Sample records for casualties

  1. Tsunami Casualty Model (United States)

    Yeh, H.


    More than 4500 deaths by tsunamis were recorded in the decade of 1990. For example, the 1992 Flores Tsunami in Indonesia took away at least 1712 lives, and more than 2182 people were victimized by the 1998 Papua New Guinea Tsunami. Such staggering death toll has been totally overshadowed by the 2004 Indian Ocean Tsunami that claimed more than 220,000 lives. Unlike hurricanes that are often evaluated by economic losses, death count is the primary measure for tsunami hazard. It is partly because tsunamis kill more people owing to its short lead- time for warning. Although exact death tallies are not available for most of the tsunami events, there exist gender and age discriminations in tsunami casualties. Significant gender difference in the victims of the 2004 Indian Ocean Tsunami was attributed to women's social norms and role behavior, as well as cultural bias toward women's inability to swim. Here we develop a rational casualty model based on humans' limit to withstand the tsunami flows. The application to simple tsunami runup cases demonstrates that biological and physiological disadvantages also make a significant difference in casualty rate. It further demonstrates that the gender and age discriminations in casualties become most pronounced when tsunami is marginally strong and the difference tends to diminish as tsunami strength increases.

  2. Marine Casualty and Pollution Data for Researchers (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  3. Methods of Vessel Casualty Process Assessment

    Directory of Open Access Journals (Sweden)

    Jaroslaw Soliwoda


    Full Text Available Maritime casualty is an event of considerable economic and social impact. For this reason, implemented the reporting systems of accidents at sea, and the Administration was obligated to establish a Commission of Maritime Accidents. On the basis of casualty analysis and reports are developed proposals preventing similar casualties in the future. However, there is no uniform evaluation system which check references of existing regulations and recommendations to the occurred casualties. This paper presents a method to evaluate the used methods of casualty prediction with respect to the real incident and catastrophe.

  4. Deterring Mass-Casualty Terrorism (United States)


    om pa ny (T ho m as B ra y) Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting...actions that could create mass casualties or specific types of attack? Should the ob- jective be preventing conflict escala - tion over a determined...E G LO B A L W A R O N T E R R O R IS M Simulated attack, Foggy Shores 02–06. 30 th C om m un ic at io ns S qu ad ro n (J en ni fe r C . W

  5. Managing mass casualties and decontamination. (United States)

    Chilcott, Robert P


    Careful planning and regular exercising of capabilities is the key to implementing an effective response following the release of hazardous materials, although ad hoc changes may be inevitable. Critical actions which require immediate implementation at an incident are evacuation, followed by disrobing (removal of clothes) and decontamination. The latter can be achieved through bespoke response facilities or various interim methods which may utilise water or readily available (dry, absorbent) materials. Following transfer to a safe holding area, each casualty's personal details should be recorded to facilitate a health surveillance programme, should it become apparent that the original contaminant has chronic health effects.

  6. 33 CFR 146.40 - Diving casualties. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Diving casualties. 146.40 Section 146.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related...

  7. Human casualties in earthquakes: modelling and mitigation (United States)

    Spence, R.J.S.; So, E.K.M.


    Earthquake risk modelling is needed for the planning of post-event emergency operations, for the development of insurance schemes, for the planning of mitigation measures in the existing building stock, and for the development of appropriate building regulations; in all of these applications estimates of casualty numbers are essential. But there are many questions about casualty estimation which are still poorly understood. These questions relate to the causes and nature of the injuries and deaths, and the extent to which they can be quantified. This paper looks at the evidence on these questions from recent studies. It then reviews casualty estimation models available, and finally compares the performance of some casualty models in making rapid post-event casualty estimates in recent earthquakes.

  8. 46 CFR 4.03-1 - Marine casualty or accident. (United States)


    ... States vessel wherever such casualty or accident occurs; or (3) With respect to a foreign tank vessel... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1... AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  9. Prescribing of benzodiazepines by casualty officers.



    The prescribing of benzodiazepines by casualty officers in a busy district hospital over a three month period was examined by a retrospective review of case notes. Benzodiazepines, mainly diazepam, were given to 1.1% of attenders, the majority of whom had disorders involving minor muscle spasm. The efficacy of diazepam in these conditions, as well as its potential for dependence, is discussed.

  10. Friendly Combat Casualties and Operational Narratives (United States)


    struggling with maintaining its narrative in the face of a growing insurgency and sectarian violence .55 Throughout the early part of 2004 the situation...Friendly Combat Casualties and Operational Narratives A Monograph by Major Errol G. MacEachern Canadian Army...this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data

  11. The Casualty Network System Capstone Project (United States)


    records information on the casualty’s injuries and the medic’s treatments via voice recognition. As the medic performs his primary survey he speaks into...providers and resources. The CNS has the potential to serve as an impromptu network in HADR settings to match providers, resources and casualties. Given

  12. An Eye Oximeter for Combat Casualty Care (United States)


    81 4 Introduction Exsanguination is the most immediate life threatening danger for the field casualty during wartime. Indeed, 60% of...intramuscular pre- anesthetic ketamine 600 mg and xylazine 100 mg. The swine were placed in the supine position, intubated endotracheally and placed on a...preanesthetic ketamine 600 mg and xylazine 100 mg. The swine were placed Study Protocol. The animal was exsanguinated in the supine position, intubated

  13. NATO Planning Guide for the Estimation of CBRN Casualties (United States)


    Static Overpressure Thresholds for Declaration of KIA Due to Tertiary Nuclear Blast Effects...Casualty The methodology estimates casualties with regard to the medical system, not the personnel system. Thus, it estimates killed in action ( KIA ...Killed in Action ( KIA ): “a battle casualty who was killed outright or who died before reaching a medical treatment facility.”27 By definition, in this

  14. The Casualty Actuarial Society: Helping Universities Train Future Actuaries (United States)

    Boa, J. Michael; Gorvett, Rick


    The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

  15. Public experiences of mass casualty decontamination. (United States)

    Carter, Holly; Drury, John; Rubin, G James; Williams, Richard; Amlôt, Richard


    In this article, we analyze feedback from simulated casualties who took part in field exercises involving mass decontamination, to gain an understanding of how responder communication can affect people's experiences of and compliance with decontamination. We analyzed questionnaire data gathered from 402 volunteers using the framework approach, to provide an insight into the public's experiences of decontamination and how these experiences are shaped by the actions of emergency responders. Factors that affected casualties' experiences of the decontamination process included the need for greater practical information and better communication from responders, and the need for privacy. Results support previous findings from small-scale incidents that involved decontamination in showing that participants wanted better communication from responders during the process of decontamination, including more practical information, and that the failure of responders to communicate effectively with members of the public led to anxiety about the decontamination process. The similarity between the findings from the exercises described in this article and previous research into real incidents involving decontamination suggests that field exercises provide a useful way to examine the effect of responder communication strategies on the public's experiences of decontamination. Future exercises should examine in more detail the effect of various communication strategies on the public's experiences of decontamination. This will facilitate the development of evidence-based communication strategies intended to reduce anxiety about decontamination and increase compliance among members of the public during real-life incidents that involve mass decontamination.

  16. 46 CFR 197.488 - Retention of records after casualty. (United States)


    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  17. Casualties, Public Opinion, and Presidential Policy during the Vietnam War. (United States)


    of his charts, reproduced here as Fig. 6, plotted the rising casualty levels in Korea against the declin- ing public support for the Korean war. Ball...relationship between U.S. casualties and public support for U.S. military int-rvention in Korea and Vietnam, and concludeb that a strong inverse...Contingencies," investigated possible configurations for a firepower projection force to be employed in the defense of Third World allies. One of the

  18. Treatment strategies for mass burn casualties

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHENG Zhi-yong; YANG Hong-ming; HAO Dai-feng; SHEN Chuan-an; JIA Xiao-ming; LI Feng; JING Sa; LI Li-gen; SONG Hui-feng; JIA Chi-yu; TUO Xiao-ye; SUN Tian-jun; HU Quan


    Background Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.Methods Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province,were admitted 48 hours post-injury. All patients were male with a mean age of (22.4±8.7) years. The burn extent ranged from 4% to 75% ((13.6±12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.Results These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver,kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.Conclusions A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of

  19. Medical management of toxicological mass casualty events. (United States)

    Markel, Gal; Krivoy, Amir; Rotman, Eran; Schein, Ophir; Shrot, Shai; Brosh-Nissimov, Tal; Dushnitsky, Tsvika; Eisenkraft, Arik


    The relative accessibility to various chemical agents, including chemical warfare agents and toxic industrial compounds, places a toxicological mass casualty event, including chemical terrorism, among the major threats to homeland security. TMCE represents a medical and logistic challenge with potential hazardous exposure of first-response teams. In addition, TMCE poses substantial psychological and economic impact. We have created a simple response algorithm that provides practical guidelines for participating forces in TMCE. Emphasis is placed on the role of first responders, highlighting the importance of early recognition of the event as a TMCE, informing the command and control centers, and application of appropriate self-protection. The medical identification of the toxidrome is of utmost importance as it may dictate radically different approaches and life-saving modalities. Our proposed emergency management of TMCE values the "Scoop & Run" approach orchestrated by an organized evacuation plan rather than on-site decontamination. Finally, continuous preparedness of health systems - exemplified by periodic CBRN (Chemical, Biological, Radio-Nuclear) medical training of both first responders and hospital staff, mandatory placement of antidotal auto-injectors in all ambulances and CBRN emergency kits in the emergency departments - would considerably improve the emergency medical response to TMCE.

  20. Development of sulfanegen for mass cyanide casualties. (United States)

    Patterson, Steven E; Moeller, Bryant; Nagasawa, Herbert T; Vince, Robert; Crankshaw, Daune L; Briggs, Jacquie; Stutelberg, Michael W; Vinnakota, Chakravarthy V; Logue, Brian A


    Cyanide is a metabolic poison that inhibits the utilization of oxygen to form ATP. The consequences of acute cyanide exposure are severe; exposure results in loss of consciousness, cardiac and respiratory failure, hypoxic brain injury, and dose-dependent death within minutes to hours. In a mass-casualty scenario, such as an industrial accident or terrorist attack, currently available cyanide antidotes would leave many victims untreated in the short time available for successful administration of a medical countermeasure. This restricted therapeutic window reflects the rate-limiting step of intravenous administration, which requires both time and trained medical personnel. Therefore, there is a need for rapidly acting antidotes that can be quickly administered to large numbers of people. To meet this need, our laboratory is developing sulfanegen, a potential antidote for cyanide poisoning with a novel mechanism based on 3-mercaptopyruvate sulfurtransferase (3-MST) for the detoxification of cyanide. Additionally, sulfanegen can be rapidly administered by intramuscular injection and has shown efficacy in many species of animal models. This article summarizes the journey from concept to clinical leads for this promising cyanide antidote.

  1. The Atomic Bomb Casualty Commission in retrospect (United States)

    Putnam, Frank W.


    For 50 years, the Atomic Bomb Casualty Commission (ABCC) and its successor, the Radiation Effects Research Foundation (RERF), have conducted epidemiological and genetic studies of the survivors of the atomic bombs and of their children. This research program has provided the primary basis for radiation health standards. Both ABCC (1947–1975) and RERF (1975 to date) have been a joint enterprise of the United States (through the National Academy of Sciences) and of Japan. ABCC began in devastated, occupied Japan. Its mission had to be defined and refined. Early research revealed the urgent need for long term study. In 1946, a Directive of President Truman enjoined the National Research Council of the National Academy of Sciences to develop the program. By 1950, ABCC staff exceeded 1,000, and clinical and genetic studies were underway. Budgetary difficulties and other problems almost forced closure in 1953. In 1955, the Francis Report led to a unified epidemiological study. Much progress was made in the next decade, but changing times required founding of a binational nonprofit organization (RERF) with equal participation by Japan and the United States. New programs have been developed and existing ones have been extended in what is the longest continuing health survey ever undertaken. PMID:9576898

  2. Decontamination of mass casualties--re-evaluating existing dogma. (United States)

    Levitin, Howard W; Siegelson, Henry J; Dickinson, Stanley; Halpern, Pinchas; Haraguchi, Yoshikura; Nocera, Anthony; Turineck, David


    The events of 11 September 2001 became the catalyst for many to shift their disaster preparedness efforts towards mass-casualty incidents. Emergency responders, healthcare workers, emergency managers, and public health officials worldwide are being tasked to improve their readiness by acquiring equipment, providing training and implementing policy, especially in the area of mass-casualty decontamination. Accomplishing each of these tasks requires good information, which is lacking. Management of the incident scene and the approach to victim care varies throughout the world and is based more on dogma than scientific data. In order to plan effectively for and to manage a chemical, mass-casualty event, we must critically assess the criteria upon which we base our response. This paper reviews current standards surrounding the response to a release of hazardous materials that results in massive numbers of exposed human survivors. In addition, a significant effort is made to prepare an international perspective on this response. Preparations for the 24-hour threat of exposure of a community to hazardous material are a community responsibility for first-responders and the hospital. Preparations for a mass-casualty event related to a terrorist attack are a governmental responsibility. Reshaping response protocols and decontamination needs on the differences between vapor and liquid chemical threats can enable local responders to effectively manage a chemical attack resulting in mass casualties. Ensuring that hospitals have adequate resources and training to mount an effective decontamination response in a rapid manner is essential.

  3. Model uniform core criteria for mass casualty triage. (United States)


    There is a need for model uniform core criteria for mass casualty triage because disasters frequently cross jurisdictional lines and involve responders from multiple agencies who may be using different triage tools. These criteria (Tables 1-4) reflect the available science, but it is acknowledged that there are significant research gaps. When no science was available, decisions were formed by expert consensus derived from the available triage systems. The intent is to ensure that providers at a mass-casualty incident use triage methodologies that incorporate these core principles in an effort to promote interoperability and standardization. At a minimum, each triage system must incorporate the criteria that are listed below. Mass casualty triage systems in use can be modified using these criteria to ensure interoperability. The criteria include general considerations, global sorting, lifesaving interventions, and assignment of triage categories. The criteria apply only to providers who are organizing multiple victims in a discrete geographic location or locations, regardless of the size of the incident. They are classified by whether they were derived through available direct scientific evidence, indirect scientific evidence, expert consensus, and/or are used in multiple existing triage systems. These criteria address only primary triage and do not consider secondary triage. For the purposes of this document the term triage refers to mass-casualty triage and provider refers to any person who assigns primary triage categories to victims of a mass-casualty incident.

  4. Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data

    Directory of Open Access Journals (Sweden)

    Richard Amlôt


    Full Text Available In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS. The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit.

  5. Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

    Energy Technology Data Exchange (ETDEWEB)

    Greenwalt, R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hibbard, W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

  6. The role of cytogenetics in early triage of radiation casualties

    Energy Technology Data Exchange (ETDEWEB)

    Lloyd, D.C. E-mail:; Edwards, A.A.; Moquet, J.E.; Guerrero-Carbajal, Y.C


    Preliminary dose estimates by chromosomal analysis can be made rapidly in order to supplement early triage of radiation casualties based on clinical signs. An in vitro simulation of an accident with many casualties receiving whole or partial body exposure in the range 0-8 Gy is described. Faced with an urgent need for rapid results, confirmation of clinical triage can generally be obtained from scoring 20 metaphases per subject. Scoring should be increased to 50 cells where there is disagreement with the initial assessments or evidence of significantly inhomogeneous exposure.

  7. 26 CFR 1.165-7 - Casualty losses. (United States)


    ... planted trees and ornamental shrubs on the grounds surrounding the building. In 1961 the land, building, trees, and shrubs are damaged by hurricane. At the time of the casualty the adjusted basis of the land is $18,000 and the adjusted basis of the building is $66,000. At that time the trees and shrubs...

  8. 46 CFR 169.807 - Notice of casualty. (United States)


    ... 46 Shipping 7 2010-10-01 2010-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS..., navigation charts, navigation work books, compass deviation cards, gyrocompass records, record of draft,...

  9. Primate bites in Gibraltar--minor casualty quirk? (United States)

    Campbell, A C


    In one year 55 patients presented to the casualty department of St Bernard's Hospital, Gibraltar, with a primate bite. The implications of such wounds on the health of these patients is contrasted with the morbidity and mortality associated with primate bites in the African subcontinent.

  10. Preliminary quantitative assessment of earthquake casualties and damages

    DEFF Research Database (Denmark)

    Badal, J.; Vázquez-Prada, M.; González, Á.;


    Prognostic estimations of the expected number of killed or injured people and about the approximate cost associated with the damages caused by earthquakes are made following a suitable methodology of wide-ranging application. For the preliminary assessment of human life losses due to the occurrence...... of a relatively strong earthquake we use a quantitative model consisting of a correlation between the number of casualties and the earthquake magnitude as a function of population density. The macroseismic intensity field is determined in accordance with an updated anelastic attenuation law, and the number...... the local social wealth as a function of the gross domestic product of the country. This last step is performed on the basis of the relationship of the macroseismic intensity to the earthquake economic loss in percentage of the wealth. Such an approach to the human casualty and damage levels is carried out...

  11. Innovations in the En Route Care of Combat Casualties (United States)


    capability of CCATT, some patients exceed that level of care in the ERC setting, particularly because of lung injuries and inadequate ventilation . To meet...remained in place for 16 days with no complications (Buckenmaier & Bleckner, 2008). One of the primary advantages of preoperative regional anesthesia ...constant innovation to ensure appropriate nursing care for combat casualties. Building on experiences in Iraq and Afghanistan, there have been tremendous

  12. A Predictive Model for Massive Transfusion in Combat Casualty Patients (United States)


    A Predictive Model for Massive Transfusion in Combat Casualty Patients Daniel F . McLaughlin, MD, Sarah E. Niles, MD, MPH, Jose Salinas, PhD, Jeremy G...Silver Springs, Maryland. Address for reprints: Daniel F . McLaughlin, MD, United States Insti- tute of Surgical Research, 3400 Rawley E. Chambers...see that here? Thank you again for an excellent study, which I believe should alter practice for many of us. Dr. Daniel F . McLaughlin (US Army

  13. Strategies for casualty mitigation programs by using advanced tsunami computation (United States)

    IMAI, K.; Imamura, F.


    1. Purpose of the study In this study, based on the scenario of great earthquakes along the Nankai trough, we aim on the estimation of the run up and high accuracy inundation process of tsunami in coastal areas including rivers. Here, using a practical method of tsunami analytical model, and taking into account characteristics of detail topography, land use and climate change in a realistic present and expected future environment, we examined the run up and tsunami inundation process. Using these results we estimated the damage due to tsunami and obtained information for the mitigation of human casualties. Considering the time series from the occurrence of the earthquake and the risk of tsunami damage, in order to mitigate casualties we provide contents of disaster risk information displayed in a tsunami hazard and risk map. 2. Creating a tsunami hazard and risk map From the analytical and practical tsunami model (a long wave approximated model) and the high resolution topography (5 m) including detailed data of shoreline, rivers, building and houses, we present a advanced analysis of tsunami inundation considering the land use. Based on the results of tsunami inundation and its analysis; it is possible to draw a tsunami hazard and risk map with information of human casualty, building damage estimation, drift of vehicles, etc. 3. Contents of disaster prevention information To improve the hazard, risk and evacuation information distribution, it is necessary to follow three steps. (1) Provide basic information such as tsunami attack info, areas and routes for evacuation and location of tsunami evacuation facilities. (2) Provide as additional information the time when inundation starts, the actual results of inundation, location of facilities with hazard materials, presence or absence of public facilities and areas underground that required evacuation. (3) Provide information to support disaster response such as infrastructure and traffic network damage prediction

  14. Portable ultrasonography in mass casualty incidents: The CAVEAT examination


    Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; David P. Bahner; Whitmill, Melissa L; Dean, Anthony J


    Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently est...

  15. Wireless Vital Sign Sensor Network Simulations for Mass Casualty Response (United States)


    Casualty, Network Simulation 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: Unclassified 18. NUMBER OF PAGES 19 19a. NAME OF... security takes priority over medical treatment of the wounded, so it assumed that only two responders are available to provide medical care ZigBee products. Since ZigBee software stacks are widely available and since a standard exists for ZigBee use in healthcare, it is a very

  16. CORTIM Project: Medical Regulation Concept Designed for Forward Field Casualty Management Based on an Information System (United States)


    CORTIM, and the quality of casualty handling by the SAMU (the French Mobile Emergency Medical Service) for the RMT concept. We consider that...of crisis situations in the case of CORTIM, and the quality of casualty handling by the SAMU (the French Mobile Emergency Medical Service) for the... SAMU for the RMT concept. We consider that operational casualty management can be enhanced in at least three areas. The first concerns improvements in

  17. A mass casualty incident involving children and chemical decontamination. (United States)

    Timm, Nathan; Reeves, Scott


    Mass casualty incidents involving contaminated children are a rare but ever-present possibility. In this article we outline one such event that resulted in 53 pediatric patients and 3 adults presenting to the emergency department of a children's hospital for decontamination and treatment. We pay special attention to the training that allowed this responses to occur. We also outline the institutional response with emphasis on incident command, communication, and resource utilization. Specific lessons learned are explored in detail. Finally, we set forth a series of recommendations to assist other institutions should they be called upon to care for and decontaminate pediatric patients.

  18. Drone Strikes in Pakistan: Reasons to Assess Civilian Casualties (United States)


    photo: An MQ-9 Reaper, armed with GB U-12 Paveway II laser guided munitions and AGM-114 Hellfire missiles, piloted by Col. Lex Turner flies a combat...campaign. v \\Te observe that drone strikes in Pakistan were more likely to cause civilian casualties on av- erage than drone stiikes by military forces in...T11e Times (London) ,July 26, 2012. V \\!hilc not accomplished with a drone strike, that raid represents one end of a spectnnn with regard to trading

  19. 33 CFR 150.825 - Reporting a diving-related casualty. (United States)


    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Reporting a diving-related casualty. 150.825 Section 150.825 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Reporting a diving-related casualty. Deaths and injuries related to diving within the safety zone of...

  20. On the Temporal Distribution of Casualties and Determination of Medical Logistical Requirements

    CERN Document Server

    Lauren, Michael Kyle


    It is demonstrated that World War II casualty data display statistical structure that would be expected from multifractal data. Given that the data displayed these properties, it is shown how the existence of power-law tails in the exceedence probability distributions can be used to estimate the likelihood of various casualty levels. Estimates made using this method matched the historical data well.

  1. 77 FR 8956 - Surety Companies Acceptable on Federal Bonds: Grange Mutual Casualty Company (United States)


    ... Supplement No. 7 to the Treasury Department Circular 570, 2011 Revision, published July 1, 2011, at 76 FR... Fiscal Service Surety Companies Acceptable on Federal Bonds: Grange Mutual Casualty Company AGENCY.... 9305 to the following company: Grange Mutual Casualty Company (NAIC 14060). Business Address: 671...

  2. Comparative analysis of showering protocols for mass-casualty decontamination. (United States)

    Amlot, Richard; Larner, Joanne; Matar, Hazem; Jones, David R; Carter, Holly; Turner, Elizabeth A; Price, Shirley C; Chilcott, Robert P


    A well-established provision for mass-casualty decontamination that incorporates the use of mobile showering units has been developed in the UK. The effectiveness of such decontamination procedures will be critical in minimizing or preventing the contamination of emergency responders and hospital infrastructure. The purpose of this study was to evaluate three empirical strategies designed to optimize existing decontamination procedures: (1) instructions in the form of a pictorial aid prior to decontamination; (2) provision of a washcloth within the showering facility; and (3) an extended showering period. The study was a three-factor, between-participants (or "independent") design with 90 volunteers. The three factors each had two levels: use of washcloths (washcloth/no washcloth), washing instructions (instructions/no instructions), and shower cycle duration (three minutes/six minutes). The effectiveness of these strategies was quantified by whole-body fluorescence imaging following application of a red fluorophore to multiple, discrete areas of the skin. All five showering procedures were relatively effective in removing the fluorophore "contaminant", but the use of a cloth (in the absence of instructions) led to a significant ( appox. 20%) improvement in the effectiveness of decontamination over the standard protocol (p mass-casualty decontamination effectiveness, especially in children, can be optimized by the provision of a washcloth. This simple but effective approach indicates the value of performing controlled volunteer trials for optimizing existing decontamination procedures.

  3. A Casualty in the Class War: Canada's Medicare. (United States)

    Evans, Robert G


    "There's class warfare, all right, but it's my class, the rich class, that's making war, and we're winning." (Warren Buffett, five years ago.) Last year's Occupy Wall Street movement suggested that people are finally catching on. Note, making war: Buffett meant that there was deliberate intent and agency behind the huge transfer of wealth, since 1980, from the 99% to the 1%. Nor is the war metaphorical. There are real casualties, even if no body bags. Sadly, much Canadian commentary on inequality is pitiably naïve or deliberately obfuscatory. The 1% have captured national governments. The astronomical cost of American elections excludes the 99%. In Canada, parliamentary government permits one man to rule as a de facto dictator. The 1% don't like medicare.

  4. Mass Casualty Incident Primary Triage Methods in China

    Institute of Scientific and Technical Information of China (English)

    Jin-Hong Chen; Jun Yang; Yu Yang; Jing-Chen Zheng


    Objective:To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China.Data Sources:Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014).The English literature was searched by PubMed (MEDLINE) (1950 to June 2014).We also searched Official Websites of Chinese Central Government's (,National Health and Family Planning Commission of China (,and China Earthquake Information ( Selection:We included studies associated with mass casualty events related to China,the PT applied in China,guidelines and standards,and application and development of the carding PT method in China.Results:From 3976 potentially relevant articles,22 met the inclusion criteria,20 Chinese,and 2 English.These articles included 13 case reports,3 retrospective analyses of MCI,two methods introductions,three national or sectoral criteria,and one simulated field testing and validation.There were a total of 19 kinds ofMCI PT methods that have been reported in China from 1950 to 2014.In addition,there were 15 kinds of PT methods reported in the literature from the instance of the application.Conclusions:The national and sectoral current triage criteria are developed mainly for earthquake relief.Classification is not clear.Vague criteria (especially between moderate and severe injuries) operability are not practical.There are no triage methods and research for children and special populations.There is no data and evidence supported triage method.We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real,practical,and efficient PT method.

  5. Defense Health: Actions Needed to Help Ensure Combat Casualty Care Research Achieves Goals (United States)


    Department of Health and Human Services JPC -6 Joint Program Committee for Combat Casualty Care MRMC Army Medical Research and...and development.) Note: The JPC -6 includes representatives from each military service (Army, Navy, Air Force, and Marine Corps) and is, which is managed by the Joint Program Committee for Combat Casualty Care ( JPC -6). The JPC -6 includes representatives from the DOD biomedical

  6. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident. (United States)

    Monteith, Raymond G; Pearce, Laurie D R


    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.

  7. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice. (United States)

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Amlôt, Richard; Larner, Joanne; Matar, Hazem; Chilcott, Robert P


    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination.

  8. RFID based patient registration in mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Nestler, Simon


    Full Text Available In MCIs (mass casualty incidents the EMC (emergency medical chief has to gain an overview on all patients at the scene. When using paper based patient tags the patient-related information remains at the patients themselves and the information relay is complex. We propose a mobile, RFID based solution, which makes the local patient-related information available to all relief workers at the scene. As a consequence all processes in an MCI are more transparent and the resulting medication and transport of the injured is more efficient. The introduction of RFID enhanced patient tags leads to various usability challenges which are discussed in this paper. Furthermore, three different implementations show, how these challenges can be solved in the future. These solutions have been evaluated in a disaster control exercise in order to get an impression of the practical suitability of the proposed solutions. The future introduction of RFID tags in rescue and emergency services can be based on this work.

  9. Infrared imaging-based combat casualty care system (United States)

    Davidson, James E., Sr.


    A Small Business Innovative Research (SBIR) contract was recently awarded to a start up company for the development of an infrared (IR) image based combat casualty care system. The company, Medical Thermal Diagnostics, or MTD, is developing a light weight, hands free, energy efficient uncooled IR imaging system based upon a Texas Instruments design which will allow emergency medical treatment of wounded soldiers in complete darkness without any type of light enhancement equipment. The principal investigator for this effort, Dr. Gene Luther, DVM, Ph.D., Professor Emeritus, LSU School of Veterinary Medicine, will conduct the development and testing of this system with support from Thermalscan, Inc., a nondestructive testing company experienced in IR thermography applications. Initial research has been done with surgery on a cat for feasibility of the concept as well as forensic research on pigs as a close representation of human physiology to determine time of death. Further such studies will be done later as well as trauma studies. IR images of trauma injuries will be acquired by imaging emergency room patients to create an archive of emergency medical situations seen with an infrared imaging camera. This archived data will then be used to develop training material for medical personnel using the system. This system has potential beyond military applications. Firefighters and emergency medical technicians could directly benefit from the capability to triage and administer medical care to trauma victims in low or no light conditions.

  10. Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica

    Directory of Open Access Journals (Sweden)

    Mills, Christopher N


    Full Text Available Antarctica is one of the most remote regions on Earth. Mass casualty incident (MCI responses in Antarctica are prone to complications from multiple environmental and operational challenges. This review of the current status of MCI risks and response strategies for Antarctica focuses on aeromedical evacuation, a critical component of many possible MCI scenarios. Extreme cold and weather, a lack of medical resources and a multitude of disparate international bases all exert unique demands on MCI response planning. Increasing cruise ship traffic is also escalating the risk of MCI occurrence. To be successful, MCI response must be well coordinated and undertaken by trained rescuers, especially in the setting of Antarctica. Helicopter rescue or aeromedical evacuation of victims to off-continent facilities may be necessary. Currently, military forces have the greatest capacity for mass air evacuation. Specific risks that are likely to occur include structure collapses, vehicle incapacitations, vehicle crashes and fires. All of these events pose concomitant risks of hypothermia among both victims and rescuers. Antarctica’s unique environment requires flexible yet robust MCI response planning among the many entities in operation on the continent. [West J Emerg Med. 2011;12(1:37-42.

  11. Benefits of multidisciplinary collaboration for earthquake casualty estimation models: recent case studies (United States)

    So, E.


    Earthquake casualty loss estimation, which depends primarily on building-specific casualty rates, has long suffered from a lack of cross-disciplinary collaboration in post-earthquake data gathering. An increase in our understanding of what contributes to casualties in earthquakes involve coordinated data-gathering efforts amongst disciplines; these are essential for improved global casualty estimation models. It is evident from examining past casualty loss models and reviewing field data collected from recent events, that generalized casualty rates cannot be applied globally for different building types, even within individual countries. For a particular structure type, regional and topographic building design effects, combined with variable material and workmanship quality all contribute to this multi-variant outcome. In addition, social factors affect building-specific casualty rates, including social status and education levels, and human behaviors in general, in that they modify egress and survivability rates. Without considering complex physical pathways, loss models purely based on historic casualty data, or even worse, rates derived from other countries, will be of very limited value. What’s more, as the world’s population, housing stock, and living and cultural environments change, methods of loss modeling must accommodate these variables, especially when considering casualties. To truly take advantage of observed earthquake losses, not only do damage surveys need better coordination of international and national reconnaissance teams, but these teams must integrate difference areas of expertise including engineering, public health and medicine. Research is needed to find methods to achieve consistent and practical ways of collecting and modeling casualties in earthquakes. International collaboration will also be necessary to transfer such expertise and resources to the communities in the cities which most need it. Coupling the theories and findings from

  12. Mass Casualty Decontamination in a Chemical or Radiological/ Nuclear Incident: Further Guiding Principles (United States)

    Carter, Holly; Amlôt, Richard; Williams, Richard; Rubin, G. James; Drury, John


    This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties' needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al. (2016). In this short report, we summarise the available evidence around likely public behaviour during mass decontamination, effective communication strategies, and potential issues resulting from a lack of privacy. Our intention is to help further focus the research needs in this area and highlight topics on which more research is needed.

  13. The effect of an out-of-hours reform on attendance at casualty wards. The Danish example

    DEFF Research Database (Denmark)

    Vedsted, Peter; Christensen, Morten Bondo


    in the attendance rate with casualty wards after the reform was statistically insignificant. CONCLUSIONS: The decrease in the total number of contacts with the out-of-hours primary health care after the reform was not met by a corresponding increase in casualty ward contacts. A clear-cut significant increase...

  14. Development and organization for casualty management on a 1,000-bed hospital ship in the Persian Gulf. (United States)

    Ochsner, M G; Harviel, J D; Stafford, P W; Blankenship, C; Bosse, M J; Timberlake, G A; McSwain, N E


    A 1,000-bed hospital ship designed for trauma patients was deployed to the Middle East with the objectives of preparing for large numbers of casualties resulting from Operation Desert Storm from conventional, chemical, and biological weapons. Plans for receipt and decontamination of casualties, triage, and optimal utilization of the 1,000-bed facility were developed. Mass casualty drills were conducted, involving all aspects of patient care from the flight deck to the wards. Trauma and critical care registries were developed to collect casualty data that could then be analyzed for specific military purposes and compared with current civilian registries. Attempts were made to identify the advances in shock resuscitation, systems management, and operative treatment from the civilian community that could be applied to care of combat casualties. Difficulties with accomplishing these objectives included limited trauma experience and supplies and poorly defined medical regulating and evacuation policies. The development of these programs, as well as the unique difficulties encountered, are discussed.

  15. Timing and Location of Blood Product Transfusion and Outcomes in Massively Transfused Combat Casualties (United States)


    blood components in a 1:1:1 ratio of platelets:fresh frozen plasma:red blood cells (RBCs) is based on analyses of massive transfusion (MT, Q10 RBC units in 24 hours). These 24-hour analyses are weakened by survival bias and do not describe the timing and location of transfusions. Mortality outcomes associated with early (first 6 hours) resuscitation incorporating platelets, for combat casualties requiring MT, have not been reported. METHODS: We analyzed records for 8,618 casualties treated at the United States military hospital in Baghdad, Iraq, between January 2004 and

  16. Derivation of Candidates for the Combat Casualty Critical Care (C4) Database (United States)


    MILITARY MEDICINE, 179, 4:370, 2014 Derivation of Candidates for the Combat Casualty Critical Care (C4) Database Maj Ian J. Stewart, USAF MC*; Col...Trauma Nurs 2008; 15: 181–4. 13. Hunt JP, Cherr GS, Hunter C, et al: Accuracy of administrative data in trauma: splenic injuries as an example. J

  17. 27 CFR 25.282 - Beer lost by fire, theft, casualty, or act of God. (United States)


    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Beer lost by fire, theft... TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Refund or Adjustment of Tax or Relief From Liability § 25.282 Beer lost by fire, theft, casualty, or act of God. (a) General. The tax paid...

  18. Combat Casualties Undergoing Lifesaving Interventions Have Decreased Heart Rate Complexity at Multiple Time Scales (United States)


    and cardioversion. 2.2. Data acquisition and analysis Upon admission to the ED, casualties were placed on a PIC 50 vital signs monitor (Welch...patient data Variable Age (y) Sex (male) Blunt or explosive mechanism HR (beats/ min) SAP (mm Hg) GCSIOtal GCSmo10r LSI (n = 12) 23 ± 15

  19. 77 FR 75263 - Surety Companies Acceptable on Federal Bonds: Termination; ULLICO Casualty Company (United States)


    ... Supplement No. 3 to the Treasury Department Circular 570; 2012 Revision, published July 2, 2012, at 77 FR... Fiscal Service Surety Companies Acceptable on Federal Bonds: Termination; ULLICO Casualty Company AGENCY... Company (NAIC 37893) under 31 U.S.C. 9305 to qualify as an acceptable surety on Federal bonds...

  20. Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma (United States)


    and en Route Care of Combat Casualties in a Swine Polytrauma PRINCIPAL INVESTIGATOR: Richard McCarron, PhD CONTRACTING ORGANIZATION: Henry M...Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma Award Number: W81XWH-13-2-0022, 3rd Annual Report JAN2016 3...models of neurotrauma and polytrauma . We plan to investigate the effects of aero-medical evacuation on neurophysiology and lung function in swine

  1. Provenancing of unidentified World War II casualties: Application of strontium and oxygen isotope analysis in tooth enamel. (United States)

    Font, Laura; Jonker, Geert; van Aalderen, Patric A; Schiltmans, Els F; Davies, Gareth R


    In 2010 and 2012 two sets of unidentified human remains of two World War II soldiers were recovered in the area where the 1944-1945 Kapelsche Veer bridgehead battle took place in The Netherlands. Soldiers of four Allied nations: British Royal Marine Commandos, Free Norwegian Commandos, Free Poles and Canadians, fought against the German Army in this battle. The identification of these two casualties could not be achieved using dental record information of DNA analysis. The dental records of Missing in Action soldiers of the Allied nations did not match with the dental records of the two casualties. A DNA profile was determined for the casualty found in 2010, but no match was found. Due to the lack of information on the identification of the casualties provided by routine methods, an isotope study was conducted in teeth from the soldiers to constrain their provenance. The isotope study concluded that the tooth enamel isotope composition for both casualties matched with an origin from the United Kingdom. For one of the casualties a probable origin from the United Kingdom was confirmed, after the isotope study was conducted, by the recognition of a characteristic belt buckle derived from a Royal Marine money belt, only issued to British Royal Marines, found with the remains of the soldier.

  2. Decontamination of multiple casualties who are chemically contaminated: a challenge for acute hospitals. (United States)

    Clarke, Simon F J; Chilcott, Rob P; Wilson, James C; Kamanyire, Robie; Baker, David J; Hallett, Anthony


    Patients who have been contaminated by chemical compounds present a number of difficulties to emergency departments, in particular, the risk of secondary contamination of healthcare staff and facilities. The Department of Health in the United Kingdom has provided equipment to decontaminate chemically contaminated casualties who present at emergency departments. The capacity of this equipment is limited, and although both the ambulance and fire services have equipment to cope with mass casualties at the scene of a chemical incident, there is still the possibility that acute hospitals will be overwhelmed by large numbers of self-presenting patients. The risks and potential consequences of this gap in resilience are discussed and a number of possible practical solutions are proposed.

  3. Frequency and Relevance of Acute Peritraumatic Pulmonary Thrombus Diagnosed by Computed Tomographic Imaging in Combat Casualties (United States)


    determine the prevalence of and risk factors for the diagnosis of APPT in casualties admitted to Bastion Hospital, Afghanistan. APPT imaging characteristics...were collected, and demographics, injury severity and mechanism, and risk factors were included in the analysis. Logistic regression was used to...segmental, and 15% (n = 10) were subsegmental. Forty-seven percent (n = 31) had bilateral APPT. Logistic regression found presence of deep venous thrombosis

  4. Effect of Hospital Staff Surge Capacity on Preparedness for a Conventional Mass Casualty Event

    Directory of Open Access Journals (Sweden)

    Welzel, Tyson B MD


    Full Text Available OBJECTIVES: To assess current medical staffing levels within the Hospital Referral System in the City of Cape Town Metropolitan Municipality, South Africa, and analyze the surge capacity needs to prepare for the potential of a conventional mass casualty incident during a planned mass gathering.METHODS: Query of all available medical databases of both state employees and private medical personnel within the greater Cape Town area to determine current staffing levels and distribution of personnel across public and private domains. Analysis of the adequacy of available staff to manage a mass casualty incident.RESULTS: There are 594 advanced pre-hospital personnel in Cape Town (17/100,000 population and 142 basic pre-hospital personnel (4.6/100,000. The total number of hospital and clinic-based medical practitioners is 3097 (88.6/100,000, consisting of 1914 general physicians; 54.7/100,000 and 1183 specialist physicians; 33.8/100,000. Vacancy rates for all medical practitioners range from 23.5% to 25.5%. This includes: nursing post vacancies (26%, basic emergency care practitioners (39.3%, advanced emergency care personnel (66.8%, pharmacy assistants (42.6%, and pharmacists (33.1%.CONCLUSION: There are sufficient numbers and types of personnel to provide the expected ordinary healthcare needs at mass gathering sites in Cape Town; however, qualified staff are likely insufficient to manage a concurrent mass casualty event. Considering that adequate correctly skilled and trained staff form the backbone of disaster surge capacity, it appears that Cape Town is currently under resourced to manage a mass casualty event. With the increasing size and frequency of mass gathering events worldwide, adequate disaster surge capacity is an issue of global relevance. [West J Emerg Med. 2010; 11(2:189-196.

  5. Review of On-Scene Management of Mass-Casualty Attacks

    Directory of Open Access Journals (Sweden)

    Annelie Holgersson


    Full Text Available Background: The scene of a mass-casualty attack (MCA entails a crime scene, a hazardous space, and a great number of people needing medical assistance. Public transportation has been the target of such attacks and involves a high probability of generating mass casualties. The review aimed to investigate challenges for on-scene responses to MCAs and suggestions made to counter these challenges, with special attention given to attacks on public transportation and associated terminals. Methods: Articles were found through PubMed and Scopus, “relevant articles” as defined by the databases, and a manual search of references. Inclusion criteria were that the article referred to attack(s and/or a public transportation-related incident and issues concerning formal on-scene response. An appraisal of the articles’ scientific quality was conducted based on an evidence hierarchy model developed for the study. Results: One hundred and five articles were reviewed. Challenges for command and coordination on scene included establishing leadership, inter-agency collaboration, multiple incident sites, and logistics. Safety issues entailed knowledge and use of personal protective equipment, risk awareness and expectations, cordons, dynamic risk assessment, defensive versus offensive approaches, and joining forces. Communication concerns were equipment shortfalls, dialoguing, and providing information. Assessment problems were scene layout and interpreting environmental indicators as well as understanding setting-driven needs for specialist skills and resources. Triage and treatment difficulties included differing triage systems, directing casualties, uncommon injuries, field hospitals, level of care, providing psychological and pediatric care. Transportation hardships included scene access, distance to hospitals, and distribution of casualties. Conclusion: Commonly encountered challenges during unintentional incidents were added to during MCAs, implying

  6. The Impacts of Air Temperature on Accidental Casualties in Beijing, China (United States)

    Ma, Pan; Wang, Shigong; Fan, Xingang; Li, Tanshi


    Emergency room (ER) visits for accidental casualties, according to the International Classification of Deceases 10th Revision Chapters 19 and 20, include injury, poisoning, and external causes (IPEC). Annual distribution of 187,008 ER visits that took place between 2009 and 2011 in Beijing, China displayed regularity rather than random characteristics. The annual cycle from the Fourier series fitting of the number of ER visits was found to explain 63.2% of its total variance. In this study, the possible effect and regulation of meteorological conditions on these ER visits are investigated through the use of correlation analysis, as well as statistical modeling by using the Distributed Lag Non-linear Model and Generalized Additive Model. Correlation analysis indicated that meteorological variables that positively correlated with temperature have a positive relationship with the number of ER visits, and vice versa. The temperature metrics of maximum, minimum, and mean temperatures were found to have similar overall impacts, including both the direct impact on human mental/physical conditions and indirect impact on human behavior. The lag analysis indicated that the overall impacts of temperatures higher than the 50th percentile on ER visits occur immediately, whereas low temperatures show protective effects in the first few days. Accidental casualties happen more frequently on warm days when the mean temperature is higher than 14 °C than on cold days. Mean temperatures of around 26 °C result in the greatest possibility of ER visits for accidental casualties. In addition, males were found to face a higher risk of accidental casualties than females at high temperatures. Therefore, the IPEC-classified ER visits are not pure accidents; instead, they are associated closely with meteorological conditions, especially temperature. PMID:27827842

  7. The Impacts of Air Temperature on Accidental Casualties in Beijing, China

    Directory of Open Access Journals (Sweden)

    Pan Ma


    Full Text Available Emergency room (ER visits for accidental casualties, according to the International Classification of Deceases 10th Revision Chapters 19 and 20, include injury, poisoning, and external causes (IPEC. Annual distribution of 187,008 ER visits that took place between 2009 and 2011 in Beijing, China displayed regularity rather than random characteristics. The annual cycle from the Fourier series fitting of the number of ER visits was found to explain 63.2% of its total variance. In this study, the possible effect and regulation of meteorological conditions on these ER visits are investigated through the use of correlation analysis, as well as statistical modeling by using the Distributed Lag Non-linear Model and Generalized Additive Model. Correlation analysis indicated that meteorological variables that positively correlated with temperature have a positive relationship with the number of ER visits, and vice versa. The temperature metrics of maximum, minimum, and mean temperatures were found to have similar overall impacts, including both the direct impact on human mental/physical conditions and indirect impact on human behavior. The lag analysis indicated that the overall impacts of temperatures higher than the 50th percentile on ER visits occur immediately, whereas low temperatures show protective effects in the first few days. Accidental casualties happen more frequently on warm days when the mean temperature is higher than 14 °C than on cold days. Mean temperatures of around 26 °C result in the greatest possibility of ER visits for accidental casualties. In addition, males were found to face a higher risk of accidental casualties than females at high temperatures. Therefore, the IPEC-classified ER visits are not pure accidents; instead, they are associated closely with meteorological conditions, especially temperature.

  8. The Impact of 10 Years of War on Combat Casualty Care Research: A Citation Analysis (United States)


    METHODS The Thompson Reuters Web of Science was queried in October 2011 for articles published between 2001 and 2011, the first 10 years of the current...within Web of Science , we limited the selected articles to those within the fol- lowing subject areas of highest relevance to combat casualty care...accessed using the Web of Science database to obtain information about the number of article citations. A final review of the top 50 most frequently

  9. Investigating the Relationship Between Drone Warfare and Civilian Casualties in Gaza

    Directory of Open Access Journals (Sweden)

    Dr. Ann Rogers


    Full Text Available Unmanned aerial vehicles (UAVs, better known as drones, are increasingly touted as ‘humanitarian’ weapons that contribute positively to fighting just wars and saving innocent lives. At the same time, civilian casualties have become the most visible and criticized aspect of drone warfare. It is argued here that drones contribute to civilian casualties not in spite of, but because of, their unique attributes. They greatly extend war across time and space, pulling more potential threats and targets into play over long periods, and because they are low-risk and highly accurate, they are more likely to be used. The assumption that drones save lives obscures a new turn in strategic thinking that sees states such as Israel and the US rely on large numbers of small, highly discriminating attacks applied over time to achieve their objectives. This examination of Israel’s 2014 war in Gaza argues that civilian casualties are not an unexpected or unintended consequence of drone warfare, but an entirely predictable outcome.

  10. Operationalizing Civilian Protection in Mali: The Case for a Civilian Casualty Tracking, Analysis, and Response Cell

    Directory of Open Access Journals (Sweden)

    Marla B. Keenan


    Full Text Available This practice note details an emerging best practice of civilian harm mitigation in armed conflict: namely, the creation of civilian casualty tracking, analysis and response processes by a warring party or peace operation force. It asserts that in Iraq, Afghanistan and soon Somalia, these processes to better understand civilian harm and address consequences have positively shaped mission tactics, training, and overall operations. In both Iraq and Afghanistan, tracking and analysis has lead to a marked decrease in civilian casualties and facilitated the making of amends for any civilian losses. The paper argues that for warring parties to achieve their mission—particularly one with a protection of civilians mandate as with the United Nations Multidimensional Integrated Stabilization Mission in Mali (MINUSMA—they must fully understand the impact of their actions on the civilian population, positive or negative. For this reason, a Civilian Casualty Tracking, Analysis, and Response Cell should be created for MINUSMA to improve its ability mitigate risk to civilians as required by its Security Council mandate.

  11. [NATO international advanced course on best way of training for mass casualty situations]. (United States)

    Klein, L; Michaelson, M


    NATO Advanced Training Course on Best Way of Training for Mass Casualty Situations was held in Haifa, Israel in November 16-18, 2009. In total, 22 participants from 8 countries of the Partnership for Peace and Mediterranean Dialogue Programmes attended the course. The participants, divided within three groups, discussed and practised the training methods for the preshospital aspect, the hospital aspect and the non-conventional aspect of the mass casualty management. An international team of experts, among others, used following teaching methods: general lectures, guided discussions, utilization of advanced multimedia tools, tabletop drills, and large scale drill as training tools. The trainees also learned about medical and clinical simulation as a training tool, and subsequently practiced it. A mass casualty drill was held in Rambam Health Care Campus at the end of the Course. The trainees of the course participated as observers and reviewers in the drill, and debriefed it together with Rambam medical staff. Realisation of the successful course was made possible by utilizing a grant of the NATO Science for Peace and Security Programme.

  12. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study

    Directory of Open Access Journals (Sweden)

    Boonthep Nuttapong


    Full Text Available Abstract Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS regarding Thai military personnel injured in the mass casualty incident (MCI April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%. These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%. A total of 18 patients (11.7% had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS. However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04, abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P P P Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future.

  13. Research approaches to mass casualty incidents response:development from routine perspectives to complexity science

    Institute of Scientific and Technical Information of China (English)

    Shen Weifeng; Jiang Libing; Zhang Mao; Ma Yuefeng; Jiang Guanyu; He Xiaojun


    Objective To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system,computational experiments and parallel execution (ACP) method.Data sources We searched PubMed,Web of Knowledge,China Wanfang and China Biology Medicine (CBM) databases for relevant studies.Searches were performed without year or language restrictions and used the combinations of the following key words:“mass casualty incident”,“MCI”,“research method”,“complexity science”,“ACP”,“approach”,“science”,“model”,“system” and “response”.Study selection Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled.Results Research methods of MCI have increased markedly over the past few decades.For now,dominating research methods of MCI are theory-based approach,empirical approach,evidence-based science,mathematical modeling and computer simulation,simulation experiment,experimental methods,scenario approach and complexity science.Conclusions This article provides an overview of the development of research methodology for MCI.The progresses of routine research approaches and complexity science are briefly presented in this paper.Furthermore,the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems.And the only feasible alternative is complexity science.Finally,this summary is followed by a review that ACP method combining artificial systems,computational experiments and parallel execution provides a new idea to address researches for complex MCI.

  14. Sociological Features of the Casualties from the 1996 Ms 7. 0 Lijiang Earthquake, Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    Li Yongqiang; Yang Jieying; Yang Dongsheng


    A statistics analysis was conducted on the basic information about fatalities from the Lijiang Ms 7.0 earthquake in 1996. The factors include age, gender, educational background, occupation, cause of death, death place, etc. We found that even though deaths caused by the Lijiang earthquake had some common features with those from earthquakes in other places in China, it also showed some specific features because of the multiracial and economically-underdeveloped situation of Lijiang area. The results reached in the paper can serve as a reference for studying the features of casualties caused by future strong earthquakes in Yunnan, and for the delicate and human-oriented emergency treatment.

  15. On constant alert: lessons to be learned from Israel's emergency response to mass-casualty terrorism incidents. (United States)

    Adini, Bruria; Peleg, Kobi


    In its short modern history, Israel has had to contend with numerous mass-casualty incidents caused by terrorism. As a result, it has developed practical national preparedness policies for responding to such events. Israel's Supreme Health Authority, a committee of the Ministry of Health, coordinates emergency management nationwide. All emergency personnel, health care providers, and medical facilities operate under national policies designed to ensure a swift and coordinated response to any incident, based on an "all hazards" approach that emphasizes core elements commonly encountered in mass-casualty incidents. Israel's emergency management system includes contingency planning, command and control, centrally coordinated response, cooperation, and capacity building. Although every nation is unique, many of the lessons that Israel has learned may be broadly applicable to preparation for mass-casualty incidents in the United States and other countries.

  16. The Vulnerability of People to Landslides: A Case Study on the Relationship between the Casualties and Volume of Landslides in China. (United States)

    Lin, Qigen; Wang, Ying; Liu, Tianxue; Zhu, Yingqi; Sui, Qi


    The lack of a detailed landslide inventory makes research on the vulnerability of people to landslides highly limited. In this paper, the authors collect information on the landslides that have caused casualties in China, and established the Landslides Casualties Inventory of China. 100 landslide cases from 2003 to 2012 were utilized to develop an empirical relationship between the volume of a landslide event and the casualties caused by the occurrence of the event. The error bars were used to describe the uncertainty of casualties resulting from landslides and to establish a threshold curve of casualties caused by landslides in China. The threshold curve was then applied to the landslide cases occurred in 2013 and 2014. The validation results show that the estimated casualties of the threshold curve were in good agreement with the real casualties with a small deviation. Therefore, the threshold curve can be used for estimating potential casualties and landslide vulnerability, which is meaningful for emergency rescue operations after landslides occurred and for risk assessment research.

  17. Comparison of Acinetobacter baumannii isolates from the United Kingdom and the United States that were associated with repatriated casualties of the Iraq conflict. (United States)

    Turton, Jane F; Kaufmann, Mary E; Gill, Martin J; Pike, Rachel; Scott, Paul T; Fishbain, Joel; Craft, David; Deye, Gregory; Riddell, Scott; Lindler, Luther E; Pitt, Tyrone L


    Acinetobacter isolates associated with casualties from the Iraq conflict from the United States were compared with those from the United Kingdom by pulsed-field gel electrophoresis and integron analysis. Representatives of the main outbreak strain associated with casualties from both countries were indistinguishable in DNA profile. Two further outbreak strains were common to both sets of isolates.

  18. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project. (United States)

    Baker, David J; Murray, Virginia S G; Carli, Pierre A


    The European Union (EU) Mass Casualties and Health (MASH) project that ran between 2008 and 2010 was designed to study the management of mass casualties from chemical and radiological releases and associated health implications. One area of study for this project concerned arrangements within EU Member States for the management of mass casualties following a chemical release. This was undertaken via a confidential online questionnaire that was sent to selected points of contact throughout the EU. Responses were obtained from 18 states from respondents holding senior positions in chemical planning and incident response. Information gathered shows a lack of uniformity within the EU about the organization of responses to chemical releases and the provision of medical care. This article presents the overall findings of the study demonstrating differences between countries on planning and organization, decontamination, prehospital emergency medical responses, clinical diagnoses, and therapy and aftercare. Although there may be an understandable reluctance from national respondents to share information on security and other grounds, the findings, nevertheless, revealed substantial differences between current planning and operational responses within the EU states for the management of mass chemical casualties. The existing international networks for response to radiation incidents are not yet matched by equivalent networks for chemical responses yet sufficient information was available from the study to identify potential deficiencies, identify common casualty management pathways, and to make recommendations for future operations within the EU. Improvements in awareness and training and the application of modern information and communications will help to remedy this situation. Specialized advanced life support and other medical care for chemical casualties appear lacking in some countries. A program of specialized training and action are required to apply the findings

  19. Health care worker protection in mass casualty respiratory failure: infection control, decontamination, and personal protective equipment. (United States)

    Daugherty, Elizabeth L


    Maintenance of a safe and stable health care infrastructure is critical to an effective mass casualty disaster response. Both secondary contamination during chemical disasters and hospital-associated infections during epidemic illness can pose substantial threats to achieving this goal. Understanding basic principles of decontamination and infection control during responses to chemical and biologic disasters can help minimize the risks to patients and health care workers. Effective decontamination following toxic chemical exposure should include both removal of contaminated clothing and decontamination of the victim's skin. Wet decontamination is the most feasible strategy in a mass casualty situation and should be performed promptly by trained personnel. In the event of an epidemic, infection prevention and control measures are based on essential principles of hand hygiene and standard precautions. Expanded precautions should be instituted as needed to target contact, droplet, and airborne routes of infectious disease transmission. Specific equipment and measures for critical care delivery may serve to decrease risk to health care workers in the event of an epidemic. Their use should be considered in developing comprehensive disaster response plans.

  20. The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents. (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Garijo Gonzalo, Gracia; Martinez Monzon, Carlos; Pelaez Corres, Nieves; Rodriguez Soler, Alberto; Turegano Fuentes, Fernando


    This text describes the process of development of the new Spanish Prehospital Advanced Triage Method (META) and explain its main features and contribution to prehospital triage systems in mass casualty incidents. The triage META is based in the Advanced Trauma Life Support (ATLS) protocols, patient's anatomical injuries and mechanism of injury. It is a triage method with four stages including early identification of patients with severe trauma that would benefit from a rapid evacuation to a surgical facility and introduces a new patient flow by-passing the advanced medical post to improve evacuation. The stages of triage META are: I) Stabilization triage that classifies patients according to severity to set priorities for initial emergency treatment; II) Identifying patients requiring urgent surgical treatment, this is done at the same time than stage I and creates a new flow of patients with high priority for evacuation; III) Implementation of Advanced Trauma Life Support protocols to patients previously classified according to stablished priority; and IV) Evacuation triage, stablishing evacuation priorities in case of lacks of appropriate transport resources. The triage META is to be applied only by prehospital providers with advanced knowledge and training in advanced trauma life support care and has been designed to be implemented as prehospital procedure in mass casualty incidents (MCI).

  1. Development of Mass-casualty Life Support-CBRNE (MCLS-CBRNE) in Japan. (United States)

    Anan, Hideaki; Otomo, Yasuhiro; Kondo, Hisayoshi; Homma, Masato; Koido, Yuichi; Morino, Kazuma; Oshiro, Kenichi; Harikae, Kiyokazu; Akasaka, Osamu


    This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course. Training opportunities for relevant organizations to learn how to act at a CBRNE disaster site currently are lacking. The developed course covers initial responses at a disaster site. This one-day training course comprises lectures, three tabletop simulations, and practical exercises in pre-decontamination triage and post-decontamination triage. With regard to field exercises conducted to date, related organizations have experienced difficulties in understanding each other and adapting their approaches. Tabletop simulations provide an opportunity for participants to learn how organizations working on-site, including fire, police, and medical personnel, act with differing goals and guiding principles. This course appears useful as a means for relevant organizations to understand the importance of developing common guidelines. The MCLS-CBRNE training is proposed to support CBRNE disaster control measures during future events. Anan H , Otomo Y , Kondo H , Homma M , Koido Y , Morino K , Oshiro K , Harikae K , Akasaka O . Development of mass-casualty life support-CBRNE (MCLS-CBRNE) in Japan. Prehosp Disaster Med. 2016;31(5):547-550.

  2. Using the Design for Demise Philosophy to Reduce Casualty Risk Due to Reentering Spacecraft (United States)

    Kelley, R. L.


    Recently the reentry of a number of vehicles has garnered public attention due to their risk of human casualty due to fragments surviving reentry. In order to minimize this risk for their vehicles, a number of NASA programs have actively sought to minimize the number of components likely to survive reentry at the end of their spacecraft's life in order to meet and/or exceed NASA safety standards for controlled and uncontrolled reentering vehicles. This philosophy, referred to as "Design for Demise" or D4D, has steadily been adopted, to at least some degree, by numerous programs. The result is that many programs are requesting evaluations of components at the early stages of vehicle design, as they strive to find ways to reduce the number surviving components while ensuring that the components meet the performance requirements of their mission. This paper will discuss some of the methods that have been employed to ensure that the consequences of the vehicle s end-of-life are considered at the beginning of the design process. In addition this paper will discuss the technical challenges overcome, as well as some of the more creative solutions which have been utilized to reduce casualty risk.

  3. Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises

    Energy Technology Data Exchange (ETDEWEB)

    Koerner, Markus; Kroetz, Michael M.; Wirth, Stefan; Boehm, Holger F.; Reiser, Maximilian; Linsenmaier, Ulrich [University Hospital Munich, Department of Clinical Radiology, Munich (Germany); Huber-Wagner, Stefan; Kanz, Karl-Georg [University Hospital Munich, Department of Surgery, Munich (Germany)


    The purpose of this study was to evaluate the feasibility, stability, and reproducibility of a dedicated CT protocol for the triage of patients in two separate large-scale exercises that simulated a mass casualty incident (MCI). In both exercises, a bomb explosion at the local soccer stadium that had caused about 100 casualties was simulated. Seven casualties who were rated ''critical'' by on-site field triage were admitted to the emergency department and underwent whole-body CT. The CT workflow was simulated with phantoms. The history of the casualties was matched to existing CT examinations that were used for evaluation of image reading under MCI conditions. The times needed for transfer and preparation of patients, examination, image reconstruction, total time in the CT examination room, image transfer to PACS, and image reading were recorded, and mean capacities were calculated and compared using the Mann-Whitney U test. We found no significant time differences in transfer and preparation of patients, duration of CT data acquisition, image reconstruction, total time in the CT room, and reading of the images. The calculated capacities per hour were 9.4 vs. 9.8 for examinations completed, and 8.2 vs. 7.2 for reports completed. In conclusion, CT triage is feasible and produced constant results with this dedicated and fast protocol. (orig.)

  4. 33 CFR 150.820 - When must a written report of casualty be submitted, and what must it contain? (United States)


    ... must also include the information relating to alcohol and drug involvement specified by 46 CFR 4.05-12... CFR part 16. (c) If filed immediately after the event, the written report required by paragraph (a) of... casualty be submitted, and what must it contain? 150.820 Section 150.820 Navigation and Navigable...

  5. Cyanide antidotes for mass casualties: water-soluble salts of the dithiane (sulfanegen) from 3-mercaptopyruvate for intramuscular administration. (United States)

    Patterson, Steven E; Monteil, Alexandre R; Cohen, Jonathan F; Crankshaw, Daune L; Vince, Robert; Nagasawa, Herbert T


    Current cyanide antidotes are administered by IV infusion, which is suboptimal for mass casualties. Therefore, in a cyanide disaster, intramuscular (IM) injectable antidotes would be more appropriate. We report the discovery of the highly water-soluble sulfanegen triethanolamine as a promising lead for development as an IM injectable cyanide antidote.

  6. Shipboard and Ground Troop Casualty Rates among Navy and Marine Corps Personnel during World War II Operations (United States)


    range of ships (major combatants, patrol craft, submarines, minecraft , landing craft, auxiliary vessels) critical to successful naval engagements. Figure... minecraft , and patrol craft. These vessels are generally small, with minrimnl rrpw rcmn1pmpntf. vieldina high rates of casualties when hit. Fuel oil

  7. Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises. (United States)

    Körner, Markus; Krötz, Michael M; Wirth, Stefan; Huber-Wagner, Stefan; Kanz, Karl-Georg; Boehm, Holger F; Reiser, Maximilian; Linsenmaier, Ulrich


    The purpose of this study was to evaluate the feasibility, stability, and reproducibility of a dedicated CT protocol for the triage of patients in two separate large-scale exercises that simulated a mass casualty incident (MCI). In both exercises, a bomb explosion at the local soccer stadium that had caused about 100 casualties was simulated. Seven casualties who were rated "critical" by on-site field triage were admitted to the emergency department and underwent whole-body CT. The CT workflow was simulated with phantoms. The history of the casualties was matched to existing CT examinations that were used for evaluation of image reading under MCI conditions. The times needed for transfer and preparation of patients, examination, image reconstruction, total time in the CT examination room, image transfer to PACS, and image reading were recorded, and mean capacities were calculated and compared using the Mann-Whitney U test. We found no significant time differences in transfer and preparation of patients, duration of CT data acquisition, image reconstruction, total time in the CT room, and reading of the images. The calculated capacities per hour were 9.4 vs. 9.8 for examinations completed, and 8.2 vs. 7.2 for reports completed. In conclusion, CT triage is feasible and produced constant results with this dedicated and fast protocol.

  8. Casualty Aversion in the Post-Cold War Era: Defined and Analyzed Through the Logic of Clausewitz (United States)


    faced with risk and self sacrifice. The paper gives few answers, but raises many questions. Suro , Roberto, “Zeroing In on “Zero Casualty Syndrome...leaders have denied themselves the ability to maneuver and thus surprise the enemy. Mr. Suro takes this thought and applies it to President Clinton

  9. A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes. (United States)

    Tekin, Akin; Namias, Nicholas; O'Keeffe, Terence; Pizano, Louis; Lynn, Mauricio; Prater-Varas, Robin; Quintana, Olga Delia; Borges, Leda; Ishii, Mary; Lee, Seong; Lopez, Peter; Lessner-Eisenberg, Sharon; Alvarez, Angel; Ellison, Tom; Sapnas, Katherine; Lefton, Jennifer; Ward, Charles Gillon


    The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2-27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 per cent bums and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event; having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support

  10. Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia (United States)

    Koay, S. P.; Tay, L. T.; Fukuoka, H.; Koyama, T.; Sakai, N.; Jamaludin, S. B.; Lateh, H.


    Northeast monsoon causes heavy rain in east coast of Peninsular Malaysia from November to March, every year. During this monsoon period, besides the happening of flood along east coast, landslides also causes millions of Malaysian Ringgit economical losses. Hence, it is essential to study the prediction of slope failure to prevent the casualty of landslides happening. In our study, we introduce prediction method of the accumulated rainfall affecting the stability of the slope. If the curve, in the graph, which is presented by rainfall intensity versus accumulated rainfall, crosses over the critical line, the condition of the slope is considered in high risk where the data are calculated and sent from rain gauge in the site via internet. If the possibility of slope failure is going high, the alert message will be sent out to the authorities for decision making on road block or setting the warning light at the road side. Besides road block and warning light, we propose to disseminate short message, to pre-registered mobile phone user, to notify the public for easing the traffic jam and avoiding unnecessary public panic. Prediction is not enough to prevent the casualty. Early warning awareness of the public is very important to reduce the casualty of landslides happening. IT technology does not only play a main role in disseminating information, early warning awareness education, by using IT technology, should be conducted, in schools, to give early warning awareness on natural hazard since childhood. Knowing the pass history on landslides occurrence will gain experience on the landslides happening. Landslides historical events with coordinate information are stored in database. The public can browse these historical events via internet. By referring to such historical landslides events, the public may know where did landslides happen before and the possibility of slope failure occurrence again is considered high. Simulation of rainfall induced slope failure mechanism

  11. Spatial-temporal patterns in Mediterranean carnivore road casualties: Consequences for mitigation (United States)

    Grilo, C.; Bissonette, J.A.; Santos-Reis, M.


    Many carnivores have been seriously impacted by the expansion of transportation systems and networks; however we know little about carnivore response to the extent and magnitude of road mortality, or which age classes may be disproportionately impacted. Recent research has demonstrated that wildlife-vehicle-collisions (WVC) involving carnivores are modulated by temporal and spatial factors. Thus, we investigated road mortality on a guild of small and medium-sized carnivores in southern Portugal using road-kill data obtained from a systematic 36 months monitoring period along highways (260 km) and national roads (314 km) by addressing the following questions: (a) which species and age class are most vulnerable to WVC? (b) are there temporal and/or spatial patterns in road-kill? and (c) which life-history and/or spatial factors influence the likelihood of collisions? We recorded a total of 806 carnivore casualties, which represented an average of 47 ind./100 km/year. Red fox and stone marten had the highest mortality rates. Our findings highlight three key messages: (1) the majority of road-killed individuals were adults of common species; (2) all carnivores, except genets, were more vulnerable during specific life-history phenological periods: higher casualties were observed when red fox and stone marten were provisioning young, Eurasian badger casualties occurred more frequently during dispersal, and higher Egyptian mongoose mortality occurred during the breeding period; and (3) modeling demonstrated that favorable habitat, curves in the road, and low human disturbance were major contributors to the deadliest road segments. Red fox carcasses were more likely to be found on road sections with passages distant from urban areas. Conversely, stone marten mortalities were found more often on national roads with high of cork oak woodland cover; Egyptian mongoose and genet road-kills were found more often on road segments close to curves. Based on our results, two key

  12. Long-term disabilities associated with combat casualties: measuring disability and reintegration in combat veterans. (United States)

    Resnik, Linda; Reiber, Gayle


    Many physical and mental health problems associated with combat casualties affect the reintegration of service members into home and community life. Quantifying and measuring reintegration is important to answer questions about clinical, research, economic, and policy issues that directly affect combat veterans. Although the construct of participation presented in the International Statistical Classification of Diseases and Related Health Problems and in the International Classification of Functioning, Disability and Health provides a theoretical framework with which to understand and measure community reintegration in general, a measure was needed that specifically addressed the reintegration of combat veterans. To address this need, the Community Reintegration for Service Members global outcomes measure was developed. It consists of three scales, which measure extent of participation, perceived limitations, and satisfaction. The measure was validated in a general sample of veterans and in a sample of severely wounded service members. The computer-adapted test version shows good precision, reliability, construct validity, and predictive validity.

  13. Truth hurts--hard lessons from Australia's largest mass casualty exercise with contaminated patients. (United States)

    Edwards, Nicholas A; Caldicott, David G E; Eliseo, Tony; Pearce, Andrew


    In response to the increasing threat of a mass casualty incident involving chemical, biological or radiological agents, and concern over the preparedness of our hospital system to cope with patients from such an incident, we conducted the largest hospital-based field exercise involving contaminated patients that has been held in Australia. In the present paper, we outline the background to, and methodology of, Exercise Supreme Truth, and the efforts made to increase its realism. We focus our discussion on three issues highlighted by the exercise, which we believe have enormous implications for the development of hospital chemical, biological or radiological plans and the likelihood of their success--hospital security, crowd control and decontamination.

  14. Loss of cabin pressure in a military transport: a mass casualty with decompression illnesses. (United States)

    Johnston, Mickaila J


    Presented here is the sudden cabin depressurization of a military C-130 aircraft carrying 66 personnel. They suffered a depressurization from 2134 to 7317 m, resulting in a potential 66-person mass casualty. The aircrew were able to descend to below 3049 m in less than 5 min. They landed in the Kingdom of Bahrain--the nearest hyperbaric recompression facility. Three cases of peripheral neurologic DCS and one case of spinal DCS were identified. Limited manning, unique host nation concerns, and limited available assets led to difficulties in triage, patient transport, and asset allocation. These led to difficult decisions regarding when and for whom to initiate ground level oxygen or hyperbaric recompression therapy.

  15. CBRNE TC3: A Hybrid Approach to Casualty Care in the CBRNE Environment. (United States)

    Strain, John W


    The implementation of Tactical Combat Casualty Care (TCCC) guidelines for the Operation Enduring Freedom and Operation Iraqi Freedom contingency operations has dramatically reduced preventable combat deaths. A study of these principles and their application to medical treatment in the chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), weapons of mass destruction (WMD) environment is presented as a potential readiness and force multiplier for units engaged in this area of operations. Preparing medical operators for support of WMD sampling and mitigation missions requires extensive preventive medicine and post-exposure and downrange trauma threat preparedness. Training and equipping CBRN operators with treatment skills and appropriate interventional material requires pre-implementation planning specific to WMD threats (e.g., anthrax, radiation, organophosphates, and contaminated trauma). A scenario-based study reveals the tactics, techniques, and procedures for training, resourcing, and fielding the CBRN operator of the future.

  16. Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil. (United States)

    Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia


    On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.

  17. Characteristics of road traffic accident casualties admitted to a tertiary care hospital in Sri Lanka. (United States)

    Fernando, Dinesh M; Tennakoon, Sampath U; Samaranayake, Achini N; Wickramasinghe, Medhani


    The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature. Of the 579 RTA casualties examined, 72% were males, 28% females, and 26% were in the 20-29 year age group. There were 44% passengers, 32% drivers, and 20% pedestrians. Of the 440 vehicle occupants, 37% were on motor cycles, 28% in three wheelers, 13% in dual purpose vehicles and 11% in buses. Of the 114 pedestrians, 33% had been struck by motor cycles, 19% by three-wheelers and 17% by dual purpose vehicles. There was at least one soft tissue injury in 84%, whilst 45% had one or more fractures. In 85% of bicycle riders, the injuries were grievous, endangering life or fatal in the ordinary course of nature. A high proportion of young adults sustained grievous injuries due to RTA. Almost two thirds of the casualties resulted from motorcycle or three wheeler accidents. Laws limiting the number of passengers carried, installation of side doors, mandatory use of seat belts in three wheelers, and protective garments for motorcyclists are recommended.

  18. Mass casualty modelling: a spatial tool to support triage decision making

    Directory of Open Access Journals (Sweden)

    Hameed Syed M


    Full Text Available Abstract Background During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. Methods This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc., and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Results Upon running the model, driving time from the MCI location to the surrounding hospitals is quickly displayed alongside information regarding hospital capacity and capability, thereby assisting the user in the decision-making process. Conclusions The use of SDSS in the prioritization of MCI evacuation decision making is potentially valuable in cases of mass casualty. The key to this model is the utilization of pre-calculated driving times from each hospital in the region to each point on the road network. The incorporation of real-time traffic and hospital capacity data would further improve this model.

  19. An Air MEDEVAC Asset Dispatching and Prioritized Casualty Transporting Model for Military Medical Evacuation Systems with Distinguishable Medical Treatment Facilities and Errors in Triage (United States)


    distinguishable medical treatment facilities and errors in triage The views, opinions and/or findings contained in this report are those of the author(s) and...facilities and errors in triage Report Title Decision making in military medical evacuation (MEDEVAC) of casualties consists of identifying which...treatment facilities. The model accounts for errors made during triage of casualties to investigate the revelation of information over time and

  20. Prophylaxis for blood-borne diseases during the London 7/7 mass casualty terrorist bombing: a review and the role of bioethics. (United States)

    Edwards, Dafydd S; Barnett-Vanes, A; Narayan, N; Patel, H D L


    The suicide bombings in London on 7 July 2005 resulted in a mass casualty situation. Over 50% of casualties were treated at the Royal London Hospital where clinicians witnessed large numbers of severely injured patients. In some casualties human biological foreign material was found embedded in the soft tissue originating from the suicide bombers or other casualties. This had the potential of placing individuals at risk of transmission of blood-borne diseases. Advances in the fields of medicine and biology have led to increased survivorship in the context of trauma and mass casualty incidents. This has resulted in the emergence of ethical scenarios surrounding patient management. A systematic review of the literature of the 7/7 bombings, and suicide bombings reported globally, where biological implantation is noted, was performed to examine the medicolegal issues arising during such attack. Twelve casualties with human tissue implanted were recorded in the 7/7 bombings. While all patients at risk were given prophylaxis based on recommendations by the Health Protection Agency, several ethical considerations surfaced as a result. In this paper, we compare the sequence of events and the management process of the victims of the 7/7 bombings and the evidence-based research regarding blood-borne infection transmission. Furthermore, it explores the ethical dilemmas, experienced by the senior author on 7/7, surrounding prophylaxis for blood-borne diseases and protocols to avoid confusion over best practice in future bombing incidents.

  1. The effects of congestion charging on road traffic casualties: a causal analysis using difference-in-difference estimation. (United States)

    Li, Haojie; Graham, Daniel J; Majumdar, Arnab


    This paper aims to identify the impacts of the London congestion charge on road casualties within the central London charging zone. It develops a full difference-in-difference (DID) model that is integrated with generalized linear models, such as Poisson and Negative Binomial regression models. Covariates are included in the model to adjust for factors that violate the parallel trend assumption, which is critical in the DID model. The lower Bayesian Information Criterion value suggests that the full difference-in-difference model performs well in evaluating the relationship between road accidents and the London congestion charge as well as other socio-economic factors. After adjusting for a time trend and regional effects, the results show that the introduction of the London congestion charge has a significant influence on the incidence of road casualties. The congestion charge reduces the total number of car accidents, but is associated with an increase in two wheeled vehicle accidents.

  2. Quantifying the causal effects of 20mph zones on road casualties in London via doubly robust estimation. (United States)

    Li, Haojie; Graham, Daniel J


    This paper estimates the causal effect of 20mph zones on road casualties in London. Potential confounders in the key relationship of interest are included within outcome regression and propensity score models, and the models are then combined to form a doubly robust estimator. A total of 234 treated zones and 2844 potential control zones are included in the data sample. The propensity score model is used to select a viable control group which has common support in the covariate distributions. We compare the doubly robust estimates with those obtained using three other methods: inverse probability weighting, regression adjustment, and propensity score matching. The results indicate that 20mph zones have had a significant causal impact on road casualty reduction in both absolute and proportional terms.

  3. MiRTE: Mixed Reality Triage and Evacuation game for Mass Casualty information systems design, testing and training. (United States)

    Yu, Xunyi; Ganz, Aura


    In this paper we introduce a Mixed Reality Triage and Evacuation game, MiRTE, that is used in the development, testing and training of Mass Casualty Incident (MCI) information systems for first responders. Using the Source game engine from Valve software, MiRTE creates immersive virtual environments to simulate various incident scenarios, and enables interactions between multiple players/first responders. What distinguishes it from a pure computer simulation game is that it can interface with external mass casualty incident management systems, such as DIORAMA. The game will enable system developers to specify technical requirements of underlying technology, and test different alternatives of design. After the information system hardware and software are completed, the game can simulate various algorithms such as localization technologies, and interface with an actual user interface on PCs and Smartphones. We implemented and tested the game with the DIORAMA system.

  4. Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties (United States)


    sequence analysis of finger blood pressure variability. Comparison with analysis of intra- arterial recordings. Hyper- tension 22: 26–33, 1993. 30. O’Rourke...detection of hemorrhage is crucial for managing combat casualties. However, mean arterial blood pressure (ABP) and other vital signs are late indicators of...physiologic mechanisms, mean arterial blood pressure (ABP) and other vital signs often change late and precipitously during progressive bleeding. By

  5. Assessment of Casualty Transport Equipment and Procedures Aboard U.S. Navy Submarines to Accommodate Anti-Shock Trousers (United States)


    maternal morbidity and mortality 11-17. Two case series reports from Pakistan in the early 2000s noted remarkable improvement in women with severe...the effect of the NIASG upon mortality and severe morbidity in maternal hemorrhage and hypovolemic shock (NCT: 00488462). Data collection for this...stretcher-bound casualty up to the sail deck. If, however, such a route is necessary due to sea state or other complication, protective padding for

  6. Management of Junctional Hemorrhage in Tactical Combat Casualty Care: TCCC Guidelines-Proposed Change 13-03 (United States)


    reasons. The casu- alty had bilateral traumatic amputations of his lower extremities. He was reported to be unresponsive with no carotid pulse at...proximal iliac ves- sels remotely to secure hemostasis in case of high leg amputation .”16 The application time of the CRoC should not exceed 4...Winter 2013 devices on casualties in the prehospital environment. The available evidence as discussed in this report are laboratory studies and case

  7. Guidelines for Mass Casualty Decontamination During a HAZMAT/Weapon of Mass Destruction Incident. Volumes 1 and 2 (Update) (United States)


    Waste Operations and Emer- gency Response). Establishing Zones In addition to the safety assessment, the First Responder should gain control of the...consistent with wind patterns or ventilation. Blisters / rashes Numerous individuals experiencing unex- plained blisters , bee sting like weals, and/ or...2013 Although the variations for setting up mass casualty decontamination systems are virtu- ally limitless, many waste precious minutes to set up

  8. A lightning multiple casualty incident in Sequoia and Kings Canyon National Parks. (United States)

    Spano, Susanne J; Campagne, Danielle; Stroh, Geoff; Shalit, Marc


    Multiple casualty incidents (MCIs) are uncommon in remote wilderness settings. This is a case report of a lightning strike on a Boy Scout troop hiking through Sequoia and Kings Canyon National Parks (SEKI), in which the lightning storm hindered rescue efforts. The purpose of this study was to review the response to a lightning-caused MCI in a wilderness setting, address lightning injury as it relates to field management, and discuss evacuation options in inclement weather incidents occurring in remote locations. An analysis of SEKI search and rescue data and a review of current literature were performed. A lightning strike at 10,600 feet elevation in the Sierra Nevada Mountains affected a party of 5 adults and 7 Boy Scouts (age range 12 to 17 years old). Resources mobilized for the rescue included 5 helicopters, 2 ambulances, 2 hospitals, and 15 field and 14 logistical support personnel. The incident was managed from strike to scene clearance in 4 hours and 20 minutes. There were 2 fatalities, 1 on scene and 1 in the hospital. Storm conditions complicated on-scene communication and evacuation efforts. Exposure to ongoing lightning and a remote wilderness location affected both victims and rescuers in a lightning MCI. Helicopters, the main vehicles of wilderness rescue in SEKI, can be limited by weather, daylight, and terrain. Redundancies in communication systems are vital for episodes of radio failure. Reverse triage should be implemented in lightning injury MCIs. Education of both wilderness travelers and rescuers regarding these issues should be pursued.

  9. Medical examination of A-bomb survivors on Nagasaki A-bomb Casualty

    Energy Technology Data Exchange (ETDEWEB)

    Tagawa, Masuko [Nagasaki Atomic Bomb Casualty Council (Japan)


    Medical examination of A-bomb survivors was described and discussed on history, time change of examinee number, action for subjects not examined, change of prevalence, cancer examination, examination for the second generation, and education and enlightenment. Free examination of the survivors was begun in 1953 and the present casualty was made in 1958 on the law for medical care for the survivors. Systematic examination started from 1967 and the examination for the 2nd generation, from 1974. Cancer examination was from 1988. The number of the survivors was the maximum of 82,439 in 1974 and decreased to 61,388 in 1994, when the actual number of examinees, which being rather settled recently, was 32,294 and their average age was 64 y. The examination is done by tour or at the Center. Subjects receive the information of the examination twice by mail. Hematopoietic diseases like anemia, hepatic ones, metabolic and endocrinic ones like diabetes, renal impairment and others (mostly hyperlipidemia) are increasing recently. The number of examinees for cancer is increasing. Lung cancer is examined by the direct roentgenography, gastric cancer by transillumination, and other cancers like myeloma, those in large bowel, uterus and mammary gland, by the respective suitable methods. Health education and enlightenment have been conceivably effective. (H.O.)

  10. Mass casualty events: blood transfusion emergency preparedness across the continuum of care. (United States)

    Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar


    Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience.

  11. Assessment of the Casualty Risk of Multiple Meteorological Hazards in China

    Directory of Open Access Journals (Sweden)

    Wei Xu


    Full Text Available A study of the frequency, intensity, and risk of extreme climatic events or natural hazards is important for assessing the impacts of climate change. Many models have been developed to assess the risk of multiple hazards, however, most of the existing approaches can only model the relative levels of risk. This paper reports the development of a method for the quantitative assessment of the risk of multiple hazards based on information diffusion. This method was used to assess the risks of loss of human lives from 11 types of meteorological hazards in China at the prefectural and provincial levels. Risk curves of multiple hazards were obtained for each province and the risks of 10-year, 20-year, 50-year, and 100-year return periods were mapped. The results show that the provinces (municipalities, autonomous regions in southeastern China are at higher risk of multiple meteorological hazards as a result of their geographical location and topography. The results of this study can be used as references for the management of meteorological disasters in China. The model can be used to quantitatively calculate the risks of casualty, direct economic losses, building collapse, and agricultural losses for any hazards at different spatial scales.

  12. Epidemiology and Antimicrobial Susceptibilities of Wound Isolates of Obligate Anaerobes from Combat Casualties (United States)

    White, Brian K.; Mende, Katrin; Weintrob, Amy C.; Beckius, Miriam L.; Zera, Wendy C.; Lu, Dan; Bradley, William; Tribble, David R.; Schnaubelt, Elizabeth R.; Murray, Clinton K.


    Data from recent conflicts related to war wounds and obligate anaerobes are limited. We define the epidemiology and antimicrobial susceptibility of obligate anaerobes from Iraq and Afghanistan casualties (6/2009–12/2013), as well as their association with clinical outcomes. Susceptibility against eleven antibiotics (7 classes) was tested. Overall, 59 patients had 119 obligate anaerobes identified (83 were first isolates). Obligate anaerobes were isolated 7–13 days post-injury, primarily from lower extremity wounds (43%), and were largely Bacteroides spp. (42%) and Clostridium spp. (19%). Patients with pelvic wounds were more likely to have Bacteroides spp. and concomitant resistant gram-negative aerobes. Seventy-three percent of isolates were resistant to ≥1 antimicrobials. Bacteroides spp. demonstrated the most resistance (16% of first isolates). Patients with resistant isolates had similar outcomes to those with susceptible strains. Serial recovery of isolates occurred in 15% of patients and was significantly associated with isolation of Bacteroides spp., along with resistant gram-negative aerobes. PMID:26607420

  13. Factor analysis of fatal road traffic crashes with massive casualties in China

    Directory of Open Access Journals (Sweden)

    Tao Chen


    Full Text Available Factor analysis refers to a collection of statistical methods for reducing correlational data into a smaller number of dimensions or factors. In this study, factor analysis theory was used to determine the main influential factors of road traffic crashes with massive casualties. Twenty variables related to personnel, vehicles, roads, and environment were collected, and the significance of their correlations was tested for validity. A correlation coefficient matrix R was calculated, and its latent root λ was obtained based on the characteristic equation. A number of common factors were determined according to the value of latent root λ . Factor loading was used to express the relationship of each variable to the underlying main influential factors. An index system of accident factors was developed based on the results of factor loading, and the weight of each factor was calculated to classify the factor influence. The main influential factors of accidents were determined to be fault behavior, driving experience, condition of vehicle safety, purpose of vehicle, road lighting, driver, road surface condition, roadside protection facilities, and road terrain.

  14. Premature chromosome condensation (PCC) assay for dose assessment in mass casualty accidents. (United States)

    Lindholm, Carita; Stricklin, Daniela; Jaworska, Alicja; Koivistoinen, Armi; Paile, Wendla; Arvidsson, Eva; Deperas-Standylo, Joanna; Wojcik, Andrzej


    The study was undertaken to establish a dose calibration curve for a practical PCC ring assay and to apply it in a simulated mass casualty accident. The PCC assay was validated against the conventional dicentric assay. A linear relationship was established for PCC rings after (60)Co gamma irradiation with doses up to 20 Gy. In the simulated accident experiment, 62 blood samples were analyzed with both the PCC ring assay and the conventional dicentric assay, applying a triage approach. Samples received various uniform and non-uniform (10-40% partial-body) irradiations up to doses of 13 Gy. The results indicated that both assays yielded good dose estimates for the whole-body exposure scenario, although in the lower-dose range (0-6 Gy) dicentric scoring resulted in more accurate whole-body estimates, whereas PCC rings were better in the high-dose range (>6 Gy). Neither assay was successful in identifying partial-body exposures, most likely due to the low numbers of cells scored in the triage mode. In conclusion, the study confirmed that the PCC ring assay is suitable for use as a biodosimeter after whole-body exposure to high doses of radiation. However, there are limitations for its use in the triage of people exposed to high, partial-body doses.

  15. Global Earthquake Casualties due to Secondary Effects: A Quantitative Analysis for Improving PAGER Losses (United States)

    Wald, David J.


    This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey’s (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER’s overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra–Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability.

  16. Performance and reliability of the CPB/ECMO Initiative Forward Lines Casualty Management System. (United States)

    Casas, Fernando; Reeves, Andrew; Dudzinski, David; Weber, Stephan; Lorenz, Markus; Akiyama, Masatoshi; Kamohara, Keiji; Kopcak, Michael; Ootaki, Yoshio; Zahr, Firas; Sinkewich, Martin; Foster, Robert; Fukamachi, Kiyotaka; Smith, William A


    The Cleveland Clinic Foundation CPB/ECMO Initiative Forward Casualty Management System is an economical, compact, transportable, disposable system designed to permit a rapid expansion of trauma management services requiring cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) pulmonary support. The system, composed of a rotary blood pump, a pump motor driver, and an electronic control console as the blood pumping subsystem, also includes commonly used compatible commercial oxygenators, venous reservoirs, and cannulae. In vitro durability testing accumulated over 100 hours without failure. In vivo reliability was tested in 10 calves under general anesthesia during 6 hours of CPB and ECMO under full heparinization at nominal operating conditions of 4-5 l/min and 2-4 l/min blood flow respectively, and mean arterial pressures between 65 and 100 mm Hg. A mean time to failure of 57 hours was reached during the animal series. Results of these test series demonstrated that this system has the capability to reliably operate during a 6-hour conventional CPB or ECMO procedure, while providing flexibility and ease of use for the operator.

  17. Global earthquake casualties due to secondary effects: A quantitative analysis for improving rapid loss analyses (United States)

    Marano, K.D.; Wald, D.J.; Allen, T.I.


    This study presents a quantitative and geospatial description of global losses due to earthquake-induced secondary effects, including landslide, liquefaction, tsunami, and fire for events during the past 40 years. These processes are of great importance to the US Geological Survey's (USGS) Prompt Assessment of Global Earthquakes for Response (PAGER) system, which is currently being developed to deliver rapid earthquake impact and loss assessments following large/significant global earthquakes. An important question is how dominant are losses due to secondary effects (and under what conditions, and in which regions)? Thus, which of these effects should receive higher priority research efforts in order to enhance PAGER's overall assessment of earthquakes losses and alerting for the likelihood of secondary impacts? We find that while 21.5% of fatal earthquakes have deaths due to secondary (non-shaking) causes, only rarely are secondary effects the main cause of fatalities. The recent 2004 Great Sumatra-Andaman Islands earthquake is a notable exception, with extraordinary losses due to tsunami. The potential for secondary hazards varies greatly, and systematically, due to regional geologic and geomorphic conditions. Based on our findings, we have built country-specific disclaimers for PAGER that address potential for each hazard (Earle et al., Proceedings of the 14th World Conference of the Earthquake Engineering, Beijing, China, 2008). We will now focus on ways to model casualties from secondary effects based on their relative importance as well as their general predictability. ?? Springer Science+Business Media B.V. 2009.

  18. The Internet's effect on personality traits: An important casualty of the "Internet addiction" paradigm. (United States)

    Aboujaoude, Elias


    Background and aims The "Internet addiction" paradigm has been criticized for several shortcomings, including inattention to specific online behaviors, not distinguishing the Internet from other media, insufficient focus on comorbidities, and definitions that do not take into account the constant access now possible. The paradigm's biggest casualty, however, may be that it has diverted attention away from subtle personality changes that seem to occur online, including in users who cannot be considered "addicted" under any definition. Methods A narrative assessment of the literature was conducted, focusing on the Internet's effects on personality traits as revealed in studies of Internet users. Results Impulsivity, narcissism, and aggression are some of the personality traits that seem to be nurtured by the Internet, with possible negative offline consequences. Discussion Ignoring the Internet's subtle effects on personality as we embrace an addiction model that implies severe pathology makes the majority of Internet users feel deceptively immune to the psychological effects of new technologies. It also limits our understanding of the big cultural shifts that are happening as a result. Conclusion The Internet's potentially negative effect on personality, and by extension on society at large, is a fundamental part of online psychology, one well worthy of further investigation.

  19. Interlaboratory comparison of the dicentric chromosome assay for radiation biodosimetry in mass casualty events. (United States)

    Wilkins, Ruth C; Romm, Horst; Kao, Tzu-Cheg; Awa, Akio A; Yoshida, Mitsuaki A; Livingston, Gordon K; Jenkins, Mark S; Oestreicher, Ursula; Pellmar, Terry C; Prasanna, Pataje G S


    This interlaboratory comparison validates the dicentric chromosome assay for assessing radiation dose in mass casualty accidents and identifies the advantages and limitations of an international biodosimetry network. The assay's validity and accuracy were determined among five laboratories following the International Organization for Standardization guidelines. Blood samples irradiated at the Armed Forces Radiobiology Research Institute were shipped to all laboratories, which constructed individual radiation calibration curves and assessed the dose to dose-blinded samples. Each laboratory constructed a dose-effect calibration curve for the yield of dicentrics for (60)Co gamma rays in the 0 to 5-Gy range, using the maximum likelihood linear-quadratic model, Y = c + alphaD + betaD(2). For all laboratories, the estimated coefficients of the fitted curves were within the 99.7% confidence intervals (CIs), but the observed dicentric yields differed. When each laboratory assessed radiation doses to four dose-blinded blood samples by comparing the observed dicentric yield with the laboratory's own calibration curve, the estimates were accurate in all laboratories at all doses. For all laboratories, actual doses were within the 99.75% CI for the assessed dose. Across the dose range, the error in the estimated doses, compared to the physical doses, ranged from 15% underestimation to 15% overestimation.

  20. Rural casualty crashes on the Kings Highway: A new approach for road safety studies. (United States)

    Alian, Sahar; Baker, R G V; Wood, Stephen


    This paper will consider the contribution that changes in road geometry and driver visual information make to the incidence and distribution of road casualties in different driving environments. This relationship will be explored specifically for the Kings Highway, a major arterial road connecting Queanbeyan with coastal southern New South Wales, Australia. It introduces and suggests a new empirical approach of plotting crashes with road segmentation, calculating sinuosity indices and grades as key features of road geometry, and critical visual points as a behavioural component of road curvature, within a GIS context. It is an approach that might be used when detailed road geometry data is not available. The visualisation and segmentation approach in this research might be used for summarising crash rates and road geometry factors, and for comparing day/night and eastbound/westbound driving conditions. The results suggest some early interpretations for detailed road safety studies that might be considered at local or national levels. The rate of crashes increases according to changes in road geometry factors during the day and for eastbound travel. This is not the case for night driving where the incidence of crashes is similar on both straight and curved roads segments due to the headlight effect and limited background visual field. Crash clusters at day-time may be due to the stronger effect of road geometry (e.g. combination of curvature and vertical grade) on driver behaviour travelling eastbound. The outcomes suggest that it might be essential to consider the effect of environmental factors in any road safety and crash analysis studies.

  1. Sample tracking in an automated cytogenetic biodosimetry laboratory for radiation mass casualties

    Energy Technology Data Exchange (ETDEWEB)

    Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Prasanna, P.G.S. [Armed Forces Radiobiology Research Institute, Uniformed Services University of Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States)], E-mail:


    Chromosome-aberration-based dicentric assay is expected to be used after mass-casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample-tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput. This paper focuses on our efforts to eliminate data-transcription errors, increase efficiency, and maintain samples' positive chain-of-custody by sample tracking during sample processing and data analysis. This sample-tracking system represents a 'beta' version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and

  2. Organization and implementation of medical rescue of mass casualties during earthquake

    Directory of Open Access Journals (Sweden)

    Yan-ling ZHANG


    Full Text Available Over the past century, there were more than 40 earthquakes greater than 7 magnitude occurred worldwide, 10 of which in China, which killed 600 thousand people accounting for 53% of global earthquake deaths. On May 12, 2008, an 8.0-magnitude earthquake occurred in Wenchuan, Sichuan Province, causing 69000 deaths, 18000 missings, and 370000 injuries. Among 10 thousand severe injuries, most were traumatic injuries, 74% of which were fracture. On April 14, 2010, a 7.1-magnitude earthquake occurred in Yushu, Qinghai Province. There were 2698 deaths, 270 missings and 11000 injuries. Among 3100 severe injuries, fracture accounted for 58.4%. After each earthquake, the Chinese Army Medical Services took actions and made quick response according to the law. They sent out elites with efficient command and scientific organization, fully participating in the medical rescue operations. After Wenchuan earthquake, 397 mobile medical service units and 7061 health workers were sent out. A total of 69000 people were treated, and 22000 cases of surgeries were performed. After Yushu earthquake, a total of 25 mobile medical service units and 2025 health workers were sent. They performed 1635 cases of surgeries with a miracle of "zero death" in mass earthquake casualties and altitude diseases in cold highlands. After each earthquake, injuries cured within 1 week accounted for 60% of the total, and patients evacuated accounted for 80% of the total, which owed to the effective first aid in site of Chinese Army Medical Service. They effectively played the role as the main force, making significant contributions for the final victory of earthquake relief. From the practice of medical rescue revelation after the two earthquakes, what Chinese Army Medical Services Services learned are: firstly, the theory of medical relief should be innovated; secondly, military and civilian organizations should be coordinated; thirdly, professional rescue force should be strengthened

  3. Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties (United States)


    compensatory reserve index for predicting which casualties are in imminent danger of cardiovascular collapse and (b) application of the techniques to the...second dog; norepi- nephrine and xylazine in the third dog; saline and progressive hem- orrhage in the fourth dog; verapamil and high-rate pacing in the...0 113 1 Norepinephrine 134 15 162 22 55 11 117 13 Xylazine 65 8 78 8 25 1 100 10 Saline 98 1 119 1 45 1 137 1 Hemorrhage 66 5 80 5 25 1 105 4

  4. 成批烧伤救治50年%Experiences in rescue and treatment of mass burn casualties in fifty years

    Institute of Scientific and Technical Information of China (English)



    The article reviewed the history and the main experiences of rescue of mass burn casualties and their treatment during the past fifty years in China. Some issues including medical support for mass burn casually and treatment regime in future, such as the prevention of burn calamities, further elevation of the eure rate and lowering in the rate of disability, further development in network of burn care and preliminary scheme of rescue of mass burn casualties and their treatment, accelerating the development and study on the substitutes of allo-skin graft were discussed.

  5. Managing bioterrorism mass casualties in an emergency department: lessons learned from a rural community hospital disaster drill. (United States)

    Vinson, Eric


    Bioterrorism represents a threat for which most emergency departments (EDs) are ill prepared. In order to develop an evidence-based plan for ED and hospital management of contaminated patients, a review was conducted of the most effective strategies developed during the severe acute respiratory syndrome (SARS) epidemic, as well as Centers for Disease Control and Prevention and military guidelines on biowarfare. Six basic steps were identified: 1) lock down the hospital and control access to the ED; 2) protect emergency care personnel with appropriate personal protective equipment; 3) decontaminate and triage patients; 4) isolate patients; 5) treat patients with appropriate medications or measures, including decontamination of wounds; and 6) use restrictive admission and transfer guidelines. By emphasizing these six basic concepts, a rural ED passed an annual state-run bioterrorism mass-casualty drill. The drill provided health care personnel with the knowledge and skills necessary to prepare for future bioterrorism casualties. These same concepts could also be used to manage highly virulent viral or bacterial outbreaks.

  6. Econometric analysis of the changing effects in wind strength and significant wave height on the probability of casualty in shipping. (United States)

    Knapp, Sabine; Kumar, Shashi; Sakurada, Yuri; Shen, Jiajun


    This study uses econometric models to measure the effect of significant wave height and wind strength on the probability of casualty and tests whether these effects changed. While both effects are in particular relevant for stability and strength calculations of vessels, it is also helpful for the development of ship construction standards in general to counteract increased risk resulting from changing oceanographic conditions. The authors analyzed a unique dataset of 3.2 million observations from 20,729 individual vessels in the North Atlantic and Arctic regions gathered during the period 1979-2007. The results show that although there is a seasonal pattern in the probability of casualty especially during the winter months, the effect of wind strength and significant wave height do not follow the same seasonal pattern. Additionally, over time, significant wave height shows an increasing effect in January, March, May and October while wind strength shows a decreasing effect, especially in January, March and May. The models can be used to simulate relationships and help understand the relationships. This is of particular interest to naval architects and ship designers as well as multilateral agencies such as the International Maritime Organization (IMO) that establish global standards in ship design and construction.

  7. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs. (United States)

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean-René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley


    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative's Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident.

  8. Longitudinal Characterization of Acinetobacter baumannii-calcoaceticus Complex, Klebsiella pneumoniae, and Methicillin-Resistant Staphylococcus aureus Colonizing and Infecting Combat Casualties (United States)


    Brief report Longitudinal characterization of Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae , and methicillin-resistant...resistant Acinetobacter baumannii-calcoaceticus complex Klebsiella pneumoniae Methicillin-resistant Staphylococcus aureus MRSA Drug-resistant...Acinetobacter baumannii-calcoaceticus complex, Klebsiella pneumoniae , and methicillin- resistant Staphylococcus aureus colonize and infect combat casualties

  9. Indoor fire in a nursing home : evaluation of the medical response to a mass casualty incident based on a standardized protocol

    NARCIS (Netherlands)

    Koning, S. W.; Ellerbroek, P. M.; Leenen, L. P. H.


    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent res

  10. [Current state of medical care of polytrauma and mass casualty incidents in Germany. Are we well-prepared?]. (United States)

    Brodauf, L; Heßing, K; Hoffmann, R; Friemert, B


    The white paper on the medical care of the severely injured published in 2006 is a collection of proposals and recommendations concerning structure, organization and equipment for the medical care of severely injured patients. Since its publication 50 networks ( ) have been established as part of the trauma network. This and the trauma register have helped to continuously improve the medical care of severely injured patients since 1993 [26]. Numerous studies have documented the progress made in measures required by the trauma network [4, 6]. For example, the mortality rate of severely injured patients has dropped from 25 % to approximately 10 % in the past 15 years. From the register and network data it is difficult to tell how each of these measures is implemented in the participating hospitals, who provides medical treatment to patients when, and how medical care is organized in detail. This is why a survey on medical care for polytrauma and in mass casualty situations was conducted among medical directors in German surgical hospitals who are members of the German Society for Trauma Surgery (DGU). Thanks to the 211 participants (most of whom specialize in orthopedic and trauma surgery) a detailed description of how medical treatment is currently organized and performed could be acquired. The survey showed that care of patients with polytrauma (i.e. medical treatment and management) is important irrespective of the level of training of physicians and of the level of patient treatment in hospitals. The central role of traumatologists was emphasized not only in terms of actual treatment but also as an administrator for organizational and management matters. Almost all hospitals have plans for a mass casualty situation; however, the levels of preparedness show considerable variation. A highly critical view is taken of the new surgical specialists with respect to interdisciplinary and comprehensive emergency medical treatment

  11. Development of an accelerated MSCT protocol (Triage MSCT) for mass casualty incidents: comparison to MSCT for single-trauma patients. (United States)

    Körner, M; Krötz, M; Kanz, K-G; Pfeifer, K-J; Reiser, M; Linsenmaier, U


    During multiple casualty incidents (MCI) emergency radiology departments have to deal with a large number of patients with suspected severe trauma within a short period of time. The aim of this study was to develop a suitable accelerated multislice computed tomography (MSCT) protocol to increase patient throughput for this kind of emergency situation. We presumed a scenario of 15 patients being admitted to the trauma service with suspicion of severe injuries after a MCI over a period of 2 h. An accelerated Triage MSCT protocol was developed and evaluated for MSCT scanner productivity (patients per hour) and time (minutes) needed for a total MSCT body workup using an anthropomorphic phantom. In addition, time (minutes) for transfer and preparation was measured. These timeframes were compared to a control group consisting of 144 single patients with multiple trauma undergoing standard MSCT according to our trauma room protocol. All MSCT studies were conducted using a 4-detector row scanner. (1) For the study group (Triage MSCT), average time for patient transfer and preparation was 2.9 min (2.5-4.3 min), mean CT examination time was 2.1 min (1.7-2.4 min); image reconstruction took 4.0 min (3.3-4.3 min). Total time in scanner room was 8.9 min (7.7-11.3 min), resulting in a maximal productivity of 6.7 patients per hour. Image transfer to the digital picture archive and communication system archive was completed after an average 9.5 min (8.9-10.8 min). (2) For the control group (single casualty MSCT), the mean time for patient transfer and preparation was 20.4 min (9.0-39.2 min), mean examination time was 6.0 min (3.1-11.3 min). Times for image reconstructions were not recorded in the patient series. Mean total time in scanner room was 25.3 min (11.0-72.4 min), resulting in a patient throughput of 2.4 patients per hour. MSCT has potential to serve as a powerful tool in triage of multiple casualty patients. The introduction of a Triage MSCT scanning protocol resulted in

  12. Using a joint triage model for multi-hospital response to a mass casualty incident in New York city

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    Arquilla Bonnie


    Full Text Available This paper defines a specific plan which allows two separate institutions, with different capabilities, to function as a single receiving entity in the event of a mass casualty incident. The street between the two institutions will be closed to traffic and a two-phase process initiated. Arriving ambulances will first be quickly screened to expedite the most critical patients followed by formal triage and directing patients to one of the two facilities. Preparation for this plan requires prior coordination between local authorities and the administrations of both institutions. This plan can serve as a general model for disaster preparedness when two or more institutions with different capabilities are located in close proximity.

  13. State propaganda and mental disorders: the issue of psychiatric casualties among Japanese soldiers during the Asia-Pacific War. (United States)

    Matsumura, Janice


    This article explores the politics of Japanese wartime medical policy, demonstrating how state propaganda about the people and their armed forces influenced authoritative views on health and what might endanger it. By focusing on the obstacles faced by psychiatrists trying to promote more official concern for mental health issues, it challenges the validity of figures indicating a low incidence of psychological trauma among the country's soldiers. Civilian psychiatrists had to contend with the threat of censorship and arrest for even discussing war-induced mental disorders; at the same time, army psychiatrists as military insiders were pressured to convince their patients that their conditions were not serious and did not merit compensation. While discussing the neglected topic of Japanese psychiatric casualties, an attempt is made to provide a comparative approach by referring to the state of military psychiatry in other national settings.

  14. Book review of "The Ethics of Coercion in Mass Casualty Medicine" by Griffin Trotter MD, PhD

    Directory of Open Access Journals (Sweden)

    Singh Sonal


    Full Text Available Abstract Public health ethics is neither taught widely in medical schools or schools of public health in the US or around the world. It is not surprising that health care professionals are particularly challenged when faced with ethical questions which extend beyond safeguarding the interests of their individual patients to matters that affect overall public good. The perceived threat of terror after September 11 2007, the anthrax attacks and the Katrina debacle are recent circumstances which may result in coercion. These have piqued the interest of medical professionals and the general public on public health ethics. The Ethics of Coercion in Mass Casualty Medicine written by Griffin Trotter MD, PhD attempts to fill a timely void in this area by examining the ethics of coercion in times of public health disasters.

  15. Lay emphasis on the treatment of massive burn casualties in conflagration%重视火灾事故成批烧伤的救治

    Institute of Scientific and Technical Information of China (English)

    唐洪泰; 马兵; 夏照帆


    Burn surgery helongs to disaster medicine.Burn is a common trauma that occurs in social activities of human beings in all ages,either in the time of peace or war.During the development of human medicine in modern times,the summary of experience in treating massive burn casualties due to severe fire accidents has effectively promoted the renovation of treating technology and theory of burns and the development of burn surgery.The results of treatment of burn injury in casualties occurred in the fire of Cocoanut Grove night club in Boston in 1942,and the high-rise apartment house fire in Shanghai in 2010 were summarized and analyzed in this article,emphasizing the correlating issues of inhalation injury.

  16. Triage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident : a prospective cross-sectional survey



    Background: In a mass casualty situation, medical personnel must rapidly assess and prioritize patients for treatment and transport. Triage is an important tool for medical management in disaster situations. Lack of common international and Swedish triage guidelines could lead to confusion. Attending the Advanced Trauma Life Support (ATLS) provider course is becoming compulsory in the northern part of Europe. The aim of the ATLS guidelines is provision of effective management of single critic...

  17. Casualty Assistance: DOD and the Coast Guard Need to Develop Policies and Outreach Goals and Metrics for Program Supporting Servicemembers Survivors (United States)


    Government Accountability Office United States Government Accountability Office Highlights of GAO-16-569, a report to the Committee on Armed...assistance process following the death of a servicemember. Senate Report 114-49 included a provision that GAO review the Gold Star Advocate...following the death of a servicemember.2 Casualty assistance is the provision of authorized and necessary assistance to eligible family members of

  18. Use and Complications of Operative Control of Arterial Inflow in Combat Casualties with Traumatic Lower-extremity Amputations Caused by Improvised Explosive Devices (United States)


    injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee . J Surg Orthop Adv. 2012;21:32Y37. 11. Andersen RC...methods of proximal control in high wartime lower-extremity amputees . Although some casualties will have abdominal injuries that necessitate...of suprainguinal vascular control and complications that arose. In cases where multiple levels of control were used, data on all vessels were collected

  19. Development of Balloon Multifunctional Vest for Casualty Triage%气囊式多功能伤员分类服的研制

    Institute of Scientific and Technical Information of China (English)

    孙海安; 刘晓荣; 刘宏鸣; 陈国良; 刘飞; 唐和蔚


    Objective To realize quick triage of massive casualties on the sea for the enhancement of naval medical support. Methods Proper materials and independent balloon were used to make the vest with the PLA's uniform size referenced. Results The balloon multifunctional vest could be used for the quick triage of massive casualties on the sea. Conclusion The balloon multifunctional vest for casualty triage can guarantee the timely treatment on the sea, and the naval medical support ability can be enhanced accordingly%目的:实现海上批量伤员快速分类,完成海上急救任务,提升海上卫勤保障能力.方法:参照解放军军服尺寸,选用适当材料,结合独立气囊制成背心.结果:气囊式多功能伤员分类服可以满足海上卫勤保障中批量伤员迅速分类的需求.结论:气囊式多功能伤员分类服保证了海上伤员救治的时效性,对提高海上卫勤保障能力有重要作用.

  20. Reducing young driver crash casualties in Great Britain - use of routine police crash data to estimate the potential benefits of graduated driver licensing. (United States)

    Jones, Sarah J; Begg, Dorothy J; Palmer, Stephen R


    Crashes involving young drivers (YD) cause significant morbidity and mortality in Great Britain (GB). Graduated Driver Licensing (GDL) is used in some countries to address this. This study assessed potential casualty and cost savings of possible GDL programmes in GB. Police road crash data were analysed to identify YD crashes at night or while carrying passengers. These data were then used to estimate the potential effects of GDL. 314,561 casualties and 3469 fatalities occurred in YD crashes. 25.1% of YD crashes occurred between 9 pm and 6 am and 24.4% occurred with a 15- to 24-year old passenger in the car. A 'strict' form of GDL in GB (night time restriction 9 pm-6 am, no 15-24 year old passengers) with 50% compliance would prevent 114 deaths and 872 serious casualties each year. The estimated value of prevention is £424M pa. A 'less strict' form of GDL (night time restriction 10 pm-5 am, maximum of one 15-19 year old passenger) with 50% compliance would prevent 81 deaths and 538 serious injuries. The estimated value of prevention is £273M pa. Implementing GDL in GB could save significant numbers of lives. Public health organisations have a duty to advocate for such legislation.

  1. A Review of Socio-Economic Consequences, Losses and Human Casualties of the 1977 Vrancea, Romania Earthquake

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    Emil-Sever GEORGESCU


    Full Text Available Although its socio-economic disaster pattern was obvious, the March 4, 1977 Vrancea, Romania earthquake was studied mainly in seismological and earthquake engineering terms. In 1977, the loss data released in Romania, referred to 32,900 collapsed or heavily damaged dwellings, 35,000 homeless families, thousands of damaged buildings, many other damages and destructions in industry and economy, 1,578 people killed, 11,321 people injured (with 90% of the killed and 67% of the injured being in the city of Bucharest. The Romanian government reported the economic losses from this event in December 1977, as being US$ 2 billion. For a long time, the evaluation of human casualties vs. collapse pattern of buildings in 1977 was not addressed and we still miss integral data. The recovery and reevaluation of economic and social impacts of the 1977 disaster was a concern of the authors, with the intent to better understand its consequences and prepare a new strategy of seismic risk reduction in view of future earthquakes in Romania, and in order to fill that gap the authors recovered many unpublished and obscure data.

  2. Air MEDEVAC in case of multiple casualties – The experience of civilian-military cooperation in RoAF

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    Dragoș C. Tudose


    Full Text Available Introduction: Starting September 2010 in Romania was created the Military Emergency Medical Service (SMMU by the Ministry of National Defense, which has as main mission to provide first aid and save the lives of military personnel during military operations using special equipped MEDEAVC aircraft. Nationwide exist the national emergency system which operates thru 112- SMURD acting in support of the civilian population. In case of accidents with multiple victims the experience has shown the need for collaboration between the two systems, in order to save lives. In the last 5 years there has been an increasing Airlift missions (MEDEVAC with multiple victims executed by joint civil-military medical teams using military aircraft. Material and methods. This paper provides a review of the most important aspects of particularities, advantages and disadvantages of this type of medical transport using the MEDEVAC missions based study carried out by the Air Force in recent years. Results and conclusions. Performing these tasks presents challenges to mission planning, use of medical equipment and procedures, command-control system, exercise programs jointly joint medical teams and, of course, managing a large number of patients in flight. The large number of patients transported safely and in the shortest time, regardless of weather conditions recommends this type of medical intervention. Given the Romanian military presence in various theaters and that NATO strategic medical evacuation is a national responsibility, the capacity of air transport in case multiple casualties is a priority.

  3. Biological dosimetry by the triage dicentric chromosome assay: potential implications for treatment of acute radiation syndrome in radiological mass casualties. (United States)

    Romm, Horst; Wilkins, Ruth C; Coleman, C Norman; Lillis-Hearne, Patricia K; Pellmar, Terry C; Livingston, Gordon K; Awa, Akio A; Jenkins, Mark S; Yoshida, Mitsuaki A; Oestreicher, Ursula; Prasanna, Pataje G S


    Biological dosimetry is an essential tool for estimating radiation dose. The dicentric chromosome assay (DCA) is currently the tool of choice. Because the assay is labor-intensive and time-consuming, strategies are needed to increase throughput for use in radiation mass casualty incidents. One such strategy is to truncate metaphase spread analysis for triage dose estimates by scoring 50 or fewer metaphases, compared to a routine analysis of 500 to 1000 metaphases, and to increase throughput using a large group of scorers in a biodosimetry network. Previously, the National Institutes for Allergies and Infectious Diseases (NIAID) and the Armed Forces Radiobiology Research Institute (AFRRI) sponsored a double-blinded interlaboratory comparison among five established international cytogenetic biodosimetry laboratories to determine the variability in calibration curves and in dose measurements in unknown, irradiated samples. In the present study, we further analyzed the published data from this previous study to investigate how the number of metaphase spreads influences dose prediction accuracy and how this information could be of value in the triage and management of people at risk for the acute radiation syndrome (ARS). Although, as expected, accuracy decreased with lower numbers of metaphase spreads analyzed, predicted doses by the laboratories were in good agreement and were judged to be adequate to guide diagnosis and treatment of ARS. These results demonstrate that for rapid triage, a network of cytogenetic biodosimetry laboratories can accurately assess doses even with a lower number of scored metaphases.

  4. Patterns of Road Traffic Accidents in North West of Iran during 2013 New Year Holidays: Complications and Casualties

    Directory of Open Access Journals (Sweden)

    Samad Shams Vahdati


    Full Text Available Objective: To determine the patterns,complications and casualties of road traffic accidents in North West of Iran during 2013 New Year holidays. Methods: One hundred and eighty one patients with trauma-related vehicle crashes were investigated in a cross sectional-descriptive study. We only included those road traffic accidents which were recorded during the 2013 Iranian New Year holidays. Severity of injury based on Glasgow Coma Scale (GCS score, patient transmission type, damaged organ and the final diagnosis was determined. The mortality rate as well as complications were also recorded and reported. The pattern was analyzed and presented using descriptive statistics. Results: Overall we included 181 patients who were victims of road traffic accidents during the study period. Most cases of multiple traumas were from two car accident (49.2%. Of 181 cases, 71 (39.2%, 66 (36.5%, 16 (8.8% and 11 (6.1% subjects had limb, head and neck, abdominal, and spinal cord injuries respectively, while 16 cases (8.8% did not have any organ damage. In final diagnosis, a limb fracture was noticed in 32 cases (17.7% and skull fractures in 5 subjects (2.8% as the first and second causes. Conclusion: As head and neck were the most damaged organs after the limbs in patients with multiple traumas, it seems that there is a necessity for these patients in transmission and examination of head traumas. So there is a need for a proper referral system.

  5. Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology (United States)

    Göransson Nyberg, Ann; Stricklin, Daniela; Sellström, Åke


    Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons “at risk” of developing health problems, these technologies can aid in securing the unaffected or “worried well”. We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking. PMID:22408587

  6. Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems. (United States)

    Matar, H; Larner, J; Kansagra, S; Atkinson, K L; Skamarauskas, J T; Amlot, R; Chilcott, R P


    The efficient removal of contaminants from the outer surfaces of the body can provide an effective means of reducing adverse health effects associated with incidents involving the accidental or deliberate release of hazardous materials. Showering with water is frequently used by first responders as a rapid method of mass casualty decontamination (MCD). However, there is a paucity of data on the generic effectiveness and safety of aqueous decontamination systems. To address these issues, we have developed a new in vitro skin diffusion cell system to model the conditions of a common MCD procedure ("ladder pipe system"). The new diffusion cell design incorporates a showering nozzle, an air sampling port for measurement of vapour loss and/aerosolisation, adjustable (horizontal to vertical) skin orientation and a circulating manifold system (to maintain a specified flow rate, temperature and pressure of shower water). The dermal absorption characteristics of several simulants (Invisible Red S, curcumin and methyl salicylate) measured with the new in vitro model were in good agreement with previous in vitro and in vivo studies. Moreover, these initial studies have indicated that whilst flow rate and water temperature are important factors for MCD, the presence of clothing during showering may (under certain circumstances) cause transfer and spreading of contaminants to the skin surface.

  7. Investigating risk factors of traffic casualties at private highway-railroad grade crossings in the United States. (United States)

    Haleem, Kirolos


    Private highway-railroad grade crossings (HRGCs) are intersections of highways and railroads on roadways that are not maintained by a public authority. Since no public authority maintains private HRGCs, fatal and injury crashes at these locations are of concern. However, no study has been conducted at private HRGCs to identify the safety issues that might exist and how to alleviate them. This study identifies the significant predictors of traffic casualties (including both injuries and fatalities) at private HRGCs in the U.S. using six years of nationwide crashes from 2009 to 2014. Two levels of injury severity were considered, injury (including fatalities and injuries) and no injury. The study investigates multiple predictors, e.g., temporal crash characteristics, geometry, railroad, traffic, vehicle, and environment. The study applies both the mixed logit and binary logit models. The mixed logit model was found to outperform the binary logit model. The mixed logit model revealed that drivers who did not stop, railroad equipment that struck highway users, higher train speeds, non-presence of advance warning signs, concrete road surface type, and cloudy weather were associated with an increase in injuries and fatalities. For example, a one-mile-per-hour higher train speed increases the probability of fatality by 22%. On the contrary, male drivers, PM peak periods, and presence of warning devices at both approaches were associated with a fatality reduction. Potential strategies are recommended to alleviate injuries and fatalities at private HRGCs.

  8. Medical lessons learnt from the US and Canadian experience of treating combat casualties from Afghanistan and Iraq. (United States)

    Dharm-Datta, Shreshth; McLenaghan, J


    The Winston Churchill Memorial Trust, established in 1965, funds Travelling Fellowships and both authors visited hospitals in Germany, Canada and the USA regarded as centres of excellence with expertise in the early care, reconstruction and rehabilitation of the combat casualties of our NATO Allies, as recipients of these Fellowships. This article presents some of the lessons learnt in the field of musculoskeletal trauma and rehabilitation from the Canadian and US military medical systems. In trauma, there were significant differences in wound debridement policy, use of external fixators for fractures, primary use of circular frames for open tibial fractures and a far more liberal use of bone morphogenetic protein in fracture treatment. Differences in soft tissue reconstruction policy regarding flaps for soft tissue cover over exposed bone, near-universal usage of topical negative pressure dressings and use of Allgöwer-Donati suture pattern to close all wounds were noted. Ertl amputation osteoplasty, a modified form of transtibial amputation, had also been reintroduced. In rehabilitation, the management of heterotopic ossification, in particular with imaging techniques and excision surgery, was identified. For the upper limb, we observed the patient training required to use a myoelectric hand and the future possibility of targeted muscle re-innervation to make controlling these myoelectric prostheses more natural using innate motor patterns. For the lower limb, we found we used identical above knee prostheses. For patients who have had limb reconstruction and have poor function, an energy-storing orthosis was demonstrated to compensate for the loss of range of motion and muscle power.

  9. An Engineer’s Mathematical Approach to Designing an Emergency Room Decontamination Area for Weapons of Mass Destruction Casualties

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    Eldo E. Frezza


    Full Text Available This study will focus on the potential requirements for an emergency response facility in case of weapons of mass destruction casualties proposing mathematical models. A complete emergency room layout will be designed taking the following analyses and requirements into consideration: quality function development (QFD and product layout; average number of patients in the system, average time in the system, average number of patients in the waiting queue and average time waiting in the queue. Our analysis showed that, assuming 150 patients per day for 2 days with average service time of 14 minutes with two lines running. λ = 75 arrivals/day = 0.0521 arrivals/min. µ = 2 patients/14min = 0.1429 patients/min. Average number of patients in system (waiting and being served. Ls = λ / (µ - λ = 0.574 patients. Average time in system (waiting and service time Ws = 1 / (µ - λ = 11.02 min. Average number of patients waiting in queue. Lq = λ2 / µ (µ - λ = 0.209 patients Average time waiting in queue, Wq = λ / µ (µ - λ = 4.016 min. From our model, we conclude to set up an engineer’s perfect ER response we need: Having a stable patient and unstable patient track will make it easy to respond to the emergency. Patients requiring the emergency track feature would be dropped off before the vehicle shower at contaminated stabilizing rooms. Time of service: waiting 14 minutes with an average of 2 patients waiting in line to be served. This is an initial study having a flow of 150 patients arriving over a long time period and it is an attempt to apply a mathematical model to a multidisciplinary approach to a clinical potential discussion.

  10. 成批重度烧伤患者相关感染的个体化治疗%Individualized treatment of infection on mass severe burn casualties

    Institute of Scientific and Technical Information of China (English)



    Successful treatment of mass severe burn casualties is one of the important criteria to test the emergency response ability of department. Burn sepsis, pulmonary infection, local wound infection, enterogenous infection, and a series of infections in the process of mass burn casualties are seriously threatening the life of the patients. In addition to the routine treatment of patients with severe burn, this article focuses on the individual treatment programs for patients with different infections, and achieved good results. Mass burn casualties with severe burn treatment, need to adjust the specific circumstances, in order to maximize the success rate of treatment.%成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。

  11. Nuclear and radiological risk: contaminated mass casualties in the hospital; Risque nucleaire et radiologique: l'afflux massif de victimes contaminees a l'hopital

    Energy Technology Data Exchange (ETDEWEB)

    Telion, C.; Lejay, M.; Carli, P. [Hopital Necker Enfants Malades, SAMU de Paris et DAR, 75 - Paris (France)


    The basic scenario for the medical response organization is the explosion of the dirty bomb in public places spreading radioactive material and contaminating casualties. The French plan gives precise directions for the organization of the emergency room and the simple protective measures for medical staff and equipment to avoid dissemination and contamination into the hospital. Decontamination consists of the undressing of the victims followed by showering. The detection of the contamination can limit the time-consuming unnecessary decontamination procedure and the radioactive waste. Medical and paramedical staff is trained to wear protective disposal paper suits and to direct the procedure of decontamination. (author)

  12. The grave is wide: the Hibakusha of Hiroshima and Nagasaki and the legacy of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation. (United States)

    O'Malley, Gerald F


    Following the atomic bomb attacks on Japan in 1945, scientists from the United States and Japan joined together to study the Hibakusha - the bomb affected people in what was advertised as a bipartisan and cooperative effort. In reality, despite the best efforts of some very dedicated and earnest scientists, the early years of the collaboration were characterized by political friction, censorship, controversy, tension, hostility, and racism. The 70-year history, scientific output and cultural impact of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation are described in the context of the development of Occupied Japan.

  13. [Conditions for the survival of combat casualties in overseas operations: procedure and experience from the Afghan out-of-hospital theater]. (United States)

    Palmier, Bruno


    Recent conflicts have led the French Army Health Service to specify the setting condition for the survival of combat casualties in overseas operations. The majority of them are victims of explosion injuries, and an early and effective control of bleeding is the primary means of improving survival. A procedure called "Combat Rescue" is taught. This chronological procedure favours external haemostasis and led to specific equipment, in particular a tourniquet and a haemostatic bandage of high efficiency. It is applied in recent years on the Afghan out-of-hospital theatre. A very front medical presence, which is systematic during evacuations, is a feature of the French Army Health Service operations support.

  14. Temporal-spatial Distribution Regularities of Forest Fire Casualties in China%我国森林火灾中人员伤亡时空分布特征研究

    Institute of Scientific and Technical Information of China (English)

    杨光; 舒立福; 孙思琦; 邸雪颖; 刘畅


    Based on forest fire statistics (2000-2012) and typical cases available in China, and by using statistical analysis method and ARCMAP spatial analysis method, the forest fire statistics with the same period of the countries where the forest fire frequently occurred in the world are compared, and the temporal-spatial distribu-tion regularities of forest fire casualties in China are analyzed.Results indicate that the forest fires caused heavy casualties during the period of 1988-2012 in China, the proportion of forest fire casualties was much higher than that of North America in that period.There were more forest fire casualties in seriously arid years.Spring was high-occurrence seasons for forest fire casualties, and the forest fire casualties of spring account for 54.2% of the total according to the statistics of 2000-2012.March was high-occurrence months for forest fire casualties, and the for-est fire casualties of March account for 33.7% of the total according to the statistics of 1999-2012.The central and southwestern areas were densely injured areas, the forest fire casualties of the southwestern areas account for 35.5%of the total and the forest fire casualties of the center areas account for 24.3%of the total during the period of 2000-2012.The Yunnan and Hunan were densely injured provinces, the forest fire casualties were found most in Yunnan and mainly involving in minor injury, and the number of minor injury casualties in Yunnan account for 73.0%of the total during the period of 2000-2012 .%基于我国1988-2012年森林火灾统计资料及典型案例,运用统计分析方法和ARCMAP空间分析方法,对比同时期世界上几个森林火灾多发国家的统计数据,分析了我国森林火灾中人员伤亡时空特征。结果表明:1988-2012年我国森林火灾造成的人员伤亡情况较为严重,森林火灾中人员伤亡比例远高于同时期的北美国家;森林火灾中人员伤亡高发于干旱严重的年份;春

  15. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR) (United States)

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard


    The UK’s Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method (“rinse-wipe-rinse”) for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants. PMID:28152053

  16. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK's Initial Operational Response (IOR). (United States)

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard; Chilcott, Robert P


    The UK's Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method ("rinse-wipe-rinse") for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants.

  17. Prairie North: a joint civilian/military mass casualty exercise highlights the role of the National Guard in community disaster response. (United States)

    Vukotich, George; Bayram, Jamil D; Miller, Miriam I


    In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. Additionally, military communication and medical equipment compatibility with the civilian infrastructure was identified as one of the top areas for the improvement of this joint exercise. Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.

  18. 谈亡人火灾事故调查工作的规范%On the Regulation of Fire Investigations Involving Fire Casualties

    Institute of Scientific and Technical Information of China (English)



    Fire accidents with casualties concern the interest of victims. The identification of fire causes is crucial in properly handling the fire accidents of this kind. This paper focuses on specific steps, investigation standards and requirements for reference to the fire investigation of the accidents with casualties.%亡人火灾涉及当事人的切身利益,规范做好亡人火灾的调查工作,准确认定火灾原因,是妥善处理亡人火灾事故的重要基础和前提,对维护社会和谐稳定具有十分重要的意义。结合实践经验,重点针对亡人火灾调查中一些容易忽视的环节,提出工作的标准和要求,以期对规范亡人火灾的调查工作提供实际指导。

  19. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios. (United States)

    Wiley, Albert L


    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations.

  20. Analysis of Casualty Risk per Police-Reported Crash for Model Year 2000 to 2004 Vehicles, using Crash Data from Five States

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Tom


    In this report we compare two measures of driver risks: fatality risk per vehicle registration-year, and casualty (fatality plus serious injury) risk per police-reported crash. Our analysis is based on three sets of data from five states (Florida, Illinois, Maryland, Missouri, and Pennsylvania): data on all police-reported crashes involving model year 2000 to 2004 vehicles; 2005 county-level vehicle registration data by vehicle model year and make/model; and odometer readings from vehicle emission inspection and maintenance (I/M) programs conducted in urban areas of four of the five states (Florida does not have an I/M program). The two measures of risk could differ for three reasons: casualty risks are different from fatality risk; risks per vehicle registration-year are different from risks per crash; and risks estimated from national data are different from risks from the five states analyzed here. We also examined the effect of driver behavior, crash location, and general vehicle design on risk, as well as sources of potential bias in using the crash data from five states.

  1. Iraqi Civilian Casualties Estimates (United States)


    Invasion of Iraq: Cluster Sample Survey,” The Lancet , October 29, 2004, 364 (9448), pp. 1857- 1864. 7 Jack Straw, Written U.K. Ministerial Statement...Health Study (the “WHO study”) March 2003 - June 2006 151,000 The Lancet , “Mortality after the 2003 Invasion of Iraq” March 19, 2003 - July 31, 2006...commonly referred to in the press as “ the Lancet studies” because they were published in the British medical journal of that name. The third study was

  2. An Alternative Health Care Facility: Concept of Operations for the Off-site Triage, Treatment, and Transportation Center (OST3C). Mass Casualty Care Strategy for a Chemical Terrorism Incident (United States)


    develop non- cardiogenic pulmonary edema within 6 hours after exposure to a “choking” agent such as phosgene. These patients should be transported to a...admitted for observation, as they may develop pulmonary edema . E. Psychological Casualties Disasters have a tremendous emotional and psychological

  3. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions. (United States)

    Burkle, Frederick M


    The threat of a BT event has catalyzed serious reflection on the troublesome issues that come with event management and triage. Such reflection has had the effect of multiplying the efforts to find solutions to what could become a catastrophic public health disaster. Management options are becoming more robust, as are reliable detection devices and rapid access to stockpiled antibiotics and vaccines. There is much to be done, however, especially in the organizing, warehousing, and granting/exercising authority for resource allocations. The introduction of these new options should encourage one to believe that, in time, evolving standards of care will make it possible to rethink the currently unthinkable consequences. Unfortunately the cost of such preparedness is high and out of reach of most governments. Most of the developing world has neither the will nor the means to plan for BT events and remains overwhelmed with basic public health concerns (i.e., water, food, sanitation, shelter) that must take priority. Therefore, developed countries will be expected to respond using international exogenous resources to mitigate the effects of such a disaster. As a result, the state capacity of the effected government will be severely compromised. If triage and management of casualties is further compromised, terrorists will have met their goals. One could argue that health sciences will continue for decades to play catch up with the advanced technology driving potential bioagent weaponry. If one lesson was learned from the review of the former Soviet Union's biological weapons program, it is that the unthinkable remains an option to terrorists who have comparable expertise. It is crucial to develop realistic strategies for a BT event. Triage planning (the process of establishing criteria for health care prioritization) permits society to see cases in the context of diverse moral perspectives, limited resources, and compelling health care demands. This includes a competent

  4. Method paper--distance and travel time to casualty clinics in Norway based on crowdsourced postcode coordinates: a comparison with other methods.

    Directory of Open Access Journals (Sweden)

    Guttorm Raknes

    Full Text Available We describe a method that uses crowdsourced postcode coordinates and Google maps to estimate average distance and travel time for inhabitants of a municipality to a casualty clinic in Norway. The new method was compared with methods based on population centroids, median distance and town hall location, and we used it to examine how distance affects the utilisation of out-of-hours primary care services. At short distances our method showed good correlation with mean travel time and distance. The utilisation of out-of-hours services correlated with postcode based distances similar to previous research. The results show that our method is a reliable and useful tool for estimating average travel distances and travel times.

  5. Development of a national burn network: providing a co-ordinated response to a burn mass casualty disaster within the Australian health system

    Directory of Open Access Journals (Sweden)

    AG Robertson


    Full Text Available With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burns Association (ANZBA highlighted the lack of a national burn disaster response before the 2000 Olympics. With the limited number of burn beds available and the protracted length of stay after such injuries, any state or territory could be overwhelmed with relatively few patient admissions. In 2002, the Australian Health Minister's Conference called for a solution. The objective of this paper is to provide an overview of the process and development of the Australian National Burn Network, which underpins the National Burn Disaster Response (AUSBURNPLAN.

  6. Method paper--distance and travel time to casualty clinics in Norway based on crowdsourced postcode coordinates: a comparison with other methods. (United States)

    Raknes, Guttorm; Hunskaar, Steinar


    We describe a method that uses crowdsourced postcode coordinates and Google maps to estimate average distance and travel time for inhabitants of a municipality to a casualty clinic in Norway. The new method was compared with methods based on population centroids, median distance and town hall location, and we used it to examine how distance affects the utilisation of out-of-hours primary care services. At short distances our method showed good correlation with mean travel time and distance. The utilisation of out-of-hours services correlated with postcode based distances similar to previous research. The results show that our method is a reliable and useful tool for estimating average travel distances and travel times.

  7. An introductory characterization of a combat-casualty-care relevant swine model of closed head injury resulting from exposure to explosive blast. (United States)

    Bauman, Richard A; Ling, Geoffrey; Tong, Lawrence; Januszkiewicz, Adolph; Agoston, Dennis; Delanerolle, Nihal; Kim, Young; Ritzel, Dave; Bell, Randy; Ecklund, James; Armonda, Rocco; Bandak, Faris; Parks, Steven


    Explosive blast has been extensively used as a tactical weapon in Operation Iraqi Freedom (OIF) and more recently in Operation Enduring Freedom(OEF). The polytraumatic nature of blast injuries is evidence of their effectiveness,and brain injury is a frequent and debilitating form of this trauma. In-theater clinical observations of brain-injured casualties have shown that edema, intracranial hemorrhage, and vasospasm are the most salient pathophysiological characteristics of blast injury to the brain. Unfortunately, little is known about exactly how an explosion produces these sequelae as well as others that are less well documented. Consequently, the principal objective of the current report is to present a swine model of explosive blast injury to the brain. This model was developed during Phase I of the DARPA (Defense Advanced Research Projects Agency) PREVENT (Preventing Violent Explosive Neurotrauma) blast research program. A second objective is to present data that illustrate the capabilities of this model to study the proximal biomechanical causes and the resulting pathophysiological, biochemical,neuropathological, and neurological consequences of explosive blast injury to the swine brain. In the concluding section of this article, the advantages and limitations of the model are considered, explosive and air-overpressure models are compared, and the physical properties of an explosion are identified that potentially contributed to the in-theater closed head injuries resulting from explosions of improvised explosive devices (IEDs).

  8. Analysis of the personnel casualty reasons and evacuating behavior in the fire%火灾中人员伤亡原因及疏散行为

    Institute of Scientific and Technical Information of China (English)



    根据火灾调查取得的有关参数,使用FDS火灾模拟软件对火灾过程进行了模拟,取得了楼梯间内一氧化碳、二氧化碳、氧气含量及能见度等模拟数据.燃烧产物毒害性、高温烟气、烟气减光性是火灾中致人伤亡的原因.针对火灾中人员的疏散行为,分析了火灾事故教训,提出了预防伤亡的措施.%The paper uses the software of Fire Dynamics Simulator to simulate the course of fire by the parameter from the investigation the fire. FDS calculates the concentration of COi CO2 > O2 and the visibility in the course of fire. It is the poison from the products of combustion. the smoke and gas with high temperature and the strong smoke that make people die and injured in the fire. It analyzes the lessons of the fire accidents, puts forward the prevention measures of personnel casualty in the fire by analyzing of evacuating behavior.

  9. A Study of Casualties of Vulnerable Groups in Fire Disasters%老弱病残火灾事故伤亡原因及消防对策

    Institute of Scientific and Technical Information of China (English)

    肖峰; 王福东


    通过对火灾起数、区域、季节、时间等方面进行比较,对老弱病残弱势群体在火灾事故中伤亡的原因进行了分析,研究了人员消防安全意识、消防安全管理、消防队伍建设等问题,提出有针对性的对老弱病残弱势群体的消防安全管理措施,为今后有效遏制弱势群体火灾多发势头提供一定的参考作用。%This paper analyzes the causes of casusualties of vulnerable groups in fire disasters in terms of the nember of fire disasters, locations and time, including fire safety awareness, fire safety management and fire forces. This pa- per offers some fire safety measures to check the increasing number of casualties of vulnerable in fire disastera.

  10. Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents (United States)

    Klein, Kelly R.; Burkle Jr., Frederick M.; Swienton, Raymond; King, Richard V.; Lehman, Thomas; North, Carol S.


    Introduction: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. Methods: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage. Results: 403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used “gestalt”.(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category. Conclusion: Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics. PMID:27651979

  11. Casualty Searching, Evacuation and Telemedicine System Based on BeiDou Navigation Satellite System%基于北斗卫星定位的伤员搜救与后送、远程医疗系统

    Institute of Scientific and Technical Information of China (English)

    邬小军; 汪陈应; 刘志; 李学成; 赵军平


    Objective To develop a casualty searching, evacuation and telemedicine system to make the soldiers accompanied by medical support. Methods Based on telemedicine technology and locating & two-way communication ability of BeiDou Navigation Satellite System, the hierarchy of the system was designed. Remits The design plan of the casualty searching, evacuation and telemedicine system based on BeiDou Navigation Satellite System was put forward. Conclusion The Casualty precision location, rescue and evacuation are realized for medical support of military operationsother than war.[Chinese Medical Equipment Journal,2011,32(12):9-12]%目的:研制适合于一线救护的伤员搜救与后送、远程医疗系统,最大限度地实现医疗与士兵同在.方法:立足军队现有远程医疗技术,利用北斗卫星同时具备定位与双向通信的能力,设计一整套伤员搜寻、后送与远程医疗体系架构.结果:构建了基于北斗卫星定位的伤员搜救、后送与远程医疗平台设计方案.结论:解决了战场伤员精确定位、援救与后送的难题,满足了非战争军事行动卫勤保障的需要.

  12. The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI – A case report

    Directory of Open Access Journals (Sweden)

    Robert Gałązkowski


    Full Text Available In 2013 a fire broke out in the Nursing Home (NH in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI. Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2:289–295

  13. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model. (United States)

    Hrdina, Chad M; Coleman, C Norman; Bogucki, Sandy; Bader, Judith L; Hayhurst, Robert E; Forsha, Joseph D; Marcozzi, David; Yeskey, Kevin; Knebel, Ann R


    Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe perimeters are established, RTR sites should be determined in real-time that are based on the extent of destruction, environmental factors, residual radiation, available infrastructure, and transportation routes. Such RTR sites are divided into three types depending on their physical/situational relationship to the incident. The RTR1 sites are near the epicenter with residual radiation and include victims with blast injuries and other major traumatic injuries including radiation exposure; RTR2 sites are situated in relationship to the plume with varying amounts of residual radiation present, with most victims being ambulatory; and RTR3 sites are collection and transport sites with minimal or no radiation present or exposure risk and a victim population with a potential variety of injuries or radiation exposures. Medical Care sites are predetermined sites at which definitive medical care is given to those in immediate need of care. They include local/regional hospitals, medical centers, other

  14. Impact of the AD 79 explosive eruption on Pompeii, II. Causes of death of the inhabitants inferred by stratigraphic analysis and areal distribution of the human casualties (United States)

    Luongo, Giuseppe; Perrotta, Annamaria; Scarpati, Claudio; De Carolis, Ernesto; Patricelli, Giovanni; Ciarallo, Annamaria


    Detailed descriptions of the effects of explosive eruptions on urban settlements available to volcanologists are relatively rare. Apart from disease and starvation, the largest number of human deaths caused by explosive eruptions in the twentieth century are due to pyroclastic flows. The relationship between the number of victims related to a specific hazard and the presence of urban settlements in the area covered by the eruption has been shown. However, pyroclastic falls are also extremely dangerous under certain conditions. These conclusions are based on archaeological and volcanological studies carried out on the victims of the well-known AD 79 eruption of Vesuvius that destroyed and buried the Roman city of Pompeii. The stratigraphic level in the pyroclastic deposit and the location of all the casualties found are described and discussed. The total number of victims recovered during the archaeological excavations amounts to 1150. Of these, 1044 well recognisable bodies plus an additional group of 100 individuals were identified based on the analysis of several groups of scattered bones. Of the former, 394 were found in the lower pumice lapilli fall deposit and 650 in the upper stratified ash and pumice lapilli pyroclastic density currents (PDCs) deposits. In addition, a tentative evaluation suggests that 464 corpses may still be buried in the unexcavated part of the city. According to the reconstruction presented in this paper, during the first phase of the eruption (August 24, AD 79) a huge quantity of pumice lapilli fell on Pompeii burying the city under 3 m of pyroclastic material. During this eruptive phase, most of the inhabitants managed to leave the city. However, 38% of the known victims were killed during this phase mainly as a consequence of roofs and walls collapsing under the increasing weight of the pumice lapilli deposit. During the second phase of the eruption (August 25, AD 79) 49% of the total victims were on the roadways and 51% inside

  15. ILE a Casualty of War (United States)


    field grade positions. Officer career progression to the field 68 Jamie Gayton , Force...Statistical data on ILE backlog by email 27 October 2007. Gayton , Jamie. “Force Stabilization.” Soldiers Magazine, June 2001 Hillen, John. "Must US

  16. Recent casualties of late globalization

    DEFF Research Database (Denmark)

    Turcan, Romeo V.


    In this essay I will expand my thoughts on universities as ‘late globalizers’ and the impact ‘being late’ has on university internationalization or globalization activities. In my earlier essay I viewed universities as ‘late globalizers’ and briefly introduced the impact of being ‘late’, e.g., wi...

  17. Recent casualties of late globalization

    DEFF Research Database (Denmark)

    Turcan, Romeo V.


    In this essay I will expand my thoughts on universities as ‘late globalizers’ and the impact ‘being late’ has on university internationalization or globalization activities. In my earlier essay I viewed universities as ‘late globalizers’ and briefly introduced the impact of being ‘late’, e...

  18. Prediction of Thermal Stress Casualties (United States)


    high- performance liquid chromatographic method for the concurrent determination of the amine metabolites vanillylmandelic acid , 3-methoxy-4...rates of high and low groups under the seven experimental conditions ....... .................. ... 14 6 3-Methoxy, 4-Hydroxy mandelic acid excretion...17 9 11cxrovanrllic acid excretion rates of hiah and low groups under the seven e~xperrimnttil conditions

  19. Effective Evaluation to Healthy Education on Functional Exercise Recovery for Post Burn Casualties%健康教育在烧伤患者功能锻炼康复中的效果评价

    Institute of Scientific and Technical Information of China (English)

    姚琼珍; 陈素英; 姚琼宝; 曾琦; 刘伟燕; 顾洁玲; 阮柳红


    Objective To explore the health education effect on burn casualties who performing functional exercise.Methods 65 burn casualties were randomly divided into healthy education group and control group.In the healthy education group,purposeful,designedly,individual healthy education guidance,as well as mental nursing was given.The patients in the education group performed functional exercise.The patients in the control group were cared by conventional nursing.Results compare the two groups,the degrees of knowledge possessed at functional exercise,active treatment cooperation and effects of treatment in education group were superior to those in the control group(P<0.01).Conclusion it can lead the patients to perform rehabilitation training actively,decease complications,reduces mortality,enhance the quality of live of patients and self-care skill by carrying out healthy education to the burn casualties accordingly.It plays a vital role in promoting recovery to the patients.%目的 探讨健康教育在烧伤患者功能锻炼中的效果.方法 对65例烧伤患者随机分为健康教育组与对照组.健康教育组进行有目的 、有计划、个体化的健康教育指导及实施心理护理、功能锻炼.对照组给予传统的护理方法.结果 健康教育组功能锻炼掌握程度、主动性配合治疗及功能恢复效果优于对照组,经临床观察差异有显著性(P<0.01).结论 通过有针对性开展烧伤病人健康教育,使患者积极主动参与康复功能的训练,减少并发症的发生,降低死亡率,提高患者生命质量及自理的能力.对促进烧伤患者的康复起着至关重要的作用.

  20. Efectividad a corto plazo de las intervenciones breves realizadas en pacientes lesionados por accidente de tráfico con alcoholemia positiva Short-term effectiveness of brief interventions in alcohol-positive traffic casualties

    Directory of Open Access Journals (Sweden)

    Alicia Rodríguez-Martos


    Full Text Available Objetivos: Investigar la efectividad de las intervenciones breves para reducir el consumo de alcohol en los pacientes lesionados por accidente de tráfico con alcoholemia positiva. Métodos: Se cribó la presencia de alcohol en 948 lesionados en accidente de tráfico (el 97,6% de los elegibles de un universo de 1.106, con 126 (13,3% positivos. Se intervino en 85 individuos, aleatoriamente distribuidos en intervención mínima (consejo simple e intervención breve (intervención de tipo motivacional, y se programó un seguimiento telefónico a los 3, 6 y 12 meses. En este trabajo se presentan los resultados del seguimiento a los 3 meses. Resultados: A los 3 meses se ha seguido a 57 pacientes (67%. EL 73,7% ha reducido el consumo, porcentaje que fue mayor en el grupo intervención breve (p = 0,06; tamaño del efecto, 0,5 y en los incluidos en la categoría de los bebedores de riesgo (p Objectives: To investigate the effectiveness of brief interventions to reduce alcohol intake in traffic casualties with a positive blood alcohol concentration. Methods: Nine hundred forty-eight eligible casualties (97.6% of eligible casualties within a universe of 1106 were screened for alcohol and 126 (13.3% were identified as positive. Interventions were performed in 85, randomly allocated to a minimal intervention (simple advice or a brief intervention (motivational intervention. Telephone follow-up was scheduled for months 3, 6 and 12. The present study reports the results of follow-up at month 3. Results: Fifty-seven patients (67% were followed up at month 3. A total of 73.7% had reduced their alcohol intake and this percentage was greater in the group who underwent the brief intervention (p = 0.06; effect size 0.5 and among heavy drinkers (p < 0.05. Conclusions: The data indicate the effectiveness of the brief intervention, although the sample size does not allow definitive conclusions to be drawn.

  1. Features of survived casualties and treatment after " July 23" EMU railway accident at Wenzhou station%“7·23"温州动车事故存活伤员损伤特点及救治分析

    Institute of Scientific and Technical Information of China (English)

    闻浩; 林露阳; 陈大庆; 吴钒; 朱烈烈


    目的 分析“7·23”温州动车追尾事故存活伤员的损伤特点,探讨并分析事故初期伤员的救治策略.方法 以事故后24h温州市各大医院救治的事故伤员为对象,收集伤员的年龄、性别、致伤部位、损伤严重程度等信息并应用创伤评分系统3.0进行分析.结果 事故发生后24h温州市各大医院共收治伤员136例,年龄在2.5 ~69岁之间,男性占55.89%,女性占44.11%;主要以钝器致伤为主;存活伤员中多发伤占79.41%,实质性受伤部位以胸部为第1位、其次是四肢和脊柱;所有伤员均现场急救后直接送至就近医院.结论 直接外力及惯性、离心力引起的钝器伤是存活伤员主要的致伤原因,胸部、四肢及脊柱为主要的受伤部位,对事故伤员救治初期的治疗以抢救生命、分诊和后送为主.%Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 (" July 23" train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89% and 44.11% respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41%.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be

  2. Transport evaluation and selection method for mass casualty in emergency%突发事件中批量伤员转运评估及方法选择

    Institute of Scientific and Technical Information of China (English)

    姚元章; 丁茂乾


    Effective and timely transport of severe trauma patients is the basic requirement of trauma profes -sional treatment,and is also one of the important measures to reduce the mortality and disability rate of severe trau -ma.How to timely and efficiently transport and to provide more specialized treatment for mass casualty is the major challenge faced by the modern trauma care and the disaster emergency rescue .To provide scientific basis for mass casualty transport in future ,the injury assessment before transport and the transport methods were discussed in this paper,so as to provide a scientific basis for the standardization of future disaster emergency rescue transfer .%对严重伤病员高效、及时的转运,是创伤专业化救治的基本要求,也是降低严重创伤死亡率和伤残率的重要措施之一。如何对批量伤员进行及时、高效转运,及早为伤病员提供更专业化的救治,是现代创伤救治及灾难应急救援面临的重大挑战。本文就批量伤员转运前的伤情评估、转运方法等进行探讨,为今后批量伤员转运实施提供科学、规范的依据。

  3. NF ISO 21243, September 2009. Radiation protection - Performance criteria for laboratories performing cytogenetic triage for assessment of mass casualties in radiological or nuclear emergencies - General principles and application to dicentric assay; NF ISO 21243, septembre 2009. Radioprotection - Criteres de performance pour les laboratoires pratiquant le tri par cytogenetique en cas d'accident radiologique ou nucleaire affectant un grand nombre de personnes - Principes generaux et application aux dicentriques

    Energy Technology Data Exchange (ETDEWEB)



    This international standard is to give an overview of the minimum requirements of process and quality-control components of the cytogenetic response for triage of mass casualties. Cytogenetic triage is the use of chromosome damage to evaluate approximately and rapidly radiation doses received by individuals in order to supplement the early clinical categorization of casualties. This standard concentrates on organizational aspects of applying the dicentric assay for operation in a triage mode. The technical aspects of the dicentric assay can be found in the ISO 19238. This international standard is applicable either to an experienced biological dosimetry laboratory working alone or to a network of collaborating laboratories.

  4. 基于最低人员伤亡的资源优化配置模型研究%Study of optimized allocation model for emergency resource based on minimal casualties

    Institute of Scientific and Technical Information of China (English)

    赵洪海; 李明泽; 李忠伟


    The present paper is aiming at introducing an optimized allocation model for emergency resource based on the minimal casualties in case of incidence of an unexpected disaster involving the entire city sphere. In order to optimize the emergency resource allocation based on the existing available emergency resources to be allocated, first of all, we have made careful consideration of the means for such kind of allocation. The so-called emergency resources can be divided into human resources, material resources and message resources according to their ability to perform their own respective functions. The urban emergency-available shelter, for instance, is a special temporary place that can provide secure refuge and basic facilities for people to shelter themselves in during the recovery period after a natural disaster. Also, it is an important means for the international society to deal with the emergent events and victims for mutual benefits. In order to minimize the total economic loss and minimize the number of casualty, it is desirable to allocate the available resources in an optimized manner. However, the traditional or habitual manner to manage the emergency resources in our country is based on the local authorities' experience without any clear-minded guide or theory for appropriate quantitative or qualitative allocation criteria and often leads to the failure to achieve the best advantage of the resources as is expected. And, secondly, the most influential factor for optimizing resource allocation in disaster-hitting period is time-urgency. The reason for this is obvious because the response to the disaster sufferers must be prompt, instantaneous and immediate, or unconditional. Therefore, we have given a detailed discussion over the most influential parameters that are likely relevant here. What is more, we have brought about a fatality model open to an open discussion. In our model, we have illustrated all the fatalities involving the likely

  5. Análisis de la analgesia en la baja de combate: Experiencia de la Sanidad Militar española Analgesia in the management of the combat casualty: Experience of the Spanish Medical Service

    Directory of Open Access Journals (Sweden)

    R. Navarro Suay


    Full Text Available Antecedentes y Objetivos: La analgesia del herido ha jugado un papel trascendental en la medicina militar. En la actualidad, continúa siendo un reto médico, táctico y logístico dentro del tratamiento integral de la baja en combate. El objetivo de este estudio es valorar la homogeneidad de los fármacos analgésicos administrados, del momento de inicio del tratamiento, del número y tipos de vías de acceso para administración de analgesia, así como del tipo de anestesia realizada en las bajas por arma de fuego o por artefacto explosivo atendidas en el ROLE 2E español de Herat (Afganistán entre 2005 y 2008, siguiendo un índice de gravedad anatómico (NISS de las lesiones. Material y métodos: Se realiza un estudio observacional, retrospectivo, obteniendo una muestra de 256 pacientes. Resultados: Los fármacos analgésicos más empleados fueron los AINEs (73%, seguidos de los mórficos mayores (44%, coadyuvantes (29%, mórficos menores (21% y ketamina (12%. La analgesia se realizó a nivel prehospitalario en un 61% y a nivel intrahospitalario en un 31% de los casos. La vía de administración más frecuente fue la intravenosa (79%. En el 75% sólo se consiguió un acceso para medicación analgésica. El procedimiento anestésico más empleado fue la anestesia general (32%. Conclusiones: El tratamiento analgésico prestado a las bajas en combate de la muestra es homogéneo en cuanto a los fármacos empleados, el tipo y número de vías de administración conseguidas. Sin embargo es heterogéneo en cuanto al tipo de AINE elegido y al inicio en la administración de los fármacos analgésicos.Antecedents and Objectives: The analgesia of the wounded has played a vital role in military medicine. Nowadays it still is a medical, tactical and logistical challenge in the integral management of the combat casualty. The objective of this study is to evaluate the homogeneity of the analgesic drugs used, starting point of the treatment, number and

  6. 煤矿员工伤亡事故行为时空特征规律研究--以淮南地区煤矿为例%On the Principle of Behavioral Spatiotemporal Characteristics of Coal Miners ’ Casualty---Taking the coal mines in Huainan area as an example

    Institute of Scientific and Technical Information of China (English)

    刘星期; 郭亚; 张欣; 周久生


    In the macro socio-historical environment, political disturbance and national economy ’s extremely difficulty are substantial reasons of coal miners’ casualty. The behaviors of coal miners’ casualty during these time are substantially more than the normal year. The behaviors of coal miners’ casualty in daytime are substantially more than in the night-time, especially at about 10 am. The behaviors of coal miners’ casualty at 5 am in coal mine are more than metal mine. At 13:00 after lunch, employees are in a stage of physiological and psychological difficulties, reducing the level of awakening, and it is disadvantageous to safety production.%在宏观社会历史环境中,政治动乱和国民经济极端困难两项因素,是煤矿员工工伤事故行为的重要致因,工伤事故行为显著高于其它正常年份。在24小时昼夜节律中,白班工伤事故行为发生频次显著高于夜班,其中上午10点前后为最。相比较于金属矿山煤矿凌晨5点亦是工伤事故高发时段。午餐后13点员工出现生理心理困顿期,致使醒觉水平降低,不利于安全生产。

  7. 绿色通道在“7·23"温州动车事故早期急救中的作用%Role of fast passage for patients to enter emergency department in rescuing and triaging traumatic casualties from the bullet train accident occurred at Wenzhou station on 23 July 2011

    Institute of Scientific and Technical Information of China (English)

    朱烈烈; 潘达; 吴钒; 闻浩; 陈大庆; 张春梅


    目的 探讨急诊绿色通道在特大交通事故伤员救治中的作用,为今后重大灾害救援积累经验.方法 回顾“7·23”温州动车事故伤员在温州市各医院急诊科的救治过程,并对不同伤情伤员在急诊科救治时停留的时间进行比较和分析.结果 事故后72 h内收治伤员136例,其中单一伤患者28例,在急诊科平均停留时间为27 min;多发伤患者108例,在急诊科平均停留时间为62 min,两者差异具有统计学意义(P<0.01).同时与本院前一年度的日常普通伤员救治时间进行回顾性对比发现,救治时间平均缩短达50 min,表明建立健全的急诊绿色通道制度,对加快应急状态下伤员救治有重要意义.结论 应根据实际情况,进一步完善绿色通道制度,使伤员在急诊科的停留时间不断缩短,从而保证伤员尽快得到专科救治,为抢救危重伤员赢得宝贵时间.%Objective To determine the effect of fast passage for patients' access to the emergency department of hospital on rescuing and triaging the traumatic casualties referred from the site of accident by collision between two bullet trains occurred at Wenzhou station on 23 July 2011 in order to accumulate experience of treating large number of traumatized casualties happened in a major accident or disaster.Methods A retrospective study was carried out to collect the data including the different courses of treatment for various types of injury in casualties and the length of stay of traumatized patients with different degrees of severity in the emergency department after casualties entered into the emergency department of hospital via fast passage.Results There were 136 traumatic casualties referred to hospital within 72 hours after the bullet train accident occurred at Wenzhou station.The average length of stay of patients with uncomplicated single injury in the hospital was 27min,and the average length of stay of 108 patients with multiple injuries in the

  8. 昆山“8·2”爆炸事故存活伤员损伤特点及救治分析%Features of survived casualties and treatment strategies in Kunshan "August 2" explosion aaccident

    Institute of Scientific and Technical Information of China (English)

    刘军; 赵富丽; 吴健; 吴曙华; 杨爱祥; 李晓英; 彭霄; 常新; 程宏宇


    目的 回顾性分析昆山“8·2”爆炸事故伤员损伤特点,探讨爆炸事故伤员的救治策略.方法 以“8·2”爆炸事故送至南京医科大学附属苏州医院ICU集中救治的40例伤者为对象,详细记录伤者性别、年龄、损伤类型、烧伤面积、深度等信息,分析伤后90 d内器官损伤的类型、感染部位及病原体、器官功能支持及医疗救治效果等.结果 爆炸事故后收住本院的伤者40例,男性28例,女性12例;创伤类型包括烧伤、吸入性损伤、爆震伤、颅脑损伤和骨折等;所有伤者均存在烧伤,平均烧伤面积为(92±14)%体表面积(TBSA),其中深Ⅱ度烧伤占(14±10)% TBSA,Ⅲ度烧伤占(77±19)% TBSA;病程中34例(85.0%)伤者出现多器官功能不全综合征(MODS),主要累及呼吸、循环、肝脏、胃肠道、肾脏及凝血功能;患者住院期间最常见的感染部位为创面、血液及肺,致病菌主要为革兰阴性菌(占91.3%),前5位致病菌分别为奇异变形杆菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌;积极救治后28 d死亡8例(病死率20.0%),90d死亡25例(病死率62.5%),主要死亡原因是感染性休克及MODS.结论 昆山“8·2”爆炸事故现场存活者主要呈大面积烧伤,以Ⅲ度烧伤为主,病程中多数伤者出现多器官功能不全综合征及合并感染.%Objective To retrospectively analyze the injury features of survived casualties and treatment strategies in the explosion accident on 2 August 2014 in Kunshan city (Kunshan "August 2" explosion accident).Methods A total of 40 survived victims in Kunshan "August 2" Explosion Accident were studied retrospectively.The age,gender,type of injury,burned extent and depth of the patients were recorded.Data of organ function,infection sites and strains of bacteria,treatment strategies and prognosis of the burned victims were analyzed.Results (1) A total of 40 victims were admitted to our hospital

  9. Application and effects of team-triage system in the rescue of mass blast casualties%成组化分诊模式在应对突发大批伤员救治中的应用

    Institute of Scientific and Technical Information of China (English)

    黄萍; 沈红; 陈雁; 刘瑛


    Objective To evaluate the effects of team-triage system in the rescue of mass casualties in grade-Ⅲ hospitals. Methods A triage team was set up based on the mode of team-triage system. Totally 124 blast injured patients were triaged and rescued according to the simple triage and rapid treatment procedure. Results Of the 124 wounded patients,35 patients were triaged to red area,30 patients to yellow area,and 59 patients to green area. The triage qualification rate was 100%. Thirty-four patients suffered from severe multiple injuries or combined injuries. One hundred and eighteen patients received debridement operation and ten patients received damage control operation. One patient died and the rescue success rate was 97.1%. Conclusions The mode of team-triage system can ensure the rapid and orderly triage and rescue procedure, raise the efficiency of triage management and increase patient satisfaction in the rescue of group wounded patients.%目的 探讨成组化分诊模式应用于三级医院应对大规模成批伤员救治的效果.方法 按照成组化分诊模式建立检伤分诊小组,按照简单检伤分类及快速治疗程序对124例爆炸伤伤员进行检伤分流管理.结果 124例伤员中分流到红区救治35例,黄区30例,绿区59例,分诊合格率100%.本组中严重多发伤及复合伤34例,行清创手术118例,损害控制性手术10例,死亡1例,抢救成功率97.1%.结论 成组化分诊模式应用于三级医院应对突发大规模成批伤员救治,可以迅速建立良好的检伤救治秩序、提高分诊全程管理的效率和患者满意度.

  10. 汶川地震后送伤员的伤情特点与后方医院处理分析%Characteristics of Wenchuan earthquake casualties transferred to rear hospitals and their treatment

    Institute of Scientific and Technical Information of China (English)

    吴雪晖; 许建中; 王序全; 周强; 唐康来


    Objective To explore treatment efficacy of Wenchuan earthquake casualties transferred to rear hospitals. Methods A statistic investigation was conducted on the 273 casualties transferred to the Southwest Hospital and Daping Hospital, the Third Military Medical University, Chongqing for further treatment. Their age, gender, rescue time, injured parts, ISS (Injury Severity Score), complications, crush injury and treatment effects were analyzed statistically. Results Ages of the injured ranged from 1 to 96years old, with an average of 48.6 years old. Ten cases were 0-14 years old (3.7%), 114 cases 15-44 years old (41.8%), 81 cases 45-64 years old (29.6%), 68 cases above 65 years old (24.9%). The ratio of male to female was 1:1.13. The average rescue time was 6.7 hours and 50.5% of the injured were rescued within24 hours. As for the injured parts, 5.6% of the patients had injury to head and neck, 0.7% to face, 15.8%to chest, 8.9% to belly, 64.7% to limbs and pelvis and 4.3% to body surface. The ISS ranged from 1 to 37, with an average of 8.6 points. One hundred and seventy-two cases (63.0%) had <16 points, and 101cases (37.0%) ≥16 points. Complications occurred in 55 cases (20.1%), 18 of which (6.5%) had ordinary wound infection, 1 of which (0.4%) gas gangrene, 1 of which (0.4%) lung infection, 2 of which (0.7%) acute renal failure, 6 of which (2.1%) diabetes, and 27 of which (9.9%) crush injury. After hospitalization, patients were given life signs evaluation firstly. Then emergency treatment was carried out to save life or control complications. When conditions were stable, surgery was conducted for 209 patients (76.6%). No death or amputation happened in this series. Conclusion Although 5.12 Wenchuan earthquake caused a large scale of multiple injures, fine and efficient treatment in rear hospitals can increase the curing rate and reduce the death and disability rates.%目的 了解汶川地震中转运至后方医院伤员的伤情特点及治疗效果,探讨地

  11. 不同海况下重度海战伤海上救护的实验研究%Experimental research on medical care at sea of severe sea-battle casualties under different sea status

    Institute of Scientific and Technical Information of China (English)

    谢培增; 汪先兵; 陈大军; 吴新文; 洪加津; 叶汉深; 刘剑; 庄永敬


    目的 探讨海上环境对严重海战伤处理的影响,为提高海战救护能力提供参考.方法 杂种犬60只,按数字表法随机分为码头组(码头环境)、海上一组(海上环境风力2~4级,浪高2~3 m,舰船摇摆度5°~10°)、海上二组(海上环境风力5~7级,浪高3~5 m,舰船摇摆度11°~25°),每组20只.海上一组、二组在航行中的医院船上进行实验,码头组在该海域码头救护所中进行实验.动物被制作成颅脑火器伤、开放性胸部伤、开放性腹部伤、下肢伤和烧伤模型,且先行海水浸泡处理,随后进行手术和海水浸泡伤常规处理.每组先后行不同部位手术20台次,每台次包括开颅术、剖胸术、剖腹术、下肢骨折内固定术、股动脉吻合术、气管切开术、静脉切开术和清创术.对3组的手术时间、手术质量及伤后3 d内动物死亡率进行比较.结果 手术时间,码头组共300.6 min,海上一组共369.4 min,海上二组共426.3 min.海上一组手术时间比码头组长22.9%(P<0.01),海上二组比海上一组长15.4%(P<0.01).股动脉吻合术后,码头组1条血管不通畅,海上一组、二组分别有3条和5条血管不通畅.3 d内码头组动物的死亡率为35%(7/20),海上一组、二组分别为45%(9/20)和55%(11/20),海上二组死亡率明显增高(P<0.01).结论 海上环境对手术时间、质量和动物死亡率有明显的影响.明确海上手术特点,提高外科医生海上手术的技巧和适应海上环境是缩短手术时间、提高质量、降低动物死亡率的关键.%Objective To explore effects of marine environment on the treatment of severe sea - battle casualties so as to improve medical care of casualties at sea. Methods Sixty mongrel dogs were randomly divided into 3 groups: the dock group, sea group 1 (scale of wind force 2~4, waves 2~3 m, rolling and pitching of the ship with 5°~10°) and sea group 2 ( scale of wind force 5~7, waves 3~5 m, rolling

  12. 两批危重烧伤患者转入院后的早期救治体会%Treatment strategies for mass burn casualties transferred from a distance-clinical experience

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 杨红明; 贾晓明; 李利根; 郝岱峰; 申传安; 吴焱秋; 梁黎明


    目的本文介绍2批共13例危重烧伤病人,伤后3~4天经长途转运至我科的早期救治体会.方法 2001年6月27日和2002年6月9日先后收治两批13例伤后3~4天经长途转运入院的烧伤患者,男性4例,女性9例,年龄20~43岁,平均31.1±6.2岁,烧伤总面积74.3%±24.7%,Ⅲ度面积53.7%±31.2%.其中,特重度烧伤10例,烧伤总面积86.0±11.5%,Ⅲ度面63.9±26.3%,合并有重度吸入性损伤4例,中度吸入性损伤6例;重度烧伤3例,烧伤总面积35.3%±10.0%,Ⅲ度面积15.3%±5.0%,均合并有中度吸入性损伤.13例患者都已气管切开,四肢或胸腹部切开减张.13例患者中,有的高热或体温不升;有的心率、呼吸增快;有的腹胀或肠鸣音消失;有的白细胞、血小板低下.13例患者均有不同程度的肝、肾功能、心肌酶和凝血功能异常.结果除2例伤前分别患有心肌炎、慢性肝炎的危重烧伤患者,最终因心肌炎于伤后29天,肝功能衰竭于伤后45天死亡外,其余11例患者全部救治成功.结论成批烧伤转入院后的特点是,伤情重,并发症多,救治难度大.严密组织,责任明确;救治力量前伸机场;入院过程中尽快确定伤情;尽快处理危及生命的并发症;综合治疗措施得当、及时是挽救病人生命的先决条件;重视代谢和凝血功能的调理是后续治疗的重要组成部分.%This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to

  13. Bio-Terrorism Threat and Casualty Prevention

    Energy Technology Data Exchange (ETDEWEB)



    The bio-terrorism threat has become the ''poor man's'' nuclear weapon. The ease of manufacture and dissemination has allowed an organization with only rudimentary skills and equipment to pose a significant threat with high consequences. This report will analyze some of the most likely agents that would be used, the ease of manufacture, the ease of dissemination and what characteristics of the public health response that are particularly important to the successful characterization of a high consequence event to prevent excessive causalities.

  14. Patient Warming Device for Casualty Care (United States)


    Silane MF, Barie PS. Hypothermia during elective abdominal aortic aneurysm repair: the high price of avoidable morbidity. J Vasc Surg. Mar 1995;21(3...1998;7(4):282-287. 35. Wallen E, Venkataraman ST, Grosso MJ, Kiene K, Orr RA. Intrahospital transport of critically ill pediatric patients. Crit Care

  15. Diagnostic and Treatment Innovations for Mass Casualties (United States)


    10 –4 coulomb per kilogram (C kg –1 ) rad [absorbed dose] 1 × 10 –2 joule per kilogram (J kg –1 ) [gray (Gy)] rem [equivalent and effective ...222 newton (N) Energy/Work/Power electron volt (eV) 1.602 177 × 10 –19 joule (J) erg 1 × 10 –7 joule (J) kiloton (kt) (TNT equivalent) 4.184...10 12 joule (J) British thermal unit (Btu) (thermochemical) 1.054 350 × 10 3 joule (J) foot-pound-force (ft lbf) 1.355 818 joule (J) calorie

  16. Ophthalmic Care of the Combat Casualty (United States)


    tified. Oral and topical steroids, anticoagulant therapy, antineoplastic agents , echothiophate prod- ucts, and topical or systemic antibiotics tend to...continuing aspirin and nonsteroidal antiinflamma- tory oral agents is prudent because of their antiplatelet effects. Acetaminophen is preferred for pain... antiplatelet agents because these could cause further intraocular hem- orrhage and complications. Following the initial globe repair, complications (eg

  17. Casualty Estimation for Nuclear and Radiological Weapons (United States)


    the amount and timing of the medical assets moved into the theater. Thus, this estimate will be of interest to the operational, personnel, and medical... assets to the theater to address this medical requirement. The civilian population scenario is not specific to an operational military unit, but available, even in the entire DOD health care system. The total number of military personnel that would likely be called upon to provide support

  18. Management of Mass Casualty Burn Disasters (United States)


    Lubricant, surgical Povidone iodine applicators Urinal Adult limb restraints Dobhoff feeding tubes Collar , cervical , Aspen, adult Cauterizer, hand-held, U...Christmas tree adaptors Scissors Regulators Nasal cannulae Oxygen masks (simple, venturi, non-rebreather, aerosol) Tracheostomy collar Oxygen tubing

  19. Early Acute Kidney Injury in Military Casualties (United States)


    myocardial infarction . Arch Intern Med. 2008;168:609Y616. 22. van Kuijk JP, Flu WJ, Chonchol M, Chonchol M, Hoeks SE, Winkel TA, Verhagen HJ, Bax JJ...the purposes of this study, we defined early AKI in our study population as the development of a new diagnosis of AKI within 14 days of admission to a...Because the development of AKI is time dependent and requires that a creatinine be drawn to make the diagnosis , we chose to model risk of AKI using Cox

  20. Casualty Evacuation in the Contemporary Operating Environment (United States)


    Made Ridiculously Simple, 2001. 52 Ibid. See also Gerard J. Tortora and Sandra Reynolds, Principles of Anatomy and Physiology, 9th Edition John Wiley...Landmark Thucydides, New York: The Free Press, 1996. Tortora , Gerard J. and Reynolds, Sandra. Principles of Anatomy and Physiology, 9th Edition New York

  1. Mass Casualty Triage Performance Assessment Tool (United States)


    tactical tasks for which Soldiers are supposed to be trained to complete and the lack of more precise measurement tools, one key gap identified for...between the wound and the heart) and elevate the wound above the level of the heart to slow the flow of blood to the wound. • Apply a clean...TERMS Assessment, Triage, Performance measurement , Feedback, Tasks-Collective, Brigade Combat Teams, Task analysis

  2. Casualty Data Assessment Team Operation Desert Storm (United States)


    none of these facilities were able or willing to volunteer such resources, at least initially. At the 2nd General Hospital, the Chief of Surgery "toe poppers" described as 2 discs joined together like a dumbbell with just enough explosive charge to destroy the forefoot . Protective...Requires hospitalization/ surgery . Black (solid) = KIA. The scenario of the first three vehicles is that of Bravo Company, 1/41 Infantry, 2nd Amiored

  3. Biomarker Use in Tailored Combat Casualty Care (United States)


    468 Brown, Safford, Caraman ica & Elster In the following sections, we describe our efforts ro define rhe role of biomarkers :moci- ated wich...Salroraf;u GH, Peru ~ G: Principle• of ’"u 12 Bently R, Nuccin P, Wolfe E tr a/.: 250(6), 1002-1007 (2009). M11gcry: cu rrtnt cunccpt~ n nd fn ru rc

  4. War casualties on the home front

    Energy Technology Data Exchange (ETDEWEB)

    Brenda J. Flinn


    On May 12, 1942, at Christopher coal mine No. 3 in Osage, West Virginia, a continent away from the frontlines of World War II, Superintendent Ed O'Neil saw the mine ventilation fan suddenly run backwards, propelled by a strong gust of air that tore the belt off the huge blower. The second shift mantrip of 115 coal miners, traversing the drift mouth for the 3:00 p.m. shift, ground to an uneasy halt. The article recounts the tragic consequences of this incident. It also tells of other events affecting coal miners during World War I and World War II.

  5. Reprioritization of Research for Combat Casualty Care (United States)


    member serves as a paid consultant to Stryker and IlluminOss; serves as an unpaid consultant to BioIntraface; has stock or stock options held in...immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or

  6. Stress Gym for Combat Casualty Patients (United States)


    1999). Attitudes and beliefs of African Americans toward participation in medical research. Journal of General Internal Medicine , 14, 537-46...R. H. (2006). Utility of a Short Screening Scale for DSM-IV PTSD in Primary Care. Journal of General Internal Medicine , 21 (1), 65–67. Retrieved

  7. Military Medical Revolution: Prehospital Combat Casualty Care (United States)


    by the US Navy and the US Marine Corps. Experimental studies demonstrated efficacy against venous bleeding10 or mixed arterial and venous bleeding...RA, Cardenas L, McManus AT, et al. Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and...2004;57:224 230. 15. Arnaud F, Teranishi K, Tomori T, Carr W, McCarron R. Comparison of 10 hemostatic dressings in a groin puncture model in swine. J

  8. An Eye Oximeter for Combat Casualty Care (United States)


    monitoring (e.g., retinitis pigmentosa, retinal detachment, macular degeneration , diabetic retinopathy, etc.). Recently, scanning laser microscopy...Date: « 1 Table of Contents Section Page number SF 298 2 Foreword 3 Table of Contents 4 Introduction 5 Body of Report EOX...implying that some form of iterative regression may be required in order to calculate the saturation. 36 3 ■■!. i i 11 i i i i i i i i i i i i i i i

  9. Análisis del agente lesivo en la baja de combate: Experiencia de la Sanidad Militar española desplegada en Herat (Afganistán Analysis of the injuring agent in the combat casualty: The Spanish Medical Service experience in Herat (Afghanistan

    Directory of Open Access Journals (Sweden)

    R. Navarro Suay


    Full Text Available Introducción: El conocimiento sobre aspectos relacionados con el armamento mejoran el diagnóstico y el tratamiento global del herido, sobretodo en el caso del médico militar. Se exponen los agentes lesivos de los principales conflictos recientes. El objetivo del estudio es el análisis del agente lesivo de las bajas atendidas en el Hospital Militar (ROLE 2 de Herat (Afganistán entre 2005 y 2008. Material y método: Se ha diseñado un estudio descriptivo, transversal sobre todo el personal civil y militar que hubiese recibido herida por arma de fuego o por artefacto explosivo en la Región Oeste de Afganistán, y fuese atendido por el ROLE 2 español de Herat (Afganistán durante los años 2005-2008. Resultados: El número total de casos analizados fue de 256. La mayor parte de los pacientes fueron heridos por artefacto explosivo, como los "Improvised Explosive Device" (IEDs (n = 183, 71%, mientras que el resto presentó lesiones por proyectiles de arma de fuego (n = 73, 29%. Conclusiones: En nuestro estudio, el mecanismo lesivo predominante ha sido el explosivo, seguido de las armas de fuego. Este dato es semejante al obtenido en otros estudios anglosajones sobre las bajas en combate durante los conflictos en Irak y Afganistán.Introduction: The medical officer's knowledge about armament-related aspects improves the diagnosis and medical care of the casualty. In this article the injuring agents in the main recent conflicts are presented. The objective of this study is the analysis of the injuring agent in the casualties received in the military hospital in Herat (Afghanistan between 2005 and 2008. Materials and methods: A descriptive, transversal study was carried out including all civilian and military personnel wounded by firearms or explosive devices in the West Region of Afghanistan, and taken care of in the Spanish Role 2 in Herat (Afghanistan during the years 2005-2008. Results: The total number of cases was 256. The majority of the

  10. 城市成批伤亡事件医院救护模式的回顾性研究%A retrospective study of hospital response model to urban mass casualty incidents

    Institute of Scientific and Technical Information of China (English)

    桂莉; 张宝胜; 张静; 厉瑛; 陈瑶; 周玲君; 席淑华


    目的 介绍上海"11.15"特大火灾成批伤员医院内救护模式,分析本模式在城市成批伤救护中的运用效果.方法 回顾性调查承担主要救治任务的某二级甲等医院的医护人负共5名,采用查看病历、问卷调查和半结构访谈等方法,获取医院及伤员基本资料、院内救护展开模式、伤员转归及医护人员评价.结果:该院共接收56例伤员,以吸入性损伤为主.医院采用的是"以急诊科为主组织院内抢救,院领导协调救护资源调配"的救护模式,以及"病房作为急诊的大后方,二三级医院联合救助"的伤员分流模式.伤员预后良好,救护人员整体评价好.结论:本次医院所采取的医院内外协作救护模式值得借鉴,但还需加强应急分队和制度建设、优化流程等措施,以提高医院对于成批伤的救护能力.%Objective To introduce the hospital responae model to the victims of 2010 Shanghai fire and analyze the effectiveness of this model in coping with urban mass casualty incidents (MCI). Methods A retrospective study was conducted by record review,questionnaire investigation and semi-structure interview in five medical staff who took part in the rescue. Data were collected on the general information of the hospital and the victims,hospital response model,prognosis of the victims and appraisal of medical staff. Results Fifty-six victims were sent to the hospital ,most of whom suffered from inhalation injuries.By establishing the green channel in emergency department,deploying rescue resources by the leader,and cooperation among second-class hospital and irst-class hospitals,the hospital responsed to the incident effectively. For most victims,their prognosis was quite good. Conclusion The hospital response model to the fire rescue had successful experiences to follow,and the urban hospitals' capacity should be further enhanced by organizing and training rapid reponse team and updating the protocol.

  11. Reflections on the Catastrophic Debris Flow Event in Zhouqu County:How to Minimize Casualties?%反思舟曲灾难事件:如何最大限度减少人员伤亡?

    Institute of Scientific and Technical Information of China (English)

    李长江; 麻土华


    A catastrophic debris flow event which occurred on August 7, 2010, in Zhouqu County, Gansu Province, China, killed 1364 people and a further401 people listed as missing. Landslides (including soil slides, debris slides, debris flows, etc. ) triggered by rainfall tend highly to occur almost every year in nearly all hilly and mountainous regions of China and constitute a major hazard that can cause serious loss of life. Conscious of the need to minimize casualties from future landslide events, the government departments and landslide scientists should focus on pre-landslide hazard event instead of post-landslide hazard event. Increasing preparedness through a realtime landslide forecasting system is one of the most effective ways to reduce the damage impact of the landslide hazards to life. We think it is possible to identify landslide susceptibility areas in the hilly and mountainous regions of China at a horizontal resolution of 1 x 1 -km grid cell using available techniques and data. And then the real-time forecasting system for evaluating the spatiotemporal probability of occurrence of rainfall-triggered landslides can be established, which uses the regional 24-hour forecast rainfall information and the real-time rainfall monitoring data from the rain-gauge network as its inputs, and provides 1 ~ 24-hour forecast of the landslide probability for every 1 × 1 -km grid cell in the hilly and mountainous regions. Public education on how to respond to landslide warnings and safe means of evacuation are also as important as the establishment of a prediction and warning system.%中国是一个降雨引发滑坡、泥石流等地质灾害十分频繁,灾害损失极为严重的国家.特别是,2010年8月7日甘肃舟曲县降雨引发特大泥石流,造成1364人死亡,401人失踪.如何把减灾工作重点放在灾前而不是灾后,避免舟曲群死群伤灾难事件的重演?笔者等认为,在现有数据资料和技术条件下,对全国滑坡、泥石流危

  12. 山东省收治汶川地震伤员的损伤特点及诊治体会%Characteristics and treatment of 396 Wenchuan earthquake casualties in Shandong province

    Institute of Scientific and Technical Information of China (English)

    周东生; 李连欣; 张辉; 陈伯华; 胡有谷


    目的 总结分析在山东省住院治疗的396例"5.12"汶川地震伤员的损伤特点及诊治经验.方法 汶川地震伤员396例,于2008年5月22日转至山东省住院治疗.山东省卫生厅及医学会成立了专家巡诊组,自5月22日至6月24日,对全部伤员逐个进行巡诊检查,统一阅读影像学资料,统一规范诊断,制定治疗方案.对伤员性别、年龄、损伤部位、骨折部位、手术情况、二次手术情况、截肢情况、伤口感染情况以及治疗结果进行调查分析.结果 本组病例在年龄分布、受伤部位、受伤特点等方面不同于交通伤.特点为多发伤常见,下肢截肢及伤口感染者较多,脊柱及骨盆骨折以稳定性骨折为主.手术治疗220例,其中转入前已经手术142例,转入后手术78例,有12例需要对转入前的手术进行二次手术调整内固定或治疗深部感染.至6月24日,已经治愈出院219例,无死亡病例,无医原性并发症出现.结论 按伤害控制理论,根据伤员的损伤特点、损伤程度制定转运及治疗方案,前线以抢救生命为主,早期清创.骨折的治疗原则是对不具备内固定条件者采用临时性外固定,复杂内固定手术留待转院后进行,可以提高救治效率,减少并发症,获得更好的综合疗效.%Objective To report the manage experience and descriptively analysis of the Wenehuan earthquake casualties who were treated in hospitals of Shandong province.Methods From May 22 to June24.396 cases Wenchuan earthquake patients were treated iu 18 hospitals of Shandong province.The expert group was organized by the Shandong Medical Association during this period and made consultations and discussions for every case to determine the diagnosis and treatment strategies.The characteristics of the in juries,fractures,wound infections,amputations,the treatment methods,as well as the patients'genders,patients'age.and the treatment result were descriptively assessed.Results Most of the

  13. Organization and implementation of medical rescue of mass casualties during earthquake%地震灾害批量伤员医学救援的组织与实施

    Institute of Scientific and Technical Information of China (English)



    Over the past century, there were more than 40 earthquakes greater than 7 magnitude occurred worldwide, 10 of which in China, which killed 600 thousand people accounting for 53% of global earthquake deaths. On May 12, 2008, an 8.0-magnitude earthquake occurred in Wenchuan, Sichuan Province, causing 69000 deaths, 18000 missings, and 370000 injuries. Among 10 thousand severe injuries, most were traumatic injuries, 74% of which were fracture. On April 14, 2010, a 7.1-magnitude earthquake occurred in Yushu, Qinghai Province. There were 2698 deaths, 270 missings and 11000 injuries. Among 3100 severe injuries, fracture injuries accounted for 58.4%. After each earthquake, the Chinese Army Medical Services took actions and made quick response according to the law. They sent out elites with efficient command and scientific organization, fully participating in the medical rescue operations. After Wenchuan earthquake, 397 mobile medical service units and 7061 health workers were sent out. A total of 69,000 people were treated, and 22,000 cases of surgeries were performed. After Yushu earthquake, a total of 25 mobile medical service units and 2025 health workers were sent. They performed 1635 cases of surgeries with a miracle of "zero death" in mass earthquake casualties and altitude diseases in cold highlands. After each earthquake, injuries cured within 1 week accounted for 60% of the total, and patients evacuated accounted for 80% of the total, which owed to the effective first aid in site of Chinese army medical service. They effectively played the role as the main force, making significant contributions for the final victory of earthquake relief. From the practice of medical rescue revelation after the two earthquakes, what Chinese Army Medical Services learned are: firstly, the theory of medical relief should be innovated; secondly, military and civilian organizations should be coordinated; thirdly, professional rescue force should he strengthened; fourthly, supporting

  14. Análisis de la topografía lesional en la baja de combate: Experiencia de la Sanidad Militar española desplegada en Herat (Afganistán Analysis of the lesional topography in the combat casualty: The Spanish Medical Service experience in Herat (Afghanistan

    Directory of Open Access Journals (Sweden)

    R. Navarro Suay


    officers deployed in the military hospital in Herat (Afghanistan about the body parts injured in combat casualties from 2005 to 2008. Materials and Methods: A descriptive, transversal study was carried out including all civilian and military personnel wounded by explosive artifacts or firearms in the West Region of Afghanistan and taken care of in the Spanish Role 2 from 2005 to 2008. Results: The total number of cases analyzed was 256. In the studied casualties the most affected area was the lower limbs (n=123; 48%, followed by the upper limbs (n=99; 39% and abdomen (n=56; 22%. The anatomical area where explosives (n=85 and firearms (n=38 have caused more injuries is the lower limbs. A little more than half the casualties (n=142; 55% presented only one affected area: 59 (23%. Conclusions: In our study the lower and upper limbs have been the anatomical areas most affected by explosives as well as firearms. These data coincides with the results obtained in other series.

  15. Development of the science of mass casualty incident management:reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire%大规模伤亡事件应对研究范式的发展:基于汶川地震和杭州公交车起火事件紧急医疗救援的反思

    Institute of Scientific and Technical Information of China (English)

    Wei-feng SHEN; Li-bing JIANG; Guan-yu JIANG; Mao ZHANG; Yue-feng MA; Xiao-jun HE‡


    Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematicaly and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The folowing key words and medical subject headings were used: ‘mass casualty incident’, ‘MCI’, ‘research method’, ‘Wenchuan’, ‘earthquake’, ‘research paradigm’, ‘science of surge’, ‘surge’, ‘surge capacity’, and ‘vulnerability’. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the

  16. The toxic handler: organizational hero--and casualty. (United States)

    Frost, P; Robinson, S


    You've watched them comfort colleagues, defuse tense situations, and take the heat from tough bosses. You've seen them step in to ease the pain during layoffs and change programs. Who are they? The authors call them toxic handlers--managers who voluntarily shoulder the sandness, frustration, bitterness, and anger of others so that high-quality work continues to get done. Toxic handlers are not new. They are probably as old as organizations themselves. But there has never been a systematic study of the role they play in business. In this article, the authors introduce the role of toxic handlers, explaining what they do and why. Managing the pain of others is hard work. Toxic handlers save organizations from self-destructing, but they often pay a high price--emotionally, professionally, and sometimes physically. Some toxic handlers experience burnout; others suffer far worse consequences, such as ulcers and heart attacks. The authors contend that these unsung corporate heroes have strategic importance in today's business environment. Effective pain management can--and does--contribute to the bottom line. No company can afford to let talented employees burn out. Nor can it afford to have a reputation as an unhappy place to work. The authors offer practical advice for managers and organizations about how to support toxic handlers--before a crisis strikes. The role of toxic handler needs to be given the attention it deserves for everyone's benefit, because the health of employees is a key element in the long-term competitiveness of companies and of society.

  17. Bi-Layer Wound Dressing System for Combat Casualty Care (United States)


    marked as 1 through 4. Eighteen full-thickness (down to the deep fascia ) wounds were created using a 2-cm diameter tissue trephine. Wounds were made...load in superficial muscles in a rat model of established wound infection [24]. Although it appears an important consideration that the dressing...moist prototype DRDC dressing prepared in our laboratories to the forearm of healthy volunteers resulted in a 3˚C reduction in skin temperature for up

  18. Nontherapeutic Laparotomy in American Combat Casualties: A 10-year Review (United States)


    in median (IQR 1YIQR 3). PRBC, packed red blood cell . TABLE 4. ICD-9 Complication Codes for NTLs Complication: ICD-9 Code NTL TL p Abdominal... collision 4.2% 4.5% Discharge status, alive 99.0% 98.6% 0.543 Age 24 (21.0Y28.5) 24 (21.0Y28.0) 0.49 ISS 19 (10.0Y27.0) 25 (17.0Y34.0) G0.0001 AIS score...the TL group compared with the NTL group. Total blood product resuscitation is found in Table 3; patients undergoing TL had higher overall blood

  19. Medical Management of Radiological Casualties Handbook. First Edition (United States)


    carcinogenesis. Irradiation in the fetal pe- riod leads to the most pronounced permanent growth retardation. The peak incidence of teratogenesis , or...abnormal genetic burden of future cellular generations. This has not been documented in humans. Fetal Exposure The four main effects of ionizing radiation...on the fetus are growth retardation; severe congenital malformations (including errors of metabolism); embryonic, fetal , or neo- 38 natal death; and

  20. Marijuana Legalization: Implications for Property/Casualty Insurance


    Brenda Wells


    An increasing number of states have legalized marijuana for recreational use. Though marijuana is still illegal at the Federal level, the administration will not seek to enforce the law in states that have legalized its use, consistent with a majority of Americans who indicate that they do not want Federal resources used to arrest and convict marijuana smokers in states that have legalized the substance (Ferner, 2012). With the legalization of marijuana comes interesting implications for the ...

  1. The 2004 Fitts Lecture: Current Perspective on Combat Casualty Care (United States)


    Hemorrhage 39 47 56 CNS 42 36 36 Multiple 12 13 8 MOF 7 4 Unknown CNS, central nervous system; MOF, multiple organ failure aMAJ Jimie Owsley, 31 CSH...34) aMAJ Jimie Owsley, 31 CSH, unpublished material, Iraq 2004. Fig. 8. Two pictures illustrating the difference between mobile temporary FST...Data courtesy of MAJ Jimie Owsley, MD. The Journal of TRAUMA Injury, Infection, and Critical Care 1000 October 2005 proving body armor, training, and

  2. 46 CFR 185.202 - Notice of casualty. (United States)


    ... does not include the cost of salvage, cleaning, gas freeing, drydocking, or demurrage. (b) A vessel is... reporting requirements of the Occupational Safety and Health Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 185.203 satisfies the requirement of...

  3. 46 CFR 122.202 - Notice of marine casualty. (United States)


    ... Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 122... condition before the occurrence, but does not include the cost of salvage, cleaning, gas freeing,...

  4. Updates to Blast Injury Criteria Models for Nuclear Casualty Estimation (United States)


    Prepared by: Nuclear Survivability and Forensics Integrated Program Team DTRA-TR-15-023 TE C H N IC A L R EP O R T REPORT DOCUMENTATION PAGE Form...dictions to data on pedestrian displacement following car accidents. For forensics purposes, data has been collected on the distance a pedestrian hit...source data. 34 Table 4.10: The 50% penetration velocities of steel and stone. Stone Mass (grams) Ballistic limits Missile Bare Skin Military Uniform

  5. Mass casualty acute pepper spray inhalation – Respiratory severity effect

    Directory of Open Access Journals (Sweden)

    B.M. Sweeting*


    Conclusion: While the respiratory complaint was perceived as being the most detrimental of all presenting complaints, there was an overall non-threatening outcome in all patients. The presenting respiratory complaints were mostly subjective with benign outcome. Although various risk factors associated with severity increase of respiratory status, were present in a few of the index cases patients, their affect was negligible with a resultant benign outcome.

  6. [War casualty triage during the First World War]. (United States)

    Ferrandis, Jean-Jacques; Lefort, Hugues; Tabbagh, Xavier; Pons, François


    Along with the front hospitals (HOE), the action of sorting out the injured was one of the most important innovations of the Great War. Progressively, it was implemented and codified on each level of the evacuating chain, with variations due to the different phases of the conflict, such as in Verdun or in the Somme. From 1917 onwards, specific sorting centers, managed by experimented soldiers, were set up in the evacuating hospitals.

  7. Job Stress and Coping in Army Casualty Operations Workers (United States)


    organizations in the United States, including policemen ( Maslach and Jackson , 1979), general human services (Cherniss, 1980), child protective workers...Harrison, 1980), public service -workers ( Maslach , 1982), doctors (Mawardi, 1983), public contact workers ( Maslach and Jackson , 1984), female human...Hall. Maslach , C. & Jackson , S.E. (1979). Burned-out cops and their families. Psychology T y, 1Z, 59-62. ----------------------- (1984, Fall). Patterns

  8. Challenges to Improving Combat Casualty Survivability on the Battlefield (United States)


    data collection in the prehospital setting, it is likely the decision cycle could be far re- duced from the 11 years observed. Changing the narrative...trying to perfect golf clubs, golf balls, and golf shoes , and virtually no research dollars on how to train the best golfers. Prehospital care...preparing for war. When not deployed or in a recovery or support cycle , they are focused on training and preparing for the next mission. Conversely, the

  9. Mines and human casualties: a robotics approach toward mine clearing (United States)

    Ghaffari, Masoud; Manthena, Dinesh; Ghaffari, Alireza; Hall, Ernest L.


    An estimated 100 million landmines which have been planted in more than 60 countries kill or maim thousands of civilians every year. Millions of people live in the vast dangerous areas and are not able to access to basic human services because of landmines" threats. This problem has affected many third world countries and poor nations which are not able to afford high cost solutions. This paper tries to present some experiences with the land mine victims and solutions for the mine clearing. It studies current situation of this crisis as well as state of the art robotics technology for the mine clearing. It also introduces a survey robot which is suitable for the mine clearing applications. The results show that in addition to technical aspects, this problem has many socio-economic issues. The significance of this study is to persuade robotics researchers toward this topic and to peruse the technical and humanitarian facets of this issue.

  10. Development of Damage and Casualty Functions for Basement Shelters (United States)


    in many cases, be offset by simplicity in constructic- formwork and by the mobility and repetitive use of this fornwork. From the standpoint of shelter...for ease of formwork ; and two-way slabs have both maximum strength and minimum materials requirements. The choice of which slab system to use is usually...than the measured ones. For the shock tunnel tests the experimental values were from about 70% to 75% of the calculated ones, while in the scale model

  11. American War and Military Operations Casualties: Lists and Statistics (United States)


    907) 428-6007, American Samoa Attorney General Sialega Malaetasi Togafau, America Samoa Government, P.O. Box 7, Pago ... Pago , AS 96799, (684) 633-4163 Arizona Major General David P. Rataczak, Emergency and Military Affairs Department, 5636 East McDowell Road, Phoenix

  12. Longterm Outcomes after Combat Casualty Emergency Department Thoracotomy (United States)


    pericardial tamponade or tension pneumo- thorax, to directly control and repair intrathoracic hemor- rhage, to allow open cardiac massage, and to cross...the effectiveness of prelaparotomy EDT. When blood fills the abdomen and causes distention, the abdom- inal wall may provide a tamponade effect in

  13. Optimization of Lyophilized Plasma for Use in Combat Casualties (United States)


    was utilized for the controlled hemorrhage and blood sampling throughout the experiment while the 6 venous line was used for administration of...cutdown was performed and polyethylene catheters were inserted respectively into the left common carotid and left external jugular vein. The arterial line ...due to the liver injury. Point-of-care laboratory values included TEG, Hct, lactate, ABG, and electrolytes. Blood samples were sent to a central core

  14. Medical Management of Radiological Casualties. Online Third Edition (United States)


    Consider DTPA. Tritium (3H) Force fluids; Water diuresis * Uranium (U) Bicarbonate* to alkalinize the urine. Consider dialysis Yttrium (Y) DTPA*, EDTA...initial daily dosage) for an additional 2 weeks of therapy. A course of treatment lasts 19 days. Water diuresis Oral: Fluids more than 3–4 L d–1

  15. Psychological casualties resulting from chemical and biological weapons. (United States)

    Romano, J A; King, J M


    This symposium addresses the complications encountered by medical planners when confronted by the use or threat of the use of weapons of mass destruction. The types of chemical warfare agents (CWA), their principal target organs, and physiological effects are discussed. We have reviewed the use of CWA in 20th century warfare and otherwise with emphasis on five cases: (1) use of sulfur mustard during World War I; (2) use by Italy against Ethiopia; (3) use in the Sino-Japanese War; (4) relatively well-studied use in the Iran-Iraq conflict; and (5) the use of sarin in the Tokyo subway terrorist incident. We reviewed the additional physiological and psychological consequences of their use and threat of use. Results from training and simulation are discussed. Finally, we present our conclusions derived from the analysis of these historical situations.

  16. Department of Defense (DOD) Military Casualty/Wounded Warrior (United States)

    Social Security Administration — SSA initiated this agreement with the Department of Defense (DOD) to transmit to SSA information that will identify military personnel injured or taken ill while in...

  17. Meeting the Chemical Threat Psychiatric Casualties in a Chemical Environment (United States)


    National Issues Regarding Women in the Military P004 075 Evaluation of Leadership Effectiveness in Mixed Gender Units P004 076 Stress, Coping, and...Support System Among Women Cadets P004 077 Psychosocial Factors Affecting the Health and Well- Being of Women iu the Army: A Pilt Study P004 078 The Impact...the byproducts of degradtion of GD innocuous?"• remain to be answered. At one point in their paper Meselson et al (1980) argued that even at the

  18. 46 CFR 28.80 - Report of casualty. (United States)


    ... GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL FISHING INDUSTRY... routine duties. (3) Loss of a vessel. (4) Damage to or by a vessel, its cargo, apparel or gear, except for fishing gear while not on board a vessel, or that impairs the seaworthiness of the vessel, or that...

  19. Development of a Mass Casualty Triage Performance Assessment Tool (United States)


    database for further analysis (see Appendix B). Second, subtasks (or steps) for each task (if any) were identified and entered into the database under...Social Sciences. U.S. Army North Public Affairs (2012). Major exercise builds solidarity amongst local, state, federal agencies. Retrieved February...18, 2013 from 15 solidarity -amongst-local,- st.aspx U.S. Department of the Army. (2002

  20. Medical Management of Radiological Casualties, Second Edition, Handbook (United States)


    metaphase spread dicentric < several months* 0.2–5 Lymphocyte-premature chromosome < several months* 0.2–20 condensation *Generally, blood is sampled...radiation dose. Many types of chromosome aberrations may appear in lymphocytes following exposure to radiation. Dicentrics ( chromosomes with two...24 hours after radiation exposure for cytological chromosome aberration analysis of dose. by an internationally accepted cytogenetic bioassay per

  1. A decision support system for managing forest fire casualties. (United States)

    Bonazountas, Marc; Kallidromitou, Despina; Kassomenos, Pavlos; Passas, Nikos


    Southern Europe is exposed to anthropogenic and natural forest fires. These result in loss of lives, goods and infrastructure, but also deteriorate the natural environment and degrade ecosystems. The early detection and combating of such catastrophes requires the use of a decision support system (DSS) for emergency management. The current literature reports on a series of efforts aimed to deliver DSSs for the management of the forest fires by utilising technologies like remote sensing and geographical information systems (GIS), yet no integrated system exists. This manuscript presents the results of scientific research aiming to the development of a DSS for managing forest fires. The system provides a series of software tools for the assessment of the propagation and combating of forest fires based on Arc/Info, ArcView, Arc Spatial Analyst, Arc Avenue, and Visual C++ technologies. The system integrates GIS technologies under the same data environment and utilises a common user interface to produce an integrated computer system based on semi-automatic satellite image processing (fuel maps), socio-economic risk modelling and probabilistic models that would serve as a useful tool for forest fire prevention, planning and management. Its performance has been demonstrated via real time up-to-date accurate information on the position and evolution of the fire. The system can assist emergency assessment, management and combating of the incident. A site demonstration and validation has been accomplished for the island of Evoia, Greece, an area particularly vulnerable to forest fires due to its ecological characteristics and prevailing wind patterns.

  2. 76 FR 8788 - Riverside Casualty, Inc.; Notice of Application (United States)


    ...''), a Delaware corporation, is a design-build company that provides architectural, engineering... will maintain and preserve, for the life of RCI and at least six years thereafter, all accounts, books... examination by the Commission and its staff. RCI will preserve the accounts, books and other...

  3. Field Management of Chemical Casualties Handbook, Second Edition (United States)


    kills within ten seconds. • Tetrodotoxin. Produced by the newt, puffer fish, and blue-ringed octopus , this toxin is a rapid, lethal...metal triangles with the NATO standard dimensions of 28 cm x 20 cm x 20 cm. To maximize camouflage , the triangles should be painted with flat green...not allow the arms to contact the exterior ( camouflage ) side of the overgarment. f. Dispose of the contaminated gloves by placing them in a trash

  4. An Integrated Civilian Medical Response to Mass Casualty Incidents (United States)


    34Decontamination of bacillus thuringiensis spores on selected surfaces by chlorine dioxide gas", Journal of Environmental Health 66: 16-20 6. Jeng, D. K., and...impaction, because it minimizes desiccation stress and allows for the direct deposition of the microorganism into growth media. The AGI-30 liquid impinger...combines this data with the chemical kinetics of non-thermal plasma to predict the rate of destruction of microorganisms under varying conditions. The

  5. Deciding Who Lives: Considered Risk Casualty Decisions in Homeland Security (United States)


    from the thoughts of St. Thomas Aquinas in the middle of the Thirteenth Century (Solomon, 2001) At its core, the principle generally states that “…in...realm in order to assist the homeland security decision maker. “Intend to kill” is the pivotal phrase in the above quote from Grisez, and St. Thomas ...comment he cited from St. Thomas by then agreeing with him (St. Thomas ) through noting the association between intention and decision making

  6. The Casualties of the Twenty-First-Century Community College (United States)

    Wilson, David McKay


    This article discusses academic freedom that is currently under threat at many public two-year schools, which serve almost one-half of the nation's first-year college students. The growing reliance on part-time faculty exacerbates the problem, with many adjuncts feeling muzzled for fear of losing their jobs. The problem of academic freedom at…

  7. American War and Military Operations Casualties: Lists and Statistics (United States)


    include the Iranian Hostage Rescue Mission; Lebanon Peacekeeping; Urgent Fury in Grenada; Just Cause in Panama; Desert Shield and Desert Storm; Restore...Army Navy Air Force Marine Corps Total Iranian Hostage Rescue Mission April 25, 1980 Nonhostilea 0 0 5 3 8 Lebanon Peacekeeping August 25

  8. Vessel Traffic Services Houston/Galveston VTS Casualty Analysis. (United States)


    unclear from the report if VTC was aware of the outages. 6349 7/14/76 The /V NOPAL VEGA was inbound the HSC when it passed the Steel Enterprises Inc...dock where the barge U.IC 730 was moored. The speed at which the NOPAL VEGA was travel- ing caused the U.IC 730 to break its mooringsstrike the dock...and cause damage to the barge and the dock. From the bell book of the NOPAL VEGA its speed was approximately 12.2 knots. CONCLUSION: If VTS had

  9. Reducing casualties involving young drivers and riders in Europe.

    NARCIS (Netherlands)

    Atchison, L.


    Young drivers and riders aged 15-25 are more likely to be killed on Europe’s roads than their older counterparts, despite continued improvements in road safety. Road collisions remain one of the highest external causes of death for young people. The risks are especially high for young males and for

  10. Infections in Combat Casualties During Operations Iraqi and Enduring Freedom (United States)


    2 996.66 Infection joint prosthesis 2 996.67 Infection orthopaedic device 12 Central nervous system 320.89 Meningitis other bacteria 1 320.9...Cellulitis arm 37 682.4 Cellulitis hand 16 682.5 Cellulitis/abscess buttock 1 682.6 Cellulitis leg 77 682.7 Cellulitis foot 30 682.9 Cellulitis/abscess...Abrasion hip/leg infected 3 916.3 Blister hip/leg infected 2 917.3 Blister foot and toes-infected 2 958.3 Post-trauma wound infection 35 997.62 Infection

  11. Acute Compartment Syndrome of the Thigh in Combat Casualties (United States)


    clinical signs and symptoms alone (27, 28). These signs include pain out of proportion, weakness and passive pain on stretch of the muscles in the...spasm/ cramping /weakness). Thirty-three percent (5/15) have pruritis. Twenty-seven percent (4/15) have symptomatic fascial herniations. Twenty...thigh. J. Orthop. Trauma 16:436–438, 2002. 6. Rooser, B., Bengtson, S., Hagglund, G. Acute compartment syndrome from anterior thigh muscle contusion: a

  12. Tactical Combat Casualty Care 2007: Evolving Concepts and Battlefield Experience (United States)


    the Prehospital Trauma Life Support ( PHTLS ) Manual. The fourth edition of this manual, published in 1999, contained for the first time a chapter on...Medical Readiness Training Institute in San Antonio, Texas. The recommendations contained in the PHTLS Manual carry the endorsement of the American...information to continually update the TCCC guidelines on a cycle matched to the publication of the PHTLS Manual. The original TCCC guidelines published

  13. Optimization of Lyophilized Plasma for Use in Combat Casualties (United States)


    lactated Ringer’s (LR) or normal saline (NS) 6. Along with the hypovolemic shock associated with the acute loss of intravascular volume in hemorrhaging...corrects coagulopathy, and decreases inflammation in a swine polytrauma and hemorrhagic shock model. This study compared the efficacy of ‘full volume’ LP...coagulation factor activity. Twenty swine were anesthetized and subjected to a validated model of polytrauma and hemorrhagic shock . They were

  14. Analysis on factors affecting the severity of post-traumatic stress disorder in transferred casualty after Earthquake%影响地震灾后转移伤员创伤后应激障碍症状严重程度的因素分析

    Institute of Scientific and Technical Information of China (English)

    高新学; 况利; 刘婉婷; 楼丹丹; 李大奇; 艾明; 陈建梅; 黎雪梅; 赵正中


    Objective To investigated the related factors which affecting the severity degrees of post-traumatic stress disorder(PTSD) in trailsferred casualty after Wenchuan Earthquake.Methods Taking PTSD symptoms self-assessment scale(PCL-C) to involve 386 wounded who sufiered 40 days after the earthquake disaster,from 11 hospitals and were transferred to Chongqing city.Multi-stage cluster sampling method was used.354 valid questionnaires were recovered to explore the relevant factors affecting the severity on the symptoms of PTSD.Results This survey contains 354 subjects,with male 154(43.6%),female 200(56.4%),age 43.76±21.22,nation alities:Han people 236(66.7%),Qiang people 114(32.2%),others4(1.1%),and marriage status as unmarried 92(26.1%),married 253(71.7%),others 9(2.2%).The wounded women PTSD have more seriotis symptoms than men,and there were differences between them in repeated and disturbing dreams of this stressful experience(t=2.46,P=0.014),a strong sense of psychological suffering annoyance (t=2.02,P=0.044),having difficulty concentrating(t=2.04,P=0.042),being"super-alert"(t=2.465,P=0.014) etc,also in the total scores(t=2.489.P=0.013)(P<0.05).The PTSD symptoms of wounded degree in who had been buried in Earthquake were more serious than those not been buried.There were significant difierences between them in the iterns as:avoid thinking about or talking about a stressful experience(t=2.661,P=0.008),avoid activities or situations that could fecall the stressful experience(t=2.705,P=0.007),trouble remembering important parts of a stressful experience (t=2.775,P=0.006),feeling emotionally numb or being unable to have loving feelings for those close to you(t=3.017,P=0.003),feeling as if your future will somehow be cut short(t=2.979,P=0.003) and total scores(t=3.175,P=0.002).The wounded that witnessed someone be buried or died in earthquake,in PTSD symptoms,were more serious than those without.In the items of feeling distant or cut off from other people

  15. The Application of Multi-objective Planning Theory in the Decision-making Management of Insurance Company --Taking the Line and Asset Structure Decision-making of Property and Casualty Insurance Company as an Example%多目标规划在保险公司决策管理中的应用研究——以产险公司业务和资产结构决策为例

    Institute of Scientific and Technical Information of China (English)

    李秀芳; 傅国耕


    本文在公司价值最大化的终极目标下,通过分析保险公司各个层级的发展目标,指出保险公司的决策管理具有多目标属性。在对多目标规划理论进行系统梳理的基础上,以产险公司的业务和资产结构决策为例,构建了以公司规模、利润和风险为目标的资本和监管约束下的多目标规划模型。分析发现,将多目标规划理论应用于保险公司管理中的确能够平衡不同目标的关系,有效提高公司经营的稳健性。%Under the premise of value maximization of insurance company, this paper analyzed the development objectives at different levels, and pointed out that the decision-making management of insurance company had a multi- ple objective property. Based on the systematic summary of the theory of multi-objective planning, the paper gave an example of the lines and assets structure of a property and casualty insurance company, and constructed a multi-ob- jective planning model covering the company's size, earnings and risks under the restraints of capital and regulation. It found out that, using the theory of multi-objective planning in the management of an insurance company could bal- ance the relationship of different goals, and improve operation robustness of the company.

  16. Continuous Renal Replacement Therapy Improves Survival in Severely Burned Military Casualties with Acute Kidney Injury (United States)


    compromise. This, in turn, leads to suboptimal delivery of dialysis; in fact, a number of patients were not offered hemodialysis because of concerns as to...criteria. None were placed on hemodialysis . The other control patients either recovered their renal func- tion and later died of other causes or died before...31 Although the data may still not be definitive , we agree with the notion that the best evidence to date supports the use of at least 35 mL/kg/h for

  17. Providing for the Casualties of War: The American Experience Through World War II (United States)


    Medicina , written by Aulus Cornelius Celsus during the time of Augustus,22 was noteworthy, especially the chapters “Treatment of Wounds,” “the Extraction...1994, pp. 151–159. 22 For a further discussion of Celsus’s work, see Southern, 2006, p. 236. De Medicina was widely read, then lost and rediscovered...Celsus’ De Medicina [Treatment of Wounds], as presented in Davies, Breeze, and Maxfield, 1989, p. 231. 25 Medici were often recruited from outside of

  18. Airport Casualties: Non-Admission and Return Risks at Times of Internalized/Externalized Border Controls

    Directory of Open Access Journals (Sweden)

    Maybritt Jill Alpes


    Full Text Available This article analyzes what can happen to forced returnees upon arrival in their country of nationality. Subjective configurations of state agents in the Global South have created return risks, which in turn transform subjectivities of post-colonial citizens. The article contributes to this Special Issue by tracing repercussions of the externalization and internalization of border controls. In the case of Cameroon, these connections have resulted in the criminalization of emigration. Aspiring migrants are prosecuted if their departure projects fail to respect the entry requirements of countries in the Global North. The article is based on research conducted in Douala, Cameroon, in the form of discussions with control agents at the international airport, investigations at a prison, a review of related case law, police registers and interviews with Cameroonians returnees (November 2013–January 2014. Border controls and connected anti-fraud programs suppress family-based forms of solidarity and allow only for subjectivities rooted in state-managed forms of national identity. The article illustrates how efforts to combat fraud fuel corruption in returnees’ social networks, whereby, instead of receiving remittances, families in emigration countries have to mobilize financial resources in order to liberate returnees from police stations or prison complexes. Migration related detention of nationals in the Global South highlights the growing significance of exit controls in migration management.

  19. Preparing South Carolina Emergency Departments for Mass Casualties with an Emphasis on the Planning Process (United States)


    Kentucky University , 1988 B.S., University of Wisconsin-Stout, 1987 Submitted in partial fulfillment of the requirements for the degree of...need for an alternate care site (ACS) or off-site location is needed. These plans include the doubling of patients/room, using cafeterias , hallways

  20. Cyanide Antidotes for Mass Casualties: Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery (United States)


    cyanide poisoning in a swine ( Sus Scrofa ) model. Annals of Emergency Medicine, in press, 2014 2. Mao, R.W., Lin, S.K., Tsai, S.C., Brenner, M...versus intravenous cobinamide in treating acute cyanide toxicity and apnea in a swine ( Sus Scrofa ) model. Manuscript submitted. CONCLUSION a Swine ( Sus scrofa ) Model Lt Col Vikhyat S. Bebarta, MC, USAF*; David A. Tanen, MD; Susan Boudreau, RN, BSN; Maria Castaneda, MS; Lee A. Zarzabal

  1. Extracorporeal Organ Support following Trauma: The Dawn of a New Era in Combat Casualty Critical Care (United States)


    hemofiltration uses ultrafiltration with subsequent replacement fluid (convection). As discussed later, the convective clearance obtained through in extracorporeal organ support (Fig. 5). Advances in nanotechnology are allowing the creation of complex filters with multiple functions...continuous renal replacement therapy at various dialy- sate and ultrafiltration flow rates. Am J Kidney Dis. 1999;34:486Y492. 61. Davenport A. Management of

  2. High Reliability Organization and Applicability to the Battlefield to Reduce Errors Associated with Combat Casualty Care (United States)


    the MHS to combine the concepts of an integrated health care system with the principles of HRO. Implementation of HRO tools within healthcare the last...2014. This report shaped the framework for the MHS to combine the concepts of an integrated health care system with the principles of HRO...recent years, the Department has made great improvements in our health care delivery system – nowhere more important than in improving trauma care

  3. The Military Casualty with Combat Related Acute Post Traumatic Stress Disorder (United States)


    through hospital inservice programs. However, hospital inservices generally address current nursing problems. Another formal education avenue is the...69 fatigue is from: (a) Medical Red Flag; (b) Inservice Education ; (c) Disaster Preparedness Education ; (d) Battlefield Nursing Course; (e) No source...50 Education ....... .................. .. 52 Nursing Experience ..... .............. ... 52 Primary Nursing Specialty Area ........... .. 52

  4. [Stationary thromboprophylaxis in casualty surgery. Relevance of postoperative mobility and preexisting risk factors]. (United States)

    Eisele, R; Maier, E; Kinzl, L; Gude, U


    The presented thromboprophylactic concept includes weight bearing and ankle motion as well as breathing therapy and drug prophylaxis (antiphlogistics, analgesic drugs, heparin). Routinely performed ultrasound screening of the deep veins (legs and pelvis) before release showed a low DVT incidence of 2.5% in a prospective clinical observation of 841 inpatients. Obesity, venous insufficiency, and a history of previous thromboembolic events were associated with a significantly increased risk of thrombosis (relative risk 4.1, 4,9, and 5.8, respectively) The duration of immobilization also had a relevant influence indicating that early postoperative physiotherapy in traumatology and orthopedic surgery has a widely underestimated thromboprophylactic effect.

  5. Glycopeptides as Analgesics: Non-Toxic Alternatives to Morphine for Combat Casualty Care (United States)


    Neil Jacobsen, Mr. Charles M. Keyari and Ms. Larisa Yeomans for experimental results, and the Office of Naval Research (N00014-02-1-0471) for...S, Khare N.K.; Saini S.K.; Seitz L.E.; Bartlett J.R.L.; Davis P.; Dersch CM.; Porreca F.; Rothman R.B.; Bilsky E.J. J. Med. Chem., 2004, 47, 2716

  6. Casualties of War: Combat Trauma and the Return of the Combat Veteran (United States)

    Kiely, Denis O.; Swift, Lisa


    The experience of the combat soldier and the road back to civilian life are recurrent themes in American literature and cinema. Whether the treatment is tragic (Stephen Crane's "Red Badge of Courage", Tim O'Brien's "The Things They Carried", or Tony Scott's "Blackhawk Down"), satirical (Joseph Heller's "Catch Twenty-Two" and Robert Altman's…

  7. Intraosseous Erythropoietin for Acute Tissue Protection in Battlefield Casualties Suffering Hypovolemic Shock (United States)


    picting the intraosseous access for drug delivery into the left tibia; vascular catheterization to monitor left ventricular pressure, aortic pressure...Resuscitation]; (d) [Myocardial Protection During Cardiac Arrest]; (e) [Chain of Survival: Community Involvement and Access to Emergency Services]; (f...Algunas Sugerencias para hacer Investigación en Medicina Intensiva, Sodium-Hydrogen Exchanger Inhibition: A Potencial New Treatment for Cardiac

  8. Popliteal Artery Repair in Massively Transfused Military Trauma Casualties: A Pursuit to Save Life and Limb (United States)


    and that includes artery, soft tissue, nerve, and osseous structure. After this identification, patient charts were also evaluated for age, sex...system failure; CVA, cerebrovascular accident ; HIT, heparin-induced thrombocytopenia; SVG, saphenous vein graft; POD, postoperative day. TABLE 5

  9. Death, the Military and Society: Casualties and Civil-Military Relations in Germany (United States)


    paraphrasing and modifying Durkheim (1973: 256-270) - for the community are much respected and honored; "* and, lastly, they prove that the state is not only a...nach: Durkheim , trmile (1973). Der Selbstmord (Soziologische Texte Vol. 32). Neuwied - Berlin

  10. Ensuring the safety of surgical teams when managing casualties of a radiological dirty bomb. (United States)

    Williams, Geraint; O'Malley, Michael; Nocera, Antony


    The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team.

  11. 75 FR 60865 - Surety Companies Acceptable on Federal Bonds: Amendment-Allegheny Casualty Company (United States)


    .... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... Carrico, Director, Financial Accounting and Services Division. BILLING CODE 4810-35-M ... AGENCY: Financial Management Service, Fiscal Service, Department of the Treasury. ACTION: Notice....

  12. Evaluation of a Scalable Information Analytics System for Enhanced Situational Awareness in Mass Casualty Events

    Directory of Open Access Journals (Sweden)

    Aura Ganz


    Full Text Available We investigate the utility of DIORAMA-II system which provides enhanced situational awareness within a disaster scene by using real-time visual analytics tools and a collaboration platform between the incident commander and the emergency responders. Our trials were conducted in different geographical areas (feature-rich and featureless regions and in different lighting conditions (daytime and nighttime. DIORAMA-II obtained considerable time gain in efficiency compared to conventional paper based systems. DIORAMA-II time gain was reflected in reduction of both average triage time per patient (up to 34.3% average triage time reduction per patient and average transport time per patient (up to 76.3% average transport time reduction per red patient and up to 66.3% average transport time reduction per yellow patient. In addition, DIORAMA-II ensured that no patients were left behind or transported in the incorrect order compared to the conventional method which resulted in patients being left behind and transported in the incorrect order.

  13. A Systems Analysis View of the Vietnam War: 1965-1972. Volume 8. Casualties and Losses (United States)


    The 9 provln.:cs w,.iich aecount..,,a ]or about 7"" of the US deahs durlig tnh- T-ast two months are sh,,nn in Tablr. ;. All fi’i’ I CML/ prtvincr.s...MACV compound in Binh Thuan province, 6 IA . "Named large unit operations, 23 KIA Small unit operations, 17 KIA JulYl 3 - L9 (80 MI) * Two rifle

  14. Continuity of care: a casualty of the 80-hour work week. (United States)

    Fischer, Josef E


    The controversy concerning the limit of residents' work time to 80 hours a week has generated unprecedented dismay for many involved in graduate medical education, particularly surgeons. The author maintains that 80 hours a week is too short a time for surgery residents to provide excellent care and that this new rule undercuts the importance of continuity of care, a principle highly valued by surgeons. General surgeons and those specialty surgeons most closely associated with them think of themselves as the last "compleat physicians," who should and can take care of the entire patient, and that when difficulties arise, they should not transfer the patient to another physician but instead ask someone else to help them continue to care for the patient. The author traces the arbitrary choice of an 80-hour work week (instead of a 92-hour one) to several sources, including the leadership of internal medicine, which he feels has largely de-emphasized patient contact for many years and has become focused on research and/or administration. He also maintains that the issue of moonlighting has also driven the push for an 80-hour work week, and that the view of moonlighting by surgical residencies (i.e., that it is almost always counterproductive) is different from that of other residencies. He concludes by acknowledging that the 80-hour work week and the abandonment of the principle of continuity of care are societal decisions, and have occurred because surgeons and other physicians did not make their case strongly enough or in time.

  15. Ground Forces Battle Casualty Rate Patterns: Current Rate Projections Compared to the Empirical Evidence. (United States)


    in terms of rate severity levels. The first kind of disrupted front may be illustrated by the German Kharkov and Donbas defensives in early 1943...kind of disrupted front is an exploitation phase which does not witness serious encirclement. At Donbas , two German divisions were briefly...Sandomierz [2nd 10 days] Kharkov Donbas 10 10 10 All < 9-14 DF-1 DF-1 DF-1 Ardennes ("Bulge") [1st 10 days] 10 CF (Def) Central Europe [November

  16. German battle casualties: the treatment of functional somatic disorders during World War I. (United States)

    Linden, Stefanie Caroline; Jones, Edgar


    World War I witnessed the admission of large numbers of German soldiers with neurological symptoms for which there was no obvious organic cause. This posed a considerable challenge for the military and medical authorities and resulted in an active discussion on the etiology and treatment of these disorders. Current historiography is reliant on published physician accounts, and this represents the first study of treatment approaches based on original case notes. We analyzed patient records from two leading departments of academic psychiatry in Germany, those at Berlin and Jena, in conjunction with the contemporaneous medical literature. Treatment, which can be broadly classified into reward and punishment, suggestion, affective shock, cognitive learning, and physiological methods, was developed in the context of the emerging fields of animal learning and neurophysiology. A further innovative feature was the use of quantitative methods to assess outcomes. These measures showed good response rates, though most cured patients were not sent back to battle because of their presumed psychopathic constitution. While some treatments appear unnecessarily harsh from today's perspective and were also criticized by leading psychiatrists of the time, the concentration of effort and involvement of so many senior doctors led to the development of psychotherapeutic methods that were to influence the field of psychiatric therapy for decades to come.

  17. Effects of Foreign Perceptions of U.S. Casualty Aversion on U.S. International Relations (United States)


    career catapulted forward when he told the angry Serbs that “no one should dare to beat you!”3 With the crowd chanting “Slobo, Slobo!” he began...Athens I Kathimerini (in Greek) 25 March 2000, 10, FBIS Document ID: GMP20000326000175. 30Adriano Sofri, “When US Soldiers Die,” Rome La Repubblica...FTS19991016000039. 7See Adriano Sofri, “When US Soldiers Die,” Rome La Repubblica (in Italian) 11 January 2002, 1, 17, FBIS Document ID

  18. Automated Decision-Support Technologies for Prehospital Care of Trauma Casualties (United States)


    thoracic or abdominal hematomas, (3) explicit vascular injury that required operative repair, or (4) limb amputation . • Alternative definitions...which an automated computer algorithm processes available data and, through artificial intelligence, offers caregivers accurate information about...processing, artificial intelligence, and knowledge engineering technologies to develop an automated decision-support system. Our system for major hemorrhage

  19. 46 CFR 185.220 - Records of a voyage resulting in a marine casualty. (United States)


    ..., records of draft, aids to mariners, night order books, radiograms sent and received, radio logs, crew and passenger lists and counts, articles of shipment, official logs, and other material that might be...

  20. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries (United States)


    in close proximity to the blast center, can result in eardrum damage (rupture of the tympanic membrane TM), lung damage (pulmonary or alveolar ...rence of psychologic deficit .12,13 The Defense and Veterans Brain Injury Center reports 22% of soldiers returning from OIF/OEF as having evidence of...psychologic deficit , specifically, posttraumatic stress disorder (PTSD).13 This in- creased risk of altered mental status, concussive symptoms, and PTSD

  1. Vasopressin for Hemorrhagic Shock Management: Revisiting the Potential Value in Civilian and Combat Casualty Care (United States)


    shock (Adapted from Guyton , Textbook of Medical Physiology).11 Figure 2. Course of arterial pressure in dogs after different degrees of acute hemorrhage...Each curve represents the av- erage result from six dogs ( Guyton , Textbook of Medical Physiology).11 Voelckel et al. The Journal of TRAUMA® Injury...systemic hemodynamics in catecholamine-resistant septic and post- cardiotomy shock: a retrospective analysis. Anesth Analg. 2001;93: 7–13. 11. Guyton AC

  2. Triage Decision Trees and Triage Protocols: Changing Strategies for Medical Rescue in Civilian Mass Casualty Situations. (United States)


    o . .. ° . - . . - • . . . . state of fruition by Gtnerall Basil Pruitt of Brooke Army Medical Center. A simple calculation based on the depth...A.S., Berstein R.S. and Johnson D.S., Ocular effects following the volcanic eruptions of Mount St. Helens, Arch Ophthalmol 101 Mar 83 p. 376 79

  3. Battlefield trauma care then and now: a decade of Tactical Combat Casualty Care. (United States)


    al. Prehospital spine immobilization for pene- trating trauma-review and recommendations from the prehospital trauma life support executive committee...J Trauma. 2011;71:763 770. 61. Lustenberger T, Talving P, Lam L, et al. Unstable cervical spine fracture after penetrating neck injury: a rare an analysis of 1,069 patients. J Trauma. 2011;70:870 872. 62. Haut E, Kalish B, Efron D, et al. Spine immobilization in penetrating trauma: more

  4. Conducted electrical weapons or stun guns: a review of 46 cases examined in casualty. (United States)

    Becour, Bertrand


    Low-lethality weapons are intended to neutralize a person with maximum security and with minimal risk of injury or death to the user of the weapon, the person arrested, and the witnesses. Under the same circumstances, the use of a firearm is causing mortality of 50%. Marketed since 1974, the Taser X26 is currently staffing services in the French police and gendarmerie. The Taser device has 3 damaging mechanisms: the direct effect of electric current on the tissues, the conversion of electrical energy into thermal energy, and the injuries caused by the general muscle contraction and resulting fall. The study aimed to analyze the specificities of the conducted electrical weapon-related injuries treated in a emergency department on a series of 46 cases. The study population was predominantly middle-aged men. The circumstances of use of the Taser X26 were most often related to an arrest. The frequency of consultation after a shot by Taser X26 was stable. The management is essentially an outpatient because of frequent and benign lesions. The impacts of electrical impulse mainly affect the chest and abdomen. This distribution of impact zones is inhomogeneous, depending on the circumstances of use.

  5. Infectious Complications of Open Type III Tibial Fractures among Combat Casualties (United States)


    13) 10 20 (M, IIIb) ESBL Klebsiella pneumoniae (3) Ampicillin, gentamicin, imipenem-cilastatin (2)d MSSA (16) Union (25) 11 27 (M, IIIb) Acb (15...CoNS, coagulase-negative staphylococci; ESBL , extended-spectrum b-lactamase–producing; M, male; MRSA, methicillin resistant Staph- ylococcus aureus

  6. Development and Evaluation of a Casualty Evacuation Model for a European Conflict. (United States)


    J.L. Goffin, "Nondifferentiable optimization and the relaxation method," in: C. Lemarechal and R. Miffin, eds., Nonsmooth Optimization, IIASA ...optimiz- ation," in: E.A. Numrinski, ed., Progress in Nondifferentiable Optimization ( IIASA , Laxenburg, * Austria, 1982) 29-59. [12] M. Held, P. Wolfe and

  7. Strategies for Preparing United States Combat Organizations for the Inevitability of Casualties (United States)


    The technique used to exercise combat fear inoculation was by requesting the cooperation of police attack dogs . The members of de Beckers...organization all became attack dog victims by donning the appropriate protective gear and allowing attack dogs to have their way with them. Grossman explains...gynecological; dental, preventive medicine, internal medicine and cardiology ; eye surgery, maxillofacial surgery, and neurosurgery; intensive/critical

  8. 77 FR 52746 - Medical Countermeasures for a Burn Mass Casualty Incident (United States)


    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... adverse health consequences arising from public health emergencies, specifically those involving... register online by 5 p.m. on September 21, 2012. Early registration is recommended because facilities...

  9. Utilizing a Trauma Systems Approach to Benchmark and Improve Combat Casualty Care (United States)


    mortality after mid-2006 was consistently below the norma - tive control level and represented a baseline shift (horizontal circle). Postinjury...the Injured Patient. Chicago , IL: American College of Surgeons; 2006. 7. Khuri SF, Daley J, Henderson W, et al. The National Veterans Adminis- tration

  10. Management of Open Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02 (United States)


    identified with thoracic trauma was 10.5%. Patients with flail chest, thoracic vascular in- juries, hemothorax, or pulmonary lacerations had the highest...mortality rates. Contusions , pneumothorax, flail chest, and chest wall trauma were associated with a lower mortality risk when controlling way of the trachea and bronchi that air, with its necessary oxygen, can reach the pulmonary al- veoli. It is evident that the percentage of air

  11. Mass Casualty Response of a Modern Deployed Head and Neck Surgical Team (United States)


    tures (maxilla, mandible, frontal sinus), and miscellaneous injuries such as a parotid duct injury. Based on review of the operative log, 6 patients...trained to consider subtle head and neck injuries such as facial nerve or parotid duct transection. The flexibility to operate alongside other trauma

  12. 75 FR 22689 - Surety Companies Acceptable on Federal Bonds: General Casualty Company of Wisconsin (United States)


    .... Surety Licenses c/: AK, AZ, AR, CA, CO, CT, DE, GA, HI, ID, IL, IN, IA, KS, KY, LA, MD, MA, MI, MN, MS... Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway..., Financial Accounting and Services Division. BILLING CODE 4810-35-M...

  13. Decontamination Efficacy Testing of COTS SteriFx Prodcuts for Mass Personnel and Casualty Decontamination (United States)


    Water‐based decontamination technologies (e.g. soap and water) facilitate removal of the biological agent from skin, but have little effect on the...runoff from personnel decontamination is still biologically hazardous. Spores and bacterial cells will be prepared for the decontamination...of the stimulants will be compared to evaluate the disinfection efficacy of the technology on bacterial cells and spores. The minimum time to reach

  14. Micronucleus test for radiation biodosimetry in mass casualty events: Evaluation of visual and automated scoring

    Energy Technology Data Exchange (ETDEWEB)

    Bolognesi, Claudia, E-mail: claudia.bolognesi@istge.i [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Balia, Cristina; Roggieri, Paola [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Cardinale, Francesco [Clinical Epidemiology Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Department of Health Sciences, University of Genoa, Genoa (Italy); Bruzzi, Paolo [Clinical Epidemiology Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Sorcinelli, Francesca [Environmental Carcinogenesis Unit, National Cancer Research Institute, Largo R. Benzi 10, 16132 Genoa (Italy); Laboratory of Genetics, Histology and Molecular Biology Section, Army Medical and Veterinary, Research Center, Via Santo Stefano Rotondo 4, 00184 Roma (Italy); Lista, Florigio [Laboratory of Genetics, Histology and Molecular Biology Section, Army Medical and Veterinary, Research Center, Via Santo Stefano Rotondo 4, 00184 Roma (Italy); D' Amelio, Raffaele [Sapienza, Universita di Roma II Facolta di Medicina e Chirurgia and Ministero della Difesa, Direzione Generale Sanita Militare (Italy); Righi, Enzo [Frascati National Laboratories, National Institute of Nuclear Physics, Via Enrico Fermi 40, 00044 Frascati, Rome (Italy)


    In the case of a large-scale nuclear or radiological incidents a reliable estimate of dose is an essential tool for providing timely assessment of radiation exposure and for making life-saving medical decisions. Cytogenetics is considered as the 'gold standard' for biodosimetry. The dicentric analysis (DA) represents the most specific cytogenetic bioassay. The micronucleus test (MN) applied in interphase in peripheral lymphocytes is an alternative and simpler approach. A dose-effect calibration curve for the MN frequency in peripheral lymphocytes from 27 adult donors was established after in vitro irradiation at a dose range 0.15-8 Gy of {sup 137}Cs gamma rays (dose rate 6 Gy min{sup -1}). Dose prediction by visual scoring in a dose-blinded study (0.15-4.0 Gy) revealed a high level of accuracy (R = 0.89). The scoring of MN is time consuming and requires adequate skills and expertise. Automated image analysis is a feasible approach allowing to reduce the time and to increase the accuracy of the dose estimation decreasing the variability due to subjective evaluation. A good correlation (R = 0.705) between visual and automated scoring with visual correction was observed over the dose range 0-2 Gy. Almost perfect discrimination power for exposure to 1-2 Gy, and a satisfactory power for 0.6 Gy were detected. This threshold level can be considered sufficient for identification of sub lethally exposed individuals by automated CBMN assay.

  15. Rotorcraft Use in Disaster Relief and Mass Casualty Incidents - Case Studies (United States)


    ground-fault within a combustible concealed space in a waitresses serving station of The Deli. Following full involvement of The Deli, a flame front...entirely limited to the Casino level and second floor office area. There was minor flame damage on one or two guest rooms on the fifth floor and heat and...smoke damage on upper floors , but the major damage by fire was in the Main Casino, the lobby areas at the main and Flamingo Road entrances, the hotel

  16. 76 FR 53364 - Recreational Vessel Propeller Strike and Carbon Monoxide Poisoning Casualty Prevention (United States)


    ... Evaluation Report: HETA #2000-0400-2956, HETA # 2002-0325-2956, Glen Canyon National Recreation Area, Arizona..., 2011. James A. Watson, Rear Admiral, U.S. Coast Guard, Director of Prevention Policy. BILLING CODE...

  17. Prevention and treatment of respiratory consequences induced by sulfur mustard in Iranian casualties

    Directory of Open Access Journals (Sweden)

    Seyed M Razavi


    Full Text Available Background: About 100,000 Iranian have been exposed to chemical weapons during Iraq-Iran conflict (1980-88. After being spent of more than two decades, still about 30,000 of them are under follow-up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases. Methods: For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed. Results: There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long-acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents. Conclusions: Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

  18. USAMRIID’s Medical Management of Biological Casualties Handbook, Fourth Edition (United States)


    1937, Japan started an ambitious biological warfare program, located 40 miles south of Harbin , Manchuria , in a laboratory complex code-named “Unit...fleas, a plague epidemic ensued in China and Manchuria . By 1945, the Japanese program had stockpiled 400 kilograms of anthrax to be used in a...or epidemic hemorrhagic fever). This is the most common disease due to hantaviruses. It was described prior to WW II in Manchuria along the Amur

  19. Evaluation and Treatment of Nuclear Casualties. Part 3. Management of Combined Injuries (United States)


    radioprotectants beta * immediately after irradiation or results in serious complications mercaptoethylamine (MEA), sero- during the latent period...from our clonal antibodies for opportunistic general, and to wound infection in laboratory suggest some caution in pathogens or core glycolipid of

  20. Are we preparing health services administration students to respond to bioterrorism and mass casualty management? (United States)

    Houser, Shannon H; Houser, Howard W


    Bioterrorism/natural disaster events add significant specialized demands and disrupt normal operation of the health system, often for an indefinite period of time. Health administration leaders should be educationally prepared for and informed about these potential events, but few receive this knowledge via their academic preparation in health administration. This study examined the existence of coverage of bioterrorism topics in health administration curricula and characteristics of bioterrorism coverage in current health administration programs through a self-completed survey among AUPHA graduate and undergraduate program members. Of the total survey respondents, only 32% of programs have current coverage of bioterrorism. The main reasons for nothavingbioterrorism coverage were not having enough resources; not having enough time to develop course/materials; and not thinking it is necessary to add these courses/materials. To prepare better and to inform future health administrators regarding major disruptive circumstances, advocacy and documentation are important to develop and implement bioterrorism awareness. Possibly, suggested minimum curricular requirements, content, and mechanisms for inclusion can be developed in the near future. Health administration educators should address the new reality and demonstrate that their graduates can function and lead in crises and situations disruptive to normal commerce.

  1. Battle Casualty Survival with Emergency Tourniquet Use to Stop Limb Bleeding (United States)


    or comparison of time periods 1 and 2, we compared roportions of key variables such as survival rates. We sed descriptive statistics and Fisher’s...Trauma 2004;56: 214–5. 2. Husum H, Ang SC, Fosse E. War surgery field manual. Penang , Malaysia: Third World Network; 1995. 3. Kragh JF Jr, Walters TJ

  2. Marine Corps CASEVAC: Determining Medical Supply Needs for Long- and Short-Range Airborne Casualty Evacuation (United States)


    control Long range Gatifloxacin* Infection control Long range Diazepam Sedate agitated patients Both Dexamethasone Head injuries Long range...Vial 10s 0.50 PG 4.625 0.1825 $896.07 6505015053476 Diazepam Inj 5mg/Ml 2 Ml Cartridge Unit 10s 0.02 PG 0.011 0.0024 $0.47 6505001487177...0.0612 0.02448 $0.86 8520013535671 Skin Cleanser 60pct Alcohol No Rinsing 0.08 PG 0.72 0.04 $3.07 6515015096866 Sling, Pelvic Fracture Stabilizer 1s

  3. EDs credit drills, community engagement with helping them manage casualties from tornado crises. (United States)


    Emergency department leaders at DCH Regional Medical Center in Tuscaloosa, AL, and Cullman Regional Medical Center in Cullman, AL, credit their regular practice drills with helping them deal with unprecedented demand when deadly tornadoes swept through the South this past April. Both facilities used the hospital instant command structure (HICS) to mobilize the resources needed to care for the surge in patients, and say the approach worked well in helping them meet the needs of their communities. However, the crises also showcased opportunities for improvement. The ED at DCH Regional Medical Center saw more than 600 patients on the day of the storm, a three-fold increase in the hospital's typical volume. CRMC treated 99 patients in the seven hours immediately following the storm when it usually treats 114 patients per day. In addition to a big surge in patients, both hospitals dealt with power outages that limited access to some services such as radiology. Triage proved particularly challenging at DCH Regional Medical Center, as patients flowed into the hospital from numerous access points. The hospital plans to assign coordinators to each area of the hospital to better manage the influx in the future. When reviewing emergency operations plans, Joint Commission reviewers often find deficiencies in hazard vulnerability analyses as well as the processes used to determine the emergency credentials of licensed independent practitioners.

  4. Oxidative Stress and Proteostasis Network: Culprit and Casualty of Alzheimer’s-Like Neurodegeneration

    Directory of Open Access Journals (Sweden)

    Fabio Di Domenico


    Full Text Available Free radical-mediated damage to proteins is particularly important in aging and age-related neurodegenerative diseases, because in the majority of cases it is a non-reversible phenomenon that requires clearance systems for removal. Major consequences of protein oxidation are loss of protein function and the formation of large protein aggregates, which are often toxic to cells if allowed to accumulate. Deposition of aggregated, misfolded, and oxidized proteins may also result from the impairment of protein quality control (PQC system, including protein unfolded response, proteasome, and autophagy. Perturbations of such components of the proteostasis network that provides a critical protective role against stress conditions are emerging as relevant factor in triggering neuronal death. In this outlook paper, we discuss the role of protein oxidation as a major contributing factor for the impairment of the PQC regulating protein folding, surveillance, and degradation. Recent studies from our group and from others aim to better understand the link between Down syndrome and Alzheimer’s disease neuropathology. We propose oxidative stress and alteration of proteostasis network as a possible unifying mechanism triggering neurodegeneration.

  5. Incidence of Pulmonary Embolus in Combat Casualties With Extremity Amputations and Fractures (United States)


    Bethesda, Maryland; and Integrated Depart- ment of Orthopedics and Rehabilitation (K.N.E., J.A.F.), Walter Reed Na- tional Military Medical Center...6.5%) Other 8 (3.0%) Hospital course Days from injury to arrival at· NNMC 6.47 :!: 7.8 LOS 27.17 20.5 Ventilator days 2.18 ::t 5.8 ICU days...provide the greatest rehabilitation ability. It is well documented that surgery alone is a risk factor for development of a VTE.D This was seen in our

  6. [The organizational aspects of treating light casualties in modern warfare (2)]. (United States)

    Nechaev, E A; Maksimov, G K; Agapov, V K; Golov, Iu S


    The experience gathered by Medical Service during the war in Afghanistan and during liquidation of the consequences of various disasters and accidents has shown that the most rational method of treatment of minor wounded near the combat area or zone of disaster was a two-staged (and sometimes a three-staged) management system. At the combat tactical zone it is expedient to render the secondary surgical care and reanimation procedures of vital cases, and also provide treatment of minor wounded who could be returned to their ranks in 10 days. For this purpose it is necessary to integrate the sections of medical triage and minor wounded treatment into organic structure of the Brigade medical company and Divisional hospital. As for Army Medical Brigade it must have in its structure a hospital for minor wounded who could be returned to their ranks in 20 days. All the wounded who have to be treated more than 20 days must be evacuated to the Front hospital for minor wounded.

  7. Infections Complicating the Care of Combat Casualties During Operations Iraqi Freedom and Enduring Freedom (United States)


    septicemia 2 38.49 Gram-negative septicemia nec 2 38.8 Septicemia OT 2 38.9 Septicemia nos 11 790.7 Bacteremia 85 Bone/joint 730.02 Acute osteomyelitis ...arm 1 730.05 Acute osteomyelitis pelvis 4 730.06 Acute osteomyelitis leg 8 730.07 Acute osteomyelitis ankle 2 730.16 Chronic osteomyelitis leg 3 730.22... Osteomyelitis unspec arm 3 730.23 Osteomyelitis unspec forearm 4 730.25 Osteomyelitis unspec pelvis 6 730.26 Osteomyelitis nos-L/leg 8 730.27

  8. Medical Treatment in Lieu of Evacuation: Techniques for Combat Casualty Care Physicians (United States)


    rehabilitative services. The Golden Hour. Dr. R. A. Cowley, a trauma surgeon, first coined this term in 1969. The golden hour is an evacuation...transmission of bacteria and allows for a less skilled operator. Resuscitative Protocols A primary concern when treating a trauma patient is the prevention of

  9. Casualties Produced by Impact and Related Topics of People Survivability in a Direct Effects Environment (United States)


    emvl lveds. 0 Floss jul ii~Ia~rC~f~lll coininit5 , adit aIt la;ter timPes, thv p ri i ainim i (A. re Sc i r cf.’s ,ii iv~ Jviný ’ws Iattemvn t s of...or some of the following communications and warning systems.. * State police radio * Sheriff’s department radio * Citizens band radio *;item is ex- pectLvd to ,e up ili’,ite~d. .. . "The .ani tnna _t )wer (on which a local government and a tvit.i- zens band antenna i.s locat ud) is

  10. Prevention and Management of Infections Associated With Burns in the Combat Casualty (United States)


    infection has not been proved effective. Early use of antibiotics such as penicillin and erythromycin aimed at controlling outbreaks of Streptococcus ...Research Unit (SRU).5 The initial focus of the SRU was characterization and delivery to the battlefield of newly-discovered penicillin . The US Army Burn...infection. Complications such as ventilator-associated pneumonia and sepsis associated with long term intensive care and invasive procedures are becom

  11. Beyond Precision: Issues of Morality and Decision Making in Minimizing Collateral Casualties (United States)


    tradition, as it grew from its roots in the church, is commonly traced through Saint Augustine, Thomas Aquinas , Francisco de Vitoria, Francisco...Headquarters, New York, New York, 10 November 2001). 23 Thomas E. Ricks, "Target Approval Delays Cost Air Force Key Hits," Target Approval Delays... Thomas E. "Target Approval Delays Cost Air Force Key Hits." Target Approval Delays. Journal of Military Ethics 1, no. 2 (2001): 109-12. Schmitt

  12. Use of Ultra Rapid Opioid Detoxification in the Treatment of US Military Burn Casualties (United States)


    military burn patients had a much greater reduction in their opioid usage as calculated by daily MEUs, decreasing the opioid burden by as much as half ... life while minimizing many of the negative consequences of chronic opioid prescription. Future studies may validate decreases in sedation...116. 12. Collins ED, Kleber HD, Whittington RA, Heitler NE. Anesthesia- assisted vs buprenorphine - or clonidine-assisted heroin detoxification and

  13. Use of Recombinant Factor VIIa in US Military Casualties for a Five-Year Period (United States)


    Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled...particularly Factor VII level, in order that all of us could help learn the ideal plasma to red cell ratio by science rather than by some gestalt ? Dr. Slate

  14. System for Initial Assessment, Management, and Physiologic Monitoring of Battlefield Casualties (United States)


    phosphatase): automated benchtop whole blood chemistry analyzer , with computer data link and interpretation. 4) Urinalysis (including specific gravity...base parameters 2) Automated hematology analyzer measurement of red cell, white cell, and platelet values 3) Automated whole blood chemistry analyzer m

  15. The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care. (United States)

    Valerio, Ian L; Campbell, Paul; Sabino, Jennifer; Dearth, Christopher L; Fleming, Mark


    Treatment of combat injuries and resulting wounds can be difficult to treat due to compromised and evolving tissue necrosis, environmental contaminants, multidrug resistant microbacterial and/or fungal infections, coupled with microvascular damage and/or hypovascularized exposed vital structures. Our group has developed surgical care algorithms with identifiable salvage techniques to achieve stable, definitive wound coverage often with the aid of certain regenerative medicine biologic scaffold materials and advanced wound care to facilitate tissue coverage and healing. This case series reports on the role of urinary bladder matrix scaffolds in the wound care and reconstruction of traumatic and combat wounds. Urinary bladder matrix was found to facilitate definitive soft tissue reconstruction by establishing a neovascularized soft tissue base acceptable for second stage wound and skin coverage options within traumatic and combat-related wounds.

  16. Unit Ministry Team Religious Support to Casualties on the Airland Battlefield (United States)


    903 151 200 Torn Meniscus/Knee, Mod 235 37 201 Lumbosacral Strain, Mod 202 Eczema , Severe 6 2 203 Eczema . Mod 204 Boils, Severe...military working dogs . E-8 ^mmrr&mww>mtm& www w wvi-j’jywjvw yj vy r^ ^J wv nr^n’ ’^ ^■t.^v.^v.’ w ^i’ i’ ^ w.1 ".■ <.’ v

  17. Redefining Projections of Disease and Nonbattle Injury Patient Condition Code Distributions with Casualty Data from Operation (United States)


    women had more diseases of the genitourinary system than men. The Patient Condition Occurrence Frequency tool was developed to account for these...cardiovascular, sexually transmitted diseases , genitourinary (female), infectious/ parasitic , neuropsychiatric, and miscellaneous. Although considerable...Gastrointestinal 9.4% 4.0% Cardiovascular 13.5% 3.4% Sexually Transmitted Disease 0.4% 0.2% Genitourinary 10.7% 7.3% Infectious/ Parasitic

  18. A rarity that can lead to a casualty - A retrospective study of 12 cases of Dermatomyositis

    Directory of Open Access Journals (Sweden)

    Matilda Naesström


    Full Text Available Aims: Lesions of the skin are omnipresent in Internal Medicine practice. The varying etiopathology when facing multiple system involvement may pose a challenge when it comes to diagnostics and management, especially when faced with less common skin diseases. Dermatomyositis is a rare skin disorder that manifests on the skin and in muscle; it also comes with a higher risk of comorbid cancers. Therefor we present the cases of dermatomyositis diagnosed at our departmet during the last 17 years, with the specific attention to ocurrance of oncological processes. Method: A retrospective study was performed on 12 cases hospitalized between 1996 to 2011 due to dermatomyositis. The analysis was based on the course of the disease, clinical picture, treatment and frequency of neoplasms. Results: Within those 12 patients (in addition to dermatomyositis five patients had concomitant oncological process. The tumors of these five patients were located in discrete anatomical locations. The oncological process occured before, during, or after the appearance of dermatomyositis. Conclusions: The combination of hallmark signs and symptoms seen in dermatomyositis are specific for the disease. Physicians need to be better informed about this rare, yet important disease, because it can be considered a paraneoplastic process.

  19. Injury Pattern and Mortality of Noncompressible Torso Hemorrhage in UK Combat Casualties (United States)


    UK Joint Theatre Trauma Registry . NCTH was defined as injury to a named torso axial vessel, pulmonary injury, solid-organ injury (Grade 4 or greater...injury to the liver, kidney , or spleen) or pelvic fracture with ring disruption. Patients with ongoing hemorrhage were identified using either a...Defence Medicine Academic Unit. The prospectively collected UK Joint Theatre Trauma Registry (JTTR) was used to ORIGINAL ARTICLE J Trauma Acute Care Surg

  20. Cyanide Antidotes for Mass Casualties: Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery (United States)


    liquid feed system. It can deliver flow rates of up to 0.2 ml/min, allowing a cyanide antidote to be given in about five minutes. We have shown...state of mitochondrial cytochrome c from the neocortex of the mammalian brain,” Biomed. Opt. Express 3(8), 1933–1946 (2012). 20. B. Chance and W. Bank ...growth rate of the MHz Faraday waves excited on a medicinal liquid layer together facilitate ejection of monodisperse droplets of desirable size range

  1. The Swiss Black Swan Bad Scenario: Is Switzerland Another Casualty of the Eurozone Crisis?

    Directory of Open Access Journals (Sweden)

    Sebastien Lleo


    Full Text Available Financial disasters to hedge funds, bank trading departments and individual speculative traders and investors seem to always occur because of non-diversification in all possible scenarios, being overbet and being hit by a bad scenario. Black swans are the worst type of bad scenario: unexpected and extreme. The Swiss National Bank decision on 15 January 2015 to abandon the 1.20 peg against the Euro was a tremendous blow for many Swiss exporters, but also Swiss and international investors, hedge funds, global macro funds, banks, as well as the Swiss central bank. In this paper, we discuss the causes for this action, the money losers and the few winners, what it means for Switzerland, Europe and the rest of the world, what kinds of trades were lost and how they have been prevented.

  2. Making the best of a bad situation for RIF casualties at the Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Patterson, J.L.; Flanagan, J.P.


    When a RIF was announced at ORNL, two specialists in training demonstrated that an effective outplacement training seminar can be developed and produced within six weeks. Forty-five days afterwards, 88% of the participants were re-employed or had chosen to leave the job market.

  3. Research and Development Strategies for the Current and Future Medical Treatment of Radiation Casualties (United States)


    Pasireotide is a small molecule that mimics the natural peptide signaling molecule, somatostatin, stimulating four out of five somatostatin receptors...Dipropionate for Ileal or Ileal-Right Colon Crohn’s Disease of Mild-to-Moderate Activity or In Remission : Retrospective Study,” Biomed Pharmacother 61 (2007... Remission : Retrospective Study.” Biomed Pharmacother 61 (2007): 370–6. “BARDA Awards 14M for Acute Radiation Countermeasure.” Global Biodefense, August

  4. Multiservice Tactics, Techniques, and Procedures for Treatment of Chemical Agent Casualties and Conventional Military Chemical Injuries (United States)


    bromide, peptic ulcer disease , and low serum acetylcholinesterase. (5) Personnel who are self-administering PB while handling or working used with caution in individuals with hyperthyroidism, sensitivity to bromide, peptic ulcer disease , and low serum acetylcholinesterase. (6) If... acid (HF) may suffer lingering chronic lung disease . Burns may take a long time to heal and may result in severe scarring, persistent pain and bone

  5. The incidence of heat casualties in sprint triathlon: the tale of two Melbourne race events. (United States)

    Gosling, Cameron McR; Gabbe, Belinda J; McGivern, Jeanne; Forbes, Andrew B


    Triathlon is a popular participation sport combining swimming, cycling and running into a single event. The Triathlon Australia medical policy advocates the use of wet bulb globe temperature as the criterion for altering race distance and an ambient temperature of 35 degrees C as a criterion for consideration of cancellation of an event, but there is little empirical evidence detailing the effectiveness of this policy. Nor has the impact of environmental thermal stress on triathletes in shorter duration events been determined. During an injury surveillance investigation of a triathlon race series over the 2006/2007 seasons, two events with similar environmental conditions were completed. One thousand eight hundred and eighty-four participants competed in event 1 (December 2006) and 2000 competed in event 2 (February 2007). Maximum dry bulb (DBT), minimum vapour pressure (VP) and minimum relative humidity (RH) for event 1 were 37 degrees C DBT, 0.56 kPa VP and 9% RH measured by the Bureau of Meteorology. Fifty-three participants presented for medical aid, 15 due to heat-related collapse. The conditions measured for event 2 were 33 degrees C DBT, 1.16 kPa VP and 24% RH and there were no heat illness presentations despite 38 individuals presenting for medical aid. These observations suggest that the risk of heat-related collapse is greatest when high-environmental temperatures occur early in the competitive season when participants may be inadequately prepared and have not yet acquired natural acclimatisation to heat. Any Triathlon Australia policy revision could place stronger emphasis on the use of ambient temperature as a limiting criterion for race organisers.

  6. Addenda to Allied Medical Publication 8, NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) to Consider the Impact of Medical Treatment on Casualty Estimation (United States)


    114 F. Venezuelan Equine Encephalitis (VEE) Model Parameters (Section C128) ..117 1. Deletions...staphylococcal enterotoxin B (SEB), Venezuelan Equine Encephalitis (VEE), plague, and smallpox. In addition, although sometimes considered a chemical agent...pre-symptom onset antibiotic prophylaxis) is assumed to be efficacious for a percentage of the population, independent of dose; there is no defeat

  7. NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN) Casualties (AMedP-8(C)) - Parameters for Estimation of Casualties from Exposure to Specified Biological Agents. Addenda to Allied Medical Publication 8 (United States)


    estimating the numbers of persons developing illness or dying from anthrax, botulism, Venezuelan equine encephalitis, plague, and smallpox. Five additional...the non-contagious biological agent explanation in Section 0106.7b, following the Venezuelan equine encephalitis (VEE) assumptions and limitations...comprehensive clinical studies of tularemia available were reported in the pre- antibiotic era before inhalation was understood to be a potential route of

  8. Application of high-frequency ventilation to treatment of chemical-warfare casualties: Animal and theoretical studies (application of high-frequency transtracheal jet ventilation to treatment of chemical-warfare casualties). Final report, March 1983-December 1986

    Energy Technology Data Exchange (ETDEWEB)

    Abbrecht, P.H.; Bryant, H.J.; Kyle, R.


    The objective of this work was to evaluate the effectiveness of transtracheal jet ventilation in organophosphate-challenged animals. Preliminary studies were done in normal canines to define the effects of ventilator operating parameters on respiratory gas exchange. Nine normal dogs, anesthetized with sodium pentobarbital, were ventilated through an eight gauge cricothyrotomy cannula using a controller that allowed separate setting of drive pressure, duty cycle, and frequency. Arterial (partial pressure of oxygen) and (partial pressure of carbon dioxide) were measured after achieving steady state gas exchange at 15-22 different combinations of drive pressure, duty cycle, and frequency in each dog. There were slight increases in PaCO2 and larger decreases in arterial oxygen partial pressure as frequency was increased from 10 to 200 cycles/min. Increases in drive pressure and duty cycle resulted in reductions in PaCO2 and increases in PaO2.

  9. Research and Development of a Convertible Use Rapidly Expandable Model for Response to Disasters and Mass Casualties (United States)


    real time and in anticipation of future incidents. Information officers will be able to use the tool as a portal for information requests. AEGIS...will be able to use the tool as a portal for information requests. AEGIS will be able to quickly generate reports and summaries both for use in action...available to identify infectious agents Provide epidemic detection Biosurveillance and bio-agent detection Guidelines for the clinical recognition

  10. Parameters for Estimation of Casualties from Ammonia (NH3), Tabun (GA), Soman (GD),Cyclosarin (GF) and Lewisite (L) (United States)


    as a function of primary and direct physiological effects. Battle stress cases and indirect effects (e.g., inju- ries resulting from car accidents...little such data exist. Some data on uncontrolled (accidental, suicidal , homicidal) exposure is available, but such data are, by their nature...For GB, for exam - ple, Table 5 (reproduced from AMedP-7.5) shows the entire GB mild cohort being RTD on Day 2, whereas the GB severe cohort’s RTD is

  11. Personal Protective Equipment Guide for Military Medical Treatment Facility Personnel Handling Casualties From Weapons of Mass Destruction and Terrorism Events (United States)


    Brucellosis ( Brucellae species) (10-100 organisms, Ref. 48) • Glanders (Burkholderia mallei) (100 – 1,000 organisms, Ref. 142) • Pneumonic...48). Brucellosis, Brucellae species, bacteria Standard Precautions (Ref 43, 48.) Cholera, Vibrio cholerae, bacteria Standard Precautions ( al., Bacillus Anthracis Aerosols in Goat Hair Processing Mills, Am. J. Hyg., Vol. 72, pp. 24-31, 1960. 100. Borio, L. et. al., Hemorrhagic

  12. Tactical Enthusiasm and Operational Blindness: Civilian Casualties during the Allied Air Campaign in Italy in 1940-1945 (United States)


    to achieve the desired strategic ends. In doing so, the monograph’s methodology purposefully avoids any moral stance. Ethics and morality tend to...that “autonomous robotic systems offer numerous other potential operational benefits to the military: faster, cheaper, better mission accomplishment...Weapons- Ethical and Doctrinal Implication” (Paper, Naval War College, Newport, RI, 2005) quoted in Ronald C. Arkin, “The Case for Ethical Autonomy in

  13. Theoretical analysis on the casualty of explosion and blower of waste heap with the mutation of intrinsic factors

    Energy Technology Data Exchange (ETDEWEB)

    Qin, B.; Wang, D.; Li, Z. [China University of Mining and Technology, Xuzhou (China). State Key Laboratory of Coal Resources and Safe Mining


    In order to solve the difficulty caused by lack of water and mud for mine fire control in the northwest area of China and overcome the shortcomings of pouring sand, a thickener with three-dimensional network structure was developed. The mechanism of the thickener suspending sand was analyzed in theory and experiments were made on the suspending sand effect and flow characteristics. The results show that the pH value and yield stress of the thickener influence its suspending ability. The suspending sand process is a stepwise gelation; it can reduce the pipeline surface wear and flow resistance and is suitable for long-distance transportation in pipelines. The thickener was successfully applied at 31305 and 31306 working faces on Bulianta Mine in Shendong.

  14. Theoretical analysis on the casualty of explosion and blower of waste heap with the mutation of intrinsic factors

    Energy Technology Data Exchange (ETDEWEB)

    Jia, H.; Yu, M.; Pan, R.; Yu, S. [Henan Polytechnic University, Jiaozuo (China). College of Safety Science and Engineering


    In order to analyse the effects of explosion and disturbance in the waste heap of No. 4 coal mine of Pingdingshan Coal Co. Ltd., the equation of state and specific internal energy equation from the theory of explosion dynamics were applied to find a kinetic model. The evolution process of the explosion and disturbance of the waste heap has the same effect as dynamite being hurled into the explosion centre and the equivalent weight of the dynamite changes with the extent of reaction of the coal, air and water. 9 refs., 2 figs., 3 tabs.

  15. The Potential Utility of Urinary Biomarkers for Risk Prediction in Combat Casualties: A Prospective Observational Cohort Study (United States)


    associated with adverse outcomes in acute renal failure . J Am Soc Nephrol. 2007;18:904–12. 14. Alge JL. Arthur JM. Biomarkers of AKI: a review of mechanistic...are associated with poor outcomes, including death and the need for renal replacement therapy. Methods: We conducted a prospective, observational study...Eighty nine patients with urine samples drawn at admission to the intensive care unit were studied. Twelve patients subsequently died or needed renal

  16. Taking a Regional Healthcare Coalition Approach to Mitigating Surge Capacity Needs of Mass Casualty or Pandemic Events (United States)


    Hertzberg, Frederick . The Motivation to Work. herzberg /. Hertzberg, Frederick . Work and the nature of man. NY...participation needs of a coalition—active involvement. In the book Work and the Nature of Man, Frederick Hertzberg details his “two-factor theory” in...59 Frederick Hertzberg; Work and the Nature of Man; 1973; Mentor Books, New York; Two-factor Theory Pp. 149-158 60 Hertzberg’s

  17. Textbook of Military Medicine. Part 1. Warfare, Weaponry, and the Casualty. Volume 2. Medical Consequences of Nuclear Warfare (United States)


    radiation-induced cataracts in man and mouse, and natural macular degeneration in man: Proposed mechanisms. Phys. Med. Biol. 30: 879-896. 19. Toda, S...Preventive Medicine and the Environment Volume I DEPLOYMENT AND MOBILIZATION 2 OCCCPATIONAL IIEALTIH: THE SOLDIER IN THE INDUSTRIAL. BASE 3 PERSONAL AND...roentgens). It was concluded that the system be reversible; that is, the surviving fraction shielded spleen contained competent and mobil - of

  18. Recommendation for a National Standard for Tactical Emergency Casualty Care and Israeli Hospital Trauma Protocols in the United States (United States)


    Trauma Registry,” Israel Medical Association Journal 9, no. (2007): 347, IMAJ /0//46/23018.pdf 57 identify...the Israel National Trauma Registry.” Israel Medical Association Journal. 9 no. 5 (May 2007): 341– 351. IMAJ /0/46

  19. ARDS: Risk Factors, Prognostic Factors, Management and Outcomes. Incidence and Mortality of ARDS in Combat Casualty Care (United States)


    important to both maintain readiness and force protection, as well as in the continued provision of clinical care during transport and in the level of care (10 subjects had multiple CPT codes). Number Code N 31.1 TEMPORARY TRACHEOSTOMY 18 33.21 BRONCHOSCOPY THRU STOMA 4 33.22 hospitals, is particularly important to both maintain readiness and force protection, as well as in the continued provision of clinical care

  20. Enhancing Public Resilience to Mass-Casualty WMD Terrorism in the United States: Definitions, Challenges, and Recommendations (United States)


    Psychological Bulletin (2001), 127(2):267-86. 53 Albert Bandura , “Exercise of Human Agency Through Collective Efficacy,” Current Directions in Psychological...either personal (“I can do something about this”) or vicarious (“Events are under control”) in nature, in keeping with Albert Bandura’s distinction

  1. The United States Army Medical Department Journal, April - June 2011. Prehospital combat casualty care; The starting point of battlefield survival (United States)


    administration is credited to Sir Christopher Wren in 1665 when he administered Opium via a sharpened quill to a dog .14 Since that time, multiple...36. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability

  2. Development of Empirically Based Time-to-death Curves for Combat Casualty Deaths in Iraq and Afghanistan (United States)


    D’Souza Ross Vickers James Zouris Vern Wing Michael Galarneau Report No. 13-15, This research received no specific grant from any funding agency...Edwin D’Souza, Ross Vickers , James Zouris, Vern Wing and Michael Galarneau Abstract The United States Department of Defense medical planners need survival...combat injury severity scales, and developing combat injury anomaly detection algorithms. Ross Vickers , PhD, is a consultant to the NHRC’s Medical

  3. EMS Response to Mass Casualty Incidents: The Critical Importance of Automatic Statewide Mutual Aid and MCI Training (United States)


    tasks with associated challenges or barriers that had to be overcome in order for the final product to emerge and become a workable system. The number...hall’s stage carrying a guitar case with a shotgun in it and three handguns 83 MABAS-Illinois, “What

  4. Guidelines for Mass Casualty Decontamination During a HAZMAT/Weapon of Mass Destruction Incident. Volumes 1 and 2 (United States)


    of maintaining and producing heat: resting (quiescent body state) metabolism, exercise , and shivering (the involuntary contraction of muscles ...agencies during response exercises include Tyvek® suits, blankets, sheets and large plastic garbage bags. Tag Victims to Identify Decontamination Status...agents are immediate and observable and range from spasms and vomiting to dizziness, disorientation and death. Because effects are determined by dosage

  5. A Patient-Controlled Analgesia Adaptor to Mitigate Postsurgical Pain for Combat Casualties With Multiple Limb Amputation: A Case Series. (United States)

    Pasquina, Paul F; Isaacson, Brad M; Johnson, Elizabeth; Rhoades, Daniel S; Lindholm, Mark P; Grindle, Garrett G; Cooper, Rory A


    The use of explosive armaments during Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn has resulted in a significant number of injured U.S. service members. These weapons often generate substantial extremity trauma requiring multiple surgical procedures to preserve life, limb, and restore function. For those individuals who require multiple surgeries, the use of patient-controlled analgesia (PCA) devices can be an effective way to achieve adequate pain management and promote successful rehabilitation and recovery during inpatient treatment. A subpopulation of patients are unable to independently control a PCA device because of severe multiple limb dysfunction and/or loss. In response to the needs of these patients, our team designed and developed a custom adaptor to assist service members who would otherwise not be able to use a PCA. Patient feedback of the device indicated a positive response, improved independence, and overall satisfaction during inpatient hospitalization.

  6. Thoracic Injuries in US Combat Casualties: A 10-Year Review of Operation Enduring Freedom and Iraqi Freedom (United States)


    explosive devices were the most common cause of injury (61.9%). Of 6,030 thoracic injuries identified, pneumothorax and pulmonary contusions were most...1,061 (51.8) Pulmonary contusion 1,028 (50.2) Rib fractures 717 (35) Hemothorax 615 (30) Other chest injury 494 (24.1) Open chest wound 264 (12.9...1890s and was used to treat pulmonary edema in combat ca- sualties during WWI.1 Transfusions with whole blood were also performed in combat hospitals

  7. Optimizing the use of Limb Tourniquets in Tactical Combat Casualty Care: TCCC Guidelines Change 14-02 (United States)


    American Civil War in 1862, Samuel Gross of the Union Army recommended issuing a tourniquet-like device to every combat soldier along with...K, Dixon P, Cowart J, Spencer J, Rasmussen TE. Hemorrhagic shock worsens neuromuscular recovery in a porcine model of hind limb vascular injury and

  8. Redefining Projections of Disease and Nonbattle Injury Patient Condition Code Distributions with Casualty Data from Operation Iraqi Freedom (United States)


    63706N.M0095.60511. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the...symptoms 0.04% 0.09% 245 Diarrheal disease severe 0.14% 0.34% 246 Diarrheal disease moderate 0.80% 1.88% 248 Gastritis acute all cases 1.69% 4.00

  9. Inspiratory Resistance Maintains Arterial Pressure During Central Hypovolemia: Implications For Treatment Of Combat Casualties With Severe Hemorrhage (United States)


    impedance of approximately 6 cm H2O increased heart rate (HR), AP (Convertino et al., 2004b, 2004c), SV ( measured with thoracic bioimpedance ) and one subject, a 23-ml (25%) increase in SV ( measured with thoracic bioimpedance ) during ITD breathing was associated with an MSNA of 23 bursts...beat-to-beat SV measured with thoracic bioimpedance during baseline supine rest and exposure to 60 mmHg LBNP with normal breathing followed by use

  10. English Language Literacies of Undergraduate Students in Malaysia's Culturally and Linguistically Diverse Environment: Casualties of National Language Policies and Globalisation? (United States)

    Wahi, Wahiza


    The issue of Malaysian graduates' unemployment, attributed largely to their flawed English language competence, has been a major concern in the country for many years. The study reported in this paper sought to better comprehend future graduates' perspectives and practices in dealing with the English language literacies prior to graduation. This…

  11. Fluid Resuscitation for Hemorrhagic Shock in Tactical Combat Casualty Care: TCCC Guidelines Change 14-01 - 2 June 2014 (United States)


    in routine blood banking practice and there- fore is not US Food and Drug Administration (FDA) compliant, the Assistant Secretary of Defense For...blood product wastage .101 DCR With Thawed Plasma or Liquid Plasma Transfusion of plasma is the standard of care for the treatment of the...Nursing. 2014;21. 60. Rice CL. Policy on the use of non–US Food and Drug Administration compliant blood products [letter]. Assis- tant Secretary of

  12. Personal factors affecting ethical performance in healthcare workers during disasters and mass casualty incidents in Iran: a qualitative study. (United States)

    Kiani, Mehrzad; Fadavi, Mohsen; Khankeh, Hamidreza; Borhani, Fariba


    In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster. According to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers.

  13. Injury and Illness Casualty Distributions Among U.S. Army and Marine Corps Personnel During Operation Iraqi Freedom (United States)


    parasitic diseases and diseases of the musculoskeletal, digestive, and nervous systems were more common. Branch of Service Marines sustained proportionally...neoplasms, mental disorders, diseases of the blood and blood-forming organs, respiratory, and genitourinary systems were more common among women than... system Circulatory Respiratory Digestive Genitourinary Pregnancy Skin Musculoskeletal Congenital Ill-defined Injury Supplementary Total OIF-I No.

  14. FY12 Line-Supported Bio-Medical Initiative Program: Advanced Photoplethysmography (PPG) Sensors for Operational and Casualty Care Medicine (United States)


    COPD, airway obstruction, and edema [2]. Figure 1: Absorption spectra of oxygenated and deoxygenated hemoglobin. The two most commonly used...resistance (vasoconstriction/dilation), cardiogenic shock, and changes in stroke volume. Currently, CO measurement is measured invasively, which

  15. Shifting the Paradigm of Trauma Medicine to Positively Influence Critical Mortality Rates Following a Mass Casualty Event (United States)


    OF ARTS IN SECURITY STUDIES (HOMELAND SECURITY AND DEFENSE) from the NAVAL POSTGRADUATE SCHOOL June 2009 Author: Dana L. Hall, RPh...system. Occurring at 8:50 am, the first attack occurred between the Aldgate and Liverpool Stations killing seven, followed subsequently within a minute...attack at 9:47 am. Police just happened to be on site. It occurred just across the street from the British Medical Association building which

  16. Advanced Product Development for Combat Casualty Care at the U.S. Army Institute of Surgical Research (United States)


    and resources to include dental , eye, and blood product research in collaboration with the U.S. Navy and U.S. Air Force as well as NATO partners...USAISR includes expansion of the mission and resources to include dental , eye, and blood product research in collaboration with the U.S. Navy and U.S...established the ability to use stem cells as a therapy for skin, muscle, and bone injuries while collaborations have made a wide variety of biomaterials

  17. Experience with Proctectomy to Manage Combat Casualties Sustaining Catastrophic Perineal Blast Injury Complicated by Invasive Mucor Soft-Tissue Infections (United States)


    traumatic amputations, open pelvic fracture with left sacroiliac joint dissociation, traumatic right orchiectomy, penile burns with membranous...transfused within 24 hours of injury).4 A recent clinical practice guideline addressing IFI has been published by the Department of Defense Joint ...1441 9. 5. Department of Defense Joint Theater Trauma System. http://www.usaisr Fungal Infection in War Wounds 1

  18. Truth is the First Casualty of War: A Brief Examination of Russian Informational Conflict during the 2014 Crisis in Ukraine (United States)


    extensive use of proxies are made, including private and state-sponsored or controlled media outlets as well as non-state actors, such as labour unions... manage the strategic socio-political discussion space. Second to psychologically distract, overwhelm and disrupt the adversary with as much...future is defined as the next five to 10 years. 78 Berzins. 12 7. Russia will seek not just to shape / manage but rather to control

  19. Textbook of Military Medicine. Part 1. Warfare, Weaponry, and the Casualty. Part 5. Conventional Warfare. Ballistic, Blast, and Burn Injuries (United States)


    submunitions are becoming increasingly common in projection that resembles a butterfly’s wings combat (Figure 1-50). around the detonation site (Figure 1...T.; Phillips, Y. Y III. 1988. Computer modelir.g -. thoracic response to blast. J. Trauma 28:S149-$152. 240 Wing , Chapter 7 THE PHYSICS AND...or postmortem sphenoid , and lacrimal bones on the medial surface of examination unless a retrobulbar hemorrhage has re- the orbital wall. In studies

  20. USCG Facility Pollution (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  1. USCG Vessel (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  2. USCG Other Events (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  3. USCG Vessel Events (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  4. USCG Vessel Pollution (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  5. USCG Injury (United States)

    Department of Homeland Security — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

  6. Improvement of Legislation on Crime of Causing Truffle Casualties%论交通肇事罪立法之完善

    Institute of Scientific and Technical Information of China (English)

    付泽; 张雅婷



  7. The "Casualties Hypothesis": The Influence of News Media Coverage of U.S. Military Deaths on Public Support for Military Operations (United States)


    use frames as "central organizing ideas or story lines that provide meaning" (Gamson & Modigliani, 1987 as cited in Pan & Kosicki , 1993, p.57...of Press / Politics, 8(2). 36-70. Pan , Z., & Kosicki , G.M. (1993). Framing analysis: An approach to news discourse. Political Communication, 10(1). 55...Jr., B.A. The Ohio State University 2005 Master’s Examination Committee Approved by Dr. Gerald M. Kosicki , Adviser Dr. Mathew Nisbet Adviser Graduate

  8. The Impact Analysis of a Mixed Squadron, Containing LCS and Multi-Mission Surface Platforms, on Blue Force Casualties and Mission Effectiveness (United States)


    He guided me and pointed out potential pitfalls before they turned into an abyss. I also want to thank the SEED Center folks, Debbie Sandoval ...Professor Paul Sanchez and Colonel Ed Lesnowicz, USMC (Ret.) for their help and support along the way and for providing a place to do quality work. I...Lucas, & Sanchez , 2004). The tool used is Map Aware Non-uniform Automata (MANA), a product developed by New Zealand’s Defence Technology Agency

  9. Intraosseous Hydroxocobalamin in the Treatment of Acute, Severe Cyanide Induced Cardiotoxicity in a Swine (Sus Scrofa) Model - An Alternate Administration Route for Chemical Mass Casualties (United States)


    methods – LICOX (PbO2), near infrared spectrophotometry (NIRS), and microdialysis. We will use three devices to assess neurologic function after...antidotal treatment. These measures are near infrared spectroscopy, brain oxygen tension, and brain microdialysis. Hypothesis We hypothesize...cerebral near infrared spectrometry (NIRS) oxygenation, and inflammatory markers. Methods 24 swine (48-52 kg) were intubated, anesthetized, and

  10. Management of External Hemorrhage in Tactical Combat Casualty Care: Chitosan-Based Hemostatic Gauze Dressings. TCCC Guidelines Change 13-05 (United States)


    studies using these methods could be the lack of an accepted consensus agreement among DoD and academic laboratories for standardized safety testing...contain much larger particles of a bioabsorbable chitosan that stick together when they get wet . Chitosan gauze manual applica- tion methods are...public re- lease as of 22 April 2014. References 1. Xie H, Lucchesi L, Teach J, et al. Comparison of hemo- static efficacy of ChitoGauze and Combat Gauze

  11. Surge Capacity and Capability. A review of the history and where the science is today regarding surge capacity during a mass casualty disaster.

    Directory of Open Access Journals (Sweden)

    Randy D. Kearns


    Full Text Available Disasters which include countless killed and many more injured, have occurred throughout recorded history. Many of the same reports of disaster also include numerous accounts of individuals attempting to rescue those in great peril and render aid to the injured and infirmed. The purpose of this paper is to briefly discuss the transition through several periods of time with managing a surge of many patients. This review will focus on the triggering event, injury and illness, location where the care is provided and specifically discuss where the science is today.

  12. An Introductory Characterization of a Combat-Casualty-Care Relevant Swine Model of Closed Head Injury Resulting from Exposure to Explosive Blast (United States)


    Richard Bauman, Geoffrey Ling, Lawrence Tong, Adolph Januszkiewicz , Denes Agoston, Nihal Delanerolle, Young Kim, Dave Ritzel, Randy Bell, James Ecklund...of Closed Head Injury Resulting from Exposure to Explosive Blast* Richard A. Bauman,1 Geoffrey Ling,2 Lawrence Tong,3 Adolph Januszkiewicz ,4 Denes...inflammation, and neuronal death cascades. J. Neurotrauma 26, 901-911. Ananiadou, O., Bibou, K ., Drossos, G., Bai, M., Haj-Yahia, S., Charchardi, A., and

  13. Non-Immunogenic Structurally and Biologically Intact Tissue Matrix Grafts for the Immediate Repair of Ballistic-Induced Vascular and Nerve Tissue Injury in Combat Casualty Care (United States)


    days after surgery. No antiplatelet or anticoagulant agents were given during or following surgery. B. Implantability Nine UVG segments from three...used in both the detergent and enzyme steps of the processing protocol as a prophylactic agent , incubation of the harvested tissue at 370C to optimize...various antibiotics covering a broad spectrum of activity and an antifungal agent . Following procurement, the tissue is shipped and stored in a

  14. Technical Reference Manual: NATO Planning Guide for the Estimation of Chemical, Biological, Radiological, and Nuclear (CBRN), Casualties, Allied Medical Publication-8(C) (United States)


    chemical blister agent HD (distilled mustard); the biological agents causing anthrax, botulism, pneumonic plague, smallpox, and Venezuelan equine ...Countermeasures—Vaccination/ Antibiotic Prophylaxis ............181 7. Literature Review and Parameter Development .......................................181 8...203 4. Venezuelan Equine Encephalitis (VEE) ....................................................212 E

  15. Safe Ride Standards for Casualty Evacuation Using Unmanned Aerial Vehicles (Normes de transport sans danger pour l’evacuation des blesses par vehicules aeriens sans pilote) (United States)


    water , earth /soil, and other natural resources; • And in this particular case, the biological contamination of the UAV due to human waste (blood...leur apparition sur le champ de bataille, avec ou sans orientation basée sur une doctrine. L’OTAN et les forces d’opérations spéciales – ainsi que les...with hot water bottles and blankets. Some of their evacuations were even more basic, reverting to the concepts of patients as cargo – they actually

  16. Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma Model (United States)


    Subtask 2. Hematologic and hematologic analysis of blood samples (months 5-28). Award Number: W81XWH-13-2-0022, 1st Annual Report JAN2014 6...HS+ARDS groups. Animals will be randomized (months 17-39) Subtask 3. Hematologic and hematologic analysis of blood samples (months 17-39). Subtask...appropriate VSP veterinarian or NCOIC to coordinate the meeting. 5. POC for this action is Mr. Seitu Q. Khafre, at 301-319-905 l^pr the undersigned, 301

  17. Proceedings of the Conference on Fleet Marine Force Combat Casualty Information System Held at San Diego, California on 2-4 April 1984 (United States)


    Quantico, VA 2213.0 CAPT Bernard R. Blais, MC, USN CiDP , J. R. Crim Force Medical Officer Groulp Surgeon Mit I tary Sea Lilt Command 1st 6SSC, FMF PACC...member may rest on the corpsman for days or weeks, even -4 in peace time. For this reason an Independent Duty Submarine Corpsman (8402) is - more...for example, as nonspecific abdominal pain. For that reason , we conducted observational studies in which one or two persons trained for that purpose

  18. Contribution of forensic autopsy to scene reconstruction in mass fire casualties: a case of alleged arson on a floor consisting of small compartments in a building. (United States)

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Maeda, Hitoshi


    A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a 'private video parlor' consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (victims, except for three victims found between the entrance and the estimated fire-outbreak site; thus, identification was completed without difficulty, supported by DNA analysis. Blood carboxyhemoglobin saturation (COHb) was higher for victims found dead in the inner area. Blood cyanide levels were sublethal, moderately correlated to COHb, but were higher in victims found around the estimated fire-outbreak site. There was no evidence of thinner, alcohol or drug abuse, or an attack of disease as a possible cause of an accidental fire outbreak. These observations contribute to evidence-based reconstruction of the fire disaster, and suggest how deaths could have been prevented by appropriate disaster measures.

  19. The Majority of US Combat Casualty Soft-Tissue Wounds are not Infected or Colonized Upon Arrival or during Treatment at a Continental US Military Medical Facility (United States)


    2%, 0.8% ), Staphylococcus haemolyticus (2%, 0.8%), Citrobacter freuntlii (2%, 0.8%), A/loicoccus otitis ( 1%, 0.4% ), and Bacillus cereus (1...multiple operating rooms, blood products surgi- cal teams, and subspccialists. Within this modem US military medical paradigm, the emphasis in the combat...Homogenized tissue spec- imens (1 J.LL and 10 J.CL) were inoculated on sheep’s blood agar and MacConkey plates in triplicate. Plates were incu- bated

  20. Preparedness for the Evaluation and Management of Mass Casualty Incidents Involving Anticholinesterase Compounds: A Survey of Emergency Department Directors in the 12 Largest Cities in the United States (United States)


    Division, US Army dical Research Institute of Chemical Defense (USAMRICD), Me A berdeen Proving Ground, Maryland. Mic haell. Greenberg , MD, MPH...seizure activity in the guinea pig . Arch Toxicol. 2003; 77(3): 167-172. 88. Capacio BR. Byers CE, Merk KA, et a1. : Pharmacokinetic studies of...intramuscular midazolam in guinea pigs challenged with soman. Drug Chem 1bxicol. 2004; 27(2): 95-110. 89. GHat E, Kadar T, Levy A, et al.: Anticonvulsant

  1. Research on Navy-Related Combat Casualty Care Issues, Navy Operational-Related Injuries and Illnesses and Approaches to Enhance Navy/Marine Corps Personnel Combat Performance. (United States)


    Health) for possible future imaging of our patients on their positron emission tomography (PET) scanner, as well as possible biopsies of our breast...potential linkage(s) between screened markers and the genetic disorders such as cleft-lip and palate, Kartagener Syndrome and Early Onset Periodontitis ...and accepted by AADR: "Interlikin-1 Genotypes and Risks of Early Onset Periodontitis " Goals/Objectives For Next Reporting Period • Continue to

  2. An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2000-2007 Light-Duty Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Tom [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Building Technology and Urban Systems Dept.


    NHTSA recently completed a logistic regression analysis (Kahane 2012) updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data for 2002 to 2008 involving MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and a category for all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.

  3. 时间敏感目标打击杀伤链的优化问题%Optimization of Time Sensitive Target on Casualty Chain Strike

    Institute of Scientific and Technical Information of China (English)

    郜越; 敖志刚; 李宁; 端木竹筠; 闫晶晶


    时间敏感目标的打击能力主要是指对战场上稍纵即逝的目标实施快速打击的能力.阐述时间敏感目标的概念,介绍时间敏感目标打击杀伤链;通过决策变量和约束条件对时间敏感目标打击杀伤链进行最优化描述,提出以网络中心化为主导、决策者主导、传感嚣主导以及射手主导的时间敏感目标打击链指挥控制模式.最后总结给出时间敏感目标打击的3个优化问题,时问敏感目标打击杀伤链的优化问题研究,能够使作战部队具有实时性,协调同步性、作战力量一体化,大幅度提高战斗力.%The strike capability of time sensitive target is the capability to quickly strike the fleeting target on battle fields. This article first describes the concept of time sensitive target and then depicts the time sensitive strike chain. Decision variables and constraint conditions are adopted for clarifying the optimization of time sensitive target strike chain. The command-and-control mode of time sensitive target strike chain with network-centric governing, decision maker governing, sensor governing and gunner governing is pointed out for optimization of time sensitive target strike chain. Three points on optimization of time sensitive target strike are summarized at the end. The research on the problem of time sensitive targets strike-chain optimization can enable combat forces real-time, coordination and synchronization, integration and significantly improve combat effectiveness.

  4. "Second class loss": political culture as a recovery barrier--the families of terrorist casualties' struggle for national honors, recognition, and belonging. (United States)

    Lebel, Udi


    Israeli families of terrorist victims have undertaken initiatives to include their dearest in the national pantheon. The objections opposed the penetration of "second-class loss" into the symbolic closure of heroic national bereavement. The "hierarchy of bereavement" is examined through the lens of political culture organized around the veneration held for the army fallen and their families, which has symbolic as well as rehabilitative outcomes. Families of civilian terror victims claims for similar status and treatment had to frame their loss as national in the eyes of the social policy. The article claimed linkage between collective memory and rehabilitation.

  5. 155-MM Shell MK II (HOW), HS-FILLED: Serviceability of War Reserve Shell and Quantities of Ammunition Required to Produce 50% Casualties on Personnel (United States)


    Caaualtie1 Baaed on Btreota on Aaiaala • . Animale were plaoed on the target area and at posi tiona d.owmrind troa the target area to oentera within a From HS liquid a from effeot• ot 2o-yd.a • and w.por J on animall •quare a a : 13𔃻 I 0 a 94 I 139 I 1 I 96 a 100...pOraFrom HS liquidaFrom etlects on no. at awithir& aEatimated man a o.t.aEetima•a and vapor a animall oenter a20-Jd,o a oaaual ties anlue ated man

  6. Main solution of sustain control casualty of forest harmful biology%林业有害生物可持续控灾的主要对策

    Institute of Scientific and Technical Information of China (English)

    崔同祥; 刘广营; 胡庆禄; 周景清


    冀北山地是河北省重点林区,以位于冀北山地的河北省木兰林管局为例,对该局40 a林业有害生物发生、危害、防治及危害的原因进行了较为详细的总结、分析和论述,并提出了林业有害生物可持续控灾的主要对策.

  7. Five principles of early prophylaxis and treatment of ARDS in casualties injuried by earthquake%防治震后伤者发生ARDS的"五早"原则

    Institute of Scientific and Technical Information of China (English)



    @@ 大地震后由于房屋坍塌等灾害因素,带来的多发伤和严重感染并由此引发急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)的比例大大增加,病死率高达34%~60%[1,2].ALI/ARDS是在严重感染、休克、创伤及烧伤等非心源性疾病过程中,肺毛细血管内皮细胞和肺泡上皮细胞损伤造成弥漫性肺间质及肺泡水肿,导致的急性低氧性呼吸功能不全或衰竭.

  8. Marine Casualty Report. Collapse and Sinking of Mobile Offshore Drilling Unit RANGER I in the Gulf of Mexico on 10 May 1979 with Loss of Life (United States)


    the rotary table, mud tanks, shale shaker , mud mixing pump and motor, surge tank, two cementing units, two air compressors and two larger auxiliary...or trim. The wedges used to reduce vibration between the top of each jackhouse and leg were also checked. The wedges in jackhouse number 2 appeared

  9. Personnel Attrition Rates in Historical Land Combat Operations: A Catalog of Attrition and Casualty Data Bases on Diskettes Usable with Personal Computers (United States)


    labor intensive and therefore very time-consuming and costly. Accordingly, making repeated passes to collect a few additional facets of information, or to...and Labor Activities in France, 1830-1960 (ICPSR 8421). (23) Analysis of Arrests in Paris, June 1848 (ICPSR 0049). (24) Violent Events in France, 1830...Pelaez (ed) Public Law and Comparative Politics. Trabajos en Homenaje a Ferran Vallis i Taberner, Vol XVII, Barcelona, Spain; Facultad de Derecho de

  10. Casualties of the Global War on Terror and their future impact on health care and society: a looming public health crisis. (United States)

    Baker, Michael S


    This article is a primer to understand the medical advances and the future health care consequences of the current conflicts in the Middle East and Southwest Asia, known as the Global War on Terror. There have been significant advances in health care learned in caring for those injured by the conflict--often a polytrauma blast victim, but there are also very high incidence rates of the hidden injuries of war--traumatic brain injury, post-traumatic stress disorder, suicide, and depression. These lead to disruptive behaviors, homelessness, and family violence. Global War on Terror returnees are using medical services and applying for disability at higher rates than in previous conflicts. The costs for veterans' care may peak 30 to 40 years or longer following the conflict, and will inflict an enormous burden on services and resources. The effects of the war will linger for years and impact across generations because of the stress on families and children. We must mobilize government agencies, create public-private partnerships, and invest our resources now to mitigate the approaching tsunami of veterans' health care needs, the impact on our social services, and the devastating costs to society.

  11. Using Modeling to Predict Medical Requirements for Special Operations Missions (United States)


    weighted more heavily with combat injuries than most casualty projection programs are designed to produce. NHRC’s warfare casualty forecasting software...Gynecological Examination 740 Reduce Dislocation 802 Initial/Subsequent Non-Surg Debride Of Burn/Wound A10 Position For Postural Drainage/Place In Coma ...Few data are available to develop statistical casualty forecasting software. Nevertheless, the information that is available on SOF casualties

  12. 我国火灾同英、美、日本诸国火灾之比较%The comparison of fire casualties among Our Country and England、U. S. A、Japan etc.

    Institute of Scientific and Technical Information of China (English)



    @@ 据不完全统计,全球每年约发生火灾700多万起,每年有70000人左右死于火灾.国际间衡量一个国家火灾势态如何,通常是以每10万人口平均值火灾发生次数、火灾死亡人数以及火灾损失额占GDP比值为标准的.有资料显示:

  13. Psychological intervention in the casualties of 4·28 train crash on the Jiao-Ji railway line%"4·28"胶济铁路交通事故伤员心理危机的干预

    Institute of Scientific and Technical Information of China (English)

    赵国秋; 汪永光; 王义强; 张素芬; 曹日芳; 唐济生; 路英智


    目的 分析淄博铁路交通事故伤员心理行为反应特点以寻找救治交通事故后患者的心理的有效方法.方法 采用心理危机结构式访谈问卷,对2008年4月28日发生的山东淄博胶济铁路重大交通事故中的226伤员进行心理状态评估,并对22名ASD患者进行眼动脱敏再加工(eyemovement desensitization and reprocessing,EMDR)治疗,比较EMDR治疗前后的心理行为反应的差异.结果 有22名达到ASD(急性应激障碍)诊断标准,本次铁路交通事故中ASD的发生率为9.73%,伤员中主要以闯入、警觉性增高表现为主,并伴随着其他的负性情绪体验.女性组ASD的发生率(14.85%)高于男性组(5.60%),P0.05).Conclusions The women showed more severe psychological consequences than men after train crash accident.EMDR was effective treatment on ASD but negative emotional symptoms.

  14. 地震和地震海啸中报道死亡人数随时间变化的一个简单模型%A Simple Model of Reported Casualties during Earthquakes and Earthquake-generated Tsunamis

    Institute of Scientific and Technical Information of China (English)

    刘倬; 吴忠良


    在防灾减灾工作中,避免人员伤亡是需要考虑的最重要问题之一。正因为如此,人们对地震伤亡的规律进行了不同角度的研究(例如Lomnitz,1970;Tsai,et al.,2001;Samardjieva and Badal,2002;贾艳等,2004)。

  15. La última baja de la División Azul (de la metralla al hepatocarcinoma The last casualty of 250 Wehrmacht Division (Blue Division (from shrapnel to liver carcinoma

    Directory of Open Access Journals (Sweden)

    A. Lisbona Gil


    Full Text Available Presentamos aquí el caso clínico y evolución de un cabo de la División Azul, que habiendo sido herido en el frente ruso, sector de Nitlikino, por metralla, el 5 de diciembre de 1941, falleció cincuenta y un años más tarde como consecuencia probablemente de dicha herida.We present the case of a corporal belonging to 250 Wehrmacht Division (Blau Division, that after he was hurt by shrapnel in the Russia front during the II World War, fifth of December 1941, he died fifty one years later, owing probably to that wound.

  16. A markov decision process model for the optimal dispatch of military medical evacuation assets. (United States)

    Keneally, Sean K; Robbins, Matthew J; Lunday, Brian J


    We develop a Markov decision process (MDP) model to examine aerial military medical evacuation (MEDEVAC) dispatch policies in a combat environment. The problem of deciding which aeromedical asset to dispatch to each service request is complicated by the threat conditions at the service locations and the priority class of each casualty event. We assume requests for MEDEVAC support arrive sequentially, with the location and the priority of each casualty known upon initiation of the request. The United States military uses a 9-line MEDEVAC request system to classify casualties as being one of three priority levels: urgent, priority, and routine. Multiple casualties can be present at a single casualty event, with the highest priority casualty determining the priority level for the casualty event. Moreover, an armed escort may be required depending on the threat level indicated by the 9-line MEDEVAC request. The proposed MDP model indicates how to optimally dispatch MEDEVAC helicopters to casualty events in order to maximize steady-state system utility. The utility gained from servicing a specific request depends on the number of casualties, the priority class for each of the casualties, and the locations of both the servicing ambulatory helicopter and casualty event. Instances of the dispatching problem are solved using a relative value iteration dynamic programming algorithm. Computational examples are used to investigate optimal dispatch policies under different threat situations and armed escort delays; the examples are based on combat scenarios in which United States Army MEDEVAC units support ground operations in Afghanistan.

  17. Cost benefit analysis of 20 mph zones in London. (United States)

    Steinbach, Rebecca; Cairns, John; Grundy, Chris; Edwards, Phil


    Evidence suggests that 20 mph zones are an effective intervention to reduce casualties from road traffic crashes in urban areas. This analysis compares the costs of construction of the 20 mph zone intervention in high and low casualty areas in London to the value of casualties avoided over 5 and 10 year time horizons. Probabilistic sensitivity analyses were conducted to quantify uncertainty in the results associated with model parameters. Results indicate a net present value (NPV) of £18 947 (90% credible limits -£75 252 to £82 021 2005 prices) after 5 years and £67 306 (£-29 157 to £137 890) after 10 years when 20 mph zones are implemented in areas with one or more casualty per kilometre of road. Simulations from our model suggest that the 'threshold of casualties' where NPVs become positive using a 10 year time horizon is 0.7 casualties per kilometre.

  18. U.S. Army Chemical Corps Historical Studies, Gas Warfare in World War I: The Use of Gas at Saint Mihiel (90th Division in September 1918) (United States)


    another thousand Casualties a3 a result of daily gas fire . Its gas casualties for the period were almost one-third of its total battle casualties...same scale as the German gas fire . Exact quantities could not he reported that first week, but "since the attack considerable quantities of gas shell... gas fire in the early morning between Preny and Zugspitze (the draw east of Preny) and that evening the gassing of Pagny.87 Again on the morning and

  19. 19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country. (United States)


    ... PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT... merchandise, such as administrative salaries, casualty and liability insurance, advertising, and...

  20. 19 CFR 10.197 - Direct costs of processing operations performed in a beneficiary country or countries. (United States)


    ... PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY ARTICLES CONDITIONALLY FREE, SUBJECT..., casualty and liability insurance, advertising, and salesmen's salaries, commissions, or expenses....

  1. De relatie tussen het ingaan van de wintertijd en het aantal verkeersslachtoffers : neemt het aantal verkeersslachtoffers toe wanneer we de klok een uur terugzetten?

    NARCIS (Netherlands)

    Bijleveld, F.D. & Stipdonk, H.L.


    The relation between the end date of daylight saving time and the number of road traffic casualties : is there an increase in the number of casualties when the clock is set back one hour? In the General Discussion on Road Safety that took place on 30 January 2013, Member of Parliament De Graaf asked

  2. 31 CFR 50.82 - Advance approval of settlements. (United States)


    ... the applicable monetary thresholds identified in paragraphs (a)(1) and (2) of this section. (c... the terms and conditions of the underlying commercial property and casualty insurance policy, as... the underlying commercial property and casualty insurance policy to be overstated; and (5) Any...

  3. Framework to implement a risk-informed performance-based fire safety approach

    NARCIS (Netherlands)

    Straalen, IJ.J. van


    The demand of a risk-informed performance-based approach for fire safety in the Netherlands is growing. Various major incidents (pub fire within the city of Volendam with 14 casualties in 2001, fire in the detention centre of Schiphol-East (airport) with 11 casualties in 2005 and the fire in the men

  4. American Airborne Operations in the Pacific Theater: Extending Operational Reach and Creating Operational Shock (United States)


    Zone GIR Glider Infantry Regiment KIA Killed In Action LTC Lieutenant Colonel MIA Missing In Action mm Millimeter PIR Parachute Infantry Regiment...casualties ( KIA , WIA, and MIA) out of a total force of 4,560 men. The Japanese suffered approximately 5,980 casualties out of a force of 6,000 men; only 20

  5. Eliminating Preventable Death on the Battlefield (United States)


    reached the next level of care alive and also ulti- mately survived. Sternal intraosseous access was used in 1 casualty. Consistent with evolving TCCC...from Hospira, Inc, Lake Forest, Illinois. cOne casualty received IVF through a FAST-1 sternal intraosseous device (Pyng Medical Corp, Richmond, British

  6. An Evaluation of the Generalized Intelligent Framework for Tutoring (GIFT) from a Learner’s Perspective (United States)


    6 2.5 Tactical Combat Casualty Care Game -Based Tutorial ...................................................8 3...showed that quiz performances were significantly higher with the PowerPoint slides than the transparencies. In another study at the University of...counterinsurgency (COIN) operations, logic puzzles, and game - based tactical combat casualty care (TC3) training. 2.3 COIN Operations When the user first

  7. Personnel Attrition Rates in Historical Land Combat Operations: Susceptibility and Vulnerability of Major Anatomical Regions (United States)


    wounds to casualties are also mathematically possible. and there is no objective way of determining which allocation is correct. In view of this...US Army Surgeon General’s Office. Volume XV (Statistics), part 2 (Medical and Casualty Statistics). of the series The Vedical Department of the United

  8. Soldier Performance in Continuous Operations. Administrative Manual for a Briefing and Seminar for Platoon and Squad Personnel (United States)


    pyschological defenses against fear is evident in over 30 percent of nonbattle casualties. He divides these casualties into five groups. In Group...condition thinly disguises a pyschological breakdown." In Group It individuals have subjective complaints but negative findings—backache, headache

  9. Monte Carlo Simulation in risk analysis of battle casualty forecasting in urban aggressive military action%蒙特卡罗模拟在城市进攻战斗减员预计风险分析中的应用

    Institute of Scientific and Technical Information of China (English)

    邓月仙; 秦超; 李瑞兴; 彭海文; 江雷


    目的:应用风险分析的理论方法改进现行预测方法.方法:以城市进攻作战减员预计为例,整理分析了历史数据和影响减员的不确定因素,确定了日均减员率的统计分布,以定量判断模型为基础,设定参战人数、地形、气候、态势、突然性、战斗效能等因素,应用蒙特卡罗方法进行模拟,采用Microsoft Excel和Crystal Ball 2000建立了相应的预测模型,对减员模拟结果进行风险分析.结果:城市进攻作战日均减员率可用正态分布变量表达.结合上述因素的量化值,1 000模拟的结果为,日均战斗减员率均数0.42%,标准差0.21%.结论:蒙特卡罗模拟方法是改进现行预测方法的有效手段.

  10. 基于迪杰斯特拉算法的大型舰艇伤员搜救路径优化软件设计与实现%Design and implementation of path optimization software about casualty rescue in large combat vessel based on Dijkstra algorithm

    Institute of Scientific and Technical Information of China (English)

    刘旭东; 刘晓荣; 谢泰; 刘文宝


    目的:设计大型舰艇伤员搜救路径优化软件.方法:软件前台程序开发工具采用Microsoft Visual Studio 2013,编程语言为C#,后台数据库采用Microsoft Access 2013,以迪杰斯特拉算法为软件后台算法.结果:设计开发出基于迪杰斯特拉算法的大型舰艇伤员搜救路径优化软件,能够计算由起始路径点到终末路径点之间最短路径所需经过的路径点及行进时间.结论:大型舰艇伤员搜救路径优化软件的应用,能够快速确定伤员搜索的最短路径,缩短卫勤力量到达伤员处的平均时间,提高大型舰艇卫勤保障的效率和精度.

  11. On the Law Conflicts of Compensation and Liability for Tourist Casualty in the Transportation on the Sea and the Application Range%论海上运输旅客人身伤亡赔偿责任的规范冲突及适用

    Institute of Scientific and Technical Information of China (English)

    张莉初; 王茹



  12. 77 FR 5817 - Ocean Renewable Power Company, Tidal Energy Project, Cobscook Bay, ME (United States)


    ... marine casualty, entanglement, or electrocution, the Coast Guard may propose regulatory action or, in the... identify any problems and appropriate solutions. We will use your comments to evaluate if the Coast...

  13. ‘We are here to stay and we won’t shut up’

    DEFF Research Database (Denmark)

    Meret, Susi; Blumensaat Rasmussen, Jeppe


    For those people who stood on that thin cusp between survival and becoming a casualty of war, the consequences of those actions were of existential proportions. For most Europeans these brushes with life, death and profiteering remain largely invisible....

  14. Toxicological mass disaster management - a hospital deployment scheme. (United States)

    Baniel, J; Ram, Z; Kami, A; Schindel, D


    Toxicological mass disasters have occurred frequently in past years and constitute a permanent threat in urban areas. From the standpoint of hospital planning, special consideration is required to treat a large number of poisoned casualties in a relatively short period. Several unique medical aspects characterize toxicological mass disasters: casualties present a single disease entity with many "borderline" cases, most medical personnel are unfamiliar with the problem and casualties present a potential contamination hazard to the hospital. A hospital deployment scheme is presented recommending Decontamination, Triage and simple Treatment Algorithms to meet the medical and organizational challenge of such a mass casualty situation. A further specific deployment scheme for treatment of organophosphorus agents poisoning is described to illustrate the principles presented.

  15. An astronomical murder? (United States)

    Belenkiy, Ari


    Ari Belenkiy examines the murder of Hypatia of Alexandria, wondering whether problems with astronomical observations and the date of Easter led to her becoming a casualty of fifth-century political intrigue.

  16. 76 FR 38459 - Surety Companies Acceptable on Federal Bonds-Redomestication and Change in Business Address... (United States)


    .... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... Carrico, Director, Financial Accounting and Services Division, Financial Management Service. BILLING CODE... Address; National Farmers Union Property and Casualty Company AGENCY: Financial Management Service,...

  17. 19 CFR 163.6 - Production and examination of entry and other records and witnesses; penalties. (United States)


    ... loss of the demanded record was the result of an act of God or other natural casualty or disaster... before the applicable due date for production of the records and must include an explanation of...

  18. Ground System Survivability Overview (United States)


    Includes permanent/term employees, local interns, STEPs , and local SCEPs (in a pay status). Total Workforce Education Civilians*111 Military...Fire Assessments Metrics Derived Requirements Theatre Data Threat & Casualty Soldier HFE Requirements Analyses (using QFD ) House of

  19. Anaphylaxis

    Institute of Scientific and Technical Information of China (English)

    Aziz Sheikh; Samantha Walker


    @@ A 60 year old man attends to discuss his recent allergic reaction to an insect sting. He presents you with the casualty letter which reads: "Treated for anaphylaxis after bee sting-see GP for follow-up."

  20. 47 CFR 5.63 - Supplementary statements required. (United States)


    ... statement describing in detail the program of research and experimentation proposed, the specific objectives sought to be accomplished; and how the program of experimentation has a reasonable promise of... of the resulting probability of human casualty....

  1. Maxillofacial trauma resulting from terror in Israel. (United States)

    Ringler, Doron; Einy, Shmuel; Giveon, Adi; Goldstein, Liab; Peleg, Kobi


    During a 33 month period, maxillofacial injuries resulting from terrorist attacks in Israel were compared with non-terror trauma maxillofacial injuries. Files of patients hospitalized from October 1, 2000 to June 30, 2003 were obtained from the Israel National Trauma Registry. Data were evaluated and compared with a hospitalized non-terror related trauma population within the same period. A literature survey was also conducted. Terror casualties totaled 1,811. In 493 patients with facial injuries, 322 had soft facial tissue injuries (excluding eyes and ears), and 104 had hard tissue injuries of the maxillofacial complex. A significantly higher prevalence was found in terror casualties (explosions and gunshots) compared with non-terror related casualties. Most suffered multiple injuries. Maxillofacial terror casualties experience a unique epidemiology, with more severe injuries and higher prevalence of soft and hard tissue injuries. Preparedness and awareness to the unique pattern of injuries are needed when terrorists strike.

  2. Prospects for improved detection of chemical, biological, radiological, and nuclear threats

    Energy Technology Data Exchange (ETDEWEB)

    Wuest, Craig R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hart, Brad [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Slezak, Thomas R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)


    Acquisition and use of Chemical, Biological, Radiological, and Nuclear (CBRN) weapons continue to be a major focus of concern form the security apparatus of nation states because of their potential for mass casualties when used by a determined adversary.

  3. 76 FR 24504 - National Offshore Safety Advisory Committee (United States)


    ... Guard Authorization Act-- Improvements to Reduce Human Error and Near Miss Incidents. (10) Updates on.... (11) Presentation on the Q4000 Marine Casualty and associated ``near miss.'' (12) Period for...

  4. 49 CFR 1242.42 - Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired... (United States)


    ... 49 Transportation 9 2010-10-01 2010-10-01 false Administration, repair and maintenance, machinery repair, equipment damaged, dismantling retired property, fringe benefits, other casualties and insurance... maintenance, machinery repair, equipment damaged, dismantling retired property, fringe benefits,...

  5. Improving Lethal Action: Learning and Adapting in U.S. Counterterrorism Operations (United States)


    25  Figure 8.   Maximum and Minimum Combatant Casualties ( KIA ) from Lethal Action Operations with Different Target Types...aka IS, ISIS) JCOA Joint and Coalition Operational Analysis Division/Joint Center for Operational Analysis KIA Killed in action NAF New...Casualties ( KIA ) from Lethal Action Operations with Different Target Types   In Figure 8, the average combatant numbers of killed in action ( KIA ) are about

  6. Landmines in the Golan Heights: a patient's perspective (United States)

    Kreniske, Jonah Susser; Harris, Asaf; Safadi, Wajdi


    Fifteen years after the Ottawa Mine Ban Treaty, landmines continue to negatively impact global public health. Recent estimates attribute 11–12 daily casualties to landmines and explosive remnants of war. The majority of these casualties are civilians. Children are disproportionately affected by landmine injuries. In this report, we examine the case and recovery of a child severely injured in a 1982 Golan Heights landmine accident, illustrating the danger landmines pose to civilians and their long-term health implications. PMID:25155496

  7. U.S. Counterterrorism Landscape: An Examination of Policy and Strategy Using a Conceptual Approach (United States)


    393-395. 9 lbid.,404. 10 Thomas E. Copeland. Fool Me Twice: Intelligence Failure and Mass Casualty Terrorism (Leiden, NLD: Martinus Nijhoff...following considerations were factored into his decision-making calculus : (1) The national goals and objectives defined by his administration in the 1997...Somalia; he believed that the Americans 4 lbid., 72. ~ Thomas E. Copeland. Fool Me Twice: Intelligence Failure and Mass Casualty Terrorism, 164-165. 6

  8. Management of Heat and Cold Stress -- Guidance to NATO Medical Personnel (Gestion des contraintes thermiques (chaleur et froid) Conseils aux personnels medicaux de I’OTAN) (United States)


    Brussels BELGIUM Prof. Dr. Vahur Ööpik Institute of Exercise Biology and Physiotherapy Estonian Centre of Behavioural and...including prior history of heat stroke , use of medications, alcohol or drugs abuse). Fit, healthy, heat acclimatized, fully hydrated, and well-rested...casualties (heat exhaustion and heat stroke ). For these casualties, preparation should include arrangements for rapid cooling (cool or cold water

  9. Gas Warfare in World War I. The 3rd. Division at Chateau Thierry, July 1918 (United States)


    almost 60 percent of his gas fire . The troops were reminded that 30 percent of gas casualties in the past had resulted from premature removal of...troops concentrating ir the attack. A few hours before this gas fire began, a German officer captured on the Fourth French Army front revealed the... gas fire , were riot directly subjected to the yperite and therefore took relatively few gas casualties. 1 0 1 99 Extracts from 10th Di’ WD, 13 Jul

  10. Effects of In Vitro Hemodilution, Hypothermia and rFVIIa Addition on Coagulation in Human Blood (United States)


    1995;78:2025-2032. [7] Fried SJ, Satiani B, Zeeb P. Normothermic rapid volume replacement for hypovolemic shock : an in vivo and in vitro study...hemorrhagic shock to restore blood volume, cardiac output and flow to the microcirculation [11-16]. Lactated Ringer’s (LR) and Hextend (HX) are the...lyte solution with glucose, was selected for the battlefield resuscitation of casualties in shock by the Tactical Combat Casualty Care commit- tee

  11. Les principaux accidents de déversements pétroliers en mer et la banque de données de l'Institut Français du Pétrole sur les accidents de navires (1955-1979 The Principal Offshore Oil-Spill Accidents and the Tanker Casualties Data-Bank(1955-1979 Compiled by Institut Français du Pétrole

    Directory of Open Access Journals (Sweden)

    Bertrand A. R. V.


    Full Text Available Après avoir exposé les principaux problèmes posés par le déversement accidentel de pétrole en mer sous ses aspects qualitatifs et quantitatifs, puis rappelé un certain nombre de données tirées d'études antérieures, nous indiquons les résultats de l'activité documentaire de l'Institut Français du Pétrole dans ce domaine : -liste d'accidents ayant donné lieu à un déversement supérieur à 500 t et d'origines diverses (navires, plates-formes, oléoducs, installations côtières; - banque de données sur les accidents de navires. Cette banque concernant plus de 400 accidents survenus de 1955 à 1979 a permis d'établir plusieurs corrélations et de préciser quelques points. En particulier si le nombre d'accidents « principaux » ne semble pas avoir augmenté d'une façon significative au cours de ces dernières années ainsi que le déversement global dû aux accidents, celui-ci nous paraît avoir été sous-estimé dans les évaluations antérieures. II devrait s'élever à 500 000 t/an au lieu de 300 000 t/an, chiffre donné en 1973 par la National Academy of Sciences américaine et constamment repris depuis dans de nombreux rapports et publications. After describing the main problems raised by occidental offshore oil spills from a qualitative and quantitative standpoint and then reviewing various data token from previous reports, this article goes on to describe the results of documentary activity by Institut Français du Pétrole in this field - list of accidents resulting in a spill of more than 500 t and coming from various origins (ships, platforms, pipelines, coastal installations; - data bank on ship accidents. This data bank includes more thon 400 accidents occurring between 1955 and 1979. It reveals various correlations and specific points. In particular, whereas the number of « principal » accidents does not seem to have appreciably increased in the last few years nor has the overall amount thus spilled, these data appear ta have been underestimated in previous evaluations. The figure for total spills due ta ship accidents should be closer to 500000 tons per year instead of the 300000tons per year, a figure given in 1973 by the National Academy of Sciences in the United States and constantly quoted since in reports and publications.

  12. Trends in traumatic limb amputation in Allied Forces in Iraq and Afghanistan

    Directory of Open Access Journals (Sweden)

    Duncan Wallace


    Full Text Available Background: Limb amputation has been a common injury occurring in the conflicts in Iraq and Afghanistan. Compared to other injuries, less attention has been given to this serious, disabling wound. Purpose: The article describes the Allied military experience of traumatic limb amputation in Iraq and Afghanistan. It intends to inform health care personnel involved in the care of serving military personnel and veterans about the scale of these casualties. Methods: A literature search of both civilian and military academic databases was conducted. Results: Both the US and UK have incurred very significant numbers of casualties involving traumatic limb amputation, many of whom have suffered multiple limb loss. The rate of blast injuries causing traumatic limb amputation among US forces has increased since the surge of troops in Afghanistan. Dismounted Complex Blast Injury (DCBI consisting of multiple limb amputations with pelvic, abdominal or genito-urinary injuries has been reported as increasing in frequency among US troops in Afghanistan since 2010. Australian Defence Force casualties suffering traumatic limb amputation remain low. Conclusions: Significant casualties involving traumatic limb amputation are likely to continue among Allied troops while current counter-insurgency tactics are continued. Planned troop withdrawals should eventually result in fewer casualties, including reduced numbers of traumatic limb amputation.

  13. Exploration of key stakeholders' preferences for pre-hospital physiologic monitoring by emergency rescue services. (United States)

    Mort, Alasdair J; Rushworth, Gordon F


    To gather preferences for novel pre-hospital physiologic monitoring technologies from emergency rescue services. Qualitative semi-structured interviews and focus groups were conducted with three groups from UK Search and Rescue (SAR); (1) Extractors (e.g. SAR teams), (2) Transporters (personnel primarily responsible for casualty transport), and (3) Treaters (e.g. Emergency Department doctors). Three themes were defined; SAR casualty management, novel physiologic monitor potential, and physiologic monitor physical properties. Some SAR groups already employed physiologic monitoring but there was no consensus on which monitor(s) to carry or what to monitor and how frequently. Existing monitors also tended to be bulky and heavy and could be unreliable in an unstable environment or if the casualty was cold. Those performing monitoring tended to have only basic first-aid training, and their workload was often high particularly if there was more than one casualty. The potential benefits of employing a novel monitor were strategic and clinical; an opportunity for transmitting data off-scene in order to facilitate monitoring or generate advice (i.e. telemedicine) was also voiced. A range of more intuitive, physical properties was also raised (e.g. small/compact, lightweight). SAR-specific technology should be simple to operate by those with less medical training, which means that clinical data interpretation and presentation should be carefully considered. It would be beneficial if novel monitors carried out a majority of the interpretation, allowing rescuers to proceed with their priority task of removing the casualty to safety.

  14. An international review of the frequency of single-bicycle crashes (SBCs) and their relation to bicycle modal share

    DEFF Research Database (Denmark)

    Schepers, Paul; Agerholm, Niels; Amoros, Emmanuelle;


    Objectives To study cyclists’ share of transport modes (modal share) and single-bicycle crashes (SBCs) in different countries in order to investigate if the proportion of cyclist injuries resulting from SBCs is affected by variation in modal share. Methods A literature search identified figures...... (largely from western countries) on SBC casualties who are fatally injured, hospitalised or treated at an emergency department. Correlation and regression analyses were used to investigate how bicycle modal share is related to SBCs. Results On average, 17% of fatal injuries to cyclists are caused by SBCs...... of SBC casualties among the total number of road crash casualties increases proportionally less than the increase in bicycle modal share. Conclusions While most fatal injuries among cyclists are due to motor vehicle–bicycle crashes, most hospital admissions and emergency department attendances result...

  15. Terrorist bombing (United States)

    Mayo, Ami; Kluger, Yoram


    Bombings and explosion incidents directed against innocent civilians are the primary instrument of global terror. In the present review we highlight the major observations and lessons learned from these events. Five mechanisms of blast injury are outlined and the different type of injury that they cause is described. Indeed, the consequences of terror bombings differ from those of non-terrorism trauma in severity and complexity of injury, and constitute a new class of casualties that differ from those of conventional trauma. The clinical implications of terror bombing, in treatment dilemmas in the multidimensional injury, ancillary evaluation and handling of terror bombing mass casualty event are highlighted. All this leads to the conclusion that thorough medical preparedness to cope with this new epidemic is required, and that understanding of detonation and blast dynamics and how they correlate with the injury patterns is pivotal for revision of current mass casualty protocols. PMID:17101058

  16. [It is not always necessary to establish a "first aid station" at mass gatherings. Cutty Sark Tallships Race 1993]. (United States)

    Larsen, S E; Sørensen, L; Røck, N D


    Previous studies from outdoor music festivals have recommended medical service facilities at first-aid stations. The Cutty Sark Tallships Race was a large outdoor event that took place over four days in Esbjerg harbour with about 500,000 participants and spectators. A total of 68 patients were treated, 28 in the first-aid station at the harbour and 40 at the nearby located hospital. The disease and injuries presented were not severe. The orthopaedic casualties dominated (82%), wounds, contusions and fractures being the most common ones. Only seven casualties were related to alcohol abuse. No casualties were related to drug abuse. The economic expense was estimated to DKK 14,676. Thus, at outdoor mass gatherings of a nature like the Cutty Sark Tallships Race, located near a hospital, first-aid stations are not necessary.

  17. Biosimmer: A Virtual Reality Simulator for Training First Responders in a BW Scenario

    Energy Technology Data Exchange (ETDEWEB)

    Shawver, D.M.; Sobel, A.L.; Stansfield, S.A.


    BioSimMER (Bioterrorism Simulated Medical Emergency Response) is a Virtual Reality-based mission rehearsal and training environment. BioSimMER employs contingency-oriented, multiple-path algorithms and MOESINIOPS focused on real-world operations. BioSimMER is network-based and immerses multiple trainees in a high resolution synthetic environment, including virtual casualties and instruments that they may interact with and manipulate. Trainees are represented as individuals by virtual human Avatars. The simulation consists of several components: virtual casualties dynamically manifest the symptoms of their injuries and respond to the intervention of the trainees. Agent transport analysis is used to simulate casualty exposures and to drive the responses of simulated sensors/detectors. The selected prototype scenario is representative of combined injuries anticipated in BW operations.

  18. The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China

    Institute of Scientific and Technical Information of China (English)

    周继红; 赵新才; 王正国; 朱佩芳; 简华刚; 刘大维; 周金玲; 刘蕾


    Objective: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years. Methods: Two police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed. Results: A total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws. Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty. Conclusions: The crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.

  19. Deprived children or deprived neighbourhoods? A public health approach to the investigation of links between deprivation and injury risk with specific reference to child road safety in Devon County, UK

    Directory of Open Access Journals (Sweden)

    Hewson Paul


    Full Text Available Abstract Background Worldwide, injuries from road traffic collisions are a rapidly growing problem in terms of morbidity and mortality. The UK has amongst the worst records in Europe with regard to child pedestrian safety. A traditional view holds that resources should be directed towards training child pedestrians. In order to reduce socio-economic differentials in child pedestrian casualty rates it is suggested that these should be directed at deprived children. This paper seeks to question whether analysis of extant routinely collected data supports this view. Methods Routine administrative data on road collisions has been used. A deprivation measure has been assigned to the location where a collision was reported, and the home postcode of the casualty. Aggregate data was analysed using a number of epidemiological models, concentrating on the Generalised Linear Mixed Model. Results This study confirms evidence suggesting a link between increasing deprivation and increasing casualty involvement of child pedestrians. However, suggestions are made that it may be necessary to control for the urban nature of an area where collisions occur. More importantly, the question is raised as to whether the casualty rate is more closely associated with deprivation measures of the ward in which the collision occurred than with the deprivation measures of the home address of the child. Conclusion Conclusions have to be drawn with great caution. Limitations in the utility of the officially collected data are apparent, but the implication is that the deprivation measures of the area around the collision is a more important determinant of socio-economic differentials in casualty rates than the deprivation measures of the casualties' home location. Whilst this result must be treated with caution, if confirmed by individual level case-controlled studies this would have a strong implication for the most appropriate interventions.

  20. Minor Morbidity with Emergency Tourniquet Use to Stop Bleeding in Severe Limb Trauma: Research, History, and Reconciling Advocates and Abolitionists (United States)


    from improper tourni- quet use than were saved by proper use.20-26 Recent develop - ments in Tactical Combat Casualty Care led by Captain Frank *U.S...was further developed by the Tactical Combat Casualty Care Committee and ButlerY The US Army later tested devices to determine the best design...J Trauma 2004; 56(1): 214-5. 26. Husum H, Ang SC, Fosse E: War Surgery Field Manual. Penang , Malaysia, Third World Network, 1995, pp 85, 145. 27

  1. The initial management of acute burns. (United States)

    Treharne, L J; Kay, A R


    The initial management of burns, in common with all trauma, follows the ABCDE approach. The outline management plan detailed above assumes the availability of certain medical supplies but even simple measures are invaluable in burn care if they are all that are available. The most basic supplies required to resuscitate a casualty are oral salt and water in appropriate volumes. Similarly it should be possible in field conditions to monitor vital signs and urine output, dress the burns with clingfilm or plastic bags and wrap the casualty in absorbent materials.

  2. Leveraging Trauma Lessons from War to Win in a Complex Global Environment. (United States)

    Remick, Kyle N


    The US military has made great strides in combat casualty care since 2001. As the Army concludes combat operations in Iraq and Afghanistan, it faces new operational challenges in trauma care. The military medical community must stay ahead of the curve through sustaining current investments in combat casualty care research. This article describes lessons learned at war from a Joint Trauma System perspective in order to place in context how we should proceed in order to provide optimal care for our Warfighters in the future.

  3. Mobile Health Systems that Optimize Resources in Emergency Response Situations. (United States)

    Massey, Tammara; Gao, Tia


    During mass casualty incidents, a large number of patients need to be triaged accurately in order to save the maximum number of lives. Recently portable health systems have been developed that can gather patient's vital signs and wireless transmit this information to a central location for analysis. This research introduces a methodology to improve triage in mass casualty incidents by combining statistical optimization techniques with mobile health systems to manage resources using evidence based data. We combine data collected during a field test with data of patient's vital signs to simulate how mobile health systems can optimize resources in emergency response situations.

  4. Indications of hematopoietic stem cell transplantations and therapeutic strategies of accidental irradiations; Indications des greffes de cellules souches hematopoietiques et strategies therapeutiques des irradiations accidentelles

    Energy Technology Data Exchange (ETDEWEB)



    Produced by a group of experts, this document first discusses the issue of accidental irradiations in terms of medical management. They notably outline the peculiar characteristics of these irradiations with respect to therapeutic irradiations. They agreed on general principles regarding casualty sorting criteria and process, and their medical treatment (systematic hematopoiesis stimulation, allogeneic transplantation of hematopoietic stem cells). They discuss some practical aspects of these issues: casualty sorting within a therapeutic perspective (actions to be performed within 48 hours), therapeutic strategies (support therapy, use of cytokines, and therapy by hematopoietic stem cell transplant). They state a set of recommendations regarding the taking into care and diagnosis, therapeutic strategies, research perspectives, and teaching


    Directory of Open Access Journals (Sweden)

    Bülent KARA


    Full Text Available In respect to social state principle, the 61’ st article of the Constitution is allocated for disadvantaged people. Because of special situations of Turkey, social rights of the casualties, the orphans and the widows, the handicapped and the veterans were determined and organized in this article. The main aim of this study is to evaluate the laws, policies and problems of the casualties, the orphans and the widows, the handicapped and the veterans who were preserved by the Constitution and some laws.

  6. Advanced rehabilitation techniques for the multi-limb amputee. (United States)

    Harvey, Zach T; Loomis, Gregory A; Mitsch, Sarah; Murphy, Ian C; Griffin, Sarah C; Potter, Benjamin K; Pasquina, Paul


    Advances in combat casualty care have contributed to unprecedented survival rates of battlefield injuries, challenging the field of rehabilitation to help injured service members achieve maximal functional recovery and independence. Nowhere is this better illustrated than in the care of the multiple-limb amputee. Specialized medical, surgical, and rehabilitative interventions are needed to optimize the care of this unique patient population. This article describes lessons learned at Walter Reed National Military Medical Center Bethesda in providing advanced therapy and prosthetics for combat casualties, but provides guidelines for all providers involved in the care of individuals with amputation.

  7. Lay further emphasis on the treatment in critical burn%进一步重视重症烧伤的救治

    Institute of Scientific and Technical Information of China (English)



    In recent years,growth in number of mass burn casualties accompanied by large number of deaths,has increased,such as dust blast occurred in Kunshan in 2014 and explosion of chemicals occurred in Tianjin in 2015.These disasters made us aware that our knowledge of care of mass burn casualties must be renewed,and therapeutic strategies currently practiced in ICU should be adopted.This paper introduces the concept of critical burn and provides reference on how to carry out fluid resuscitation,early enteral nutrition,mechanical ventilation,continuous renal replacement therapy,wound management,as well as infection control,etc.

  8. [Lay further emphasis on the treatment in critical burn]. (United States)

    Guo, G H


    In recent years, growth in number of mass burn casualties accompanied by large number of deaths, has increased, such as dust blast occurred in Kunshan in 2014 and explosion of chemicals occurred in Tianjin in 2015. These disasters made us aware that our knowledge of care of mass burn casualties must be renewed, and therapeutic strategies currently practiced in ICU should be adopted. This paper introduces the concept of critical burn and provides reference on how to carry out fluid resuscitation, early enteral nutrition, mechanical ventilation, continuous renal replacement therapy, wound management, as well as infection control, etc.

  9. "Bomb explosion on the Nis express" - lessons from a major incident, Kosovo 16 Feb 2001. (United States)

    Vassallo, D J; Graham, P J K; Gupta, G; Alempijevic, Dj


    On Friday 16 February 2001, terrorists detonated a bomb under a civilian coach travelling from Nis in Serbia to Gracanica in Kosovo. 10 people were killed at the scene. 13 casualties were treated in the British KFOR hospital (Reynolds Hospital) in Pristina. Another 8 casualties were evacuated to the American KFOR hospital at Camp Bondsteel. The incident provided a unique opportunity for co-operation between British, American, Russian, German and French KFOR hospitals, as well as with Serbian clinicians and forensic pathologists. This article analyses the medical management of this major incident, identifies the lessons to be learned from it, and also provides enough detail for teaching scenarios.

  10. Improvised explosive devices and the oral and maxillofacial surgeon. (United States)

    Goksel, Tamer


    Improvised explosive devices have created a new class of casualties that presents a unique surgical challenge for oral and maxillofacial surgeons. The injury pattern and severity are different from those seen in conventional trauma patients. Because of battlefield circumstances, patients are sometimes delayed significantly in their transport to a trauma center, and they frequently arrive at a trauma center with hypotension, hypothermia, and acidosis. Definitive care is delayed while the hemodynamic status and life-threatening injuries are stabilized. Hospital triage protocols must be well established in advance to prepare a timely response to the mass casualty event. Proper resource use is an ever-evolving challenge for hospital staff during these times.

  11. 46 CFR 4.01-3 - Reporting exclusion. (United States)


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Reporting exclusion. 4.01-3 Section 4.01-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Authority and Scope of Regulations § 4.01-3 Reporting exclusion. (a) Vessels subject to 33 CFR...

  12. 36 CFR 910.3 - Program administration. (United States)


    ..., described below, provides interested parties with the urban planning and design information sufficient to... subpart B of this part 910. Each set of Square Guidelines is adopted by the Board of Directors, issued by... of a major change or casualty which would render it impossible or impracticable to meet...

  13. American Public Support for US Military Operations from Mogadishu to Baghdad (United States)


    release, June 23, 2003. ", "Bush Faces Rising Public Doubts on Credibility and Casualties Alike," news release, July 11, 2003. Ajzen , Icek , and be amply supported by psychological research on persuasion. See, for example, Petty and Cacioppo (1981, 1986). Ajzen and Fishbein (1980, pp. 219

  14. Plastic Surgery Response in Natural Disasters. (United States)

    Chung, Susan; Zimmerman, Amanda; Gaviria, Andres; Dayicioglu, Deniz


    Disasters cause untold damage and are often unpredictable; however, with proper preparation, these events can be better managed. The initial response has the greatest impact on the overall success of the relief effort. A well-trained multidisciplinary network of providers is necessary to ensure coordinated care for the victims of these mass casualty disasters. As members of this network of providers, plastic surgeons have the ability to efficiently address injuries sustained in mass casualty disasters and are a valuable member of the relief effort. The skill set of plastic surgeons includes techniques that can address injuries sustained in large-scale emergencies, such as the management of soft-tissue injury, tissue viability, facial fractures, and extremity salvage. An approach to disaster relief, the types of disasters encountered, the management of injuries related to mass casualty disasters, the role of plastic surgeons in the relief effort, and resource management are discussed. In order to improve preparedness in future mass casualty disasters, plastic surgeons should receive training during residency regarding the utilization of plastic surgery knowledge in the disaster setting.

  15. China lost worship for the West

    Institute of Scientific and Technical Information of China (English)



    The financial crisis has dented the former sense of Western cultural superiority over Beijing and is taking all into unchartered waters.It may take a long time to recognize,but it will happen:The most important casualty of the financial crisis is not the disruption of the Wall Street-centered fi nancial order

  16. 46 CFR 4.03-6 - Qualified medical personnel. (United States)


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Qualified medical personnel. 4.03-6 Section 4.03-6 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-6 Qualified medical personnel. The term qualified medical personnel means a physician, physician's...

  17. 77 FR 38718 - Safety Zone; NOBLE DISCOVERER, Outer Continental Shelf Drillship, Chukchi and/or Beaufort Seas, AK (United States)


    ... established shipping fairways, fueling and supply storage/ operations, and size of the crew increase the... recommended an extension of the outer boundaries of the safety zone to include the anchor chain extending from... marine casualty will present unique challenges due to the remote locations, lack of infrastructure...

  18. 77 FR 39164 - Safety Zone; KULLUK, Outer Continental Shelf Mobile Offshore Drilling Unit (MODU), Beaufort Sea, AK (United States)


    ...; (4) the lack of any established shipping fairways, fueling and supply storage/operations, and size of... include the anchor chain extending from the OCS facilities; one comment recommended an extension to 1,500... casualty will present unique challenges due to the remote locations, lack of infrastructure and...

  19. COMOPTEVFOR Acronym and Abbreviation List (CAAL). (United States)


    ed Tor1 neck, :.. CAR Configuration Audit Review CAS Calibrated Airspeed Casualty Close Air Support Combined Antenna System Computer-assisted Search...Time to Repair MBMF Multibeam Multifrequency MCA Maintenance Capability Audit MCBF Mean Cycles Between Failures MCC Monitor Control Console MCDSP...Repairs and Alteration PERT Program Evaluation Review Technique PES Projected Engagement Scheduler PESD Program Element Summary Data PFE Post Fire

  20. Safety on board. (United States)

    Duffin, Christian

    NHS staff have completed a three-year project to improve the rescue and care of competitors injured at sea in next summer's Olympic Games and Paralympics. The team, which included critical care nurses, tested rescue equipment for use in water, and drew up good practice guidelines for the safe handling of casualties with spinal injuries.

  1. Dutch dikes, and risk hikes; a thematic policy evaluation of risks of flooding in the Netherlands. Extended summary

    NARCIS (Netherlands)

    MNP; MNP


    Dams in the Netherlands have never been stronger so the probability of encountering floods from rivers or on the coast similar to the great flood in the south-western part of the Netherlands in 1953 has declined. However, the risks of casualties and economic damage from flooding have become much gr

  2. Deadly Earth

    Institute of Scientific and Technical Information of China (English)


    Casualties mount in Chongqing landslide as questions arise over what triggered it At least nine people have died and 63 are still missing from a massive June 5 landslide in southwest China’s Chongqing Municipality. A local gov- ernment spokesman said the landslide buried

  3. Department of Defense In-House RDT&E Activities. Management Analysis Report (United States)



  4. Department of Defense In-House RDT&E Activities. Management Analysis Report: Department of the Army, Department of the Navy, Department of the Air Force (United States)



  5. The Strategic and Political Impacts of Collateral Damage from Strike Warfare (United States)


    Chance,” Foreign Affairs 78, no. 4 (1999): 40, EBSCOhost (00157120). See also Tania Voon, “Pointing the Finger: Civilian Casualties of NATO Bombing in...44. EBSCOhost (00157120). Millet, Alan R. The War for Korea, 1950–1951 They Came from the North. Lawrence, KS: University of Kansas Press, 2010

  6. Understanding the Enemy: The Enduring Value of Technical and Forensic Exploitation (United States)


    EA) for forensic disciplines relating to DNA, serology, firearms and tool marks, latent prints, questioned documents, drug chemistry , and trace...122 Features / Value of Technical and Forensic Exploitation JFQ 75, 4th Quarter 2014 Understanding the Enemy The Enduring Value of Technical and... Forensic Exploitation By Thomas B. Smith and Marc Tranchemontagne T he escalation of improvised explosive device (IED) incidents and related casualties

  7. Development of a motorcycle rider model with focus on head and neck biofidelity, recurring to line element muscle models and feedback control

    NARCIS (Netherlands)

    Fraga, F.; Rooij, L. van; Happee, R.; Wismans, J.; Symeonidis, I.; Peldschus, S.


    Despite continuing improvements in vehicle safety, motorcyclist casualties are estimated between 13% and 17% of road fatalities. Looking at the last two ESV conferences for a tentative measure of the research effort that is geared towards motorcycle safety, oral/written papers referring to two-wheel

  8. [Caring for the soldiers of the Great War, the nurses' contribution]. (United States)

    Debout, Christophe


    The notion of the nurse serving in the Great War is very heterogeneous. It is important to emphasise the capacity to adapt which these nurses demonstrated. During the four years of conflict, they were able to keep up with the many changes made to the way casualties were treated.

  9. Ulykker med motorkædesave

    DEFF Research Database (Denmark)

    Mortensen, N H; Jørgensen, H R


    During the three-year period 1987-1989, 80 persons were registered with lesions following accidents with chain saws. The information in the casualty department records was supplemented by an interview questionnaire. Sale of chain saws increased from the middle of the nineteen eighties although...

  10. Tenure Shrugged (United States)

    Glenn, David


    In late April, John D. Lewis, a historian and classicist at Ashland University, flew to Virginia to deliver a lecture at George Mason University about U.S. policy toward Iran. Mr. Lewis is an admirer of the late Ayn Rand, and he shares her belief that democracies should respond to external attacks without much concern for civilian casualties. He…

  11. The valuation of human losses of road deaths.

    NARCIS (Netherlands)


    A considerable part of the total social road safety costs consists of human losses. This is damage in the form of suffering, pain, sorrow, and loss of the joy of living of the casualties as well as their family and friends. It is important for policy and its supporting research to be able to attach

  12. Safety and Efficacy of Oral Transmucosal Fentanyl Citrate for Prehospital Pain Control on the Battlefield (United States)


    parenterally since the early 1960s. Because fentanyl quickly crosses the blood- brain barrier, allowing for rapid onset of pain relief, it is often used...O’Connor KC, Johnson TR, Mosely DS, Meyer DE, Holcomb JB. A novel pain management strategy for combat casualty care. Ann Emerg Med. 2004;44:121 127. 7

  13. Turning Chaos into Order : Preparedness, Concepts and Lessons Learned in Disaster Medicine

    NARCIS (Netherlands)

    Haverkort, J. J Mark


    Optimal care for a sudden, unexpected large number of victims from a mass casualty incident (MCI) is demanding and challenging for every healthcare system. It requires paradigm shift from regular trauma care. Instead of focusing on the individual patient with unlimited resources the focus of care sh

  14. Critical Review of Selected Components of RIPD (Radiation-Induced Performance Decrement) (United States)


    NAME OF RESPONSIBLE PERSON Paul K. Blake, PhD a. REPORT b. ABSTRACT a. THIS PAGE UNLIMITED 42 19b. TELEPHONE NUMBER (include area code) UNCLASS...time-phased casualties, patient streams, and medical care requirements. 28 Section 5. References Ahlberg, K., Ekman T., and Gaston

  15. Turkey’s Soft Power Assets in Peacekeeping Operations (United States)


    accepted the sovereignty of a neutral Afghan state and completed its withdrawal from Afghanistan in 1989. The total casualties of Soviet invasion were... POWER ASSETS IN PEACEKEEPING OPERATIONS by Nuri Sener June 2015 Thesis Advisor: Victoria Clement Second Reader: Tristan James Mabry THIS...

  16. Tactical Surgical Intervention with Temporary Shunting of Peripheral Vascular Trauma Sustained during Operation Iraqi Freedom: One Unit’s Experience (United States)


    sufficient recovery and communication with the receiving facility, casualties underwent MEDEVAC accom- panied by an en-route care nurse who continued...failure requiring 1 month of dialysis Acalculous cholecystitis Wound infections (abdominal wall and disarticulation sites) Pneumonia Line sepsis 16

  17. The trauma of war in Sierra Leone

    NARCIS (Netherlands)

    Jong, Kaz de; Mulhern, M.; Ford, N.; Kam, S. van der; Kleber, R.J.


    Civilians are increasingly targeted in today's wars. To reduce military casualties, civilians are used as protective shields; to facilitate guerrilla warfare, they are abducted or enslaved; torture, rape, and executions are carried out to undermine morale and to eradicate the cultural links and self

  18. 26 CFR 1.262-1 - Personal, living, and family expenses. (United States)


    ... property by reason of casualty, etc. (5) Expenses incurred in traveling away from home (which include..., attorney's fees and other costs paid in connection with a divorce, separation, or decree for support are... of the other costs paid in connection with a divorce, legal separation, written separation...

  19. Vapor Pressure of Bis-(2-chloroethyl)ethylamine (HN1) (United States)


    are delayed-casualty agents that produce conjunctivitis, laryngitis, bronchitis, hoarseness, coughing, elevated temperature, nausea, and vomiting on...AD-B960467). 3. Redemann, C. E.; Chaikin, S. W.; Fearing , R. B.; Van Hoesen, D.; Savitt, J.; Benedict, D.; Rotariu, G. J.; Geiling, E. M. K

  20. Time-Critical Detection of Anomalous Behaviour

    NARCIS (Netherlands)

    Huizing, A.G.


    Terrorist attacks such a suicide bombings and detonation of improved explosive devices are a worldwide problem that caused many casualties and economic damage. To prevent these attacks, human intelligence gathering, social network analysis and data mining of databases containing financial transactio

  1. 24 CFR 965.205 - Qualified PHA-owned insurance entity. (United States)


    ... property/casualty underwriter (CPCU), associate in risk management (ARM), or associate in claims (AIC), of... procurements, the HUD Appropriations Act for Fiscal Year 1992 provides an exception to this requirement. PHAs... selection procedures. Procurement of insurance from other entities is subject to competitive...

  2. Towards a Czech Road Safety Information System : a feasibility study.

    NARCIS (Netherlands)

    Craen, S. de & Wegman, F.


    The Czech Republic aims at improving its road safety and in the last years it achieved significant successes in reducing the number of road traffic casualties. Increasingly, road safety measures have to be taken in an effor to lower the number of accidents. A Road Safety Information System (RSIS), w

  3. Captive birds on Dutch Mauritius: bad-tempered parrots, warty pigeons and notes on other native animals

    NARCIS (Netherlands)

    J.P. Hume; R. Winters


    During the occupation of Mauritius by the Dutch in the seventeenth century, live dodos and other animals were transported to the east and west as curiosities and gifts by the Dutch East India Company. How these animals managed to survive these journeys, when human casualties on-board ship were so hi

  4. Factors limiting endurance of armor, artillery, and infantry units under simulated NBC conditions

    Energy Technology Data Exchange (ETDEWEB)

    Rauch, T.M.; Tharion, W.J.; Banderet, L.E.; Lussier, A.R.


    The war of the future will require 72-hour operations in environments contaminated with nuclear/biological/chemical (NBC) agents. The 1985 P2NBC2 (Physiological and Psychological Effects of NBC and Extended Operations on Combined Arms Crews) Program assessed soldier endurance and performance under simulated NBC conditions. A total of 175 soldiers were observed during four tests differing in design, site, climatic conditions, and performance demands. In all but one of the iterations where the full chemical-protective ensemble (MOPP 4) was used without cooling, soldier endurance fell far short of the projected requirement. Psychological data were analyzed to determine which factors were associated with the incidence of casualties. The findings showed that perceived intensity of symptoms resembling the hyperventilation syndrome was significantly greater in soldiers classified as Casualties. Five of these symptoms (painful breathing, difficulty breathing, shortness of breath, headache, and nausea) showed Casualty-Survivor differences in all tests. Symptom intensity was attributed to two factors. (1) External conditions. Thermal stress exacerbated the five basic symptoms, induced others (tetany and paresthesia), and decreased endurance. Periodic relief from respirator use attenuated these symptoms and enhanced endurance. (2) Individual differences. Significant Casualty-Survivor differences in anxiety, depression, and cognitive strategy scores indicated that perception of hyperventilation symptoms and endurance were related to personality variables. Hyperventilation symptoms could incapacitate the soldier or induce removal of the protective mask under actual chemical attack.

  5. Posterior skulderluksation--en diagnostisk udfordring

    DEFF Research Database (Denmark)

    Trollegaard, Anton Mitchell


    A case of posterior shoulder dislocation is described. The dislocation was misinterpreted twice clinically and radiographically in two different casualty departments before it was diagnosed and treated with closed reposition in a third facility. Treatment was conservative and the arm was placed...

  6. Rainfall-triggering response patterns of post-seismic debris flows in the Wenchuan earthquake area

    NARCIS (Netherlands)

    Zhou, W.; Tang, C.; van Asch, Th.W.J.; Zhou, nn.


    Several giant debris flows occurred in southwestern China after the Wenchuan earthquake, causing serious casualties and economic losses. Debris flows were frequently triggered after the earthquake. A relatively accurate prediction of these post-seismic debris flows can help to reduce the consequent

  7. Analysis of México's Narco-War Network (2007-2011). (United States)

    Espinal-Enríquez, Jesús; Larralde, Hernán


    Since December 2006, more than a thousand cities in México have suffered the effects of the war between several drug cartels, amongst themselves, as well as with Mexican armed forces. Sources are not in agreement about the number of casualties of this war, with reports varying from 30 to 100 thousand dead; the economic and social ravages are impossible to quantify. In this work we analyze the official report of casualties in terms of the location and the date of occurrence of the homicides. We show how the violence, as reflected by the number of casualties, has increased over time and spread across the country. Next, based on the correlations between cities in the changes of the monthly number of casualties attributed to organized crime, we construct a narco-war network where nodes are the affected cities and links represent correlations between them. We find that close geographical distance between violent cities does not imply a strong correlation amongst them. We observe that the dynamics of the conflict has evolved in short-term periods where a small core of violent cities determines the main theatre of the war at each stage. This kind of analysis may also help to describe the emergence and propagation of gang-related violence waves.

  8. "In flight catering": feeding critical care patients during aeromedical evacuation. (United States)

    Turner, S; Ruth, M J; Bruce, D L


    The benefits of early enteral nutrition are well recognised but may be incompatible with CCAST evacuation due to the risk of micro-aspiration predisposing to pneumonia. A study has been approved by the Surgeon Generals Research Strategy Group designed to quantify the risks of microaspiration during CCAST flights in order to inform DMA policy with regard to feeding critically ill casualties during flight.

  9. Toxicological Evaluation of Depleted Uranium in Rats: Six-Month Evaluation Point (United States)


    casualties with DU shrapnel. 20 Special Publication SP98-1 References 1. Andrews PM, Bates SB (1987) Effects of dietary protein on uranyl-nitrate...induced by uranyl ion in the ileal longitudinal muscle of guinea- pig . European Journal of Pharmacology 113:199- 204 14. Galibin GP, Parfenov YD (1971

  10. 76 FR 46824 - Information Collection Requests to Office of Management and Budget (United States)


    ... commercial vessel casualties involving death, vessel damage, etc., as mandated by Congress. Chemical testing... & Periodic Chemical Drug and Alcohol Testing of Commercial Vessel Personnel; 1625-0013, Plan Approval and... Engineering Systems--46 CFR subchapter F; and 1625-0101, Periodic Gauging and Engineering Analyses for...

  11. Available and (proper) adjustment of head restraints in the Netherlands.

    NARCIS (Netherlands)

    Kampen, L.T.B. van


    Dutch national accident data show a considerable increase of the number of rear end collisions during the last 10 years. The numbers of cars involved and casualties from these accidents have also increased. Neck injuries, typical for rear end collisions, are expected to become a major health problem

  12. The great eastern Japan earthquake and Tsunami: Field observations on the coast of Tohoku six month later

    NARCIS (Netherlands)

    Tsimopoulou, V.


    The tsunami that hit the north pacific coast of Japan on March 11, 2011 has been characterized as a mega disaster. It inundated over 560 square kilometers of land, devastating a large number of coastal communities, causing over 20,000 casualties and huge economic damage in Tohoku region. The purpose

  13. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 3, Data Warehouse: Deliverable 3.5: Annual Statistical Report - 2011.

    NARCIS (Netherlands)

    Brandstaetter, C. Evgenikos, P. Yannis, G. Papantoniou, P. Argyropoulou E. Broughton, J. Knowles, J. Reurings, M. Vis, M. Pace, J F.F. López-de-Cozar, E. Pérez-Fuster P. Sanmartín J. & Haddak, M.


    The CARE database brings together the disaggregate details of road accidents and casualties across Europe, by combining the national accident databases that are maintained by all EU member states. Access to the CARE database is restricted, however, so it is important that a comprehensive range of pu

  14. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 3, Data Warehouse: Deliverable 3.9: Assembly of basic fact sheets and annual statistical report 2012.

    NARCIS (Netherlands)

    Broughton, J. Brandstaetter, C. Yannis, G. Evgenikos, P. Papantoniou, P. Candappa, N. Christoph, M.W.T. Duijvenvoorde, K. van Vis, M. Pace, J-F. Tormo, M. Sanmartín J. Haddak, M. Pascal, L. Amoros, E. Thomas, P. Kirk, A. Brown, L.


    The CARE database brings together the disaggregate details of road accidents and casualties across Europe. It is based on the national accident databases maintained by all EU member states, taking account of the differences between national systems for recording accidents. It is thus a vital resourc

  15. Road Safety Data, Collection, Transfer and Analysis DaCoTa. Workpackage 3, Data Warehouse: Deliverable 3.1: Annual statistical report 2010.

    NARCIS (Netherlands)

    Brandstaetter, C. Evgenikos, P. Yannis, G. Papantoniou, P. Argyropoulou E. Broughton, J. Knowles, J. Reurings, M. Vis, M. Pace, J.F. López de Cozar, E. Pérez-Fuster, P. Sanmartín J. & Haddak, M.


    The CARE database brings together the disaggregate details of road accidents and casualties across Europe, by combining the national accident databases that are maintained by all EU member states. Access to the CARE database is restricted, however, so it is important that a comprehensive range of pu

  16. Including an Exam P/1 Prep Course in a Growing Actuarial Science Program (United States)

    Wakefield, Thomas P.


    The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

  17. Multidimensional credibility: a Bayesian analysis of policyholders holding multiple contracts

    NARCIS (Netherlands)

    Antonio, K.; Guillén, M.; Pérez Marín, A.M.


    Property and casualty actuaries are professional experts in the economic assessment of uncertain events related to non-life insurance products (e.g. fire, liability or motor insurance). For the construction of a fair and reasonable tariff associated with the risks in their portfolio, actuaries have

  18. Multidimensional credibility: a Bayesian analysis of policyholders holding multiple policies

    NARCIS (Netherlands)

    Antonio, K.; Guillén, M.; Pérez Martín, A.M.


    Property and casualty actuaries are professional experts in the economic assessment of uncertain events related to non-life insurance products (eg fire, liability or motor insurance). For the construction of a fair and reasonable tariff associated with the risks in their portfolio, actuaries have ma

  19. Trauma Care in War and Peace: The Army/AAST Synergism: 1992 Fitts Lecture, (United States)


    Paul E. Teschan reported on current re- seriously wounded casualties.4" The strikingly different search in acute renal insufficiency, emphasizing the ben...Trauma 15:628, 1975 24. Hollis AU, Grozinger KH, Artz CP: The effects of low molecular 50. Pfefferman R, Rozin RR, Durst AL, et al: Modern war surgery

  20. Experience of Soviet Medicine in a Great Patriotic War 1941-1945. Part 3 (Opyt Sovetskoy Meditsimy v Velikoy Otechestvennoy Voyne 1941-1945), (United States)


    38.8o/o, from 7 hours and later - into 49.7o/o of casos . Consquently, by casualty with the bullet break of thigh medical aid more than in half of the...this method in the great Patriotic war in the rear hospitals. For this clinico -static analysis are used not only the materials of the deepened and