WorldWideScience

Sample records for accident and emergency services

  1. Emergency nurse practitioner services in major accident and emergency departments: a United Kingdom postal survey.

    OpenAIRE

    Tye, C C; Ross, F.; Kerry, S. M.

    1998-01-01

    OBJECTIVE: To establish the current and predicted distribution of formal emergency nurse practitioner services in major accident and emergency departments in the United Kingdom; to determine organisational variations in service provision, with specific reference to funding, role configuration, training, and scope of clinical activity. METHODS: Postal survey of senior nurses of all major accident and emergency departments in the United Kingdom (n = 293) in May/June 1996. RESULTS: There were 27...

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

    OpenAIRE

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

    2001-01-01

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

  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. [Emergency care for traffic accidents in Bavaria: current process analysis depending on hospital and emergency service structures].

    Science.gov (United States)

    Lackner, C K; Bielmeier, S; Burghofer, K

    2010-03-01

    A change is emerging in the hospital landscape due to health political measures, which in consequence also influences the prehospital medical care in emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data from Bavarian emergency medical services. In 2006 there were 14,261 traffic accidents in Bavaria where an emergency doctor attended the scene. The patients were primarily cared for by land-based rescue services and air rescue services were only used in 19.1% of the cases. Of the patients involved in a traffic accident 47.6% were transported to a primary health care hospital. A prehospital interval of more than 60 min occurred in 20% of the missions. Of the patients 96.2% were transported to tertiary or maximum care hospital by air rescue services but emergency facilities were, however restricted to daylight hours. There was a further limitation due to the routine duty hours in hospitals as only 36.7% of accidents occurred during this time intervall. An increase of admission post trauma in maximum care clinics occurred from 2002 until 2006 while simultaneously the prehospital period was extended. In order to assure sufficient trauma care for seriously injured persons a continuous 24 h availability of emergency trauma facilities is necessary. For this purpose it is necessary to establish regional trauma networks between receiving hospitals as well as air rescue services at night time. Furthermore, a cost-efficient compensation of the structural, personnel and logistic expenses for the treatment of the severely injured has to be assured.

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Mariana Gonçalves de Freitas

    2015-03-01

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

  8. 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.

  9. 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...... a detailed analysis to identify population and primary care characteristics associated with A&E attendance rates, particularly those that may be amenable to change by primary care services. DESIGN AND SETTING: This study used a cross-sectional population-based design. The setting was general practices.......1, B = 547.3 [95% CI = 418.6 to 676.0]). The final model explained 34.4% of the variation in A&E attendance rates, mostly due to factors that could not be modified by primary care services. CONCLUSION: Demographic characteristics were the strongest predictors of A&E attendance rates. Primary care...

  10. Guidelines for accident prevention and emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-05-01

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

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

    Directory of Open Access Journals (Sweden)

    J Hinkelbein

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Carlos Gorios

    2014-08-01

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

  13. Coordination of Emergency Medical Services for a Major Road Traffic Accident on a Swiss Suburban Highway.

    Science.gov (United States)

    Dami, Fabrice; Fuchs, Vincent; Péclard, Etienne; Potin, Mathieu; Vallotton, Laurent; Carron, Pierre-Nicolas

    2009-06-01

    On 9th April 2008 at 2:14 p.m., on the highway between Lausanne and Vevey in western Switzerland, there was a 72-car pileup including five trucks that caused one death and injured 26 others. The relatively light toll was attributed to reduced vehicular speeds on account of foggy weather, together with the quick actions and effectiveness of the first responders and the excellent collaboration between the various rescue groups (medical rescue services, fire and police departments). For the first time, we used an innovative on-site medical command and control system, based on a binomial team. Two hours after the accident, the last of the injured had been evacuated and first aid on the site had ended. This article describes how the Emergency Medical Services from the State of Vaud, Switzerland, handled the situation and how the binomial team is structured.

  14. 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

  15. The Effectiveness of Emergency Response System’s Service Providers for Road Accidents in Johor Bahru, Malaysia

    Directory of Open Access Journals (Sweden)

    Kazunori H.

    2012-01-01

    Full Text Available In Malaysia, there are three core services involved in emergency, namely the fire and rescue, police, and ambulance services. The aim of the service providers is to prevent the loss of life and damage by improving their response time. The Civil Defence Department and the 999 call centre also assist the main providers. This paper aims to provide an overview of emergency response system (ERS for road accidents in Johor Bahru. The objective is to find the effective services from ERS works. There are three sections of chronological events involved: the call centre receiving reports on accidents, at location of the accident and the time during which the victims are brought to the hospital. The paper studies the operation scheme of the ERS by describing the condition; to analyse the questionnaire using a set of questions on the ERS service; and to determine the effectiveness of the services provided. The provider’s services can be identified as a main factor in improving the ERS services provided in the study area.

  16. Designing the accident and emergency system: lessons from manufacturing.

    Science.gov (United States)

    Walley, P

    2003-03-01

    To review the literature on manufacturing process design and demonstrate applicability in health care. Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers. It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments. Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services.

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

    Directory of Open Access Journals (Sweden)

    Naveen Ramachandran,

    2011-07-01

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

  18. Redundancy in the accident and emergency department.

    Science.gov (United States)

    Durcan, T

    1994-04-01

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

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

    OpenAIRE

    Hinkelbein, J; Schwalbe, M.; H V Genzwuerker

    2010-01-01

    J Hinkelbein1,2, M Schwalbe2, H V Genzwuerker2,31Department for Anesthesiology and Intensive Care Medicine, University Hospital Cologne, Germany; 2Working Group “Emergency Medicine and Air Rescue”, German Society of Aviation and Space Medicine (DGRLM) eV; 3Clinic of Anesthesiology and Intensive Care Medicine, Neckar-Odenwald-Kliniken gGmbH, Hospitals Buchen and Mosbach, Buchen, GermanyAim: Each year approximately two to four helicopter emergency medical services (HEMS) cra...

  20. Emergency Management of Maritime Accidents in the Yangtze River: Problems, Practice and Prospects

    Directory of Open Access Journals (Sweden)

    Xin Ping Yan

    2017-03-01

    Full Text Available Maritime accidents have received considerable attentions due to the enormous property damage, casualties and serious environmental pollution. This paper first makes statistical analysis of the different types of maritime accidents in the period of 2012 to 2014 in the Yangtze River. Second, the problems of emergency management of maritime accidents are also proposed from the analysis of the major accident “Eastern Star”.. Afterwards, four practice cases, including decision support for maritime accidents, emergency resource allocation, emergency simulation system and effectiveness of emergency management, are introduced to present the insights gained from these practices. Last, in order to address these problems, this paper proposes that an artificial societies, Computational experiments, and Parallel execution (ACP approach should be introduced to establish an improved management system for maritime accidents in the future, and an ACP based maritime accident emergency management framework is proposed.

  1. Communication in Hong Kong Accident and Emergency Departments

    Directory of Open Access Journals (Sweden)

    Eloise Chandler

    2015-03-01

    Full Text Available In this article, we report findings from the first qualitatively driven study of patient–clinician communication in Hong Kong Accident and Emergency Departments (AEDs. In light of the Hong Kong Hospital Authority’s policy emphasis on patient-centered care and communication in the public hospitals it oversees, we analyze clinicians’ perceptions of the role and relevance of patient-centered communication strategies in emergency care. Although aware of the importance of effective communication in emergency care, participants discussed how this was frequently jeopardized by chronic understaffing, patient loads, and time pressures. This was raised in relation to the absence of spoken interdisciplinary handovers, the tendency to downgrade interpersonal communication with patients, and the decline in staff attendance at communication training courses. Participants’ frequent descriptions of patient-centered communication as dispensable from, and time-burdensome in, AEDs highlight a discrepancy between the stated Hong Kong Hospital Authority policy of patient-centered care and the reality of contemporary Hong Kong emergency practice.

  2. Privatization and emergency medical services.

    Science.gov (United States)

    Reissman, S G

    1997-01-01

    Osborne and Gaebler's Reinventing Government has sparked discussion amongst elected officials, civil servants, the media, and the general public regarding advantages of privatizing government services. Its support stems from an effort to provide services to municipalities while reducing taxpayer expenditure. Many echo the sentiment of former New York Governor Mario Cuomo, who said, "It is not government's obligation to provide services, but to see that they're provided." Even in the area of public safety, privatization has found a "market." In many localities, privatizing Emergency Medical Services (EMS) is a popular and successful method for providing ambulance services. Privately owned ambulance services staff and respond to medical emergencies in a given community as part of the 9-1-1 emergency response system. Regulations for acceptable response times, equipment, and other essential components of EMS systems are specified by contract. This allows the municipality oversight of the service provided, but it does not provide the service directly. As will be discussed, this "contracting-out" model has many benefits. Privatizing EMS services is a decision based not only on cost-savings, but on accountability. A thorough evaluation must be utilized in the selection process. Issues of efficiency, effectiveness, quality, customer service, responsiveness, and equity must be considered by the government, in addition to cost of service. The uncertain future of health care in the United States has led those in EMS to look beyond the field's internal market to explore additional opportunities for expanding and redefining its roles beyond emergency care. It is important, however, to consider how emergency medical care, the original role of EMS, can be best delivered. Responding to emergencies is not just one of the functions involved in this field, it is the principal function from which public perception of EMS is formed, and from which support for entering other markets can

  3. The Consumer Quality Index in an accident and emergency department : Internal consistency, validity and discriminative capacity

    NARCIS (Netherlands)

    Bos, Nanne; Sturms, Leontien M.; Stellato, Rebecca K.; Schrijvers, Augustinus J P; van Stel, Henk F.

    2015-01-01

    Background: Patients' experiences are an indicator of health-care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. Th

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

    Science.gov (United States)

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

    2016-04-01

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

  5. Financial Services and Emerging Markets

    NARCIS (Netherlands)

    B. Karreman (Bas)

    2011-01-01

    textabstractThis study addresses the organization and strategy of firms in emerging markets with an explicit application to financial services. Given the relevance of a well-functioning financial system for economic growth, understanding the organization and strategy of firms contributing to the dev

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

    Science.gov (United States)

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

    2014-01-01

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

  7. The Veterinary Public Health Service and the National Organization for Nuclear Emergency Planning and Response in the Netherlands: Development of a measurement strategy in case of nuclear accidents. De Veterinaire Hoofdinspectie en het NPK: Ontwikkeling van een meetstrategie

    Energy Technology Data Exchange (ETDEWEB)

    Lembrechts, J.F.M.M.; Pruppers, M.J.M.

    1993-12-01

    In this report the position of the Veterinary Public Health Service (VHI), which is part of the Ministry of Welfare, Health and Cultural Affairs, within the National Organisation for Nuclear Emergency Planning and Response (NPK), is evaluated. NPK is activated in case of nuclear accidents in order to describe and model the evolution of the environmental contamination, to advise on countermeasures and to supervise their application and effects. Within this organisation VHI has to organize or execute measurements on animals and veterinary products and to coordinate countermeasures pertaining to their field of work. The suggestion is made to integrate the tasks of VHI and those of the Inspectorate for Health Protection (IGB) and to attune the activities of VHI and those of the State Institute for Quality Control of Agricultural Products (RIKILIT). Advices are given on how to detail the tasks of VHI adequately in the context of NPK, amongst others by describing methods to collect and interpret data. It is suggested to firstly put into practice in vivo monitoring techniques for '3'I and [sup 134]Cs/[sup 137]Cs and to agree with other institutions on plans for sampling, sample preparation and measurements of milk. Finally a monitoring strategy for VHI is broadly outlined. It provides the framework for the definition of a detailed programme on sampling and measurement in case of a real accident. The monitoring strategy gives answers on the crucial question 'what has to be measured why and how by which person'. Since questions on where, when and how frequently measurements have to made should be tailored to the actual emergency situation, they are not dealt with in this report. 5 figs., 5 tabs., 66 refs.

  8. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims

    OpenAIRE

    Gholipour, Changiz; Vahdati, Samad Shams; NOTASH, Mehdi; MIRI, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2016-01-01

    SUMMARY Objectives Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a s...

  9. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims

    OpenAIRE

    Gholipour, Changiz; Vahdati, Samad Shams; NOTASH, Mehdi; MIRI, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2016-01-01

    SUMMARY Objectives Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a s...

  10. Avoidable attendance at accident and emergency by the elderly in Hong Kong.

    OpenAIRE

    Lau, E M; Woo, J; Chan, J. T.

    1997-01-01

    Twenty per cent of Accident and Emergency department attendance by the elderly in a regional hospital in Hong Kong were deemed 'avoidable' by the attending doctors. The 'avoidable' attendants were younger and physically more independent than the appropriate attendants, and more of them were illiterate. Half of them attended the Accident and Emergency department for somatic complaints. Strategies to reduce these 'avoidable' attendances should be formulated.

  11. EMERGENCY RESPONSE OF THE ADMINISTRATION OF THE FEDERAL SERVICE FOR SURVEILLANCE ON CONSUMER RIGHTS PROTECTION AND HUMAN WELL-BEING IN SAKHALIN REGION TO THE FUKUSHIMA NUCLEAR POWER PLANT ACCIDENT

    Directory of Open Access Journals (Sweden)

    B. B. Darizhapov

    2011-01-01

    Full Text Available The article describes the experience of the Administration of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in Sakhalin Region in organizing prevention of conditions that endanger the public radiation safety related to the nuclear accident at the Fukushima nuclear power plant. The authors present results of the measurements of the radiation situation in the Sakhalin region and propose ways to improve organizational and sanitary-hygienic measures aimed on ensuring public protectiony in events of radiation accidents.

  12. 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.

  13. Impacts of the 2011 Fukushima nuclear accident on emergency medical service times in Soma District, Japan: a retrospective observational study

    Science.gov (United States)

    Morita, Tomohiro; Furutani, Tomoyuki; Nomura, Shuhei; Leppold, Claire; Takahara, Kazuhiro; Shimada, Yuki; Fujioka, Sho; Kami, Masahiro; Kato, Shigeaki; Oikawa, Tomoyoshi

    2016-01-01

    Objective To assess the influence of the 3.11 triple disaster (earthquake, tsunami and nuclear accident) on the emergency medical service (EMS) system in Fukushima. Methods Total EMS time (from EMS call to arrival at a hospital) was assessed in the EMS system of Soma district, located 10–40 km north of the nuclear plant, from 11 March to 31 December 2011. We defined the affected period as when total EMS time was significantly extended after the disasters compared with the historical control data from 1 January 2009 to 10 March 2011. To identify risk factors associated with the extension of total EMS time after the disasters, we investigated trends in 3 time segments of total EMS time; response time, defined as time from an EMS call to arrival at the location, on-scene time, defined as time from arrival at the location to departure, and transport time, defined as time from departure from the location to arrival at a hospital. Results For the affected period from week 0 to week 11, the median total EMS time was 36 (IQR 27–52) minutes, while that in the predisaster control period was 31 (IQR 24–40) min. The percentage of transports exceeding 60 min in total EMS time increased from 8.2% (584/7087) in the control period to 22.2% (151/679) in the affected period. Among the 3 time segments, there was the most change in transport time (standardised mean difference: 0.41 vs 0.13–0.17). Conclusions EMS transport was significantly delayed for ∼3 months, from week 1 to 11 after the 3.11 triple disaster. This delay may be attributed to malfunctioning emergency hospitals after the triple disaster. PMID:27683521

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

    Energy Technology Data Exchange (ETDEWEB)

    Putman, V.L.

    1995-09-01

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

  15. Characterization of motorcycle accident victims attended by the mobile emergency service (SAMU-192, Recife, Pernambuco State, Brazil - 10.4025/actascihealthsci.v34ispec.11524

    Directory of Open Access Journals (Sweden)

    Betise Mery Alencar Sousa Macau Furtado

    2012-12-01

    Full Text Available This study described the epidemiological characteristics of victims of accidents involving motorcycles, attended by the Mobile Emergency Service (SAMU-192 in the city of Recife (PE in 2006. This is a descriptive cross-sectional study that analyzed a sample of 703 cases. The results showed that 81.8% were male, aged 20 to 29 years. It was noted that 406 of them were wearing a helmet at the time of the accident. The accidents occurred most frequently on Sundays (19.3% between 18:00 and 24:00 hours (0.28%. The extremities were the most affected body segment, with 341 occurrences. Regarding the severity of injuries, it was found that 37.6% were superficial or mild (scrapes, cuts and bruises. These results demonstrate the need for educational campaigns to encourage the use of personal protective equipment among motorcyclists. The best way to reduce the risks and damages from motorcycle accidents is through primary prevention. For this, are needed integrated intersectoral actions aimed at reducing the incidence and severity of injuries.  

  16. Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom.

    Science.gov (United States)

    McQueen, Carl; Crombie, Nick; Cormack, Stef; George, Arun; Wheaton, Steve

    2015-05-01

    The utilisation of Helicopter Emergency Medical Services (HEMS) in response to equestrian accidents has been an integral part of operations for many years throughout the UK. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided and the incidence of time critical injury in cases of equestrian accidents has been shown to be low. This study assesses the impact made on the utilisation of the different HEMS resources for cases of equestrian accidents within the West Midlands following the launch of the regional trauma network. We present a retrospective analysis of all equestrian accidents attended by Midlands Air Ambulance (MAA) between 1 April 2012 and 1 April 2013. Data were abstracted from the MAA operational database relating to mission activations/scene attendances; team configuration (physician led and Critical Care Paramedic (CCP) led); on-scene interventions; mission timings and patient conveyance by helicopter. A total of 114 activations involved equestrian accidents (6% of overall workload). The contribution of equestrian accidents to overall workload was similar for physician led and CCP-led (69/1069) platforms (5% vs. 6%, p=0.50). Only three patients (3%) required pre-hospital RSI during the period analysed and there were no recorded cases of ketamine administration for analgesia/conscious sedation. In approximately half of all scene attendances patients did not require any medication to be administered by the HEMS team. The vast majority of incidents occurred in rural locations with over 80% of patients conveyed to hospital by helicopter. The average mission time for scene attendances resulting in conveyance by helicopter was in excess of 90 min on both types of platform. There is a clear requirement for the design and implementation of informed and intelligent tasking models to respond to the need for assistance in equestrian accidents

  17. Causas externas em adolescentes: atendimentos em serviços sentinelas de urgência e emergência nas Capitais Brasileiras - 2009 Accidents by external causes in adolescents: care in sentinel urgency and emergency services in the Brazilian State Capitals - 2009

    Directory of Open Access Journals (Sweden)

    Deborah Carvalho Malta

    2012-09-01

    Full Text Available Os adolescentes estão em busca de novas referências e experiências, o que pode implicar atitudes de risco e exposição às causas externas - acidentes e violências. Estes eventos constituem um grave problema em Saúde Pública. O objetivo deste estudo foi analisar as ocorrências de causas externas em adolescentes de 10 a 19 anos atendidos em serviços sentinela de urgência e emergência no Brasil. Foram analisados dados do inquérito da Vigilância de Violências e Acidentes (Inquérito VIVA 2009 em 74 Unidades de Emergência em 23 capitais e no Distrito Federal. Os achados mostraram que 6.434 (89,8% adolescentes foram vítimas de acidentes e 730 (10,2 % de violências. As principais causas de acidentes foram as quedas, outros acidentes e o trânsito e entre as violências predominaram as agressões. Tanto para acidentes como para violências os adolescentes do sexo masculino e a raça/cor não branca foram predominantes; as ocorrências foram mais frequentes na via pública. A alta foi a evolução mais frequente, com maior ocorrência de internação hospitalar nas vítimas de violências entre 15 a 19 anos. Conhecer a realidade epidemiológica das causas externas entre os adolescentes representa uma importante ferramenta para as políticas de prevenção, promoção à saúde e da cultura de paz, visando à redução da morbimortalidade.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

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

    OpenAIRE

    MacNamara, A; Durham, S

    1997-01-01

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

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

    Science.gov (United States)

    MacNamara, A; Durham, S

    1997-05-01

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

  20. Emergency medical services: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Jelenko, C.; Frey, C.F.

    1976-01-01

    The organization and delivery of emergency care are reviewed in a book based on the judgments of 28 national leaders in various fields. It is noted that acute illness has become a major health problem due to the rapid growth of the United States and the increased demands of consumers for improved medical care. Critical needs in the field of emergency care are identified as communications, prompt and proper rescue handling, rapid and careful transportation of victims, and adequate emergency care at hospitals. The long-term solution to the problem of injury is viewed as prevention through efforts made by educators, industrialists, engineers, public health officials, and private citizens. The statement is made that accidents are exceeded only by heart disease, neoplasms, and cerebral vascular disease as a major cause of death in the United States. The dimensions of the accident problem are explored. Other topics addressed are: motor vehicle trauma and emergency medical services; the provision of emergency care to cardiac patients; medicolegal implications of emergency care; and field treatment and transport of emergency victims. The importance of telecommunications, emergency medical technician training, and public education is stressed. Hospital education and training for emergency department personnel are detailed for physicians and nurses. Functional and design aspects of hospital emergency departments are described, and the role of community planning in the provision of emergency health services is considered. A checklist for airport disaster planning and a Michigan law regarding emergency medical services are appended.

  1. Preventing post traumatic stress disorder in accident and emergency nursing. A review of the literature.

    Science.gov (United States)

    Cudmore, J

    1996-01-01

    Nurses working in Accident and Emergency may be susceptible to post-traumatic stress disorder (Rentoul and Ravenscroft 1993, Scott and Stradling 1994). The literature suggests that defusing immediately following a resuscitation may help to reduce abnormal stress reactions (Mitchell, 1988; Wright, 1992, 1993). Critical incident stress debriefing is recommended following critical incidents to help prevent emergency personnel developing post-traumatic stress disorder (Jimmerson, 1988; Mitchell, 1983, 1988; Parkinson, 1995).

  2. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims.

    Science.gov (United States)

    Gholipour, Changiz; Vahdati, Samad Shams; Notash, Mehdi; Miri, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2014-06-01

    Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a study on the success rate of PHEMS personnel in implementing PHTLS guidelines at the scene of trauma. Severe trauma patients who had been transferred to the emergency department were included in the study. Evaluations included transfer time, airway management, spinal immobilization, external bleeding management, intravenous (IV) line access, and fluid therapy. All evaluations were performed by an expert emergency physician in the emergency department. The mean response time was 17.87±9.1 minutes. The PHEMS personnel immobilized cervical spine in 60.4% of patients, out of whom 16.7% were not properly immobilized. Out of 99 (98%) cases of established IV line access by the PHEMS providers, 57% were satisfactory. Fluid therapy, which was carried out in 99 (98%) patients by the PHEMS personnel, was appropriate in 92% of the cases. PHEMS personnel need more education and supervising to provide services according to PHTLS guidelines.

  3. Correlates of work-related stress among consultants and senior registrars in accident and emergency medicine.

    OpenAIRE

    Heyworth, J; Whitley, T W; Allison, E J; Revicki, D. A.

    1993-01-01

    A mail survey was conducted of consultants and senior registrars practising accident and emergency (A&E) medicine in the United Kingdom. The 201 respondents (72%) comprised 154 consultants (70.6%) and 47 senior registrars (77%), who provided demographic information and completed inventories measuring stress, depression, task and role clarity, work group functioning and overall satisfaction with work. The respondents did not report particularly high levels of stress or depression and generally...

  4. Emergency medical services in India: the present and future.

    Science.gov (United States)

    Sharma, Mohit; Brandler, Ethan S

    2014-06-01

    India is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.

  5. Characteristics of female victims of assault attending a Scottish accident and emergency department.

    OpenAIRE

    Wright, J; Kariya, A

    1997-01-01

    OBJECTIVE: To compare the characteristics of female victims of assault with those of male victims and to see if there is a difference between female victims of domestic assault and females assaulted by strangers or acquaintances. DESIGN: A two month prospective study (June and July 1995) of all assault victims attending a Scottish accident and emergency (A&E) department. SETTING: A large district general A&E department (the Royal Alexandra Hospital in Paisley) seeing 60,000 new patients per y...

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

    OpenAIRE

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

    1994-01-01

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

  7. Emergency Medical Services

    Science.gov (United States)

    ... and need help right away, you should use emergency medical services. These services use specially trained people and specially equipped facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  8. Influences on tetanus immunization in accident and emergency.

    OpenAIRE

    Montague, A; Glucksman, E

    1990-01-01

    We studied the casualty records of 479 patients with open skin injury arriving over 2 single weeks, 3 months apart, to assess adequacy of adherence to protocols for active immunization against tetanus. 234 patients were treated correctly. In 114 cases immunization was insufficient or tetanus was not mentioned at all; in 29 cases immunization was excessive and 102 records were ambiguous and no conclusion could be drawn. There was no evidence in junior doctors' management indicating learning ov...

  9. 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

    ). 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...... significantly elevated concentrations of adrenaline and glucagon were found in diabetic patients admitted with severe hypoglycaemia to an Accident and Emergency Department....

  10. 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

  11. Utilization of the atmospheric release advisory capability (ARAC) services during and after the Three Mile Island accident

    Energy Technology Data Exchange (ETDEWEB)

    Knox, J.B.; Dickerson, M.H.; Greenly, G.D.; Gudiksen, P.H.; Sullivan, T.J.

    1980-07-01

    At 0820 PST on 28 March 1979, the Department of Energy's Emergency Operations Center advised the Atmospheric Release Advisory Capability (ARAC) that the Three Mile Island nuclear power plant in Harrisburg, Pennsylvania, had experienced an accident some four hours earlier, resulting in the atmospheric release of xenon-133 and krypton-88. This report describes ARAC's response to the Three Mile Island accident, including the role ARAC played throughout the 20 days that real-time assessments were made available to the Department of Energy on-scene commander. It also describes the follow-up population-dose calculations performed for the President's Commission on Three Mile Island. At the request of the Nuclear Regulatory Commission, a questionnaire addressing the usefulness of ARAC products during the accident was sent to ARAC-product users. A summary of the findings from this questionnaire, along with recommendations for improving ARAC service, is also presented. The accident at Mississauga, Ontario, Canada, is discussed in the context of a well-planned emergency response by local and Federal officials.

  12. Towards emergency management of natural disasters and critical accidents: the Greek experience.

    Science.gov (United States)

    Nivolianitou, Zoe; Synodinou, Barbara

    2011-10-01

    This paper presents the findings of a prototype study which sought to identify factors that contribute to effective emergency management in Greece and other European states regarding both natural disasters and critical accidents. The parameters for proper action and successful intervention in operational and logistical are identified based on the document analysis and interviews with emergency responders. The interviews are conducted between state-owned and voluntary organizations. They were asked to rate in terms of their importance for effective emergency response efforts. This paper offers useful information of the organization and management of emergency response in Greece, as well as provides interesting responders' opinions data concerning important priorities in the emergency management area. Despite the fact that the data come from the Greek experience, the conclusions may be applied for a broader use in the emergency planning of disasters. The whole study has been undertaken within the European Pre-Emergencies (PreEm) project. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Infections in traumatic wounds sutured at a Norwegian Accident and Emergency Department.

    Science.gov (United States)

    Brudvik, Christina; Tariq, Hina; Bernardshaw, Soosaipillai V; Steen, Knut

    2015-05-05

    Different countries have different wound treatment traditions. We have studied the incidence and different factors related to infections in wound injuries sutured at a Norwegian A&E department. In this prospective study, clinical data were collected on 102 patients with traumatic wound injuries treated with sutures at Bergen Accident and Emergency Department between 30 February 2011 and 30 June 2011. Any wound infections in 97 of these patients at the time of suture removal were assessed and classified according to severity on a scale of grade 0 to grade 4. There were no serious infections, but mild clinical wound infections occurred in 15% of patients: 11% grade 1 and 4% grade 2 infections. Patients less than 65 years old had often cut themselves with knives (n = 33, 37%), and on their hands (n = 60, 67%), Men were most frequently injured at work (n = 38, 54%) and women most often at home (n = 18, 56%). No statistically significant correlation was found between the incidence of wound infections and the length of the wound, the time elapsed before suturing, the wound's location on the body, contamination or underlying chronic diseases. Two of the three self-inflictors in our study had clinical wound infections. Half of the bacteriological samples from ten of 15 wounds with clinical infection had plentiful growth of Staphylococcus aureus. One patient received oral antibiotic treatment for wound infection, and two had local antibiotic treatment. Mild clinical infections were found in almost one of six wounds sutured at a Norwegian A&E department. More studies are necessary to provide basic data to enable targeted improvements in wound treatment in the primary healthcare service.

  14. Diagnostic characterization of services providing care to victims of accidents and violence in five Brazilian state capitals

    Directory of Open Access Journals (Sweden)

    Suely Ferreira Deslandes

    2006-06-01

    Full Text Available This article characterizes the services providing care to victims in five Brazilian regions with high violence and accident rates. It analyzes care activities and strategies, the profile of the teams, the conditions of installations, equipment and supplies, integrated care and registration services and the opinion of health managers with respect to the needs and requirements for a better care to the victims. The sample is composed by 103 services: 34 from Recife, 25 from Rio de Janeiro, 18 from Manaus, 18 from Curitiba and 8 from Brasília. The still preliminary results indicate: lower number of services focusing on the elderly; scarce investment in preventive actions; the principal actions carried out are social assistance, ambulatory and hospital care and psychological assistance; patients received from Basic Health Units require attention of the communities and families; need for investment in capacity building programs for professionals; precarious registries, data handled manually. The wording of the National Policy for Reduction of Morbidity and Mortality from Accidents and Violence is not well-known and there is a lack of articulation among and inside sectors and between prehospital and emergency care services. Rehabilitation services are insufficient in all cities.

  15. WHO/INRUD prescribing indicators and prescribing trends of antibiotics in the Accident and Emergency Department of Bahawal Victoria Hospital, Pakistan

    National Research Council Canada - National Science Library

    Atif, Muhammad; Azeem, Muhammad; Sarwar, Muhammad Rehan; Shahid, Samia; Javaid, Sidra; Ikram, Huria; Baig, Uzma; Scahill, Shane

    2016-01-01

    A descriptive, retrospective and cross sectional study was conducted to assess the prescribing practices and antibiotic use patterns in the Accident and Emergency department of the Bahawal Victoria...

  16. 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.

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

    Science.gov (United States)

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

    1996-03-01

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

  18. 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

    2017-05-03

    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.

  19. 42 CFR 405.440 - Emergency and urgent care services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency and urgent care services. 405.440 Section... Emergency and urgent care services. (a) A physician or practitioner who has opted-out of Medicare under this subpart need not enter into a private contract to furnish emergency care services or urgent care...

  20. 48 CFR 1842.7003 - Emergency medical services and evacuation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Emergency medical services... NASA Contract Clauses 1842.7003 Emergency medical services and evacuation. The contracting officer must insert the clause at 1852.242-78, Emergency Medical Services and Evacuation, in all solicitations...

  1. Pediatric emergency medical services and their drawbacks

    Directory of Open Access Journals (Sweden)

    Abdullah Foraih Al-Anazi

    2012-01-01

    Full Text Available Aim: To survey the literature on Pediatric Emergency Medical Services (PEMS with an aim to focus its drawbacks and emphasize the means of improvement. Materials and Methods: Published articles selected for inclusion were based on the significance and understanding of literature search on different aspects of PEMS. To meet this criterion, PubMed, PubMed Central, Science Direct, Uptodate, Med Line, comprehensive databases, Cochrane library and the Internet (Google, Yahoo were thoroughly searched. Results: PEMS provide out-of-hospital medical care and/or transport the patients to definitive care. The task force represents specialties of ambulance transport, first aid, emergency medical care, life saving, trauma, emergency medicine, water rescue, and extrication. Preliminary care is undertaken to save the patients from different medical exigencies. The techniques and procedures of basic and advanced life-support are employed. A large number of weaknesses are recorded in PEMS system, such as ambulance transport irregularities, deficit equipment, lack of expertise, and ignorance of the pre-hospital care providers. These are discussed with special reference to a few examples of medical exigencies. Conclusions: The appointments in PEMS should be regularized with specific qualifications, experience, and expertise in different areas. Responsibility of PEMS should not be left to pre-hospital care providers, who are non clinicians and lack proper education and training. Pediatricians should be adequately trained to play an active role in PEMS. Meetings should be convened to discuss the lapses and means of improvement. Networks of co-operation between pre-hospital providers and experts in the emergency department should be established.

  2. Screening for Type 2 diabetes in the accident and emergency department.

    Science.gov (United States)

    George, P M; Valabhji, J; Dawood, M; Henry, J A

    2005-12-01

    To assess the proportion of patients, aged 40 years and over, attending an inner city accident and emergency department that have Type 2 diabetes, and the proportion previously undiagnosed, and to assess whether the identification of undiagnosed Type 2 diabetes is feasible in this setting. Five hundred unselected people participated. All completed a demographic questionnaire regarding risk factors for diabetes. In those without known diabetes, random capillary blood glucose (CBG) was measured. If this was greater than 7.0 mmol/l, patients were asked to return for two fasting blood glucose tests. Diagnosis of diabetes was based on World Health Organization criteria. Of the 500 participating subjects, 73 were already known to have Type 2 diabetes. Of the remaining 427 subjects, 36 had CBG>7.0 mmol/l. All 36 returned for fasting blood tests: 13 fulfilled the diagnostic criteria for Type 2 diabetes, eight for impaired fasting glucose (IFG), and 15 had normal fasting glucose values. The prevalence of Type 2 diabetes was therefore 17.2%, including 2.6% with a new diagnosis, and 14.6% with pre-existing disease; 1.6% were found to have IFG. Body mass index was greater in those with Type 2 diabetes (previously and newly diagnosed) [27.1 (5.15) (mean+/-standard deviation)] vs. 25.8 (4.70) kg/m2; unpaired t-test P=0.0213), and those with Type 2 diabetes were more likely to be of black and minority ethnic origin (57 vs. 28%; chi2 P<0.001) and to have a first-degree family history of diabetes (45 vs. 23%; chi2 P<0.001). It can be estimated from this survey that, annually, this case-finding methodology could identify 539 (95% CI 249-828) people aged 40 years and over attending our accident and emergency department with previously undiagnosed Type 2 diabetes.

  3. Clinical benefits of early cold therapy in accident and emergency following ankle sprain.

    Science.gov (United States)

    Sloan, J P; Hain, R; Pownall, R

    1989-03-01

    One hundred and forty-three patients presenting with ankle sprains within 24 h of injury were entered into a double blind study. Treatment consisted of a standardized regime of high dose non-steroidal anti-inflammatory medication and an elastic support for all patients, who were then randomly allocated to two groups. One group received immediate cold therapy, the other received simulated therapy. Assessments made at 7 days showed a trend in favour of the group receiving cold therapy, although this did not reach significance. It is concluded that cold therapy together with compression may have a beneficial effect but that a single application in the accident and emergency department is not justified when a background therapy of non-steroidal anti-inflammatory medication is given.

  4. Designing of an emergency call system for traffic accidents

    Directory of Open Access Journals (Sweden)

    Ziya Ekşi

    2013-06-01

    Full Text Available In our country, many people have been seriously injured or died in traffic accidents. Fatal accidents often occur because of not complying with traffic rules or carelessness. Except these driver mistakes, heavy injuries can result in deaths because of emergency aid teams failing to arrive to accident scene in time. In this study, an accident emergency call system is designed to help injured people's treatment as soon as possible by notifying emercengy team automatically in accidents. The designed system sends messages, including information such as vehicle location, exploding airbag number, vehicle model, age and registration plate, to emergency aid team using GPS module at the moment of crashed vehicle's airbag explosion.

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

    Science.gov (United States)

    Pinnington, Sarah; Atterton, Brigid; Ingleby, Sarah

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marcin eWojnar

    2014-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

    CHI Bing; LI Hong; FANG Dong

    2007-01-01

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

  8. Psychosocial service needs of pediatric transport accident survivors: Using clinical data-mining to establish demographic and service usage characteristics.

    Science.gov (United States)

    Manguy, Alys-Marie; Joubert, Lynette; Bansemer, Leah

    2016-09-01

    The objectives in this article are the exploration of demographic and service usage data gained through clinical data mining audit and suggesting recommendations for social work service delivery model and future research. The method is clinical data-mining audit of 100 sequentially sampled cases gathering quantitative demographic and service usage data. Descriptive analysis of file audit data raised interesting trends with potential to inform service delivery and usage; the key areas of the results included patient demographics, family involvement and impact, and child safety and risk issues. Transport accidents involving children often include other family members. Care planning must take into account psychosocial issues including patient and family emotional responses, availability of primary carers, and other practical needs that may impact on recovery and discharge planning. This study provides evidence to plan for further research and development of more integrated models of care.

  9. 42 CFR 438.114 - Emergency and poststabilization services.

    Science.gov (United States)

    2010-10-01

    ... Section 438.114 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Enrollee Rights and Protections § 438.114 Emergency and poststabilization services. (a) Definitions. As used in this section— Emergency medical...

  10. Idling Reduction for Emergency and Other Service Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-07

    This is a fact sheet about reducing idling for emergency and service vehicles. Emergency vehicles, such as police cars, ambulances, and fire trucks, along with other service vehicles such as armored cars, are often exempt from laws that limit engine idling. However, these vehicles can save fuel and reduce emissions with technologies that allow them to perform vital services without idling.

  11. 76 FR 63353 - Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

    Science.gov (United States)

    2011-10-12

    ... Collection (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA... information technology. Title: Payment and Reimbursement for Emergency Services for Non Service-Connected... information needed to determine a claimant's eligibility for reimbursement or payment for emergency...

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

    Directory of Open Access Journals (Sweden)

    Po Thaw DA

    2012-06-01

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

  13. 76 FR 78739 - Agency Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

    Science.gov (United States)

    2011-12-19

    ... AFFAIRS Agency Information Collection (Payment and Reimbursement for Emergency Services for Non Service... Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities, 38 U.S.C. 1725... CONTACT: Denise McLamb, Enterprise Records Service (005R1B), Department of Veterans Affairs, 810...

  14. [Domestic violence in the accident and emergency department: don't forget the children].

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva M M; van der Lee, Johanna H; Brilleslijper-Kater, Sonja N; van Leerdam, Frank J M; Teeuw, Arianne H

    2014-01-01

    In 2013, the Dutch Government mandated a new policy stating that all healthcare professionals caring for adults in difficult psychosocial situations should always investigate the safety of any children involved. We describe two cases of such 'child checks' in the accident and emergency department (A&E). Patient A, a 10-year-old girl, was referred to the outpatient paediatric department (OPD) after her mother had attended the A&E as a victim of domestic violence (DV). The child had witnessed DV on multiple occasions. The family were referred to voluntary social and psychiatric healthcare. Patient B, a 46 year-old woman, attended the A&E with serious injuries, and said she had tripped over. The A&E physician suspected that the injuries were caused by DV, and the mother and her 9-year-old daughter were referred to the OPD. However, the mother refused to attend, and the family was reported to the Youth Care Office. Because parents' psychosocial problems, such as DV, can seriously affect children, their safety should always be investigated by performing a 'child check'.

  15. Correlates of work-related stress among consultants and senior registrars in accident and emergency medicine.

    Science.gov (United States)

    Heyworth, J; Whitley, T W; Allison, E J; Revicki, D A

    1993-01-01

    A mail survey was conducted of consultants and senior registrars practising accident and emergency (A&E) medicine in the United Kingdom. The 201 respondents (72%) comprised 154 consultants (70.6%) and 47 senior registrars (77%), who provided demographic information and completed inventories measuring stress, depression, task and role clarity, work group functioning and overall satisfaction with work. The respondents did not report particularly high levels of stress or depression and generally evaluated aspects of their work environments favourably. Higher levels of stress were reported by consultants and respondents from district general hospitals. Levels of stress were similar to those reported by other groups of health care providers. Respondents generally considered tasks and roles to be clearly defined, work groups to be supportive, efficient units and work satisfying. There was no statistically significant correlation on the affective scales for the number of patient attendances, on call commitment or staffing numbers. Senior staff with more than 10 years experience in the specialty reported more satisfaction with work and work group functioning, and perceived their tasks and roles to be significantly clearer. Consultants over 45 evaluated their work groups favourably and were more likely to view them as cohesive, smoothly functioning units than senior registrars. The results probably reflect the ad hoc coping strategies adopted by a group of doctors, who have already demonstrated appropriate personality characteristics by completing a long training programme, with no realistic alternative late career opportunities. To prevent mid or late career attrition, however, A&E doctors should receive formal training in stress recognition and avoidance. Accessible counselling without stigma should be easily available. Senior A&E doctors have a role in detecting and managing stress amongst other staff in the department. PMID:8110315

  16. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    Science.gov (United States)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; pNVG) (r=.38; pNVG, TAWS, and SMS, HEMS years of experience explained 81.4% of the variance in accident rate scores (p<.05), and HEMS years of experience was found to be a significant predictor of accident rates (p<.05). Additional quantitative regression analysis was recommended to replicate the results of this study and to consider the influence of these variables for continued reduction of HEMS accidents, and to induce execution of SMS and aviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A quantitative longitudinal study would further explore inferential relationships between the study variables. Current strategies should include the increased utilization of available aviation technology resources as this proactive stance may be beneficial for the establishment of

  17. Emergency Medical Service

    Science.gov (United States)

    1980-01-01

    Lewis Research Center helped design the complex EMS Communication System, originating from space operated telemetry, including the telemetry link between ambulances and hospitals for advanced life support services. In emergency medical use telemetry links ambulances and hospitals for advanced life support services and allows transmission of physiological data -- an electrocardiogram from an ambulance to a hospital emergency room where a physician reads the telemetered message and prescribes emergency procedures to ambulance attendants.

  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 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)

  20. Overcrowding of accident & emergency units: is it a growing concern ...

    African Journals Online (AJOL)

    Background: The inability of the Nigeria's Accident and Emergency .... tertiary care to the then Midwestern Region (now Edo .... Table 3: Common causes of poor outcome of patients' management in AEDs ... bulance diversion, (4) threat to disaster preparedness, and (5) eroding reliability of the emergency care system.

  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.

  2. Servant Leadership Theory and the Emergency Services Student

    Science.gov (United States)

    Russell, Eric James

    2014-01-01

    This present case study explores the influence a servant leadership class had on a group of emergency service students' understanding of the roles and characteristics of a leader. The setting for the study was a state university in the Western United States. The six participants were undergraduate emergency services majors that underwent a 15-week…

  3. 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.)

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

    Directory of Open Access Journals (Sweden)

    Caroline Gouder

    2013-01-01

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

  5. Using queuing theory to analyse the government's 4-H completion time target in accident and emergency departments.

    Science.gov (United States)

    Mayhew, L; Smith, D

    2008-03-01

    This paper uses a queuing model to evaluate completion times in Accident and Emergency (A&E) departments in the light of the Government target of completing and discharging 98% of patients inside 4 h. It illustrates how flows though an A&E can be accurately represented as a queuing process, how outputs can be used to visualise and interpret the 4-h Government target in a simple way and how the model can be used to assess the practical achievability of A&E targets in the future. The paper finds that A&E targets have resulted in significant improvements in completion times and thus deal with a major source of complaint by users of the National Health Service in the U.K. It suggests that whilst some of this improvement is attributable to better management, some is also due to the way some patients in A&E are designated and therefore counted through the system. It finds for example that the current target would not have been possible without some form of patient re-designation or re-labelling taking place. Further it finds that the current target is so demanding that the integrity of reported performance is open to question. Related incentives and demand management issues resulting from the target are also briefly discussed.

  6. 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)

  7. [Violence and accidents among older and younger adults: evidence from the Surveillance System for Violence and Accidents (VIVA), Brazil].

    Science.gov (United States)

    Luz, Tatiana Chama Borges; Malta, Deborah Carvalho; Sá, Naíza Nayla Bandeira de; Silva, Marta Maria Alves da; Lima-Costa, Maria Fernanda

    2011-11-01

    Data from the Brazilian Surveillance System for Violence and Accidents (VIVA) in 2009 were used to examine socio-demographic characteristics, outcomes, and types of accidents and violence treated at 74 sentinel emergency services in 23 Brazilian State capitals and the Federal District. The analysis included 25,201 individuals aged > 20 years (10.1% > 60 years); 89.3% were victims of accidents and 11.9% victims of violence. Hospitalization was the outcome in 11.1% of cases. Compared to the general population, there were more men and non-white individuals among victims of accidents, and especially among victims of violence. As compared to younger adults (20-59 years), accidents and violence against elderly victims showed less association with alcohol, a higher proportion of domestic incidents, more falls and pedestrian accidents, and aggression by family members. Policies for the prevention of accidents and violence should consider the characteristics of these events in the older population.

  8. The accident and emergency department as a single portal of entry for the reassessment of all trauma patients transferred to specialist units.

    OpenAIRE

    O'Connor, P. M.; Steele, J A; Dearden, C H; Rocke, L G; Fisher, R. B.

    1996-01-01

    127 patients who were transferred to a regional referral centre for specialist treatment within 48 h of serious injury were reassessed on arrival in the receiving accident and emergency department by a trauma team. 80 transferred patients (63%) required intervention in the accident and emergency department to complete assessment or resuscitation. In view of the well recognised difficulties in managing patients with multiple trauma and the possibility that initially occult injuries may become ...

  9. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    Science.gov (United States)

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Yu-Chun Wang

    Full Text Available 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.

  12. Emergency Medical Services Program Guide.

    Science.gov (United States)

    Georgia Univ., Athens. Dept. of Vocational Education.

    This program guide contains the standard emergency medical services curriculum for technical institutes in Georgia. The curriculum encompasses the minimum competencies required for entry-level workers in the emergency medical services field, and includes job skills in six emergency medical services divisions outlined in the national curriculum:…

  13. 78 FR 67463 - National Emergency Medical Services Advisory Council (NEMSAC) and Federal Interagency Committee...

    Science.gov (United States)

    2013-11-12

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC) and Federal Interagency Committee on Emergency Medical Services (FICEMS); Notice of Federal Advisory... Transportation (DOT). ACTION: Meeting Notice--National Emergency Medical Services Advisory Council and...

  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. Serviço de Atendimento Móvel de Urgência: um observatório dos acidentes de transportes terrestre em nível local Mobile Emergency Care Service: a survey of local land transportation accidents

    Directory of Open Access Journals (Sweden)

    Amanda Priscila de Santana Cabral

    2011-03-01

    Full Text Available Conhecer a epidemiologia dos acidentes de transportes terrestres é fundamental para definir políticas de prevenção desse agravo e das mortes por ele causados. Objetivou-se caracterizar o perfil epidemiológico das vítimas do trânsito e a distribuição dos atendimentos por acidentes de transporte a partir de técnica de análise espacial. Estudo descritivo, utilizou como fonte de dados o banco de atendimentos do Serviço de Atendimento Móvel de Urgência do município de Olinda, Pernambuco, entre julho de 2006 a junho de 2007. A distribuição geográfica das ocorrências foi analisada por meio do Índice de Moran. Pedestres, ocupantes de motocicleta e ciclistas concentraram 78% dos atendimentos; houve predomínio do sexo masculino (79% e da faixa etária 20-39 anos (65%. Os finais de semana concentraram a maioria dos atendimentos (56,1%; χ² = 123,7; p Understanding the occurrence of land transportation accidents and describing the victims is fundamental for the definition of prevention and control policies regarding these events and the deaths they cause. The aim of the present study was to characterize the epidemiological profile of land transportation victims and the distribution of emergency care for land transportation accidents using spatial analysis. A descriptive study was carried out using the Mobile Emergency Care Service database of the city of Olinda (Pernambuco, Brazil for occurrences between July 2006 and June 2007. The geographic distribution was analyzed using the Moran Index. Pedestrians, motorcyclists and bicyclists concentrated 78% of the emergency care; there was a predominance of male victims (79% and victims between 20 and 39 years of age (65%. A greater concentration of occurrences was found on weekends (56%; χ² = 123.7; p < 0.001. Between Monday and Thursday, 52% of occurrences were concentrated between 6 am and 5:59 pm; on weekends, 57% of the occurrences were concentrated between 6 pm and 5:59 am. Motorcycles

  17. 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.

  18. Guidelines for Induction and Intubation Sequence Fast in Emergency Service

    OpenAIRE

    Pérez Perilla, Patricia; Pontificia Universidad Javeriana-Hospital Universitario de San Ignacio; Moreno Carrillo, Atilio; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Gempeler Rueda, Fritz E.; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio

    2012-01-01

    The rapid sequence intubation (RSI) is a procedure designed to minimize the time spent in securing the airway by endotracheal tube placement in emergency situations in patients at high risk of aspiration. Being clear about this situation, it is unquestionable the importance of education and training related to rapid sequence intubation to be made to the physicians responsible for the recovery rooms, emergency services and paramedics responsible for managing emergencies and disasters field . T...

  19. Rural Emergency Medical Services (EMS) and Trauma

    Science.gov (United States)

    ... deaths, and rural areas have higher rates of passenger vehicle and large truck occupant deaths. In 2014, ... uses data from the National Electronic Injury Surveillance System, and includes information about what types of nonfatal injuries are treated ...

  20. [Prehospital trauma care training course. Integration of emergency physician and rescue services].

    Science.gov (United States)

    Kopschina, C; Stangl, R

    2008-08-01

    With the emergence of a trauma network in the metropolitan area of Nuremberg, Germany, the question arose whether prehospital trauma management and emergency department management could be better integrated. A training scheme was designed for prehospital trauma care by the rescue services of the Workers' Samaritan Federation Germany (ASB), the Bavarian Red Cross, Maltese Ambulance, St. Johns Ambulance, representatives of the emergency physicians, and physicians of Rummelsberg Hospital. A detailed search of the international literature was done for all subjects regarding prehospital trauma management, and the American training systems (ITLS, PHTLS) were studied. The review was followed by a critical evaluation of the reality of on site-care, and the German and American systems were compared. A 2-day course with 6 sessions (accident place and kinetics, trauma investigation, pathologies, resuscitation, practical training, and evaluation) was developed, adapted from the Advanced Trauma Life Support (ATLS) algorithm. Special attention was given to the integration and position of the emergency physician in Germany, as well as to the defined authority of the rescue services. Conversion into practice was facilitated by teamwork. The course is free of charge to all rescue services and members of the concept group. With a qualified prehospital system that works smoothly with the ATLS concepts, improved prehospital care for trauma patients seems possible.

  1. [Analysis of knowledge attitudes and practices of health care workers facing blood exposure accidents in a general surgery service].

    Science.gov (United States)

    Ennigrou, Samir; Ben Ameur Khechine, Imène; Cherif, Ali; Najah, Nabil; Ben Hamida, Abdelmajid

    2004-06-01

    In order to assess the degree of knowledge, attitudes and the personnel's practices exercising in a service of general surgery of the hospital Charles Nicolle of Tunis, concerning blood exposure accidents, we did a transverse survey during the month of January of the year 2002. A questionnaire has been addressed to 114 people while using the technique of the direct interview. The middle age of investigated is 35.7 years. The sex ratio is 0.7. Only the 2/3 declare have been vaccinated against the B hepatitis. The results show a good knowledge of the exposure risk to a communicable disease by blood (95.6%), but less good for the risk of contamination by the three viruses HBV, HCV and HIV. The resheathing of needles, considered like gesture to risk, is underestimated by 71.2% of investigated. The majority of investigated declare to know universal precaution principles (85.8%). However, to the maximum 4 measures only on the 10 advisable have been mentioned by investigated. The conduct to hold in case of blood exposure accident seems insufficiently known by our sample. It is represented, in 78.8% of cases, in the application of disinfectants Betadine type or alcohol iodized, whereas the practice of a serology to the patient source is ignored completely. 75% of investigated having had a blood exposure accident lasting the last 12 months (n = 44) didn't declare their blood exposure accident and only 11.4% declare to have undergone cares. Actions of information and formation, to the intention of the whole of the personnel of the service, on risks incurred by the nursing, gestures and procedures to risk, the universal precaution respect, the conduct to hold in case of a blood exposure accident, the interest of the declaration and the interest of the vaccination against the B hepatitis, are primordial.

  2. Helicopter Emergency Medical Services: effects, costs and benefits

    NARCIS (Netherlands)

    A.N. Ringburg (Akkie)

    2009-01-01

    textabstractAdvanced prehospital medical care with air transport was introduced in the Netherlands in May 1995. The fi rst helicopter Mobile Medical Team, also called Helicopter Emergency Medical Service (HEMS) was a joint venture initiative of the VU Medical Center in Amsterdam and the Algemene Ned

  3. An analysis of the effectiveness of emergency locator transmitters to reduce response time and locate wreckage in U.S. general aviation accidents

    Science.gov (United States)

    Jesudoss, Ajit

    Emergency Locator Transmitters (ELT) help search crews to locate aircraft in distress and to rescue survivors. This study analyzed ELT data from U.S. General Aviation accidents during the period 2006 to 2010. This study examined the effectiveness of ELTs in terms of ELT Success Rate (ESR) and False Negative Rate (FNR) based on ELT-Aided. This study found a significant difference between ELT-Operated and ELT-Aided. The ESR was found to be 38.58% whereas the FNR was found to be 61.42 %. The Missing Data Ratio (MDR), where accident reports had no ELT information, was found to be above 95%. Recommendations were made to include ELT information in all accident reports and to stress the importance of including response time in the accident report. Also the significant differences between ELT-Operated and ELT-Aided were explained.

  4. A comparison of the quality of care in accident and emergency departments in England and the Netherlands as experienced by patients

    NARCIS (Netherlands)

    Bos, Nanne; Seccombe, Ian J.; Sturms, Leontien M.; Stellato, Rebecca; Schrijvers, Augustinus J P; van Stel, Henk F.

    2016-01-01

    Background: Measuring patients' experiences to determine health-care performance and quality of care from their perspective can provide valuable evidence for international improvements in the quality of care. We compare patients' experiences in Accident & Emergency departments (A&E) in England and t

  5. On-scene alternatives for emergency ambulance crews attending patients who do not need to travel to the accident and emergency department: a review of the literature.

    Science.gov (United States)

    Snooks, H A; Dale, J; Hartley-Sharpe, C; Halter, M

    2004-03-01

    With rising demand and recognition of the variety of cases attended by emergency ambulance crews, services have been considering alternative ways of providing non-urgent care. This paper describes and appraises the research literature concerning on-scene alternatives to conveyance to an emergency department, focusing on the: (1) profile and outcomes of patients attended but not conveyed by emergency crews; (2) triage ability of crews; (3) effectiveness and safety of protocols that allow crews to convey patients to alternative receiving units or to self care. The literature search was conducted through standard medical databases, supplemented with manual searches. Very few "live" studies were identified, and fewer still that included a control group. Findings indicated a complex area, with the introduction of protocols allowing crews to leave patients at scene carrying clinical risk. Robust research evidence concerning alternatives to current emergency care models is needed urgently to inform service and practice development.

  6. Planning the content of a brief educational course in maxillofacial emergencies for staff in accident and emergency departments: a modified Delphi study.

    Science.gov (United States)

    Elledge, Ross O C; McAleer, Sean

    2015-02-01

    It is well known that staff in accident and emergency (A&E) departments lack the knowledge and confidence needed to deal with maxillofacial emergencies, and that it is related to limited education at undergraduate and postgraduate levels. We therefore aimed to design a syllabus for a short course to educate staff about the most common emergencies. To find out which learning outcomes should be included and to reach a consensus, we did a 3-stage modified Delphi study of the opinions of members of the British Association of Oral and Maxillofacial Surgeons (BAOMS). Of a possible 890 members, 188 responded (21%) in the second round and 105 in the third (12%). Eighteen (37%) of the 49 proposed learning outcomes were rated very important and all of them were retained in the syllabus after the third round. Thirty (61%) items were retained with a consensus of 51% or above in the final round. The Delphi technique is a useful addition to the armamentarium of those involved in education, and has been used effectively in syllabus design. We achieved good consensus on the items to be included and the syllabus will be piloted locally.

  7. Organization structure and the performance of hospital emergency services.

    Science.gov (United States)

    Georgopoulos, B S

    1985-07-01

    A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

  10. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  11. Workplace belongingness, distress, and resilience in emergency service workers.

    Science.gov (United States)

    Shakespeare-Finch, Jane; Daley, Emma

    2017-01-01

    Ambulance personnel provide emergency medical services to the community, often attending to highly challenging and traumatic scenes in complex and chaotic circumstances. Currently, the assessment of predictors of psychological well-being remains limited. The current study investigated whether workplace belongingness was significant in predicting psychological distress as well as the presence of resilience in ambulance personnel while controlling for more routinely examined factors. Australian ambulance officers (N = 740) completed a survey battery including the Kessler 10, Brief Resilience Scale, and Psychological Sense of Organizational Membership scale. Controlling for more commonly examined factors such as severity of trauma exposure and length of service, hierarchical multiple regression analyses demonstrated that workplace belongingness was significantly associated with reduced distress levels and enhanced resilience levels. Results suggest that strategies to enhance a sense of workplace belongingness in emergency service organizations could promote the well-being of emergency workers despite routine exposure to potentially traumatic events. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency outpatient services furnished by a... SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.66 Emergency outpatient... for payment of emergency inpatient services furnished by a nonparticipating U.S. hospital and...

  13. 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

  14. 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.

  15. Accident investigation and analysis

    NARCIS (Netherlands)

    Kampen, J. van; Drupsteen, L.

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    G. G. Onischenko

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    V. K. Ivanov

    2011-01-01

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

  18. Communication and industrial accidents

    NARCIS (Netherlands)

    As, Sicco van

    2001-01-01

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

  19. 风险识别和事故应急处理方法%Risk Identification and Accident Emergency Response Measures

    Institute of Scientific and Technical Information of China (English)

    郭祥义

    2016-01-01

    This paper introduces the general engineering construction proj ects of hazards identification and risk anal-ysis methods,expounds the emergency response measures after the accident and accident treatment procedures and methods,reiterates about risk analysis in proj ect construction safety management and the points of accident treatment, combining with the characteristics of the engineering construction proj ect.%该文介绍了一般工程建设项目中的危险源的识别和相关风险分析方法,阐述了事故发生后的应急响应举措和事故处理程序与方法,结合工程建设项目施工的特点,重申了项目施工安全管理中关于风险分析和事故处理的要点。

  20. Designated Medical Directors for Emergency Medical Services: Recruitment and Roles

    Science.gov (United States)

    Slifkin, Rebecca T.; Freeman, Victoria A.; Patterson, P. Daniel

    2009-01-01

    Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight. Purpose: To assess rural-urban…

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

    Science.gov (United States)

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

    2016-08-01

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

  2. [Injuries in children and adolescents in emergency services].

    Science.gov (United States)

    Ruffing, T; Danko, S; Danko, T; Henzler, T; Winkler, H; Muhm, M

    2016-08-01

    A differentiated knowledge of trauma in children and adolescents is essential for the treatment of injured minors. The aim of this study was to present the focus of treatment in trauma emergency services. Over a period of 2 years all acutely injured children and adolescents (n = 4784) in the emergency service were analyzed prospectively. The data were analyzed according to sex, age, date of examination, indications for x-ray imaging, diagnosis and therapy. Seasonal differences in the treatment spectrum were detected. In total 34.4 % of the patients presented with bruises/contusions, 23 % wounds, 19.9 % fractures, 14.9 % sprains/strains/ligament ruptures, 4.1 % craniocerebral trauma, 1.5 % dislocations, 1.1 % muscle/tendon injuries and 0.9 % burns. Of the patients 60 % underwent an x-ray examination and 8.3 % were hospitalized. Different injuries were found in the different age groups. Most fractures (25.7 %) were found at the distal forearm and most osteosyntheses (22.5 %) were also carried out at this anatomical location. Knowledge of the frequency and age dynamics is essential for competent treatment of injuries in children and adolescents. Analysis of the reality of the treatment in emergency services allows a much better evaluation of the requirements with respect to this clientele. The collected data can serve as a basis for the development of major capability foci, training concepts, treatment algorithms as well as prevention measures.

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

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1992-06-01

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

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    苏虹

    2011-01-01

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

  7. 48 CFR 1852.242-78 - Emergency Medical Services and Evacuation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Emergency Medical Services... Provisions and Clauses 1852.242-78 Emergency Medical Services and Evacuation. As prescribed in 1842.7003, insert the following clause: Emergency Medical Services and Evacuation—April 2001 The Contractor...

  8. Investigation and management of patients with pleuritic chest pain presenting to the accident and emergency department.

    OpenAIRE

    Jones, K.; Raghuram, A

    1999-01-01

    The assessment of a patient with pleuritic chest pain calls for a high degree of clinical acumen and a high degree of suspicion that the diagnosis might be pulmonary embolism. This area is one of the most difficult in A&E medicine (and indeed chest medicine). One error is to "think the best" when considering the diagnosis in such patients but experience soon teaches to "think PE" and diagnose less serious conditions only when pulmonary embolism has been excluded. A key consideration is the pr...

  9. Emergency Medical Service (EMS) Stations

    Data.gov (United States)

    Kansas Data Access and Support Center — EMS Locations in Kansas The EMS stations dataset consists of any location where emergency medical services (EMS) personnel are stationed or based out of, or where...

  10. Screening and brief interventions for hazardous alcohol use in accident and emergency departments: a randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Myles Judy

    2009-07-01

    service utilisation. Discussion This paper presents a protocol for a large multi-centre pragmatic factorial cluster randomised trial to evaluate the effectiveness and cost-effectiveness of screening and brief interventions for hazardous alcohol users attending emergency departments. Trial Registration ISRCTN 93681536

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

    Science.gov (United States)

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

    2006-01-01

    This paper investigates the pattern of sexual offence cases attended at the One Stop Crisis Center (OSCC) of the Accident and Emergency Department, Hospital Universiti Sains Malaysia (HUSM), Kelantan. A total of 439 reported sexual offence cases were examined over a period of 4 years from 2000 to 2003. Sexual offence constituted by male partner or boyfriend in 18.9%, by relatives in 27.3% and by "others" in 53.8% of cases. Only 0.7% of victims did not attempt to lodge a police report. There is a significant relationship between occupation and the risk of experiencing sexual violence. Students were mostly targeted by the perpetrator throughout the study period. Among the offences, rape cases were the highest in number, among those who attended at the OSCC, HUSM with a total of 72.7%; followed by 27.3% of incest; 26.4% of child sexual abuse; 4.8% of sodomy and lastly 1.6% of gerontophilia cases. Only 70% of the specimens obtained from sexual offences victims were sent for laboratory analysis. The result remained negative in 82.4% specimens and thus the laboratory analysis result is merely functioning as a supportive evidence for sexual offence cases attended at OSCC. The studies showed that most of the sexual assault perpetrators were known to the victims. The place of crime was also known to the perpetrators. Health sectors of various levels should be working in conjunction to promote a societal changes to improve more of the women's right and thus to reduce the violence crime.

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

    Directory of Open Access Journals (Sweden)

    Raquel Forgiarini Saldanha

    2014-09-01

    Full Text Available Driving under the influence of alcohol/ drugs (DUI is a well-established risk factor for traffic accidents, and men and women have different consumption patterns. The scope of this paper is to analyze differences in alcohol and drug consumption, as well as on behavior associated with traffic accidents among men and women. A cross-sectional study was conducted with 609 sequential traffic accident victims attended in emergency care from Porto Alegre. Subjects gave a structured interview, were breathalyzed and had a saliva test for alcohol/drug screening. Results showed that women were mainly passengers or pedestrians (p < 0.001. There was no significant difference in positive blood alcohol concentration. However, men reported more binge drinking and THC use, while women had more benzodiazepine in their saliva (p<0.05. This is the first Brazilian study to compare alcohol and drug use among men and women who were the victims of traffic accidents. Results point to differences in the pattern of substance abuse, as well on risk behavior. Data may be useful for specific prevention strategies that take gender differences into consideration.

  13. Pain prevalence and pain relief in trauma patients in the Accident & Emergency department.

    NARCIS (Netherlands)

    Berben, S.A.; Meijs, T.H.; Dongen, R.T.M. van; Vugt, A.B. van; Vloet, L.C.M.; Mintjes-de Groot, J.J.; Achterberg, T. van

    2008-01-01

    BACKGROUND: Acute pain in the A&E department (ED) has been described as a problem, however insight into the problem for trauma patients is lacking. OBJECTIVE: This study describes the prevalence of pain, the pain intensity and the effect of conventional pain treatment in trauma patients in the ED. M

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

    Directory of Open Access Journals (Sweden)

    Deborah Carvalho Malta

    2012-09-01

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

  15. 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 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.

  16. Paciente vítima de violência no trânsito: análise do perfil socioeconômico, características do acidente e intervenção do Serviço Social na emergência A patient victim of car traffic violence: an analysis of socioeconomic profile, accident characteristics and Social Services intervention in the emergency room

    Directory of Open Access Journals (Sweden)

    Kátia Campos dos Anjos

    2007-01-01

    Full Text Available OBJETIVO: Identificar e analisar o perfil dos pacientes; o meio de transporte que causou o acidente; as normas do Código de Trânsito Brasileiro, se foram ou não seguidas; a rede de apoio e as intervenções do Serviço Social. MÉTODO: A pesquisa foi realizada com 100% dos pacientes internados nesta Instituição no período de 15/08/04 a 19/11/04, que foram vítimas de acidente no trânsito. Entrevistamos: 37 condutores de motocicletas, 26 pedestres, 15 condutores de veículo a motor e 06 passageiros, totalizando 84 pacientes. Foram utilizados formulários com questões abertas e fechadas de abordagem quantitativa e qualitativa. Resultado: A maior demanda foi de motociclistas, sendo que 83% são do sexo masculino, jovens com escolaridade até o ensino médio e renda mensal de dois salários mínimos. 62% residem em São Paulo e somente 36,5% possuem vínculo formal de trabalho. A maior parte das fraturas ocorreu nos membros inferiores (54%. Todos os pacientes necessitaram de cuidados após alta hospitalar, sendo que 98% contaram com o apoio familiar. CONCLUSÃO: Os elevados números de acidentes nos indicam que a violência no trânsito pode ser considerada um problema de saúde pública e estudos devem ser realizados para subsidiar as políticas públicas nesta área.OBJECTIVE: To identify and analyze patients' profile; the means of transportation that caused the accident; whether the rules of the Brazilian Traffic Code were respected or not; and the support network and actions of social services. METHODS: A survey was conducted with 100% of the patients admitted in this institution between August 15th and November 19th, 2004, who were victims of car accidents. We interviewed 37 motorcycle riders, 26 pedestrians, 15 drivers and 6 passengers, totaling 84 patients. Forms with open and closed questions, adopting both a quantitative and a qualitative approach were used. RESULTS: The greatest demand was from motorcyclists, of whom 83% were male

  17. The 2012 derecho: emergency medical services and hospital response.

    Science.gov (United States)

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  18. Work Accidents and Professional Diseases

    Directory of Open Access Journals (Sweden)

    Doru Hauptmann

    2009-10-01

    Full Text Available The major accident is defined as “any event occurred, like an emission of dangerous materials or agents, which emerges from uncontrolled evolutions along the exploitation of any objective that leads to the immediate or delayed occurrence of serious dangers with impact over human health or over the environment, inside or outside the objective in which are involved one or more than one dangerous materials”.The dangerous phenomenon is a potential source of harms. In the ambit of industrial risks of accidental origins, this expression more frequently refers to physical phenomena like conflagrations, explosions, toxic gases dispersion, etc.Any accident scenario relates itself to the potential effects at the level of environmental “targets”. In the case of major accidents, we can distinguish the following categories of “targets”: human (employees of the objective, working or resident people in the nearby of the emplacement; the installation or equipments that may stay at the origin of the accidents (dangerous equipments; certain all-important equipments to ensure the safety level of the installation (critical security equipments: control rooms, civil fire brigade headquarters, etc; goods and structures situated in the installation’ environment (ground water, rivers, soil, flora, fauna.

  19. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

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

    Science.gov (United States)

    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.

  1. 液氨储罐泄露后果模拟及应急处置%Consequences Simulation and Emergency Disposal of Liquid Ammonia Tank Leakage Accidents

    Institute of Scientific and Technical Information of China (English)

    孙高穹; 刘剑俊

    2016-01-01

    Taking a liquid ammonia tank of a enterprise cold storage as an example,This paper identified the risk of ammonia storage possible poisoning and explosion accident,used the TNT equivalent method and overpressure criterion to simulate the accident consequences of the steam explosion caused by the leakage of a single tank,predicted the toxic gas leakage diffusion effect based on multi-puff model,Finally put forward prevention and emergency response measures of the liquid ammonia tank leak accident.%文章以某企业冷库配备的液氨储罐为实例,对液氨储存过程可能发生的中毒和爆炸事故进行风险识别,运用TNT当量法和超压准则模拟单个储罐泄露后引发蒸汽云爆炸的事故后果,同时运用多烟团模式预测有毒气体泄露扩散影响范围,最后提出液氨储罐泄露事故防范和应急处置措施。

  2. Teammate familiarity and risk of injury in emergency medical services.

    Science.gov (United States)

    Patterson, P Daniel; Weaver, Matthew D; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Vena, John E; Hughes, Ashley M; Salas, Eduardo; Yealy, Donald M

    2016-04-01

    We investigated the association between teammate familiarity and workplace injury in the emergency medical services (EMS) setting. From January 2011 to November 2013, we abstracted a mean of 29 months of shift records and Occupational Safety Health Administration injury logs from 14 EMS organisations with 37 total bases located in four US Census regions. Total teammate familiarity was calculated for each dyad as the total number of times a clinician dyad worked together over the study period. We used negative binomial regression to examine differences in injury incidence rate ratios (IRRs) by familiarity. We analysed 715 826 shift records, representing 4197 EMS clinicians and 60 701 unique dyads. We determined the mean shifts per dyad was (5.9, SD 19.7), and quartiles of familiarity were 1 shift worked together over the study period, 2-3 shifts, 4-9 shifts and ≥10 shifts worked together. More than half of all dyads worked one shift together (53.9%, n=32 739), 24.8% of dyads 2-3 shifts, 11.8% worked 4-9 shifts and 9.6% worked ≥10 shifts. The overall incidence rate of injury across all organisations was 17.5 per 100 full-time equivalent (FTE), range 4.7-85.6 per 100 FTE. The raw injury rate was 33.5 per 100 FTEs for dyads with one shift of total familiarity, 14.2 for 2-3 shifts, 8.3 for 4-9 shifts and 0.3 for ≥10 shifts. Negative binomial regression confirmed that dyads with ≥10 shifts had the lowest incidence of injury (IRR 0.03; 95% CI 0.02 to 0.04). Familiarity between teammates varies in the EMS setting, and less familiarity is associated with greater incidence of workplace injury. 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/

  3. An audit of the NICE self-harm guidelines at a local Accident and Emergency department in North Wales.

    Science.gov (United States)

    Jones, Russell; Avies-Jones, Alison

    2007-10-01

    This paper reports the findings of a self-harm audit based on data collected at an A&E department in North Wales. The National Institute for Clinical Excellence (NICE) guidelines on the short term physical and psychological management of self-harm were published in 2004 and the audit was based on technical criteria recommended in the guideline booklet, including standards of psychosocial assessment, staff training and patient satisfaction information. The data in this study related to fifty consecutive self-harm attendances at the A&E department Ysbyty Glan Clwyd in the Spring of 2007. The hospital serves a mixed rural/urban population of approximately 250,000. Patient satisfaction questionnaires were made available to the group subsequently, whilst the staff training audit was distributed more widely to include emergency, medicine and mental health divisions of the Conwy & Denbighshire NHS Trust. The results demonstrated generally high standards of care on psychosocial assessment, though information relating to initial ambulance involvement in treatment was often unclear. The response to the staff-training questionnaire was an encouraging 44% and indicated wide variations between staff groups and areas of work. The patient satisfaction returns demonstrated favourable responses, with several comments added to expand on tick box replies. Service developments, as a result of the audit, include the proposal to provide mental health and self-harm training to all those staff likely to encounter the behaviour--not just to those who work in mental health. Patients, from the questionnaire, who express a willingness to become part of a mental health planning group are now provided details of the patient participation involvement (PPI) group, where their experiences can often inform service improvement. Meanwhile the case note audit has reinforced the need for a practical self-harm pathway which will ensure consistency.

  4. [A guide to successful public relations for hospitals and emergency medical services].

    Science.gov (United States)

    Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

    2014-04-01

    Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

  5. Geographic Discordance Between Patient Residence and Incident Location in Emergency Medical Services Responses.

    Science.gov (United States)

    Hsia, Renee Y; Dai, Mengtao; Wei, Ran; Sabbagh, Sarah; Mann, N Clay

    2017-01-01

    The location of a patient's residence is often used for emergency medical services (EMS) system planning. Our objective is to evaluate the association between patient residence and emergency incident zip codes for 911 calls. We used data from the 2013 National Emergency Medical Services Information System (NEMSIS) Public-Release Research Dataset. We studied all 911 calls with a valid complaint by dispatch, identifying zip codes for both the residence and incident locations (n=12,376,784). The primary outcomes were geographic and distance discordances between patient residence and incident zip codes. We used a multivariate logistic regression model to determine geographic discordance between residence and incident zip codes by dispatch complaint, age, and sex. We also measured distances between locations with geospatial processing. The overall proportion of geographic discordance for all 911 calls was 27.7% (95% confidence interval [CI] 27.7% to 27.8%) and the median distance discordance was 11.5 miles (95% CI 11.5 to 11.5 miles). Lower geographic discordance rates were found among patients aged 65 to 79 years (20.2%; 95% CI 20.1% to 20.2%) and 80 years and older (14.5%; 95% CI 14.5% to 14.6%). Motor vehicle crashes (63.5%; 95% CI 63.5% to 63.6%), industrial accidents (59.3%; 95% CI 58.0% to 60.6%), and mass casualty incidents (50.6%; 95% CI 49.6% to 51.5%) were more likely to occur outside a patient's residence zip code. Median network distance between home and incident zip centroid codes ranged from 8.6 to 23.5 miles. In NEMSIS, there was geographic discordance between patient residence zip code and call location zip code in slightly more than one quarter of EMS responses records. The geographic discordance rates between residence and incident zip codes were associated with dispatch complaints and age. Although a patient's residence might be a valid proxy for incident location for elderly patients, this relationship holds less true for other age groups and among

  6. 22 CFR 102.13 - Protective services with respect to deceased victims of accidents.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Protective services with respect to deceased victims of accidents. 102.13 Section 102.13 Foreign Relations DEPARTMENT OF STATE ECONOMIC AND OTHER... remains. When a scheduled United States air carrier meets with an accident, the United States airline...

  7. [Prehospital teamwork life support service for traffic accident victims].

    Science.gov (United States)

    Pereira, Waleska Antunes da Porciúncula; Lima, Maria Alice Dias da Silva

    2009-06-01

    The objective of this study is to characterize prehospital teamwork service for traffic accident victims, identifying the actors' activities, the teamwork and the relations with actors from other areas. This is a qualitative study, in which data collection took place by observing the events that occurred at a public service in the city of Porto Alegre, in addition to interviews with each professional involved in the service. The results showed that prehospital care is founded on teamwork and that the understanding among professionals should go beyond the historical hierarchic relation existing in health organizations. There is a need to value the broad field of knowledge, which is associated with the core of care activities that meet most trauma victim needs.

  8. Video and Cable: Emerging Forms of Library Service.

    Science.gov (United States)

    Genova, B. K. L.

    1979-01-01

    Sketches the history of video and cable communications use in libraries, current library activities in video collection and production, problems with some library video projects, trends in video services, and plans for future video uses within libraries. (FM)

  9. Chernobyl accident and its consequences

    Energy Technology Data Exchange (ETDEWEB)

    Gittus, J.H.

    1987-06-01

    The paper concerns the Chernobyl reactor accident, with emphasis on the design of the RBMK reactor and nuclear safety. A description is given of the Chernobyl nuclear power plant, including details of the RMBK reactor and safety systems. Comments on the design of the RBMK by UK experts prior to the accident are summarized, along with post-accident design changes to improve RBMK safety. Events of the Chernobyl accident are described, as well as design deficiencies highlighted by the accident. Differences between the USSR and UK approaches to nuclear safety are commented on. Finally source terms, release periods and environmental consequences are briefly discussed.

  10. Highway traffic safety accident prevention and emergency handling%高速公路突发交通安全事故预防和应急处置

    Institute of Scientific and Technical Information of China (English)

    彭佳

    2016-01-01

    The highway has been rapidly developed,but also brought a lot of traffic congestion and traffic safety issues.In recent years,more and more highway emergencies,natural disasters,social problems,hazardous chemical spills can cause traffic congestion problems,and even traffic accidents.Therefore,this paper will analyze the severity of highway incidents and affecting highway traffic safety factors,and finally have a detailed study of highway burst traffic safety accident preven-tion and emergency response programs.%新时期,高速公路已经得到了快速发展,但是也带来很多交通拥挤和交通安全问题。近年来,高速公路突发事件越来越多,自然灾害、社会问题、危险化学物品泄漏等都会导致交通拥堵问题,甚至发生交通事故。对此,将分析高速公路突发事件的严重性以及影响高速公路交通安全的因素,最后详细探究高速公路突发交通安全事故预防和应急处置方案。

  11. Risk Assessment for Emergency Planning Related to Nuclear Weapons Accidents

    Science.gov (United States)

    1985-09-25

    agencies for handling emergencies (e.g., police , ambulance , medical, hospital, and fire-fighting organ zations should be specified). The facility...emerganey aczions, Including protective mesures . 1. Request for any needed on-site support by off-site organizations. a. Prognosis for worsening cr...decontamination. f. Providing ambulance servlce. S. Providing medical treatment services. 2. Each organization should establish a radiation protection program

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

    Institute of Scientific and Technical Information of China (English)

    徐卸古; 甄蓓; 杨晓明; 陈肖华

    2012-01-01

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

  13. 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

    Energy Technology Data Exchange (ETDEWEB)

    Genkel, Simone (ed.)

    2008-07-01

    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).

  14. Survival benefit of physician-staffed Helicopter Emergency Medical Services (HEMS) assistance for severely injured patients

    NARCIS (Netherlands)

    D. den Hartog (Dennis); J. Romeo (Jamie); A.N. Ringburg (Akkie); M.H.J. Verhofstad (Michiel); E.M.M. van Lieshout (Esther)

    2015-01-01

    markdownabstractBackground: Physician-staffed Helicopter Emergency Medical Services (HEMS) provide specialist medical care to the accident scene and aim to improve survival of severely injured patients. Previous studies were often underpowered and showed heterogeneous results, leaving the subject at

  15. Crisis Nurseries: Emergency Services for Children and Families in Need

    Science.gov (United States)

    Haynes-Lawrence, Darbi

    2009-01-01

    All parents face stressors. For parents with resources, the stressors can be minimal. For parents without resources, a most basic stressor can have a "pile-up" effect, and become a crisis situation (McCubbin & Patterson, 1983). For parents with limited resources--or for those whose resources are not available during an emergency--there is help.…

  16. Older adults and the emerging digital service delivery

    DEFF Research Database (Denmark)

    Siren, Anu; Knudsen, Sine Grønborg

    2017-01-01

    Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were...... associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use...

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

    Directory of Open Access Journals (Sweden)

    José Luís Guedes dos Santos

    2008-09-01

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

  18. The New Mexico School Nurse and Emergency Medical Services Emergency Preparedness Course: Program Description and Evaluation

    Science.gov (United States)

    Elgie, Robert; Sapien, Robert E.; Fullerton-Gleason, Lynne

    2005-01-01

    Illness and injuries are common among students and school staff. Therefore, school nurses must be prepared. In this study, a 16-hour scenario-based emergency preparedness course for school nurses was evaluated for its effectiveness. Effectiveness was measured by (a) traditional methods (written exams and confidence surveys) and (b) skills and…

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

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

  20. Emergency Contraception Education for Health and Human Service Professionals: An Evaluation of Knowledge and Attitudes

    Science.gov (United States)

    Colarossi, Lisa; Billowitz, Marissa; Breitbart, Vicki

    2010-01-01

    Objective: To assess the knowledge and attitudes of health care providers, health educators, and social service providers before and after a training session on emergency contraceptive pills. Design: A survey study using pre-post training measurements. Setting: Two hundred and twenty-three medical, social service, and health education providers in…

  1. Resilient National Security and Emergency Preparedness Communications: Service Metrics

    Science.gov (United States)

    2015-10-01

    concepts of resilience. An architectural framework for resilience and survivability in communication networks is provided in [1], as well as a survey...coverage, the device may use 3G technology to support voice, text, and data services. The device may even resort to analog 1G to provide simple...An approach to evaluating resilience in command and control Architectures ,” Conference on Systems Engineering Research, vol. 8, pp. 141-146, 2012

  2. Facilities and regionalization--emergency medical services systems.

    Science.gov (United States)

    Stewart, R D

    1990-02-01

    Advanced life support and the modern EMS system were born out of the hope that by extending hospital emergency facilities outside the bounds of the hospital, earlier and more intensive care could be provided to those patients requiring it. EMS systems have since left the nest and only recently, following a turbulent adolescence, is prehospital care returning as a partner with the medical facilities and physicians that presided over their modern origins. The next decade will see the continuing trend toward hospitals and practitioners regaining some influence in the design and direction of prehospital care.

  3. [Pediatric emergencies in the emergency medical service].

    Science.gov (United States)

    Silbereisen, C; Hoffmann, F

    2015-01-01

    Out-of-hospital pediatric emergencies occur rarely but are feared among medical personnel. The particular characteristics of pediatric cases, especially the unaccustomed anatomy of the child as well as the necessity to adapt the drug doses to the little patient's body weight, produce high cognitive and emotional pressure. In an emergency standardized algorithms can facilitate a structured diagnostic and therapeutic approach. The aim of this article is to provide standardized procedures for the most common pediatric emergencies. In Germany, respiratory problems, seizures and analgesia due to trauma represent the most common emergency responses. This article provides a practical approach concerning the diagnostics and therapy of emergencies involving children.

  4. Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management.

    Science.gov (United States)

    LaMantia, Michael A; Messina, Frank C; Jhanji, Shola; Nazir, Arif; Maina, Mungai; McGuire, Siobhan; Hobgood, Cherri D; Miller, Douglas K

    2017-04-01

    Purpose of the study The study objective was to understand providers' perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient's home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms

  5. Emergency response service personnel and the critical incident stress debriefing debate.

    Science.gov (United States)

    Wagner, Shannon L

    2005-01-01

    Previous research has demonstrated the potential for work-related stress associated with employment in the emergency service field. However, little research has considered effective interventions that may be used to mediate the effects of this work-related stress. Critical Incident Stress Debriefing (CISD) is one intervention that is currently employed with emergency service workers. However, the efficacy of this intervention is currently the source of much debate. The present discussion reviews the available literature regarding the effectiveness of CISD for use with emergency service workers and concludes that at this time, for this population, the call for the removal of current programs using CISD is unwarranted.

  6. Emerging trends in the evolution of service-oriented and enterprise architectures

    CERN Document Server

    Zimmermann, Alfred; Jain, Lakhmi

    2016-01-01

    This book presents emerging trends in the evolution of service-oriented and enterprise architectures. New architectures and methods of both business and IT are integrating services to support mobility systems, Internet of Things, Ubiquitous Computing, collaborative and adaptive business processes, Big Data, and Cloud ecosystems. They inspire current and future digital strategies and create new opportunities for the digital transformation of next digital products and services. Services Oriented Architectures (SOA) and Enterprise Architectures (EA) have emerged as a useful framework for developing interoperable, large-scale systems, typically implementing various standards, like Web Services, REST, and Microservices. Managing the adaptation and evolution of such systems presents a great challenge. Service-Oriented Architecture enables flexibility through loose coupling, both between the services themselves and between the IT organizations that manage them. Enterprises evolve continuously by transforming and ext...

  7. [Chernobyl nuclear power plant accident and Tokaimura criticality accident].

    Science.gov (United States)

    Takada, Jun

    2012-03-01

    It is clear from inspection of historical incidents that the scale of disasters in a nuclear power plant accident is quite low level overwhelmingly compared with a nuclear explosion in nuclear war. Two cities of Hiroshima and Nagasaki were destroyed by nuclear blast with about 20 kt TNT equivalent and then approximately 100,000 people have died respectively. On the other hand, the number of acute death is 30 in the Chernobyl nuclear reactor accident. In this chapter, we review health hazards and doses in two historical nuclear incidents of Chernobyl and Tokaimura criticality accident and then understand the feature of the radiation accident in peaceful utilization of nuclear power.

  8. Psychological emergency attendance as a psychological service in educational psychology: limits and possibilities

    Directory of Open Access Journals (Sweden)

    Edson do Nascimento Bezerra

    2014-04-01

    Full Text Available The School Psychology Emergency Practices differs from others School Psychology practices, is more than type of psychology service and should have more institutional visibility. This paper reflects on these references from both the practice of the author and the currently literature in school psychology. To this purpose, we use as reference the concept of Extended Clinic and its relation with Psychology Emergency Service area. We discuss the opportunity of the school psychologist has, among other things, to be able to listen and to welcome spontaneously anyone in the school community seeking for support in case of emergency. In so doing, the author reflects on the condition of psychological emergency service as service and as a type of treatment at school, and school psychology as an area of expertise inserted in this complex environment different of views and perspectives.

  9. Homelessness and housing crises among individuals accessing services within a Canadian emergency department.

    Science.gov (United States)

    Forchuk, C; Reiss, J P; Mitchell, B; Ewen, S; Meier, A

    2015-08-01

    Studies have indicated that individuals who are homeless access hospital emergency departments more frequently and may have different needs than individuals who are housed. Successful interventions have been developed and tested to reduce discharge to homelessness for psychiatric inpatients but have not been similarly tested for discharge from emergency departments. This study was developed to provide baseline data on this issue to inform future emergency department interventions. Findings from the current study suggest that discharge from emergency departments to homelessness happens frequently in London, Canada. Participants are unlikely to spontaneously disclose their housing/homelessness issue when first entering the emergency department, which may result in services that do not adequately meet their complex needs. Screening for housing issues is necessary within emergency departments and psychiatric crisis teams as housing issues may be a reason for accessing care or contribute to the presenting condition. Nurses are in an ideal position to evaluate housing needs among emergency department patients. Services outside of the emergency department are also needed to address housing issues, particularly outside of regular office hours. Individuals who have mental health issues and are homeless or in housing crisis have been found to access emergency departments more frequently than individuals with stable housing. While emergency departments primarily focus on medical issues, homeless individuals may require psychosocial support as well. This study examined issues around housing crises and emergency department use for individuals with mental illness in Canada. Collecting baseline data about these issues is important to inform subsequent interventions. Administrative data from a hospital emergency department and psychiatric crisis service were collected, and five individuals accessing the emergency department for psychiatric reasons were interviewed. Results

  10. Aftercare services for international sex trafficking survivors: informing U.S. service and program development in an emerging practice area.

    Science.gov (United States)

    Macy, Rebecca J; Johns, Natalie

    2011-04-01

    International sex trafficking into the United States appears to be a serious and growing problem, although the evidence regarding prevalence, risk, and consequences is incomplete. Nonetheless, human service providers are increasingly being asked to offer services to sex trafficking survivors. Consequently, providers need information to guide services and program development in this emerging practice area. To address this knowledge need, we systematically reviewed and synthesized 20 documents addressing the needs of and services for international survivors of sex trafficking into the United States. The main finding from the review shows the importance of a continuum of aftercare services to address survivors' changing needs as they move from initial freedom to recovery and independence. Based on our synthesis of the reviewed literature, we present a service delivery framework to guide providers' development of services for survivors.

  11. The Fukushima Dai-ichi accident: additional lessons from a radiological emergency assistance mission.

    Science.gov (United States)

    Becker, Steven M

    2013-11-01

    In response to the March 2011 earthquake-tsunami disaster and the Fukushima Dai-ichi nuclear accident, a special nongovernmental Radiological Emergency Assistance Mission flew to Japan from the United States. Invited by one of Japan's largest hospital and healthcare groups and facilitated by a New York-based international disaster relief organization, the mission included an emergency physician, a health physicist, and a disaster management specialist. During the 10 d mission, team members conducted fieldwork in areas affected by the earthquake, tsunami, and nuclear accident; went to cities and towns in the 20-30 km Emergency Evacuation Preparation Zone around the damaged nuclear plant; visited other communities affected by the nuclear accident; went to evacuation shelters; met with mayors and other local officials; met with central government officials; exchanged observations, experiences, and information with Japanese medical, emergency response, and disaster management colleagues; and provided radiological information and training to more than 1,100 Japanese hospital and healthcare personnel and first responders. The mission produced many insights with potential relevance for radiological/nuclear emergency preparedness and response. The first "lessons learned" were published in December 2011. Since that time, additional broad insights from the mission and mission followup have been identified. Five of these new lessons, which focus primarily on community impacts and responses and public communication issues, are presented and discussed in this article.

  12. Overcrowding of accident & emergency units: is it a growing concern ...

    African Journals Online (AJOL)

    ed. Therefore, this study was intended to determine the prevalence, causes, and effects of overcrowding AEDs in Nigeria. Materials and .... logical, paediatric, psychiatric services, medical services and laboratory services. All these are tertiary ...

  13. Bulgarian Emergency Response System (BERS) in case of nuclear accident with exposure doses estimation

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-07-01

    A PC-oriented Emergency Response System in case of nuclear accident (BERS) is developed and works operationally in the National Institute of Meteorology and Hydrology (NIMH). The creation and development of BERS was highly stimulated by the ETEX (European Tracer Experiment) project. BERS comprises two main parts - the operational and the accidental ones. The operational part, run automatically every 12 hours, prepares the input meteorological file used by both trajectory and dispersion models, runs the trajectory models, visualizes the results and uploads the maps of trajectories to a dedicated web-site. The accidental part is activated manually when a real radioactive releases occur or during emergency exercises. Its core is the Bulgarian dispersion models EMAP. Outputs are concentration, accumulated deposition and selected doses fields. In the paper, the BERS overall structure is described and examples of its products are presented. Key words: nuclear accident, emergency response, early warning system, air dispersion models, radioactive exposure dose. (Author)

  14. Learning from incidents and accidents

    NARCIS (Netherlands)

    Drupsteen, L.; Kampen, J. van

    2014-01-01

    There are many different definitions for what constitutes an incident or an accident, however the focus is always on unintended and often unforeseen events that cause unintended consequences. This article is focused on the process of learning from incidents and accidents. The focus is on making sure

  15. Learning from incidents and accidents

    NARCIS (Netherlands)

    Drupsteen, L.; Kampen, J. van

    2014-01-01

    There are many different definitions for what constitutes an incident or an accident, however the focus is always on unintended and often unforeseen events that cause unintended consequences. This article is focused on the process of learning from incidents and accidents. The focus is on making sure

  16. Characterization of motorcycle accident victims attended by the mobile emergency service (SAMU-192, Recife, Pernambuco State, Brazil = Caracterização das vítimas de acidentes de motocicleta atendidas pelo serviço de atendimento móvel de urgência (SAMU-192, Recife, Estado de Pernambuco, Brasil

    Directory of Open Access Journals (Sweden)

    Flávia Gomes Medeiros Fernandes da Costa

    2012-10-01

    Full Text Available This study described the epidemiological characteristics of victims of accidents involving motorcycles, attended by the Mobile Emergency Service (SAMU-192 in the city of Recife (PE in 2006. This is a descriptive cross-sectional study that analyzed a sample of 703 cases. The results showed that 81.8% were male, aged 20 to 29 years. It was noted that 406 of them were wearing a helmet at the time of the accident. The accidents occurred most frequently on Sundays (19.3% between 18:00 and 24:00 hours (0.28%. The extremities were the most affected body segment, with 341 occurrences. Regarding the severity of injuries, it was found that 37.6% were superficial or mild (scrapes, cuts and bruises. These results demonstrate the need for educational campaigns to encourage the use of personal protective equipment among motorcyclists. The best way to reduce the risks and damages from motorcycle accidents is through primary prevention. For this, are needed integrated intersectoral actions aimed at reducing the incidence and severity of injuries.Descrevem-se as características epidemiológicas das vítimas de acidentes envolvendo motocicletas atendidas pelo Serviço de Atendimento Móvel de Urgência (SAMU-192, da cidade do Recife (PE, no ano de 2006. Trata-se de um estudo descritivo de corte transversal, no qual foi analisada uma amostra de 703 atendimentos. Os resultados mostraram que 81,8% eram do sexo masculino, na faixa etária entre 20 e 29 anos. Observou-se que 406 motociclistas utilizavam o capacete no momento do acidente. Os acidentes ocorreram com maior frequência no domingo (19,3%, no horário compreendido entre as 18h e 24h (0,28%. As extremidades foram o segmento do corpo mais atingidos com 341 ocorrências. Quanto à gravidade das lesões, verificou-se que 37,6% eram superficiais ou de baixa gravidade (escoriações, cortes e contusões. Esses resultados são importantes para demonstrar a necessidade de campanhas educativas incentivando o uso

  17. Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

    Science.gov (United States)

    Dil, L. M.; Vuijk, P. J.

    2012-01-01

    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

  18. Fatal motorcycle accidents and alcohol

    DEFF Research Database (Denmark)

    Larsen, C F; Hardt-Madsen, M

    1987-01-01

    A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC...

  19. Access to emergency number services.

    Science.gov (United States)

    Harkins, Judith E; Strauss, Karen Peltz

    2008-01-01

    Access to emergency services is mandated by Title II of the Americans with Disabilities Act (ADA). The Department of Justice oversees the accessibility of public safety answering points (PSAPs), popularly called 9-1-1 centers. The Federal Communications Commission (FCC) has at least two roles in emergency number access: (1) as regulator of the ADA's Title IV on telecommunications access, and (2) as regulator of communications companies with regard to support of and interconnection with PSAPs. The rules of both agencies contributed significantly to the improvement during the 1990s of access to 9-1-1 for people who are deaf, hard of hearing, or speech disabled. However, as new technologies for text wireless communications and relay services have moved quickly to Internet protocol (IP)-based technologies over the past 5-8 years, the use of traditional wireline telephones and text telephones among deaf, hard of hearing, and speech-disabled people has declined. PSAPs cannot be contacted via the newer forms of telecommunications, such as e-mail, instant messaging, and IP-based forms of relay services, including video relay services. The gap between the technology supported by policy and the technologies currently being used by deaf and hard of hearing people has become a serious problem that is difficult to solve because of the separate jurisdictions of the two agencies, the need for coordination within the FCC, technological challenges, and funding issues. In this article, the key policy and technology challenges will be analyzed and recommendations made for short-and long-term solutions to this dilemma.

  20. User violence towards nursing professionals in mental health services and emergency units

    Directory of Open Access Journals (Sweden)

    Bartolomé Llor-Esteban

    2017-01-01

    Full Text Available Workplace violence is present in many work sectors, but in the area of mental health, nurses have a higher risk due to the close relationship they have with users. This study analyzed hostile user statements against nursing professionals of Mental Health Services and Emergency Units in Health Service (MHS hospitals in Murcia, Spain, and determined the frequency of exposure to the different violent user behaviors. The study was carried out with a sample of 518 nursing professionals from four hospital services: Mental Health, Emergency Units, Medical Hospitalization, and Maternal-and-Child. The nursing staff of Mental Health and Emergency Units was the most exposed to violence. Non-physical violence was more frequent in Emergency Units, whereas physical violence was more frequent in Mental Health. Among the consequences of exposure to non-physical violence are workers’ emotional exhaustion and the presence of psychological distress.

  1. Pediatric and adolescent mental health emergencies in the emergency medical services system.

    Science.gov (United States)

    Dolan, Margaret A; Fein, Joel A

    2011-05-01

    Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

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

    Science.gov (United States)

    Anderson, M

    1997-06-01

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

  3. Chernobyl accident and its consequences

    Energy Technology Data Exchange (ETDEWEB)

    Gittus, J.H.; Bonell, P.G.; Hicks, D.

    1987-01-01

    The USSR power reactor programme is first described. The reasons for the accident at the Chernobyl-4 RBMK nuclear reactor on 26 April 1986, the sequence of events that took place, and the immediate and long-term consequences are considered. A description of the RBMK-type reactors is given and the design changes resulting from the experience of the accident are explained. The source terms describing the details of the radioactivity release associated with the accident and the environmental consequences are covered in the last two sections of the report. Throughout the text comments referring to the UK Nuclear Installations Inspectorate Safety assessment principles have been inserted. (U.K.).

  4. Incidence and mortality of solid cancer among emergency workers of the Chernobyl accident: assessment of radiation risks for the follow-up period of 1992-2009

    Energy Technology Data Exchange (ETDEWEB)

    Kashcheev, V.V.; Chekin, S.Yu.; Maksioutov, M.A.; Tumanov, K.A.; Kochergina, E.V.; Kashcheeva, P.V.; Shchukina, N.V.; Ivanov, V.K. [Russian Ministry of Health, Federal State Institution, Medical Radiological Research Center, Obninsk, Kaluga Region (Russian Federation)

    2015-03-15

    This paper presents the results of a retrospective cohort study of cancer incidence and mortality among emergency workers of the Chernobyl accident, for the follow-up period 1992-2009. The cohort selected for analysis consists of 67,568 emergency workers who worked in the Chernobyl exclusion zone in 1986-1987. External radiation whole-body absorbed dose varied from 0.0001 gray (Gy) to 1.24 Gy, with a median of 0.102 Gy. Over the follow-up period 1992-2009, a total of 4,002 solid cancers of different sites were identified as the result of annual compulsory health examination, and a total of 2,442 deaths from all solid cancers in the study cohort were reported. Poisson regression was applied for the analysis of cancer incidence and mortality. The analysis of the standardized incidence ratio (SIR) has shown a statistically significant increase in cancer incidence in the cohort as compared with baseline cancer incidence among males of Russia. The average excess over the entire follow-up period is 18 % [SIR = 1.18, 95 % confidence interval (CI) 1.15; 1.22]. In contrast, however, no increase in the mortality from all cancers among the emergency workers as compared to the baseline mortality in Russian men was found. Values of excess relative risk of cancer incidence and mortality per 1 Gy (ERR Gy{sup -1}) are 0.47 (95 % CI 0.03; 0.96, p value = 0.034) and 0.58 (95 % CI 0.002; 1.25, p value = 0.049), respectively. These values are statistically significant. (orig.)

  5. Emerging framework of safety management after Fukushima accident

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-10-15

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

  6. Factors influencing satisfaction with emergency department medical service: Patients' and their companions' perspectives.

    Science.gov (United States)

    Son, Heesook; Yom, Young-Hee

    2017-01-01

    To examine the individual determinants that influence satisfaction with medical services at the emergency department and to compare the factors that influence satisfaction for the patients, compared with their companions. Using data from the 2009 Korea Health Panel Survey, Andersen's behavioral model was used to examine the factors that affect satisfaction with service. A logistic regression analysis was conducted with the data. Patients who were older, female, and employed were more satisfied with the service, as were patients who visited more frequently and those who had non-surgical treatment. Companions who had less education, were accompanying non-Medicaid-holders, and spent a longer time in the emergency department were less likely to be satisfied. This was in contrast to those who spent a shorter amount of time in the emergency department and who visited due to illness, rather than injury; these companions were more satisfied with the service. When all the factors were analyzed simultaneously, they differed significantly between the two groups of patients and companions. Different factors contributed to the satisfaction with the services for the patients and their companions. In order to increase the satisfaction levels and improve the quality of care in emergency departments, it is necessary to consider more specific approaches that reflect the different perspectives of the visitors to the emergency department. © 2016 Japan Academy of Nursing Science.

  7. Service robotics: an emergent technology field at the interface between industry and services.

    Science.gov (United States)

    Ott, Ingrid

    2012-12-01

    The paper at hand analyzes the economic implications of service robots as expected important future technology. The considerations are embedded into global trends, focusing on the interdependencies between services and industry not only in the context of the provision of services but already starting at the level of the innovation process. It is argued that due to the various interdependencies combined with heterogenous application fields, the resulting implications need to be contextualized. Concerning the net labor market effects, it is reasonable to assume that the field of service robotics will generate overall job creation that goes along with increasing skill requirements demanded from involved employees. It is analyzed which challenges arise in evaluating and further developing the new technology field and some policy recommendations are given.

  8. MDCT findings in sports and recreational accidents

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-15

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

  9. 42 CFR 482.55 - Condition of participation: Emergency services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Emergency services. 482... Optional Hospital Services § 482.55 Condition of participation: Emergency services. The hospital must meet...: Organization and direction. If emergency services are provided at the hospital— (1) The services must...

  10. 28 CFR 35.162 - Telephone emergency services.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Telephone emergency services. 35.162... IN STATE AND LOCAL GOVERNMENT SERVICES Communications § 35.162 Telephone emergency services. Telephone emergency services, including 911 services, shall provide direct access to individuals who use...

  11. Social Networking and eDating: Charting the Boundaries of an Emerging Self-Service Arena

    Science.gov (United States)

    Romm, Celia T.; Oliver, Dave

    This chapter focuses on social networking and eDating as emerging areas of self-service. Following an overview of the theoretical aspects of self-service, two models or typologies for categorizing business models in the two areas are presented, namely, one typology for social networking services and another for eDating services. The chapter concludes with a discussion of the psychological, social, legal, and other implications from the models, as well as suggestions for future research that emanate from the issues presented in the chapter.

  12. Providing emergency services in Internet telephony

    Science.gov (United States)

    Schulzrinne, Henning G.; Arabshian, Knarig

    2002-07-01

    Assisting during emergencies is one of the important functions of the telephone system. Emergency communications has three components: summoning help during emergencies, coordinating emergency response and notifying citizens and public officials of local emergencies. As we transition to an Internet-based telecommunications system, these functions need to be provided, but there is also an opportunity to add new functionality and improve scalability and robustness. We discuss three aspects of Internet-based communications related to emergencies: First, we describe how Internet telephony can be used to provide emergency call (``911'' or ``112'') services. Secondly, Internet telephony needs to be enhanced to allow prioritized access to communications resources during emergency-induced network congestion. Finally, Internet event notification can be a valuable new mechanism to alert communities to pending or on-going emergencies such as hurricanes or chemical spills.

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

    Science.gov (United States)

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

    2016-06-01

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

  14. [The emergence of China's Railway Health Services and its motivation in the late Qing Dynasty].

    Science.gov (United States)

    Huang, Huaping

    2014-03-01

    In the late Qing Dynasty, the railway authority of China commenced establishing their self-run medical institutions, setting up the hygienic standards of railway system, and opening a new prospects of railway health services and epidemic prevention, reflecting the emergence of China's Railway Health Services. The motivations of all these approaches were related to three factors, that is,"the eastward dissemination of western medicine","the medical requirement of railway employees", and"the emergent situation of railway health and epidemic prevention".

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

    Institute of Scientific and Technical Information of China (English)

    朱亚菲

    2012-01-01

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

  16. Hypoglycaemic complications with diabetes mellitus management: the predominant adverse drug reaction presenting to the Accident and Emergency Department of The University Hospital of the West Indies.

    Science.gov (United States)

    Gossell-Williams, M; Williams-Johnson, J; Francis, L

    2010-10-01

    Evaluation of adverse drug reactions (ADRs) is important to the assessment of risk factors in an aim to ensure maximum benefits of drug therapy. This study was done to assess the types of ADRs presenting to the Accident and Emergency department (A&E) of the University Hospital of the West Indies. Admissions to the A&E associated with drugs were followed on a weekly basis for 19 weeks from October 2007 to February 2008 using the patient logbook. Medical records of patients with suspected ADRs were collected and evaluated by an Emergency Medicine Consultant of A & E to confirm the occurrence of ADRs and the suspected drug. Of the 8170 admissions to A&E, 48 (0.6%) were related to ADRs, with most occurring in females and the mean age (+/- standard error) was 58.9 (+/- 3.4) years. Drug induced hypoglycaemia accounted for 28 (56.3%) cases of ADRs and included mainly patients on insulin, with or without a sulphonylurea therapy. Most of these diabetic patients also had co-morbidities and were on multi-drug therapy (18). Allergic reactions accounted for 10 (21%) of the ADR outcomes. Other drugs accounting for ADRs included cardiovascular drugs (10.4%), analgesic/anti-inflammatory medications (8.3%), drugs acting on the central nervous system (8.3%) and anti-infectives (8.3%). It is concluded that drug-induced hypoglycaemia is the major ADR presenting to the A&E of the University Hospital of the West Indies; it is a preventable ADR and therefore further investigation should evaluate possible factors attributed to the occurrences.

  17. 50 CFR 401.17 - Safety and accident prevention.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Safety and accident prevention. 401.17 Section 401.17 Wildlife and Fisheries JOINT REGULATIONS (UNITED STATES FISH AND WILDLIFE SERVICE... FISHERIES CONSERVATION, DEVELOPMENT AND ENHANCEMENT § 401.17 Safety and accident prevention. In...

  18. Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

    OpenAIRE

    Fiona Cocker; Nerida Joss

    2016-01-01

    Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS) and cumulative burnout (BO), a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing...

  19. 38 CFR 17.95 - Outpatient medical services for Department of Veterans Affairs employees and others in emergencies.

    Science.gov (United States)

    2010-07-01

    ... services for Department of Veterans Affairs employees and others in emergencies. 17.95 Section 17.95... Outpatient medical services for Department of Veterans Affairs employees and others in emergencies. Outpatient medical services for which charges shall be made as required by § 17.101 may be authorized...

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

    Science.gov (United States)

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

    2016-06-05

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

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

    Science.gov (United States)

    Duan, Weili; He, Bin

    2015-07-10

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

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

    Directory of Open Access Journals (Sweden)

    Weili Duan

    2015-07-01

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

  3. Frequent users of emergency services: associated factors and reasons for seeking care

    Directory of Open Access Journals (Sweden)

    Aline Marques Acosta

    2015-04-01

    Full Text Available Aim: to identify the profile of frequent users of emergency services, to verify the associated factors and to analyze the reasons for the frequent use of the services. METHOD: An explanatory sequential type mixed method was adopted. Quantitative data were collected from the electronic medical records, with a sample of 385 users attended four or more times in an emergency service, during the year 2011. Qualitative data were collected through semi-structured interviews with 18 users, intentionally selected from the results of the quantitative stage. Quantitative data were analyzed using descriptive and inferential statistics and qualitative data using thematic analysis. RESULTS: It was found that 42.9% were elderly, 84.9% had chronic diseases, 63.5% were classified as urgent, 42.1% stayed for more than 24 hours in the service and 46.5% were discharged. Scheduled follow-up appointment, risk classification, length of stay and outcome were factors associated with frequent use. The reasons for seeking the services were mainly related to the exacerbation of chronic diseases, to easier access and concentration of technology, to the bond, and to the scheduled appointments. CONCLUSIONS: The results contribute to comprehending the repeated use of emergency services and provide additional data to plan alternatives to reduce frequent use.

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

    Institute of Scientific and Technical Information of China (English)

    李晶晶; 朱渊; 陈国明; 李修峰

    2014-01-01

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

  5. Indications and results of emergency surgical airways performed by a physician-staffed helicopter emergency service

    NARCIS (Netherlands)

    Peters, J.; Bruijstens, L.; Ploeg, J. van der; Tan, E.; Hoogerwerf, N.; Edwards, M.J.

    2015-01-01

    BACKGROUND: Airway management is essential in critically ill or injured patients. In a "can't intubate, can't oxygenate" scenario, an emergency surgical airway (ESA), similar to a cricothyroidotomy, is the final step in airway management. This procedure is infrequently performed in the prehospital

  6. Managerial and Organisational Challenges In Emergency Services Work

    DEFF Research Database (Denmark)

    Visholm, Steen

    This pilot study attempts to make these percentages and figures “come to life” in a more everyday picture of how stress is experienced, and how it is related to management and organisation. A number of qualitative single and group interviews with 5 leaders and 10 EMTs were recorded, transcribed...... and analysed. With a point of departure in the interviews some psychodynamic patterns in the work of the EMTs are identified and theorized: The active-passive inversion, The princess, the Dragon and the Knight, Repair, The by Identification broken distance screen, Containing and the defence mechanisms...

  7. Recovery and well-being among Helicopter Emergency Medical Service (HEMS) pilots

    NARCIS (Netherlands)

    Radstaak, M.; Geurts, S.A.E.; Beckers, D.G.J.; Brosschot, J.F.; Kompier, M.A.J.

    2014-01-01

    This study investigated the effects of a compressed working week with high cognitive and emotional work demands within the population of Dutch Helicopter Emergency Medical Service (HEMS) pilots. Work stressors were measured and levels of well-being were examined before, during and after a series of

  8. Theatre and emergency services rendered by generalist medical ...

    African Journals Online (AJOL)

    sterilization was the most frequently performed surgical procedure, and secondly ... surgery, anaesthetics and orthopaedics. 3,4,5 ... profile of medical practitioners in ..... was carried out of the186 nurses who completed the Diploma in Clinical ...

  9. Student-selected component in the medical curriculum: investigations and psychiatric referral for paracetamol overdose in an accident and emergency department

    Directory of Open Access Journals (Sweden)

    Cowman JG

    2017-08-01

    Full Text Available James G Cowman, Manuel Bakheet Royal College of Surgeons in Ireland – Medical University of Bahrain, Manama, Bahrain Background: A student-selected component (SSC of the medical curriculum requires the student to be self-directed in locating and undertaking a placement in a clinical specialty of their choosing and completing a project. The clinical area for experience was an accident and emergency department, and our topic was a focused audit on the investigations and referral for paracetamol overdose. The purpose of this paper is twofold: to reflect on the education value to medical students of an SSC in a medical curriculum, and to highlight learning and understanding through completion of an audit.Materials and methods: An audit approach was applied. The aim of the project study was to investigate the level of compliance with best-practice guidelines for investigations and psychiatric referral in paracetamol overdose.Results: A total of 40 cases meeting the inclusion criteria were randomly selected. The sample had a mean age of 27 years, of whom 70.5% were female, and the ingested dose of paracetamol ranged from 0.864 to 80 g. Paracetamol abuse may present as intentional and unintentional overdose. In our study, 85% of cases were identified as intentional overdose and 76% had a history of psychiatric illness. Generally, medical management was compliant with guidelines, with some minor irregularities. The international normalized ratio was the most underperformed test.Conclusion: Our choice of topic, paracetamol overdose, contributed to our understanding of the breadth of factors to be considered in the emergency medical management of a patient. In this regard, we had the benefit of understanding how the diagnostic and therapeutic factors, when applied in accordance with best-practice guidelines, work very effectively. The SSC impacted positively on our cognitive, personal, and professional development. In facilitating the student with

  10. Using community partners to deliver low-cost and effective emergency management and business continuity services.

    Science.gov (United States)

    Thomas, Joan; Roggiero, Jean Paul; Silva, Brian

    2010-11-01

    Small to medium-sized organisations enhance their business mission as well as their communities by continuing to offer services in extreme circumstances. Developing emergency preparedness and business continuity plans that are cost-effective, comprehensive and operational for small to medium-sized organisations with limited resources requires a consistent, supportive, hands-on approach over time with professionals to create appropriate and sustainable strategies. Using a unique, multi-layered and applied approach to emergency preparedness training, organisations have successfully created plans that are effective and sustainable.

  11. Rider injury rates and emergency medical services at equestrian events

    OpenAIRE

    Paix, B. R.

    1999-01-01

    BACKGROUND: Horse riding is a hazardous pastime, with a number of studies documenting high rates of injury and death among horse riders in general. This study focuses on the injury experience of cross country event riders, a high risk subset of horse riders. METHOD: Injury data were collected at a series of 35 equestrian events in South Australia from 1990 to 1998. RESULTS: Injury rates were found to be especially high among event riders, with frequent falls, injuries, and even deaths. ...

  12. [Helicopter emergency medical service missions at night: 2 years of experience in the Dutch Regional Emergency Healthcare Network East].

    Science.gov (United States)

    Hoogerwerf, Nico; Heijne, Amon; Geeraedts, Leo M G; van Riessen, Christine; Scheffer, Gert-Jan

    2010-01-01

    To study whether there are differences between day and night in the dispatch of helicopter emergency medical services (HEMS) and in their response and travelling times, medical treatment and transport of patients. Retrospective, descriptive study. All data on helicopter emergency medical service (HEMS) missions available 24/7 from Nijmegen, the Netherlands, during 2007 and 2008 were collected. All missions in this period were divided into daytime and night-time missions. Next, the reason for dispatch, the duration of distinct times during the mission, the method of transport of the HEMS team, medical treatments and patient transport were compared. In 2007 and 2008 the HEMS team was dispatched 2891 times. 1107 patients were treated during daytime and 479 during the night. The mean distance to the incident scene was longer for night missions. During night-time the HEMS team was dispatched more often for road traffic accidents and violence-related accidents but less often for falls, drowning, horse riding accidents and people becoming trapped (non-traffic-related). There were no differences in medical treatment given by the HEMS physician between day and night, but fewer patients were transported by helicopter at night. Travelling times and on-scene times were only slightly different. The number of dispatches of the HEMS team at night was higher than expected, but night missions were cancelled more often due to weather conditions than missions by day. Prehospital times and operations of the Netherlands HEMS differed slightly between day and night.

  13. Prevalence and relief of pain in trauma patients in emergency medical services

    NARCIS (Netherlands)

    Berben, S.A.A.; Schoonhoven, L.; Meijs, T.H.; Vugt, A.B. van; Grunsven, P.M. van

    2011-01-01

    OBJECTIVES: The aim of this study was to give insight in the prevalence of pain, and the (effect of) pain management according to the national emergency medical services analgesia protocol in trauma patients in the Netherlands. METHODS: The retrospective document study included adult and alert traum

  14. Development, testing and implementation of an emergency services methodology in Alberta.

    Science.gov (United States)

    Eliasoph, H; Ashdown, C

    1995-01-01

    Alberta was the first province in Canada to mandate reporting of hospital-based emergency services. This reporting is based on a workload measurement system that groups emergency visits into five discreet workload levels/classes driven by ICD-9-CM diagnoses. Other related workload measurement variables are incorporated, including admissions, transfers, maintenance monitoring, nursing and non-nursing patient support activities, trips, staff replacement, and personal fatigue and delay. The methodology used to design the reporting system has been subjected to extensive testing, auditing and refinement. The results of one year of province-wide data collection yielded approximately 1.5 million emergency visits. These data reveal consistent patterns/trends of workload that vary by hospital size and type. Although this information can assist in utilization management efforts to predict and compare workload and staffing levels, the impetus for establishing this system derived from its potential for funding hospital-based emergency services. This would be the first time that such services would be funded on a systemic, system-wide basis whereby hospitals would be reimbursed in relation to workload. This proposed funding system would distribute available funding in a consistent, fair and equitable manner across all hospitals providing a similar set of services, thus achieving one of the key goals of the Alberta Acute Care Funding Plan. Ultimately, this proposed funding methodology would be integrated into a broader Ambulatory Care Funding system currently being developed in Alberta.

  15. ACTIVITIES OF THE ADMINISTRATION OF FEDERAL SERVICE FOR SURVEILLANCE ON CONSUMER RIGHTS PROTECTION AND HUMAN WELL-BEING IN KHABAROVSKY KRAI IN CONDITIONS OF THE FUKUSHIMA ACCIDENT AND MEASURES UNDERTAKEN TO PROTECT THE TERRITORY AND POPULATION THE REGION

    Directory of Open Access Journals (Sweden)

    V. A. Ott

    2011-01-01

    Full Text Available The article analyzes activities of the Administration of Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in Khabarovsky Krai and the Federal Health Organization "Center of Hygiene and Epidemiology in Khabarovsky Krai" in the situation related to the Fukushima accident in Japan

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

    Science.gov (United States)

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865

  17. Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

    Directory of Open Access Journals (Sweden)

    Cha-Nam Shin

    2017-01-01

    Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h. Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier, public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.

  18. Existence and functionality of emergency obstetric care services at district level in Kenya

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Kombe, Yeri; Dubourg, Dominique

    2013-01-01

    The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both...... and functionality of EmOC services at district level....

  19. Service-Learning and Emergent Communities of Practice: A Teacher Education Case Study

    Science.gov (United States)

    Kaschak, Jennifer Cutsforth; Letwinsky, Karim Medico

    2015-01-01

    This study investigates the unexpected emergence of a community of practice in a middle level mathematics and science methods course. The authors describe how preservice teacher participation in a collaborative, project-based service-learning experience resulted in the formation of a community of practice characterized by teamwork, meaningful…

  20. Emergency Medical Service (EMS): Rotorcraft Technology Workshop

    Science.gov (United States)

    Bauchspies, J. S.; Adams, R. J.

    1981-01-01

    A lead organization on the national level should be designated to establish concepts, locations, and the number of shock trauma air medical services. Medical specialists desire a vehicle which incorporates advances in medical technology trends in health care. Key technology needs for the emergency medical services helicopter of the future include the riding quality of fixed wing aircraft (reduced noise and vibration), no tail rotor, small rotor, small rotor diameter, improved visibility, crashworthy vehicle, IFR capability, more affordability high reliability, fuel efficient, and specialized cabins to hold medical/diagnostic and communications equipment. Approaches to a national emergency medical service are discussed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-01

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

  2. Frequent visitors to psychiatric emergency services: staff attitudes and temporal patterns.

    Science.gov (United States)

    Arfken, Cynthia; Zeman, Lori Lackman; Yeager, Lindsay; Mischel, Edward; Amirsadri, Alireza

    2002-11-01

    Providing quality psychiatric emergency services is becoming more difficult as utilization rates soar, especially by individuals who are frequent visitors. To address this issue, a staff survey and analysis of admission patterns were conducted. Staff were more likely to believe that frequent visitors sought care because they had difficulty accessing alternative services, had basic needs unmet, were substance abusers, wanted inpatient admission, and were noncompliant with treatment plans. The 1999 temporal admission pattern documented that frequent visitors' admissions were higher during the first week of the month and inclement weather. Surprisingly, the infrequent visitors' admissions also were higher during the first week of the month. Together, these findings suggest that, in this urban location, frequent visitors are disadvantaged individuals lacking support and alternative treatment settings who use psychiatric emergency services to meet basic needs.

  3. A review of patients presenting to accident and emergency department with deliberate self-harm, KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Josephat O. Ani

    2017-01-01

    Full Text Available Background: The World Health Organization has described deliberate self-harm (DSH as a major global health challenge. Little is known about the profile of patients admitted following DSH at district and regional combo hospitals in KwaZulu-Natal, South Africa.Aim: The aim of this study was to assess the profiles of patients and reasons for admission following DSH.Setting: The study was conducted on data from a busy Accident and Emergency (A&E department in a combination district and regional hospital situated in Empangeni in northern KwaZulu-Natal.Method: This was a retrospective descriptive study. Data were collected from charts of all patients admitted to the A&E department from April 2012 to March 2013 following DSH. Variables assessed included age, gender, race, occupation, religion, education level, coexisting medical and mental health conditions, and reasons for DSH. Data were entered into SPSS and analysed descriptively.Results: A total of 262 charts were identified and 215 (82% were selected for inclusion. Most patients admitted following DSH were young, single African women with at least secondary-level education. Most (169/215;78% admissions were for parasuicide, with relational issues contributing in more than 50% of cases and circumstance challenges contributing in just under 30%.Conclusion: Although an underestimation, DSH is not an uncommon reason for patients to present in the A&E at this district and regional combo hospital. Findings from this study are consistent with those of other studies on DSH and highlight the need for a validated screening tool for the identification of patients at risk of DSH. There is a need to explore community-based intervention, which could address reasons for DSH and prevent future admissions.

  4. A review of patients presenting to accident and emergency department with deliberate self-harm, KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Ani, Josephat O; Ross, Andrew J; Campbell, Laura M

    2017-05-29

    The World Health Organization has described deliberate self-harm (DSH) as a major global health challenge. Little is known about the profile of patients admitted following DSH at district and regional combo hospitals in KwaZulu-Natal, South Africa. The aim of this study was to assess the profiles of patients and reasons for admission following DSH. The study was conducted on data from a busy Accident and Emergency (A&E) department in a combination district and regional hospital situated in Empangeni in northern KwaZulu-Natal. This was a retrospective descriptive study. Data were collected from charts of all patients admitted to the A&E department from April 2012 to March 2013 following DSH. Variables assessed included age, gender, race, occupation, religion, education level, coexisting medical and mental health conditions, and reasons for DSH. Data were entered into SPSS and analysed descriptively. A total of 262 charts were identified and 215 (82%) were selected for inclusion. Most patients admitted following DSH were young, single African women with at least secondary-level education. Most (169/215;78%) admissions were for parasuicide, with relational issues contributing in more than 50% of cases and circumstance challenges contributing in just under 30%. Although an underestimation, DSH is not an uncommon reason for patients to present in the A&E at this district and regional combo hospital. Findings from this study are consistent with those of other studies on DSH and highlight the need for a validated screening tool for the identification of patients at risk of DSH. There is a need to explore community-based intervention, which could address reasons for DSH and prevent future admissions.

  5. Availability, utilisation and quality of basic and comprehensive emergency obstetric care services in Malawi.

    Science.gov (United States)

    Kongnyuy, Eugene J; Hofman, Jan; Mlava, Grace; Mhango, Chisale; van den Broek, Nynke

    2009-09-01

    To establish a baseline for the availability, utilisation and quality of maternal and neonatal health care services for monitoring and evaluation of a maternal and neonatal morbidity/mortality reduction programme in three districts in the Central Region of Malawi. Survey of all the 73 health facilities (13 hospitals and 60 health centres) that provide maternity services in the three districts (population, 2,812,183). There were 1.6 comprehensive emergency obstetric care (CEmOC) facilities per 500,000 population and 0.8 basic emergency obstetric care (BEmOC) facilities per 125,000 population. About 23% of deliveries were conducted in emergency obstetric care (EmOC) facilities and the met need for emergency obstetric complications was 20.7%. The case fatality rate for emergency obstetric complications treated in health facilities was 2.0%. Up to 86.7% of pregnant women attended antenatal clinic at least once and only 12.0% of them attend postnatal clinic at least once. There is a shortage of qualified staff and unequal distribution with more staff in hospitals leaving health centres severely understaffed. The total number of CEmOC facilities is adequate but the distribution is unequal, leaving some rural areas with poor access to CEmOC services. There are no functional BEmOC facilities in the three districts. In order to reduce maternal mortality in Malawi and countries with similar socio-economic profile, there is a need to upgrade some health facilities to at least BEmOC level by training staff and providing equipment and supplies.

  6. European Gravity Service for Improved Emergency Management - Status and project highlights

    Science.gov (United States)

    Mayer-Guerr, Torsten; Adrian, Jäggi; Meyer, Ulrich; Jean, Yoomin; Susnik, Andreja; Weigelt, Matthias; van Dam, Tonie; Flechtner, Frank; Gruber, Christian; Güntner, Andreas; Gouweleeuw, Ben; Kvas, Andreas; Klinger, Beate; Flury, Jakob; Bruinsma, Sean; Lemoine, Jean-Michel; Zwenzner, Hendrik; Bourgogne, Stephane; Bandikova, Tamara

    2016-04-01

    The European Gravity Service for Improved Emergency Management (EGSIEM) is a project of the Horizon 2020 Framework Programme for Research and Innovation of the European Commission. EGSIEM shall demonstrate that observations of the redistribution of water and ice mass derived from the current GRACE mission, the future GRACE-FO mission, and additional data provide critical and complementary information to more traditional Earth Observation products and open the door for innovative approaches to flood and drought monitoring and forecasting. In the frame of EGSIEM three key services should established: 1) a scientific combination service to deliver the best gravity products for applications in Earth and environmental science research based on the unified knowledge of the European GRACE community, 2) a near real-time and regional service to reduce the latency and increase the temporal resolution of the mass redistribution products, and 3) a hydrological and early warning service to develop gravity-based indicators for extreme hydrological events and to demonstrate their value for flood and drought forecasting and monitoring services. All of these services shall be tailored to the various needs of the respective communities. Significant efforts shall also be devoted to transform the service products into user-friendly and easy-to-interpret data sets and the development of visualization tools. In this talk the status of the ongoing project is presented and selected results are discussed.

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

    Directory of Open Access Journals (Sweden)

    P Gokulakrishnan

    Full Text Available A Road Accident Prevention (RAP scheme based on Vehicular Backbone Network (VBN structure is proposed in this paper for Vehicular Ad-hoc Network (VANET. The RAP scheme attempts to prevent vehicles from highway road traffic accidents and thereby reduces death and injury rates. Once the possibility of an emergency situation (i.e. an accident is predicted in advance, instantly RAP initiates a highway road traffic accident prevention scheme. The RAP scheme constitutes the following activities: (i the Road Side Unit (RSU constructs a Prediction Report (PR based on the status of the vehicles and traffic in the highway roads, (ii the RSU generates an Emergency Warning Message (EWM based on an abnormal PR, (iii the RSU forms a VBN structure and (iv the RSU disseminates the EWM to the vehicles that holds the high Risk Factor (RF and travels in High Risk Zone (HRZ. These vehicles might reside either within the RSU's coverage area or outside RSU's coverage area (reached using VBN structure. The RAP scheme improves the performance of EWM dissemination in terms of increase in notification and decrease in end-to-end delay. The RAP scheme also reduces infrastructure cost (number of RSUs by formulating and deploying the VBN structure. The RAP scheme with VBN structure improves notification by 19 percent and end-to-end delay by 14.38 percent for a vehicle density of 160 vehicles. It is also proved from the simulation experiment that the performance of RAP scheme is promising in 4-lane highway roads.

  8. Road characteristics and bicycle accidents.

    Science.gov (United States)

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

    1996-12-01

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

  9. Heterogeneity of Health Profiles of Older People Presenting to an Accident and Emergency Department With a Fall

    Directory of Open Access Journals (Sweden)

    Pui-Yee Yeung

    2009-09-01

    Conclusion: Older people presenting with falls at the A&E have multiple health problems and varying degrees of frailty. A homogeneous management pathway may not be appropriate, but rather, the approach should be in the context of management of the frailty syndrome, requiring an individualized approach and taking into account the heterogeneity of their health profile.

  10. The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): The First 10 Years and a Look at Public Perception of Emergency Medical Services (EMS).

    Science.gov (United States)

    Crowe, Remle P; Bentley, Melissa A; Levine, Roger

    2016-12-01

    Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.

  11. Ethical, legal and professional issues arising from social media coverage by UK Helicopter Emergency Medical Services.

    Science.gov (United States)

    Steele, Sarah; Adcock, Christopher; Steel, Alistair

    2016-01-01

    Social media (SoMe) are gaining increasing acceptance among, and use by, healthcare service deliverers and workers. UK Helicopter Emergency Medical Services (HEMS) use SoMe to deliver service information and to fundraise, among other purposes. This article examines UK HEMS use of SoMe between January and February 2014 to determine the extent of adoption and to highlight trends in use. The database of the Association of Air Ambulances, crosschecked with UK Emergency Aviation, was used to identify flying, charitable UK HEMS. This search identified 28 UK HEMS, of which 24 services met the criteria for selection for review. Using information harvested from the public domain, we then systematically documented SoMe use by the services. SoMe use by UK HEMS is extensive but not uniform. All selected UK HEMS maintained websites with blogs, as well as Facebook, Twitter, Wikipedia and JustGiving profiles, with the majority of services using Ebay for Charity, LinkedIn and YouTube. Some HEMS also held a presence on Pinterest, Google+, Instagram and Flickr, with a minority of services maintaining their own Rich Site Summary (RSS) feed. The SoMe adopted, while varied, allowed for increased, and different forms of, information delivery by HEMS to the public, often in real time. Such use, though, risks breaching patient confidentiality and data protection requirements, especially when information is viewed cumulatively across platforms. There is an urgent need for the continued development of guidance in this unique setting to protect patients while UK HEMS promote and fundraise for their charitable activities. 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/

  12. [Accidents with caterpillar Lonomia obliqua (Walker, 1855). An emerging problem].

    Science.gov (United States)

    Sánchez, Matías N; Mignone Chagas, Mariana A; Casertano, Sergio A; Cavagnaro, Luis E; Peichoto, María E

    2015-01-01

    Lonomia obliqua (Walker, 1855) is a moth from the family Saturniidae, widely distributed in tropical rainforests of South America. In its larval stage (caterpillar) it is characterized by bristles that cover the animal's body. These structures are hard and branched spiny evaginations of the cuticle, underneath which a complex mixture of toxic molecules is stored. When spicules are brought into contact with the skin of people, toxins enter passively through the injury, causing not only local but also systemic poisoning (primarily hemorrhagic manifestations). When the whole animal is accidentally crushed, the insect's chitinous bristles are broken and the venomous secretions penetrate the human skin, reaching the blood circulation. Due to the numerous registered cases of erucism in Southern Brazil, the Butantan Institute has produced an antivenom able to neutralize the deleterious effects produced by contact with L. obliqua caterpillar bristles. In Argentina, these kinds of accidents are rare and restricted to the province of Misiones. Taking into account that to date there is no report in this country about clinical cases submitted to a specific treatment (antivenom), our aim is to communicate here six cases of Lonomia caterpillar-induced bleeding syndrome that were treated in the Hospital SAMIC of Puerto Iguazú (Misiones, Argentina) during 2014 with the antilonomic serum produced in Brazil. It is worthy to note that all patients evolved favorably within the first few hours, and for this reason, the use of this antivenom is recommended to treat the cases of Lonomia erucism in Argentina.

  13. Relating aviation service difficulty reports to accident data for safety trend prediction

    Energy Technology Data Exchange (ETDEWEB)

    Fullwood, R.; Hall, R.; Martinez, G.; Uryasev, S.

    1996-03-13

    This work explores the hypothesis that Service Difficulty Reports (SDR - primarily inspection reports) are related to Accident Incident Data System (AIDS - reports primarily compiled from National Transportation Safety Board (NTSB) accident investigations). This work sought and found relations between equipment operability reported in the SDR and aviation safety reported in AIDS. Equipment is not the only factor in aviation accidents, but it is the factor reported in the SDR. Two approaches to risk analysis were used: (1) The conventional method, in which reporting frequencies are taken from a data base (SDR), and used with an aircraft reliability block diagram model of the critical systems to predict aircraft failure, and (2) Shape analysis that uses the magnitude and shape of the SDR distribution compared with the AIDS distribution to predict aircraft failure.

  14. European Gravity Service for Improved Emergency Management - Project Overview and First Results

    Science.gov (United States)

    Jaeggi, A.; Jean, Y.; Weigelt, M. L. B.; Flechtner, F.; Gruber, C.; Guntner, A.; Gouweleeuw, B.; Mayer-Gürr, T.; Kvas, A.; Martinis, S.; Zwenzer, H.; Bruinsma, S.; Lemoine, J. M.; Flury, J.; Bourgogne, S.

    2015-12-01

    The project European Gravity Service for Improved Emergency Management (EGSIEM) of the Horizon 2020 Framework Programme for Research and Innovation of the European Commission has started in January 2015. EGSIEM shall demonstrate that observations of the redistribution of water and ice mass derived from the current GRACE mission, the future GRACE-FO mission, and additional data provide critical and complementary information to more traditional Earth Observation products and open the door for innovative approaches to flood and drought monitoring and forecasting. We give an overview of the project and present first results from the three key objectives that EGSIEM shall address: 1) to establish a scientific combination service to deliver the best gravity products for applications in Earth and environmental science research based on the unified knowledge of the European GRACE community, 2) to establish a near real-time and regional service to reduce the latency and increase the temporal resolution of the mass redistribution products, and 3) to establish a hydrological and early warning service to develop gravity-based indicators for extreme hydrological events and to demonstrate their value for flood and drought forecasting and monitoring services. All of these services shall be tailored to the various needs of the respective communities. Significant efforts shall also be devoted to transform the service products into user-friendly and easy-to-interpret data sets and the development of visualization tools.

  15. Crime, accidents and social control

    NARCIS (Netherlands)

    Junger, Marianne; Terlouw, Gert-Jan; van der Heijden, Peter G.M.

    1995-01-01

    This paper addresses to questions. (1) Is there a demonstrable relation between accidents and crime, does this relation hold for each type of crime and each means of transport, and does it subsist after controlling for age and gender? (2) Can social control theory explain involvements in both

  16. Patient characteristics and patterns of intoxication: one-time and repeated use of emergency ambulance services.

    Science.gov (United States)

    Holzer, Barbara M; Minder, Christoph E; Rosset, Nina; Schaetti, Gabriela; Battegay, Edouard; Mueller, Stefan; Zimmerli, Lukas

    2013-05-01

    The aim of this study was to investigate the utilization of ambulance services that resulted from alcohol and drug intoxication over a period of 1 year in a metropolitan area, with an emphasis on characteristic differences between patients with one-time versus repeated use. All ambulance-service report forms filed in 2010 were systematically screened for utilizations in which alcohol intoxication or intoxication resulting from consumption of illicit or legal drugs other than alcohol was the chief complaint (N = 2,341 patients; 65% male). Repeat users differed from persons with one-time use in their characteristics and patterns of intoxication. On average, patients with repeated ambulance use were almost 8 years older and had a different pattern of ambulance use over the course of the week with no clear peak on any specific day. The mean number of ambulance services in patients with repeated use was 2.8 (SD = 1.517) in the 1-year study period. Repeat users were less likely to be injured than patients with one-time ambulance-service use and more often showed aggression or uncooperative behavior toward paramedics. All cases of death associated with intoxication involved patients with one-time ambulance use. The ambulance-service users' generally slight impairment of consciousness and the high proportion of intoxicated patients without any injuries raise the question of how many of these patients could be adequately cared for in a sobering center. Sobering centers might relieve hospital emergency departments of patients not requiring acute emergency care and, in addition, could provide intervention services to prevent relapses.

  17. Emergency biochemistry services--are they abused?

    Science.gov (United States)

    Smith, A D; Shenkin, A; Dryburgh, F J; Morgan, H G

    1982-09-01

    An out-of-hours emergency biochemistry service, which allows access by all medical practitioners of varying experience within a hospital, can lead to overuse or even abuse of limited and costly facilities. When the workload increases, problems of staffing a voluntary (but paid) working rota may emerge. An industrial dispute involving medical laboratory scientific officers (MLSOs) caused the role of the emergency service to be examined and alternative regulating mechanisms to be tested. Experience at Glasgow Royal Infirmary between 1974 and 1981 has been reviewed. From 1977 to 1979, when clinicians (usually junior) arranged analyses directly with the MLSOs, test numbers increased by about 26% per annum. This was not associated with any concomitant increase in the range of analyses offered. During a five-week period in 1980, consultant clinicians had to contact a consultant clinical biochemist to arrange all emergency analyses, and test numbers were reduced to 13% of the previous levels. Subsequently, all requests for emergency analyses were made by clinicians to laboratory medical staff, and test numbers fell to approximately 60% of 1979 levels. This requesting system is now firmly established. Continued vigilance is required to maintain the reduced level of requesting, but too great a limitation on emergency requests may cause less efficient patient management. Senior clinical staff should be encouraged to take greater responsibility for the use of emergency laboratory services.

  18. Internet protocol-based emergency services

    CERN Document Server

    Schulzrinne, Henning

    2013-01-01

    Written by international experts in the field, this book covers the standards, architecture and deployment issues related to IP-based emergency services This book brings together contributions from experts on technical and operational aspects within the international standardisation and regulatory processes relating to routing and handling of IP-based emergency calls.  Readers will learn how these standards work, how various standardization organizations contributed to them and about pilot projects, early deployment and current regulatory situation. Key Featur

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

    Science.gov (United States)

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

    2013-12-01

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

  20. 31 CFR 544.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 544.508 Section 544.508 Money and Finance: Treasury Regulations Relating to Money and...

  1. 31 CFR 593.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 593.508 Section 593.508 Money and Finance: Treasury Regulations Relating to Money and...

  2. 31 CFR 547.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... of emergency medical services. The provision of nonscheduled emergency medical services in the United... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 547.508 Section 547.508 Money and Finance: Treasury Regulations Relating to Money and...

  3. Mental health services availability and admission of the seriously mentally ill from the emergency department.

    Science.gov (United States)

    Moseley, Charles; Shen, Jay; Cochran, Christopher

    2008-01-01

    This study used a cross-sectional, multiple logistic regression design to examine the relationship between mental health service availability and the admission of 111,527 seriously mentally ill (SMI) patients from the emergency department (ED) in New York State in 2002. The study found that SMI patients were admitted from the ED in counties that were mental health professional shortage areas and in counties with less long-term inpatient psychiatric days. Contrary to expectations, counties with community mental health centers (CMHCs) had more admissions than counties without CMHCs. The results support prior research that indicates the need for more specialized mental health services for the SMI, including more psychiatric beds.

  4. [Activities and awareness of public health nurses working at local government facilities and health centers regarding potential nuclear accidents].

    Science.gov (United States)

    Kitamiya, Chiaki

    2011-05-01

    The purpose was to study public health service activities developed during non-emergency periods to respond to potential nuclear accidents and to contribute to an understanding of public health nurses' awareness of the possibility of such accidents. For the purpose of this study, we chose prefectural health centers located in a prefecture with a nuclear power plant and in two adjacent prefectures, along with all local administrative bodies (cities, towns, and villages) in these prefectures. For each one of 124 entities, we selected one public health nurse in charge of health crisis management from among the personnel to be targeted for a questionnaire survey conducted by mail. The survey period was from October to November 2009, and the questionnaire contained questions on the following: whether there had been any disasters over the past ten years; whether the respondent had received training in public health services regarding nuclear accidents; and public health service activities developed during non-emergency periods to respond to potential nuclear accidents (and the amount of work done in this regard). The response rate for our survey was 71.8%. Of the total of 124 entities chosen, 9 were aware of the possibility of radiation accidents and 12 had manuals on radiation accidents. Two local governments and five health centers had participated in accident drills, and at both of two local governments, public health nurses were expected to act as guides during resident evacuation in the event of a nuclear accident. Public health nurses were sent to participate in workshops on radiation at four facilities located in the prefecture with a nuclear power plant. Our analysis revealed a lack of knowledge (beta = -0.404, P manuals, provision of opportunities to gain knowledge of materials regarding past damage to the health of residents and how such damage can be coped with is likely to be effective in developing effective measures in response to disasters.

  5. CBR in the service of accident cases evaluating

    Directory of Open Access Journals (Sweden)

    Lassaâd Mejri

    2013-01-01

    Full Text Available This paper introduces a research aiming at the development of a decision support system concerning the approval of automated railway transportation systems. The objective is to implement a valuation method for the degree of compliance of the automated transportation system in-group of safety standards by the analysis of the scenarios of accident. To reach this target, we envisaged an approach Rex (Return of experience who draws the lessons of accidents / incidents lived and/or imagined by the experts of the analysis of security in the IFSTAAR. Our approach consists in offering a decision support in the side of the experts of the certification based on a reuse of the scenarios of accidents already validated historically on other approved transportation systems. This approach Rex is very useful since it provides to the experts a class of scenarios of accidents similar to the new case treated and getting closer to the context of new case. The Case-based reasoning is then exploited as a mode of reasoning by analogy allowing to choose and to recollect one under group of historical cases that can help in the resolution of the new case introduced by the experts. Process-Oriented Case-Based Reasoning (PO-CBR is a growing application area in which CBR is used to address problems involving process data in a variety of specialized domains. PO-CBR systems often use structured cases. Our approach is characterized by a two-phased retrieval strategy. A first phase consists in retrieving a set of cases to be considered (a class of cases most similar to a problem to resolve. In a second phase, a more fine grained strategy is then applied to the pool of candidate cases already selected by the mean of similarity measures. This approach can enhance the process of retrieving cases compared to an exhaustive case-by-case comparison.

  6. Emergency care and the national quality strategy: highlights from the Centers for Medicare & Medicaid Services.

    Science.gov (United States)

    Venkatesh, Arjun K; Goodrich, Kate

    2015-04-01

    The Centers for Medicare & Medicaid Services (CMS) of the US Department of Health and Human Services seeks to optimize health outcomes by leading clinical quality improvement and health system transformation through a variety of activities, including quality measure alignment, prioritization, and implementation. CMS manages more than 20 federal quality measurement and public reporting programs that cover the gamut of health care providers and facilities, including both hospital-based emergency departments (EDs) and individual emergency physicians. With more than 130 million annual visits, and as the primary portal of hospital admission, US hospital-based EDs deliver a substantial portion of acute care to Medicare beneficiaries. Given the position of emergency care across clinical conditions and between multiple settings of care, the ED plays a critical role in fulfilling all 6 priorities of the National Quality Strategy. We outline current CMS initiatives and future opportunities for emergency physicians and EDs to effect each of these priorities and help CMS achieve the triple aim of better health, better health care, and lower costs.

  7. [Implantation of the emergency ambulance service in Salvador, Bahia: reality and challenges].

    Science.gov (United States)

    Vieira, Célia Maria Sales; Mussi, Fernanda Carneiro

    2008-12-01

    The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192). The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS) of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

  8. 77 FR 31143 - Emergency Medical Services Week, 2012

    Science.gov (United States)

    2012-05-24

    ... President Proclamation 8824--Emergency Medical Services Week, 2012 Proclamation 8825--National Safe Boating..., in communities across our country, men and women providing emergency medical services (EMS) stand at... efficiency at a moment's notice. During Emergency Medical Services Week, we honor their...

  9. Using Participatory and Service Design to Identify Emerging Needs and Perceptions of Library Services among Science and Engineering Researchers Based at a Satellite Campus

    Science.gov (United States)

    Johnson, Andrew; Kuglitsch, Rebecca; Bresnahan, Megan

    2015-01-01

    This study used participatory and service design methods to identify emerging research needs and existing perceptions of library services among science and engineering faculty, post-graduate, and graduate student researchers based at a satellite campus at the University of Colorado Boulder. These methods, and the results of the study, allowed us…

  10. Using Participatory and Service Design to Identify Emerging Needs and Perceptions of Library Services among Science and Engineering Researchers Based at a Satellite Campus

    Science.gov (United States)

    Johnson, Andrew; Kuglitsch, Rebecca; Bresnahan, Megan

    2015-01-01

    This study used participatory and service design methods to identify emerging research needs and existing perceptions of library services among science and engineering faculty, post-graduate, and graduate student researchers based at a satellite campus at the University of Colorado Boulder. These methods, and the results of the study, allowed us…

  11. Barriers to learning from incidents and accidents

    NARCIS (Netherlands)

    Dechy, N.; Dien, Y.; Drupsteen, L.; Felicio, A.; Cunha, C.; Roed-Larsen, S.; Marsden, E.; Tulonen, T.; Stoop, J.; Strucic, M.; Vetere Arellano, A.L.; Vorm, J.K.J. van der; Benner, L.

    2015-01-01

    This document provides an overview of knowledge concerning barriers to learning from incidents and accidents. It focuses on learning from accident investigations, public inquiries and operational experience feedback, in industrial sectors that are exposed to major accident hazards. The document disc

  12. Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

    Directory of Open Access Journals (Sweden)

    Dorota Rębak

    2015-01-01

    Full Text Available Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education. Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS teams and specialisation of EMS system physicians according to their education level and sense of coherence. Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author. Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32% rather than physicians (21.05%. Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07% than those with licentiate education (17.32%. As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a

  13. Intersection layout, traffic volumes and accidents.

    NARCIS (Netherlands)

    Poppe, F.

    1988-01-01

    This paper reports on the accident research carried out as a part of a large project started in 1983. For this accident research an inventory was made of a large number of intersections.Recorded were layout features, accident data and estimates of traffic volumes. Attention will be given to the

  14. Study on emergency mechanism for major process safety accidents in petroleum and petrochemical industry%石油石化重大工艺安全事故应急机制浅析

    Institute of Scientific and Technical Information of China (English)

    李峰; 储胜利; 程宗华

    2014-01-01

    Three features of major process safety accidents in petroleum and petrochemical industry , such as strong-ly professional,high accident harm and liability to secondary disaster were summarized in the paper .Combining with the accidents characteristics and practical situation , five key emergency tactics for these accidents were presen -ted, including adequate risk identification , professional emergency organization, plentiful supply of emergency ma-terials, efficient joint-action mechanism of government & enterprise and right -hand guidance of public opinions .Fi-nally 5 work points of constructing perfect risk identification mechanism , training professional emergency team , es-tablishing complete emergency conservation system , building efficient joint-action mechanism and practical emer-gency tactics for social crisis were analyzed in detail .%石油石化生产关键工艺设备或流程蕴藏的风险能量巨大,一旦发生事故,后果往往极其严重。分析了石油石化重大工艺安全事故专业性强、事故规模大、易形成连锁反应和诱发环境污染事件等3个典型特征。通过事故应急经验分析,研究提出了石油石化重大工艺安全事故应急工作需要遵循的风险辨识充分到位、专业应急保障有力、应急资源保障充足、企地联动迅速高效、社会舆论引导得力等5方面的重点应急策略。设计了工艺安全事故风险辨识与评估、专业应急队伍建设与能力提升、应急资源联合储备、区域应急联动和公共危机公关等5项石油石化企业重大工艺安全事故应急重点工作机制内容和建设要点。石油石化企业需要不断建立和完善5项应急工作机制,才能为重大工艺安全事故应急工作提供可靠保障。

  15. The UCLan community engagement and service user support (Comensus) project: valuing authenticity, making space for emergence

    Science.gov (United States)

    Downe, Soo; McKeown, Mick; Johnson, Eileen; Koloczek, Lidia; Grunwald, Angela; Malihi‐Shoja, Lisa

    2007-01-01

    Abstract Objective  To develop and evaluate service user, carer and community involvement in health and social care education. Background  Despite the high policy profile of involvement issues, there appear to be no published accounts of schemes that have used a systematic whole‐faculty approach to community engagement in health and social care higher education. Focus of this paper  The set up and early development of a faculty‐wide community engagement project. Setting and participants  Staff from the faculty of health in one University, local service users and carers and community group project workers and local National Health Service (NHS) and public sector staff. Design  Participatory action research including document review, field notes, questionnaires and interviews. Analysis  Thematic analysis. The emerging themes were tested by seeking disconfirming data, and through verification with stake‐holders. Results  Prior to the study, there were examples of community engagement in the participating faculty, but they occurred in specific departments, and scored low on the ‘ladder of involvement’. Some previous attempts at engagement were perceived to have failed, resulting in resistance from staff and the community. Despite this, an advisory group was successfully formed, and project framing and development evolved with all stake‐holders over the subsequent year. The four themes identified in this phase were: building accessibility; being ‘proper’ service users/carers;moving from suspicion to trust: mutually respectful partnerships as a basis for sustainable change; and responses to challenge and emergence. Conclusions  Successful and sustainable engagement requires authenticity. Many problems and solutions arising from authentic engagement are emergent, and potentially challenging to organizations. PMID:17986075

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

    Science.gov (United States)

    Petrov, A.; Petrova, D.

    2016-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    邢娟娟

    2011-01-01

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

  18. 78 FR 44523 - Burned Area Emergency Response, Forest Service

    Science.gov (United States)

    2013-07-24

    ... Forest Service RIN 0596-AC73 Burned Area Emergency Response, Forest Service AGENCY: Forest Service, USDA... Service is correcting a notice of interim directive that appeared in the Federal Register of June 6, 2013... Area Emergency Response revisions. This correction lists the Web site for the interim directive and...

  19. Bulgarian Emergency Response System (BERS) in case of nuclear accident with exposure doses’estimation

    Energy Technology Data Exchange (ETDEWEB)

    Syrakov, M.; Prodanova, M.; Slavov, K.; Veleva, B.

    2015-07-01

    A PC-oriented Emergency Response System in case of nuclear accident (BERS) is developed and works operationally in the National Institute of Meteorology and Hydrology (NIMH). The creation and development of BERS was highly stimulated by the ETEX (European Tracer Experiment) project. BERS comprises two main parts - the operational and the accidental ones. The operational part, run automatically every 12 hours, prepares the input meteorological file used by both trajectory and dispersion models, runs the trajectory models, visualizes the results and uploads the maps of trajectories to a dedicated web-site. The accidental part is activated manually when a real radioactive releases occur or during emergency exercises. Its core is the Bulgarian dispersion models EMAP. Outputs are concentration, accumulated deposition and selected doses fields. In the paper, the BERS overall structure is described and examples of its products are presented. (Author)

  20. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    Science.gov (United States)

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  1. Chernobyl and Fukushima nuclear accidents: what has changed in the use of atmospheric dispersion modeling?

    Science.gov (United States)

    Benamrane, Y; Wybo, J-L; Armand, P

    2013-12-01

    The threat of a major accidental or deliberate event that would lead to hazardous materials emission in the atmosphere is a great cause of concern to societies. This is due to the potential large scale of casualties and damages that could result from the release of explosive, flammable or toxic gases from industrial plants or transport accidents, radioactive material from nuclear power plants (NPPs), and chemical, biological, radiological or nuclear (CBRN) terrorist attacks. In order to respond efficiently to such events, emergency services and authorities resort to appropriate planning and organizational patterns. This paper focuses on the use of atmospheric dispersion modeling (ADM) as a support tool for emergency planning and response, to assess the propagation of the hazardous cloud and thereby, take adequate counter measures. This paper intends to illustrate the noticeable evolution in the operational use of ADM tools over 25 y and especially in emergency situations. This study is based on data available in scientific publications and exemplified using the two most severe nuclear accidents: Chernobyl (1986) and Fukushima (2011). It appears that during the Chernobyl accident, ADM were used few days after the beginning of the accident mainly in a diagnosis approach trying to reconstruct what happened, whereas 25 y later, ADM was also used during the first days and weeks of the Fukushima accident to anticipate the potentially threatened areas. We argue that the recent developments in ADM tools play an increasing role in emergencies and crises management, by supporting stakeholders in anticipating, monitoring and assessing post-event damages. However, despite technological evolutions, its prognostic and diagnostic use in emergency situations still arise many issues.

  2. The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand.

    Science.gov (United States)

    Jespersen, Sean; Lawman, Bronwyn; Reed, Fiona; Hawke, Kari; Plummer, Virginia; Gaskin, Cadeyrn J

    2016-12-01

    This investigation focused on the impact of integrating crisis team members into community mental health services on emergency department and adult mental health inpatient unit demand within an Australian public health service. Mixed methods were used including (a) the comparison of service use data with that of two other comparable services (both of which had community-based crisis teams), (b) surveys of (i) patients and carers and (ii) staff, and (c) focus groups with staff. The numbers of emergency department presentations with mental health conditions and adult mental health inpatient separations increased 13.9 and 5.7 %, respectively, from FY2006/07 to FY2012/13. Between the three services, there were minimal differences in the percentages of presentations with mental health conditions, the distribution of mental health presentations across a 24-h period, and the triage categories assigned to these patients. Survey participants reported that patients used the emergency department due to the urgency of situations, perceptions that gaining access to mental health services would take less time, and the unavailability of mental health services when help is needed. Staff identified several issues (e.g. inappropriate referrals) that may be unnecessary in increasing emergency department demand. The integration of crisis team members into community mental health services does not seem to have produced an increase in emergency department admissions or inpatient separations beyond what might be expected from population growth. The potential may exist, however, to reduce emergency department admissions through addressing the issue of inappropriate referrals.

  3. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers

    OpenAIRE

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age...

  4. Availability and use of emergency obstetric services: Kenya, Rwanda, Southern Sudan, and Uganda.

    Science.gov (United States)

    Pearson, L; Shoo, R

    2005-02-01

    The article summarises the baseline assessments of emergency obstetric care (EmOC) carried out in Uganda, Kenya, Southern Sudan, and Rwanda in 2003 and 2004. Our objectives were to: (1) set up program baselines on the availability and utilization of EmOC services in these countries; (2) identify gaps and obstacles in providing EmOC services; and (3) make recommendations to governments based on evidence generated. Data were collected from clinical record reviews, provider and client interviews, observations, and focus group discussions. Either random or universal sampling was applied in the selection of health facilities assessed. Local nurses and midwives participated in the data collection and, to some extent, data processing and analysis. The coverage of basic EmOC services ranged 0-1.1/500,000 population compared to the UN-recommended level of 4/500,000. The coverage of comprehensive EmOC services ranged 0.5-4.3/500,000 compared to the recommended level of 1/500,000. Between 0.6% and 8.8% of all births took place in EmOC facilities, and 2.1% and 18.5% of all expected direct obstetric complications were treated. Cesarean section as a proportion of all births was between 0.1% and 1%. Shortage of trained staff especially mid-level providers, poor basic infrastructure such as lack of electricity and water supplies, inadequate supply of drugs and essential equipment, poor working conditions and staff morale, lack of communication and referral facilities, cost of treatment, and lack of accountability and proper management were identified as the main obstacles in providing 24-h quality EmOC services especially in remote and rural areas. Lack of basic EmOC services limits women's access to life-saving services during obstetric complications. To reduce maternal mortality ratio the states and development partners need to focus their effort to improve the coverage, quality, and utilization of EmOC services through supportive national policy, effective program strategies

  5. Ambulance transport of noncritical children: emergency medical service providers' knowledge, opinions, and practice.

    Science.gov (United States)

    O'Neil, Joseph; Steele, Gregory K; Weinstein, Elizabeth; Collins, Robert; Talty, Judith; Bull, Marilyn J

    2014-03-01

    Safe ambulance transport of children presents unique challenges. Our study describes child passenger restraint practices during ambulance transport, Emergency Medical Service (EMS) providers' knowledge, training, and use of child passenger restraint devices (CRD). A child passenger safety technician (CPST) recorded restraint used for pediatric ambulance transport. The CPST assessed and documented type of CRD used, securement, and whether the child was properly restrained. EMS providers' knowledge, training, and CRD use for ambulance transport were assessed. The study period spanned July 2009 to July 2010; 63 EMS personnel were interviewed and 40 children were observed. Approximately 75% of emergency medical technicians surveyed felt their knowledge of pediatric transport was adequate. Fourteen percent allowed a stable patient to be transported via parent's lap. Twelve percent were transported unrestrained. None of the 11 patients, birth to 3 years, were found to be transported correctly. Study findings supports education and training of EMS personnel to improve the safe ambulance transport of children.

  6. The Demographics and Education of Emergency Medical Services (EMS) Professionals: A National Longitudinal Investigation.

    Science.gov (United States)

    Bentley, Melissa A; Shoben, Abigail; Levine, Roger

    2016-12-01

    The objectives of this study were to assess longitudinal and cross-sectional changes in Emergency Medical Technician (EMT)-Basics and Paramedics: (1) demographics, (2) employment characteristics, and (3) initial Emergency Medical Services (EMS) education. These data were collected between 1999 and 2008 employing survey techniques aimed at collecting valid data. A random, stratified sample was utilized to allow results to be generalizable to the nationally certified EMS population. Survey weights that were adjusted for each stratum's response were estimated. Weighted percentages, averages for continuous variables, and 95% confidence intervals (CIs) were calculated. Significant changes over time were noted when the CIs did not overlap. In all 10 years of data collection, the proportion of EMT-Paramedics who were male was greater than the proportion of EMT-Basics who were male. A substantial proportion of respondents performed EMS services for more than one agency: between 39.8% and 43.5% of EMT-Paramedics and 18.4% and 22.4% of EMT-Basic respondents reported this. The most common type of employer for both EMT-Basics and EMT-Paramedics was fire-based organizations. About one-third of EMT-Basics (32.3%-40.1%) and almost one-half of EMT-Paramedics (43.1%-45.3%) reported that these organizations were their main EMS employer. Rural areas (education changes over time. Bentley MA , Shoben A , Levine R . The demographics and education of Emergency Medical Services (EMS) professionals: a national longitudinal investigation. Prehosp Disaster Med. 2016;31(Suppl. 1):s18-s29.

  7. [Hanggliding accidents. Distribution of injuries and accident analysis].

    Science.gov (United States)

    Ballmer, F T; Jakob, R P

    1989-12-01

    Paragliding--a relatively new sport to Switzerland--brought 23 patients with 48 injuries (38% lower limb and 29% spinal) within a period of 8 months to the Inselspital University hospital in Berne. The aim of the study in characterizing these injuries is to formulate some guidelines towards prevention. With over 90% of accidents occurring at either take off or landing, emphasis on better training for the beginner is proposed with strict guidelines for the more experienced pilot flying in unfavourable conditions.

  8. Authority structure and industrial accidents

    NARCIS (Netherlands)

    As, Sicco van

    2001-01-01

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

  9. Differences in access to services in rural emergency departments of Quebec and Ontario.

    Directory of Open Access Journals (Sweden)

    Richard Fleet

    Full Text Available Rural emergency departments (EDs are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers.Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario.All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013. There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001 and most the consultant support and ICU (92% vs 31%, p < .0001. Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers.Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

  10. Use of a service evaluation and lean thinking transformation to redesign an NHS 111 refer to community Pharmacy for Emergency Repeat Medication Supply Service (PERMSS).

    Science.gov (United States)

    Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate

    2016-08-26

    To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a

  11. Availability, utilization, and quality of emergency obstetric care services in Bauchi State, Nigeria.

    Science.gov (United States)

    Abegunde, Dele; Kabo, Ibrahim A; Sambisa, William; Akomolafe, Toyin; Orobaton, Nosa; Abdulkarim, Masduk; Sadauki, Habib

    2015-03-01

    To report the availability, utilization, and quality of emergency obstetric care (EmOC) services in Bauchi State, Nigeria. Between June and July 2012, a cross-sectional survey of health facilities was conducted. Data on the performance of EmOC services between June 2011 and May 2012 were obtained from records of 20 general hospitals and 39 primary healthcare centers providing delivery services. Additionally, structured interviews with facility managers were conducted. Only 6 (10.2%) of the 59 facilities met the UN requirements for EmOC centers. None of the three senatorial zones in Bauchi State had the minimum acceptable number of five EmOC facilities per 500 000 population. Overall, 10 517 (4.4%) of the estimated 239 930 annual births took place in EmOC facilities. Cesarean delivery accounted for 3.6% (n=380) of the 10 517 births occurring in EmOC facilities and 0.2% of the 239 930 expected live births. Only 1416 (3.9%) of the expected 35 990 obstetric complications were managed in EmOC facilities. Overall, 45 (3.2%) of 1416 women with major direct obstetric complications treated at EmOC facilities died. Among 379 maternal deaths, 317 (83.6%) were attributable to major direct obstetric complications. Availability, utilization, and quality of EmOC services in Bauchi State, Nigeria, are suboptimal. The health system's capacity to manage emergency obstetric complications needs to be strengthened. Copyright © 2014 International Federation of Gynecology and Obstetrics. All rights reserved.

  12. Epidemiologic Profile of an Otolaryngologic Emergency Service

    Directory of Open Access Journals (Sweden)

    Prestes, Luciano

    2014-06-01

    Full Text Available Introduction According to current research, the number of patients seen in the emergency room is progressively increasing. There are few studies on the characteristics of ear, nose, and throat diseases treated in the emergency room. Objectives (1 To establish the epidemiologic profile of patients with these complaints treated at a referral emergency hospital in locoregional city Curitiba, and (2 to evaluate the calls that truly required emergency care. Methods This is a contemporary cross-study of urgent and emergency referrals to a hospital with otolaryngologic services during the year 2012. Data were collected and epidemiologic characteristics analyzed. Results We analyzed 1,067 patients: 312 presented in spring, 255 in summer, 253 in autumn, and 247 in winter. We found 17 diseases that were common during the year, with 244 (23.99% upper respiratory tract infections being the most frequent disease. There was no statistically significant difference in the incidence of diseases, except that acute otitis media was most common during the summer (p = 0.02; distribution between the sexes was balanced. The predominant age group was adults. We found 9.27% cases were true emergencies. Conclusion Patients were 20 to 40 years, with upper respiratory tract infection the most incident disease; 9.27% of cases were emergencies.

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

    Science.gov (United States)

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

    2010-01-01

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

  14. Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan.

    Science.gov (United States)

    Sriram, V; Gururaj, G; Razzak, J A; Naseer, R; Hyder, A A

    2016-08-01

    Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Why Do People Choose Emergency and Urgent Care Services? A Rapid Review Utilizing a Systematic Literature Search and Narrative Synthesis.

    Science.gov (United States)

    Coster, Joanne E; Turner, Janette K; Bradbury, Daniel; Cantrell, Anna

    2017-09-01

    Rising demand for emergency and urgent care services is well documented, as are the consequences, for example, emergency department (ED) crowding, increased costs, pressure on services, and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions, and behavioral changes relating to how people choose to access health services. The aim of this systematic mapping review was to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care. Systematic searches were conducted across Medline (via Ovid SP), EMBASE (via Ovid), The Cochrane Library (via Wiley Online Library), Web of Science (via the Web of Knowledge), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; via EBSCOhost). Peer-reviewed studies written in English that reported reasons for accessing or choosing emergency or urgent care services and were published between 1995 and 2016 were included. Data were extracted and reasons for choosing emergency and urgent care were identified and mapped. Thematic analysis was used to identify themes and findings were reported qualitatively using framework-based narrative synthesis. Thirty-eight studies were identified that met the inclusion criteria. Most studies were set in the United Kingdom (39.4%) or the United States (34.2%) and reported results relating to ED (68.4%). Thirty-nine percent of studies utilized qualitative or mixed research designs. Our thematic analysis identified six broad themes that summarized reasons why patients chose to access ED or urgent care. These were access to and confidence in primary care; perceived urgency, anxiety, and the value of reassurance from emergency-based services; views of family, friends, or healthcare professionals; convenience (location, not having to make appointment, and opening hours

  16. Radiation protection issues on preparedness and response for a severe nuclear accident: experiences of the Fukushima accident.

    Science.gov (United States)

    Homma, T; Takahara, S; Kimura, M; Kinase, S

    2015-06-01

    Radiation protection issues on preparedness and response for a severe nuclear accident are discussed in this paper based on the experiences following the accident at Fukushima Daiichi nuclear power plant. The criteria for use in nuclear emergencies in the Japanese emergency preparedness guide were based on the recommendations of International Commission of Radiological Protection (ICRP) Publications 60 and 63. Although the decision-making process for implementing protective actions relied heavily on computer-based predictive models prior to the accident, urgent protective actions, such as evacuation and sheltering, were implemented effectively based on the plant conditions. As there were no recommendations and criteria for long-term protective actions in the emergency preparedness guide, the recommendations of ICRP Publications 103, 109, and 111 were taken into consideration in determining the temporary relocation of inhabitants of heavily contaminated areas. These recommendations were very useful in deciding the emergency protective actions to take in the early stages of the Fukushima accident. However, some suggestions have been made for improving emergency preparedness and response in the early stages of a severe nuclear accident.

  17. 31 CFR 595.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services to a specially designated terrorist... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 595.507 Section 595.507 Money and Finance: Treasury Regulations Relating to Money and...

  18. 31 CFR 548.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 548.508 Section 548.508 Money and Finance: Treasury Regulations Relating to Money and...

  19. 31 CFR 542.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 542.508 Section 542.508 Money and Finance: Treasury Regulations Relating to Money and...

  20. 31 CFR 588.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 588.508 Section 588.508 Money and Finance: Treasury Regulations Relating to Money and...

  1. 31 CFR 543.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 543.508 Section 543.508 Money and Finance: Treasury Regulations Relating to Money and...

  2. 31 CFR 551.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 551.507 Section 551.507 Money and Finance: Treasury Regulations Relating to Money and...

  3. 31 CFR 541.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 541.508 Section 541.508 Money and Finance: Treasury Regulations Relating to Money and...

  4. 31 CFR 594.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 594.507 Section 594.507 Money and Finance: Treasury Regulations Relating to Money and...

  5. 31 CFR 545.517 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services in the United States to persons... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 545.517 Section 545.517 Money and Finance: Treasury Regulations Relating to Money and...

  6. 31 CFR 546.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 546.508 Section 546.508 Money and Finance: Treasury Regulations Relating to Money and...

  7. 31 CFR 537.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... services. The provision of nonscheduled emergency medical services in the United States to persons whose... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 537.508 Section 537.508 Money and Finance: Treasury Regulations Relating to Money and...

  8. 31 CFR 536.507 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... medical services. The provision of nonscheduled emergency medical services to a specially designated... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency medical services. 536.507 Section 536.507 Money and Finance: Treasury Regulations Relating to Money and...

  9. 75 FR 27917 - Emergency Medical Services Week, 2010

    Science.gov (United States)

    2010-05-18

    ... medical education, train themselves on the latest life-saving techniques, and maintain vital emergency... Proclamation 8519--Emergency Medical Services Week, 2010 Executive Order 13542--Providing an Order of... President ] Proclamation 8519 of May 13, 2010 Emergency Medical Services Week, 2010 By the President of...

  10. 31 CFR 587.508 - Authorization of emergency medical services.

    Science.gov (United States)

    2010-07-01

    ... Licensing Policy § 587.508 Authorization of emergency medical services. The provision of nonscheduled emergency medical services in the United States to persons designated in or pursuant to § 587.201(a) is... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Authorization of emergency...

  11. Elderly and Nonelderly Use of a Dedicated Ambulance Corps’ Emergency Medical Services in Taiwan

    Directory of Open Access Journals (Sweden)

    Chien-Chia Huang

    2016-01-01

    Full Text Available Backgrounds and Aim. Taiwan’s population is gradually aging; however, there are no comparative data on emergency medical services (EMS use between the elderly and nonelderly. Methods. We analyzed the emergency calls dealt with between January 1 and April 4, 2014, by EMS in one city in Taiwan. All calls were divided into two groups: elderly (≥65 years and nonelderly (<65 years. Nontransport and transport calls were compared between the groups for demographic characteristics, transport time, reasons for calling EMS, vital signs, and emergency management. Results. There were 1,001 EMS calls: 226 nontransport and 775 transport calls. The elderly accounted for significantly (P<0.05 fewer (28 (9.2% nontransport calls than did the nonelderly (136 (21.4%. In the transport calls, 276 (35.6% were the elderly. The elderly had a higher proportion of histories for cardiovascular disease, cerebrovascular disease, hypertension, diabetes, end-stage renal disease, cancer, Parkinson’s disease, and Alzheimer’s disease. In addition, the elderly had significantly longer total transport time, more nontrauma reasons, and poorer consciousness levels and lower oxygen saturation and needed more respiratory management and more frequent resuscitation during transport than did the nonelderly. Conclusion. The elderly have more specific needs than do the nonelderly. Adapting EMS training, operations, and government policies to aging societies is mandatory and should begin now.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  13. Police referral to psychiatric emergency services and its effect on disposition decisions.

    Science.gov (United States)

    Watson, M A; Segal, S P; Newhill, C E

    1993-11-01

    Some clinicians and researchers have questioned the appropriateness of police referrals to psychiatric emergency services and have suggested that police exercise undue influence on hospital admission decisions. The purpose of this study was to test these assertions. Research clinicians in nine emergency services in California observed staff evaluations of 772 cases and rated patients' symptom severity, danger to self or others, and grave disability. They also reviewed the criminal justice records of these patients both before and for 18 months after the index evaluation. A total of 186 patients referred by police were compared with 577 patients not referred by police. Patients brought by police were more likely to be subsequently hospitalized, but they were also more psychiatrically disturbed. They were more dangerous to others and more gravely disabled. They were no more likely to have a criminal record than patients not referred by police. Police did not exercise undue influence on dispositions nor were the patients they brought in more "criminal" than others.

  14. A Cloud Robotics Based Service for Managing RPAS in Emergency, Rescue and Hazardous Scenarios

    Science.gov (United States)

    Silvagni, Mario; Chiaberge, Marcello; Sanguedolce, Claudio; Dara, Gianluca

    2016-04-01

    Cloud robotics and cloud services are revolutionizing not only the ICT world but also the robotics industry, giving robots more computing capabilities, storage and connection bandwidth while opening new scenarios that blend the physical to the digital world. In this vision, new IT architectures are required to manage robots, retrieve data from them and create services to interact with users. Among all the robots this work is mainly focused on flying robots, better known as drones, UAV (Unmanned Aerial Vehicle) or RPAS (Remotely Piloted Aircraft Systems). The cloud robotics approach shifts the concept of having a single local "intelligence" for every single UAV, as a unique device that carries out onboard all the computation and storage processes, to a more powerful "centralized brain" located in the cloud. This breakthrough opens new scenarios where UAVs are agents, relying on remote servers for most of their computational load and data storage, creating a network of devices where they can share knowledge and information. Many applications, using UAVs, are growing as interesting and suitable devices for environment monitoring. Many services can be build fetching data from UAVs, such as telemetry, video streaming, pictures or sensors data; once. These services, part of the IT architecture, can be accessed via web by other devices or shared with other UAVs. As test cases of the proposed architecture, two examples are reported. In the first one a search and rescue or emergency management, where UAVs are required for monitoring intervention, is shown. In case of emergency or aggression, the user requests the emergency service from the IT architecture, providing GPS coordinates and an identification number. The IT architecture uses a UAV (choosing among the available one according to distance, service status, etc.) to reach him/her for monitoring and support operations. In the meantime, an officer will use the service to see the current position of the UAV, its

  15. Emergency medical service (EMS): A unique flight environment

    Science.gov (United States)

    Shively, R. Jay

    1993-01-01

    The EMS flight environment is unique in today's aviation. The pilots must respond quickly to emergency events and often fly to landing zones where they have never been before . The time from initially receiving a call to being airborne can be as little as two to three minutes. Often the EMS pilot is the only aviation professional on site, they have no operations people or other pilots to aid them in making decisons. Further, since they are often flying to accident scenes, not airports, there is often complete weather and condition information. Therefore, the initial decision that the pilot must make, accepting or declining a flight, can become very difficult. The accident rate of EMS helicopters has been relatively high over the past years. NASA-Ames research center has taken several steps in an attempt to aid EMS pilots in their decision making and situational awareness. A preflight risk assessment system (SAFE) was developed to aid pilots in their decision making, and was tested at an EMS service. The resutls of the study were promising and a second version incorporating the lessons learned is under development. A second line of research was the development of a low cost electronic chart display (ECD). This is a digital map display to help pilots maintain geographical orientation. Another thrust was undertaken in conjunction with the Aviation Safety Reporting System (ASRS). This involved publicizing the ASRS to EMS pilots and personnel, and calling each of the reporters back to gather additional information. This paper will discuss these efforts and how they may positively impact the safety of EMS operations.

  16. Análise dos serviços hospitalares clínicos aos idosos vítimas de acidentes e violências Analysis of hospital clinical services to elderly victims of accidents and violence

    Directory of Open Access Journals (Sweden)

    Maria Luiza Carvalho de Lima

    2010-09-01

    Full Text Available O aumento de idosos na população e a vida mais ativa permitem maior exposição a acidentes e violências nessa população. Realizou-se uma análise diagnóstica dos serviços hospitalares de atendimento às urgências e emergências às vítimas de acidentes e violências na população idosa de cinco capitais do Brasil. A investigação foi fundamentada nos princípios da triangulação de métodos, integrando as abordagens quantitativa, com a aplicação de questionários aos gestores e profissionais de serviços de atenção hospitalar, e qualitativa, em que foram realizadas entrevistas com gestores e profissionais. Com base nas diretrizes das políticas estudadas, observou-se que nenhuma das capitais cumpriu todos os requisitos, apresentando um atendimento deficiente caracterizado pela falta de estrutura para manter um acompanhante para o idoso, encaminhamentos para serviços de referência, protocolos clínicos específicos, fichas de notificação, suporte aos idosos, capacitação profissional e definição do fluxo para tal população. Os resultados demonstraram que os serviços de saúde selecionados não apresentam o perfil adequado e integral necessário ao atendimento aos idosos, demonstrando a necessidade de adequação desses serviços para o cumprimento das diretrizes das políticas analisadas.The increase of elderly population and more active life allow a greater exposure to accidents and violence in this population. A diagnostic analysis of hospital services for emergency and urgent care to victims of accidents and violence in the elderly population was carried out in five capitals of Brazil. The research was based on the principles of triangulation of methods, including quantitative approaches, through the application of questionnaires to managers and pre-hospital, hospital and rehabilitation service professionals, as well as qualitative, in which interviews were made with managers and professionals and with those in

  17. Who killed Rambhor?: The state of emergency medical services in India

    Directory of Open Access Journals (Sweden)

    Rajesh H Garg

    2012-01-01

    Full Text Available In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS. These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the "health" of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India.

  18. The Role of Emergency Medical Services in Geriatrics: Bridging the Gap between Primary and Acute Care.

    Science.gov (United States)

    Goldstein, Judah; McVey, Jennifer; Ackroyd-Stolarz, Stacy

    2016-01-01

    Caring for older adults is a major function of emergency medical services (EMS). Traditional EMS systems were designed to treat single acute conditions; this approach contrasts with best practices for the care of frail older adults. Care might be improved by the early identification of those who are frail and at highest risk for adverse outcomes. Paramedics are well positioned to play an important role via a more thorough evaluation of frailty (or vulnerability). These findings may inform both pre-hospital and subsequent emergency department (ED) based decisions. Innovative programs involving EMS, the ED, and primary care could reduce the workload on EDs while improving patient access to care, and ultimately patient outcomes. Some frail older adults will benefit from the resources and specialized knowledge provided by the ED, while others may be better helped in alternative ways, usually in coordination with primary care. Discerning between these groups is a challenge worthy of further inquiry. In either case, care should be timely, with a focus on identifying emergent or acute care needs, frailty evaluation, mobility assessments, identifying appropriate goals for treatment, promoting functional independence, and striving to have the patient return to their usual place of residence if this can be done safely. Paramedics are uniquely positioned to play a larger role in the care of our aging population. Improving paramedic education as it pertains to geriatrics is a critical next step.

  19. NPP accident scenario. Which emergency measures are planned in Switzerland?; Szenario KKW-Unfall. Welche Notfallschutzmassnahmen sind in der Schweiz geplant?

    Energy Technology Data Exchange (ETDEWEB)

    Flury, Christoph [Bundesamt fuer Bevoelkerungsschutz (BABS), Bern (Switzerland). Eidgenoessisches Departement fuer Verteidigung Bevoelkerungsschutz und Sport (VBS)

    2016-07-01

    As a consequence of the reactor accident in Fukushima the Swiss government has ordered an extensive analysis of emergency planning in case of a NPP accident Switzerland. A special working group has analyzed the possible improvements of Swiss emergency planning based on the experiences in Japan. Under the special direction of the Bundesamt fuer Bevoelkerungsschutz (BABS) the agreed improvements were integrated into the emergency concept. The reference scenarios have been re-assessed and the zone concept adapted. The emergency measures include shelter-type rooms (basement or window-less rooms), the preventive distribution of iodine pills, measures concerning agriculture, aquatic systems, preventive evacuation, traffic regulations, and delayed evacuation.

  20. Characteristics and Outcomes of Patients Injured in Road Traffic Crashes and Transported by Emergency Medical Services

    Directory of Open Access Journals (Sweden)

    Chun-Ying Huang

    2016-02-01

    Full Text Available To investigate the injury characteristics and mortality of patients transported by emergency medical services (EMS and hospitalized for trauma following a road traffic crash, data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions between 1 January 2009 and 31 December 2013 in a Level I trauma center. Of 16,548 registered patients, 3978 and 1440 patients injured in road traffic crashes were transported to the emergency department by EMS and non-EMS, respectively. Patients transported by EMS had lower Glasgow coma scale (GCS scores and worse hemodynamic measures. Compared to patients transported by non-EMS, more patients transported by EMS required procedures (intubation, chest tube insertion, and blood transfusion at the emergency department. They also sustained a higher injury severity, as measured by the injury severity score (ISS and the new injury severity score (NISS. Lastly, in-hospital mortality was higher among the EMS than the non-EMS group (1.8% vs. 0.3%, respectively; p < 0.001. However, we found no statistically significant difference in the adjusted odds ratio (AOR for mortality among patients transported by EMS after adjustment for ISS (AOR 4.9, 95% CI 0.33–2.26, indicating that the higher incidence of mortality was likely attributed to the patients’ higher injury severity. In addition, after propensity score matching, logistic regression of 58 well-matched pairs did not show a significant influence of transportation by EMS on mortality (OR: 0.578, 95% CI: 0.132–2.541 p = 0.468.

  1. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

    2014-01-01

    barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. Methods: A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced...... obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Elizabeth Echoka1,&, Anselimo Makokha2, Dominique Dubourg3, Yeri Kombe1, Lillian Nyandieka1, Jens Byskov4 Results: Findings indicate that pregnant women experienced delays in making...

  2. Relationship between childhood hyperactivity and accident proneness.

    Science.gov (United States)

    Gayton, W F; Bailey, C; Wagner, A; Hardesty, V A

    1986-10-01

    Previous research suggested that hyperactive children are especially susceptible to accidents. Two questions remain: is the relationship peculiar to hyperactivity in childhood or for behaviorally disturbed children in general and does the relationship hold for females as well as for males? To answer these questions 189 patients at a child psychiatric clinic were rated on a scale which included measures of hyperactivity and accident proneness. The hyperactive patients were more likely to be described as accident prone than nonhyperactive patients. The relationship between childhood hyperactivity and accident proneness is confirmed and is specific. The relationship holds for both boys and girls.

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

    Energy Technology Data Exchange (ETDEWEB)

    Petrov, M.M.

    1993-12-31

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-05-15

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

  5. 77 FR 46802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-08-06

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... medical services representatives and consumers to provide advice and recommendations regarding Emergency... of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC 20590,...

  6. 77 FR 27278 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-05-09

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... services representatives and consumers to provide advice and recommendations regarding Emergency Medical... Transportation, Office of Emergency Medical Services, 1200 New Jersey Avenue SE., NTI-140, Washington, DC...

  7. 78 FR 801 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-01-04

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... to the public. The purpose of NEMSAC, a nationally recognized council of emergency medical services representatives and consumers, is to provide advice and recommendations regarding Emergency Medical Services...

  8. 77 FR 9297 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2012-02-16

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... council of emergency medical services (EMS) representatives and consumers to provide advice and..., Director, U.S. Department of Transportation, Office of Emergency Medical Services, 1200 New Jersey...

  9. 76 FR 64174 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2011-10-17

    ... TRANSPORTATION National Highway Traffic Safety Administration National Emergency Medical Services Advisory... emergency medical services representatives and consumers to provide advice and recommendations regarding Emergency Medical Services (EMS) to DOT's NHTSA. DATES: The meeting will be held on December 13, 2011,...

  10. 77 FR 12908 - Appointment/Reappointment to the National Emergency Medical Services Advisory Council (NEMSAC)

    Science.gov (United States)

    2012-03-02

    ... the National Emergency Medical Services Advisory Council (NEMSAC). SUMMARY: NHTSA is soliciting... nationally recognized council of emergency medical services (EMS) representatives and consumers to provide..., Office of Emergency Medical Services, Attn: NEMSAC, 1200 New Jersey Avenue SE., NTI-140, Washington,...

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

    DEFF Research Database (Denmark)

    Janstrup, Kira Hyldekær

    of the reasons for heterogeneity has been made, which in the end may lead to devising policy measures (Paper 1). 3) A connection between the occurrence probability of trauma type and crash, vehicle and person characteristics exists (Paper 2). 4) The attitudes that accident reporting is useless are found...... the literature about under-reporting and gives new and innovative knowledge which can contribute to new policy measures for improving the reporting rate. For that reason this thesis should be used as an important tool whenever addressing the under-reporting challenge....... management tool.Initially models were built by using existing traffic accident data collected by the police and emergency rooms in Denmark. The data registered by the police was collected on traffic accidents occurred on Danish roads in the period between 2002 and 2008. The emergency room data were collected...

  12. Improvement of Severe Accident Analysis Computer Code and Development of Accident Management Guidance for Heavy Water Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soo Yong; Kim, Ko Ryu; Kim, Dong Ha; Kim, See Darl; Song, Yong Mann; Choi, Young; Jin, Young Ho

    2005-03-15

    The objective of the project is to develop a generic severe accident management guidance(SAMG) applicable to Korean PHWR and the objective of this 3 year continued phase is to construct a base of the generic SAMG. Another objective is to improve a domestic computer code, ISAAC (Integrated Severe Accident Analysis code for CANDU), which still has many deficiencies to be improved in order to apply for the SAMG development. The scope and contents performed in this Phase-2 are as follows: The characteristics of major design and operation for the domestic Wolsong NPP are analyzed from the severe accident aspects. On the basis, preliminary strategies for SAM of PHWR are selected. The information needed for SAM and the methods to get that information are analyzed. Both the individual strategies applicable for accident mitigation under PHWR severe accident conditions and the technical background for those strategies are developed. A new version of ISAAC 2.0 has been developed after analyzing and modifying the existing models of ISAAC 1.0. The general SAMG applicable for PHWRs confirms severe accident management techniques for emergencies, provides the base technique to develop the plant specific SAMG by utility company and finally contributes to the public safety enhancement as a NPP safety assuring step. The ISAAC code will be used inevitably for the PSA, living PSA, severe accident analysis, SAM program development and operator training in PHWR.

  13. Quantitative Imaging in Radiation Oncology: An Emerging Science and Clinical Service.

    Science.gov (United States)

    Jaffray, David Anthony; Chung, Caroline; Coolens, Catherine; Foltz, Warren; Keller, Harald; Menard, Cynthia; Milosevic, Michael; Publicover, Julia; Yeung, Ivan

    2015-10-01

    Radiation oncology has long required quantitative imaging approaches for the safe and effective delivery of radiation therapy. The past 10 years has seen a remarkable expansion in the variety of novel imaging signals and analyses that are starting to contribute to the prescription and design of the radiation treatment plan. These include a rapid increase in the use of magnetic resonance imaging, development of contrast-enhanced imaging techniques, integration of fluorinated deoxyglucose-positron emission tomography, evaluation of hypoxia imaging techniques, and numerous others. These are reviewed with an effort to highlight challenges related to quantification and reproducibility. In addition, several of the emerging applications of these imaging approaches are also highlighted. Finally, the growing community of support for establishing quantitative imaging approaches as we move toward clinical evaluation is summarized and the need for a clinical service in support of the clinical science and delivery of care is proposed. Copyright © 2015. Published by Elsevier Inc.

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

    Institute of Scientific and Technical Information of China (English)

    陈蜀海

    2012-01-01

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

  15. Emergency medical services and "psych calls": Examining the work of urban EMS providers.

    Science.gov (United States)

    Prener, Christopher; Lincoln, Alisa K

    2015-11-01

    Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs. (PsycINFO Database Record

  16. Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

    Science.gov (United States)

    Tansley, Gavin; Schuurman, Nadine; Amram, Ofer; Yanchar, Natalie

    2015-01-01

    Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding how spatial access

  17. Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

    Directory of Open Access Journals (Sweden)

    Gavin Tansley

    Full Text Available Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs, the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding

  18. Defining and improving the role of emergency medical services in Cape Town, South Africa.

    Science.gov (United States)

    Anest, Trisha; Stewart de Ramirez, Sarah; Balhara, Kamna S; Hodkinson, Peter; Wallis, Lee; Hansoti, Bhakti

    2016-08-01

    Low and middle income countries bear a disproportionate burden of paediatric morbidity and mortality. South Africa, a middle income country, has unacceptably high mortality in children less than 5 years of age. Many factors that contribute to the child mortality rate are time sensitive and require efficient access to emergency care. Delays and barriers within the emergency medical services (EMS) system increase paediatric morbidity and mortality from time sensitive illnesses. This study is a qualitative evaluation of the prehospital care system for paediatric patients in Cape Town, South Africa. A purposive sample of healthcare personnel within and interacting with the EMS system were interviewed. A structured interview form was used to gather data. All interviews were audio recorded and transcribed; two independent reviewers performed blinded content analysis of the transcribed script. 33 structured interviews were conducted over a 4 week period. Eight broad themes were identified during coding, including: access, communication, community education, equipment, infrastructure, staffing, training and triage. Subcategories were used to identify areas for targeted intervention. Overall agreement between the two independent coders was 93.36%, with a κ coefficient of 0.69. The prehospital system is central to delivering time sensitive care for paediatric patients. In a single centre middle income setting, communication barriers between dispatch personnel and medical facilities/EMS personnel were deemed to be a high priority intervention in order to improve care delivery. Other areas for targeted interventions should include broadening the advanced life support provider base and introducing basic medical language in dispatch staff training. 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/

  19. [Emergency room services utilization in the province of Reggio Emilia: a comparison between immigrants and Italians].

    Science.gov (United States)

    Bonvicini, Laura; Broccoli, Serena; D'Angelo, Stefania; Candela, Silvia

    2011-01-01

    The aim of the study is to compare Italian and immigrant accesses to Emergency Room (ER) Services in the province of Reggio Emilia, with particular attention to time differences and to potentially inappropriate accesses. the database of ER accesses in the province of Reggio Emilia was analyzed for the years 2007- 2010. In the analysis of the resident population all autochthonous citizens and all immigrants from Developed Countries were considered Italians, while citizens from Developing Countries were Immigrants. Temporary Immigrants were those immigrants with residence and citizenship in a Developing Country. A descriptive analysis was conducted using demographic variables related to patients (age, gender, citizenship and residence) and variables related to access (admission emergency codes, cause of admission, hour, day of the week, month and discharge modality). Standardized access Ratios (SRs) were calculated for the resident population, together with 95%Confidence Intervals (95% CI). The SRs were calculated separately for children and for adults. In the years 2007-2010, 562,658 accesses to ER were recorded for Italians, 95,300 accesses for Immigrants and 6,800 for the Temporary Immigrants. Access rates for resident Immigrants were higher than Italian ones. In 2010, the SR for men was 1.24 (95%CI 1.22-1.27) while for women it was 1.18 (95%CI 1.15-1.27). Considering only non-urgent accesses, the SRs were even higher (SR men=1.65, 95% CI 1.58-1.72, women=1.43, 95% CI 1.36-1.50). Similar findings were observed in children. Immigrants access the ER services more than Italians do.They also show more non-urgent accesses in comparison with Italians. This finding is consistent with results of studies conducted in other European countries and it underlines the necessity to reorganize primary care in order to better meet immigrants' needs.

  20. [IMSS in numbers: demand of services in the emergency room, 2004].

    Science.gov (United States)

    2006-01-01

    The emergency room is one of the most productive services in any medical institution, where the demand of health services is diverse and complex in nature. Around 15 % of all the medical attentions provided at IMSS were done at the emergency room. There was an important increase in the number of consultations provided from 1995 to 2004; the death rate in the service also increased but the incapacity rate decreased. Adult and elderly women were among the most frequent users of emergency services. The main problems seen were respiratory infections (19.4%), trauma and poisoning (18.8%) and diarrheas (8%). Cholelithiasis, migraine, urinary infections and diabetes were more frequent in women, while trauma, accidents and conjunctivitis were more frequent in men. In relation to mortality, around 21% of all deaths registered at IMSS occurred in the emergency room. Diabetes and cardiovascular diseases appeared among the main death causes, especially in the adult and elderly population. Mortality was higher in men than in women.

  1. Improving European Wildfire Emergency Information Services

    Science.gov (United States)

    Bielski, Conrad; Whitmore, Ceri; O'Brien, Victoria; Zeug, Gunter; Kalas, Milan; Porras, Ignasi; Solé, Josep Maria; Gálvez, Pedro; Navarro, Maria; Nurmi, Pertti; Kilpinen, Juha; Ylinen, Kaisa; Furllanelo, Cesare; Maggio, Valerio; Alikadic, Azra; Dolci, Claudia

    2017-04-01

    European wildfires are a seasonal natural hazard that many regions must battle regularly. However, as European urbanization continues to encroach on natural areas and the climate changes it is likely that the frequency of wildfires will increase likewise the number of areas prone to wildfires. It is therefore paramount not only to increase public awareness of this natural hazard but also to be prepared by improving wildfire hazard forecasting, monitoring, and mapping. As part of the H2020 funded project entitled Improving Resilience to Emergencies through Advanced Cyber Technologies: I-REACT (Grant Agreement #700256) , there is a task with the goal to develop models and implement technologies to improve the support around the entire emergency management cycle with respect to wildfire hazards. Based on operational weather forecasts, pan-European geospatial data as well as regularly acquired Earth Observation imagery through the Copernicus program, and other sources of information such as social media channels a European wildfire service is being developed. This will be achieved by improving on the successes of the European Forest Fire Information Service (EFFIS) and the guidance of emergency managers experienced in wildfire hazards. Part of the research will be to reduce the number of false alarms. However, once a wildfire has been identified, the system focuses on the disaster region to provide situational information to the decision makers applying state-of-the-art approaches to improve disaster response. Post-wildfire information will continue to be produced for damage and recovery assessments. Ultimately, I-REACT expects to reduce wildfire costs to life, property and livelihood. This work will improve wildfire disaster emergency management through the development and integration of new data and technologies respectively as well as the knowledge from emergency managers who not only understand the hazard itself but also can provide insights into the information

  2. National Trends in the Utilization of Emergency Medical Services for Acute Myocardial Infarction and Stroke

    Directory of Open Access Journals (Sweden)

    Katie Tataris

    2014-11-01

    Full Text Available Introduction: The emergency medical services (EMS system plays a crucial role in the chain of survival for acute myocardial infarction (AMI and stroke. While regional studies have shown underutilization of the 911 system for these time-sensitive conditions, national trends have not been studied. Our objective was to describe the national prevalence of EMS use for AMI and stroke, examine trends over a six-year period, and identify patient factors that may contribute to utilization. Methods: Using the National Hospital Ambulatory Medical Care Survey-ED (NHAMCS dataset from 2003-2009, we looked at patients with a discharge diagnosis of AMI or stroke who arrived to the emergency department (ED by ambulance. We used a survey-weighted χ2 test for trend and logistic regression analysis. Results: In the study, there were 442 actual AMI patients and 220 (49.8% presented via EMS. There were 1,324 actual stroke patients and 666 (50.3% presented via EMS. There was no significant change in EMS usage for AMI or stroke over the six-year period. Factors independently associated with EMS use for AMI and stroke included age (OR 1.21; 95% CI 1.12-1.31, Non-Hispanic black race (OR 1.72; 95% CI 1.16-2.29, and nursing home residence (OR 11.50; 95% CI 6.19-21.36. Conclusion: In a nationally representative sample of ED visits from 20003-2009, there were no trends of increasing EMS use for AMI and stroke. Efforts to improve access to care could focus on patient groups that underutilize the EMS system for such conditions. [West J Emerg Med. 2014;15(7:–0.

  3. Fatal traffic accidents and forensic medicine

    Directory of Open Access Journals (Sweden)

    Kazuhiko Kibayashi

    2014-07-01

    Full Text Available In the event of a traffic accident fatality, the death is reported as an “unusual death,” an inquest is conducted, and, if necessary, a forensic autopsy is performed to prove any causal relationship between the accident and the death, identify the vehicle at fault, and determine the cause of the accident. A forensic autopsy of a traffic accident fatality needs to both determine the cause of death and identify the mechanism of injury, an analytical task that requires observation of three major traffic accident factors: the body, the vehicles involved, and the scene of the accident. Also crucial to determining the cause of death is the process of looking into whether the people involved in the accident had any diseases that might affect their driving performance or were under the influence of alcohol or drugs. In order to reduce the number of people killed in traffic accidents, it will be important to promote joint research uniting forensic medicine, clinical medicine, automotive engineering, and road engineering, take measures to limit the impact of inebriated pedestrians and pedestrians suffering from dementia, and ensure proper screening of alcohol and illegal drug consumption in drivers.

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

    Energy Technology Data Exchange (ETDEWEB)

    Meieran, H.B.

    1988-04-01

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

  5. Nuclide reduction module for the purpose the Information and Documentation Centre (IDC) for nuclear accidents emergency planning. Nuclide-reductie module t. b. v. het Informatie en Documentatiecentrum (IDC) voor kernongevallenbestrijding

    Energy Technology Data Exchange (ETDEWEB)

    Blaauboer, R.O.

    1993-11-01

    Within the framework of a national program on emergency response planning and preparedness for a nuclear accident (PKOB) an Information and Documentation Centre (IDC) has been developed at RIVM. This IDC projects for instance the effective dose equivalent due to radionuclides that may be released during a nuclear accident. One of the tools in use is an air transport model. To direct the attention to the most significant radionuclides, as far as the dose to the population due to internal radiation after inhalation and external radiation is concerned, and to speed up calculations, a method was developed to sort the 54 most important radionuclides from a nuclear release according to their contribution to dose. This method has been turned into a spreadsheet model and is described in this report. Also an outline is given that was used for the implementation of the method within the IDC on a HP-9000/370 computer. Using the 'radionuclide reduction' method it can be shown that for source terms of different types of accidents a quite different set of radionuclides is of importance for the effective dose equivalent during or after the passage of a cloud of radioactive material. Another result is that on the short term (upto a few days) the set of seven radionuclides that contribute the most to the effective dose equivalent (during or after passage) is not significantly influenced by the transport time of the cloud of radioactive material to the location where the dose is delivered. 2 tabs., 4 appendices, 11 refs.

  6. 对日本福岛核事故的应急响应及对中心应急准备工作的改进建议%The Emergency Response to Fukushima Nuclear Accident and Proposals of Improvement for the Emergency Preparedness of NSC

    Institute of Scientific and Technical Information of China (English)

    杨玲; 岳会国; 林权益; 李冰; 郜建伟

    2011-01-01

    The paper described the emergency response activities to Fukushima nuclear severe accidents by Nuclear and Radiation Safety Center(NSC).According to this emergency response and the available situation of the emergency planning;emergency preparedness in NSC,some improvement suggestions are proposed.%本文简述了环境保护部核与辐射安全中心在日本福岛第一核电厂发生严重事故期间的应急响应活动,并根据此次的响应情况结合核与辐射安全中心的现状,提出了核与辐射安全中心在应急计划;应急准备工作方面需要改进的一些建议。

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

    Directory of Open Access Journals (Sweden)

    Amanda Lima de Oliveira

    2015-02-01

    Full Text Available Introduction: traffic accidents are one of the main causes of death and disability, with motorcyclists representing the great majority of both the victims and the perpetrators. Objective: this work studied the characteristics of motorcyclists injured in accidents involving motorcycles and automobiles. Method: this study sought to interview 100 motorcyclists who had been injured in collisions between motorcycles and automobiles, and who were undergoing emergency hospital treatment in the region of Belo Horizonte, Brazil. The questionnaires included demographic information (age, gender, skin color, education level, profession and questions about years of licensed driving practice, how often they would drive an automobile, how long they had had a motorcycle driver’s license, how often they would ride a motorcycle, the number of prior accidents involving a car, and the number of prior accidents not involving a car. Results: of the 100 consecutive accidents studied, 91 occurred with men and 9 with women, aged between 16 and 79 (m = 29 ± 11 years. Regarding their reason for using a motorcycle, 83% reported using it for transport, 7% for work, and 10% for leisure. Most of these accident victims had secondary or higher education (47%. Of the motorcyclists who held a car driver’s license, 68.3% drove the vehicle daily or weekly and held the license for more than one year. Sixty-seven percent of the accident victims used a motorcycle daily and had a motorcycle driver’s license for at least one year. Conclusion: among the motorcyclists injured, most were men aged 20 years or older, with complete secondary education, and experienced in driving both motorcycles and cars, indicating that recklessness while driving the motorcycle is the main cause of traffic accidents.

  8. An Epidemiological Study on the Incidence of Accidents Among under 5 Years of Age Referred to Emergency Hospital Units in Hamadan Province

    Directory of Open Access Journals (Sweden)

    Salman Khazaei

    2016-09-01

    Full Text Available Background and objectives : Accidents and injuries are the leading causes of avoidable illness and death in most of the countries in the world. For health policymakers, it is essential to have knowledge about the occurrence of accidents. The aim of this study was to evaluate the incidence of accidents in children under 5 years of age referring to emergency departments in Hamadan province. Material and Methods: This is a retrospective study that all under 5 years of age patients referred to hospitals in Hamadan province were enrolled in the study during 2009 to 2014. Data were extracted from injury register software and by using descriptive and analytic statistics, data were analyzed with STATA software version 12 at the level of error less        than 5%. Results: A total of 7409 under 5 years of age patients were registered during this period. 70.4% were male and 38.97% of them were under 1 year old. Home accidents included 45.07% of the accidents. Car accidents (27.89%, hit (22.16% and fall (16.79% were the most occurred accidents in both sexes. Conclusion: Due to the high incidence of accidents at home and roads, necessary precautions should be taken in this regard

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

    Institute of Scientific and Technical Information of China (English)

    张建峰; 苏旭; 李文红; 拓飞

    2013-01-01

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

  10. A Rare and Serious Syndrome That Requires Attention in Emergency Service: Traumatic Asphyxia

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.

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

    Science.gov (United States)

    Staff, Trine; Søvik, Signe

    2011-03-31

    Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP) was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend). 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: pground and 92% of cases by air ambulance. EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research. © 2011 Staff and S

  12. Prototype for Integrating Internet of Things and Emergency Service in an IP Multimedia Subsystem for Wireless Body Area Networks

    Institute of Scientific and Technical Information of China (English)

    KaiDi Chang; JiannLiang Chen; HanChieh Chao

    2014-01-01

    In recent years, the application of the Internet of Things (IoT) has become an emerging business. The most important concept of next-generation network for providing a common global IT platform is combining seamless networks and networked things, objects or sensors. Also, wireless body area networks (WBANs) are becoming mature with the widespread usage of the IoT. In order to support WBAN, the platform, scenario and emergency service are necessary due to the sensors in WBAN being related to wearer's life. The sensors on the body detect a lot of information about bioinformatics and medical signals, such as heartbeat and blood. Thus, the integration of IoT and network communication in daily life is important. However, there is not only a lack of common fabric for integrating IoT with current Internet and but also no emergency call process in the current network communication envi-ronment. To overcome such situations, the prototype of integrating IoT and emergency call process is discussed. A simulated boot-strap platform to provide the discussion of open challenges and solutions for deploying IoT in Internet and the emergency commu-nication system are analyzed by using a service of 3GPP IP multimedia subsystem. Finally, the prototype for supporting WBAN with emergence service is also addressed and the performance results are useful to service providers and network operators that they can estimate their migration to IoT by referring to this experience and experiment results. Furthermore, the queuing model used to achieve the performance of emergency service in IMS and the delay time of the proposed model is analyzed.

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

    Directory of Open Access Journals (Sweden)

    Staff Trine

    2011-03-01

    Full Text Available Abstract Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs. Methods Records from police, Emergency Medical Communication Centers (EMCC, ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS, respiratory rate (RR, and systolic blood pressure (SBP was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend. Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our finding indicates a need for improved procedures, training, and tools for EMS documentation. Documentation is in itself a quality criterion for appropriate care and is crucial to trauma research.

  14. Appraisals and Cognitive Coping Styles Associated with Chronic Post-Traumatic Symptoms in Child Road Traffic Accident Survivors

    Science.gov (United States)

    Stallard, Paul; Smith, Elisabeth

    2007-01-01

    Background: Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions. Methods: Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department…

  15. Emergency department patient satisfaction: customer service training improves patient satisfaction and ratings of physician and nurse skill.

    Science.gov (United States)

    Mayer, T A; Cates, R J; Mastorovich, M J; Royalty, D L

    1998-01-01

    Customer service initiatives in healthcare have become a popular way of attempting to improve patient satisfaction. This study investigates the effect of clinically focused customer service training on patient satisfaction in the setting of a 62,000-visit emergency department and level I trauma center. Analysis of patient complaints, patient compliments, and a statistically verified patient-satisfaction survey indicate that (1) all 14 key quality characteristics identified in the survey increased dramatically in the study period; (2) patient complaints decreased by over 70 percent from 2.6 per 1,000 emergency department (ED) visits to 0.6 per 1,000 ED visits following customer service training; and (3) patient compliments increased more than 100 percent from 1.1 per 1,000 ED visits to 2.3 per 1,000 ED visits. The most dramatic improvement in the patient satisfaction survey came in ratings of skill of the emergency physician, likelihood of returning, skill of the emergency department nurse, and overall satisfaction. These results show that clinically focused customer service training improves patient satisfaction and ratings of physician and nurse skill. They also suggest that such training may offer a substantial competitive market advantage, as well as improve the patients' perception of quality and outcome.

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

    Institute of Scientific and Technical Information of China (English)

    殷志明; 张红生; 周建良; 李迅科

    2015-01-01

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

  17. Development of Public Training System for Emergency Exercise Using Virtual Reality Technology Based on Radioactive Release Accident

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Il; Park, Seong Jun; Lee, Dewhey; Song, Sub Lee; Park, Younwon [BEES Inc., Daejeon (Korea, Republic of)

    2016-10-15

    An exercise is normally conducted for a day or two days depending on the scale of the exercise. What we have experienced up to date there are several limitations in the radiological emergency exercises such as low public acceptance, poor enthusiasm in the exercise participation, not very attracting exercise scenarios, low efficiency in conducting an exercise, and so on. In order to overcome the limitations of the present exercising system, we would like to develop a radiological emergency exercise system using VR (virtual reality) technology based on a radioactive release accident. In this paper, we just introduce some basic development methods and event tree based scenario as a beginning stage. After the accident in Fukushima Daiichi NPP, the importance of emergency exercise especially for the public is far more emphasized around the world more and more. However, the human labor focused radiological emergency exercise up to now has many limitations. After developing this system properly and by using it, we could even expect to estimate the weak points of the emergency arrangements and strategy we have.

  18. Training in emergency and severe accident (current situation and future after Fukushima); Formacion en emergencias y accidentes severos (situacion actual y futuro tras Fukushima)

    Energy Technology Data Exchange (ETDEWEB)

    Caro, R. J.; Delgado, J. L.; Martinez Fanegas, R.; Gonzalez Anez, F.

    2012-07-01

    After Fukushima, training in emergency response has got a renewed meaning to cope, successfully with accidental scenarios that can occur in nuclear power plants. The authors in this paper review the fundamentals of training, considering from the training process to the main contents, including the main technological and methodological tools. The know-how acquired in training the NPPs staff and the development and in application of new methods and tools, allows analyzing the evolution expected in training to better contribute to the Nuclear Safety. (Author)

  19. Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams.

    Science.gov (United States)

    Hughes, Ashley M; Patterson, P Daniel; Weaver, Matthew D; Gregory, Megan E; Sonesh, Shirley C; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Lazzara, Elizabeth H; Wang, Xiao; Vena, John E; Salas, Eduardo; Yealy, Donald M

    2017-07-01

    Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro. We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased. The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  20. The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah.

    Science.gov (United States)

    Mohammadi, Mohsen; Nasiripour, Amir Ashkan; Fakhri, Mahmood; Bakhtiari, Ahad; Azari, Samad; Akbarzadeh, Arash; Goli, Ali; Mahboubi, Mohammad

    2014-09-28

    This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients' cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

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

    Institute of Scientific and Technical Information of China (English)

    唐灵芝; 陈由珠; 李云燕

    2008-01-01

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

  2. Accidents in Canada: mortality and hospitalization.

    Science.gov (United States)

    Riley, R; Paddon, P

    1989-01-01

    For Canadians under 45, accidents are the leading cause of both death and hospitalization. For the Canadian population as a whole, accidents rank fourth as a cause of death, after cardiovascular disease (CVD), cancer and respiratory disease. This article analyzes accident mortality and hospitalization in Canada using age-specific rates, age-standardized mortality rates (ASMR), and potential years of life lost (PYLL). The six major causes of accidental death for men are motor vehicle traffic accidents (MVTA), falls, drowning, fires, suffocation and poisoning. For women, the order is slightly different: MVTA, falls, fires, suffocation, poisoning and drowning. From 1971 to 1986, age-standardized mortality rates (ASMR) for accidents decreased by 44% for men and 39% for women. The largest decrease occurred in the under 15 age group. Accidents accounted for 11.5% of total hospital days in 1985, and 8% of hospital discharges. Because young people have the highest rates of accidental death, potential years of life lost (PYLL) are almost as high for accidents as for cardiovascular disease, although CVD deaths outnumbered accidental deaths by almost five to one in 1985.

  3. Road accidents and business cycles in Spain.

    Science.gov (United States)

    Rodríguez-López, Jesús; Marrero, Gustavo A; González, Rosa Marina; Leal-Linares, Teresa

    2016-11-01

    This paper explores the causes behind the downturn in road accidents in Spain across the last decade. Possible causes are grouped into three categories: Institutional factors (a Penalty Point System, PPS, dating from 2006), technological factors (active safety and passive safety of vehicles), and macroeconomic factors (the Great recession starting in 2008, and an increase in fuel prices during the spring of 2008). The PPS has been blessed by incumbent authorities as responsible for the decline of road fatalities in Spain. Using cointegration techniques, the GDP growth rate, the fuel price, the PPS, and technological items embedded in motor vehicles appear to be statistically significantly related with accidents. Importantly, PPS is found to be significant in reducing fatal accidents. However, PPS is not significant for non-fatal accidents. In view of these results, we conclude that road accidents in Spain are very sensitive to the business cycle, and that the PPS influenced the severity (fatality) rather than the quantity of accidents in Spain. Importantly, technological items help explain a sizable fraction in accidents downturn, their effects dating back from the end of the nineties.

  4. Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis

    OpenAIRE

    Gavin Tansley; Nadine Schuurman; Ofer Amram; Natalie Yanchar

    2015-01-01

    Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs), the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LM...

  5. STUDY OF ROAD TRAFFIC ACCIDENTS WITH SPECIAL REFERENCE TO THE ACCIDENT VICTIMS ADMITTED IN GAUHATI MEDICAL COLLEGE AND HOSPITAL, ASSAM

    Directory of Open Access Journals (Sweden)

    Rocket Chandra

    2016-05-01

    Full Text Available BACKGROUND In the present scenario, road traffic accidents have become a major cause of human mortality and morbidity. Accidents are increasing at alarming rates in India. The objective of our study was to assess the socio-demographic profile of road traffic accident victims admitted in a tertiary care setting, and to assess the pattern of injuries. METHODOLOGY The present study is prospective and analytical hospital based study. RESULTS The present studies show that more than 70% of the victims are in the age group of below 45 years (n=3196 and with male preponderance. Out of 14364 accident patients visiting the emergency department of Gauhati Medical College and Hospital, 4953 patients were admitted. The majorities of the patients (n=2995 were admitted in surgery department and 1586 in orthopaedic department. CONCLUSIONS Several factors are responsible for causing road accidents such as drunk driving, lack of awareness of traffic rules, nonadherence to safety measures. To reduce morbidity and mortality following road accidents, comprehensive policy has to be adopted by the government

  6. Integrated resource planning in maintenance logistics with spare parts emergency shipment and service engineers backlogging

    NARCIS (Netherlands)

    Rahimi-Ghahroodi, S.; Al Hanbali, A.M.; Zijm, W.H.M.; Ommeren, van J.C.W.; Sleptchenko, A.

    2016-01-01

    In this paper, we consider the integrated planning of resources in a service maintenance logistics system in which spare parts supply and service engineers deployment are considered simultaneously. The objective is to determine close-to-optimal stock levels as well as the number of service engineers

  7. The Transforming Self: Service Narratives and Identity Change in Emerging Adulthood

    Science.gov (United States)

    Cox, Keith; McAdams, Dan P.

    2012-01-01

    The study examined the extent to which a service trip to Nicaragua affected college students' narrative understanding of themselves and their commitment to volunteer service. College students who went on a spring break service trip to work with poor citizens of Nicaragua wrote narrative accounts of three important experiences on the trip shortly…

  8. Severe accident research and management in Nordic Countries - A status report

    Energy Technology Data Exchange (ETDEWEB)

    Frid, W. [Swedish Nuclear Power Inspectorate, SKI (Sweden)] (ed.)

    2002-01-01

    The report describes the status of severe accident research and accident management development in Finland, Sweden, Norway and Denmark. The emphasis is on severe accident phenomena and issues of special importance for the severe accident management strategies implemented in Sweden and in Finland. The main objective of the research has been to verify the protection provided by the accident mitigation measures and to reduce the uncertainties in risk dominant accident phenomena. Another objective has been to support validation and improvements of accident management strategies and procedures as well as to contribute to the development of level 2 PSA, computerised operator aids for accident management and certain aspects of emergency preparedness. Severe accident research addresses both the in-vessel and the ex-vessel accident progression phenomena and issues. Even though there are differences between Sweden and Finland as to the scope and content of the research programs, the focus of the research in both countries is on in-vessel coolability, integrity of the reactor vessel lower head and core melt behaviour in the containment, in particular the issues of core debris coolability and steam explosions. Notwithstanding that our understanding of these issues has significantly improved, and that experimental data base has been largely expanded, there are still important uncertainties which motivate continued research. Other important areas are thermal-hydraulic phenomena during reflooding of an overheated partially degraded core, fission product chemistry, in particular formation of organic iodine, and hydrogen transport and combustion phenomena. The development of severe accident management has embraced, among other things, improvements of accident mitigating procedures and strategies, further work at IFE Halden on Computerised Accident Management Support (CAMS) system, as well as plant modifications, including new instrumentation. Recent efforts in Sweden in this area

  9. Review of Severe Accident Phenomena in LWR and Related Severe Accident Analysis Codes

    Directory of Open Access Journals (Sweden)

    Muhammad Hashim

    2013-04-01

    Full Text Available Firstly, importance of severe accident provision is highlighted in view of Fukushima Daiichi accident. Then, extensive review of the past researches on severe accident phenomena in LWR is presented within this study. Various complexes, physicochemical and radiological phenomena take place during various stages of the severe accidents of Light Water Reactor (LWR plants. The review deals with progression of the severe accidents phenomena by dividing into core degradation phenomena in reactor vessel and post core melt phenomena in the containment. The development of various computer codes to analyze these severe accidents phenomena is also summarized in the review. Lastly, the need of international activity is stressed to assemble various severe accidents related knowledge systematically from research organs and compile them on the open knowledge base via the internet to be available worldwide.

  10. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    Science.gov (United States)

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings.

  11. Job task characteristics of Australian emergency services volunteers during search and rescue operations.

    Science.gov (United States)

    Silk, Aaron; Lenton, Gavin; Savage, Robbie; Aisbett, Brad

    2017-07-28

    Search and rescue operations are necessary in locating, assisting and recovering individuals lost or in distress. In Australia, land-based search and rescue roles require a range of physically demanding tasks undertaken in dynamic and challenging environments. The aim of the current research was to identify and characterise the physically demanding tasks inherent to search and rescue operation personnel within Australia. These aims were met through a subjective job task analysis approach. In total, 11 criterion tasks were identified by personnel. These tasks were the most physically demanding, frequently occurring and operationally important tasks to these specialist roles. Muscular strength was the dominant fitness component for 7 of the 11 tasks. In addition to the discrete criterion tasks, an operational scenario was established. With the tasks and operational scenario identified, objective task analysis procedures can be undertaken so that practitioners can implement evidence-based strategies, such as physical selection procedures and task-based physical training programs, commensurate with the physical demands of search and rescue job roles. Practitioner Summary: The identification of physically demanding tasks amongst specialist emergency service roles predicates health and safety strategies which can be incorporated into organisations. Knowledge of physical task parameters allows employers to mitigate injury risk through the implementation of strategies modelled on the precise physical demands of the role.

  12. Importance of risk communication during and after a nuclear accident.

    Science.gov (United States)

    Perko, Tanja

    2011-07-01

    Past nuclear accidents highlight communication as one of the most important challenges in emergency management. In the early phase, communication increases awareness and understanding of protective actions and improves the population response. In the medium and long term, risk communication can facilitate the remediation process and the return to normal life. Mass media play a central role in risk communication. The recent nuclear accident in Japan, as expected, induced massive media coverage. Media were employed to communicate with the public during the contamination phase, and they will play the same important role in the clean-up and recovery phases. However, media also have to fulfill the economic aspects of publishing or broadcasting, with the "bad news is good news" slogan that is a well-known phenomenon in journalism. This article addresses the main communication challenges and suggests possible risk communication approaches to adopt in the case of a nuclear accident.

  13. Militarised violence in the service of state-imposed emergencies over Palestine and Kenya

    Directory of Open Access Journals (Sweden)

    Annie Pfingst

    2015-02-01

    Full Text Available States of Emergency are declared against the disorder-ing of state sovereign power by acts of resistance, rebellion and revolt and are characterised by the technologies of control, containment and punishment. Through spatial, archival and visual encounters with emergency landscapes and the geographies of resistance, the essay considers the historic and contemporary operations, provisions, regulations and practices authorised under state-imposed emergencies. It does so in order firstly, to bring attention to the practices authorised through state-imposed emergencies and the currency and saliency of their ongoing effects, and secondly to re-frame the militarised violence of settlement/occupation as an integral part of state-imposed emergencies in which all that is necessary will be done to protect the sovereign state from the resistance of the colonised/occupied and to effect a return to ‘order’.     Through encounters with the archival record, and the architectures, remnants and territorial arrangements found in post-colonial Kenya and across the multiple geographies of Palestine, the essay draws out seven clusters of state imposed emergency practices and effects. The work grapples with a number of questions: what is it that a declared state of emergency performs for the state? Does a state of emergency enable particular forms of militarised violence? Are there common practices to be found across different modes of state-imposed emergencies? What is the genealogy to the states of emergency across Palestine and Kenya? Does our excavation of the practices of state-imposed emergency shed light on the ways we apprehend state violence in colonial, post-colonial and neo-colonial geographies?

  14. Patient safety in emergency medical services: executive summary and recommendations from the Niagara Summit.

    Science.gov (United States)

    Bigham, Blair L; Bull, Ellen; Morrison, Merideth; Burgess, Rob; Maher, Janet; Brooks, Steven C; Morrison, Laurie J

    2011-01-01

    Emergency medical services (EMS) personnel care for patients in challenging and dynamic environments that may contribute to an increased risk for adverse events. However, little is known about the risks to patient safety in the EMS setting. To address this knowledge gap, we conducted a systematic review of the literature, including nonrandomized, noncontrolled studies, conducted qualitative interviews of key informants, and, with the assistance of a pan-Canadian advisory board, hosted a 1-day summit of 52 experts in the field of EMS patient safety. The intent of the summit was to review available research, discuss the issues affecting prehospital patient safety, and discuss interventions that might improve the safety of the EMS industry. The primary objective was to define the strategic goals for improving patient safety in EMS. Participants represented all geographic regions of Canada and included administrators, educators, physicians, researchers, and patient safety experts. Data were collected through electronic voting and qualitative analysis of the discussions. The group reached consensus on nine recommendations to increase awareness, reduce adverse events, and suggest research and educational directions in EMS patient safety: increasing awareness of patient safety principles, improving adverse event reporting through creating nonpunitive reporting systems, supporting paramedic clinical decision making through improved research and education, policy changes, using flexible algorithms, adopting patient safety strategies from other disciplines, increasing funding for research in patient safety, salary support for paramedic researchers, and access to graduate training in prehospital research.

  15. Prehospital emergency medical services in Malaysia.

    Science.gov (United States)

    Hisamuddin, N A R Nik; Hamzah, M Shah; Holliman, C James

    2007-05-01

    Once a very slowly developing country in a Southeast Asia region, Malaysia has undergone considerable change over the last 20 years after the government changed its focus from agriculture to developing more industry and technology. The well-known "Vision 2020," introduced by the late Prime Minister, set a target for the nation to be a developed country in the Asia region by the year 2020. As the economy and standard of living have improved, the demand from the public for a better health care system, in particular, emergency medical services (EMS), has increased. Despite the effort by the government to improve the health care system in Malaysia, EMS within the country are currently limited, best described as being in the "developing" phase. The Ministry of Health, Ministry of Education, Civil Defense, and non-governmental organizations such as Red Crescent and St. John's Ambulance, provide the current ambulance services. At the present time, there are no uniform medical control or treatment protocols, communication systems, system management, training or education, or quality assurance policies. However, the recent development of and interest in an Emergency Medicine training program has gradually led to improved EMS and prehospital care.

  16. Trends in diagnostic patterns and mortality in emergency ambulance service patients in 2007-2014

    DEFF Research Database (Denmark)

    Christensen, Erika Frischknecht; Bendtsen, Mette Dahl; Larsen, Thomas Mulvad

    2017-01-01

    , distribution of their age, sex, hospital diagnoses, comorbidity, and 1-day and 30-day mortality were assessed by calendar year. Poisson regression with robust variance estimation was used to estimate both age-and sex-adjusted relative risk of death and prevalence ratios for Charlson Comorbidity Index (CCI......) to allow comparison by year, with 2007 as reference year. RESULTS: The annual number of emergency ambulance service patients increased from 24.3 in 2007 to 40.2 in 2014 per 1000 inhabitants. The proportions of women increased from 43.1% to 46.4% and of patients aged 60+ years from 39.9% to 48.......39). The 1-day and 30 day mortality decreased from 2.40% to 1.21% and from 5.01% to 4.36%, respectively, from 2007 to 2014, corresponding to age-adjusted and sex-adjusted relative risk of 0.43 (95% CI 0.37 to 0.50) and 0.72 (95% CI 0.66 to 0.79), respectively. CONCLUSION: During the 8-year period...

  17. Relating aviation service difficulty reports to accident data for safety trend prediction

    Energy Technology Data Exchange (ETDEWEB)

    Fullwood, R.R.; Hall, R.E.; Martinez-Guridi, G.; Uryasev, S. [Brookhaven National Lab., Upton, NY (United States); Sampath, S.G. [Federal Aviation Administration, Atlantic City, NJ (United States)

    1996-10-01

    A synthetic model of scheduled-commercial U.S. aviation fatalities was constructed from linear combinations of the time-spectra of critical systems reporting using 5.5 years of Service Difficulty Reports (SDR){sup 2} and Accident Incident Data System (AIDS) records{sup 3}. This model, used to predict near-future trends in aviation accidents, was tested by using the first 36 months of data to construct the synthetic model which was used to predict fatalities during the following eight months. These predictions were tested by comparison with the fatality data. A reliability block diagram (RBD) and third-order extrapolations also were used as predictive models and compared with actuality. The synthetic model was the best predictor because of its use of systems data. Other results of the study are a database of service difficulties for major aviation systems, and a rank ordering of systems according to their contribution to the synthesis. 4 refs., 8 figs., 3 tabs.

  18. Acidentes ocupacionais por exposição a material biológico entre a equipe multiprofissional do atendimento pré-hospitalar Accidentes ocupacionales por exposición a material biológico entre el equipo multiprofesional de atención pre hospitalaria Occupational accidents due to exposure to biological material in the multidisciplinary team of the emergency service

    Directory of Open Access Journals (Sweden)

    Adriana Cristina Oliveira

    2009-09-01

    ñamiento serológico, 61,2%. Estuvieron asociados al accidente: tiempo en la institución, (Odds ratio-OR 2,84; Intervalo de confianza-IC 95% 1,22-6,62, asignado en la Unidad de Soporte Avanzado, (OR 4,18; IC 95% 1,64-10,64; interacción: tiempo en la institución y asignado en la Unidad de Soporte Básico, (OR 0,27; IC 95% 0,07-1,00. Se sugiere: la implantación de protocolos después de accidentes, con el objetivo de reducirlos; la subnotificación y el aumento del acompañamiento después del accidente.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.

  19. Recovery and well-being among Helicopter Emergency Medical Service (HEMS) pilots.

    Science.gov (United States)

    Radstaak, Mirjam; Geurts, Sabine A E; Beckers, Debby G J; Brosschot, Jos F; Kompier, Michiel A J

    2014-07-01

    This study investigated the effects of a compressed working week with high cognitive and emotional work demands within the population of Dutch Helicopter Emergency Medical Service (HEMS) pilots. Work stressors were measured and levels of well-being were examined before, during and after a series of day and night shifts. Results revealed that (i) the start of a series of day shifts was more taxing for well-being than the start of a series of night shifts, (ii) there were no differences in the decrease in well-being during day and night shifts, (iii) distress during shifts was more strongly related to a decrease in well-being during night than during day shifts and (iv) it took HEMS pilots more time to recover from a series of night shifts than from a series of day shifts. It is concluded that HEMS pilots should not start earlier during day shifts, nor have longer series of night shifts. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  20. Hand hygiene in emergency medical services.

    Science.gov (United States)

    Teter, Jonathan; Millin, Michael G; Bissell, Rick

    2015-01-01

    Hospital-acquired infections (HAIs) affect millions of patients annually (World Health Organization. Guidelines on Hand Hygiene in Healthcare. Geneva: WHO Press; 2009). Hand hygiene compliance of clinical staff has been identified by numerous studies as a major contributing factor to HAIs around the world. Infection control and hand hygiene in the prehospital environment can also contribute to patient harm and spread of infections. Emergency medical services (EMS) practitioners are not monitored as closely as hospital personnel in terms of hand hygiene training and compliance. Their ever-changing work environment is less favorable to traditional hospital-based aseptic techniques and education. This study aimed to determine the current state of hand hygiene practices among EMS providers and to provide recommendations for improving practices in the emergency health services environment. This study was a prospective, observational prevalence study and survey, conducted over a 2-month period. We selected participants from visits to three selected hospital emergency departments in the mid-Atlantic region. There were two data components to the study: a participant survey and hand swabs for pathogenic cultures. This study recruited a total sample of 62 participants. Overall, the study revealed that a significant number of EMS providers (77%) have a heavy bacterial load on their hands after patient care. All levels of providers had a similar distribution of bacterial load. Survey results revealed that few providers perform hand hygiene before (34%) or in between patients (24%), as recommended by the Centers for Disease Control and Prevention guidelines. This study demonstrates that EMS providers are potential vectors of microorganisms if proper hand hygiene is not performed properly. Since EMS providers treat a variety of patients and operate in a variety of environments, providers may be exposed to potentially pathogenic organisms, serving as vectors for the exposure of

  1. Consideration of Command and Control Performance during Accident Management Process at the Nuclear Power Plant

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Nisrene M. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kim, Sok Chul [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-10-15

    The accident at the Fukushima Daiichi nuclear power plants shifted the nuclear safety paradigm from risk management to on-site management capability during a severe accident. The kernel of on-site management capability during an accident at a nuclear power plant is situation awareness and agility of command and control. However, little consideration has been given to accident management. After the events of September 11, 2001 and the catastrophic Fukushima nuclear disaster, agility of command and control has emerged as a significant element for effective and efficient accident management, with many studies emphasizing accident management strategies, particularly man-machine interface, which is considered a key role in ensuring nuclear power plant safety during severe accident conditions. This paper proposes a conceptual model for evaluating command and control performance during the accident management process at a nuclear power plant. Communication and information processing while responding to an accident is one of the key issues needed to mitigate the accident. This model will give guidelines for accurate and fast communication response during accident conditions.

  2. Audit of an emergency biochemistry service.

    Science.gov (United States)

    Smellie, W S; Murphy, M J; Galloway, P J; Hinnie, J; McIlroy, J; Dryburgh, F J

    1995-12-01

    To examine a model for the evaluation of appropriateness of testing in an emergency biochemistry laboratory. A model was devised in which incoming emergency test requests were categorised as appropriate or inappropriate. Explicit criteria were used to define eight minor categories, which were chosen to reflect accurately current working practice within the hospital and laboratory. Five junior medical staff each undertook a prospective 24 hour assessment, during which time all incoming requests were monitored and categorised according to these criteria. Concordance between monitors was evaluated before and during assessments. Of 509 requests, 384 (75%) were appropriate and 125 (25%) were inappropriate according to the criteria used to define categories. Inappropriate requests fell into three main groups: preoperative samples (43.2% (54/125) of all inappropriate requests), missed routine samples (33.6% (42/125)) and accelerated (priority) analyses (16% (20/125)). Various other reasons accounted for the remaining 7.2% (9/125). This model may be used to obtain valid information about current clinical and laboratory practice. Strategies to reduce the number of inappropriate requests have been identified in order to reserve the emergency service for situations of true need.

  3. Train accidents involving pedestrians, motor vehicles, and motorcycles.

    Science.gov (United States)

    Goldberg, B A; Mootha, R K; Lindsey, R W

    1998-04-01

    In the United States, train-related accidents account for more than 18,000 injuries and 1,200 fatalities annually, yet there is a paucity of literature pertaining to this unique injury. We reviewed the medical records of 98 of 135 cases of train-related trauma treated at Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas, from 1990 to 1995. There were 50 train-pedestrian accidents, 47 train-automobile accidents, and 1 train-motorcycle accident, with a mean patient age of 30.1 years (range, 2 to 66 years). Eighteen patients (18%) were pronounced dead on arrival or died shortly after admission. Of the other 80 patients, 27 (34%) were discharged from the emergency department after minor medical treatment, while 53 (66%) were hospitalized, of whom 10 (13%) later expired. The mean Injury Severity Score (ISS) was 11.9 (discharged, 1.8; hospitalized, 14.3; expired, 29.2). Forty-five patients (56%) sustained 57 extremity fractures, and 30 patients (38%) required 40 amputations. Mean Mangled Extremity Severity Score (MESS) for all injured extremities was 5.2 (amputation, 7.7; no amputation, 2.8). On average, the hospitalization cost per patient was greater than $18,698, while the reimbursement from the patients was $2,261, leaving the hospital with a net deficit of approximately 2 million dollars. Surprisingly, train accidents do not always result in serious injury. However, when serious injury is sustained, it is often of high morbidity (amputation) and mortality, which appears to correlate well with the initial MESS and ISS. Extrapolating our cost data to include all train-related accident injuries and deaths indicates that the direct costs to society may exceed 300 million dollars annually. Greater public awareness and preventive measures may reduce the tremendous human and financial costs of train-related accidents.

  4. 78 FR 24802 - National Emergency Medical Services Advisory Council (NEMSAC); Notice of Federal Advisory...

    Science.gov (United States)

    2013-04-26

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council (NEMSAC... nationally recognized council of emergency medical services representatives and consumers, is to advise and... (NHTSA), U.S. Department of Transportation (DOT). ACTION: Meeting Notice--National Emergency...

  5. Emergency Medical Services Public Health Implications and Interim Guidance for the Ebola Virus in the United States

    Directory of Open Access Journals (Sweden)

    Christopher E. McCoy

    2014-11-01

    Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.

  6. Rural-urban inequity in unmet obstetric needs and functionality of emergency obstetric care services in a Zambian district

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'Anjo; Fylkesnes, Knut; Moland, Karen Marie

    2016-01-01

    Background: Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district....... Method: A cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included...... was used to assess deficit of life-saving interventions in urban and rural areas. Results: A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural...

  7. On emergencies and emigration: how (not) to justify compulsory medical service.

    Science.gov (United States)

    Blake, Michael

    2016-04-20

    I have argued that the best way to understand the supposed right to restrict emigration is with reference to the concept of an emergency; restrictions on emigration are permitted, if at all, only as responses to an emergency situation, and must be judged with reference to the ethics of responding to such an emergency. Eszter Kollar argues, against this, that the concept of 'emergency' fails to describe the actual situation in low/middle-income countries, in which shortages of medical personnel are long-standing problems; she also argues that there is no need to invoke the concept of an emergency, when we might simply discuss these restrictions with reference to the relative importance of the human goods and interests involved. I argue, against Kollar, that we have no reason to think that an emergency must involve novelty; if the moral stakes are significant enough, we have reason to think of a situation as an emergency, regardless of when that situation began. I argue, too, that we have reason to differentiate between restrictions of liberties undertaken as part of the process of specifying liberal freedoms and emergency restrictions of those liberties defended by liberalism itself. The latter, I suggest, ought to be recognised and defended as a distinct moral category, if only to recognise the continuing moral remainder when a liberal right is temporarily suspended under emergency circumstances. I conclude that a permission to restrict emigration is, if at all, only justifiable as an emergency response to unfavourable circumstances, and ought not to be analysed in the more conventional liberal terms Kollar deploys.

  8. Professional experience and traffic accidents/near-miss accidents among truck drivers.

    Science.gov (United States)

    Girotto, Edmarlon; Andrade, Selma Maffei de; González, Alberto Durán; Mesas, Arthur Eumann

    2016-10-01

    To investigate the relationship between the time working as a truck driver and the report of involvement in traffic accidents or near-miss accidents. A cross-sectional study was performed with truck drivers transporting products from the Brazilian grain harvest to the Port of Paranaguá, Paraná, Brazil. The drivers were interviewed regarding sociodemographic characteristics, working conditions, behavior in traffic and involvement in accidents or near-miss accidents in the previous 12 months. Subsequently, the participants answered a self-applied questionnaire on substance use. The time of professional experience as drivers was categorized in tertiles. Statistical analyses were performed through the construction of models adjusted by multinomial regression to assess the relationship between the length of experience as a truck driver and the involvement in accidents or near-miss accidents. This study included 665 male drivers with an average age of 42.2 (±11.1) years. Among them, 7.2% and 41.7% of the drivers reported involvement in accidents and near-miss accidents, respectively. In fully adjusted analysis, the 3rd tertile of professional experience (>22years) was shown to be inversely associated with involvement in accidents (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.16-0.52) and near-miss accidents (OR 0.17; 95% CI 0.05-0.53). The 2nd tertile of professional experience (11-22 years) was inversely associated with involvement in accidents (OR 0.63; 95% CI 0.40-0.98). An evident relationship was observed between longer professional experience and a reduction in reporting involvement in accidents and near-miss accidents, regardless of age, substance use, working conditions and behavior in traffic. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. 76 FR 22166 - Renewal of Charter for the National Emergency Medical Services Advisory Council (NEMSAC)

    Science.gov (United States)

    2011-04-20

    ... of the National Emergency Medical Services Advisory Council to provide advice and recommendations regarding emergency medical services (EMS) matters to the U.S. Department of Transportation, National... National Highway Traffic Safety Administration Renewal of Charter for the National Emergency...

  10. 76 FR 39977 - National Emergency Medical Services Advisory Council Teleconference Meeting

    Science.gov (United States)

    2011-07-07

    ... National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council... nationally recognized council of Emergency Medical Services (EMS) representatives and consumers to provide... proper arrangements. FOR FURTHER INFORMATION CONTACT: Drew Dawson, Director, Office of Emergency...

  11. Nursing Service Innovation: a case study examining emergency nurse practitioner service sustainability.

    Science.gov (United States)

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2017-09-14

    This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, 2014). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Defining Components of Team Leadership and Membership in Prehospital Emergency Medical Services.

    Science.gov (United States)

    Crowe, Remle P; Wagoner, Robert L; Rodriguez, Severo A; Bentley, Melissa A; Page, David

    2017-01-01

    Teamwork is critical for patient and provider safety in high-stakes environments, including the setting of prehospital emergency medical services (EMS). We sought to describe the components of team leadership and team membership on a single patient call where multiple EMS providers are present. We conducted a two-day focus group with nine subject matter experts in crew resource management (CRM) and EMS using a structured nominal group technique (NGT). The specific question posed to the group was, "What are the specific components of team leadership and team membership on a single patient call where multiple EMS providers are present?" After round-robin submission of ideas and in-depth discussion of the meaning of each component, participants voted on the most important components of team leadership and team membership. Through the NGT process, we identified eight components of team leadership: a) creates an action plan; b) communicates; c) receives, processes, verifies, and prioritizes information; d) reconciles incongruent information; e) demonstrates confidence, compassion, maturity, command presence, and trustworthiness; f) takes charge; g) is accountable for team actions and outcomes; and h) assesses the situation and resources and modifies the plan. The eight essential components of team membership identified included: a) demonstrates followership, b) maintains situational awareness, c) demonstrates appreciative inquiry, d) does not freelance, e) is an active listener, f) accurately performs tasks in a timely manner, g) is safety conscious and advocates for safety at all times, and h) leaves ego and rank at the door. This study used a highly structured qualitative technique and subject matter experts to identify components of teamwork essential for prehospital EMS providers. These findings and may be used to help inform the development of future EMS training and assessment initiatives.

  13. 76 FR 72750 - Meeting Notice-Federal Interagency Committee on Emergency Medical Services

    Science.gov (United States)

    2011-11-25

    ..., Director, Office of Emergency Medical Services, National Highway Traffic Safety Administration, 1200 New... of several officials from Federal agencies as well as a State emergency medical services director... and Human Services and the Director of the Preparedness Division, Directorate of...

  14. Militarised violence in the service of state-imposed emergencies over Palestine and Kenya

    National Research Council Canada - National Science Library

    Pfingst, Annie

    Colonial states of emergency are declared and promulgated to contain the disorder of rebellion, resistance and revolt and to effect a return to an order integral to colonial settlement and occupation...

  15. Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar.

    Science.gov (United States)

    Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A

    2013-09-01

    Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.

  16. National Characteristics of Emergency Medical Services in Frontier and Remote Areas.

    Science.gov (United States)

    Mueller, Landon R; Donnelly, John P; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

    2016-01-01

    Although much is known about EMS care in urban, suburban, and rural settings, only limited national data describe EMS care in isolated and sparsely populated frontier regions. We sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). We performed a cross-sectional analysis of the 2012 National Emergency Medical Services Information System (NEMSIS) data set, encompassing EMS response data from 40 States. We linked the NEMSIS dataset with Economic Research Service-identified FAR areas, defined as a ZIP Code >60 minutes driving time to an urban center with >50,000 persons. We excluded EMS responses resulting in intercepts, standbys, inter-facility transports, and medical transports. Using odds ratios, t-tests and the Wilcoxon rank-sum test, we compared patient demographics, response characteristics (location type, level of care), clinical impressions, and on-scene death between EMS responses in FAR and non-FAR areas. There were 15,005,588 EMS responses, including 983,286 (7.0%) in FAR and 14,025,302 (93.0%) in non-FAR areas. FAR and non-FAR EMS events exhibited similar median response 5 [IQR 3-10] vs. 5 [3-8] min), scene (14 [10-20] vs. 14 [10-20] min), and transport times (11 [5.,24] vs. 12 [7,19] min). Air medical (1.51% vs. 0.42%; OR 4.15 [95% CI: 4.03-4.27]) and Advanced Life Support care (62.4% vs. 57.9%; OR 1.25 [1.24-1.26]) were more common in FAR responses. FAR responses were more likely to be of American Indian or Alaska Native race (3.99% vs. 0.70%; OR 5.04, 95% CI: 4.97-5.11). Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses (12.2 vs. 9.6 deaths/1,000 responses; OR 1.28, 95% CI: 1.25-1.30). Approximately 1 in 15 EMS responses in the continental US occur in FAR areas. FAR EMS responses are more likely to involve air medical or ALS care as well

  17. Features of coronary heart disease development in emergency workers of the Chornobyl accident depending on the action of radiation and non radiation risk factors and genotypes of single nucleotide polymorphism rs966221 of phosphodiesterase 4D gene.

    Science.gov (United States)

    Belyi, D; Pleskach, G; Nastina, O; Sidorenko, G; Kursina, N; Bazyka, O; Kovalev, O; Chumak, A; Abramenko, I

    2016-12-01

    This study devoted to specific features of coronary heart disease (CHD) development in emergency work ers (EW) of the accident at the Chernobyl nuclear power plant (ChNPP) based on analysis the interaction between radiation and non radiation risk factors and single nucleotide polymorphism (SNP) rs966221 of phosphodiesterase (PDE) 4D gene. It was examined 397 men with CHD, including 274 EW of 1986-1987 and 123 non irradiated persons (con trol group) who were 66±10 and 69±11 years old relatively. The program studies included clinical examination, elec trocardiography (ECG), ECG daily monitoring, ECG stress testing, echo doppler cardiography, analysis of serum lipid spectrum, polymerase chain reaction with restriction of reaction products, retrospective analysis of case histories. Diagnosis of CHD or its approval was carried out in accordance with the standards of diagnosis, accepted in Ukraine. All EW before their taking part in cleaning ChNPP territory did not suffered from CHD. According to the analysis of contingency tables, carriers of the TT genotype of rs966221 increased the risk of myocardial infarction (MI) in 2.538 times compared with carriers of genotypes CC and CT. The use of Kaplan Meier method showed that a half of EW with the TT genotype developed MI before 64 years old, while with the other geno types up to 78.7 years old. In the control group statistically significant increase of cumulative proportion of patients with MI, carriers of the TT genotype, began from 60 years old. Compared to the non irradiated patients EW fell ill with CHD on 9.4 years earlier. Using proportional hazards analysis (Cox regression), it was found that EW had 3.9 times higher risk of CHD than in non irradiated individuals. Smoking and overweight brought three times less but significant risk - 1.37 and 1.33 respectively. The TT genotype unlike genotypes CC and CT gene PDE4D increased risk of MI in 1.757 times more both in EW and control group. The risk of CHD development was

  18. Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes.

    Science.gov (United States)

    Gary, Tiffany L; Maiese, Eric M; Batts-Turner, Marian; Wang, Nae-Yuh; Brancati, Fredrick L

    2005-12-01

    The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of Consumer Assessment of Health Plans Survey (CAHPS) and use of diabetes-related preventive health care and ER were assessed by self-report. We then followed participants for 12 months to determine ER use prospectively. In general, participants gave favorable ratings of their care; over 70% reported that they had no problem getting care, over 60% reported the highest ratings on the communication and courtesy domains, and mean ratings (0-10 scale) for personal doctor and overall health care were high (8.8 and 8.4, respectively). Using poisson regression models adjusted for age, education, and self-reported rating of health, several aspects of patient satisfaction were associated with subsequent ER use. Participants who reported that medical staff were usually helpful or that doctors and nurses usually spent enough time were 0.49 and 0.37 times, respectively, less likely to use the ER (all p < 0.05). However, few aspects of patient satisfaction were associated with better preventive services. These data suggest that greater patient satisfaction was associated with lower ER use in urban African-Americans. Whether measures to improve patient satisfaction would reduce ER use requires further prospective study.

  19. Occupational Burnout and Its Determinants among Personnel of Emergency Medical Services in Iran.

    Science.gov (United States)

    Khatiban, Mahnaz; Hosseini, Saboor; Bikmoradi, Ali; Roshanaei, Ghodratollah; Karampourian, Arezou

    2015-11-01

    Several observations have addressed high rates of occupational burnout among personnel of emergency medical services (EMSs) centers. Occupational burnout influences EMS personnel's well-being and quality of life. The main objective of this study was to assess burnout and its determinants among Iranian EMS personnel. This study was carried out at all EMS centers in two provinces of Kermanshah and Hamadan located at the west of Iran. The sample consists of 260 personnel (110 in Hamadan and 150 in Kermanshah) that were consecutively entered. The information was collected by researcher attendance at their workplaces using a self-administered questionnaire. Occupational-burnout was measured using the Maslach Burnout Inventory. An average of 46.54% of personnel displayed high frequency in the subscale emotional exhaustion, 38.85% displayed high frequency in the subscale depersonalization, and only 2.69% of them displayed high frequency in the subscale incompetence/lack of personal accomplishment. Regarding the severity of burnout, severe emotional exhaustion and depersonalization were detected in an average of 25.39% and 37.69 of the personnel, respectively; while, an average of 97.31% expressed a low level of the lack of personal accomplishment. Frequency and severity of burnout were adversely affected by younger age, single status, history of smoking, lower income, higher work experience, longer shifts, and even work status of the spouse. Iranian EMSs personnel considerably suffered from emotional exhaustion and depersonalization. This should be effectively managed and improved by organizational supports, psychological consultations, and effective management aimed to improve determinants of appearing occupation-related burnout.

  20. Exiting the Emergency Medical Services Profession and Characteristics Associated with Intent to Return to Practice.

    Science.gov (United States)

    Cash, Rebecca E; Crowe, Remle P; Agarwal, Riddhima; Rodriguez, Severo A; Panchal, Ashish R

    2017-06-28

    Inadequate staffing of agencies, increasing attrition rates, and frequent turnover of personnel make employee retention an ongoing concern for Emergency Medical Services (EMS). Faced with increasing demand for EMS, understanding the causes underlying turnover is critical. The objectives of this study were to describe the proportion of individuals that left EMS, likelihood of returning to the profession, and key factors contributing to the decision to leave EMS. This was a cross-sectional study of nationally-certified EMS professionals who left EMS. Respondents to a census survey who reported not practicing EMS were directed to a subsection of items regarding their choice to leave EMS. Demographic and employment characteristics, likelihood of returning to EMS, and factors influencing the decision to leave EMS were assessed. Descriptive and comparative statistics (Chi-square and nonparametric test of trend [p-trend]) and univariable odds ratios were calculated. The overall response rate for the full survey was 10% (n = 32,114). A total of 1247 (4%) respondents reported leaving the profession and completed the exit survey. The majority (72%) reported that they will likely return to EMS. A stepwise decrease in the reported likelihood of returning was seen with increasing years of EMS experience (e.g., 2 or less years of experience: 83%; 16 or more years: 52%; p-trend rate of approximately 4% among nationally certified EMS professionals; however, the majority reported that they intended to return to the EMS profession. Intention to return to EMS decreased as years of experience and months away from the profession increased. Important factors in the decision to leave EMS included a desire for better pay and benefits and the decision to pursue further education. Targeting the factors identified as important in this study should be a priority for key stakeholders in improving recruitment and retention of EMS professionals.

  1. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Provision of emergency services by nonparticipating... General Provisions § 482.2 Provision of emergency services by nonparticipating hospitals. (a) The services..., nevertheless, be reimbursed under the program if— (1) The services are emergency services; and (2)...

  2. 硫酸二甲酯泄漏事故消防应急救援与处置探究%Exploration of Fire Emergency Rescue and Disposal of Dimethylsulfate Leakage Accident

    Institute of Scientific and Technical Information of China (English)

    曾笑

    2014-01-01

    Dimethylsulfate was one of the common dangerous chemicals , as a kind of important chemical raw material, which was mainly used as methylating agent in organic synthesis , widely used in pesticide , medicine, dyes and spices and other industrial production.In the process of production , storage , transportation and use the leaking was easy to cause combustion , explosion and poisoning accidents , and cause casualties and regional pollution.How to dispose of such accidents as soon as possible was introduced , and the study of emergency rescue technology was enhanced to minimize losses caused by disasters.At the same time , the corresponding safety measures were proposed.%硫酸二甲酯是常见的危险化学品之一,作为一种重要的化工原料,工业上主要用作甲基化剂,广泛应用于农药、医药、染料和香料等工业生产方面的有机合成,在生产、储存、运输、使用过程中发生泄漏事故,容易造成人员伤亡和区域性污染。本文介绍了如何尽快处置此类事故,加强应急救援技术的研究,最大限度减少灾害造成的损失,同时提出了相应的消防安全措施建议。

  3. Health Services Utilization Patterns Associated with Emergency Department Closure

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Enemark, Ulrika; Foldspang, Anders

    2011-01-01

    , 1997-2003. Data were extracted from administrative registries including information on individual use of emergency services and other hospital care, contact with GPs and socioeconomic background. Health services' use by the Morsø population was measured before reduction in emergency room opening hours......, during a period of reduced opening hours and after closure, compared with the rest of Viborg County. RESULTS: Emergency service use did not change among Morsø municipality residents compared to other Viborg County residents. Compared to men in other parts of the county, Morsø men did not change their use...

  4. Hazard perception in emergency medical service responders.

    Science.gov (United States)

    Johnston, K A; Scialfa, C T

    2016-10-01

    The perception of on-road hazards is critically important to emergency medical services (EMS) professionals, the patients they transport and the general public. This study compared hazard perception in EMS and civilian drivers of similar age and personal driving experience. Twenty-nine EMS professionals and 24 non-professional drivers were given a dynamic hazard perception test (HPT). The EMS group demonstrated an advantage in HPT that was independent of simple reaction time, another indication of the validity of the test. These results are also consistent with the view that professional driving experience results in changes in the ability to identify and respond to on-road hazards. Directions for future research include the development of a profession-specific hazard perception tool for both assessment and training purposes.

  5. Barriers to emergency obstetric care services

    DEFF Research Database (Denmark)

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique

    2014-01-01

    Introduction: Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore...... decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay...... was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Conclusion: Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching...

  6. Fire Service Emergency Management Handbook

    Science.gov (United States)

    1985-01-01

    Department 2525 S. Carson Street, 2525 S. Carson Street, Capitol Complex Capital Complex Carson City, NV 89710 Carson City, NV 89710 (702) 887-7302 (702...Training - Twenty-First Floor Capital Plaza Tower Mero Street Frankfurt, KY 40601 (502) 564-2326 Department of Housing, Fire Prevention and Buildings...out cops and their families. Psycology Stisy inhololsesnlictl an reicsit. Nmewrk Meohna Series, .-d loday, 1979, May, 59-62. Pelletier, K.R. Mind as

  7. Predicting symptomatic distress in emergency services personnel.

    Science.gov (United States)

    Weiss, D S; Marmar, C R; Metzler, T J; Ronfeldt, H M

    1995-06-01

    This study identified predictors of symptomatic distress in emergency services (EMS) personnel exposed to traumatic critical incidents. A replication was performed in 2 groups: 154 EMS workers involved in the 1989 Interstate 880 freeway collapse during the San Francisco Bay area earthquake, and 213 counterparts from the Bay area and from San Diego. Evaluated predictors included exposure, social support, and psychological traits. Replicated analyses showed that levels of symptomatic distress were positively related to the degree of exposure to the critical incident. Level of adjustment was also related to symptomatic distress. After exposure, adjustment, social support, years of experience on the job, and locus of control were controlled, 2 dissociative variables remained strongly predictive of symptomatic response. The study strengthens the literature linking dissociative tendencies and experiences to distress from exposure to traumatic stressors.

  8. Stroke awareness among Dubai emergency medical service staff and impact of an educational intervention.

    Science.gov (United States)

    Shire, Fatima; Kasim, Zahra; Alrukn, Suhail; Khan, Maria

    2017-07-06

    Emergency medical services (EMS) play a vital role in expediting hospital arrival in stroke patients. The objective of our study was to assess the level of awareness regarding pre-hospital identification and management of acute stroke among EMS Staff in Dubai and to evaluate the impact of an educational lecture on their knowledge. Ours was a cross-sectional study with a pre-test and post-test design. The intervention was an educational lecture, based on the updated guidelines in pre-hospital care of acute stroke. Participants were assessed before and after the intervention on various aspects of stroke care. Paired t test were used to compare the impact of the intervention. A total of 274 EMS workers participated in our study. The baseline knowledge of participants regarding stroke types was inadequate with only 68% correctly identifying these. 79% were able to name the cardinal stroke symptoms. Knowledge of stroke mimics was poor with only 6.6% identifying stroke mimics correctly. With respect to management, most participants were unable to correctly identify the points to illicit in the history of an acute stroke patient (25.2%) and also the steps in pre-hospital management (40%). All these aspects showed remarkable improvement post intervention. The baseline awareness of most aspects of acute stroke identification and management was poor in our EMS participants. Our educational lecture proved effective in improving this knowledge when tested immediately post intervention. However, there is a need to re-assess this at periodic intervals to identify the need for refresher courses on pre-hospital stroke management.

  9. Availability and use of emergency obstetric care services in four districts of West Bengal, India.

    Science.gov (United States)

    Biswas, Akhil Bandhu; Das, Dilip Kumar; Misra, Raghunath; Roy, Rabindra Nath; Ghosh, Debdatta; Mitra, Kaninika

    2005-09-01

    Process indicators have been recommended for monitoring the availability and use of emergency obstetric care (EmOC) services. A health facility-based study was carried out in 2002 in four districts of West Bengal, India, to analyze these process indicators. Relevant records and registers for 2001 of all studied facilities in the districts were reviewed to collect data using a pre-designed schedule. The numbers of basic and comprehensive EmOC facilities were inadequate in all the four districts compared to the minimum acceptable level. Overall, 26.2% of estimated annual births took place in the EmOC facilities (ranged from 16.2% to 45.8% in 4 districts) against the required minimum of 15%. The rate of caesarean section calculated for all expected births in the population varied from 3.5% to 4.4% in the four districts with an overall rate of 4%, which is less than the minimum target of 5%. Only 29.9% of the estimated number of complications (which is 15% of all births) was managed in the EmOC facilities. The combined case-fatality rate in the basic/comprehensive EmOC facilities was 1.7%. Major obstetric complications contributed to 85.7% of maternal deaths, and pre-eclampsia/eclampsia was the most common cause. It can be concluded that all the process indicators, except proportion of deliveries in the EmOC facilities, were below the acceptable level. Certain priority measures, such as making facilities fully functional, effective referral and monitoring system, skill-based training, etc., are to be emphasized to improve the situation.

  10. Availability and Distribution of Emergency Obstetric Care Services in Karnataka State, South India: Access and Equity Considerations

    OpenAIRE

    Mony, Prem K; Jayanna Krishnamurthy; Annamma Thomas; Kiruba Sankar; B M Ramesh; Stephen Moses; James Blanchard; Lisa Avery

    2013-01-01

    BACKGROUND: As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC) services in eight northern districts of Karnataka state in south India. METHODS & FINDINGS: We undertook a cross-sectional study of 444 government and 422 private health fac...

  11. Availability and Distribution of Emergency Obstetric Care Services in Karnataka State, South India: Access and Equity Considerations

    OpenAIRE

    Prem K Mony; Jayanna Krishnamurthy; Annamma Thomas; Kiruba Sankar; Ramesh, B. M.; Stephen Moses; James Blanchard; Lisa Avery

    2013-01-01

    BACKGROUND: As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC) services in eight northern districts of Karnataka state in south India. METHODS & FINDINGS: We undertook a cross-sectional study of 444 government and 422 private health fac...

  12. Emergency Medical Service Personnel Recognize Pediatric Concussions.

    Science.gov (United States)

    Speirs, Joshua N; Lyons, Matthew I; Johansson, Bert E

    2017-01-01

    Concussions are a major cause of morbidity in pediatrics. Many concussions occur during activities with emergency medical service (EMS) providers present to determine if a higher level of care is needed. Data are limited on how capable these providers are. We assessed the ability of EMS providers to recognize pediatric concussions. Fifty-six total responses were included, 38 from EMS and 18 from our MD/RN (medical doctor/registered nurse) group. No statistical differences were found between the 2 groups when adjusted for age, gender, number of years in practice, and number of pediatric concussions managed. This first of its kind pilot study was designed to assess EMS personnel's ability to recognize and triage pediatric concussions. Our findings show EMS providers are statistically identical in their ability to recognize and triage concussions to physicians. The performance of our MD participants was lower than expected. Larger studies are needed to further investigate EMS providers' ability to recognize a concussion.

  13. Emergence of Mobility Services in Urban China

    Institute of Scientific and Technical Information of China (English)

    Jean-Francois Doulet

    2010-01-01

    This article points out the limits of top-down strategies in China rooted in the construction of large-scale transportation facilities, primarily road networks. It helps to identify emerging trends that show a shift from a "hardware" approach, which focuses mainly on heavy in- frastructure investments, to a "software" approach, which rather relies on improving travel conditions. Based on the description of three existing mobility services that won awards in the 2010 "Better Mobility, Better Life" Prize for Innovative Urban Mobility Solutions, this article assesses these bottom-up, multi-participation strategies, and the effects of these "soft strategies" on improving travel conditions, reducing car dependency, building communities, etc. Finally, it concludes that these soft measures can contribute to the building of a harmonious society and low-carbon cities, and should receive more attention and support.

  14. Planning for emergency services using GIS-based geographic ...

    African Journals Online (AJOL)

    and applies a methodology to determine the locations of additional fire stations, ... Mr Mark te Water, Chief Fire Officer and Acting Head, Fire and Emergency Services, ... Systems (GIS) are used in each .... support other decision-making.

  15. Comparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base.

    Science.gov (United States)

    Mommsen, Philipp; Bradt, Nikolas; Zeckey, Christian; Andruszkow, Hagen; Petri, Max; Frink, Michael; Hildebrand, Frank; Krettek, Christian; Probst, Christian

    2012-01-01

    In consideration of rising cost pressure in the German health care system, the usefulness of helicopter emergency medical service (HEMS) in terms of time- and cost-effectiveness is controversially discussed. The aim of the present study was to investigate whether HEMS is associated with significantly decreased arrival and transportation times compared to ground EMS. In a retrospective study, we evaluated 1,548 primary emergency missions for time sensitive diagnoses (multiple trauma, traumatic brain and burn injury, heart-attack, stroke, and pediatric emergency) performed by a German HEMS using the medical database, NADIN, of the German Air Rescue Service. Arrival and transportation times were compared to calculated ground EMS times. HEMS showed significantly reduced arrival times at the scene in case of heart-attack, stroke and pediatric emergencies. In contrast, HEMS and ground EMS showed comparable arrival times in patients with multiple trauma, traumatic brain and burn injury due to an increased flight distance. HEMS showed a significantly decreased transportation time to the closest centre capable of specialist care in all diagnosis groups (pambulance services with significantly decreased transportation times.

  16. Truck Drivers' Experiences and Perspectives Regarding Factors Influencing Traffic Accidents: A Qualitative Study.

    Science.gov (United States)

    Karimi Moonaghi, Hossein; Ranjbar, Hossein; Heydari, Abbas; Scurlock-Evans, Laura

    2015-08-01

    Traffic accidents are a major public health problem, leading to death and disability. Although pertinent studies have been conducted, little data are available in Iran. This study explored the experiences of truck drivers and their perspectives regarding factors contributing to traffic accidents. Eighteen truck drivers, purposively sampled, participated in semi-structured interviews. Data were analyzed using qualitative content analysis. A main theme, lack of ability to control stress, emerged as a factor influencing the incidence of traffic accidents. This main theme was found to have three subthemes: poor organization of the job, lack of workplace facilities and proper equipment, and unsupportive environment. Although several factors were found to contribute to traffic accidents, their effects were not independent, and all were considered significant. Identifying factors that contribute to traffic accidents requires a systematic and holistic approach. Findings could be used by the transportation industry and community health centers to prevent traffic accidents. © 2015 The Author(s).

  17. 44 CFR 19.440 - Health and insurance benefits and services.

    Science.gov (United States)

    2010-10-01

    ... Education Programs or Activities Prohibited § 19.440 Health and insurance benefits and services. Subject to § 19.235(d), in providing a medical, hospital, accident, or life insurance benefit, service, policy, or... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Health and insurance...

  18. Hand Washing Practices Among Emergency Medical Services Providers

    National Research Council Canada - National Science Library

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-01-01

    Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS...

  19. National study of emergency department observation services.

    Science.gov (United States)

    Wiler, Jennifer L; Ross, Michael A; Ginde, Adit A

    2011-09-01

    The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. The authors analyzed the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Characteristics of EDs with observation units (OUs) were compared to those without, and patients with a disposition of ED observation were compared to those with a "short-stay" (observational analysis. An estimated 1,746 U.S. EDs (36%) reported having OUs, of which 56% are administratively managed by ED staff. Fifty-two percent of hospitals with ED-managed OUs are in an urban location, and 89% report ED boarding, compared to 29 and 65% of those that do not have an OU. The admission rate is 38% at those with ED-managed OUs and 15% at those without OUs. Of the 15.1% of all ED patients who are kept in the hospital following an ED visit, one-quarter are kept for either a short-stay admission (1.8%) or an ED observation admission (2.1%). Most (82%) ED observation patients were discharged from the ED. ED observation patients were similar to short-stay admission patients in terms of age (median = 52 years for both, interquartile range = 36 to 70 years), self-pay (12% vs. 10%), ambulance arrival (37% vs. 36%), urgent/emergent triage acuity (77% vs. 74%), use of ≥1 ED medication (64% vs.76%), and the most common primary chief complaints and primary diagnoses. Over one-third of U.S. EDs have an OU. Short-stay admission patients have similar characteristics as ED observation patients and may represent an opportunity for the growth of OUs. © 2011 by the Society for Academic Emergency Medicine.

  20. The Linked Response: Lessons Emerging from Integration of HIV and Reproductive Health Services in Cambodia

    Directory of Open Access Journals (Sweden)

    Joanna White

    2013-01-01

    Full Text Available A qualitative assessment was made of service provider and user perceptions of the quality of integrated reproductive health services established through a pilot intervention in Cambodia. The intervention aimed to promote pregnant women's HIV testing and general utilization of reproductive health facilities as well as improve the follow-up of HIV-positive women and exposed infants through strengthened referral and operational linkages amongst health facilities/services and community-based support interventions for PLHIV. The study was conducted in one operational district where the intervention was piloted and for comparative purposes in a district where integrated services had yet to be implemented. Service providers in the pilot district reported improved collaboration and coordination of services, more effective referral, and the positive impact of improved proximity of HIV testing through integrated local level facilities. Community-based support teams for PLHIV embraced their expanded role, were valued by families receiving their assistance, and were understood to have had an important role in referral, PMTCT follow-up and countering PLHIV stigmatization; findings which underscore the potential role of community support in integrated service provision. Challenges identified included stigmatization of PLHIV by health staff at district hospital level and a lack of confidence amongst non-specialized health staff when managing deliveries by HIV-positive women, partly due to fear of HIV transmission.

  1. Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

    Science.gov (United States)

    Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

    2015-10-01

    To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  2. 交通伤致颈椎挥鞭样损伤的急诊诊治%Emergency diagnosis and treatment of whiplash injury to cervical spinal cord caused by traffic accidents

    Institute of Scientific and Technical Information of China (English)

    朱颉; 韩敦富; 吴晓翔; 罗自通; 皮斌; 彭吉才

    2010-01-01

    Objective To summarize the clinical features of whiplash injury to the cervical spine caused bv traffic accident for the emergency diagnosis and treatment. Methods Two hundred and sixty-three drives and passengers with whiplash injury caused by a road accident were reviewed.The clinical manifestations,imaging examinations,and early emergency treatments of the injury were analyzed. Results Among its many clinical manifestations,neck pain and tenderness was the common symptom,emerging within several hours after the injury.However,the clinical manifestations were delayed in about 1/3 cases.The positive results of X-ray films were much lower compared with CT and MRI.Followups for a mean of 7.2 months revealed 222 satisfactory conservative cases and 41 satisfactory operative cases. Conclusions The whiplash injury can be diagnosed and treated early according to the clinical manifestations and likely conditions in the traffic accident.The prognosis can be fine in most cases.Different imaging examinations,especially CT,can reduce misdiagnosis.%目的 总结交通伤致颈椎挥鞭样损伤的临床特点,为急诊诊治提供参考.方法 对2002年1月至2008年12月急诊收治的交通伤所致的263例颈椎挥鞭样损伤患者的临床表现、影像学检查结果和急诊早期处理方法进行回顾性分析总结.结果 该损伤临床表现呈多样性,以颈肩枕部疼痛不适和压痛最常见,多数患者伤后数小时内出现症状,但约1/3患者症状迟发;影像学检查中,X线片阳性结果最低,CT和MRI阳性结果高;222例保守治疗和41例手术治疗的患者,经平均7.2个月随访总体治疗效果满意.结论 根据交通事故中驾乘人员易出现颈椎挥鞭样损伤的创伤条件,结合临床表现可以对其进行早期诊断、及时治疗,多数预后较好,综合应用影像学检查町避免漏诊,CT检查可以作为诊断的重要手段.

  3. Accidents - Chernobyl accident; Accidents - accident de Tchernobyl

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This file is devoted to the Chernobyl accident. It is divided in four parts. The first part concerns the accident itself and its technical management. The second part is relative to the radiation doses and the different contaminations. The third part reports the sanitary effects, the determinists ones and the stochastic ones. The fourth and last part relates the consequences for the other European countries with the case of France. Through the different parts a point is tackled with the measures taken after the accident by the other countries to manage an accident, the cooperation between the different countries and the groups of research and studies about the reactors safety, and also with the international medical cooperation, specially for the children, everything in relation with the Chernobyl accident. (N.C.)

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

    Directory of Open Access Journals (Sweden)

    Soo-Yong Park

    2015-10-01

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

  5. The longitudinal study of turnover and the cost of turnover in emergency medical services.

    Science.gov (United States)

    Patterson, P Daniel; Jones, Cheryl B; Hubble, Michael W; Carr, Matthew; Weaver, Matthew D; Engberg, John; Castle, Nicholas

    2010-01-01

    Few studies have examined employee turnover and associated costs in emergency medical services (EMS). To quantify the mean annual rate of turnover, total median cost of turnover, and median cost per termination in a diverse sample of EMS agencies. A convenience sample of 40 EMS agencies was followed over a six-month period. Internet, telephone, and on-site data-collection methods were used to document terminations, new hires, open positions, and costs associated with turnover. The cost associated with turnover was calculated based on a modified version of the Nursing Turnover Cost Calculation Methodology (NTCCM). The NTCCM identified direct and indirect costs through a series of questions that agency administrators answered monthly during the study period. A previously tested measure of turnover to calculate the mean annual rate of turnover was used. All calculations were weighted by the size of the EMS agency roster. The mean annual rate of turnover, total median cost of turnover, and median cost per termination were determined for three categories of agency staff mix: all-paid staff, mix of paid and volunteer (mixed) staff, and all-volunteer staff. The overall weighted mean annual rate of turnover was 10.7%. This rate varied slightly across agency staffing mix (all-paid = 10.2%, mixed = 12.3%, all-volunteer = 12.4%). Among agencies that experienced turnover (n = 25), the weighted median cost of turnover was $71,613.75, which varied across agency staffing mix (all-paid = $86,452.05, mixed = $9,766.65, and all-volunteer = $0). The weighted median cost per termination was $6,871.51 and varied across agency staffing mix (all-paid = $7,161.38, mixed = $1,409.64, and all-volunteer = $0). Annual rates of turnover and costs associated with turnover vary widely across types of EMS agencies. The study's mean annual rate of turnover was lower than expected based on information appearing in the news media and EMS trade magazines. Findings provide estimates of two key

  6. Customer satisfaction measurement in emergency medical services.

    Science.gov (United States)

    Kuisma, Markku; Määttä, Teuvo; Hakala, Taisto; Sivula, Tommi; Nousila-Wiik, Maria

    2003-07-01

    The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

  7. 42 CFR 417.558 - Emergency, urgently needed, and out-of-area services for which the HMO or CMP accepts...

    Science.gov (United States)

    2010-10-01

    ... Basis § 417.558 Emergency, urgently needed, and out-of-area services for which the HMO or CMP accepts... 42 Public Health 3 2010-10-01 2010-10-01 false Emergency, urgently needed, and out-of-area services for which the HMO or CMP accepts responsibility. 417.558 Section 417.558 Public Health CENTERS...

  8. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Directory of Open Access Journals (Sweden)

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  9. Balancing Academic Teaching, Research, and Service: a Paradigm Emerging from NSF-TUES Sponsored Project Experiences

    Science.gov (United States)

    De Paor, D. G.

    2012-12-01

    training. Our policy has lead to the emergence of a paradigm for academic inquiry. We develop and test learning resources to cover the gamut of earth and planetary sciences, which we view as the science of four-dimensional place-time. Our learning objects emphasize the role of visualization in promoting understanding. If these resources fail to achieve desired outcomes, we look into their design but also examine our own understanding of topics, since instructor misconceptions are an obvious hindrance to learning. Redesign of visualizations may improve outcomes but sometimes the problem lies not with presentation or content knowledge, but rather with gaps in the science itself. Thus teaching and public outreach can become vehicles for the discovery of fertile research questions. Dissemination of a policy that eastablishes teaching and service as bridges leading to research products has the potential to generate transformative changes in the education that graduate students deliver and thus the education that undergraduate students receive.

  10. A survey of dental school's emergency departments in Ireland and the UK: provision of undergraduate teaching and emergency care

    OpenAIRE

    2015-01-01

    Aim Emergency dental care is a vital service that new graduates should be prepared to offer. There are few published data relating to emergency dental care education. To assess this, and to gain a profile of accident and emergency departments (A&E) in dental schools, an online survey was sent to all of the dental schools in the Republic of Ireland and the UK. Setting The survey addressed the school's A&E curriculum, teaching methods, undergraduate exposure and departmental details. Results Th...

  11. Rural-urban inequity in unmet obstetric needs and functionality of emergency obstetric care services in a Zambian district

    DEFF Research Database (Denmark)

    Phiri, Selia Ng'Anjo; Fylkesnes, Knut; Moland, Karen Marie;

    2016-01-01

    Background: Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district....... Method: A cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included...... registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities...

  12. [Systematization of nursing care in urgency and emergency services: feasibility of implementation].

    Science.gov (United States)

    Maria, Monica Antonio; Quadros, Fátima Alice Aguiar; Grassi, Maria de Fátima Oliveira

    2012-01-01

    This study analyzes the feasibility of implementing the Nursing Care Systematization in an emergency and urgency hospital department. This is a field study, descriptive, qualitative structured according to the content analysis described by Bardin (2009). It was performed in a hospital specialized in emergency care. The sample consisted of eight practical nurses, five nurses and two assistants, all of them with experience of at least six months in the emergency room. The difficulties referred to the implementation of the NCS are: complexity in their steps; disinterest of the institution; theoretical unpreparedness of nursing, its devaluation by other professionals, inadequate sizing of employees and inadequacy of the hospital physical structure. In this context, it was note that the nurse loses representation in the health team and the application of SAE turns out to be often underestimated.

  13. Patient satisfaction with nursing care in an emergency service

    OpenAIRE

    Patrícia Fátima Levandovski; Maria Alice Dias da Silva Lima; Aline Marques Acosta

    2015-01-01

    To analyze patient satisfaction with nursing care received at a hospital emergency service. Methodology. This is a quantitative, descriptive, cross-sectional study. The sample was composed by 250 patients over 18 years old who used an emergency service in the south region of Brazil. Data were collected using an identification form and the Patient Satisfaction Instrument. Results. Results point to a good level of satisfaction of patients with the nursing care received, with the greatest mean f...

  14. An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya.

    Science.gov (United States)

    Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

    2015-01-01

    In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities.

  15. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation

    Directory of Open Access Journals (Sweden)

    Tan-Hsu Tan

    2017-01-01

    Full Text Available This study presents a new ubiquitous emergency medical service system (UEMS that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  16. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation

    Science.gov (United States)

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y.; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr

    2017-01-01

    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients’ biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient’s biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios. PMID:28117724

  17. Ubiquitous Emergency Medical Service System Based on Wireless Biosensors, Traffic Information, and Wireless Communication Technologies: Development and Evaluation.

    Science.gov (United States)

    Tan, Tan-Hsu; Gochoo, Munkhjargal; Chen, Yung-Fu; Hu, Jin-Jia; Chiang, John Y; Chang, Ching-Su; Lee, Ming-Huei; Hsu, Yung-Nian; Hsu, Jiin-Chyr

    2017-01-21

    This study presents a new ubiquitous emergency medical service system (UEMS) that consists of a ubiquitous tele-diagnosis interface and a traffic guiding subsystem. The UEMS addresses unresolved issues of emergency medical services by managing the sensor wires for eliminating inconvenience for both patients and paramedics in an ambulance, providing ubiquitous accessibility of patients' biosignals in remote areas where the ambulance cannot arrive directly, and offering availability of real-time traffic information which can make the ambulance reach the destination within the shortest time. In the proposed system, patient's biosignals and real-time video, acquired by wireless biosensors and a webcam, can be simultaneously transmitted to an emergency room for pre-hospital treatment via WiMax/3.5 G networks. Performances of WiMax and 3.5 G, in terms of initialization time, data rate, and average end-to-end delay are evaluated and compared. A driver can choose the route of the shortest time among the suggested routes by Google Maps after inspecting the current traffic conditions based on real-time CCTV camera streams and traffic information. The destination address can be inputted vocally for easiness and safety in driving. A series of field test results validates the feasibility of the proposed system for application in real-life scenarios.

  18. Evaluation of an evidence based quality improvement innovation for patients with musculoskeletal low back pain in an accident and emergency setting.

    Science.gov (United States)

    Potier, Tara; Tims, Emily; Kilbride, Cherry; Rantell, Khadija

    2015-01-01

    We conducted a five stage pilot study which initially consisted of a review of 75 case notes of people attending an emergency department (ED) in an inner London Teaching Hospital with musculoskeletal (MSK) low back pain (LBP). This review highlighted inconsistencies in how they were assessed and managed across and within different staff groups. We found patient documentation was often incomplete and that a biomedical model approach to the management of these patients was common. As a result, four further stages in the project were conducted. Our primary aim was to evaluate the impact of implementing a locally developed quality improvement intervention for the assessment and treatment of MSK LBP in this ED. Secondary aims were to explore the user experience of the new pathway, measured by the patient experience questionnaire (PEQ), and any associated health economic costs of changes in practice. The quality improvement intervention consisted of an evidence based low back pain pathway (EBLBPP), a staff educational program, and a patient education booklet. We undertook a retrospective baseline audit of 100 clinical records of patients was undertaken prior to the instigation of the quality improvement intervention, and four months post implementation. The pre-defined variables of interest were: documentation of the case history, examination, classification of back pain (and if correct), prescribed management and if the documentation was compliant with medico-legal standards. All patients in the study were sent a PEQ to complete and return in a self-addressed envelope. Estimated health costs associated with each patient episode of care were calculated including re-attendance episodes for any people presenting with MSK LBP within a four week period. There was a significant improvement in all areas evaluated post implementation in all groups (simple, referred and simple, referred and serious spinal pathology combined). In particular; screening for red flags (22%) and

  19. Knowledge, attitude, practice, and determinants emergency contraceptive use among women seeking abortion services in Dire Dawa, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Meskerem Abate

    Full Text Available BACKGROUND: Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average. OBJECTIVES: To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia. METHODS: A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant's knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression. RESULT: Out of 390 women interviewed, 162 women (41.5% heard about EC, only 133 (34.1% had good knowledge, and 200 (51.3% of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%. Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR = 0.027, 95% CI (0.007, 0.105]. CONCLUSION: The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low. RECOMMENDATIONS: Health professions should give

  20. Bundled automobile insurance coverage and accidents.

    Science.gov (United States)

    Li, Chu-Shiu; Liu, Chwen-Chi; Peng, Sheng-Chang

    2013-01-01

    This paper investigates the characteristics of automobile accidents by taking into account two types of automobile insurance coverage: comprehensive vehicle physical damage insurance and voluntary third-party liability insurance. By using a unique data set in the Taiwanese automobile insurance market, we explore the bundled automobile insurance coverage and the occurrence of claims. It is shown that vehicle physical damage insurance is the major automobile coverage and affects the decision to purchase voluntary liability insurance coverage as a complement. Moreover, policyholders with high vehicle physical damage insurance coverage have a significantly higher probability of filing vehicle damage claims, and if they additionally purchase low voluntary liability insurance coverage, their accident claims probability is higher than those who purchase high voluntary liability insurance coverage. Our empirical results reveal that additional automobile insurance coverage information can capture more driver characteristics and driving behaviors to provide useful information for insurers' underwriting policies and to help analyze the occurrence of automobile accidents.

  1. Accident history, risk perception and traffic safe behaviour.

    Science.gov (United States)

    Ngueutsa, Robert; Kouabenan, Dongo Rémi

    2017-09-01

    This study clarifies the associations between accident history, perception of the riskiness of road travel and traffic safety behaviours by taking into account the number and severity of accidents experienced. A sample of 525 road users in Cameroon answered a questionnaire comprising items on perception of risk, safe behaviour and personal accident history. Participants who reported involvement in more than three accidents or involvement in a severe accident perceived road travel as less risky and also reported behaving less safely compared with those involved in fewer, or less severe accidents. The results have practical implications for the prevention of traffic accidents. Practitioner Summary: The associations between accident history, perceived risk of road travel and safe behaviour were investigated using self-report questionnaire data. Participants involved in more than three accidents, or in severe accidents, perceived road travel as less risky and also reported more unsafe behaviour compared with those involved in fewer, or less severe accidents. Campaigns targeting people with a less serious, less extensive accident history should aim to increase awareness of hazards and the potential severity of their consequences, as well as emphasising how easy it is to take the recommended preventive actions. Campaigns targeting those involved in more frequent accidents, and survivors of serious accidents, should address feelings of invulnerability and helplessness.

  2. Developing A Shared Service Unmanned Aerial Vehicle Capability For Regional Emergency Services

    Science.gov (United States)

    2016-09-01

    SHARED SERVICE UNMANNED AERIAL VEHICLE CAPABILITY FOR REGIONAL EMERGENCY SERVICES by Thomas Charles Lakamp September 2016 Thesis Co-Advisors... REGIONAL EMERGENCY SERVICES 5. FUNDING NUMBERS 6. AUTHOR(S) Thomas Charles Lakamp 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval...attributes, and then applied those characteristics to the development of a regional UAV asset that would avoid duplication of resources. The study addressed

  3. 3 CFR 8383 - Proclamation 8383 of May 20, 2009. Emergency Medical Services Week, 2009

    Science.gov (United States)

    2010-01-01

    ... responders, emergency medical technicians, paramedics, nurses, physicians, and many others. These highly... skills. All share a common aspiration to help those in need, and during Emergency Medical Services...

  4. 47 CFR 97.407 - Radio amateur civil emergency service.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radio amateur civil emergency service. 97.407... SERVICES AMATEUR RADIO SERVICE Providing Emergency Communications § 97.407 Radio amateur civil emergency service. (a) No station may transmit in RACES unless it is an FCC-licensed primary, club, or...

  5. Integrating emergency services in an urban health system.

    Science.gov (United States)

    Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

    2000-03-01

    When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

  6. The Danish quality database for prehospital emergency medical services

    DEFF Research Database (Denmark)

    Frischknecht Christensen, Erika; Berlac, Peter Anthony; Nielsen, Henrik;

    2016-01-01

    AIM OF DATABASE: The aim of the Danish quality database for prehospital emergency medical services (QEMS) is to assess, monitor, and improve the quality of prehospital emergency medical service care in the entire prehospital patient pathway. The aim of this review is to describe the design......: Descriptive data included age, region, and Danish Index for Emergency Care including urgency level. CONCLUSION: QEMS is a new database under establishment and is expected to provide the basis for quality improvement in the prehospital setting and in the entire patient care pathway, for example, by providing...

  7. Security Risks of Cloud Computing and Its Emergence as 5th Utility Service

    Science.gov (United States)

    Ahmad, Mushtaq

    Cloud Computing is being projected by the major cloud services provider IT companies such as IBM, Google, Yahoo, Amazon and others as fifth utility where clients will have access for processing those applications and or software projects which need very high processing speed for compute intensive and huge data capacity for scientific, engineering research problems and also e- business and data content network applications. These services for different types of clients are provided under DASM-Direct Access Service Management based on virtualization of hardware, software and very high bandwidth Internet (Web 2.0) communication. The paper reviews these developments for Cloud Computing and Hardware/Software configuration of the cloud paradigm. The paper also examines the vital aspects of security risks projected by IT Industry experts, cloud clients. The paper also highlights the cloud provider's response to cloud security risks.

  8. Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, Mitchell T. [Argonne National Lab. (ANL), Argonne, IL (United States); Bunt, R. [Southern Nuclear, Atlanta, GA (United States); Corradini, M. [Univ. of Wisconsin, Madison, WI (United States); Ellison, Paul B. [GE Power and Water, Duluth, GA (United States); Francis, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Gabor, John D. [Erin Engineering, Walnut Creek, CA (United States); Gauntt, R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Henry, C. [Fauske and Associates, Burr Ridge, IL (United States); Linthicum, R. [Exelon Corp., Chicago, IL (United States); Luangdilok, W. [Fauske and Associates, Burr Ridge, IL (United States); Lutz, R. [PWR Owners Group (PWROG); Paik, C. [Fauske and Associates, Burr Ridge, IL (United States); Plys, M. [Fauske and Associates, Burr Ridge, IL (United States); Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rempe, J. [Rempe and Associates LLC, Idaho Falls, ID (United States); Robb, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Wachowiak, R. [Electric Power Research Inst. (EPRI), Knovville, TN (United States)

    2015-01-31

    The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy’s (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affect reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).

  9. [Communicative process in the mobile emergency service (SAMU/192)].

    Science.gov (United States)

    dos Santos, Maria Claudia; Bernardes, Andrea; Gabriel, Carmen Silvia; Evora, Yolanda Dora Martinez; Rocha, Fernanda Ludmilla Rossi

    2012-03-01

    This study aims to characterize the communication process among nursing assistants who work in vehicles of the basic life support of the mobile emergency service, in the coordination of this service, and in the unified medical regulation service in a city of the state of São Paulo, Brazil. This descriptive and qualitative research used the thematic content analysis for data analysis. Semi-structured interviews were used for the data collection, which was held in January, 2010. Results show diffculties in communication with both the medical regulation service and the coordination. Among the most highlighted aspects are failures during the radio transmission, lack of qualified radio operators, difficult access to the coordination and lack of supervision by nurses. However, it was possible to detect solutions that aim to improve the communication ana consequently, the service offered by the mobile emergency service.

  10. Availability and distribution of emergency obstetric care services in Karnataka State, South India: access and equity considerations.

    Science.gov (United States)

    Mony, Prem K; Krishnamurthy, Jayanna; Thomas, Annamma; Sankar, Kiruba; Ramesh, B M; Moses, Stephen; Blanchard, James; Avery, Lisa

    2013-01-01

    As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC) services in eight northern districts of Karnataka state in south India. We undertook a cross-sectional study of 444 government and 422 private health facilities, functional 24-hours-a-day 7-days-a-week. EmOC availability and distribution were evaluated for 8 districts and 42 taluks (sub-districts) during the year 2010, based on a combination of self-reporting, record review and direct observation. Overall, the availability of EmOC services at the sub-state level [EmOC = 5.9/500,000; comprehensive EmOC (CEmOC) = 4.5/500,000 and basic EmOC (BEmOC) = 1.4/500,000] was seen to meet the benchmark. These services however were largely located in the private sector (90% of CEmOC and 70% of BemOC facilities). Thirty six percent of private facilities and six percent of government facilities were EmOC centres. Although half of eight districts had a sufficient number of EmOC facilities and all eight districts had a sufficient number of CEmOC facilities, only two-fifths of the 42 taluks had a sufficient number of EmOC facilities. With the private facilities being largely located in select towns only, the 'non-headquarter' taluks and 'backward' taluks suffered from a marked lack of coverage of these services. Spatial mapping further helped identify the clustering of a large number of contiguous taluks without adequate government EmOC facilities in northeastern Karnataka. In conclusion, disaggregating information on emergency obstetric care service availability at district and subdistrict levels is critical for health policy and planning in the Indian setting. Reducing maternal deaths will require greater attention by the government in addressing inequities in

  11. Availability and distribution of emergency obstetric care services in Karnataka State, South India: access and equity considerations.

    Directory of Open Access Journals (Sweden)

    Prem K Mony

    Full Text Available BACKGROUND: As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC services in eight northern districts of Karnataka state in south India. METHODS & FINDINGS: We undertook a cross-sectional study of 444 government and 422 private health facilities, functional 24-hours-a-day 7-days-a-week. EmOC availability and distribution were evaluated for 8 districts and 42 taluks (sub-districts during the year 2010, based on a combination of self-reporting, record review and direct observation. Overall, the availability of EmOC services at the sub-state level [EmOC = 5.9/500,000; comprehensive EmOC (CEmOC = 4.5/500,000 and basic EmOC (BEmOC = 1.4/500,000] was seen to meet the benchmark. These services however were largely located in the private sector (90% of CEmOC and 70% of BemOC facilities. Thirty six percent of private facilities and six percent of government facilities were EmOC centres. Although half of eight districts had a sufficient number of EmOC facilities and all eight districts had a sufficient number of CEmOC facilities, only two-fifths of the 42 taluks had a sufficient number of EmOC facilities. With the private facilities being largely located in select towns only, the 'non-headquarter' taluks and 'backward' taluks suffered from a marked lack of coverage of these services. Spatial mapping further helped identify the clustering of a large number of contiguous taluks without adequate government EmOC facilities in northeastern Karnataka. CONCLUSIONS: In conclusion, disaggregating information on emergency obstetric care service availability at district and subdistrict levels is critical for health policy and planning in the Indian setting. Reducing maternal deaths will require

  12. Evaluation of Dutch Helicopter Emergency Medical Services in transporting children

    NARCIS (Netherlands)

    Peters, J.H.; Beekers, C.; Eijk, R.J.R.; Edwards, M.J.; Hoogerwerf, N.

    2014-01-01

    OBJECTIVE: In the Netherlands, helicopter emergency medical services (HEMS) function as an adjunct to paramedic ambulance service delivering hospital-level medical care to a prehospital location. The main goal of Dutch HEMS is to provide on-scene medical expertise and not primarily to serve as trans

  13. The experience of linking Victorian emergency medical service trauma data

    OpenAIRE

    Boyle Malcolm J

    2008-01-01

    Abstract Background The linking of a large Emergency Medical Service (EMS) dataset with the Victorian Department of Human Services (DHS) hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM) dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. Methods The linking o...

  14. Mobile emergency care service: the work on display

    OpenAIRE

    Velloso,Isabela Silva Cancio; Araújo,Meiriele Tavares; Nogueira,Jéssica Dias; Alves,Marília

    2014-01-01

    The aim of the present study was to discuss the way visibility constitutes a power device in the everyday practice of the Mobile Emergency Care Service in Belo Horizonte, Minas Gerais, Brazil. A qualitative case study was developed and data were collected through semi-structured interviews with 31 workers of the service (five physicians, 11 nurses, seven nursing assistants and eight ambulance drivers) and submitted to discourse analysis. The analysis of power relations in the service allowed ...

  15. Biomass accident investigations – missed opportunities for learning and accident prevention

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2017-01-01

    selected serious accidents involving biogas and wood pellets in Denmark and argues that such opportunities for learning were missed because accident investigations were superficial, follow-up incomplete and information sharing absent. In one particularly distressing case, a facility saw a repeat accident......, this time with fatal outcome, still without any learning taking place. The paper presents some information on other biomass accidents in Denmark, mostly involving biogas from anaerobic digestion. Details are lacking however, precisely because the accidents were insufficiently investigated and results...... not communicated. The biomass industry needs to pay more attention to safety. Utmost care should be taken to avoid so-called mediashifting i.e. that the resolution of a problem within one domain, the environmental, creates a new problem in another, the workplace safety domain....

  16. Emergency obstetrics care services in District Neelum, Azad Jammu and Kashmir.

    Science.gov (United States)

    Mateen, Abdul; Shaikh, Babar Tasneem; Kumar, Ramesh

    2013-01-01

    Globally 529,000 women die annually due to pregnancy related problems and in Pakistan alone this toll is about 35,000 deaths per annum. This situation is even more critical in the rural remote areas of Azad Jammu & Kashmir (AJK). The whole phenomenon needs a contextual assessment to ascertain the geographical, financial and socio culturaI accessibility, and availability of EmOC services in order to generate fresh evidence for the decision makers and concerned stakeholders for improving these services. A cross-sectional study was conducted using a structured questionnaire with the women delivered in the last 15 days, whereas the geographical accessibility and availability of EmOC services were assessed by visiting EmOC facilities in the district Neelum of AJK. Over a hundred women delivered in the last 15 days, participated in the study. Geographically, a central EmOC facility is far away and the terrain is hilly and dangerous. Women's social status, education, husband's employment and household income were found to have a significant association with the use of EmOC services. The health facilities audit showed that around 90% centres do not have a female medical officer appointed. Moreover, the state of the equipment, medicines and the basic utilities such as water, sanitation, and electricity are not satisfactory. Accessibility of EmOC services is poor in the district Neelum. Evidence on ground calls for organisational reforms at EmOC service delivery level as well as for long term planning in other sectors for improving socioeconomic and education status of the women in Azad Jammu & Kashmir.

  17. National Weather Service, Emergency Medical Services, Scripps Institution of Oceanography/UCSD and California EPA Collaboration on Heat Health Impact and Public Notification for San Diego County

    Science.gov (United States)

    Tardy, A. O.; Corcus, I.; Guirguis, K.

    2015-12-01

    The National Weather Service (NWS) has issued official heat alerts in the form of either a heat advisory or excessive heat warning product to the public and core partners for many years. This information has traditionally been developed through the use of triggers for heat indices which combine humidity and temperature. The criteria typically used numeric thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality or population acclimation. In 2013, the Scripps Institution of Oceanography, University of California, San Diego in collaboration with the Office of Environmental Health Hazard Assessment, of the California Environmental Protection Agency and the NWS completed a study of heat health impact in California, while the NWS San Diego office began modifying their criteria towards departure from climatological normal with much less dependence on humidity or heat index. The NWS changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system which documents heat health impacts. Results from the UCSD study were finalized and published in 2014; they supported the need for significant modification of the traditional criteria. In order to better understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch, which is charged by the County's Public Health Officer to monitor heat-related illness and injury daily from June through September. The data were combined with UCSD research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, practices and procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services. The end result of the

  18. Emergency service organization in conditions of commission separation at subject and municipality levels

    Directory of Open Access Journals (Sweden)

    Kravchuk D.A.

    2011-03-01

    Full Text Available The analysis of stages of formation of the modern legislation, established kinds of medical aid and sources of their financing depending on levels of the power, structure of a network of organization of public health services concerning protection of constitutional laws of citizens on reception of timely, qualitative, highly technological and accessible medical aid is presented in the article. Aspects of formation of standard-legal base of service of the first aid, including specialized aid are considered in detail. The classification signs defining technologies of rendering of medical aid and the form of its organization are considered

  19. Railway-controller-perceived competence in incidents and accidents.

    Science.gov (United States)

    Cheng, Yung-Hsiang; Tsai, Yu-Chun

    2011-12-01

    Railway controllers play a pivotal role in service recovery of normal rail system operations when incidents and accidents occur. Those in this position must have sufficient competence to overcome task difficulties caused by accident uncertainties. This study adopts Taiwan's railway system as a case study to diagnose railway-controller-perceived competence when facing diverse tasks during incidents and accidents that are derived from a proposed conceptual model. Railway-controller-perceived competence is measured using the Rasch model. Analytical results indicate that working with an external rescue agency handling a rescue operation, explanations to the public, and communication with an external rescue agency are considered the most troublesome tasks. Additionally, railway-controller-perceived competence differs based on the work experience. This information will prove useful for rail system operators and government regulators when designing and regulating railway controller competence management systems. STATEMENT OF RELEVANCE: This study presents a systematic approach for examining the gap between railway-controller-perceived competence and task difficulties associated with incidents and accidents. The relevance of findings encompasses the effects of transportation ergonomics and railway issues on the problem-solving competence and decision-making skills of railway controllers, and the competence management system.

  20. Production layout improvement in emergency services: a participatory approach.

    Science.gov (United States)

    Zanatta, Mateus; Amaral, Fernando Gonçalves

    2012-01-01

    Volunteer fire department is a service that responds emergency situations in places where there are no military emergency services. These services need to respond quickly, because time is often responsible for the operation success besides work environment and setup time interfere with the prompt response to these calls and care efficiency. The layout design is one factor that interferes with the quick setup. In this case, the spaces arrangement can result in excessive or unnecessary movements; also the equipment provision may hinder the selection and collection of these or even create movement barriers for the workers. This work created a new layout for the emergency assistance service, considering the human factors related to work through the task analysis and workers participation on the alternatives of improvement. The results showed an alternate layout with corridors and minimization of unusable sites, allowing greater flexibility and new possibilities of requirements.

  1. Woodworking injuries: a comparative study of work-related and hobby-related accidents.

    Science.gov (United States)

    Loisel, F; Bonin, S; Jeunet, L; Pauchot, J; Tropet, Y; Obert, L

    2014-10-01

    The primary objective of this study was to describe the injury characteristics and demographics of patients injured during woodworking activities, upon their arrival to the emergency department in a regional of France where this industry is prevalent. The secondary objective was to compare patient and injury characteristics for work-related and hobby-related accidents. A cohort of 87 patients who had suffered a woodworking accident over a two-year period was evaluated; 79 were available for follow-up. The context and circumstances of the accident, nature and location of the injuries and patient demographics were recorded. Hobby-related accidents accounted for two-thirds of the accidents (51/79). Most of the injured workers were either loggers (35%) or carpenters (46%). The hand was injured in 53 cases (67%). Work-related accidents resulted in significantly more serious consequences in terms of hospital stay, work stoppage, resumption of work or retraining than hobby-related accidents. For the workplace accidents, 86% occurred on new machines; more than 25% of the machines involved in accidents at home were over 15 years. Sixty-eight per cent of workers were wearing their safety gear, while only 31% of those injured during recreational woodworking wore the appropriate gear. Several elements of prevention should be improved: information about the need to maintain the equipment, protect the worker with suitable clothing, and learn which maneuvers are considered hazardous. Safety gear should be regularly inspected in the workplace.

  2. Medical emergencies in Goa

    Directory of Open Access Journals (Sweden)

    Saddichha Sahoo

    2010-01-01

    Full Text Available Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa′s roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%, which were mainly of the nature of accidents or assaults (17% and fever related (17%. Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa.

  3. Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments.

    Science.gov (United States)

    Wijesekera, Olindi; Reed, Amanda; Chastain, Parker S; Biggs, Shauna; Clark, Elizabeth G; Kole, Tamorish; Chakrapani, Anoop T; Ashish, Nandy; Rajhans, Prasad; Breaud, Alan H; Jacquet, Gabrielle A

    2016-12-01

    Introduction Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

  4. RADIATION ACCIDENTS: EXPERIENCE OF MEDICAL PROTECTION AND MODERN STRATEGY OF PHARMACOLOGICAL MAINTENANCE

    Directory of Open Access Journals (Sweden)

    A. N. Grebenyuk

    2012-01-01

    Full Text Available Experience of medical protection at radiation accidents is analyzed. It is shown, that medicines that have been in the arsenal of medical service during the liquidation of consequences of the Chernobyl nuclear power plant accident satisfied their predestination in a whole and were rather effective for radiation protection. The modern strategy of pharmacological maintenance based on use of means and methods, allowing to keeping a life, health and professional serviceability of people in conditions of amazing action of a complex of factors of radiation accidents, is submitted.

  5. EMERGING TRENDS IN TRADING OF GOODS AND SERVICES- E COMMERCE: TECHNICAL AND LEGAL ISSUES

    OpenAIRE

    Dr. Shamsuddin

    2016-01-01

    E-commerce is business communication through electronic resources, including the internet, televisions, telephones, and computers. By the rapid growth of e-commerce we can assume that it may be the fast growing way to complete business transactions. In e-commerce any person can perches goods from any place without keeping the time constraint i.e. business hours. It is a win-win situation for the consumer and the product/service provider. The various advantages E-Commerce offers to customers a...

  6. Advanced payload concepts and system architecture for emerging services in Indian National Satellite Systems

    Science.gov (United States)

    Balasubramanian, E. P.; Rao, N. Prahlad; Sarkar, S.; Singh, D. K.

    2008-07-01

    Over the past two decades Indian Space Research Organization (ISRO) has developed and operationalized satellites to generate a large capacity of transponders for telecommunication service use in INSAT system. More powerful on-board transmitters are built to usher-in direct-to-home broadcast services. These have transformed the Satcom application scenario in the country. With the proliferation of satellite technology, a shift in the Indian market is witnessed today in terms of demand for new services like Broadband Internet, Interactive Multimedia, etc. While it is imperative to pay attention to market trends, ISRO is also committed towards taking the benefits of technological advancement to all round growth of our population, 70% of which dwell in rural areas. The initiatives already taken in space application related to telemedicine, tele-education and Village Resource Centres are required to be taken to a greater height of efficiency. These targets pose technological challenges to build a large capacity and cost-effective satellite system. This paper addresses advanced payload concepts and system architecture along with the trade-off analysis on design parameters in proposing a new generation satellite system capable of extending the reach of the Indian broadband structure to individual users, educational and medical institutions and enterprises for interactive services. This will be a strategic step in the evolution of INSAT system to employ advanced technology to touch every human face of our population.

  7. Ecosystem services and emergent vulnerability in managed ecosystems: A geospatial decision-support tool

    Science.gov (United States)

    Colin M. Beier; Trista M. Patterson; F. Stuart Chapin III

    2008-01-01

    Managed ecosystems experience vulnerabilities when ecological resilience declines and key flows of ecosystem services become depleted or lost. Drivers of vulnerability often include local management actions in conjunction with other external, larger scale factors. To translate these concepts to management applications, we developed a conceptual model of feedbacks...

  8. [Pediatric cases in preclinical emergency medicine: critical aspects in the range of missions covered by ground ambulance and air rescue services].

    Science.gov (United States)

    Schlechtriemen, T; Masson, R; Burghofer, K; Lackner, C K; Altemeyer, K H

    2006-03-01

    The aim of this study was to demonstrate differences in structure and severity of pediatric emergencies treated by aeromedical (air rescue) or ground ambulances services. Conclusions for the training of emergency physicians are discussed. In a 3-year study period, a total of 9,274 pediatric emergencies covered by the ADAC air rescue service are compared to 4,344 pediatric patients of ground ambulance services in Saarland. In aeromedical services pediatric emergencies are more frequent (12.9% vs. 6.4%), trauma predominates (59.9% vs. 35.6%) and severe injuries or diseases occur more frequently (30.5% vs. 15.0%). In both groups pediatric emergency cases are concentrated into very few diagnostic groups: more than one third of the cases involving pre-school children is due to convulsions. Respiratory diseases and intoxication are the next most frequent causes and are more common in ground ambulance patients. Head trauma is the most common diagnosis in cases of pediatric trauma, followed by musculoskeletal and thoracoabdominal trauma. All types of severe trauma are more frequent in pediatric patients of the aeromedical services. Training of emergency physicians should include pediatric life support and specific information about frequent pediatric emergency situations. For emergency physicians in aeromedical services, an intensive training in pediatric trauma life support is also necessary.

  9. Speed Variance and Its Influence on Accidents.

    Science.gov (United States)

    Garber, Nicholas J.; Gadirau, Ravi

    A study was conducted to investigate the traffic engineering factors that influence speed variance and to determine to what extent speed variance affects accident rates. Detailed analyses were carried out to relate speed variance with posted speed limit, design speeds, and other traffic variables. The major factor identified was the difference…

  10. Motorcycle accidents, rider behaviour, and psychological models.

    Science.gov (United States)

    Özkan, Türker; Lajunen, Timo; Doğruyol, Burak; Yıldırım, Zümrüt; Çoymak, Ahmet

    2012-11-01

    The aims of the present study were to: (a) investigate the factor structure of the Motorcycle Rider Behaviour Questionnaire (MRBQ) [Elliott, M.A., Baughan, B.J., Sexton, B.F., 2007. Errors and violations in relation to motorcyclists' crash risk. Accident Analysis and Prevention 39, 491-499] in among Turkish riders, and (b) study the relationships between different types of rider behaviour and motorcyclists' active and passive accidents and offences, and (c) investigate the usefulness of the Theory of Planned Behaviour (TPB), Health Belief Model (HBM), and Locus of Control (T-LOC) in explaining rider behaviours. MRBQ was administered to a sample of motorcyclists (N=451). Principal components analysis yielded a 5-factor solution including traffic errors, control errors, speed violations, performance of stunts, and use of safety equipment. Annual mileage was related to higher number of active and passive accidents and offences whereas age was related to lower number of active and passive accidents. Stunts were the main predictors of active accidents and offences. Speeding violations predicted offences. Stunts and speeding violations were associated with the fate factor of the T-LOC, and with attitudes, subjective norms, and intention components of TPB, and cues to action and perceived severity components of the HBM. Use of safety equipment was related to the high level of perceived behavioural control and intention components of the TPB, the low score of perceived barriers component of the HBM, and the low fate factor of the T-LOC. While traffic errors were associated with the high score of perceived barriers and cues to action component of the HBM, control errors were related to the high score of vehicle and environment factor of the T-LOC. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Examination of offsite radiological emergency measures for nuclear reactor accidents involving core melt. [PWR

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, D.C.; McGrath, P.E.; Rasmussen, N.C.

    1978-06-01

    Evacuation, sheltering followed by population relocation, and iodine prophylaxis are evaluated as offsite public protective measures in response to nuclear reactor accidents involving core-melt. Evaluations were conducted using a modified version of the Reactor Safety Study consequence model. Models representing each measure were developed and are discussed. Potential PWR core-melt radioactive material releases are separated into two categories, ''Melt-through'' and ''Atmospheric,'' based upon the mode of containment failure. Protective measures are examined and compared for each category in terms of projected doses to the whole body and thyroid. Measures for ''Atmospheric'' accidents are also examined in terms of their influence on the occurrence of public health effects.

  12. Visualization of Traffic Accidents

    Science.gov (United States)

    Wang, Jie; Shen, Yuzhong; Khattak, Asad

    2010-01-01

    Traffic accidents have tremendous impact on society. Annually approximately 6.4 million vehicle accidents are reported by police in the US and nearly half of them result in catastrophic injuries. Visualizations of traffic accidents using geographic information systems (GIS) greatly facilitate handling and analysis of traffic accidents in many aspects. Environmental Systems Research Institute (ESRI), Inc. is the world leader in GIS research and development. ArcGIS, a software package developed by ESRI, has the capabilities to display events associated with a road network, such as accident locations, and pavement quality. But when event locations related to a road network are processed, the existing algorithm used by ArcGIS does not utilize all the information related to the routes of the road network and produces erroneous visualization results of event locations. This software bug causes serious problems for applications in which accurate location information is critical for emergency responses, such as traffic accidents. This paper aims to address this problem and proposes an improved method that utilizes all relevant information of traffic accidents, namely, route number, direction, and mile post, and extracts correct event locations for accurate traffic accident visualization and analysis. The proposed method generates a new shape file for traffic accidents and displays them on top of the existing road network in ArcGIS. Visualization of traffic accidents along Hampton Roads Bridge Tunnel is included to demonstrate the effectiveness of the proposed method.

  13. The evolution of Earth Observation satellites in Europe and its impact on the performance of emergency response services

    Science.gov (United States)

    Denis, Gil; de Boissezon, Hélène; Hosford, Steven; Pasco, Xavier; Montfort, Bruno; Ranera, Franck

    2016-10-01

    The paper reviews the evolution of Earth Observation systems in Europe and Worldwide and analyses the potential impact of their performance in support of emergency response services. Earth Observation satellites play already a significant role in supporting the action of first responders in case of major disasters. The main principle is the coordinated use of satellites in order to ensure a rapid response and the timely delivery of images and geospatial information of the area affected by the event. The first part of the paper reviews the main instruments and evaluates their current performance. The International Charter "Space and Major Disasters", signed in October 2000, was the first international initiative aimed at establishing a unified system for the acquisition of space data. The charter is a cooperation agreement between space agencies and operators of space systems. At regional level, a similar instrument exists in Asia: Sentinel-Asia. In the frame of the European programme Copernicus, the emergency management service was launched in 2009. Geo-information products derived from space imagery are delivered during all phases of the emergency management cycle, in either rush or non-rush mode, free of charge for the users. In both cases, the capacities were historically drawn from national missions, funded with public money and directly operated by the space agencies or by national operators.

  14. The role of the emergency services in the optimisation of primary angioplasty: experience from London and the Heart Attack Team.

    Science.gov (United States)

    Dalby, Miles; Whitbread, Mark

    2013-08-22

    Early ambulance services often confined their activities to a "scoop and run" approach, conveying sick patients quickly to the nearest emergency department. With the advent of modern ST-elevation myocardial infarction (STEMI) management and primary percutaneous coronary intervention (PPCI), the role of the emergency medical service (EMS) has expanded significantly. This review discusses the critical and evolving collaboration between the EMS and the heart attack centre. Speed of reperfusion is a major determinant of outcome in STEMI and, whilst the patient delay (symptom to call time) has a central role in this, system delay (first medical contact to balloon time) is linked to mortality and is used to measure the response of a PPCI programme and is a key element of contemporary guidelines. In addition to rapid diagnosis and transfer to the heart attack centre, the EMS has to deliver a growing number of established treatments including resuscitation and drug therapy. EMS also continually needs to develop expertise in new techniques such as advanced management of cardiac arrest patients, including automated cardiopulmonary resuscitation, and will need to deliver newer therapies if trials support their use, including cooling and preconditioning. Ultimately, the EMS has a central role in the management of STEMI patients which needs to be fully aligned with the heart attack centres. This integration of services is perhaps best regarded as the Heart Attack Team.

  15. A Comparative Study of Compression Methods and the Development of CODEC Program of Biological Signal for Emergency Telemedicine Service

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, T.S.; Kim, J.S. [Changwon National University, Changwon (Korea); Lim, Y.H. [Visionite Co., Ltd., Seoul (Korea); Yoo, S.K. [Yonsei University, Seoul (Korea)

    2003-05-01

    In an emergency telemedicine system such as the High-quality Multimedia based Real-time Emergency Telemedicine(HMRET) service, it is very important to examine the status of the patient continuously using the multimedia data including the biological signals(ECG, BP, Respiration, S{sub p}O{sub 2}) of the patient. In order to transmit these data real time through the communication means which have the limited transmission capacity, it is also necessary to compress the biological data besides other multimedia data. For this purpose, we investigate and compare the ECG compression techniques in the time domain and in the wavelet transform domain, and present an effective lossless compression method of the biological signals using JPEG Huffman table for an emergency telemedicine system. And, for the HMRET service, we developed the lossless compression and reconstruction program of the biological signals in MSVC++ 6.0 using DPCM method and JPEG Huffman table, and tested in an internet environment. (author). 15 refs., 17 figs., 7 tabs.

  16. A study on industrial accident rate forecasting and program development of estimated zero accident time in Korea.

    Science.gov (United States)

    Kim, Tae-gu; Kang, Young-sig; Lee, Hyung-won

    2011-01-01

    To begin a zero accident campaign for industry, the first thing is to estimate the industrial accident rate and the zero accident time systematically. This paper considers the social and technical change of the business environment after beginning the zero accident campaign through quantitative time series analysis methods. These methods include sum of squared errors (SSE), regression analysis method (RAM), exponential smoothing method (ESM), double exponential smoothing method (DESM), auto-regressive integrated moving average (ARIMA) model, and the proposed analytic function method (AFM). The program is developed to estimate the accident rate, zero accident time and achievement probability of an efficient industrial environment. In this paper, MFC (Microsoft Foundation Class) software of Visual Studio 2008 was used to develop a zero accident program. The results of this paper will provide major information for industrial accident prevention and be an important part of stimulating the zero accident campaign within all industrial environments.

  17. Ambulance emergency services for patients with coronary heart disease in Lancashire: achieving standards and improving performance

    OpenAIRE

    Stoykova, B; Dowie, R; Bastow, P; Rowsell, K; GREGORY, R.

    2004-01-01

    Methods: Audit datasets on two cohorts of patients with chest pain and suspected AMI were assembled by the Lancashire Ambulance Service NHS Trust in north west England: 3706 patients during 1996/97 and 3423 in 2001. They were transported to four hospitals. The analyses covered journey timings, role of rapid response vehicles (RRV), and clinical procedures and the results were compared with prevailing national standards.

  18. Violent deaths among composers (accidents, drownings and murders)

    OpenAIRE

    Breitenfeld, Darko; Vodanović, Marijo; Akrap, Ankica; Juran, Dominik; Kranjčec, Darko; Vuksanović, Marina

    2015-01-01

    In this study, we described different accidents, drowning and murders as the main cause of death among 145 composers. We included accidents (48 composers), drowning (26 composers) and murders (71 composers) which were mainly fatal, and premature. Accidents are the third leading cause of deaths today. Murders were often during the wars and revolutions (World War I, II, French, Russian revolution). We mentioned all of the etiologies of these accidents, drowning and murders according to the c...

  19. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

    Science.gov (United States)

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21-57 years (M=35.27; SD=8.13). Polish versions of the Impact of Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

  20. Developmental and social factors in Nigerian children's accidents.

    Science.gov (United States)

    Pfeffer, K

    1991-01-01

    Accidents to children are discussed in terms of developmental and social factors in Nigeria. The types of accidents involving children and age trends in accident incidence are reported. Physical, perceptual, cognitive and social development are discussed. Social factors identified are family variables, the physical environment, and attitudes and folk beliefs.

  1. ABUSE OF INTERNET SERVICES IN THE WORKPLACE AND THE EMERGENCE OF ADDICTION

    Directory of Open Access Journals (Sweden)

    Mateja Gorenc

    2016-05-01

    Full Text Available Employees who abuse Internet privileges have become a major concern among today's employers. Employees misuse Internet at the workplace due to the overcrowded schedule, pressures at work, etc. Internet for private purposes is also used as a release or escape from work, escape from the reality of the workplace or due to poor organizational climate; it can be used as an efficient use of time at work but it can also be excessively used when the employees are not monitored. The survey results show that there is a correlation between Internet addiction and misuse of the Internet in the workplace. Electronic monitoring has a strong impact on the abuse of the Internet. More electronic monitoring will decrease the abuse of the internet services in the workplace and vice versa. Organizational climate, relations in the working organization, the Internet policy and demographic factors do not affect the abuse of Internet services in the workplace.

  2. Is there a connection between car accidents, near accidents, and type A drivers?

    Science.gov (United States)

    Karlberg, L; Undén, A L; Elofsson, S; Krakau, I

    1998-01-01

    The authors examined Type A behavior pattern, which has been investigated primarily as a risk factor for coronary heart disease, as a risk factor for car accidents and near accidents. Type A behavior pattern, which is characterized by excessive impatience, competitiveness, hostility, and time pressure, was assessed by means of the Videotaped Structured Interview. One hundred thirty-five Swedish car drivers (66 men and 69 women) were studied: 78 Type A and 58 Type B (that is, not having, Type A behavior). Time pressure was significantly associated with near accidents when age, sex, annual mileage, and urban driving were controlled in a multivariate model.

  3. 77 FR 36039 - Federal Interagency Committee on Emergency Medical Services

    Science.gov (United States)

    2012-06-15

    ... National Highway Traffic Safety Administration Federal Interagency Committee on Emergency Medical Services... Interagency Committee on Emergency Medical Services. SUMMARY: NHTSA announces a meeting of the Federal Interagency Committee on Emergency Medical Services (FICEMS) to be held in the Washington, DC area....

  4. 78 FR 30727 - Emergency Medical Services Week, 2013

    Science.gov (United States)

    2013-05-22

    ... Documents#0;#0; ] Proclamation 8982 of May 17, 2013 Emergency Medical Services Week, 2013 By the President... calm under pressure delivers comfort to neighbors in need. During Emergency Medical Services Week, we... proclaim May 19 through May 25, 2013, as Emergency Medical Services Week. I encourage all Americans...

  5. 47 CFR 25.284 - Emergency Call Center Service.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Emergency Call Center Service. 25.284 Section... SATELLITE COMMUNICATIONS Technical Operations § 25.284 Emergency Call Center Service. (a) Providers of mobile satellite service to end-user customers (part 25, subparts A-D) must provide Emergency Call...

  6. First international workshop on severe accidents and their consequences. [Chernobyl Accident

    Energy Technology Data Exchange (ETDEWEB)

    1989-07-01

    An international workshop on past severe nuclear accidents and their consequences was held in Dagomys region of Sochi, USSR on October 30--November 3, 1989. The plan of this meeting was approved by the USSR Academy of Sciences and by the USSR State Committee of the Utilization of Atomic Energy. The meeting was held under the umbrella of the ANS-SNS agreement of cooperation. Topics covered include analysis of the Chernobyl accident, safety measures for RBMK type reactors and consequences of the Chernobyl accident including analysis of the ecological, genetic and psycho-social factors. Separate reports are processed separately for the data bases. (CBS)

  7. ACTIONS OF THE ADMINISTRATION OF THE FEDERAL SERVICE FOR SURVEILLANCE ON CONSUMER RIGHTS PROTECTION AND HUMANWELL-BEING IN KAMCHATSKY KRAI AND FEDERAL HEALTH ORGANIZATION"CENTER OF HYGIENE AND EPIDEMIOLOGYIN THE KAMCHATSKY KRAI" FOR RADIATION PROTECTION OF THE POPULATION IN CONNECTION WITH THE FUKUSHIMA ACCIDENT

    Directory of Open Access Journals (Sweden)

    N. I. Zhdanova

    2011-01-01

    Full Text Available The article describes actions of the Administration of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in KamchatskyKrai and the Federal Health Organization "Center of Hygiene and Epidemiology in the Kamchatsky Krai" to ensure radiation protection of the population in conditions of the radiation accident at Fukushima nuclear power plant and their co-operation with other regional administrations in solution of this problem. The article also presents results of radiation monitoring in the region and shows absence of any significant radiation exposure to the population of the region resulting from the Fukushima nuclear power plant accident.

  8. EMERGENCY PATIENTS RIGHTS AND DIGNITY IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Desislava Todorova

    2017-02-01

    Full Text Available In addition to the emergency medical services the victims of various disasters and accidents need to keep their dignity as human beings. Dignity is a term used in morals and ethics to designate that people have the right to be respected and treated ethically. Providers of emergency medical services perform their activities in compliance with the rules of good medical practices while keeping professional secrecy and observing patient rights. Patient rights and in particular moral rights ensure respect for patients’ lives and dignity in the health care system. The aim of the research is to study the ethical dilemma of saving patients’ lives and protecting their dignity in cases of emergency. The purpose of the survey is to study the medical, ethical and legal aspects of the issue. A documentary method of collection data from scientific sources is used with regard to the different aspects of the topic. In a number of cases during their routine medical practice, especially in emergencies, medical experts have to make their choice of medical behavior – whether it has to comply with ethics or law. Making the right decision and choice of behavior depends on the moral values, professional training, knowledge of legal requirements and personal qualities of the relevant medical professional. One should always take into account that protecting victims’ dignity is especially important in emergencies when they feel most vulnerable.

  9. Being in front of the patient. Nurse-patient interaction and use of technology in emergency services

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    Yeimy Yesenia Granados-Pembertty

    2013-12-01

    Full Text Available Objective. This study sought to describe how the use of technology intervenes in the nurse-patient relationship, from the nurse's point of view. Methodology. This was a qualitative research with tools from grounded theory. Twenty semi-structured interviews were conducted with nurses working in emergency services in three municipalities of Colombia. Results. Four categories emerged: 1 direct care, the maximum interaction or being in front of the patient; 2 fairly direct care; 3 indirect care, institutional management; and 4 minimum interaction; technology as facilitator of the interaction and awareness of the necessity for interaction. Conclusion. This study shows the irreplaceable nature of the nurse and the fundamental necessity of technology. The dual mediations of technology constitute a paradoxical matter that reveals the importance of placing it as a means; warning on the danger of converting it an end in and of itself.

  10. [With the introduction of Infection Control Committees in mid-sized private hospitals, cutting-edge accident prevention methods and solutions will be utilized to reduce the impact of needlestick accidents].

    Science.gov (United States)

    Hatano, Yoshiji

    2012-10-01

    Exposure to medical equipment, such as needles and other sharp objects, can accidentally cause injury or transmit an infectious blood-borne disease. Because the risk of infection due to needlestick injury accidents is always a possibility it is important to inform medical staff of the best ways to reduce the possible risks and the appropriate measures to take when an accident occurs, in order to reduce the frequency or seriousness of an accident; however, it is extremely difficult to completely prevent accidents. Therefore, when needlestick accidents do occur, steps need to be taken to ease the psychological burden and reduce the severity of accidents. Contingency measures for needlestick and related injuries will be introduced in private and mid-sized hospital facilities. This will be accomplished by taking measure against exposure and emergent accidents. Introducing an Infection Committee will change administrative procedures.

  11. Car accidents determined by stopped cars and traffic flow

    Science.gov (United States)

    Yang, Xian-qing; Ma, Yu-qiang

    2002-12-01

    The product of traffic flow and the fraction of stopped cars is proposed to determine the probability Pac for car accidents in the Fukui-Ishibashi model by analysing the necessary conditions of the occurrence of car accidents. Qualitative and quantitative characteristics of the probability Pac can well be explained. A strategy for avoiding car accidents is suggested.

  12. Decision support system for the response to infectious disease emergencies based on WebGIS and mobile services in China.

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    Ya-pin Li

    Full Text Available BACKGROUND: For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. METHODOLOGY/PRINCIPAL FINDINGS: Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE. The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. CONCLUSIONS/SIGNIFICANCE: The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and

  13. Preventable trauma deaths after traffic accidents in Chiba Prefecture, Japan, 2011: problems and solutions.

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    Motomura, Tomokazu; Mashiko, Kunihiro; Matsumoto, Hisashi; Motomura, Ayumi; Iwase, Hirotaro; Oda, Shigeto; Shimamura, Fumihiko; Shoko, Tomohisa; Kitamura, Nobuya; Sakaida, Koji; Fukumoto, Yuichi; Kasuya, Miyuki; Koyama, Tsutomu; Yokota, Hiroyuki

    2014-01-01

    The incidence of preventable trauma death in the current Japanese emergency medical system remains high. The present study aimed to determine rates of clearly preventable and possibly preventable trauma deaths due to traffic accidents in Chiba Prefecture, Japan, and to consider associated problems and solutions. During 2011, 175 victims died after traffic accidents in Chiba Prefecture. Of these, the deaths of 69 persons who had vital signs at the time of emergency medical service contact were classified as clearly preventable, possibly preventable, or not preventable through the peer review discussion. We also examined problems associated with deaths that were clearly preventable or possibly preventable. Of the 69 deaths, 9 (13%) were classified as clearly preventable, 11 (16%) as possibly preventable, and 49 (71%) as not preventable. Of the 20 clearly or possibly preventable deaths (each death potentially comprising multiple problems), 5 were related to selection of the hospital before hospital arrival, 4 to problems with regional emergency medical systems, and 15 to inappropriate hemodynamic management, including transfusion and delayed (or not attempted) hemostasis in the hospital. Problems of these 20 deaths showed that appropriate triage at the scene, centralization of patients with severe trauma, and trauma centers are necessary in Japan. Under-triage before arrival at the hospital was related to clearly and possibly preventable deaths. Upgrading the triage category for victims with torso injury must be considered. Not all emergency critical care centers in Japan are able to provide severe trauma care. Preventable trauma deaths occur even in some emergency critical care centers; therefore, we need centralization of severe trauma patients from wider area to reduce the incidence of preventable trauma death.

  14. Development of a downstream emergency response service for flood and related risks in Romania based on satellite data

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    Stancalie Gheorghe

    2016-01-01

    Full Text Available Recently, the National Meteorological Administration initiated and started to implement user-driven services, based on satellite remote sensing and geo-information capacities. The paper presents this downstream emergency response service whose aim is to provide updated and accurate cartographic information in river flood prevention and post-crisis phase. The service is targeted to develop an interoperable framework for the management of the available geo-information using cutting-edge techniques and satellite data in order to provide high quality and accurate spatial products. An appropriate methodology was developed and tested, in order to process the optical or radar satellite imagery, with medium and high range spatial resolution, to rapid mapping the flood extent, to integrate the information in a GIS environment and finally to obtain standardized, cartographic products. The service is able to provide customized flood geospatial products (updated reference maps for the area affected, near real-time flood delineation maps, maximum flood extent maps, flooded area classification, flood evolution maps, damage assessment maps and reports tailored to specific users and featuring near-real time delivery. A dedicated geo-portal, was developed to display, query, analyse and retrieve the spatial products. The end-users are able to access the system using a simple web browser to view and query the flood related product archive or download the selected products.

  15. The UCLan Engagement and Service User Support (Comensus) project: Valuing authenticity making space for emergence.

    OpenAIRE

    2007-01-01

    Objective  To develop and evaluate service user, carer and community involvement in health and social care education.\\ud \\ud Background  Despite the high policy profile of involvement issues, there appear to be no published accounts of schemes that have used a systematic whole-faculty approach to community engagement in health and social care higher education.\\ud \\ud Focus of this paper  The set up and early development of a faculty-wide community engagement project.\\ud \\ud Setting and partic...

  16. Luminescence properties of common salt (NaCl available in Nigeria for use as accident dosimeter in radiological emergency situation

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    Janet Ayobami Ademola

    2017-04-01

    Full Text Available In the event of a radiological accident or attack, it is important to assess and quantify radiation dose to the population. This could be done using materials in the vicinity that are sensitive to ionizing radiation. Common salt (NaCl is known to be a sensitive thermoluminescence (TL phosphor. Luminescence properties of common salt (NaCl used in Nigeria were investigated using an automated luminescence reader Risø TL/OSL-DA-15, with attention focused more on the Optically Stimulated Luminescence (OSL. Strong radiation-induced TL and OSL signals were observed. The TL peaks occurred at about 100 °C, 240 °C and 280 °C. The dose response of both the TL and OSL signals showed a linear relationship. From the OSL pulse anneal curve with TL curve, a preheat temperature of 190 °C for 10 s was found adequate for the OSL measurements. There was no significant difference in the OSL decay for stimulation temperatures of 100 and 120 °C. Fading experiment over a storage period of 14 days showed about 13 and 3% decrease in the OSL signal of sample 1 and sample 2, respectively. The ratios of measured to given dose for dose recovery test were within ±19% of unity. Within the limit of error the samples could be used as a complementary emergency dosimeter in radiological accident situation.

  17. Acute stroke alert activation, emergency service use, and reperfusion therapy in Sweden.

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    Eriksson, Marie; Glader, Eva-Lotta; Norrving, Bo; Stegmayr, Birgitta; Asplund, Kjell

    2017-04-01

    Ambulance services and stroke alerts reduce the time from stroke onset to acute stroke diagnosis. We describe the use of stroke alerts and ambulance services in different hospitals and patient groups and their relationship with reperfusion therapy. This nationwide study included 49,907 patients admitted with acute stroke who were registered in The Swedish Stroke Register (Riksstroke) in 2011-2012. The proportions of patients admitted as stroke alerts out of all acute stroke admissions varied from 12.2% to 45.7% in university hospitals (n = 9), 0.5% to 38.7% in specialized nonuniversity hospitals (n = 22), and 4.2% to 40.3% in community hospitals (n = 41). Younger age, atrial fibrillation (AF), living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were factors associated with a higher probability of stroke alerts. Living alone, primary school education, non-European origin, previous stroke, diabetes, smoking, and dependency in activities of daily living (ADL) were associated with a lower probability of stroke alert. The proportion of patients arriving at the hospital by ambulance varied from 60.3% to 94.5%. Older age, living alone, primary school education, being born in a European country, previous stroke, AF, dependency in ADL, living in an institution, reduced consciousness upon admission, and hemorrhagic stroke were associated with ambulance services. Hospital stroke alert frequencies correlat