WorldWideScience

Sample records for accident and emergency medicine

  1. 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)

  2. Burnout among nursing staff in accident and emergency and acute medicine: a comparative study.

    Science.gov (United States)

    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.

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

    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

  4. Accident knowledge and emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, B; Groenberg, C D

    1997-03-01

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

  5. Accident knowledge and emergency management

    International Nuclear Information System (INIS)

    Rasmussen, B.; Groenberg, C.D.

    1997-03-01

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

  6. Emergency medicine and general practice

    OpenAIRE

    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...

  7. 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...

  8. 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

  9. [Emergency medicine and vulnerable populations].

    Science.gov (United States)

    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.

  10. Medical Journalism and Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Saeed Safari

    2015-07-01

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

  11. 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

  12. 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

  13. 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.

  14. Medical Journalism and Emergency Medicine

    OpenAIRE

    Saeed Safari; Alireza Baratloo; Mahmoud Yousefifard

    2015-01-01

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

  15. 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)

  16. 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

  17. 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

  18. 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

  19. 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 ...

  20. 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 ...

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

    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)

  2. 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

  3. 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)

  4. Burns and scalds in pre-school children attending accident and emergency: accident or abuse?

    OpenAIRE

    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.

  5. 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

  6. Human factors and safety in emergency medicine

    Science.gov (United States)

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

    1994-01-01

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

  7. 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.)

  8. The epidemiology and cost analysis of patients presented to Emergency Department following traffic accidents.

    Science.gov (United States)

    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.

  9. 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)

  10. 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.

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

    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

  12. 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.

  13. 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)

  14. A major sporting event does not necessarily mean an increased workload for accident and emergency departments. Euro96 Group of Accident and Emergency Departments

    OpenAIRE

    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 ...

  15. 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

  16. The characters of emergency rescue and the measures to prevent accidents for nuclear-powered submarine

    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

  17. 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)

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

    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.

  19. Double take--fracture fishing in accident and emergency practice.

    Science.gov (United States)

    Hyland-McGuire, P; Guly, H R; Hughes, P M

    1997-03-01

    To investigate conditions where, after initially negative plain x rays following trauma, there subsequently proves to be fracture, and to explore ways in which the management might be improved. A 16 month prospective study. Patient details were collected from accident and emergency (A&E) review clinics and returns, A&E ward admissions, correspondence from other services, and discussions at a weekly clinicoradiological conference. The inclusion criteria comprised A&E trauma patients with normal initial plain x rays and proven fractures on subsequent imaging for the same patient event. A large A&E department seeing 65,000 new attendances per annum with full back up services. 55 cases were identified: 41 fractures were identified on subsequent plain x ray, six on bone scan, six on CAT scan, and two on MRI scan. The commonest regions involved were the wrist, pelvis/hip, ankle/foot, and leg. Follow up had not been arranged at the initial attendance in 17 instances and between two and 135 days were required for definitive fracture recognition. All but nine patients required alteration in treatment because of fracture detection. Clinical suspicion of fracture at initial A&E attendance should prompt organised follow up even in the face of normal plain x rays. Consideration should be given to alternative imaging techniques which may have a higher resolution than plain x rays. Close corroboration between A&E and radiology departments has benefits in patient care in this group of patients and may lead to a reduction in functional disability and litigation.

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

    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.)

  1. Analysis of emergency response to fukushima nuclear accident in Japan and suggestions for China's nuclear emergency management

    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)

  2. 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.

  3. Emergency medicine and the airline passenger

    Science.gov (United States)

    Mohler, S. R.; Nicogossian, A.; Margulies, R. A.

    1980-01-01

    Problems related to immediate medical care in case of in-flight emergencies are discussed with reference to such critical types of medical emergencies as obstructed airway, cardiac dysfunction, trauma, hemorrhage, hypoxia, and pain. It is shown that training flight attendants to deal with in-flight medical emergencies and to use first-aid support equipment and essential and useful drugs may later help with stabilization of a victim and allow continuing the flight to the scheduled destination without the need for a diverted landing. Among the steps suggested in order to upgrade inflight welfare and safety of passengers are the development of an advisory circular by the FAA covering standardized training for flight attendants, regulatory action requiring upgrading of the present rudimentary first-aid kit, and the enactment of Good Samaritan legislation by the U.S. Government.

  4. Audit of litigation against the accident and emergency radiology department.

    Science.gov (United States)

    Cantoni, S; De Stefano, F; Mari, A; Savaia, F; Rosso, R; Derchi, L

    2009-09-01

    The aims of this study were to reduce and monitor litigation due to failure to diagnose a fracture, to evaluate whether the cases were due to radiological error or other problems in the diagnostic and therapeutic management of patients and to identify organisational, technical or functional changes or guidelines to improve the management of patients with suspected fracture and their expectations. We analysed the litigation database for the period 2004-2006 and extracted all episodes indicating failure to diagnose a fracture at the accident and emergency radiology department of our centre. The radiographs underwent blinded review by two experts, and each case was jointly analysed by a radiologist and a forensic physician to see what led to the compensation claim. We identified 22 events (2004 seven cases; 2005 eight cases; 2006 seven cases). Six cases were unrelated to radiological error. Six were due to imperceptible fractures at the time of the examination. These were accounted for by the presence of a major lesion distracting the examiner's attention from a less important associated lesion in one case, a false negative result in a patient examined on a incompletely radiolucent spinal board and underexposure of the coccyx region in an obese patient. Six cases were related to an interpretation error by the radiologist. In the remaining cases, the lesion being referred to in the compensation claim could either not be established or the case was closed by the insurance company without compensation. Corrective measures were adopted. These included planning the purchase of a higher performance device, drawing up a protocol for imaging patients on spinal boards, reminding radiologists of the need to carefully scrutinise the entire radiogram even after having identified a lesion, and producing an information sheet explaining to patients the possibility of false negative results in cases of imperceptible lesions and inviting them to return to the department if symptoms

  5. Reflections on the emergency preparations and responses of China to Fukushima nuclear accident in Japan

    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)

  6. Resuscitation debriefing for nurses at the Accident and Emergency ...

    African Journals Online (AJOL)

    professional nurse, who followed a semi-structured questionnaire with both open and closed ... Postgraduate student, Division of Family Medicine and Primary Care, University of Stellenbosch ..... depression or on work-related issues, although ...

  7. 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

  8. 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)

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

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Youngen, G.

    1988-10-01

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

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

    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

  12. Nanotechnology: emerging tools for biology and medicine.

    Science.gov (United States)

    Wong, Ian Y; Bhatia, Sangeeta N; Toner, Mehmet

    2013-11-15

    Historically, biomedical research has been based on two paradigms. First, measurements of biological behaviors have been based on bulk assays that average over large populations. Second, these behaviors have then been crudely perturbed by systemic administration of therapeutic treatments. Nanotechnology has the potential to transform these paradigms by enabling exquisite structures comparable in size with biomolecules as well as unprecedented chemical and physical functionality at small length scales. Here, we review nanotechnology-based approaches for precisely measuring and perturbing living systems. Remarkably, nanotechnology can be used to characterize single molecules or cells at extraordinarily high throughput and deliver therapeutic payloads to specific locations as well as exhibit dynamic biomimetic behavior. These advances enable multimodal interfaces that may yield unexpected insights into systems biology as well as new therapeutic strategies for personalized medicine.

  13. Technology and work within emergency medicine

    DEFF Research Database (Denmark)

    Kristensen, Margit

    and technologies, they make use of, are most often of very diverse character.Below I describe the characteristics for the mobile and nomadic work for the two different work situations of an anaesthesiologist - in-hospital and pre-hospital - and in these descriptions I include description of which technologies...... are used and how they are used.   The paper builds on use-driven research carried out through the last 3½ years within the context of the PalCom project (PalCom). As a part of the research we have carried out extensive fieldstudies within the emergency response area, have held interviews and have had...

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

    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

  15. Helicopter type and accident severity in Helicopter Emergency Medical Services missions.

    Science.gov (United States)

    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.

  16. Burnout and Associated Factors among Iranian Emergency Medicine Practitioners

    OpenAIRE

    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...

  17. 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

  18. 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

  19. 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.

  20. Assessing interpersonal and communication skills in emergency medicine.

    Science.gov (United States)

    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.

  1. 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

  2. [Accidents and violence among women attended in Sentinel Emergency Services--Brazil, 2009].

    Science.gov (United States)

    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.

  3. [Accidents and violence in childhood: survey evidence of emergency care for external causes--Brazil, 2009].

    Science.gov (United States)

    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.

  4. 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

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

    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

  6. 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)

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

    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

  8. 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

  9. 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.)

  10. 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.)

  11. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

    Science.gov (United States)

    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

  12. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.

    Science.gov (United States)

    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.

  13. Uncertainty analysis of accident notification time and emergency medical service response time in work zone traffic accidents.

    Science.gov (United States)

    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.

  14. 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

  15. Planning and preparing for emergency response to transport accidents involving radioactive material. Safety guide

    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

  16. 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

  17. 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

  18. 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)

  19. Attention-Deficit/Hyperactivity Disorder and Fatal Accidents in Aviation Medicine.

    Science.gov (United States)

    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.

  20. 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

  1. 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

  2. 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.)

  3. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services.

    Science.gov (United States)

    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.

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

    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)

  5. Interprofessional education of medical students and paramedics in emergency medicine.

    Science.gov (United States)

    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.

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

    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

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

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  9. 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.

  10. 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

  11. Evaluation of secondary exposure doses to transportation and medical personnel in the radiation emergency medicine

    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)

  12. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    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.

  13. Emergency medicine in Dubai, UAE

    OpenAIRE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

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

  14. [Ambulance in emergency medicine].

    Science.gov (United States)

    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

  15. 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

  16. Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

    Science.gov (United States)

    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.

  17. 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

  18. Current and emerging applications of 3D printing in medicine.

    Science.gov (United States)

    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.

  19. 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

  20. [Diving accidents. Emergency treatment of serious diving accidents].

    Science.gov (United States)

    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.

  1. Effect of Strathclyde police initiative "Operation Blade" on accident and emergency attendances due to assault.

    OpenAIRE

    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...

  2. Burnout and Associated Factors among Iranian Emergency Medicine Practitioners.

    Science.gov (United States)

    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.

  3. 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

  4. Evaluation of care for traffic accidents victims made by on duty emergency physicians and surgeons in the emergency room

    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.

  5. 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)

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

    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)

  7. Traumatic Brain Injury in the Accident and Emergency Department of ...

    African Journals Online (AJOL)

    Background: Traumatic brain injury is a major public health problem in Nigeria, as it could be associated with long term and life long deficits. Unlike other parts of the world, in our country, motorcycles are possibly the main cause of this injury. Unfortunately, we do not have a national epidemiological data base yet. This study ...

  8. 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)

  9. Nuclear medicine in emergency

    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

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

    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

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

    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

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

    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.

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

    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

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

    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

  15. 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)

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

    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

  17. Complementary and alternative medicine use among paediatric emergency department patients.

    Science.gov (United States)

    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).

  18. Analysis of emergency response after the Chernobyl accident in Belarus: observed and prevented medical consequences, lessons learned

    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

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

    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)

  20. Family presence preference when patients are receiving resuscitation in an accident and emergency department.

    Science.gov (United States)

    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.

  1. State of emergency medicine in Azerbaijan

    OpenAIRE

    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...

  2. 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.

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

    International Nuclear Information System (INIS)

    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)

  4. Education Scholarship and its Impact on Emergency Medicine Education

    Science.gov (United States)

    Sherbino, Jonathan

    2015-01-01

    Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development. PMID:26594270

  5. Education Scholarship and its Impact on Emergency Medicine Education.

    Science.gov (United States)

    Sherbino, Jonathan

    2015-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Steven Tan

    2004-01-01

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

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

    International Nuclear Information System (INIS)

    Yanke, R.

    2002-01-01

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

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

    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.)

  9. The association between money and opinion in academic emergency medicine.

    Science.gov (United States)

    Birkhahn, Robert H; Blomkalns, Andra; Klausner, Howard; Nowak, Richard; Raja, Ali S; Summers, Richard; Weber, Jim E; Briggs, William M; Arkun, Alp; Diercks, Deborah

    2010-05-01

    Financial conflicts of interest have come under increasing scrutiny in medicine, but their impact has not been quantified. Our objective was to use the results of a national survey of academic emergency medicine (EM) faculty to determine if an association between money and personal opinion exists. We conducted a web-based survey of EM faculty. Opinion questions were analyzed with regard to whether the respondent had either 1) received research grant money or 2) received money from industry as a speaker, consultant, or advisor. Responses were unweighted, and tests of differences in proportions were made using Chi-squared tests, with pmoney. Respondents with research money were more likely to be comfortable accepting gifts (40% vs. 29%) and acting as paid consultants (50% vs. 37%). They had a more favorable attitude with regard to societal interactions with industry and felt that industry-sponsored lectures could be fair and unbiased (52% vs. 29%). Faculty with fee-for-service money mirrored those with research money. They were also more likely to believe that industry-sponsored research produces fair and unbiased results (61% vs. 45%) and less likely to believe that honoraria biased speakers (49% vs. 69%). Accepting money for either service or research identified a distinct population defined by their opinions. Faculty engaged in industry-sponsored research benefitted socially (collaborations), academically (publications), and financially from the relationship.

  10. The future of emergency medicine.

    Science.gov (United States)

    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.

  11. Workplace Violence and Harassment Against Emergency Medicine Residents.

    Science.gov (United States)

    Schnapp, Benjamin H; Slovis, Benjamin H; Shah, Anar D; Fant, Abra L; Gisondi, Michael A; Shah, Kaushal H; Lech, Christie A

    2016-09-01

    Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe "Occasionally," "Seldom" or "Never" while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  12. The application of the assessment of nuclear accident status in emergency decision-making during nuclear accident

    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)

  13. 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

  14. 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

  15. 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 ...

  16. Clinical audit of emergency unit before and after establishment of the emergency medicine department.

    Science.gov (United States)

    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.

  17. [Accidents by external causes in adolescents: care in sentinel urgency and emergency services in the Brazilian State Capitals--2009].

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Morrison, Ann; Roman, Brenda; Borges, Nicole

    2012-01-01

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

  19. Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

    Science.gov (United States)

    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

  20. Workplace Violence and Harassment Against Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Benjamin H. Schnapp

    2016-09-01

    Full Text Available Introduction: Several studies have shown that workplace violence in the emergency department (ED is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results: A majority of residents (66%, 78/119 reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119 experienced verbal harassment, 78% (93/119 had experienced verbal threats, and 52% (62/119 reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion: Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts.

  1. Workplace Violence and Harassment Against Emergency Medicine Residents

    Science.gov (United States)

    Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

    2016-01-01

    Introduction Several studies have shown that workplace violence in the emergency department (ED) is common. Residents may be among the most vulnerable staff, as they have the least experience with these volatile encounters. The goal for this study was to quantify and describe acts of violence against emergency medicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods This cross-sectional survey study queried EM residents at multiple New York City hospitals. The primary outcome was the incidence of violence experienced by residents while working in the ED. The secondary outcomes were the subtypes of violence experienced by residents, as well as the perceived barriers to safety while at work. Results A majority of residents (66%, 78/119) reported experiencing at least one act of physical violence during an ED shift. Nearly all residents (97%, 115/119) experienced verbal harassment, 78% (93/119) had experienced verbal threats, and 52% (62/119) reported sexual harassment. Almost a quarter of residents felt safe “Occasionally,” “Seldom” or “Never” while at work. Patient-based factors most commonly cited as contributory to violence included substance use and psychiatric disease. Conclusion Self-reported violence against EM residents appears to be a significant problem. Incidence of violence and patient risk factors are similar to what has been found previously for other ED staff. Understanding the prevalence of workplace violence as well as the related systems, environmental, and patient-based factors is essential for future prevention efforts. PMID:27625721

  2. 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

  3. Radiology in emergency medicine

    International Nuclear Information System (INIS)

    Levy, R.; Barsan, W.G.

    1986-01-01

    This book gives a discussion of radiologic modalities currently being used in emergency situations. Radiographs, echocardiographs, radionuclide scans and CT scans are systematically analyzed and evaluated to provide a step-by-step diagnostic process for emergency physicians to follow when a radiologist is not present

  4. Analysis of emergency response after the Chernobyl accident in Belarus: observed and prevented medical consequences, lessons learned

    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.

  5. 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)

  6. A review on contamination and emergency response actions in USSR, European countries and Japan in the reactor accident at Chernobyl

    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.)

  7. 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.

  8. Emergency medicine and internal medicine trainees’ smartphone use in clinical settings in the United States

    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.

  9. Sudden water pollution accidents and reservoir emergency operations: impact analysis at Danjiangkou Reservoir.

    Science.gov (United States)

    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.

  10. Night shift preparation, performance, and perception: are there differences between emergency medicine nurses, residents, and faculty?

    Science.gov (United States)

    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.

  11. Experience in accident liquidation at the Chernobyl' NPP and problems of organization of the emergency-engineering service

    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

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

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  14. Management of whiplash injuries presenting to accident and emergency departments in Wales

    Science.gov (United States)

    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

  15. Cost of a roller skating rink to the local accident and emergency department.

    Science.gov (United States)

    Nayeem, N; Shires, S E; Porter, J E

    1990-01-01

    A 14 month retrospective study was undertaken to determine the cost implications of the opening of a roller skating rink to the local hospital accident and emergency department (A and E). A total of 398 patients attended following injury at the roller skating rink, of whom 384 were included in the study. The estimated cost of their injuries was determined by the hospital accounts department. The average cost per patient attending the A and E department following roller skating injury was about 100 pounds. The total cost to the A and E department of all injuries sustained at the rink over this period was 38,412 pounds. The cost implications of opening a roller skating rink for the A and E department are considerable. If proposals for self-budgeting are applied, A and E departments will have to seek additional funding if such leisure facilities are opened in their vicinity. PMID:2097020

  16. Football emergency medicine

    African Journals Online (AJOL)

    may be called upon to intervene medically when a football player succumbs to a severe ... including safety and security services, emergency and primary health care medical ..... of the European Resuscitation Council (ERC) guidelines 2005.

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

    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

  18. Calculation and experimental study of the RBMK-1500 reactor emergency cooling at maximum designed accident

    International Nuclear Information System (INIS)

    Cherkashov, Yu.M.; Vasilevskij, V.P.; Labazov, V.H.; Loninov, A.Ya.; Molochnikov, Yu.S.; Novosel'skij, O.Yu.; Podlazov, L.N.; Pavlov, V.B.; Pushkarev, V.I.

    1981-01-01

    The analysis of thermohydraulic and neutron-physical processes occurring in the RBMK-1500 reactor during the reactor emergency cooling system triggering (RECS) after the maximum designed accident (MDA) is conducted. The MDA means hypothetical instant hilliotine break of the main circulating pump head collector. During the whole cooling down period the RECS should provide the temperature level of the fuel elements not exceeding 1200 deg C and the channel pipe temperature - 600 deg C. The principal flowsheet of the balloon type RECS is described. Calculations of the valve fast response effect on the RECS productivity are carried out. It is concluded that the chosen balloon RECS provides reliable temperature modes of fuel elements naand channel pipes under the MDA conditions. At the same time a momentary splash of neutron power by the value not more than 10% can take place [ru

  19. Emergency medicine resident well-being: stress and satisfaction.

    Science.gov (United States)

    Hoonpongsimanont, W; Murphy, M; Kim, C H; Nasir, D; Compton, S

    2014-01-01

    Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress. To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms. An online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level. There were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods. Residents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities.

  20. Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.

    Science.gov (United States)

    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.

  1. Exploring Scholarship and the Emergency Medicine Educator: A Workforce Study.

    Science.gov (United States)

    Jordan, Jaime; Coates, Wendy C; Clarke, Samuel; Runde, Daniel P; Fowlkes, Emilie; Kurth, Jacqueline; Yarris, Lalena M

    2017-01-01

    Recent literature calls for initiatives to improve the quality of education studies and support faculty in approaching educational problems in a scholarly manner. Understanding the emergency medicine (EM) educator workforce is a crucial precursor to developing policies to support educators and promote education scholarship in EM. This study aims to illuminate the current workforce model for the academic EM educator. Program leadership at EM training programs completed an online survey consisting of multiple choice, completion, and free-response type items. We calculated and reported descriptive statistics. 112 programs participated. Mean number of core faculty/program: 16.02 ± 7.83 [14.53-17.5]. Mean number of faculty full-time equivalents (FTEs)/program dedicated to education is 6.92 ± 4.92 [5.87-7.98], including (mean FTE): Vice chair for education (0.25); director of medical education (0.13); education fellowship director (0.2); residency program director (0.83); associate residency director (0.94); assistant residency director (1.1); medical student clerkship director (0.8); assistant/associate clerkship director (0.28); simulation fellowship director (0.11); simulation director (0.42); director of faculty development (0.13). Mean number of FTEs/program for education administrative support is 2.34 ± 1.1 [2.13-2.61]. Determination of clinical hours varied; 38.75% of programs had personnel with education research expertise. Education faculty represent about 43% of the core faculty workforce. Many programs do not have the full spectrum of education leadership roles and educational faculty divide their time among multiple important academic roles. Clinical requirements vary. Many departments lack personnel with expertise in education research. This information may inform interventions to promote education scholarship.

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

    Science.gov (United States)

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

    2015-03-01

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

  3. Emergency Evacuation of Hazardous Chemical Accidents Based on Diffusion Simulation

    OpenAIRE

    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...

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

    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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

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

    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)

  7. Non-urgent accident and emergency department use as a socially shared custom: a qualitative study.

    Science.gov (United States)

    Keizer Beache, Simone; Guell, Cornelia

    2016-01-01

    We explored attitudes of non-urgent accident and emergency department (AED) patients in the middle-income healthcare setting Saint Vincent and the Grenadines (SVG) in the Caribbean to understand how and why they decide to seek emergency care and resist using primary care facilities. In 2013, we conducted 12 semistructured interviews with a purposive sample of non-urgent AED users from a variety of social backgrounds. Verbatim transcripts were analysed with a grounded theory approach. In this study, we found, first, that participants automatically chose to visit the AED and described this as a locally shared custom. Second, the healthcare system in SVG reinforced this habitual use of the AED, for example, by health professionals routinely referring non-urgent cases to the AED. Third, there was also some deliberate use; patients took convenience and the systemic encouragement into account to determine that the AED was the most appropriate choice for healthcare. We conclude that the attitudes and habits of the Vincentian non-urgent patient are major determinants of their AED use and are intricately linked to local, socially shared practices of AED use. Findings show that health services research should reconsider rational choice behaviour models and further explore customs of health-seeking. 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/

  8. Law Enforcement and Emergency Medicine: An Ethical Analysis.

    Science.gov (United States)

    Baker, Eileen F; Moskop, John C; Geiderman, Joel M; Iserson, Kenneth V; Marco, Catherine A; Derse, Arthur R

    2016-11-01

    Emergency physicians frequently interact with law enforcement officers and patients in their custody. As always, the emergency physician's primary professional responsibility is to promote patient welfare, and his or her first duty is to the patient. Emergency physicians should treat criminals, suspects, and prisoners with the same respect and attention they afford other patients while ensuring the safety of staff, visitors, and other patients. Respect for patient privacy and protection of confidentiality are of paramount importance to the patient-physician relationship. Simultaneously, emergency physicians should attempt to accommodate law enforcement personnel in a professional manner, enlisting their aid when necessary. Often this relates to the emergency physician's socially imposed duties, governed by state laws, to report infectious diseases, suspicion of abuse or neglect, and threats of harm. It is the emergency physician's duty to maintain patient confidentiality while complying with Health Insurance Portability and Accountability Act regulations and state law. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  9. Setting the agenda in emergency medicine in the southern African region: Conference assumptions and recommendations, Emergency Medicine Conference 2014: Gaborone, Botswana

    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.

  10. How alternative payment models in emergency medicine can benefit physicians, payers, and patients.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Kim Paula Colette Kuypers

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

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

    International Nuclear Information System (INIS)

    Brealey, S.D.; King, D.G.; Hahn, S.; Crowe, M.; Williams, P.; Rutter, P.; Crane, S.

    2005-01-01

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

  13. Psychiatry and emergency medicine: medical student and physician attitudes toward homeless persons.

    Science.gov (United States)

    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.

  14. [Biomarkers in emergency medicine and critical care patients: advances and pitfalls for news tools].

    Science.gov (United States)

    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.

  15. 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

  16. 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

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-04-15

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

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

    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)

  20. Analysis of loss of coolant accident and emergency core cooling system

    International Nuclear Information System (INIS)

    Abe, Kiyoharu; Kobayashi, Kenji; Hayata, Kunihisa; Tasaka, Kanji; Shiba, Masayoshi

    1977-01-01

    In this paper, the analysis for the performance evaluation of emergency core cooling system is described, which is the safety protection device to the loss of coolant accidents due to the break of primary cooling pipings of light water reactors. In the LOCA analysis for the performance evaluation of ECCS, it must be shown that a reactor core keeps the form which can be cooled with the ECCS in case of LOCA, and the overheat of the core can be prevented. Namely, the shattering of fuel cladding tubes is never to occur, and for the purpose, the maximum temperature of Zircaloy 2 or 4 cladding tubes must be limited to 1200 deg C, and the relative thickness of oxide film must be below 15%. The calculation for determining the temperature of cladding tubes in case of the LOCA in BWRs and PWRs is explained. First, the primary cooling system, the ECCS and the related installations of BWRs and PWRs are outlined. The code systems for LOCA/ECCS analysis are divid ed into several steps, such as blowdown process, reflooding process and heatup calculation. The examples of the sensitivity analysis of the codes are shown. The LOCA experiments carried out so far in Japan and foreign countries and the LOCA analysis of a BWR with RELAP-4J code are described. The guidance for the performance evaluation of ECCS was established in 1975 by the Reactor Safety Deliberation Committee in Japan, and the contents are quoted. (Kako, I.)

  1. 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.

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

    International Nuclear Information System (INIS)

    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)

  3. Emergency medicine: Concepts and clinical practice. Second edition. Volume 2

    International Nuclear Information System (INIS)

    Rosen, P.

    1988-01-01

    This book contains over 50 selections. Some of the titles are: Radiation Injuries; Hydrocarbons; Pain control: anesthesia and analgesia; Techniques of endotracheal intubation and muscle relaxation; Neck injuries; Vascular and cardiac injuries; Foreign bodies; Dental emergencies; Knee and lower leg; and Orthopedic injuries

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

    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

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

    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

  6. Does alcohol contribute to accident and emergency department attendance in elderly people?

    Science.gov (United States)

    van der Pol, V; Rodgers, H; Aitken, P; James, O; Curless, R

    1996-01-01

    OBJECTIVE: To evaluate the possible contribution of alcohol to presentation of elderly subjects at a hospital accident and emergency (A&E) department. METHODS: 105 patients aged 70 years and over who attended the department were interviewed by a single observer using a structured questionnaire based on previously validated general population surveys. Details of alcohol consumption within the previous 24 hours were recorded. Usual consumption of alcohol in the preceding 12 months was estimated by the quantity frequency method. Alcohol dependence was screened for by the CAGE questionnaire. An assessment of disability was made using the Barthel index. Breath alcohol was measured. RESULTS: In only 2% of attenders was alcohol thought to be a contributory factor. Breath alcohol measurements were technically unsatisfactory in this age group. Regular drinkers were functionally and socially more independent than non-regular drinkers. Drinking patterns in this age group may partly be determined by the physical ability to obtain alcohol. CONCLUSIONS: Alcohol was not found to be a major factor in A&E attendance in elderly people. PMID:8832344

  7. Development of emergency medicine as academic and distinct clinical discipline in Bosnia & Herzegovina.

    Science.gov (United States)

    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

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

    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

  9. 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

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

    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

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

    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)

  12. Workplace Violence and Harassment Against Emergency Medicine Residents

    OpenAIRE

    Schnapp, Benjamin H.; Slovis, Benjamin H.; Shah, Anar D.; Fant, Abra L.; Gisondi, Michael A.; Shah, Kaushal H.; Lech, Christie A.

    2016-01-01

    Introduction: Several studies have shown that workplace violence in the emergency department (ED) iscommon. Residents may be among the most vulnerable staff, as they have the least experience with thesevolatile encounters. The goal for this study was to quantify and describe acts of violence against emergencymedicine (EM) residents by patients and visitors and to identify perceived barriers to safety. Methods: This cross-sectional survey study queried EM residents at mul...

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    Williams, Stuart M.; Connelly, Daniel J.; Wadsworth, Susan; Wilson, David

    2000-01-01

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

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

    DEFF Research Database (Denmark)

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

    1998-01-01

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

  16. Reactor accidents and how to protect oneself from them. Emergency measures. Schutz bei Atomunfaellen. Vorbereitet sein auf den Notfall

    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.

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

    Science.gov (United States)

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

    2015-08-01

    The number of online resources read by and pertinent to clinicians has increased dramatically. However, most healthcare professionals still use mainstream search engines as their primary port of entry to the resources on the Internet. These search engines use algorithms that do not make it easy to find clinician-oriented resources. FOAMSearch, a custom search engine (CSE), was developed to find relevant, high-quality online resources for emergency medicine and critical care (EMCC) clinicians. Using Google™ algorithms, it searches a vetted list of >300 blogs, podcasts, wikis, knowledge translation tools, clinical decision support tools and medical journals. Utilisation has increased progressively to >3000 users/month since its launch in 2011. Further study of the role of CSEs to find medical resources is needed, and it might be possible to develop similar CSEs for other areas of medicine. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. [The department of interdisciplinary emergency medicine: organization, structure and process optimization].

    Science.gov (United States)

    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.

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

    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)

  20. Emergency Management and Radiation Moni-toring in Nuclear and Radiological Accidents. Summary Report on the NKS Project EMARAD

    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)

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

    Science.gov (United States)

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

    2014-07-15

    The environmental pollution resulting from chemical accidents has caused increasingly serious concerns. Therefore, it is very important to be able to determine in advance the appropriate emergency treatment and disposal technology for different types of chemical accidents. However, the formulation of an emergency plan for chemical pollution accidents is considerably difficult due to the substantial uncertainty and complexity of such accidents. This paper explains how the event tree method was used to create 54 different scenarios for chemical pollution accidents, based on the polluted medium, dangerous characteristics and properties of chemicals involved. For each type of chemical accident, feasible emergency treatment and disposal technology schemes were established, considering the areas of pollution source control, pollutant non-proliferation, contaminant elimination and waste disposal. Meanwhile, in order to obtain the optimum emergency disposal technology schemes as soon as the chemical pollution accident occurs from the plan repository, the technique evaluation index system was developed based on group decision-improved analytical hierarchy process (AHP), and has been tested by using a sudden aniline pollution accident that occurred in a river in December 2012. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. [Adverse drug reaction reporting in emergency medicine].

    Science.gov (United States)

    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.

  3. 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)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-08-01

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

  5. Generational influences in academic emergency medicine: teaching and learning, mentoring, and technology (part I).

    Science.gov (United States)

    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.

  6. Just allocation and team loyalty: a new virtue ethic for emergency medicine

    Science.gov (United States)

    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

  7. 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

  8. Combined residency training in emergency medicine and internal medicine: an update on career outcomes and job satisfaction.

    Science.gov (United States)

    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.

  9. 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.

  10. 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

  11. Incorporating teledermatology into emergency medicine.

    Science.gov (United States)

    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.

  12. [Rotator cuff diseases in occupational medicine between occupational diseases and accidents: medical-legal considerations].

    Science.gov (United States)

    Spigno, F; Galli, R; Casali, C; Lagattolla, N; De Lucchi, M

    2010-01-01

    The authors have gone through the complaints concerning all the cases of shoulder accidents at work filed by the Genoa office of the Italian Workers' National compensation Agency (INAIL) during the two years' period 2006-2007, reviewing in particular those somehow affecting rotator components. The aim of this paper is to assess the real role played by the occupational trauma in the rotator cuff tear. The data gathered so far have shown, on the one hand, a high prevalence of pre-existing inflammatory and degenerative diseases and, on the other, a rather modest influence of the trauma which, for this reason, has usually borne, as an immediate medico-legal consequence, the rejection of a cause-effect relationship between the accident and the rotator cuff lesion, without taking into any account whether the worker was likely to be affected by an occupational disease (ex table Ministerial Decree n. 81 April 9th 2008- item 78). In such cases a systematic and in-depth investigation of the occupational case history is suggested, in order to highlight the possible pre-existence of a former biomechanical overload of the upper limbs, so as to allow the physician to detect a pathology often misdiagnosed.

  13. 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

  14. 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

  15. Rapid analysis of key radionuclides in urine and estimation of internal dose for nuclear accident emergency

    International Nuclear Information System (INIS)

    Zhao Shuquan; Hu Heping; Wu Mingyu; Zhu Guoying; Huang Shibin; Liu Shiming

    2005-01-01

    Objective: To estimate the internal doses of a Chinese visiting scholar in the Chernobyl accident. Methods: The contents of 134 Cs and 137 Cs in urine were measured using a Ge(Li) γ-spectrometer. Their internal doses were estimated according to ICRP reports. Dose review of 131I was performed referring to UNSCEAR 2000 report. Results: The effective dose equivalent from 134 Cs, 137 Cs and 131 I were 66 μSv, 88 μSv and 1728 μSv respectively. Their summation was 1.9 mSv. Conclusion: The internal dose from 131 I was 10 times higher than that from 134 Cs and 137 Cs. So, the earlier estimation of internal doses for 131 I is significant in evaluation on radiation injuries of a nuclear reactor accident. (authors)

  16. A national survey of terrorism preparedness training among pediatric, family practice, and emergency medicine programs.

    Science.gov (United States)

    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.

  17. Publication rate of abstracts presented at the emergency medicine congresses held by the European Society for Emergency Medicine (EUSEM) in 2011 and 2012.

    Science.gov (United States)

    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

  18. The German emergency and disaster medicine and management system-history and present.

    Science.gov (United States)

    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.

  19. Knowledge, Skills and Experience Managing Tracheostomy Emergencies: A Survey of Critical Care Medicine trainees

    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.

  20. Skills and educational needs of accident and emergency nurses in Ghana: An initial needs analysis

    Directory of Open Access Journals (Sweden)

    Sarah Rominski

    2011-09-01

    Discussion: Current nurse knowledge and function as well as areas to focus on for future specialty training in emergency nursing have been identified by this needs assessment. The emergency department nurses shared an overwhelming interest in increasing their skill level, learning new methods of patient care and implementing new technologies into their clinical practice.

  1. The consumer quality index (CQ-index in an accident and emergency department: development and first evaluation

    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

  2. Developing Off-site Emergency Preparedness and Response Model (OEPRM) for Severe Accident of NPP in a Densely Populated Country Using System Dynamics Approach

    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.

  3. Developing Off-site Emergency Preparedness and Response Model (OEPRM) for Severe Accident of NPP in a Densely Populated Country Using System Dynamics Approach

    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

  4. Education scholarship in emergency medicine part 1: innovating and improving teaching and learning.

    Science.gov (United States)

    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.

  5. 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)

  6. 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/...

  7. Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.

    Science.gov (United States)

    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

  8. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Psychiatric Emergencies Small Group Module

    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

  9. Attitude of interns towards implementation and contribution of undergraduate Emergency Medicine training: Experience of an Ethiopian Medical School

    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.

  10. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Genitourinary Emergencies Small Group Module

    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

  11. 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

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

    International Nuclear Information System (INIS)

    Milligan, Patricia A.; Jones, Joseph; Walton, F.; Smith, J.D.

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Brown, G.S.; Cashwell, J.W.; Apple, M.L.

    1991-01-01

    Shipments of radioactive material (RAM) constitute but a small fraction of the total hazardous materials shipped in the United States each year. Public perception, however, of the potential consequences of a release from a transportation package containing RAM has resulted in significant regulation of transport operations, both to ensure the integrity of a package in accident conditions and to place operational constraints on the shipper. Much of this attention has focused on shipments of spent nuclear fuel and high level wastes which, although comprising a very small number of total shipments, constitute a majority of the total curies transported on an annual basis. This report discusses the shipment of these highly radioactive materials

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

    Directory of Open Access Journals (Sweden)

    Kamphuis Helen CM

    2008-11-01

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

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

    Science.gov (United States)

    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.

  16. 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.

  17. Emergency department discharge prescription interventions by emergency medicine pharmacists.

    Science.gov (United States)

    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.

  18. Emergency medicine clerkship curriculum in a high-income developing country: methods for development and application.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Stoneking LR

    2016-08-01

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

  20. Resident involvement in civilian tactical emergency medicine.

    Science.gov (United States)

    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.

  1. Professional Competencies of Cuban Specialists in Intensive Care and Emergency Medicine.

    Science.gov (United States)

    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.

  2. 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...

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

    Science.gov (United States)

    Chapman, Dane M.; And Others

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

  4. Association between temperature and emergency room visits for cardiorespiratory diseases, metabolic syndrome-related diseases, and accidents in metropolitan Taipei.

    Science.gov (United States)

    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.

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

    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

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

    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)

  7. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Gastrointestinal Emergencies Small Group Module

    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

  8. 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)

  9. Generational Influences in Academic Emergency Medicine: Teaching and Learning, Mentoring, and Technology (Part I)

    Science.gov (United States)

    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

  10. 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)

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

    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

  12. State of emergency medicine in Azerbaijan.

    Science.gov (United States)

    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

  13. Corporate and Hospital Profiteering in Emergency Medicine: Problems of the Past, Present, and Future.

    Science.gov (United States)

    Derlet, Robert W; McNamara, Robert M; Plantz, Scott H; Organ, Matthew K; Richards, John R

    2016-06-01

    Health care delivery in the United States has evolved in many ways over the past century, including the development of the specialty of Emergency Medicine (EM). With the creation of this specialty, many positive changes have occurred within hospital emergency departments (EDs) to improve access and quality of care of the nation's de facto "safety net." The specialty of EM has been further defined and held to high standards with regard to board certification, sub-specialization, maintenance of skills, and research. Despite these advances, problems remain. This review discusses the history and evolution of for-profit corporate influence on EM, emergency physicians, finance, and demise of democratic group practice. The review also explores federal and state health care financing issues pertinent to EM and discusses potential solutions. The monopolistic growth of large corporate contract management groups and hospital ownership of vertically integrated physician groups has resulted in the elimination of many local democratic emergency physician groups. Potential downsides of this trend include unfair or unlawful termination of emergency physicians, restrictive covenants, quotas for productivity, admissions, testing, patient satisfaction, and the rising cost of health care. Other problems impact the financial outlook for EM and include falling federal, state, and private insurance reimbursement for emergency care, balance-billing, up-coding, unnecessary testing, and admissions. Emergency physicians should be aware of the many changes happening to the specialty and practice of EM resulting from corporate control, influence, and changing federal and state health care financing issues. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. emergency medicine pretest® self-assessment and review

    International Development Research Centre (IDRC) Digital Library (Canada)

    Over time, groups of farmers experimented with green manures, composting and mixed ..... to the 'Lahore Karai' – a particular way of cooking meat in Lahore, Pakistan. .... Yelakachevula Koora (Merremial emarginata) is rich in copper with 0.9 ...

  15. Training programmes and experiences of medical emergency preparedness for radiation accident in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki-Yasumoto, M

    1982-01-01

    Our policy of training programmes for medical radiation emergency preparedness is described. We found it is necessary to have two approaches to the training of relevant personnel. The first approach was to conduct adequate basic training of nurses and health physics personnel in large nuclear installations for medical radiation emergency preparedness. We found it was necessary to have courses for basic knowledge of nuclear radiation and industrial activities, radiation monitoring procedures, radiation injuries, human counters and wound monitors, first aid practices, and radiation medical emergency procedures including practices. The second approach was to make a simple and introductory training program on the subject using lectures and visual presentations in the vicinity of big nuclear installations for personnel relating to the nuclear industrial activities and for concerned local personnel, including medical doctors and nurses. These two training courses and approaches were planned and have been conducted. 2 refs. (DT)

  16. 36th International Symposium on Intensive Care and Emergency Medicine

    OpenAIRE

    Bateman, R. M.; Sharpe, M. D.; Jagger, J. E.; Ellis, C. G.; Sol?-Viol?n, J.; L?pez-Rodr?guez, M.; Herrera-Ramos, E.; Ru?z-Hern?ndez, J.; Border?as, L.; Horcajada, J.; Gonz?lez-Quevedo, N.; Rajas, O.; Briones, M.; Rodr?guez de Castro, F.; Rodr?guez Gallego, C.

    2016-01-01

    Table of contents P001 - Sepsis impairs the capillary response within hypoxic capillaries and decreases erythrocyte oxygen-dependent ATP efflux R. M. Bateman, M. D. Sharpe, J. E. Jagger, C. G. Ellis P002 - Lower serum immunoglobulin G2 level does not predispose to severe flu. J. Sol?-Viol?n, M. L?pez-Rodr?guez, E. Herrera-Ramos, J. Ru?z-Hern?ndez, L. Border?as, J. Horcajada, N. Gonz?lez-Quevedo, O. Rajas, M. Briones, F. Rodr?guez de Castro, C. Rodr?guez Gallego P003 - Brain protective effects...

  17. Emergency medicine as a specialty in Asia.

    Science.gov (United States)

    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.

  18. 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)

  19. Emergency Medicine Gender-specific Education.

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    Syrakov, D.; Prodanova, M.; Slavov, K.

    2004-01-01

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

  1. On a Work Expected to the Department of Emergency and Critical Care Medicine and the Emergency Unit of the Niigata University Hospital

    OpenAIRE

    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...

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

    Science.gov (United States)

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

    2016-08-01

    Emergency physicians work in a fast-paced environment that is characterized by frequent interruptions and the expectation that they will perform multiple tasks efficiently and without error while maintaining oversight of the entire emergency department. However, there is a lack of definition and understanding of the behaviors that constitute effective task switching and multitasking, as well as how to improve these skills. This article reviews the literature on task switching and multitasking in a variety of disciplines-including cognitive science, human factors engineering, business, and medicine-to define and describe the successful performance of task switching and multitasking in emergency medicine. Multitasking, defined as the performance of two tasks simultaneously, is not possible except when behaviors become completely automatic; instead, physicians rapidly switch between small tasks. This task switching causes disruption in the primary task and may contribute to error. A framework is described to enhance the understanding and practice of these behaviors. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  3. Video-Based Learning vs Traditional Lecture for Instructing Emergency Medicine Residents in Disaster Medicine Principles of Mass Triage, Decontamination, and Personal Protective Equipment.

    Science.gov (United States)

    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.

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

    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

  5. 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.

  6. 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

  7. 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.

  8. Web technology for emergency medicine and secure transmission of electronic patient records.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Alireza Aala

    2014-07-01

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

  10. 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)

  11. Helicopter emergency medical services response to equestrian accidents.

    Science.gov (United States)

    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.

  12. The IAEA Conventions on Early Notification of a Nuclear Accident and on Assistance in the Case of a Nuclear Accident or Radiological Emergency

    International Nuclear Information System (INIS)

    Moser, B.

    1989-01-01

    This article provides a comprehensive analysis of the provisions of both IAEA Conventions. Special attention is paid to the rules of the Convention on Early Notification which identify the events subject to notification and the content and addresses of the information to be provided with regard to a nuclear accident, as well as to the provisions of the Convention on Assistance concerning the request and grant of international assistance with regard to a nuclear accident and the duties attributed in this field to the IAEA. The author also considers the liability questions raised by that Convention. (NEA) [fr

  13. Survey of emergency medicine resident debt status and financial planning preparedness.

    Science.gov (United States)

    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.

  14. Episodes of care: is emergency medicine ready?

    Science.gov (United States)

    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.

  15. The American Board of Emergency Medicine ConCert Examination: Emergency Physicians' Perceptions of Learning and Career Benefits.

    Science.gov (United States)

    Marco, Catherine A; Wahl, Robert P; Counselman, Francis L; Heller, Barry N; Harvey, Anne L; Joldersma, Kevin B; Kowalenko, Terry; Coombs, Andrea B; Reisdorff, Earl J

    2016-09-01

    As part of the American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program, ABEM-certified physicians are required to pass the Continuous Certification (ConCert) examination at least every 10 years. With the 2015 ConCert examination, ABEM sought to better understand emergency physicians' perceptions of the benefits of preparing for and taking the examination and the career benefits of staying ABEM-certified. This was a prospective survey study. A voluntary postexamination survey was administered at the end of the 2015 ABEM ConCert examination (September 21-26, 2015). Physicians were asked about the benefits of preparing for the examination and maintaining ABEM certification. Examination performance was compared to perceptions of learning and career benefits. Of the 2,601 on-time test takers, 2,511 respondents participated (96.5% participation rate). The majority of participants (92.0%) identified a benefit to preparing for the ConCert examination, which included reinforced medical knowledge (73.9%), increased knowledge (66.8%), and making them a better clinician (39.4%). The majority of respondents (90.8%) identified a career benefit of maintaining ABEM certification, which included more employment options (73.8%), more positively viewed by other physicians (56.8%), and better financial outcomes (29.8%). There was a statistically significant association between the perception of knowledge reinforcement and examination performance (p Medicine.

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

    OpenAIRE

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

    2015-01-01

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

  17. 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)

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

    Science.gov (United States)

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

    2016-02-01

    Many graduates will take up junior roles in accident and emergency (A&E) departments to which a large proportion of patients present with facial injuries caused by interpersonal violence. However, it is widely recognised that undergraduates and postgraduates have few opportunities for training in oral and maxillofacial surgery. We aimed to assess the impact of a specifically designed maxillofacial emergencies virtual learning environment (VLE) on the knowledge and confidence of junior doctors in two A&E departments. They were given free access to the VLE for one month, and were asked to complete multiple choice questions and to rate their confidence to deal with 10 common situations on visual analogue scales (VAS) at baseline and one month after training. A total of 29 doctors agreed to pilot the website, 21 (72%) completed both sets of questions, and 18 (62%) completed both VAS assessments. The mean (SD) multiple choice score improved from 10 (2.52) to 13 (3.56) out of a maximum of 20 (p=0.004) and the mean (SD) VAS improved from 29.2 (19.2) mm to 45.7 (16.6) mm out of a maximum of 100 mm (p=0.007). This was a small pilot study with limited numbers, but it showed improvements in the knowledge of maxillofacial emergencies and in confidence, although the latter remained low. Further work is needed to examine how these brief educational interventions affect the attitudes of frontline staff to maxillofacial emergencies. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Time-to-collision analysis of pedestrian and pedal-cycle accidents for the development of autonomous emergency braking systems.

    Science.gov (United States)

    Lenard, James; Welsh, Ruth; Danton, Russell

    2018-06-01

    The aim of this study was to describe the position of pedestrians and pedal cyclists relative to the striking vehicle in the 3 s before impact. This information is essential for the development of effective autonomous emergency braking systems and relevant test conditions for consumer ratings. The UK RAIDS-OTS study provided 175 pedestrian and 127 pedal-cycle cases based on in-depth, at-scene investigations of a representative sample of accidents in 2000-2010. Pedal cyclists were scattered laterally more widely than pedestrians (90% of cyclists within around ±80° compared to ±20° for pedestrians), however their distance from the striking vehicle in the seconds before impact was no greater (90% of cyclists within 42 m at 3 s compared to 50 m for pedestrians). This data is consistent with a greater involvement of slow moving vehicles in cycle accidents. The implication of the results is that AEB systems for cyclists require almost complete 180° side-to-side vision but do not need a longer distance range than for pedestrians. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Nishiwaki, Y.; Kawai, H.; Shono, N.; Fujita, S.; Matsuoka, H.; Fujiwara, S.; Hosoda, T.

    2000-01-01

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

  1. 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)

  2. Radiological emergencies arising from accidents in Italy

    International Nuclear Information System (INIS)

    Bazzan, A.

    1986-01-01

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

  3. 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

  4. 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

  5. The development of the specialism of emergency medicine: media and cultural influences.

    Science.gov (United States)

    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.

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

    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

  7. Use of emergency care services by immigrants—a survey of walk-in patients who attended the Oslo Accident and Emergency Outpatient Clinic.

    Science.gov (United States)

    Ruud, Sven Eirik; Aga, Ruth; Natvig, Bård; Hjortdahl, Per

    2015-10-07

    The Oslo Accident and Emergency Outpatient Clinic (OAEOC) experienced a 5-6% annual increase in patient visits between 2005 and 2011, which was significantly higher than the 2-3% annual increase among registered Oslo residents. This study explored immigrant walk-in patients' use of both the general emergency and trauma clinics of the OAEOC and their concomitant use of regular general practitioners (RGPs) in Oslo. A cross-sectional survey of walk-in patients attending the OAEOC during 2 weeks in September 2009. We analysed demographic data, patients' self-reported affiliation with the RGP scheme, self-reported number of OAEOC and RGP consultations during the preceding 12 months. The first approach used Poisson regression models to study visit frequency. The second approach compared the proportions of first- and second-generation immigrants and those from the four most frequently represented countries (Sweden, Pakistan, Somalia and Poland) among the patient population, with their respective proportions within the general Oslo population. The analysis included 3864 patients: 1821 attended the Department of Emergency General Practice ("general emergency clinic"); 2043 attended the Section for Orthopaedic Emergency ("trauma clinic"). Both first- and second-generation immigrants reported a significantly higher OAEOC visit frequency compared with Norwegians. Norwegians, representing 73% of the city population accounted for 65% of OAEOC visits. In contrast, first- and second-generation immigrants made up 27% of the city population but accounted for 35% of OAEOC visits. This proportional increase in use was primarily observed in the general emergency clinic (42% of visits). Their proportional use of the trauma clinic (29%) was similar to their proportion in the city. Among first-generation immigrants only 71% were affiliated with the RGP system, in contrast to 96% of Norwegians. Similar finding were obtained when immigrants were grouped by nationality. Compared to

  8. Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study

    Science.gov (United States)

    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

  9. Current Status of Gender and Racial/Ethnic Disparities Among Academic Emergency Medicine Physicians.

    Science.gov (United States)

    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.

  10. 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

  11. 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

  12. 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)

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

    Directory of Open Access Journals (Sweden)

    K Asish

    2016-01-01

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

  14. 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

  15. Decision Making Processes for a Pregnant Woman Admitted to the Accident and Emergency Department Requiring Emergency Diagnostic X-ray – A Case Study

    Directory of Open Access Journals (Sweden)

    S. Ismanto

    2017-07-01

    Full Text Available The objective of this study is to apply the decision-making processes for a pregnant woman who was involved in a motor vehicle accident and admitted to a private middle-class hospital in the capital of Indonesia requiring radiologic X-ray examination.  It also aims to examine and evaluate the patient who was in her 20th week of gestation in order to provide her with the best emergency care, diagnostic investigations and treatments.The descriptive, normative and prescriptive models of decision-making are demonstrated. The descriptive model used intuition, while the normative model used decision trees as decision options and lastly the prescriptive decision used the information processing theory (IPT to decide on the best emergency care, diagnostic investigations and treatments for the patient. The IPT dominated the decision-making process; hence an X-ray examination was done that was safe for the fetus and the childbearing mother. Decision option was not used since the patient was in pain and could not understand much of the procedure that was explained.  Intuition helped in the decision-making in order to ensure safe and effective practice.

  16. 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

  17. 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.

  18. Pediatric crisis resource management training improves emergency medicine trainees' perceived ability to manage emergencies and ability to identify teamwork errors.

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

    Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were to provide a realistic learning experience for residents and to help the learners recognize common errors in teamwork and improve their perceived abilities to manage ill pediatric patients. Residents participated in a 4-hour objectives-based workshop derived from a formal needs assessment. To quantify their subjective abilities to manage pediatric cases, the residents completed a postworkshop survey (with a retrospective precomponent to assess perceived change). Ability to identify CRM errors was determined via a written assessment of scripted errors in a prerecorded video observed before and 1 month after completion of the workshop. Fifteen of the 16 eligible emergency medicine residents (postgraduate year 1-5) attended the workshop and completed the surveys. There were significant differences in 15 of 16 retrospective pre to post survey items using the Wilcoxon rank sum test for non-parametric data. These included ability to be an effective team leader in general (P < 0.008), delegating tasks appropriately (P < 0.009), and ability to ensure closed-loop communication (P < 0.008). There was a significant improvement in identification of CRM errors through the use of the video assessment from 3 of the 12 CRM errors to 7 of the 12 CRM errors (P < 0.006). The pediatric CRM simulation-based workshop improved the residents' self-perceptions of their pediatric CRM abilities and improved their performance on a video assessment task.

  19. The Emergence of the Dose–Response Concept in Biology and Medicine

    Directory of Open Access Journals (Sweden)

    Edward J. Calabrese

    2016-12-01

    Full Text Available A historical assessment of the origin of the dose–response in modern toxicology and its integration as a central concept in biology and medicine is presented. This article provides an overview of how the threshold, linear and biphasic (i.e., hormetic dose–response models emerged in the late 19th and early 20th centuries and competed for acceptance and dominance. Particular attention is directed to the hormetic model for which a general description and evaluation is provided, including its historical basis, and how it was marginalized by the medical and pharmacology communities in the early decades of the 20th century.

  20. 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

  1. 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)

  2. 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)

  3. A randomized controlled evaluation of specialist nurse education following accident and emergency department attendance for acute asthma.

    Science.gov (United States)

    Levy, M L; Robb, M; Allen, J; Doherty, C; Bland, J M; Winter, R J

    2000-09-01

    We investigated whether hospital-based specialist asthma nurses improved recognition and self-treatment of asthma episodes by patients followed up after attending accident and emergency departments (A&E) for asthma exacerbations. We carried out a randomized prospective controlled trial of adult asthma self-management, following a hospital outpatient nurse consultation in two outer-London District General Hospitals (secondary care centres). The study included 211 adults, over 18 years old (mean age 40 years) who attended for asthma in two accident and emergency departments over 13 months. One hundred and eight evaluable patients were randomized into the control group who continued with their usual medical treatment and were not offered any intervention during the study period. One hundred and three evaluable patients were randomized into the intervention group. They were offered three 6-weekly outpatient appointments with one of two specialist asthma nurses for a structured asthma consultation, after attendance at the accident and emergency department. Following assessment of their asthma treatment and control, the nurses advised patients, through the use of self-management-plans, how to recognize and manage uncontrolled asthma and when to seek medical assistance. Medication and inhaler device type were altered if necessary The primary outcome was patient reported self-management of asthma exacerbations for 6 months. Secondary outcomes were assessed at baseline, 3 months and 6 months. These included home peak flow and symptom diaries, structured telephone questionnaires and audit of general practitioner records to determine utilization of services (6 months before and after A&E). Data were analysed on an intention to treat basis by multiple and logistic regression. The intervention group increased their use of inhaled topical steroids in 31/61 (51%) vs. 15/70 (21%) attacks in controls (OR 3.91 CI 1.8-8.4, Pentry. Thirty-four percent of intervention patients vs. 42

  4. Characteristics of training and motivation of physicians working in emergency medicine

    Directory of Open Access Journals (Sweden)

    Gilson Soares Feitosa-Filho

    Full Text Available Summary Introduction: Emergency medicine is an area in which correct decisions often need to be made fast, thus requiring a well-prepared medical team. There is little information regarding the profile of physicians working at emergency departments in Brazil. Objective: To describe general characteristics of training and motivation of physicians working in the emergency departments of medium and large hospitals in Salvador, Brazil. Method: A cross-sectional study with standardized interviews applied to physicians who work in emergency units in 25 medium and large hospitals in Salvador. At least 75% of the professionals at each hospital were interviewed. One hospital refused to participate in the study. Results: A total of 659 physicians were interviewed, with a median age of 34 years (interquartile interval: 29-44 years, 329 (49.9% were female and 96 (14.6% were medical residents working at off hours. The percentage of physicians who had been trained with Basic Life Support, Advanced Cardiovascular Life Support and Advanced Trauma Life Support courses was 5.2, 18.4 and 11.0%, respectively, with a greater frequency of Advanced Cardiovascular Life Support training among younger individuals (23.6% versus 13.9%; p<0.001. Thirteen percent said they were completely satisfied with the activity, while 81.3% expressed a desire to stop working in emergency units in the next 15 years, mentioning stress levels as the main reason. Conclusion: The physicians interviewed had taken few emergency immersion courses. A low motivational level was registered in physicians who work in the emergency departments of medium and large hospitals in Salvador.

  5. Basic concept of the nuclear emergency preparedness and response in Japan after the accident of the Fukushima Dai-ichi Nuclear Power Station. The plain explanation for regional officials and emergency workers

    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)

  6. 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

  7. Electronic Whiteboards in Emergency Medicine

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus

    2012-01-01

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

  8. Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review

    Directory of Open Access Journals (Sweden)

    Alyson J. McGregor

    2017-10-01

    Full Text Available The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. This move has resulted in a rapidly increasing body of literature on SABV with important implications for changing the clinical practice of emergency medicine (EM. Translation of this new knowledge to the bedside requires an understanding of how sex-based research will ultimately impact patient care. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.

  9. Emergency medicine journal impact factor and change compared to other medical and surgical specialties.

    Science.gov (United States)

    Reynolds, Joshua C; Menegazzi, James J; Yealy, Donald M

    2012-11-01

    A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time. The 2010 impact factors and 5-year impact factors for each journal indexed by the Thomson Reuters ISI Web of Knowledge Journal Citation Reports (JCR) were collected, and EM, medical, and surgical specialties were evaluated. The maximum, median, and interquartile range (IQR) of the current impact factor and 5-year impact factor in each journal category were determined, and specialties were ranked according to the summary statistics. The "top three" impact factor journals for each specialty were analyzed, and growth trends from 2001 through 2010 were examined with random effects linear regression. Data from 2,287 journals in 31 specialties were examined. There were 23 EM journals with a current maximum impact factor of 4.177, median of 1.269, and IQR of 0.400 to 2.176. Of 23 EM journals, 57% had a 5-year impact factor available, with a maximum of 4.531, median of 1.325, and IQR of 0.741 to 2.435. The top three EM journals had a mean standard deviation (±SD) impact factor of 3.801 (±0.621) and median of 4.142 and a mean (±SD) 5-year impact factor of 3.788 (±1.091) and median of 4.297, with a growth trend of 0.211 (95% confidence interval [CI] = 0.177 to 0.245; p journals ranked no higher than 24th among 31 specialties. Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties. © 2012 by the Society for Academic Emergency Medicine.

  10. Nanotechnology in medicine emerging applications

    CERN Document Server

    Koprowski, Gene

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kuhlen, Johannes

    2014-07-01

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

  12. Newly approved antibiotics and antibiotics reserved for resistant infections: Implications for emergency medicine.

    Science.gov (United States)

    Mazer-Amirshahi, Maryann; Pourmand, Ali; May, Larissa

    2017-01-01

    Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical. Increasing rates of antibiotic resistance, drug allergies, and antibiotic shortages further complicates the choice of antibiotics. Patients may have a history of prior resistant infections or culture data indicating that common first-line antibiotics used in the ED may be ineffective. In recent years, there have been several new antibiotic approvals as well as renewed interest in second and third line antibiotics because of the aforementioned concerns. In addition, several newly approved antibiotics have the advantage of being administered once weekly or even as a single infusion, which has the potential to decrease hospitalizations and healthcare costs. This article reviews newly approved antibiotics and antibiotics used to treat resistant infections with a focus on implications for emergency medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Pattern and outcome of cases seen at the Adult Accident and Emergency Department of the Lagos University Teaching Hospital, Idi-Araba, Lagos.

    Science.gov (United States)

    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

  14. Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap

    OpenAIRE

    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...

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

    Science.gov (United States)

    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.

  16. A review of existing and emerging digital technologies to combat the global trade in fake medicines.

    Science.gov (United States)

    Mackey, Tim K; Nayyar, Gaurvika

    2017-05-01

    The globalization of the pharmaceutical supply chain has introduced new challenges, chief among them, fighting the international criminal trade in fake medicines. As the manufacture, supply, and distribution of drugs becomes more complex, so does the need for innovative technology-based solutions to protect patients globally. Areas covered: We conducted a multidisciplinary review of the science/health, information technology, computer science, and general academic literature with the aim of identifying cutting-edge existing and emerging 'digital' solutions to combat fake medicines. Our review identified five distinct categories of technology including mobile, radio frequency identification, advanced computational methods, online verification, and blockchain technology. Expert opinion: Digital fake medicine solutions are unifying platforms that integrate different types of anti-counterfeiting technologies as complementary solutions, improve information sharing and data collection, and are designed to overcome existing barriers of adoption and implementation. Investment in this next generation technology is essential to ensure the future security and integrity of the global drug supply chain.

  17. 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)

  18. 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

  19. Interpreter services in emergency medicine.

    Science.gov (United States)

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

    2010-02-01

    Emergency physicians are routinely confronted with problems associated with language barriers. It is important for emergency health care providers and the health system to strive for cultural competency when communicating with members of an increasingly diverse society. Possible solutions that can be implemented include appropriate staffing, use of new technology, and efforts to develop new kinds of ties to the community served. Linguistically specific solutions include professional interpretation, telephone interpretation, the use of multilingual staff members, the use of ad hoc interpreters, and, more recently, the use of mobile computer technology at the bedside. Each of these methods carries a specific set of advantages and disadvantages. Although professionally trained medical interpreters offer improved communication, improved patient satisfaction, and overall cost savings, they are often underutilized due to their perceived inefficiency and the inconclusive results of their effect on patient care outcomes. Ultimately, the best solution for each emergency department will vary depending on the population served and available resources. Access to the multiple interpretation options outlined above and solid support and commitment from hospital institutions are necessary to provide proper and culturally competent care for patients. Appropriate communications inclusive of interpreter services are essential for culturally and linguistically competent provider/health systems and overall improved patient care and satisfaction. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  20. 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)

  1. Approach to Reptile Emergency Medicine.

    Science.gov (United States)

    Long, Simon Y

    2016-05-01

    This article summarizes the physiology and anatomy of reptiles, highlighting points relevant for emergency room veterinarians. Other systems, such as the endocrine and immune systems, have not been covered. The many other aspects of reptile species variation are too numerous to be covered. This article provides an overview but encourages clinicians to seek additional species-specific information to better medically diagnose and treat their reptile patients. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

    Ivanov, V.K.; Tsyb, A.F.; Gorsky, A.I.; Maksyutov, M.A.; Rastopchin, E.M.; Konogorov, A.P.; Korelo, A.M.; Biryukov, A.P.; Matyash, V.A.

    1997-01-01

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

  4. Electronic strategies for information and research: cyberNephrology/cyberMedicine in the emerging world.

    Science.gov (United States)

    Solez, Kim; Hales, Michele; Katz, Sheila Moriber

    2005-09-01

    Communication and medicine have evolved together. Internet resources now provide an unprecedented opportunity to provide health assistance to the developing world. The International Society of Nephrology Informatics Commission and National Kidney Foundation cyberNephrology initiative (http://www.cybernephrology.org) have created e-mail discussion groups (e.g., NEPHROL, NEPHKIDS, and so forth) and online texts and web resources (e.g., the Schrier Atlas: http://www.kidneyatlas.org) that are, in many respects, ahead of other areas of medicine. On the other hand, nephrology is quite behind in its embrace of some specific communications initiatives that could benefit emerging nations: the Health InterNetwork Access to Research Initiative program, which provides free full-text access to medical journals and books in poorer countries; the Global Health Network Supercourse, which provides specially designed online lectures for the developing world; and Internet2/Abilene and similar research networks around the world, which provide reliable, guaranteed bandwidth for high-quality Internet videoconferencing as an alternative to face-to-face lectures and meetings. The intent of many educational ventures in nephrology, particularly in the clinical practice guideline realm (National Kidney Foundation Kidney Disease Outcomes Quality Initiative, Kidney Disease Improving Global Outcomes, and so forth), is not just to disseminate information but to change human behavior: physician practice and referral patterns, patient compliance, and so forth. Concepts from the worlds of marketing and entertainment, where the science of changing human behavior is highly evolved, can be used to create high-impact, educational offerings to promote health. They can also be highly beneficial to share Internet educational innovations and future vision across boundaries of medical specialties, which is part of the intent of the cyberMedicine joint venture (http://www.cyber-medicine.org).

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

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J

    2010-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Ching-Hsing Lee

    2014-01-01

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

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

    Science.gov (United States)

    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.

  8. Stem cells in drug discovery, tissue engineering, and regenerative medicine: emerging opportunities and challenges.

    Science.gov (United States)

    Nirmalanandhan, Victor Sanjit; Sittampalam, G Sitta

    2009-08-01

    Stem cells, irrespective of their origin, have emerged as valuable reagents or tools in human health in the past 2 decades. Initially, a research tool to study fundamental aspects of developmental biology is now the central focus of generating transgenic animals, drug discovery, and regenerative medicine to address degenerative diseases of multiple organ systems. This is because stem cells are pluripotent or multipotent cells that can recapitulate developmental paths to repair damaged tissues. However, it is becoming clear that stem cell therapy alone may not be adequate to reverse tissue and organ damage in degenerative diseases. Existing small-molecule drugs and biologicals may be needed as "molecular adjuvants" or enhancers of stem cells administered in therapy or adult stem cells in the diseased tissues. Hence, a combination of stem cell-based, high-throughput screening and 3D tissue engineering approaches is necessary to advance the next wave of tools in preclinical drug discovery. In this review, the authors have attempted to provide a basic account of various stem cells types, as well as their biology and signaling, in the context of research in regenerative medicine. An attempt is made to link stem cells as reagents, pharmacology, and tissue engineering as converging fields of research for the next decade.

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

    Science.gov (United States)

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

    2016-01-01

    To guarantee the security of water quality in water transfer channels, especially in open channels, analysis of potential emergent pollution sources in the water transfer process is critical. It is also indispensable for forewarnings and protection from emergent pollution accidents. Bridges above open channels with large amounts of truck traffic are the main locations where emergent accidents could occur. A Bayesian Network model, which consists of six root nodes and three middle layer nodes, was developed in this paper, and was employed to identify the possibility of potential pollution risk. Dianbei Bridge is reviewed as a typical bridge on an open channel of the Middle Route of the South to North Water Transfer Project where emergent traffic accidents could occur. Risk of water pollutions caused by leakage of pollutants into water is focused in this study. The risk for potential traffic accidents at the Dianbei Bridge implies a risk for water pollution in the canal. Based on survey data, statistical analysis, and domain specialist knowledge, a Bayesian Network model was established. The human factor of emergent accidents has been considered in this model. Additionally, this model has been employed to describe the probability of accidents and the risk level. The sensitive reasons for pollution accidents have been deduced. The case has also been simulated that sensitive factors are in a state of most likely to lead to accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-03-01

    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 US emergency departments to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to US acute care facilities, ethical questions have been raised in both the press and medical literature as to how US emergency departments, emergency physicians, emergency nurses and other stakeholders in the healthcare 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 US emergency physicians, emergency nurses and other stakeholders in the healthcare 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 US emergency departments in how they approach preparation for and management of potential patients with EVD. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Petr Štourač

    2014-12-01

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

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

    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)

  13. "Futile Care"-An Emergency Medicine Approach: Ethical and Legal Considerations.

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

    Sugai, Kenji

    2012-01-01

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

  15. 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

  16. Focus on the emerging new fields of network physiology and network medicine

    Science.gov (United States)

    Ivanov, Plamen Ch; Liu, Kang K. L.; Bartsch, Ronny P.

    2016-10-01

    Despite the vast progress and achievements in systems biology and integrative physiology in the last decades, there is still a significant gap in understanding the mechanisms through which (i) genomic, proteomic and metabolic factors and signaling pathways impact vertical processes across cells, tissues and organs leading to the expression of different disease phenotypes and influence the functional and clinical associations between diseases, and (ii) how diverse physiological systems and organs coordinate their functions over a broad range of space and time scales and horizontally integrate to generate distinct physiologic states at the organism level. Two emerging fields, network medicine and network physiology, aim to address these fundamental questions. Novel concepts and approaches derived from recent advances in network theory, coupled dynamical systems, statistical and computational physics show promise to provide new insights into the complexity of physiological structure and function in health and disease, bridging the genetic and sub-cellular level with inter-cellular interactions and communications among integrated organ systems and sub-systems. These advances form first building blocks in the methodological formalism and theoretical framework necessary to address fundamental problems and challenges in physiology and medicine. This ‘focus on’ issue contains 26 articles representing state-of-the-art contributions covering diverse systems from the sub-cellular to the organism level where physicists have key role in laying the foundations of these new fields.

  17. A High-yield Fall Risk and Adverse Events Screening Questions From the Stopping Elderly Accidents, Death, and Injuries (STEADI) Guideline for Older Emergency Department Fall Patients.

    Science.gov (United States)

    Sri-On, Jiraporn; Tirrell, Gregory Philip; Kamsom, Anucha; Marill, Keith A; Shankar, Kalpana Narayan; Liu, Shan W

    2018-03-25

    The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall. We conducted a prospective study at two urban, teaching hospitals. We included patients aged ≥ 65 years who presented to the ED for an accidental fall. Data were gathered for fall-relevant comorbidities, high-risk medications for falls, and the responses to 12 questions from the STEADI guideline recommendation. Our outcomes were the number of 6-month adverse events that were defined as mortality, ED revisit, subsequent hospitalization, recurrent falls, and a composite outcome. There were 548 (86.3%) patients who completed follow-up and 243 (44.3%) patients experienced an adverse event after a fall within 6 months. In multivariate analysis, seven questions from the STEADI guideline predicted various outcomes. The question "Had previous fall" predicted recurrent falls (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.52 to 3.97), the question "Feels unsteady when walking sometimes" (OR = 2.34, 95% CI = 1.44 to 3.81), and "Lost some feeling in their feet" predicted recurrent falls. In addition to recurrent falls risk, the supplemental questions "Use or have been advised to use a cane or walker," "Take medication that sometimes makes them feel light-headed or more tired than usual," "Take medication to help sleep or improve mood," and "Have to rush to a toilet" predicted other outcomes. A STEADI score of ≥4 did not predict adverse outcomes although seven individual questions from the STEADI guidelines were associated with increased adverse outcomes within 6 months. These may be organized into three categories (previous falls, physical activity, and high-risk medications) and may assist emergency physicians to evaluate and refer high-risk fall patients for a comprehensive

  18. 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

  19. Investigating the effect of Alcohol Brief Interventions within accident and emergency departments using a data informatics methodology.

    Science.gov (United States)

    Baldacchino, Alex; O'Rourke, Louise; Humphris, Gerry

    2018-07-01

    Alcohol Brief Interventions (ABI) have been implemented throughout Scotland since 2008 and aim to reduce hazardous drinking through a Scottish Government funded initiative delivered in a range of settings, including Accident and Emergency (A and E) departments. To study the extent to which Alcohol Brief Interventions (ABI) are associated with later health service use. An opportunistic informatics approach was applied. A unique patient identifier was used to link patient data with core datasets spanning two years previous and two years post ABI. Variables included inpatient attendance, outpatient attendance, psychiatric admissions, and A and E attendance and prescribing. Patients (N = 1704) who presented at A and E departments who reported an average alcohol consumption of more than 8 units daily received the ABI. Fast Alcohol Screening Test (FAST) was used to assess patients for hazardous alcohol consumption. Multilevel linear modelling was employed to predict post-intervention utilisation using pre-ABI variables and controlling for person characteristics and venue. Significant decrease in A and E usage was found at one and two years following the ABI intervention. Previous health service use was predictive of later service use. A single question (Item 4) on the FAST was predictive of A and E attendance at one and two years. This investigation and methodology used provide support for the delivery of the ABI. However, it cannot be ascertained whether this is due to the ABI or simply is a result of making contact with a specialist in the addiction field. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. 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

  1. 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.

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

    Science.gov (United States)

    Heng, Kenneth Wj

    2014-01-01

    Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated.

  3. 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.)

  4. Technology-enhanced simulation in emergency medicine: a systematic review and meta-analysis.

    Science.gov (United States)

    Ilgen, Jonathan S; Sherbino, Jonathan; Cook, David A

    2013-02-01

    Technology-enhanced simulation is used frequently in emergency medicine (EM) training programs. Evidence for its effectiveness, however, remains unclear. The objective of this study was to evaluate the effectiveness of technology-enhanced simulation for training in EM and identify instructional design features associated with improved outcomes by conducting a systematic review. The authors systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Original research articles in any language were selected if they compared simulation to no intervention or another educational activity for the purposes of training EM health professionals (including student and practicing physicians, midlevel providers, nurses, and prehospital providers). Reviewers evaluated study quality and abstracted information on learners, instructional design (curricular integration, feedback, repetitive practice, mastery learning), and outcomes. From a collection of 10,903 articles, 85 eligible studies enrolling 6,099 EM learners were identified. Of these, 56 studies compared simulation to no intervention, 12 compared simulation with another form of instruction, and 19 compared two forms of simulation. Effect sizes were pooled using a random-effects model. Heterogeneity among these studies was large (I(2) ≥ 50%). Among studies comparing simulation to no intervention, pooled effect sizes were large (range = 1.13 to 1.48) for knowledge, time, and skills and small to moderate for behaviors with patients (0.62) and patient effects (0.43; all p 0.1). Qualitative comparisons of different simulation curricula are limited, although feedback, mastery learning, and higher fidelity were associated with improved learning outcomes. Technology-enhanced simulation for EM learners is associated with moderate or large favorable effects in comparison with no intervention and generally small and nonsignificant benefits in comparison

  5. Resident experience of abuse and harassment in emergency medicine: ten years later.

    Science.gov (United States)

    Li, Siu Fai; Grant, Kelly; Bhoj, Tanuja; Lent, Gretchen; Garrick, Jocelyn Freeman; Greenwald, Peter; Haber, Marc; Singh, Malini; Prodany, Karla; Sanchez, Leon; Dickman, Eitan; Spencer, James; Perera, Tom; Cowan, Ethan

    2010-02-01

    In 1995, a Society for Academic Emergency Medicine in-service survey reported high rates of verbal and physical abuse experienced by Emergency Medicine (EM) residents. We sought to determine the prevalence of abuse and harassment 10 years later to bring attention to these issues and determine if there has been a change in the prevalence of abuse over this time period. To determine the prevalence of abuse and harassment in a sample of EM residencies. We conducted a cross-section survey of EM residents from 10 residencies. EM residents were asked about their experience with verbal abuse, verbal threats, physical threats, physical attacks, sexual harassment, and racial harassment; and by whom. The primary outcome of the study was the prevalence of abuse and harassment as reported by EM residents. There were 196 of 380 residents (52%) who completed the survey. The prevalence of any type of abuse experienced was 91%; 86% of residents experienced verbal abuse, 65% verbal threats, 50% physical threats, 26% physical attacks, 23% sexual harassment, and 26% racial harassment. Women were more likely than men to encounter sexual harassment (37% [38/102] vs. 8% [7/92]; p harassment was not limited to minorities (23% [16/60] for Caucasians vs. 26% [29/126] for non-Caucasians; p = 0.59). Senior residents were more likely to have encountered verbal and physical abuse. Only 12% of residents formally reported the abuse they experienced. Abuse and harassment during EM residency continues to be commonplace and is underreported. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  6. Emergence of a rehabilitation medicine model for low vision service delivery, policy, and funding.

    Science.gov (United States)

    Stelmack, Joan

    2005-05-01

    A rehabilitation medicine model for low vision rehabilitation is emerging. There have been many challenges to reaching consensus on the roles of each discipline (optometry, ophthalmology, occupational therapy, and vision rehabilitation professionals) in the service delivery model and finding a place in the reimbursement system for all the providers. The history of low vision, legislation associated with Centers for Medicare and Medicaid Services coverage for vision rehabilitation, and research on the effectiveness of low vision service delivery are reviewed. Vision rehabilitation is now covered by Medicare under Physical Medicine and Rehabilitation codes by some Medicare carriers, yet reimbursement is not available for low vision devices or refraction. Also, the role of vision rehabilitation professionals (rehabilitation teachers, orientation and mobility specialists, and low vision therapists) in the model needs to be determined. In a recent systematic review of the scientific literature on the effectiveness of low vision services contracted by the Agency for Health Care Quality Research, no clinical trials were found. The literature consists primarily of longitudinal case studies, which provide weak support for third-party funding for vision rehabilitative services. Providers need to reach consensus on medical necessity, treatment plans, and protocols. Research on low vision outcomes is needed to develop an evidence base to guide clinical practice, policy, and funding decisions.

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

    International Nuclear Information System (INIS)

    1992-02-01

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

  8. Curriculum Design and Implementation of the Emergency Medicine Chief Resident Incubator.

    Science.gov (United States)

    Gisondi, Michael A; Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle

    2018-02-24

    Background Chief residents receive minimal formal training in preparation for their administrative responsibilities. There is a lack of professional development programs specifically designed for chief residents. Objective In 2015, Academic Life in Emergency Medicine designed and implemented an annual, year-long, training program and virtual community of practice for chief residents in emergency medicine (EM). This study describes the curriculum design process and reports measures of learner engagement during the first two cycles of the curriculum. Methods Kern's Six-Step Approach for curriculum development informed key decisions in the design and implementation of the Chief Resident Incubator. The resultant curriculum was created using constructivist social learning theory, with specific objectives that emphasized the needs for a virtual community of practice, longitudinal content delivery, mentorship for participants, and the facilitation of multicenter digital scholarship. The 12-month curriculum included 11 key administrative or professional development domains, delivered using a combination of digital communications platforms. Primary outcomes measures included markers of learner engagement with the online curriculum, recognized as modified Kirkpatrick Level One outcomes for digital learning. Results An average of 206 chief residents annually enrolled in the first two years of the curriculum, with an overall participation by 33% (75/227) of the allopathic EM residency programs in the United States (U.S.). There was a high level of learner engagement, with an average 13,414 messages posted per year. There were also 42 small group teaching sessions held online, which included 39 faculty and 149 chief residents. The monthly e-newsletter had a 50.7% open rate. Digital scholarship totaled 23 online publications in two years, with 67 chief resident co-authors and 21 faculty co-authors. Conclusions The Chief Resident Incubator is a virtual community of practice that

  9. Do emergency medicine residents and faculty have similar learning styles when assessed with the Kolb learning style assessment tool?

    Science.gov (United States)

    Fredette, Jenna; O'Brien, Corinne; Poole, Christy; Nomura, Jason

    2015-04-01

    Experiential learning theory and the Kolb Learning Style Inventory (Kolb LSI) have influenced educators worldwide for decades. Knowledge of learning styles can create efficient learning environments, increase information retention, and improve learner satisfaction. Learning styles have been examined in medicine previously, but not specifically with Emergency Medicine (EM) residents and attendings. Using the Kolb LSI, the learning styles of Emergency Medicine residents and attendings were assessed. The findings showed that the majority of EM residents and attendings shared the accommodating learning style. This result was different than prior studies that found the majority of medical professionals had a converging learning style and other studies that found attendings often have different learning styles than residents. The issue of learning styles among emergency medical residents and attendings is important because learning style knowledge may have an impact on how a residency program structures curriculum and how EM residents are successfully, efficiently, and creatively educated.

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

    International Nuclear Information System (INIS)

    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.)

  11. Building of communication system for nuclear accident emergency disposal based on IP multimedia subsystem

    Science.gov (United States)

    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.

  12. Radiographer-led discharge in accident and emergency - The results of a pilot project

    International Nuclear Information System (INIS)

    Snaith, Beverly A.

    2007-01-01

    Introduction: The radiographers role in trauma has been traditionally limited to image acquisition, but has evolved to include responsibility for image interpretation. The contribution to ongoing patient management has been limited, despite pressure on A and E systems to decrease any potential delays. Background: Three experienced reporting radiographers were trained to discharge patients with a normal radiology report or refer to A and E for further management, following a documented management plan by the examining clinician in A and E. Discharge included advice on the acute management of soft tissue injuries including analgesia and exercise. Methodology: Over a 4-month period in early 2004 all patients whose examinations received a report at the time of attendance (hot report) were included and data were collected in relation to those who were discharged including journey times and further A and E attendances. Data were also collected regarding patients recalled to the A and E department due to misinterpretation of radiographs during the study period. Results: The radiographers hot reported 1760 examinations, discharging 88 (5%) and referring a further 26 (2%) directly for treatment. The number of patients recalled due to misinterpretation of the radiographs was decreased by 52% when compared with the previous 3 years data. Conclusion: Radiographers can safely extend their roles outside of the radiology department and contribute to the management of patients whilst decreasing risk of radiographic misinterpretation by A and E

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

    International Nuclear Information System (INIS)

    Wernli, G.

    1989-01-01

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

  14. Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

    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

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

    Directory of Open Access Journals (Sweden)

    Brian Dawson, MD

    2010-05-01

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

  16. 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.)

  17. Error identification, disclosure, and reporting: practice patterns of three emergency medicine provider types.

    Science.gov (United States)

    Hobgood, Cherri; Xie, Jipan; Weiner, Bryan; Hooker, James

    2004-02-01

    To gather preliminary data on how the three major types of emergency medicine (EM) providers, physicians, nurses (RNs), and out-of-hospital personnel (EMTs), differ in error identification, disclosure, and reporting. A convenience sample of emergency department (ED) providers completed a brief survey designed to evaluate error frequency, disclosure, and reporting practices as well as error-based discussion and educational activities. One hundred sixteen subjects participated: 41 EMTs (35%), 33 RNs (28%), and 42 physicians (36%). Forty-five percent of EMTs, 56% of RNs, and 21% of physicians identified no clinical errors during the preceding year. When errors were identified, physicians learned of them via dialogue with RNs (58%), patients (13%), pharmacy (35%), and attending physicians (35%). For known errors, all providers were equally unlikely to inform the team caring for the patient. Disclosure to patients was limited and varied by provider type (19% EMTs, 23% RNs, and 74% physicians). Disclosure education was rare, with error to a patient. Error discussions are widespread, with all providers indicating they discussed their own as well as the errors of others. This study suggests that error identification, disclosure, and reporting challenge all members of the ED care delivery team. Provider-specific education and enhanced teamwork training will be required to further the transformation of the ED into a high-reliability organization.

  18. Draft bill relating to the IAEA convention of September 26, 1986, on early notification of nuclear accident, and on mutual assistance in care of nuclear accident or radiological emergency (IAEA Conventions on notification and on assistance)

    International Nuclear Information System (INIS)

    1989-01-01

    The purpose of the two Conventions signed in Vienna on Sept. 26, 1986, is to support and improve international cooperation in case of a nuclear accident or a radiological emergency probably involving transfrontier contamination, and to provide the necessary legal framework for cooperation and assistance, as well as a basis for an information system. The bill presented by the Federal Government creates the legal basis for ratification of the Conventions in compliance with Art. 59, paragraph 2, first sentence of the Basic Law. Majority decision. (orig./HP) [de

  19. Female authorship in emergency medicine parallels women practicing academic emergency medicine.

    Science.gov (United States)

    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.

  20. 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

  1. Smartphones and Medical Apps in the Practice of Emergency Medicine in Iran

    Directory of Open Access Journals (Sweden)

    Amirhosein Jahanshir

    2017-01-01

    Full Text Available Introduction: Medical applications help physicians to make more rapid and evidence based decisions that may provide better patient care. This study aimed to determine the extent to which smart phones and medical applications are integrated in the emergency department daily practice.Method: In a cross sectional study, a modified standard questionnaire (Payne et al. consisting of demographic data and information regarding quality and quantity of smartphone and medical app utilization was sent to emergency-medicine residents and interns twice (two weeks apart, in January 2015. The questionnaire was put online using open access "Web-form Module" and the address of the web page was e-mailed along with a cover letter explaining the survey. Finally, responses were analyzed using descriptive statistics and SPSS 22 software.Results: 65 cases participated (response rate 86%. The mean age of interns and residents were 25.03 ± 1.13 and 30.27 ± 4.68 years, respectively (p < 0.001. There was no significant difference between interns and residents in owning a smartphone (p = 0.5. Android was more popular than IOS (67.7% against 25.8% and the most popular medical apps were Medscape and UpToDate, respectively. 38 (61.3% of the respondents were using their apps more than once a day and mostly for drug information. English (83.9%, Persian (12.9%, and other languages (3.2% were preferred languages for designing a medical software among the participants, respectively.Conclusion: The findings of present study showed that smartphones are very popular among Iranian interns and residents in emergency department and a substantial number of them own a smartphone and are using medical apps regularly in their clinical practice. 

  2. 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)

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

    Science.gov (United States)

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

    2016-05-01

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

  4. Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

    Science.gov (United States)

    Hobgood, Cherri; Weiner, Bryan; Tamayo-Sarver, Joshua H

    2006-04-01

    To determine if the three types of emergency medicine providers--physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs])--differ in their identification, disclosure, and reporting of medical error. A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p error types, identification, disclosure, and reporting increased with increasing severity. Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type.

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

    Directory of Open Access Journals (Sweden)

    M. Fernanda Bellolio

    2014-09-01

    Full Text Available Introduction: Compassion fatigue (CF is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM resident physicians, including an assessment of contributing factors. Methods: We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress, with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results: We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013, or did not work overnight (mean score 23.5 vs 21.3; p=0.022. EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048, and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012. Conclusion: CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily

  6. 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

  7. Implementation and assessment of a training course for residents in neonatology and pediatric emergency medicine.

    Science.gov (United States)

    Brossier, D; Bellot, A; Villedieu, F; Fazilleau, L; Brouard, J; Guillois, B

    2017-05-01

    Residents must balance patient care and the ongoing acquisition of medical knowledge. With increasing clinical responsibilities and patient overload, medical training is often left aside. In 2010, we designed and implemented a training course in neonatology and pediatric emergency medicine for residents in pediatrics, in order to improve their medical education. The course was made of didactic sessions and several simulation-based seminars for each year of residency. We conducted this study to assess the impact of our program on residents' satisfaction and self-assessed clinical skills. A survey was conducted at the end of each seminar. The students were asked to complete a form on a five-point rating scale to evaluate the courses and their impact on their satisfaction and self-assessed clinical skills, following the French National Health Institute's adapted Kirkpatrick model. Sixty-four (84%) of the 76 residents who attended the courses completed the form. The mean satisfaction score for the entire course was 4.78±0.42. Over 80% of the students felt that their clinical skills had improved. Medical education is an important part of residency training. Our training course responded to the perceived needs of the students with consistently satisfactory evaluations. Before the evaluation of the impact of the course on patient care, further studies are needed to assess the acquisition of knowledge and skills through objective evaluations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. CAEP 2014 Academic Symposium: "How to make research succeed in your emergency department: How to develop and train career researchers in emergency medicine".

    Science.gov (United States)

    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

  9. Burnout among female emergency medicine physicians: A nationwide study.

    Science.gov (United States)

    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.

  10. 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)

  11. Reliability analysis of emergency decay heat removal system of nuclear ship under various accident conditions

    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)

  12. The Rhode Island Life Saving Score (RILSS)--a proposed life-saving definition for EMS and emergency medicine.

    Science.gov (United States)

    Williams, Kenneth A; Sullivan, Francis M

    2013-12-03

    Emergency Medical Services (EMS) and Emergency Medicine staff are often described as life-saving providers, but there is no generally accepted objective definition of a life saved by these providers. Therefore, a proposed definition is described. Development of this definition began with conceptual rules, followed by a survey of physician EMS medical directors, and then by the development of a tool to implement the definition, and measure its validity and reliability through a review of 100 critical care transport EMS patient charts.

  13. Nuclear accidents and epidemiology

    International Nuclear Information System (INIS)

    1987-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  15. Hypothetical accidents of light-water moderated nuclear power plants in the framework of emergency planning

    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

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

    Directory of Open Access Journals (Sweden)

    Celeste de Souza Rodrigues

    2012-09-01

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

  17. Customizing anaphylaxis guidelines for emergency medicine.

    Science.gov (United States)

    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.

  18. Occupational accidents among ambulance drivers in the emergency relief.

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    David Pearson

    2015-10-01

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

  20. What does remediation and probation status mean? A survey of emergency medicine residency program directors.

    Science.gov (United States)

    Weizberg, Moshe; Smith, Jessica L; Murano, Tiffany; Silverberg, Mark; Santen, Sally A

    2015-01-01

    Emergency medicine (EM) residency program directors (PDs) nationwide place residents on remediation and probation. However, the Accreditation Council for Graduate Medical Education and the EM PDs have not defined these terms, and individual institutions must set guidelines defining a change in resident status from good standing to remediation or probation. The primary objective of this study was to determine if EM PDs follow a common process to guide actions when residents are placed on remediation and probation. An anonymous electronic survey was distributed to EM PDs via e-mail using SurveyMonkey to determine the current practice followed after residents are placed on remediation or probation. The survey queried four designations: informal remediation, formal remediation, informal probation, and formal probation. These designations were compared for deficits in the domains of medical knowledge (MK) and non-MK remediation. The survey asked what process for designation exists and what actions are triggered, specifically if documentation is placed in a resident's file, if the graduate medical education (GME) office is notified, if faculty are informed, or if resident privileges are limited. Descriptive data are reported. Eighty-one of 160 PDs responded. An official policy on remediation and/or probation was reported by 41 (50.6%) programs. The status of informal remediation is used by 73 (90.1%), 80 (98.8%) have formal remediation, 40 (49.4%) have informal probation, and 79 (97.5%) have formal probation. There was great variation among PDs in the management and definition of remediation and probation. Between 81 and 86% of programs place an official letter into the resident's file regarding formal remediation and probation. However, only about 50% notify the GME office when a resident is placed on formal remediation. There were no statistical differences between MK and non-MK remediation practices. There is significant variation among EM programs regarding the

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

    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...

  2. [Needs and expectations of general physicians exposed to emergency medicine: a study in Neuchâtel].

    Science.gov (United States)

    Hanhart, W-A; Gusmini, W; Kehtari, R

    2008-11-12

    The emergency ward constitutes the main extra/intra-hospital interface most in demand by general physicians (GP). In order to evaluate the needs and the expectations of GP and, thus, to improve the cooperation between different partners, we underwent a study over 150 GP in Neuchâtel, Switzerland. The rate of participation within the time limit was 61.3%. The results showed that only 49% of GP find an interest in emergency medicine and less than a half (43%) feel not at ease when facing to vital emergencies. However 67% of GP confirmed being highly interested to attend special training in emergency field. The cooperation with medical emergency team (SMUR) and paramedics came out to be satisfactory. Facilities to access to the medico-technical platform of the emergency ward is also highly requested.

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

    Directory of Open Access Journals (Sweden)

    Majid Shojaee

    2014-09-01

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

  4. CAEP 2015 Academic Symposium: Leadership within the emergency medicine academic community and beyond.

    Science.gov (United States)

    Sinclair, Doug; Worthington, James R; Joubert, Gary; Holroyd, Brian R; Stempien, James; Letovsky, Eric; Rutledge, Tim; LeBlanc, Constance; Pitters, Carrol; McCallum, Andrew; Carr, Brendan; Gerace, Rocco; Stiell, Ian G; Artz, Jennifer D; Christenson, Jim

    2016-05-01

    A panel of emergency medicine (EM) leaders endeavoured to define the key elements of leadership and its models, as well as to formulate consensus recommendations to build and strengthen academic leadership in the Canadian EM community in the areas of mentorship, education, and resources. The expert panel comprised EM leaders from across Canada and met regularly by teleconference over the course of 9 months. From the breadth of backgrounds and experience, as well as a literature review and the development of a leadership video series, broad themes for recommendations around the building and strengthening of EM leadership were presented at the CAEP 2015 Academic Symposium held in Edmonton, Alberta. Feedback from the attendees (about 80 emergency physicians interested in leadership) was sought. Subsequently, draft recommendations were developed by the panel through attendee feedback, further review of the leadership video series, and expert opinion. The recommendations were distributed to the CAEP Academic Section for further feedback and updated by consensus of the expert panel. The methods informed the panel who framed recommendations around four themes: 1) leadership preparation and training, 2) self-reflection/emotional intelligence, 3) academic leadership skills, and 4) gender balance in academic EM leadership. The recommendations aimed to support and nurture the next generation of academic EM leaders in Canada and included leadership mentors, availability of formal educational courses/programs in leadership, self-directed education of aspiring leaders, creation of a Canadian subgroup with the AACEM/SAEM Chair Development Program, and gender balance in leadership roles. These recommendations serve as a roadmap for all EM leaders (and aspiring leaders) to build on their success, inspire their colleagues, and foster the next generation of Canadian EM academic leaders.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Thoma, Brent

    2015-03-01

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

  7. Homocysteine and cerebrovascular accidents.

    Science.gov (United States)

    Datta, Saikat; Pal, Salil K; Mazumdar, Hirak; Bhandari, Biswanath; Bhattacherjee, Sharmistha; Pandit, Sudipta

    2009-06-01

    Hyperhomocysteinaemia is rapidly emerging as an important risk factor for coronary artery disease, possibly because of its propensity to accelerate atherosclerosis. Whether it is also a risk factor for cerebrovascular accidents (CVA) is a matter of debate till now, as there are conflicting results of the various prospective studies. The present study was performed to correlate the levels of plasma homocysteine levels with that of ischaemic and haemorrhagic CVA. Forty-two cases of CVA were randomly selected over a period of one year, and their risk factors were assessed. It was observed that serum homocysteine levels were significantly raised in those with intracerebral infarcts when compared to those with intracerebral haemorrhage, although homocysteine levels didn't prove to be prognostically significant.

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

    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

  9. 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. Volume 2 contains copies of original documents issued by Danish authorities during the first accident phase and afterwards. Evaluations, monitoring data, press releases, legislation acts etc. are included. (author)

  10. Chernobyl accident and Danmark

    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. Volume 1 contains copies of original documents issued by Danish authorities during the first accident phase and afterwards. Evaluations, monitoring data, press releases, legislation acts etc. are included. (author)

  11. The Reactive Species Interactome: Evolutionary Emergence, Biological Significance, and Opportunities for Redox Metabolomics and Personalized Medicine.

    Science.gov (United States)

    Cortese-Krott, Miriam M; Koning, Anne; Kuhnle, Gunter G C; Nagy, Peter; Bianco, Christopher L; Pasch, Andreas; Wink, David A; Fukuto, Jon M; Jackson, Alan A; van Goor, Harry; Olson, Kenneth R; Feelisch, Martin

    2017-10-01

    Oxidative stress is thought to account for aberrant redox homeostasis and contribute to aging and disease. However, more often than not, administration of antioxidants is ineffective, suggesting that our current understanding of the underlying regulatory processes is incomplete. Recent Advances: Similar to reactive oxygen species and reactive nitrogen species, reactive sulfur species are now emerging as important signaling molecules, targeting regulatory cysteine redox switches in proteins, affecting gene regulation, ion transport, intermediary metabolism, and mitochondrial function. To rationalize the complexity of chemical interactions of reactive species with themselves and their targets and help define their role in systemic metabolic control, we here introduce a novel integrative concept defined as the reactive species interactome (RSI). The RSI is a primeval multilevel redox regulatory system whose architecture, together with the physicochemical characteristics of its constituents, allows efficient sensing and rapid adaptation to environmental changes and various other stressors to enhance fitness and resilience at the local and whole-organism level. To better characterize the RSI-related processes that determine fluxes through specific pathways and enable integration, it is necessary to disentangle the chemical biology and activity of reactive species (including precursors and reaction products), their targets, communication systems, and effects on cellular, organ, and whole-organism bioenergetics using system-level/network analyses. Understanding the mechanisms through which the RSI operates will enable a better appreciation of the possibilities to modulate the entire biological system; moreover, unveiling molecular signatures that characterize specific environmental challenges or other forms of stress will provide new prevention/intervention opportunities for personalized medicine. Antioxid. Redox Signal. 00, 000-000.

  12. Self reported involvement in emergency medicine among GPs in Norway.

    Science.gov (United States)

    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.

  13. Free Open Access Medical Education resource knowledge and utilisation amongst Emergency Medicine trainees: A survey in four countries

    Directory of Open Access Journals (Sweden)

    Natalie Thurtle

    2016-03-01

    The Emergency Medicine trainees in both developed and low resource settings studied were aware that Free Open Access Medical Education resources exist, but trainees in lower income settings were generally less aware of specific resources. Lack of internet and device access was not a barrier to use in this group.

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

    Directory of Open Access Journals (Sweden)

    Gabrielle A. Jacquet

    2013-01-01

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

  15. Emergency medicine resident physicians' perceptions of electronic documentation and workflow: a mixed methods study.

    Science.gov (United States)

    Neri, P M; Redden, L; Poole, S; Pozner, C N; Horsky, J; Raja, A S; Poon, E; Schiff, G; Landman, A

    2015-01-01

    To understand emergency department (ED) physicians' use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving

  16. Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital based study.

    Science.gov (United States)

    Seid, Mohammed; Azazh, Aklilu; Enquselassie, Fikre; Yisma, Engida

    2015-05-20

    Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world's roads, and the risk of dying as a result of a road traffic injury is highest in Africa. A prospective hospital based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 20.0. Hierarchical multiple regression analysis was used to identify predictors of fatalities among the road traffic crash victims. A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims' ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4%. Hierarchical multiple regression analysis showed that age of the victims (ß = 0.16, p road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

  17. Educational technology improves ECG interpretation of acute myocardial infarction among medical students and emergency medicine residents.

    Science.gov (United States)

    Pourmand, Ali; Tanski, Mary; Davis, Steven; Shokoohi, Hamid; Lucas, Raymond; Zaver, Fareen

    2015-01-01

    Asynchronous online training has become an increasingly popular educational format in the new era of technology-based professional development. We sought to evaluate the impact of an online asynchronous training module on the ability of medical students and emergency medicine (EM) residents to detect electrocardiogram (ECG) abnormalities of an acute myocardial infarction (AMI). We developed an online ECG training and testing module on AMI, with emphasis on recognizing ST elevation myocardial infarction (MI) and early activation of cardiac catheterization resources. Study participants included senior medical students and EM residents at all post-graduate levels rotating in our emergency department (ED). Participants were given a baseline set of ECGs for interpretation. This was followed by a brief interactive online training module on normal ECGs as well as abnormal ECGs representing an acute MI. Participants then underwent a post-test with a set of ECGs in which they had to interpret and decide appropriate intervention including catheterization lab activation. 148 students and 35 EM residents participated in this training in the 2012-2013 academic year. Students and EM residents showed significant improvements in recognizing ECG abnormalities after taking the asynchronous online training module. The mean score on the testing module for students improved from 5.9 (95% CI [5.7-6.1]) to 7.3 (95% CI [7.1-7.5]), with a mean difference of 1.4 (95% CI [1.12-1.68]) (p<0.0001). The mean score for residents improved significantly from 6.5 (95% CI [6.2-6.9]) to 7.8 (95% CI [7.4-8.2]) (p<0.0001). An online interactive module of training improved the ability of medical students and EM residents to correctly recognize the ECG evidence of an acute MI.

  18. Relationship between category size and journals' impact factor: implications for emergency medicine journals and researchers.

    Science.gov (United States)

    Miró, Òscar; Brown, Anthony F T; Graham, Colin A; Ducharme, James; Martin-Sanchez, Francisco J; Cone, David C

    2015-10-01

    We assessed the relationship between the size of the 39 Journal Citation Reports (JCR) medical categories and impact factor (IF) of journals in these categories, and the implications that it might have for emergency medicine (EM) journals. Using the 2010 JCR database, we calculated the mean IF, 5-year IF (5y-IF), Eigenfactor (EF), and Article Influence (AI) scores including all journals for each category. We also calculated a 'weighted IF' for all journals by dividing each journal IF by the mean IF of its category. We ranked EM journals according to IF and 'weighted IF' into all the journals included in the 39 categories. We assessed the relationship between category size and bibliometric scores by linear regression. Category size varied from 252 journals (Pharmacology and Pharmacy) to 14 (Primary Healthcare), EM category occupying the 36th position (23 journals). The mean IF of EM category ranked in 34th position, 5-yIF in 32nd, EF in 34th, and AI in 34th position. Category size had a direct and significant association with mean IF, 5y-IF, and AI but not with mean EF. When the EM journals were ranked among all the journals according to their IF, only two (9%) were placed into the first quartile and raised up to eight (35%) when 'weighted IF' was considered. There is a negative relationship between JCR size category and IF achieved by the journals. This places EM journals at a clear disadvantage because they represent one of the smallest clinical medical research disciplines.

  19. Communication and industrial accidents

    NARCIS (Netherlands)

    As, Sicco van

    2001-01-01

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

  20. [Injury pattern and identification after airplane catastrophies. Cooperation between forensic medicine and federal criminal investigations. An airplane accident in Mühlheim/Ruhr 8 February 1988].

    Science.gov (United States)

    Weiler, G; Risse, M

    1989-01-01

    On February 8th 1988, a two-motor passenger aircraft of Metroliner type with 21 people on board entered a front of heavy weather at an altitude of 900 m and crashed after being struck by lightning which led to complete breakdown of the electrical systems on board. The site of the crash was in the marshy Ruhr meadows. The formation of the terrain enabled a subdivision into plan squares for rescue. The identification of the 21 bodies was carried out in the Essen Institute of Forensic Medicine in collaboration with the identification commission of the Federal Criminal Investigation Office. The experience and recommendations for future (possibly larger-scale) disasters derived from this are described. Furthermore, the accident pattern in the casualties typical for this air crash is discussed.

  1. Administration and leadership competencies: establishment of a national consensus for emergency medicine.

    Science.gov (United States)

    Thoma, Brent; Poitras, Julien; Penciner, Rick; Sherbino, Jonathan; Holroyd, Brian R; Woods, Robert A

    2015-03-01

    The Royal College of Physicians and Surgeons of Canada requires emergency medicine (EM) residency programs to meet training objectives relating to administration and leadership. The purpose of this study was to establish a national consensus on the competencies for inclusion in an EM administration and leadership curriculum. A modified Delphi process involving two iterative rounds of an electronic survey was used to achieve consensus on competencies for inclusion in an EM administration and leadership curriculum. An initial list of competencies was compiled using peer-reviewed and grey literature. The participants included 14 EM residency program directors and 43 leadership and administration experts from across Canada who were recruited using a snowball technique. The proposed competencies were organized using the CanMEDS Physician Competency Framework and presented in English or French. Consensus was defined a priori as >70% agreement. Nearly all (13 of 14) of the institutions with an FRCPC EM program had at least one participant complete both surveys. Thirty-five of 57 (61%) participants completed round 1, and 30 (53%) participants completed both rounds. Participants suggested an additional 16 competencies in round 1. The results of round 1 informed the decisions in round 2. Fifty-nine of 109 (54.1%) competencies achieved consensus for inclusion. Based on a national modified Delphi process, we describe 59 competencies for inclusion in an EM administration and leadership curriculum that was arranged by CanMEDS Role. EM educators may consider these competencies when designing local curricula.

  2. The social media index: measuring the impact of emergency medicine and critical care websites.

    Science.gov (United States)

    Thoma, Brent; Sanders, Jason L; Lin, Michelle; Paterson, Quinten S; Steeg, Jordon; Chan, Teresa M

    2015-03-01

    The number of educational resources created for emergency medicine and critical care (EMCC) that incorporate social media has increased dramatically. With no way to assess their impact or quality, it is challenging for educators to receive scholarly credit and for learners to identify respected resources. The Social Media index (SMi) was developed to help address this. We used data from social media platforms (Google PageRanks, Alexa Ranks, Facebook Likes, Twitter Followers, and Google+ Followers) for EMCC blogs and podcasts to derive three normalized (ordinal, logarithmic, and raw) formulas. The most statistically robust formula was assessed for 1) temporal stability using repeated measures and website age, and 2) correlation with impact by applying it to EMCC journals and measuring the correlation with known journal impact metrics. The logarithmic version of the SMi containing four metrics was the most statistically robust. It correlated significantly with website age (Spearman r=0.372; pimpact metrics except number of articles published. The strongest correlations were seen with the Immediacy Index (r=0.609; pimpact factors suggests that it may be a stable indicator of impact for medical education websites. Further study is needed to determine whether impact correlates with quality and how learners and educators can best utilize this tool.

  3. LABORATORY OF CLINICAL IMMUNOLOGY N.V. SKLIFOSOVSKY RESEARCH INSTITUTE FOR EMERGENCY MEDICINE (HISTORY AND PRESENT

    Directory of Open Access Journals (Sweden)

    M. A. Godkov

    2013-01-01

    Full Text Available ABSTRACT. Assessment of the immune status of patients with urgent types of pathology in the Institute for Emergency Medicine is performed according to three main objects of research: humoral , phagocytic and lymphocytic components of immune system . This complex allows to fully and adequately evaluate the condition of the immune system of patients at different stages of traumatic disease and after transplantation of organs and tissues , to forecast the probability of septic complications developing, adjust the therapy . During 45 years of work of immunological service formed the algorithm of the adequate immunological screening was formed, number of innovative methods of diagnosis was developed, the ideology of post-test counseling of patients by immunologists was created, mathematical methods of storage, modeling and processing of research results was introduced. Laboratory staff identified a number of medical and social factors in the spread of blood-borne viral infections (HIV, hepatitis B and C. New organizational and economic methods of management team were introduced in the laboratory. The basis of the work is equal integration of scientific and clinical staff of the laboratory. 

  4. 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.

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

    Science.gov (United States)

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

    2010-09-01

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

  6. Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on women in academic emergency medicine.

    Science.gov (United States)

    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.

  7. Do emergency medicine journals promote trial registration and adherence to reporting guidelines? A survey of "Instructions for Authors".

    Science.gov (United States)

    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

  8. Emergency medicine: an operations management view.

    Science.gov (United States)

    Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

    2011-12-01

    Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider. © 2011 by the Society for Academic Emergency Medicine.

  9. Reflections on the consensus process: a leadership role for emergency medicine in educational scholarship and practice across health care.

    Science.gov (United States)

    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.

  10. Emergency ultrasound and echocardiography in patients with infarct-related cardiogenic shock : A survey among members of the German Society of Medical Intensive Care and Emergency Medicine.

    Science.gov (United States)

    Michels, G; Hempel, D; Pfister, R; Janssens, U

    2018-04-09

    Current international and national guidelines promote the use of emergency echocardiography in patients with cardiogenic shock. We assessed whether these recommendations are followed in clinical practice of infarct-related cardiogenic shock patients. For this purpose we conducted a web-based survey among all members of the German Society of Medical Intensive Care and Emergency Medicine (DGIIN); 40% of the DGIIN members completed the survey. Participants reported that in their department emergency echocardiography/ultrasound is performed on most patients in infarct-related cardiogenic shock presenting to the emergency department/chest pain unit or intensive care unit (58.6% versus 81.4%). Only 33% stated that on patients admitted directly to the catheterization laboratory emergency ultrasound/echocardiography is applied in their institution. Local availability of a standardized algorithm was lacking in the majority of departments (77.2%). A great proportion (38.3%) of participants stated that they personally had no formal training in emergency ultrasound. In order to meet the demands of the current guidelines, in addition to integration of ultrasound examinations into diagnostic algorithms, a structured training of all emergency and intensive care physicians is necessary.

  11. Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

    Science.gov (United States)

    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.

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    Kasal, B.; Dodig, D.; Tezak, S.

    2000-01-01

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

  14. Ethics curriculum for emergency medicine graduate medical education.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2015-07-01

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

  16. [Accidents and injuries at work].

    Science.gov (United States)

    Standke, W

    2014-06-01

    In the case of an accident at work, the person concerned is insured by law according to the guidelines of the Sozialgesetzbuch VII as far as the injuries have been caused by this accident. The most important source of information on the incident in question is the accident report that has to be sent to the responsible institution for statutory accident insurance and prevention by the employer, if the accident of the injured person is fatal or leads to an incapacity to work for more than 3 days (= reportable accident). Data concerning accidents like these are sent to the Deutsche Gesetzliche Unfallversicherung (DGUV) as part of a random sample survey by the institutions for statutory accident insurance and prevention and are analyzed statistically. Thus the key issues of accidents can be established and used for effective prevention. Although the success of effective accident prevention is undisputed, there were still 919,025 occupational accidents in 2011, with clear gender-related differences. Most occupational accidents involve the upper and lower extremities. Accidents are analyzed comprehensively and the results are published and made available to all interested parties in an effort to improve public awareness of possible accidents. Apart from reportable accidents, data on the new occupational accident pensions are also gathered and analyzed statistically. Thus, additional information is gained on accidents with extremely serious consequences and partly permanent injuries for the accident victims.

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

    International Nuclear Information System (INIS)

    Parfenova, L.N.

    1995-01-01

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

  18. Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.

    Science.gov (United States)

    Musey, Paul I; Linnstaedt, Sarah D; Platts-Mills, Timothy F; Miner, James R; Bortsov, Andrey V; Safdar, Basmah; Bijur, Polly; Rosenau, Alex; Tsze, Daniel S; Chang, Andrew K; Dorai, Suprina; Engel, Kirsten G; Feldman, James A; Fusaro, Angela M; Lee, David C; Rosenberg, Mark; Keefe, Francis J; Peak, David A; Nam, Catherine S; Patel, Roma G; Fillingim, Roger B; McLean, Samuel A

    2014-12-01

    Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender

  19. Domino effect in chemical accidents: main features and accident sequences

    OpenAIRE

    Casal Fàbrega, Joaquim; Darbra Roman, Rosa Maria

    2010-01-01

    The main features of domino accidents in process/storage plants and in the transportation of hazardous materials were studied through an analysis of 225 accidents involving this effect. Data on these accidents, which occurred after 1961, were taken from several sources. Aspects analyzed included the accident scenario, the type of accident, the materials involved, the causes and consequences and the most common accident sequences. The analysis showed that the most frequent causes a...

  20. Complex systems thinking in emergency medicine: A novel paradigm for a rapidly changing and interconnected health care landscape.

    Science.gov (United States)

    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.

  1. Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Head, Eyes, Ears, Nose and Throat Emergencies Small Group Module

    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

  2. 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

  3. CAEP 2016 Academic Symposium: How to have an impact as an emergency medicine educator and scholar.

    Science.gov (United States)

    Frank, Jason R; Cheung, Warren J; Sherbino, Jonathan; Primavesi, Robert; Woods, Robert A; Bandiera, Glen; LeBlanc, Constance

    2017-05-01

    In a time of major medical education transformation, emergency medicine (EM) needs to nurture education scholars who will influence EM education practice. However, the essential ingredients to ensure a career with impact in EM education are not clear. To describe how to prepare EM educators for a high-impact career. The Canadian Association of Emergency Physicians (CAEP) Academic Section commissioned an "Education Impact" working group (IWG) to guide the creation of consensus recommendations from the EM community. EM educators from across Canada were initially recruited from the networks of the IWG members, and additional educators were recruited via snowball sampling. "High impact educators" were nominated by this network. The high impact educators were then interviewed using a structured question guide. These interviews were transcribed and coded for themes using qualitative methods. The process continued until no new themes were identified. Proposed themes and recommendations were presented to the EM community at the CAEP 2016 Academic Symposium. Feedback was then incorporated into a final set of recommendations. Fifty-five (71%) of 77 of identified Canadian EM educators participated, and 170 names of high impact educators were submitted and ranked by frequency. The IWG achieved sufficiency of themes after nine interviews. Five recommendations were made: 1) EM educators can pursue a high impact career by leveraging either traditional or innovative career pathways; 2) EM educators starting their education careers should have multiple senior mentors; 3) Early-career EM educators should immerse themselves in their area of interest and cultivate a community of practice, not limited to EM; 4) Every academic EM department and EM teaching site should have access to an EM educator with protected time and recognition for their EM education scholarship; and 5) Educators at all stages should continuously compile an impact portfolio. We describe a unique set of

  4. 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

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

    Science.gov (United States)

    O'Donnell, John C

    2013-01-01

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

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

    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

  7. 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)

  8. The Cost and Burden of the Residency Match in Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Bush, Jeffrey S

    2017-01-01

    Full Text Available To obtain a residency match, medical students entering emergency medicine (EM must complete away rotations, submit a number of lengthy applications, and travel to multiple programs to interview. The expenses incurred acquiring this residency position are burdensome, but there is little specialty-specific data estimating it. We sought to quantify the actual cost spent by medical students applying to EM residency programs by surveying students as they attended a residency interview. Researchers created a 16-item survey, which asked about the time and monetary costs associated with the entire EM residency application process. Applicants chosen to interview for an EM residency position at our institution were invited to complete the survey during their interview day. In total, 66 out of a possible 81 residency applicants (an 81% response rate completed our survey. The “average applicant” who interviewed at our residency program for the 2015-16 cycle completed 1.6 away, or “audition,” rotations, each costing an average of $1,065 to complete. This “average applicant” applied to 42.8 programs, and then attended 13.7 interviews. The cost of interviewing at our program averaged $342 and in total, an average of $8,312 would be spent in the pursuit of an EM residency. Due to multiple factors, the costs of securing an EM residency spot can be expensive. By understanding the components that are driving this trend, we hope that the academic EM community can explore avenues to help curtail these costs.

  9. Delivering bad news in emergency care medicine.

    Science.gov (United States)

    Maynard, Douglas W

    2017-01-01

    Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.

  10. [Occupational accidents due to exposure to biological material in the multidisciplinary team of the emergency service].

    Science.gov (United States)

    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.

  11. Quantifying federal funding and scholarly output related to the academic emergency medicine consensus conferences.

    Science.gov (United States)

    Nishijima, Daniel K; Dinh, Tu; May, Larissa; Yadav, Kabir; Gaddis, Gary M; Cone, David C

    2014-01-01

    Every year since 2000, Academic Emergency Medicine (AEM) has presented a one-day consensus conference to generate a research agenda for advancement of a scientific topic. One of the 12 annual issues of AEM is reserved for the proceedings of these conferences. The purpose of this study was to measure academic productivity of these conferences by evaluating subsequent federal research funding received by authors of conference manuscripts and calculating citation counts of conference papers. This was a cross-sectional study. In 2012, the NIH RePORTER system was searched to identify subsequent federal funding obtained by authors of the consensus conference issues from 2000 to 2010. Funded projects were coded as related or unrelated to conference topic. Citation counts for all conference manuscripts were quantified using Scopus and Google Scholar. Simple descriptive statistics were reported. Eight hundred fifty-two individual authors contributed to 280 papers published in the 11 consensus conference issues. One hundred thirty-seven authors (16%) obtained funding for 318 projects. A median of 22 topic-related projects per conference (range 10-97) accounted for a median of $20,488,331 per conference (range $7,779,512 to $122,918,205). The average (± SD) number of citations per paper was 15.7 ± 20.5 in Scopus and 23.7 ± 32.6 in Google Scholar. The authors of consensus conference manuscripts obtained significant federal grant support for follow-up research related to conference themes. In addition, the manuscripts generated by these conferences were frequently cited. Conferences devoted to research agenda development appear to be an academically worthwhile endeavor.

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

    International Nuclear Information System (INIS)

    Raskov, W.; Ehrhardt, J.; Landman, C.; Pasler-Sauer, J.

    2006-01-01

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

  13. Industrial Accidents Triggered by Natural Hazards: an Emerging Risk Issue

    Science.gov (United States)

    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

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

    International Nuclear Information System (INIS)

    Zalina Laili; Muhamat Omar; Woo, Y.M.

    2011-01-01

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

  15. The Emerging Role of Proteomics in Precision Medicine: Applications in Neurodegenerative Diseases and Neurotrauma.

    Science.gov (United States)

    Alaaeddine, Rana; Fayad, Mira; Nehme, Eliana; Bahmad, Hisham F; Kobeissy, Firas

    2017-01-01

    Inter-individual variability in response to pharmacotherapy has provoked a higher demand to personalize medical decisions. As the field of pharmacogenomics has served to translate personalized medicine from concept to practice, the contribution of the "omics" disciplines to the era of precision medicine seems to be vital in improving therapeutic outcomes. Although we have observed significant advances in the field of genomics towards personalized medicine , the field of proteomics-with all its capabilities- is still in its infancy towards the area of personalized precision medicine. Neurodegenerative diseases and neurotrauma are among the areas where the implementation of neuroproteomics approaches has enabled neuroscientists to broaden their understanding of neural disease mechanisms and characteristics. It has been shown that the influence of epigenetics, genetics and environmental factors were among the recognized factors contributing to the diverse presentation of a single disease as well as its treatment establishing the factor-disease interaction. Thus, management of these variable single disease presentation/outcome necessitated the need for factoring the influence of epigenetics, genetics, epigenetics, and other factors on disease progression to create a custom treatment plan unique to each individual. In fact, neuroproteomics with its high ability to decipher protein alterations along with their post translational modifications (PTMs) can be an ideal tool for personalized medicine goals including: discovery of molecular mechanisms underlying disease pathobiology, development of novel diagnostics, enhancement of pharmacological neurotherapeutic approaches and finally, providing a "proteome identity" for patients with certain disorders and diseases. So far, neuroproteomics approaches have excelled in the areas of biomarker discovery arena where several diagnostic, prognostic and injury markers have been identified with a direct impact on the

  16. Below the radar innovations and emerging property right approaches in Tibetan medicine.

    Science.gov (United States)

    Madhavan, Harilal

    2017-11-01

    Outside the established legal framework of intellectual property rights, countries have pursued multiple pathways to protect and promote traditional medicine. As Tibetan medicine is a late entrant into commercialization, the proposals to propertize generally fall within the rationale of existing sui-generis paradigms of Intellectual property. In this context, the article enquires the state of innovations in this sector viz-a-viz the property right approaches in place especially in India and China. It argues that beyond the usual complex medical science and technology led-innovations, the pathways of cumulative processes and creative additions through informal experiential learning platforms, where the transfers of knowledge become part of livelihood and social benefits (we call them "below the radar innovations") is ubiquitous in Tibetan medicine. The trends and politics in two recent strategies of protection, that is, Tibetan medicine as economic property (emphasizing patents here among many others) and as a cultural property (intangible cultural heritage) are juxtaposed with these informal innovative attempts. The paper underlines that the productivity-based economic rationale of these protection mechanisms should not obscure sustainability alternatives of "below the radar" (BtR) innovations in Tibetan medicine.

  17. Occupational Accidents And Preventive Measures

    CERN Document Server

    Fassnacht, V

    2006-01-01

    This report presents the 2005 statistics concerning occupational accidents involving members of the CERN personnel and contractors' personnel. It sets out the accident frequency and severity rates and provides a breakdown of accidents by cause and injury. It also contains a summary analysis of the most serious accidents and the associated recommendations.

  18. 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)

  19. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine').

    Science.gov (United States)

    Orth, Matthias; Averina, Maria; Chatzipanagiotou, Stylianos; Faure, Gilbert; Haushofer, Alexander; Kusec, Vesna; Machado, Augusto; Misbah, Siraj A; Oosterhuis, Wytze; Pulkki, Kari; Twomey, Patrick J; Wieland, Eberhard

    2017-12-22

    The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts-exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians. © 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.

  20. Gender-specific research for emergency diagnosis and management of ischemic heart disease: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

    Science.gov (United States)

    Safdar, Basmah; Nagurney, John T; Anise, Ayodola; DeVon, Holli A; D'Onofrio, Gail; Hess, Erik P; Hollander, Judd E; Legato, Mariane J; McGregor, Alyson J; Scott, Jane; Tewelde, Semhar; Diercks, Deborah B

    2014-12-01

    Coronary artery disease (CAD) is the most common cause of death for both men and women. However, over the years, emergency physicians, cardiologists, and other health care practitioners have observed varying outcomes in men and women with symptomatic CAD. Women in general are 10 to 15 years older than men when they develop CAD, but suffer worse postinfarction outcomes compared to age-matched men. This article was developed by the cardiovascular workgroup at the 2014 Academic Emergency Medicine (AEM) consensus conference to identify sex- and gender-specific gaps in the key themes and research questions related to emergency cardiac ischemia care. The workgroup had diverse stakeholder representation from emergency medicine, cardiology, critical care, nursing, emergency medical services, patients, and major policy-makers in government, academia, and patient care. We implemented the nominal group technique to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Through three rounds of nomination and refinement, followed by an in-person meeting on May 13, 2014, we achieved consensus on five priority themes and 30 research questions. The overarching themes were as follows: 1) the full spectrum of sex-specific risk as well as presentation of cardiac ischemia may not be captured by our standard definition of CAD and needs to incorporate other forms of ischemic heart disease (IHD); 2) diagnosis is further challenged by sex/gender differences in presentation and variable sensitivity of cardiac biomarkers, imaging, and risk scores; 3) sex-specific pathophysiology of cardiac ischemia extends beyond conventional obstructive CAD to include other causes such as microvascular dysfunction, takotsubo, and coronary artery dissection, better recognized as IHD; 4) treatment and prognosis are influenced by sex-specific variations in biology, as well as patient

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

    International Nuclear Information System (INIS)

    Genkel, Simone

    2008-01-01

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

  2. 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