Summit agreed on the following: 1) Emergency medical care is an essential community service that should be available to all; 2) An insufficient emergency physician workforce also represents a potential threat to patient safety; 3) Accreditation Council for Graduate Medical Education/American Osteopathic Association (AOA)-accredited EM residency training and American Board of Medical Specialties/AOA EM board certification is the recognized standard for physician providers currently entering a career in emergency care; 4) Physician supply shortages in all fields contribute to-and will continue to contribute to-a situation in which providers with other levels of training may be a necessary part of the workforce for the foreseeable future; 5) A maldistribution of EM residency-trained physicians persists, with few pursuing practice in small hospital or rural settings; 6) Assuring that the public receives high quality emergency care while continuing to produce highly skilled EM specialists through EM training programs is the challenge for EM's future; 7) It is important that all providers of emergency care receive continuing postgraduate education. Copyright 2010. Published by Elsevier Inc.
Management of a radiological emergency. Experience feedback and post-accident management
International Nuclear Information System (INIS)
Dubiau, Ph.
2007-01-01
In France, the organization of crisis situations and the management of radiological emergency situations are regularly tested through simulation exercises for a continuous improvement. Past severe accidents represent experience feedback resources of prime importance which have led to deep changes in crisis organizations. However, the management of the post-accident phase is still the object of considerations and reflections between the public authorities and the intervening parties. This document presents, first, the nuclear crisis exercises organized in France, then, the experience feedback of past accidents and exercises, and finally, the main aspects to consider for the post-accident management of such events: 1 - Crisis exercises: objectives, types (local, national and international exercises), principles and progress, limits; 2 - Experience feedback: real crises (major accidents, other recent accidental situations or incidents), crisis exercises (experience feedback organization, improvements); 3 - post-accident management: environmental contamination and people exposure, management of contaminated territories, management of populations (additional protection, living conditions, medical-psychological follow up), indemnification, organization during the post-accident phase; 4 - conclusion and perspectives. (J.S.)
Emergency response plan for accidents in Saudi Arabia
International Nuclear Information System (INIS)
Al-Solaiman, K.M.; Al-Arfaj, A.M.; Farouk, M.A.
2000-01-01
This paper presents a brief description of the general emergency plan for accidents involving radioactive materials in the Kingdom of Saudi Arabia. Uses of radioactive materials and radiation sources and their associated potential accident are specified. Most general accident scenarios of various levels have been determined. Protective measures have been specified to reduce individual and collective doses arising during accident situations. Intervention levels for temporary exposure situations, as established in the IAEA's basic safety standards for protection against ionising radiation and for the safety of radiation sources, are adopted as national intervention levels. General procedures for implementation of the response plan, including notification and radiological monitoring instrumentation and equipment, are described and radiation monitoring teams are nominated. Training programs for the different parties which may be called upon to respond are studied and will be started. (author)
Burns and scalds in pre-school children attending accident and emergency: accident or abuse?
Benger, J; McCabe, S
2001-01-01
Objectives—To assess how frequently and adequately information relating to the possibility of non-accidental injury (NAI) is documented and considered by doctors assessing pre-school children with burns and scalds in the accident and emergency (A&E) department, and to determine the effect of introducing a routine reminder mechanism into the A&E notes, coupled with an improved programme of NAI education and awareness.
Analysis of emergency response procedures and air traffic accidents ...
African Journals Online (AJOL)
Incessant air transport accidents have been a source of concern to stakeholders and aviation experts in Nigeria, yet the response and process has not been adequately appraised. This study attempts an evaluation of the emergency response procedures in the aviation industry with particular focus on Murtala Muhammed ...
[Emergency medicine and vulnerable populations].
Guillemaud, André-Michel
2012-01-01
In emergency medicine, assessing a situation of precarity is sometimes extremely complex. Home visits often provide useful information which can lead to the putting in place of a system of support. Medical marginalisation results from a combination of multiple difficulties, notably financial. This article is the testimony of a doctor working in a structure providing emergency medical care in the home.
Analysis of search and rescue emergency evaluation in ship accidents in Indonesia
Directory of Open Access Journals (Sweden)
Arleiny
2018-01-01
Full Text Available The objectives og this research is to describe the factors causing ship accident in Indonesia and know the effectiveness of SAR emergency in ship accident in Indonesia. The research method used in this research is qualitative research. Techniques Collection of literature study data and documents. Data validity method using triangulation. Data analysis uses interactive data analysis. The conclusions of this study are Factors that cause the occurrence of ship accidents in Indonesia, among others, the resources of the crew, the eligibility of ships, supporting facilities for shipping, operators, lack of supervision of apparatus, service users and other factors. The high number of ship accidents in Indonesia shows the ineffective implementation of SAR in ship accident in Indonesia.
Emergency preparedness to nuclear accidents in the Czech Republic
International Nuclear Information System (INIS)
Starostova, V.; Prouza, Z.; Koldus, F.; Rutova, H.
2003-01-01
Full text: Emergency preparedness to nuclear accidents (radiation emergency preparedness) is a part of general emergency preparedness and crisis management in the Czech Republic. The bases for it were given in 1997 when radiation emergency preparedness was defined and requirements to it were given in Act No. 18/1997 Coll., so called the Atomic Act, which entered into force in July 1997. In 2000, the bases for general emergency preparedness and crisis management in the Czech Republic were given namely in two acts - in Act No. 239/2000 Coll., an integrated rescue system, and in Act No. 240/2000 Coll., on crisis management. Both these acts entered into force on 1 January 2001. The Atomic Act determines duties of licensees in the field of preparedness. One of them is obligation to prepare and submit to SUJB the on-site emergency plan as one of attachments to his application for the licence. (The licence can be issued if defined documents, including this plan, are approved.) The licensee is obliged, under conditions given in detail in one of implementing regulation, to prepare a proposal of the emergency planning zone and submit it to SUJB. In the Act, there are also given the requirements for licensee's actions in case of a radiation emergency occurrence. On the other hand the Atomic Act names what are SUJB competencies and also what are these ones from the point of view of radiation emergency. Among others SUJB establishes the emergency planning zone, controls the activity of the National Radiation Monitoring Network, provides for the activities of an Emergency Response Centre and ensures the availability of background information necessary to take decisions aimed at reducing or averting exposure in the case of a radiation accident. SUJB has its own crisis staff; it has 4 shifts, which change regularly weekly. About 50 SUJB employees divided into 12 different functions are members of this staff. The Emergency Response Centre (ERC) of SUJB organizes work of this staff
A model national emergency plan for radiological accidents
International Nuclear Information System (INIS)
2000-07-01
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
Qualitative Research on Emergency Medicine Physicians
DEFF Research Database (Denmark)
Paltved, Charlotte; Musaeus, Peter
2012-01-01
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...... and training, communication, professional roles, and organizational factors, and into 12 sub-themes. Conclusion: The strength of qualitative research is its ability to grasp and operationalize complex relations within EM. Although qualitative research methodologies have gained in rigour in recent years and few...
Emergency Evacuation of Hazardous Chemical Accidents Based on Diffusion Simulation
Directory of Open Access Journals (Sweden)
Jiang-Hua Zhang
2017-01-01
Full Text Available The recent rapid development of information technology, such as sensing technology, communications technology, and database, allows us to use simulation experiments for analyzing serious accidents caused by hazardous chemicals. Due to the toxicity and diffusion of hazardous chemicals, these accidents often lead to not only severe consequences and economic losses, but also traffic jams at the same time. Emergency evacuation after hazardous chemical accidents is an effective means to reduce the loss of life and property and to smoothly resume the transport network as soon as possible. This paper considers the dynamic changes of the hazardous chemicals’ concentration after their leakage and simulates the diffusion process. Based on the characteristics of emergency evacuation of hazardous chemical accidents, we build a mixed-integer programming model and design a heuristic algorithm using network optimization and diffusion simulation (hereafter NODS. We then verify the validity and feasibility of the algorithm using Jinan, China, as a computational example. In the end, we compare the results from different scenarios to explore the key factors affecting the effectiveness of the evacuation process.
Mutual emergency assistance for radiation accidents
International Nuclear Information System (INIS)
1983-03-01
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
Automobile Accidents Attended by Mobile Emergency Care Service
Directory of Open Access Journals (Sweden)
Ana Virgínia Gomes Barros
2017-05-01
Full Text Available Background: Automobile accidents are increasing every day and are becoming a serious public health problem due to the high morbidity and mortality rate. The goal of the current study was to characterise the traffic accidents attended by the Mobile Emergency Care Service (MECS in Ibiara, PB. Methods: This exploratory, descriptive, documentary study adopted a quantitative approach and analysis of data. The population consisted of all victims of traffic accidents attended by MECS in the city of Ibiara, PB, from June 2015 to June 2016. The following variables were studied: age, gender, time and day of the week the accident occurred, nature of the incident, substance ingested by the victim, wearing personal protective equipment (PPE or not, the anatomical lesions on the victim and the body regions hit during the accident. Results: The sample consisted of 49 accident victims, and the majority (81.6% were male, predominately 30 to 59 years. Events occurring at night (63.3% and during the week (65.3% predominated. The most frequent type of accident was motorcycle fall (71.4%, with almost half having consumed alcohol (46.9% and most not wearing PPE (77.6%. The regions of the body most affected were the lower limbs (67.3% and upper limbs (53.1%. Conclusion: The main factor/cause of these accidents was due to imprudence and violation of traffic laws, highlighting the need to invest in traffic education policies, to direct campaigns for the prevention of traffic accidents, as well as expand the surveillance of traffic laws by authorities.
Severe accidents risk assessment as a basis for emergency preparedness
International Nuclear Information System (INIS)
Sinka, D.; Mikulicic, V.
2000-01-01
The paper demonstrates, by example of the Republic of Croatia, the possibilities of implementing risk assessment as basis for nuclear accident emergency preparedness development. Individual risks of severe accidents for citizens of the biggest Croatian population centers, as well as collective risk for entire population have been assessed using the PRONEL method. The assessment covered 90 power reactors located at a distance up to 1.000 km. The conducted assessment shows the risks for various regions of the Republic of Croatia, and comparison between them. If risk would be taken as basic criterion in nuclear emergency planning, the results of assessment would directly indicate the necessary preparation level for each region. Furthermore, the assessment of risks from individual power plants and power plant types indicates to which facilities the greatest attention should be paid in nuclear accidents preparedness development. Risks from groups of power plants formed in accordance with their respective distance from exposure location shows what kind of tools for determining consequences and protective actions during a nuclear accident should be made available. (author)
The link between off-site-emergency planning and plant-internal accident management
Energy Technology Data Exchange (ETDEWEB)
Braun, H.; Goertz, R.
1995-02-01
A variety of accident management measures has been developed and implemented in the German nuclear power plants. They constitute a fourth level of safety in the defence-in-depth concept. The containment venting system is an important example. A functioning link with well defined lines of communication between plant-internal accident management and off-site disaster emergency planning has been established.
Resident involvement in civilian tactical emergency medicine.
Ramirez, Mario Luis; Slovis, Corey M
2010-07-01
Tactical emergency medicine services (TEMS) has emerged as a specialized niche within the field of emergency medicine. With increasing demand for physician participation in civilian tactical teams, there will be efforts by residents to become involved at earlier points in their clinical training. This article discusses resident involvement with a civilian TEMS unit and provides five maxims for emergency physicians to better understand the difference between working in the emergency department or with emergency medical services vs. in a TEMS environment. Differences between TEMS and other trauma life support models, institutional and political barriers likely to be encountered by the resident, the value of preventive medicine and the role of the physician in long-term tactical operations, opportunities for subspecialty growth, and the role of operational security are all discussed in detail. Tactical emergency medicine is a specialty that utilizes the full array of the emergency physician's skill set. It is also a field that is ripe for continued expansion, but the resident looking to become involved with a team should be aware of the requirements necessary to do so and the obstacles likely to be encountered along the way. Copyright 2010 Elsevier Inc. All rights reserved.
Mortality Patterns In The Accident And Emergency Department Of An ...
African Journals Online (AJOL)
Mortality Patterns In The Accident And Emergency Department Of An Urban Hospital In Nigeria. ... Nigerian Journal of Clinical Practice ... subset being 4.6:1 and 1.2:1 respectively Most of the cases were of non-traumatic origin (79.8%), with the ...
Helicopter type and accident severity in Helicopter Emergency Medical Services missions.
Hinkelbein, Jochen; Schwalbe, Mandy; Wetsch, Wolfgang A; Spelten, Oliver; Neuhaus, Christopher
2011-12-01
Whereas accident rates and fatal accident rates for Helicopter Emergency Medical Services (HEMS) were investigated sufficiently, resulting consequences for the occupants remain largely unknown. The present study aimed to classify HEMS accidents in Germany to prognosticate accident severity with regard to the helicopter model used. German HEMS accidents (1 Sept. 1970-31 Dec. 2009) were gathered as previously reported. Accidents were categorized in relation to the most severe injury, i.e., (1) no; (2) slight; (3) severe; and (4) fatal injuries. Only helicopter models with at least five accidents were analyzed to retrieve representative data. Prognostication was estimated by the relative percentage of each injury type compared to the total number of accidents. The model BO105 was most often involved in accidents (38 of 99), followed by BK117 and UH-1D. OfN = 99 accidents analyzed, N = 63 were without any injuries (63.6%), N = 8 resulted in minor injuries of the occupants (8.1%), and N = 9 in major injuries (9.1%). Additionally, N = 19 fatal accidents (19.2%) were registered. EC135 and BK1 17 had the highest incidence of uninjured occupants (100% vs. 88.2%) and the lowest percentage of fatal injuries (0% vs. 5.9%; all P > 0.05). Most fatal accidents occurred with the models UH-1D, Bell 212, and Bell 412. Use of the helicopter models EC135 and BK117 resulted in a high percentage of uninjured occupants. In contrast, the fatality rate was highest for the models Bell UH-I D, Bell 222, and Bell 412. Data from the present study allow for estimating accident risk in HEMS missions and prognosticating resulting fatalities, respectively.
Design of a High Power Robotic Manipulator for Emergency Response to the Nuclear Accidents
International Nuclear Information System (INIS)
Park, Jongwon; Bae, Yeong-Geol; Kim, Myoung Ho; Choi, Young Soo
2016-01-01
An accident in a nuclear facility causes a great social cost. To prevent an unexpected nuclear accident from spreading to the catastrophic disaster, emergency response action in early stage is required. However, high radiation environment has been proved as a challenging obstacle for human workers to access to the accident site and take an action in previous accident cases. Therefore, emergency response robotic technology to be used in a nuclear accident site instead of human workers are actively conducted in domestically and internationally. Robots in an accident situation are required to carry out a variety of tasks depend on the types and patterns of accidents. An emergency response usually includes removing of debris, make an access road to a certain place and handling valves. These tasks normally involve high payload handling. A small sized high power robotic manipulator can be an appropriate candidate to deal with a wide spectrum of tasks in an emergency situation. In this paper, we discuss about the design of a high power robotic manipulator, which is capable of handling high payloads for an initial response action to the nuclear facility accident. In this paper, we presented a small sized high power robotic manipulator design. Actuator types of manipulator was selected and mechanical structure was discussed. In the future, the servo valve and hydraulic pump systems will be determined. Furthermore, control algorithms and test bed experiments will be also conducted
Design of a High Power Robotic Manipulator for Emergency Response to the Nuclear Accidents
Energy Technology Data Exchange (ETDEWEB)
Park, Jongwon; Bae, Yeong-Geol; Kim, Myoung Ho; Choi, Young Soo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
2016-10-15
An accident in a nuclear facility causes a great social cost. To prevent an unexpected nuclear accident from spreading to the catastrophic disaster, emergency response action in early stage is required. However, high radiation environment has been proved as a challenging obstacle for human workers to access to the accident site and take an action in previous accident cases. Therefore, emergency response robotic technology to be used in a nuclear accident site instead of human workers are actively conducted in domestically and internationally. Robots in an accident situation are required to carry out a variety of tasks depend on the types and patterns of accidents. An emergency response usually includes removing of debris, make an access road to a certain place and handling valves. These tasks normally involve high payload handling. A small sized high power robotic manipulator can be an appropriate candidate to deal with a wide spectrum of tasks in an emergency situation. In this paper, we discuss about the design of a high power robotic manipulator, which is capable of handling high payloads for an initial response action to the nuclear facility accident. In this paper, we presented a small sized high power robotic manipulator design. Actuator types of manipulator was selected and mechanical structure was discussed. In the future, the servo valve and hydraulic pump systems will be determined. Furthermore, control algorithms and test bed experiments will be also conducted.
Medical emergency planning in case of severe nuclear power plant accidents
International Nuclear Information System (INIS)
Ohlenschlaeger, L.
1980-01-01
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.) [de
Wang, Kang; Gao, Guiqing; Qin, Yuanli; He, Xiangyong
2018-05-01
The nuclear accident emergency disposal must be supported by an efficient, real-time modularization and standardization communication system. Based on the analysis of communication system for nuclear accident emergency disposal which included many functions such as the internal and external communication, multiply access supporting and command center. Some difficult problems of the communication system were discussed such as variety access device type, complex composition, high mobility, set up quickly, multiply business support, and so on. Taking full advantages of the IP Multimedia Subsystem (IMS), a nuclear accident emergency communication system was build based on the IMS. It was studied and implemented that some key unit and module functions of communication system were included the system framework implementation, satellite access, short-wave access, load/vehicle-mounted communication units. The application tests showed that the system could provide effective communication support for the nuclear accident emergency disposal, which was of great practical value.
Emergency room management of radiation accidents
International Nuclear Information System (INIS)
Rosenberg, R.; Mettler, F.A. Jr.
1990-01-01
Emergency room management of radioactively contaminated patients who have an associated medical injury requiring immediate attention must be handled with care. Radioactive contamination of the skin of a worker is not a medical emergency and is usually dealt with at the plant. Effective preplanning and on-the-scene triage will allow the seriously injured and contaminated patients to get the medical care they need with a minimum of confusion and interference. Immediate medical and surgical priorities always take precedence over radiation injuries and radioactive contamination. Probably the most difficult aspect of emergency management is the rarity of such accidents and hence the unfamiliarity of the medical staff with the appropriate procedures. The authors discuss how the answer to these problems is preplanning, having a simple and workable procedure and finally having 24-h access to experts
Energy Technology Data Exchange (ETDEWEB)
Wu, Wen-Hsiung, E-mail: whwu1127@aec.gov.tw [Atomic Energy Council, 2F., No. 80, Sec.1, Chenggong Rd., Yonghe Dist., New Taipei City 234, Taiwan (China); Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Sec. 2, Guangfu Rd., Hsinchu City 300, Taiwan (China); Liao, Lih-Yih, E-mail: lyliao@iner.gov.tw [Institute of Nuclear Energy Research, Atomic Energy Council, No. 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 325, Taiwan (China)
2016-12-01
Highlights: • Discuss the problem of EOPs at the time of Fukushima accident to deal with the prolonged SBO. • Elaborate the potential risk accompanied with the emergency depressurization in the SBO. • Describe a special guideline to cope with Fukushima-like accidents and provide its technical basis. • Point out that Fukushima accident might have been prevented if improved EOPs had been used. • Propose key points and suggestions for improving the EOPs. - Abstract: One of the lessons learned from the Fukushima Daiichi accident is the emergency operating procedures (EOPs) have to be improved. The BWR Owners’ Group revised the emergency procedure guidelines and addressed the lesson learned from the Fukushima Daiichi accident in revision 3 in order to avoid loss of turbine-driven makeup water systems during reactor depressurization. However, the improvement deserves much more attention. The existing EOPs at the time of the accident may not be adequate enough for the prolonged station blackout condition, because resources required for performing the EOPs are vastly unavailable or gradually exhausted. The improved EOPs must not only permit early reactor pressure vessel depressurization, but also address the risk accompanied with the emergency depressurization. For this reason, Taiwan Power Company proposed the Ultimate Response Guideline (URG) to cope with Fukushima-like accidents. The main content of the URG is a two-stage depressurization strategy, namely the controlled depressurization and the emergency depressurization. The technical basis of the two-stage depressurization strategy was discussed in this paper. The effectiveness of the URG was verified by using TRAC/RELAP Advanced Computational Engine (TRACE). Besides, the emergency responses performed by Fukushima Daini nuclear power plant (Fukushima Daini NPP) were found to be very similar to the URG. The consequences of Fukushima Daini NPP somehow demonstrate that the URG is effective for Fukushima
International Nuclear Information System (INIS)
Wu, Wen-Hsiung; Liao, Lih-Yih
2016-01-01
Highlights: • Discuss the problem of EOPs at the time of Fukushima accident to deal with the prolonged SBO. • Elaborate the potential risk accompanied with the emergency depressurization in the SBO. • Describe a special guideline to cope with Fukushima-like accidents and provide its technical basis. • Point out that Fukushima accident might have been prevented if improved EOPs had been used. • Propose key points and suggestions for improving the EOPs. - Abstract: One of the lessons learned from the Fukushima Daiichi accident is the emergency operating procedures (EOPs) have to be improved. The BWR Owners’ Group revised the emergency procedure guidelines and addressed the lesson learned from the Fukushima Daiichi accident in revision 3 in order to avoid loss of turbine-driven makeup water systems during reactor depressurization. However, the improvement deserves much more attention. The existing EOPs at the time of the accident may not be adequate enough for the prolonged station blackout condition, because resources required for performing the EOPs are vastly unavailable or gradually exhausted. The improved EOPs must not only permit early reactor pressure vessel depressurization, but also address the risk accompanied with the emergency depressurization. For this reason, Taiwan Power Company proposed the Ultimate Response Guideline (URG) to cope with Fukushima-like accidents. The main content of the URG is a two-stage depressurization strategy, namely the controlled depressurization and the emergency depressurization. The technical basis of the two-stage depressurization strategy was discussed in this paper. The effectiveness of the URG was verified by using TRAC/RELAP Advanced Computational Engine (TRACE). Besides, the emergency responses performed by Fukushima Daini nuclear power plant (Fukushima Daini NPP) were found to be very similar to the URG. The consequences of Fukushima Daini NPP somehow demonstrate that the URG is effective for Fukushima
Directory of Open Access Journals (Sweden)
Lloyd D. Christopher
2014-09-01
Full Text Available The first international emergency medicine (EM conference in Botswana was held on 15th and 16th May 2014 at the Gaborone International Convention Centre. The support from key stakeholders positioned the conference, from its conception, to deliver expert guidance on emergency medicine relevance, education and systems implementation. The conference theme was aptly: “Setting the Agenda in Emergency Medicine in the Southern African Region.” Over 300 local, regional and international delegates convened to participate in this landmark event. Country representation included Botswana, South Africa, Zambia, Namibia, Zimbabwe, Swaziland, Lesotho, Nigeria and the United States of America. Conference assumptions intersected emergency care, African burden of injury and illness and the role of the state; the public protection ethic of emergency care, and the developmental, economic and health interest in promoting EM. The recommendations addressed emergency care relevance; health systems research as an imperative for emergency systems development in southern Africa; community agency as a requisite for emergency care resilience; emergency care workers as pivotal to the emergency medical system, and support of EM system implementation. The conference recommendations – by way of setting an agenda, augur well for emergency care development and implementation in the southern African region and are likely to prove useful to the southern African countries seeking to address health service quality, EM advocacy support and implementation guidance. Emergency medicine is the only discipline with ‘universality’ and ‘responsivity’ at the point of need. This implies the widespread potential for facilitation of access to health care: a public health goal nuanced by the African development agenda.
Burnout among female emergency medicine physicians: A nationwide study.
Soltanifar, Atefeh; Pishbin, Elham; Attaran Mashhadi, Negin; Najaf Najafi, Mona; Siahtir, Maryam
2018-02-13
The challenging and stressful nature of emergency medicine place the practitioners of this young branch of medicine at risk of burnout. In Iran, the number of women choosing the specialty of emergency medicine has been increasing in recent years. No studies have focused on burnout among female emergency medicine physicians. We conducted this study to evaluate the level of burnout in female emergency medicine physicians in Iran. In this cross-sectional study, all Iranian female emergency medicine physicians with more than 2 years of work experience as specialists, received a questionnaire containing 22-item Maslach Burnout Inventory scales and 7-item Cassidy social support scale, as well as questions about workload and career satisfaction. In total, 77 questionnaires were analysed (response rate: 75%; median age: 36 years, median for work experience = 3 years). A total of 34% of participants were academic faculties. The level of burnout in three subscales of emotional exhaustion, depersonalisation and perceived low personal accomplishment was moderate to high in 84.5, 48.1 and 80.5% of participants respectively. A total of 94.8% of female emergency medicine physicians perceived their workload to be moderate to high and only 1.3% of them had high job satisfaction. Alarming high rate of burnout and job dissatisfaction among female emergency medicine physicians in our study requires careful attention. Further investigations are suggested to identify the contributory factors to burnout and the probability of some gender disparities in this field. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
International Nuclear Information System (INIS)
1978-10-01
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
Attention-Deficit/Hyperactivity Disorder and Fatal Accidents in Aviation Medicine.
Laukkala, Tanja; Bor, Robert; Budowle, Bruce; Sajantila, Antti; Navathe, Pooshan; Sainio, Markku; Vuorio, Alpo
2017-09-01
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms of inattention and/or hyperactivity-impulsivity that interfere with functioning and/or development. ADHD occurs in about 2.5% of adults. ADHD can be an excluding medical condition among pilots due to the risk of attentional degradation and therefore impact on flight safety. Diagnosis of ADHD is complex, which complicates aeromedical assessment. This study highlights fatal accident cases among pilots with ADHD and discusses protocols to detect its presence to help to assess its importance to flight safety. To identify fatal accidents in aviation (including airplanes, helicopters, balloons, and gliders) in the United States between the years 2000 to 2015, the National Transportation Safety Board (NTSB) database was searched with the terms ADHD, attention deficit hyperactivity disorder, and attention deficit disorder (ADD). The NTSB database search for fatal aviation accidents possibly associated with ADHD yielded four accident cases of interest in the United States [4/4894 (0.08%)]. Two of the pilots had ADHD diagnosed by a doctor, one was reported by a family member, and one by a flight instructor. An additional five cases were identified searching for ADD [5/4894 (0.1%)]. Altogether, combined ADHD and ADD cases yielded nine accident cases of interest (0.18%). It is generally accepted by aviation regulatory authorities that ADHD is a disqualifying neurological condition. Yet FAA and CASA provide specific protocols for tailor-made pilot assessment. Accurate evaluation of ADHD is essential because of its potential negative impact on aviation safety.Laukkala T, Bor R, Budowle B, Sajantila A, Navathe P, Sainio M, Vuorio A. Attention-deficit/hyperactivity disorder and fatal accidents in aviation medicine. Aerosp Med Hum Perform. 2017; 88(9):871-875.
Emergency medicine program targets "brain drain" in Ethiopia ...
International Development Research Centre (IDRC) Digital Library (Canada)
2016-04-29
Apr 29, 2016 ... ... (TAAAC-EM) project, access to emergency medicine is increasing for Ethiopians. With IDRC support, the TAAAC-EM postgraduate emergency medicine training program ... From hospitals to herbalists: Rx herbal medicines.
Extension of emergency operating procedures for severe accident management
International Nuclear Information System (INIS)
Chiang, S.C.
1992-01-01
To enhance the capability of reactor operators to cope with the hypothetical severe accident its the key issue for utilities. Taiwan Power Company has started the enhancement programs on extension of emergency operating procedures (EOPs). It includes the review of existing LOPs based on the conclusions and recommendations of probabilistic risk assessment studies to confirm the operator actions. Then the plant specific analysis for accident management strategy will be performed and the existing EOPs will be updated accordingly
An Ontology-Underpinned Emergency Response System for Water Pollution Accidents
Directory of Open Access Journals (Sweden)
Xiaoliang Meng
2018-02-01
Full Text Available With the unceasing development and maturation of environment geographic information system, the response to water pollution accidents has been digitalized through the combination of monitoring sensors, management servers, and application software. However, most of these systems only achieve the basic and general geospatial data management and functional process tasks by adopting mechanistic water-quality models. To satisfy the sustainable monitoring and real-time emergency response application demand of the government and public users, it is a hotspot to study how to make the water pollution information being semantic and make the referred applications intelligent. Thus, the architecture of the ontology-underpinned emergency response system for water pollution accidents is proposed in this paper. This paper also makes a case study for usability testing of the water ontology models, and emergency response rules through an online water pollution emergency response system. The system contributes scientifically to the safety and sustainability of drinking water by providing emergency response and decision-making to the government and public in a timely manner.
Energy Technology Data Exchange (ETDEWEB)
Costa, V.S.G.; Alcantara, Y.P. [Faculdade Casa Branca, SP (Brazil); Lima, C.M.A. [MAXIM Cursos, Rio de Janeiro, RJ (Brazil); Silva, F. C. A. da, E-mail: franciscodasilva13uk@gmail.com [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)
2017-07-01
During a radiological or nuclear emergency, a number of necessary actions are taken, both within the radiation protection of individuals and the environment, involving many institutions and highly specialized personnel. Among them it is possible to emphasize the air transportation of radiation accident victims.The procedures and measures for the safe transport of these radiation accident victims are generally the responsibility of the armed forces, specifically the Aeronautics, with the action denominated 'Aeromedical Military Evacuation of Radiation Accident Victims'. The experience with the Radiological Accident of Goiânia demonstrated the importance of adequate preparation and response during a radiological emergency and the need for procedures and measures with regard to the transport of radiation victims are clearly defined and clearly presented for the effectiveness of the actions. This work presents the necessary actions for the transport of radiation accident victim during a radiological emergency, through the road map technique, which has been widely used in scientific technical area to facilitate understanding and show the way to be followed to reach the proposed objectives.
Preclinical diagnosis and emergency medical care in case of radiation accidents
International Nuclear Information System (INIS)
Ohlenschlaeger, L.
1990-01-01
Reference is made to preclinical diagnosis and emergency medical care at the site of a potential radiation accident. Possibilities and limits, respectively, of the medical measures are shown. Cooperation between the experts of the technical and medical rescue services is described. Exposition to radiation for the emergency medical staff resulting from the medical care of contaminated persons, is negligible if the personal precautions are observed. (orig.) [de
[Adverse drug reaction reporting in emergency medicine].
Milojevic, Kolia; Chassagnol, Isabelle; Brion, Nathalie; Cléro, Joël; Degrèze, Nathalie; Lambert, Yves
2004-01-01
A regional survey was performed between June and September 2002, to evaluate knowledge and attitudes of emergency physicians regarding adverse drug reaction (ADR) reporting in a French district. 100 questionnaires completed by physicians working in emergency departments and/or mobile intensive care units were analysed. The frequency of ADRs encountered by emergency practitioners was estimated at > or = 0.73 per year and per physician. The ADR notification rate in emergency medicine was estimated at advertising ADR reporting procedures could help to improve the notification rate in emergency medicine.
Episodes of care: is emergency medicine ready?
Wiler, Jennifer L; Beck, Dennis; Asplin, Brent R; Granovsky, Michael; Moorhead, John; Pilgrim, Randy; Schuur, Jeremiah D
2012-05-01
Optimizing resource use, eliminating waste, aligning provider incentives, reducing overall costs, and coordinating the delivery of quality care while improving outcomes have been major themes of health care reform initiatives. Recent legislation contains several provisions designed to move away from the current fee-for-service payment mechanism toward a model that reimburses providers for caring for a population of patients over time while shifting more financial risk to providers. In this article, we review current approaches to episode of care development and reimbursement. We describe the challenges of incorporating emergency medicine into the episode of care approach and the uncertain influence this delivery model will have on emergency medicine care, including quality outcomes. We discuss the limitations of the episode of care payment model for emergency services and advocate retention of the current fee-for-service payment model, as well as identify research gaps that, if addressed, could be used to inform future policy decisions of emergency medicine health policy leaders. We then describe a meaningful role for emergency medicine in an episode of care setting. Copyright © 2011. Published by Mosby, Inc.
Recovery operations in the event of a nuclear accident or radiological emergency
International Nuclear Information System (INIS)
1990-01-01
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
Emergency response planning for transport accidents involving radioactive materials
International Nuclear Information System (INIS)
1982-03-01
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
A model national emergency response plan for radiological accidents
International Nuclear Information System (INIS)
1993-09-01
The IAEA has supported several projects for the development of a national response plan for radiological emergencies. As a results, the IAEA has developed a model National Emergency Response Plan for Radiological Accidents (RAD PLAN), particularly for countries that have no nuclear power plants. This plan can be adapted for use by countries interested in developing their own national radiological emergency response plan, and the IAEA will supply the latest version of the RAD PLAN on computer diskette upon request. 2 tabs
International Nuclear Information System (INIS)
1984-01-01
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
Emergency medicine as a specialty in Asia.
Pek, Jen Heng; Lim, Swee Han; Ho, Hiu Fai; Ramakrishnan, T V; Jamaluddin, Sabariah Faizah; Mesa-Gaerlan, Faith Joan C; Tiru, Mohan; Hwang, Sung Oh; Choi, Wai-Mau; Kanchanasut, Somchai; Khruekarnchana, Pairoj; Avsarogullari, Levent; Shimazu, Takeshi; Hori, Shingo
2016-04-01
We aim to examine the similarities and differences in areas of EM development, workload, workforce, and capabilities and support in the Asia region. Emerging challenges faced by our EM community are also discussed. The National Societies for Emergency Medicine of Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand and Turkey participated in the joint Japanese Association of Acute Medicine (JAAM) and Asian Conference of Emergency Medicine (ACEM) Special Symposium held in October 2013 at Tokyo, Japan. The findings are reviewed in this paper. Emergency medicine (EM) has over the years evolved into a distinct and recognized medical discipline requiring a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. EM has contributed to healthcare by providing effective, safe, efficient and cost-effective patient care. Integrated systems have developed to allow continuity of emergency care from the community into emergency departments. Structured training curriculum for undergraduates, and specialty training programs for postgraduates are in place to equip trainees with the knowledge and skills required for the unique practice of EM. The practice of EM still varies among the Asian countries. However, as a region, we strive to continue in our efforts to develop the specialty and improve the delivery of EM.
Helicopter emergency medical services response to equestrian accidents.
Lyon, Richard M; Macauley, Ben; Richardson, Sarah; de Coverly, Richard; Russell, Malcolm
2015-04-01
Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 2012). All missions were screened for accidents involving a horse. Call details, patient demographics, suspected injuries, clinical interventions and patient disposition were all analysed. In the 12-month data collection period there were 47 equestrian accidents, representing ∼3% of the total annual missions. Of the 42 cases HEMS attended, one patient was pronounced life extinct at the scene. In 15 (36%) cases the patient was airlifted to hospital. In four (10%) cases, the patient underwent prehospital anaesthesia. There were no specific predictors of HEMS intervention. Admission to a major trauma centre was associated with the rider not wearing a helmet, a fall onto their head or the horse falling onto the rider. Equestrian accidents represent a significant proportion of HEMS missions. The majority of patients injured in equestrian accidents do not require HEMS intervention, however, a small proportion have life-threatening injuries, requiring immediate critical intervention. Further research is warranted, particularly regarding HEMS dispatch, to further improve accuracy of tasking to equestrian accidents.
Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Bernal, Regina Tomie Ivata; Viegas, Anna Paula Bise; de Sá, Naiza Nayla Bandeira; da Silva Junior, Jarbas Barbosa
2012-09-01
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 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, besides guiding health professionals, teachers and families in the prevention of such causes.
Nuclear accident dosimetry. Revision of emergency data sheets
International Nuclear Information System (INIS)
Delafield, H.J.
1976-09-01
The Emergency Data Sheets on Nuclear Accident Dosimetry have been revealed following the publication of a three part manual on this subject (Delafield, Dennis and Gibson, AERE-R 7485/6/7, 1973). This memo provides an explanation of the action levels adopted for the initial segregation of irradiated persons following a criticality accident, by monitoring the activity of indium foils contained in personnel dosimeters and the induced body sodium activity. The data sheets are given as an Appendix. They provide basic information on; the segregation of irradiated persons, the estimation of radiation exposure, and the assessment of personnel γ-ray and neutron doses. (author)
Supporting system in emergency response plan for nuclear material transport accidents
International Nuclear Information System (INIS)
Nakagome, Y.; Aoki, S.
1993-01-01
As aiming to provide the detailed information concerning nuclear material transport accidents and to supply it to the concerned organizations by an online computer, the Emergency Response Supporting System has been constructed in the Nuclear Safety Technology Center, Japan. The system consists of four subsystems and four data bases. By inputting initial information such as name of package and date of accident, one can obtain the appropriate initial response procedures and related information for the accident immediately. The system must be useful for protecting the public safety from nuclear material transport accidents. But, it is not expected that the system shall be used in future. (J.P.N.)
Accidents and emergency conditions: Tasks of the radiation protection expert
International Nuclear Information System (INIS)
Hacke, J.
1985-01-01
This paper reviews and explains the tasks of the radiation protection expert at a given site in the event of accidents or emergencies involving a radiation hazard to the personnel. The various measures recommended discriminate between the main two types of hazards, namely external radiation or internal radiation. The paper discusses the first-aid and emergency measures recommended in various publications (BG, 1982; ICRP, 1980; MO, 1972; ME, 1980) and also cites recommendations contained therein, referring to preventive means and measures and to communications to the press and the general public. (DG) [de
State of emergency medicine in Azerbaijan.
Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam
2008-04-01
There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline
PWR auxiliary systems, safety and emergency systems, accident analysis, operation
International Nuclear Information System (INIS)
Meyer, P.J.
1976-01-01
The author presents a description of PWR auxiliary systems like volume control, boric acid control, coolant purification, -degassing, -storage and -treatment system and waste processing systems. Residual heat removal systems, emergency systems and containment designs are discussed. As an accident analysis the author gives a survey over malfunctions and disturbances in the field of reactor operations. (TK) [de
A decision support system for emergency response to major nuclear accidents
International Nuclear Information System (INIS)
Papazoglou, I.A.; Christou, M.D.
1997-01-01
A methodology for the optimization of the short-term emergency response in the event of a nuclear accident is presented. The method seeks an optimum combination of protective actions in the presence of a multitude of conflicting objectives and under uncertainty. Conflicting objectives arise in the attempt to minimize simultaneously the potential adverse effects of an accident and the associated socioeconomic impacts. Additional conflicting objectives arise whenever an emergency plan tends to decrease a particular health effect, such as acute deaths, while it increases another, such as latent deaths. The uncertainty is due to the multitude of possible accident scenarios and their respective probability of occurrence, the stochastic variability in the weather conditions, and the variability and/or lack of knowledge of the parameters of the risk assessment models. A multiobjective optimization approach is adopted. An emergency protection plan consists of defining a protective action at each spatial cell around the plant. Three criteria are used as the objective functions of the problem, namely, acute fatalities, latent effects, and socioeconomic cost. The optimization procedure defines the efficient frontier, i.e., all emergency plans that are not dominated by another in all three criteria. No value trade-offs are necessary up to this point. The most preferred emergency plan is then chosen among the set of efficient plans. Finally, the methodology is integrated into a computerized decision support system, and its use is demonstrated in a realistic application
Assessing interpersonal and communication skills in emergency medicine.
Chan, Teresa M; Wallner, Clare; Swoboda, Thomas K; Leone, Katrina A; Kessler, Chad
2012-12-01
Interpersonal and communication skills (ICS) are a key component of several competency-based schemata and key competency in the set of six Accreditation Council for Graduate Medical Education (ACGME) core competencies. With the shift toward a competency-based educational framework, the importance of robust learner assessment becomes paramount. The journal Academic Emergency Medicine (AEM) hosted a consensus conference to discuss education research in emergency medicine (EM). This article summarizes the initial preparatory research that was conducted to brief consensus conference attendees and reports the results of the consensus conference breakout session as it pertains to ICS assessment of learners. The goals of this consensus conference session were to twofold: 1) to determine the state of assessment of observable learner performance and 2) to determine a research agenda within the ICS field for medical educators. The working group identified six key recommendations for medical educators and researchers. © 2012 by the Society for Academic Emergency Medicine.
Coping with Unanticipated Accidents using Emergency Operating Procedures
International Nuclear Information System (INIS)
Kim, Yochan; Jung, Wondea
2013-01-01
In, unsafe acts associated with a literal following of a procedure were reported. A report of the Fukushima accident also revealed that a tendency to adhere to procedures and prior practices can impede applying effective countermeasures. To overcome the conflicts between benefit and jeopardy of procedures during unanticipated accidents, we reviewed the literature on the perspectives of cognitive engineering and artificial intelligence. From the insights about human planning of the literatures, we also proposed an approach of how to train operators to effectively use EOPs during unanticipated accidents. There are three key processes required to effectively cope with emergency situations: how correctly the operators are aware of the occurring situations, how properly they develop corresponding plans for the situations, and how accurately they execute the plans. This paper presents a way to develop the plans using EOPs from some literature of human planning. Even if professional operators have implicitly shaped good structures of procedures already, it is expected that this approach will provide a more systematic and concrete training strategy. If the operators are trained with this strategy, a higher level of human reliability would be ensured in unanticipated accidents
Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.
Morrison, Ann; Roman, Brenda; Borges, Nicole
2012-05-01
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 curriculum" in medical education, in which values are communicated from teacher to student outside of the formal instruction. A group of 79 students on Psychiatry and 66 on Emergency Medicine clerkships were surveyed at the beginning and end of their rotation regarding their attitudes toward homeless persons by use of the Health Professionals' Attitudes Toward the Homeless Inventory (HPATHI). The HPATHI was also administered to 31 Psychiatry residents and faculty and 41 Emergency Medicine residents and faculty one time during the course of this study. For Psychiatry clerks, t-tests showed significant differences pre- and post-clerkship experiences on 2 of the 23 items on the HPATHI. No statistically significant differences were noted for the Emergency Medicine students. An analysis of variance revealed statistically significant differences on 7 out of the 23 survey questions for residents and faculty in Psychiatry, as compared with those in Emergency Medicine. Results suggest that medical students showed small differences in their attitudes toward homeless people following clerkships in Psychiatry but not in Emergency Medicine. Regarding resident and faculty results, significant differences between specialties were noted, with Psychiatry residents and faculty exhibiting more favorable attitudes toward homeless persons than residents and faculty in Emergency Medicine. Given that medical student competencies should be addressing the broader social issues of homelessness, medical schools need to first understand the attitudes of medical students to such issues, and then develop curricula to overcome inaccurate or stigmatizing beliefs.
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
Development of a novel sports medicine rotation for emergency medicine residents.
Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe
2016-01-01
Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational
Emergency feature. Great east Japan earthquake disaster Fukushima Daiichi accident
International Nuclear Information System (INIS)
Kawata, Tomio; Tsujikura, Yonezo; Kitamura, Toshiro
2011-01-01
The Tohoku Pacific Ocean earthquake occurred in March 11, 2011. The disastrous tsunami attacked Fukushima Daiichi nuclear power plants after automatically shutdown by the earthquake and all motor operated pumps became inoperable due to station black out. Despite the strenuous efforts of operators, if caused serious accident such as loss of cooling function, hydrogen explosion and release of large amount of radioactive materials into the environment, leading to nuclear power emergency that ordered resident to evacuate or remain indoors. This emergency feature consisted of four articles. The first was the interview with the president of JAIF (Japan Atomic Industrial Forum) on how to identify the cause of the accident completely, intensify safety assurance measures and promote discussions on a role of nuclear power in the nation's entire energy policy toward the reconstruction. Others were reactor states and events sequence after the accident with trend data of radiation in the reactor site, statement of president of AESJ (Atomic Energy Society of Japan) on nuclear crisis following Tohoku Pacific Ocean earthquake our response and my experience in evacuation life. (T. Tanaka)
International Nuclear Information System (INIS)
Andreev, Yu.B.; Samojlenko, Yu.N.
1989-01-01
The efficiency of measures realized in order to eliminate the Chernobyl' accident effects is estimated. The principles of organization of the emergency-engineering service for accident elimination in nuclear power engineering are described. The automated information safety system should from the technical basis for this service. The information system structure is determined. The list of main directions of research and design works realized in the emergency-engineering service interests is given. It is noted that all parts of the emergency-engineering service must prepare the plants of works together with the USSR civil defense service, and they should interact in the process of accident elimination basing on coordinated organizational and technical solutions
Salihefendic, Nizama; Zildzic, Muharem; Masic, Izet; Hadziahmetovic, Zoran; Vasic, Dusko
2011-01-01
Emergency medicine is a new academic discipline, as well as a recent independent clinical specialization with the specific principles of practice, education and research. It is also a very important segment of the overall health care and health system. Emergency medicine as a distinct specialty was introduced in the U.S. in 1970. Ten years later and relatively quickly emergency medicine was introduced in the health system in Bosnia and Herzegovina as a specialty with a special education program for specialist and a final exam. Compare the development of emergency medicine in Bosnia and Herzegovina with the trends of development of this discipline in the world as a specialization and an academic discipline. Identify specific problems and possible solutions and learn lessons from other countries. Reviewed are the literature data on the development of emergency medicine in the world, programs of undergraduate and postgraduate teaching, the organizational scheme of emergency centers and residency. This is then compared with data of the current status of emergency medicine as an academic discipline and a recognized specialization, in Bosnia and Herzegovina. There are substantial differences in the development of emergency medicine in the United States, European Union and Bosnia and Herzegovina. Although Bosnia and Herzegovina relatively early recognized specialty of emergency medicine in academia, it failed to mach the academic progress with the practical implementation. A&E departments in the Community Health Centers failed to meet the desired objectives even though they were led by specialists in emergency medicine. The main reason being the lack of space and equipment as well as staff needed to meet set standards of good clinical practice, education and research. Furthermore the Curriculum of undergraduate education and specialization does not match modern concept of educational programs that meet the principles set out in emergency medicine and learning through
Yang, D D; Xu, J N; Zhu, B L
2016-11-20
Objective: To investigate and analyze the influential factors of occupational hazard acci-dents, emergency facilities and emergency management in Silicon solar cell producing enterprises, then to pro-vide scientific strategies. Methods: The methods of occupationally healthy field investigating, inspecting of ven-tilation effectiveness, setup of emergency program and wearing chemical suit were used. Results: The mainly occupational hazard accidents factors in the process of Silicon solar cell producing included poisoning chemi-cals, high temperature, onizing radiation and some workplaces. The poisoning chemicals included nitric acid, hydrofluoric acid, sulfuric acid, hydrochloric acid, sodium hydroxide, potassium hydroxide, chlorine, phos-phorus oxychloride, phosphorus pentoxide, nitrogen dioxide, ammonia, silane, and so on; the workplaces in-cluded the area of producing battery slides and auxiliary producing area. Among the nine enterprises, gas detec-tors were installed in special gas supplying stations and sites, but the height, location and alarmvalues of gas detectors in six enterprises were not according with standard criteria; emergency shower and eyewash equip-ment were installed in workplaces with strong corrosive chemicals, but the issues of waste water were not solved; ventilation systems were set in the workplaces with ammonia and silane, but not qualified with part lo-cations and parameters in two enterprises; warehouses with materials of acid, alkali, chemical ammonia and phosphorus oxychloride were equipped with positive - pressure air respirator resuscitator and emergency cabi-nets, but with insufficient quantity in seven enterprises and expiration in part of products. The error rate of set-up emergency program and wearing chemical cloth were 30%~100% and 10%~30%, respectively. Among the nine enterprises, there were emergency rescue plans for dangerous chemical accidents, but without profession-al heatstroke and irradiation accident emergency plans
International Nuclear Information System (INIS)
1979-07-01
Hypothetical accidents in nuclear power plants are events which by definition can have a devastating impact on the surroundings of the plant. Apart from an adequate plant design, the protection of the population in case of an accident is covered by the emergency planning. Of major importance are the measures for the short-term emergency protection. The decision on whether these measures are applied has to be based on appropriate measurements within the plant. The aim and achieved result of this investigation is to specify accident types. They serve as operational decision making criteria to determine the necessary measurements for analysing the accident in the accident situation, and to provide indications for choosing the suitable strategy for the protection measures. (orig.) [de
Ethics curriculum for emergency medicine graduate medical education.
Marco, Catherine A; Lu, Dave W; Stettner, Edward; Sokolove, Peter E; Ufberg, Jacob W; Noeller, Thomas P
2011-05-01
Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution. Copyright © 2011 Elsevier Inc. All rights reserved.
On-site emergency intervention plan for nuclear accident situation at INR-Pitesti TRIGA reactor
International Nuclear Information System (INIS)
Oprea, I.; Margenu, S.; Preda, M.
2001-01-01
A nuclear incident is defined as a series of events leading to release of radioactive materials into the environment of sufficient concentration to make necessary protective actions. The decision to initiate a protective action is a complex process. The benefits of taking the action is weighed against the involved risk and constraints. In addition the decision will be made under difficult emergency conditions, probably with little detailed information available. Therefore, considerable planing is necessary to reduce to manageable levels the types of decisions leading to effective responses to protect the public in the event of a nuclear incident. The sequence of events for developing emergency plans and responding to nuclear incidents will vary according to individual circumstances, because the international recommendations and site-specific emergency plans cannot provide detailed guidance for all accident scenarios and variations in local conditions. Flexibility must be maintained in emergency response to reflect the actual circumstances encountered (e.g. source term characteristics, the large number of possible weather conditions and environmental situation such as time of the day, season of the year, land use and soil types, population distribution and economic structures, uncertainties in the availability of technical and administrative support and the behaviour of the population). This further complicates the decision-making process, especially under accident conditions where there are time pressures and psychological stress. Therefore one the most important problems in the case of a nuclear emergency is quantifying all these very different types of off-site consequences. Last years, and in particular since the Chernobyl accident, there has been a considerable increase in the resources allocated to development of computerised systems which allow for predicting the radiological impact of accidents and to provide information in a manageable and effective form to
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)
International Nuclear Information System (INIS)
1997-01-01
Part I: Status lists as of 31 December 1996. A. Convention on Early Notification of a Nuclear Accident (Notification Convention). B. Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention). PART II: Texts of reservations/declarations made upon or following expressing consent to be bound and objections thereto Part III: Texts of reservations/declarations made upon signature
[Spanish doctoral theses in emergency medicine (1978-2013)].
Fernández-Guerrero, Inés María
2015-01-01
To quantitatively analyze the production of Spanish doctoral theses in emergency medicine. Quantitative synthesis of productivity indicators for 214 doctoral theses in emergency medicine found in the database (TESEO) for Spanish universities from 1978 to 2013. We processed the data in 3 ways as follows: compilation of descriptive statistics, regression analysis (correlation coefficients of determination), and modeling of linear trend (time-series analysis). Most of the thesis supervisors (84.1%) only oversaw a single project. No major supervisor of 10 or more theses was identified. Analysis of cosupervision indicated there were 1.6 supervisors per thesis. The theses were defended in 67 departments (both general and specialist departments) because no emergency medicine departments had been established. The most productive universities were 2 large ones (Universitat de Barcelona and Universidad Complutense de Madrid) and 3 medium-sized ones (Universidad de Granada, Universitat Autónoma de Barcelona, and Universidad de La Laguna). Productivity over time analyzed as the trend for 2-year periods in the time-series was expressed as a polynomial function with a correlation coefficient of determination of R2 = 0.80. Spanish doctoral research in emergency medicine has grown markedly. Work has been done in various university departments in different disciplines and specialties. The findings confirm that emergency medicine is a disciplinary field.
Convention on assistance in the case of a nuclear accident or radiological emergency
International Nuclear Information System (INIS)
1986-11-01
The full text of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency adopted by the General Conference at its special session from 24-26 September 1986 is presented. It is stipulated that the States Parties shall cooperate between themselves and with the Agency to facilitate prompt assistance in the event of a nuclear accident or radiological emergency to minimize its consequences and to protect life, the property and the environment from the effects of radioactive releases
ALWR severe accident issue resolution in support of updated emergency planning
International Nuclear Information System (INIS)
Additon, Stephen L.; Leaver, David E.; Sorrell, Steven W.; Theofanous, Theo G.
2004-01-01
The Advanced Light Water Reactor (ALWR) Program in the U.S. is a cooperative, cost-sharing undertaking between the U.S. government, industry, and a number of international participants, with the objective of developing the next generation of nuclear power plants. The ALWR designs emphasize improvements in safety and operational reliability through simplification, improved safety margins, innovative passive safety systems, enhanced man-machine interfaces, and incorporation of the lessons learned from the operation of existing LWR plants. An important component of the improved safety characteristics of ALWRs is the consideration of severe accidents in the plant design. The U.S. Department of Energy (DOE) initiated the Advanced Reactor Severe Accident Program (ARSAP) to assist in the transfer of severe accident technology from the U.S. national laboratories to the industry to implement this approach. The basic design requirements for this new generation of nuclear power plants were developed, under the management of the Electric Power Research Institute (EPRI) by the utilities and documented in the Utility Requirements Document (URD). The URD safety policy is based on the traditional 'defense-in-depth' approach, which emphasizes prevention through safety systems which prevent accidents from progressing to core damage, and mitigation to ensure that accidents are mitigated and contained. In a major departure from previous practice, severe accidents, including postulated core melt events, are specifically included in the defense-in-depth design considerations for ALWRs. As a result of this approach, the emergency planning assumptions and criteria warrant a review and reevaluation for ALWR designs. ALWRs present a risk profile that is significantly different than that which served as the basis for the emergency planning requirements for operating plants. The determination of this profile necessarily requires the characterization of the severe accident response of ALWRs
International Nuclear Information System (INIS)
Salama, M.
2004-01-01
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 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 6 ) and its high risk of chemical toxicity. The probability of a fire accident with a cargo carrying (UF 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 hazards
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/...
Self reported involvement in emergency medicine among GPs in Norway.
Hjortdahl, Magnus; Zakariassen, Erik; Halvorsen, Peder A
2018-04-10
To examine general practitioners' (GPs') perception of their role in emergency medicine and participation in emergency services including ambulance call outs, and the characteristics of the GPs and casualty clinics associated with the GPs' involvement in emergency medicine. Cross-sectional online survey. General practice. General practitioners in Norway (n = 1002). Proportion of GPs perceiving that they have a large role in emergency medicine, regularly being on call, and the proportion of ambulance callouts with GP participation. Forty six percent of the GPs indicated that they play a large role in emergency medicine, 63 percent of the GPs were regularly on call, and 28 percent responded that they usually took part in ambulance call outs. Multivariable logistic regression analyses indicated that these outcomes were strongly associated with participation in multidisciplinary training. Furthermore, the main outcomes were associated with traits commonly seen at smaller casualty clinics such as those with an absence of nursing personnel and extra physicians, and based on the distance to the hospital. Our findings suggest that GPs play an important role in emergency medicine. Multidisciplinary team training may be important for their continued involvement in prehospital emergencies. Key Points Health authorities and other stakeholders have raised concerns about general practitioner's (GPs) participation in emergency medicine, but few have studied opinions and perceptions among the GPs themselves. • Norwegian GPs report playing a large role in emergency medicine, regularly being on call, and taking part in selected ambulance call outs. • A higher proportion of GPs who took part in team training perceived themselves as playing a large role in emergency medicine, regularly being on call, and taking part in ambulance call outs. • These outcomes were also associated with attributes commonly seen at smaller casualty clinics.
International Nuclear Information System (INIS)
Shi, Shenggang; Cao, Jingcan; Feng, Li; Liang, Wenyan; Zhang, Liqiu
2014-01-01
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
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.
Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.
April, Michael D; Murray, Brian P
2017-06-01
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policymakers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the U.S. Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of noncost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic evaluation
Emergency reception of accidents and incidents in working with ionizing radiation
International Nuclear Information System (INIS)
Abrahamse, J.C.; Gispen, J.G.W.
1989-01-01
This manual is intended to be a general manual for the responsible expert regarding radiation hygienics in order to assist him in establishing an organization for combat of accidents and incidents. First attention is paid considerations underlying emergency measures and aid, subsequently the demands and desirabilities in the practical organization are discussed. (author). 3 figs
Work shifts in Emergency Medicine
Directory of Open Access Journals (Sweden)
Roberto Recupero
2007-06-01
Full Text Available Emergency Medicine is known as a high stress specialty. The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field. In this work problems tied with night shift work will be taken into account and some solutions to reduce the impact of night work on the emergency physicians will be proposed.
Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak
2015-01-01
There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Teaching EM with workshops improved student satisfaction in EM education for medical students.
International Nuclear Information System (INIS)
1991-09-01
The document refers to the Convention on Early Notification of a Nuclear Accident (IAEA-INFCIRC-335) and to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (IAEA-INFCIRC-336). Part I contains the status lists as of August 31, 1991. Part II contains reservations/declarations made upon expressing consent to be bound and objections there to. Part III contains reservations/declarations made upon signature
International Nuclear Information System (INIS)
Lahtinen, J.
2006-04-01
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)
Radiological accident and incident in Thailand: Lesson to be learned
International Nuclear Information System (INIS)
Ya-anant, N.; Tiyapun, K.; Saiyut, K.
2011-01-01
Radioactive materials in Thailand have been used in medicine, research and industry for more than 50 y. Several radiological accident and incidents happened in the past 10 y. A serious one was the radiological accident that occurred in Samut Prakan (Thailand) in 2000. The serious radiological accident occurred when the 60 Co head was partially dismantled, taken from that storage to sell as scrap metal. Three victims died and 10 people received high dose from the source. The lesson learned from the radiological accident in Samut Prakan was to improve in many subjects, such as efficiency in Ministerial Regulations and Atomic Energy Act, emergency response and etc. In addition to the serious accident, there are also some small incidents that occurred, such as detection of contaminated scrap metals from the re-cycling of scrap metals from steel factories. Therefore, the radiation protection infrastructure was established after the accident. Laws and regulations of radiation safety and the relevant regulatory procedures must be revised. (authors)
International Nuclear Information System (INIS)
Selby, J.M.; Vallario, E.J.; Moeller, D.W.; Stephan, J.G.
1987-08-01
Within a nuclear facility, an emergency can range from a situation that only involves the employees of that facility to a series of events that have both onsite and offsite consequences. Analyses of nuclear and non-nuclear emergencies can provide valuable information on the causes of, as well as the problems encountered during emergencies. Reports on facility emergencies indicate that up to 90% involve human error. Such events occur more frequently during the night shifts or on weekends. These occurrences may result from the absence of experienced personnel as well as the reduced alertness of onsite personnel. Therefore, this paper emphasizes the human element in a review of accidents that have occurred at nuclear facilities including Windscale, SL-1, the Recuplex criticality, the Wood River Junction criticality, the Browns Ferry fire, Three Mile Island, and Chernobyl. These accidents are described, and their consequences are evaluated. The information obtained from these evaluations may be useful for inclusion in nuclear plant operating and testing procedures. 21 refs
Promoting interventional radiology in clinical practice of emergency medicine
International Nuclear Information System (INIS)
Zhou Bing; Yuan Jianhua
2009-01-01
Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive, highly-effective and immediately-efficient, moreover, it integrates the diagnosis with the therapy perfectly. Besides, the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization, embolectomy, etc, but also the nonvascular interventions, such as tracheal s tent implantation, percutaneous vertebroplasty and so forth. However, importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice. (authors)
International Nuclear Information System (INIS)
Chen Xiaoqiu; Li Bing; Yu Shaoqing
2012-01-01
This paper reviewed the emergency response of Japan in Fukushima nuclear accident, provided and discussed the issues should be of concern on emergency preparedness and response in future: (1) modifying the existing emergency preparedness and response system; (2) consolidating the concept of emergency preparedness as the ultimate level of defense-in-depth; (3) promoting the emergency response decision-making support capabilities; (4) valuing the information opening of involving nuclear news and radiation environmental information. (authors)
Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.
Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie
2016-07-01
Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.
Smith, Jason; Keating, Liza; Flowerdew, Lynsey; O'Brien, Rachel; McIntyre, Sam; Morley, Richard; Carley, Simon
2017-07-01
Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Kuhn, Gloria J; Abbuhl, Stephanie B; Clem, Kathleen J
2008-08-01
The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.
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. Copyright © 2014 Elsevier B.V. All rights reserved.
Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren
2009-04-01
The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must
Emergency planning practices and criteria in the OECD countries after the Chernobyl accident
International Nuclear Information System (INIS)
Boeri, G.; Wiktorsson, C.
1988-09-01
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
Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons
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…
Legislative framework on establishing emergency response plan in the case of a nuclear accident
International Nuclear Information System (INIS)
Novosel, N.; Valcic, I.; Biscan, R.
2000-01-01
To give an overview of the legislative framework, which defined emergency planning in Croatia in the case of a nuclear accident, it's necessary to look at all international recommendations and obligations and the national legislation, acts and regulations. It has to be emphasized that Croatia signed three international conventions in this field, and by that took over some responsibilities and obligations. Beside that, it is also in Croatian interest to follow the recommendations of international institutions such as International Atomic Energy Agency (IAEA standards and technical documents). On the other hand, national legislation in this field consists of several laws, which cover nuclear safety measures, governmental organization, natural disasters and acts (decree, decisions) of responsible authority for emergency planning in the case of a nuclear accident (Ministry of Economy). This paper presents an overview of the international and Croatian legislation which influenced the emergency planning in the case of a nuclear accident. (author)
COMMUNITY MEDICINE & PRIMARY HEALTH CARE
African Journals Online (AJOL)
ajiboro
2Department of Community Medicine & Primary Care, Faculty of Clinical Sciences, ... It may result from road traffic accident, near saving basic principles in emergency care that even drowning, electric ... (4.3%) at place of work, 8 (11.4%) at.
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
International Nuclear Information System (INIS)
Matsuoka, Takeshi
1984-01-01
A reliability analysis is given for the emergency decay heat removal system of the Nuclear Ship ''Mutsu'' and the emergency sea water cooling system of the Nuclear Ship ''Savannah'', under ten typical nuclear ship accident conditions. Basic event probabilities under these accident conditions are estimated from literature survey. These systems of Mutsu and Savannah have almost the same reliability under the normal condition. The dispersive arrangement of a system is useful to prevent the reduction of the system reliability under the condition of an accident restricted in one room. As for the reliability of these two systems under various accident conditions, it is seen that the configuration and the environmental condition of a system are two main factors which determine the reliability of the system. Furthermore, it was found that, for the evaluation of the effectiveness of safety system of a nuclear ship, it is necessary to evaluate its reliability under various accident conditions. (author)
International Nuclear Information System (INIS)
1992-09-01
The document refers to the Convention on Early Notification of a Nuclear Accident (CENNA) (IAEA-INFCIRC-335) and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (CANARE) (IAEA-INFCIRC-336). Part I contains the status lists as of 10 September 1992, part II contains the texts of reservations/declarations made upon expressing consent to be bound and objections there to, and part III contains the texts of reservations/declarations made upon signature
International Nuclear Information System (INIS)
1997-01-01
The document refers to the Convention on Early Notification of a Nuclear Accident (CENNA) (IAEA-INFCIRC-335) and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (CANARE) (IAEA-INFCIRC-336). Part I contains the status list as of 31 December 1996, Part II contains the texts of reservations/declarations made upon or following expressing consent to be bound and objections thereto, and Part III contains the texts of reservations/declarations made upon signature
Energy Technology Data Exchange (ETDEWEB)
NONE
1997-02-28
The document refers to the Convention on Early Notification of a Nuclear Accident (CENNA) (IAEA-INFCIRC-335) and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (CANARE) (IAEA-INFCIRC-336). Part I contains the status list as of 31 December 1996, Part II contains the texts of reservations/declarations made upon or following expressing consent to be bound and objections thereto, and Part III contains the texts of reservations/declarations made upon signature.
Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond
Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie
2016-01-01
Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434
Emergency response to a highway accident in Springfield, Massachusetts, on December 16, 1991
International Nuclear Information System (INIS)
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
Directory of Open Access Journals (Sweden)
VLAUDIMIR DIAS MARQUES
Full Text Available ABSTRACT Objective: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. Methods: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. Results: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12. Statistical analysis showed that in the cases conducted by the emergency physicians (n=187, the recording of the Glasgow Coma Scale and the performance of surgical procedures were less common, whereas the recording of blood pressure values was performed in greater numbers when compared with cases led by surgeons (n=501. There was a statistically significant relationship (p<0.01 between the length of hospital stay and surgical specialty, with a greater chance (crude OR=28 in the period from one to six hours for the group treated by emergency doctors. Most physicians participating in the study were young, with emergency room time of up to one to two years, and with ATLS training. Among those who had attended the ATLS course, 60% did so in the last four years. Surgeons performed 73% of hospital treatments. Conclusion: in the care of traffic victims with minor injuries, the Glasgow Coma Scale, the blood pressure levels, the type of treatment in the emergency room and hospital stay had different approaches between emergency physicians and surgeons.
State of emergency medicine in Rwanda 2015: an innovative trainee and trainer model.
Mbanjumucyo, Gabin; DeVos, Elizabeth; Pulfrey, Simon; Epino, Henry M
2015-01-01
The 1994 Rwandan war and genocide left more than 1 million people dead; millions displaced; and the country's economic, social, and health infrastructure destroyed. Despite remaining one of the poorest countries in the world, Rwanda has made remarkable gains in health, social, and economic development over the last 20 years, but modern emergency care has been slow to progress. Rwanda has recently established the Human Resources for Health program to rapidly build capacity in multiple sectors of its healthcare delivery system, including emergency medicine. This project involves multiple medical and surgical residencies, nursing programs, allied health professional trainings, and hospital administrative support. A real strength of the program is that trainers work with international faculty at Rwanda's referral hospital, but also as emergency medicine specialty trainers when returning to their respective district hospitals. Rwanda's first emergency medicine trainees are playing a unique and important role in the implementation of emergency care systems and education in the country's district hospitals. While there has been early vital progress in building emergency medicine's foundations in Rwanda, there remains much work to be done. This will be accomplished with careful planning and strong commitment from the country's healthcare and emergency medicine leaders.
Hung, Maria S Y; Pang, Samantha M C
2011-01-01
This paper is a report of a study to illuminate the experience of family members whose relatives survived the resuscitation in an accident and emergency department, and their preferences with regard to being present. Family presence during resuscitation can offer benefits to both patient and family members, and large healthcare organizations support and recommend offering the option for their presence. However, many staff believe that this is too distressing or traumatic for families and that they would interfere with the resuscitation process. An interpretive phenomenological approach was used to collect data in 2007-2008 with 18 family members of patients who survived life-sustaining interventions in an accident and emergency department in Hong Kong. Audio-recorded interviews were transcribed verbatim for thematic analysis and verified with the participants in second interviews. None of the family members was present in resuscitation room during the life-sustaining interventions, and five entered the room after the patients' condition was stable. The majority indicated a strong preference to be present if given the option. Three interrelated themes emerged: (i) emotional connectedness, (ii) knowing the patient, and (iii) perceived (in)appropriateness, with 10 subthemes representing affective, rational and contextual determinants of family presence preferences. The interplay of these determinants and how they contributed to strong or weak preference for family presence was analysed. Variations among the contributing determinants to each family member's preference to be present were revealed. Appropriate nursing interventions, policy and guidelines should be developed to meet individualized needs during such critical and life-threatening moments in accident and emergency departments. © 2010 Blackwell Publishing Ltd.
Kalkan, Asim; Kose, Ozkan; Bilir, Ozlem; Ersunan, Gokhan; Ozel, Deniz; Guler, Ferhat
2015-09-01
The purpose of this study was to assess the publication rate of the abstracts presented at the 6th Mediterranean Emergency Medicine Congress, 2011 and the 7th European Congress on Emergency Medicine, 2012. All abstracts, both posters and oral presentations, from the international emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012 were identified. To establish whether these abstracts were subsequently published in peer-reviewed medical journals, the names of all the authors and the title of the abstracts were searched for in the databases of Clinical Key/Elsevier, EBSCO Discovery Service, MD Consult, Science Direct, Scopus, EMBASE, Medscape, Google Scholar and local ULAKBIM. The year of publication, consistency of author names and titles, the type of study, the journals in which papers were published and countries from which reports were submitted were all recorded. A total of 1721 abstracts were examined; 626 from 2011 (307 oral presentations and 319 posters) and 1095 from 2012 (154 oral presentations and 941 posters). Of all abstracts in 2011, 172 (27.5%) and of all abstracts in 2012, 265 (24.2%) were subsequently published as full-text reports in peer-reviewed journals. Of the 172 papers published in 2011, 152 (88.4%) were accepted by Science Citation Index (SCI) and/or SCI Expanded (SCI-E) journals and 155 (58.5%) of 265 papers were accepted by SCI and/or SCI-E journals in 2012 (p=0.0001). The publication rate of abstracts submitted to international emergency medicine congresses held by EUSEM over those 2 years was low compared with that of abstracts presented in other emergency medicine congresses. Presenters should be encouraged to send their studies to peer-reviewed journals. During the selection process by the scientific panel, constructive critics should be notified to the presenters instead of simply accepting or rejecting the studies that submitted to the congress, which may increase the
The Fukushima Daiichi Accident. Technical Volume 3/5. Emergency Preparedness and Response. Annexes
International Nuclear Information System (INIS)
2015-08-01
The Fukushima Daiichi Accident consists of a Report by the IAEA Director General and five technical volumes. It is the result of an extensive international collaborative effort involving five working groups with about 180 experts from 42 Member States with and without nuclear power programmes and several international bodies. It provides a description of the accident and its causes, evolution and consequences, based on the evaluation of data and information from a large number of sources available at the time of writing. The Fukushima Daiichi Accident will be of use to national authorities, international organizations, nuclear regulatory bodies, nuclear power plant operating organizations, designers of nuclear facilities and other experts in matters relating to nuclear power, as well as the wider public. The set contains six printed parts and five supplementary CD-ROMs. Contents: Report by the Director General; Technical Volume 1/5, Description and Context of the Accident; Technical Volume 2/5, Safety Assessment; Technical Volume 3/5, Emergency Preparedness and Response; Technical Volume 4/5, Radiological Consequences; Technical Volume 5/5, Post-accident Recovery; Annexes. The Report by the Director General is available separately in Arabic, Chinese, English, French, Russian, Spanish and Japanese
Baskin, Sean M; Lin, Christina; Carlson, Jestin N
2014-01-01
Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. Methods: We performed a retrospective literature re...
Stress in accident and post-accident management at Chernobyl
International Nuclear Information System (INIS)
Girard, P.; Dubreuil, G.H.
1996-01-01
The effects of the Chernobyl nuclear accident on the psychology of the affected population have been much discussed. The psychological dimension has been advanced as a factor explaining the emergence, from 1990 onwards, of a post-accident crisis in the main CIS countries affected. This article presents the conclusions of a series of European studies, which focused on the consequences of the Chernobyl accident. These studies show that the psychological and social effects associated with the post-accident situation arise from the interdependency of a number of complex factors exerting a deleterious effect on the population. We shall first attempt to characterise the stress phenomena observed among the population affected by the accident. Secondly, we will be presenting an anlysis of the various factors that have contributed to the emerging psychological and social features of population reaction to the accident and in post-accident phases, while not neglecting the effects of the pre-accident situation on the target population. Thirdly, we shall devote some initial consideration to the conditions that might be conducive to better management of post-accident stress. In conclusion, we shall emphasise the need to restore confidence among the population generally. (Author)
The main regularities of 137Cs accumulation by medicinal plants after nuclear accidents
International Nuclear Information System (INIS)
Orlov, A.A.; Krasnov, V.P.; Get'manchuk, A.I.
2004-01-01
The main regularities of 137 Cs accumulation by medicinal plants after nuclear accidents have been analyzed. Tendencies in study of this problem have been underlined on literary data. The mean values of transfer factor of 137 Cs from soil to medicinal row in different habitat types have been elucidated for Ukrainian Polessye. It was found that species with the wide ecological amplitude were characterized by the highest intensity of 137 Cs accumulation in forest habitats in comparison with non-forest ones. For some species of medicinal plants multiyear dynamics of 137 Cs specific activity has been shown on stationary experimental plots. (author)
Authorship Trends of Emergency Medicine Publications over the Last Two Decades.
Lammers, Richard; Simunich, Thomas; Ashurst, John
2016-05-01
With the recent merger of the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) a heightened pressure for publication may become evident. Our objective was to determine whether there was a gap in the type of both medical degree designation and advanced degree designation among authorship in three United States-based academic emergency medicine journals. We reviewed the Journal of Emergency Medicine, Academic Emergency Medicine and Annals of Emergency Medicine for the type of degree designation that the first and senior authors had obtained for the years 1995, 2000, 2005, 2010 and 2014. A total of 2.48% of all authors held a degree in osteopathic medicine. Osteopathic physician first authors contributed to 3.26% of all publications while osteopathic physician senior authors contributed 1.53%. No statistical trend could be established for the years studied for osteopathic physicians. However, we noted an overall trend for increased publication for allopathic senior authors (p=0.001), allopathic first authors with a dual degree (p=0.003) and allopathic senior authors with a dual degree (p=0.005). For each journal studied, no statistical trend could be established for osteopathic first or senior authors but a trend was noted for allopathic first and senior authors in the Journal of Emergency Medicine (p-value=0.020 and 0.006). Of those with dual degrees, osteopathic physicians were in the minority with 1.85% of osteopathic first authors and 0.60% of osteopathic senior authors attaining a dual degree. No statistical trend could be established for increased dual degree publications for osteopathic physicians over the study period, nor could a statistical trend be established for any of the journals studied. Very few osteopathic physicians have published in the Journal of Emergency Medicine, Academic Emergency Medicine or Annals of Emergency Medicine over the last two decades. Despite a trend for increased
Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L
2012-02-01
Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software. Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents' confidence in their ability to manage a disaster increased on both a personal and and a departmental level. A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.
Process criticality accident likelihoods, consequences and emergency planning
International Nuclear Information System (INIS)
McLaughlin, T.P.
1992-01-01
Evaluation of criticality accident risks in the processing of significant quantities of fissile materials is both complex and subjective, largely due to the lack of accident statistics. Thus, complying with national and international standards and regulations which require an evaluation of the net benefit of a criticality accident alarm system, is also subjective. A review of guidance found in the literature on potential accident magnitudes is presented for different material forms and arrangements. Reasoned arguments are also presented concerning accident prevention and accident likelihoods for these material forms and arrangements. (Author)
Building emergency medicine in Ethiopia | IDRC - International ...
International Development Research Centre (IDRC) Digital Library (Canada)
2014-09-05
Sep 5, 2014 ... Ethiopia faces a critical gap in emergency medical care. ... Dr Biruk Germa, Senior Emergency Medicine Resident at Addis Ababa University, also ... The issue Inaccessibility to veterinary services in Ethiopia's livestock sector.
Decision making process and emergency management in different phases of a nuclear accident
International Nuclear Information System (INIS)
Duranova, T.
2005-01-01
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)
Planning for the Handling of Radiation Accidents
International Nuclear Information System (INIS)
1969-01-01
The developing atomic energy programmes and the widespread use of radiation sources in medicine, agriculture, industry and research have had admirable safety records. Throughout the world the number of known accidents in which persons have been exposed to harmful am ounts of ionizing radiation is relatively small, and only a few deaths have occurred. Meticulous precautions are being taken to maintain this good record in all work with radiation sources and to keep the exposure of persons as low as practicable. In spite of all the precautions that are taken, accidents may occur and they may be accompanied by the injury or death of persons and damage to property. It is only prudent to take those steps that are practicable to prevent accidents and to plan in advance the emergency action that would limit the injuries and damage caused by those accidents that do occur. Emergency plans should be sufficiently broad to cover unforeseen or very improbable accidents as well as those that are considered credible. Some accidents may involve only the workers in an establishment, those working directly with the source and possibly their colleagues. Other accidents may have consequences, notably in the form of radioactive contamination of the environment, that affect the general public, possibly far from the site of the accident. The preparation of plans for dealing with radiation accidents is therefore obligatory both for the various authorities that are responsible for protecting the health and the food and water supplies of the public, and for the operator of an installation containing radiation sources.
International Nuclear Information System (INIS)
Kang, K. S.; Jeong, H. J.
1998-01-01
The Advanced EOP(AEOP) has been developed by focusing on the importance of the operators role in emergency conditions. In the AEOP, to overcome the complexity of current EOPs and maintain the consistency of operators action according to plant emergency conditions, operator's task were allocated according to their duties. As an alternative, the Computerized Operator Aid System (COAS) has been developed to reduce operator's burden and provide detailed instructions of procedure. Probabilistic Safety Assessment (PSA) results were synthesized in the AEOP using the event tree to give the awareness and the prediction of accident progression in advance. In conclusion, the existing EOP with its inherent complexity should be simplified and consolidated using computerized operator support system and task allocation to prevent more severe accidents and to reduce operator cognitive overload in emergency conditions
Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine.
Véliz-Martínez, Pedro L; Jorna-Calixto, Ana R; Oramas-González, René
2016-10-01
INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVE Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists' competence and performance. KEYWORDS Clinical competency, competency-based education, professional education, intensive care, emergency medicine, urgent care, continuing medical education, curriculum, medical residency, Cuba.
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.
Malta, Deborah Carvalho; Mascarenhas, Márcio Dênis Medeiros; Bernal, Regina Tomie Ivata; Andrade, Silvania Suely Caribé de Araújo; das Neves, Alice Cristina Medeiros; de Melo, Elza Machado; da Silva Junior, Jarbas Barbosa
2012-09-01
Adolescents are seeking new references and experiences, which may involve attitudes of risk and exposure to accidents and violence from external causes. These events constitute a serious Public Health problem. The scope of this study was to analyze the occurrence of accidents by external causes in adolescents from 10 to 19 years of age attended at sentinel urgency and emergency services in Brazil. Data from the 2009 Surveillance System for Violence and Accidents (VIVA 2009) was analyzed in 74 emergency units in 23 state capitals and the Federal District. The findings revealed that 6,434 adolescents (89.8%) were victims of accidents and 730 (10.2 %) were victims of violence. The main causes of the accidents were falls and traffic accidents, and assaults were predominant in violence. For both accidents and violence, non-white male adolescents were predominant and the events occurred most frequently on the public highways. A marked increase was detected, with hospitalization of victims of violence between 15 and 19 years of age. Understanding the epidemiological reality of external causes among adolescents represents an important tool for health prevention and promotion policies and the culture of peace seeking to reduce morbidity and mortality.
Energy Technology Data Exchange (ETDEWEB)
Hossena, Muhammed Mufazzal; Kang, Kyoung Ho; Song, Jin Ho [KAERI, Deajeon (Korea, Republic of)
2016-05-15
The main objectives of this study are to find the influencing factors of systems and sub-systems of OEPRM, to find the interdependency among the influencing factors, and to develop a conceptual qualitative OEPRM for densely populated NPP country in case of SA using system dynamics (SD). NPP accidents are classified as nuclear accidents and incidents depending on the severity. Severe accident (SA) is certain low probability accident that are beyond design basis accident which may arise due to multiple failures of safety systems leading to significant core degradation and jeopardize the integrity of many or all of the barriers to the release of radioactive material. The weakness to the off-site emergency response in the time of Fukushima accident was observed. So, it is crucial to develop an off-site emergency preparedness and responses model (OEPRM) for radiological emergency in densely populated country from the Fukushima emergency response lesson. In this study, an OEPRM is developed for densely populated NPP country to mitigate radiological effects in case of SA using SD approach. Besides, this study focuses the weakness of emergency response in Fukushima accident and proposed solution approach. The development of OEPRM in case of SA of NPP is very complex because of the involvement of various organization and it requires highly specialized agencies and technical experts. Moreover, if the country is agriculture based, it will make completely sophisticated.
International Nuclear Information System (INIS)
Hossena, Muhammed Mufazzal; Kang, Kyoung Ho; Song, Jin Ho
2016-01-01
The main objectives of this study are to find the influencing factors of systems and sub-systems of OEPRM, to find the interdependency among the influencing factors, and to develop a conceptual qualitative OEPRM for densely populated NPP country in case of SA using system dynamics (SD). NPP accidents are classified as nuclear accidents and incidents depending on the severity. Severe accident (SA) is certain low probability accident that are beyond design basis accident which may arise due to multiple failures of safety systems leading to significant core degradation and jeopardize the integrity of many or all of the barriers to the release of radioactive material. The weakness to the off-site emergency response in the time of Fukushima accident was observed. So, it is crucial to develop an off-site emergency preparedness and responses model (OEPRM) for radiological emergency in densely populated country from the Fukushima emergency response lesson. In this study, an OEPRM is developed for densely populated NPP country to mitigate radiological effects in case of SA using SD approach. Besides, this study focuses the weakness of emergency response in Fukushima accident and proposed solution approach. The development of OEPRM in case of SA of NPP is very complex because of the involvement of various organization and it requires highly specialized agencies and technical experts. Moreover, if the country is agriculture based, it will make completely sophisticated
Bernhard, Michael; Pietsch, Christian; Gries, André
2009-06-01
The essential tasks of a department of interdisciplinary emergency medicine are the initial triage and assessment of vital function as well as the subsequent organization und initiation of emergency treatment. A previously defined set of diagnostic and therapeutic measures is carried out before the patient is allocated to an in-hospital clinical service and is admitted to a ward. Moreover, diagnosis and treatment for outpatients are performed. "Time" is a critical factor to be considered for all organizational and structural aspects of a department of interdisciplinary emergency medicine.
Mascarenhas, Márcio Dênis Medeiros; Souto, Rayone Moreira Costa Veloso; Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Lima, Cheila Marina de; Montenegro, Marli de Mesquita Silva
2016-12-01
Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.
Burnout and Associated Factors among Iranian Emergency Medicine Practitioners
JALILI, Mohammad; SADEGHIPOUR ROODSARI, Gholamreza; BASSIR NIA, Anahita
2013-01-01
Abstract Background Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. Methods In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, deperso...
Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de
2016-12-01
Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.
Accident management in the case of serious emergencies in nuclear power plant
International Nuclear Information System (INIS)
1990-06-01
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) [de
Energy Technology Data Exchange (ETDEWEB)
Chen, S.H.; Feng, T.S.; Huang, K.C. [National Tsing-Hua Univ., Hsinchu, Taiwan (China); Wang, J.R. [Inst. of Nuclear Energy Research, Longtan, Taiwan (China); Cheng, Y.H. [Industrial Tech. Res. Inst., Hsinchu, Taiwan (China); Shih, C., E-mail: ckshih@ess.nthu.edu.tw [National Tsing-Hua Univ., Hsinchu, Taiwan (China)
2011-07-01
We have investigated the roles of Firewater Addition System and Passive Flooder in ABWR severe accidents, such as LOCA and SBO. The results are apparent that Firewater System is vital in the highly unlikely situation where all AC are lost. Also in this paper, we present EPZDose, an effective and faster-than-real time code for offsite dose consequences predictions and evaluations. Illustrations with the release from our severe accident scenario show friendly and informative user's interface for supporting decision makings in nuclear emergency situations. (author)
Process criticality accident likelihoods, consequences, and emergency planning
Energy Technology Data Exchange (ETDEWEB)
McLaughlin, T.P.
1991-01-01
Evaluation of criticality accident risks in the processing of significant quantities of fissile materials is both complex and subjective, largely due to the lack of accident statistics. Thus, complying with standards such as ISO 7753 which mandates that the need for an alarm system be evaluated, is also subjective. A review of guidance found in the literature on potential accident magnitudes is presented for different material forms and arrangements. Reasoned arguments are also presented concerning accident prevention and accident likelihoods for these material forms and arrangements. 13 refs., 1 fig., 1 tab.
Energy Technology Data Exchange (ETDEWEB)
Kang, K. S.; Jeong, H. J. [KOPEC, Taejon (Korea, Republic of)
1998-10-01
The Advanced EOP(AEOP) has been developed by focusing on the importance of the operators role in emergency conditions. In the AEOP, to overcome the complexity of current EOPs and maintain the consistency of operators action according to plant emergency conditions, operator's task were allocated according to their duties. As an alternative, the Computerized Operator Aid System (COAS) has been developed to reduce operator's burden and provide detailed instructions of procedure. Probabilistic Safety Assessment (PSA) results were synthesized in the AEOP using the event tree to give the awareness and the prediction of accident progression in advance. In conclusion, the existing EOP with its inherent complexity should be simplified and consolidated using computerized operator support system and task allocation to prevent more severe accidents and to reduce operator cognitive overload in emergency conditions.
The Radiological Accident in Lia, Georgia
Energy Technology Data Exchange (ETDEWEB)
NONE
2014-12-15
The use of radioactive material offers a wide range of benefits to medicine, research and industry throughout the world. Precautions are necessary, however, to limit the exposure of people to the radiation emitted. Where the amount of radioactive material is substantial, as in the case of radiotherapy or industrial radiography sources, great care is required to prevent accidents which could have severe consequences. Nevertheless, in spite of the precautions taken, serious accidents involving radiation sources continue to occur, albeit infrequently. The IAEA conducts follow-up reviews of such serious accidents to provide an account of their circumstances and consequences, from which organizations with responsibilities for radiation protection, safety of sources and emergency preparedness and response may learn. A serious radiological accident occurred in Georgia on 2 December 2001, when three inhabitants of the village of Lia found two metal objects in the forest while collecting firewood. These objects were {sup 90}Sr sources with an activity of 1295 TBq. The three inhabitants used the objects as heaters when spending the night in the forest. The major cause of the accident was the improper and unauthorized abandonment of radiation sources in Georgia and the absence of clear labels or radiation signs on the sources warning of the potential radiation hazard. Under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), the Georgian authorities requested assistance from the IAEA to advise on the dose assessment, source recovery and medical management of those involved in the accident. This publication describes the circumstances and events surrounding the accident, its management and the medical treatment of the people exposed. It also describes the dose reconstruction calculations and biodosimetry assessments conducted. A number of uncertainties remain relating to some details of the accident. However
The Radiological Accident in Lia, Georgia
International Nuclear Information System (INIS)
2014-12-01
The use of radioactive material offers a wide range of benefits to medicine, research and industry throughout the world. Precautions are necessary, however, to limit the exposure of people to the radiation emitted. Where the amount of radioactive material is substantial, as in the case of radiotherapy or industrial radiography sources, great care is required to prevent accidents which could have severe consequences. Nevertheless, in spite of the precautions taken, serious accidents involving radiation sources continue to occur, albeit infrequently. The IAEA conducts follow-up reviews of such serious accidents to provide an account of their circumstances and consequences, from which organizations with responsibilities for radiation protection, safety of sources and emergency preparedness and response may learn. A serious radiological accident occurred in Georgia on 2 December 2001, when three inhabitants of the village of Lia found two metal objects in the forest while collecting firewood. These objects were 90 Sr sources with an activity of 1295 TBq. The three inhabitants used the objects as heaters when spending the night in the forest. The major cause of the accident was the improper and unauthorized abandonment of radiation sources in Georgia and the absence of clear labels or radiation signs on the sources warning of the potential radiation hazard. Under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), the Georgian authorities requested assistance from the IAEA to advise on the dose assessment, source recovery and medical management of those involved in the accident. This publication describes the circumstances and events surrounding the accident, its management and the medical treatment of the people exposed. It also describes the dose reconstruction calculations and biodosimetry assessments conducted. A number of uncertainties remain relating to some details of the accident. However, sufficient
Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study
Directory of Open Access Journals (Sweden)
Atefe Kamaloo
2017-06-01
Full Text Available Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome.Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded by MAXQDA10 software.Results: Data were categorized in 4 themes as follow: (1 the characteristics of emergency medicine; (2 ambiguity in residents’ duties; (3 educational planning; and (4 careers.Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1 changes in personal life; (2 arrangement in shifts; and (3 educational issues.Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out.
International Nuclear Information System (INIS)
Kikuchi, Toru
2014-01-01
From the abstract of contents of the 'Radiation management manual in medical field (2012),' the utilization technique of the manual is introduced. Introduced items are as follows: (1) Exposure management; exposure management for radiation medical workers, patients, and citizens in the medical field, and exposure management for radiation workers and citizens involved in the emergency work related to the Fukushima nuclear accident, (2) Health management; health management for radiation medical workers, (3) Radiation education: Education/training for radiation medical workers, and radiation education for health care workers, (4) Accident and emergency measures; emergency actions involved in the radiation accidents and radiation medicine at medical facilities
International Nuclear Information System (INIS)
1987-05-01
The document refers to the Convention on early notification of a nuclear accident (INFCIRC-335) and to the Convention on assistance in the case of a nuclear accident or radiological emergency (INFCIRC-336). Part I of the document contains the texts of reservations/declarations made by some of the countries upon or following signature. Part II contains the texts of reservations/declarations made upon or following deposit of instrument, expressing consent to be bound
Emergency planning lessons learned from a review of past major radiological accidents
International Nuclear Information System (INIS)
Stephan, J.G.; Selby, J.M.; Martin, J.B.; Moeller, D.W.; Vallario, E.J.
1988-01-01
In examining a range of nuclear accidents from the 1950s to the present that were reported in the literature, the authors have identified a number of contributing factors which affected human judgement during these events. One common thread found in a large number of accidents is the time of occurrence; a second is the adequacy of emergency training. The data show that events, whether severe accidents or operational incidents, appear to occur more frequently during off-normal hours such as the early morning shift, weekends, or holidays. Accidents seldom occur during the day shift when the full management team and senior operations personnel are present. As a result, those facility employees most expert in coping with the situation may not be available, and the normal chain of command may be disrupted. At several nuclear power plants, it was also observed that new or less experienced technicians are often assigned to night shifts. The lack of experienced human resources and the pressure of an accident situation can have an adverse impact on individuals who are faced with making important decisions
Problems of pharmacological supply of disaster medicine
International Nuclear Information System (INIS)
Sabaev, V.V.; Il'ina, S.L.
1995-01-01
The paper reviews a number of pharmacological problems, being important for the disaster medicine, of theoretical and practical nature, the settlement of which would promote more efficient rendering emergency medical aid to the injured persons in the conditions of emergency situations and further expert medical care. On the example of radiation accidents there are studied methodical approaches to organization of drug prophylaxis and therapy of the injured persons in emergency situations. The authors have proved the necessity of arranging proper pharmacological supply of disaster medicine which is to settle the whole complex of scientific-applied and organizational questions relating to the competence of pharmacology and pharmacy. 17 refs
Emergency department operations and management education in emergency medicine training
Institute of Scientific and Technical Information of China (English)
Bret A Nicks; Darrell Nelson
2012-01-01
BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.
Just allocation and team loyalty: a new virtue ethic for emergency medicine
Girod, J; Beckman, A
2005-01-01
When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595
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)...... significantly elevated concentrations of adrenaline and glucagon were found in diabetic patients admitted with severe hypoglycaemia to an Accident and Emergency Department.......). Eighteen adult patients with insulin-treated diabetes mellitus admitted to the Accident and Emergency Department with hypoglycaemia (plasma glucose 1.23 +/- 0.15 mmol l(-1) on admission) were randomized to one of the above treatments and plasma glucose and counterregulatory hormones were measured before...
International Nuclear Information System (INIS)
2005-01-01
The objective of this Safety Guide is to provide guidance to the public authorities and others (including consignors, carriers and emergency response authorities) who are responsible for developing and establishing emergency arrangements for dealing effectively and safely with transport accidents involving radioactive material. It may assist those concerned with establishing the capability to respond to such transport emergencies. It provides guidance for those Member States whose involvement with radioactive material is just beginning. It also provides guidance for those Member States that have already developed their radioactive material industries and the attendant emergency plans but that may need to review and improve these plans
The German emergency and disaster medicine and management system—history and present
Directory of Open Access Journals (Sweden)
Norman Hecker
2018-04-01
Full Text Available As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the “Golden Standard” of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Keywords: Emergency medical systems, Disaster medicine, Public health, Germany
How alternative payment models in emergency medicine can benefit physicians, payers, and patients.
Harish, Nir J; Miller, Harold D; Pines, Jesse M; Zane, Richard D; Wiler, Jennifer L
2017-06-01
While there has been considerable effort devoted to developing alternative payment models (APMs) for primary care physicians and for episodes of care beginning with inpatient admissions, there has been relatively little attention by payers to developing APMs for specialty ambulatory care, and no efforts to develop APMs that explicitly focus on emergency care. In order to ensure that emergency care is appropriately integrated and valued in future payment models, emergency physicians (EPs) must engage with the stakeholders within the broader health care system. In this article, we describe a framework for the development of APMs for emergency medicine and present four examples of APMs that may be applicable in emergency medicine. A better understanding of how APMs can work in emergency medicine will help EPs develop new APMs that improve the cost and quality of care, and leverage the value that emergency care brings to the system. Copyright © 2017 Elsevier Inc. All rights reserved.
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.
FOAMSearch.net: A custom search engine for emergency medicine and critical care.
Raine, Todd; Thoma, Brent; Chan, Teresa M; Lin, Michelle
2015-08-01
The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
International Nuclear Information System (INIS)
Ohlenschlaeger, L.
1981-03-01
Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de
Mutual emergency assistance for radiation accidents
International Nuclear Information System (INIS)
1980-11-01
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
International Nuclear Information System (INIS)
Salama, M.
2004-01-01
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 (UF 6 ) passing through the canal every year. In spite of all the precautions taken in the transport, accidents with packages containing UF 6 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 UF 6 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)
Pilot Domain Task Experience in Night Fatal Helicopter Emergency Medical Service Accidents.
Aherne, Bryan B; Zhang, Chrystal; Newman, David G
2016-06-01
In the United States, accident and fatality rates in helicopter emergency medical service (HEMS) operations increase significantly under nighttime environmentally hazardous operational conditions. Other studies have found pilots' total flight hours unrelated to HEMS accident outcomes. Many factors affect pilots' decision making, including their experience. This study seeks to investigate whether pilot domain task experience (DTE) in HEMS plays a role against likelihood of accidents at night when hazardous operational conditions are entered. There were 32 flights with single pilot nighttime fatal HEMS accidents between 1995 and 2013 with findings of controlled flight into terrain (CFIT) and loss of control (LCTRL) due to spatial disorientation (SD) identified. The HEMS DTE of the pilots were compared with industry survey data. Of the pilots, 56% had ≤2 yr of HEMS experience and 9% had >10 yr of HEMS experience. There were 21 (66%) accidents that occurred in non-visual flight rules (VFR) conditions despite all flights being required to be conducted under VFR. There was a statistically significant increase in accident rates in pilots with pilots with >10 yr HEMS DTE. HEMS DTE plays a preventive role against the likelihood of a night operational accident. Pilots with limited HEMS DTE are more likely to make a poor assessment of hazardous conditions at night, and this will place HEMS flight crew at high risk in the VFR night domain.
Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey
Directory of Open Access Journals (Sweden)
Erdem CEVIK
2015-03-01
Full Text Available SUMMARY: Objectives: The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. Methods: This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education. Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. Results: 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1% of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88 were animal studies. Conclusions: It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E. Key words: Emergency medicine, systematic analysis, theses
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
International Nuclear Information System (INIS)
Buglova, E.; Kenigsberg, J.
1997-01-01
Belarus is one of the most contaminated Republic due to the Chernobyl accident. 23% of the entire area of Belarus was contaminated with radionuclides. To protect the population after the accident different types of protective actions were performed during all phases, based on various temporary dose limits. An analysis of conducted protective actions and lessons obtained during the emergency response is briefly presented
International Nuclear Information System (INIS)
Singh, Hukum; Dash, M.; Shukla, Vikas; Vijayan, P.; Krishnamurthy, P.R.
2012-01-01
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
Energy Technology Data Exchange (ETDEWEB)
Singh, Hukum; Dash, M.; Shukla, Vikas; Vijayan, P.; Krishnamurthy, P.R., E-mail: vshukla@aerb.gov.in [Operating Plants Safety Division, Atomic Energy Regulatory Board, Mumbai (India)
2012-07-01
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
International Nuclear Information System (INIS)
Akaishi, Jun; Ohhata, Tsutomu
1987-01-01
The accident occurred in the Chernobyl No.4 reactor on April 26, 1986 became the largest accident of nuclear reactors so far as the quantity of release of radioactive substances was very much, and the wide area contamination over the whole Northern Hemisphere was brought about. Consequently, the revision over wide ranges, such as the desigh and operation of nuclear reactors and the response at the time of emergency, was to be urgently demanded. As to this accident, many reports have been already made. In this report, the contamination and the response carried out at the time of emergency including the state in Japan are mainly described. The contents of this report are based on the data sent from the international organizations, the results of measurement by the organizations in respective countries, the publication by USSR at the IAEA expert conference in August, 1986, and the data published in respective countries by research institutes. The state in respective countries after the accident, the radioactivity contamination due to the accident in USSR, European countries and Japan, the diffusion and move of radioactive substances, the countermeasures to the accident such as the estimation of exposure dose, scientific investigation, the evacuation of people and so on are reported. (Kako, I.)
Energy Technology Data Exchange (ETDEWEB)
Buglova, E.; Kenigsberg, J. [Research Clinical Inst. of Radiation Medicine and Endocrinology, Minsk (Belarus)
1997-12-31
Belarus is one of the most contaminated Republic due to the Chernobyl accident. 23% of the entire area of Belarus was contaminated with radionuclides. To protect the population after the accident different types of protective actions were performed during all phases, based on various temporary dose limits. An analysis of conducted protective actions and lessons obtained during the emergency response is briefly presented 9 refs.
Walby, A; Kelly, A M; Georgakas, C
2001-12-01
The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.
Society for Academic Emergency Medicine Statement on Plagiarism.
Asher, Shellie L; Iserson, Kenneth V; Merck, Lisa H
2017-10-01
The integrity of the research enterprise is of the utmost importance for the advancement of safe and effective medical practice for patients and for maintaining the public trust in health care. Academic societies and editors of journals are key participants in guarding scientific integrity. Avoiding and preventing plagiarism helps to preserve the scientific integrity of professional presentations and publications. The Society for Academic Emergency Medicine (SAEM) Ethics Committee discusses current issues in scientific publishing integrity and provides a guideline to avoid plagiarism in SAEM presentations and publications. © 2017 by the Society for Academic Emergency Medicine.
Can emergency medicine research benefit from adaptive design clinical trials?
Flight, Laura; Julious, Steven A; Goodacre, Steve
2017-04-01
Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013. We determined the proportion that used an adaptive design as well as the proportion that could have used a simple adaptive design based on the time to primary outcome and length of recruitment. Only 19 of 188 trials included in the review were considered to have used an adaptive trial design. A total of 154/165 trials that were fixed in design had the potential to use an adaptive design. Currently, there seems to be limited uptake in the use of adaptive trial designs in emergency medicine despite their potential benefits to save time and resources. Failing to take advantage of adaptive designs could be costly to patients and research. It is recommended that where practical and logistical considerations allow, adaptive designs should be used for all emergency medicine clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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
International Nuclear Information System (INIS)
1990-08-01
The document refers to the Convention on Early Notification of a Nuclear Accident (IAEA-INFCIRC-335) and to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (IAEA-INFCIRC-336). Part I contains reservations/declarations made upon or following signature and Part II contains reservations/declarations made upon or following deposit of instrument expressing consent to be bound. The status of signature, ratification, acceptance, approval or accession by States or organizations as of 31 July 1990 is presented in two attachments
International Nuclear Information System (INIS)
1989-08-01
The document refers to the Convention on early notification of a nuclear accident (INFCIRC-335) and to the Convention on assistance in the case of a nuclear accident or radiological emergency (INFCIRC-336). Part I contains reservations/declarations made upon or following signature and Part II contains reservations/declarations made upon or following deposit of instrument expressing consent to be bound. The status of signature, ratification, acceptance, approval or accession by States or organizations as of 31 July 1989 for the conventions is presented in two attachments
Development of a clinical forensic medicine curriculum for emergency physicians in the USA.
Smock, W S
1994-06-01
To address the forensic needs of living patients, the Department of Emergency Medicine at the University of Louisville School of Medicine in Louisville, Kentucky, USA initiated the first clinical forensic medicine training programme in the USA. In July 1991, formal training in clinical forensic medicine was incorporated into the core curriculum of the USA's second oldest academic emergency medicine training programme. The University of Louisville, in cooperation with the Kentucky Medical Examiner's Office, developed the curriculum to provide the emergency physician with the knowledge base and technical skills to perform forensic evaluations of living patients. Forensic lectures are given monthly by local and regional forensic experts including: forensic pathologists, prosecuting attorneys, firearm and ballistics examiners, law enforcement officers, forensic chemists and forensic odontologists. Topics which are presented include: forensic pathology, forensic photography, ballistics and firearms analysis, paediatric physical and sexual assault, crime scene investigation, forensic odontology, courtroom and expert testimony and the forensic evaluation of penetrating trauma. As a result of the introduction of clinical forensic medicine into the core curriculum of an emergency medicine training programme the residents are now actively addressing the forensic issues encountered in the Emergency department. Key, often short-lived forensic evidence, which was frequently overlooked or discarded while delivering patient care is now recognized, documented and preserved. The development and introduction of a clinical forensic medicine curriculum into emergency medicine training has greatly enhanced the emergency physician's ability to recognize, document and address the forensic needs of their patients who are victims of violent and non-fatal trauma.
Systematic Analysis of Theses in the Field of Emergency Medicine in Turkey.
Cevik, Erdem; Karakus Yilmaz, Banu; Acar, Yahya Ayhan; Dokur, Mehmet
2015-03-01
The aim of this study is to systematically evaluate the theses in the field of emergency medicine in Turkey and to determine whether they were published as a scientific paper. This is a retrospective observational study. Theses in the field of emergency medicine between 1998 and 2013 were browsed from the internet database of National Thesis Center (Council of Higher Education). Study type, both if it was in the field of emergency, or if it was published and the journal's scope of published studies were assessed and recorded in the study chart. 579 theses were included in the study. 27.1% of them were published and 14.9% of them were published in SCI/SCI-E journals. Advisors of theses were emergency medicine specialists in 67.6% of theses and 493 (85.1%) of them were in the field of emergency medicine. 77.4% of theses were observational and 20.9% were experimental study. Most of the experimental studies (72.7%, n=88) were animal studies. It was concluded that very few theses in the field of emergency medicine were published in journals that were indexed in SCI/SCI-E.
International Nuclear Information System (INIS)
Fukuda, Toshihiko
2012-01-01
Fukushima nuclear accident was caused by loss of all AC power sources (SBO) and loss of ultimate heat sink (LUHS) at Fukushima Daiichi Nuclear Power Plants (NPPs) hit by the Great East Japan Earthquake. This article reviewed outline of Fukushima nuclear accident progression when on year had passed since and referred to lessons learned from accident and countermeasure plan to prevent severe accident in SBO and LUHS events by earthquake and tsunami as future action. This countermeasure would be taken to (1) prevent serious flooding in case a tsunami overwhelms the breakwater, with improving water tightness of rooms for emergency diesel generator, batteries and power centers, (2) enhance emergency power supply and cooling function with mobile electricity generator, high pressure fire pump car and alternate water supply source, (3) mitigate environmental effects caused by core damage with installing containment filtered venting, and (4) enforce emergency preparedness in case of severe accident. Definite countermeasure plan for Kashiwazaki-Kariwa NPPs was enumerated. (T. Tanaka)
Examination of off-site emergency protective measures for core melt accidents
International Nuclear Information System (INIS)
Aldrich, D.C.; Ericson, D.M. Jr.; Jones, R.B.
1978-01-01
Results from the Reactor Safety Study (RSS) have shown that to cause significant impacts off-site, i.e., sufficient quantities of biologically important radionuclides released, it is necessary to have a core melt accident. To mitigate the impact of such potential accidents, the design of appropriate emergency response actions requires information as to the relative merit of publicly available protective measures. In order to provide this information, a study using the consequence model developed for the RSS is being conducted to evaluate (in terms of reduced public health effects and dose exposure) potential off-site protective strategies. The paper describes the methods being used in the study as well as the results and conclusions obtained
Meng, Qiang; Weng, Jinxian
2013-01-01
Taking into account the uncertainty caused by exogenous factors, the accident notification time (ANT) and emergency medical service (EMS) response time were modeled as 2 random variables following the lognormal distribution. Their mean values and standard deviations were respectively formulated as the functions of environmental variables including crash time, road type, weekend, holiday, light condition, weather, and work zone type. Work zone traffic accident data from the Fatality Analysis Report System between 2002 and 2009 were utilized to determine the distributions of the ANT and the EMS arrival time in the United States. A mixed logistic regression model, taking into account the uncertainty associated with the ANT and the EMS response time, was developed to estimate the risk of death. The results showed that the uncertainty of the ANT was primarily influenced by crash time and road type, whereas the uncertainty of EMS response time is greatly affected by road type, weather, and light conditions. In addition, work zone accidents occurring during a holiday and in poor light conditions were found to be statistically associated with a longer mean ANT and longer EMS response time. The results also show that shortening the ANT was a more effective approach in reducing the risk of death than the EMS response time in work zones. To shorten the ANT and the EMS response time, work zone activities are suggested to be undertaken during non-holidays, during the daytime, and in good weather and light conditions.
International Nuclear Information System (INIS)
Mansi, L.; Rambaldi, P.F.; Cuccurullo, V.; Varetto, T.
2005-01-01
The role of a procedure depends not only on its own capabilities but also on a cost/effective comparison with alternative technique giving similar information. Starting from the definition of emergency as a sudden unexpected occurrence demanding immediate action, the role of nuclear medicine (NM) is difficult to identify if it is not possible to respond 24h a day, 365 days a year, to clinical demands. To justify a 24 h NM service it is necessary to reaffirm the role in diagnosis of pulmonary embolism in the spiral CT era, to spread knowledge of the capabilities of nuclear cardiology in reliability diagnosis myocardial infraction (better defining admission and discharge to/from the emergency department), to increase the number of indications. Radionuclide technique could be used as first line, alternative, complementary procedures in a diagnostic tree taking into account not only the diagnosis but also the connections with prognosis and therapy in evaluating cerebral pathologies, acute inflammation/infection, transplants, bleeding, trauma, skeletal, hepatobiliary, renal and endocrine emergencies, acute scrotal pain
Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents
International Nuclear Information System (INIS)
1963-01-01
The text of the Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents, which was signed on 17 October 1963 by the Director General and by representatives of the Governments of Denmark, Finland, Norway and Sweden, is reproduced in this document for the information of all Members. The entry into force of the Agreement in accordance with Article IX will be notified to Members in an Addendum to this document
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.
THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY
Directory of Open Access Journals (Sweden)
WK Mallon
2017-03-01
Full Text Available Chile is uniquely situated to be a leader in South American development of the specialty of Emergency Medicine. Chilean emergency medicine has successfully transitioned from a novelty training idea to a nationally and internationally recognized entity with serious public health goals. There are more residency training programs in Chile than in any other South American or Latin American country, and the specialty is formally recognized by the Ministry of Health. Chilean emergency medicine thought leaders have networked internationally with multiple groups, intelligently used outside resources, and created durable academic relationships. While focusing on locally important issues and patient care they have successfully advanced their agenda. Despite this, the specialty faces many new challenges and remains fragile but sustainable. Policy makers and the Chilean MOH need to be acutely aware of this fragility to preserve the progress achieved so far, and support ongoing maturation of the specialty of Emergency Medicine.
International Nuclear Information System (INIS)
Xin Jing; Tang Huaqing; Zhang Yinghua; Zhang Limin
2009-01-01
A risk assessment model of nuclear accident emergency protection countermeasure based on fuzzy matter-element analysis and Euclid approach degree is proposed in the paper. The weight of assessed index is determined by information entropy and the scoring by experts, which could not only make full use of the inherent information of the indexes adequately, but reduce subjective assumption in the course of assessment effectively. The applied result shows that it is reasonable that the model is adopted to make risk assessment for nuclear accident emergency protective countermeasure,and it could be a kind of effective analytical method and decision making basis to choose the optimum protection countermeasure. (authors)
Radiological accidents, scenarios, planning and answers
International Nuclear Information System (INIS)
Solis Delgado, Alexander.
2008-01-01
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 [es
Interprofessional education of medical students and paramedics in emergency medicine.
Hallikainen, J; Väisänen, O; Rosenberg, P H; Silfvast, T; Niemi-Murola, L
2007-03-01
Emergency medicine is team work from the field to the hospital and therefore it is also important for physicians to understand the work of paramedics, and vice versa. Interprofessional emergency medicine education for medical and paramedic students in Helsinki was started in 2001. It consisted of a 15 European credit transfer system (ECTS) credits programme combining 22 students in 2001. In 2005, the number of students had increased to 25. The programme consisted of three parts: acute illness in childhood and adults (AI), advanced life support (ALS) and trauma life support (TLS). In this paper, we describe the concept of interprofessional education of medical students and paramedics in emergency medicine. After finishing the programmes in 2001 and in 2005, the students' opinions regarding the education were collected using a standardized questionnaire. There were good ratings for the courses in AI (2001 vs. 2005, whole group; 4.3 +/- 0.7 vs. 4.2 +/- 0.4, P = 0.44) ALS (4.7 +/- 0.5 vs. 4.4 +/- 0.5, P = 0.06) and TLS (3.9 +/- 0.7 vs. 4.4 +/- 0.5, P = 0.01) in both years. Most of the medical students considered that this kind of co-education should be arranged for all medical students (2001 vs. 2005; 4.8 +/- 0.6 vs. 4.4 +/- 0.5, P = 0.02) and should be obligatory (3.5 +/- 1.5 vs. 3.1 +/- 1.3, P = 0.35). Co-education was well received and determined by the students as an effective way of improving their knowledge of emergency medicine and medical skills. The programme was rated as very useful and it should be included in the educational curriculum of both student groups.
[Ambulance in emergency medicine].
Aksoy, Fikret; Ergun, Alper
2002-07-01
The ambulance service is very important in emergency medicine. The aim of this study was to investigate the new governing statuate of private ambulance service and to propose some new ideas. We examinated the new governing statuate of private ambulance service, rules of patient transporte between the hospitals and reports written by SSK Goztepe Educational Hospital ambulance drivers. We concluded that SSK Goztepe Educational Hospital ambulance drivers have a iot of problems especially at the rules of patient transport between the hospitals and there are some defiencies at the new governing statuate of private ambulance service. We concluded that it is necesssary to manage all the ambulance services in one center; all the private ambulance services have to have a specialist and all these must be determinated by the special rules. Key words: Regulation ofprivate ambulance, emergency head maintanence, ambulance services
Current and emerging applications of 3D printing in medicine.
Liaw, Chya-Yan; Guvendiren, Murat
2017-06-07
Three-dimensional (3D) printing enables the production of anatomically matched and patient-specific devices and constructs with high tunability and complexity. It also allows on-demand fabrication with high productivity in a cost-effective manner. As a result, 3D printing has become a leading manufacturing technique in healthcare and medicine for a wide range of applications including dentistry, tissue engineering and regenerative medicine, engineered tissue models, medical devices, anatomical models and drug formulation. Today, 3D printing is widely adopted by the healthcare industry and academia. It provides commercially available medical products and a platform for emerging research areas including tissue and organ printing. In this review, our goal is to discuss the current and emerging applications of 3D printing in medicine. A brief summary on additive manufacturing technologies and available printable materials is also given. The technological and regulatory barriers that are slowing down the full implementation of 3D printing in the medical field are also discussed.
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.
Energy Technology Data Exchange (ETDEWEB)
Syrakov, D.; Prodanova, M.; Slavov, K.; Veleva, B.
2015-07-01
A PC-oriented Emergency Response System in case of nuclear accident (BERS) is developed and works operationally in the National Institute of Meteorology and Hydrology (NIMH). The creation and development of BERS was highly stimulated by the ETEX (European Tracer Experiment) project. BERS comprises two main parts - the operational and the accidental ones. The operational part, run automatically every 12 hours, prepares the input meteorological file used by both trajectory and dispersion models, runs the trajectory models, visualizes the results and uploads the maps of trajectories to a dedicated web-site. The accidental part is activated manually when a real radioactive releases occur or during emergency exercises. Its core is the Bulgarian dispersion models EMAP. Outputs are concentration, accumulated deposition and selected doses fields. In the paper, the BERS overall structure is described and examples of its products are presented. Key words: nuclear accident, emergency response, early warning system, air dispersion models, radioactive exposure dose. (Author)
Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents
International Nuclear Information System (INIS)
1963-01-01
The text of the Nordic Mutual Emergency Assistance Agreement in Connection with Radiation Accidents, which was signed on 17 October 1963 by the Director General and by representatives of the Governments of Denmark, Finland, Norway and Sweden, is reproduced in this document for the information of all Members. The entry into force of the Agreement in accordance with Article IX will be notified to Members in an Addendum to this document [es
A Model Curriculum for an Emergency Medical Services (EMS Rotation for Emergency Medicine Residents
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Michael Mancera
2018-01-01
Full Text Available Audience: This EMS curriculum is designed for Emergency Medicine residents at all levels of training. Introduction: Emergency Medicine (EM physicians have routine interaction with Emergency Medical Services (EMS in their clinical practice. Additionally, the American College of Graduate Medical Education (ACGME mandates that all Emergency Medicine resident physicians receive specific training in the area of EMS.1 Historically, EMS training for EM residents has been conducted in the absence of a standardized didactic curriculum. Despite advancements in the area of prehospital training, there remains wide inconsistency in EMS training experiences among EM residency training programs.2 To our knowledge a standardized and reproducible EMS curriculum for EM residents does not exist. Objectives: The aim of this curriculum is to provide a robust learning experience for EM residents around prehospital care and EMS that fulfills the ACGME requirements and which can be easily replicated and implemented in a variety of EM residency training programs. Method: The educational strategies used in this curriculum include didactics, asynchronous learning through online modules and a focused reading list, experiential learning through ride-alongs, structured small group discussion, supervised medical command shifts, and mentored practice in organizing and delivering didactics to EMS providers.
Curtis, Henry A; Trang, Karen; Chason, Kevin W; Biddinger, Paul D
2018-02-01
Introduction Great demands have been placed on disaster medicine educators. There is a need to develop innovative methods to educate Emergency Physicians in the ever-expanding body of disaster medicine knowledge. The authors sought to demonstrate that video-based learning (VBL) could be a promising alternative to traditional learning methods for teaching disaster medicine core competencies. Hypothesis/Problem The objective was to compare VBL to traditional lecture (TL) for instructing Emergency Medicine residents in the American College of Emergency Physicians (ACEP; Irving, Texas USA) disaster medicine core competencies of patient triage and decontamination. A randomized, controlled pilot study compared two methods of instruction for mass triage, decontamination, and personal protective equipment (PPE). Emergency Medicine resident learning was measured with a knowledge quiz, a Likert scale measuring comfort, and a practical exercise. An independent samples t-test compared the scoring of the VBL with the TL group. Twenty-six residents were randomized to VBL (n=13) or TL (n=13). Knowledge score improvement following video (14.9%) versus lecture (14.1%) did not differ significantly between the groups (P=.74). Comfort score improvement also did not differ (P=.64) between video (18.3%) and lecture groups (15.8%). In the practical skills assessment, the VBL group outperformed the TL group overall (70.4% vs 55.5%; Plearning vs traditional lecture for instructing emergency medicine residents in disaster medicine principles of mass triage, decontamination, and personal protective equipment. Prehosp Disaster Med. 2018;33(1):7-12.
Application of improved topsis method to accident emergency decision-making at nuclear power station
International Nuclear Information System (INIS)
Zhang Jin; Cai Qi; Zhang Fan; Chang Ling
2009-01-01
Given the complexity in multi-attribute decision-making on nuclear accident emergency, and by integrating subjective weight and impersonal weight of each evaluating index, a decision-making model for emergency plan at nuclear power stations is established with the application of improved TOPSIS model. The testing results indicated that the improved TOPSIS-based multi-attribute decision-making has a better assessment results. (authors)
The radiological accident in Istanbul
International Nuclear Information System (INIS)
2000-01-01
The use of radioactive materials offers a wide range of benefits throughout the world in medicine, research and industry. Precautions are, however, necessary in order to limit the exposure of persons to the radiation that is emitted. Where the amount of radioactive material is substantial, as in the case of radiotherapy sources or industrial radiography sources, extreme care is necessary to prevent accidents which may have severe consequences. Nevertheless, in spite of the precautions taken, accidents with radiation sources continue to occur, albeit infrequently. As part of its subprogramme on the safety of radiation sources, the IAEA conducts follow-up reviews of such serious accidents to give an account of their circumstances and of the medical aspects, from which organizations with responsibilities for radiation protection and the safety of sources may learn. A serious radiological accident occurred in Istanbul, Turkey, in December 1998 and January 1999 when two packages used to transport 60 Co teletherapy sources were sold as scrap metal. The persons who purchased the two packages opened them and broke open the shielded containers, thereby unknowingly exposing themselves and several others to radiation from at least one unshielded 60 Co source. The persons who dismantled the containers suffered from acute radiation syndrome. The accident came to the attention of the relevant national authority when a doctor who had examined the victims reported that he suspected the possibility of radiation exposure. The national authorities identified other individuals who might have undergone acute radiation exposures, and a total of 18 persons (including seven children) were admitted to hospital. Of these, ten adults exhibited clinical signs and symptoms of acute radiation exposure. Under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, the Turkish authorities requested assistance from the IAEA in terms of advice on the medical
Application research of cloud computing in emergency system platform of nuclear accidents
International Nuclear Information System (INIS)
Zhang Yan; Yue Huiguo; Lin Quanyi; Yue Feng
2013-01-01
This paper described the key technology of the concept of cloud computing, service type and implementation methods. Combined with the upgrade demand of nuclear accident emergency system platform, the paper also proposed the application design of private cloud computing platform, analyzed safety of cloud platform and the characteristics of cloud disaster recovery. (authors)
International Nuclear Information System (INIS)
Lahtinen, J.
2006-04-01
In order to manage various nuclear or radiological emergencies the authorities must have pre-prepared plans. The purpose of the NKS project EMARAD (Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents) was to produce and gather various data and information that could be useful in drawing up emergency plans and radiation monitoring strategies. One of the specific objectives of the project was to establish a www site that would contain various radiation-threat and radiation-monitoring related data and documents and that could be accessed by all Nordic countries. Other important objectives were discussing various factors affecting measurements in an emergency, efficient use of communication technology and disseminating relevant information on such topics as urban dispersion and illicit use of radiation. The web server is hosted by the Radiation and Nuclear Safety Authority (STUK) of Finland. The data stored include pre-calculated consequence data for nuclear power plant accidents as well as documents and presentations describing e.g. general features of monitoring strategies, the testing of the British urban dispersion model UDM and the scenarios and aspects related to malicious use of radiation sources and radioactive material. As regards the last item mentioned, a special workshop dealing with the subject was arranged in Sweden in 2005 within the framework of the project. (au)
Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology
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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.
Diagnostic ultrasound use in physiotherapy, emergency medicine, and anaesthesiology
International Nuclear Information System (INIS)
McKiernan, Sharmaine; Chiarelli, Pauline; Warren-Forward, Helen
2010-01-01
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.
[Occupational aspects of emergency medicine practice in Catalonia: the OPENCAT opinion survey].
Jacob, Javier; Gené, Emili; Alonso, Gilberto; Rimbau, Pere; Zorrilla, José; Casarramona, Francesc; Netto, Cristina; Sánchez, Pere; Hernández, Ricard; Escalada, Xavier; Miró, Òscar
2017-01-01
To gather information on the contracting and training of members of the Catalan Society of Emergency Medicine (SoCMUE) who work in emergency medicine and services in Catalonia. To survey their opinions on certain aspects of resource availability and working conditions. Cross-sectional descriptive study based on a survey sent to SoCMUE members. We studied the opinions of 5 types of respondent: hospital physicians, out-of-hospital physicians, hospital nurses, out-of-hospital nurses, and emergency medical technicians. Responses were grouped to compare the opinions of physicians and nurses and workers in hospital and prehospital settings. We received 616 responses from 1273 members (48.4% response rate). More physicians than nurses come from outside Catalonia and have contracts specifically linked to emergency care; in addition, physicians have done less postgraduate training in emergency medicine. More hospital staff than prehospital staff have permanent contracts linked to the department where they work. More hospital physicians are specialized in internal medicine than in family and community medicine. The opinion that emergency services are inadequately staffed was widespread. Most respondents believed that patient transport is good or adequate. However, respondents working in prehospital services expressed a lower opinion of transport. Great difficulty in combining work with family (life achieving work-life balance) was expressed by 13.5% overall, and more often by hospital staff. Some type of aggression was experienced by 88.2%; 60% reported the event to superiors. Nurses reported aggression more often than physicians. A police report was filed by 10.1%. Emergency medicine working conditions can be improved in Catalonia according to members of SoCMUE. Relations between groups of professionals are not optimum in some aspects.
Aircraft accident analysis for emergency planning and safety analysis
International Nuclear Information System (INIS)
Nicolosi, S.L.; Jordan, H.; Foti, D.; Mancuso, J.
1996-01-01
Potential aircraft accidents involving facilities at the Rocky Flats Environmental Technology Site (Site) are evaluated to assess their safety significance. This study addresses the probability and facility penetrability of aircraft accidents at the Site. The types of aircraft (large, small, etc.) that may credibly impact the Site determine the types of facilities that may be breached. The methodology used in this analysis follows elements of the draft Department of Energy Standard ''Accident Analysis for Aircraft Crash into Hazardous Facilities'' (July 1995). Key elements used are: the four-factor frequency equation for aircraft accidents; the distance criteria for consideration of airports, airways, and jet routes; the consideration of different types of aircraft; and the Modified National Defense Research Committee (NDRC) formula for projectile penetration, perforation, and minimum resistant thickness. The potential aircraft accident frequency for each type of aircraft applicable to the Site is estimated using a four-factor formula described in the draft Standard. The accident frequency is the product of the annual number of operations, probability of an accident, probability density function, and area. The annual number of operations is developed from site-specific and state-wide data
The state of emergency medicine in the United Republic of Tanzania
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B.A. Nicks
2012-09-01
Currently at most hospitals, emergency patients are cared for in Emergency Centres (ECs staffed with rotating personnel who are neither trained nor equipped to provide complete resuscitative care, but dedicated emergency care training projects are emerging. The first Emergency Medicine residency in the country was initiated in 2010 and will produce its first graduates in 2013. In 2011, a dedicated Emergency Nursing curriculum was introduced, and the Emergency Medical Association of Tanzania (EMAT, the first Emergency Medicine professional society in the country, was formed and ratified by the Ministry of Health. EMAT has been given a mandate to develop feasible initiatives for the dissemination of emergency care training to district and sub-district facilities. However, significant gaps exist in the capacity for emergency medical care including deficits in human resources, essential equipment and infrastructure – concurrent issues that EMAT must address within its development strategy.
The development of the specialism of emergency medicine: media and cultural influences.
Timmons, Stephen; Nairn, Stuart
2015-01-01
In this article we analyse, via a critical review of the literature, the development of a relatively new medical specialism in the United Kingdom, that of emergency medicine. Despite the high media profile of emergency care, it is a low-status specialism within UK medicine. The creation of a specialist College in 2008 means that, symbolically, recognition as a full specialism has now been achieved. In this article, we will show, using a sociology of professions approach, how emergency medicine defined itself as a specialism, and sought to carve out a distinctive jurisdiction. While, in the context of the UK National Health Service, the state was clearly an important factor in the development of this profession, we wish to develop the analysis further than is usual in the sociology of professions. We will analyse the wider cultural context for the development of this specialism, which has benefited from its high profile in the media, through both fictional and documentary sources. © The Author(s) 2014.
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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
Emergency preparedness: medical management of nuclear accidents involving large groups of victims
International Nuclear Information System (INIS)
Parmentier, N.; Nenot, J.C.
1988-01-01
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
Facchin, Luiza Tayar; Gir, Elucir; Pazin-Filho, Antonio; Hayashida, Miyeko; da Silva Canini, Silvia Rita Marin
2013-01-01
Pathogens can be transmitted to health professionals after contact with biological material. The exact number of infections deriving from these events is still unknown, due to the lack of systematic surveillance data and under-reporting. A cross-sectional study was carried out, involving 451 nursing professionals from a Brazilian tertiary emergency hospital between April and July 2009. Through an active search, cases of under-reporting of occupational accidents with biological material by the nursing team were identified by means of individual interviews. The Institutional Review Board approved the research project. Over half of the professionals (237) had been victims of one or more accidents (425 in total) involving biological material, and 23.76% of the accidents had not been officially reported using an occupational accident report. Among the underreported accidents, 53.47% were percutaneous and 67.33% were bloodborne. The main reason for nonreporting was that the accident had been considered low risk. The under-reporting rate (23.76%) was low in comparison with other studies, but most cases of exposure were high risk.
Accident management strategy in Sweden - implementation and verification
International Nuclear Information System (INIS)
Loewenhielm, Gustaf; Engqvist, Alf; Espefaelt, Ralf
1994-01-01
A comprehensive program for severe accident mitigation was completed in Sweden by the end of 1988. As described in this paper, this program included plant modifications such as the introduction of filtered containment venting, and an accident management system comprising emergency operating strategies and procedures, training and emergency drills. The accident management system at Vattenfall has been further developed since 1988 and some results and experience from this development are reported in this paper. The main aspects covered concern the emergency organization and the supporting tools developed for use by the emergency response teams, the radiological implications such as accessibility to various locations and the long-term aspects of accident management. ((orig.))
Refining the Enrolment Process in Emergency Medicine Research.
Sahan, Kate M; Channon, Keith M; Choudhury, Robin P; Kharbanda, Rajesh K; Lee, Regent; Sheehan, Mark
2016-04-01
Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient's lack of mental capacity and insufficient time to contact legal representatives. Regulatory frameworks which allow this research to proceed with a consent 'waiver', provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the 'emergent' stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed.
Mohr, Nicholas M; Moreno-Walton, Lisa; Mills, Angela M; Brunett, Patrick H; Promes, Susan B
2011-02-01
For the first time in history, four generations are working together-traditionalists, baby boomers, generation Xers (Gen Xers), and millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. 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 emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another. © 2011 by the Society for Academic Emergency Medicine.
Human factors and safety in emergency medicine
Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.
1994-01-01
A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.
Uzoechina, N S; Abiola, A O; Akodu, B A; Mbakwem, A; Arogundade, A R; Tijani, H; Adegbesan-Omilabu, M A
2012-01-01
The accident and emergency department constitutes one of the vital entry points of patients into the healthcare facility of the hospital the world over. It responds to and manages variety of cases in all the clinical areas and thus pr vides an insight to the quality of care available in the health institution. The aim of this study is to determine the pattern of cases seen as well as the causes of deaths at the adult accident and emergency department of the Lagos UniversityTeaching Hospital, Idi-Araba, Lagos. Retrospective review of records of all patients attended to at the adult accident and emergency department of the Lagos University Teaching Hospital in 2009 and 2010 was carried out. Data spread sheet was used to collect data on demographic indices, diagnosis, outcome, date admitted, date discharged and amount paid from casualty attendance register and Nurses' report books. Data was collated and analysed using Epi-Info version 3.4.1 statistical software package. Out of the 5,427 available patients' records reviewed, 4,761(87.7%) were recorded as "discharged alive", 546 (10.1%) were recorded as "died", while 120 (2.2%) were recorded as "brought in dead". Of those discharged alive, male attendance was 2,376 (49.10%) while that of the female was 2,385 (50.10%). Majority of these patients were aged 20-39 years and the mean age of the patients was 39.96 +/- 18.22 yrs. Majority of cases seen were medical in origin (53.7%) and highest medical case seen was cerebrovascular accident, Commonest cause of death was from medical cases [69.2%] (cerebrovascular accident 22.0%). Male mortality was 55.3% while female mortality was 44.7%, mean age was 46.86 +/- 17.61. Most affected age group was 40 - 59 years (35.4%) and highest number of death was seen in December. The commonest case seen as well as commonest cause of death was cerebrovascular accident. A high number of heart failure, head injuries, road traffic accidents, upper gastrointestinal bleeding and post partum
ESR accident dosimetry using medicine tablets coated with sugar
International Nuclear Information System (INIS)
Kai, A.; Miki, T.; Ikeya, M.
1990-01-01
Properties of radiation-induced radicals in medicine tablets were investigated using electron spin resonance (ESR). A sharp ESR signal sensitive to gamma ray irradiation was observed in the sugar coating part of the tablets. The signal has anisotropic g values of g 1 = 2.0009, g 2 = 2.0007 and g 3 = 2.0002. The signal grows linearly with dose at least up to about 20 Gy. No fading was observed at room temperature even when exposed to sunlight. The dose to artificially irradiated tablets was estimated using the signal intensity and a previously determined calibration curve. The signal in sugar coated tablets can be utilised for dose measurements. In particular, the wide distribution of sugar coated tablets allows the use of the tablets as accident dosemeters. (author)
Directory of Open Access Journals (Sweden)
Bos Nanne
2012-08-01
Full Text Available Abstract Background Assessment of patients’ views are essential to provide a patient-centred health service and to evaluating quality of care. As no standardized and validated system for measuring patients’ experiences in accident and emergency departments existed, we have developed the Consumer Quality index for the accident and emergency department (CQI A&E. Methods Qualitative research has been undertaken to determine the content validity of the CQI A&E. In order to assess psychometric characteristics an 84-item questionnaire was sent to 653 patients who had attended a large A&E in the Netherlands. Also, fifty importance questions were added to determine relevance of the questions and for future calculations of improvement scores. Exploratory factor analysis was applied to detect the domains of the questionnaire. Results Survey data of 304 (47% patients were used for the analysis. The first exploratory factor analysis resulted in three domains based on 13 items: ‘Attitude of the healthcare professionals’, ‘Environment and impression of the A&E’ and ‘Respect for and explanation to the patient’. The first two had an acceptable internal consistency. The second analysis, included 24 items grouped into 5 domains: ‘Attitude of the healthcare professionals’, ‘Information and explanation’, ‘Environment of the A&E’,’Leaving the A&E’ and ‘General information and rapidity of care’. All factors were internal consistent. According to the patients, the three most important aspects in healthcare performance in the A&E were: trust in the competence of the healthcare professionals, hygiene in the A&E and patients’ health care expectations. In general, the highest improvement scores concerned patient information. Conclusions The Consumer Quality index for the accident and emergency department measures patients’ experiences of A&E healthcare performance. Preliminary psychometric characteristics are sufficient to justify
Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?
Limkakeng, Alexander T; Monte, Andrew A; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L; Shapiro, Nathan I
2016-10-01
Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users. © 2016 by the Society for Academic Emergency Medicine.
Survey of emergency medicine resident debt status and financial planning preparedness.
Glaspy, Jeffrey N; Ma, O John; Steele, Mark T; Hall, Jacqueline
2005-01-01
Most resident physicians accrue significant financial debt throughout their medical and graduate medical education. The objective of this study was to analyze emergency medicine resident debt status, financial planning actions, and educational experiences for financial planning and debt management. A 22-item questionnaire was sent to all 123 Accreditation Council on Graduate Medical Education-accredited emergency medicine residency programs in July 2001. Two follow-up mailings were made to increase the response rate. The survey addressed four areas of resident debt and financial planning: 1) accrued debt, 2) moonlighting activity, 3) financial planning/debt management education, and 4) financial planning actions. Descriptive statistics were used to analyze the data. Survey responses were obtained from 67.4% (1,707/2,532) of emergency medicine residents in 89 of 123 (72.4%) residency programs. Nearly one half (768/1,707) of respondents have accrued more than 100,000 dollars of debt. Fifty-eight percent (990/1,707) of all residents reported that moonlighting would be necessary to meet their financial needs, and more than 33% (640/1,707) presently moonlight to supplement their income. Nearly one half (832/1,707) of residents actively invested money, of which online trading was the most common method (23.3%). Most residents reported that they received no debt management education during residency (82.1%) or medical school (63.7%). Furthermore, 79.1% (1,351/1,707) of residents reported that they received no financial planning lectures during residency, although 84.2% (1,438/1,707) reported that debt management and financial planning education should be available during residency. Most emergency medicine residency programs do not provide their residents with financial planning education. Most residents have accrued significant debt and believe that more financial planning and debt management education is needed during residency.
Homma, T; Takahara, S; Kimura, M; Kinase, S
2015-06-01
Radiation protection issues on preparedness and response for a severe nuclear accident are discussed in this paper based on the experiences following the accident at Fukushima Daiichi nuclear power plant. The criteria for use in nuclear emergencies in the Japanese emergency preparedness guide were based on the recommendations of International Commission of Radiological Protection (ICRP) Publications 60 and 63. Although the decision-making process for implementing protective actions relied heavily on computer-based predictive models prior to the accident, urgent protective actions, such as evacuation and sheltering, were implemented effectively based on the plant conditions. As there were no recommendations and criteria for long-term protective actions in the emergency preparedness guide, the recommendations of ICRP Publications 103, 109, and 111 were taken into consideration in determining the temporary relocation of inhabitants of heavily contaminated areas. These recommendations were very useful in deciding the emergency protective actions to take in the early stages of the Fukushima accident. However, some suggestions have been made for improving emergency preparedness and response in the early stages of a severe nuclear accident. © The Chartered Institution of Building Services Engineers 2014.
Radiologic procedures, policies and protocols for pediatric emergency medicine
International Nuclear Information System (INIS)
Woodward, George A.
2008-01-01
Protocol development between radiology and pediatric emergency medicine requires a multidisciplinary approach to manage straightforward as well as complex and time-sensitive needs for emergency department patients. Imaging evaluation requires coordination of radiologic technologists, radiologists, transporters, nurses and coordinators, among others, and might require accelerated routines or occur at sub-optimal times. Standardized protocol development enables providers to design a best practice in all of these situations and should be predicated on evidence, mission, and service expectations. As in any new process, constructive feedback channels are imperative for evaluation and modification. (orig.)
The safe use of radiation: application in medicine
International Nuclear Information System (INIS)
Mohamed Ali Abdul Khader
2009-01-01
There are various peaceful uses of radiation in our everyday life like its use in industries, agriculture, medicine etc. However if the radiation source is not utilize in an orderly and controlled manner, radiation accidents can occur. Depending on the degree of accident, the dose/source of radioactive material involved, the effect ranges from the mild side effect to severe radiation syndrome which may lead to death. Radiation accidents in time of peace that require treatment are quite rare. Medical response to a radiological emergency is to provide first aid treatment and to take appropriate actions to protect responder from radiation. In Malaysia, our experience in medical response is limited due to the rarity of such accident occurring in our country. Nevertheless we had two minor incidents where radiation accident occurred in the industrial sector which required response and management. Public perception of anything about nuclear/radiation can be exaggerated especially with recent events like the radiation accidents occurring in various countries involving various radioactive/nuclear sources. This presentation will highlight the two minor radiation cases that occurred in Malaysia. It will also briefly highlight the many splendid uses of radiation in the medical arena touching upon its use in Radiology, Nuclear Medicine and Radiotherapy. The latest in the field of Nuclear Medicine using Cyclotron and Positron Emission Tomography in the diagnosis, grading, response to therapy, detection of recurrence of disease will be emphasized. It is hope that the experience that we can share will be of contributory input to expel the public fear of radiation and the term nuclear. (Authors)
Van Nieuwenhuyse, A; Fierens, S; De Smedt, T; De Cremer, K; Vleminckx, C; Mertens, B; Van Overmeire, I; Bader, M; De Paepe, P; Göen, T; Nemery, B; Schettgen, T; Stove, C; Van Oyen, H; Van Loco, J
2014-12-15
On May 4, 2013, a train transporting chemicals derailed in Wetteren, Belgium. Several tanks loaded with acrylonitrile (ACN) exploded, resulting in a fire and a leakage of ACN. To determine exposure to ACN and to assess discriminating factors for ACN exposure in the emergency responders involved in the on-site management of the train accident. The study population consisted of 841 emergency responders. Between May 21 and June 28, they gave blood for the determination of N-2-cyanoethylvaline (CEV) hemoglobin adducts and urine for the measurement of cotinine. They also filled in a short questionnaire. 163 (26%) non-smokers and 55 (27%) smokers showed CEV concentrations above the reference values of 10 and 200 pmol/g globin, respectively. The 95th percentile in the non-smokers was 73 pmol/g globin and the maximum was 452 pmol/g globin. ACN exposure among the non-smokers was predicted by (1) the distance to the accident, (2) the duration of exposure, and (3) the occupational function. Emergency responders involved in the on-site management of the train accident were clearly exposed to ACN from the accident. However, the extent of exposure remained relatively moderate with CEV concentrations staying within the ranges described in literature as background for a smoking population. Moreover, the exposure was less pronounced in the emergency responders as compared to that in the local population. Copyright © 2014. Published by Elsevier Ireland Ltd.
Burnout and Associated Factors among Iranian Emergency Medicine Practitioners.
Jalili, Mohammad; Sadeghipour Roodsari, Gholamreza; Bassir Nia, Anahita
2013-09-01
Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, depersonalization and personal accomplishment, also demographic factors, work related factors and sources of stress in emergency department using anonymous self-administered questionnaire. Descriptive analysis, univariate analysis to evaluate association with higher score of burnout, and multivariate logistic regression analysis to predict high burnout in 3 subscales was performed. Totally, 165 questionnaires were filled (response rate: 88%; mean age: 33.6 years, 91% male). Mean burnout scores were 22.94 for emotional exhaustion (95% CI=20.78-25.01; moderate), 9.3 for depersonalization (95% CI=8.24-10.36; moderate to high), and 31.47 for personal accomplishment (95% CI=29.87-33.07; moderate to high). Frequent reported sources of stress were shortage of equipment, problem with work physical environment, and relationship with other services. All 19 sources of stress were associated with higher score of emotional exhaustion and depersonalization; while twelve out of 19 were significantly associated with lower level of personal accomplishment. In logistic regression model, the significant predictors for high emotional exhaustion were work overload, feeling of insecurity for future career and difficulties to balance professional and private life. Burnout is high among Iranian emergency medicine practitioners and some interventions can be proposed to reduce stress.
[Biomarkers in emergency medicine and critical care patients: advances and pitfalls for news tools].
Claessens, Yann-Erick; Mallet-Coste, Thomas; Riqué, Thomas; Macchi, Marc-Alexis; Ray, Patrick; Chenevier-Gobeaux, Camille
2014-01-01
The use of biomarkers has changed approach of diagnosis and treatment procedures in emergency medicine, especially in the field of cardiovascular disorders. Effectiveness of new strategies that integrate biomarkers has precluded development and research in novel tools that may improve safety and efficiency at bedside. This mini-review presents current knowledge on utility of biomarkers in emergency medicine, including data that should be taken into account to avoid misleading utilization. Copyright © 2013. Published by Elsevier Masson SAS.
On-site emergency intervention plan for nuclear accident situation at SCN-Pitesti TRIGA Reactor
International Nuclear Information System (INIS)
Margeanu, S.; Oprea, I.
2008-01-01
A 14 MW TRIGA research reactor is operated on the Institute for Nuclear Research site. In the event of a nuclear accident or radiological emergency that may affect the public the effectiveness of protective actions depends on the adequacy of intervention plans prepared in advance. Considerable planning is necessary to reduce to manageable levels the types of decisions leading to effective responses to protect the public in such an event. The essential structures of our on-site, off-site and county emergency intervention plan and the correlation between emergency intervention plans are presented. (authors)
Energy Technology Data Exchange (ETDEWEB)
Lahtinen, J [Radiation and Nuclear Safety Authority (STUK) (Finland)
2006-04-15
In order to manage various nuclear or radiological emergencies the authorities must have pre-prepared plans. The purpose of the NKS project EMARAD (Emergency Management and Radiation Monitoring in Nuclear and Radiological Accidents) was to produce and gather various data and information that could be useful in drawing up emergency plans and radiation monitoring strategies. One of the specific objectives of the project was to establish a www site that would contain various radiation-threat and radiation-monitoring related data and documents and that could be accessed by all Nordic countries. Other important objectives were discussing various factors affecting measurements in an emergency, efficient use of communication technology and disseminating relevant information on such topics as urban dispersion and illicit use of radiation. The web server is hosted by the Radiation and Nuclear Safety Authority (STUK) of Finland. The data stored include pre-calculated consequence data for nuclear power plant accidents as well as documents and presentations describing e.g. general features of monitoring strategies, the testing of the British urban dispersion model UDM and the scenarios and aspects related to malicious use of radiation sources and radioactive material. As regards the last item mentioned, a special workshop dealing with the subject was arranged in Sweden in 2005 within the framework of the project. (au)
Kessler, Chad S; Stallings, Leonard A; Gonzalez, Andrew A; Templeman, Todd A
2009-09-01
This study was designed to provide an update on the career outcomes and experiences of graduates of combined emergency medicine-internal medicine (EM-IM) residency programs. The graduates of the American Board of Emergency Medicine (ABEM) and American Board of Internal Medicine (ABIM)-accredited EM-IM residencies from 1998 to 2008 were contacted and asked to complete a survey concerning demographics, board certification, fellowships completed, practice setting, academic affiliation, and perceptions about EM-IM training and careers. There were 127 respondents of a possible 163 total graduates for a response rate of 78%. Seventy graduates (55%) practice EM only, 47 graduates (37%) practice both EM and IM, and nine graduates (7%) practice IM or an IM subspecialty only. Thirty-one graduates (24%) pursued formal fellowship training in either EM or IM. Graduates spend the majority of their time practicing clinical EM in an urban (72%) and academic (60%) environment. Eighty-seven graduates (69%) spend at least 10% of their time in an academic setting. Most graduates (64%) believe it practical to practice both EM and IM. A total of 112 graduates (88%) would complete EM-IM training again. Dual training in EM-IM affords a great deal of career opportunities, particularly in academics and clinical practice, in a number of environments. Graduates hold their training in high esteem and would do it again if given the opportunity.
The response to a worst-case scenario - the national emergency plan for nuclear accidents
Energy Technology Data Exchange (ETDEWEB)
Cunningham D, John [Radiological Protection Inst. of Ireland (Ireland)
1996-10-01
The Chernobyl accident in 1986 highlighted many deficiencies in the preparedness of countries to deal with a major accident. It demonstrated how vulnerable countries are to transboundary contamination. Ireland had no emergency plan at the time of the accident and only minimal facilities with which to assess the consequences of the accident. Nonetheless, the then Nuclear Energy Board with the assistance of Government Departments and the Civil Defence organisation reacted quickly to assess the situation despite the complete lack of information about the accident from the then USSR. Even countries with advanced nuclear technologies faced similar difficulties. It was quickly recognised by Government that the national laboratory facilities were totally inadequate. The Nuclear Energy Board was provided with additional resources to assist it to cope in the short term with the very large demand for monitoring. In the longer term a new national radiation laboratory was provided and the Board was formally replaced by the Radiological Protection Institute of Ireland. It was given statutory responsibility to monitor radiation levels, to advise measures to be taken for the protection of the public and to provide information for the public. An emergency plan based on the Chernobyl experience was drafted in 1987, amended and published in 1992. Certain features of this plan were implemented from 1987 onwards, notably the classification of responsibilities and the installation of a national continuous radiation monitoring system. The paper outlines the responsibilities of those who could be involved in a response to a nuclear incident, the procedures used to evaluate its consequences and the provision of information for the public. The plan provides an integrated management system which has sufficient flexibility to enable a rapid response to be made to a major or minor crisis, either foreseen or unforeseen and whatever its cause.
The report of the criticality accident in a uranium conversion test plant in Tokai-mura
International Nuclear Information System (INIS)
Murata, Hajime; Akashi, Makoto
2002-03-01
The criticality accident in the title occurred at around 10:35, on Sep. 30, 1999, cost the lives of two workers and caused many residents concern on their health. Moreover, rumors had both social and economic consequences. This report is a detailed account of the roles that many individuals and groups in the National Institute of Radiological Sciences (NIRS) performed in a range of the areas, and is published to discharge NIRS responsibilities in regards to the accident. The report involves chapters of detailed outline of the accident; acceptance of the victims and communications until the identification of the ''criticality'' accident; initial treatment; dose estimation (medical, hematological, physical and biological ones and that by dental metals activated by the neutron); decision making for therapeutic strategies; cooperation with the Network Council for Radiation Emergency Medicine and other medical facilities; emergency importation of medical supplies; treatment and progress (nursing system and radiation injuries); protection from radiation in medical facilities; response to nearby residents of the Plant; international response; press release; Uranium Processing Plant Criticality Accident Investigation Committee and the Health Management Committee organized by the Nuclear Safety Commission; handling of information; and radiation emergency medical preparedness at the NIRS (future issues and prospect). The report is hoped to be useful in preventing the occurrence of future accidents. (K.H.)
Energy Technology Data Exchange (ETDEWEB)
Gerosa, K
1986-01-01
The Chernobyl reactor accident has sharpened our sense of nuclear energy risks and dangers. Much as we hope it to never occur again in the future we know that there is no way of guaranteeing this to be the case. What is to be done in case of another reactor accident with radioactive radiation threatening to destroy us and the environment. Emergency measures protecting and saving our lives and health cannot be taken but with sufficient information at hand. The book informs about measures to be taken under emergency conditions. Nuclear energy and its alternatives, preventive measures, adequate nutrition and advice for pregnant women and for children are among the further subjects dealt with.
Incorporating teledermatology into emergency medicine.
Muir, Jim; Xu, Cathy; Paul, Sanjoy; Staib, Andrew; McNeill, Iain; Singh, Philip; Davidson, Samantha; Soyer, H Peter; Sinnott, Michael
2011-10-01
The aim of the present study was to investigate the feasibility of using a store-and-forward Skin Emergency Telemedicine Service (SETS) to provide rapid specialist diagnostic and management advice for dermatological cases in an ED. This pilot study was conducted at the Princess Alexandra Hospital between August 2008 and August 2009. Study subjects were consenting patients over 18 years of age who presented with a dermatological condition to the ED. The ED doctor sent the patient's history, examination findings and the digital images of the skin conditions to a secure email address, which automatically forwarded this to the teledermatologist. The teledermatologist reviewed the cases and sent advice on diagnosis and management to the referring ED doctor via email and/or telephone. Face-to-face follow-up consultations with the patients were conducted within 2 weeks. The diagnostic and management concordance between ED doctors, teledermatologists and reviewing dermatologists were analysed. A total of 60 patients participated in the present study. SETS provided a rapid response with 56 (93%) of ED consultations receiving a dermatology opinion within 2 h. Face-to-face follow up occurred in 50 patients (83%). Statistical analysis showed significant levels of agreement between tele-diagnosis and ED diagnosis of 71.2% (Kappa 0.42) and tele-diagnosis and final clinical diagnosis of 98% (Kappa: 0.93). The clinical management concordance was 96% in complete agreement and 4% in relative agreement between the teledermatologists and reviewing dermatologists, based on chart review. The present study has shown that SETS can provide rapid and accurate diagnostic and treatment advice from a specialist for dermatological presentations to the ED. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Energy Technology Data Exchange (ETDEWEB)
Flury, Christoph [Bundesamt fuer Bevoelkerungsschutz (BABS), Bern (Switzerland). Eidgenoessisches Departement fuer Verteidigung Bevoelkerungsschutz und Sport (VBS)
2016-07-01
As a consequence of the reactor accident in Fukushima the Swiss government has ordered an extensive analysis of emergency planning in case of a NPP accident Switzerland. A special working group has analyzed the possible improvements of Swiss emergency planning based on the experiences in Japan. Under the special direction of the Bundesamt fuer Bevoelkerungsschutz (BABS) the agreed improvements were integrated into the emergency concept. The reference scenarios have been re-assessed and the zone concept adapted. The emergency measures include shelter-type rooms (basement or window-less rooms), the preventive distribution of iodine pills, measures concerning agriculture, aquatic systems, preventive evacuation, traffic regulations, and delayed evacuation.
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
2011-11-17
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for... notification of voluntary relinquishment from Emergency Medicine Patient Safety Foundation of its status as a...
Global Emergency Medicine: A Review of the Literature From 2016.
Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Hayward, Alison Schroth; Hexom, Braden J; Lunney, Kevin M; Marsh, Regan H; Osei-Ampofo, Maxwell; Trehan, Indi; Chang, Julia; Levine, Adam C
2017-09-01
The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. © 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of the Society for Academic Emergency Medicine (SAEM).
The Biology of Emergency Medicine: what have 30 years meant for Rosen's original concepts?
Zink, Brian J
2011-03-01
In 1979 Peter Rosen, MD, a leading academic figure in the developing field of emergency medicine (EM), wrote an article, "The Biology of Emergency Medicine," in response to criticism from other specialties and medical leaders that there was no unique biology of EM that would qualify it as a legitimate medical specialty. This essay received much attention at the time and served as rallying cry for emergency physicians (EPs) who were trying to find their places in the house of medicine and especially in medical schools and academic teaching hospitals. Thirty years later, the opposition that prompted many of Rosen's strongly worded impressions and observations on the biology of EM, clinical emergency department (ED) practice, education, and research has largely faded. Many of Rosen's predictions on the eventual success of EM have come true. However, core issues that existed then continue to present challenges for academic EM and clinical emergency practice. © 2011 by the Society for Academic Emergency Medicine.
Regenerative Medicine as an Emergent Cluster in Tampere Region
Directory of Open Access Journals (Sweden)
Tuomo Heinonen
2015-01-01
Full Text Available Clusters are important for regional economies and emergent clusters are in a key position, as a means of adding more diversification to the current economic activity by involving new technologies and industries. Science-based industries may be the most promising in this regard since they are encouraged to develop and enhance the economic imaginaries of territories under the umbrella of radical innovations or in the name of broadening the current economic model based on mostly traditional industries. Regenerative medicine (RM could be an example of these so-called emergent clusters. Regenerative medicine is highly dependent on academic research, which means that local territories must fund the research in this field and, hence, they expect some returns as well. As territories do not typically have existing industries specifically in RM, these industries must emerge or expand from existing ones. Regenerative medicine involves a wide spectrum of different technologies and industries that are likely to form a cluster and benefit from it if successfully developed. The first aim of this paper is to show how some obstacles eventually impede the proper development of these emergent clusters. The second aim is to shed light on how innovations emerge in the cluster and what are the main implications for the territory. In this study, existing literature is used in order to describe the technology market and commercial aspects of the RM sector. Empirically this study is based on the emergent RM cluster in the region of Tampere in Finland. Analysis of 24 conducted interviews helps to contextualize the emergence of the RM cluster in Tampere, where academia is both the booster and the driver of the emergent RM cluster. Commercialization of research in the RM field is one of the goals at the university, even though there are no commercial outcomes yet available. This study contributes to the understanding of emergent cluster development in science
Quality of registration for clinical trials published in emergency medicine journals.
Jones, Christopher W; Platts-Mills, Timothy F
2012-10-01
In 2005, the International Committee of Medical Journal Editors established clinical trial registration as a requirement for articles submitted to member journals, with the goal of improving the transparency of clinical research. The objective of this study is to characterize the registration of clinical trials published in emergency medicine journals. Randomized trials involving human subjects and published between June 1, 2008, and May 31, 2011 in the 5 emergency medicine journals with the highest impact factors were included. We assessed the clarity of registered primary outcomes, timing of registration relative to patient enrollment, and consistency between registered and published outcomes. Of the 123 trials included, registry entries were identified for 57 (46%). Of the 57 registered studies, 45 (79%) were registered after the initiation of subject enrollment, 9 (16%) had registered outcomes that were unclear, and 26 (46%) had discrepancies between registered and published outcomes. Only 5 studies were registered before patient enrollment with a clear primary outcome that was consistent with the published primary outcome. Annals of Emergency Medicine was the only journal in which the majority of trials were registered. Current compliance with clinical trial registration guidelines is poor among trials published in emergency medicine journals. Copyright © 2012. Published by Mosby, Inc.
Senneseth, Mette; Alsaker, Kjersti; Natvig, Gerd Karin
2012-01-01
Aims This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. PMID:21740459
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.
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.
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.
International Nuclear Information System (INIS)
1988-05-01
The document refers to the Convention on early notification of a nuclear accident (INFCIRC-335) and to the Convention on assistance in the case of a nuclear accident or radiological emergency (INFCIRC-336). Part I of the document contains reservations/declarations made upon or following signature made by Algeria, Iraq and Thailand. Part II contains reservations/declarations made upon or following deposit of instrument expressing consent to be bound made by Australia, Bulgaria, China, India, Japan, Malaysia, Mongolia, Poland, South Africa, United Arab Emirates and Socialist Republic of Viet Nam. The status of signature, notification, acceptance, approval or accession of the two conventions as of 13 May 1988 is presented in two attachments
The accident analysis in the framework of emergency provisions
International Nuclear Information System (INIS)
Tietze, A.
1981-03-01
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.) [de
Energy Technology Data Exchange (ETDEWEB)
Lee, Byung Il; Park, Seong Jun; Lee, Dewhey; Song, Sub Lee; Park, Younwon [BEES Inc., Daejeon (Korea, Republic of)
2016-10-15
An exercise is normally conducted for a day or two days depending on the scale of the exercise. What we have experienced up to date there are several limitations in the radiological emergency exercises such as low public acceptance, poor enthusiasm in the exercise participation, not very attracting exercise scenarios, low efficiency in conducting an exercise, and so on. In order to overcome the limitations of the present exercising system, we would like to develop a radiological emergency exercise system using VR (virtual reality) technology based on a radioactive release accident. In this paper, we just introduce some basic development methods and event tree based scenario as a beginning stage. After the accident in Fukushima Daiichi NPP, the importance of emergency exercise especially for the public is far more emphasized around the world more and more. However, the human labor focused radiological emergency exercise up to now has many limitations. After developing this system properly and by using it, we could even expect to estimate the weak points of the emergency arrangements and strategy we have.
International Nuclear Information System (INIS)
Lee, Byung Il; Park, Seong Jun; Lee, Dewhey; Song, Sub Lee; Park, Younwon
2016-01-01
An exercise is normally conducted for a day or two days depending on the scale of the exercise. What we have experienced up to date there are several limitations in the radiological emergency exercises such as low public acceptance, poor enthusiasm in the exercise participation, not very attracting exercise scenarios, low efficiency in conducting an exercise, and so on. In order to overcome the limitations of the present exercising system, we would like to develop a radiological emergency exercise system using VR (virtual reality) technology based on a radioactive release accident. In this paper, we just introduce some basic development methods and event tree based scenario as a beginning stage. After the accident in Fukushima Daiichi NPP, the importance of emergency exercise especially for the public is far more emphasized around the world more and more. However, the human labor focused radiological emergency exercise up to now has many limitations. After developing this system properly and by using it, we could even expect to estimate the weak points of the emergency arrangements and strategy we have
Oliveira, Adriana Cristina; Lopes, Aline Cristine Souza; Paiva, Maria Henriqueta Rocha Siqueira
2009-09-01
This transversal, survey-based research was carried out with a multiprofessional emergency care team in Belo Horizonte, between June and December 2006. The study aimed at estimating the incidence of occupational accidents by exposure to biological material, post-accidents conducts and demographic determinant factors. The study applied a structured questionnaire and descriptive analyses, as well as incidence calculations and logistic regression. The incidence of accidents with biological material reached 20.6%, being 40.8% by sharp materials and 49.0% by body fluids; 35.3% of the accidents took place among physicians and 24.0% among nurses. Post-accidents procedures: no medical assessment, 63.3%; under-notification, 81.6%; no conduct, 55.0%; and no serological follow-up, 61.2%. Factors associated with accidents: working time in the institution (Odds Ratio--OR, 2.84; Credible Interval--CI 95%-1.22-6.62); working in advanced support units (OR = 4.18; CI 95%--1.64-10.64); and interaction between working time in the institution and working in Basic Support Unit (OR 0.27; CI 95%--0.07-1.00). In order to reduce accidents, the implementation of post-accident protocols and follow-up, as well as under-notification norms, are suggested.
International Nuclear Information System (INIS)
Melikhova, E.; Arutyunyan, R.
2014-01-01
The paper reviews recent results of content analysis of the Russian press and data of all-Russia public opinion polls on the subject of the Fukushima accident and discusses them in the wider context of challenges in communication of 'no risk' messages to the public in the case of a nuclear accident. Radiation risk regulation base in the low dose range is proposed to be one of the main obstacles for the communication and a new approach to emergency risk communication is proposed. (author)
Pines, Jesse M
2006-05-01
Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.
Highlights in emergency medicine medical education research: 2008.
Farrell, Susan E; Coates, Wendy C; Khun, Gloria J; Fisher, Jonathan; Shayne, Philip; Lin, Michelle
2009-12-01
The purpose of this article is to highlight medical education research studies published in 2008 that were methodologically superior and whose outcomes were pertinent to teaching and education in emergency medicine. Through a PubMed search of the English language literature in 2008, 30 medical education research studies were independently identified as hypothesis-testing investigations and measurements of educational interventions. Six reviewers independently rated and scored all articles based on eight anchors, four of which related to methodologic criteria. Articles were ranked according to their total rating score. A ranking agreement among the reviewers of 83% was established a priori as a minimum for highlighting articles in this review. Five medical education research studies met the a priori criteria for inclusion and are reviewed and summarized here. Four of these employed experimental or quasi-experimental methodology. Although technology was not a component of the structured literature search employed to identify the candidate articles for this review, 14 of the articles identified, including four of the five highlighted articles, employed or studied technology as a focus of the educational research. Overall, 36% of the reviewed studies were supported by funding; three of the highlighted articles were funded studies. This review highlights quality medical education research studies published in 2008, with outcomes of relevance to teaching and education in emergency medicine. It focuses on research methodology, notes current trends in the use of technology for learning in emergency medicine, and suggests future avenues for continued rigorous study in education.
Reactor accidents and the environment
International Nuclear Information System (INIS)
Beattie, J.R.; Griffiths, R.F.; Kaiser, G.D.; Kinchin, G.H.
1978-01-01
This is a condensed version of a paper, entitled 'The Environmental Impact of Radioactive Releases from Accidents in Nuclear Power Reactors', by the authors, presented to the Nuclear Energy Panel of the International Atomic Energy Agency/United Nations Environmental Programme. Headings include - Effects of ionising radiation on man; number of deaths expected from leukaemia and other cancers; risk estimates for incidence of benign nodules and thyroid cancer; maximum permissible levels and emergency levels of radiation and radioactivity; ICRP recommended dose limits for members of the general public; atmospheric dispersion and modelling; ICRP emergency reference levels for 1 131 , Cs 137 , Ru 106 and Sr 90 ; environmental consequences of accidental releases from nuclear power reactors; environmental impact of accidents to Magnox gas-cooled reactors; environmental impact of accidents to advanced gas-cooled reactors; environmental impact of accidents to fast reactors; and nature of risks. consequences are examined in terms of early and late biological effects on man, and contamination of land areas. Serious accidents are of low probability of occurrence, and the risk of accidents to nuclear power reactors is estimated to be very small. 43 references. (U.K.)
International Nuclear Information System (INIS)
Sato, Sohei; Yamamoto, Kazuya
2013-07-01
After the accident of TEPCO's Fukushima Dai-ichi Nuclear Power Station occurred on March 11, 2011, actions for controlling the accident and protective actions for the residents like evacuation were taken. In parallel with this, it has been developed to reform the nuclear regulatory systems and the emergency preparedness and response systems in Japan. Especially the Nuclear Regulation Authority's Nuclear Emergency Preparedness and Response Guidelines were adopted with the introducing the basic concepts and the criteria on the basis of the IAEA's safety standards and differed greatly from the prior guidelines. Thus the arrangement of emergency response systems, resources and the operational procedures will be developed complying with according to the guidelines in municipalities around the nuclear power station sites. This work attempts to provide a plain explanation as possible for the regional officials and emergency workers about the basic concepts of the new guidelines. (author)
International Nuclear Information System (INIS)
Selling, H.A.
1984-01-01
The study consist of a compilation of information on the relevant emergency response plans that are at present in existence in the ten countries of the European Community. Consideration is given to the development of proposals for facilitating co-operation between the emergency services in different countries, particularly with regard to accidents that might occur near national boundaries or in countries in which all the necessary resources might not be available. The particular items of interest covered in this study are: compilation of information on existing organizational emergency response arrangements within each Member State relating to accidents in the transport of radioactive materials by all modes, including road, rail, inland waterways, air and compilation of information on existing arrangements for receiving or providing assistance from or to other Member States. Identification of any avoidable incompatibilities on an international scale. Recommendations for improving the existing arrangements and for encouraging the development of adequate systems of mutual emergency notification, liaison and assistance as required by the circumstances, recommendations should be compatible with the broader framework of emergency response for all types of accidents developed within Member States and envisaged in the IAEA system for mutual emergency assistance
Chan, Jannet W M; Graham, Colin A
2011-09-01
The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.
Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma
2014-07-01
In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.
International Nuclear Information System (INIS)
1985-01-01
This Safety Guide is based on the report of an Advisory Group which met in Vienna in October 1984 in order to develop guidance on the radiation protection principles concerning emergency response planning and the establishment of intervention levels to be applied for the protection of the public in the event of a nuclear accident or radiological emergency. It considers the relationship between emergency response planning and various accident sequences, examines the pathways for radiation exposure and the sources of advice to decision makers during each of the three main accident phases, and specifies the dosimetric quantities that apply. The relevant pathological effects that must be protected against are summarized and the measures that may need to be implemented to provide protection with respect to each of the exposure pathways are discussed. It sets out the principles which underline decisions on intervention planning for each of the accident phases, gives guidance on dose values for the introduction of relevant protective measures and considers the application of cost-benefit analysis and the determination of the optimum dose level at which to withdraw protective measures
The Nuclear Emergency Assistance Team, a mobile intervention facility for nuclear accidents
International Nuclear Information System (INIS)
Koelzer, W.
1975-01-01
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) [de
Cevik, Arif Alper; Cakal, Elif Dilek; Abu-Zidan, Fikri M
2018-06-07
The published recommendations for international emergency medicine curricula cover the content, but exclude teaching and learning methods, assessment, and evaluation. We aim to provide an overview on available emergency medicine clerkship curricula and report the development and application experience of our own curriculum. Our curriculum is an outcome-based education, enriched by e-learning and various up-to-date pedagogic principles. Teaching and learning methods, assessment, and evaluation are described. The theory behind our practice in the light of recent literature is discussed aiming to help other colleagues from developing countries to have a clear map for developing and tailoring their own curricula depending on their needs. The details of our emergency medicine clerkship will serve as an example for developing and developed countries having immature undergraduate emergency medicine clerkship curricula. However, these recommendations will differ in various settings depending on available resources. The main concept of curriculum development is to create a curriculum having learning outcomes and content relevant to the local context, and then align the teaching and learning activities, assessments, and evaluations to be in harmony. This may assure favorable educational outcome even in resource limited settings.
Toward a definition of teamwork in emergency medicine.
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.
LENUS (Irish Health Repository)
Nizam, AA
2016-10-01
Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies. Trainees who had received specific tracheostomy training or who had previous experience of dealing with tracheostomy emergencies were more confident in dealing with such emergencies compared to trainees without such training or experience. Only a minority of trainees were aware of local hospital guidelines regarding tracheostomy care. Our results highlight the importance of increased awareness of tracheostomy emergencies and the importance of specific training for Anaesthesia and Critical Care Medicine trainees.
Martin, Shelly D; Bush, Anneke C; Lynch, Julia A
2006-09-01
Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.
Medical care of radiation accidents
International Nuclear Information System (INIS)
Nakao, Isamu
1986-02-01
This monograph, divided into six chapters, focuses on basic knowledge and medical strategies for radiation accidents. Chapters I to V deal with practice in emergency care for radiation exposure, covering 1) medical strategies for radiation accidents, 2) personnel dosimetry and monitoring, 3) nuclear facilities and their surrounding areas with the potential for creating radiation accidents, and emergency medical care for exposed persons, 4) emergency care procedures for radiation exposure and radioactive contamination, and 5) radiation hazards and their treatment. The last chapter provides some references. (Namekawa, K.)
Directory of Open Access Journals (Sweden)
Andrew King
2017-07-01
Full Text Available Audience: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: In 2007, there were 12 million adult Emergency Department visits for mental health and substance abuse complaints. This represents 12.5% of all adult emergency department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of psychiatric emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of psychiatric emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group
Directory of Open Access Journals (Sweden)
Andrew King
2017-07-01
Full Text Available Audience: This curriculum, created and implemented at The Ohio State University Wexner Medical Center, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students. Introduction: In 2013, there were over 6 million Emergency Department visits in the United States which resulted in a primary diagnosis of the genitourinary system. This represents 5.2% of all Emergency Department visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of genitourinary emergencies. This flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University Wexner Medical Center EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of genitourinary emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real
Emergency thoracic ultrasound and clinical risk management
Directory of Open Access Journals (Sweden)
Interrigi MC
2017-02-01
Full Text Available Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS has been proposed as an easy-option replacement for chest X-ray (CXR in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion; in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed
Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J
2015-05-01
We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a
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.)
Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit.
Battaglioli, Nicole; Ankel, Felix; Doty, Christopher I; Chung, Arlene; Lin, Michelle
2018-03-01
Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM). Through a joint collaboration involving Academic Life in Emergency Medicine's (ALiEM) Wellness Think Tank, Essentials of Emergency Medicine (EEM), and the Emergency Medicine Residents' Association (EMRA), a one-day Resident Wellness Consensus Summit (RWCS) was organized. The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.
Hayes, BD; Kobner, S; Trueger, NS; Yiu, S; 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...
Raukar, Neha P; Zonfrillo, Mark R; Kane, Kathleen; Davenport, Moira; Espinoza, Tamara R; Weiland, Jessica; Franco, Vanessa; Vaca, Federico E
2014-12-01
Title IX, the commercialization of sports, the social change in sports participation, and the response to the obesity epidemic have contributed to the rapid proliferation of participation in both competitive organized sports and nontraditional athletic events. As a consequence, emergency physicians are regularly involved in the acute diagnosis, management, disposition, and counseling of a broad range of sports-related pathology. Three important and highly publicized mechanisms of injury in sports relevant to emergency medicine (EM) include concussion, heat illness, and sudden cardiac death. In conjunction with the 2014 Academic Emergency Medicine consensus conference "Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes," a consensus group consisting of experts in EM, emergency neurology, sports medicine, and public health convened to deliberate and develop research questions that could ultimately advance the field of sports medicine and allow for meaningful application in the emergency department (ED) clinical setting. Sex differences in injury risk, diagnosis, ED treatment, and counseling are identified in each of these themes. This article presents the consensus-based priority research agenda. © 2014 by the Society for Academic Emergency Medicine.
Accident analysis. A review of the various accidents classifications
International Nuclear Information System (INIS)
Martin Martin, L.; Figueras, J.M.
1982-01-01
The objective of the accident analysis, in relation with the safety evaluation, environmental impact and emergency planning, should be to identify the total risk to the population and workers from potential accidents in the facility, analizing it over full spectrum of severity. (auth.)
Plint, Amy C; Stang, Antonia S; Calder, Lisa A
2015-01-01
Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for
NIRS report of the criticality accident in a uranium conversion test plant in Tokai-mura
International Nuclear Information System (INIS)
2001-01-01
This report is a detailed account of the roles that National Institute of Radiological Sciences (NIRS) played at the criticality accident in the title, which occurred at around 10:35, on Sep. 30, 1999 and resulted in death of two workers after all, and is published to discharge NIRS responsibilities in regards to the accident. The accident caused many residents concern on their health and rumors had both social and economic consequences. The report involves chapters of detailed outline of the accident; demand for acceptance of the victims and communications until the identification of the criticality'' accident; the acceptance and initial treatment; the exposure dose estimation (based on acute symptoms, on physics, on chromosomal analyses and on neutron-activated dental metals, and detailed analyses for dose distribution); decision made for therapeutic strategies; cooperation with the Network Council for Radiation Emergency and with other medical facilities; the urgent import of medicine; treatment and processes (patients, nursing system and radiation injuries); radiation protection in medical facilities; response to nearby residents of the Plant; international response; press release; Uranium Processing Plant Criticality Accident Investigation Committee and the Health Management Committee organized by the Nuclear Safety Commission; handling of information; and radiation emergency medical preparedness at the NIRS (future issues and prospect). The report is hopefully useful in preventing the occurrence of future accidents. (N.I.)
Chernobyl accident and Denmark
International Nuclear Information System (INIS)
1986-12-01
The report describes the Chernobyl accident and its consequences for Denmark in particular. It was commissioned by The Secretary of State for the Environment. The event at the accident site, the release and dispersal of radioactive substances into the atmosphere and over Europe, is described. A discussion of the Danish organisation for nuclear emergencies, how it was activated and adapted to the actual situation, is given. A comprehensive description of the radiological contamination in Denmark following the accident and the estimated health effects, is presented. The situation in other European countries is mentioned. (author)
International Nuclear Information System (INIS)
2000-11-01
The Convention on Early Notification of a Nuclear Accident (the 'Early Notification Convention') and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the 'Assistance Convention') are the prime legal instruments that establish an international framework to facilitate the exchange of information and the prompt provision of assistance in the event of a nuclear accident or radiological emergency, with the aim of minimizing the consequences. The International Atomic Energy Agency (IAEA) has specific functions assigned to it under these Conventions, to which the World Health Organization (WHO), the World Meteorological Organization (WMO) and the Food and Agriculture Organization of the United Nations (FAO) are full parties. Since 1989, the arrangements between the IAEA, States which are IAEA Member States and/or Parties to one or both Conventions, all other relevant international intergovernmental organizations, and other States for facilitating the implementation of the Conventions - specifically of those of their articles which are operational in nature have been documented in the Emergency Notification and Assistance Technical Operations Manual (ENATOM). Recent events, for example, the launch of the Cassini satellite (USA, 1997), the Acerinox accident (Spain, 1998), the JCO criticality accident (Japan, 1999), the Istanbul accident (Turkey, 1999) and the Samut Prakarn accident (Thailand, 2000), have raised new issues and highlighted the expectation of States that the IAEA will use the framework of the Early Notification and Assistance Conventions to obtain and provide real-time emergency related information on such events. While the Early Notification Convention requires States Parties to report only accidents that may have significant transboundary radiological consequences, States may under the Assistance Convention legitimately request the assistance of the IAEA or an Accident State in obtaining information concerning a
Schrading, Walter A; Battaglioli, Nicole; Drew, Jonathan; McClure, Sarah Frances
2018-03-01
Wilderness medicine training has become increasingly popular among medical professionals with numerous educational opportunities nationwide. Curricula for fellowship programs and for medical student education have previously been developed and published, but a specific curriculum for wilderness medicine education during emergency medicine (EM) residency has not. The objective of this study is to create a longitudinal wilderness medicine curriculum that can be incorporated into an EM residency program. Interest-specific tracks are becoming increasingly common in EM training. We chose this model to develop our curriculum specific to wilderness medicine. Outlined in the article is a 3-year longitudinal course of study that includes a core didactic curriculum and a plan for graduated level of responsibility. The core content is specifically related to the required EM core content for residency training with additions specific to wilderness medicine for the residents who pursue the track. The wilderness medicine curriculum would give residencies a framework that can be used to foster learning for residents interested in wilderness medicine. It would enhance the coverage of wilderness and environmental core content education for all EM residents in the program. It would provide wilderness-specific education and experience for interested residents, allowing them to align their residency program requirements through a focused area of study and enhancing their curriculum vitae at graduation. Finally, given the popularity of wilderness medicine, the presence of a wilderness medicine track may improve recruitment for the residency program. Copyright © 2017 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Elements of a national emergency response system for nuclear accidents
International Nuclear Information System (INIS)
Dickerson, M.H.
1987-01-01
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
International Nuclear Information System (INIS)
Lutz, R.J.; Monty, B.S.; Liparulo, N.J.; Desaedeleer, G.
1989-01-01
The foundation of the framework for a Severe Accident Management Program is the contained in the Probabilistic Safety Study (PSS) or the Individual Plant Evaluations (IPE) for a specific plant. The development of a Severe Accident Management Program at a plant is based on the use of the information, in conjunction with other applicable information. A Severe Accident Management Program must address both accident prevention and accident mitigation. The overall Severe Accident Management framework must address these two facets, as a living program in terms of gathering the evaluating information, the readiness to respond to an event. Significant international experience in the development of severe accident management programs exist which should provide some direction for the development of Severe Accident Management in the U.S. This paper reports that the two most important elements of a Severe Accident Management Program are the Emergency Consultation process and the standards for measuring the effectiveness of individual Severe Accident Management Programs at utilities
Variation in Emergency Department vs Internal Medicine Excess Charges in the United States.
Xu, Tim; Park, Angela; Bai, Ge; Joo, Sarah; Hutfless, Susan M; Mehta, Ambar; Anderson, Gerard F; Makary, Martin A
2017-08-01
Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. To examine the variation in excess charges for services provided by emergency medicine and internal medicine physicians. Retrospective analysis was conducted of professional fee payment claims made by the Centers for Medicare & Medicaid Services for all services provided to Medicare Part B fee-for-service beneficiaries in calendar year 2013. Data analysis was conducted from January 1 to July 31, 2016. Markup ratios for ED and internal medicine professional services, defined as the charges submitted by the hospital divided by the Medicare allowable amount. Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. Services provided by emergency medicine physicians had an overall markup ratio of 4.4 (340% excess charges), which was greater than the markup ratio of 2.1 (110% excess charges) for all services performed by internal medicine physicians. Markup ratios for all ED services ranged by hospital from 1.0 to 12.6 (median, 4.2; interquartile range [IQR], 3.3-5.8); markup ratios for all internal medicine services ranged by hospital from 1.0 to 14.1 (median, 2.0; IQR, 1.7-2.5). The median markup ratio by hospital for ED evaluation and management procedure codes varied between 4.0 and 5.0. Among the most common ED services, laceration repair had the highest median markup ratio (7.0); emergency medicine physician review of a head computed tomographic scan had the greatest interhospital variation (range, 1.6-27.7). Across hospitals, markups in the ED were often substantially higher than those in the internal medicine department for the same services. Higher ED markup ratios were associated with hospital for-profit ownership (median, 5.7; IQR, 4.0-7.1), a greater percentage of uninsured patients seen
Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby
2013-07-22
The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.
Directory of Open Access Journals (Sweden)
Temesgen Beyene
2017-09-01
Conclusion: An Emergency Medicine rotation during the final year of medical school provides opportunities to learn about undifferentiated medical emergencies and it should be included for other medical schools in the country. Participants suggest that leadership aspects of Emergency Medicine need more emphasis as the curriculum is further developed in the future.
Auckland regional emergency medicine trainee mentoring uptake survey.
Nicholls, Gordon Michael Mike; Lawrey, Emma; Jones, Peter
2017-10-01
The primary objective of this study is to quantify how many Auckland region emergency medicine (EM) trainees would like a formal mentoring programme. The secondary objectives were to quantify how many Auckland region EM trainees would like to participate in a formal mentoring programme; to determine trainees' current understanding of mentoring; how trainees prefer mentors to be allocated; why trainees may want a mentor; what mentees perceive would be good qualities in a mentor; and trainees' prior experience with mentoring. Online survey of EM trainees in the Auckland region in June 2015. Of 61 potential respondents, 40 (65.6%) respondents replied to the survey. Of the 40, 38 (95%; 95% confidence interval (CI) 82.6-99.5) respondents indicated they would like some form of mentoring system, and of the 38, 25 (65.8%; 95% CI 49.8-78.9) preferred this to be formal. Of the 38, 19 (50%; 95% CI 34.9-65.2) currently wanted assistance obtaining a mentor. Of the 40, 30 (75%; 95% CI 59.6-86.0) are not currently in any form of mentoring relationship. Respondents believed that mentors would be most beneficial in critical incidents, career development and with work/life balance. The attributes participants considered most important in a mentor were respecting confidentiality, being honest and the ability to provide constructive feedback. Many EM trainees in Auckland want a formal mentoring system and would like a mentor. Appropriate mentor-mentee matching through a formalised voluntary system, with adequate mentor training, may enable the Auckland region to develop a suitable mentoring programme for EM trainees. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Bleetman, A; Perry, C H; Crawford, R; Swann, I J
1997-01-01
OBJECTIVE: To review assault victim attendance at the accident and emergency department of Glasgow Royal Infirmary before and after a police initiative to curb knife carrying and tackle violent assaults ("Operation Blade"). METHODS: Assault victim attendance was reviewed for the month before the implementation of Operation Blade and for one month a year later. The number of victims requiring treatment in the resuscitation room for stab wounds before, during, and after Operation Blade was also...
Global Emergency Medicine: A review of the literature from 2017.
Becker, Torben K; Trehan, Indi; Hayward, Alison Schroth; Hexom, Braden J; Kivlehan, Sean M; Lunney, Kevin M; Modi, Payal; Osei-Ampofo, Maxwell; Pousson, Amelia; Cho, Daniel K; Levine, Adam C
2018-05-23
The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 848 articles met our inclusion criteria and underwent full review. 63% were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as emergency medicine development. 21 articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's Kappa of 0.344. In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
International Nuclear Information System (INIS)
Nakoski, John
2013-01-01
intervention and performance under extreme conditions; evaluations of metallic components and structures under high-seismic loads; risks assessments for natural external initiating events; and defence-in-depth, including the robustness of electrical systems. A recent joint research project has also been started that will include a benchmarking study of accident codes and the collection of data from the damaged reactors at the Fukushima Daiichi NPS. CRPPH activities in response to the Fukushima Daiichi NPS accident include an update of report on Short-term Countermeasures in Case of a Nuclear or Radiological Emergency that was last updated in 2003; the performance of a survey on emergency management lessons learned; developing lesson learned in the management of occupational exposure in high-radiation areas; and providing support to the Japanese Government by co-ordination and participation in workshops on decontamination and recovery and other technical topics
International Nuclear Information System (INIS)
Jung, Gunhyo; Kim, Juyoul; Shin, Hyeongki
2007-01-01
The Chernobyl accident took place on 25 April 1986 in Ukraine. Consequently large amount of radionuclides were released into the atmosphere. The release was a widespread distribution of radioactivity throughout the northern hemisphere, mainly across Europe. A total of 31 persons died as a consequence of the accident, and about 140 persons suffered various degrees of radiation sickness and health impairment in the acute health impact. The possible increase of cancer incidence has been a real and significant increase of carcinomas of the thyroid among the children living in the contaminated regions as the late health effects. Recently, a variety of atmospheric dispersion models have been developed and used around the world. Among them, HYSPLIT (HYbrid Single-Particle Lagrangian Integrated Trajectory) model developed by NOAA (National Oceanic and Atmospheric Administration)/ARL (Air Resources Laboratory) is being widely used. To verify the HYSPLIT model for radiological aerial monitoring in nuclear emergencies, a case study on the Chernobyl accident is performed
DEMİRCAN, Ahmet; KELEŞ, Ayfer; GÜRBÜZ, Neslihan; BİLDİK, Fikret
2008-01-01
Aims: Clinical forensic medicine deals with cases involving both the legal and medical aspects of patient care, such as motor vehicle trauma or poisoning. In this study, we aimed to draw attention to the forensic issues by retrospective investigation of 13823 emergency cases and to share our experiences on this topic. Materials and Methods: This retrospective study was conducted in a university Emergency Department (ED) in Ankara, Turkey. The data were collected from official hospital polic...
Wang, Wei; Huang, Li; Liang, Xuedong
2018-01-06
This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks' statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.
On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues
Wang, Wei; Huang, Li; Liang, Xuedong
2018-01-01
This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. PMID:29316614
The handling of radiation accidents
International Nuclear Information System (INIS)
1977-01-01
The symposium was attended by 204 participants from 39 countries and 5 international organizations. Forty-two papers were presented in 8 sessions. The purpose of the meeting was to foster an exchange of experiences gained in establishing and exercising plans for mitigating the effects of radiation accidents and in the handling of actual accident situations. Only a small number of accidents were reported at the symposium, and this reflects the very high standards of safety that has been achieved by the nuclear industry. No accidents of radiological significance were reported to have occurred at commercial nuclear power plants. Of the accidents reported, industrial radiography continues to be the area in which most of the radiation accidents occur. The experience gained in the reported accident situations served to confirm the crucial importance of the prompt availability of medical and radiological services, particularly in the case of uptake of radioactive material, and emphasized the importance of detailed investigation into the causes of the accident in order to improve preventative measures. One of the principal themes of the symposium involved emergency procedures related to nuclear power plant accidents, and several papers defining the scope, progression and consequences of design base accidents for both thermal and fast reactor systems were presented. These were complemented by papers defining the resultant protection requirements that should be satisfied in the establishment of plans designed to mitigate the effects of the postulated accident situations. Several papers were presented describing existing emergency organizational arrangements relating both to specific nuclear power plants and to comprehensive national schemes, and a particularly informative session was devoted to the topic of training of personnel in the practical conduct of emergency arrangements. The general feeling of the participants was one of studied confidence in the competence and
Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby
2013-01-01
Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...
Emergency Medicine Curriculum: Complications of Pregnancy Small Group Module
Directory of Open Access Journals (Sweden)
Linda L Herman
2017-07-01
Full Text Available Audience: This curriculum, created and implemented at Kaweah Delta HCD emergency medicine program, was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: Obstetrical (OB emergencies pose a unique challenge to the EM physician. Given the relative rarity of these presentations within the Emergency Department (ED, it is important that residents are educated in a comprehensive manner to ensure understanding and retention.1 The exact prevalence of emergency department (ED visits that are associated with complications of pregnancy is unknown, but they are likely a sizeable portion of the patient population of the ED. Also, many hospitals in rural areas have closed their labor and delivery units due to higher operating costs and lack of available medical personnel.2 New models of high-quality teaching that ensure retention of clinically rare, but critical presentations are required. There is a body of research that suggests a small-group discussion model rather than traditional lecture-based content may improve learner engagement and retention. This model encourages active learning, which requires simultaneous instructor and learner engagement.3, 4, 5, 6, 7 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine.3 The small group discussion classroom is facilitated by content experts with personal experience in the topic at hand. Objectives: We aim to teach the presentation and management of pregnancy complications through interactive teaching during small group discussions concerning patient cases. This curriculum utilizes resources chosen by education faculty, study questions, actual experience, and small group discussions in place of a traditional lecture-based format. In doing so, a goal of the curriculum is to
Management of whiplash injuries presenting to accident and emergency departments in Wales
Logan, A; Holt, M
2003-01-01
Methods: Questionnaires were sent to 76 full time accident and emergency staff across Wales inquiring into their management of soft tissue sprains/strains of the neck and soft collar use. Results: The overall response rate was 74% (SHO 70%, registrar 65%, consultant 100%). Half of consultants and more than half of the middle grade and junior staff reported soft collar use in this condition. As required wear was most commonly recommended and instructions for use ranged from one day only to until the patient was pain free. Conclusion: The study recommends treatment protocols for whiplash injuries prescribing regular analgesia, early home exercises with the help of an advice sheet, and physiotherapy if symptoms persist. PMID:12835348
Catastrophe medicine; Medecine de catastrophe
Energy Technology Data Exchange (ETDEWEB)
Lebreton, A. [Service Technique de l`Energie Electrique et des Grands Barrages (STEEGB), (France)
1996-12-31
The `Catastrophe Medicine` congress which took place in Amiens (France) in December 5 to 7 1996 was devoted to the assessment and management of risks and hazards in natural and artificial systems. The methods of risk evaluation and prevision were discussed in the context of dams accidents with the analysis of experience feedbacks and lessons gained from the organisation of emergency plans. Three round table conferences were devoted to the importance of psychological aspects during such major crises. (J.S.)
Energy Technology Data Exchange (ETDEWEB)
Bourrel, M.; Calmon, Ph.; Calvez, M.; Chambrette, V.; Champion, D.; Devin, P.; Godino, O.; Lombard, J.; Rzepka, J.P.; Schneider, Th.; Verhaeghe, B.; Cogez, E.; Kayser, O.; Guenon, C.; Jourdain, J.R.; Bouchot, E.; Murith, Ch.; Lochard, J.; Cluchier, A.; Vandecasteele, Ch.; Pectorin, X.; Dubiau, Ph.; Gerphagnon, O.; Roche, H.; Cessac, B.; Cochard, A.; Machenaud, G.; Jourdain, J.R.; Pirard, Ph.; Leger, M.; Bouchot, E.; Demet, M.; Charre, J.P.; Poumadere, M.; Cogez, E.
2010-07-01
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
Reis, Phillipe Geraldo Teixeira de Abreu; Driessen, Anna Luiza; da Costa, Ana Claudia Brenner Affonso; Nasr, Adonis; Collaço, Iwan Augusto; Tomasich, Flávio Daniel Saavedra
2013-01-01
To evaluate the accidents with biological material among medical students interning in a trauma emergency room and identify key related situations, attributed causes and prevention. we conducted a study with a quantitative approach. Data were collected through a questionnaire applied via internet, with closed, multiple-choice questions regarding accidents with biological material. The sample comprised 100 students. thirty-two had accidents with biological material. Higher-risk activities were local anesthesia (39.47%), suture (18.42%) and needle recapping (15.79%). The main routes of exposure to biological material were the eyes or mucosa, with 34%, and syringe needle puncture, with 45%. After contamination, only 52% reported the accident to the responsible department. The main causes of accidents and routes of exposure found may be attributed to several factors, such as lack of training and failure to use personal protective equipment. Educational and preventive actions are extremely important to reduce the incidence of accidents with biological materials and improve the conduct of post-exposure. It is important to understand the main causes attributed and situations related, so as general and effective measures can be applied.
International Nuclear Information System (INIS)
Datta, D.; Sharma, R.M.
2002-01-01
Full text: Experience gained after the Chernobyl accident clearly demonstrated the importance of improving administrative, organizational and technical emergency management arrangements in India. The more important areas where technical improvements were needed were early warning monitoring, communication networks for the rapid and reliable exchange of radiological and other information and decision support systems for off-site emergency management. A PC based artificial intelligent software has been developed to have a decision support system that can easily implement to manage off-site nuclear emergency and subsequently analyze the off-site consequences of the nuclear accident. A decision support tool, STEPS (source term estimate based on plant status), that provides desired input to the present software was developed. The tool STEPS facilitates meta knowledge of the system. The paper describes the details of the design of the software, functions of various modules, tuning of respective knowledge base and overall its scope in real sense in nuclear emergency preparedness and response
Young, Timothy P; Brown, Madison M; Reibling, Ellen T; Ghassemzadeh, Sassan; Gordon, Dawn M; Phan, Tammy H; Thomas, Tamara L; Brown, Lance
2016-10-01
In 2001, less than 20% of emergency medicine residents had more than $150,000 of educational debt. Our emergency medicine residents anecdotally reported much larger debt loads. Surveys have reported that debt affects career and life choices. Qualitative approaches are well suited to explore how and why such complex phenomena occur. We aim to gain a better understanding of how our emergency medicine residents experience debt. We conducted individual semistructured interviews with emergency medicine residents. We collected self-reported data related to educational debt and asked open-ended questions about debt influence on career choices, personal life, future plans, and financial decisions. We undertook a structured thematic analysis using a qualitative approach based in the grounded theory method. Median educational debt was $212,000. Six themes emerged from our analysis: (1) debt influenced career and life decisions by altering priorities; (2) residents experienced debt as a persistent source of background stress and felt powerless to change it; (3) residents made use of various techniques to negotiate debt in order to focus on day-to-day work; (4) personal debt philosophy, based on individual values and obtained from family, shaped how debt affected each individual; (5) debt had a normative effect and was acculturated in residency; and (6) residents reported a wide range of financial knowledge, but recognized its importance to career success. Our emergency medicine residents' debt experience is complex and involves multiple dimensions. Given our current understanding, simple solutions are unlikely to be effective in adequately addressing this issue. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Trends in National Emergency Medicine Conference Didactic Lectures Over a 6-Year Period.
Gottlieb, Michael; Riddell, Jeff; Njie, Abdoulie
2017-01-01
National conference didactic lectures have traditionally featured hour-long lecture-based presentations. However, there is evidence that longer lectures can lead to both decreased attention and retention of information. The authors sought to identify trends in lecture duration, lecture types, and number of speakers at four national emergency medicine (EM) conferences over a 6-year period. The authors performed a retrospective analysis of the length, number of speakers, and format of didactic lectures at four different national EM conferences over 6 years. The authors abstracted data from the national academic assemblies for the four largest not-for-profit EM organizations in the United States: American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine. There was a significant yearly decrease in the mean lecture lengths for three of the four conferences. There was an increase in the percentage of rapid fire sessions over the preceding 2 years with a corresponding decrease in the percentage of general educational sessions. There was no significant difference in the mean number of speakers per lecture. An analysis of 4210 didactic lecture sessions from the annual meetings of four national EM organizations over a 6-year period showed significant decreases in mean lecture length. These findings can help to guide EM continuing medical education conference planning and research.
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. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Richards, John R; Stayton, Taylor L; Wells, Jason A; Parikh, Aman K; Laurin, Erik G
2018-04-30
Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.
Customizing anaphylaxis guidelines for emergency medicine.
Nowak, Richard; Farrar, Judith Rosen; Brenner, Barry E; Lewis, Lawrence; Silverman, Robert A; Emerman, Charles; Hays, Daniel P; Russell, W Scott; Schmitz, Natalie; Miller, Judi; Singer, Ethan; Camargo, Carlos A; Wood, Joseph
2013-08-01
Most episodes of anaphylaxis are managed in emergency medical settings, where the cardinal signs and symptoms often differ from those observed in the allergy clinic. Data suggest that low recognition of anaphylaxis in the emergency setting may relate to inaccurate coding and lack of a standard, practical definition. Develop a simple, consistent definition of anaphylaxis for emergency medicine providers, supported by clinically relevant consensus statements. Definitions of anaphylaxis and criteria for diagnosis from current anaphylaxis guidelines were reviewed with regard to their utilization in emergency medical settings. The agreed-upon working definition is: Anaphylaxis is a serious reaction causing a combination of characteristic findings, and which is rapid in onset and may cause death. It is usually due to an allergic reaction but can be non-allergic. The definition is supported by Consensus Statements, each with referenced discussion. For a positive outcome, quick diagnosis and treatment of anaphylaxis are critical. However, even in the emergency setting, the patient may not present with life-threatening symptoms. Because mild initial symptoms can quickly progress to a severe, even fatal, reaction, the first-line treatment for any anaphylaxis episode--regardless of severity--is intramuscular injection of epinephrine into the anterolateral thigh; delaying its administration increases the potential for morbidity and mortality. When a reaction appears as "possible anaphylaxis," it is generally better to err on the side of caution and administer epinephrine. We believe that this working definition and the supporting Consensus Statements are a first step to better management of anaphylaxis in the emergency medical setting. Copyright © 2013 Elsevier Inc. All rights reserved.
Convention on assistance in the case of a nuclear accident or radiological emergency
International Nuclear Information System (INIS)
1987-03-01
The document presents the status of signatures and notifications of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency which entered into force on 26 February 1987, i.e. thirty days after the date (26 January 1987) on which the third State expressed its consent to be bound by the Convention. The list of signature, notification, acceptance, approval or accession by States or Organizations is given
International Nuclear Information System (INIS)
Higginson, Antony P.; Braybrook, Jason; Williams, Stephen; Finlay, David
2001-01-01
AIM: To determine the prevalence of isolated scaphotrapeziotrapezoid osteoarthritis in a population presenting to an Accident and Emergency Department of Leicester Royal Infirmary with acute wrist injuries. Also to identify the presence of scapholunate ligament disruption in this patient group and quantify symptoms and loss of function in terms of the modified system of Green and O'Brien, a recognized clinical scoring system. MATERIALS AND METHODS: A total of 1711 radiographs of patients attending the Accident and Emergency Department were prospectively reviewed over a 5-month period. Those patients with isolated scaphotrapeziotrapezoid osteoarthritis were invited for clinical review. RESULTS: Sixteen patients were identified with isolated scaphotrapeziotrapezoid osteoarthritis. Two had a poor Green and O'Brien score and evidence of scapholunate ligament disruption (P < 0.05). CONCLUSION: Isolated scaphotrapeziotrapezoid osteoarthritis has a prevalence of 1% in a population presenting to an Accident and Emergency Department with acute wrist injuries over the age of 30 years. Isolated scaphotrapeziotrapezoid osteoarthritis may be asymptomatic even though the changes in the joint are severe. Scapholunate ligament disruption is associated with a poor Green and O'Brien score, but is not present in the majority of cases. Higginson, A.P. et al. (2001)
Scheffer, Alice C.; van Hensbroek, Pieter Boele; van Dijk, Nynke; Luitse, Jan S. K.; Goslings, Johannes C.; Luigies, René H.; de Rooij, Sophia E.
2013-01-01
Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a
Guide on medical management of persons exposed in radiation accidents
International Nuclear Information System (INIS)
1990-01-01
The present guide has been prepared in order to provide guidance to medical and para-medical personnel regarding medical management of the different types of radiation accidents. It discusses briefly the physical aspects and biological effect of radiation, for the benefit of those who have not specialised in radiation medicine. The diagnosis, medical management and follow-up of persons involved in different types of radiation accidents are also dealt with. The implementation of the procedures described calls for organisation of appropriate facilities and provision of requisite equipment as well as education and training of the staff. It is emphasised that major radiation accidents are rare events and the multi-disciplinary nature of the response required to deal with them calls for proper planning and continuous liaison among plant management, radiation protection personnel, first-aid assistants and medical and paramedical staff. The organisation and conduct of emergency drills may help in maintaining preparedness of the medical facilities for efficient management of radiation casualities. (original). 64 refs., tabs., figs
Gordon, James A
2012-12-01
In just a few decades, emergency medicine (EM) has assumed a leadership role in medical education across many academic medical centers. This rapid evolution suggests medical education as a natural priority area for EM scholarship. This year's Academic Emergency Medicine consensus conference provides an ideal forum to focus on educational research as a core element of the specialty's academic portfolio. © 2012 by the Society for Academic Emergency Medicine.
Investigation on legal problems encountered by emergency medicine physicians in Turkey.
Directory of Open Access Journals (Sweden)
Afsin Emre Kayipmaz
Full Text Available Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases.An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05. The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and
Energy Technology Data Exchange (ETDEWEB)
NONE
2013-08-15
At the time of the occurrence of the Fukushima Dai-ichi nuclear power plant accident, JNES implemented various emergency correspondences. On the other hand, various organizations published the report about the Fukushima Dai-ichi nuclear power plant accident. In them, the problems about the regulatory body's regulatory process, regulatory organization, etc. are also pointed out. JNES is a designated public institution. JNES is required to improve process, organization, etc. related to emergency correspondence continuously based on the lessons learned obtained from the emergency corresponding experience about the Fukushima Dai-ichi nuclear power plant accident. Specifically, the following activities will be implemented in the 2014 and 2015 fiscal year. 1. Collect systematically and comprehensively the information about emergency correspondence of JNES in case of the Fukushima Dai-ichi nuclear power plant accident, and create the timeline of the event. 2. Specify problems and analyze human factors and organizational factors. 3. Specify the requirements for establishing a designated public institution's emergency correspondence based on the viewpoint of a human and an organization. 4. Publish the report which indicates collected information, the contents of analysis, proposals of improvement, etc. (author)
DEFF Research Database (Denmark)
Laursen, Christian B; Nielsen, Klaus; Riishede, Minna
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...
Zheng, Hezhen; Lei, Xiaohui; Shang, Yizi; Duan, Yang; Kong, Lingzhong; Jiang, Yunzhong; Wang, Hao
2018-03-01
Danjiangkou Reservoir is the source reservoir of the Middle Route of the South-to-North Water Diversion Project (MRP). Any sudden water pollution accident in the reservoir would threaten the water supply of the MRP. We established a 3-D hydrodynamic and water quality model for the Danjiangkou Reservoir, and proposed scientific suggestions on the prevention and emergency management for sudden water pollution accidents based on simulated results. Simulations were performed on 20 hypothetical pollutant discharge locations and 3 assumed amounts, in order to model the effect of pollutant spreading under different reservoir operation types. The results showed that both the location and mass of pollution affected water quality; however, different reservoir operation types had little effect. Five joint regulation scenarios, which altered the hydrodynamic processes of water conveyance for the Danjiangkou and Taocha dams, were considered for controlling pollution dispersion. The results showed that the spread of a pollutant could be effectively controlled through the joint regulation of the two dams and that the collaborative operation of the Danjiangkou and Taocha dams is critical for ensuring the security of water quality along the MRP.
The German emergency and disaster medicine and management system-history and present.
Hecker, Norman; Domres, Bernd Dieter
2018-04-01
As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Copyright © 2018. Production and hosting by Elsevier B.V.
French policy for managing the post-accident phase of a nuclear accident.
Gallay, F; Godet, J L; Niel, J C
2015-06-01
In 2005, at the request of the French Government, the Nuclear Safety Authority (ASN) established a Steering Committee for the Management of the Post-Accident Phase of a Nuclear Accident or a Radiological Emergency, with the objective of establishing a policy framework. Under the supervision of ASN, this Committee, involving several tens of experts from different backgrounds (e.g. relevant ministerial offices, expert agencies, local information commissions around nuclear installations, non-governmental organisations, elected officials, licensees, and international experts), developed a number of recommendations over a 7-year period. First published in November 2012, these recommendations cover the immediate post-emergency situation, and the transition and longer-term periods of the post-accident phase in the case of medium-scale nuclear accidents causing short-term radioactive release (less than 24 h) that might occur at French nuclear facilities. They also apply to actions to be undertaken in the event of accidents during the transportation of radioactive materials. These recommendations are an important first step in preparation for the management of a post-accident situation in France in the case of a nuclear accident. © The Chartered Institution of Building Services Engineers 2014.
First Responders and Criticality Accidents
Energy Technology Data Exchange (ETDEWEB)
Valerie L. Putman; Douglas M. Minnema
2005-11-01
Nuclear criticality accident descriptions typically include, but do not focus on, information useful to first responders. We studied these accidents, noting characteristics to help (1) first responders prepare for such an event and (2) emergency drill planners develop appropriate simulations for training. We also provide recommendations to help people prepare for such events in the future.
The nuclear accidents: Causes and consequences
International Nuclear Information System (INIS)
Rochd, M.
1988-01-01
The author discussed and compared the real causes of T.M.I. and Chernobyl accidents and cited their consequences. To better understand how these accidents occurred, a brief description of PWR type (reactor type of T.M.I.) and of RBMK type (reactor type of Chernobyl) has been presented. The author has also set out briefly the safety analysis objectives and the three barriers established to protect the public against the radiological consequences. To distinguish failures that cause severe accidents and to analyze them in details, it is necessary to classify the accidents. There are many ways to do it according to their initiator event, or to their frequency, or to their degree of gravity. The safety criteria adopted by nuclear industry have been explained. These criteria specify the limits of certain physical parameters that should not be exceeded in case of incidents or accidents. To compare the real causes of T.M.I. and Chernobyl accidents, the events that led to both have been presented. As observed the main common contributing factors in both cases are that the operators did not pay attention to warnings and signals that were available to them and that they were not trained to handle these accident sequences. The essential conclusions derived from these severe accidents are: -The improvement of operators competence contribute to reduce the accident risks; -The rapid and correct diagnosis of real conditions at each point of the accidents permits an appropriate behavior that would bring the plant to a stable state; -Competent technical teams have to intervene and to assist the operators in case of emergency; -Emergency plans and an international collaboration are necessary to limit the accident risks. 11 figs. (author)
小山, 真; Koyama, Shin
2001-01-01
The author would like to celebrate the start of the Department of emergency and critical care medicine and the Emergency unit of the Niigata University Hospital. The author also wishes to express his opinion, which is mentioned below, on preparing the Department and the Emergency unit for their future activity. 1 . The stuff members of the Department are expected to instruct undergraduate students in the knowledge and technique of Triage and the first aid in emergency exactly. 2 . The Emergen...
International Nuclear Information System (INIS)
Svanda, J.; Hustakova, H.; Fiser, V.
2008-01-01
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.)
ECONO-MARC: A method for assessing the cost of emergency countermeasures after an accident
International Nuclear Information System (INIS)
Clark, M.J.; Dionian, J.
1982-12-01
A method is proposed for assessing the cost of emergency countermeasures taken to reduce radiation exposures after an accidental release of radionuclides into the environment. The cost is estimated as the potential loss of goods and services due to the imposition of countermeasures, measured by a lost contribution to the nation's Gross Domestic Product (GDP). A primary aim in developing such a method is to provide the basis for clear quantitative inputs to difficult decisions in emergency planning; decisions on whether to apply countermeasures, and on the extent to which they should be applied. The method should also provide useful inputs to nuclear siting policy and to safety design assessments. While the method should aid decision-making, it does not measure all the costs; other major costs of nuclear accidents, such as the loss of nuclear plant capacity and the social disruption caused by countermeasures require separate additional assessment. The models in the MARC procedure for accident assessment are under continuing review. This memorandum records the method currently included in ECONO-MARC; additional models and improved procedures will be incorporated, as appropriate, in the future. (author)
A top-five list for emergency medicine: a pilot project to improve the value of emergency care.
Schuur, Jeremiah D; Carney, Dylan P; Lyn, Everett T; Raja, Ali S; Michael, John A; Ross, Nicholas G; Venkatesh, Arjun K
2014-04-01
IMPORTANCE The mean cost of medical care in the United States is growing at an unsustainable rate; from 2003 through 2011, the cost for an emergency department (ED) visit rose 240%, from $560 to $1354. The diagnostic tests, treatments, and hospitalizations that emergency clinicians order result in significant costs. OBJECTIVE To create a "top-five" list of tests, treatments, and disposition decisions that are of little value, are amenable to standardization, and are actionable by emergency medicine clinicians. DESIGN, SETTING, AND PARTICIPANTS Modified Delphi consensus process and survey of 283 emergency medicine clinicians (physicians, physician assistants, and nurse practitioners) from 6 EDs. INTERVENTION We assembled a technical expert panel (TEP) and conducted a modified Delphi process to identify a top-five list using a 4-step process. In phase 1, we generated a list of low-value clinical decisions from TEP brainstorming and e-mail solicitation of clinicians. In phase 2, the TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. In phase 3, we surveyed all ordering clinicians from the 6 EDs regarding distinct aspects of each item. In phase 4, the TEP voted for a final top-five list based on survey results and discussion. MAIN OUTCOMES AND MEASURES A top-five list for emergency medicine. The TEP ranked items on contribution to cost, benefit to patients, and actionability by clinicians. The survey asked clinicians to score items on the potential benefit or harm to patients and the provider actionability of each item. Voting and surveys used 5-point Likert scales. A Pearson interdomain correlation was used. RESULTS Phase 1 identified 64 low-value items. Phase 2 narrowed this list to 7 laboratory tests, 3 medications, 4 imaging studies, and 3 disposition decisions included in the phase 3 survey (71.0% response rate). All 17 items showed a significant positive correlation between benefit and actionability (r, 0.19-0.37 [P
International Nuclear Information System (INIS)
2003-04-01
The Parties to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency have undertaken to co-operate among themselves and with the IAEA in facilitating the prompt provision of assistance in the event of a nuclear accident or radiological emergency, and in minimizing the consequences and in protecting life, property and the environment from the effects of any radioactive releases. As part of the IAEA strategy for supporting such co-operation, the Secretariat of the IAEA is establishing a global Emergency Response Network (ERNET) of teams suitably qualified to respond rapidly, on a regional basis, to nuclear accidents or radiological emergencies. This manual sets out the criteria and requirements to be met by ERNET teams. It is intended for use by institutions in Member States in developing, applying and maintaining their emergency response capabilities and in implementing quality assurance programmes within the context of ERNET. The manual is worded on the assumption that a State Competent Authority designated as the body responsible for reacting to nuclear accidents or radiological emergencies which occur outside the jurisdiction of that State will be the State Contact Point for receiving requests for assistance from the IAEA under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency
International Nuclear Information System (INIS)
2000-12-01
The Parties to the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency have undertaken to co-operate among themselves and with the IAEA in facilitating the prompt provision of assistance in the event of a nuclear accident or radiological emergency, and in minimizing the consequences and in protecting life, property and the environment from the effects of any radioactive releases. As part of the IAEA strategy for supporting such co-operation, the Secretariat of the IAEA is establishing a global Emergency Response Network (ERNET) of teams suitably qualified to respond rapidly, on a regional basis, to nuclear accidents or radiological emergencies. This manual sets out the criteria and requirements to be met by ERNET teams. It is intended for use by institutions in Member States in developing, applying and maintaining their emergency response capabilities and in implementing quality assurance programmes within the context of ERNET. The manual is worded on the assumption that a State Competent Authority designated as the body responsible for reacting to nuclear accidents or radiological emergencies which occur outside the jurisdiction of that State will be the State Contact Point for receiving requests for assistance from the IAEA under the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency
International Nuclear Information System (INIS)
Niel, J.Ch.; Godet, J.L.
2008-01-01
For several years, public Authorities have defined an organization for the management of emergency situations arising from an accident occurring at a nuclear installation. So far, the management of the risk arising from the post accident phase was, in itself, not explored with the same care. What so ever, no format policy on which the action of public Authority could be based is today available. The nuclear safety Authority (ASN), in relation with the other concerned departments, is now in charge, according to the above mentioned directive, to prepare and implement the necessary provisions to respond to a post accident situation. In dune 2005, ASN established the steering committee for the management of post nuclear or radiological emergency situations (CODIRPA). The definition of a national policy related to the management of the radiological risk during a post event situation having to integrate various organization aspects as: lifting of protection emergency provisions and rehabilitation of buildings, life in contaminated rural territories, agriculture and water, dose and radiological consequences, sanitary surveillance of victims and populations, indemnification, waste management of contaminated crops and soils, organization of public Authorities. During the 2. phase of CODIRPA work (2008-2009), the first elements of policy will be consolidated and new scenarios will be studied (one worsened scenario and one scenario with alpha emitting radionuclide). in parallel, a procedure for local actor's consultation should be elaborated. (authors)
Directory of Open Access Journals (Sweden)
Sonja E. Raaum
2015-10-01
Full Text Available Purpose: Smartphone technology offers a multitude of applications (apps that provide a wide range of functions for healthcare professionals. Medical trainees are early adopters of this technology, but how they use smartphones in clinical care remains unclear. Our objective was to further characterize smartphone use by medical trainees at two United States academic institutions, as well as their prior training in the clinical use of smartphones. Methods: In 2014, we surveyed 347 internal medicine and emergency medicine resident physicians at the University of Utah and Brigham and Women’s Hospital about their smartphone use and prior training experiences. Scores (0%–100% were calculated to assess the frequency of their use of general features (email, text and patient-specific apps, and the results were compared according to resident level and program using the Mann-Whitney U-test. Results: A total of 184 residents responded (response rate, 53.0%. The average score for using general features, 14.4/20 (72.2% was significantly higher than the average score for using patient-specific features and apps, 14.1/44 (33.0%, P<0.001. The average scores for the use of general features, were significantly higher for year 3–4 residents, 15.0/20 (75.1% than year 1–2 residents, 14.1/20 (70.5%, P=0.035, and for internal medicine residents, 14.9/20 (74.6% in comparison to emergency medicine residents, 12.9/20 (64.3%, P= 0.001. The average score reflecting the use of patient-specific apps was significantly higher for year 3–4 residents, 16.1/44 (36.5% than for year 1–2 residents, 13.7/44 (31.1%; P=0.044. Only 21.7% of respondents had received prior training in clinical smartphone use. Conclusion: Residents used smartphones for general features more frequently than for patient-specific features, but patient-specific use increased with training. Few residents have received prior training in the clinical use of smartphones.
Investigation on legal problems encountered by emergency medicine physicians in Turkey.
Kayipmaz, Afsin Emre; Kavalci, Cemil; Gulalp, Betul; Kocalar, Ummu Gulsum; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem
2015-01-01
Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases. An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. pmedicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.
International Nuclear Information System (INIS)
2010-05-01
This National Guide provides basic explanations and methods to assist in drawing up a local plan for the emergency phase way-out, subsequent to a nuclear accident of moderate magnitude causing short-term (under 24 hours) radioactive release, which could possibly occur in France. The accident situations considered in this Guide have little likelihood of arising and are representative of environmental contamination accidents that might occur at French nuclear facilities covered by a special intervention plan (plan particulier d'intervention, PPI). Such accidents may cause environmental contamination warranting action for post-accident impact management within a range of ten to fifty kilometres from the accident site. To provide some perspective, the accidents considered here would be classified Levels 3, 4 or 5 (incidents or accidents causing release into the environment) on the INES scale customarily used to help the public and media to immediately understand the severity of an incident or accident in the nuclear field. This Guide was drawn up subsequently to the work carried out by the Steering Committee on Post- Accident Phase Management in the Event of a Nuclear Accident or Radiological Emergency Situation (CODIRPA), instituted by the French Nuclear Safety Authority (ASN) in June 2005, and in charge of setting out the basic principles underlying the management of nuclear post-accident situations. This version of the Guide shall be updated on the basis of the operating experience feedback received on its use. The Guide is a planning tool, intended for the Prefectures of department where a basic nuclear facility PPI has been instituted. Its purpose is to enable Prefects to plan and effectively conduct preparedness measures at the local level with the aim of winding down the emergency phase, actively involving all of the relevant actors for this purpose. The exit period from the emergency phase is defined as extending approximately one week from the end of the
International Nuclear Information System (INIS)
Dynes, R.R.
1982-01-01
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
Regulatory perspective on accident management issues
International Nuclear Information System (INIS)
Barrett, R.J.
1988-01-01
Effective response to reactor accidents requires a combination of emergency operations, technical support and emergency response. The NRC and industry have actively pursued programs to assure the adequacy of emergency operations and emergency response. These programs will continue to receive high priority. By contrast, the technical support function has received relatively little attention from NRC and the industry. The results from numerous PRA studies and the severe accident programs of NRC and the industry have yielded a wealth of insights on prevention and mitigation of severe accidents. The NRC intends to work with the industry to make these insights available to the technical support staffs through a combination of guidance, training and periodic drills
Accident management on french PWRS
International Nuclear Information System (INIS)
Queniart, D.
1990-06-01
After a brief recall of French safety rationale, the reactor operation and severe accident management is given. The research and development aimed at developing accident management procedures and emergency organization in France for the case of a NPP accident are also given
Directory of Open Access Journals (Sweden)
Andrew King
2017-01-01
Full Text Available Audience and type of curriculum: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction/Background: Gastrointestinal (GI emergencies comprise approximately 12% of emergency department (ED visits.1 Residents must be proficient in the differential diagnosis and management of the wide variety of GI emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.2-4 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.4-6 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.7-10 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. This proposed curriculum utilizes an 18-month curricular cycle. The flipped classroom curriculum maximizes didactic time and resident engagement, fosters intellectual curiosity and active learning, and meets the needs of today’s learners. 3,6,11 Objectives: We aim to teach the presentation and management of GI emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self
International Nuclear Information System (INIS)
Kosako, Toshiso
2012-01-01
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)
Assisting emergency operating procedures execution with AMAS, an Accident Management Advisor System
International Nuclear Information System (INIS)
Guarro, S.; Milici, T.; Wu, J.S.; Apostolakis, G.
2004-01-01
In an accident situation, because any decisions that the operators make will depend on how instrumentation readings are ultimately interpreted, the issue of instrument uncertainty is of paramount importance. This uncertainty exists because instrument readings may not be available in the desired form - i.e., only indirect readings for a parameter of interest may exist, with uncertainty on which physical models may be used to deduce its value from these indirect indications -, or because readings may be coming from instruments whose accuracy and reliability in the face of the severe conditions produced by the accident are far from what may be expected under normal operating conditions. In following the EOPs, the operators must rely on instrumentation whose readings may not reflect the real situation. The Accident Management Advisor System (AMAS) is a decision aid intended to supplement plant Emergency Operating Procedures (EOPs) by accounting for instrumentation uncertainty, and by alerting the operators if they are on the wrong procedures, or otherwise performing an action that is not optimal in terms of preventing core damage. In AMAS, the availability and reliability of certain important instrument readings is treated in probabilistic, rather than deterministic terms. This issue is discussed in greater detail later in the paper, since it relates to one of the key characteristics of the AMAS decision aid. (author)
Use of accident experience in developing criteria for teleoperator equipment
International Nuclear Information System (INIS)
Vallario, E.J.; Selby, J.M.
1985-10-01
The 1961 SL-1 reactor accident in Idaho and the Recuplex accident at Hanford are reviewed to identify problems common to emergency situations, lessons learned from accidents, criteria for emergency equipment, and recommendations for using robotics to solve problems during emergencies. Teleoperator equipment could be used to assess the extent of the damage and the condition of the reactor, retrieve dosimeters, evacuate and treat accident victims, clean up debris and decontaminate accident areas. 2 refs., 9 figs
International Nuclear Information System (INIS)
Lushbaugh, C.C.; Andrews, G.A.; Huebner, K.F.; Cloutier, R.J.; Beck, W.L.; Berger, J.D.
1976-01-01
Because serious radiation incidents have been rare, few medical personnel (notably only some in France, Russia, Belgium, Canada, Yugoslavia, Japan, Great Britain and the United States) have first-hand experience in radiation-accident management. The generation of physicians who participated in those accidents now needs to pass on the bits of knowledge that were gleaned from them. These case histories are difficult for the local, non-radiology physician to obtain when he is called upon to help formulate the medical-emergency response plan required everywhere for licensing power reactors. The Radiation Emergency Assistance Center and Training Site (REACTS) in Oak Ridge, Tennessee, supported by the US Energy Research and Development Administration, is designed to meet these medical and educational needs. REACTS, located in the Oak Ridge Hospital of the Methodist Church, is not involved in the hospital's daily community functions except insofar as REACTS is the radiation emergency arm of the area's major disaster plan. Its dual mission is training physicians, nurses, and paramedical emergency personnel in radiation-accident management, and treating irradiated and contaminated persons. Its training activities are carried out by the Special Training Division of Oak Ridge Associated Universities. Formal courses in radiation medicine and health physics and practical laboratory experience are now conducted twice a year for physicians. They will be expanded in the future to include training of paramedical personnel. Follow-up studies of radiation-accident survivors are carried out in REACTS to ensure the preservation of valuable human data and radiation-accident experiences. This unique facility and its staff are dedicated to meet the needs of the far-flung public and private medical domains in the United States for nuclear-production energy
The epidemiology of bicyclist's collision accidents
DEFF Research Database (Denmark)
Larsen, L. B.
1994-01-01
of bicyclists and risk situations. The findings should make a basis for preventive programmes in order to decrease the number and severity of bicyclists collision accidents. Data from the emergency room in a 2 year period was combined with data from questionnaires. The study group consisted of 1021 bicyclists......The number of bicyclists injured in the road traffic in collision accidents and treated at the emergency room at Odense University Hospital has increased 66% from 1980 to 1989. The aim of this study was to examine the epidemiology of bicyclist's collision accidents and identify risk groups...... injured in collision accidents, and 1502 bicyclists injured in single accidents was used as a reference group. The young bicyclists 10-19 years of age had the highest incidence of injuries caused by collision accidents. The collision accidents had different characteristics according to counterpart. One...
Time-Driven Activity-Based Costing in Emergency Medicine.
Yun, Brian J; Prabhakar, Anand M; Warsh, Jonathan; Kaplan, Robert; Brennan, John; Dempsey, Kyle E; Raja, Ali S
2016-06-01
Value in emergency medicine is determined by both patient-important outcomes and the costs associated with achieving them. However, measuring true costs is challenging. Without an understanding of costs, emergency department (ED) leaders will be unable to determine which interventions might improve value for their patients. Although ongoing research may determine which outcomes are meaningful, an accurate costing system is also needed. This article reviews current costing mechanisms in the ED and their pitfalls. It then describes how time-driven activity-based costing may be superior to these current costing systems. Time-driven activity-based costing, in addition to being a more accurate costing system, can be used for process improvements in the ED. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
Chupin, A.; Hu, L. W.; Buongiorno, J.
2008-01-01
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)
Energy Technology Data Exchange (ETDEWEB)
NONE
1996-08-01
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.
International Nuclear Information System (INIS)
1996-08-01
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
Regulation Plans on Severe Accidents developed by KINS Severe Accident Regulation Preparation TFT
International Nuclear Information System (INIS)
Kim, Kyun Tae; Chung, Ku Young; Na, Han Bee
2016-01-01
Some nuclear power plants in Fukushima Daiichi site had lost their emergency reactor cooling function for long-time so the fuels inside the reactors were molten, and the integrity of containment was damaged. Therefore, large amount of radioactive material was released to environment. Because the social and economic effects of severe accidents are enormous, Korean Government already issued 'Severe Accident Policy' in 2001 which requires nuclear power plant operators to set up 'Quantitative Safety Goal', to do 'Probabilistic Safety Analysis', to install 'Severe Accident Countermeasures' and to make 'Severe Accident Management Plan'. After the Fukushima disaster, a Special Safety Inspection was performed for all operating nuclear power plants of Korea. The inspection team from industry, academia, and research institutes assessed Korean NPPs capabilities to cope with or respond to severe accidents and emergency situation caused by natural disasters such as a large earthquake or tsunami. As a result of the special inspection, about 50 action items were identified to increase the capability to cope with natural disaster and severe accidents. Nuclear Safety Act has been amended to require NPP operators to submit Accident Management Plant as part of operating license application. The KINS Severe Accident Regulation Preparation TFT had first investigated oversea severe accident regulation trend before and after the Fukushima accident. Then, the TFT has developed regulation draft for severe accidents such as Severe accident Management Plans, the required design features for new NPPs to prevent severe accident against multiple failures and beyond-design external events, countermeasures to mitigate severe accident and to keep the integrity of containment, and assessment methodology on safety assessment plan and probabilistic safety assessment
LENUS (Irish Health Repository)
Walsh, K
2012-02-03
BACKGROUND AND OBJECTIVE: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine. METHODS: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone. RESULTS: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%). CONCLUSIONS: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.
Occupational accidents among ambulance drivers in the emergency relief.
Takeda, Elisabete; do Carmo Cruz Robazzi, Maria Lúcia
2007-01-01
We analyzed the occurrence of occupational accidents (OA) among ambulance drivers in Emergency Relief (ER), with a view to disclosing the types of events and their causes. A quantitative-qualitative study was carried out through the interview of 22 workers in a city in São Paulo, Brazil. The subjects were male, between 36 and 40 years old (40.9%), married (81.82%), with uncompleted primary education (40.9%), individual (90.9%) and family (54.55%) income between two and four Brazilian minimum wages, not performing any other paid occupation (45.45%). The majority of the OA were typical, due to an excess of exercises and vigorous and repeated movements (42.11%) and aggression through body strength and other means (26.33%). The OA occurs mainly because drivers carry out tasks that do not suit their professional formation.
Executive Summary from the 2017 Emergency Medicine Resident Wellness Consensus Summit
Directory of Open Access Journals (Sweden)
Felix Ankel
2018-02-01
Full Text Available Introduction: Physician wellness has recently become a popular topic of conversation and publication within the house of medicine and specifically within emergency medicine (EM. Through a joint collaboration involving Academic Life in Emergency Medicine’s (ALiEM Wellness Think Tank, Essentials of Emergency Medicine (EEM, and the Emergency Medicine Residents’ Association (EMRA, a one-day Resident Wellness Consensus Summit (RWCS was organized. Methods: The RWCS was held on May 15, 2017, as a pre-day event prior to the 2017 EEM conference in Las Vegas, Nevada. Seven months before the RWCS event, pre-work began in the ALiEM Wellness Think Tank, which was launched in October 2016. The Wellness Think Tank is a virtual community of practice involving EM residents from the U.S. and Canada, hosted on the Slack digital-messaging platform. A working group was formed for each of the four predetermined themes: wellness curriculum development; educator toolkit resources for specific wellness topics; programmatic innovations; and wellness-targeted technologies. Results: Pre-work for RWCS included 142 residents from 100 different training programs in the Wellness Think Tank. Participants in the actual RWCS event included 44 EM residents, five EM attendings who participated as facilitators, and three EM attendings who acted as participants. The four working groups ultimately reached a consensus on their specific objectives to improve resident wellness on both the individual and program level. Conclusion: The Resident Wellness Consensus Summit was a unique and novel consensus meeting, involving residents as the primary stakeholders. The summit demonstrated that it is possible to galvanize a large group of stakeholders in a relatively short time by creating robust trust, communication, and online learning networks to create resources that support resident wellness.
The prevention of the local nuclear accidents in the Republic of Moldova
International Nuclear Information System (INIS)
Bahnarel, I.
1998-01-01
Although there are no nuclear reactors in Moldova, there are numerous radiation sources situated in a few waste disposal sites as well as the sources applied in medicine, science, education, industry, agriculture, which demand serious concern from safety and radiation protection point of view. Under cooperation with IAEA national Regulatory Control in the Field of Nuclear Protection and Safety was established since 1993. A number of governmental regulatory bodies supervise the following activities: radiation standardization; radiological supervision of sources storage, exploitation and disposal; radiological monitoring of radioactive substances, food products, building materials; supervision of personnel exposure and environmental exposure; investigation of radiological accidents; etc. In 1998, Moldova has joined The International Convention for early Notification of Nuclear Accidents; The Convention on Nuclear Safety; The Convention on Assistance in Case of Nuclear Accident of Radiological Emergency and The Convention on the Physical protection of Nuclear Material
Advances in point-of-care ultrasound in pediatric emergency medicine.
Gallagher, Rachel A; Levy, Jason A
2014-06-01
Point-of-care ultrasound (POCUS) has become an integral part of emergency medicine practice. Research evaluating POCUS in the care of pediatric patients has improved the understanding of its potential role in clinical care. Recent work has investigated the ability of pediatric emergency medicine (PEM) physicians to perform a wide array of diagnostic and procedural applications in POCUS ultrasound. Studies have demonstrated that PEM providers are able to identify an array of diseases, including intussusception, pyloric stenosis and appendicitis. Novel applications of ultrasound, such as a cardiac evaluation in the acutely ill patient or identification of skull fractures in the assessment of a patient with head injury, have shown excellent promise in recent studies. These novel applications have the potential to reshape pediatric diagnostic algorithms. Key applications in PEM have been investigated in the recent publications. Further exploration of the ability to integrate ultrasound into routine practice will require larger-scale studies and continued growth of education in the field. The use of ultrasound in clinical practice has the potential to improve safety and efficiency of care in the pediatric emergency department.
Web technology for emergency medicine and secure transmission of electronic patient records.
Halamka, J D
1998-01-01
The American Heritage dictionary defines the word "web" as "something intricately contrived, especially something that ensnares or entangles." The wealth of medical resources on the World Wide Web is now so extensive, yet disorganized and unmonitored, that such a definition seems fitting. In emergency medicine, for example, a field in which accurate and complete information, including patients' records, is urgently needed, more than 5000 Web pages are available today, whereas fewer than 50 were available in December 1994. Most sites are static Web pages using the Internet to publish textbook material, but new technology is extending the scope of the Internet to include online medical education and secure exchange of clinical information. This article lists some of the best Web sites for use in emergency medicine and then describes a project in which the Web is used for transmission and protection of electronic medical records.
Evaluation of Social Media Use by Emergency Medicine Residents and Faculty.
Pearson, David; Bond, Michael C; Kegg, Jason; Pillow, Tyson; Hopson, Laura; Cooney, Robert; Garg, Manish; Khadpe, Jay; Runyon, Michael; Patterson, Leigh
2015-09-01
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. 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. We received 1,314 responses: 63% of respondents were male, 40% were 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% [psocial media. Awareness of these utilization patterns could benefit future educational endeavors.
Acceptability of the flipped classroom approach for in-house teaching in emergency medicine.
Tan, Eunicia; Brainard, Andrew; Larkin, Gregory L
2015-10-01
To evaluate the relative acceptability of the flipped classroom approach compared with traditional didactics for in-house teaching in emergency medicine. Our department changed its learning model from a 'standard' lecture-based model to a 'flipped classroom' model. The 'flipped classroom' included provided pre-session learning objectives and resources before each 2 h weekly session. In-session activities emphasised active learning strategies and knowledge application. Feedback was sought from all medical staff regarding the acceptability of the new approach using an online anonymous cross-sectional qualitative survey. Feedback was received from 49/57 (86%) medical staff. Ninety-eight per cent (48/49) of respondents preferred the flipped classroom over the traditional approach. Aspects of the flipped classroom learners liked most included case-based discussion, interaction with peers, application of knowledge, self-directed learning and small-group learning. Barriers to pre-session learning include work commitments, 'life', perceived lack of time, family commitments, exam preparation and high volume of learning materials. Reported motivational factors promoting pre-session learning include formal assessment, participation requirements, more time, less material, more clinical relevance and/or more interesting material. Case studies and 'hands-on' activities were perceived to be the most useful in-session activities. The flipped classroom shows promise as an acceptable approach to in-house emergency medicine teaching. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
The IAEA Accident Management Programme
Energy Technology Data Exchange (ETDEWEB)
Kabanov, L.; Jankowski, M.; Mauersberger, H. (International Atomic Energy Agency, Vienna (Austria))
1993-02-01
Accident prevention and mitigation programmes and the Emergency Response System (ERS) are important elements of the Agency's activities in the area of nuclear power plant (NPP) safety. Safety Codes and Guides on siting, design, quality assurance and the operation of NPPs have been produced and are used by NPP operating organizations. Nuclear safety evaluation services are provided by the IAEA. The Emergency Response System and the International Nuclear Event Scale (INES) have been developed. The framework for the development of an accident management programme has been set up. The main goal is to develop an Accident Management Manual to provide a systematic, structured approach to the development and implementation of an accident management programme at NPPs. An outline of the Manual has been distributed and the first draft is available. The component parts are: Co-ordinated research programmes (CRPs) on severe accident management and containment behaviour; the use of vulnerability analysis; mitigation of the effects of hydrogen, and generic symptom oriented emergency operating procedures. The IAEA provides guidance by the dissemination of information on methods for accident management; collates information on approaches in this field in different organizations and countries; and arranges exchange of experience and the promulgation of knowledge through the training of NPP managers and senior technical staff. (orig.).
The IAEA Accident Management Programme
International Nuclear Information System (INIS)
Kabanov, L.; Jankowski, M.; Mauersberger, H.
1993-01-01
Accident prevention and mitigation programmes and the Emergency Response System (ERS) are important elements of the Agency's activities in the area of nuclear power plant (NPP) safety. Safety Codes and Guides on siting, design, quality assurance and the operation of NPPs have been produced and are used by NPP operating organizations. Nuclear safety evaluation services are provided by the IAEA. The Emergency Response System and the International Nuclear Event Scale (INES) have been developed. The framework for the development of an accident management programme has been set up. The main goal is to develop an Accident Management Manual to provide a systematic, structured approach to the development and implementation of an accident management programme at NPPs. An outline of the Manual has been distributed and the first draft is available. The component parts are: Co-ordinated research programmes (CRPs) on severe accident management and containment behaviour; the use of vulnerability analysis; mitigation of the effects of hydrogen, and generic symptom oriented emergency operating procedures. The IAEA provides guidance by the dissemination of information on methods for accident management; collates information on approaches in this field in different organizations and countries; and arranges exchange of experience and the promulgation of knowledge through the training of NPP managers and senior technical staff. (orig.)
Supervisor's accident investigation handbook
International Nuclear Information System (INIS)
1980-02-01
This pamphlet was prepared by the Environmental Health and Safety Department (EH and S) of Lawrence Berkeley Laboratory (LBL) to provide LBL supervisors with a handy reference to LBL's accident investigation program. The publication supplements the Accident and Emergencies section of LBL's Regulations and Procedures Manual, Pub. 201. The present guide discusses only accidents that are to be investigated by the supervisor. These accidents are classified as Type C by the Department of Energy (DOE) and include most occupational injuries and illnesses, government motor-vehicle accidents, and property damages of less than $50,000
Education scholarship in emergency medicine part 1: innovating and improving teaching and learning.
Sherbino, Jonathan; Van Melle, Elaine; Bandiera, Glen; McEwen, Jill; Leblanc, Constance; Bhanji, Farhan; Frank, Jason R; Regehr, Glenn; Snell, Linda
2014-05-01
As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Canadian Association for Medical Education's definition, education scholarship (including both research and innovation) is defined. A rationale for why education scholarship should be a priority for EM is discussed.
Emergency planning and preparedness of the Dalat Nuclear Research Institute
International Nuclear Information System (INIS)
Luong, B.V.
2001-01-01
The effectiveness of measures taken in case of accident or emergency to protect the site personnel, the general public and the environment will depend heavily on the adequacy of the emergency plan prepared in advance. For this reason, an emergency plan of the operating organization shall cover all activities planned to be carried out in the event of an emergency, allow for determining the level of the emergency and corresponding level of response according to the severity of the accident condition, and be based on the accidents analysed in the SAR as well as those additionally postulated for emergency planning purposes. The purpose of this paper is to present the practice of the emergency planning and preparedness in the Dalat Nuclear Research Institute (DNRI) for responding to accidents/incidents that may occur at the DNRI. The DNRI emergency plan and emergency procedures developed by the DNRI will be discussed. The information in the DNRI emergency plan such as the emergency organization, classification and identification of emergencies; intervention measures; the co-ordination with off-site organizations; and emergency training and drills will be described in detail. The emergency procedures in the form of documents and instructions for responding to accidents/incidents such as accidents in the reactor, accidents out of the reactor but with significant radioactive contamination, and fire and explosion accidents will be mentioned briefly. As analysed in the Safety Analysis Report for the DNRI, only the in-site actions are presented in the paper and no off-site emergency measures are required. (author)
Radiological accidents: education for prevention and confrontation
International Nuclear Information System (INIS)
Cardenas Herrera, Juan; Fernandez Gomez, Isis Maria
2008-01-01
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 [es
Sarin, Ritu R; Cattamanchi, Srihari; Alqahtani, Abdulrahman; Aljohani, Majed; Keim, Mark; Ciottone, Gregory R
2017-08-01
The increase in natural and man-made disasters occurring worldwide places Emergency Medicine (EM) physicians at the forefront of responding to these crises. Despite the growing interest in Disaster Medicine, it is unclear if resident training has been able to include these educational goals. Hypothesis This study surveys EM residencies in the United States to assess the level of education in Disaster Medicine, to identify competencies least and most addressed, and to highlight effective educational models already in place. The authors distributed an online survey of multiple-choice and free-response questions to EM residency Program Directors in the United States between February 7 and September 24, 2014. Questions assessed residency background and details on specific Disaster Medicine competencies addressed during training. Out of 183 programs, 75 (41%) responded to the survey and completed all required questions. Almost all programs reported having some level of Disaster Medicine training in their residency. The most common Disaster Medicine educational competencies taught were patient triage and decontamination. The least commonly taught competencies were volunteer management, working with response teams, and special needs populations. The most commonly identified methods to teach Disaster Medicine were drills and lectures/seminars. There are a variety of educational tools used to teach Disaster Medicine in EM residencies today, with a larger focus on the use of lectures and hospital drills. There is no indication of a uniform educational approach across all residencies. The results of this survey demonstrate an opportunity for the creation of a standardized model for resident education in Disaster Medicine. Sarin RR , Cattamanchi S , Alqahtani A , Aljohani M , Keim M , Ciottone GR . Disaster education: a survey study to analyze disaster medicine training in emergency medicine residency programs in the United States. Prehosp Disaster Med. 2017;32(4):368-373.
Energy Technology Data Exchange (ETDEWEB)
NONE
2000-07-01
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.
The current status and reinforcement plan for radiation emergency medicine in Korea
International Nuclear Information System (INIS)
Kim, Hyun Ki; Lee, Youngmin; Lee, Jai Ki
2011-01-01
Korea operating twenty nuclear power plants was ranked 6th in nuclear power generation in the world. The potential risk for radiological emergency also increases along with the growing use of radiation and radioisotopes and a constant expansion of the nuclear industry in neighboring countries, Japan and China. This paper is intended for finding ways to strengthen medical planning and response preparedness from achievements in radiation emergency medicine over the years. 'Integrated Medical Preparedness System' for a radiological disaster is proposed as a practical way to enhance mobilization of existing human and material resources in the health care. It is based on the collaborative response among the related medical institutes : radiation emergency medical institutes around the Korean Institute of Radiological and Medical Sciences, emergency medical centers around the National Emergency Medical Center and other hospitals available. (author)
Handling of emergency situations: organization and plans
International Nuclear Information System (INIS)
Swindell, G.E.
1975-01-01
Sources of exposure and foreseeable types of accidents; responsibilities for the prevention and control of accidents; organization for controlling emergency situations; emergency control plans. (HP) [de
Mohr, Nicholas M.; Moreno-Walton, Lisa; Mills, Angela M.; Brunett, Patrick H.; Promes, Susan B.
2010-01-01
For the first time in history, four generations are working together – Traditionalists, Baby Boomers, Generation Xers, and Millennials. Members of each generation carry with them a unique perspective of the world and interact differently with those around them. Through a review of the literature and consensus by modified Delphi methodology of the Society for Academic Emergency Medicine (SAEM) Aging and Generational Issues Task Force, the authors have developed this two-part series to address generational issues present in academic emergency medicine (EM). Understanding generational characteristics and mitigating strategies can help address some common issues encountered in academic EM. Through recognition of the unique characteristics of each of the generations with respect to teaching and learning, mentoring, and technology, academicians have the opportunity to strategically optimize interactions with one another. PMID:21314779
International Nuclear Information System (INIS)
Kim, Juyub; Kim, Juyoul; Kim, Sukhoon; Lee, Seunghee; Yoon, Taebin; Cliff, Li-Chi
2015-01-01
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
Dose calculations for severe LWR accident scenarios
International Nuclear Information System (INIS)
Margulies, T.S.; Martin, J.A. Jr.
1984-05-01
This report presents a set of precalculated doses based on a set of postulated accident releases and intended for use in emergency planning and emergency response. Doses were calculated for the PWR (Pressurized Water Reactor) accident categories of the Reactor Safety Study (WASH-1400) using the CRAC (Calculations of Reactor Accident Consequences) code. Whole body and thyroid doses are presented for a selected set of weather cases. For each weather case these calculations were performed for various times and distances including three different dose pathways - cloud (plume) shine, ground shine and inhalation. During an emergency this information can be useful since it is immediately available for projecting offsite radiological doses based on reactor accident sequence information in the absence of plant measurements of emission rates (source terms). It can be used for emergency drill scenario development as well
Directory of Open Access Journals (Sweden)
Andrew King
2017-09-01
Full Text Available Audience: This curriculum created and implemented at The Ohio State University Wexner Medical Center was designed to educate our emergency medicine (EM residents, PGY-1 to PGY-3, as well as medical students and attending physicians. Introduction: Head, Eyes, Ears, Nose and Throat (HEENT complaints are very commonly seen in the Emergency Department. Numbers vary as to exact prevalence, but sources show that there are about 2 million annual emergency department (ED visits in the United States for non-traumatic dental problems, representing 1.5% of all ED visits.1 Other sources show that symptoms referable to the throat encompass 2,496,000 visits or 1.9% of total visits.2 Notably, about 8% of the written exam in emergency medicine covers the topic of head and neck complaints, making it the second most tested topic behind cardiovascular.3 Residents must be proficient in the differential diagnosis and management of the wide variety of HEENT emergencies. The flipped classroom curricular model emphasizes self-directed learning activities completed by learners, followed by small group discussions pertaining to the topic reviewed. The active learning fostered by this curriculum increases faculty and learner engagement and interaction time typically absent in traditional lecture-based formats.4-6 Studies have revealed that the application of knowledge through case studies, personal interaction with content experts, and integrated questions are effective learning strategies for emergency medicine residents.6-8 The Ohio State University EM Residency didactic curriculum recently transitioned to a “flipped classroom” approach.9-13 We created this innovative curriculum aimed to improve our residency education program and to share educational resources with other EM residency programs. Our curriculum utilizes an 18-month curricular cycle to cover the defined emergency medicine content. The flipped classroom curriculum maximizes didactic time and resident
Regulation Plans on Severe Accidents developed by KINS Severe Accident Regulation Preparation TFT
Energy Technology Data Exchange (ETDEWEB)
Kim, Kyun Tae; Chung, Ku Young; Na, Han Bee [KINS, Daejeon (Korea, Republic of)
2016-05-15
Some nuclear power plants in Fukushima Daiichi site had lost their emergency reactor cooling function for long-time so the fuels inside the reactors were molten, and the integrity of containment was damaged. Therefore, large amount of radioactive material was released to environment. Because the social and economic effects of severe accidents are enormous, Korean Government already issued 'Severe Accident Policy' in 2001 which requires nuclear power plant operators to set up 'Quantitative Safety Goal', to do 'Probabilistic Safety Analysis', to install 'Severe Accident Countermeasures' and to make 'Severe Accident Management Plan'. After the Fukushima disaster, a Special Safety Inspection was performed for all operating nuclear power plants of Korea. The inspection team from industry, academia, and research institutes assessed Korean NPPs capabilities to cope with or respond to severe accidents and emergency situation caused by natural disasters such as a large earthquake or tsunami. As a result of the special inspection, about 50 action items were identified to increase the capability to cope with natural disaster and severe accidents. Nuclear Safety Act has been amended to require NPP operators to submit Accident Management Plant as part of operating license application. The KINS Severe Accident Regulation Preparation TFT had first investigated oversea severe accident regulation trend before and after the Fukushima accident. Then, the TFT has developed regulation draft for severe accidents such as Severe accident Management Plans, the required design features for new NPPs to prevent severe accident against multiple failures and beyond-design external events, countermeasures to mitigate severe accident and to keep the integrity of containment, and assessment methodology on safety assessment plan and probabilistic safety assessment.
Overview of Fukushima accident and regulatory issues for FCFS after the accident
International Nuclear Information System (INIS)
Ueda, Y.
2013-01-01
In the first part of his presentation Yoshinori Ueda (JNES, Japan) gave an overview of the Fukushima accident and an outline of the emergency safety measures and response at the NPP site. The second part was focused on the regulatory issues for FCFs after the accident. The first issue was the emergency safety measures in case of total loss of AC power (loss capabilities of decay heat removal and hydrogen accumulation prevention) and tsunami in the reprocessing facilities and associated spent fuel storages at Tokai and Rokkasho plants. The second issue was the directions to the licensees of these facilities to secure the work environment in the main control rooms in case of complete loss of AC power, to secure communication within the facility in case of such emergency, and to secure material and equipment for radiation protection, and to deploy heavy tools for rubble removal. No paper has been made available for this presentation
Accident management insights after the Fukushima Daiichi NPP accident
International Nuclear Information System (INIS)
Degueldre, Didier; Viktorov, Alexandre; Tuomainen, Minna; Ducamp, Francois; Chevalier, Sophie; Guigueno, Yves; Tasset, Daniel; Heinrich, Marcus; Schneider, Matthias; Funahashi, Toshihiro; Hotta, Akitoshi; Kajimoto, Mitsuhiro; Chung, Dae-Wook; Kuriene, Laima; Kozlova, Nadezhda; Zivko, Tomi; Aleza, Santiago; Jones, John; McHale, Jack; Nieh, Ho; Pascal, Ghislain; ); Nakoski, John; Neretin, Victor; Nezuka, Takayoshi; )
2014-01-01
The Fukushima Daiichi nuclear power plant (NPP) accident, that took place on 11 March 2011, initiated a significant number of activities at the national and international levels to reassess the safety of existing NPPs, evaluate the sufficiency of technical means and administrative measures available for emergency response, and develop recommendations for increasing the robustness of NPPs to withstand extreme external events and beyond design basis accidents. The OECD Nuclear Energy Agency (NEA) is working closely with its member and partner countries to examine the causes of the accident and to identify lessons learnt with a view to the appropriate follow-up actions to be taken by the nuclear safety community. Accident management is a priority area of work for the NEA to address lessons being learnt from the accident at the Fukushima Daiichi NPP following the recommendations of Committee on Nuclear Regulatory Activities (CNRA), Committee on the Safety of Nuclear Installations (CSNI), and Committee on Radiation Protection and Public Health (CRPPH). Considering the importance of these issues, the CNRA authorised the formation of a task group on accident management (TGAM) in June 2012 to review the regulatory framework for accident management following the Fukushima Daiichi NPP accident. The task group was requested to assess the NEA member countries needs and challenges in light of the accident from a regulatory point of view. The general objectives of the TGAM review were to consider: - enhancements of on-site accident management procedures and guidelines based on lessons learnt from the Fukushima Daiichi NPP accident; - decision-making and guiding principles in emergency situations; - guidance for instrumentation, equipment and supplies for addressing long-term aspects of accident management; - guidance and implementation when taking extreme measures for accident management. The report is built on the existing bases for capabilities to respond to design basis
Updated tool for nuclear criticality accident emergency response
International Nuclear Information System (INIS)
Broadhead, B.L.; Hopper, C.M.
1995-01-01
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/ 235 U ratio of 500, (c) an unreflected sphere of damp 93.2 wt% enriched uranium oxide with a H/ 235 U ratio of 10, (d) an unreflected sphere of 4.95 wt% enriched uranyl fluoride solution having a H/ 235 U ratio of 410, and (e) an unreflected sphere of damp 5 wt% enriched uranium dioxide having a H/ 235 U ratio of 200
Amini, Afshin; Dindoost, Payam; Moghimi, Mehrdad; Kariman, Hamid; Shahrami, Ali; Dolatabadi, Ali Arhami; Ali-Mohammadi, Hossein; Alavai-Moghaddam, Mostafa; Derakhshanfar, Hojjat; Hatamabadi, HamidReza; Heidari, Kamran; Alamdari, Shahram; Meibodi, Mohammad Kalantar; Shojaee, Majid; Foroozanfar, Mohammad Mehdi; Hashemi, Behrooz; Sabzeghaba, Anita; Kabir, Ali
2012-02-01
To assess the deficiencies and potential areas through a medical audit of the emergency departments, in six general hospitals affiliated to Shahid Beheshti University of Medical Sciences at Tehran, Iran, after preparing specific wards-based international standards. A checklist was completed for all hospitals which met our eligibility criteria mainly observation and interviews with head nurses and managers of the emergency medicine unit of the hospitals before (2003) and after (2008) the establishment of emergency departments there. Domains studied included staffing, education and continuing professional development (CPD), facility (design), equipment, ancillary services, medical records, manuals and references, research, administration, pre-hospital care, information systems, disaster planning, bench-marking and hospital accreditation. Education and CPD (p = 0.042), design and facility (p = 0.027), equipment (p = 0.028), and disaster (p = 0.026) had significantly improved after the establishment of emergency departments. Nearly all domains showed a positive change though it was non-significant in a few. In terms of observation, better improvement was seen in disaster, security, design, and research. According to the score for each domain compared to what it was in the earlier phase, better improvement was observed in hospital accreditation, information systems, security, disaster planning, and research. Security, disaster planning, research, design and facility had improved in hospitals that wave studied, while equipment, records, ancillary services, administration and bench-marking had the lowest improvement even after the establishment of emergency department, and, hence, needed specific attention.
The role of emergency physicians in the institutionalization of emergency medicine.
van Schothorst, Jannine; van den Brand, Crispijn L; Gaakeer, Menno I; Wallenburg, Iris
2017-08-01
Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. A cross-case ethnographic study was conducted, comprising observations, document analysis, and in-depth interviews in three emergency departments in the Netherlands. Drawing on the theoretical concept of institutional work, we show that managers, already established medical specialties, and EPs all conduct institutional work to enhance private interests, which both restricts and enlarges EPs' work domain. These actions are strategic and intentional, as well as unintentional and part of EPs' everyday work in acute care delivery. It is in this very process that tasks and responsibilities are redistributed and the role of the EP is shaped. In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.
Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C
2015-05-01
The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. © 2015 by the Society for Academic Emergency Medicine.
International Nuclear Information System (INIS)
Jeong, Hyo Joon; Hwang, Won Tae; Kim, Eun Han; Han, Moon Hee
2010-01-01
Toxic materials in an urban area can be caused by a variety of events, such as accidental releases on industrial complexes, accidents during the transportation of hazardous materials and intentional explosions. Most governments around the world and their citizens have become increasingly worried about intentional accidents in urban area after the 911 terrorist attack in the United States of America. Even though there have been only a few attempted uses of Radiological Dispersal Devices (RDDs), accidental releases have occurred many times at commercial nuclear power plants and nuclear waste disposal sites. When an intentional release of radioactive materials occurs in an urban area, air quality for radioactive materials in the environment is of great importance to take action for countermeasures and environmental risk assessments. Atmospheric modeling is part of the decision making tasks and that it is particularly important for emergency managers as they often need to take actions quickly on very inadequate information(1). A simple model such as HOTSPOT required wind direction and source term would be enough to support the decision making in the early phase of an accident, but more sophisticated atmospheric modeling is required to adjust decontamination area and relocation etc after the early phase of an accidental event. In this study, we assume an explosion of 137 Cs using RDDs in the metropolitan area of Soul, South Korea. California Puff Model (CALPUFF) is used to calculate an atmospheric dispersion and transport for 137 Cs. Atmospheric dispersion and quantitative radiological risk analysis for 137 Cs were performed assuming an intentional explosion in the metropolitan area of Soul, South Korea after the early phase of emergency. These kinds of atmospheric modeling and risk analysis could provide a means for decision makers to take action on important issues such as the cleanup of the contaminated area and countermeasures to protect the public caused by
International Nuclear Information System (INIS)
Fenolland, J.L.; Laporte, E.
2003-01-01
After some disappointments when the first French nuclear units were started, it became clear that all the aspects linked to radio-protection needed to be taken into account in the context of emergency aid in the case of an industrial accident in radiological controlled area. In the case of an accident involving people, on-site first aid is provided by permanent services of the power plant. These teams are trained in first aid and fire-fighting. They are well trained in radioprotection. The specificity of an industrial event in controlled zone is that the victims' conventional injuries, whether it be a wound, a burn or a fracture, can be complicated by radioactive contamination. If it is justified, the exterior emergency services (firemen and medical teams) sire immediately called in. These teams are not necessarily trained in radioprotection. (authors)
Drug abuse-related accidents leading to emergency department visits at two medical centers.
Chen, Isaac Chun-Jen; Hung, Dong-Zong; Hsu, Chi-Ho; Wu, Ming-Ling; Deng, Jou-Fang; Chang, Chin-Yu; Shih, Hsin-Chin; Liu, Chen-Chi; Wang, Chien-Ying; Wen, Yi-Szu; Wu, Jackson Jer-Kan; Huang, Mu-Shun; Yang, Chen-Chang
2012-05-01
Drug abuse is becoming more prevalent in Taiwan, as evidenced by increasing reports of drug trafficking and drug abuse-related criminal activity, and the wide use of more contemporary illicit drugs. Consequently, drug abuse-related accidents are also expected to occur with greater frequency. However, no study has yet specifically evaluated the prevalence, pattern, and outcomes of drug abuse-related accidents among patients visiting emergency departments (EDs) in Taiwan. We conducted an ambidirectional study with patients who visited the EDs of Taipei Veterans General Hospital (TVGH) and China Medical University Hospital (CMUH) due to drug abuse-related accidents from January 2007 through September 2009. Information on the patients' baseline characteristics and clinical outcomes was collected and analyzed. During the study period, a total of 166 patients visited the EDs of one of the two study hospitals due to drug abuse-related accidents. This yielded a prevalence of drug abuse of 0.1% among all patients visiting the ED due to accident and/or trauma. Fifty-six out of the 166 patients visited the ED at TVGH, most patients being between 21 and 40 years old. Opioids (41.1%) were the drugs most commonly abused by the patients, followed by benzodiazepines (32.1%). More than two-thirds of the patients (n=38, 67.9%) required hospitalization, and three patients died (5.4%). In contrast, 110 patients with drug abuse-related accidents visited the ED at CMUH during the study period. Most of these subjects had abused benzodiazepines (69.1%), were between 21 and 40 years old, and were female. Fewer than one-fifth of the patients (n=19, 17.3%) required hospitalization, with no deaths reported. There were significant between-hospital differences in terms of patient gender, drugs of choice, injury mechanisms, method and time of the ED visit, triage levels, and need for hospitalization. Although the prevalence of drug abuse-related accidents was low, and only three patient deaths
Character and consequence of nuclear criticality accident
International Nuclear Information System (INIS)
Liu Xinhua; Liu Hua; Wu Deqiang; Li Bing
2001-01-01
The author describes some concepts, the process and magnitude of energy release and the destruction of the nuclear criticality accident and also describes the radiation consequence of criticality accidents from three aspects: prompt radiation, contamination in working place and release of fission products to the environment. It shows that the effects of radioactivity release from criticality accidents in the nuclear fuel processing plants on the environment and the public is minor, the main danger is from the external exposure of prompt rays. The paper make as have a correct understanding of the nuclear criticality accident and it would be helpful to take appropriate emergency response to potential criticality accident
Industrial Accidents Triggered by Natural Hazards: an Emerging Risk Issue
Renni, Elisabetta; Krausmann, Elisabeth; Basco, Anna; Salzano, Ernesto; Cozzani, Valerio
2010-05-01
Natural disasters such as earthquakes, tsunamis, flooding or hurricanes have recently and dramatically hit several countries worldwide. Both direct and indirect consequences involved the population, causing on the one hand a high number of fatalities and on the other hand so relevant economical losses that the national gross product may be affected for many years. Loss of critical industrial infrastructures (electricity generation and distribution, gas pipelines, oil refineries, etc.) also occurred, causing further indirect damage to the population. In several cases, accident scenarios with large releases of hazardous materials were triggered by these natural events, causing so-called "Natech events", in which the overall damage resulted from the simultaneous consequences of the natural event and of the release of hazardous substances. Toxic releases, large fires and explosions, as well as possible long-term environmental pollution, economical losses, and overloading of emergency systems were recognised by post-event studies as the main issues of these Natech scenarios. In recent years the increasing frequency and severity of some natural hazards due to climate change has slowly increased the awareness of Natech risk as an emerging risk among the stakeholders. Indeed, the iNTeg-Risk project, co-funded by the European Commission within the 7th Framework Program specifically addresses these scenarios among new technological issues on public safety. The present study, in part carried out within the iNTeg-Risk project, was aimed at the analysis and further development of methods and tools for the assessment and mitigation of Natech accidents. Available tools and knowledge gaps in the assessment of Natech scenarios were highlighted. The analysis mainly addressed the potential impact of flood, lightning and earthquake events on industrial installations where hazardous substances are present. Preliminary screening methodologies and more detailed methods based on
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
Role of the RDO in a transportation accident
International Nuclear Information System (INIS)
Goldberg, I.
1974-01-01
The role of the RDO in a radioactive materials transport accident in California is discussed. The California Radiological Emergency Assistance Plan (CREAP) and the Emergency Procedures for Transportation Accidents (EPTA) are mentioned
The national radiological emergency preparedness and response plan in the Philippines
International Nuclear Information System (INIS)
Valdezco, Eulinia Mendoza
2007-01-01
The use of radiation sources of various types and activities is now widespread in the fields of industry, medicine, research and education in the Philippines. These radiation sources have been under the regulatory control of the Philippine Nuclear Research Institute (PNRI) to ensure that these materials are used in a safe manner and stored in a safe and secure location, and that those which have exceeded their useful life are appropriately disposed of. And while the safety record of the nuclear industry remains admirable compared to other industries, the occurrence of an accident affecting members of the public is always a possibility but with very low probability. In 2001, the National Disaster Coordinating Council (NDCC) approved the revised National Radiological Emergency Preparedness and Response Plan (RADPLAN). This plan outlines the activities and organizations necessary to mitigate the effects of nuclear emergencies or radiation related accidents. An important component of this plan is the education of the public as well as the emergency responders such as the police authorities fire emergency personnel, medical responders, community leaders and the general public. The threat of nuclear terrorism as an aftermath of the September 11 incident in the United States has also been considered in the latest revision of this document. (author)
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.
Kool, Rudolf B; Homberg, Daniel J; Kamphuis, Helen C M
2008-11-04
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. 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. 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. 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.
A Formalized Three-Year Emergency Medicine Residency Ultrasound Education Curriculum
Directory of Open Access Journals (Sweden)
Andrew King
2016-09-01
Full Text Available Audience and type of curriculum: The Ohio State University Wexner Medical Center Emergency Medicine Residency Program Ultrasound Education Curriculum is a three-year curriculum for PGY-1 to PGY-3 learners. Introduction/Background: Each year of the three-year The Ohio State University Wexner Medical Center Emergency Medicine Ultrasound Curriculum focuses on different aspects of emergency ultrasonography, thereby promoting progressive understanding and utilization of point-of-care ultrasound in medical decision-making during residency training. Ultrasound is an invaluable bedside tool for emergency physicians; this skill must be mastered by resident learners during residency training, and ultrasound competency is a required ACGME milestone.1 The American College of Emergency Physicians (ACEP currently recommends that 11 applications of emergency ultrasound be part of the core skills of an emergency physician.2 This curriculum acknowledges the standards developed by ACEP and the ACGME. Objectives: Learners will 1 know the indications for each the 11 ACEP point-of-care ultrasound (POCUS applications; 2 perform each of the 11 ACEP POCUS applications; 3 integrate POCUS into medical decision-making. Methods: The educational strategies used in this curriculum include: independent, self-directed learning (textbook and literature reading, brief didactic sessions describing indications and technique for each examination, hands-on ultrasound scanning under the direct supervision of ultrasound faculty with real-time feedback, and quality assurance review of ultrasound images. Residents are expected to perform a minimum of 150 ultrasound examinations with associated quality assurance during the course of their residency training. The time requirements, reading material, and ultrasound techniques taught vary depending on the year of training. Length of curriculum: The entirety of the curriculum is three years; however, each year of residency training has
International Nuclear Information System (INIS)
Ananiev, V.V.; Ermakov, S.V.; Ershov, V.N.; Stovbur, V.I.; Shvedov, M.O.
2004-01-01
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
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.
Systematic Molecular Phenotyping: A Path Towards Precision Emergency Medicine?
Limkakeng, Alexander T.; Monte, Andrew; Kabrhel, Christopher; Puskarich, Michael; Heitsch, Laura; Tsalik, Ephraim L.; Shapiro, Nathan I.
2016-01-01
Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department. While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the emergency department will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end users. PMID:27288269
Energy Technology Data Exchange (ETDEWEB)
Sadeghi, Nahid; Ahangari, Rohollah; Kasesaz, Yaser; Noori-kalkhoran, O. [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of). Reactor Research School
2017-11-15
In the case of Fukushima Daiichi nuclear power plant (FNP) accident, the radioactive material was released from reactor units 1-3 and transported to short and long distances due to the atmospheric pathways-motions. Power sources for monitoring posts were lost due to earthquake and tsunami. Based on air dose rates and other data measured by monitoring cars, the amount of radioactive material released to the atmosphere from the power station was obtained. The atmospheric dispersion and the transport model used in the RASCAL code, estimate the radionuclide concentrations downwind, both in the air and on the ground due to deposition. The calculated concentrations are then used to estimate the projected doses for workers in vicinity of the accident area in the first minutes of accident time. For dose modeling, we assumed that each worker was 15 min in vicinity of FNP in accident situation, once without and once with protective clothes or respirator. According to Tokyo Electric Power Company (TEPCO) report six workers had received doses over 250 mSv (309 to 678 mSv) apparently due to inhaling Iodine-131 fume. In this paper the calculated dose results using RASCAL code shows that, if emergency workers who work in early phase of accident had not used protective equipment, for 15 min, inhalation doses from iodine in their thyroid gland up to 12 March afternoon would have been 520 mSv. A comparison between calculation results and TEPCO report shows that dose calculated virtually is nearly equal to TEPCO measurement results.
Nanotechnology in reproductive medicine: emerging applications of nanomaterials.
Barkalina, Natalia; Charalambous, Charis; Jones, Celine; Coward, Kevin
2014-07-01
In the last decade, nanotechnology has been extensively introduced for biomedical applications, including bio-detection, drug delivery and diagnostic imaging, particularly in the field of cancer diagnostics and treatment. However, there is a growing trend towards the expansion of nanobiotechnological tools in a number of non-cancer applications. In this review, we discuss the emerging uses of nanotechnology in reproductive medicine and reproductive biology. For the first time, we summarise the available evidence regarding the use of nanomaterials as experimental tools for the detection and treatment of malignant and benign reproductive conditions. We also present an overview of potential applications for nanomaterials in reproductive biology, discuss the benefits and concerns associated with their use in a highly delicate system of reproductive tissues and gametes, and address the feasibility of this innovative and potentially controversial approach in the clinical setting and for investigative research into the mechanisms underlying reproductive diseases. This unique review paper focuses on the emerging use of nanotechnology in reproductive medicine and reproductive biology, highlighting the role of nanomaterials in the detection and treatment of various reproductive conditions, keeping in mind the benefits and potential concerns associated with nanomaterial use in the delicate system of reproductive tissue and gametes. Copyright © 2014 Elsevier Inc. All rights reserved.
Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians.
Madsen, Tracy E; Linden, Judith A; Rounds, Kirsten; Hsieh, Yu-Hsiang; Lopez, Bernard L; Boatright, Dowin; Garg, Nidhi; Heron, Sheryl L; Jameson, Amy; Kass, Dara; Lall, Michelle D; Melendez, Ashley M; Scheulen, James J; Sethuraman, Kinjal N; Westafer, Lauren M; Safdar, Basmah
2017-10-01
A 2010 survey identified disparities in salaries by gender and underrepresented minorities (URM). With an increase in the emergency medicine (EM) workforce since, we aimed to 1) describe the current status of academic EM workforce by gender, race, and rank and 2) evaluate if disparities still exist in salary or rank by gender. Information on demographics, rank, clinical commitment, and base and total annual salary for full-time faculty members in U.S. academic emergency departments were collected in 2015 via the Academy of Administrators in Academic Emergency Medicine (AAAEM) Salary Survey. Multiple linear regression was used to compare salary by gender while controlling for confounders. Response rate was 47% (47/101), yielding data on 1,371 full-time faculty: 33% women, 78% white, 4% black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown race. Comparing white race to nonwhite, 62% versus 69% were instructor/assistant, 23% versus 20% were associate, and 15% versus 10% were full professors. Comparing women to men, 74% versus 59% were instructor/assistant, 19% versus 24% were associate, and 7% versus 17% were full professors. Of 113 chair/vice-chair positions, only 15% were women, and 18% were nonwhite. Women were more often fellowship trained (37% vs. 31%), less often core faculty (59% vs. 64%), with fewer administrative roles (47% vs. 57%; all p disparities in salary and rank persist among full-time U.S. academic EM faculty. There were gender and URM disparities in rank and leadership positions. Women earned less than men regardless of rank, clinical hours, or training. Future efforts should focus on evaluating salary data by race and developing systemwide practices to eliminate disparities. © 2017 by the Society for Academic Emergency Medicine.
EM Talk: communication skills training for emergency medicine patients with serious illness.
Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert
2016-06-01
The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Hekimoglu, Yavuz; Dursun, Recep; Karadas, Sevdegul; Asirdizer, Mahmut
2015-10-01
The purpose of this study is to identify the impacts of major disasters, on the basis of the Van earthquake (October 23, 2011, Turkey), on the profile of the injuries due to occupational accidents. In this study, we evaluated 245 patients of occupational accidents who were admitted to emergency services of Van city hospitals in the 1-year periods including pre-earthquake and post-earthquake. We determined that there was a 63.4% (P accidents in the post-earthquake period compared to the pre-earthquake period. Also, injuries due to occupational accidents increased 211% (P accidents. In this study, the impact of disasters such as earthquakes on the accidents at work was evaluated as we have not seen in literature. This study emphasizes that governments should make regulations and process relating to the post-disaster business before the emergence of disaster by taking into account factors that may increase their work-related accidents. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Preventing radiological accidents and emergencies by legislative and regulatory means
International Nuclear Information System (INIS)
Pelzer, N.
1998-01-01
The Goiania radiation accident triggered a reassessment of radiation safety systems. From a legal point of view, the course of events indicates that there were deficiencies either in the existing legal framework or in the implementation of that framework. Proposals to avoid similar accidents in the future are discussed, stressing the need for a sound legal regime and a close co-operation between state authorities and users of radioactive sources. In particular, the importance is underscored of the human factor in achieving a high level of radiation safety. (author)
International Nuclear Information System (INIS)
Lochand, J.
1995-01-01
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)
Sims, Matthew T; Henning, Nolan M; Wayant, C Cole; Vassar, Matt
2016-11-24
The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross-tabulations and descriptive statistics were calculated using IBM SPSS 22. Of the 27 emergency medicine journals, 11 (11/27, 40.7%) did not mention a single guideline within their "Instructions for Authors," while the remaining 16 (16/27, 59.3%) mentioned one or more guidelines. The QUOROM statement and SRQR were not mentioned by any journals whereas the ICMJE guidelines (18/27, 66.7%) and CONSORT statement (15/27, 55.6%) were mentioned most often. Of the 27 emergency medicine journals, 15 (15/27, 55.6%) did not mention trial or review registration, while the remaining 12 (12/27, 44.4%) at least mentioned one of the two. Trial registration through ClinicalTrials.gov was mentioned by seven (7/27, 25.9%) journals while the WHO registry was mentioned by four (4/27, 14.8%). Twelve (12/27, 44.4%) journals mentioned trial registration through any registry platform. The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of
International Nuclear Information System (INIS)
2000-01-01
The Nuclear Safety Commission was received a decision on thorough investigations of accident reason on criticality accident at the Tokai-mura uranium processing factory of the JCO Incorporation occurred on September 30, 1999, to establish the Committee of Uranium Processing Factory Criticality Accident Survey to elucidate its reason thoroughly and contribute to set up a sufficient reforming prevention countermeasure. This Committee judged that it was important to propose a countermeasure directly obtainable by grasping some fact relations clarified before now as soon as possible and intended to conduct this meantime report of 'emergent proposal' by arrangement of such fact relations. Here were described on accidental conditions and their effects, response to the accident (on prevention of the accident), its reasons and their relating conditions, and some emergent proposals. In the last items, safety security at accidental site, health countermeasures to residents and others, establishment of safety security for nuclear business workers and others, and reconstruction on safety regulation in national government. (G.K.)
International Nuclear Information System (INIS)
Son, Kwang Seop; Kim, Chang Hwoi; Kang, Hyun Gook
2015-01-01
Highlights: • The emergency communication system requires the performances of the throughput of 1 Mbps, BER of 10 −6 and network configuration of 1:12 communication. • The emergency communication system consists of the terrestrial communication and satellite communication system. • In the terrestrial communication system, at least two wireless repeaters are needed to secure LOS and the throughput and delay time are 16 Mbps and 16 ms, respectively. • In the satellite communication system, DSSS and FDMA are used and the fade margin range is from 1.3 to 16 dB. - Abstract: The Fukushima accident induced by the great earthquake and tsunami reveals the vulnerability of I and C System. In the severe environment, the normal I and C system did not work properly and results in false information about the internal situation in NPP. Eventually the accident was not properly handled at the early stage. Therefore advanced emergency response system using a wireless channel is necessary to cope with the severe accident. In this paper, we introduce the ERS consisting of the HMS and MCS the ECS linking the HMS with MCS and the performance requirement of the ECS is analyzed. The ECS satisfying the requirement is designed conceptually and the performance of the ECS is evaluated through analysis and simulator. To secure a reliable and diverse configuration, the ECS is configured as the dual system which consists of the terrestrial communication and satellite communication. The terrestrial communication system is designed based on the IEEE 802.11. Analyzed performance results prove that the performance requirement can be sufficiently achieved. But if the scalability of data capacity is considered later, use of the advanced 802.11 standard such as 802.11n and multiple signal paths between the HMS and MCS are necessary. In the satellite communication system, the FDMA is used in the status link and the DSSS is used in the control link. The network supporting various data rates is
International Nuclear Information System (INIS)
Claudino, Gutemberg L. Sales; Vieira, Jose Wilson; Leal Neto, Viriato; Lima, Fernando R. Andrade
2013-01-01
Objective of this work is to develop an algorithm simulator for dosimetric evaluation of accidents that may happen in Nuclear Medicine using PDF NT (Probability Density Functions). A software was developed using C# and WPF technology, in the integrated environment of Microsoft Visual Studio to organize and present the dosimetric results
Belon, Ana Paula; da Silveira, Naoko Yanagizawa Jardim; Barros, Marilisa Berti de Azevedo; Baldo, Caroline; da Silva, Marta Maria Alves
2012-09-01
The scope of this study is to analyze the differences in the profile of emergency care for external causes between public and private emergency departments. With data come from VIVA-Campinas 2009, the association between the nature of healthcare and the characteristics of the victims was verified using the chi-square test. Using Poisson regression, proportion ratios of care in the public and private network were estimated. In the sample of 1094 victims, 67.8% were treated by public health. Traffic accidents, animal-related accidents, and assaults were 2 times higher in public units, whereas collisions with objects and sprains were 75% and 2.7 times higher in private units. Cranium-encephalic trauma/polytrauma and cuts/lacerations were 3.8 times and 61% more frequent in public care, while victims with no injuries, with dislocations/sprains or fractures being predominant in private care. Head and multiple organ injuries, road accident and work-related injuries, the use of public transport or mobile emergency care services/ambulances were predominant in public care. Revealing significant differences in care in public and private care can contribute to the organization of healthcare.
Duluc, Matthieu; Bardelay, Aurélie; Celik, Cihangir; Heinrichs, Dave; Hopper, Calvin; Jones, Richard; Kim, Soon; Miller, Thomas; Troisne, Marc; Wilson, Chris
2017-09-01
AWE (UK), IRSN (France), LLNL (USA) and ORNL (USA) began a long term collaboration effort in 2015 to update the nuclear criticality Slide Rule for the emergency response to a nuclear criticality accident. This document, published almost 20 years ago, gives order of magnitude estimates of key parameters, such as number of fissions and doses (neutron and gamma), useful for emergency response teams and public authorities. This paper will present, firstly the motivation and the long term objectives for this update, then the overview of the initial configurations for updated calculations and preliminary results obtained with modern 3D codes.
Directory of Open Access Journals (Sweden)
Duluc Matthieu
2017-01-01
Full Text Available AWE (UK, IRSN (France, LLNL (USA and ORNL (USA began a long term collaboration effort in 2015 to update the nuclear criticality Slide Rule for the emergency response to a nuclear criticality accident. This document, published almost 20 years ago, gives order of magnitude estimates of key parameters, such as number of fissions and doses (neutron and gamma, useful for emergency response teams and public authorities. This paper will present, firstly the motivation and the long term objectives for this update, then the overview of the initial configurations for updated calculations and preliminary results obtained with modern 3D codes.
Luz, Tatiana Chama Borges; Malta, Deborah Carvalho; Sá, Naíza Nayla Bandeira de; Silva, Marta Maria Alves da; Lima-Costa, Maria Fernanda
2011-11-01
Data from the Brazilian Surveillance System for Violence and Accidents (VIVA) in 2009 were used to examine socio-demographic characteristics, outcomes, and types of accidents and violence treated at 74 sentinel emergency services in 23 Brazilian State capitals and the Federal District. The analysis included 25,201 individuals aged > 20 years (10.1% > 60 years); 89.3% were victims of accidents and 11.9% victims of violence. Hospitalization was the outcome in 11.1% of cases. Compared to the general population, there were more men and non-white individuals among victims of accidents, and especially among victims of violence. As compared to younger adults (20-59 years), accidents and violence against elderly victims showed less association with alcohol, a higher proportion of domestic incidents, more falls and pedestrian accidents, and aggression by family members. Policies for the prevention of accidents and violence should consider the characteristics of these events in the older population.
"Futile Care"-An Emergency Medicine Approach: Ethical and Legal Considerations.
Simon, Jeremy R; Kraus, Chadd; Rosenberg, Mark; Wang, David H; Clayborne, Elizabeth P; Derse, Arthur R
2017-11-01
Futility often serves as a proposed reason for withholding or withdrawing medical treatment, even in the face of patient and family requests. Although there is substantial literature describing the meaning and use of futility, little of it is specific to emergency medicine. Furthermore, the literature does not provide a widely accepted definition of futility, and thus is difficult if not impossible to apply. Some argue that even a clear concept of futility would be inappropriate to use. This article will review the origins of and meanings suggested for futility, specific challenges such cases create in the emergency department (ED), and the relevant legal background. It will then propose an approach to cases of perceived futility that is applicable in the ED and does not rely on unilateral decisions to withhold treatment, but rather on avoiding and resolving the conflicts that lead to physicians' believing that patients are asking them to provide "futile" care. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Taylor, David McD; Cohen, Donna R; Epstein, Joseph; Freeman, Peter; Gosbell, Andrew D; Judkins, Simon; Mowatt, Elizabeth J M; O'Reilly, Gerard M; Vinen, John
2016-02-01
In recent years, the Australasian College for Emergency Medicine (ACEM) has increasingly focused on the need for high-quality research in emergency medicine (EM). One important initiative was the establishment of the ACEM Foundation, which among other responsibilities, is required to support clinical research through the provision of research funding and other measures. In February 2015, the Foundation held a Research Forum that was attended by the leading EM researchers from Australasia. The Forum aimed to determine how a productive research culture could be developed within the ACEM. Nine key objectives were determined including that research should be a core business of the ACEM and a core activity of the EM workforce, and that EM research should be sustainable and adequately supported. This report describes the background and conduct of the Forum, its recommendations and the way in which they could be implemented. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Saddichha, Sahoo; Saxena, Mukul Kumar
2010-01-01
Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921
International Nuclear Information System (INIS)
Fukutsu, Kumiko; Yamada, Yuji; Kurihara, Osamu; Akashi, Makoto; Momose, Takumaro; Miyabe, Kenjiro
2008-01-01
At nuclear emergency accident such as inhalation intake of alpha nuclide, an indispensable nasal swab method has not been used for the precise internal dose estimation. One of the reasons is uncertainty in its radiation measurement, so that precise measurement with alpha spectrometry was examined for filter samples simulating nasal swab. It was confirmed that the alpha spectrometry made possible the distinction between solution and particulate in addition to the nuclide identification. The alpha activity in swab sample was precisely evaluated only when the detection efficiency was determined considering the self-absorption with filter fibers. Another big problem of wiping efficiency in nasal swabbing is still remain, but this study certainly raised the usefulness of the nasal swab method for rapid response in emergency. (author)
Emergency planning and operating experience
International Nuclear Information System (INIS)
Halpern, O.; Breniere, J.
1984-01-01
The purpose of this paper is to derive lessons from operating experience for the planning of emergency measures. This operating experience has two facets: it is obtained not only from the various incidents and accidents which have occurred in countries with nuclear power programmes and from the resulting application of emergency plans but also from the different exercises and simulations carried out in France and in other countries. Experience generally confirms the main approaches selected for emergency plans. The lessons to be derived are of three types: first, it appears necessary to set forth precisely the responsibilities of each person involved in order to prevent a watering-down of decisions in the event of an accident; secondly, considerable improvements need to be made in the different communication networks to be used; and thirdly, small accidents with minor radiological consequences deserve as systematic and thorough an approach as large and more improbable accidents. (author)
Energy Technology Data Exchange (ETDEWEB)
Dubiau, Ph. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Clamart (France)
2007-07-15
In France, the organization of crisis situations and the management of radiological emergency situations are regularly tested through simulation exercises for a continuous improvement. Past severe accidents represent experience feedback resources of prime importance which have led to deep changes in crisis organizations. However, the management of the post-accident phase is still the object of considerations and reflections between the public authorities and the intervening parties. This document presents, first, the nuclear crisis exercises organized in France, then, the experience feedback of past accidents and exercises, and finally, the main aspects to consider for the post-accident management of such events: 1 - Crisis exercises: objectives, types (local, national and international exercises), principles and progress, limits; 2 - Experience feedback: real crises (major accidents, other recent accidental situations or incidents), crisis exercises (experience feedback organization, improvements); 3 - post-accident management: environmental contamination and people exposure, management of contaminated territories, management of populations (additional protection, living conditions, medical-psychological follow up), indemnification, organization during the post-accident phase; 4 - conclusion and perspectives. (J.S.)
Directory of Open Access Journals (Sweden)
Anita Sabzghabaei
2014-09-01
Full Text Available Introduction: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO on the training of emergency medicine residents (EMR is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR’s education. Methods: In this cross-sectional study, the effects of overcrowding on EMR’s education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs. The crowding level was calculated based on the national emergency department overcrowding scale (NEDOCS. The relationship between the two studied variables was evaluated using independent sample t-test and SPSS 21 statistical software. Results: 130 questionnaires were filled out during 61 shifts. 47 (77.05% shifts were overcrowded. The attend’s ability to teach was not affected by overcrowding in the resuscitation room (p=0.008. The similar results were seen regarding the attend’s training ability in the acute care unit. Conclusion: It seems that the emergency department overcrowding has no effect on the quality of education to the EMRs.
LENUS (Irish Health Repository)
Deasy, C
2012-02-03
A rapid response team was instigated in Cork to improve prehospital care and reduce unnecessary Emergency Department (ED) visits. This consisted of a Specialist Registrar (SpR) in Emergency Medicine and a Paramedic who attended all "999" calls in a designated rapid response vehicle on the allotted study days. Two hundred and sixty-three patients were seen on designated days between Jan 2004 and March 2006. Presentations seen included; road traffic accident (23%) collapse (12%), fall (10%) and seizure (8%). The majority of calls were to houses (36%). The most common medical intervention was intravenous cannulation (25%). Intravenous medications were administered in 21% of these patients--morphine sulphate was the most common drug given. It was possible to safely discharge 31% of patients on scene. In our experience skilled Emergency Medicine doctors attending at scene could provide advanced care and reduce ambulance transportation and patient attendance.
Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling
Energy Technology Data Exchange (ETDEWEB)
Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)
2015-05-15
The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined
The work of the South Manchester Accident Rescue Team (SMART).
Redmond, A D
1990-01-01
Skills acquired in the hospital do not necessarily translate to the scene of an accident. However, training in certain hospital specialties, particularly accident and emergency medicine, will expose doctors to dealing with very ill patients in a less rigidly structured environment. The operating theatre is a disciplined and controlled environment. Skill in anaesthesia, monitoring and operating, if tested only in these circumstances may be found to be gravely inadequate when exposed to the fluctuant and hostile environment at the site. Doctors who wish to do this sort of work or are designated to do it, must undergo regular and frequent training, especially if they are not trained in accident and emergency departments. This has long been recognised by the British Association for Immediate Care. In combination with the Royal College of Surgeons of Edinburgh they have now established a diploma in Immediate Medical Care. In urban areas the need for a doctor to attend at the scene of an accident is usually limited to entrapment. These occasions are likely to be infrequent and this can result in a lack of preparedness for such events. Interhospital transfer, primarily from peripheral hospitals to the specialist services of a teaching hospital, often involves critically ill and injured patients. The management of these cases by the mobile team provides regular, frequent exposure to working in a 'hostile' environment. Relationships with the rescue services are developed and staff become familiar with equipment and call-out procedures. The care of transported patients is improved. None of our patients have died in transit or within 6 h of arrival at base.(ABSTRACT TRUNCATED AT 250 WORDS)
International Nuclear Information System (INIS)
Suto, Yumiko
2016-01-01
Japan faced with the nuclear accident of the Fukushima Daiichi Nuclear Power Station (NPS) caused by the combined disaster of the Great East Japan Earthquake and the subsequent tsunamis on 11 March 2011. National Institute of Radiological Sciences received all nuclear workers who were engaged in emergency response tasks at the NPS and suspected of being overexposed to acute radiation. Biological dosimetry by dicentric chromosome assay was helpful for medical triage and management of the workers. When an unplanned radiation exposure occurs, biological dosimetry based on cytogenetic assays has been used to estimate the absorbed dose in the exposed individual to get useful information for the medical management of radiological casualties with suspected acute radiation syndrome (ARS). Nowadays, more cytogenetic assays to measure chromosomal aberrations, such as micronuclei in bi-nucleated cells, prematurely condensed chromosomes (PCCs) and inter-chromosomal exchanges detected by fluorescence in situ hybridization (FISH) techniques, are available. However, the dicentric chromosome assay (DCA) using peripheral blood lymphocytes is still considered to be the 'gold standard' of biological dosimetry for the radiation emergency medicine. Experimental protocols of DCA has been standardized and shared among laboratories all over the world. In fact, DCA was useful in previous radiation accidents, e.g. the Chernobyl accident in 1986, the Goiania accident in 1987, the JCO criticality accident in 1999 and the Tokyo electric power company (TEPCO) Fukushima Daiichi Nuclear Power Station (NPS) accident in 2011. The recent development of microscopic image analysis system with automatic metaphase finding and capturing functions was helpful for rapid detection of dicentric chromosomes to perform DCA for the Fukushima NPS restoration workers. (author)
International Nuclear Information System (INIS)
Onda, Yuichi; Kato, Hiroaki; Hoshi, Masaharu; Takahashi, Yoshio; Nguyen, Minh-Long
2015-01-01
The Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident resulted in extensive radioactive contamination of the environment via deposited radionuclides such as radiocesium and 131 I. Evaluating the extent and level of environmental contamination is critical to protecting citizens in affected areas and to planning decontamination efforts. However, a standardized soil sampling protocol is needed in such emergencies to facilitate the collection of large, tractable samples for measuring gamma-emitting radionuclides. In this study, we developed an emergency soil sampling protocol based on preliminary sampling from the FDNPP accident-affected area. We also present the results of a preliminary experiment aimed to evaluate the influence of various procedures (e.g., mixing, number of samples) on measured radioactivity. Results show that sample mixing strongly affects measured radioactivity in soil samples. Furthermore, for homogenization, shaking the plastic sample container at least 150 times or disaggregating soil by hand-rolling in a disposable plastic bag is required. Finally, we determined that five soil samples within a 3 m × 3-m area are the minimum number required for reducing measurement uncertainty in the emergency soil sampling protocol proposed here. - Highlights: • Emergency soil sampling protocol was proposed for nuclear hazards. • Various sampling procedures were tested and evaluated in Fukushima area. • Soil sample mixing procedure was of key importance for measured radioactivity. • Minimum number of sampling was determined for reducing measurement uncertainty
Hogan, Teresita M; Losman, Eve D; Carpenter, Christopher R; Sauvigne, Karen; Irmiter, Cheryl; Emanuel, Linda; Leipzig, Rosanne M
2010-03-01
The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes. The objective was to develop a consensus document, "Geriatric Competencies for Emergency Medicine Residents," by identified experts. This is a minimum set of behaviorally based performance standards that all residents should be able to demonstrate by completion of their residency training. This consensus-based process utilized an inductive, qualitative, multiphase method to determine the minimum geriatric competencies needed by emergency medicine (EM) residents. Assessments of face validity and reliability were used throughout the project. In Phase I, participants (n=363) identified 12 domains and 300 potential competencies. In Phase II, an expert panel (n=24) clustered the Phase I responses, resulting in eight domains and 72 competencies. In Phase III, the expert panel reduced the competencies to 26. In Phase IV, analysis of face validity and reliability yielded a 100% consensus for eight domains and 26 competencies. The domains identified were atypical presentation of disease; trauma, including falls; cognitive and behavioral disorders; emergent intervention modifications; medication management; transitions of care; pain management and palliative care; and effect of comorbid conditions. The Geriatric Competencies for EM Residents is a consensus document that can form the basis for EM residency curricula and assessment to meet the demands of our aging population. Copyright (c) 2010 by the Society for Academic Emergency Medicine.
[The importance of teamwork in emergency medicine training].
Vermeulen, B; Carron, P-N
2007-08-15
The study of dynamics in relation to performing in small groups has increased pedagogic knowledge about teamwork. The successful management of patients with life-threatening pathologies depends highly from a succession of teams with a specific mission as: the call centre 144, Paramedics, the ED, the Operating Theatre and the Intensive care. To enable each team to operate successfully, it is essential to coordinate their qualifications and synergism. This can be efficiently attained by simulating real situations and by following protocols dedicated to teamwork. Emergency Medicine, which is on the brink of acquiring its proper curriculum, must adopt this concept to integrate knowledge and know-how, and the art of being and doing. At this stage, the Emergency Physician will have the competence which will enable him to be a real "team leader".
Widmer, Matthew A; Swanson, R Chad; Zink, Brian J; Pines, Jesse M
2017-12-27
The specialty of emergency medicine is experiencing the convergence of a number of transformational forces in the United States, including health care reform, technological advancements, and societal shifts. These bring both opportunity and uncertainty. 21ST CENTURY CHALLENGES: Persistent challenges such as the opioid epidemic, rising health care costs, misaligned incentives, patients with multiple chronic diseases, and emergency department crowding continue to plague the acute, unscheduled care system. The traditional approach to health care practice and improvement-reductionism-is not adequate for the complexity of the twenty-first century. Reductionist thinking will likely continue to produce unintended consequences and suboptimal outcomes. Complex systems thinking provides a perspective and set of tools better suited for the challenges and opportunities facing public health in general, and emergency medicine more specifically. This article introduces complex systems thinking and argues for its application in the context of emergency medicine by drawing on the history of the circumstances surrounding the formation of the specialty and by providing examples of its application to several practice challenges. © 2017 John Wiley & Sons, Ltd.
Medical aspects of radiation accidents
International Nuclear Information System (INIS)
Messerschmidt, O.
1990-01-01
Reactor accidents and nuclear bomb explosions are compared including the release of radioactivity in an accident, results of risk studies, emergency measures of nuclear power plants, and evacuation of the population. The medical aspects refer to the prophylaxies of the thyroid gland, contamination and decontamination of body surfaces, recommendations of the ICRP, radiation injury after total body exposure and medical problems after a reactor accident. (DG)
International Nuclear Information System (INIS)
Raskob, W.
2007-01-01
Full text: Under the auspices of its Euratom Research Framework Programmes, the European Commission (EC) has supported the development of the RODOS (Real-time On-line Decision Support) system for off-site emergency management after nuclear accidents for more than a decade. Significant additional funds have been provided by many national RTD programmes, research institutes and industrial collaborators. In particular, the German Ministry of Environment, Nature Conservation and Reactor Safety (BMU) financially contributed to the project with emphasis on early emergency response. As a result of these collaborative actions, a comprehensive decision support system (RODOS) has been developed which can be applied generally within and across Europe. The current version of the system has been, or is being, installed in national emergency centres in several European countries for (pre-operational) use (Germany, Finland, Spain, Portugal, Austria, the Netherlands, Poland, Hungary, Slovakia, Ukraine, Slovenia, and the Czech Republic). Installation is foreseen or under consideration in Switzerland, Greece, Romania, Bulgaria, and Russia within the next few years. RODOS provides coherent support at all stages of an accident (i.e., before, during and after a release), including the long term management and restoration of contaminated areas. The system is able to support decisions about the introduction of a wide range of potentially useful countermeasures (e.g., sheltering and evacuation of people, distribution of iodine tablets, food restrictions, agricultural countermeasures, relocation, decontamination, restoration, etc.) mitigating the consequences of an accident with respect to health, the environment, and the economy. It can be applied to accidental releases into the atmosphere and into various aquatic environments. Appropriate interfaces exist with local and national radiological monitoring data, meteorological measurements and forecasts, and for adaptation to local, regional
Complementary and alternative medicine use among paediatric emergency department patients.
Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E
2015-09-01
To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
International Nuclear Information System (INIS)
Pointner, W.; Broecker, A.
2012-01-01
The report on safeguarding of emergency core cooling in case of loss-of-coolant accidents with insulation material release covers the following issues: assessment of the relevant status for PWR, evaluation of the national and international (USA, Canada, France) status, actualization of recommendations, transferability from PWR to BWR. Generic studies on the core cooling capability in case of insulation material release in BWR-type reactors were evaluated.
Review of the CRAC and SILENE Criticality Accident Studies
International Nuclear Information System (INIS)
Barbry, F.; Fouillaud, P.; Grivot, P.; Reverdy, L.
2009-01-01
In 1967, the Commissariat et l'Energie Atomique (French Atomic Energy Agency) performed its first research on criticality accidents for the purpose of limiting their impact on people, the environment, and nuclear facilities themselves. A criticality accident is accompanied by intense neutron and gamma emissions and release of radioactive fission products-gases and aerosols-gene rating risk of irradiation and contamination. This work has supplemented earlier work in criticality safety, which concentrated on critical mass measurements and computations. Understanding of the consequences of criticality accidents was limited. Emergency planning was hampered by lack of data. Information became available from pulsed reactor experiments, but the experiments were restricted to the established reactor configurations. The objectives of research performed at the Valduc criticality laboratory, mainly on aqueous fissile media, using the CRAC and SILENE facilities, by multidisciplinary teams of physicists, dosimetry specialists, and radio-biologists, were to model criticality accident physics, estimate irradiation risks and radioactive releases, detect excursions, and organize emergency response. The results of the Valduc experiments have contributed toward improved understanding of criticality accident phenomenology and better evaluation of the risks associated with such accidents. (authors)
Review of the CRAC and SILENE Criticality Accident Studies
Energy Technology Data Exchange (ETDEWEB)
Barbry, F.; Fouillaud, P.; Grivot, P.; Reverdy, L. [CEA Valduc, Serv Rech Neutron and Critcite, 21 - Is-sur-Tille (France)
2009-02-15
In 1967, the Commissariat et l'Energie Atomique (French Atomic Energy Agency) performed its first research on criticality accidents for the purpose of limiting their impact on people, the environment, and nuclear facilities themselves. A criticality accident is accompanied by intense neutron and gamma emissions and release of radioactive fission products-gases and aerosols-gene rating risk of irradiation and contamination. This work has supplemented earlier work in criticality safety, which concentrated on critical mass measurements and computations. Understanding of the consequences of criticality accidents was limited. Emergency planning was hampered by lack of data. Information became available from pulsed reactor experiments, but the experiments were restricted to the established reactor configurations. The objectives of research performed at the Valduc criticality laboratory, mainly on aqueous fissile media, using the CRAC and SILENE facilities, by multidisciplinary teams of physicists, dosimetry specialists, and radio-biologists, were to model criticality accident physics, estimate irradiation risks and radioactive releases, detect excursions, and organize emergency response. The results of the Valduc experiments have contributed toward improved understanding of criticality accident phenomenology and better evaluation of the risks associated with such accidents. (authors)
International Nuclear Information System (INIS)
Biharyová, Michaela
2018-01-01
Following up amendment to the Slovak Atomic Act, the Decree No. 55/2006 on details concerning emergency planning in case of nuclear incident or accident has also been amended now. Following a short introductory text by the author, the entire text of the ‘Decree of the Nuclear Regulatory Authority of the Slovak Republic No 9/2018 Coll. of 2 January 2018 amending Decree of the Nuclear Regulatory Authority of the Slovak Republic No 55/2006 Coll. on details in emergency planning in case of nuclear incident or accident as amended by Decree No. 35/2012 Coll.’ is reproduced. The Amendment entered into force 1 February 2018. (orig.)
Hayes, Bryan D; Kobner, Scott; Trueger, N Seth; Yiu, Stella; Lin, Michelle
2015-05-01
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 innovations revolving around the featured article and made possible by the immediacy of social media technologies. Six online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and YouTube, which featured 3 preselected questions. Engagement was tracked through various Web analytic tools, and themes were identified by content curation. The dialogue resulted in 1,222 unique page views from 325 cities in 32 countries on the ALiEM Web site, 569,403 Twitter impressions, and 120 views of the video interview with the authors. Five major themes we identified in the discussion included curriculum design, pedagogy, and learning theory; digital curation skills of the 21st-century emergency medicine practitioner; engagement challenges; proposed solutions; and best practice examples. The immediacy of social media technologies provides clinicians the unique opportunity to engage a worldwide audience within a relatively short time frame. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Morecroft, Charles W; Mackridge, Adam J; Stokes, Elizabeth C; Gray, Nicola J; Wilson, Sarah E; Ashcroft, Darren M; Mensah, Noah; Pickup, Graham B
2015-07-10
To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October-November 2012 and April 2013); interviews with CPs (February-April 2013); follow-up interviews with patients (April-May 2013); interactive feedback sessions with general practice teams (October-November 2013). 22 community pharmacies and 6 general practices in Northwest England. 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were 'loaned' in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured and funded NHS emergency supply service from community pharmacies, with
Wang, Yu-Chun; Lin, Yu-Kai
2014-01-01
This study evaluated risks of the emergency room visits (ERV) for cerebrovascular diseases, heart diseases, ischemic heart disease, hypertensive diseases, chronic renal failure (CRF), diabetes mellitus (DM), asthma, chronic airway obstruction not elsewhere classified (CAO), and accidents associated with the ambient temperature from 2000 to 2009 in metropolitan Taipei. The distributed lag non-linear model was used to estimate the cumulative relative risk (RR) and confidence interval (CI) of cause-specific ERV associated with daily temperature from lag 0 to lag 3 after controlling for potential confounders. This study identified that temperatures related to the lowest risk of ERV was 26 °C for cerebrovascular diseases, 18 °C for CRF, DM, and accidents, and 30 °C for hypertensive diseases, asthma, and CAO. These temperatures were used as the reference temperatures to measure RR for the corresponding diseases. A low temperature (14°C) increased the ERV risk for cerebrovascular diseases, hypertensive diseases, and asthma, with respective cumulative 4-day RRs of 1.56 (95% CI: 1.23, 1.97), 1.78 (95% CI: 1.37, 2.34), and 2.93 (95% CI: 1.26, 6.79). The effects were greater on, or after, lag one. At 32°C, the cumulative 4-day RR for ERV was significant for CRF (RR = 2.36; 95% CI: 1.33, 4.19) and accidents (RR = 1.23; 95% CI: 1.14, 1.33) and the highest RR was seen on lag 0 for CRF (RR = 1.69; 95% CI: 1.01, 3.58), DM (RR = 1.69; 95% CI: 1.09, 2.61), and accidents (RR = 1.19; 95% CI: 1.11, 1.27). Higher temperatures are associated with the increased ERV risks for CRF, DM, and accidents and lower temperatures with the increased ERV risks for cerebrovascular diseases, hypertensive diseases, and asthma in the subtropical metropolitan.
Full-text publication of abstracts in emergency medicine in Denmark.
Ravn, Anne Katrine; Petersen, Dan Brun; Folkestad, Lars; Hallas, Peter; Brabrand, Mikkel
2014-05-24
Abstracts presented at medical conferences or scientific meetings should ideally be published as full-text articles in peer-reviewed journals after initial presentation and feedback regardless of the findings. The aim of this survey was to determine the publication rate of papers presented at the Danish Emergency Medicine Conferences in 2009, 2010 and 2011. Abstracts presented at the conferences were identified and authors contacted to obtain publication information. A further search was conducted using relevant databases. Publication rates for the 2009 and 2010 were approximately 30% (25-31.6%). The publication rate for the 2011 conference was 14.5% within 18 months with an additional 9% under review prior to publication. When comparing full-text publication rates from DEMC to previous international studies in EM Danish EM research community has similar publication rates. However, other more established specialties have higher publication levels. Knowledge of reasons for non-publication could lead to efforts to promote publication like funding; the possibility of discussion between authors and editors at conferences; "publication mentors"; and/or research courses provided by the Danish Society of Emergency Medicine.
Dose assessment in radiological accidents
International Nuclear Information System (INIS)
Donkor, S.
2013-04-01
The applications of ionizing radiation bring many benefits to humankind, ranging from power generation to uses in medicine, industry and agriculture. Facilities that use radiation source require special care in the design and operation of equipment to prevent radiation injury to workers or to the public. Despite considerable development of radiation safety, radiation accidents do happen. The purpose of this study is therefore to discuss how to assess doses to people who will be exposed to a range of internal and external radiation sources in the event of radiological accidents. This will go a long way to complement their medical assessment thereby helping to plan their treatment. Three radiological accidents were reviewed to learn about the causes of those accidents and the recommendations that were put in place to prevent recurrence of such accidents. Various types of dose assessment methods were discussed.(au)
Dean, Anthony J; Breyer, Michael J; Ku, Bon S; Mills, Angela M; Pines, Jesse M
2010-02-01
Emergency Medicine (EM) residency graduates are trained to perform Emergency Medicine bedside ultrasound (EMBU). However, the degree to which they use this skill in their practice after graduation is unknown. We sought to test the amount and type of usage of EMBU among recent residency graduates, and how usage and barriers vary among various types of EM practice settings. Graduates from 14 EM residency programs in 2003-2005 were surveyed on their current practice setting and use of EMBU. There were 252 (73%) graduates who completed the survey. Of the 73% of respondents reporting access to EMBU, 98% had used it within the past 3 months. Access to EMBU was higher in academic (97%) vs. community teaching (79%) vs. community non-teaching settings (62%) (p < 0.001), and in Emergency Departments (EDs) where yearly census exceeded 60,000 visits (87% vs. 65%, p < 0.001). Physicians in academic settings reported "high use" of EMBU more frequently than those in community settings for most modalities. FAST (focused assessment by sonography in trauma) was the most common high-use application and the most useful in practice. The greatest impediment to EMBU use was "not enough time" (61%). Ultrasound usage among recent EM residency graduates is significantly higher in teaching than in community settings and in high-volume EDs. Its use is more widespread than in previous reports in all types of practice. There is a wide range of utilization of ultrasound in the various applications in emergency practice, with the evaluation of trauma being the most common. Copyright (c) 2010 Elsevier Inc. All rights reserved.
The implementation of the IAEA accident response plan in Yugoslav practice
International Nuclear Information System (INIS)
Orlic, M.; Pavlovic, R.; Markovic, S.; Pavlovic, S.
1996-01-01
One of the important lessons from the Chernobyl accident is the necessity of existence of operational national emergency response plan. Summarizing consequences and experiences after Chernobyl accident, expert groups from IAEA, ICRP and other international scientific organizations, have been extensively worked on reviewing old ones, and preparing new radiation protection and nuclear safety principals and codes. One of the important issue is national emergency response plan for radiological accident. The nuclear accident response plan in Yugoslavia is presented in this paper. It is essentially based on IAEA model national response plan for radiological accident. This model has to be adjusted to the specificity of member states. The optimum society organization for emergency management in the case of accidents in ionizing radiation sources practices is suggested in this paper. Specific characteriztics of Yugoslav state organization relating to accident response are emphasised. (author)
International Nuclear Information System (INIS)
Aoki, Yoshiro
1994-01-01
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.)
Introduction of new terms and lessons for radiological protection after Fukushima Dai-Ichi accident
International Nuclear Information System (INIS)
Singh, Vishwanath P.; Managanvi, S.S.; Bhat, H.R.
2012-01-01
The nuclear accidents in the world are very few among various types of operating facilities. However when an accident happened, we have learnt a lot to improve the philosophy, term, definitions, document preparation, equipment's requirement, supporting systems, awareness program and restriction etc. After Fukushima Dai-ichi we have learnt a lot, in this view this paper has been prepared to discuss for radiological protection aspects. Discussion: The probability of nuclear accidents is negligible but when happens, it opens new doors of lessons for radiological protection practices for occupational workers, emergency workers for damage control to prevent catastrophic situation/rescue to life saving actions and the member of the public. The Chernobyl and Three Mile Island accidents have provided a lot experiences for management of emergency situations, documentation, radiation emergency preparedness, emergency equipment's, concept of defense-in-depth, emergency planning zone (EPZ), accidental dose limits, estimation of source term and public dose, intervention levels, decision supporting system, remedial actions in public domain; decontamination of person, houses/building and land and etc. Recent Fukushima Dai-ichi accident in Japan was managed in appreciable manner but still new definitions and lessons for radiological protection have been emerged out. The present paper discusses difficulties w. r. t. the radiological aspects observed/faced by Japanese during nuclear crises. The accident introduced new terms as Natural Dose Rate Unit (NDRU), voluntary evacuation, deliberate evacuation area, restricted area and difference between evacuation zone and EPZ. The Fukushima accident has enforced worldwide regulators and operators to review the individual dose limit and amendment for raise in the dose limit during accident, availability of efficient/adequate quantities of personal dosimeter in public domain, collection arrangement of bulk amount of radioactive wastes
Expert software for accident identification
International Nuclear Information System (INIS)
Dobnikar, M.; Nemec, T.; Muehleisen, A.
2003-01-01
Each type of an accident in a Nuclear Power Plant (NPP) causes immediately after the start of the accident variations of physical parameters that are typical for that type of the accident thus enabling its identification. Examples of these parameter are: decrease of reactor coolant system pressure, increase of radiation level in the containment, increase of pressure in the containment. An expert software enabling a fast preliminary identification of the type of the accident in Krsko NPP has been developed. As input data selected typical parameters from Emergency Response Data System (ERDS) of the Krsko NPP are used. Based on these parameters the expert software identifies the type of the accident and also provides the user with appropriate references (past analyses and other documentation of such an accident). The expert software is to be used as a support tool by an expert team that forms in case of an emergency at Slovenian Nuclear Safety Administration (SNSA) with the task to determine the cause of the accident, its most probable scenario and the source term. The expert software should provide initial identification of the event, while the final one is still to be made after appropriate assessment of the event by the expert group considering possibility of non-typical events, multiple causes, initial conditions, influences of operators' actions etc. The expert software can be also used as an educational/training tool and even as a simple database of available accident analyses. (author)
International Nuclear Information System (INIS)
Kayser, O.
2010-01-01
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
International Nuclear Information System (INIS)
1987-01-01
This Guide is intended to complement the IAEA's existing technical guidance on emergency planning and preparedness by providing information and practical guidance related to the assessment of off-site consequences of an accident in a nuclear or radioactive materials installation and to the decision making process in implementing protective measures. This Guide contains information on emergency response philosophy, fundamental factors affecting accident consequences, principles of accident assessment, data acquisition and handling, systems, techniques and decision making principles. Many of the accident assessment concepts presented are considerably more advanced than some of those that now pertain in most countries. They could, if properly interpreted, developed and applied, significantly improve emergency response in the early and intermediate phases of an accident. Furthermore, they are considered to be applicable to a broad range of serious nuclear accidents and radiological emergencies. The extent of their application is governed by both the scale of the accident and by the availability of preplanned resources for accident assessment and emergency response. 68 refs, 28 figs, 14 tabs
Retrospective on the construction and practice of a state-level emergency medical rescue team.
Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang
2014-10-01
For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.
Directory of Open Access Journals (Sweden)
Nee-Kofi Mould-Millman
2015-09-01
To facilitate the development of EMD systems appropriate for the African setting, the African Federation for Emergency Medicine (AFEM and the International Academies of Emergency Dispatch (IAED convened a working group in November 2014 to provide conceptual, technical, and innovative recommendations for contextually appropriate EMD systems for African settings. It is hoped that these recommendations will augment efficiency, effectiveness, and standardisation within and among African EMD systems, thereby improving health outcomes for sufferers of acute illness or injury.
Uncertainties and severe-accident management
International Nuclear Information System (INIS)
Kastenberg, W.E.
1991-01-01
Severe-accident management can be defined as the use of existing and or alternative resources, systems, and actions to prevent or mitigate a core-melt accident. Together with risk management (e.g., changes in plant operation and/or addition of equipment) and emergency planning (off-site actions), accident management provides an extension of the defense-indepth safety philosophy for severe accidents. A significant number of probabilistic safety assessments have been completed, which yield the principal plant vulnerabilities, and can be categorized as (a) dominant sequences with respect to core-melt frequency, (b) dominant sequences with respect to various risk measures, (c) dominant threats that challenge safety functions, and (d) dominant threats with respect to failure of safety systems. Severe-accident management strategies can be generically classified as (a) use of alternative resources, (b) use of alternative equipment, and (c) use of alternative actions. For each sequence/threat and each combination of strategy, there may be several options available to the operator. Each strategy/option involves phenomenological and operational considerations regarding uncertainty. These include (a) uncertainty in key phenomena, (b) uncertainty in operator behavior, (c) uncertainty in system availability and behavior, and (d) uncertainty in information availability (i.e., instrumentation). This paper focuses on phenomenological uncertainties associated with severe-accident management strategies