WorldWideScience

Sample records for emergency incident management

  1. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  2. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  3. Preparedness of emergency departments in northwest England for managing chemical incidents: a structured interview survey

    Directory of Open Access Journals (Sweden)

    Walter Darren

    2007-12-01

    Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.

  4. [Incidence of acute agitation and variation in acute agitation management by emergency services].

    Science.gov (United States)

    Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

    2017-07-01

    To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

  5. Emergency and crisis management: critical incident stress management for first responders and business organisations.

    Science.gov (United States)

    Guenthner, Daniel H

    2012-01-01

    A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

  6. Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

    Science.gov (United States)

    Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

    2014-10-01

    On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

  7. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2009-12-01

    Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

  8. Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

    Science.gov (United States)

    Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

    2012-04-01

    The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

  9. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  10. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS

  11. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  12. Food risk management quality: Consumer evaluations of past and emerging food safety incidents

    NARCIS (Netherlands)

    Kleef, van E.; Ueland, O.; Theodoridis, G.; Rowe, G.; Pfenning, U.; Houghton, J.R.; Dijk, van H.; Chryssochoidis, G.; Frewer, L.J.

    2009-01-01

    In European countries, there has been growing consumer distrust regarding the motives of food safety regulators and other actors in the food chain, partly as a result of recent food safety incidents. If consumer confidence in food safety is to be improved, a systematic understanding of what

  13. Emergency response to mass casualty incidents in Lebanon.

    Science.gov (United States)

    El Sayed, Mazen J

    2013-08-01

    The emergency response to mass casualty incidents in Lebanon lacks uniformity. Three recent large-scale incidents have challenged the existing emergency response process and have raised the need to improve and develop incident management for better resilience in times of crisis. We describe some simple emergency management principles that are currently applied in the United States. These principles can be easily adopted by Lebanon and other developing countries to standardize and improve their emergency response systems using existing infrastructure.

  14. FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

    Science.gov (United States)

    Jones, M.; Pitts, R.

    2017-12-01

    For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that

  15. Emergency management

    International Nuclear Information System (INIS)

    1996-01-01

    In 1995, major efforts of the Nuclear Regulatory Authority of the Slovak Republic (NRA SR) were focused on tasks associated with completion and incorporation of the Emergency Response Centre (ERC) of NRA SR in emergency planning and crisis management. Construction of the ERC had begun based on NRA SR's knowledge, as well as recommendations of Regulatory Assistance Management Group (RAMG) International Mission in 1993 and follow-up missions in 1994. Early in 1994, re-construction of selected rooms had been done and early in 1995, supported by the UK and U.S.A. Government's funding, technical equipment was purchased. The equipment was necessary for ERC operation as tools to improve NRA SR readiness for the management of emergency situations at nuclear installations. NRA SR commenced operation of the Centre in April 1995. The Centre has been on-line connected to a teledosimetric system of Radiation Monitoring Laboratory in Trnava. The basic software for assessment of radiation consequences of a NPP accident was supplied were also focused on cooperation with state administration authorities and organizations which were involved in an emergency planning structure. In September 1995, staffing of the ERC was completed and parallel, the first document concerning the ERC prime task, i.e. activities and procedures of of NRA SR Crisis crew in case of an accident at a nuclear installation on the territory of the Slovak Republic, was approved by the NRA SR's Management. In the period that is being assessed, NRA SR made significant progress in events classification and emergency planning terminology in order to unify the above between both the Slovak NPPs

  16. Traffic incident management resource management.

    Science.gov (United States)

    2009-01-01

    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  17. INCIDENCE OF AMPUTATION IN EMERGENCY

    Directory of Open Access Journals (Sweden)

    K. Rojaramani Kumbha

    2016-08-01

    Full Text Available Advanced Technology and early detection of disease by recent improvements in investigation modalities lead to decreased incidents of amputations while Road Traffic Accidents (RTA increase. Furthermore, it leads to variation and decreased morbidity, mortality and accidents (crush injuries, and better equipped and trained staff, specialist services, diabetic food, rehabilitation centres, and giving good support physically and psychologically for Amputated patients. OBJECTIVE To know incidence rates of Emergency Amputation who attended causality with advanced disease and severe Trauma. METHODOLOGY The study is done over a period of one year i.e. between June 2015 to June 2016 who attended causality with advanced and severe disease affecting the limbs either due to diabetes, trauma or vascular diseases. RESULTS During one-year period, total 6,371 patients attended for general surgery OP. In those, 187 patients needed emergency surgery which included both major and minor operations. Among those, 81 patients were amputated. CONCLUSION As per our available records and observation, even though there is increased literacy and access to advanced technology, there is still increased incidence of patients undergoing amputations due to diseases. Therefore, there is a need to improve awareness and importance of early detection of diabetes, hazards of smoking, and regular general health checkups for patients at root level. With that we can treat diabetes and/or any disease in time. So there must be awareness in peripheral health staff i.e. PHC, subcentres, and community health centres about early detection of disease which in turn improves the quality of life of the patient. Due to diabetes slight injury to the glucose laden tissue may cause chronic infection and ulcer formation.(1 The tumours are seen commonly in the age group of 20-40 years after bone fusion, bones affected commonly are those around the knee (lower end of knee, upper end of tibia. A lytic

  18. Accident and emergency management

    International Nuclear Information System (INIS)

    Andersen, V.; Moellenbach, K.; Heinonen, R.; Jakobsson, S.; Kukko, T.; Berg, Oe.; Larsen, J.S.; Westgaard, T.; Magnusson, B.; Andersson, H.; Holmstroem, C.; Brehmer, B.; Allard, R.

    1988-06-01

    There is an increasing potential for severe accidents as the industrial development tends towards large, centralised production units. In several industries this has led to the formation of large organisations which are prepared for accidents fighting and for emergency management. The functioning of these organisations critically depends upon efficient decision making and exchange of information. This project is aimed at securing and possibly improving the functionality and efficiency of the accident and emergency management by verifying, demonstrating, and validating the possible use of advanced information technology in the organisations mentioned above. With the nuclear industry in focus the project consists of five main activities: 1) The study and detailed analysis of accident and emergency scenarios based on records from incidents and rills in nuclear installations. 2) Development of a conceptual understanding of accident and emergency management with emphasis on distributed decision making, information flow, and control structure sthat are involved. 3) Development of a general experimental methodology for evaluating the effects of different kinds of decision aids and forms of organisation for emergency management systems with distributed decision making. 4) Development and test of a prototype system for a limited part of an accident and emergency organisation to demonstrate the potential use of computer and communication systems, data-base and knowledge base technology, and applications of expert systems and methods used in artificial intelligence. 5) Production of guidelines for the introduction of advanced information technology in the organisations based on evaluation and validation of the prototype system. (author)

  19. Setting up an off-site emergency mortuary facility (EMF) to deal with a DVI incident: disaster victim management (DVM).

    Science.gov (United States)

    Eitzen, David; Zimmermann, Alex

    2012-06-01

    Forensic mortuaries in all Australian jurisdictions are dealing with increasing workloads, with routine cases regularly occupying greater than 50%, and often as much as 85%, of existing cold room body storage capacity, particularly over long weekends and during seasonal increases in respiratory infections. Hence the need to deal with a sudden influx of deceased persons or multiple body parts in a mass fatality incident would overwhelm most Australian forensic mortuaries, thereby requiring other means of body storage and processing. Exercise "Construct" was a joint South Australian Police (SAPol) and Forensic Science South Australia exercise designed to practice the establishment and construction of an emergency mortuary facility (EMF) to deal with a mass fatality incident and the subsequent disaster victim identification process. The aims of the exercise were to test preparedness, activation and construction processes relative to the establishment of an EMF. The exercise provided the opportunity to identify gaps in the capacity to successfully complete the tasks within the allotted time frames. The exercise reinforced the need to have a comprehensive and clearly documented process which must include a current list of suppliers who can deliver goods and services in a timely manner. The aim of this paper is to report on the exercise findings and share the experience with other jurisdictions. It will also provide other jurisdictions with the opportunity to consider whether the South Australian model will be useful to them in improving their own response when confronted with a mass fatality incident that may overwhelm existing local mortuary capacities and capabilities.

  20. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  1. Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    Science.gov (United States)

    Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter

    2018-02-15

    Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

  2. What have we learned about intelligent transportation systems? Chapter 2, What have we learned about freeway incident and emergency management and electronic toll collection?

    Science.gov (United States)

    2000-12-01

    The intelligent infrastructure is often the most visible manifestation of intelligent transportation systems (ITS) along with roads, freeways, and incident management is often among the first ITS elements implemented. They can significantly contribut...

  3. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  4. Training for emergency management

    International Nuclear Information System (INIS)

    Grauf, E.

    1993-01-01

    There are specific boundary conditions where preparedness for in-plant emergency management is as necessary and useful as is the training for the management of design-based accidents. The shift personnel has to be trained to cope particularly with the difficult and demanding initial phase of an emergency, and care must be taken to be very close to reality. Only thus can weak points be discovered and removed by pinpointed measures such as organisational changes, optimization of emergency management procedures, or hardware conditions. (orig.) [de

  5. Measures of reducing obstetric emergencies hysterectomy incidence.

    Science.gov (United States)

    Ren, Guo-ping; Wang, Bao-lian; Wang, Yan-hong

    2016-03-01

    To study the obstetric emergency hysterectomy which can reduce the incidence of measures. In maternity of Xinxiang Central Hospital, the total number of deliveries cases has been up to 50,526 in 20 years, of which 48 cases were retrospectively analyzed for the clinical data of Emergency uterine surgery cases. Cases underwent obstetric emergency hysterectomy accounted for 0.095% of total deliveries (48/50 526), in which 11 cases of vaginal delivery, 37 cases of cesarean section. The indications for surgery: 27 cases were cased by placental factors accounted for 56.25%; 14 cases of uterine inertia, accounting for 29.17%; uterine rupture in 4 cases, accounting for 8.33%; 3 cases of coagulopathy, accounting for 6.25%. Where the maternal placental factors hysterectomy is the most common (69.70%, 23/33) and the predominant factor is early maternal uterine inertia (60.00%, 9/15). There are 74.09% (20/27) of patients with placental abnormalities history of previous cesarean section or uterine surgery. The major risk factors leading to obstetric emergency hysterectomy is placental factors. Preventing the occurrence of placental abnormalities planting actively can effectively reduce the rate of obstetric hysterectomy.

  6. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

    NARCIS (Netherlands)

    Berger, Ferco H.; Körner, Markus; Bernstein, Mark P.; Sodickson, Aaron D.; Beenen, Ludo F.; McLaughlin, Patrick D.; Kool, Digna R.; Bilow, Ronald M.

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior

  7. Emergency management at sea

    International Nuclear Information System (INIS)

    Bockholts, I.P.

    1992-01-01

    In the past years, all kind of activities in the field of emergency management have been taken in order to handle accidents. In the scope of this paper, emergencies are those accidents that may lead to severe releases of oil and gas, whereby also attention is paid to collisions between offshore installations and drifting objects and the situation where people fall overboard. Case histories show that coping with these serious accidents is not always as effective and successful as intended. The stage from being aware of the risks, to being prepared to cope with the consequences, to actually being capable to combat is long and consists of many elements. This paper will deal with the general approach of emergency management, the development of automated tools for decision support on emergencies as well as some fate and effect models

  8. Emergency management and the nuclear terrorism threat

    International Nuclear Information System (INIS)

    DeVito, D.A.; Suiter, L.

    1987-01-01

    Counterterrorism is not the province of the emergency manager. Generally law enforcement has that role. Instead, the emergency manager's role is crisis management; the responsibility is to be the focal point for the chief executive officer (mayor, governor, or national executive) regarding the protection of the population. Managers must be able to gather and synthesize sufficient information, rapidly and accurately, on which to base sound decisions. To do so, they must have a highly efficient, coordinated emergency management organization in place at the state and local levels of government, and there must be a workable plan for emergency operations that integrates all public safety forces into an effective response to all types of emergencies. A major goal of emergency management is to ensure that government is in control and that the public perceives that the system is working. All states have an emergency management organization at the state level, as do most counties and large cities. However, some states and local governments, particularly those that have nuclear power plants within their borders, are better staffed, equipped, and trained than others to deal with nuclear incidents. States with nuclear facilities have an emergency management organization, an emergency plan, and adequate communications, equipment, and trained personnel to handle a nuclear accident or incident at a plant. 21 references

  9. Information of the public, the media, and the population in the event of a nuclear incident. Seminar of the Working Group 'Emergency management'

    International Nuclear Information System (INIS)

    Bayer, A.

    1997-01-01

    Experience from the TMI accident and the accident at Chernobyl has shown that the population in an affected area quickly tends to take their own decisions and proceed to action spoiling all official emergency planning, if information to the population comes too late and is not adequately formulated. Rapid and understandable information about safety relevance of the emergency according to the INES event scale may be of higher value and effectiveness than any detailed account of the accident. For example, information given about an explosion o n the s i t e of XY NPP may easily become falsified on the dissemination pathway and end up as news about an explosion o f the XY NPP. Suitable accident management today primarily is a question of prompt, competent and adequately presented information through the responsible bodies. Technological emergency management may demand less manpower than the required public information campaign. In the event of an emergency in Europe, one has to reckon with several hundreds of journalists of the various news media gathering on site within short, demands for information coming in from a multitude of European countries or organisations, channeled through the IAEA (EMERCOM) or Brussels (ECURIE), and, last but not least, from the countries' populations. Realising these needs, the AKN decided to organise the seminar and hopes that it will contribute its share to underline the importance of information of the public in the event of a nuclear emergency. (orig/CB) [de

  10. Emergency surgical airway management in Denmark

    DEFF Research Database (Denmark)

    Rosenstock, C V; Nørskov, A K; Wetterslev, J

    2016-01-01

    for difficult airway management. RESULTS: In the DAD cohort 27 out of 452 461 patients had an ESA representing an incidence of 0.06 events per thousand (95% CI; 0.04 to 0.08). A total of 12 149/452 461 patients underwent Ear-Nose and Throat (ENT) surgery, giving an ESA incidence among ENT patients of 1.6 events...... of which three failed. Reviewers evaluated airway management as satisfactory in 10/27 patients. CONCLUSIONS: The incidence of ESA in the DAD cohort was 0.06 events per thousand. Among ENT patients, the ESA Incidence was 1.6 events per thousand. Airway management was evaluated as satisfactory for 10......BACKGROUND: The emergency surgical airway (ESA) is the final option in difficult airway management. We identified ESA procedures registered in the Danish Anaesthesia Database (DAD) and described the performed airway management. METHODS: We extracted a cohort of 452 461 adult patients undergoing...

  11. Successful emergency operations and the Incident Command System

    International Nuclear Information System (INIS)

    Montgomery, M.

    1994-01-01

    The Incident Command System (ICS) was developed to provide an ''all-risk'' system of effective emergency scene management. The Cy-Fair Volunteer Fire Department (CFVFD) has made ICS an integral part of their operations since 1987. On January 26, 1993, CFVFD was called to investigate a petroleum odor and possible spill near State Highway 6 and Jackrabbit Road in northwest Harris County. Over the next six-hour period, the dispatch center received over 100 calls an hour regarding this incident. Personnel from CFVFD, the oil company, mutual aid fire departments, and private contractors worked around the dock to successfully contain, clean and reduce the effects of a 25,000 gallon crude oil spill next to a 141-foot diameter oil storage tank at the Satsuma Station. Among the keys to success was proper use of the Incident Command System (ICS). Problems overcome included the lack of a readily available water source, limited foam supplies, time of day, and incident duration

  12. Resources planning for radiological incidents management

    Science.gov (United States)

    Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

    2017-01-01

    Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

  13. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  14. Major incidents in Kenya: the case for emergency services development and training.

    Science.gov (United States)

    Wachira, Benjamin W; Smith, Wayne

    2013-04-01

    Kenya's major incidents profile is dominated by droughts, floods, fires, terrorism, poisoning, collapsed buildings, accidents in the transport sector and disease/epidemics. With no integrated emergency services and a lack of resources, many incidents in Kenya escalate to such an extent that they become major incidents. Lack of specific training of emergency services personnel to respond to major incidents, poor coordination of major incident management activities, and a lack of standard operational procedures and emergency operation plans have all been shown to expose victims to increased morbidity and mortality. This report provides a review of some of the major incidents in Kenya for the period 2000-2012, with the hope of highlighting the importance of developing an integrated and well-trained Ambulance and Fire and Rescue service appropriate for the local health care system.

  15. Stroke Incidence in Victoria, Australia—Emerging Improvements

    Directory of Open Access Journals (Sweden)

    Benjamin B. Clissold

    2017-05-01

    Full Text Available BackgroundEvidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed, a measure of new stroke cases. In Victoria, all public emergency department visits and public and private hospital admissions are reported to the Department of Health and Human Services and include demographic, diagnostic, and procedural/treatment information.MethodsWe obtained data from financial years 1997/1998 to 2007/2008 inclusive, for all cases with a primary stroke diagnosis (ICD-10-AM categories with associated data fields. Incident cases were established by using a 5-year clearance period.ResultsFrom 2003/2004 to 2007/2008 inclusive, there were 53,425 patients with a primary stroke or TIA diagnosis. The crude incident stroke rate for first ever stroke was 211 per 100,000 per year (95% CI 205–217 [females—205 per 100,000 per year (95% CI 196–214 and males—217 per 100,000 per year (95% CI 210–224]. The overall stroke rates were seen to significantly decline over the period [males (per 100,000 per year 227 in 2003/2004 to 202 in 2007/2008 (p = 0.0157 and females (per 100,000 per year 214 in 2003/2004 to 188 in 2007/2008 (p = 0.0482]. Ischemic stroke rates also appeared to decline; however, this change was not significant.ConclusionThese results demonstrate a significant decline in stroke incidence during the study period and may suggest evidence for effectiveness of primary and secondary prevention strategies in cerebrovascular risk factor management.

  16. Emergency cardiac surgery during transfemoral and transapical transcatheter aortic valve implantation: incidence, reasons, management, and outcome of 411 patients from a single center.

    Science.gov (United States)

    Griese, Daniel P; Reents, Wilko; Kerber, Sebastian; Diegeler, Anno; Babin-Ebell, Jörg

    2013-11-01

    Transcatheter aortic valve implantation (TAVI) is increasingly performed in high-risk patients with severe aortic valve stenosis. Incidence and impact of emergency cardiac surgery (ECS) during TAVI is unclear. Two-hundred twenty one transapical (TA) and 190 transfemoral (TF) TAVIs were performed at our hospital between 01/2009 and 12/2012. Twenty patients (4.9%) required ECS, more frequently in the TF- (n = 11; 5.8%) than in the TA-group (n = 9; 4.1%; P = 0.017). ECS-cases were evenly distributed throughout the 4 years. Baseline characteristics of the ECS-patients were not different from the non-ECS-patients. Reasons were acute cardiac failure, coronary obstruction, annular rupture, valve migration, right- and left-ventricular perforation, severe paravalvular leakage, aortic dissection, and mitral valve damage. Surgical intervention consisted of peripheral CPB, switch to TA, thoracotomy and suture of perforated cardiac chambers and conventional aortic valve replacement with concomitant repair of associated cardiovascular injury. Thirty-day mortality was 35.0%, and 55.0% could be salvaged to hospital discharge. Kaplan-Meier 1-year survival curves were significantly impaired for patients requiring ECS (TF: P proportion during TAVI. ECS dramatically affects early and late outcome after TAVI. Under optimal conditions more than half of the ECS-patients can be salvaged. With the current technology of THV-systems ECS should be an integral part of the logistic conditions surrounding TAVI and is far from being futile in this patient population. Copyright © 2013 Wiley Periodicals, Inc.

  17. Security and Emergency Management Division

    Data.gov (United States)

    Federal Laboratory Consortium — Volpe's Security and Emergency Management Division identifies vulnerabilities, risks, and opportunities to improve the security of transportation systems, critical...

  18. Effect of Emergency Argon on FCF Operational Incidents

    International Nuclear Information System (INIS)

    Solbrig, Charles

    2011-01-01

    The following report presents analyses of operational incidents which are considered in the safety analysis of the FCF argon cell and the effect that the operability of the emergency argon system has on the course of these incidents. The purpose of this study is to determine if the emergency argon system makes a significant difference in ameliorating the course of these incidents. Six incidents were considered. The following three incidents were analyzed. These are: 1. Cooling failing on 2. Vacuum Pump Failing on 3. Argon Supplies Failing on. In the remaining three incidents, the emergency argon supply would have no effect on the course of these transients since it would not come on during these incidents. The transients are 1. Loss of Cooling 2. Loss of power (Differs from above by startup delay till the Diesel Generators come on.) 3. Cell rupture due to an earthquake or other cause. The analyses of the first three incidents are reported on in the next three sections. This report is issued realizing the control parameters used may not be optimum, and additional modeling must be done to model the inertia of refrigeration system, but the major conclusion concerning the need for the emergency argon system is still valid. The timing of some events may change with a more accurate model but the differences between the transients with and without emergency argon will remain the same. Some of the parameters assumed in the analyses are Makeup argon supply, 18 cfm, initiates when pressure is = -6 iwg., shuts off when pressure is = -3.1 iwg. 170,000 ft3 supply. Min 1/7th always available, can be cross connected to HFEF argon supply dewar. Emergency argon supply, 900 cfm, initiates when pressure is = -8 iwg. shuts off when pressure is =-4 iwg. reservoir 220 ft3, refilled when tank farm pressure reduces to 1050 psi which is about 110 ft3.

  19. Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-06-01

    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  20. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  1. Training teams for emergency management

    NARCIS (Netherlands)

    Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.

    2001-01-01

    Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM

  2. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  3. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Science.gov (United States)

    2011-10-04

    ...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...

  4. Fire Service Emergency Management Handbook

    Science.gov (United States)

    1985-01-01

    Adapted from Formulating Public Policy in Emergency Management Course Book and ResourceMRanual for Public OTTicials, ILMA Emergency Management Institute...659-2447 (202) 785-2757 Christian Reformed World Relief Presbyterian Church in U.S. Committee General Assemby Mission Board C. Neil Molenaar 341 Ponce...Healer, Mind as Slayer. New York: Delta Books , 1977. 86B:6 B-45 4) Mitchell, J.T., & Resnik, HLP: Emergency Response to Crisis: A Crisis Intervention

  5. Emergency management information system (EMINS)

    International Nuclear Information System (INIS)

    Desonier, L.M.

    1987-01-01

    In a time of crisis or in an emergency, a manager is required to make many decisions to facilitate the proper solution and conclusion to the emergency or crisis. In order to make these decisions, it is necessary for the manager to have correct up-to-date information on the situation, which calls for an automated information display and entry process. The information handling needs are identified in terms of data, video, and voice. Studies of existing Emergency Operations Centers and evaluations of hardware and software have been completed. The result of these studies and investigations is the design and implementation of an automated Emergency Management Information System. Not only is the system useful for Emergency Management but for any information management requirement

  6. Management of Radiological emergencies

    International Nuclear Information System (INIS)

    Lentijo, J. C.; Gil, E.; San Nicolas, J.; Lazuen, J. A.

    2004-01-01

    Spain has a system of planning and response to emergency situations that is structured and coordinated by the General Directorship of civil Defense of the Ministry of the Interior and in which all levels of the Public Administration. state, autonomous and municipal-and owners of potentially hazardous activities participate. Activities involving a nuclear or radiological risk have specific emergency plans whose general principles are based on the general emergency system and whose technical bases are consistent with international practices and recommendations. The Consejo de Seguridad Nuclear actively participates in the design, implementation and activation of these plans, and for this purpose has an organization superimposed on its ordinary working organization that is activated in the event of an accident, as well as an Emergency Room specifically designed to deal with nuclear and radiological emergencies. (Author)

  7. Review article: A systematic review of emergency department incident classification frameworks.

    Science.gov (United States)

    Murray, Matthew; McCarthy, Sally

    2017-10-11

    As in any part of the hospital system, safety incidents can occur in the ED. These incidents arguably have a distinct character, as the ED involves unscheduled flows of urgent patients who require disparate services. To aid understanding of safety issues and support risk management of the ED, a comparison of published ED specific incident classification frameworks was performed. A review of emergency medicine, health management and general medical publications, using Ovid SP to interrogate Medline (1976-2016) was undertaken to identify any type of taxonomy or classification-like framework for ED related incidents. These frameworks were then analysed and compared. The review identified 17 publications containing an incident classification framework. Comparison of factors and themes making up the classification constituent elements revealed some commonality, but no overall consistency, nor evolution towards an ideal framework. Inconsistency arises from differences in the evidential basis and design methodology of classifications, with design itself being an inherently subjective process. It was not possible to identify an 'ideal' incident classification framework for ED risk management, and there is significant variation in the selection of categories used by frameworks. The variation in classification could risk an unbalanced emphasis in findings through application of a particular framework. Design of an ED specific, ideal incident classification framework should be informed by a much wider range of theories of how organisations and systems work, in addition to clinical and human factors. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  8. Reporting Helicopter Emergency Medical Services in Major Incidents

    DEFF Research Database (Denmark)

    Fattah, Sabina; Johnsen, Anne Siri; Sollid, Stephen J M

    2016-01-01

    OBJECTIVE: Research on helicopter emergency medical services (HEMS) in major incidents is predominately based on case descriptions reported in a heterogeneous fashion. Uniform data reported with a consensus-based template could facilitate the collection, analysis, and exchange of experiences...... variables were determined by consensus. These variables were formatted in a template with 4 main categories: HEMS background information, the major incident characteristics relevant to HEMS, the HEMS response to the major incident, and the key lessons learned. CONCLUSION: Based on opinions from European...

  9. Incident Management Organization succession planning stakeholder feedback

    Science.gov (United States)

    Anne E. Black

    2013-01-01

    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  10. Decision support for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1989-05-01

    A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)

  11. Emergency Department Management of Trauma

    DEFF Research Database (Denmark)

    MacKenzie, Colin; Lippert, Freddy

    1999-01-01

    services (EMS) response times and advanced prehospital care increase the number of critically injured patients surviving sufficiently long to reach a hospital “in extremis.” Both scenarios provide challenges in the management of traumatized patients. This article addresses the management of severely......Initial assessment and management of severely injured patients may occur in a specialized area of an emergency department or in a specialized area of a trauma center. The time from injury until definitive management is of essence for survival of life-threatening trauma. The initial care delivered...... injured patients after these patients reach a hospital emergency department or a trauma center....

  12. German emergency management concept

    International Nuclear Information System (INIS)

    Burkart, K.

    1993-01-01

    The advantages and disadvantages of the margin and start-up value concepts (according to ICRP 40 and EU-ordinances) are explained, and it is demonstrated that the two concepts are combinable. The combined concept has the advantage of immediately providing, if required, intervention levels for the various measures to be taken, and of obliging those persons concerned with emergency protection to study and quantify, already at the planning stage, the influence of a range of accident conditions on the decision on measures. In this context, the use of computerized decision support systems which are currently being developed is indispensable. (orig./DG) [de

  13. Emergency management logistics must become emergency supply chain management.

    Science.gov (United States)

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events.

  14. Emergency preparedness and response in the Commonwealth of Pennsylvania - the Three Mile Island incident

    International Nuclear Information System (INIS)

    Henderson, O.K.

    1981-01-01

    This paper addresses the emergency response mechanism and legal basis in effect in the Commonwealth of Pennsylvania at the time of the Three Mile Island incident. It reviews the sequence of events as they directly affected the Pennsylvania Emergency Management Agency and examines the method used by the Agency to discharge its responsibilities. Finally, the paper lists some of the lessons learned from the Three Mile Island experience. (author)

  15. Answering the request for emergency assistance worldwide. The Incident and Emergency Centre (IEC)

    International Nuclear Information System (INIS)

    2007-01-01

    In 2005, the IAEA announced the establishment of a fully integrated Incident and Emergency Centre (IEC). The functions of the IEC include coordinating prompt assistance to requesting States in the case of a nuclear security incident. As the global focal point for international preparedness, communication and response to nuclear and radiological incidents or emergencies irrespective of their cause, the IEC stands at the centre of coordinating effective and efficient activities worldwide. The IEC's work includes the evaluation of emergency plans and assistance in their development. The Centre also develops accident classifications based on plant conditions and supports effective communication between neighbouring countries. In addition, it develops various response procedures and facilitates national exercises on response to reactor emergencies. This includes training a broad range of IAEA staff to respond to emergencies as well as training of external experts. Response to incidents and emergencies can involve the exchange of information, provision of advice and/or the coordination of field response. In order to coordinate a global response, the IEC hosts a Response Assistance Network (RANET) under which Member States, Parties to the Emergency Conventions and relevant international organizations are able to register their response capabilities. This network aims to facilitate assistance in case of a nuclear or radiological incident or emergency in a timely and effective manner. An important component of the global emergency response system is the notification and reporting arrangements and systems operated by the IEC. The IEC operates systems that are reliable and secure. Member States, Non-Member States and international organizations have historically reported events and requests for assistance to the IAEA through the ENATOM arrangements using the ENAC web site, phone or fax. Under these arrangements, States have nominated Competent Authorities and National Warning

  16. Information to the public, the media, and the population in the event of a nuclear incident; an important component of nuclear emergency management

    International Nuclear Information System (INIS)

    Bayer, A.

    1997-01-01

    In the case of a nuclear incident, information is obtained from the plant operator and via the monitoring systems of the authorities. Information is passed on to the authorities (confidential area of communication) and to the media and the population (largely more accessible area of communication). Within the authorities, alongside the processing of information (actual situation, prognosis, evaluation, issuing of recommendations), an exchange of information takes place on the national, bilateral, supranational and international levels. The authorities inform those in political circles (the government), and via them, parliament and the general public (the media and the population). The informing of the public occurs directly (via, alongside other means, Videotext, T-Online and Internet), and also, via the mass media (press, radio, television). There are a number of problems which can only be solved with difficulty or, possibly, only on a more long-term basis. These lie in the areas of supply of and demand for information, communication, and preception and selection of information within the population. (orig.) [de

  17. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  18. Los Alamos National Laboratory emergency management plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  19. Emergency Managers Confront Climate Change

    Directory of Open Access Journals (Sweden)

    John R. Labadie

    2011-08-01

    Full Text Available Emergency managers will have to deal with the impending, uncertain, and possibly extreme effects of climate change. Yet, many emergency managers are not aware of the full range of possible effects, and they are unsure of their place in the effort to plan for, adapt to, and cope with those effects. This may partly reflect emergency mangers’ reluctance to get caught up in the rancorous—and politically-charged—debate about climate change, but it mostly is due to the worldview shared by most emergency managers. We focus on: extreme events; acute vs. chronic hazards (floods vs. droughts; a shorter event horizon (5 years vs. 75–100 years; and a shorter planning and operational cycle. This paper explores the important intersection of emergency management, environmental management, and climate change mitigation and adaptation. It examines the different definitions of terms common to all three fields, the overlapping strategies used in all three fields, and the best means of collaboration and mutual re-enforcement among the three to confront and solve the many possible futures that we may face in the climate change world.

  20. Information technology for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1990-01-01

    Improved performance in emergency management by the use of modern information technology has been investigated. Limited parts of a preparedness system have been chosen based on analysis of drills with respect to emergency situations and real accidents. Specific functions relevant for the situation have been selected and implemented in prototype test systems. Finally, the usefulness of the prototype systems has been evaluated by experiments following specific scenarios. (author) 24 refs

  1. Expecting the unexpected [The IAEA's Incident and Emergency Centre helps prepare States to face radiological emergencies

    International Nuclear Information System (INIS)

    Stern, W.; Buglova, E.

    2007-01-01

    The IAEA works with its partners worldwide to promote safe, secure and peaceful nuclear technologies. The IAEA's Statute assigns functions to the Secretariat in relation to radiation emergencies, including fostering international cooperation in the area of emergency preparedness and response. The Convention on Early Notification of a Nuclear Accident and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (often called the 'Emergency Conventions') place specific legal obligations on the IAEA with regard to emergency preparedness and response. In 2005, the IAEA established a fully integrated Incident and Emergency Centre (IEC) which acts as the global focal point for international preparedness, communication and response to nuclear and radiological incidents or emergencies irrespective of their cause. In this role, the IEC stands at the centre of coordinating effective and efficient activities worldwide. While emergency response capabilities have existed within the IAEA since concluding the Emergency Conventions in the 1980s, the decision to create an integrated Centre within the IAEA became more pressing with the growing use of nuclear applications worldwide as well as increasing concern over malicious use of nuclear or radioactive materials. Today, the IEC provides around-the-clock assistance to States dealing with nuclear and radiological events. Under the Emergency Conventions, the IEC coordinates actions of global experts and efforts within the IAEA. It also helps coordinate the responses of States as well as other international organizations, such as the WHO (World Health Organization), FAO (Food and Agricultural Organization) or WMO (World Meteorological Organization) in case of a nuclear or radiological emergency. Response to incidents and emergencies can involve exchange of information, provision of advice and/or coordination of field response. The IEC ensures that the IAEA's incident and emergency arrangements are fully

  2. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  3. Explaining implementation behaviour of the National Incident Management System (NIMS).

    Science.gov (United States)

    Jensen, Jessica; Youngs, George

    2015-04-01

    This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

  4. The Role of Emergency Medical Service in CBR Incidents

    International Nuclear Information System (INIS)

    Castulik, P.

    2007-01-01

    Majority of Emergency Medical Services (EMS) have daily extensive experience with rescue of casualties having trauma injuries, resulting from conventional incidents. In the case of non-conventional incidents involving chemical, bacteriological or radiological (CBR) hazardous materials operational scene for all responders is begin to be more complicated due contamination of casualties, equipment and environment. Especially EMS personnel and receiving staff at the hospital have to work under very demanding condition due to burden of personal protective equipment (PPE) and awareness to avoiding cross-contamination during handling casualties. Those conditions require significantly different approaches for search and rescue of victims from incident site, through transportation and effective treatment at medical facilities. In cases when chemicals will be major hazard materials, the speed of rescue and treatment of victims is a major challenge. Each minute matter, and any delay of response could seriously complicated saving of lives and successful recovery of exposed victims. Success in rescue victims is finally measured thorough the ability of the first responders to save people... ALIVE..., no matter what surrounding condition is. The presentation is providing a view and suggestions on more rapid immediate medical response during non-conventional incidents. It names basic concept based on preparedness, early identification of CBR hazards through signs and symptoms of casualties, priorities of rescue procedures and care on-site, needs of decontamination, rapid evacuation casualties from a scene and immediate hospital response.(author)

  5. Frozen moments: flashback memories of critical incidents in emergency personnel.

    Science.gov (United States)

    Kleim, Birgit; Bingisser, Martina-Barbara; Westphal, Maren; Bingisser, Roland

    2015-07-01

    Emergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion. Emergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires. A majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion. The present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

  6. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger

    2008-01-01

    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

  7. Integrated emergency management in KKG

    International Nuclear Information System (INIS)

    Kluegel, J.U.; Plank, H.

    2007-01-01

    The development and introduction of emergency measures in Switzerland was mainly characterized by the evaluation of international experience and by systematic analysis of beyond-design basis accidents within the framework of plant-specific probabilistic safety analyses. As early as in the mid-eighties, the Swiss regulatory authority demanded that measures be taken against severe accidents, and periodically added more detailed requirements, most recently in 2000 when the introduction of Severe Accident Management Guidelines (SMAG) was demanded for power operation as well as operation in the non-power mode. The SMAG were introduced at the Goesgen nuclear power station within a project in the period between 2003 and 2005. For this purpose, a concept of integrated emergency management was developed which is based on updates of the proven emergency manual. One important aspect of this integrative concept is the distinction between preventive and mitigating procedures by defining appropriate criteria. The findings made in the implementation phase of the project include the realization that the introduction of procedures dealing with severe accidents also requires the ability to develop new ways of thinking and acting in accident management. This implies the awareness that procedures covering severe accidents must be applied much more flexibly and in the light of the situation than regulations covering fault conditions. Also possibilities to simulate severe accidents were created within the project both for the development of procedures and for training plant operators and members of the emergency staff. (orig.)

  8. Managing Materials and Wastes for Homeland Security Incidents

    Science.gov (United States)

    To provide information on waste management planning and preparedness before a homeland security incident, including preparing for the large amounts of waste that would need to be managed when an incident occurs, such as a large-scale natural disaster.

  9. Hazardous Materials Management and Emergency Response (HAMMER)

    Data.gov (United States)

    Federal Laboratory Consortium — The Volpentest Hazardous Materials Management and Emergency Response (HAMMER) Federal Training Center is a safety and emergency response training center that offers...

  10. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton

    2013-01-01

    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  11. Information technology support for emergency management

    International Nuclear Information System (INIS)

    Uuspaeae, P.

    1990-01-01

    Information systems for distributed decision support for emergency management are considered. Specific applications include nuclear power plant emergencies. Emergencies in other industries such as chemical industry may also be considered. Research in the ISEM project is briefly summarized

  12. Management of gynecologic oncology emergencies

    International Nuclear Information System (INIS)

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-01-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references

  13. Operations Manual for Incident and Emergency Communication. Date Effective: 1 June 2012

    International Nuclear Information System (INIS)

    2012-01-01

    years, the Unified System for Information Exchange in Incidents and Emergencies (USIE) for Contact Points and for INES national officers, revision of the Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan), and changes to better reflect that emergency situations can arise from both accidents and criminal and other unauthorized acts. The General Conference of the IAEA in resolution GC(49)/RES/9 requested the Secretariat to continue to review and, as necessary, streamline its mechanisms for reporting and for sharing information and encouraged Member States to do the same. In 2007 the General Conference of the IAEA, in resolution GC(51)/RES/11, welcomed the decision to develop a global, unified incident and emergency reporting system which combines the Emergency Notification and Assistance Technical Operations Manual (ENATOM) arrangements and the Nuclear Events Web-based System (NEWS) mechanism. In resolution GC(54)/RES/7 the General Conference of the IAEA requested the Secretariat to continue its efforts to finalize and implement a global and unified system for reporting and sharing information on nuclear and radiological accidents and incidents, and to act upon the feedback provided by Member States. The General Conference of the IAEA, in resolution GC(54)/RES/7, also encouraged all Member States to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences and, where necessary, to request support from the Secretariat or from other Member States in developing national capabilities consistent with international standards, and urges all Member States to take part in these exercises. The General Conference in resolution GC(55)/RES/9 urges Member States to reinforce emergency notification, reporting and information sharing arrangements and capabilities

  14. Operations Manual for Incident and Emergency Communication. Date Effective: 1 June 2012 (Chinese Edition)

    International Nuclear Information System (INIS)

    2013-01-01

    years, the Unified System for Information Exchange in Incidents and Emergencies (USIE) for Contact Points and for INES national officers, revision of the Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan), and changes to better reflect that emergency situations can arise from both accidents and criminal and other unauthorized acts. The General Conference of the IAEA in resolution GC(49)/RES/9 requested the Secretariat to continue to review and, as necessary, streamline its mechanisms for reporting and for sharing information and encouraged Member States to do the same. In 2007 the General Conference of the IAEA, in resolution GC(51)/RES/11, welcomed the decision to develop a global, unified incident and emergency reporting system which combines the Emergency Notification and Assistance Technical Operations Manual (ENATOM) arrangements and the Nuclear Events Web-based System (NEWS) mechanism. In resolution GC(54)/RES/7 the General Conference of the IAEA requested the Secretariat to continue its efforts to finalize and implement a global and unified system for reporting and sharing information on nuclear and radiological accidents and incidents, and to act upon the feedback provided by Member States. The General Conference of the IAEA, in resolution GC(54)/RES/7, also encouraged all Member States to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences and, where necessary, to request support from the Secretariat or from other Member States in developing national capabilities consistent with international standards, and urges all Member States to take part in these exercises. The General Conference in resolution GC(55)/RES/9 urges Member States to reinforce emergency notification, reporting and information sharing arrangements and capabilities

  15. Operations Manual for Incident and Emergency Communication. Date Effective: 1 June 2012 (Spanish Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    years, the Unified System for Information Exchange in Incidents and Emergencies (USIE) for Contact Points and for INES national officers, revision of the Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan), and changes to better reflect that emergency situations can arise from both accidents and criminal and other unauthorized acts. The General Conference of the IAEA in resolution GC(49)/RES/9 requested the Secretariat to continue to review and, as necessary, streamline its mechanisms for reporting and for sharing information and encouraged Member States to do the same. In 2007 the General Conference of the IAEA, in resolution GC(51)/RES/11, welcomed the decision to develop a global, unified incident and emergency reporting system which combines the Emergency Notification and Assistance Technical Operations Manual (ENATOM) arrangements and the Nuclear Events Web-based System (NEWS) mechanism. In resolution GC(54)/RES/7 the General Conference of the IAEA requested the Secretariat to continue its efforts to finalize and implement a global and unified system for reporting and sharing information on nuclear and radiological accidents and incidents, and to act upon the feedback provided by Member States. The General Conference of the IAEA, in resolution GC(54)/RES/7, also encouraged all Member States to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences and, where necessary, to request support from the Secretariat or from other Member States in developing national capabilities consistent with international standards, and urges all Member States to take part in these exercises. The General Conference in resolution GC(55)/RES/9 urges Member States to reinforce emergency notification, reporting and information sharing arrangements and capabilities

  16. Operations Manual for Incident and Emergency Communication. Date Effective: 1 June 2012 (Arabic Edition)

    International Nuclear Information System (INIS)

    2012-01-01

    years, the Unified System for Information Exchange in Incidents and Emergencies (USIE) for Contact Points and for INES national officers, revision of the Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan), and changes to better reflect that emergency situations can arise from both accidents and criminal and other unauthorized acts. The General Conference of the IAEA in resolution GC(49)/RES/9 requested the Secretariat to continue to review and, as necessary, streamline its mechanisms for reporting and for sharing information and encouraged Member States to do the same. In 2007 the General Conference of the IAEA, in resolution GC(51)/RES/11, welcomed the decision to develop a global, unified incident and emergency reporting system which combines the Emergency Notification and Assistance Technical Operations Manual (ENATOM) arrangements and the Nuclear Events Web-based System (NEWS) mechanism. In resolution GC(54)/RES/7 the General Conference of the IAEA requested the Secretariat to continue its efforts to finalize and implement a global and unified system for reporting and sharing information on nuclear and radiological accidents and incidents, and to act upon the feedback provided by Member States. The General Conference of the IAEA, in resolution GC(54)/RES/7, also encouraged all Member States to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences and, where necessary, to request support from the Secretariat or from other Member States in developing national capabilities consistent with international standards, and urges all Member States to take part in these exercises. The General Conference in resolution GC(55)/RES/9 urges Member States to reinforce emergency notification, reporting and information sharing arrangements and capabilities

  17. Increasing incidence of hypotension in the emergency department

    DEFF Research Database (Denmark)

    Holler, Jon G; Henriksen, Daniel P; Mikkelsen, Søren

    2016-01-01

    BACKGROUND: The epidemiology of hypotension as presenting symptom among patients in the Emergency Department (ED) is not clarified. The aim of this study was to describe the incidence, etiology, and overall mortality of hypotensive patients in the ED. METHODS: Population-based cohort study......,000 person years at risk (pyar) and etiological characteristics by means of the International Classification of Diseases, Tenth Revision (ICD-10), as well as 7-day, 30-day, and 90-day all-cause mortality. RESULTS: We identified 3,268 of 438,198 (1 %) cases with a mean overall IR of 125/100,000 pyar (95 % CI......: 121-130). The IR increased 28 % during the period (from 113 to 152 cases per 100,000 pyar). Patients ≥65 years had the highest IR compared to age

  18. Effective emergency management: reconsidering the bureaucratic approach.

    Science.gov (United States)

    Neal, D M; Phillips, B D

    1995-12-01

    The command and control approach is compared with the Emergent Human Resources Model (EHRM) approach to emergency management. Four decades of systematic research shows that a rigid, bureaucratic command and control approach to emergency management generally leads to an ineffective emergency response. Previous studies and our own research suggest that flexible, malleable, loosely coupled, organizational configurations can create a more effective disaster response.

  19. Medical management of radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2002-01-01

    This review deals specifically with the medical management of victims, such as, the triage of exposed individuals on the basis of preliminary observations and investigations, planning priority of treatment to different groups, emergency care, and definitive care. The infrastructure for appropriate management involves first aid posts, decontamination centre, Site Hospital and Specialized Central Hospital. Medical management of life threatening radiation doses involve haematological examinations, blood component therapy, treatment with growth factors and if necessary, bone marrow transplantation as the last option. Most of the radiation accidents involving partial body and localized exposures are associated with industrial radiography sources. Such exposures are generally not life threatening but may involve serious skin injury, such as, ulceration, necrosis and gangrene. Methods have been developed to carry out decontamination of skin and decorporation of internally deposited radio nuclides. This article also provides information on the Radiation Emergency Medical Preparedness and Assistance Network and also outlines the role of media in reducing the human suffering in the event of an accident

  20. Managing hypopituitarism in emergency departments.

    Science.gov (United States)

    Welsh, Jeanette

    2015-10-01

    Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient's complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband.

  1. Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

    Science.gov (United States)

    Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

    2014-10-01

    At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

  2. Computer managed emergency operating procedures

    International Nuclear Information System (INIS)

    Salamun, I.; Mavko, B.; Stritar, A.

    1994-01-01

    New computer technology is a very effective tool for developing a new design of nuclear power plant control room. It allows designer possibility to create a tool for managing with large database of power plant parameters and displaying them in different graphic forms and possibility of automated execution of well known task. The structure of Emergency Operating Procedures (EOP) is very suitable for programming and for creating expert system. The Computerized Emergency Operating Procedures (CEOP) described in this paper can be considered as an upgrading of standard EOP approach. EmDiSY (Emergency Display System - computer code name for CEOP) main purpose is to supply the operator with necessary information, to document all operator actions and to execute well known tasks. It is a function oriented CEOP that gives operator guidance on how to verify the critical safety functions and how to restore and maintain these functions where they are degraded. All knowledge is coded and stored in database files. The knowledge base consists from stepping order for verifying plant parameters, desired values of parameters, conditions for comparison and links between procedures and actions. Graphical shell allows users to read database, to follow instruction and to find out correct task. The desired information is concentrated in one screen and allows users to focus on a task. User is supported in two ways: desired parameter values are displayed on the process picture and automated monitoring critical safety function status trees are all time in progress and available to the user. (author). 4 refs, 4 figs

  3. Information Systems Coordinate Emergency Management

    Science.gov (United States)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  4. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  5. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  6. Assessment of hospital emergency management in the Beijing area.

    Science.gov (United States)

    Yantao, Xin

    2011-06-01

    In recent years, the number of public health emergencies has increased. Improving hospital emergency management is an important challenge. This is a pilot study intended to assess hospital emergency management in the Beijing area, make recommendations to government health authorities and hospital managers, and offer references for similar studies. This was an observational, cross-sectional survey. Forty-five hospitals in the Beijing area were selected randomly. A self-administered questionnaire was used as a data collection tool. It comprised of three sections: (1) Section A was the introduction; (2) Section B asked for the respondent's personal information; and (3) Section C comprised the major part of the questionnaire and was intended to gather information regarding the hospital's general emergency management situation. The survey response rate was 44%, accounting for 29% of total hospitals that the study targeted. No hospital had an established emergency management department or full-time staff for emergency management. A total of 15-45% of the hospitals had established a hospital emergency management committee, performed a vulnerability analysis, or evaluated emergency management regularly. Twenty-five percent of respondents thought that the local government health authority had established an integrated hospital incident command system. A total of 40%-55% of hospitals contracted with outside institutions for supplements, backup of key functional systems and professional support. After the occurrence of the 2003 severe acute respiratory syndrome (SARS) epidemic, Chinese hospital managers took many measures to improve hospital resilience. However, most of these efforts lacked the guidance of theories, concepts, principles, and methods. An integrated, standardized, operational hospital emergency management model has not been established. Although the survey response rate was relatively low, some clues for further study were discovered, and suggestions to the

  7. ISEM: Europe's ESPRIT support for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1991-01-01

    The CEC-supported ISEM project to develop Information technology Support for Emergency Management was started in 1989. Two specific applications to demonstrate the ISEM system were selected; a NPP accident and a chemical plant emergency. An Emergency Management System provides user-friendly facilities for communication between the numerous local, regional and national organizations

  8. Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics

    Directory of Open Access Journals (Sweden)

    Janice Halpern

    2014-01-01

    Full Text Available Effective workplace-based interventions after critical incidents (CIs are needed for emergency medical technicians (EMT/paramedics. The evidence for a period out of service post-CI (downtime is sparse; however it may prevent posttraumatic stress disorder (PTSD and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores. Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between 1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.

  9. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.

    1993-12-01

    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  10. A Tactical Emergency Response Management System (Terms ...

    African Journals Online (AJOL)

    2013-03-01

    Mar 1, 2013 ... information is a result of collaboration between accident response personnel. ... Tactical Emergency Response Management System (TERMS) which unifies all these different ... purpose of handling crisis and emergency.

  11. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Terblanche, Lourie

    2014-04-01

    Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

  12. Development of Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-05-01

    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  13. Regulatory Information by Topic: Emergency Management

    Science.gov (United States)

    Regulatory information about emergencies, including chemical accident prevention, risk management plans (RMPs), chemical reporting, community right to know, and oil spills and hazardous substances releases.

  14. Flexible UAV Mission Management Using Emerging Technologies

    National Research Council Canada - National Science Library

    Desimone, Roberto; Lee, Richard

    2002-01-01

    This paper discusses recent results and proposed work in the application of emerging artificial intelligence technologies for flexible mission management, especially for unmanned (combat) airborne vehicles...

  15. Emergency Management of Hypertension in Children

    Directory of Open Access Journals (Sweden)

    Dinesh Singh

    2012-01-01

    Full Text Available Systemic arterial hypertension in children has traditionally been thought to be secondary in origin. Increased incidence of risk factors like obesity, sedentary life-styles, and faulty dietary habits has led to increased prevalence of the primary arterial hypertension (PAH, particularly in adolescent age children. PAH has become a global epidemic worldwide imposing huge economic constraint on health care. Sudden acute increase in systolic and diastolic blood pressure can lead to hypertensive crisis. While it generally pertains to secondary hypertension, occurrence of hypertensive crisis in PAH is however rare in children. Hypertensive crisis has been further subclassified depending on presence or absence of end-organ damage into hypertensive emergency or urgency. Both hypertensive emergencies and urgencies are known to cause significant morbidity and mortality. Increasing awareness among the physicians, targeted at investigation of the pathophysiology of hypertension and its complications, better screening methods, generation, and implementation of novel treatment modalities will impact overall outcomes. In this paper, we discuss the etiology, pathogenesis, and management of hypertensive crisis in children. An extensive database search using keywords was done to obtain the information.

  16. Major Incident Hospital: Development of a Permanent Facility for Management of Incident Casualties.

    Science.gov (United States)

    Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke

    2009-06-01

    . Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma, but also to provide centralized care of patients under quarantine conditions for, say, MRSA, SARS, smallpox, chemical or biological hazards. Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure. Caps facilitate role distribution and recognizibility. The PBR resulted in more accurate registration and real-time availability of patient and group information. Infrastructure and a plan is not enough; training, research and evaluation are necessary to continuously work on disaster preparedness. The MIH in Utrecht (Netherlands) is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances. Resulting from the cooperation between a large academic medical institution, a trauma center, a military hospital and the NVIC, the MIH offers not only a good and complete infrastructure but also the expertise required to provide large-scale emergency care during disasters and major incidents.

  17. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali

    2012-01-01

    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  18. Highly Enhanced Risk Management Emergency Satellite

    DEFF Research Database (Denmark)

    Dalmeir, Michael; Gataullin, Yunir; Indrajit, Agung

    HERMES (Highly Enhanced Risk Management Emergency Satellite) is potential European satellite mission for global flood management, being implemented by Technical University Munich and European Space Agency. With its main instrument - a reliable and precise Synthetic Aperture Radar (SAR) antenna...

  19. Spinoffs from radiological emergency preparedness programmes to generic emergency management

    International Nuclear Information System (INIS)

    Sanders, M.E.

    1986-01-01

    In the USA, the radiological emergency preparedness (REP) programme for nuclear power plants is being used to enhance emergency management programmes for other types of emergencies. The REP programme is particularly useful in developing plans and preparedness measures for chemical accidents. The Integrated Emergency Management System (IEMS) approach provides a means for maximizing relationships between the REP programme and other programmes. IEMS essentially involves applying common elements of planning and preparedness to all types of emergencies, while recognizing that unique characteristics of specific natural and man-made emergencies require special planning and preparedness considerations. Features of the REP programme that make it compatible with the IEMS approach and useful in coping with other types of emergencies are: (1) the close co-operation between the national nuclear regulatory and emergency management organizations; (2) the programme integration among all levels of government, the nuclear power industry, public interest groups and the general public and (3) the comprehensiveness and sophistication of the programme. The REP programme in the USA represents a state-of-the-art emergency management capability. Some of its elements are readily transferrable to most other types of emergency preparedness programmes, while other elements can be adapted more readily to other hazard-specific programmes. The Bhopal accident has been a catalyst for this adaptation to chemical accidents, in such areas as furnishing hazard-specific information to the public, alert and notification systems, definition of the hazards and risks involved, establishing planning zones and developing close working relationships among the industry, the public and government

  20. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

    Science.gov (United States)

    Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

    2011-08-01

    Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  1. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  2. Examining professional emergency managers in Korea

    International Nuclear Information System (INIS)

    Ha, Kyoo-Man

    2017-01-01

    Although the number of emergency managers has risen in South Korea (hereafter referred to as Korea) over the years, their role is not yet as defined and noteworthy compared to other professions because of its unidisciplinary approach. This article investigates how Korea has to improve emergency managers' disciplinary approach to ultimately contribute to the goal of effective transnational disaster management. This study uses qualitative content analysis of government policies, college curricula, nongovernmental organizations' (NGOs') emergency-manager certification, and mass media coverage to compare emergency managers' unidisciplinary and multidisciplinary approaches. The key tenet is that Korea must change its emergency managers' unidisciplinary approach into a multidisciplinary approach because the former is less effective when dealing with complicated disaster management systems. To achieve this change, the stakeholders must carry out their assigned responsibilities under risk-oriented management. As for the study's international implications, developing nations may consider the enhancement of related educational curricula, collaborative learning, continuous evaluation, disaster awareness, and disaster prevention for the emergency managers' multidisciplinary approach.

  3. Examining professional emergency managers in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Kyoo-Man, E-mail: ha1999@hotmail.com

    2017-01-15

    Although the number of emergency managers has risen in South Korea (hereafter referred to as Korea) over the years, their role is not yet as defined and noteworthy compared to other professions because of its unidisciplinary approach. This article investigates how Korea has to improve emergency managers' disciplinary approach to ultimately contribute to the goal of effective transnational disaster management. This study uses qualitative content analysis of government policies, college curricula, nongovernmental organizations' (NGOs') emergency-manager certification, and mass media coverage to compare emergency managers' unidisciplinary and multidisciplinary approaches. The key tenet is that Korea must change its emergency managers' unidisciplinary approach into a multidisciplinary approach because the former is less effective when dealing with complicated disaster management systems. To achieve this change, the stakeholders must carry out their assigned responsibilities under risk-oriented management. As for the study's international implications, developing nations may consider the enhancement of related educational curricula, collaborative learning, continuous evaluation, disaster awareness, and disaster prevention for the emergency managers' multidisciplinary approach.

  4. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  5. Safer travel, improved economic productivity : incident management systems

    Science.gov (United States)

    1999-01-01

    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  6. Healthcare logistics in disaster planning and emergency management: A perspective.

    Science.gov (United States)

    VanVactor, Jerry D

    2017-12-01

    This paper discusses the role of healthcare supply chain management in disaster mitigation and management. While there is an abundance of literature examining emergency management and disaster preparedness efforts across an array of industries, little information has been directed specifically toward the emergency interface, interoperability and unconventional relationships among civilian institutions and the US Department of Defense (US DoD) or supply chain operations involved therein. To address this imbalance, this paper provides US DoD healthcare supply chain managers with concepts related to communicating and planning more effectively. It is worth remembering, however, that all disasters are local - under the auspice of tiered response involving federal agencies, the principal responsibility for responding to domestic disasters and emergencies rests with the lowest level of government equipped and able to deal with the incident effectively. As such, the findings are equally applicable to institutions outside the military. It also bears repeating that every crisis is unique: there is no such thing as a uniform response for every incident. The role of the US DoD in emergency preparedness and disaster planning is changing and will continue to do so as the need for roles in support of a larger effort also continues to change.

  7. Applying business intelligence innovations to emergency management.

    Science.gov (United States)

    Schlegelmilch, Jeffrey; Albanese, Joseph

    2014-01-01

    The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation.

  8. Simulating traffic for incident management and ITS investment decisions

    Science.gov (United States)

    1998-08-01

    UTPS-type models were designed to adequately support planning activities typical of the 1960s and 1970s. However, these packages were not designed to model intelligent transportation systems (ITS) and support incident management planning. To ov...

  9. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark

    2004-01-01

    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  10. Emergency nurses' knowledge of pain management principles.

    Science.gov (United States)

    Tanabe, P; Buschmann, M

    2000-08-01

    The purpose of this study was to determine areas of emergency nurses' knowledge deficit regarding pain management, and to identify barriers to pain management as perceived by emergency nurses. Data were collected anonymously in a mail survey using a 52-item knowledge questionnaire addressing pain management principles and asking emergency nurses (Illinois Emergency Nurses Association members) to rate various barriers as to how often they affect their practice. Questionnaires were mailed to all Illinois ENA members (n = 1000). Three hundred five emergency nurses' questionnaires were returned. A significant deficit existed on 2 domains of knowledge: understanding of the terms "addiction," "tolerance," and "dependence"; and knowledge of various pharmacologic analgesic principles. Nurses with a master's degree or higher, or those who attended a 1-day seminar on pain management, achieved statistically significantly higher scores. The 2 barriers identified by emergency nurses as the most common were the inability to administer medication until a diagnosis is made (53%), and inadequate assessment of pain and pain relief (48%) (the percentage indicates how often the emergency nurses believed the barrier was present in their practice). The data indicate that emergency nurses may not have a good understanding of the management of pain with drugs, or of such issues as risk of addiction.

  11. The emerging land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    for comprehensive information about environmental conditions in combination with other land related data. It is argued that development of such a model is important or even necessary for facilitating a holistic approach to the management of land as the key asset of any nation or jurisdiction. Finally, the paper......Land management is the process by which the resources of land are put into good effect. Land management encompasses all activities associated with the management of land that are required to achieve sustainable development. The concept of land includes properties and natural resources and thereby...... encompasses the total natural and built environment. Land Administration Systems (LAS) are institutional frameworks complicated by the tasks they must perform, by national cultural, political and judicial settings, and by technology. This paper facilitates an overall understanding of the land management...

  12. Social media best practices in emergency management.

    Science.gov (United States)

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

  13. Development on the radiological emergency management guide

    Energy Technology Data Exchange (ETDEWEB)

    Khang, Byung Oui; Lee, Jong Tai; Lee, Goan Yup; Lee, Moon

    2000-01-01

    The comprehensive emergency management system in KAERI describes the requirements for emergency plan, preparedness, evaluations and readiness assurance, response and recovery activities to timely and effectively countermeasure according to the type and size of an event. The guidance of facility emergency plan and detailed response procedures for initial action, building/site evacuation, personnel accountability, search and fire fighting in the radioactive, fissionable, toxic and inflammable hazardous substances handling facilities are also developed. (author)

  14. Accident knowledge and emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, B; Groenberg, C D

    1997-03-01

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

  15. Accident knowledge and emergency management

    International Nuclear Information System (INIS)

    Rasmussen, B.; Groenberg, C.D.

    1997-03-01

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

  16. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  17. Emergency department operations and management education in emergency medicine training

    Institute of Scientific and Technical Information of China (English)

    Bret A Nicks; Darrell Nelson

    2012-01-01

    BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

  18. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  19. Emergency department management of shoulder dystocia.

    Science.gov (United States)

    Del Portal, Daniel A; Horn, Amanda E; Vilke, Gary M; Chan, Theodore C; Ufberg, Jacob W

    2014-03-01

    Precipitous obstetric deliveries can occur outside of the labor and delivery suite, often in the emergency department (ED). Shoulder dystocia is an obstetric emergency with significant risk of adverse outcome. To review multiple techniques for managing a shoulder dystocia in the ED. We review various techniques and approaches for achieving delivery in the setting of shoulder dystocia. These include common maneuvers, controversial interventions, and interventions of last resort. Emergency physicians should be familiar with multiple techniques for managing a shoulder dystocia to reduce the chances of fetal and maternal morbidity and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  1. The emerging land management paradigm

    DEFF Research Database (Denmark)

    Enemark, Stig

    2006-01-01

    Manchet: This paper was first presented by Professor Enemark at the RICS Christmas Lecture in December last year. It provides a cogent and detailed reference point for the current state of land management in developed countries, charts a course for the future and looks at how education must chang...

  2. Emerging vector borne diseases – incidence through vectors

    Directory of Open Access Journals (Sweden)

    Sara eSavic

    2014-12-01

    Full Text Available Vector borne diseases use to be a major public health concern only in tropical and subtropical areas, but today they are an emerging threat for the continental and developed countries also. Nowdays, in intercontinetal countries, there is a struggle with emerging diseases which have found their way to appear through vectors. Vector borne zoonotic diseases occur when vectors, animal hosts, climate conditions, pathogens and susceptible human population exist at the same time, at the same place. Global climate change is predicted to lead to an increase in vector borne infectious diseases and disease outbreaks. It could affect the range and popultion of pathogens, host and vectors, transmission season, etc. Reliable surveilance for diseases that are most likely to emerge is required. Canine vector borne diseases represent a complex group of diseases including anaplasmosis, babesiosis, bartonellosis, borreliosis, dirofilariosis, erlichiosis, leishmaniosis. Some of these diseases cause serious clinical symptoms in dogs and some of them have a zoonotic potential with an effect to public health. It is expected from veterinarians in coordination with medical doctors to play a fudamental role at primeraly prevention and then treatment of vector borne diseases in dogs. The One Health concept has to be integrated into the struggle against emerging diseases.During a four year period, from 2009-2013, a total number of 551 dog samples were analysed for vector borne diseases (borreliosis, babesiosis, erlichiosis, anaplasmosis, dirofilariosis and leishmaniasis in routine laboratory work. The analysis were done by serological tests – ELISA for borreliosis, dirofilariosis and leishmaniasis, modified Knott test for dirofilariosis and blood smear for babesiosis, erlichiosis and anaplasmosis. This number of samples represented 75% of total number of samples that were sent for analysis for different diseases in dogs. Annually, on avarege more then half of the samples

  3. Combining internet technology and mobile phones for emergency response management

    International Nuclear Information System (INIS)

    Palsson, S.E.

    2002-12-01

    The report is intended for persons involved in radiological emergency response management. An introduction is given to the technical basis of the mobile Internet and ongoing development summarised. Examples are given describing how mobile Internet technology has been used to improve monitoring media coverage of incidents and events, and a test is described where web based information was selectively processed and made available to WAP enabled mobile phones. The report concludes with recommendations stressing the need for following mobile Internet developments and taking them into account when designing web applications for radiological response management. Doing so can make web based material accessible to mobile devices at minimal additional cost. (au)

  4. Emergency management in the early phase

    International Nuclear Information System (INIS)

    Crick, M.

    2003-01-01

    Full text: An overview of emergency management is provided from a systems approach with the aim of providing a common understanding for the diverse symposium participants of the elements of the management system required for preparedness and response for the early phase of an emergency at a nuclear installation. The systems approach starts with the recognition of response goals, and using detailed analyses of threats, past experience, international law and principles, a response strategy is developed. This step is illustrated with the case of severe accidents at PWRs and identifies the need for and nature of: emergency classification based an plant conditions; notification; radiological monitoring and assessment strategies; operational criteria for implementing protective action decisions; management of public information. From the strategy, detailed functional requirements can be defined addressing: establishing emergency management and operations; identifying, notifying and activating; taking mitigatory action; taking urgent protective action; providing information and issuing instructions and warnings to the public; protecting emergency workers; assessing the initial phase; managing the medical response; keeping the public informed; taking countermeasures against ingestion; mitigating the non-radiological consequences of the emergency and the response. Meeting these requirements necessitates decisions from competent authorities, the means to implement them, and mechanisms for response co-ordination, which need to be prepared in advance. These are supported by infrastructure, including: clear authorities; organization; coordinated plans and procedures; logistical support, facilities and tools; training and exercises; and a quality assurance programme. Some reflections an the key differences between response to emergencies arising from accidents and these arising from deliberate acts will be provided. An impression will be given of the level of preparedness and

  5. Emerging Vector-Borne Diseases - Incidence through Vectors.

    Science.gov (United States)

    Savić, Sara; Vidić, Branka; Grgić, Zivoslav; Potkonjak, Aleksandar; Spasojevic, Ljubica

    2014-01-01

    Vector-borne diseases use to be a major public health concern only in tropical and subtropical areas, but today they are an emerging threat for the continental and developed countries also. Nowadays, in intercontinental countries, there is a struggle with emerging diseases, which have found their way to appear through vectors. Vector-borne zoonotic diseases occur when vectors, animal hosts, climate conditions, pathogens, and susceptible human population exist at the same time, at the same place. Global climate change is predicted to lead to an increase in vector-borne infectious diseases and disease outbreaks. It could affect the range and population of pathogens, host and vectors, transmission season, etc. Reliable surveillance for diseases that are most likely to emerge is required. Canine vector-borne diseases represent a complex group of diseases including anaplasmosis, babesiosis, bartonellosis, borreliosis, dirofilariosis, ehrlichiosis, and leishmaniosis. Some of these diseases cause serious clinical symptoms in dogs and some of them have a zoonotic potential with an effect to public health. It is expected from veterinarians in coordination with medical doctors to play a fundamental role at primarily prevention and then treatment of vector-borne diseases in dogs. The One Health concept has to be integrated into the struggle against emerging diseases. During a 4-year period, from 2009 to 2013, a total number of 551 dog samples were analyzed for vector-borne diseases (borreliosis, babesiosis, ehrlichiosis, anaplasmosis, dirofilariosis, and leishmaniasis) in routine laboratory work. The analysis was done by serological tests - ELISA for borreliosis, dirofilariosis, and leishmaniasis, modified Knott test for dirofilariosis, and blood smear for babesiosis, ehrlichiosis, and anaplasmosis. This number of samples represented 75% of total number of samples that were sent for analysis for different diseases in dogs. Annually, on average more then half of the samples

  6. Cosmetic allergy: incidence, diagnosis, and management.

    Science.gov (United States)

    Orton, David I; Wilkinson, John D

    2004-01-01

    A recent epidemiologic survey in the UK revealed that 23% of women and 13.8% of men experience some sort of adverse reaction to a personal care product over the course of a year. Although most of these reactions may be due to subjective sensory irritation, various studies reveal that up to 10% of dermatologic patients who are patch tested are allergic to cosmetic products or their constituent ingredients. Causative products include deodorants and perfumes, skin care products, hair care products, and nail cosmetics. Allergic contact dermatitis mainly results from fragrance chemicals and preservatives. Recent work has suggested that additional fragrance chemicals may need to be tested in order to identify those patients 'missed' by the current fragrance mix; in particular, hydroxy-isohexyl-3-cyclohexene carboxaldehyde (HMPPC Lyral) has been singled out as an important sensitizing agent. The increased usage of natural fragrances and botanic extracts can also cause problems in their own right or through co-reactivity. The preservative methyldibromo glutaronitrile has also been recognized as an increasingly important sensitizer in Europe, which has led to the recent recommendation that it should be prohibited from 'leave-on' products until information on 'safe' consumer levels becomes available. Other emerging allergens include UV filters, tosylamide/formaldehyde resin, and nail acrylates. The diagnosis of cosmetic allergy should be confirmed with patch testing, including testing of 'whole' products, when necessary, and repeat open application tests can be used to confirm the relevance of reactions in cases of doubt.

  7. Cultivating stakeholder interaction in emergency management

    International Nuclear Information System (INIS)

    Weaver, W.J.; Brownell, L.F.

    1994-01-01

    The Secretary of Energy has defined the mission for the Department. Her vision for the Department of Energy (DOE) is to promote environmental excellence, economic growth, and leadership in science and technology. The Office of Environmental Restoration and Waste Management (EM), which is responsible for implementing an emergency management system for EM facilities and the transport of non-weapons-related radioactive materials, has addressed this mission through the establishment of six goals. This paper specifically discusses efforts to accomplish the last goal: Develop a stronger partnership between the DOE and its stakeholders. EM's Emergency Management Program supports strong partnerships with all interested parties. The EM Emergency Management Program provides the capability for preparedness in the event of an operational emergency at EM facilities, and it gives DOE the capability for preparedness in the event of an operational emergency involving DOE shipments of non-weapons-related radioactive and hazardous materials in transit. The Program is committed to plan, train, and provide material resources for the protection and safety of DOE workers, the public, and the environment. A great deal of stakeholder interaction is associated with the transport of DOE radioactive materials. To assure a communication link to other DOE program areas and interested stakeholders outside the DOE, the Emergency Management Program has committed extensive resources within the transportation program to promote and support EM's commitment to stakeholder involvement. The Transportation Emergency Preparedness Program (TEPP) develops and enhances integrated emergency preparedness in the area of transportation. TEPP coordinates programs across the DOE complex and supplies a DOE-wide unified approach to the public

  8. Medical emergency management among Iranian dentists.

    Science.gov (United States)

    Khami, Mohammad Reza; Yazdani, Reza; Afzalimoghaddam, Mohammad; Razeghi, Samaneh; Moscowchi, Anahita

    2014-11-01

    More than 18,000 patients need medical emergencies management in dental offices in Iran annually. The present study investigates medical emergencies management among Iranian dentists. From the list of the cell phone numbers of the dentists practicing in the city of Tehran, 210 dentists were selected randomly. A self-administered questionnaire was used as the data collection instrument. The questionnaire requested information on personal and professional characteristics of the dentists, as well as their knowledge and self-reported practice in the field of medical emergency management, and availability of required drugs and equipments to manage medical emergencies in their offices. Totally, 177 dentists (84%) completed the questionnaire. Less than 60% of the participants were knowledgeable about characteristics of hypoglycemic patient, chest pain with cardiac origin, and true cardiopulmonary resuscitation (CPR) practice. Regarding practice, less than one quarter of the respondents acquired acceptable scores. In regression models, higher practice scores were significantly associated with higher knowledge scores (p < 0.001). The results call for a need to further education on the subject for dentists. Continuing education and changing dental curriculum in the various forms seems to be useful in enhancement of the self-reported knowledge and practice of dentists. To successful control of medical emergencies in the dental office, dentists must be prepared to recognize and manage a variety of such conditions. In addition to dentist's knowledge and skill, availability of necessary equipments and trained staff is also of critical importance.

  9. [Regional Study of Patient Safety Incidents (ERIDA) in the Emergency Services].

    Science.gov (United States)

    Alcaraz-Martínez, J; Aranaz-Andrés, J M; Martínez-Ros, C; Moreno-Reina, S; Escobar-Álvaro, L; Ortega-Liarte, J V

    2016-01-01

    Evaluate the patient safety incidents that occur in the emergency departments of our region. Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization -ENEAS- and the Adverse Events Related to Spanish Hospital Emergency Department Care -EVADUR-. A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases. A rate of incidents in the emergency departments, representative of the region, has been obtained. The implications of the results for the population means that 12 out of every 100 patients treated in emergency departments have an adverse event, and 7 of these are avoidable. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. The management of radiation treatment error through incident learning

    International Nuclear Information System (INIS)

    Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval

    2010-01-01

    Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.

  11. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  12. Medical management and planning for radiation emergencies

    International Nuclear Information System (INIS)

    Bongirwar, P.R.

    2001-01-01

    Radiation Emergencies which result as a consequence of nuclear or radiological accidents can produce a spectrum of different types of radiation injuries which could include cases of whole body irradiation causing Acute Radiation Syndrome, partial body irradiation, radiation burns (localized irradiation), radioactive contamination and combined injuries having component of conventional injuries. General principles of managing these cases entail doing triage, offering immediate emergency care and instituting definitive treatment. Infra-structural facilities which are required to facilitate their management include first aid post at plant site, personnel decontamination centre, site clinic and specialized hospital which can offer comprehensive investigational and treatment modalities. Training of medical and paramedical personnel is crucial as part of emergency preparedness programme and if needed, help can be sought from WHO's Radiation Emergency Medical Preparedness and Assistance Network Centres. (author)

  13. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Yarmohammadian

    2011-01-01

    Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  14. National Energy Board Emergency Management Program : annex to Natural Resources Canada Civil Emergency Plan no. 004

    International Nuclear Information System (INIS)

    Lever, G.; LeMay, R.

    2006-01-01

    As a matter of primary public interest, safety is included in the National Energy Board's (NEB) mandate. The Board is responsible for ensuring companies involved with energy development and pipelines comply with regulations concerning the safety of employees, the public, and the environment. The purpose of the NEB's Emergency Management Program is to establish a prompt and coordinated response to an emergency which occurs at any facility or operation regulated by the NEB; promote safety and security and assure compliance with regulatory requirements in order to protect the public, workers, property and the environment during the life cycle of facilities and operations; and, have a documented set of procedures that accomplish these objectives. The Board ensures that companies identify and manage the potential hazards associated with their facilities; conduct a risk analysis of those hazards; and, manage the risks in order to protect the public and personnel, the security of the facilities and the environment. All companies under the Board's jurisdiction are responsible for developing and maintaining an Emergency Response and Preparedness Program for all aspects of their operations. In the event an emergency occurs, the regulated company is responsible for responding to the emergency and coordinating emergency response activities. Typically, the NEB responds on site to incidents that result in death or serious injury; involve a significant release of hydrocarbons; could result in potential or real impact due to loss of service; pose imminent threats identified by Public Safety and Emergency Preparedness Canada or other agencies; attract significant media attention, or on the advice of Natural Resources Canada or other federal Agencies. The first part of this document described the initial response check list while the second part outlined the Emergency response framework. 2 tabs., 3 figs., 15 appendices

  15. National Emergency Preparedness and Response: Improving for Incidents of National Significance

    National Research Council Canada - National Science Library

    Clayton, Christopher M

    2006-01-01

    The national emergency management system has need of significant improvement in its contingency planning and early consolidation of effort and coordination between federal, state, and local agencies...

  16. The emergence of scientific management in America

    Directory of Open Access Journals (Sweden)

    Sorin-George Toma

    2014-05-01

    Full Text Available A scientific approach to management was initiated for the first time in America in the late 19th century. Scientific management arose mainly from the need to increase efficiency in America, but other key factors were the spread of big businesses and the expanding application of science in industry. The aims of our paper are to present the emergence of scientific management in America and to emphasize the contribution of some of the most representatives American authors to its development. The methodological approach is literature review. Our paper shows that scientific management was essentially an American achievement that provided useful lessons for the whole human society.

  17. Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

    Science.gov (United States)

    Loop, Carole

    2013-01-01

    Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

  18. Nuclear emergency management procedures in Europe

    Science.gov (United States)

    Carter, Emma

    The Chernobyl accident brought to the fore the need for decision-making in nuclear emergency management to be transparent and consistent across Europe. A range of systems to support decision-making in future emergencies have since been developed, but, by and large, with little consultation with potential decision makers and limited understanding of the emergency management procedures across Europe and how they differ. In nuclear emergency management, coordination, communication and information sharing are of paramount importance. There are many key players with their own technical expertise, and several key activities occur in parallel, across different locations. Business process modelling can facilitate understanding through the representation of processes, aid transparency and structure the analysis, comparison and improvement of processes. This work has been conducted as part of a European Fifth Framework Programme project EVATECH, whose aim was to improve decision support methods, models and processes taking into account stakeholder expectations and concerns. It has involved the application of process modelling to document and compare the emergency management processes in four European countries. It has also involved a multidisciplinary approach taking a socio-technical perspective. The use of process modelling did indeed facilitate understanding and provided a common platform, which was not previously available, to consider emergency management processes. This thesis illustrates the structured analysis approach that process modelling enables. Firstly, through an individual analysis for the United Kingdom (UK) model that illustrated the potential benefits for a country. These are for training purposes, to build reflexive shared mental models, to aid coordination and for process improvement. Secondly, through a comparison of the processes in Belgium, Germany, Slovak Republic and the UK. In this comparison of the four processes we observed that the four process

  19. Maritime emergency management capabilities in the Arctic

    DEFF Research Database (Denmark)

    Roud, Ensieh Kheiri Pileh; Borch, Odd Jarl; Jakobsen, Uffe

    2016-01-01

    Growing maritime commercial activities in the High North increase the possibility of unwanted incidents. The vulnerability related to human safety and environment and a challenging context, call for a strengthening of the maritime preparedness system, and cross-boundary and cross-institutional co......Growing maritime commercial activities in the High North increase the possibility of unwanted incidents. The vulnerability related to human safety and environment and a challenging context, call for a strengthening of the maritime preparedness system, and cross-boundary and cross......-institutional collaboration. In this paper, we look into the different stressors and risk factors of the sea regions in the High North. We elaborate on emergencies where integrated operations such as mass evacuation, oil spill recovery and salvage are needed. Coordination of such operations is a challenging task, where...

  20. Current management of surgical oncologic emergencies.

    Science.gov (United States)

    Bosscher, Marianne R F; van Leeuwen, Barbara L; Hoekstra, Harald J

    2015-01-01

    For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  1. Incidence and management of chyle leakage after esophagectomy

    NARCIS (Netherlands)

    Lagarde, Sjoerd M.; Omloo, Jikke M. T.; de Jong, Koen; Busch, Olivier R. C.; Obertop, Hugo; van Lanschot, J. Jan B.

    2005-01-01

    BACKGROUND: Postoperative chyle leakage is a rare but well-recognized complication after esophageal surgery. The aim of this study was to identify its incidence and potentially predisposing factors and to assess the consequences and management. METHODS: A consecutive series of 536 patients who

  2. Hanford emergency management plan - release 15

    International Nuclear Information System (INIS)

    CARPENTER, G.A.

    1999-01-01

    The Hanford emergency management plan for the US Department of Energy Richland, WA and Office of River Protection. The program was developed in accordance with DOE Orders as well as Federal and State regulations to protect workers and public health and safety

  3. Hanford emergency management plan - release 15

    Energy Technology Data Exchange (ETDEWEB)

    CARPENTER, G.A.

    1999-07-19

    The Hanford emergency management plan for the US Department of Energy Richland, WA and Office of River Protection. The program was developed in accordance with DOE Orders as well as Federal and State regulations to protect workers and public health and safety.

  4. Management of information within emergencies departments in ...

    African Journals Online (AJOL)

    Introduction: the management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the ...

  5. Managing a Nuclear Emergency Originating from Abroad

    International Nuclear Information System (INIS)

    Grlicarev, I.

    1998-01-01

    The basic aspects of managing a nuclear emergency, which occurred in a foreign country, are considered. The most important sources of information are defined by the bilateral or multilateral conventions. The decision aiding techniques and intervention levels can substantially improve the decision making. The experiences from the INEX-2 exercises are presented after the Swiss and Finnish exercise. (author)

  6. Emergency room management of radiation accidents

    International Nuclear Information System (INIS)

    Rosenberg, R.; Mettler, F.A. Jr.

    1990-01-01

    Emergency room management of radioactively contaminated patients who have an associated medical injury requiring immediate attention must be handled with care. Radioactive contamination of the skin of a worker is not a medical emergency and is usually dealt with at the plant. Effective preplanning and on-the-scene triage will allow the seriously injured and contaminated patients to get the medical care they need with a minimum of confusion and interference. Immediate medical and surgical priorities always take precedence over radiation injuries and radioactive contamination. Probably the most difficult aspect of emergency management is the rarity of such accidents and hence the unfamiliarity of the medical staff with the appropriate procedures. The authors discuss how the answer to these problems is preplanning, having a simple and workable procedure and finally having 24-h access to experts

  7. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

  8. Emergency response information within the National LLW Information Management System

    International Nuclear Information System (INIS)

    Paukert, J.G.; Fuchs, R.L.

    1986-01-01

    The U.S. Department of Energy, with operational assistance from EG and G Idaho, Inc., maintains the National Low-Level Waste Information Management System, a relational data base management system with extensive information collection and reporting capabilities. The system operates on an IBM 4341 main-frame computer in Idaho Falls, Idaho and is accessible through terminals in 46 states. One of the many programs available on the system is an emergency response data network, which was developed jointly by EG and G Idaho, Inc. and the Federal Emergency Management Agency. As a prototype, the program comprises emergency response team contacts, policies, activities and decisions; federal, state and local government contacts; facility and support center locations; and news releases for nine reactor sites in the southeast. The emergency response program provides a method for consolidating currently fragmented information into a central and user-friendly system. When the program is implemented, immediate answers to response questions will be available through a remote terminal or telephone on a 24-hour basis. In view of current hazardous and low-level waste shipment rates and future movements of high-level waste, the program can offer needed and timely information for transportation as well as site incident response

  9. Using social media for disaster emergency management

    Science.gov (United States)

    Wang, Y. D.; Wang, T.; Ye, X. Y.; Zhu, J. Q.; Lee, J.

    2016-06-01

    Social media have become a universal phenomenon in our society (Wang et al., 2012). As a new data source, social media have been widely used in knowledge discovery in fields related to health (Jackson et al., 2014), human behaviour (Lee, 2014), social influence (Hong, 2013), and market analysis (Hanna et al., 2011). In this paper, we report a case study of the 2012 Beijing Rainstorm to investigate how emergency information was timely distributed using social media during emergency events. We present a classification and location model for social media text streams during emergency events. This model classifies social media text streams based on their topical contents. Integrated with a trend analysis, we show how Sina-Weibo fluctuated during emergency events. Using a spatial statistical analysis method, we found that the distribution patterns of Sina-Weibo were related to the emergency events but varied among different topics. This study helps us to better understand emergency events so that decision-makers can act on emergencies in a timely manner. In addition, this paper presents the tools, methods, and models developed in this study that can be used to work with text streams from social media in the context of disaster management.

  10. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  11. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  12. Engineering risk assessment for emergency disposal projects of sudden water pollution incidents.

    Science.gov (United States)

    Shi, Bin; Jiang, Jiping; Liu, Rentao; Khan, Afed Ullah; Wang, Peng

    2017-06-01

    Without an engineering risk assessment for emergency disposal in response to sudden water pollution incidents, responders are prone to be challenged during emergency decision making. To address this gap, the concept and framework of emergency disposal engineering risks are reported in this paper. The proposed risk index system covers three stages consistent with the progress of an emergency disposal project. Fuzzy fault tree analysis (FFTA), a logical and diagrammatic method, was developed to evaluate the potential failure during the process of emergency disposal. The probability of basic events and their combination, which caused the failure of an emergency disposal project, were calculated based on the case of an emergency disposal project of an aniline pollution incident in the Zhuozhang River, Changzhi, China, in 2014. The critical events that can cause the occurrence of a top event (TE) were identified according to their contribution. Finally, advices on how to take measures using limited resources to prevent the failure of a TE are given according to the quantified results of risk magnitude. The proposed approach could be a potential useful safeguard for the implementation of an emergency disposal project during the process of emergency response.

  13. MEMbrain. A software emergency management system

    International Nuclear Information System (INIS)

    Drager, K.H.; Brokke, I.

    1998-01-01

    MEMbrain is the name of the EUREKA project EU904. MEM is an abbreviation for Major Emergency Management and brain refers to computer technology. MEMbrain is a strategic European project - the consortium includes partners from six countries, covering the European continent from North to South (Finland, Norway, Denmark, France, Portugal and Greece). The strategy for the project has been to develop a dynamic decision support tool based on: information, prediction, communication, on-line training. The project's results has resulted in a set of knowledge-based software tools supporting MEM activities e.g.; public protection management, man to man communication management, environment information management, resource management, as well as an implementation of an architecture to integrate such tools. (R.P.)

  14. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  15. The German emergency and disaster medicine and management system—history and present

    Directory of Open Access Journals (Sweden)

    Norman Hecker

    2018-04-01

    Full Text Available As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the “Golden Standard” of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Keywords: Emergency medical systems, Disaster medicine, Public health, Germany

  16. Addressing the gap between public health emergency planning and incident response

    OpenAIRE

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods:?This study was conducted using critical case study methodology consisting of document review and 18 k...

  17. FEMA's Integrated Emergency Management Information System (IEMIS)

    International Nuclear Information System (INIS)

    Jaske, R.T.; Meitzler, W.

    1987-01-01

    FEMA is implementing a computerized system for use in optimizing planning, and for supporting exercises of these plans. Called the Integrated Emergency Management Information System (IEMIS), it consists of a base geographic information system upon which analytical models are superimposed in order to load data and report results analytically. At present, it supports FEMA's work in offsite preparedness around nuclear power stations, but is being developed to deal with a full range of natural and technological accident hazards for which emergency evacuation or population movement is required

  18. IT support for emergency management - ISEM

    International Nuclear Information System (INIS)

    Andersen, V.

    1990-11-01

    The project is aimed at the development of an integrated information system capable of supporting the complex, dynamic distributed decision making in the management of emergencies. Emphasis will be put on definition of a system architecture and on development of an application generator and tools to support the full life cycle of the system. The development will be driven by the requirements derived from emergency organisations in two different industries. Care is taken that the results are easily applicable and adaptable to other organisations. (author)

  19. Contributions of incidence and persistence to the prevalence of childhood obesity during the emerging epidemic in Denmark

    DEFF Research Database (Denmark)

    Andersen, Lise Geisler; Baker, Jennifer L; Sørensen, Thorkild I A

    2012-01-01

    Prevalence of obesity is the result of preceding incidence of newly developed obesity and persistence of obesity. We investigated whether increasing incidence and/or persistence during childhood drove the prevalence of childhood obesity during the emerging epidemic....

  20. EMERGENCY PERIPARTUM HYSTERECTOMY IN THE LAKES REGION OF TURKEY: INCIDENCE AND MATERNAL MORBIDITY

    Directory of Open Access Journals (Sweden)

    Mehmet Güney

    2006-06-01

    Full Text Available OBJECTIVE: To estimate the incidence, indications, risk factors, and complications of peripartum hysterectomy in a university clinic and a state hospital in the Lakes region of Anatolia.\tDesign: Retrospective clinical study.\tSetting: This retrospective study was conducted between December 1996 and December 2005 at the Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology and Isparta Women’s and Children’s Hospital.\tPatients: Twenty-eight patients who underwent emergency peripartum hysterectomy.\tMain Outcome Measures: Twenty-eight patients with emergency peripartum hysterectomy were evaluated with respect to the demographic characteristics, clinical manifestation, state of parity and type of hysterectomy.\tRESULTS: In the study period, the incidence of emergency peripartum hysterectomy was 0.8 per 1000 deliveries. The main indications for emergency hysterectomy were uterine atony in 18 cases (64 %, rupture of uterus in 6 cases (21 % and placenta accreta in 4 cases (14 %. There were 20 (71 % multiparaous and 8 (28 % primiparaous women. There were 4 total abdominal hysterectomies and 24 subtotal hysterectomies.The rate of maternal mortality was 4% (1 cases.\tCONCLUSION: Our incidence of emergent peripartum hysterectomy was low when compared with most of the studies and uterine atony was the most common indication for emergent peripartum hysterectomy.

  1. Regional coordination in medical emergencies and major incidents; plan, execute and teach

    Directory of Open Access Journals (Sweden)

    Hedelin Annika

    2009-07-01

    Full Text Available Abstract Background Although disasters and major incidents are difficult to predict, the results can be mitigated through planning, training and coordinated management of available resources. Following a fire in a disco in Gothenburg, causing 63 deaths and over 200 casualties, a medical disaster response centre was created. The center was given the task to coordinate risk assessments, disaster planning and training of staff within the region and on an executive level, to be the point of contact (POC with authority to act as "gold control," i.e. to take immediate strategic command over all medical resources within the region if needed. The aim of this study was to find out if the centre had achieved its tasks by analyzing its activities. Methods All details concerning alerts of the regional POC was entered a web-based log by the duty officer. The data registered in this database was analyzed during a 3-year period. Results There was an increase in number of alerts between 2006 and 2008, which resulted in 6293 activities including risk assessments and 4473 contacts with major institutions or key persons to coordinate or initiate actions. Eighty five percent of the missions were completed within 24 h. Twenty eight exercises were performed of which 4 lasted more than 24 h. The centre also offered 145 courses in disaster and emergency medicine and crisis communication. Conclusion The data presented in this study indicates that the center had achieved its primary tasks. Such regional organization with executive, planning, teaching and training responsibilities offers possibilities for planning, teaching and training disaster medicine by giving immediate feed-back based on real incidents.

  2. Emergency Management for Disasters in Malaysian Hotel Industry

    OpenAIRE

    AlBattat Ahmad Rasmi; Mat Som Ahmad Puad; Abukhalifeh Ala`a

    2014-01-01

    This paper aims to identify major emergencies that have the potential to place Malaysian hotels in emergency and disaster situations; investigate how hotels were prepared for emergencies, how they manage and overcome emergencies when occurred; and limitations and factors influencing successful emergency planning and adoption emergency management in Malaysian hotels. Face-to-face interview with managers from three, four and five star hotels from different backgrounds: local; regional; and Inte...

  3. [Primary emergencies: management of acute ischemic stroke].

    Science.gov (United States)

    Leys, Didier; Goldstein, Patrick

    2012-01-01

    The emergency diagnostic strategy for acute ischemic stroke consists of:--identification of stroke, based on clinical examination (sudden onset of a focal neurological deficit);--identification of the ischemic or hemorrhagic nature by MRI or CT;--determination of the early time-course (clinical examination) and the cause. In all strokes (ischemic or hemorrhagic), treatment consists of:--the same general management (treatment of a life-threatening emergency, ensuring normal biological parameters except for blood pressure, and prevention of complications);--decompressive surgery in the rare cases of intracranial hypertension. For proven ischemic stroke, other therapies consist of: rt-PA for patients admitted with 4.5 hours of stroke onset who have no contraindications, and aspirin (160 to 300 mg) for patients who are not eligible for rt-PA. These treatments should be administered within a few hours. A centralized emergency call system (phone number 15 in France) is the most effective way of achieving this objective.

  4. Emergency department management of priapism [digest].

    Science.gov (United States)

    Podolej, Gregory S; Babcock, Christine; Kim, Jeremy

    2017-01-22

    Priapism is a genitourinary emergency that demands a thorough, time-sensitive evaluation. There are 3 types of priapism: ischemic, nonischemic, and recurrent ischemic priapism; ischemic priapism accounts for 95% of cases. Ischemic priapism must be treated within 4 to 6 hours to minimize morbidity, including impotence. The diagnosis of ischemic priapism relies heavily on the history and physical examination and may be facilitated by penile blood gas analysis and penile ultrasound. This issue reviews current evidence regarding emergency department treatment of ischemic priapism using a stepwise approach that begins with aspiration of cavernosal blood, cold saline irrigation, and penile injection with sympathomimetic agents. Evidence-based management and appropriate urologic follow-up of nonischemic and recurrent ischemic priapism maximizes patient outcomes and resource utilization. [Points & Pearls is a digest of Emergency Medicine Practice].

  5. Emergency reception of accidents and incidents in working with ionizing radiation

    International Nuclear Information System (INIS)

    Abrahamse, J.C.; Gispen, J.G.W.

    1989-01-01

    This manual is intended to be a general manual for the responsible expert regarding radiation hygienics in order to assist him in establishing an organization for combat of accidents and incidents. First attention is paid considerations underlying emergency measures and aid, subsequently the demands and desirabilities in the practical organization are discussed. (author). 3 figs

  6. ARAC: A support capability for emergency managers

    Energy Technology Data Exchange (ETDEWEB)

    Pace, J.C.; Sullivan, T.J.; Baskett, R.L. [and others

    1995-08-01

    This paper is intended to introduce to the non-radiological emergency management community the 20-year operational history of the Atmospheric Release Advisory Capability (ARAC), its concept of operations, and its applicability for use in support of emergency management decision makers. ARAC is a centralized federal facility for assessing atmospheric releases of hazardous materials in real time, using a robust suite of three-dimensional atmospheric transport and diffusion models, extensive geophysical and source-description databases, automated meteorological data acquisition systems, and experienced staff members. Although originally conceived to respond to nuclear accidents, the ARAC system has proven to be extremely adaptable, and has been used successfully during a wide variety of nonradiological hazardous chemical situations. ARAC represents a proven, validated, operational support capability for atmospheric hazardous releases.

  7. Current management of surgical oncologic emergencies.

    Directory of Open Access Journals (Sweden)

    Marianne R F Bosscher

    Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  8. 'Hidden messages' emerging from Afrocentric management perspectives

    Directory of Open Access Journals (Sweden)

    H. Van den Heuvel

    2008-12-01

    Full Text Available Purpose: This paper aims to examine how 'African management' discourse has emerged in South Africa. Altogether, it has stimulated debates - sometimes in controversial ways - on 'taboo issues', e.g. relating to 'cultural diversity' and 'ethnicity'. The stimulation of such debates within organisations is probably a more valuable contribution than a static, essentialised 'African identity' that it proclaims. Design/Methodology/Approach: The paper draws on a qualitative research project conducted in South Africa in 2003-2004. Its relevance lies in gaining in-depth insights into ('non-western' local management discourse. It seeks to contribute to the body of knowledge on political and cultural contexts in which South African organizations operate, and how they impact on local management perspectives, and vice versa. Findings: The research findings make clear how and under what circumstances 'African management' discourse has come about in South Africa, and how it could be interpreted. Implications: 'African management' advocates allegedly attempt to revise dominant management thinking and promote 'humane-ness' and participatory decision-making in South African organisations, in search of a contextualised management approach. Amongst others, it has produced new meanings of 'Africanness' and has opened up space for 'hidden messages', resentments and aspirations to become openly articulated. This throws another light on phenomena such as cultural diversity and ethnicity that usually tend to be 'neutralised'. This may turn out to be far healthier for blooming organisational cultures in South Africa than relentlessly hammering on prescribed 'corporate values'. Originality/Value: This paper informs the reader in detail about the emergence and evolvement of 'African management' discourse in South Africa. It is a unique attempt to develop an interpretative viewpoint on this intriguing phenomenon that offers a potentially valuable contribution in reading

  9. COMMUNICATION IN THE EMERGENCY SITUATIONS MANAGEMENT

    OpenAIRE

    Ovidiu Aurel GHIUȚĂ; Gabriela PRELIPCEAN

    2014-01-01

    This paper is talking about communication use in emergency situations management from a marketing perspective. We have analyzed if this communication is different from the communication of a company with her publics; the legislation which provides the framework for this type of communication in Romania, when is applicable and who is in charge. As methodology we have utilized documentary research. We mention similarities and differences between this type of communication and Integrated Ma...

  10. COMMUNICATION IN THE EMERGENCY SITUATIONS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ovidiu Aurel GHIUȚĂ

    2014-12-01

    Full Text Available This paper is talking about communication use in emergency situations management from a marketing perspective. We have analyzed if this communication is different from the communication of a company with her publics; the legislation which provides the framework for this type of communication in Romania, when is applicable and who is in charge. As methodology we have utilized documentary research. We mention similarities and differences between this type of communication and Integrated Marketing Communication (IMC.

  11. NNSA/NV Consequence Management Capabilities for Radiological Emergency Response

    International Nuclear Information System (INIS)

    Bowman, D. R.

    2002-01-01

    The U.S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) provides an integrated Consequence Management (CM) response capability for the (NNSA) in the event of a radiological emergency. This encompasses planning, technical operations, and home team support. As the lead organization for CM planning and operations, NNSA/NV coordinates the response of the following assets during the planning and operational phases of a radiological accident or incident: (1) Predictive dispersion modeling through the Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) and the High Consequence Assessment Group at Sandia National Laboratories (SNL); (2) Regional radiological emergency assistance through the eight Radiological Assistance Program (RAP) regional response centers; (3) Medical advice and assistance through the Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee; (4) Aerial radiological mapping using the fixed-wing and rotor-wing aircraft of the Aerial Measuring System (AMS); (5) Consequence Management Planning Teams (CMPT) and Consequence Management Response Teams (CMRT) to provide CM field operations and command and control. Descriptions of the technical capabilities employed during planning and operations are given below for each of the elements comprising the integrated CM capability

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

    Science.gov (United States)

    Hecker, Norman; Domres, Bernd Dieter

    2018-04-01

    As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach. Copyright © 2018. Production and hosting by Elsevier B.V.

  13. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

    Science.gov (United States)

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-02-09

    This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Emergency medicine: an operations management view.

    Science.gov (United States)

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

    2011-12-01

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

  15. A governor's guide to emergency management. Volume one, Natural disasters

    Science.gov (United States)

    2001-02-27

    With lives, infrastructure, and resources at stake, governors must become instant experts in emergency management when their states are affected by natural disaster. The purpose of A Governor's Guide to Emergency Management is to provide governors an...

  16. The Profession of Emergency Management: Educational Opportunities and Gaps

    National Research Council Canada - National Science Library

    Darlington, Joanne D

    2008-01-01

    For the past several years, as the profession of emergency management has been evolving, there has been a growing interest in the need for more formalized training for the nation s hazards and emergency managers...

  17. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  18. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  19. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.

    2009-01-01

    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  20. Emergency management of acute abdomen in children.

    Science.gov (United States)

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology.

  1. Psychiatric Case Management in the Emergency Department.

    Science.gov (United States)

    Turner, Stephanie B; Stanton, Marietta P

    2015-01-01

    The care of the mentally ill has reached a real crisis in the United States. There were more than 6.4 million visits to emergency departments (EDs) in 2010, or about 5% of total visits, involved patients whose primary diagnosis was a mental health condition or substance abuse (). That is up 28% from just 4 years earlier, according to the latest figures available from the Agency for Healthcare Research and Quality in Rockville, MD. Using a method called scoping, the purpose of this article is to examine the range, extent, and evidence available regarding case management as an intervention in the ED to manage mental health patients, to determine whether there is sufficient quantity and quality of evidence on this topic to conduct a meta-analysis, and to identify relevant studies that balance comprehensiveness with reasonable limitations. One solution for ensuring that the costs are contained, efficiency is maintained, and quality outcomes are achieved is the placement of a case manager in the ED. According to , because the majority of hospital admissions come through the ED, it makes sense to have case managers located there to act as gatekeepers and ensure that patients who are admitted meet criteria and are placed in the proper bed with the proper status. From the scoping techniques implemented in this study, the authors came to the conclusion that case management has been and can be used to effectively treat mental health patients in the emergency room. A good number of patients with psych mental health issues are frequent visitors and repeat visitors. Case management has not been used very often as a strategy for managing patients through the ED or for follow-up after the visit. Hospitals that have developed a protocol for managing these patients outside the main patient flow have had successful results. Staff training and development on psych mental health issues have been helpful in the ED. While there are not a large number of studies available on this topic

  2. Emergency management: Concepts and strategies for effective programs

    OpenAIRE

    Lucus, Valerie

    2007-01-01

    Review of Emergency Management: Concepts and Strategies for Effective Programs By Lucien G. Canton, CEM. By taking a different perspective on local government emergency management programs, this book presents the vision for a very different model--one that includes an independent emergency manager leading an enterprise-wide program focused on strategies that promote disaster resilient communities.

  3. Emerging technologies for knowledge resource management

    CERN Document Server

    Pandian, M

    2007-01-01

    Emerging Technologies for Knowledge Resource Management examines various factors that contribute to an enabled environment for optimum utilisation of information resources. These include the digital form of information resources, which are inherently sharable, consortia as a concept to bring people and materials together and unified portals as technology to bring together disparate and heterogeneous resources for sharing and access. The book provides a step-by-step guideline for system analysis and requirements analysis. The book also provides reviews of existing portal models for sharing reso

  4. Telemedicine for Trauma, Emergencies, and Disaster Management

    CERN Document Server

    Latifi, Rifat

    2010-01-01

    Telemedicine has evolved to become an important field of medicine and healthcare, involving everything from simple patient care to actual performance of operations at a distance. This groundbreaking volume addresses the complex technical and clinical development in the management of trauma, disaster, and emergency situations using telemedicine. The book explains how telemedicine and related technologies can be used to effectively handle a wide range of scenarios, from a situation as small as a car crash, to major disasters such as an earthquake. Professionals find critical discussions on the p

  5. Survey of state and tribal emergency response capabilities for radiological transportation incidents

    Energy Technology Data Exchange (ETDEWEB)

    Vilardo, F J; Mitter, E L; Palmer, J A; Briggs, H C; Fesenmaier, J [Indiana Univ., Bloomington, IN (USA). School of Public and Environmental Affairs

    1990-05-01

    This publication is the final report of a project to survey the fifty states, the District of Columbia, Puerto Rico, and selected Indian Tribal jurisdictions to ascertain their emergency-preparedness planning and capabilities for responding to transportation incidents involving radioactive materials. The survey was conducted to provide the Nuclear Regulatory Commission and other federal agencies with information concerning the current level of emergency-response preparedness of the states and selected tribes and an assessment of the changes that have occurred since 1980. There have been no major changes in the states' emergency-response planning strategies and field tactics. The changes noted included an increased availability of dedicated emergency-response vehicles, wider availability of specialized radiation-detection instruments, and higher proportions of police and fire personnel with training in the handling of suspected radiation threats. Most Indian tribes have no capability to evaluate suspected radiation threats and have no formal relations with emergency-response personnel in adjacent states. For the nation as a whole, the incidence of suspected radiation threats declined substantially from 1980 to 1988. 58 tabs.

  6. Developing a highway emergency response plan for incidents involving hazardous materials, second edition, March 1992

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This provides minimum guidelines for developing an emergency response plan for incidents involving hazardous liquid hydrocarbons, such as gasoline and crude oil, transported in MC 306/DOT 406 and MC 307/DOT 407 aluminum cargo tanks and for coordinating and cooperating with local, state, and federal officials. This publication covers response plan priorities, personnel training, special equipment, media relations, environmental relations, and post-response activities. The apprendixes to this recommended practice outline a highway emergency response plan and suggest a procedure for removing liquid hydrocarbons from overturned cargo tanks and righting the tank vehicles

  7. PREDICTIVE MODELS FOR SUPPORT OF INCIDENT MANAGEMENT PROCESS IN IT SERVICE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Martin SARNOVSKY

    2018-03-01

    Full Text Available ABSTRACT The work presented in this paper is focused on creating of predictive models that help in the process of incident resolution and implementation of IT infrastructure changes to increase the overall support of IT management. Our main objective was to build the predictive models using machine learning algorithms and CRISP-DM methodology. We used the incident and related changes database obtained from the IT environment of the Rabobank Group company, which contained information about the processing of the incidents during the incident management process. We decided to investigate the dependencies between the incident observation on particular infrastructure component and the actual source of the incident as well as the dependency between the incidents and related changes in the infrastructure. We used Random Forests and Gradient Boosting Machine classifiers in the process of identification of incident source as well as in the prediction of possible impact of the observed incident. Both types of models were tested on testing set and evaluated using defined metrics.

  8. Technical information management in an emergency response

    International Nuclear Information System (INIS)

    Berry, H.A.; Greve, C.; Best, R.G.; Phillipson, D.S.

    1991-01-01

    Through many experiences in responding to real radiation accidents and emergency response exercises, the Department of Energy (DOE) has developed a technical information management system that will be used in the Federal Radiological Monitoring and Assessment Center (FRMAC) in the event of a major radiological accident. The core of the system is the Data Center in the FRMAC, utilizing a computerized database of all off-site environmental radiological data. The information contained and managed by the Data Center will be comprehensive, accountable, and traceable, providing information to the assessors for immediate health and safety needs as well as for long-term documentation requirements. A DOE task force has been formed to develop compatibility guidelines for video, automated data processing, and communication systems. An electronic mail, information status, and bulletin board system is also being developed to assist in the dissemination of information. Geographic Information Systems (GIS) offer a giant step forward in displaying and analyzing information in a geographically referenced system

  9. [Second victim : Critical incident stress management in clinical medicine].

    Science.gov (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

    2013-09-01

    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  10. Formal analysis of empirical traces in incident management

    International Nuclear Information System (INIS)

    Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei

    2008-01-01

    Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plans, and training logs need to be thoroughly analysed. This paper presents a formal approach for such an analysis that pays special attention to spatial and temporal aspects, to information exchange, and to organisational structure. The formal nature of the approach enables automation of analysis, which is illustrated by case studies of two disasters

  11. Addressing the gap between public health emergency planning and incident response

    Science.gov (United States)

    Freedman, Ariela M; Mindlin, Michele; Morley, Christopher; Griffin, Meghan; Wooten, Wilma; Miner, Kathleen

    2013-01-01

    Objectives: Since 9/11, Incident Command System (ICS) and Emergency Operations Center (EOC) are relatively new concepts to public health, which typically operates using less hierarchical and more collaborative approaches to organizing staff. This paper describes the 2009 H1N1 influenza outbreak in San Diego County to explore the use of ICS and EOC in public health emergency response. Methods: This study was conducted using critical case study methodology consisting of document review and 18 key-informant interviews with individuals who played key roles in planning and response. Thematic analysis was used to analyze data. Results: Several broad elements emerged as key to ensuring effective and efficient public health response: 1) developing a plan for emergency response; 2) establishing the framework for an ICS; 3) creating the infrastructure to support response; 4) supporting a workforce trained on emergency response roles, responsibilities, and equipment; and 5) conducting regular preparedness exercises. Conclusions: This research demonstrates the value of investments made and that effective emergency preparedness requires sustained efforts to maintain personnel and material resources. By having the infrastructure and experience based on ICS and EOC, the public health system had the capability to surge-up: to expand its day-to-day operation in a systematic and prolonged manner. None of these critical actions are possible without sustained funding for the public health infrastructure. Ultimately, this case study illustrates the importance of public health as a key leader in emergency response. PMID:28228983

  12. Towards emergence phenomenon in business process management

    Directory of Open Access Journals (Sweden)

    Koryl Maciej

    2017-06-01

    Full Text Available A standard solution regarding business process management automation in enterprises is the use of workflow management systems working by the Rule-Based Reasoning approach. In such systems, the process model which is designed entirely before the implementation has to meet all needs deriving from business activity of the organization. In practice, it means that great limitations arise in process control abilities, especially in the dynamic business environment. Therefore, new kinds of workflow systems may help which typically work in more agile way e.g. following the Case-Based Reasoning approach. The paper shows another possible solution – the use of emergence theory which indicates among other conditions required to fulfill stimulation of the system (for example the business environment to run grass-roots processes that lead to arising of new more sophisticated organizing forms. The paper also points the using opportunity of such techniques as the processing of complex events to fulfill key conditions pointed by the emergence theory.

  13. Emergency Peripartum Hysterectomy as Postpartum Hemorrhage Treatment: Incidence, Risk factors, and Complications

    Directory of Open Access Journals (Sweden)

    Meena Pradhan

    2014-03-01

    Full Text Available Introduction: The aim of the research was to investigate incidence, risk factors, and complications associated with emergency peripartum hysterectomy, the ultimate treatment method for intractable postpartum hemorrhage. Methods: This is a single center case-control study conducted in Chongqing city in central China from 1st January 2007 to 31st December 2012 for emergency peripartum hysterectomy performed as a treatment of postpartum hemorrhage both in caesarean and vaginal delivery cases. While the study group included emergency peripartum hysterectomy (n=61 due to intractable postpartum hemorrhage, the control group included no hysterectomy (n=333 during the same study period. Results: We found 61 cases recorded for emergency peripartum hysterectomy for intractable postpartum hemorrhage. Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries. Emergency peripartum hysterectomy as treatment of intractable postpartum hemorrhage include the followings: (i blood loss 1000-2000 ml, crude odd ratio (OR =18.48 (95% CI 5.1-65.7, adjusted odd ratio (AOR = 9.1 (95% CI 2.2-37.7; (ii blood loss >2000 ml, OR = 152 (95% CI 43.7-528.4, AOR = 45.3 (95% CI 11.6-176.9; (iii previous caesarean section, OR = 5.5 (95% CI 2.9-9.7, AOR = 3.7(95% CI 1.4-9.9; (iv uterine atony, OR = 11.9 (95% CI 5.8-24.6, AOR = 7.5 (95% CI 1.8-30.2; (v placenta previa, OR = 2.04 (95% CI 1.1-3.5, AOR = none. Conclusions: Emergency peripartum hysterectomy is the last resort as treatment of intractable severe postpartum hemorrhage. Our study depicts that severe post partum hemorrhage, further dreaded complex events for emergency peripartum hysterectomy, has significant association with placental factors, previous caesarean section, and uterine atony. Pathologically, placenta accreta remained the most leading cause of hysterectomy. Keywords: caesarean section; hemorrhage; peripartum hysterectomy; placenta previa.

  14. Emergency thoracic ultrasound and clinical risk management

    Directory of Open Access Journals (Sweden)

    Interrigi MC

    2017-02-01

    Full Text Available Maria Concetta Interrigi,1 Francesca M Trovato,2,3 Daniela Catalano,3,4 Guglielmo M Trovato3,5 1Accident and Emergency Department, Ospedale Cannizzaro, Catania, 2Accident and Emergency Department, Ospedale Civile, Ragusa, 3Department of Clinical and Experimental Medicine, The School of Medicine, University of Catania, 4Postgraduate School of Clinical Ultrasound, Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria Policlinico, University of Catania, 5Postgraduate School of e-Learning and ICT in Health Sciences, The School of Medicine, University of Catania, Catania, Italy Purpose: Thoracic ultrasound (TUS has been proposed as an easy-option replacement for chest X-ray (CXR in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods: This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results: Three hundred and seventy emergency TUS scans (excluding trauma patients were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion; in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed

  15. Emergency Management for Disasters in Malaysian Hotel Industry

    Directory of Open Access Journals (Sweden)

    AlBattat Ahmad Rasmi

    2014-01-01

    Full Text Available This paper aims to identify major emergencies that have the potential to place Malaysian hotels in emergency and disaster situations; investigate how hotels were prepared for emergencies, how they manage and overcome emergencies when occurred; and limitations and factors influencing successful emergency planning and adoption emergency management in Malaysian hotels. Face-to-face interview with managers from three, four and five star hotels from different backgrounds: local; regional; and International in Kuala Lumpur, Subang, and Putrajaya are undertaken. The result revealed that Malaysian hotels are exposed to a wide range of natural and man-made disasters. Malaysian hotels lack proactive emergency planning and a lot of constraints which impede successful emergency planning for disasters in the hotel industry in Malaysia, with emphasizing on the relevant authority’s role to demonstrate emergency management to hotels convincing them to adopt such practices, so they can be able to cope with emergencies effectively.

  16. The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.

    Science.gov (United States)

    Mortaro, Alberto; Pascu, Diana; Zerman, Tamara; Vallaperta, Enrico; Schönsberg, Alberto; Tardivo, Stefano; Pancheri, Serena; Romano, Gabriele; Moretti, Francesca

    2015-07-01

    The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

  17. Development of incident progress prediction technologies for nuclear emergency preparedness. Current status and future subjects

    International Nuclear Information System (INIS)

    Yoshida, Yoshitaka; Yamamoto, Yasunori; Kusunoki, Takayoshi; Kawasaki, Ikuo; Yanagi, Chihiro; Kinoshita, Ikuo; Iwasaki, Yoshito

    2014-01-01

    Nuclear licensees are required to maintain a prediction system during normal condition for using a nuclear emergency by the Basic Plan for Disaster Prevention of government. With prediction of the incident progress, if the present condition of nuclear power plant is understood appropriately and it grows more serious with keeping the present situation, it is in predicting what kind of situation will be occurred in the near future, choosing the effective countermeasures against the coming threat, and understanding the time available of intervention time. Following the accident on September 30 1999 in the nuclear fuel fabrication facility in Tokai Village of Ibaraki Prefecture, the Institute of Nuclear Safety System started development of incident progress prediction technologies for nuclear emergency preparedness. We have performed technical applications and made improvements in nuclear emergency exercises and verified the developed systems using the observed values of the Fukushima Daiichi Nuclear Power Plant accident. As a result, our developed Incident Progress Prediction System was applied to nuclear emergency exercises and we accumulated knowledge and experience by which we improved the system to make predictions more rapidly and more precisely, including for example, the development of a prediction method for leak size of reactor coolant. On the other hand, if a rapidly progressing incident occurs, since end users need simple and quick predictions about the public's protection and evacuation areas, we developed the Radioactive Materials Release, Radiation Dose and Radiological Protection Area Prediction System which changed solving an inverse problem into a forward problem solution. In view of the water-level-decline incident of the spent fuel storage facility at the Fukushima Daiichi Nuclear Power Plant, the spent fuel storage facility water level and the water temperature evaluation tool were improved. Such incident progress prediction technologies were

  18. [Use of complementary tests in emergencies and their relation with patient safety incidents].

    Science.gov (United States)

    Alcaraz-Martínez, J; Aranaz-Andrés, J M; Cantero-Sandoval, A; Piñera-Salmerón, P; Mas-Luzón, J; Serrano-Martínez, J A; González Garro, E

    2018-03-10

    To analyse the use of complementary tests and their relationship with safety incidents in hospital emergency departments. An analysis was performed on 935 patients seen in the 9 hospital emergency departments. The source of data used for the detection of incidents were: emergency department clinical record and reports, together with face-to-face observation in the department, plus a telephone survey of the patient or family member at one week after the care. Statistical tests used: The Student t test for quantitative variables, Chi squared test for qualitative variables, and the ANOVA test. A peripheral venous catheter was used in 397 patients (42.4% (95% CI; 39.3-45.5%)), with a variability with significant differences between hospitals (P<.01), with a range of use from 37% to 81.8%. It was also observed that in 23.4% (95% CI; 19.2-27.6%) of the cases, the catheter was not used after the first blood draw. Radiological tests were requested for 351 patients, 37.7% (95% CI; 34.6-40.8%), also with significant differences between hospitals (P<.01), ranging from 24.6 to 65, 1%. Incidents were detected in 95 (10.2%) patients (95% CI; 8.3-12.1%) in the all the study centres. A higher proportion of safety incidents have been observed in patients where peripheral venous catheter has been used (12.8%) than in those in whom they had not been used (8.5%) (P=.03), as well as in patients on whom an x-ray was requested (12.8%) compared to those who did not (8.64%) (P=.04). A longer stay was also observed in cases with an incident (mean 248.9minutes) than in those where there were none (mean 164.1minutes) (P<.001). No statistically significant differences were found in the other parameters studied. A relationship was observed between the use of a peripheral venous catheter (many of them without use) and radiological tests and the occurrence of safety incidents in the Emergency Departments. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Emergency radiology and mass casualty incidents-report of a mass casualty incident at a level 1 trauma center.

    Science.gov (United States)

    Bolster, Ferdia; Linnau, Ken; Mitchell, Steve; Roberge, Eric; Nguyen, Quynh; Robinson, Jeffrey; Lehnert, Bruce; Gross, Joel

    2017-02-01

    The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage. Nineteen patients were transferred to our level 1 trauma center. Eighteen casualties arrived within 72 min. Sixteen arrived within 1 h of the first patient arrival, and 1 casualty was transferred 3 h later having initially been assessed at another hospital. Eighteen casualties (94.7 %) underwent diagnostic imaging in the emergency department. Of these 18 casualties, 15 had a trauma series (portable chest x-ray and x-ray of pelvis). Whole-body trauma computed tomography scans (WBCT) were performed on 15 casualties (78.9 %), 12 were immediate and performed during the initial active phase of the MCI, and 3 WBCTs were delayed. The initial 12 WBCTs were completed in 101 min. The mean number of radiographic studies performed per patient was 3 (range 1-8), and the total number of injuries detected was 88. The surge in imaging requirements during an MCI can be significant and exceed normal operating capacity. This report of our radiology experience during a recent MCI and subsequent after-action review serves to provide an example of how radiology capacity and workflow functioned during an MCI, in order to provide emergency radiologists and response planners with practical recommendations for implementation in the event of a future MCI.

  20. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    International Nuclear Information System (INIS)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo

    2012-01-01

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  1. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  2. IAEA response assistance network. Incident and Emergency Centre. Emergency preparedness and response. Date effective: 1 May 2006

    International Nuclear Information System (INIS)

    2006-03-01

    This publication is intended to serve as a tool for supporting the provision of international assistance in the case of nuclear or radiological incident or emergency, cooperation between States, their Competent Authorities and the IAEA, and harmonization of response capabilities of States offering assistance. The publication is issued under the authority of the Director General of the IAEA: (1) under the auspices of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the Assistance Convention) [1], to promote, facilitate and support cooperation between States Parties to coordinate and/or provide assistance to a State Party and/or Member State; and (2) in the case of an incident or emergency, as statutory functions, to provide for the application of its safety standards, upon request by a Member State, and to act as an intermediary for the purposes of securing the performance of services or the supplying of materials, equipment or facilities by one Member State for another. The publication sets out the following: a) the RANET concept and the organizational structure for providing assistance; b) functions, responsibilities and activities within the RANET; c) the RANET response operations and arrangements needed for preparedness; and d) the prerequisites for RANET membership and conditions of registration. The RANET is divided into four sections. After the introduction in Section 1, the RANET concept, objectives and scope are described in Section 2. Section 3 presents the concept of operations of the RANET and Section 4 describes expected tasks, capabilities and resources. In addition, EPR-RANET (2006) has three supporting documents, which are issued separately, as follows: 1. Assistance Action Plans with samples of Assistance Action Plans for providing international assistance. 2. Registry with the details of the registry and instructions on how to register national assistance capabilities for the RANET. 3. Technical Guidelines

  3. Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

    Science.gov (United States)

    Ward, C L; Lombard, C J; Gwebushe, N

    2006-01-01

    Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

  4. Exposure management systems in emergencies as comprehensive medical care

    International Nuclear Information System (INIS)

    Shinohara, Teruhiko

    2000-01-01

    The emergency management of nuclear hazards relies on a comprehensive medical care system that includes accident prevention administration, environmental monitoring, a health physics organization, and a medical institution. In this paper, the care organization involved in the criticality accident at Tokai-mura is described, and the problems that need to be examined are pointed out. In that incident, even the expert was initially utterly confused and was unable to take appropriate measures. The author concluded that the members of the care organization were all untrained for dealing with nuclear hazards and radiation accidents. The education and training of personnel at the job site are important, and they are even more so for the leaders. Revisions of the regional disaster prevention plans and care manual are needed. (K.H.)

  5. Emerging trends in disaster management and the Ethiopian ...

    African Journals Online (AJOL)

    Emerging trends in disaster management and the Ethiopian experience: genesis, reform and transformation. ... Journal of Business and Administrative Studies ... Key words: disaster management, drought, pre-disaster action, post-disaster action, hazards, disaster, Ethiopian disaster management system, Ethiopia.

  6. A framework for evaluating the effectiveness of flood emergency management systems in Europe

    NARCIS (Netherlands)

    Gilissen, H.K.|info:eu-repo/dai/nl/314838732; Alexander, Meghan; Matczak, Piotr; Pettersson, Maria; Bruzzone, Silvia

    2016-01-01

    Society is faced with a range of contemporary threats to everyday life, from natural and technological hazards, to accidents and terrorism. These are embodied within integrated emergency management arrangements, designed to enhance preparedness and response to such incidents, and in turn facilitate

  7. Using principles from emergency management to improve emergency response plans for research animals.

    Science.gov (United States)

    Vogelweid, Catherine M

    2013-10-01

    Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

  8. Calming the campus: training school staff and crisis teams to manage student behavior during emergencies.

    Science.gov (United States)

    Johnson, Kendall

    2007-01-01

    Conversations with school and crisis personnel following large scale emergencies in and around schools, such as shootings, wildfires, and the attack on the World Trade Center on September 11, 2001, indicated a need for pre-incident training in managing student behavior during emergencies. This article outlines a training program of this kind and offers suggestions regarding both content and process of this training. The suggestions follow discussion of the unique context and needs of the school setting.

  9. Management of In-Field Patient Tracking and Triage by Using Near-Field Communication in Mass Casualty Incidents.

    Science.gov (United States)

    Cheng, Po-Liang; Su, Yung-Cheng; Hou, Chung-Hung; Chang, Po-Lun

    2017-01-01

    Near field communications (NFC) is an emerging technology that may potentialy assist with disaster management. A smartphone-based app was designed to help track patient flow in real time. A table-drill was held as a brief evaluation and it showed significant imporvement in both efficacy and accuracy of patient management. It is feasible to use NFC-embedded smartphones to clarify the ambiguous and chaotic patient flow in a mass casualty incident.

  10. Emergency planning and management in health care: priority research topics.

    Science.gov (United States)

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-06-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making.

  11. Management of a radiological emergency. Organization and operation

    International Nuclear Information System (INIS)

    Dubiau, Ph.

    2007-01-01

    After a recall of potential radiological emergency situations and their associated risks, this article describes the organization in France of the crisis management and its operation at the national and international scale: 1 - Nuclear or radiological emergency situations and their associated risks: inventory of ionising radiation sources, accidental situations, hazards; 2 - crisis organization in situation of radiological or nuclear emergency: organization at the local scale, organization at the national scale; 3 - management of emergency situations: accident at a facility, action circle, radiological emergency situations outside nuclear facilities, international management of crisis, situations that do not require the implementation of an emergency plan. (J.S.)

  12. 'Heads you win, tails I lose': a critical incident study of GPs' decisions about emergency admission referrals.

    Science.gov (United States)

    Dempsey, Owen P; Bekker, Hilary L

    2002-12-01

    Acute hospital Trusts' inability to cope with the numbers of emergency admissions has led to the production of guidelines by the Department of Health aimed at reducing inappropriate admissions by GPs. There is a paucity of research describing GPs' decisions to (not) admit patients and it is unclear how effective these guidelines are in changing these practices. To describe GPs' decision-making about referrals for emergency hospital admissions. Observational design using the critical incident technique to elicit data. Eight GPs in West Yorkshire recorded details of memorable emergency admission decisions, both prospective and retrospective consultations. The transcript data were classified by theme using NUD*IST. Forty prospective and 8 retrospective consultations were analysed. Factors affecting GPs' decisions were:Identification of all consequences for all stakeholders in the decision. Emotional impact on the GP of managing these conflicting needs. 'Peer review' of the GP's professionalism about the decision. Contextual pressures limiting effectiveness of GPs' decision-making. Referral decisions require the evaluation of several conflicting consequences for many stakeholders in time-pressured and peer-reviewed situations. These factors encourage the use of heuristics, i.e. GPs' judgements will be influenced more by the social context of the choice than information about the patient's condition. Emergency referral guidelines provide more information to evaluate from another stakeholder; introducing guidelines is likely to increase GPs' use of heuristics and the making of less optimal decisions.

  13. Emergency management of ureteral stones: Recent advances

    Directory of Open Access Journals (Sweden)

    Luis Osorio

    2008-01-01

    Full Text Available Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators′ experience, patients′ preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  14. Emergency management of ureteral stones: Recent advances.

    Science.gov (United States)

    Osorio, Luis; Lima, Estêvão; Autorino, Riccardo; Marcelo, Filinto

    2008-10-01

    Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators' experience, patients' preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  15. Chernobyl experience of emergency data management

    International Nuclear Information System (INIS)

    Bolshov, L.; Linge, I.; Arutyunyan, R.; Ilushkin, A.; Kanevsky, M.; Kiselev, V.; Melikhova, E.; Ossipiants, I.; Pavlovsky, O.

    1997-01-01

    The use of the Chernobyl experience in emergency data management is presented. Information technologies for the generalization of practical experience in the protection of the population after the Chernobyl accident are described. The two main components of this work are the development of the administrative information system (AIS) and the creation of the central data bank. The current state of the AIS, the data bank and the bank of models is described. Data accumulated and models are used to estimate the consequences of radiation accidents and to provide different types of prognosis. Experience of accumulated analysis data allows special software to be developed for large-scale simulation of radiation consequences of major radiation accidents and to organize practical exercises. Some examples of such activity are presented. (orig.)

  16. Development of a highway incident management operational and training guide for incident responders in Illinois.

    Science.gov (United States)

    2011-08-01

    Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...

  17. The incidence of and risk factors for emergence delirium in U.S. military combat veterans.

    Science.gov (United States)

    McGuire, Jason M

    2012-08-01

    The purpose of this research was to identify the incidence and potential risk factors for emergence delirium (ED) in a U.S. military combat veteran surgical population at Naval Hospital Camp Pendleton. ED is a postanesthetic phenomenon that occurs immediately after emergence from general anesthesia and is characterized by agitation, confusion, and violent behavior. Clinical evidence suggests that ED is increasingly seen among military personnel returning from the wars in Iraq and Afghanistan, and that the incidence of anxiety, depression, and post-traumatic stress disorder (PTSD) are higher in this population than in noncombat troops or nonmilitary populations. The incidence of ED in this sample of 130 postoperative military personnel with combat exposure was 20% (n=26). Those previously diagnosed with a psychological disorder had a higher rate of ED (50%) than those who did not (17.5%), χ(2)=5.53, PPTSD symptoms, and depression [state anxiety: r(128)=0.40, PPTSD: r(128)=0.35, PPTSD, and depression as risk factors. Regression modeling suggested that state-anxiety served as the best predictor. These findings increase clinicians' understanding of ED among combat veterans and give direction to future studies that should focus on preventive treatment. Published by Elsevier Inc.

  18. Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

    Science.gov (United States)

    Pedigo, Ryan Anthony; Zaurova, Milana

    2017-06-22

    Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

  19. Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

    OpenAIRE

    Terblanche, Lourie; van Wyk, André

    2014-01-01

    Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

  20. Risk of influenza transmission in a hospital emergency department during the week of highest incidence.

    Science.gov (United States)

    Esteve-Esteve, Miguel; Bautista-Rentero, Daniel; Zanón-Viguer, Vicente

    2018-02-01

    To estimate the risk of influenza transmission in patients coming to a hospital emergency department during the week of highest incidence and to analyze factors associated with transmission. Retrospective observational analysis of a cohort of patients treated in the emergency room during the 2014-2015 flu season. The following variables were collected from records: recorded influenza diagnosis, results of a rapid influenza confirmation test, point of exposure (emergency department, outpatient clinic, or the community), age, sex, flu vaccination or not, number of emergency visits, time spent in the waiting room, and total time in the hospital. We compiled descriptive statistics and performed bivariate and multivariate analyses by means of a Poisson regression to estimate relative risk (RR) and 95% CIs. The emergency department patients had a RR of contracting influenza 3.29 times that of the communityexposed population (95% CI, 1.53-7.08, P=.002); their risk was 2.05 times greater than that of outpatient clinic visitors (95% CI, 1.04-4.02, P=.036). Emergency patients under the age of 15 years had a 5.27 greater risk than older patients (95% CI, 1.59-17.51; P=.007). The RR of patients visiting more than once was 11.43 times greater (95% CI, 3.58-36.44; P<.001). The risk attributable to visiting the emergency department risk was 70.5%, whereas risk attributable to community exposure was 2%. The risk of contracting influenza is greater for emergency department patients than for the general population or for patients coming to the hospital for outpatient clinic visits. Patients under the age of 15 years incur greater risk.

  1. MANAGEMENT OF EXTRIMITY FRACTURE IN EMERGENCY DEPARTMENT

    Directory of Open Access Journals (Sweden)

    Putu Sukma Parahita

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Fracture injuries in the extremities are accounted for 40% of the incidence of fractures in the United States and causes high morbidity (physical suffering, lost time, and mental stress. High-energy fractures of the lower limbs can also cause life threatening condition like major vascular injury, crush syndrome, and compartment syndrome. Initial treatment in the emergency room is essential to save lives and to save the fractured extremities. Primary survey (securing the airway, breathing and circulation and the secondary survey will be able to quickly and accurately identify dangerous early complication of fractures, such as major arterial injury, crush syndrome and compartment syndrome. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  2. Improving emergency preparedness and crisis management capabilities in transportation.

    Science.gov (United States)

    2009-11-30

    Despite the heightened attention disaster preparedness and emergency management have received over the past decade, serious weaknesses in the United States emergency response capabilities remain at all levels of government and across a wide range ...

  3. Department of Energy Emergency Management Functional Requirements Study

    International Nuclear Information System (INIS)

    1987-05-01

    This Study, the Emergency Management Functional Requirements Study (EMFRS), identifies the physical environment, information resources, and equipment required in the DOE Headquarters Emergency Operations Center (EOC) to support the DOE staff in managing an emergency. It is the first step toward converting the present Forrestal EOC into a practical facility that will function well in each of the highly diverse types of emergencies in which the Department could be involved. 2 figs

  4. Conflicts between managed care organizations and emergency departments in California.

    OpenAIRE

    Johnson, L A; Derlet, R W

    1996-01-01

    To control costs, managed care organizations have begun to restrict the use of hospital emergency departments by their enrollees. They are doing this by educating enrollees, providing better access to 24-hour urgent care, denying preauthorizations for care for some patients who do present to emergency departments, and retrospectively denying payment for certain patients who use emergency services. Changing traditional use of emergency departments has resulted in conflicts between managed care...

  5. Social Media's New Role in Emergency Management

    Energy Technology Data Exchange (ETDEWEB)

    Ethan Huffman; Sara Prentice

    2008-03-01

    As technology continues to evolve, emergency management organizations must adapt to new ways of responding to the media and public. This paper examines a brief overview of social media's new role in emergency management. This includes definitions of social media, the benefits of utilizing social media, examples of social media being used and finally a discussion of how agencies, such as Department of Energy national laboratories, can begin including social media in their emergency management plans.

  6. The Information Management Platform on Nuclear Emergency Resources of China

    International Nuclear Information System (INIS)

    Dong, L.

    2016-01-01

    Full text: The Chinese government has always attached great importance to nuclear emergency work, and has invested to form lots of nuclear emergency resources. Meanwhile, there also exist some management problems such as repeated investment, fragmented inventory list, inefficient management, etc. To achieve integrated management on the nuclear emergency resources of China, the Chinese government initiated the project “The Information Management Platform on Nuclear Emergency Resources of China”. The goal of the project is to support a timely, managed, controlled, coordinated and effective response while the resources managing process remains economically efficient. The project team firstly completed the nuclear emergency resources classification and encoding. Based on these, the nuclear emergency resources information management software system was developed. The pilot operation in the system was carried out both in Guangxi and Liaoning Province at the same time. Nuclear emergency resources survey was done as the relevant information was put into the database in these regions. The evaluation result on the pilot operation showed that, the information management platform on emergency resources would apparently improve efficiency of nuclear emergency preparedness and response, and it also would increase economical efficiency on inventory list, information management and invest decision. (author

  7. Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

    Science.gov (United States)

    Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

    2017-04-28

    Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

  8. A Cognitive Task Analysis for an Emergency Management Serious Game.

    Science.gov (United States)

    Dass, Susan; Barnieu, Joanne; Cummings, Paul; Cid, Victor

    2016-01-01

    The Bethesda Hospitals' Emergency Preparedness Partnership identified a need to design training systems for hospital emergency management scenarios that included incident command situations. As part of this partnership, the National Library of Medicine (NLM) was challenged to develop an engaging, learner-centered simulation to specifically address hospital procedures for highly infectious diseases (HIDs) for multiple hospital roles. A serious game approach was selected for the simulation because collaborative (multiplayer) immersive, game-based simulations have been proven to generate realistic and engaging learning experiences and, when properly designed, can enhance training while minimizing cost compared to full-scale disaster exercises (Spain et al., 2013). Although substantial research effort has been put into design and evaluation of serious games, less time has been spent on developing sound instructional design methodologies to support serious game development. So how does one collect the appropriate, relevant, contextualized content and then align with serious game design elements? This paper describes how a cognitive task approach supported by a live demonstration with a think-aloud protocol was used to collect the rich psychomotor, procedural, and cognitive data necessary for the design of a serious game for handling HIDs. Furthermore, the paper presents a process to translate the collected data into meaningful content to support rapid prototyping. Recommendations for data collection and translation for a serious game close the paper.

  9. [Development and application of emergency medical information management system].

    Science.gov (United States)

    Wang, Fang; Zhu, Baofeng; Chen, Jianrong; Wang, Jian; Gu, Chaoli; Liu, Buyun

    2011-03-01

    To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine. Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine. The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data. This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.

  10. Quality assurance measurement for emergency management

    International Nuclear Information System (INIS)

    Pawlowski, M.S.

    1993-01-01

    Under the Federal Civil Defense Act of 1950, as amended, the Federal Emergency Management Agency (FEMA) is charged with maintenance of a nationwide inventory of 4.3 million radiological instruments procured and granted by the federal government to state and local governments. These instruments are used by trained state Radiological Response Team Members, first responders, and critical workers to support the population from a national security or large-scale peacetime radiological disaster, e.g., Chernobyl, Three Mile Island, Satellite Reentry, etc. The inventory is maintained through a network of 100% federally funded state maintenance and calibration facilities, with overall technical guidance and standardization provided by the FEMA Radiological Instrumentation Test Facility. The system used to support maintenance and standardized calibration of the inventory consists of CDV-794 Radiation Calibrator (High Range), CDV-765 Model 2 Gamma Transfer Standard, CDV-790 Model 1 Calibrator (Low Range), and Dosimeter Transfer Standards. Past studies have indicated the open-quotes Readinessclose quotes and open-quotes Reliabilityclose quotes of the inventory to meet mission requirements based upon a standardized system of maintenance and calibration. FEMA has just initiated a new instrument Readiness and Reliability study with the State of Ohio Radiological Instrument Maintenance and Calibration Program to provide data to reassess the capability of the current inventory to support all types of peacetime and national security missions

  11. Quality assurance measurement for emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Pawlowski, M.S. [SL-OE-SD-IN Federal Emergency Management Agency, Washington, DC (United States)

    1993-12-31

    Under the Federal Civil Defense Act of 1950, as amended, the Federal Emergency Management Agency (FEMA) is charged with maintenance of a nationwide inventory of 4.3 million radiological instruments procured and granted by the federal government to state and local governments. These instruments are used by trained state Radiological Response Team Members, first responders, and critical workers to support the population from a national security or large-scale peacetime radiological disaster, e.g., Chernobyl, Three Mile Island, Satellite Reentry, etc. The inventory is maintained through a network of 100% federally funded state maintenance and calibration facilities, with overall technical guidance and standardization provided by the FEMA Radiological Instrumentation Test Facility. The system used to support maintenance and standardized calibration of the inventory consists of CDV-794 Radiation Calibrator (High Range), CDV-765 Model 2 Gamma Transfer Standard, CDV-790 Model 1 Calibrator (Low Range), and Dosimeter Transfer Standards. Past studies have indicated the {open_quotes}Readiness{close_quotes} and {open_quotes}Reliability{close_quotes} of the inventory to meet mission requirements based upon a standardized system of maintenance and calibration. FEMA has just initiated a new instrument Readiness and Reliability study with the State of Ohio Radiological Instrument Maintenance and Calibration Program to provide data to reassess the capability of the current inventory to support all types of peacetime and national security missions.

  12. Special event planning for the emergency manager.

    Science.gov (United States)

    Gaynor, Peter T

    2009-11-01

    In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan.

  13. Emergency management of acute colonic cancer obstruction.

    Science.gov (United States)

    Gainant, A

    2012-02-01

    Emergency management of obstructing colonic cancer depends on both tumor location and stage, general condition of the patient and surgeon's experience. Right sided or transverse colon obstructing cancers are usually treated by right hemicolectomy-extended if necessary to the transverse colon-with primary anastomosis. For left-sided obstructing cancer, in patients with low surgical risk, primary resection and anastomosis associated with on-table irrigation or manual decompression can be performed. It prevents the confection of a loop colostomy but presents the risk of anastomotic leakage. Subtotal or total colectomy allows the surgeon to encompass distended and fecal-loaded colon, and to perform one-stage resection and anastomosis. Its disadvantage is an increased daily frequency of stools. It must be performed only in cases of diastatic colon perforation or synchronous right colonic cancer. In patients with high surgical risk, Hartmann procedure must be preferred. It allows the treatment of both obstruction and cancer, and prevents anastomotic leakage but needs a second operation to reverse the colostomy. Colonic stenting is clinically successful in up to 90% in specialized groups. It is used as palliation in patients with disseminated disease or bridge to surgery in the others. If stent insertion is not possible, loop colostomy is still indicated in patients at high surgical risk. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  14. Emerging carbon constraints for corporate risk management

    International Nuclear Information System (INIS)

    Busch, Timo; Hoffmann, Volker H.

    2007-01-01

    While discussions about global sustainability challenges abound, the financial risks that they incur, albeit important, have received less attention. We suggest that corporate risk assessments should include sustainability-related aspects, especially with relation to the natural environment, and encompass the flux of critical materials within a company's value chain. Such a comprehensive risk assessment takes into account input- as well as output-related factors. With this paper, we focus on the flux of carbon and define carbon constraints that emerge due to the disposition of fossil fuels in the input dimension and due to direct and indirect climate change effects in the output dimension. We review the literature regarding the financial consequences of carbon constraints on the macroeconomic, sector, and company level. We conclude that: a) financial consequences seem to be asymmetrically distributed between and within sectors, b) the individual risk exposure of companies depends on the intensity of and dependency on carbon-based materials and energy, and c) financial markets have only started to incorporate these aspects in their valuations. This paper ends with recommendations on how to incorporate our results in an integrated carbon risk management framework. (author)

  15. Incidence and risk factors of emergence agitation in pediatric patients after general anesthesia.

    Science.gov (United States)

    Saringcarinkul, Ananchanok; Manchupong, Sithapan; Punjasawadwong, Yodying

    2008-08-01

    To study the incidence and evaluate factors associated with emergence agitation (EA) in pediatrics after general anesthesia. A prospective observational study was conducted in 250 pediatric patients aged 2-9 years, who received general anesthesia for various operative procedures in Maharaj Nakorn Chiang Mai Hospital between October 2006 and September 2007. The incidence of EA was assessed Difficult parental-separation behavior, pharmacologic and non-pharmacologic interventions, and adverse events were also recorded Univariate and multivariate analysis were used to determine the factors associated with EA. A p-value of less than 0.05 was considered significant. One hundred and eight children (43.2%) had EA, with an average duration of 9.6 +/- 6.8 minutes. EA associated with adverse events occurred in 32 agitated children (29.6%). From univariate analysis, factors associated with EA were difficult parental-separation behavior, preschool age (2-5 years), and general anesthesia with sevoflurane. However; difficult parental-separation behavior; and preschool age were the only factors significantly associated with EA in the multiple logistic regression analysis with OR = 3.021 (95% CI = 1.680, 5.431, p anesthesia personnel responsible for pediatric anesthesia should have essential skills and knowledge to effectively care for children before, during, and after an operation, including implementing the methods that minimize incidence of EA.

  16. Off-site nuclear emergency management

    International Nuclear Information System (INIS)

    Miska, H.

    2003-01-01

    Full text: Urgent protective measures for the possibly affected population are the main items to be addressed here, that means actions to be planned and taken in the pre-release and release phase of a nuclear accident. Since we will focus an off-site nuclear emergency management, the utility or licensee only plays a subordinate role, but nevertheless may be the potential cause of all actions. At the other end, there is the possible affected population, the environment, and also economic values. Emergency preparedness and response aims at minimizing adverse effects from the power plant to the values to protect. In the early phase of an accident under consideration here, prompt and sharp actions are necessary to ensure efficacy. On the other hand, the available information on the situation is most limited in this phase such that pre-determined actions based on simple criteria are indispensable. The responsibility for early response actions normally rest with a regional authority which may have some county administrations at subordinate level. The leader of the regional staff has to decide upon protective measures to be implemented at county or municipal level; thus, coherence of the response is ensured at least at a regional level. The decision will be governed at the one side by the existing or predicted radiological situation, on the other side an practical limitations like availability of teams and means. The radiological situation has to be assessed by an advisory team that compiles all information from the utility, the weather conditions, and monitoring results. While the staff leader is experienced through response to major non-nuclear events, the advisors mainly come from the environmental side, having no experience in taking swift decisions in an emergency, but are used to control and prevent. This might be the source of conflicts as observed in several exercises. The radiation protection advisors collect information from the utility, especially about time

  17. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  18. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    Science.gov (United States)

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

  19. Occult pneumothorax in Chinese patients with significant blunt chest trauma: incidence and management.

    Science.gov (United States)

    Lee, Ka L; Graham, Colin A; Yeung, Janice H H; Ahuja, Anil T; Rainer, Timothy H

    2010-05-01

    Occult pneumothorax (OP) is a pneumothorax not visualised on a supine chest X-ray (CXR) but detected on computed tomography (CT) scanning. With increasing CT use for trauma, more OP may be detected. Management of OP remains controversial, especially for patients undergoing mechanical ventilation. This study aimed to identify the incidence of OP using thoracic CT as the gold standard and describe its management amongst Hong Kong Chinese trauma patients. Analysis of prospectively collected trauma registry data. Consecutive significantly injured trauma patients admitted through the emergency department (ED) suffering from blunt chest trauma who underwent thoracic computed tomography (TCT) between in calendar years 2007 and 2008 were included. An OP was defined as the identification (by a specialist radiologist) of a pneumothorax on TCT that had not been previously detected on supine CXR. 119 significantly injured patients were included. 56 patients had a pneumothorax on CXR and a further 36 patients had at least one OP [OP incidence 30% (36/119)]. Bilateral OP was present in 8/36 patients, so total OP numbers were 44. Tube thoracostomy was performed for 8/44 OP, all were mechanically ventilated in the ED. The remaining 36 OP were managed expectantly. No patients in the expectant group had pneumothorax progression, even though 8 patients required subsequent ventilation in the operating room for extrathoracic surgery. The incidence of OP (seen on TCT) in Chinese patients in Hong Kong after blunt chest trauma is higher than that typically reported in Caucasians. Most OP were managed expectantly without significant complications; no pneumothorax progressed even though some patients were mechanically ventilated. (c) 2010 Elsevier Ltd. All rights reserved.

  20. Experience feedback committee in emergency medicine: a tool for security management.

    Science.gov (United States)

    Lecoanet, André; Sellier, Elodie; Carpentier, Françoise; Maignan, Maxime; Seigneurin, Arnaud; François, Patrice

    2014-11-01

    Emergency departments are high-risk structures. The objective was to analyse the functioning of an experience feedback committee (EFC), a security management tool for the analysis of incidents in a medical department. We conducted a descriptive study based on the analysis of the written documents produced by the EFC between November 2009 and May 2012. We performed a double analysis of all incident reports, meeting minutes and analysis reports. During the study period, there were 22 meetings attended by 15 professionals. 471 reported incidents were transmitted to the EFC. Most of them (95%) had no consequence for the patients. Only one reported incident led to the patient's death. 12 incidents were analysed thoroughly and the committee decided to set up 14 corrective actions, including eight guideline writing actions, two staff trainings, two resource materials provisions and two organisational changes. The staff took part actively in the EFC. Following the analysis of incidents, the EFC was able to set up actions at the departmental level. Thus, an EFC seems to be an appropriate security management tool for an emergency department. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  1. Military Personnel: DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database

    Science.gov (United States)

    2017-01-01

    MILITARY PERSONNEL DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database Report to...to DSAID’s system speed and ease of use; interfaces with MCIO databases ; utility as a case management tool; and users’ ability to query data and... Managing Its Sexual Assault Incident Database What GAO Found As of October 2013, the Department of Defense’s (DOD) Defense Sexual Assault Incident

  2. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    Science.gov (United States)

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.

  3. Federal Emergency Management Agency (FEMA) Regions

    Data.gov (United States)

    Department of Homeland Security — Regional Offices manage, operate and maintain all delegated programs, functions and activities not managed, operated or maintained by headquarters organizational...

  4. Challenges of measuring quality in emergency management

    DEFF Research Database (Denmark)

    Lynette, Jennifer Elyse

    2016-01-01

    This paper describes the challenges and importance of measuring quality within the field of emergency response. Using quality as a standard of measurement to evaluate response efforts of trained personnel in emergency situations is necessary to increase effectiveness in the response phase...... of an emergency event. The intended outcome of utilizing quality as a tool of measurement is to save additional lives, property, and resources. The adoption of a system to measure quality can be utilized by multiple professions under the broader field of emergency response services. Quality is discussed in terms...

  5. Serious Games as Experiments for Emergency Management Research : A Review

    NARCIS (Netherlands)

    Van Ruijven, T.W.J.

    2011-01-01

    Serious games and virtual environments are increasingly used for emergency management training and research. The development of these technologies seems to contribute to a solution to some problems in the existing literature on emergency management which is mainly based on case study research.

  6. Management of a radiological emergency. Experience feedback and post-accident management

    International Nuclear Information System (INIS)

    Dubiau, Ph.

    2007-01-01

    In France, the organization of crisis situations and the management of radiological emergency situations are regularly tested through simulation exercises for a continuous improvement. Past severe accidents represent experience feedback resources of prime importance which have led to deep changes in crisis organizations. However, the management of the post-accident phase is still the object of considerations and reflections between the public authorities and the intervening parties. This document presents, first, the nuclear crisis exercises organized in France, then, the experience feedback of past accidents and exercises, and finally, the main aspects to consider for the post-accident management of such events: 1 - Crisis exercises: objectives, types (local, national and international exercises), principles and progress, limits; 2 - Experience feedback: real crises (major accidents, other recent accidental situations or incidents), crisis exercises (experience feedback organization, improvements); 3 - post-accident management: environmental contamination and people exposure, management of contaminated territories, management of populations (additional protection, living conditions, medical-psychological follow up), indemnification, organization during the post-accident phase; 4 - conclusion and perspectives. (J.S.)

  7. Federal Emergency Management Information System (FEMIS) Data Management Guide for FEMIS Version 1.5

    Energy Technology Data Exchange (ETDEWEB)

    Bower, John C.(BATTELLE (PACIFIC NW LAB)); Burnett, Robert A.(BATTELLE (PACIFIC NW LAB)); Carter, Richard J.(BATTELLE (PACIFIC NW LAB)); Holter, Nancy A.(BATTELLE (PACIFIC NW LAB)); Hoza, Mark (BATTELLE (PACIFIC NW LAB)); Johnson, Daniel M.(BATTELLE (PACIFIC NW LAB)); Johnson, Ranata L.(BATTELLE (PACIFIC NW LAB)); Johnson, Sharon M.(BATTELLE (PACIFIC NW LAB)); Loveall, Robert M.(BATTELLE (PACIFIC NW LAB)); Schulze, Stacy A.(BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Wood, Blanche M.(BATTELLE (PACIFIC NW LAB))

    2001-12-01

    The Federal Emergency Management System (FEMIS) is an emergency management planning and response tool. The FEMIS Data Management Guide provides the information needed to manage the data used to support the administrative, user-environment, database management, and operational capabilities of FEMIS.

  8. Mapping Best and Emerging Practices of Project Management

    OpenAIRE

    Thuesen, Christian; Aaris Boas, Charlotte; Thorslund, Michael V.; Marmier, Francois; Grex, Sara; Lybecker, Søren

    2013-01-01

    This paper presents results of a study of the connection between Best and Emerging practices of project management. Drawing upon network mapping as an analytical strategy, cases of Best and Emerging practices is analysed and juxtaposed. The case of Best practice is represented by the newly published ISO 21500 standard and the case for the Emerging practices by a deconstruction of the practices of a group of experienced project managers. The network analysis reveals a substantial difference be...

  9. Care management in nursing within emergency care units

    OpenAIRE

    Roberta Juliane Tono de Oliveira; Patrícia Madalena Vieira Hermida; Fernanda Hannah da Silva Copelli; José Luís Guedes dos Santos; Alacoque Lorenzini Erdmann; Selma Regina de Andrade

    2015-01-01

    Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency se...

  10. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  11. Municipal resilience: A paradigm shift in emergency and continuity management.

    Science.gov (United States)

    Solecki, Greg; Luchia, Mike

    More than a decade of emergency and continuity management vision was instrumental in providing the unprecedented level of response and recovery from the great flood of 2013. Earlier assessments, planning and validation promulgated development of corporate continuity, emergency and contingency plans along with tactical, strategic and recovery operations centres that all led to a reliable emergency management model that will continue to provide the backbone for municipal resilience.

  12. Best practices in managing child and adolescent behavioral health emergencies.

    Science.gov (United States)

    Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M

    2018-01-01

    Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.

  13. Incidence and Cost of Ankle Sprains in United States Emergency Departments

    Science.gov (United States)

    Shah, Shweta; Thomas, Abbey C.; Noone, Joshua M.; Blanchette, Christopher M.; Wikstrom, Erik A.

    2016-01-01

    Background: Ankle sprains represent a common injury in emergency departments, but little is known about common complications, procedures, and charges associated with ankle sprains in emergency departments. Hypothesis: There will be a higher incidence of ankle sprains among younger populations (≤25 years old) and in female patients. Complications and procedures will differ between ankle sprain types. Lateral ankle sprains will have lower health care charges relative to medial and high ankle sprains. Study Design: Descriptive epidemiological study. Level of Evidence: Level 3. Methods: A cross-sectional study of the 2010 Nationwide Emergency Department Sample was conducted. Outcomes such as charges, complications, and procedures were compared using propensity score matching between lateral and medial as well as lateral and high ankle sprains. Results: The sample contained 225,114 ankle sprains. Female patients sustained more lateral ankle sprains (57%). After propensity score adjustment, lateral sprains incurred greater charges than medial ankle sprains (median [interquartile range], $1008 [$702-$1408] vs $914 [$741-$1108]; P sprain of the foot (2.96% vs 0.70%, P ankle sprain events. Among procedures, medial ankle sprains were more likely to include diagnostic radiology (97.91% vs 83.62%, P ankle sprains (0.87% vs 2.79%, P ankle sprains than lateral ankle sprains (24 [6.06%] vs 1 [0.25%], P Ankle sprain emergency department visits account for significant health care charges in the United States. Age- and sex-related differences persist among the types of ankle sprains. Clinical Relevance: The health care charges associated with ankle sprains indicate the need for additional preventive measures. There are age- and sex-related differences in the prevalence of ankle sprains that suggest these demographics may be risk factors for ankle sprains. PMID:27474161

  14. Establishing functional requirements for emergency management information systems

    Energy Technology Data Exchange (ETDEWEB)

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  15. Project plan, Hazardous Materials Management and Emergency Response Training Center: Project 95L-EWT-100

    International Nuclear Information System (INIS)

    Borgeson, M.E.

    1994-01-01

    The Hazardous Materials Management and Emergency Response (HAMMER) Training Center will provide for classroom lectures and hands-on practical training in realistic situations for workers and emergency responders who are tasked with handling and cleanup of toxic substances. The primary objective of the HAMMER project is to provide hands-on training and classroom facilities for hazardous material workers and emergency responders. This project will also contribute towards complying with the planning and training provisions of recent legislation. In March 1989 Title 29 Code of Federal Regulations Occupational Safety and Health Administration 1910 Rules and National Fire Protection Association Standard 472 defined professional requirements for responders to hazardous materials incidents. Two general types of training are addressed for hazardous materials: training for hazardous waste site workers and managers, and training for emergency response organizations

  16. Real-time information support for managing plant emergency responses

    International Nuclear Information System (INIS)

    Cain, D.G.; Lord, R.J.; Wilkinson, C.D.

    1983-01-01

    The Three Mile Island Unit 2 accident highlighted the need to develop a systematic approach to managing plant emergency responses, to identify a better decision-making process, and to implement real-time information support for decision-making. The overall process management function is described and general information requirements for management of plant emergencies are identified. Basic information systems are being incorporated and future extensions and problem areas are discussed. (U.K.)

  17. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  18. 40 ANAESTHETIC MANAGEMENT OF SURGICAL EMERGENCIES ...

    African Journals Online (AJOL)

    drclement

    2009-12-01

    Dec 1, 2009 ... *Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City,. Nigeria ... anaesthesia for emergency surgery. This expose seeks .... and the hospital's capacity for ... planning and clinical prudence in the.

  19. Financial Management: Emergency Steel Loan Guarantee Program

    National Research Council Canada - National Science Library

    2001-01-01

    In a February 1, 2001 letter, you expressed concerns about repayments of federally guaranteed loans by borrowers under the Emergency Steel Loan Guarantee Program and the effect of the program on the U.S. steel industry...

  20. [Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

    Science.gov (United States)

    Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

    2009-06-01

    Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

  1. Mapping Best and Emerging Practices of Project Management

    DEFF Research Database (Denmark)

    Thuesen, Christian; Aaris Boas, Charlotte; Thorslund, Michael V.

    2013-01-01

    This paper presents results of a study of the connection between Best and Emerging practices of project management. Drawing upon network mapping as an analytical strategy, cases of Best and Emerging practices is analysed and juxtaposed. The case of Best practice is represented by the newly...... published ISO 21500 standard and the case for the Emerging practices by a deconstruction of the practices of a group of experienced project managers. The network analysis reveals a substantial difference between the Best and Emerging practices. Only two central concepts where shared namely Communication...... and Planning. Of these two concepts Communication where found to be the most central to both the Emerging and Best practices. The analysis further reveals a soft side of project management that is central in the Emerging practice but absent from the Best practices. Although this soft side might be interpreted...

  2. Recommendations to establish a waste management group for emergency situations

    International Nuclear Information System (INIS)

    Tello, Cledola Cassia Oliveira de; Silva, Eliane Magalhaes Pereira da; Prado, Maria Augusta Silva do

    1997-01-01

    The establishment of a radiation waste group to work in the emergency situations is proposed, as well as the guidelines for its formation. The purpose is to avoid or minimise possible wastes arising from accidents/incidents, and therefore minimise the environmental, economical and social impacts originated from these situations to the present and future generations

  3. The influence of incident management teams on the deployment of wildfire suppression resources

    Science.gov (United States)

    Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson

    2017-01-01

    Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...

  4. Factors affecting fire suppression costs as identified by incident management teams

    Science.gov (United States)

    Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

    2006-01-01

    This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

  5. Coordinated Traffic Incident and Congestion Management (TIM-CM) : Mitigating Regional Impacts of Major Traffic Incidents in the Seattle I-5 Corridor

    Science.gov (United States)

    2018-02-02

    Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...

  6. Developing an incident management system to support Ebola response -- Liberia, July-August 2014.

    Science.gov (United States)

    Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M

    2014-10-17

    The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.

  7. Nuclear emergency management: what is new?

    International Nuclear Information System (INIS)

    Lazo, T.; Mundigl, S.

    2003-01-01

    Through the use of internationally organised, multinational drills, a wealth of experience and knowledge have been gained at both the national and international levels. The lessons learnt primarily concerned the early, urgent-communication phases of nuclear emergencies, and are currently in the process of being consolidated and incorporated into national structures and approaches. The focus of current works is shifting towards later accident phases, particularly to the mid-term phase, when control has been regained of the emergency situation but the accident consequences have yet to be addressed. In addition to these ''classic'' nuclear emergency response interests, since the 11 september 2001 national authorities have been concerned with accident response capabilities in case of terrorist acts that might involve radiation. (A.L.B.)

  8. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are ... Results: Seventy five people were admitted in the acute psychiatric wards during this ... Although the study sample is small and convenience-based, the dearth of ...

  9. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  10. Risk assessment of several incidents in nuclear waste management facilities

    International Nuclear Information System (INIS)

    Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.

    1981-01-01

    Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de

  11. Managing emerging threats to spotted owls

    Science.gov (United States)

    Ho Yi Wan; Joseph L. Ganey; Christina D. Vojta; Samuel A. Cushman

    2018-01-01

    The 3 spotted owl (Strix occidentalis) subspecies in North America (i.e., northern spotted owl [S. o. caurina], California spotted owl [S. o. occidentalis], Mexican spotted owl [S. o. lucida]) have all experienced population declines over the past century due to habitat loss and fragmentation from logging. Now, the emerging influences of climate change, high-severity...

  12. Emergency Evacuation Management Requirements and Concepts

    Science.gov (United States)

    1981-05-01

    state government would assert positive leadership , motivate the public, and issue emergency directives. In other words, local officials assume...feasible way to implement such a program is for FEMA to assume leadership through subordinate units considered relevant and prestigous. Active...Supply and Organizations and recruits Organizations control per- D&C and organizatins ronitor Distribution control operations. ations. and reallocate

  13. Current management of surgical oncologic emergencies

    NARCIS (Netherlands)

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    OBJECTIVES: For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for

  14. Basic management of medical emergencies: recognizing a patient's distress.

    Science.gov (United States)

    Reed, Kenneth L

    2010-05-01

    Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

  15. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira

    2015-12-01

    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  16. Care management in nursing within emergency care units.

    Science.gov (United States)

    Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma

    2015-12-01

    Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  17. Tactical training of emergency management - the MUSTER concept

    International Nuclear Information System (INIS)

    Andersen, Verner.

    1996-08-01

    The efficiency with which complex, large-scale organisations respon d to emergencies and critical situations depends crucially on the co-ordination of actions and communication among decision makers. However, decision makers have typically few opportunities to train distributed crisis management under artificial, yet realistic conditions; and at the same time, real emergencies occur fortunately so relatively infrequently that few decision makers have a chance of establishing a useful real-life experience of crisis management. There is therefore a need for having available realistic and flexible multi-user training environments in which co-ordinated response to crises or emergencies may be trained. The objective of the MUSTER project (Multi-User System for Training and Evaluating Environmental Emergency Response) is to produce specifications for a training system supporting collaborative training and evaluation directed to the special needs of environmental emergency management. The MUSTER project was partially funced by CEC

  18. Strategic aspects of nuclear and radiological emergency management

    International Nuclear Information System (INIS)

    Ahier, B.

    2010-01-01

    Emergency situations demand that actions be taken by responsible organisations in a timely and effective manner to mitigate consequences for the population, infrastructure and the environment, and to support the return of affected areas to normal social and economic activity to the extent possible. To deliver an effective response over the emergency management time-line, it is necessary to make, maintain and exercise adequate plans and arrangements in advance of an emergency situation. These must contain appropriate elements and resources for preparedness, response and assistance to identified threats, recognize and include all implicated partners, and take account of international interfaces. Effective management of complex emergency situations that can lead to a wide range of consequences and involve multiple organisations at the local, national and international levels also requires anticipation of the range of decision-making needs, an understanding of the interactions between response organisations and a model for their co-ordination. Experience from managing emergency situations has shown that the integration of these factors into emergency preparedness and response arrangements should be based on a guiding strategic vision. Emergency response is a dynamic process that develops in time from a situation of little information to one of potentially overwhelming information. Within this context, emergency response organisations must be able to respond in an appropriate and timely manner at any point along the emergency management time-line. This will be facilitated by an overarching framework to guide the decision-making process. To contribute to work in this area, the NEA Committee on Radiation Protection and Public Health (CRPPH) Working Party on Nuclear Emergency Matters (WPNEM) reviewed its collective experience to extract key themes that could form a strategy for improving decision-making in emergency management. This focused on the NEA International Nuclear

  19. The effect of Ramadan fast on the incidence of renal colic emergency department visits.

    Science.gov (United States)

    Sagy, I; Zeldetz, V; Halperin, D; Abu Tailakh, M; Novack, V

    2017-09-01

    Renal colic (RC) is one of the most common reasons for emergency department (ED) visits. Although RC is associated with high ambient temperature and with physiological changes that occur during fast, the literature on between Ramadan and RC incidence is scarce. To investigate the association of ED visits with RC during Ramadan fast. We obtained health data of patients visited the ED of a large tertiary centre during the years 2004-15, with a primary diagnosis of RC. To estimate the association of RC and Ramadan, we utilized bi-weekly RC incidence Poisson models adjusted for ambient temperature and seasonality in two ethnic groups residing in the region: Muslims and Jews. We identified 10 435 unique patients with 18 163 ED visits with primary diagnosis of RC. Although Muslims represent 18.5% of the population in the region, approximately 25% of the ED visits with RC attributed to this group. There was a positive and significant association of temperature and ED visits within all subgroups after adjusting for seasons. Positive association with Ramadan was observed during the first 2 weeks of fast within Muslims (R.R 1.27, 95% C.I 1.03-1.50) but not within Jewish community (R.R 1.061, 95% C.I 0.855-1.238). Our study demonstrates a significant and positive association between RC and Ramadan, while controlling to ambient temperature. In view of these findings, different prevention strategies should be investigated. © The Author 2017. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. A governor's guide to emergency management. Volume two : homeland security

    Science.gov (United States)

    2002-09-19

    Homeland security is a complex challenge that demands significant investment; collaboration among local, state, and federal governments; and integration with the private sector. The purpose of A Governor's Guide to Emergency Management Volume Two: Ho...

  1. Factors affecting the organization and management of emergency ...

    African Journals Online (AJOL)

    Factors affecting the organization and management of emergency mass casualty ... service all under a unified command of leadership with a specified job description. Factors identified were: Political will, human resource planning, appropriate ...

  2. Real-time emergency forecasting technique for situation management systems

    Science.gov (United States)

    Kopytov, V. V.; Kharechkin, P. V.; Naumenko, V. V.; Tretyak, R. S.; Tebueva, F. B.

    2018-05-01

    The article describes the real-time emergency forecasting technique that allows increasing accuracy and reliability of forecasting results of any emergency computational model applied for decision making in situation management systems. Computational models are improved by the Improved Brown’s method applying fractal dimension to forecast short time series data being received from sensors and control systems. Reliability of emergency forecasting results is ensured by the invalid sensed data filtering according to the methods of correlation analysis.

  3. A Model of Workflow Composition for Emergency Management

    Science.gov (United States)

    Xin, Chen; Bin-ge, Cui; Feng, Zhang; Xue-hui, Xu; Shan-shan, Fu

    The common-used workflow technology is not flexible enough in dealing with concurrent emergency situations. The paper proposes a novel model for defining emergency plans, in which workflow segments appear as a constituent part. A formal abstraction, which contains four operations, is defined to compose workflow segments under constraint rule. The software system of the business process resources construction and composition is implemented and integrated into Emergency Plan Management Application System.

  4. Intelligent web data management software architectures and emerging technologies

    CERN Document Server

    Ma, Kun; Yang, Bo; Sun, Runyuan

    2016-01-01

    This book presents some of the emerging techniques and technologies used to handle Web data management. Authors present novel software architectures and emerging technologies and then validate using experimental data and real world applications. The contents of this book are focused on four popular thematic categories of intelligent Web data management: cloud computing, social networking, monitoring and literature management. The Volume will be a valuable reference to researchers, students and practitioners in the field of Web data management, cloud computing, social networks using advanced intelligence tools.

  5. Incidence, admission rates, and economic burden of pediatric emergency department visits for urinary tract infection: data from the nationwide emergency department sample, 2006 to 2011.

    Science.gov (United States)

    Sood, Akshay; Penna, Frank J; Eleswarapu, Sriram; Pucheril, Dan; Weaver, John; Abd-El-Barr, Abd-El-Rahman; Wagner, Jordan C; Lakshmanan, Yegappan; Menon, Mani; Trinh, Quoc-Dien; Sammon, Jesse D; Elder, Jack S

    2015-10-01

    The Emergency Department (ED) is being increasingly utilized as a pathway for management of acute conditions such as the urinary tract infections (UTIs). We sought to assess the contemporary trends in pediatric UTI associated ED visits, subsequent hospitalization, and corresponding financial expenditure, using a large nationally representative pediatric cohort. Further, we describe the predictors of admission following a UTI associated ED visit. The Nationwide Emergency Department Sample (NEDS; 2006-2011) was queried to assess temporal-trends in pediatric (age ≤17 years) ED visits for a primary diagnosis of UTI (ICD9 CM code 590.X, 595.0, and 599.0), subsequent hospital admission, and total charges. These trends were examined using the estimated annual percent change (EAPC) method. Multivariable regression models fitted with generalized estimating equations (GEE) identified the predictors of hospital admission. Of the 1,904,379 children presenting to the ED for management of UTI, 86 042 (4.7%) underwent hospital admission. Female ED visits accounted for almost 90% of visits and increased significantly (EAPC 3.28%; p = 0.003) from 709 visits per 100 000 in 2006 to 844 visits per 100 000 in 2011. Male UTI incidence remained unchanged over the study-period (p = 0.292). The overall UTI associated ED visits also increased significantly during the study-period (EAPC 3.14%; p = 0.006) because of the increase in female UTI associated ED visits. Overall hospital admissions declined significantly over the study-period (EAPC -5.59%; p = 0.021). Total associated charges increased significantly at an annual rate of 18.26%, increasing from 254 million USD in 2006 to 464 million USD in 2011 (p predictors of admission included younger age (p pediatric UTI is on the rise. This rise in incidence could be due to several factors, including increasing prevalence of metabolic conditions such as obesity, diabetes and metabolic syndrome in children predisposing them to infections, or

  6. Resuscitation and emergency management for neonatal foals.

    Science.gov (United States)

    Corley, Kevin T T; Axon, Jane E

    2005-08-01

    Early intervention can dramatically alter outcome in foals. Cardio-pulmonary cerebral resuscitation can be successful and clinically worthwhile when applied to foals that arrest as part of the birthing process. Readily available equipment and an ordered plan starting with addressing the respiratory system (airway and breathing) followed by the circulatory system (circulation and drugs) are the keys to success. Hypoglycemia is common in foals that are not nursing and in septic foals. Support of serum glucose can be an important emergency treatment. Respiratory support with oxygen therapy should be considered in all foals following resuscitation and dystocia. Other foals that are likely to benefit from oxygen are those that are dyspneic, cyanotic, meconium-stained after birth,or recumbent. Emergency therapies, applied correctly, are expected to result in decreased mortality and morbidity.

  7. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    enforcement standards and guides identified the following four guides as having content that supports incident management: • TE-02-02 Guide to Radio Communications Interoperability Strategies and Products • OSHA 335-10N Preparing and Protecting Security Personnel in Emergencies • NIJ 181584 Fire and Arson Scene Evidence: A Guide for Public Safety Personnel • NIJ 181869 A Guide for Explosion and Bombing Scene Investigation In conversations with various state and local law enforcement officials, it was determined that the following National Fire Protection Association (NPFA) standards are generally recognized and tend to be universally used by law enforcement organizations across the country: • NFPA 1600 Standard on Disaster/Emergency Management and Business Continuity Programs • NFPA 1561 Standard on Fire Department Incident Management Systems • NFPA 472 Standard for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents (2008 Edition) • NFPA 473 Standard for Competencies for EMS Personnel Responding to Hazardous Materials/Weapons of Mass Destruction Incidents (2008 Edition)

  8. Working relationships between obstetric care staff and their managers: a critical incident analysis.

    Science.gov (United States)

    Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish

    2016-08-26

    Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi's disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres' providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers' lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers' job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.

  9. [Telematics equipment for poison control surveillance. Its applications in the health management of relevant chemical incidents].

    Science.gov (United States)

    Butera, R; Locatelli, C; Gandini, C; Minuco, G; Mazzoleni, M C; Giordano, A; Zanuti, M; Varango, C; Petrolini, V; Candura, S M; Manzo, L

    1997-01-01

    Health management of major chemical incidents requires a close collaboration between rescuers (on the disaster site and in the emergency department) and the poison center. The study tested telematic technologies allowing telepresence and teleconsulting, a real time and continuous connection among health care personnel and toxicologists involved in the management of the emergency. The link between the poison center (PC) and the emergency department in the local hospital is provided by a ISDN operating video conferencing system, while the data transmission from the site of the accident to the PC is achieved with a personal computer and GSM cellular data transmission. Toxicological databases and risk assessment software are integrated in the system, to support information sharing. To test such instruments in operative nearly realistic conditions, the main phase of the study has implemented simulated chemical disasters in different locations in Italy. Instruments for telepresence and teleconsulting have been effectively utilized to evaluate from a remote location the scenario and the severity of the accident, by inspecting either specific details or the whole scene, to enable PC guiding the triage of the victims before and after hospitalization, to utilize and share data, such as intervention protocols or patient records, and to document all the activities. In summary, this experience shows that the telematic link allows the toxicologists of the poison center to rapidly understand the situation, and to correctly learn about the conditions of patients with the help of images. The results of this study indicate the valuable benefits of telematic instruments for the health care in case of major chemical disasters occurring in a remote geographical location or in an area which lacks local toxicological experts, where specialized expertise can be achieved by the use of telematic technologies.

  10. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    Science.gov (United States)

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  11. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  12. Emergency management in nuclear power plants: a regulatory view

    International Nuclear Information System (INIS)

    Shukla, Vikas; Chander, Vipin; Vijayan, P.; Nair, P.S.; Krishnamurthy, P.R.

    2011-01-01

    The nuclear power plants in India adopts a high level of defence in depth concept in design and operates at highest degree of safety, however the possibility of nuclear accidents cannot be ruled out. The safety and regulatory review of Nuclear Power Plants (NPPs) in India are carried out by Atomic Energy Regulatory Board (AERB). Section 33 of Atomic Energy (Radiation Protection) Rules-2004 provides the basic requirements of emergency preparedness aspects for a nuclear facility. Prior to the issuance of a license for the operation of NPPs, AERB ensures that the site specific emergency response manuals are in place and tested. The emergency response plan includes the emergency response organization, their responsibilities, the detailed scheme of emergency preparedness, response, facilities, equipments, coordination and support of various organizations and other technical aspects. These emergency preparedness plans are tested at periodic interval to check the overall effectiveness. The plant and site emergency exercise is handled by the plant authorities as per the site emergency plan. The events with off-site consequences are handled by the district authorities according to the off-site emergency plan. In off-site emergency exercises, observers from AERB and other associated organizations participate. Observations of the participants are discussed in the feedback session of the exercise for their disposition. This paper reviews the current level of emergency planning and preparedness, statistics of emergency exercises conducted and their salient findings. The paper highlights improvement in the emergency management programme over the years including development of advance technical support systems. The major challenges in off-site emergency management programme such as industrial growth and increase in population within the sterilized zone, frequent transfer of district officials and the floating population around the NPPs are outlined. The areas for improvement in

  13. Experts' Perceptions on China's Capacity to Manage Emerging and Re-emerging Zoonotic Diseases in an Era of Climate Change.

    Science.gov (United States)

    Hansen, A; Xiang, J; Liu, Q; Tong, M X; Sun, Y; Liu, X; Chen, K; Cameron, S; Hanson-Easey, S; Han, G-S; Weinstein, P; Williams, C; Bi, P

    2017-11-01

    Zoonotic diseases transmitted by arthropods and rodents are a major public health concern in China. However, interventions in recent decades have helped lower the incidence of several diseases despite the country's large, frequently mobile population and socio-economic challenges. Increasing globalization, rapid urbanization and a warming climate now add to the complexity of disease control and prevention and could challenge China's capacity to respond to threats of emerging and re-emerging zoonoses. To investigate this notion, face-to-face interviews were conducted with 30 infectious disease experts in four cities in China. The case study diseases under discussion were malaria, dengue fever and haemorrhagic fever with renal syndrome, all of which may be influenced by changing meteorological conditions. Data were analysed using standard qualitative techniques. The study participants viewed the current disease prevention and control system favourably and were optimistic about China's capacity to manage climate-sensitive diseases in the future. Several recommendations emerged from the data including the need to improve health literacy in the population regarding the transmission of infectious diseases and raising awareness of the health impacts of climate change amongst policymakers and health professionals. Participants thought that research capacity could be strengthened and human resources issues for front-line staff should be addressed. It was considered important that authorities are well prepared in advance for outbreaks such as dengue fever in populous subtropical areas, and a prompt and coordinated response is required when outbreaks occur. Furthermore, health professionals need to remain skilled in the identification of diseases for which incidence is declining, so that re-emerging or emerging trends can be rapidly identified. Recommendations such as these may be useful in formulating adaptation plans and capacity building for the future control and

  14. Psychiatric boarding incidence, duration, and associated factors in United States emergency departments.

    Science.gov (United States)

    Nolan, Jason M; Fee, Christopher; Cooper, Bruce A; Rankin, Sally H; Blegen, Mary A

    2015-01-01

    Boarding, especially among psychiatric patients, has been characterized as a significant cause of ED crowding, but no quantitative analysis has described boarding nationally. This study determines the incidence, duration, and factors associated with ED boarding in the United States. 2008 National Hospital Ambulatory Medical Care Survey ED data were stratified by visit type (psychiatric vs. non-psychiatric), boarding status, and patient and hospital characteristics. Boarding was defined as a visit with an ED length of stay >6 hours, and boarding time as ED length of stay minus 6 hours. Pearson's chi-square tests describe hospital and patient characteristics stratified by boarding status. Multilevel multivariable logistic and linear regressions determine associations with boarding and boarding time. While 11% of all ED patients boarded, 21.5% of all psychiatric ED patients boarded. Boarding was also more prolonged for psychiatric ED patients. Controlling for confounders, odds of boarding for psychiatric patients were 4.78 (2.63-8.66) times higher than non-psychiatric, and psychiatric patients boarded 2.78 (1.91-3.64) hours longer than non-psychiatric. US EDs experienced high proportions and durations of boarding with psychiatric patients disproportionately affected. Additional research concerning mental health care services and legislation may be required to address ED psychiatric patient boarding. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  15. WHY DO COMPANIES FROM EMERGING COUNTRIES MANAGE EARNINGS?

    Directory of Open Access Journals (Sweden)

    Susana Callao

    2017-06-01

    Full Text Available This paper provides evidence in terms of the incentives which lead managers from emerging European countries to manage earnings. In particular, we focused on four Eastern European countries: the Czech Republic, Poland, Hungary and Slovakia, as the majority of studies on earnings management in developing countries were based on the Asian emerging market. The market of developing European countries is still barely explored. After we confirmed that managers from emerging European companies manage earnings, we find that within the different incentives which lead managers to earnings management, the avoidance of debt covenants violations is a strong incentive for managers. Additionally, those firms considered as poor investments (with less value have incentives to manage earnings down as a consequence to opt for market niche. Moreover, emerging Eastern European companies have incentives to flatten earnings of current periods in order to benefit in the future as the source of future nonmanipulated earnings will be insufficient, as they may expect reduced, or at least lower future performance of their companies affected by increasing global competition. Finally, we confirm that privately-owned companies tend to maximize accounting earnings more than state-owned companies because they are in a weaker position related to a specific political and historical factors.

  16. Emergency Anaesthetic Management of Extensive Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    H C Chandola

    2007-01-01

    Full Text Available High speed vehicles, drug abuse, alcohol and easy availability of handguns are the main reasons of increasing number of trauma especially thoracic trauma. Anaesthesiologist plays an important role in the management of extensive thoracic trauma. Thoracic trauma, penetrating or blunt, may cause damage to organs suspended in thorax viz. pleura, lungs, heart, great vessels, trachea and oesophagus. It may lead to pneumothorax, cardiac tamponade or life threatening haemorrhage. With aggressive care and management of these factors, majority of patients can survive and return to normal life.

  17. Multiple Trauma and Emergency Room Management.

    Science.gov (United States)

    Frink, Michael; Lechler, Philipp; Debus, Florian; Ruchholtz, Steffen

    2017-07-24

    The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016. The goal of initial emergency room care is the rapid recognition and prompt treatment of acutely life-threatening injuries in the order of their priority. The initial assessment includes physical examination and ultrasonography according to the FAST concept (Focused Assessment with Sonography in Trauma) for the recognition of intraperitoneal hemorrhage. Patients with penetrating chest injuries, massive hematothorax, and/or severe injuries of the heart and lungs undergo emergency thoracotomy; those with signs of hollow viscus perforation undergo emergency laparotomy. If the patient is hemo - dynamically stable, the most important diagnostic procedure that must be performed is computerized tomography with contrast medium. Therapeutic decision-making takes the patient's physiological parameters into account, along with the overall severity of trauma and the complexity of the individual injuries. Depending on the severity of trauma, the immediate goal can be either the prompt restoration of organ structure and function or so-called damage control surgery. The latter focuses, in the acute phase, on hemostasis and on the avoidance of secondary damage such as intra-abdominal contamination or compartment syndrome. It also involves the temporary treatment of fractures with external fixation and the planning of definitive care once the patient's organ functions have been securely stabilized. The care of the severely injured patient should be performed in structured fashion according to the

  18. Conceptual design of the national nuclear emergency management information system

    International Nuclear Information System (INIS)

    Wang Xingyu; Shi Zhongqi

    2003-01-01

    A Conceptual Design of the National Nuclear Emergency Management Information System was brought forward in this paper, based on the summarization of some emergency management information systems used in China and some other countries. The conceptual system should have four basic characteristics, that are (1) a graphic displaying and querying interface based on GIS (2) data and results shared with the assessment software of nuclear accident (3) a complete set of databases and (4) the capability of on-line data receiving or real-time distributing of the commands and information for emergency response

  19. NKA/INF: A project on emergency management

    International Nuclear Information System (INIS)

    Jakobsson, S.; Brehmer, B.

    1990-01-01

    The paper describes the development of a prototype emergency management system for the nuclear sector (project started in 1985 by the Nordic liaison committee for atomic energy). Two prototype systems have been implemented, one for on-site and one for off-site. The intended users of the systems are the plant emergency manager on-site and the chief of staff of the county emergency centre off-site. The proto-types are implemented in Lisp on Symbolics workstations using WIMP (windows, icons, menus and pointing) interface techniques

  20. Pediatric wound care and management in the emergency department [digest].

    Science.gov (United States)

    Sanders, Jennifer E; Pade, Kathryn H

    2017-10-23

    Traumatic wounds and lacerations are common pediatric presenting complaints to emergency departments. Although there is a large body of literature on wound care, many emergency clinicians base management of wounds on theories and techniques that have been passed down over time. Therefore, controversial, conflicting, and unfounded recommendations are prevalent. This issue reviews evidence-based recommendations for wound care and management, including wound cleansing and irrigation, anxiolysis/sedation techniques, closure methods, and post-repair wound care. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  1. [Impact on the improvement of paediatric emergency services using a standardised model for the declaration and analysis of incidents].

    Science.gov (United States)

    Vilà de Muga, M; Serrano Llop, A; Rifé Escudero, E; Jabalera Contreras, M; Luaces Cubells, C

    2015-10-01

    The aim of this study is to analyse changes in the incidents reported after the implementation of a new model, and study its results on patient safety. In 2012 an observational study with prospective collection of incidents reported between 2007 and 2011 was conducted. In May 2012 a model change was made in order to increase the number of reports, analyse their causes, and improve the feedback to the service. Professional safety representatives were assigned to every department, information and diffusion sessions were held, and a new incident reporting system was implemented. With the new model, a new observational study with prospective collection of the reports during one year was initiated, and the results compared between models. In 2011, only 19 incidents were reported in the Emergency Department, and between June 1, 2012 to June 1, 2013, 106 incidents (5.6 times more). The incidents reported were medication incidents (57%), identification (26%), and procedures (7%). The most frequent causes were human (70.7%), lack of training (22.6%), and working conditions (15.1%). Some measures were implemented as a result of these incidents: a surgical checklist, unit doses of salbutamol, tables of weight-standardised doses of drugs for cardiopulmonary resuscitation. The new model of reporting incidents has enhanced the reports and has allowed improvements and the implementation of preventive measures, increasing the patient safety in the Emergency Department. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  2. The Critical Incident Technique in Library and Information Management Research.

    Science.gov (United States)

    Fisher, Shelagh; Oulton, Tony

    1999-01-01

    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  3. Defining Incident Management Processes for CSIRTs: A Work in Progress

    Science.gov (United States)

    2004-10-01

    royalty -free government-purpose license to use, duplicate, or disclose the work, in whole or in part and in any manner, and to have or permit others to...Methodology of Incident Handling.” InfoSecurity 2001 Conference Program. Malaysian National Computer Confederation, 2001. 22 CMU/SEI-2004-TR-015

  4. Incidence and management of pancreatic leakage after pancreatoduodenectomy

    NARCIS (Netherlands)

    de Castro, S. M. M.; Busch, O. R. C.; van Gulik, T. M.; Obertop, H.; Gouma, D. J.

    2005-01-01

    Background: Optimal management of severe pancreatic leakage after pancreatoduodenectomy can reduce morbidity and mortality. Completion pancreatectomy may be adequate but leads to endocrine insufficiency. This study evaluated an alternative management strategy for pancreatic leakage. Methods: Outcome

  5. Managing patients with oncologic complications in the emergency department [digest].

    Science.gov (United States)

    Wacker, David; McCurdy, Michael T; Nusbaum, Jeffrey; Gupta, Nachi

    2018-01-22

    As the prevalence of cancer continues to increase in the general population and improvements in cancer treatment prolong survival, the incidence of patients presenting to the emergency department with oncologic complications will, similarly, continue to rise. This issue reviews 3 of the more common presentations of oncology patients to the emergency department: metastatic spinal cord compression, tumor lysis syndrome, and febrile neutropenia. Signs and symptoms of these conditions can be varied and nonspecific, and may be related to the malignancy itself or to an adverse effect of the cancer treatment. Timely evidence-based decisions in the emergency department regarding diagnostic testing, medications, and arrangement of disposition and oncology follow-up can significantly improve a cancer patient's quality of life. [Points & Pearls is a digest of Emergency Medicine Practice.].

  6. Approaches to emergency management teaching at the master's level.

    Science.gov (United States)

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  7. Emergency airway management with laryngeal mask airway

    African Journals Online (AJOL)

    2009-12-01

    Dec 1, 2009 ... management and as a ventilatory device during anesthesia. It is concluded that ... minutes with a tight fitting face mask and a closed system; and 0.6 mg of ... In the operating suite, intravenous access was secured and saline ...

  8. Appraisal of Scientific Resources for Emergency Management.

    Science.gov (United States)

    1983-09-01

    scientific, technical, and management skills. These included entomology , toxicology, public health, environmental impact analysis, economic analysis...Legionnaire’s Disease, Microbiology, chemical analysis & epidem- 1976 iology studies essential. 7. Medfly Controversy, 1981 Entomology , toxicology...Analytical 2. Inorganic 3. Organic 4. Physical 5. Nuclear 6. Forensic 7. Ordnance 8. Drugs 9. Narcotics 10. Chemical Warfare Agents 11. Insecticides

  9. Social Media in Emergency Management: Capability Assessment

    Science.gov (United States)

    2014-05-01

    pushed to them; and partnering with citizen groups, NGOs, industry and local businesses to: recruit and manage volunteers; bridge expertise and capacity...innovative mesh network solutions [48]. The partnerships that FEMA has built with the private sector also played an important role. Cisco Systems, for

  10. Emergency Department Management of Delirium in the Elderly

    Directory of Open Access Journals (Sweden)

    Lynn E.J. Gower, DO

    2012-05-01

    Full Text Available An increasing number of elderly patients are presenting to the emergency department. Numerousstudies have observed that emergency physicians often fail to identify and diagnose delirium in theelderly. These studies also suggest that even when emergency physicians recognized delirium, theystill may not have fully appreciated the import of the diagnosis. Delirium is not a normal manifestation ofaging and, often, is the only sign of a serious underlying medical condition. This article will review thesignificance, definition, and principal features of delirium so that emergency physicians may betterappreciate, recognize, evaluate, and manage delirium in the elderly.

  11. Analysis of Emergency Information Management Research Hotspots Based on Bibliometric and Co-occurrence Analysis

    Directory of Open Access Journals (Sweden)

    Zou Qingyun

    2017-04-01

    Full Text Available [Purpose/significance] Emergency information management is an interdisciplinary field of emergency management and information management. Summarizing the major research output is helpful to strengthen the effective utilization of information resources in emergency management research, and to provide references for the follow-up development and practical exploration of emergency information management research. [Method/process] By retrieving concerned literature from CNKI, this paper used the bibliometric and co-word clustering analysis methods to analyze the domestic emergency management research output. [Result/conclusion] Domestic emergency information management research mainly focuses on five hot topics: disaster emergency information management, crisis information disclosure, emergency information management system, emergency response, wisdom emergency management. China should strengthen the emergency management information base for future theoretical research, and build the emergency information management theoretical framework.

  12. Operation Windshield and the simplification of emergency management.

    Science.gov (United States)

    Andrews, Michael

    2016-01-01

    Large, complex, multi-stakeholder exercises are the culmination of years of gradual progression through a comprehensive training and exercise programme. Exercises intended to validate training, refine procedures and test processes initially tested in isolation are combined to ensure seamless response and coordination during actual crises. The challenges of integrating timely and accurate situational awareness from an array of sources, including response agencies, municipal departments, partner agencies and the public, on an ever-growing range of media platforms, increase information management complexity in emergencies. Considering that many municipal emergency operations centre roles are filled by staff whose day jobs have little to do with crisis management, there is a need to simplify emergency management and make it more intuitive. North Shore Emergency Management has accepted the challenge of making emergency management less onerous to occasional practitioners through a series of initiatives aimed to build competence and confidence by making processes easier to use as well as by introducing technical tools that can simplify processes and enhance efficiencies. These efforts culminated in the full-scale earthquake exercise, Operation Windshield, which preceded the 2015 Emergency Preparedness and Business Continuity Conference in Vancouver, British Columbia.

  13. Computer technologies for industrial risk prevention and emergency management

    International Nuclear Information System (INIS)

    Balduccelli, C.; Bologna, S.; Di Costanzo, G.; Vicoli, G.

    1996-07-01

    This document provides an overview about problems related to the engineering of computer based systems for industrial risk prevention and emergency management. Such systems are rather complex and subject to precise reliability and safety requirements. With the evolution of informatic technologies, such systems are becoming to be the means for building protective barriers for reduction of risk associated with plant operations. For giving more generality to this document, and for not concentrating on only a specific plant, the emergency management systems will be dealt with more details than ones for accident prevention. The document is organized in six chapters. Chapter one is an introduction to the problem and to its state of art, with particular emphasis to the aspects of safety requirements definition. Chapter two is an introduction to the problems related to the emergency management and to the training of operators in charge of this task. Chapter three deals in details the topic of the Training Support Systems, in particular about MUSTER (multi-user system for training and evaluation of environmental emergency response) system. Chapter four deals in details the topic of decision support systems, in particular about ISEM (information technology support for emergency management) system. Chapter five illustrates an application of support to the operators of Civil Protection Department for the management of emergencies in the fields of industrial chemical. Chapter six is about a synthesis of the state of art and the future possibilities, identifying some research and development activities more promising for the future

  14. Managing emerging and conflicting groupware use in organisations

    DEFF Research Database (Denmark)

    Nicolajsen, Hanne Westh

    2008-01-01

    In this paper, the need for management of emerging groupware use is proposed. It is argued that allowing for distributed innovation in use is needed to get the best out of a new groupware system. However, allowing for distributed and thus local innovations of groupware use necessitates management...

  15. The emergence and change of management accounting routines

    NARCIS (Netherlands)

    van der Steen, M.P.

    2011-01-01

    Purpose - The purpose of this paper is to explore the dynamics involved in the emergence and change of management accounting routines. It seeks to provide an understanding of the ways in which these complex routines foster stability and change in management accounting practices.

  16. Perception and processing of information relevant to critical incidents and emergencies

    International Nuclear Information System (INIS)

    Dombrowsky, W.R.

    1997-01-01

    Based on the results of empirical research, which implemented and evaluated information to the public requested by law (HIO-Paragraph-11a) and based on the general findings of crisis- and risk-communication research, some disturbing elements in the relationship between entrepreneurs, administration and the public will be described in terms of cognitive dissonance, prejudice, fears and false expectations. The empirical example of public information in emergencies will evidence the conflicting views on types, styles, size and profoundity of such information as well as the differences in perception, motivation and interest of all parties involved. Finally, the cultural context of risk perception and of coping capabilities will be interrelated with historical changes of risk-management to prepare for the understanding that risk- and crisis communication has to be more than talking about safety. (orig.) [de

  17. Responses to professional identity threat: Identity management strategies in incident narratives of health care professionals.

    Science.gov (United States)

    van Os, Annemiek; de Gilder, Dick; van Dyck, Cathy; Groenewegen, Peter

    2015-01-01

    The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat. The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives. The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison. The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care. The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents. This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.

  18. Prudency reviews, cash management issues emerge

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    Utility management is paying increasing attention to the broadening of regulatory commission prudency reviews to cover operating generating plants as well as those under construction. Utilities can expect a prudency review after a major outage, and should investigate the possibility for legal action against a third party or be prepared to defend itself. The Shoreham nuclear plant serves as a warning to utilities of the need for on-going documentation of cost-benefit analyses conducted during the construction period. Utility managers should demand a prudency standard from their regulators, and minority owners in large projects should make independent prudency findings. There is also a growing need for utilities to develop intelligent strategies for handling excess cash. Methods for handling cash flow include the financial investment, grid refurbishment, dividend payout, decapitalization, and diversification

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

    International Nuclear Information System (INIS)

    Ohlenschlaeger, L.

    1981-03-01

    Medical measures in case of radiation damages are discussed on the basis of five potential categories of radiation incidents and accidents, respectively, viz. contaminations, incorporations, external local and general radiation over-exposures, contaminated wounds, and combinations of radiation damages and conventional injuries. Considerations are made for diagnostic and therapeutic initial measures especially in case of minor and moderate radiation accidents. The medical emergency planning is reviewed by means of definations used in the practical handling of incidents or accidents. The parameters are: extent of the incident or accident, number of persons involved, severity of radiation damage. Based on guiding symptoms the criteria for the classification into minor, moderate or severe radiation accidents are discussed. Reference is made to the Medical Radiation Protection Centers existing in the Federal Republic of Germany and the possibility of getting advices in case of radiation incidents and accidents. (orig.) [de

  20. Nuclear emergency preparedness and management the international nuclear emergency exercise Inex 2000

    International Nuclear Information System (INIS)

    Mundigl, St.

    2003-01-01

    With the initiation of the first international nuclear emergency exercise INEX 1, performed as a table-top exercise in 1993, the international community tested, for the first time, approaches and policies in place to manage a nuclear or radiological emergency. INEX 1 with its related workshops led to a wealth of lessons learned and to an improvement in nuclear emergency management. The INEX 2 exercise series, initiated by the NEA and performed between 1996 and 1999, established an international nuclear emergency 'exercise culture' leading to a clear improvement of the international aspects of nuclear emergency preparedness and management. INEX 2 was a series of four command post exercises based on national nuclear emergency exercises in Switzerland, Finland, Hungary and Canada. Simulated accidents at nuclear power plants were used to test existing procedures in emergency response and management, and to analyse local, regional, national and international emergency plans under realistic conditions. In addition, the exercises allowed the participating countries to gain experience using new concepts and tools. The most significant result of INEX 2 and a major step forward in nuclear emergency management was the development of a new communication and information exchange strategy, which is currently implemented by various NEA member countries as well as by the international community in general. The objective of this new strategy is to assist the decision-maker by improving the selection of the data transmitted, by encouraging the transmission and reception of such data and information using modern communication methods, e.g. secure world wide web technologies, and by defining emergency monitoring and modelling needs. To test the validity and usefulness of the newly-developed strategy, the NEA proposed to organize an international nuclear emergency exercise, INEX 2000, similar in scope to the INEX 2 exercises. In addition, the NEA suggested to include, for the first

  1. Emergency managers as change agents: recognizing the value of management, leadership, and strategic management in the disaster profession.

    Science.gov (United States)

    Urby, Heriberto; McEntire, David A

    2015-01-01

    This article discusses the influence of management theory, some principles of leadership, four strategic management considerations, that are applied to emergency management, allow emergency managers to transform their followers, organizations, and communities at large. The authors argue that in the past there has been little recognition of the value, or application, of these three areas of emphasis in the disaster profession. Using more of these principles, emergency managers may transform into transformational change agents who make a difference in their followers' lives, who themselves transform other people and improve emergency management.

  2. The Evolution of Public Health Emergency Management as a Field of Practice.

    Science.gov (United States)

    Rose, Dale A; Murthy, Shivani; Brooks, Jennifer; Bryant, Jeffrey

    2017-09-01

    The health impacts of recent global infectious disease outbreaks and other disasters have demonstrated the importance of strengthening public health systems to better protect communities from naturally occurring and human-caused threats. Public health emergency management (PHEM) is an emergent field of practice that draws on specific sets of knowledge, techniques, and organizing principles necessary for the effective management of complex health events. We highlight how the nascent field of PHEM has evolved in recent years. We explore this development by first examining multiple sites of intersection between the fields of public health and emergency management. We then analyze 2 of the principal pillars on which PHEM was built: organizational and programmatic (i.e., industry) standards and the incident management system. This is followed by a sketch of the key domains, or functional areas, of PHEM and their application to the emergency management cycle. We conclude with some observations about PHEM in a global context and discuss how the field might continue to evolve.

  3. Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

    Science.gov (United States)

    Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

    2015-01-01

    Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

  4. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    Science.gov (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  5. Federal Emergency Management Information System (FEMIS) Installation Guide for FEMIS Version 1.5

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, Robert A.(BATTELLE (PACIFIC NW LAB)); Carter, Richard J.(BATTELLE (PACIFIC NW LAB)); Downing, Timothy R.(BATTELLE (PACIFIC NW LAB)); Dunkle, Julie R.(BATTELLE (PACIFIC NW LAB)); Homer, Brian J.(BATTELLE (PACIFIC NW LAB)); Johnson, Daniel M.(BATTELLE (PACIFIC NW LAB)); Johnson, Ranata L.(BATTELLE (PACIFIC NW LAB)); Johnson, Sharon M.(BATTELLE (PACIFIC NW LAB)); Loveall, Robert M.(BATTELLE (PACIFIC NW LAB)); Ramos Jr., Juan (BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Wood, Blanche M.(BATTELLE (PACIFIC NW LAB))

    2001-12-01

    The Federal Emergency Management System (FEMIS) is an emergency management planning and response tool. The FEMIS Installation Guide provides instructions for installing and configuring the FEMIS software package.

  6. The Role of the International Atomic Energy Agency in a Response to Nuclear and Radiological Incidents and Emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Buglova, E.; Baciu, F., E-mail: E.Buglova@iaea.org [International Atomic Energy Agency (IAEA), Department of Nuclear Safety and Security, Wagramer Strasse 5, P.O. Box 100, 1400 Vienna (Austria)

    2014-10-15

    Full text: The role of the International Atomic Energy Agency (IAEA) in a response to nuclear and radiological incidents and emergencies has been defined and further expanded through the IAEA Statute, the Convention on Early Notification of a Nuclear Accident, the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency, the Convention on Physical Protection of Nuclear Material, IAEA safety standards, relevant decisions by Policy Making Organs of the IAEA, inter-agency agreements and other documents such as the IAEA Action Plan on Nuclear Safety. The IAEA Secretariat fulfils its roles through the Agency's Incident and Emergency System (IES) and the Incident and Emergency Centre (IEC). The IEC is the global focal point for international preparedness and response to nuclear and radiological safety or security related incidents, emergencies, threats or events of media interest and for coordination of International assistance. During a response the IEC performs and facilitates for Member States many specific functions which include: prompt notification; official information exchange; assessment of potential consequences; prognosis of emergency progression; provision, facilitation and coordination of International assistance; provision of timely, accurate and easily understandable public information; coordination of inter-agency response at the International level. Through officially designated contact points of Member States the IEC is able to communicate at any time with national authorities to ensure the prompt and successful sharing of information and resources. The IEC routinely performs internal exercising of all aspects of the IAEA response and in cooperation with Member States, the IAEA organizes and facilitates the conduct of large scale international exercises to practice cooperation and coordination. This presentation outlines in detail the specific functions of the IAEA IEC during a response. (author)

  7. Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

    Science.gov (United States)

    Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

    2017-09-01

    Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

  8. Emergency Communications Network for Disasters Management in Venezuela

    Science.gov (United States)

    Burguillos, C.; Deng, H.

    2018-04-01

    The integration and use of different space technology applications for disasters management, play an important role at the time of prevents the causes and mitigates the effects of the natural disasters. Nevertheless, the space technology counts with the appropriate technological resources to provide the accurate and timely information required to support in the decision making in case of disasters. Considering the aforementioned aspects, in this research is presented the design and implementation of an Emergency Communications Network for Disasters Management in Venezuela. Network based on the design of a topology that integrates the satellites platforms in orbit operation under administration of Venezuelan state, such as: the communications satellite VENESAT-1 and the remote sensing satellites VRSS-1 and VRSS-2; as well as their ground stations with the aim to implement an emergency communications network to be activated in case of disasters which affect the public and private communications infrastructures in Venezuela. In this regard, to design the network several technical and operational specifications were formulated, between them: Emergency Strategies to Maneuver the VRSS-1 and VRSS-2 satellites for optimal images capture and processing, characterization of the VENESAT-1 transponders and radiofrequencies for emergency communications services, technologies solutions formulation and communications links design for disaster management. As result, the emergency network designed allows to put in practice diverse communications technologies solutions and different scheme or media for images exchange between the areas affected for disasters and the entities involved in the disasters management tasks, providing useful data for emergency response and infrastructures recovery.

  9. The incidence of emergence delirium and risk factors following sevoflurane use in pediatric patients for day case surgery, Kingston, Jamaica

    Directory of Open Access Journals (Sweden)

    Rachel Gooden

    2014-12-01

    Full Text Available Background and objectives: Emergence delirium is a distressing complication of the use of sevoflurane for general anesthesia. This study sought to determine the incidence of emergence delirium and risk factors in patients at a specialist pediatric hospital in Kingston, Jamaica. Methods: This was a cross-sectional, observational study including pediatric patients aged 3-10 years, ASA I and II, undergoing general anesthesia with sevoflurane for elective day-case procedures. Data collected included patients' level of anxiety pre-operatively using the modified Yale Preoperative Anxiety Scale, surgery performed, anesthetic duration and analgesics administered. Postoperatively, patients were assessed for emergence delirium, defined as agitation with non-purposeful movement, restlessness or thrashing; inconsolability and unresponsiveness to nursing and/or parental presence. The need for pharmacological treatment and post-operative complications related to emergence delirium episodes were also noted. Results: One hundred and forty-five (145 children were included, with emergence delirium occurring in 28 (19.3%. Emergence delirium episodes had a mean duration of 6.9±7.8 min, required pharmacologic intervention in 19 (67.8% children and were associated with a prolonged recovery time (49.4±11.9 versus 29.7± 10.8 min for non-agitated children; p<0.001. Factors positively associated with emergence delirium included younger age (p = 0.01, OR 3.3, 95% CI 1.2-8.6 and moderate and severe anxiety prior to induction (p <0.001, OR 5.6, 95% CI 2.3-13.0. Complications of emergence delirium included intravenous line removal (n = 1, and surgical site bleeding (n = 3. Conclusion: Children of younger age with greater preoperative anxiety are at increased risk of developing emergence delirium following general anesthesia with sevoflurane. The overall incidence of emergence delirium was 19%.

  10. Making the connection: advancing traffic incident management in transportation planning : a primer.

    Science.gov (United States)

    2013-07-01

    "The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...

  11. Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

    Science.gov (United States)

    Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.

  12. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  13. [Health alert management and emerging risk].

    Science.gov (United States)

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  14. Reflections on Leadership and Governance from the Incident Manager of Liberia's Ebola Response.

    Science.gov (United States)

    Nyenswah, Tolbert

    The 2014-2016 epidemic of Ebola virus disease occurred in a region with a recent history of civil war, unstable health systems, and widespread poverty. Despite these contextual challenges, the national Ebola response in Liberia controlled transmission under strong leadership that was able to rapidly coordinate activities, to manage local and international players, and to adapt upon recognizing missteps. Such leadership has persisted to improve public health capacity in post-Ebola Liberia. This article highlights the progress made toward developing a resilient health security system with capacity to prevent, detect, and respond to disease threats before they reach epidemic level. In particular, Liberia's development of a Global Health Security Agenda roadmap, a Joint External Evaluation (JEE) report for International Health Regulation (2005) core capacities, and recent establishment of a National Public Health Institute are described. To better protect the country's population and the greater global community from health threats, emerging institutions and policies in Liberia will depend on leadership and governance that draws from the successes and lessons learned during the Ebola outbreak. The author provides insight based on his role as incident manager of Liberia's Ebola response.

  15. Chernobyl experience of emergency data management

    International Nuclear Information System (INIS)

    Linge, I.; Ossipants, I.

    1998-01-01

    Experience of work on the Chernobyl problem carried out by the Nuclear Safety Institute within 1990-95 for the information analytic support of the USSR and Russian government bodies is briefly examined. During this period approaches to the problem have become more corresponding to those realised by the government of a democratic State responsible to its population. Within the limits of the information analytic support of Russian government bodies an information management system was created. It included: Central bank of generalised data, Bank of models, Information systems for federal and local authorities intercommunicated with information systems of departments and scientific database. Analysis of results of this practical exercise permits to ascertain that the preparation of argued proposals on the population protection in time-limit conditions as well as the material resource insufficiency and the available information incompleteness are difficult problems. The acquired experience of work with the Chernobyl area databases is constantly developing and expanding. (R.P.)

  16. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment : Research Summary

    Science.gov (United States)

    2017-12-01

    In designing an effective traffic management plan for non-recurrent congestion, it is critical for responsible highway agencies to have some vital information, such as estimated incident duration, resulting traffic queues, and the expected delays. Ov...

  17. The key incident monitoring and management system - history and role in quality improvement.

    Science.gov (United States)

    Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

    2018-01-26

    The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

  18. Local Emergency Operations Centers (EOC)

    Data.gov (United States)

    Department of Homeland Security — The physical location at which the coordination of information and resources to support domestic incident management activities normally takes place. An Emergency...

  19. Traffic incident management in construction and maintenance work zones.

    Science.gov (United States)

    2009-01-01

    In 2004, the Federal Highway Administration published updated rules governing work zone safety and mobility; all highway construction and maintenance projects using federal-aid highway funds are required to develop transportation management plans (TM...

  20. A Framework for Modeling Emerging Diseases to Inform Management.

    Science.gov (United States)

    Russell, Robin E; Katz, Rachel A; Richgels, Katherine L D; Walsh, Daniel P; Grant, Evan H C

    2017-01-01

    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

  1. Business continuity management in emerging markets: the case of Jordan.

    Science.gov (United States)

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

  2. A Risk Management Architecture for Emergency Integrated Aircraft Control

    Science.gov (United States)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  3. Controlling disasters: Local emergency management perceptions about Federal Emergency Management and Homeland Security actions after September 11, 2001.

    Science.gov (United States)

    Hildebrand, Sean

    This article examines local emergency manager's beliefs regarding control over tasks during various stages of the hazard cycle since federal policies went into effect following the September 11 attacks. The study considers whether a disparity exists between the actions of local officials during each phase of the "hazard cycle" and the policy expectations of the federal government, which call for greater federal control over activities in emergency management and homeland security. To do so, hypothesis testing investigates the jurisdiction's use of comprehensive emergency management (CEM) practices, the perceived "clarity" of the federal policy demands, and if the local actors feel coerced to comply with federal policy demands so that grant funding is not compromised. Using a model developed from "third-generation" policy implementation research, the results show that the odds of local officials citing federal control over these actions have very limited statistical significance. This signals that the perceived lack of local input into the development of these federal policies and the policies' limited use of traditional CEM measures may not be in concert with what local actors perform in the field. Simply put, the respondents claim to understand the federal policy demands, support the concept of federal control as the policies describe, yet follow their own plans or traditional CEM principles, even if such actions do not support the federal policy demands. These results align with pre-existing research in the emergency management field that show issues with efforts to centralize policies under the Department of Homeland Security and Federal Emergency Management Agency.

  4. Managing mild casualties in mass-casualty incidents: lessons learned from an aborted terrorist attack.

    Science.gov (United States)

    Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron

    2007-01-01

    Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties. Data were collected during and after the event, using patient records and formal debriefings. They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission. A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint. During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently. Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%). Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine. Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to

  5. Proceedings of emerging technologies for hazardous waste management

    International Nuclear Information System (INIS)

    Tedder, D.W.

    1992-01-01

    This book contains proceedings of emerging technologies for hazardous waste management. Topics covered include: Low-temperature oxidation of organic chemical wastes; Advanced waste minimization strategies; Treatment of manufactured gas plant (MGP) and similar wastes; Bioremediation of soils and sediments; Advances in radioactive waste treatment; Computer aides approaches to hazardous waste management; Advances in soil remediation; Low-temperature oxidation of organic chemical waste; Boremediation: Micro, meso, and macro-scale processes; In situ remediation techniques; Treatment of hazardous organics with radiation or solar energy; Technologies for management of municipal waste combustion residues; Environmental restoration and waste management; and Advanced separation and stabilization technologies

  6. Handling Emergency Management in [an] Object Oriented Modeling Environment

    Science.gov (United States)

    Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

    2010-01-01

    It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

  7. In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

    Directory of Open Access Journals (Sweden)

    Hinkelbein J

    2017-02-01

    Full Text Available Jochen Hinkelbein,1,2 Christopher Neuhaus,2,3 Lennert Böhm,1 Steffen Kalina,1 Stefan Braunecker1,2 1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, 2Working group “Emergency Medicine and Air Rescue”, German Society for Aviation and Space Medicine (DGLRM, Munich, 3Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany Background: Data on the incidence of in-flight medical emergencies on-board civil aircraft are uncommon and rarely published. Such data could provide information regarding required medical equipment on-board aircraft and requisite training for cabin crew. The aim of the present study was to gather data on the incidences, nature, and medical equipment for in-flight medical emergencies by way of a survey of physician members of a German aerospace medical society.Materials and methods: Using unipark.de (QuestBack GmbH, Cologne, Germany, an online survey was developed and used to gather specific information. Members of the German Society for Aviation and Space Medicine (Deutsche Gesellschaft für Luft- und Raumfahrtmedizin e.V.; DGLRM were invited to participate in the survey during a 4-week period (21 March 2015 to 20 April 2015. Chi-square test was used for statistical analysis (p<0.05 was considered significant.Results: Altogether, 121 members of the society responded to the survey (n=335 sent out. Of the 121 respondents, n=54 (44.6% of the participants (89.9% male and 10.1% female; mean age, 54.1 years; n=121 were involved in at least one in-flight medical emergency. Demographic parameters in this survey were in concordance with the society members’ demographics. The mean duration of flights was 5.7 hours and the respondents performed 7.1 airline flights per year (median. Cardiovascular (40.0% and neurological disorders (17.8% were the most frequent diagnoses. The medical equipment (78.7% provided was sufficient. An emergency diversion was

  8. Emergency management and mass fatalities: who owns the dead?

    Science.gov (United States)

    Crabtree, Jim

    2009-11-01

    Mass fatality incidents are always unexpected and put a sudden stress on local response agencies to cooperate and share resources to accomplish tasks that are outside their normal activities. Lines of legal authority are often conflicting when two or more agencies are statutorily in charge. Within the USA, the local coroner system is almost universally delegated as responsible for all involved tasks including body recovery, yet the coroner is almost always the smallest responding agency, with the smallest labour pool from which to draw and the least experience of formal Incident Command System (ICS) procedures at large incidents. This paper explores the many tasks required following a mass fatality incident and the necessity for pre-event written agreements to be negotiated between local, state and federal agencies to ensure that material and personnel can be readily shared and reimbursed without bureaucratic misunderstanding in order to accomplish known objectives. Also explored are potential National Incident Management System conflicts in applying unified command to situations where legal authority and level of commitment are not synonymous.

  9. IMI - An information system for effective Multidisciplinary Incident Management

    NARCIS (Netherlands)

    Lee, M.D.E. van der; Vugt, M. van der

    2004-01-01

    The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of

  10. Potential applications of advanced information technology in emergency management

    International Nuclear Information System (INIS)

    Andersson, H.; Holmstrom, C.

    1987-01-01

    Within nuclear-, offshore- and petrochemical industries there is always a potential risk for severe incidents and accidents. It is a commonly shared belief that timely and correct decisions in these situations could either prevent an incident to develop into a severe accident or to mitigate the negative consequences of an accident. It is also a common belief that in those cases where poor decisions have been taken it has been because of insufficient access to information and expert knowledge when the decisions were taken. These are the background experiences for the joint Nordic research program on the use of advanced information technology in emergency preparedness organizations. Important initial research tasks in the program have been to identify and specify the needs for advanced information technology applications in emergency preparedness organizations. So far a couple of studies aiming for a needs assessment of advanced information technologies in nuclear power emergency preparedness organizations in Sweden and Finland have been completed. The conclusions from these studies are presented in this paper

  11. Emergency management, Twitter and social media evangelism

    DEFF Research Database (Denmark)

    Latonero, Mark; Shklovski, Irina

    2011-01-01

    media tools from the emergency management professional’s viewpoint with a particular focus on the use of Twitter. Limited research has investigated Twitter usage in crisis situations from an organizational perspective. This paper contributes to the understanding of organizational innovation, risk...... organizations face engaging with social media and Twitter. This article provides insights into practices and challenges of new media implementation for crisis and risk management organizations....

  12. The IAEAs incident and emergency centre: the global focal point for nuclear and radiological emergency preparedness and response

    Energy Technology Data Exchange (ETDEWEB)

    Buglova, E.

    2016-08-01

    The continuous use of nuclear power to generate electricity and the continued threat of radioactive materials being used for nefarious reasons reminds us of the importance to stay prepared to respond to nuclear or radiological emergencies. Stringent nuclear safety and nuclear security requirements, the training of personnel, operational checks and legal frameworks cannot always prevent radiation-related emergencies. Though these events can range in severity, each has the potential to cause harm to the public, employees, patients, property and the environment. Until the Chernobyl nuclear accident in 1986, there was no international information exchange system. Immediately following that accident, the international community negotiated the so-called Emergency Conventions to ensure that the country suffering an accident with an international transboundary release of radioactive material would issue timely, authenticated information, while the States that could field technical support, would do so in a coordinated fashion. The Conventions also place specific legal obligations on the International Atomic energy Agency (IAEA) with regard to emergency preparedness and response. (Author)

  13. Incidence of fistula after management of perianal abscess

    Directory of Open Access Journals (Sweden)

    Riyadh Mohamad Hasan

    2016-10-01

    Full Text Available Background: Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. There is a close relationship of abscess and fistula in etiology, anatomy, pathophysiology, therapy, complications and morbidity, it is appropriate to consider them as one entity. Aim of study: To determine the incidence of fistula formation and recurrent abscess in a sample of Iraqi patients in Baghdad and decide whether primary fistulotomy should be performed at the time of incision and drainage of perianal abscesses. Patients and methods: A retrospective study of 68 patients with perianal abscess operations conducted in Baghdad. They underwent incision and drainage under either local or general anesthesia at Al-Kindy Teaching Hospitals and private hospitals over a 15-year period from January 2000 to December 2015. Their ages ranged from 20 to 68 years (40.21 ± 1.34 males (63/68 (92.64% were more than females (5/68 (7.35%. Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 68 (92.64% patients with perianal abscess with a median age 39 years (range 20–68 years. The mean follow-up period was identified to be 18 months (range 12–24 months. Males (63/68 (92.64% were more than females (5/68 (7.35%. The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 31/68 (45.58% and males (30/31 (44.11% were more than females (1/31 (1.47%. The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 6 (8.82%were lower than fistula formation n = 31 (45.58%. The percentage of males n = 4/6 (5.88% were more than females 2/6 (2.94%. Conclusions: The

  14. Over a decade of nuclear emergency management at the Nea

    International Nuclear Information System (INIS)

    Ahier, B.

    2005-01-01

    The OECD Nuclear Energy Agency has a long tradition of expertise in the area of nuclear emergency policy, planning, preparedness and management. Through its activities in this field, the Agency offers its member countries unbiased assistance on nuclear preparedness matters, with a view to facilitating improvements in nuclear emergency preparedness strategies and response at the international level. The 1986 Chernobyl accident demonstrated that nuclear accidents can have international consequences, highlighting the need for international co-operation, and leading to improvements in the areas of international communication, information exchange and harmonization of response actions between countries. From its inception, the NEA Working Party on Nuclear Emergency Matters has focused on improving the effectiveness of international nuclear emergency preparedness and management. Part of its work programme is set on exploring and developing new concepts and future procedures to enhance national and international preparedness and response management. A central approach to this has been the preparation and conduct of the International Nuclear Emergency Exercise (INEX) series. The role and strategies of exercises and future directions are discussed in this presentation. (A.L.B.)

  15. Traffic incident and crisis management : challenges and obstacles in information sharing

    NARCIS (Netherlands)

    Steenbruggen, J.G.M.; Nijkamp, P.; Smits, J.M.; Mohabir, G.

    2012-01-01

    Disaster Management and Traffic Incident Management involves the coordinated interactions of many public and private actors. On many levels, there is clearly a strong relation be-tween the road infrastructure and the effective handling of large scale disasters. To support these tasks in an effective

  16. Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department

    Directory of Open Access Journals (Sweden)

    Bedriye Sonmez

    2014-03-01

    Full Text Available Aim: Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2% of patients were male and 28 (37.8% were female. Mean age of the study population was 34.85±19.17 (min 7- max 80 years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%. 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose. Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.

  17. Surgeons’ and Emergency Physicians’ Perceptions of Trauma Management and Training

    Directory of Open Access Journals (Sweden)

    Hemphill, Robin R

    2009-08-01

    Full Text Available Objective: The study objective was to determine whether surgeons and emergency medicine physicians (EMPs have differing opinions on trauma residency training and trauma management in clinical practice.Methods: A survey was mailed to 250 EMPs and 250 surgeons randomly selected.Results: Fifty percent of surgeons perceived that surgery exclusively managed trauma compared to 27% of EMPs. Surgeons were more likely to feel that only surgeons should manage trauma on presentation to the ED. However, only 60% of surgeons currently felt comfortable with caring for the trauma patient, compared to 84% of EMPs. Compared to EMPs, surgeons are less likely to feel that EMPs can initially manage the trauma patient (71% of surgeons vs. 92% of EMPs.Conclusion: EMPs are comfortable managing trauma while many surgeons do not feel comfortable with the complex trauma patient although the majority of surgeons responded that surgeons should manage the trauma.[WestJEM. 2009;10:144-149.

  18. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    Science.gov (United States)

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  19. Supporting emergency management through process-aware information systems

    NARCIS (Netherlands)

    Hagebölling, D.; Leoni, de M.; Ardagna, D.; Mecella, M.; Yang, J.

    2009-01-01

    This short paper aims at summarising the invited talk given by Dirk Hagebölling in the PM4HDPS workshop and the subsequent discussion with participants. The talk concerned the current situation of systems for emergency management and their drawbacks. Moreover, it dealt also with the expectation for

  20. An emergency management demonstrator using the high level architecture

    International Nuclear Information System (INIS)

    Williams, R.J.

    1996-12-01

    This paper addresses the issues of simulation interoperability within the emergency management training context. A prototype implementation in Java of a subset of the High Level Architecture (HLA) is described. The use of Web Browsers to provide graphical user interfaces to HLA is also investigated. (au)

  1. 75 FR 16623 - Emergency Management for Higher Education Grant Program

    Science.gov (United States)

    2010-04-01

    ... range of campus problems including sexual assault, arson, robbery, harassment, simple assault, binge... framework of the four phases of emergency management (Prevention-Mitigation, Preparedness, Response, and..., enhance, implement, and evaluate campus-based and/or community-based prevention strategies to reduce high...

  2. Emergency management and homeland security: Exploring the relationship.

    Science.gov (United States)

    Kahan, Jerome H

    2015-01-01

    In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions.

  3. Privacy Impact Assessment for the Emergency Management Portal

    Science.gov (United States)

    The Emergency Management Portal System collects cleanup site data, and personnel readiness data. Learn how this data will be collected in the system, how it will be used, access to the data, the purpose of data collection, and record retention policies.

  4. Some reflections on the emerging notion of personal quality management

    NARCIS (Netherlands)

    Jonker, J.

    1999-01-01

    States that the concept of the “classical” organisation is undoubtedly in transition. As a result new organisational concepts emerge. Addresses the nature of quality management and assurance in “organisations under construction”. Starting with a brief overview of the characteristics of new

  5. Identifying and Managing Engineering Design Requirements for Emerging Markets

    DEFF Research Database (Denmark)

    Li, Xuemeng

    , especially for those companies originally from developed markets, to acquire an in-depth understanding of particular design requirements in emerging markets in order to adapt both company products and approaches in such contexts. Prior studies on the identification and management of design requirements have...... predominantly been conducted in the context of developed countries and relatively affluent markets. Emerging markets are distinct from developed markets in terms of numerous contextual factors, e.g., regulatory environments and competitive landscapes. These factors influence the requirement identification...... attention. There is a need for an overview of different perspectives in requirement identification for manufacturing companies and their corresponding assessments in the context of emerging markets. Therefore, this research project is motivated to 1) investigate the process of identifying and managing...

  6. First contact: acute stress reactions and experiences of emergency department consultations following an incident of intimate partner violence.

    Science.gov (United States)

    Olive, Philippa

    2017-08-01

    The aim of this research was to explore women's emotional and affective responses following an incident of intimate partner violence experienced during emergency department attendances. A growing body of research has explored women's experiences of emergency departments following intimate partner violence still little remains known about the experience and impact of emotional and affective responses during these attendances. A descriptive qualitative design was used, underpinned theoretically by critical realism and postmodern complexity theory to attend to multiple, intersecting mechanisms that lie behind events and experiences. Semistructured interviews with six women who had attended an emergency department directly following an incident of intimate partner violence. Interview data were transcribed and thematically analysed in nvivo9 using a coding framework. There were three interconnected key findings. First, was the commonality of acute stress experiences among women attending an emergency department following partner violence, second was that these acute stress reactions negatively impacted women's consultations, and third was the need for specialist domestic violence services at the point of first contact to assist service users navigate an effective consultation. Acute stress reactions were an important feature of women's experiences of emergency department consultations following intimate partner violence. Attending to psychological first aid; providing a safe and quiet space; and affording access to specialist violence advocacy services at the point of first contact will limit harm and improve health consultation outcomes for this population. This research provides an account of emotional and affective responses experienced by women attending emergency departments following intimate partner violence and explicates how these acute stress reactions impacted their consultation. This research has relevance for practitioners in many first contact health

  7. Assessment and Prognosis for Nuclear Emergency Management in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seung-Young; Lee, Hyun-Ha; Lee, Young-Min; Park, Sang-Hyun; Nam, Kwang-Woo; Jeong, Sang-Houn; Jin, Sobeom; Kim, Dong-Il; Kim, Wan-Joo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2015-05-15

    The nuclear accident of Fukushima, March 2011, raised public concerns over the safety of nuclear facilities and emergency preparedness in Korea. Therefore, KINS has enhanced the AtomCARE for assessment and prognosis and environmental monitoring system. The KINS has reinforced the radiological/radioactive environment monitoring system across the country to ensure prompt and effective protective measures for the public. Also, the act of radiological emergency management revised to adopt (PAZ) and the (UPZ) at 2014. All in all, Korea will give comprehensive effort to reflect the lessons learned from Fukushima accident for improvement of the assessment and prognosis system. This paper reviews the status of assessment and prognosis system for nuclear emergency response in Korea. The Korea Institute of Nuclear Safety (KINS) performs the regulation and radiological emergency preparedness of the nuclear facilities and radiation utilizations.

  8. Monitoring and data management strategies for nuclear emergencies

    International Nuclear Information System (INIS)

    2000-01-01

    Since the accident at Chernobyl in 1986, many countries have intensified their efforts in nuclear emergency planning, preparedness and management. Experience from the NEA nuclear emergency exercises (INEX 1 and INEX 2) indicated a need to improve the international system of communication and information in case of a radiological emergency. To address this need, research was carried out by three NEA working groups, the findings of which are synthesised in the present report. This report defines emergency monitoring and modelling needs, and proposes strategies which will assist decision makers by improving the selection of data that is transmitted, and the way in which data and information are transmitted and received. Modern communication methods, such as the Internet, are a key part of the strategies described. (author)

  9. The promises and facts of emergent strategy in public management

    DEFF Research Database (Denmark)

    Aagaard, Peter

    Public managers are experiencing a growing demand for innovation. One of the promising approaches to instigating innovation is that of emergent strategic patterns (ESPs). According to the literature, the institutional barriers and drivers of ESPs are shaped by the two dominant public management...... models, NPM (the barriers) and governance (the drivers). However, based on an empirical case study of the institutional barriers and drivers for ESPs in the Danish Crime Prevention Council, this article concludes that ESPs are in fact enabled by a much more mixed management model....

  10. A Risk Radar driven by Internet of intelligences serving for emergency management in community.

    Science.gov (United States)

    Huang, Chongfu; Wu, Tong; Renn, Ortwin

    2016-07-01

    Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Emergency strategies and trends in the management of liver trauma.

    Science.gov (United States)

    Jiang, Hongchi; Wang, Jizhou

    2012-09-01

    The liver is the most frequently injured organ during abdominal trauma. The management of hepatic trauma has undergone a paradigm shift over the past several decades, with mandatory operation giving way to nonoperative treatment. Better understanding of the mechanisms and grade of liver injury aids in the initial assessment and establishment of a management strategy. Hemodynamically unstable patients should undergo focused abdominal sonography for trauma, whereas stable patients may undergo computed tomography, the standard examination protocol. The grade of liver injury alone does not accurately predict the need for operation, and nonoperative management is rapidly becoming popular for high-grade injuries. Hemodynamic instability with positive focused abdominal sonography for trauma and peritonitis is an indicator of the need for emergent operative intervention. The damage control concept is appropriate for the treatment of major liver injuries and is associated with significant survival advantages compared with traditional prolonged surgical techniques. Although surgical intervention for hepatic trauma is not as common now as it was in the past, current trauma surgeons should be familiar with the emergency surgical skills necessary to manage complex hepatic injuries, such as packing, Pringle maneuver, selective vessel ligation, resectional debridement, and parenchymal sutures. The present review presents emergency strategies and trends in the management of liver trauma.

  12. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment

    Science.gov (United States)

    2017-12-01

    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  13. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.

    1991-01-01

    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  14. Improving the safety of remote site emergency airway management.

    Science.gov (United States)

    Wijesuriya, Julian; Brand, Jonathan

    2014-01-01

    Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations. The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist's responsibilities regarding checks and maintenance. Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources. Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications

  15. NDMA guidelines on management of nuclear and radiological emergencies

    International Nuclear Information System (INIS)

    Abani, M.C.

    2011-01-01

    The National Disaster Management Authority (NDMA), ever since it's formation as an apex policy making body for the country in the field of disaster management, has formulated a set of guidelines to assist the various ministries, states and stakeholders in preparing their plans to handle different types of disasters. The guidelines on management of nuclear and radiological emergencies assume great importance in the present context, as our country has very ambitious programme to exploit nuclear energy for peaceful uses. Though, we have an enviable and impeccable record of safety and virtually fail-safe operations in all our nuclear establishments, the possibility, however, remote it may be, of human error, systems failure, sabotage, earthquake, floods, terrorist attacks etc leading to the release of radioactive material in the public domain, cannot be entirely ruled out. With this view, it was decided to prepare the national guidelines by NDMA to manage any nuclear/radiological emergency in public domain. Through these guidelines, we aim to further strengthen our existing nuclear/radiological emergency management framework and generate public awareness, which will go a long way in allaying misapprehensions, if any, amongst the public about the country's nuclear programme. Like in all our guidelines for handling of different types of the disasters, in these Guidelines also, maximum emphasis has been laid on the prevention of nuclear and radiological emergencies, along with a detailed consideration of all other elements of the disaster management continuum. The national guidelines have been prepared and a consensus was arrived on various issues, after widespread consultations and elaborates discussions amongst experts as well as stakeholders. It is assumed that once these guidelines are implemented by the stakeholders and converted into action plans followed by SOPs that will further reduce the chances of accidents in the nuclear arena. (author)

  16. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  17. The application of supply chain management principles to emergency management logistics: An empirical study.

    Science.gov (United States)

    Peterson, Matthew R; Young, Richard R; Gordon, Gary A

    2016-01-01

    Key elements of supply chain theory remain relevant to emergency management (EM) logistics activities. The Supply Chain Operations Reference model can also serve as a useful template for the planning, organizing, and execution of EM logistics. Through a series of case studies (developed through intensive survey of organizations and individuals responsible for EM), the authors identified the extent supply chain theory is being adopted and whether the theory was useful for emergency logistics managers. The authors found several drivers that influence the likelihood of an organization to implement elements of supply chain management: the frequency of events, organizational resources, population density, range of events, and severity of the disaster or emergency.

  18. Evaluating Emergency Department Asthma Management Practices in Florida Hospitals.

    Science.gov (United States)

    Nowakowski, Alexandra C H; Carretta, Henry J; Dudley, Julie K; Forrest, Jamie R; Folsom, Abbey N

    2016-01-01

    To assess gaps in emergency department (ED) asthma management at Florida hospitals. Survey instrument with open- and closed-ended questions. Topics included availability of specific asthma management modalities, compliance with national guidelines, employment of specialized asthma care personnel, and efforts toward performance improvement. Emergency departments at 10 large hospitals in the state of Florida. Clinical care providers and health administrators from participating hospitals. Compliance with national asthma care guideline standards, provision of specific recommended treatment modalities and resources, employment of specialized asthma care personnel, and engagement in performance improvement efforts. Our results suggest inconsistency among sampled Florida hospitals' adherence to national standards for treatment of asthma in EDs. Several hospitals were refining their emergency care protocols to incorporate guideline recommendations. Despite a lack of formal ED protocols in some hospitals, adherence to national guidelines for emergency care nonetheless remained robust for patient education and medication prescribing, but it was weaker for formal care planning and medical follow-up. Identified deficiencies in emergency asthma care present a number of opportunities for strategic mitigation of identified gaps. We conclude with suggestions to help Florida hospitals achieve success with ED asthma care reform. Team-based learning activities may offer an optimal strategy for sharing and implementing best practices.

  19. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  20. A Multi Agent Based Approach for Prehospital Emergency Management.

    Science.gov (United States)

    Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh

    2017-07-01

    To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities.  The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.

  1. Nonbronchial systemic arteries: incidence and endovascular interventional management for hemoptysis

    International Nuclear Information System (INIS)

    Jiang Sen; Zhu Xiaohua; Sun Xiwen; You Zhengqian; Ma Jun; Yu Dong; Peng Gang; Jie Bing; Sun Chunyi

    2009-01-01

    Objective: To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsibly NBSA for hemoptysis. Methods: The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectasis in 41 (1 case with post-lobectomy and 1 case with post-ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results: Seventy-three patients (52.5%) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 case with post-ligation of patent ductus arteriosus, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n=88), internal thoracic arteries (n=27), inferior phrenic arteries (n=21), proper esophageal arteries (n=20), lateral thoracic arteries (n=9), subscapular arteries (n=7), costocervical trunks (n=5) and thyrocervical trunks (n=4). Main responsible NBSA were posterior intercostal arteries (n=75) and branches of subclavian and axillary artery (n=44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n=16) and inferior phrenic arteries (n=17) in bronchiectasis. The clinical

  2. Study on the operational guides of the off-site emergency management center

    International Nuclear Information System (INIS)

    Park, Won Jong; Han, S. J.; Oh, K. H.

    2005-01-01

    The emergency response organizational groups and roles of Off-site Emergency Management Center was proposed to respond in case of radiological emergency. Development of implementing procedures of Off-site Emergency Management Center in case of radiological emergency to improve effective co-operation and rapid response in radiological emergency. Establishment of 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' and announced by the Minister of Science and Technology. The Implementing procedures of Off-site Emergency Management Center and 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' can be provide guidelines in case of emergency

  3. Haematological emergencies managing hypercalcaemia in adults and children with haematological disorders.

    LENUS (Irish Health Repository)

    Sargent, Jeremy T S

    2012-02-01

    Hypercalcaemia is a common metabolic complication of malignant disease often requiring emergency intervention. Although it is more frequently associated with solid tumours, malignancy-associated hypercalcaemia (MAH) is seen in a significant number of patients with blood diseases. Its association with myeloma and adult T-cell leukaemia\\/lymphoma is well recognized but the incidence of hypercalcaemia in other haematological neoplasms, affecting adults and children, is less clearly defined. Haematologists need to be familiar with the clinical manifestations of, the differential diagnosis to be considered and the most effective management strategies that are currently available for MAH. The key components of management of MAH include aggressive rehydration, specific therapy to inhibit bone resorption and, crucially, treatment of the underlying malignancy. Bisphosphonates have revolutionized the management of MAH over the last 20 years, however the elucidation of molecular pathways implicated in MAH is facilitating the development of more targeted approaches to treatment.

  4. National incidence, management and survival of urachal carcinoma

    Directory of Open Access Journals (Sweden)

    Dearbhaile C. Collins

    2016-10-01

    Full Text Available Urachal carcinoma is an uncommon cancer whose rarity has precluded its study and evidence-based management strategies are lacking. This study assessed all urachal carcinomas in Ireland and clinical parameters in order to improve understanding. Urachal carcinomas diagnosed from 1994 to 2011 were identified from the National Cancer Registry in Ireland. Data obtained included patient age, gender, diagnostic year, pathology, tumor stage, patient treatment strategies and survival. Twenty-six urachal carcinomas were identified, the majority being adenocarcinoma. This comprised 0.3% of all invasive bladder tumors. Patients were predominantly male (62% and over 50 years of age (58%. Twenty-two patients (85% underwent surgery, with only six (23% undergoing chemotherapy. On average, median overall survival was 2.6 years (range 0-15.2 yrs. Survival was longer in women (5 vs. 1.9 yrs, patients under 50 years of age (3.6 vs. 1.9 yrs, those without confirmed metastasis (4.1 vs. 0.7 yrs and those who received chemotherapy (3.6 vs. 2.6 yrs. The overall survival of urachal carcinoma in Ireland is less than expected from published literature. This study highlights the need for centralization of rare tumors with international collaboration to identify the optimal treatment strategy and improve outcome.

  5. Hazardous Materials Management and Emergency Response training Center needs assessment

    International Nuclear Information System (INIS)

    McGinnis, K.A.; Bolton, P.A.; Robinson, R.K.

    1993-09-01

    For the Hanford Site to provide high-quality training using simulated job-site situations to prepare the 4,000 Site workers and 500 emergency responders for known and unknown hazards a Hazardous Materials Management and Emergency Response Training Center is needed. The center will focus on providing classroom lecture as well as hands-on, realistic training. The establishment of the center will create a partnership among the US Department of Energy; its contractors; labor; local, state, and tribal governments; and Xavier and Tulane Universities of Louisiana. This report presents the background, history, need, benefits, and associated costs of the proposed center

  6. Joint Radiation Emergency Management Plan of the International Organizations. Date Effective: 1 January 2010

    International Nuclear Information System (INIS)

    2010-01-01

    The purpose of this Plan is to describe the inter-agency framework for preparedness for and response to a radiation5 incident or emergency irrespective of its cause. In particular, its objectives are: 1. To provide a common understanding of the emergency preparedness and response roles and responsibilities, objectives, authorities, capabilities and arrangements of each participating international organization, and any relevant inter-agency arrangements; 2. To provide an overall concept of operations between the international organizations based on the emergency response objectives, responsibilities, authorities, capabilities and arrangements of each participating international organization, and any existing inter-agency arrangements, in order to facilitate a timely, effective and co-ordinated response; 3. To facilitate development of agreements among the participating international organizations on practical issues, if appropriate; 4. To provide a common understanding of the process for improving and changing the inter-agency response arrangements; 5. To provide a common understanding of roles and responsibilities of the participating international organizations with respect to: international standards, supporting national capabilities through provision of guidance and training, relevant research, emergency exercises and other preparedness considerations; 6. To guide the managers in each participating organization who need to ensure that all appropriate arrangements are given the necessary support within their organization; 7. To facilitate the well founded development, maintenance and training of plans and procedures for each organization; 8. To draw the attention of personnel in States and international organizations6 to these arrangements and to facilitate the development of compatible arrangements, if appropriate. The Joint Plan describes the arrangements of the participating international organizations7 for responding to a radiation incident or emergency

  7. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing

    Directory of Open Access Journals (Sweden)

    Kapileswar Nellore

    2016-11-01

    Full Text Available Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2

  8. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing.

    Science.gov (United States)

    Nellore, Kapileswar; Hancke, Gerhard P

    2016-11-10

    Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC) protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC) with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2 simulation results

  9. FEMME- post-Fire Emergency ManageMEnt tool.

    Science.gov (United States)

    Vieira, Diana; Serpa, Dalila; Rocha, João; Nunes, João; Keizer, Jacob

    2017-04-01

    Wildfires can have important impacts on hydrological and soil erosion processes in forest catchments, due to the destruction of vegetation cover and changes to soil properties. The involved processes however, are non-linear and not fully understood. This has severely limited the understanding on the impacts of wildfires, and, as a consequence, current runoff-erosion models are poorly adapted to recently burned forest conditions. Furthermore, while post-fire forestry operations and, to a lesser extent, post-fire soil conservation measures are commonly applied, their hydrological and erosion impacts continue poorly known, hampering decision-making by land owners and managers. Past post-wildfire research in Portugal has involved simple adaptations of plot-scale runoff-erosion models to post-fire conditions. This follow-up study focusses on model adaptation to selected post-fire soil conservation measures. To this end, full stock is taken of various datasets collected by several (past and ongoing research projects. The selected model is the Morgan-Morgan-Finney model (MMF, Morgan,2001), which already proved its suitability for post-fire conditions in Portugal (Vieira et al, 2010, 2014) as well as NW-Spain ( Fernández et al., 2010). The present results concerned runoff and erosion different burn severities and various post-fire mitigation treatments (mulch, hydromulch, needle cast, barriers), focussing on the plot and field scale. The results for both the first and the second year following the wildfire revealed good model efficiency, not only for burned and untreated conditions but also for burned and treated conditions. These results thus reinforced earlier findings that MMF is a suitable model for the envisaged post-fire soil erosion assessment tool, coined "FEMME". The data used for post-fire soil erosion calibration with the MMF already allows the delineation of the post-fire management FEMME tool. Nevertheless, further model assessment will address additional

  10. Apneic oxygenation reduces the incidence of hypoxemia during emergency intubation: A systematic review and meta-analysis.

    Science.gov (United States)

    Pavlov, Ivan; Medrano, Sofia; Weingart, Scott

    2017-08-01

    Apneic oxygenation has been advocated for the prevention of hypoxemia during emergency endotracheal intubation. Because of conflicting results from recent trials, the efficacy of apneic oxygenation remains unclear. We performed a systematic review and meta-analysis to investigate the effect of apneic oxygenation on the incidence of clinically significant hypoxemia during emergency endotracheal intubation. MEDLINE, EMBASE, and PubMed databases were searched without language and time restrictions for studies of apneic oxygenation performed in a critical care setting. Meta-analysis was conducted with a random-effect model, and according to intention-to-treat allocation wherever applicable. Subgroup analyses were performed to ensure the robustness of findings across various clinical outcomes. Eight studies (n=1953) were included in the meta-analysis. The pooled absolute risk of clinically significant hypoxemia was 27.6% in the usual care group and 19.1% in the apneic oxygenation group, without any heterogeneity across studies (I 2 =0%; p=0.42). Apneic oxygenation reduced the relative risk of hypoxemia by 30% (95% confidence interval 0.59 to 0.82). There was a trend toward lower mortality in the apneic oxygenation group (relative risk of death 0.77; 95% confidence interval 0.59 to 1.02). Apneic oxygenation significantly reduces the incidence of hypoxemia during emergency endotracheal intubation. These findings support the inclusion of apneic oxygenation in everyday clinical practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  12. Emergency Management Governance: Examining Leadership Styles across Cultures

    Directory of Open Access Journals (Sweden)

    Dean Karalekas

    2018-04-01

    Full Text Available While Taiwan is a modern culture, it is also a deeply traditional one, and Taiwan’s public administrators often struggle to implement new and innovative disaster response programs in the nation that accommodate these two disparate influences. This research examines leadership styles that are employed in Taiwan with those used in Japan, as well as in the West. Much of the research on leadership styles across cultures is being conducted in the field of business administration, which has value for public administrators as well. In order to understand the qualities required of effective emergency managers in East Asia, particularly Taiwan, and how these qualities differ from those of emergency managers in the West, it is essential to take a culturalist perspective on the issue.

  13. Advanced information technology for training and emergency management

    International Nuclear Information System (INIS)

    Wahlstroem, B.

    1989-01-01

    Modern information technology provides many possibilities for improving both the safety and the availability of nuclear installations. A Nordic research programme was started in 1977, in which several organizations in Denmark, Finland, Norway and Sweden has been participating. The work has on a general level been addressing control rooms, human reliability and information technology for nuclear power plants. The research has had impact on the development of the control room solutions and the training simulators in Finland and also in the other Nordic countries. The present phase of the Nordic cooperation is investigating the use of advanced information technology in emergency management. The paper gives a brief introduction to the use of advance information technology for training and emergency management, which is based on the experience from the Nordic projects and other similar application projects in Finland. The paper includes also references to results from several of the projects. (author)

  14. Protecting your business: from emergency planning to crisis management

    International Nuclear Information System (INIS)

    Ramsay, C.G.

    1999-01-01

    The forthcoming UK Control of Major Accident Hazards (COMAH) regulations under the European Community's Seveso II Directive will impose a new formal requirement to test emergency plans. This might be approached as an added burden on industry to demonstrate safe operation, or can be viewed alternatively as an opportunity to improve crisis management systems and thereby decrease the risks to the business. Crisis is by nature an ambiguous and complex environment, demanding endless initiative, inventiveness, communication, co-ordination and learning. Because large-scale crises threatening the entire business are not frequent, learning from experience must be replaced by competence-assurance based on systems thinking, on risk assessment, on wide scenario simulations and on rigorous training. This paper discusses the benefits from various types of testing of emergency plans and from a business approach to continuous improvement in crisis management capability. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  15. Are current processes for nuclear emergency management in Europe adequate?

    Energy Technology Data Exchange (ETDEWEB)

    Carter, E; French, S [Manchester Business School, University of Manchester, Booth Street West, Manchester M15 6PB (United Kingdom)

    2006-12-15

    We describe the results of process mapping of nuclear emergency management procedures in four European countries. We find clear differences and explore these in relation to their suitability for building a shared understanding across the emergency management team of the evolving situation and a balanced appreciation of the uncertainties. Our findings indicate that there are some issues that cause concern in that the procedures may run smoothly and efficiently but they may also risk underestimating uncertainty or ignore key issues that have only been identified by a minority of experts or models. We are concerned that they do not facilitate the building of shared mental models that the literature such as that on highly reliable organisations has shown is important.

  16. Social Networking for Emergency Management and Public Safety

    Energy Technology Data Exchange (ETDEWEB)

    Lesperance, Ann M.; Olson, Jarrod; Godinez, Melanie A.

    2010-08-31

    On March 10, 2010 the workshop titled Social Networking for Emergency Management and Public Safety was held in Seattle, WA. The objective of this workshop was to showcase ways social media networking technologies can be used to support emergency management and public safety operations. The workshop highlighted the current state of social networking and where this dynamic engagement is heading, demonstrated some of the more commonly used technologies, highlighted case studies on how these tools have been used in a variety of jurisdictions and engaged the private sector on how these tools might serve as a conduit for two way communication between with the public sector to address regional recovery issues and decision making.

  17. Are current processes for nuclear emergency management in Europe adequate?

    International Nuclear Information System (INIS)

    Carter, E; French, S

    2006-01-01

    We describe the results of process mapping of nuclear emergency management procedures in four European countries. We find clear differences and explore these in relation to their suitability for building a shared understanding across the emergency management team of the evolving situation and a balanced appreciation of the uncertainties. Our findings indicate that there are some issues that cause concern in that the procedures may run smoothly and efficiently but they may also risk underestimating uncertainty or ignore key issues that have only been identified by a minority of experts or models. We are concerned that they do not facilitate the building of shared mental models that the literature such as that on highly reliable organisations has shown is important

  18. Recognizing and managing adrenal disorders in the emergency department [digest].

    Science.gov (United States)

    Cutright, Amy; Ducey, Stephen; Barthold, Claudia L; Kim, Jeremy

    2017-09-22

    Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement. This issue provides recommendations on effective management of patients presenting with adrenal insufficiency, with particular attention to the management of critically ill and septic patients, pregnant patients, and children. [Points & Pearls is a digest of Emergency Medicine Practice.].

  19. Spatial-Temporal Hotspot Pattern Analysis of Provincial Environmental Pollution Incidents and Related Regional Sustainable Management in China in the Period 1995–2012

    Directory of Open Access Journals (Sweden)

    Lei Ding

    2015-10-01

    Full Text Available Spatial-temporal hotspot pattern analysis of environmental pollution incidents provides an indispensable source of information for the further development of incident prevention measures. In this study, the spatial-temporal patterns of environmental pollution incidents in China in the period of 1995–2012 were analyzed, using the Spatial Getis-Ord statistic and an Improved Prediction Accuracy Index (IAPI. The results show that, in this period, the occurrence of environmental incidents exhibited a dynamic growth pattern but then dropped and continued to drop after the year 2006, which was considered a crucial turning point. Not coincidentally, this corresponds to the year when the State Council issued its National Environmental Emergency Plan, and following the examination of major incidents, special actions were taken to strengthen the control of incidents and emergency responses. The results from Getis-Ord General G statistical analysis show that the spatial agglomeration phenomenon was statistically significant after 1999 and that the level of spatial agglomeration was rising, while the Getis-Ord Gi* statistical analysis reveals that environmental pollution incidents were mainly agglomerated in the Pan Yangtze River Delta and Pan Pearl River Delta regions. Accordingly, the spatial-temporal hotspot pattern based on the IAPI values at the provincial scale could be categorized into: stable hotspots, unstable hotspots, and cold-spot areas. The stable hotspots category was further divided into three subtypes: industrial distribution type, industrial transfer type, and extensive economic growth type. Finally, the corresponding measures for sustainable management were proposed: stable hotspots were classified as essential regions requiring the immediate prevention and control of environmental pollution incidents; unstable hotspots were characterized by their need for ongoing and continual prevention measures, and cold-spots were those areas that

  20. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Ecological user interface for emergency management decision support systems

    DEFF Research Database (Denmark)

    Andersen, V.

    2003-01-01

    The user interface for decision support systems is normally structured for presenting relevant data for the skilled user in order to allow fast assessment and action of the hazardous situation, or for more complex situations to present the relevant rules and procedures to be followed in order to ...... of this paper is to discuss the possibility of using the same principles for emergency management with the aim of improved performance in complex and unanticipated situations....

  2. Reconstruction of the Chernobyl emergency and accident management

    International Nuclear Information System (INIS)

    Schinner, F.; Andreev, I.; Andreeva, I.; Fritsche, F.; Hofer, P.; Lettner, E.; Seidelberger, E.; Kromp-Kolb, H.; Kromp, W.

    1998-01-01

    Full text of publication follows: on April 26, 1986 the most serious civil technological accident in the history of mankind occurred of the Chernobyl Nuclear Power Plant (ChNPP) in the former Soviet Union. As a direct result of the accident, the reactor was severely destroyed and large quantities of radionuclides were released. Some 800000 persons, also called 'liquidators' - including plant operators, fire-fighters, scientists, technicians, construction workers, emergency managers, volunteers, as well as medical and military personnel - were part of emergency measurements and accident management efforts. Activities included measures to prevent the escalation of the accident, mitigation actions, help for victims as well as activities in order to provide a basic infrastructure for this unprecedented and overwhelming task. The overall goal of the 'Project Chernobyl' of the Institute of Risk Research of the University of Vienna was to preserve for mankind the experience and knowledge of the experts among the 'liquidators' before it is lost forever. One method used to reconstruct the emergency measures of Chernobyl was the direct cooperation with liquidators. Simple questionnaires were distributed among liquidators and a database of leading accident managers, engineers, medical experts etc. was established. During an initial struggle with a number of difficulties, the response was sparse. However, after an official permit had been issued, the questionnaires delivered a wealth of data. Furthermore a documentary archive was established, which provided additional information. The multidimensional problem in connection with the severe accident of Chernobyl, the clarification of the causes of the accident, as well as failures and successes and lessons to be learned from the Chernobyl emergency measures and accident management are discussed. (authors)

  3. ARGOS-NT: A computer based emergency management system

    International Nuclear Information System (INIS)

    Hoe, S.; Thykier-Nielsen, S.; Steffensen, L.B.

    2000-01-01

    In case of a nuclear accident or a threat of a release the Danish Emergency Management Agency is responsible for actions to minimize the consequences in Danish territory. To provide an overview of the situation, a computer based system called ARGOS-NT has been developed in 1993/94. This paper gives an overview of the system with emphasis on the prognostic part of the system. An example calculation shows the importance of correct landscape modeling. (author)

  4. Extension of emergency operating procedures for severe accident management

    International Nuclear Information System (INIS)

    Chiang, S.C.

    1992-01-01

    To enhance the capability of reactor operators to cope with the hypothetical severe accident its the key issue for utilities. Taiwan Power Company has started the enhancement programs on extension of emergency operating procedures (EOPs). It includes the review of existing LOPs based on the conclusions and recommendations of probabilistic risk assessment studies to confirm the operator actions. Then the plant specific analysis for accident management strategy will be performed and the existing EOPs will be updated accordingly

  5. Improving emergency management through shared information processing - considerations in Emergency Operations Center design

    International Nuclear Information System (INIS)

    DeBusk, R.E.; Walker, J.A.

    1987-01-01

    An Emergency Operations Center (EOC) is a shared information processing facility. Although seemingly obvious, many EOCs are designed and operated based on other criteria. The results, measured in terms of response effectiveness, are difficult to determine. A review of some recent disasters reveals a pattern of poor performance for the EOCs involved. These conclusions are tentative because so little research has been done on the design, operation, or evaluation of emergency operations centers. The EOC is not an onsite response command post but a facility removed from the response where tactical and strategic decisions are made based on information from the response site and elsewhere. The EOC is therefore the central focus of emergency information processing and higher-level decision making. Examining existing EOCs, several common functions emerge. These functions can be described in terms of shared information processing. However, many factors impact the design and operation of EOCs. Politics, budgets, and personal ambition are only a few such factors. Examining EOC design and operation in terms of shared information processing operationalized in the seven principal functions within the EOC provides a framework for establishing principles of EOC design and operation. In the response to emergencies such as Bhopal or Chernobyl the stakes are high. Applying new techniques and technologies of management systems can improve the probability of success. This research is a beginning step - to understand how EOCs function, to define the system. Predictive or prescriptive analysis must wait until sufficient empirical data is available to complete a descriptive model for EOC operations

  6. [Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol].

    Science.gov (United States)

    Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J

    2010-01-01

    To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.

  7. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  8. Coastal emergency managers' preferences for storm surge forecast communication.

    Science.gov (United States)

    Morrow, Betty Hearn; Lazo, Jeffrey K

    2014-01-01

    Storm surge, the most deadly hazard associated with tropical and extratropical cyclones, is the basis for most evacuation decisions by authorities. One factor believed to be associated with evacuation noncompliance is a lack of understanding of storm surge. To address this problem, federal agencies responsible for cyclone forecasts are seeking more effective ways of communicating storm surge threat. To inform this process, they are engaging various partners in the forecast and warning process.This project focuses on emergency managers. Fifty-three emergency managers (EMs) from the Gulf and lower Atlantic coasts were surveyed to elicit their experience with, sources of, and preferences for storm surge information. The emergency managers-who are well seasoned in hurricane response and generally rate the surge risk in their coastal areas above average or extremely high-listed storm surge as their major concern with respect to hurricanes. They reported a general lack of public awareness about surge. Overall they support new ways to convey the potential danger to the public, including the issuance of separate storm surge watches and warnings, and the expression of surge heights using feet above ground level. These EMs would like more maps, graphics, and visual materials for use in communicating with the public. An important concern is the timing of surge forecasts-whether they receive them early enough to be useful in their evacuation decisions.

  9. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  10. Development of software to provide practical guidance in the managing of a radiological emergency

    International Nuclear Information System (INIS)

    Ferreira Filho, Alfredo L.; Lima, Fernando R.A.; Loureiro, Eduardo C.M.

    2008-01-01

    One of the most important aspects of managing a radiological emergency is the ability to promptly and adequately determine and take actions to protect members of public and emergency workers. This work brings up to date a computer software program in Delphi, with the tools, generic procedures and the data necessary to support the Incident Commander, the Radiological Assessor and other members of a generic response organization in case of radiological accident. The aim is also to provide practical guidance for the first responders who will respond during the first few hours to a radiological emergency and for the national officials who would support this early response. Software is now based on the Manual for First Responders to a Radiological Emergency (EPR-First Responders), published in 2006 as part of the IAEA Emergency Preparedness and Response Series, as well as in the IAEA technical document, Generic Procedures for Assessment and Response during a Radiological Emergency, the IAEA-TECDOC-1162, taking account of the lessons learned from using this last document in the area of early response and first responders' actions. The proposed procedures provide action criteria that are clear, concise and predetermined, based on the present knowledge and the accumulated experiences, allowing the immediate decision-making. The objective is to provide, through a portable computer, practical guidance, in the form of action guides, instructions, and supporting data for emergency response that, if implemented, will provide a basic assessment and the response capability needed to protect public and workers in case of different types of radiological emergencies. In addition to appropriate protective action recommendations, it will also provide, when it is necessary, general guidance on the recovery of radioactive sources and initial cleanup operations. The philosophy is to keep the process simple and fast, yet effective. Software is available in Spanish, English and Portuguese

  11. Management and training aspects of the emergency plan

    International Nuclear Information System (INIS)

    Lakey, J.R.A.

    1996-01-01

    The main objectives of an emergency management system are to prevent or reduce the likelihood of consequential loss in the event of an emergency occurring. In the event of a nuclear accident the effectiveness of measures for the protection of the public will depend on the advance preparation especially in education and training. This paper reviews two recent initiatives and concludes with comments on the future development of this subject. There is an increasing requirement in legal and moral terms for industry to inform the population of health hazards to which they are exposed. In a report published by the Nuclear Energy Agency (NEA/OECD) radiation protection was described as a subject which is impenetrable to the layman and as wide as it is complex. For this and other reasons radiation hazards are perceived to exceed all others and the public appear to have a poor image of the radiation protection specialists. Communication with the public and the media is widely recognized as a key pan of an emergency plan. This view is supported in the European Union which has sponsored the book on 'Radiation and Radiation Protection - a course for primary and secondary schools' which is described in this paper. The training of emergency teams includes the use of drills and exercises to maintain skills and can also be used to test the adequacy of plans. Every effort should be made to simulate the pressure on time and resources which would occur in a real event. Radiation emergencies are fortunately rare and so there is little practical experience of these events. The emergency worker must gain some radiation protection skills and must be able to use some technical language when communicating with specialist advisors. For this reason the European Union has sponsored the book 'Radiation Protection for Emergency Workers' which is also described in this paper. (author)

  12. Managing climate change risk : emerging financial sector expectations

    International Nuclear Information System (INIS)

    Williams, R.

    2004-01-01

    Engagement of the financial sector in the climate change debate is apparent, with social investors and advocacy groups launching 32 climate change related shareholder resolutions with American and Canadian energy companies in 2003. Eos Research and Consulting Ltd. recently conducted a study to examine emerging standards for how energy companies manage climate change related risks. A survey was conducted in the first part of the study to determine the environmental awareness of energy companies. Financial firms were asked whether they sought information concerning GHG inventories; projections of future emissions; action plans for addressing climate change and energy efficiency; evaluation of relative risk; estimation of cost of carbon; assessment of financial impact; evaluation of future regulations; and emissions trading activity. The second part of the study compared the response of 11 leading energy companies. The result was 2 opposing views on how climate change risks should be managed. The survey revealed that while most mainstream financial institutions are not paying much attention to climate change issues, socially responsible investment (SRI) investors are aware and working to factor climate change risk management information into their activities. In addition, SRI is growing at a faster pace than other investment segments, which may lead to greater future expectations for energy companies' climate change risk management efforts. It was concluded that the financial sector may emerge as an important source of direction that will guide energy companies in their future efforts to manage climate change risks. The five trends that contribute to the sector's emerging role are the continuing influence of advocacy groups; evolution of socially responsible approaches to investment; growing concerns for reputation; development of financial risk assessment approaches in terms of climate change; and, increase focus on corporate governance issues. 15 refs., 2 tabs., 1

  13. Research of an emergency medical system for mass casualty incidents in Shanghai, China: a system dynamics model.

    Science.gov (United States)

    Yu, Wenya; Lv, Yipeng; Hu, Chaoqun; Liu, Xu; Chen, Haiping; Xue, Chen; Zhang, Lulu

    2018-01-01

    Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program. Intervention scenarios were designed as adjusting scales of MCIs, allocation of ambulances, allocation of emergency medical staff, and efficiency of organization and command. Mortality increased with the increasing scale of MCIs, medical rescue capability of hospitals was relatively good, but the efficiency of organization and command was poor, and the prehospital time was too long. Mortality declined significantly when increasing ambulances and improving the efficiency of organization and command; triage and on-site first-aid time were shortened if increasing the availability of emergency medical staff. The effect was the most evident when 2,000 people were involved in MCIs; however, the influence was very small under the scale of 5,000 people. The keys to decrease the mortality of MCIs were shortening the prehospital time and improving the efficiency of organization and command. For small-scale MCIs, improving the utilization rate of health resources was important in decreasing the mortality. For large-scale MCIs, increasing the number of ambulances and emergency medical professionals was the core to decrease prehospital time and mortality. For super-large-scale MCIs, increasing health resources was the premise.

  14. Smothering in UK free-range flocks. Part 1: incidence, location, timing and management.

    Science.gov (United States)

    Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A

    2014-07-05

    Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.

  15. Web-of-Objects (WoO)-based context aware emergency fire management systems for the Internet of Things.

    Science.gov (United States)

    Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

    2014-02-13

    Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository.

  16. Web-of-Objects (WoO-Based Context Aware Emergency Fire Management Systems for the Internet of Things

    Directory of Open Access Journals (Sweden)

    Zia Ush Shamszaman

    2014-02-01

    Full Text Available Recent advancements in the Internet of Things (IoT and the Web of Things (WoT accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository.

  17. Web-of-Objects (WoO)-Based Context Aware Emergency Fire Management Systems for the Internet of Things

    Science.gov (United States)

    Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

    2014-01-01

    Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository. PMID:24531299

  18. Management of Complications Following Emergency and Elective Surgery for Diverticulitis.

    Science.gov (United States)

    Holmer, Christoph; Kreis, Martin E

    2015-04-01

    The clinical spectrum of sigmoid diverticulitis (SD) varies from asymptomatic diverticulosis to symptomatic disease with potentially fatal complications. Sigmoid colectomy with restoration of continuity has been the prevailing modality for treating acute and recurrent SD, and is often performed as a laparoscopy-assisted procedure. For elective sigmoid colectomy, the postoperative morbidity rate is 15-20% whereas morbidity rates reach up to 30% in patients who undergo emergency surgery for perforated SD. Some of the more common and serious surgical complications after sigmoid colectomy are anastomotic leaks and peritonitis, wound infections, small bowel obstruction, postoperative bleeding, and injuries to the urinary tract structures. Regarding the management of complications, it makes no difference whether the complication is a result of an emergency or an elective procedure. The present work gives an overview of the management of complications in the surgical treatment of SD based on the current literature. To achieve successful management, early diagnosis is mandatory in cases of deviation from the normal postoperative course. If diagnostic procedures fail to deliver a correlate for the clinical situation of the patient, re-laparotomy or re-laparoscopy still remain among the most important diagnostic and/or therapeutic principles in visceral surgery when a patient's clinical status deteriorates. The ability to recognize and successfully manage complications is a crucial part of the surgical treatment of diverticular disease and should be mastered by any surgeon qualified in this field.

  19. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    Directory of Open Access Journals (Sweden)

    Gianluca Raffaello Damiani

    2014-01-01

    Full Text Available A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management.

  20. Emergency management: Does it have a sufficiently comprehensive understanding of decision-making, process and context?

    International Nuclear Information System (INIS)

    Niculae, C.; French, S.; Carter, E.

    2004-01-01

    It is widely recognised in the social and management sciences that the effective support of decision-making requires a multidisciplinary perspective. This trend is also clear in nuclear emergency management (EM). However, communication between disciplines is not easy to maintain in EM contexts when the decision makers (DMs) are likely to be highly stressed. Such circumstances can lead them to revert to the instinctive patterns of perception of their core disciplines, making communication between disciplines difficult and, perhaps, obscuring complex interactions that have not been rehearsed in practice exercises. This paper explores decision making in EM and the nature of the socio-technical issues that will arise, suggesting that despite the lessons of past accidents the research EM community is still not taking a broad enough view of what future incidents may entail. (authors)

  1. Poststroke Fatigue: Emerging Evidence and Approaches to Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Hinkle, Janice L; Becker, Kyra J; Kim, Jong S; Choi-Kwon, Smi; Saban, Karen L; McNair, Norma; Mead, Gillian E

    2017-07-01

    At least half of all stroke survivors experience fatigue; thus, it is a common cause of concern for patients, caregivers, and clinicians after stroke. This scientific statement provides an international perspective on the emerging evidence surrounding the incidence, prevalence, quality of life, and complex pathogenesis of poststroke fatigue. Evidence for pharmacological and nonpharmacological interventions for management are reviewed, as well as the effects of poststroke fatigue on both stroke survivors and caregivers. © 2017 American Heart Association, Inc.

  2. Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

    OpenAIRE

    Tanya W. Moseley; Ashley Stanley; Wei Wei; Jay R. Parikh

    2018-01-01

    Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinic...

  3. Pain management: association with patient satisfaction among emergency department patients.

    Science.gov (United States)

    Bhakta, Hemangini C; Marco, Catherine A

    2014-04-01

    Patient satisfaction with emergency care is associated with timeliness of care, empathy, technical competence, and information delivery. Previous studies have demonstrated inconsistent findings regarding the association between pain management and patient satisfaction. This study was undertaken to determine the association between pain management and patient satisfaction among Emergency Department (ED) patients presenting with acute painful conditions. In this survey study, a standardized interview was conducted at the Emergency Department at the University of Toledo Medical Center in May-July 2011. Participants were asked to answer 18 questions pertaining to patient satisfaction. Additional data collected included demographic information, pain scores, and clinical management. Among 328 eligible participants, 289 (88%) participated. The mean triage pain score on the verbal numeric rating scale was 8.2 and the mean discharge score was 6.0. The majority of patients (52%) experienced a reduction in pain of 2 or more points. Participants received one pain medication dose (44%), two medication doses (14%), three medication doses (5%), or four medication doses (2%). Reduction in pain scores of 2 or more points was associated with a higher number of medications administered. Reduction in pain scores was associated with higher satisfaction as scored on questions of patient perceptions of adequate assessment and response to pain, and treatment of pain. There was a significant association between patient satisfaction and a reduction in pain of 2 or more points and number of medications administered. Effective pain management is associated with improved patient satisfaction among ED patients with painful conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Federal Emergency Management Information system (FEMIS) data management guide. Version 1.2

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Johnson, S.M.; Loveall, R.M.; Winters, C.

    1996-05-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical and Biological Defense Command. The FEMIS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain the data resources in the system. Database administrators, system administrators, and general users can use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of FEMIS. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, how it is loaded, and how it is managed while the system is in operation.

  5. Integrated Safety, Environmental and Emergency Management System (ISEEMS)

    International Nuclear Information System (INIS)

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-01-01

    The Risk Management and NEPA (National Environmental Policy Act) Department of Sandia National Laboratories/New Mexico (SNL/NM) recognized the need for hazard and environmental data analysis and management to support the line managers' need to know, understand, manage and document the hazards in their facilities and activities. The Integrated Safety, Environmental, and Emergency Management System (ISEEMS) was developed in response to this need. SNL needed a process that would quickly and easily determine if a facility or project activity contained only standard industrial hazards and therefore require minimal safety documentation, or if non-standard industrial hazards existed which would require more extensive analysis and documentation. Many facilities and project activities at SNL would benefit from the quick screening process used in ISEEMS. In addition, a process was needed that would expedite the NEPA process. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables SNL line organizations to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. All hazard-related information contained within ISEEMS is location based and can be displayed using on-line maps and building floor plans. This visual representation provides for quick assimilation and analysis

  6. Application of geographic information system for emergency management

    International Nuclear Information System (INIS)

    Best, R.G.; Guber, A.L.; Kliman, D.H.

    1991-01-01

    One of the responsibilities of the DOE Nevada Operations Office, under the Federal Radiological Emergency Response Plan (FRERP) and the Aerial Measuring System (AMS) program, is the acquisition and analysis of radiological and associated environmental data. Much of the data are in the form of maps, tabular summaries, and vertical imagery. It is critical that these data be rapidly compiled into a common format in order to make accurate observations and informed decisions. This data management task is both large and complex. Within the Federal Radiological Monitoring and Assessment Center (FRMAC) there is a continuing effort to improve the data management and communication process. The most recent addition to this essential function has been the development and testing of a deployable Digital Image Processing (IP) / Geographic Information System (GIS). To demonstrate the potential of GIS for emergency response, the system was utilized at an interagency post-emergency table top exercise. A geographic database, consisting of 27 coregistered ''layers'' of cultural, radiological, satellite image,and environmental data was developed for the area within a 50-mile radius of the River Bend Station in Louisiana. In support of the exercise, maps and real time displays of individual layers and combinations of layers were produced to determine the impact of a hypothetical radiological release and to develop mitigation plans. 3 refs., 2 figs

  7. Reverse quality management: developing evidence-based best practices in health emergency management.

    Science.gov (United States)

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  8. Managing Emergencies in Rural North Queensland: The Feasibility of Teletraining

    Directory of Open Access Journals (Sweden)

    Tarsh Pandit

    2018-01-01

    Full Text Available Introduction. Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors in Australia, minimal evidence exists in the literature. This paper aimed to explore the use of teletraining in the context of managing emergency presentations in rural hospitals. Methods. Using a qualitative approach, a mixture of junior and senior doctors were invited to participate in semistructured interviews. Data were transcribed and analysed line by line. Applying the grounded theory principles of open and axial coding, themes and subthemes were generated. Results. A total of 20 interviews were conducted with rural doctors, rural doctors who are medical educators, and emergency medicine specialists. Two major themes—(1 teletraining as education and (2 personal considerations—and ten subthemes were evident from the data. Most participants had some previous experience with teletraining. Access to peer teaching over videoconference was requested by rural generalist registrars. There was a preference for interactive training sessions, over didactic lectures with little mention of technical barriers to engagement. The ability of teletraining to reduce professional isolation was a major benefit for doctors practicing in remote locations. Discussion. For these rural doctors, teletraining is a feasible method of education delivery. Wider application of teletraining such as its use in peer teaching needs to be explored. The benefits of teletraining suggest that teletraining models need to be core business for health services and training providers, including specialist colleges.

  9. Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.5

    Energy Technology Data Exchange (ETDEWEB)

    Bower, John C.(BATTELLE (PACIFIC NW LAB)); Burnett, Robert A.(BATTELLE (PACIFIC NW LAB)); Carter, Richard J.(BATTELLE (PACIFIC NW LAB)); Downing, Timothy R.(BATTELLE (PACIFIC NW LAB)); Homer, Brian J.(BATTELLE (PACIFIC NW LAB)); Holter, Nancy A.(BATTELLE (PACIFIC NW LAB)); Johnson, Daniel M.(BATTELLE (PACIFIC NW LAB)); Johnson, Ranata L.(BATTELLE (PACIFIC NW LAB)); Johnson, Sharon M.(BATTELLE (PACIFIC NW LAB)); Loveall, Robert M.(BATTELLE (PACIFIC NW LAB)); Ramos Jr., Juan (BATTELLE (PACIFIC NW LAB)); Schulze, Stacy A.(BATTELLE (PACIFIC NW LAB)); Sivaraman, Chitra (BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Stoops, Lamar R.(BATTELLE (PACIFIC NW LAB)); Wood, Blanche M.(BATTELLE (PACIFIC NW LAB))

    2001-12-01

    The Federal Emergency Management System (FEMIS) is an emergency management planning and response tool. The FEMIS System Administration Guide provides information on FEMIS System Administrator activities as well as the utilities that are included with FEMIS.

  10. Transient global amnesia: emergency department evaluation and management [digest].

    Science.gov (United States)

    Faust, Jeremy Samuel; Nemes, Andreea; Zaurova, Milana

    2016-08-22

    Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department. [Points & Pearls is a digest of Emergency Medicine Practice].

  11. CMSMAP : oil, chemical, search and rescue, and marine emergency response crisis management system

    International Nuclear Information System (INIS)

    Anderson, E.L.; Howlett, E.; Galagan, C.; Giguere, T.; Wee, F.; Chong, J.

    2002-01-01

    This paper describes a newly developed Crisis Management System (CMS) which makes it possible to view oil and chemical spills on the seafloor. The CMS is designed to run in a network environment, so that multiple stations can be used cooperatively to respond to a spill incident. It was developed by the Maritime and Port Authority in Singapore and represents a singular integration of a ship's bridge simulator hardware and software. It incorporates numerical models and emergency response software. The CMS is installed in a specifically designed building at the Singapore Polytechnic University, and is integrated with two shipping bridge simulators. One user interface has access to models dealing with oil spills, chemical spills, search and rescues, marine emergencies, and nuclear disasters. The interface is linked to a response management system. The entire system is used to train response personnel to marine emergencies. The histories and costs of planned response activities are described and logged for reference purposes. Estimates of damages associated with spills can be obtained. Alternative response plans can also be determined. Further research in 2002 will focus on developing real time response. 3 refs., 6 figs

  12. Alaska GRIN project : development of geospatial data management interface for oil spill and emergency response

    Energy Technology Data Exchange (ETDEWEB)

    Catalano, S. [Cook Inlet Regional Citizens Advisory Council, Kenai, AK (United States); Robertson, T.L. [Nuka Research and Planning Group LLC, Seldovia, AK (United States); DeCola, E. [Nuka Research and Planning Group LLC, Plymouth, MA (United States)

    2009-07-01

    A geographic response network (GRIN) project was conducted in 2005 to develop a computer-based tool for organizing maps and data related to oil spill and emergency response logistics and community resources. Originally conceived as an html-based website where information was organized based on incident command system divisions of responsibility, open source mapping applications are also being added to crate an interactive map interface with geospatially referenced information. GRIN information is organized by community. A locator map is embedded in the lower right-hand corner of each map. GRIN includes categories of information related to emergency management, air logistics, law enforcement, marine logistics, and shore-side logistics. A project is now being conducted by the Cook Inlet Regional Citizens' Advisory Council to convert the html-based GRIN into a geospatial data management tool. A prototype has now been populated with data for several Cook Inlet communities. GRIN can also be accessed on only computer with an Internet browser. It was concluded that the use of open source programming will make GRIN an easy tool for planners and emergency responders. 5 refs., 6 figs.

  13. Management of novel oral anticoagulants in emergency and trauma surgery.

    Science.gov (United States)

    Pinho-Gomes, Ana-Catarina; Hague, Adam; Ghosh, Jonathan

    2016-08-01

    The compelling safety, efficacy and predictable effect of novel oral anticoagulants (NOACs) is driving a rapid expansion in their therapeutic indications. Management of the increasing number of patients on those new agents in the setting of emergency or trauma surgery can be challenging and the absence of specific reversal agents has been a matter of concern. This review summarises the key principles that underpin the management of those patients with a particular emphasis on the recent development of specific antidotes. As of 2015, a new line of antidotes, specific for these drugs, are at different stages of their development with their release imminent. However, as NOACs are innately reversible due to their short half-life, the use of reversal agents will probably be restricted to a few exceptional cases. Post-marketing surveillance will be paramount to better clarify the role of these promising drugs. Management of patients on NOACs in the context of emergency or trauma surgery relies on best supportive care in combination with the blood products and/or specific antidotes as required. Familiarity with the new reversal agents is essential but further evidence on their indications, safety and efficacy as well as consensus guidelines are warranted prior to widespread adoption. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

    Science.gov (United States)

    Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

    2013-01-01

    As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

  15. Surgical management of acutely presenting gastrointestinal stromal tumors of the stomach among elderly: experience of an emergency surgery department.

    Science.gov (United States)

    Marano, Luigi; Arru, Giovanni Maria Antonio; Piras, Mario; Fiume, Stefania; Gemini, Sergio

    2014-01-01

    The incidence of gastrointestinal stromal tumors (GISTs), requiring often an emergency surgical management, is extremely rare among elderly. We aimed to present the experience of the Emergency Surgery Department, Brotzu Hospital, in the management of elderly patients with GIST related emergencies. This study was carried out on 12 patients with gastrointestinal stromal tumors who presented to in an emergency situation during the period from January 2010 to December 2013. All patients' data, clinical presentations, surgical procedures, complications, and survival data were collected and analyzed. Between 2010 and 2013, 12 patients (8 males and 4 females), with a mean age of 70 years (range: 65-79 years) were admitted with different emergency presentations of clinically and radiologically suspected GISTs. The incidence of proximal obstruction was 41.7% of all gastric GIST cases, resulting acute gastrointestinal bleeding and perforation in 41.7% and 16.6% respectively. The mean length of hospitalization was 9.1 ± 2.3 days and there were no posterative complications or mortalities. At a mean follow-up of 21 months, 11 patients (91.6%) were alive and disease free. Although GISTs are uncommon among elderly, their incidence is increasing especially in their emergency presentation and surgeon should be prepared to treat this condition following the principles of GIST surgery as stated by the GIST consensus conference. In conclusion our data demonstrate that age itself does not affect the outcome of surgical treatment of GISTs in emergency situation. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Emergency preparedness incident response and radiation monitoring in Finland. Annual report 1999

    International Nuclear Information System (INIS)

    Ristonmaa, S.

    2000-04-01

    The Radiation and Nuclear Safety Authority (STUK) publishes annually a report about STUK's preparedness measures. The report describes notifications received by STUK's on duty system and further measures carried out after receiving a message. In addition, the emergence exercises STUK participated in during the year are described. The radiation situation in Finland is continuously monitored. STUK is the authority who carries out a wide range of environmental measurements, sampling and sensitive laboratory analyses. The measurement results are presented in the form of tables and graphically. (editor)

  17. Emergency preparedness incident response and radiation monitoring in Finland. Annual report 1998

    International Nuclear Information System (INIS)

    Ristonmaa, S.

    1999-03-01

    The Radiation and Nuclear Safety Authority (STUK) publishes annually a report about STUK's preparedness measures. The report describes notifications received by STUK's on duty system and further measures carried out after receiving a message. In addition, the emergence exercises STUK participated in during the year are described. The radiation situation in Finland is continuously monitored. STUK is the authority who carries out a wide range of environmental measurements, sampling and sensitive laboratory analyses. The measurement results are presented in the form of tables and graphically. (editor)

  18. Incident Reporting to Improve Patient Safety: The Effects of Process Variance on Pediatric Patient Safety in the Emergency Department.

    Science.gov (United States)

    OʼConnell, Karen J; Shaw, Kathy N; Ruddy, Richard M; Mahajan, Prashant V; Lichenstein, Richard; Olsen, Cody S; Funai, Tomohiko; Blumberg, Stephen; Chamberlain, James M

    2018-04-01

    Medical errors threaten patient safety, especially in the pediatric emergency department (ED) where overcrowding, multiple handoffs, and workflow interruptions are common. Errors related to process variance involve situations that are not consistent with standard ED operations or routine patient care. We performed a planned subanalysis of the Pediatric Emergency Care Applied Research Network incident reporting data classified as process variance events. Confidential deidentified incident reports (IRs) were collected and classified by 2 independent investigators. Events categorized as process variance were then subtyped for severity and contributing factors. Data were analyzed using descriptive statistics. The study intention was to describe and measure reported medical errors related to process variance in 17 EDs in the Pediatric Emergency Care Applied Research Network from 2007 to 2008. Between July 2007 and June 2008, 2906 eligible reports were reviewed. Process variance events were identified in 15.4% (447/2906). The majority were related to patient flow (35.4%), handoff communication (17.2%), and patient identification errors (15.9%). Most staff involved included nurses (47.9%) and physicians (28%); trainees were infrequently reported. The majority of events did not result in harm (65.7%); 17.9% (80/447) of cases were classified as unsafe conditions but did not reach the patient. Temporary harm requiring further treatment or hospitalization was reported in 5.6% (25/447). No events resulted in permanent harm, near death, or death. Contributing factors included human factors (92.1%), in particular handoff communication, interpersonal skills, and compliance with established procedures, and system-level errors (18.1%), including unclear or unavailable policies and inadequate staffing levels. Although process variance events accounted for approximately 1 in 6 reported safety events, very few led to patient harm. Because human and system-level factors contributed to

  19. Developing an electronic system to manage and track emergency medications.

    Science.gov (United States)

    Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

    2018-03-01

    The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Improved nuclear emergency management system reflecting lessons learned from the emergency response at Fukushima Daini Nuclear Power Station after the Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Kawamura, Shinichi; Narabayashi, Tadashi

    2016-01-01

    Three nuclear reactors at Fukushima Daini Nuclear Power Station lost all their ultimate heat sinks owing to damage from the tsunami caused by the Great East Japan Earthquake on March 11, 2011. Water was injected into the reactors by alternate measures, damaged cooling systems were restored with promptly supplied substitute materials, and all the reactors were brought to a cold shutdown state within four days. Lessons learned from this experience were identified to improve emergency management, especially in the areas of strategic response planning, logistics, and functions supporting response activities continuing over a long period. It was found that continuous planning activities reflecting information from plant parameters and response action results were important, and that relevant functions in emergency response organizations should be integrated. Logistics were handled successfully but many difficulties were experienced. Therefore, their functions should be clearly established and improved by emergency response organizations. Supporting emergency responders in the aspects of their physical and mental conditions was important for sustaining continuous response. As a platform for improvement, the concept of the Incident Command System was applied for the first time to a nuclear emergency management system, with specific improvement ideas such as a phased approach in response planning and common operation pictures. (author)

  1. Deployment of Small Unmanned Aerial Systems (sUAS) in Emergency and Disaster Response Scenarios to Support Local Emergency Management Agencies

    Science.gov (United States)

    Calamaio, C. L.; Walker, J.; Beck, J. M.; Graves, S. J.; Johnson, C.

    2017-12-01

    Researchers at the Information Technology and Systems Center at the University of Alabama in Huntsville are working closely with the Madison County Emergency Management Agency (EMA), GeoHuntsville's UAS Working Group, and the NOAA UAS Program Office, to conduct a series of practical demonstrations testing the use of small unmanned aerial systems (sUAS) for emergency response activities in Madison County, Alabama. These exercises demonstrate the use of UAS to detect and visualize hazards in affected areas via the delivery of aerial imagery and associated data products to law enforcement first responders in a variety of different scenarios, for example, search and rescue, tornado track mapping, damage assessment, and situational awareness/containment during active shooter incidents. In addition to showcasing the use of UAS as a tool for emergency services, these pilot exercises provide the opportunity to engage the appropriate stakeholders from several communities including first responders, geospatial intelligence, active members of the unmanned systems industry, and academia. This presentation will showcase the challenges associated with delivering quality data products for emergency services in a timely manner as well as the related challenges in integrating the technology into local emergency management.

  2. Plant incident progress scenario analysis for nuclear emergency exercise of Fukui Pref. 2009

    International Nuclear Information System (INIS)

    Tatebe, Yasumasa; Yoshida, Yoshitaka; Minami, Noritoshi

    2010-01-01

    Severe accident scenario was analyzed to assist the nuclear emergency exercise of Fukui prefecture in 2009. The evaluation of the postulated disaster was evaluated based on analysis result, including the time of occurrence of specified events, response of the plant to the AM measures, etc. The evaluation results are as follows: (1) loss of core cooling took place about 7 hours after, abnormal leakage of fission products from containment vessel to the containment annulus started about 17 hours after and the disaster terminated about 46 hours after the initiation of the accident, (2) although multiple failures of the engineered safety system and failure of AM measures were postulated in the accident scenario, the integrity of the containment vessel could be maintained successfully for a long term, if the AM measures are taken to protect the containment vessel. (3) according to the evaluation of radiation dose rate during the emergency response assuming the operation of recirculation mode using containment spray A, the dose rate could be too high for the operators to work not only in the containment spray A area but also in the another containment spray heat exchanger and the residual heat removal system heat exchanger areas. (author)

  3. OEM Emergency Response Information

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Office of Emergency Management retains records of all incident responses in which it participates. This data asset includes three major sources of information:...

  4. 76 FR 60067 - Privacy Act of 1974; Department of Homeland Security Federal Emergency Management Agency-012...

    Science.gov (United States)

    2011-09-28

    ... 1974; Department of Homeland Security Federal Emergency Management Agency--012 Suspicious Activity... establish a new system of records titled, ``Department of Homeland Security/Federal Emergency Management... Department of Homeland Security/Federal Emergency Management Agency to collect, maintain, and retrieve...

  5. Emergency Status Management in Energetic Field . Risk Transfer

    Directory of Open Access Journals (Sweden)

    Gherasim Solovestru DOMIDE

    2016-12-01

    Full Text Available The state of emergency in the energy sector generates technical problems such as: disruption in the operation of machinery and equipment, replacement of equipment or others needs. Besides the technical problems which appear, also intervene economic and financial issues that generate costs for the replacement of machines, equipment and installations and expenses of compensation to third parties who have suffered losses by disconnecting the power supply or lack of electricity over a longer or shorter period. Modern methods of risk management include also economic solutions. Some of these solutions will be treated in this paper.

  6. Corticosteroid use in management of pediatric emergency conditions [digest].

    Science.gov (United States)

    Thabet, Asalim; Greenfield, Tyler; Cantor, Richard M; Wilson, Bryan

    2018-03-01

    Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  7. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...... and handling of symptoms of downhole drilling contingencies at an early stage are therefore crucial for the reliability and safety of MPD operations. In this paper we describe a method for early detection and localization of such incidents, based on a fit for purpose model of the downhole pressure hydraulics...... successfully been tested on experimental data from a medium-scale horizontal flow loop in Sta- vanger, Norway. The flow loop represents a 700 m borehole with emulation of the following downhole contingencies: drillstring washout, drill bit nozzle plugging, gas influx and fluid loss. In the tests...

  8. Education and training of physicians for radiation emergency management

    International Nuclear Information System (INIS)

    Reiners, Christoph; Schneider, Rita

    2012-01-01

    The project orders implied the development, testing, and evaluation of a curriculum for educating and training physicians in prehospital radiation accident management and the development of a master curriculum. Objectives were to develop, preserve, and enlarge medical competence concerning prehospital care of radiation accident patients. The project is expected to contribute to qualify emergency physicians challenged by scenarios related to radiological and nuclear hazards. The development and the content of the curriculum for educating and training physicians in prehospital radiation accident management are being described. The conduction and evaluation of two pilot training courses with a total of 40 participating physicians are being presented. Successful testing of the pilot courses proves the value of the curriculum developed. Self-contained courses can be performed according to the master curriculum and the respective master presentations. Moreover, single modules can be integrated in existing education and training programmes. Suggestions for the implementation and accreditation of the curriculum are being made. (orig.)

  9. Do formal management practices impact the emergence of bootlegging behavior?

    DEFF Research Database (Denmark)

    Globocnik, Dietfried; Salomo, Søren

    2014-01-01

    behavior, research has barely addressed the antecedents of this deviance. Drawing on strain theory and social cognitive theory, we study whether the emergence of bootlegging behavior is influenced by formal management practices, in particular, strategic autonomy, front-end formality, rewards, and sanctions......Innovation in an organization often relies on initiatives by employees who take action to develop their ideas and obtain buy-in by organizational decision-makers. To achieve this, employees sometimes apply unorthodox approaches, ignoring formal structures to further elaborate their ideas' potential...... and promote their implementation. They work without formal legitimacy and gather their own resources until sufficient clarity allows for informed decisions. Finally, they bypass formal communication channels to convince top management of the merits of their ideas. Despite the significance of such bootlegging...

  10. Joint Radiation Emergency Management Plan of the International Organizations. Date Effective: 1 July 2013

    International Nuclear Information System (INIS)

    2013-01-01

    The Convention on Early Notification of a Nuclear Accident (the 'Early Notification Convention') and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the 'Assistance Convention') are prime legal instruments that establish an international framework to facilitate the exchange of information and the prompt provision of assistance in the event of a radiation emergency, with the aim of minimizing the consequences. The International Atomic Energy Agency (IAEA) has specific functions assigned to it under these Conventions, to which the the European Commission, through the European Atomic Energy Community (Euratom), the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Meteorological Organization (WMO) are full Parties. The arrangements between the IAEA, States and international intergovernmental organizations ('international organizations') for facilitating the practical implementation of those articles of the two Conventions that are operational in nature are documented in the IAEA's Operations Manual for Incident and Emergency Communication (IEComm). In addition to the IEComm arrangements and pursuant to the obligations placed on the IAEA by the Conventions, the IAEA regularly convenes the Inter-Agency Committee on Radiological and Nuclear Emergencies (IACRNE), whose purpose is to coordinate the arrangements of the relevant international organizations for preparing for and responding to radiation incidents or emergencies. Although the Conventions assign specific response functions and responsibilities to the IAEA and the Parties, various international organizations have - by virtue of their statutory functions or of related legal instruments (including, for example, the WHO International Health Regulations 2005) - functions and responsibilities that encompass aspects of preparedness and response in this context. Moreover, some regional organizations/bodies (e.g. the

  11. Joint Radiation Emergency Management Plan of the International Organizations. Date Effective: 1 July 2013

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-01

    The Convention on Early Notification of a Nuclear Accident (the 'Early Notification Convention') and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (the 'Assistance Convention') are prime legal instruments that establish an international framework to facilitate the exchange of information and the prompt provision of assistance in the event of a radiation emergency, with the aim of minimizing the consequences. The International Atomic Energy Agency (IAEA) has specific functions assigned to it under these Conventions, to which the the European Commission, through the European Atomic Energy Community (Euratom), the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Meteorological Organization (WMO) are full Parties. The arrangements between the IAEA, States and international intergovernmental organizations ('international organizations') for facilitating the practical implementation of those articles of the two Conventions that are operational in nature are documented in the IAEA's Operations Manual for Incident and Emergency Communication (IEComm). In addition to the IEComm arrangements and pursuant to the obligations placed on the IAEA by the Conventions, the IAEA regularly convenes the Inter-Agency Committee on Radiological and Nuclear Emergencies (IACRNE), whose purpose is to coordinate the arrangements of the relevant international organizations for preparing for and responding to radiation incidents or emergencies. Although the Conventions assign specific response functions and responsibilities to the IAEA and the Parties, various international organizations have - by virtue of their statutory functions or of related legal instruments (including, for example, the WHO International Health Regulations 2005) - functions and responsibilities that encompass aspects of preparedness and response in this context. Moreover, some regional organizations/bodies (e.g. the

  12. Federal Emergency Management Information System (FEMIS) Data Management Guide for FEMIS Version 1.4.6

    Energy Technology Data Exchange (ETDEWEB)

    Angel, L.K.; Bower, J.C.; Burnett, R.A.; Downing, T.R.; Fangman, P.M.; Hoza, M.; Johnson, D.M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Schulze, S.A.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  13. Workload management and geographic disorientation in aviation incidents: A review of the ASRS data base

    Science.gov (United States)

    Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.

    1993-01-01

    NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.

  14. [Results of provisional use of a system for voluntary anonymous reporting of incidents that threaten patient safety in the emergency medical services of Asturias].

    Science.gov (United States)

    Galván Núñez, Pablo; Santander Barrios, María Dolores; Villa Álvarez, María Cristina; Castro Delgado, Rafael; Alonso Lorenzo, Julio C; Arcos González, Pedro

    2016-06-01

    To describe the reported incidents and adverse events in the emergency medical services of Asturias, Spain, and assess their consequences, delays caused, and preventability. Prospective, observational study of incidents reported by the staff of the emergency medical services of Asturias after implementation of a system devised by the researchers. Incident reports were received for 0.48% (95% CI, 0.41%-0.54%) of the emergencies attended. Patient safety was compromised in 74.7% of the reported incidents. Problems arising in the emergency response coordination center (ERCC) accounted for 37.6% of the incidents, transport problems for 13.4%, vehicular problems for 10.8%, and communication problems for 8.8%. Seventy percent of the reported incidents caused delays in care; 55% of the reported incidents that put patients at risk (according to severity assessment code ratings) corresponded to problems related to human or material resources. A total of 88.1% of the incidents reported were considered avoidable. Some type of intervention was required to attenuate the effects of 46.2% of the adverse events reported. The measures that staff members most often proposed to prevent adverse events were to increase human and material resources (28.3%), establish protocols (14.5%), and comply with quality of care recommendations (9.7%). It is important to promote a culture of safety and incident reporting among health care staff in Asturias given the number of serious adverse events. Reporting is necessary for understanding the errors made and taking steps to prevent them. The ERCC is the point in the system where incidents are particularly likely to appear and be noticed and reported.

  15. Innovation Management in Emerging Technology Ventures – The Concept of an Integrated Idea Management

    DEFF Research Database (Denmark)

    Brem, Alexander; Voigt, K.-I.

    2007-01-01

    , development and sales. Here especially, differentiating potentials are offered for emerging technology ventures. But it is important that idea and innovation management are integrated during the building-up stage while internal and external network structures are still manageable and often consist...... of the managers' and founders' personal contacts. Hence, the earlier an integrated idea management is implemented, the greater is the probability of high numbers of successful innovations.......For decades, suggestion systems have been used to include employees in the innovation process. However, in order to gather superior ideas, integrating external stakeholders is critical to the innovation success. Within this paper, the authors derive a sophisticated model of an integrated idea...

  16. Abdominal emergencies after liver transplantation: Presentation and surgical management.

    Science.gov (United States)

    Cesaretti, Manuela; Dioguardi Burgio, Marco; Zarzavadjian Le Bian, Alban

    2017-11-01

    With an increasing number of liver transplantation (LT) and an enhanced overall survival, LT recipients are more likely to be admitted in emergency departments of general hospitals. Yet, in LT recipients, common but also benign symptoms may reveal a LT-related (or not) severe condition. To improve management of LT recipients by emergency physicians and general surgeons and potentially improve long-term outcomes, a clinical review was performed. Overall, CT scan and blood tests should be systematically performed. Immunosuppressive side effects should be excluded using blood tests. LT-related complications are more likely to occur during the first three months after LT, including mainly bile leak, arterial aneurysm, and pseudoaneurysm. Patients should be referred in emergency to tertiary centers. Non-LT-related complications and common abdominal conditions may also be diagnosed in LT recipients. Except in case of diffuse peritonitis or in hemodynamically unstable patients when surgical procedure should be performed, most conditions should be reassessed regarding the immunosuppressive treatment and the adhesive abdominal cavity. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Recognition and management of seizures in children in emergency departments.

    Science.gov (United States)

    Caplan, Edward; Dey, Indranil; Scammell, Andrea; Burnage, Katy; Paul, Siba Prosad

    2016-09-01

    Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management. Seizures in children can be an extremely distressing experience for parents, who should be supported and kept informed by experienced ED nurses. Nurses also play a vital role in educating parents on correct administration of anticonvulsants and safety advice. This article discusses the aetiology, clinical presentation, diagnosis and management of children with seizures, with particular emphasis on epilepsy. It includes two reflective case studies to highlight the challenges faced by healthcare professionals managing children who present with convulsions.

  18. [Paediatric emergencies; example of the management of winter epidemics].

    Science.gov (United States)

    Mercier, Jean-Christophe; Bellettre, Xavier; Lejay, Émilie; Desmarest, Marie; Titomanlio, Luigi

    2015-01-01

    Every year, epidemics of viral bronchiolitis and gastroenteritis occur with a significant increase in the number of visits (by a factor 1.8) and hospitalisations that can over-exceed bed capacity leading to transfer sick children to other hospitals. This kind of hospital 'crisis' is not limited to paediatrics, big cities or western nations. It is a worldwide worrying problem. Because our hospital sits in the Northern districts of Paris where a large community of m.ncants lives in poverty, our number of visits is high (mean 250 per day), and winter epidemics further jeopardise the difficult equilibrium achieved between quality management and waiting times. Thus, we have taken various initiatives in terms of organisation of the paediatric emergency department and other wards, including a "fast track" clinic, the opening of beds dedicated to winter epidemics, the institution of a "bed manager" in order to more easily find a bed, and a larger use of home hospitalisations. Furthermore, we created a specific committee which may decide on various indicators of tension whether it is necessary to cancel programmed hospitalisations or surgery.in order to resolve the emergency crisis. This kind of organisation can serve as a model for other hospitals facing winter epidemics crises.

  19. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

  20. Emergency information management needs and practices of older adults: A descriptive study.

    Science.gov (United States)

    Turner, Anne M; Osterhage, Katie; Loughran, Julie; Painter, Ian; Demiris, George; Hartzler, Andrea L; Phelan, Elizabeth A

    2018-03-01

    To better understand how older adults currently manage emergency information, the barriers and facilitators to planning and management of emergency information, as well as the potential role of information technology to facilitate emergency planning and management. Older adults face a much higher risk of sudden illness/injury and are the age group with the largest percentages of emergent and urgent healthcare visits. Emergency information (health information needed in an emergency situation such as emergency contact information, diagnoses, and advance directives) needs to be maintained and easily accessible to ensure older adults get appropriate care and treatment consistent with their wishes in emergency situations. Current health information technologies rarely take into consideration the emergency information needs of older adults, their caregivers, and emergency responders. As part of a larger study we performed in-depth interviews with 90 older adults living in a variety of residential settings (independent living, retirement communities, assisted living) regarding how they manage information about their health. Interview sessions included photos of important health information artifacts. Interviews were transcribed and coded. Analysis of in-depth interviews revealed that emergency information is a type of health information that older adults frequently manage. Participants differed in whether they practice emergency planning (e.g. the preparation and continued management of emergency information), and in whether they involve others in emergency information and emergency planning. Despite its importance, emergency information was often not up-to-date and not always kept in locations readily apparent to emergency responders. Emergency information, such as emergency contact information, diagnoses, and advance directives, is a type of health information that older adults manage. Considering emergency information in the design of health information technologies

  1. Operations Manual for Incident and Emergency Communication. Date Effective: 1 June 2012 (Spanish Edition); Manual de Operaciones para la Comunicacion de Incidentes y Emergencias. Fecha de Validez: 1 Junio de 2012

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-06-01

    years, the Unified System for Information Exchange in Incidents and Emergencies (USIE) for Contact Points and for INES national officers, revision of the Joint Radiation Emergency Management Plan of the International Organizations (Joint Plan), and changes to better reflect that emergency situations can arise from both accidents and criminal and other unauthorized acts. The General Conference of the IAEA in resolution GC(49)/RES/9 requested the Secretariat to continue to review and, as necessary, streamline its mechanisms for reporting and for sharing information and encouraged Member States to do the same. In 2007 the General Conference of the IAEA, in resolution GC(51)/RES/11, welcomed the decision to develop a global, unified incident and emergency reporting system which combines the Emergency Notification and Assistance Technical Operations Manual (ENATOM) arrangements and the Nuclear Events Web-based System (NEWS) mechanism. In resolution GC(54)/RES/7 the General Conference of the IAEA requested the Secretariat to continue its efforts to finalize and implement a global and unified system for reporting and sharing information on nuclear and radiological accidents and incidents, and to act upon the feedback provided by Member States. The General Conference of the IAEA, in resolution GC(54)/RES/7, also encouraged all Member States to enhance, where necessary, their own preparedness and response capabilities for nuclear and radiological incidents and emergencies, by improving capabilities to prevent accidents, to respond to emergencies and to mitigate any harmful consequences and, where necessary, to request support from the Secretariat or from other Member States in developing national capabilities consistent with international standards, and urges all Member States to take part in these exercises. The General Conference in resolution GC(55)/RES/9 urges Member States to reinforce emergency notification, reporting and information sharing arrangements and capabilities

  2. How The Australian National University's emergency management and continuity plans responded to a large-scale fire.

    Science.gov (United States)

    Meehan, Bart

    2008-01-01

    On 18th January, 2003, one of the worst bushfires in the history of Australia hit the capital city, Canberra. By the time it was under control, four people were dead and more than 500 homes were destroyed. The fire also destroyed the Mount Stromlo campus of the Australian National University, the location of the Research School of Astronomy and Astrophysics. In response to the fires, the University initiated its emergency management strategy and business continuity plans. These allowed the School to recommence limited operations within two weeks of the disaster. This paper details a case study of the impact of the fire (in part using personal recollections of staff and students), and the emergency response implemented by the University. It describes the development of the University's emergency management strategy, with its emphasis on the key elements of clear chain of command and flexibility in developing an incident-specific response. The paper also provides an assessment of how the plan worked during an actual incident and some of the lessons learned, including the importance of the early response, managing the impact on people, media management, insurance and communications.

  3. A national retrospective survey of anisakidosis in France (2010-2014: decreasing incidence, female predominance, and emerging allergic potential

    Directory of Open Access Journals (Sweden)

    Yera Hélène

    2018-01-01

    Full Text Available A retrospective survey was carried out over the years 2010–2014 among all Parasitology laboratories of University hospitals in France (ANOFEL network. The objective was to estimate the incidence of anisakidosis in France as new culinary habits such as the consumption of raw fish (sushi or undercooked fish are increasing. A total of 37 cases of anisakidosis were notified by all French laboratories: 7 proven cases with evidence of a worm, 12 possible cases with abdominal pain after consumption of raw fish with detection of anti-Anisakis precipitins, and 18 allergic cases defined as acute manifestations after consumption of fish, associated with specific IgE for Anisakis. The median age of affected individuals was 42 years (11-69 and there was a significant predominance of women (67%. Compared with previous surveys in France, this study indicates a decrease in clinical cases of anisakidosis and illustrates the emerging allergic potential of anisakids.

  4. Factors Influencing Quality of Pain Management in a Physician Staffed Helicopter Emergency Medical Service.

    Science.gov (United States)

    Oberholzer, Nicole; Kaserer, Alexander; Albrecht, Roland; Seifert, Burkhardt; Tissi, Mario; Spahn, Donat R; Maurer, Konrad; Stein, Philipp

    2017-07-01

    Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score helicopter emergency service associated with insufficient pain management. A total of 778 patients were included in the analysis. Insufficient pain management (NRS > 3 at hospital admission) was identified in 298 patients (38%). Factors associated with insufficient pain management were higher National Advisory Committee for Aeronautics scores, high NRS at the scene, nontrauma patients, no analgesic administration, and treatment by a female physician. In 16% (128 patients), despite ongoing pain, no analgesics were administered. Factors associated with this untreated persisting pain were short time at the scene (below 10 minutes), secondary missions of helicopter emergency service, moderate pain at the scene, and nontrauma patients. Sufficient management of severe pain is significantly better if ketamine is combined with an opioid (65%), compared to a ketamine or opioid monotherapy (46%, P = .007). In the studied specific Swiss cohort, nontrauma patients, patients on secondary missions, patients treated only for a short time at the scene before transport, patients who receive no

  5. Federal Emergency Management Information System (FEMIS) Data Management Guide Version 1.3

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Hoza, M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Winters, C.; Wood, B.M.

    1996-12-01

    FEMIS is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical and Biological Defense Command. FEMIS is designed to help civilian emergency management personnel to plan for and support their responses to a chemical-releasing event at a military chemical stockpile. This guide provides the background as well as the operations and procedures needed to generate and maintain the data resources in the system. Database administrators, system administrators, and general users can use this guide to manage the datafiles and database. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, loaded, and managed while the system is in operation.

  6. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

    Science.gov (United States)

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

  7. Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway.

    Science.gov (United States)

    Young, Victoria Solveig; Eggesbø, Heidi B; Gaarder, Christine; Næss, Pål Aksel; Enden, Tone

    2017-07-01

    To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. Nine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff. Plain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected. • Minimum acceptable care (MAC) should replace normal routines in mass casualty incidents. • MAC implied reduced use of imaging in the emergency department (ED). • CT in ED was restricted to suspected severe head injuries during MAC. • The radiologist should cancel all non-head CTs in the ED during MAC.

  8. FeOOH-loaded MnO2 nano-composite: An efficient emergency material for thallium pollution incident.

    Science.gov (United States)

    Chen, Meiqing; Wu, Pingxiao; Yu, Langfeng; Liu, Shuai; Ruan, Bo; Hu, Haihui; Zhu, Nengwu; Lin, Zhang

    2017-05-01

    A FeOOH-loaded MnO 2 nano-composite was developed as an emergency material for Tl(I) pollution incident. Structural characterizations showed that FeOOH successfully loaded onto MnO 2 , the nanosheet-flower structure and high surface area (191 m 2  g -1 ) of material contributed to the excellent performance for Tl(I) removal. FeOOH-loaded MnO 2 with a Fe/Mn molar ratio of 1:2 exhibited a noticeable enhanced capacity for Tl(I) removal compared to that of pure MnO 2 . The outstanding performance for Tl(I) removal involves in extremely high efficiency (achieved equilibrium and drinking water standard within 4 min) and the large maximum adsorption capacity (450 mg g -1 ). Both the control-experiment and XPS characterization proved that the removal mechanism of Tl(I) on FeOOH-loaded MnO 2 included adsorption and oxidation: the oxidation of MnO 2 played an important role for Tl(I) removal, and the adsorption of FeOOH loaded on MnO 2 enhanced Tl(I) purification at the same time. In-depth purification of Tl(I) had reach drinking water standards (0.1 μg L -1 ) at pH above 7, and there wasn't security risk produced from the dissolution of Mn 2+ and Fe 2+ . Moreover, the as-prepared material could be utilized as a recyclable adsorbent regenerated by using NaOH-NaClO binary solution. Therefore, the synthesized FeOOH-loaded MnO 2 in this study has the potential to be applied as an emergency material for thallium pollution incident. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Y-12 National Security Complex Emergency Management Hazards Assessment (EMHA) Process; FINAL

    International Nuclear Information System (INIS)

    Bailiff, E.F.; Bolling, J.D.

    2001-01-01

    This document establishes requirements and standard methods for the development and maintenance of the Emergency Management Hazards Assessment (EMHA) process used by the lead and all event contractors at the Y-12 Complex for emergency planning and preparedness. The EMHA process provides the technical basis for the Y-12 emergency management program. The instructions provided in this document include methods and requirements for performing the following emergency management activities at Y-12: (1) hazards identification; (2) hazards survey, and (3) hazards assessment

  10. Oak Ridge Y-12 Plant Emergency Management Hazards Assessment (EMHA) Process

    International Nuclear Information System (INIS)

    Bailiff, E.G.; Bolling, J.D.

    2000-01-01

    This report establishes requirements and standard methods for the development and maintenance of the Emergency Management Hazards Assessment (EMHA) process used by the lead and all event contractors at the Y-12 Plant for emergency planning and preparedness. The EMHA process provides the technical basis for the Y-12 emergency management program. The instructions provides in this report include methods and requirements for performing the following emergency management activities at Y-12: hazards identification; hazards survey, and hazards assessment

  11. Mantram repetition for stress management in veterans and employees: a critical incident study.

    Science.gov (United States)

    Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann

    2006-03-01

    This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.

  12. Emergency Management of Malignant Acute Left-Sided Colonic Obstruction

    Science.gov (United States)

    Trompetas, Vasileios

    2008-01-01

    INTRODUCTION The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes such as mortality, morbidity, long-term prognosis and cost effectiveness. DISCUSSION Colonic stenting is the best option either for palliation or as a bridge to surgery. It reduces morbidity and mortality rate and the need for colostomy formation. Stenting is likely to be cost effective, but data are variable depending on the individual healthcare system. Nevertheless, surgical management remains relevant as colonic stenting has a small rate of failure, and it is not always available. There are various surgical options. One-stage primary resection and anastomosis is the preferred choice for low-risk patients. Intra-operative colonic irrigation has no proven benefit. Subtotal colectomy is useful in cases of proximal bowel damage or synchronous tumours. Hartmann's procedure should be reserved for high-risk patients. Simple colostomy has no role other than for use in very ill patients who are not fit for any other procedure. PMID:18430330

  13. Federal Emergency Management Information System (FEMIS) data management guide, version 1.4.5

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L. [and others

    1998-06-26

    The Federal Emergency Management Information System (FEMIS) information resources are described in this FEMIS Data Management Guide. To comprehend what types of data are present, where the data is located, and how it is managed during the life span of the system, a basic understanding of the FEMIS architecture is necessary. The system is being developed by Pacific Northwest National Laboratory (PNNL) and is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). The capability to connect to remote CSEPP sites and share information will be present in a future release. Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide efficient EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links. FEMIS is a client/server system where much of the application software is located in the client PC. This client software integrates the FEMIS application, government furnished dispersion and evacuation models, and Commercial-Off-The-Shelf (COTS) software tools such as the ArcView geographic information system (GIS) and Microsoft Project (electron planning). A UNIX server provides data management services, ARC/INFO GIS capabilities, evacuation (Evac) modeling, electron main (E-mail), and meteorological (Met) input processing. A PC communication utility is available to interface with external subsystems. At this time, the weather collection system (Handar Met System) is the only external subsystem.

  14. Preliminary report on operational guidelines developed for use in emergency preparedness and response to a radiological dispersal device incident.

    Energy Technology Data Exchange (ETDEWEB)

    Yu, C.; Cheng, J.-J.; Kamboj, S.; Domotor, S.; Wallo, A.; Environmental Science Division; DOE

    2006-12-15

    This report presents preliminary operational guidelines and supporting work products developed through the interagency Operational Guidelines Task Group (OGT). The report consolidates preliminary operational guidelines, all ancillary work products, and a companion software tool that facilitates their implementation into one reference source document. The report is intended for interim use and comment and provides the foundation for fostering future reviews of the operational guidelines and their implementation within emergency preparedness and response initiatives in the event of a radiological dispersal device (RDD) incident. The report principally focuses on the technical derivation and presentation of the operational guidelines. End-user guidance providing more details on how to apply these operational guidelines within planning and response settings is being considered and developed elsewhere. The preliminary operational guidelines are categorized into seven groups on the basis of their intended application within early, intermediate, and long-term recovery phases of emergency response. We anticipate that these operational guidelines will be updated and refined by interested government agencies in response to comments and lessons learned from their review, consideration, and trial application. This review, comment, and trial application process will facilitate the selection of a final set of operational guidelines that may be more or less inclusive of the preliminary operational guidelines presented in this report. These and updated versions of the operational guidelines will be made available through the OGT public Web site (http://ogcms.energy.gov) as they become finalized for public distribution and comment.

  15. The incidence of injury presentations to emergency departments: what we don't know can hurt us.

    LENUS (Irish Health Repository)

    Meaney, S

    2012-01-01

    The incidence of injury presentations to emergency departments in the Republic of Ireland has not been established. Data were collected relating to all injuries that presented on every eighth day in July-December 2005 to the three hospitals in Cork City. In total, 2,967 injury presentations were recorded. The total, male and female age-adjusted rate of injury presentations was 11,322, 13,933 and 8,550 per 100,000, respectively. The peak male rate was among 15-29 year-olds (26,735 per 100,000), 2.5 times the female rate in the same age range (10,719 per 100,000). The peak female rate was among over 85 year-olds (18,543 per 100,000). Place of injury, activity at time of injury and underlying substance\\/object causing injury were unspecified for 44%, 46% and 43% of recorded injuries. Improving the recording of injury data needs to be prioritised in Irish emergency departments ideally in conjunction with the development of a national injury surveillance system.

  16. Integrating Emerging Data Sources into Operational Practice : Opportunities for Integration of Emerging Data for Traffic Management and TMCs.

    Science.gov (United States)

    2017-11-01

    With the emergence of data generated from connected vehicles, connected travelers, and connected infrastructure, the capabilities of traffic management systems or centers (TMCs) will need to be improved to allow agencies to compile and benefit from u...

  17. Comparing badger (Meles meles) management strategies for reducing tuberculosis incidence in cattle.

    Science.gov (United States)

    Smith, Graham C; McDonald, Robbie A; Wilkinson, David

    2012-01-01

    Bovine tuberculosis (bTB), caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles) is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2) and were evaluated over the whole of a 300 km(2) area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2) plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.

  18. Comparing badger (Meles meles management strategies for reducing tuberculosis incidence in cattle.

    Directory of Open Access Journals (Sweden)

    Graham C Smith

    Full Text Available Bovine tuberculosis (bTB, caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2 and were evaluated over the whole of a 300 km(2 area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2 plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.

  19. Incidence, prevalence and clinical correlates of antidepressant-emergent mania in bipolar depression: a systematic review and meta-analysis.

    Science.gov (United States)

    Fornaro, Michele; Anastasia, Annalisa; Novello, Stefano; Fusco, Andrea; Solmi, Marco; Monaco, Francesco; Veronese, Nicola; De Berardis, Domenico; de Bartolomeis, Andrea

    2018-05-01

    Treatment-emergent mania (TEM) represents a common phenomenon inconsistently reported across primary studies, warranting further assessment. A systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were conducted. Major electronic databases were searched from inception to May 2017 to assess the incidence and prevalence rates and clinical features associated with manic switch among bipolar depressed patients receiving antidepressants, using meta-regression and subgroup analysis. Overall, 10 098 depressed patients with bipolar disorder (BD) across 51 studies/arms were included in the quantitative analysis. The cumulative incidence of cases (TEM + ) among 4767 patients with BD over 15 retrospective studies was 30.9% (95% confidence interval [CI] 19.6-45.0%, I 2  = 97.9%). The cumulative incidence of TEM + among 1929 patients with BD over 12 prospective open studies was 14.4% (95% CI 7.4-26.1%, I 2  = 93.7%). The cumulative incidence of TEM + among 1316 patients with BD over 20 randomized controlled trials (RCTs) was 11.8% (95% CI 8.4-16.34%, I 2  = 73.46%). The pooled prevalence of TEM + among 2086 patients with BD over four cross-sectional studies was 30.9% (95% CI 18.1-47.4%, I 2  = 95.6%). Overall, concurrent lithium therapy predicted the lowest TEM rates. Inconsistent operational definitions of TEM were recorded, and the lack of information about age, sex, co-occurring anxiety, and other clinically relevant moderators precluded further stratification of the results. Rates of TEM vary primarily depending on study setting, which is concordant with the high degree of heterogeneity of the included records. Forthcoming RCT studies should adopt consistent operational definitions of TEM and broaden the number of moderators, in order to contribute most effectively to the identification of clear-cut sub-phenotypes of

  20. Neurology Concepts: Young Women and Ischemic Stroke-Evaluation and Management in the Emergency Department.

    Science.gov (United States)

    Chang, Bernard P; Wira, Charles; Miller, Joseph; Akhter, Murtaza; Barth, Bradley E; Willey, Joshua; Nentwich, Lauren; Madsen, Tracy

    2018-01-01

    Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g., premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting. A panel of six board-certified emergency physicians, one with fellowship training in stroke and one with training in sex- and sex-based medicine, along with one vascular neurologist were coauthors involved in the paper. Each author used various search strategies (e.g., PubMed, PsycINFO, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors. Estimates on the incidence of ischemic stroke in premenopausal women range from 3.65 to 8.9 per 100,000 in the United States. Several risk factors for ischemic stroke exist for young women including oral contraceptive (OCP) use and migraine with aura. Pregnancy and the postpartum period (up to 12 weeks) is also an important transient state during which risks for both ischemic stroke and cerebral hemorrhage are elevated, accounting for 18% of strokes in women under 35. Current evidence regarding the management of acute ischemic stroke in young women is also summarized including use of thrombolytic agents (e.g., tissue plasminogen activator) in both pregnant and nonpregnant individuals. Unique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment

  1. Studying protocol-based pain management in the emergency department

    Directory of Open Access Journals (Sweden)

    Akkamahadevi Patil

    2017-01-01

    Full Text Available Background: Majority of the patients presenting to emergency department (ED have pain. ED oligoanalgesia remains a challenge. Aims: This study aims to study the effect of implementing a protocol-based pain management in the ED on (1 time to analgesia and (2 adequacy of analgesia obtained. Settings and Design: Cross-sectional study in the ED. Methods: Patients aged 18–65 years of age with pain of numeric rating scale (NRS ≥4 were included. A series of 100 patients presenting before introduction of the protocol-based pain management were grouped “pre-protocol,” and managed as per existing practice. Following this, a protocol for management of all patients presenting to ED with pain was implemented. Another series of 100 were grouped as “post-protocol” and managed as per the new pain management protocol. The data of patients from both the groups were collected and analyzed. Statistical Analysis Used: Descriptive statistical tests such as percentage, mean and standard deviation and inferential statistical tests such as Pearson coefficient, Student's t-test were applied. Differences were interpreted as significant when P < 0.05. Results: Mean time to administer analgesic was significantly lesser in the postprotocol group (preprotocol 20.30 min vs. postprotocol 13.05 min; P < 0.001. There was significant difference in the pain relief achieved (change in NRS between the two groups, with greater pain relief achieved in the postprotocol group (preprotocol group 4.6800 vs. postprotocol group 5.3600; P < 0.001. Patients' rating of pain relief (assessed on E5 scale was significantly higher in the postprotocol group (preprotocol 3.91 vs. postprotocol 4.27; P = 0.001. Patients' satisfaction (North American Spine Society scale with the overall treatment was also compared and found to be significantly higher in postprotocol group (mean: preprotocol 1.59 vs. postprotocol 1.39; P = 0.008. Conclusion: Protocol-based pain management provided timely and

  2. Knowledge and Confidence of a Convenience Sample of Australasian Emergency Doctors in Managing Dental Emergencies: Results of a Survey

    Directory of Open Access Journals (Sweden)

    Hossein Samaei

    2015-01-01

    Full Text Available Background. We aimed to determine Australasian Specialist Emergency Physicians’ and Emergency Physicians in Training (Trainees’ level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011 and directly (November 2011 to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405 and college members were proportionally represented by region. Fewer than half (186/446; 42% had received dental training. Sixty-two percent (244/391, 95% CI 57.5–67.1 passed (>50% a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416 incorrectly answered a question about Ludwig’s Angina. Eighty-three percent (360/433 were confident in the pharmacological management of toothache but only 26% (112/434 confident in recognizing periodontal disease. Knowledge was correlated with confidence (r=0.488. Interactive workshops were preferred by most (386/415, 93%. Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted.

  3. Research on Group Decision-Making Mechanism of Internet Emergency Management

    Science.gov (United States)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

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

    Science.gov (United States)

    Bank, Ilana; Snell, Linda; Bhanji, Farhan

    2014-12-01

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

  5. Enhanced risk management by an emerging multi-agent architecture

    Science.gov (United States)

    Lin, Sin-Jin; Hsu, Ming-Fu

    2014-07-01

    Classification in imbalanced datasets has attracted much attention from researchers in the field of machine learning. Most existing techniques tend not to perform well on minority class instances when the dataset is highly skewed because they focus on minimising the forecasting error without considering the relative distribution of each class. This investigation proposes an emerging multi-agent architecture, grounded on cooperative learning, to solve the class-imbalanced classification problem. Additionally, this study deals further with the obscure nature of the multi-agent architecture and expresses comprehensive rules for auditors. The results from this study indicate that the presented model performs satisfactorily in risk management and is able to tackle a highly class-imbalanced dataset comparatively well. Furthermore, the knowledge visualised process, supported by real examples, can assist both internal and external auditors who must allocate limited detecting resources; they can take the rules as roadmaps to modify the auditing programme.

  6. Emergency department management of smoke inhalation injury in adults [digest].

    Science.gov (United States)

    Otterness, Karalynn; Ahn, Christine; Nusbaum, Jeffrey; Gupta, Nachi

    2018-03-01

    Smoke inhalation injury portends increased morbidity and mortality in fire-exposed patients. Upper airway thermal burns, inflammation from lower airway irritants, and systemic effects of carbon monoxide and cyanide can contribute to injury. A standardized diagnostic protocol for inhalation injury is lacking, and management remains mostly supportive. Clinicians should maintain a high index of suspicion for concomitant traumatic injuries. Diagnosis is mostly clinical, aided by bronchoscopy and other supplementary tests. Treatment includes airway and respiratory support, lung protective ventilation, 100% oxygen or hyperbaric oxygen therapy for carbon monoxide poisoning, and hydroxocobalamin for cyanide toxicity. Due to its progressive nature, many patients with smoke inhalation injury warrant close monitoring for development of airway compromise. [Points & Pearls is a digest of Emergency Medicine Practice.].

  7. Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

    Science.gov (United States)

    Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

    2018-02-01

    With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

  8. Behavioral aspects of emergency management and public involvement

    International Nuclear Information System (INIS)

    Dombrowsky, W.R.

    1999-01-01

    The importance of risk communication is undisputed. Although communication problems result less from little or poor planning but more from false assumptions and prejudice. The ideologies of the masses and of dangerous mass behavior during crisis and emergencies as well as a so-called 'false' risk perception of lay-people are seen and analyzed as major misconceptions which prevent from including the perspective of the affected population and their basic needs. The traditional risk communication, which is based on definitions of experts, condemns the fears and outrage of the people as irrational and inappropriate, who therefore feel excluded and not taken seriously. Thus, risk communication does not match both the problem and the addressee. Consequently, enhancing crisis communication becomes important to industry, government and the public. Better knowledge and preparedness will increase public acceptance of and confidence in ability to manage high consequence technologies as well as emergency situations, whereas failed communications increase public skepticism with the tendency to result in general risk avoidance. (orig.) [de

  9. Emergency room management of ureteral calculi: current practices.

    Science.gov (United States)

    Phillips, Elizabeth; Kieley, Sam; Johnson, Elizabeth B; Monga, Manoj

    2009-06-01

    To evaluate current practice patterns in U.S. emergency departments (EDs) for the diagnosis, treatment, and counseling of patients with ureteral calculi. Hospital-based ED physicians were invited by e-mail to participate in a Survey-Monkey survey. E-mails were delivered in March 2008 by Direct Medical Data using a listserv provided by the American Medical Association. Of the e-mails sent, 173 e-mails were opened, and 135 physicians responded. Physicians were compensated with a $10 Amazon.com gift card. Ninety percent of ED physicians use noncontrast CT as their initial imaging modality, and 63% use alpha-blockers for medical expulsive therapy. Only 13% of evaluated EDs have guidelines for the management of renal colic, and only 58% of these guidelines that recommend the use of an alpha-blocker. Alpha-blocker use was more common with physicians who have been practicing fewer than 5 years (81%) compared with those with more than 10 years of experience (56%). The majority of physicians used ketorolac and morphine to achieve effective analgesia. Although the average responses concerning the chance of spontaneous stone passage for stones 4 mm (44%) were close to evidence-based values, great variation in the answers was noted (standard deviations: 12% and 22%, respectively). Indeed, 38% of respondents stated that stones 95% chance of passage. Twenty-eight percent of ED physicians would arrange follow-up with a primary care physician, while the remainder would arrange follow-up with a urologist. This study establishes a need for educational opportunities for ED physicians in the management of renal colic. The development of collaborative practice guidelines between urology and emergency medicine associations may be warranted.

  10. Updated Decision Support Tool for the Management of Waste and Debris from Radiological Incidents

    International Nuclear Information System (INIS)

    Lemieux, P.; Thorneloe, S.; Hayes, C.; Rodgers, M.; Christman, R.

    2009-01-01

    Unique challenges exist for the handling, transport, and disposal of debris resulting from homeland security incidents, disasters or other national emergencies. Access to guidance for facilitating decision making in the safe and timely disposal of debris is critical to helping restore a community or region and prevent further contamination or spread of disease. For a radiological dispersal device (RDD) or other radiological incident, proper characterization of the quantity, properties, and level of contamination of debris and decontamination residue can have a significant impact on cleanup costs and timelines. A suite of decision support tools (DSTs) is being developed by the U.S. EPA's Office of Research and Development to assist individuals responsible for making decisions associated with handling, transport, treatment, and disposal of such debris. The DSTs are location-specific to help identify specific facilities and contacts for making final disposal decisions. The DSTs provide quick reference to technical information, regulations, and other information to provide decision makers with assistance in guiding disposal decisions that are important for the protection of public health, first responders, and the environment. This tool is being developed in partnership with other U.S. government agencies, EPA program offices, industry, and state and local emergency response programs. (authors)

  11. Evaluation of management of communication in the actions of preparedness and response to nuclear and radiological emergencies

    Energy Technology Data Exchange (ETDEWEB)

    Mello Filho, Mauro Otto de Cavalcanti; Beserra, Marcela Tatiana Fernandes, E-mail: maurootto@cefet-rj.br, E-mail: maurootto@gmail.com, E-mail: mbeserra@cefet-rj.br [Centro Federal de Educacao Celso Sucknow da Fonseca (CEFET-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Maria Angelica Vergara, E-mail: mwasserman@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Wasserman, Julio Cesar de Faria Alvim, E-mail: geowass@vm.uff.br [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2013-07-01

    The use of practices involving the use of ionizing radiation in diverse areas of knowledge increases every day. This growth warning about the increased probability of accidents, radiological and nuclear emergencies, with possible consequences for the public, workers and the environment. Within this scenario, it is clear that studies and reassessments of the emergency response actions, receive proposals for continuous improvement. The achievement of the objectives of the response must be sustained by tactical, operation and logistics optimized processes. The articulation through communication between the teams involved in the response must be adaptable to each accident or emergency, respecting its size. The objectives of this study is to perform an assessment on the management of communication in the actions of Preparedness and Response to Nuclear and Radiological Emergencies. This assessment is supported by best practices of the Incident Command System (ICS) and the Institute of Project Management (Project Management Institute-PMI). For this purpose, based on models referred were established performance indicators supported by the BSC (Balanced Scorecard). These indicators allowed to evaluate more objectively the performance of the communication processes associated with each phase of the response. The study resulted in the proposed model documents aiming to assist planning of communications exercises in preparation and response actions, supported and adapted the best practices of PMI. These methodologies were evaluated by real cases selected from radiological and nuclear emergencies published by the International Atomic Energy Agency (IAEA). (author)

  12. Evaluation of management of communication in the actions of preparedness and response to nuclear and radiological emergencies

    International Nuclear Information System (INIS)

    Mello Filho, Mauro Otto de Cavalcanti; Beserra, Marcela Tatiana Fernandes; Wasserman, Maria Angelica Vergara; Wasserman, Julio Cesar de Faria Alvim

    2013-01-01

    The use of practices involving the use of ionizing radiation in diverse areas of knowledge increases every day. This growth warning about the increased probability of accidents, radiological and nuclear emergencies, with possible consequences for the public, workers and the environment. Within this scenario, it is clear that studies and reassessments of the emergency response actions, receive proposals for continuous improvement. The achievement of the objectives of the response must be sustained by tactical, operation and logistics optimized processes. The articulation through communication between the teams involved in the response must be adaptable to each accident or emergency, respecting its size. The objectives of this study is to perform an assessment on the management of communication in the actions of Preparedness and Response to Nuclear and Radiological Emergencies. This assessment is supported by best practices of the Incident Command System (ICS) and the Institute of Project Management (Project Management Institute-PMI). For this purpose, based on models referred were established performance indicators supported by the BSC (Balanced Scorecard). These indicators allowed to evaluate more objectively the performance of the communication processes associated with each phase of the response. The study resulted in the proposed model documents aiming to assist planning of communications exercises in preparation and response actions, supported and adapted the best practices of PMI. These methodologies were evaluated by real cases selected from radiological and nuclear emergencies published by the International Atomic Energy Agency (IAEA). (author)

  13. Penetrating and blunt trauma to the neck: clinical presentation, assessment and emergency management.

    Science.gov (United States)

    Perdonck, P; de Schoutheets, J C; Monsieurs, K G; Van Laer, C; Vander Poorten, V; Vanderveken, O

    Penetrating and blunt trauma to the neck: clinical presentation, assessment ana emergency management. In Belgium, and even in Western Europe, penetrating and blunt injury to the neck is relatively uncommon in both the civilian and military populations. Pre-hospital and emergency assessment and management will therefore always prove challenging, as individual exposure to this specific type of injury remains low. Historically, the neck has been divided into three anatomical zones with specific landmarks to guide the diagnostic and therapeutic approach to penetrating neck injuries. Most penetrating injuries need to be explored surgically, although with the advent of multi-detector computed tomographic angiography (MDCTA), which yields high diagnostic sensitivity, this inflexible approach has recently changed to a more targeted management, based on clinical, radiographic and, if deemed necessary, endoscopic findings. However, some authors have addressed their concern about this novel, 'no-zone' approach, since the risk of missing less apparent aerodigestive tract injuries may increase. It is recommended, therefore, that all patients with penetrating neck injuries be closely observed, irrespective of the initial findings. The incidence of blunt neck injury is much lower, and this makes risk assessment and management even more difficult in comparison with penetrating injuries. Again, MDCTA is most often the first diagnostic tool if a blunt neck injury is suspected, due to its good sensitivity for blunt cerebrovascular injuries (BCVI) as well as for aerodigestive tract injuries. Specific patterns of injury and unexpected neurological and neuro-radiological findings in trauma patients should always warrant further investigation. Despite ongoing debate, systemic anticoagulation is recommended for most BCVI, sometimes combined with endovascular treatment. Aerodigestive tract injuries may present dramatically, but are often more subtle, making the diagnosis more difficult

  14. Incompletely characterized incidental renal masses: emerging data support conservative management.

    Science.gov (United States)

    Silverman, Stuart G; Israel, Gary M; Trinh, Quoc-Dien

    2015-04-01

    With imaging, most incidental renal masses can be diagnosed promptly and with confidence as being either benign or malignant. For those that cannot, management recommendations can be devised on the basis of a thorough evaluation of imaging features. However, most renal masses are either too small to characterize completely or are detected initially in imaging examinations that are not designed for full evaluation of them. These masses constitute a group of masses that are considered incompletely characterized. On the basis of current published guidelines, many masses warrant additional imaging. However, while the diagnosis of renal cancer at a curable stage remains the first priority, there is the additional need to reduce unnecessary healthcare costs and radiation exposure. As such, emerging data now support foregoing additional imaging for many incompletely characterized renal masses. These data include the low risk of progression to metastases or death for small renal masses that have undergone active surveillance (including biopsy-proven cancers) and a better understanding of how specific imaging features can be used to diagnose their origins. These developments support (a) avoidance of imaging entirely for those incompletely characterized renal masses that are highly likely to be benign cysts and (b) delay of further imaging of small solid masses in selected patients. Although more evidence-based data are needed and comprehensive management algorithms have yet to be defined, these recommendations are medically appropriate and practical, while limiting the imaging of many incompletely characterized incidental renal masses.

  15. Using online analytical processing to manage emergency department operations.

    Science.gov (United States)

    Gordon, Bradley D; Asplin, Brent R

    2004-11-01

    The emergency department (ED) is a unique setting in which to explore and evaluate the utility of information technology to improve health care operations. A potentially useful software tool in managing this complex environment is online analytical processing (OLAP). An OLAP system has the ability to provide managers, providers, and researchers with the necessary information to make decisions quickly and effectively by allowing them to examine patterns and trends in operations and patient flow. OLAP software quickly summarizes and processes data acquired from a variety of data sources, including computerized ED tracking systems. It allows the user to form a comprehensive picture of the ED from both system-wide and patient-specific perspectives and to interactively view the data using an approach that meets his or her needs. This article describes OLAP software tools and provides examples of potential OLAP applications for care improvement projects, primarily from the perspective of the ED. While OLAP is clearly a helpful tool in the ED, it is far more useful when integrated into the larger continuum of health information systems across a hospital or health care delivery system.

  16. Channelopathies - Emerging Trends in The Management of Inherited Arrhythmias

    Directory of Open Access Journals (Sweden)

    Priya Chockalingam, MBBS, MRCPCH, PhD

    2015-01-01

    Full Text Available In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent.

  17. Complications of bariatric surgery: Presentation and emergency management.

    Science.gov (United States)

    Kassir, Radwan; Debs, Tarek; Blanc, Pierre; Gugenheim, Jean; Ben Amor, Imed; Boutet, Claire; Tiffet, Olivier

    2016-03-01

    The epidemic in obesity has led to an increase in number of so called bariatric procedures. Doctors are less comfortable managing an obese patient after bariatric surgery. Peri-operative mortality is less than 1%. The specific feature in the obese patient is that the classical signs of peritoneal irritation are never present as there is no abdominal wall and therefore no guarding or rigidity. Simple post-operative tachycardia in obese patients should be taken seriously as it is a WARNING SIGNAL. The most common complication after surgery is peritonitis due to anastomotic fistula formation. This occurs typically as an early complication within the first 10 days post-operatively and has an incidence of 1-6% after gastric bypass and 3-7% after sleeve gastrectomy. Post-operative malnutrition is extremely rare after restrictive surgery (ring, sleeve gastrectomy) although may occur after malabsorbative surgery (bypass, biliary pancreatic shunt) and is due to the restriction and change in absorption. Prophylactic cholecystectomy is not routinely carried out during the same procedure as the bypass. Superior mesenteric vein thrombosis after bariatric surgery is a diagnosis which should be considered in the presence of any postoperative abdominal pain. Initially a first etiological assessment is performed (measurement of antithrombin III and of protein C and protein S, testing for activated protein C resistance). If the least doubt is present, a medical or surgical consultation should be requested with a specialist practitioner in the management of obese patients as death rates increase with delayed diagnosis. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  18. Integration of resilience capabilities for Critical Infrastructures into the Emergency Management set-up

    DEFF Research Database (Denmark)

    Kozine, Igor; Andersen, Henning Boje

    2015-01-01

    We suggest an approach for maintaining and enhancing resilience that integrates the resilience capabilities of Critical Infrastructures (CIs) into the emergency management cycle (prevention, preparedness, response, and recovery). This allows emergency services to explicitly address resilience...

  19. Improving emergency preparedness and crisis management capabilities in transportation : year 2.

    Science.gov (United States)

    2013-03-01

    While disaster preparedness and emergency management have had a high public : profile over the past decade, Hurricane Katrina revealed serious weaknesses in the : United States emergency response capabilities. There is thus much left to do : befor...

  20. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...