Symptom-based emergency operating procedures development for Ignalina NPP

International Nuclear Information System (INIS)

Kruglov, Y.

1999-01-01

In this paper and lecture are presented: (1) Introduction; (2) EOP project work stages and documentation; (3) Selection and justification of accident management strategy; (4) Content of EOP package; (5) Development of EOP package; (6) EOP package verification; (7) EOP package validation; (8) EOP training; (9) EOP implementation; (10) Conditions of symptom-based emergency operating producers package application and its interconnection with event-based emergency operating procedures; (11) Rules of EOP application; EOP maintenance

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

Energy Technology Data Exchange (ETDEWEB)

Suzuki-Yasumoto, M

1982-01-01

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

Step Complexity Measure for Emergency Operating Procedures - Determining Weighting Factors

International Nuclear Information System (INIS)

Park, Jinkyun; Jung, Wondea; Kim, Jaewhan; Ha, Jaejoo

2003-01-01

In complex systems, such as nuclear power plants (NPPs) or airplane control systems, human error has been regarded as the primary cause of many events. Therefore, to ensure system safety, extensive effort has been made to identify the significant factors that can cause human error. According to related studies, written manuals or operating procedures are revealed as one of the important factors, and the understandability is pointed out as one of the major reasons for procedure-related human errors.Many qualitative checklists have been suggested to evaluate emergency operating procedures (EOPs) of NPPs so as to minimize procedure-related human errors. However, since qualitative evaluations using checklists have some drawbacks, a quantitative measure that can quantify the complexity of EOPs is indispensable.From this necessity, Park et al. suggested the step complexity (SC) measure to quantify the complexity of procedural steps included in EOPs. To verify the appropriateness of the SC measure, averaged step performance time data obtained from emergency training records of the loss-of-coolant accident (LOCA) and the excess steam demand event were compared with estimated SC scores. However, although averaged step performance time data and estimated SC scores show meaningful correlation, some important issues such as determining proper weighting factors have to be clarified to ensure the appropriateness of the SC measure. These were not properly dealt with due to a lack of backup data.In this paper, to resolve one of the important issues, emergency training records are additionally collected and analyzed in order to determine proper weighting factors. The total number of collected records is 66, and the training scenarios cover five emergency conditions including the LOCA, the steam generator tube rupture, the loss of all feedwater, the loss of off-site power, and the station blackout. From these records, average step performance time data are retrieved, and new

Experience with Emergency Ultrasound Training by Canadian Emergency Medicine Residents

Directory of Open Access Journals (Sweden)

Daniel J. Kim

2014-05-01

Full Text Available Introduction: Starting in 2008, emergency ultrasound (EUS was introduced as a core competency to the Royal College of Physicians and Surgeons of Canada (Royal College emergency medicine (EM training standards. The Royal College accredits postgraduate EM specialty training in Canada through 5-year residency programs. The objective of this study is to describe both the current experience with and the perceptions of EUS by Canadian Royal College EM senior residents. Methods: This was a web-based survey conducted from January to March 2011 of all 39 Canadian Royal College postgraduate fifth-year (PGY-5 EM residents. Main outcome measures were characteristics of EUS training and perceptions of EUS. Results: Survey response rate was 95% (37/39. EUS was part of the formal residency curriculum for 86% of respondents (32/37. Residents most commonly received training in focused assessment with sonography for trauma, intrauterine pregnancy, abdominal aortic aneurysm, cardiac, and procedural guidance. Although the most commonly provided instructional material (86% [32/37] was an ultrasound course, 73% (27/37 of residents used educational resources outside of residency training to supplement their ultrasound knowledge. Most residents (95% [35/37] made clinical decisions and patient dispositions based on their EUS interpretation without a consultative study by radiology. Residents had very favorable perceptions and opinions of EUS. Conclusion: EUS training in Royal College EM programs was prevalent and perceived favorably by residents, but there was heterogeneity in resident training and practice of EUS. This suggests variability in both the level and quality of EUS training in Canadian Royal College EM residency programs.

Development and verification of symptom based emergency procedure support system

International Nuclear Information System (INIS)

Saijou, Nobuyuki; Sakuma, Akira; Takizawa, Yoji; Tamagawa, Naoko; Kubota, Ryuji; Satou, Hiroyuki; Ikeda, Koji; Taminami, Tatsuya

1998-01-01

A Computerized Emergency Procedure Guideline (EPG) Support System has been developed for BWR and evaluated using training simulator. It aims to enhance the effective utilization of EPG. The system identifies suitable symptom-based operating procedures for present plant status automatically. It has two functions : one is plant status identification function, and the other is man-machine interface function. For the realization of the former function, a method which identifies and prioritize suitable symptom-based operational procedures against present plant status has been developed. As man-machine interface, operation flow chart display has been developed. It express the flow of the identified operating procedures graphically. For easy understanding of the display, important information such as plant status change, priority of operating procedures and completion/uncompletion of the operation is displayed on the operation flow display by different colors. As evaluation test, the response of the system to the design based accidents was evaluated by actual plant operators, using training simulator at BWR Training Center. Through the analysis of interviews and questionnaires to operators, it was shown that the system is effective and can be utilized for a real plant. (author)

Realism of procedural task trainers in a pediatric emergency medicine procedures course.

Science.gov (United States)

Shefrin, Allan; Khazei, Afshin; Cheng, Adam

2015-01-01

Pediatric emergency medicine (PEM) physicians have minimal experience in life saving procedures and have turned to task trainers to learn these skills. Realism of these models is an important consideration that has received little study. PEM physicians and trainees participated in a day long procedural training course that utilized commercially available and homemade task trainers to teach pericardiocentesis, chest tube insertion, cricothyroidotomy and central line insertion. Participants rated the realism of the task trainers as part of a post-course survey. The homemade task trainers received variable realism ratings, with 91% of participants rating the pork rib chest tube model as realistic, 82% rating the gelatin pericardiocentesis mold as realistic and 36% rating the ventilator tubing cricothyroidotomy model as realistic. Commercial trainers also received variable ratings, with 45% rating the chest drain and pericardiocentesis simulator as realistic, 74% rating the crichotracheotomy trainer as realistic and 80% rating the central line insertion trainer as realistic. Task training models utilized in our course received variable realism ratings. When deciding what type of task trainer to use future courses should carefully consider the desired aspect of realism, and how it aligns with the procedural skill, balanced with cost considerations.

Evaluating an australian emergency nurse practitioner candidate training program.

Science.gov (United States)

Plath, Sharyn J; Wright, Mary; Hocking, Julia

2017-11-01

Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate. The training team defined milestones for Semesters one and two, and developed a case review form to assess application of the candidate's knowledge in new clinical situations, as well as check for gaps in understanding. A clinical skills guide was developed for the candidate to work toward, and a comprehensive assessment was carried out at two time points in the training program. Feedback was obtained from the mentors and the candidate at the end point of the training program, and has been used to refine the program for 2017. This in-house training program provided specialised, evidence-based training for the emergency department environment, resulting in development of the nurse practitioner candidate as a high functioning team member. Copyright © 2017 College of Emergency Nursing Australasia. All rights reserved.

Methods for implementing revisions to emergency operating procedures. Final report

International Nuclear Information System (INIS)

Myers, L.B.; Bell, A.J.

1984-05-01

In response to the Three Mile Island (TMI) accident, the US Nuclear Regulatory Commission (NRC) has published the TMI Action Plan. The TMI Action Plan Item I.C.1 called for the upgrading of Emergency Operating Procedures (EOPs) at nuclear power plants. The program developed from this Action Plan item has resulted in utility efforts to: (1) revise EOPs; (2) train personnel in the use of the EOPs; and (3) implement the revised EOPs. The NRC supported the study presented in this report to identify factors which influence the effectiveness of training and implementation of revised EOPs. The NRC's major concern was the possible effects of negative transfer of training. The report includes a summary of existing methods for implementing revisions to procedures based on interviews of plant personnel, a review of the training literature applicable to the effect of previously learned procedures on the learning of and performance with revised procedures (i.e., negative transfer) and recommendations of methods and schedules for implementing revised EOPs. While the study found that the concern over negative transfer of training was not as great as anticipated, several recommendations were made. These include: (1) overtraining of operators to reduce the effect of observed negative transfer; and (2) implementation of the revised EOPs as soon as possible after training to minimize the time operators must rely upon the old EOPs after having been trained on the revised EOPs. The results of the study should be useful both to the utilities and the NRC in the development and review of EOP implementation programs

Train operation in emergencies

CERN Document Server

Jia, Limin; Qin, Yong

2017-01-01

This book presents the latest findings on train operation theories and methods in the context of emergencies. It examines and assesses a range of aspects—including the definition of a railway emergency, transport organization modes in emergencies, calculating railway transport capacity in emergencies, line planning in emergencies, train re-pathing in emergencies and train re-scheduling in emergencies—that are urgently needed in the railway transportation field, which faces the serious challenge of dealing with emergencies worldwide. The book highlights the latest research results in an integrated and systematic way, and the methodology presented is oriented on real-world problems, allowing it to be used not only directly in railway operational management, but also as the point of departure for further applications or theoretical research. As such, the book will be of considerable interest to graduate students and researchers in the field of traffic and transportation engineering.>.

Otolaryngology-specific emergency room as a model for resident training.

Science.gov (United States)

Sethi, Rosh K V; Kozin, Elliott D; Remenschneider, Aaron K; Lee, Daniel J; Gliklich, Richard E; Shrime, Mark G; Gray, Stacey T

2015-01-01

There is a paucity of data on junior resident training in common otolaryngology procedures such as ear debridement, nasal and laryngeal endoscopy, epistaxis management, and peritonsillar abscess drainage. These common procedures represent a critical aspect of training and are necessary skills in general otolaryngology practice. We sought to determine how a dedicated otolaryngology emergency room (ER) staffed by junior residents and a supervising attending provides exposure to common otolaryngologic procedures. Retrospective review. Diagnostic and procedural data for all patients examined in the Massachusetts Eye and Ear Infirmary ER between January 2011 and September 2013 were evaluated. A total of 12,234 patients were evaluated. A total of 5,673 patients (46.4%) underwent a procedure. Each second-year resident performed over 450 procedures, with the majority seen Monday through Friday (75%). The most common procedures in our study included diagnostic nasolaryngoscopy (52.0%), ear debridement (34.4%), and epistaxis control (7.0%) An otolaryngology-specific ER provides junior residents with significant diagnostic and procedural volume in a concentrated period of time. This study demonstrates utility of a unique surgical education model and provides insight into new avenues of investigation for otolaryngology training. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

The operators' non-compliance behavior to conduct emergency operating procedures--comparing with the work experience and the complexity of procedural steps

International Nuclear Information System (INIS)

Park, Jinkyun; Jung, Wondea

2003-01-01

Many kinds of procedures have been used to reduce the operators' workload throughout various industries, such as in the aviation, the chemical and the nuclear industry. It is remarkable that, however, significant portion of accidents or incidents was caused by procedure related human error due to non-compliance of procedures. In this study, to investigate the operators' non-compliance behavior, emergency-training records were collected using a full scope simulator. And three types of the operators' behavior (such as strict adherence, skipping redundant actions and modifying action sequences) observed from collected emergency training records were compared with both their work experience and the complexity of procedural steps. As the results, three remarkable relationships are obtained. They are: (1) the operators who have an intermediate work experience seem to frequently adopt non-compliance behavior to conduct the procedural steps, (2) the operators seem to frequently adopt non-compliance behavior to conduct the procedural steps that have an intermediate procedural complexity, and (3) the senior reactor operators seem to accommodate their non-compliance behavior based on the complexity of procedural steps. Therefore, it is expected that these relationships can be used as meaningful clues not only to scrutinize the reason for non-compliance behavior but also to suggest appropriate remedies for the reduction of non-compliance behavior that can result in procedure related human error

The step complexity measure for emergency operating procedures - comparing with simulation data

International Nuclear Information System (INIS)

Park, Jinkyun; Jung, Wondea; Kim, Jaewhan; Ha, Jaejoo; Shin, Yunghwa

2001-01-01

In complex systems, such as nuclear power plants (NPPs) or airplane control systems, human errors play a major role in many accidents. Therefore, to prevent occurrences of accidents or to ensure system safety, extensive effort has been made to identify significant factors that cause human errors. According to related studies, written manuals or operating procedures are revealed as one of the most important factors, and complexity or understandability of a procedure is pointed out as one of the major reasons that make procedure-related human errors. Many qualitative checklists are suggested to evaluate emergency operating procedures (EOPs) of NPPs. However, since qualitative evaluations using checklists have some drawbacks, a quantitative measure that can quantify the complexity of EOPs is imperative to compensate for them. In order to quantify the complexity of EOPs, Park et al. suggested the step complexity (SC) measure to quantify the complexity of a step included in EOPs. In this paper, to ensure the appropriateness of the SC measure, SC scores are compared with averaged step performance time data obtained from emergency training records. The total number of available records is 36, and training scenarios are the loss of coolant accident and the excess steam dump event. The number of scenario is 18 each. From these emergency training records, step performance time data for 39 steps are retrieved, and they are compared with estimated SC scores of them. In addition, several questions that are needed to clarify the appropriateness of the SC measure are also discussed. As a result, it was observed that estimated SC scores and step performance time data have a statistically meaningful correlation. Thus, it can be concluded that the SC measure can quantify the complexity of steps included in EOPs

An innovative longitudinal curriculum to increase emergency medicine residents’ exposure to rarely encountered and technically challenging procedures

Directory of Open Access Journals (Sweden)

Grall KH

2014-07-01

Full Text Available Kristi H Grall,1 Lisa R Stoneking,1 Lawrence A DeLuca,1 Anna L Waterbrook,1 T Gail Pritchard,2,3 Kurt R Denninghoff1 1Department of Emergency Medicine, The College of Medicine, The University of Arizona, 2Office Medical Student Education, 3Office of Graduate Medical Education, The College of Medicine, The University of Arizona, Tucson, AZ, USA Background: Procedural skills have historically been taught at the bedside. In this study, we aimed to increase resident knowledge of uncommon emergency medical procedures to increase residents’ procedural skills in common and uncommon emergency medical procedures and to integrate cognitive training with hands-on procedural instruction using high- and low-fidelity simulation. Methods: We developed 13 anatomically/physiologically-based procedure modules focusing on uncommon clinical procedures and/or those requiring higher levels of technical skills. A departmental expert directed each session with collaboration from colleagues in related subspecialties. Sessions were developed based on Manthey and Fitch’s stages of procedural competency including 1 knowledge acquisition, 2 experience/technical skill development, and 3 competency evaluation. We then distributed a brief, 10-question, online survey to our residents in order to solicit feedback regarding their perceptions of increased knowledge and ability in uncommon and common emergency medical procedures, and their perception of the effectiveness of integrated cognitive training with hands-on instruction through high- and low-fidelity simulation. Results: Fifty percent of our residents (11/22 responded to our survey. Responses indicated the procedure series helped with understanding of both uncommon (65% strongly agreed [SA], 35% agreed [A] and common (55% SA, 45% A emergency medicine procedures and increased residents’ ability to perform uncommon (55% SA, 45% A and common (45% SA, 55% A emergency medical procedures. In addition, survey results

Planning and training in emergency preparedness

International Nuclear Information System (INIS)

Perkins, T.G.

1985-01-01

Link Simulation Systems Division of the Singer Company is combining its tactical simulation and display system with state-of-the-art decision and control technology to provide a combined operations, planning, and training (COPAT) system. This system provides for the total integration of the three primary responsibilities of emergency managers: planning and training for and decision and control of an emergency. The system is intended to be a complete operations center for emergency management personnel. In the event of a natural disaster or man-made emergency, the national, state, county, and city emergency managers require a secure and reliable operations center. The COPAT system combines the decision and control capabilities with proven simulation techniques allowing for integrated planning and training. The hardware system, software, data bases, and maps used during planning and training are the same as those used during actual emergencies

Integration of emergency action levels with Combustion Engineering Emergency Operating Procedures

International Nuclear Information System (INIS)

Faletti, D.W.; Jamison, J.D.

1985-09-01

This report documents the development of a method for integrating Emergency Action Levels (EALs) with plant-specific Emergency Operating Procedures (EOPs) using the Combustion Engineering Owners' Group Emergency Operating Procedure Technical Guidelines (CEOG EOPTFs). EALs are discrete conditions or values of plant operating parameters which, if exceeded, require declaration of an appropriate level of emergency. At most operating plants, the EALs and event classification procedures are totally separate from the Emergency Operating Procedures used by the plant staff to control the plant during abnormal conditions. Control room personnel using the EOPs to deal with abnormal plant conditions must recognize when plant safety is sufficiently degraded that an emergency declaration may be warranted, and then enter a separate classification procedure containing EALs for a number of plant conditions and parameters. The operator then compares the existing plant conditions to the EALs and makes an emergency declaration accordingly. Using the Combustion Engineering Owners' Group Technical Guidelines document, a set of emergency class definitions and criteria were developed based on the status of the three main fission product barriers (fuel cladding, primary coolant system and containment). The EOPTGs were then annotated with suggested guidance to a procedure writer. The proposed method was tested by applying it to the reactor accident sequences that were shown in the reactor safety study to dominate accident risk. The object of the test was to determine if an EAL set linked to the EOP annotations would produce timely and accurate classification of the risk-dominant sequences. 6 refs., 13 figs., 31 tabs

A simulator-based nuclear reactor emergency response training exercise.

Science.gov (United States)

Waller, Edward; Bereznai, George; Shaw, John; Chaput, Joseph; Lafortune, Jean-Francois

Training offsite emergency response personnel basic awareness of onsite control room operations during nuclear power plant emergency conditions was the primary objective of a week-long workshop conducted on a CANDU® virtual nuclear reactor simulator available at the University of Ontario Institute of Technology, Oshawa, Canada. The workshop was designed to examine both normal and abnormal reactor operating conditions, and to observe the conditions in the control room that may have impact on the subsequent offsite emergency response. The workshop was attended by participants from a number of countries encompassing diverse job functions related to nuclear emergency response. Objectives of the workshop were to provide opportunities for participants to act in the roles of control room personnel under different reactor operating scenarios, providing a unique experience for participants to interact with the simulator in real-time, and providing increased awareness of control room operations during accident conditions. The ability to "pause" the simulator during exercises allowed the instructors to evaluate and critique the performance of participants, and to provide context with respect to potential offsite emergency actions. Feedback from the participants highlighted (i) advantages of observing and participating "hands-on" with operational exercises, (ii) their general unfamiliarity with control room operational procedures and arrangements prior to the workshop, (iii) awareness of the vast quantity of detailed control room procedures for both normal and transient conditions, and (iv) appreciation of the increased workload for the operators in the control room during a transient from normal operations. Based upon participant feedback, it was determined that the objectives of the training had been met, and that future workshops should be conducted.

Comparing the operators' behavior in conducting emergency operating procedures with the complexity of procedural steps

International Nuclear Information System (INIS)

Park, Jin Kyun; Jung, Won Dea

2003-01-01

Many kinds of procedures have been used to reduce the operators' workload throughout various industries. However, significant portion of accidents or incidents was caused by procedure related human errors that are originated from non-compliance of procedures. According to related studies, several important factors for non-compliance behavior have been identified, and one if them is the complexity of procedures. This means that comparing the change of the operators' behavior with the complexity of procedures may be meaningful for investigating plausible reasons for the operators' non-compliance behavior. In this study, emergency training records were collected using a full scope simulator in order to obtain data related to the operators' non-compliance behavior. And then, collected data are compared with the complexity of procedural steps. As the result, two remarkable relationships are found, which indicate that the operators' behavior could be reasonably characterized by the complexity of procedural steps. Thus, these relationships can be used as meaningful clues not only to scrutinize the reason of non-compliance behavior but also to suggest appropriate remedies for the reduction of non-compliance behavior that can result in procedure related human errors

Emergency Medical Care Training and Adolescents.

Science.gov (United States)

Topham, Charles S.

1982-01-01

Describes an 11-week emergency medical care training program for adolescents focusing on: pretest results; factual emergency instruction and first aid; practical experience training; and assessment. (RC)

Virtual reality and simulation: training the future emergency physician.

Science.gov (United States)

Reznek, Martin; Harter, Phillip; Krummel, Thomas

2002-01-01

The traditional system of clinical education in emergency medicine relies on practicing diagnostic, therapeutic, and procedural skills on live patients. The ethical, financial, and practical weaknesses of this system are well recognized, but the alternatives that have been explored to date have shown even greater flaws. However, ongoing progress in the area of virtual reality and computer-enhanced simulation is now providing educational applications that show tremendous promise in overcoming most of the deficiencies associated with live-patient training. It will be important for academic emergency physicians to become more involved with this technology to ensure that our educational system benefits optimally.

Radiological transportation emergency response training course funding and timing in the southern states

International Nuclear Information System (INIS)

1991-10-01

The following is a review of the enabling statutes of 16 southern states regarding training for personnel preparing for or responding to a transportation-related emergency involving highway route-controlled quantities of spent fuel and high-level radioactive waste. This report outlines the funding sources and procedures for administering funds for programs attended by state and local officials. Additionally, the report outlines the views of emergency response officials in the southem states concerning the timing and administration of future federal assistance to be provided under section 180(c) of the Nuclear Waste Policy Amendments Act. Under section 180(c) of the Nuclear Waste Policy Amendments Act of 1987, the US Department of Energy (DOE) is required to provide technical assistance and funds to states for training public safety officials of appropriate units of local government and Indian tribes when spent nuclear fuel or high-level radioactive waste is transported through their jurisdictions. The Comprehensive Cooperative Agreement (CCA) is the primary funding mechanism for federal assistance to states for the development of their overall emergency management capabilities. FEMA supports 12 separate emergency management programs including the Emergency Management Training program (EMT). This program provides funds for emergency management training and technical assistance to states for unique state training needs. Funds may be used for instructors, students and other related costs

Procedural specificity in laparoscopic simulator training

DEFF Research Database (Denmark)

Bjerrum, Flemming; Sørensen, Jette Led; Konge, Lars

2014-01-01

. The secondary outcome is the total training time to proficiency. The improvement in motor skills and effect on cognitive load are also explored. DISCUSSION: The results of this trial might provide new knowledge on how the technical part of surgical training curricula should be comprised in the future......BACKGROUND: The use of structured curricula for minimally invasive surgery training is becoming increasingly popular. However, many laparoscopic training programs still use basic skills and isolated task training, despite increasing evidence to support the use of training models with higher...... functional resemblance, such as whole procedural modules. In contrast to basic skills training, procedural training involves several cognitive skills such as elements of planning, movement integration, and how to avoid adverse events. The objective of this trial is to investigate the specificity...

Procedural wound geometry and blood flow generation for medical training simulators

Science.gov (United States)

Aras, Rifat; Shen, Yuzhong; Li, Jiang

2012-02-01

Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.

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.

Self-Reported Emergency Medicine Residency Applicant Attitudes Towards a Procedural Cadaver Laboratory Curriculum

Directory of Open Access Journals (Sweden)

Hoffman, Lance

2008-08-01

Full Text Available OBJECTIVE: Residency applicants consider a variety of factors when ranking emergency medicine (EM programs for their NRMP match list. A human cadaver emergency procedure lab curriculum is uncommon. We hypothesized that the presence this curriculum would positively impact the ranking of an EM residency program.METHODS: The EM residency at Nebraska Medical Center is an urban, university-based program with a PGY I-III format. Residency applicants during the interview for a position in the PGY I class of 2006 were surveyed by three weekly electronic mailings. The survey was distributed in March 2006 after the final NRMP match results were released. The survey explored learner preferences and methodological commonality of models of emergency procedural training, as well as the impact of a procedural cadaver lab curriculum on residency ranking. ANOVA of ranks was used to compare responses to ranking questions.RESULTS: Of the 73 potential subjects, 54 (74% completed the survey. Respondents ranked methods of procedural instruction from 1 (most preferred or most common technique to 4 (least preferred or least common technique. Response averages and 95% confidence intervals for the preferred means of learning a new procedure are as follows: textbook (3.69; 3.51-3.87, mannequin (2.83; 2.64-3.02, human cadaver (1.93; 1.72-2.14, and living patient (1.56; 1.33-1.79. Response averages for the commonality of means used to teach a new procedure are as follows: human cadaver (3.63; 3.46-3.80, mannequin (2.70; 2.50-2.90, living patient (2.09; 1.85-2.33, and textbook (1.57; 1.32-1.82. When asked if the University of Nebraska Medical Center residency ranked higher in the individual's match list because of its procedural cadaver lab, 14.8% strongly disagreed, 14.8% disagreed, 40.7% were neutral, 14.8% agreed, and 14.8% strongly agreed.CONCLUSION: We conclude that, although cadaveric procedural training is viewed by senior medical student learners as a desirable means

Training in Emergency Obstetrics: A Needs Assessment of U.S. Emergency Medicine Program Directors

Directory of Open Access Journals (Sweden)

Daniel W. Robinson

2017-12-01

Full Text Available Introduction Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH, shoulder dystocia, and breech presentation through email invitations to all program directors (PD of U.S. EM residency programs. The survey focused on curricular details as well as the comfort level of the PDs in the preparation of their graduating residents to treat obstetrical emergencies and normal vaginal deliveries. Results Our survey had a 55% return rate (n=105/191. Of the residencies responding, 75% were in the academic setting, 20.2% community, 65% urban, and 29.8% suburban, and the obstetrical curricula were 2–4 weeks long occurring in post-graduate year one. The most common teaching method was didactics (84.1–98.1%, followed by oral cases for pre-eclampsia (48% and PPH (37.2%, and homemade simulation for shoulder dystocia (37.5% and breech delivery (33.3%. The PDs’ comfort about residency graduate skills was highest for normal spontaneous vaginal delivery, pre-eclampsia, and PPH. PDs were not as comfortable about their graduates’ skill in handling shoulder dystocia or breech delivery. Conclusion Our survey found that PDs are less comfortable in their graduates’ ability to perform non-routine emergency obstetrical procedures.

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

Design of test and emergency procedures to improve operator behaviour in French nuclear power plants

International Nuclear Information System (INIS)

Griffon-Fouco, M.; Gomolinski, M.

1982-09-01

The incident analyses performed in French nuclear power plants high-lighted that deficiencies in the design of procedures are frequent causes of human errors. The process for developing new guidelines for the writing of test and emergency procedures is presented: this process is based on operators interviews and observations at the plants or at simulators. The main principles for the writing of procedures are developed. For example: - the elaboration of a procedure for action and of a separate educational procedure, - the coordination of crew responses, - the choice of vocabulary, graphs, flow charts and so on as regards the format. Other complementary actions, such as the training of operators in the use of procedures, are described

Design of test and emergency procedures to improve operator behavior in French nuclear power plants

International Nuclear Information System (INIS)

Griffon-Fouco, M.; Gomolinski, M.

1983-01-01

The incident analyses performed in French nuclear power plants high-lighted that deficiencies in the design of procedures are frequent causes of human errors. The process for developing new guidelines for the writing of test and emergency procedures is presented: this process is based on operators interviews and observations at the plants or at simulators. The main principles for the writing of procedures are developed. For example: the elaboration of a procedure for action and of separate educational procedure; the coordination of crew responses; and the choice of vocabulary, graphs, flow charts and so on as regards the format. Other complementary actions, such as the training of operators in the use of procedures, are described

Emergency preparedness training for local communities

International Nuclear Information System (INIS)

Cooley, M.J.; Thompson, K.K.

1987-01-01

Detroit Edison, in cooperation with Monroe County, has developed a comprehensive training program for local emergency workers in the area surrounding the Fermi 2 Nuclear Power Plant. Using expertise from both organizations, a program consisting of two videotapes, two slide-tapes and nine narrated slide series was produced to address the worker-specific training needs of county emergency workers. In June of 185, the program was approved by Detroit Edison and the Monroe County Board of Commissioners. To date, Monroe County has trained more than 1000 emergency workers. This program has been so well received that the county staff has developed and presented a modified version of this program to the general public. The result of this cooperative effort is increased public confidence in emergency preparedness at the state, local and utility level and a renewed spirit of cooperation and trust between the utility and local units of government

Behavior changes after minor emergency procedures.

Science.gov (United States)

Brodzinski, Holly; Iyer, Srikant

2013-10-01

Procedures are common in pediatric emergency departments and frequently cause distress from pain and/or anxiety. The objective of this study was to describe the incidence, types, and magnitude of long-term behavior changes after procedures in the emergency setting. This is a descriptive pilot study to determine if children display negative behavioral changes after a minor emergency department procedure (abscess drainage or laceration repair). Behavior change was measured at 1 week by telephone follow-up using the 27-item Post Hospitalization Behavior Questionnaire, a well-validated instrument that measures behavior changes across 6 categories: general anxiety, separation anxiety, anxiety about sleep, eating disturbances, aggression toward authority, and apathy/withdrawal. Significant behavior change was defined as 5 or more negative behavior changes on the 27-item questionnaire. Twenty percent of children who underwent abscess drainage (n = 30) and 20% who underwent laceration repair (n = 30) displayed significant negative behavior change at 1 week. Children who displayed significant negative behavior change tended to be younger (3.6 vs 5.9 years) and trended toward being more likely to have received anxiolysis or sedation (16.7% vs 8.3%). Separation anxiety, sleep difficulties, and aggression toward authority were the most common behavior changes. In this pilot study, a significant percentage of children undergoing common emergency procedures exhibited an appreciable burden of negative behavior change at 1 week; these results demonstrate the need for further rigorous investigation of predictors of these changes and interventions, which can ameliorate these changes.

Experiences and findings from the operators' point of view 'Emergency protection training'

International Nuclear Information System (INIS)

Grauf, E.

1992-01-01

To exercise in-plant emergency measures, under special marginal conditions, proves to be as useful and necessary as the training of design basis accidents. The strating phase which is particularly difficult for shift personnel, because it is labour-intensive, has to be exercised and considered with special attention and close to reality. That is the only way to detect weak spots and to get rid of them if necessary also in hardware installations, by well-aimed measures, such as modification of organizational sequences, optimization of emergency procedures. (orig.) [de

Emergency response training with the BNL plant analyzer

International Nuclear Information System (INIS)

Cheng, H.S.; Guppy, J.G.; Mallen, A.N.; Wulff, W.

1987-01-01

Presented is the experience in the use of the BNL Plant Analyzer for NRC emergency response training to simulated accidents in a BWR. The unique features of the BNL Plant Analyzer that are important for the emergency response training are summarized. A closed-loop simulation of all the key systems of a power plant in question was found essential to the realism of the emergency drills conducted at NRC. The faster than real-time simulation speeds afforded by the BNL Plant Analyzer have demonstrated its usefulness for the timely conduct of the emergency response training

Procedures and practices for abnormal occurrences and emergencies

International Nuclear Information System (INIS)

Blaesig, H.

1986-01-01

This lecture contains the concept of the Emergency Operating Procedures (EOPs) of German power plants. As the procedures depend on the technique of the plant the level of automation and the types of information are described first. After this, the method to diagnose a transient or accident, following entry into an emergency procedure is explained. An overview about the design basis accidents and the aim of the actions in the procedures is given basing on the existing rules and regulations. Finally the theoretical principles are explained taking the corresponding procedures and examples of two German PWRs. (orig.)

Determining procedures for simulation-based training in radiology

DEFF Research Database (Denmark)

Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth

2018-01-01

, and basic abdominal ultrasound. CONCLUSION: A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. KEY POINTS: • Simulation-based training can supplement training on patients......OBJECTIVES: New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs...... assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. METHODS: A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored...

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom.

Science.gov (United States)

Sharrock, A E; Gokani, V J; Harries, R L; Pearce, L; Smith, S R; Ali, O; Chu, H; Dubois, A; Ferguson, H; Humm, G; Marsden, M; Nepogodiev, D; Venn, M; Singh, S; Swain, C; Kirkby-Bott, J

2015-01-01

The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general surgical procedures are performed, yet surgical training prioritisation and organisation of NHS institutions is predicated upon elective care. The increasing ratio of emergency general surgery consultant posts compared to traditional sub-specialities has yet to be addressed. How should the capability gap be bridged to equip motivated, skilled surgeons of the future to deliver a high standard of emergency surgical care? The aim was to address both training requirements for the acquisition of necessary emergency general surgery skills, and the formation of job plans for trainee and consultant posts to meet the current and future requirements of the NHS. Twenty nine trainees and a consultant emergency general surgeon convened as a Working Group at The Association of Surgeons in Training Conference, 2015, to generate a united consensus statement to the training requirement and delivery of emergency general surgery provision by future general surgeons. Unscheduled general surgical care provision, emergency general surgery, trauma competence, training to meet NHS requirements, consultant job planning and future training challenges arose as key themes. Recommendations have been made from these themes in light of published evidence. Careful workforce planning, education, training and fellowship opportunities will provide well-trained enthusiastic individuals to meet public and societal need.

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

Medical intervention in radiological emergencies, formation and training

International Nuclear Information System (INIS)

Cardenas H, J.

2006-01-01

The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

Revised radiation emergency procedures at Pakistan research reactor PINSTECH

International Nuclear Information System (INIS)

Orfi, S.D.; Javed, M.; Ahmad, S.; Akhtar, K.M.; Mubarak, M.A.

1984-12-01

Necessary procedures have been laid down in this report to meet the radiation emergency at Pakistan Research Reactor PINSTECH. The Nuclear Safety Committee PINSTECH (NSCP) had also recommended a number of improvements in the existing procedures. Revision of the procedures was also considered necessary to incorporate into it new radiation units/limits and new emergency equipment available. Radiation emergency preparedness programme is of continuous nature. Latest developments else-where and local experience contribute to the improvement of the existing arrangements under this programme. (A.B.)

Moving toward New Horizons for Marketing Education: Designing a Marketing Training for the Poor in Developing and Emerging Markets

Science.gov (United States)

Teklehaimanot, Mebrahtu L.; Ingenbleek, Paul T. M.; Tessema, Workneh K.; van Trijp, Hans C. M.

2017-01-01

In recent years, marketing education has broadened to poor people in developing and emerging countries. In this article, the authors use four empirical studies that apply well-established training design procedures to design a marketing training program for Ethiopian pastoralists. Because pastoralists operate in extremely remote, traditional, and…

Emergency procedures of nuclear power plants-Evolution

International Nuclear Information System (INIS)

Atalla, D.L.

1988-01-01

During the TMI event the operators had some difficulties to accurately diagnose the accident, causing delay to recover the plant, and allowing the conditions to deteriorate. Further analysis concluded that the plant emergency procedures were incomplete, and did not cover the possibility of multiple and simultaneous failures. This paper covers a new approach for developing emergency procedures to create a new general strategy by providing valid instructions for all kinds of possible incidents in a nuclear power plant. (author) [pt

Emergency Kausch-Whipple procedure: indications and experiences.

Science.gov (United States)

Standop, Jens; Glowka, Tim; Schmitz, Volker; Schaefer, Nico; Hirner, Andreas; Kalff, Jörg C

2010-03-01

Pancreaticoduodenectomy is a demanding procedure even in selected patients but becomes formidable when performed in cases of emergency. This study analyzed our experience with urgent pancreatoduodenectomies; special emphases were put on the evaluation of diagnostic means and the validation of existing indications for performance of this procedure. Three hundred one patients who underwent pancreatoduodenectomy between 1989 and 2008 were identified from a pancreatic resection database and reviewed for emergency indications. Six patients (2%) underwent emergency pancreatoduodenectomy. Indications included endoscopy-related perforation, postoperative complications, and uncontrollable intraduodenal tumor bleeding. Length of stay and occurrence of nonsurgical complications were increased in emergency compared with elective pancreatoduodenectomies. Although increased, no significant differences were found regarding mortality and surgery-related complications. Indications for emergency pancreatoduodenectomies were based on clinical decisions rather than on radiologic diagnostics. Urgent pancreatic head resections may be considered as an option in selected patients if handling of local complications by interventional measures or limited surgery seems unsafe.

Short radiological emergency response training program

International Nuclear Information System (INIS)

Williams, R.D.; Greenhouse, N.A.

1977-01-01

This paper presents an outline of a radiological emergency response training program conducted at Brookhaven National Laboratory by the health physics and safety training staff. This course is given to groups from local, county, state, and federal agencies and industrial organizations. It is normally three days in length, although the structure is flexible to accommodate individual needs and prior training. An important feature of the course is an emergency exercise utilizing a short lived radionuclide to better simulate real accident conditions. Groups are encouraged to use their own instruments to gain better familiarity with their operating characteristics under field conditions. Immediately following the exercise, a critical review of the students' performance is conducted

Training review criteria and procedures

International Nuclear Information System (INIS)

1986-07-01

The industry, through commitment to the INPO-managed Training Accreditation Program, is implementing what is referred to as performance-based training, or the Systems Approach to Training (SAT). The NRC considers the following five elements as essential to these training programs: Systematic analysis of the jobs to be performed; learning objectives that are derived from the analysis and that describe desired performance after training; Training design and implementation based on the learning objectives; Evaluation of trainee mastery of the objectives during training; and evaluation and revision of the training based on the performance of trained personnel in the job setting. As indicated in the ''Commission Policy Statement on Training and Qualifications of Nuclear Power Plant Personnel'' of March 20, 1985,''the NRC will continue to closely monitor the process [INPO Accreditation] and its results, and ''It remains the continuing responsibility of the NRC to independently evaluate applicants' and licensees' implementation of improvement programs....'' These procedures provide a systematic means for implementing two of the NRC monitoring functions identified in the Commission Policy Statement: ''Continuing evaluation of industry training and qualification program effectiveness,''; and ''Monitoring plant and industry trends and events involving personnel errors.''

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

Training to the Nuclear emergency plans

International Nuclear Information System (INIS)

Vera Navascues, I.

2003-01-01

In 1994 the Civil Protection Directorate outlined a formation plan related to the Nuclear emergency plans with the purpose of guaranteeing for the communities involved in this material a basic and homogeneous formation. In the preparation of this Plan the following phases had been developed: 1. Study of formative needs of the different participant communities involved in nuclear plans. This has been done throw the information collected by: nuclear emergency plans and procedures that develop them, questionnaires, observation list, exercise, drills, etc. 2. With all the needs detected and in function of them was designed the objectives to teach in relation with the knowledge and the abilities that the formation can give to the participants. 3. Definition of thematic areas related with the different matters to teach, derived from the different objectives. 4. Organization: The development of the formative activities through a specific material with orientations for the professors (content of material to impart, didactic resources, etc.) and a short summary of the Didactic Units imparted to the students. The methodology is based in short theoretical classes and in the active implication through practice activities exercises and drills to train its functions and the coordination of the different implied organizations. 5. Evaluation: the implantation of the formation plan contributes new formative needs. (Author)

A multi disciplinary obstetric emergency training programme.

LENUS (Irish Health Repository)

Whelan, Mary

2012-09-01

The Rotunda Hospital (Dublin) obstetric emergency training programme (RHOET) was designed, in 2008, to meet the ongoing education and training needs of the local multidisciplinary team. Prior to its implementation, senior midwives attended the advanced life support in obstetrics (ALSO) course, and many of the obstetricians attended the Management of obstetric emergencies and trauma (MOET) and\\/or ALSO courses. Attendance at these off site courses meant that the only opportunity for team training was the informal and ad hoc \\'drills and skills\\' that took place in the birthing suite. This paper documents our journey since RHOET was implemented.

Sexual Assault Training in Emergency Medicine Residencies: A Survey of Program Directors

Directory of Open Access Journals (Sweden)

Margaret K Sande

2013-09-01

Full Text Available Introduction: There is currently no standard forensic medicine training program for emergency medicine residents. In the advent of sexual assault nurse examiner (SANE programs aimed at improving the quality of care for sexual assault victims, it is also unclear how these programs impact emergency medicine (EM resident forensic medicine training. The purpose of this study was togather information on EM residency programs’ training in the care of sexual assault patients and determine what impact SANE programs may have on the experience of EM resident training from the perspective of residency program directors (PDs.Methods: This was a cross-sectional survey. The study cohort was all residency PDs from approved EM residency training programs who completed a closed-response self-administered survey electronically.Results: We sent surveys to 152 PDs, and 71 responded for an overall response rate of 47%. Twenty-two PDs (31% reported that their residency does not require procedural competency for the sexual assault exam, and 29 (41% reported their residents are required only to observe sexual assault exam completion to demonstrate competency. Residency PDs were asked how their programs established resident requirements for sexual assault exams. Thirty-seven PDs (52% did not know how their sexual assault exam requirement was established.Conclusion: More than half of residency PDs did not know how their sexual assault guidelines were established, and few were based upon recommendations from the literature. There is no clear consensus as to how PDs view the effect of SANE programs on resident competency with the sexual assault exam. This study highlights both a need for increased awareness of EM resident sexual assault education nationally and also a possible need for a training curriculum defining guidelines forEM residents performing sexual assault exams. [West J Emerg Med. 2013;14(5:461–466.

Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial.

Science.gov (United States)

Azizkhani, Reza; Bahadori, Azadeh; Shariati, Mohammadreza; Golshani, Keyhan; Ahmadi, Omid; Masoumi, Babak

2018-01-01

The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO 4 ) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO 4 or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups. The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg/kg), in both groups was similar. After the injection of the second dose of ketamine (1 mg/kg) the status of TOF in four patients in ketamine plus MgSO 4 (0.45 mg/kg) group changed, it was three quarters but in ketamine group, the status of TOF in all patients was four quarters. The difference between groups was not statistically significant ( P = 0.12). The findings revealed that for muscle relaxation during medical procedures in the emergency department, ketamine in combination with MgSO 4 with this dose was not effective for muscle relaxation during procedures.

12 CFR 1731.5 - Internal controls, procedures, and training.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Internal controls, procedures, and training... HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS MORTGAGE FRAUD REPORTING § 1731.5 Internal controls, procedures, and training. An Enterprise shall establish adequate and efficient internal controls and...

Procedural training in virtual reality: A comparison of technology types

International Nuclear Information System (INIS)

Sebok, A.; Nystad, E.

2006-01-01

This paper describes a study investigating questions of learning effectiveness in different VR technology types. Four VR display technology types were compared in terms of their ability to support procedural learning. The VR systems included two desktop displays (mono-scopic and stereoscopic view), a large screen stereoscopic display, and a mono-scopic head-mounted display. Twenty-four participants completed procedural training scenarios on these different display types. Training effectiveness was assessed in terms of objective task performance. Following the training session, participants performed the procedure they had just learned using the same VR display type they used for training. Time to complete the procedure and errors were recorded. Retention and transfer of training were evaluated in a talk-through session 24 hours after the training. In addition, subjective questionnaire data were gathered to investigate perceived workload, Sense of Presence, simulator sickness, perceived usability, and ease of navigation. While no difference was found for the short-term learning, the study results indicate that retention and transfer of training were better supported by the large screen stereoscopic condition. (authors)

Generic procedures for monitoring in a nuclear or radiological emergency

International Nuclear Information System (INIS)

1999-06-01

One of the most important aspects of managing a radiological emergency is the ability to promptly and adequately assess the need for protective actions. Protective action accident management must make use of the key relevant information available. Decision-making and accident assessment will be an iterative and dynamic process aimed at refining the initial evaluation as more detailed and complete information becomes available. Emergency monitoring is one of the main sources for obtaining needed information. This publication is in the scope of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Legal Series No. 14) under which the IAEA is authorized to assist a State Party or a Member State among other matters in developing appropriate radiation monitoring programmes, procedures and standards (Article 5). The scope of this manual is restricted to practical guidance for environmental and source monitoring during a nuclear or other radiological emergency. It does not address emergency response preparedness, nor does it cover the emergency management aspects of accident assessment. This manual is organised into sections relating to measurements in order of priority of a major reactor accident, namely: ambient gamma/beta dose rates from plume, ground deposition or source; radionuclide concentrations in air; deposition maps for 131 I and 137 Cs and other important radionuclides; radionuclide mix in deposition and radionuclide concentrations in food, drinking water and other samples. The introductory section provides an overview of the design of emergency monitoring and sampling programmes, monitoring teams and their qualifications and training, monitoring equipment and instrumentation, protective actions for emergency monitoring teams and quality assurance and quality control checks

Inservice inspection procedures and training according to the ASME code

International Nuclear Information System (INIS)

Greenwald, S.M.; Chockie, L.J.

1987-01-01

Mandatory training of the technical staff at a nuclear power plant is of paramount importance if we are to avoid costly plant shutdowns. This training should include the requirements for both Preservice and Inservice Inspection, in addition to Quality Assurance procedures as required by the American Society of Mechanical Engineers (ASME) Code. The training is best accomplished by utilizing instructors who are thoroughly familiar with plant operations and the ASME Code, as well as serving on one of the Code committees. This paper focuses on the Inservice Inspection procedures and the results of an intensive training effort to implement such procedures. (author)

Assessment procedures results of training in biology

Directory of Open Access Journals (Sweden)

Elena A. Galkina

2018-04-01

Full Text Available The article describes the procedures for evaluating the results of training in biology. The mechanisms for monitoring the learning outcomes of a biology teacher are presented. Examples of algorithms for procedures for evaluating learning outcomes in biology are demonstrated.

Propofol for procedural sedation and analgesia reduced dedicated emergency nursing time while maintaining safety in a community emergency department.

Science.gov (United States)

Reynolds, Joshua C; Abraham, Michael K; Barrueto, Fermin F; Lemkin, Daniel L; Hirshon, Jon M

2013-09-01

Procedural sedation and analgesia is a core competency in emergency medicine. Propofol is replacing midazolam in many emergency departments. Barriers to performing procedural sedation include resource utilization. We hypothesized that emergency nursing time is shorter with propofol than midazolam, without increasing complications. Retrospective analysis of a procedural sedation registry for two community emergency departments with combined census of 100,000 patients/year. Demographics, procedure, and ASA physical classification status of adult patients receiving procedural sedation between 2007-2010 with midazolam or propofol were analyzed. Primary outcome was dedicated emergency nursing time. Secondary outcomes were procedural success, ED length of stay, and complication rate. Comparative statistics were performed with Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher's exact test. Linear regression was performed with log-transformed procedural sedation time to define predictors. Of 328 procedural sedation and analgesia, 316 met inclusion criteria, of which 60 received midazolam and 256 propofol. Sex distribution varied between groups (midazolam 3% male; propofol 55% male; P = 0.04). Age, procedure, and ASA status were not significantly different. Propofol had shorter procedural sedation time (propofol 32.5 ± 24.2 minutes; midazolam 78.7 ± 51.5 minutes; P differences between complication rates (propofol 14%; midazolam 13%; P = 0.88) or emergency department length of stay (propofol 262.5 ± 132.8 minutes; midazolam 288.6 ± 130.6 minutes; P = 0.09). Use of propofol resulted in shorter emergency nursing time and higher procedural success rate than midazolam with a comparable safety profile. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Dehydration treatment practices among pediatrics-trained and non-pediatrics trained emergency physicians.

Science.gov (United States)

Nunez, Jeranil; Liu, Deborah R; Nager, Alan L

2012-04-01

We sought to survey emergency physicians in the United States regarding the management of pediatric dehydration secondary to acute gastroenteritis. We hypothesized that responses from physicians with dedicated pediatric training (PT), that is, board certification in pediatrics or pediatric emergency medicine, would differ from responses of physicians with no dedicated pediatric training (non-PT). An anonymous survey was mailed to randomly selected members of the American College of Emergency Physicians and sent electronically to enrollees of Brown University pediatric emergency medicine listserv. The survey consisted of 17 multiple-choice questions based on a clinical scenario depicting a 2-year-old with acute gastroenteritis and moderate dehydration. Questions asked related to treatment preferences, practice setting, and training information. One thousand sixty-nine surveys were received: 997 surveys were used for data analysis, including 269 PT physicians and 721 non-PT physicians. Seventy-nine percent of PT physicians correctly classified the scenario patient as moderately dehydrated versus 71% of non-PT physicians (P = 0.063). Among those who correctly classified the patient, 121 PT physicians (58%) and 350 non-PT physicians (68%) would initially hydrate the patient with intravenous fluids. Pediatrics-trained physicians were more likely to initially choose oral or nasogastric hydration compared with non-PT physicians (P = 0.0127). Pediatrics-trained physicians were less likely to perform laboratory testing compared with the non-PT group (n = 92, 45%, vs n = 337, 66%; P dehydrated children, significantly more PT physicians, compared with non-PT physicians, follow established guidelines.

Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

Science.gov (United States)

Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

2018-01-09

New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

Emergency procedures beyond design basis ''Feed and Bleed''

International Nuclear Information System (INIS)

Dominguez Bautista, M.T.; Campuzano Pena, F.

1994-01-01

The incorporation of Beyond-Design-Basis Emergency Procedures, also called the Emergency Manual or Severe Accident Manual, has been an important step forward in nuclear power plant safety. These procedures cover situations in which the deterministic criteria used in plant design have been contravened. In such situations new accident scenarios, unforeseen system actions or a combination of both, need to be considered. Establishing these procedures is actually the last in a sequence of activities the sequence includes definition of scenarios, study of their phenomena, analysis of optional system actions, verification of their effectiveness and finally, implementation of the procedure. The systematization of these new strategies is supported by the results of the probabilistic analyses which serve in this case to pinpoint the objectives of these strategies. This paper describes the application of this methodology in the definition of a procedure for heat sink recovery on the secondary side (feed and bleed) if this has been totally or partially lost in a beyond-design-basis event. (Author)

Astronaut Stephen Oswald during emergency bailout training

Science.gov (United States)

1994-01-01

Suited in a training version of the Shuttle partial-pressure launch and entry garment, astronaut Stephen S. Oswald, STS-67 commander, gets help with a piece of gear from Boeing's David Brandt. The scene was photographed prior to a session of emergency bailout training in the 25-feet deep pool at JSC's Weightless Environment Training Facility (WETF).

Process improvement of the emergency operating procedures for Embalse Nuclear Power Plant

Energy Technology Data Exchange (ETDEWEB)

Mariotti, A.D.; Pomerantz, M.; Moreno, C., E-mail: dmariotti@na-sa.com.ar, E-mail: mpomerantz@na-sa.com.ar, E-mail: cmoreno@na-sa.com.ar [Embalse Nuclear Power Plant, Nuclear Safety Dept., Embalse (Argentina)

2014-07-01

Emergency Operating Procedures (EOP) package of the Embalse Nuclear Power Plant (CNE) were made entirely by the plant staff since the beginning of its operation. With the emergence of Severe Accidents Guidelines (SAMG) and the latest events related to Fukushima, the EOP philosophy should include a new concept. It should consider that the EOP may be unsuccessful and an exit to the SAMG must be necessary. However, due to abnormal event mitigation using EOP is the way to prevent the beginning of a severe accident, EOP always had significant relevance in the plant documentation. For this reason, added to the overall requirement of an exit to the SAMG, it emerges a general review of the use efficiency of the EOP during an abnormal event. For this reason, a comprehensive process improvement has emerged using the operating experience, full-scope simulator training of the control room staff, advances in technology and the arrival of new generations. In this work, fundamental changes, new document format and ergonomic redesign for validation at full-scope simulator and use at main control room of new EOP for CNE are presented. (author)

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

A symptom based decision tree approach to boiling water reactor emergency operating procedures

International Nuclear Information System (INIS)

Knobel, R.C.

1984-01-01

This paper describes a Decision Tree approach to development of BWR Emergency Operating Procedures for use by operators during emergencies. This approach utilizes the symptom based Emergency Procedure Guidelines approved for implementation by the USNRC. Included in the paper is a discussion of the relative merits of the event based Emergency Operating Procedures currently in use at USBWR plants. The body of the paper is devoted to a discussion of the Decision Tree Approach to Emergency Operating Procedures soon to be implemented at two United States Boiling Water Reactor plants, why this approach solves many of the problems with procedures indentified in the post accident reviews of Three Mile Island procedures, and why only now is this approach both desirable and feasible. The paper discusses how nuclear plant simulators were involved in the development of the Emergency Operating Procedure decision trees, and in the verification and validation of these procedures. (orig./HP)

Police procedures in civil nuclear emergencies

International Nuclear Information System (INIS)

Smith, F.H.

1989-01-01

The responsibilities of the police in the event of a nuclear emergency are summarized. Preparation and planning is needed with site operators and other organisations who would also be involved in the event of an accident. Several points in particular are discussed; shelter and evacuation, the issue of potassium iodate tablets, protection of police officers, the police involvement in the operation support centres, public education and further discussion on the integration and development of the organisation of emergency procedures. (U.K.)

Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management.

Science.gov (United States)

Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

2013-01-01

In this study, by using a problem-oriented approach in the needs assessment, identifying the defects and deficiencies in emergency health training centers has been determined as the basis for the requirements. The main objective of the study was the implementation of surgical emergencies integration of the five surgical groups (general surgery, urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy. THIS INTERVENTIONAL STUDY WAS CONDUCTED IN THREE PHASES: (1) Phase I (design and planning): Needs assessment, recognition of implementation barriers and providing the objectives and training program for integrated emergencies. (2) Phase II (implementation): Justification of the main stakeholders of the project, preparation of students' duties in the emergency department, preparation of on-duty plans, supervising the implementation of the program, and reviewing the plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing the evidences based on the amount of efficiency of the plan and justification for its continuation. In the first and the second phase, the data were collected through holding focus group meetings and interviews. In the third phase, the opened-reply and closed-reply researcher-made questionnaires were used. The questionnaire face and content validity were confirmed by experts and the reliability was assessed by calculating the Cronbach's alpha. ACCORDING TO THE VIEWS OF THE INTERNS, ASSISTANTS, TEACHERS, AND EMERGENCY PERSONNEL, THE POSITIVE FEATURES OF THE PLAN INCLUDED THE FOLLOWING: Increasing the patients' satisfaction, reducing the patients' stay in the Emergency Department, increasing the speed of handling the patients, balancing the workloads of the interns, direct training of interns by young teachers of emergency medicine, giving the direct responsibility of the patient to the intern, practical and operational training of emergency issues, increasing the teamwork

The introduction of emergency cricothyroidotomy simulation training in Zimbabwe contributed to the saving of two lives

DEFF Research Database (Denmark)

Avnstorp, M. B.; Jensen, P. V. F.; Dzongodza, T.

2016-01-01

and neck progressing to cardiac arrest. Cardiopulmonary resuscitation was initiated and a secure surgical airway was established via an emergency cricothyroidotomy, saving the patient. A 70-year-old male presented with upper airway obstruction secondary to intubation for an elective procedure. When...... extubated, the patient exhibited severe stridor followed by respiratory arrest. Re-intubation attempts were unsuccessful and emergency cricothyroidotomy was performed to secure the airway, preserving the life of the patient. Conclusion: Emergency cricothyroidotomy training should be considered for all......Background: In developing countries with limited access to ENT services, performing emergency cricothyroidotomy in patients with upper airway obstruction may be a life-saving last resort. An established Danish-Zimbabwean collaboration of otorhinolaryngologists enrolled Zimbabwean doctors...

Interprofessional Emergency Training Leads to Changes in the Workplace.

Science.gov (United States)

Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D; Exadaktylos, Aristomenis K; Machner, Mareen; Hautz, Wolf E

2018-01-01

Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one's roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants' "Commitment to Change." In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication , behavior , knowledge and attitude . Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., "acknowledge other professions' work

Interprofessional Emergency Training Leads to Changes in the Workplace

Directory of Open Access Journals (Sweden)

Dorothea Eisenmann

2017-12-01

Full Text Available Introduction Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. Methods We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one’s roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students, a handover (everyone, and an ED section (medical students and emergency nurses. After each training module, we assessed participants’ “Commitment to Change.” In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. Results In total, 64 of 80 participants (80.0% made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication, behavior, knowledge and attitude. Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics

[Simulation as possible training for palliative emergencies: prospective initial data analysis of participants from two simulation training sessions].

Science.gov (United States)

Wiese, C H R; Bosse, G; Schröder, T; Lassen, C L; Bundscherer, A C; Graf, B M; Zausig, Y A

2015-01-01

Palliative emergencies describe an acute situation in patients with a life-limiting illness. At present defined curricula for prehospital emergency physician training for palliative emergencies are limited. Simulation-based training (SBT) for such palliative emergency situations is an exception both nationally and internationally. This article presents the preparation of recommendations in the training and development of palliative care emergency situations. A selected literature search was performed using PubMed, EMBASE, Medline and the Cochrane database (1990-2013). Reference lists of included articles were checked by two reviewers. Data of the included articles were extracted, evaluated und summarized. In the second phase the participants of two simulated scenarios of palliative emergencies were asked to complete an anonymous 15-item questionnaire. The results of the literature search and the questionnaire-based investigation were compared and recommendations were formulated based on the results. Altogether 30 eligible national and international articles were included. Overall, training curricula in palliative emergencies are currently being developed nationally and internationally but are not yet widely integrated into emergency medical training and education. In the second part of the investigation, 25 participants (9 male, 16 female, 20 physicians and 5 nurses) were included in 4 multiprofessional emergency medical simulation training sessions. The most important interests of the participants were the problems for training and further education concerning palliative emergencies described in the national and international literature. The literature review and the expectations of the participants underlined that the development and characteristics of palliative emergencies will become increasingly more important in outpatient emergency medicine. All participants considered palliative care to be very important concerning the competency for end-of-life decisions

Explanation of procedure on site medical emergency response for nuclear accident

International Nuclear Information System (INIS)

Liu Yulong; Jiang Zhong

2012-01-01

National occupational health standard-Procedure on Site Medical Emergency Response for Nuclear Accident has been approved and issued by the Ministry of Health. This standard is formulated according to the Emergency Response Law of the People's Republic of China, Law of the People 's Republic of China on Prevention and Control of Occupational Diseases, Regulations on Emergency Measures for Nuclear Accidents at Nuclear Power Plants, and Health Emergency Plans for Nuclear and Radiological Accidents of Ministry of Health, supporting the use of On-site Medical Emergency Planning and Preparedness for Nuclear Accidents and Off-site Medical Emergency Planning and Preparedness for Nuclear Accidents. Nuclear accident on-site medical response procedure is a part of the on-site emergency plan. The standard specifies the basic content and requirements of the nuclear accident on-site medical emergency response procedures of nuclear facilities operating units to guide and regulate the work of nuclear accident on-site medical emergency response of nuclear facilities operating units. The criteria-related contents were interpreted in this article. (authors)

Spill exercise 1980: an LLNL emergency training exercise

International Nuclear Information System (INIS)

Morse, J.L.; Gibson, T.A.; Vance, W.F.

1981-01-01

An emergency training exercise at Lawrence Livermore National Laboratory (LLNL) demonstrated that off-hours emergency personnel can respond promptly and effecively to an emergency situation involving radiation, hazardous chemicals, and injured persons. The exercise simulated an explosion in a chemistry laboratory and a subsequent toxic-gas release

LNG - emergency control

Energy Technology Data Exchange (ETDEWEB)

Berardinelli, Ricardo Porto; Correa, Kleber Macedo; Moura Filho, Nelson Barboza de; Fernandez, Carlos Antonio [TRANSPETRO, Rio de Janeiro, RJ (Brazil); Matos, Jose Eduardo Nogueira de [PETROBRAS, Rio de Janeiro, RJ (Brazil)

2009-07-01

The operation of liquefied natural gas (LNG) is pioneering within the PETROBRAS System. PETROBRAS Transporte - TRANSPETRO is going to operate two flexible LNG terminals, located in Ceara and Rio de Janeiro. In accordance with the Corporate Health, Safety and Environmental (HSE) Directive - Training, Education and Awareness, PETROBRAS Transporte S.A. - TRANSPETRO has prepared an action plan with the objective of ensuring the operational safety of the undertaking. Among other actions a training program for the emergency control of LNG will be inserted into the timetable. The above mentioned training program was held over a period of 20 hours, and was divided between theory and practice. In the theoretical part, the characteristics of the product, the history of accidents and the emergency response procedures were covered. In the practical part, 3000 gallons of LNG were utilized where the behavior of the product could be confirmed following a confined leak, thereby verifying the efficacy of the emergency control resources. The teaching process of the course was developed in the company through the preparation of specific procedures, emergency plans and the formation of internal instructors. (author)

Sector emergency procedures for Pakistan Research Reactor-1 (PARR-1) PINSTECH

International Nuclear Information System (INIS)

Aziz, A.; Aslam, M.; Faruq, M.U.; Ahmad, B.; Hasan, S.; Lodhi, N.P.K.

1992-12-01

A plan for handling of the radiation emergency situation prevailing outside PINSTECH has been incorporated in this report. This report outlines the detailed procedures and collective responsibilities and actions to be undertaken for meeting the emergency situation. These procedures include announcement/notification of emergency, evaluation of emergency, control of access and aggress, personnel monitoring and internal dosimetry, medical care of injured etc. A summary of the role and responsibilities of PINSTECH and the public organisations during a sector emergency at PINSTECH has been included as an appendix. (Orig./A.B.)

Operator behaviors observed in following emergency operating procedure under a simulated emergency

International Nuclear Information System (INIS)

Choi, Sun Yeong; Park, Jin Kyun

2012-01-01

A symptom-based procedure with a critical safety function monitoring system has been established to reduce the operator's diagnosis and cognitive burden since the Three-Mile Island (TMI) accident. However, it has been reported that a symptom-based procedure also requires an operator's cognitive efforts to cope with off-normal events. This can be caused by mismatches between a static model, an emergency operating procedure (EOP), and a dynamic process, the nature of an ongoing situation. The purpose of this study is to share the evidence of mismatches that may result in an excessive cognitive burden in conducting EOPs. For this purpose, we analyzed simulated emergency operation records and observed some operator behaviors during the EOP operation: continuous steps, improper description, parameter check at a fixed time, decision by information previously obtained, execution complexity, operation by the operator's knowledge, notes and cautions, and a foldout page. Since observations in this study are comparable to the results of an existing study, it is expected that the operational behaviors observed in this study are generic features of operators who have to cope with a dynamic situation using a static procedure.

[Simulation-based training in anesthesia and emergency medicine: preparation for the unexpected: on the way to new standards of education in Germany].

Science.gov (United States)

Issleib, Malte; Zöllner, C

2015-01-01

Medical expertise consists of knowledge, professional skills and individual attitudes. Training and education of this expertise starts in medical school and develops throughout the qualification process of anesthesists and emergency physicians. Medical decisions are not only rational but also intuitive. The combination of these characteristics cannot and should not be trained on patients. The implementation of modern simulation techniques offers the opportunity to train for emergency situations similar to training systems in the energy industry and aviation. Repetitive training of rare emergency situations brings routine to seldomly used procedures. In simulation training mistakes can be detected and systematically corrected. The team interactions and soft skills can also be focussed on. Video analysis gives the participant the opportunity for self-reflection and can lead to correction of individual behavior patterns. This dimension of education cannot be done in real patient care. This training goes far beyond the level of skills training. Through simulation training involves the whole team, the communication and the interaction between the team members in medically challenging situations. Crisis resource management leads to measurable improvements in patient safety and safety culture as well as personnel satisfaction.

The learning effect of intraoperative video-enhanced surgical procedure training.

Science.gov (United States)

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, L J; Koopal, S A; Pierie, J P E N

2011-07-01

The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST). Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method. Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02). INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.

Once upon a time (training for emergency situations)

International Nuclear Information System (INIS)

Olsen, W.C.

1979-01-01

Taking the pretend out of the emergency is discussed in this manual on emergency response training. The following suggestions are made: (1) plan credible emergency situations, (2) select plausible locations, (3) write scenarios, (4) tailor situations to locations, (5) involve other organizations, (6) make injuries look realistic, and (7) let employees take part

Astronauts and cosmonauts during emergency bailout training session

Science.gov (United States)

1994-01-01

Using small life rafts, several cosmonauts and astronauts participating in joint Russia - United States space missions take part in an emergency bailout training session in the JSC Weightless Environment Training Facility (WETF) 25-feet-deep pool. In the

Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

Directory of Open Access Journals (Sweden)

Serkan Toy

2017-03-01

Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

Realism of procedural task trainers in a pediatric emergency medicine procedures course

Directory of Open Access Journals (Sweden)

Allan Shefrin

2015-04-01

Conclusions: Task training models utilized in our course received variable realism ratings. When deciding what type of task trainer to use future courses should carefully consider the desired aspect of realism, and how it aligns with the procedural skill, balanced with cost considerations.

Emergency medical technician education and training.

Science.gov (United States)

Lauro, Joseph; Sullivan, Francis; Williams, Kenneth A

2013-12-03

Emergency Medical Services (EMS) training and education are vital and vibrant aspects of a young and evolving profession. This article provides a perspective on this effort in the United States and reviews current activity in Rhode Island.

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training

NARCIS (Netherlands)

van Det, M.J.; Meijerink, W.J.; Hoff, C.; Middel, B.; Pierie, J.P.

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training

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.

Development of assessment procedures at the CEGB's nuclear power training centre

International Nuclear Information System (INIS)

Chapman, C.R.; Harris, N.D.C.

1986-01-01

The work of a power station engineer can be considered under four aspects: technology, diagnosis action and communication. The development, validation and use of assessment procedures can successfully incorporate the same aspects. The purposes of assessment are reporting training achievement and giving feedback to course members and tutorial staff. The development of standardized procedures to produce, evaluate and mark assessments and to optimize feedback ensures objectivity and uniformity. This has been achieved at the Central Electricity Generating Board's Nuclear Power Training Centre by enlisting an educational consultant to provide guidance and assist in training the resident tutors in assessment procedures. (author)

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

Science.gov (United States)

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

Science.gov (United States)

Tukey, Melissa H; Wiener, Renda Soylemez

2014-03-01

At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

Just-In-Time eTraining Applied To Emergency Medical Services

OpenAIRE

Vico Vela, Francisco José; Sánchez Canteli, Vicente; Lobo Fernández, Daniel; Fernández Rodríguez, Jose David; Bandera, César; Rivas, Ramón; Rosen, M.; Schlegel, M.

2013-01-01

While the applications of just-in-time training are more and more spread, the ubiquitous mobile technology has not found practical uses of this training strategy. As an original example of services for healthcare, we present in this work an application of eTraining that makes use of mobile telephones to transmit medical and on-site information content to emergency medical personnel that attend and emergency. The state-of-the-art in related technologies, overall architectu...

Acquisition of Formal Operations: The Effects of Two Training Procedures.

Science.gov (United States)

Rosenthal, Doreen A.

1979-01-01

A study of 11- and 12-year-old girls indicates that either of two training procedures, method training or dimension training, can aid in the transition from concrete operational to formal operational thought by promoting a hypothesis-testing attitude. (BH)

Economic evaluation of emergency obstetric care training: a systematic review.

Science.gov (United States)

Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

2017-12-04

Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a

Mobile Phone Training Platform for the Nursing Staff in the Emergency Department.

Science.gov (United States)

Liu, Xueqing; Cheng, Jing; Huang, Sufang

2018-05-09

Continuous education is required for nursing staff, but continuous education can be complicated for nurses working shifts, such as those in the emergency department (ED). To explore the effectiveness of the ED Training Platform of Tongji Hospital for conventional continuing education of emergency nurses. The training completion rate and training outcomes were validated. This was a retrospective study of all in-service emergency nurses working at the Tongji Medical College of Huazhong University of Science and Technology between August 2016 and August 2017. The training results of the previous year of the same group were used as controls. The platform used was an online system called JikeXuetang ( www.jkxuetang.com/ ), using the WeChat application as a carrier. The training completion rate and pass rate were compared with the control data. Among 124 nurses, the training completion rate increased from training course; 89.7% believed it as an effective tool of learning, and intended to join public courses after completion; and 63.4% nurses expressed the wish to receive push services once or twice weekly for training course. The outcome of emergency nurse training was improved using the mobile training platform. This approach was more feasible and easier for training.

Randomized trial to examine procedure-to-procedure transfer in laparoscopic simulator training

DEFF Research Database (Denmark)

Bjerrum, F; Sorensen, J L; Konge, L

2016-01-01

-centre educational superiority trial. Surgical novices practised basic skills on a laparoscopic virtual reality simulator. On reaching proficiency, participants were randomized to proficiency-based training. The intervention group practised two procedures on the simulator (appendicectomy followed by salpingectomy...

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

Science.gov (United States)

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

2015-07-01

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

Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

Energy Technology Data Exchange (ETDEWEB)

Kelly, K.E. [Westinghouse Hanford Co., Richland, WA (United States)

1994-11-09

For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel.

Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

International Nuclear Information System (INIS)

Kelly, K.E.

1994-01-01

For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel

Generic procedures for assessment and response during a radiological emergency

International Nuclear Information System (INIS)

2000-08-01

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 the public and emergency workers. Radiological accident assessment must take account of all critical information available at any time and must be an iterative and dynamic process aimed at reviewing the response as more detailed and complete information becomes available. This manual provides the tools, generic procedures and data needed for an initial response to a non-reactor radiological accident. This manual is one out of a set of IAEA publications on emergency preparedness and response, including Method for the Development of Emergency Response Preparedness for Nuclear or Radiological Accidents (IAEA-TECDOC-953), Generic Assessment Procedures for Determining Protective Actions During a Reactor Accident (IAEA-TECDOC-955) and Intervention Criteria in a Nuclear or Radiation Emergency (Safety Series No. 109)

Identification of training and emergency-planning needs through job-safety analysis

Energy Technology Data Exchange (ETDEWEB)

Veltrie, J.

1987-01-01

Training and emergency-planning needs within the photovoltaic industry may be more accurately determined through the performance of detailed job-safety analysis. This paper outlines the four major components of such an analysis, namely operational review, hazards evaluation, personnel review and resources evaluation. It then shows how these may be developed into coherent training and planning recommendations, for both emergency and non-emergency situations.

Improving child protection: a systematic review of training and procedural interventions.

Science.gov (United States)

Carter, Y H; Bannon, M J; Limbert, C; Docherty, A; Barlow, J

2006-09-01

To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals. Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour. Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process. Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

Skin resurfacing procedures: new and emerging options.

Science.gov (United States)

Loesch, Mathew M; Somani, Ally-Khan; Kingsley, Melanie M; Travers, Jeffrey B; Spandau, Dan F

2014-01-01

The demand for skin resurfacing and rejuvenating procedures has progressively increased in the last decade and has sparked several advances within the skin resurfacing field that promote faster healing while minimizing downtime and side effects for patients. Several technological and procedural skin resurfacing developments are being integrated into clinical practices today allowing clinicians to treat a broader range of patients' skin types and pathologies than in years past, with noteworthy outcomes. This article will discuss some emerging and developing resurfacing therapies and treatments that are present today and soon to be available.

Audit of Childbirth Emergency Referrals by Trained Traditional Birth ...

African Journals Online (AJOL)

Medicine, Enugu State University of Science and Technology, 5Department of Obstetrics and ... Aim: The aim was to audit childbirth emergency referrals by trained TBAs to a ..... training of TBAs has been documented by previous African.

45 CFR 1634.12 - Emergency procedures and waivers.

Science.gov (United States)

2010-10-01

... COMPETITIVE BIDDING FOR GRANTS AND CONTRACTS § 1634.12 Emergency procedures and waivers. The President of the... requirements imposed by law on the awards of grants and contracts for a particular fiscal year. ...

Patient satisfaction with procedural sedation in the emergency department.

Science.gov (United States)

Johnson, Olivia G; Taylor, David McD; Lee, Marina; Ding, Juen-Li; Ashok, Aadith; Johnson, Damian; Peck, Daniel; Knott, Jonathan; Weinberg, Laurence

2017-06-01

The aim of this study was to determine patient satisfaction with procedural sedation as a function of nature of the procedure and depth of sedation. We undertook a prospective observational study of adult patients who received procedural sedation in two EDs (20 month period). The level of sedation was determined by an investigator, using the Observers Assessment of Anaesthesia/Sedation Scale (1 = awake to 6 = no response to noxious stimuli). Patient satisfaction was measured with the Iowa Satisfaction with Anaesthesia Scale after full recovery. This was self-administered, comprised 11 items (e.g. 'I felt pain') and has a score range of -3 (poor satisfaction) to +3 (very satisfied). A total of 163 patients were enrolled (51.2% men, mean age 50.7 years). The median (interquartile range) satisfaction score was 2.7 (0.7). Patient satisfaction was lower among patients who had orthopaedic procedures (median 2.6 vs 2.8, P patient satisfaction is high. Greater satisfaction is associated with deeper sedation, sedation with propofol and non-orthopaedic procedures. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Development of procedure for emergency response in the combined disaster

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

Lessons learned from operating experience at the emergency after a East Japan Great Earthquake, have shown that development of decision making procedure and criteria for protective action implementation would be important at the emergency in the combined disaster such as nuclear accidents caused by natural disasters (including tsunami, flood, heavy snow, fire, etc.). In this study, the problemdefinition, the concept of operation and the data development were planned for three years since fiscal year 2011. In tins year, trial calculation of evacuation time estimate (ETE) for the wide area was performed. Moreover, the basic concept and procedure for carrying out ETE condidering the combined emergency were developed based on the last year results. (author)

Development of procedure for emergency response in the combined disaster

International Nuclear Information System (INIS)

2013-01-01

Lessons learned from operating experience at the emergency after a East Japan Great Earthquake, have shown that development of decision making procedure and criteria for protective action implementation would be important at the emergency in the combined disaster such as nuclear accidents caused by natural disasters (including tsunami, flood, heavy snow, fire, etc.). In this study, the problemdefinition, the concept of operation and the data development were planned for three years since fiscal year 2011. In tins year, trial calculation of evacuation time estimate (ETE) for the wide area was performed. Moreover, the basic concept and procedure for carrying out ETE condidering the combined emergency were developed based on the last year results. (author)

Train Repathing in Emergencies Based on Fuzzy Linear Programming

Directory of Open Access Journals (Sweden)

Xuelei Meng

2014-01-01

Full Text Available Train pathing is a typical problem which is to assign the train trips on the sets of rail segments, such as rail tracks and links. This paper focuses on the train pathing problem, determining the paths of the train trips in emergencies. We analyze the influencing factors of train pathing, such as transferring cost, running cost, and social adverse effect cost. With the overall consideration of the segment and station capability constraints, we build the fuzzy linear programming model to solve the train pathing problem. We design the fuzzy membership function to describe the fuzzy coefficients. Furthermore, the contraction-expansion factors are introduced to contract or expand the value ranges of the fuzzy coefficients, coping with the uncertainty of the value range of the fuzzy coefficients. We propose a method based on triangular fuzzy coefficient and transfer the train pathing (fuzzy linear programming model to a determinate linear model to solve the fuzzy linear programming problem. An emergency is supposed based on the real data of the Beijing-Shanghai Railway. The model in this paper was solved and the computation results prove the availability of the model and efficiency of the algorithm.

Train repathing in emergencies based on fuzzy linear programming.

Science.gov (United States)

Meng, Xuelei; Cui, Bingmou

2014-01-01

Train pathing is a typical problem which is to assign the train trips on the sets of rail segments, such as rail tracks and links. This paper focuses on the train pathing problem, determining the paths of the train trips in emergencies. We analyze the influencing factors of train pathing, such as transferring cost, running cost, and social adverse effect cost. With the overall consideration of the segment and station capability constraints, we build the fuzzy linear programming model to solve the train pathing problem. We design the fuzzy membership function to describe the fuzzy coefficients. Furthermore, the contraction-expansion factors are introduced to contract or expand the value ranges of the fuzzy coefficients, coping with the uncertainty of the value range of the fuzzy coefficients. We propose a method based on triangular fuzzy coefficient and transfer the train pathing (fuzzy linear programming model) to a determinate linear model to solve the fuzzy linear programming problem. An emergency is supposed based on the real data of the Beijing-Shanghai Railway. The model in this paper was solved and the computation results prove the availability of the model and efficiency of the algorithm.

Creation of an emergency surgery service concentrates resident training in general surgical procedures.

Science.gov (United States)

Ahmed, Hesham M; Gale, Stephen C; Tinti, Meredith S; Shiroff, Adam M; Macias, Aitor C; Rhodes, Stancie C; Defreese, Marissa A; Gracias, Vicente H

2012-09-01

Emergency general surgery (EGS) is increasingly being provided by academic trauma surgeons in an acute care surgery model. Our tertiary care hospital recently changed from a model where all staff surgeons (private, subspecialty academic, and trauma academic) were assigned EGS call to one in which an emergency surgery service (ESS), staffed by academic trauma faculty, cares for all EGS patients. In the previous model, many surgeries were "not covered" by residents because of work-hour restrictions, conflicting needs, or private surgeon preference. The ESS was separate from the trauma service. We hypothesize that by creating a separate ESS, residents can accumulate needed and concentrated operative experience in a well-supervised academic environment. A prospectively accrued EGS database was retrospectively queried for the 18-month period: July 2010 to June 2011. The Accreditation Council for Graduate Medical Education (ACGME) databases were queried for operative numbers for our residency program and for national resident data for 2 years before and after creating the ESS. The ACGME operative requirements were tabulated from online sources. ACGME requirements were compared with surgical cases performed. During the 18-month period, 816 ESS operations were performed. Of these, 307 (38%) were laparoscopy. Laparoscopic cholecystectomy and appendectomy were most common (138 and 145, respectively) plus 24 additional laparoscopic surgeries. Each resident performed, on average, 34 basic laparoscopic cases during their 2-month rotation, which is 56% of their ACGME basic laparoscopic requirement. A diverse mixture of 70 other general surgical operations was recorded for the remaining 509 surgical cases, including reoperative surgery, complex laparoscopy, multispecialty procedures, and seldom-performed operations such as surgery for perforated ulcer disease. Before the ESS, the classes of 2008 and 2009 reported that only 48% and 50% of cases were performed at the main academic

A knowledge based system for training radiation emergency response personnel

International Nuclear Information System (INIS)

Kuriakose, K.K.; Peter, T.U.; Natarajan, A.

1992-01-01

One of the important aspects of radiation emergency preparedness is to impart training to emergency handling staff. Mock exercises are generally used for this purpose. But practical considerations limit the frequency of such exercises. A suitably designed computer software can be effectively used to impart training. With the advent of low cost personal computers, the frequency with which the training programme can be conducted is unlimited. A computer software with monotonic behaviour is inadequate for such training. It is necessary to provide human like tutoring capabilities. With the advances in knowledge based computer systems, it is possible to develop such a system. These systems have the capability of providing individualized training. This paper describes the development of such a system for training and evaluation of agencies associated with the management of radiation emergency. It also discusses the utility of the software as a general purpose tutor. The details required for the preparation of data files and knowledge base files are included. It uses a student model based on performance measures. The software is developed in C under MS-DOS. It uses a rule based expert system shell developed in C. The features of this shell are briefly described. (author). 5 refs

The Evolution of On-Board Emergency Training for the International Space Station Crew

Science.gov (United States)

LaBuff, Skyler

2015-01-01

The crew of the International Space Station (ISS) receives extensive ground-training in order to safely and effectively respond to any potential emergency event while on-orbit, but few people realize that their training is not concluded when they launch into space. The evolution of the emergency On- Board Training events (OBTs) has recently moved from paper "scripts" to an intranet-based software simulation that allows for the crew, as well as the flight control teams in Mission Control Centers across the world, to share in an improved and more realistic training event. This emergency OBT simulator ensures that the participants experience the training event as it unfolds, completely unaware of the type, location, or severity of the simulated emergency until the scenario begins. The crew interfaces with the simulation software via iPads that they keep with them as they translate through the ISS modules, receiving prompts and information as they proceed through the response. Personnel in the control centers bring up the simulation via an intranet browser at their console workstations, and can view additional telemetry signatures in simulated ground displays in order to assist the crew and communicate vital information to them as applicable. The Chief Training Officers and emergency instructors set the simulation in motion, choosing the type of emergency (rapid depressurization, fire, or toxic atmosphere) and specific initial conditions to emphasize the desired training objectives. Project development, testing, and implementation was a collaborative effort between ISS emergency instructors, Chief Training Officers, Flight Directors, and the Crew Office using commercial off the shelf (COTS) hardware along with simulation software created in-house. Due to the success of the Emergency OBT simulator, the already-developed software has been leveraged and repurposed to develop a new emulator used during fire response ground-training to deliver data that the crew receives

Lessons learned from operating experience, maintenance procedures and training measures

International Nuclear Information System (INIS)

Guttner, K.; Gronau, D.

2003-01-01

Training programmes for nuclear facility personnel as a result of the developing phase of SAT have to be approved in the subsequent implementation and evaluation phases with the consequence of several feedback activities in the whole training process. The effectiveness of this procedure has to be evaluated especially with respect to an improvement of safety culture, shorter outage times or better plant performance, resulting in a smaller number of incidents due to human failures. The first two arguments are directly connected with all types of maintenance work in a nuclear power plant and the related preparatory training measures. The reduction of incidents due to human failures is the result of different influences, i.e. training of the operational as well as of the maintenance personnel together with changes of the operating procedures or system design. Though an evaluation of the training process should always be based on a clear definition of criteria by which the fulfilment of the learning objectives can be measured directly, the real effectiveness of training is proven by the behaviour and attitude of the personnel which can only be taken from indirect indicators. This is discussed in more detail for some examples being partly related to the above mentioned arguments. An excellent plant performance, representing a general objective of all activities, can be analysed by the changed number and reasons of incidents in a plant during its operation time. Two further examples are taken from the reactor service field where there is a tendency to reduce the individual dose rates by changed devices and/or procedures as an output from training experience with mockups. Finally the rationalisation of refresher training for operational personnel by the use of interactive teaching programs (Computer Based Training - CBT) is presented which integrate learning objectives together with a test module. (author)

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

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training

OpenAIRE

van Det, M.J.; Meijerink, W.J.; Hoff, C.; Middel, B.; Pierie, J.P.

2013-01-01

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST co...

Preparing for Emergency

DEFF Research Database (Denmark)

Melchiors, Jacob; Todsen, Tobias; Nilsson, Philip

2015-01-01

OBJECTIVE: Emergency cricothyrodotomy (EC) is a lifesaving procedure. Evidence-based assessment of training effects and competency levels is relevant to all departments involved in emergency airway management. As most training uses low-fidelity models, the predictive value of good performance....... Sixteen physicians (7 experienced surgeons and 9 novice physicians) performed an EC on a low-fidelity model and a cadaver. Two blinded raters assessed video recordings of performances using the assessment tool. RESULTS: We found a high interrater reliability, based on a Pearson's r (0.81), and good...

Human Factors in Training: Space Medical Proficiency Training

Science.gov (United States)

Byrne, Vicky E.; Barshi, I.; Arsintescu, L.; Connell, E.

2010-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and the International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to the ISS, medical equipment will be located on the ISS, and carried into CEV in the event of an emergency. Flight surgeons (FS) on the ground in Mission Control will be expected to direct the crew medical officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). This is a joint project consisting of human factors team from the Ames Research Center (ARC) with Immanuel Barshi as Principal Investigator and the Johnson Space Center (JSC). Human factors researchers at JSC have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. Work on medical training has been conducted in collaboration with the Medical Training Group at the Johnson Space Center (JSC) and with Wyle Laboratories that provides medical training to crew members, biomedical engineers (BMEs), and to flight surgeons under the Bioastronautics contract. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. A second area of research involves FS performance support tools. Information needed by the FS during the ISS mission

Project management plan, Hazardous Materials Management and Emergency Response Training Center

International Nuclear Information System (INIS)

Borgeson, M.E.

1994-01-01

For the next 30 years, the main activities at the Hanford Site will involve the handling and cleanup of toxic substances. Thousands of workers involved in these new activities will need systematic training appropriate to their tasks and associated risks. This project is an important part of the Hanford Site mission and will enable the US Department of Energy (DOE) to meet high standards for safety. The Hazardous Materials Management and Emergency Response Training Center (HAMMER) project will construct a centralized regional training center dedicated to training hazardous materials workers and emergency responders in classrooms and with hands-on, realistic training aids representing actual field conditions. The HAMMER Training Center will provide a cost-effective, high-quality way to meet the Hanford Site training needs. The training center creates a partnership among DOE; government contractors; labor; local, state, and tribal governments; and selected institutions of higher education

Effect of simulated emergency skills training and assessments on ...

African Journals Online (AJOL)

... of emergency skills in simulation was highly effective in enhancing the competence and confidence of medical students when managing a clinical emergency. However, students appeared to be overconfident, which could be ascribed to ignorance, and possibly indicates that feedback during training should be improved.

Role of the IAEA's ALMERA network in harmonization of analytical procedures applicable worldwide for radiological emergencies

International Nuclear Information System (INIS)

Pitois, A.; Osvath, I.; Tarjan, S.; Groening, M.; Osborn, D.; )

2016-01-01

The International Atomic Energy Agency (IAEA) coordinates and provides analytical support to the worldwide network of Analytical Laboratories for the Measurement of Environmental Radioactivity (ALMERA), consisting at the end of 2015 of 154 laboratories in 85 countries. This network, established by the IAEA in 1995, has for aim to provide timely and reliable measurement results of environmental radioactivity in routine monitoring and emergency situations. The IAEA supports the ALMERA laboratories in their routine and emergency response environmental monitoring activities by organizing proficiency tests and inter-laboratory comparison exercises, developing validated analytical procedures for environmental radioactivity measurement, and organizing training courses and workshops. The network also acts as a forum for sharing knowledge and expertise. The aim of this paper is to describe the current status of ALMERA analytical method development activities for radiological emergencies and the plans for further development in the field

Surgical and procedural skills training at medical school - a national review.

Science.gov (United States)

Davis, Christopher R; Toll, Edward C; Bates, Anthony S; Cole, Matthew D; Smith, Frank C T

2014-01-01

This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

Science.gov (United States)

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

2013-08-01

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

Emergency Medical Rescue in a Radiation Environment

International Nuclear Information System (INIS)

Briesmeister, L.; Ellington, Y.; Hollis, R.; Kunzman, J.; McNaughton, M.; Ramsey, G.; Somers, B.; Turner, A.; Finn, J.

1999-01-01

Previous experience with emergency medical rescues in the presence of radiation or contamination indicates that the training provided to emergency responders is not always appropriate. A new course developed at Los Alamos includes specific procedures for emergency response in a variety of radiological conditions

Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.

Science.gov (United States)

Sawyer, Taylor; White, Marjorie; Zaveri, Pavan; Chang, Todd; Ades, Anne; French, Heather; Anderson, JoDee; Auerbach, Marc; Johnston, Lindsay; Kessler, David

2015-08-01

Acquisition of competency in procedural skills is a fundamental goal of medical training. In this Perspective, the authors propose an evidence-based pedagogical framework for procedural skill training. The framework was developed based on a review of the literature using a critical synthesis approach and builds on earlier models of procedural skill training in medicine. The authors begin by describing the fundamentals of procedural skill development. Then, a six-step pedagogical framework for procedural skills training is presented: Learn, See, Practice, Prove, Do, and Maintain. In this framework, procedural skill training begins with the learner acquiring requisite cognitive knowledge through didactic education (Learn) and observation of the procedure (See). The learner then progresses to the stage of psychomotor skill acquisition and is allowed to deliberately practice the procedure on a simulator (Practice). Simulation-based mastery learning is employed to allow the trainee to prove competency prior to performing the procedure on a patient (Prove). Once competency is demonstrated on a simulator, the trainee is allowed to perform the procedure on patients with direct supervision, until he or she can be entrusted to perform the procedure independently (Do). Maintenance of the skill is ensured through continued clinical practice, supplemented by simulation-based training as needed (Maintain). Evidence in support of each component of the framework is presented. Implementation of the proposed framework presents a paradigm shift in procedural skill training. However, the authors believe that adoption of the framework will improve procedural skill training and patient safety.

Experience with simulator training for emergency conditions

International Nuclear Information System (INIS)

1987-12-01

The training of operators by the use of simulators is common to most countries with nuclear power plants. Simulator training programmes are generally well developed, but their value can be limited by the age, type, size and capability of the simulator. Within these limits, most full scope simulators have a capability of training operators for a range of design basis accidents. It is recognized that human performance under accident conditions is difficult to predict or analyse, particularly in the area of severe accidents. These are rare events and by their very nature, unpredictable. Of importance, therefore, is to investigate the training of operators for severe accident conditions, and to examine ways in which simulators may be used in this task. The International Nuclear Safety Advisory Group (INSAG) has reviewed this field and the associated elements of human behaviour. It has recommended that activities are concentrated on this area. Initially it is encouraging the following objectives: i) To train operators for accident conditions including severe accidents and to strongly encourage the development and use of simulators for this purpose; ii) To improve the man-machine interface by the use of computer aids to the operator; iii) To develop human performance requirements for plant operating staff. As part of this work, the IAEA convened a technical committee on 15-19 September 1986 to review the experience with simulator training for emergency conditions, to review simulator modelling for severe accident training, to examine the role of human cognitive behaviour modelling, and to review guidance on accident scenarios. A substantial deviation may be a major fuel failure, a Loss of Coolant Accident (LOCA), etc. Examples of engineered safety features are: an Emergency Core Cooling System (ECCS), and Containment Systems. This report was prepared by the participants during the meeting and reviewed further in a Consultant's Meeting. It also includes papers which were

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

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service.

NARCIS (Netherlands)

Gerritse, B.M.; Schalkwijk, A.; Pelzer, B.J.; Scheffer, G.J.; Draaisma, J.M.T.

2010-01-01

BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures

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

Science.gov (United States)

Martin, Shelly D; Bush, Anneke C; Lynch, Julia A

2006-09-01

Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.

Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

Science.gov (United States)

Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

2016-11-01

To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Emergence of tacts following mand training in young children with autism.

LENUS (Irish Health Repository)

Egan, Claire E

2009-01-01

This study sought to examine the effects of training mands on the emergence of tacts with the same response forms. Results indicated that training adjective sets as mands resulted in the emergence of adjective sets as tacts under modified, but not standard, antecedent conditions. The findings suggested that the apparent functional independence of mands and tacts may be explained by a lack of appropriate antecedent control over responding.

Stabilization and treatment of dental avulsions and fractures by emergency physicians using just-in-time training.

Science.gov (United States)

McIntosh, Mark S; Konzelmann, Jason; Smith, Jeffrey; Kalynych, Colleen J; Wears, Robert L; Schneider, Howard; Wylie, Todd; Kaminski, Anne; Matar-Joseph, Madeline

2009-10-01

The objective of this investigation is to use a dental simulation model to compare splinting and bandaging methods for managing tooth avulsions and fractures, as measured by dentist evaluators for quality and time to complete each stabilization procedure. This was a randomized crossover study comparing 3 splinting techniques for managing a traumatically avulsed tooth (periodontal pack, wire, and bondable reinforcement ribbon) and 2 bandage techniques for managing a fractured tooth (calcium hydroxide paste and light-cured composite). After viewing a Just-in-Time training video, a convenience sample of emergency physicians performed the 5 stabilization techniques on dental models containing extracted teeth embedded in clay to simulate a segment of the human dentition. Data collected included time to complete each procedure, the evaluation of dentists about whether the procedure was performed satisfactorily or unsatisfactorily, and the ranking of dentists' and participants' preferred technique. Twenty-five emergency physicians participated in the study: 17 residents, 2 pediatric emergency medicine fellows, and 6 attending physicians. Reported median time, as well as minimum and maximum times to complete each splinting technique for an avulsed tooth, was as follows: periodontal pack 4.4 minutes (2.5 to 6.5 minutes), wire 8.6 minutes (5.8 to 12.9 minutes), and bondable reinforcement ribbon 8.9 minutes (5.6 to 15 minutes). Median time (and minimum and maximum times) to complete each protective bandaging technique for a fractured tooth was calcium hydroxide paste 4.6 minutes (3 to 9.6 minutes) and light-cured composite 7.1 minutes (5.5 to 14.1 minutes). When asked to choose a preferred splinting and bandaging technique according to the performance of the physicians, the dentists chose the bondable reinforcement ribbon 96% (24/25) and the light-cured composite 100% (25/25) of the time. Study participants had no measurable or agreeable preference for a particular splinting

Investigation of a reinforcement-based toilet training procedure for children with autism.

Science.gov (United States)

Cicero, Frank R; Pfadt, Al

2002-01-01

Independent toileting is an important developmental skill which individuals with developmental disabilities often find a challenge to master. Effective toilet training interventions have been designed which rely on a combination of basic operant principles of positive reinforcement and punishment. In the present study, the effectiveness of a reinforcement-based toilet training intervention was investigated with three children with a diagnosis of autism. Procedures included a combination of positive reinforcement, graduated guidance, scheduled practice trials and forward prompting. Results indicated that all procedures were implemented in response to urination accidents. A three participants reduced urination accidents to zero and learned to spontaneously request use of the bathroom within 7-11 days of training. Gains were maintained over 6-month and 1-year follow-ups. Findings suggest that the proposed procedure is an effective and rapid method of toilet training, which can be implemented within a structured school setting with generalization to the home environment.

The 2015 Academic College of Emergency Experts in India's INDO-US Joint Working Group White Paper on Establishing an Academic Department and Training Pediatric Emergency Medicine Specialists in India

Science.gov (United States)

Mahajan, Prashant; Batra, Prerna; Shah, Binita R; Saha, Abhijeet; Galwankar, Sagar; Aggrawal, Praveen; Hassoun, Ameer; Batra, Bipin; Bhoi, Sanjeev; Kalra, Om Prakash; Shah, Dheeraj

2015-01-01

The concept of pediatric emergency medicine (PEM) is virtually nonexistent in India. Suboptimally, organized prehospital services substantially hinder the evaluation, management, and subsequent transport of the acutely ill and/or injured child to an appropriate facility. Furthermore, the management of the ill child at the hospital level is often provided by overburdened providers who, by virtue of their training, lack experience in the skills required to effectively manage pediatric emergencies. Finally, the care of the traumatized child often requires the involvement of providers trained in different specialities, which further impedes timely access to appropriate care. The recent recognition of Doctor of Medicine (MD) in Emergency Medicine (EM) as an approved discipline of study as per the Indian Medical Council Act provides an unprecedented opportunity to introduce PEM as a formal academic program in India. PEM has to be developed as a 3-year superspeciality course (in PEM) after completion of MD/Diplomate of National Board (DNB) Pediatrics or MD/DNB in EM. The National Board of Examinations (NBE) that accredits and administers postgraduate and postdoctoral programs in India also needs to develop an academic program – DNB in PEM. The goals of such a program would be to impart theoretical knowledge, training in the appropriate skills and procedures, development of communication and counseling techniques, and research. In this paper, the Joint Working Group of the Academic College of Emergency Experts in India (JWG-ACEE-India) gives its recommendations for starting 3-year DM/DNB in PEM, including the curriculum, infrastructure, staffing, and training in India. This is an attempt to provide an uniform framework and a set of guiding principles to start PEM as a structured superspeciality to enhance emergency care for Indian children. PMID:26807394

Contingency planning and emergency response in construction activities: Training the construction worker

International Nuclear Information System (INIS)

Jones, E.

1987-01-01

Construction activities have the potential for environmental and/or health impacts at Oak Ridge National Laboratory (ORNL) particularly as site cleanup and restoration plans are initiated. ORNL has instituted special training for all construction workers and related contractors. Individuals learn how construction activities at ORNL can potentially have adverse effects on the environment and their health, and to learn how to respond to potential chemical and radiation hazards. Workers are given a review of basic information on radiation and chemicals in a framework that emphasizes the situations in which workers or the environment may be exposed to potential risk. Specific instructions are presented on what to do when contamination is suspected, with identification of emergency procedures and response personnel. 5 refs., 1 fig

Optimal training for emergency needle thoracostomy placement by prehospital personnel: didactic teaching versus a cadaver-based training program.

Science.gov (United States)

Grabo, Daniel; Inaba, Kenji; Hammer, Peter; Karamanos, Efstathios; Skiada, Dimitra; Martin, Matthew; Sullivan, Maura; Demetriades, Demetrios

2014-09-01

Tension pneumothorax can rapidly progress to cardiac arrest and death if not promptly recognized and appropriately treated. We sought to evaluate the effectiveness of traditional didactic slide-based lectures (SBLs) as compared with fresh tissue cadaver-based training (CBT) for placement of needle thoracostomy (NT). Forty randomly selected US Navy corpsmen were recruited to participate from incoming classes of the Navy Trauma Training Center at the LAC + USC Medical Center and were then randomized to one of two NT teaching methods. The following outcomes were compared between the two study arms: (1) time required to perform the procedure, (2) correct placement of the needle, and (3) magnitude of deviation from the correct position. During the study period, a total of 40 corpsmen were enrolled, 20 randomized to SBL and 20 to CBT arms. When outcomes were analyzed, time required to NT placement was not different between the two arms. Examination of the location of needle placement revealed marked differences between the two study groups. Only a minority of the SBL group (35%) placed the NT correctly in the second intercostal space. In comparison, the majority of corpsmen assigned to the CBT group demonstrated accurate placement in the second intercostal space (75%). In a CBT module, US Navy corpsmen were better trained to place NT accurately than their traditional didactic SBL counterparts. Further studies are indicated to identify the optimal components of effective simulation training for NT and other emergent interventions.

Generic Procedures for Medical Response During a Nuclear or Radiological Emergency

International Nuclear Information System (INIS)

2009-01-01

The aim of this manual is to provide the medical community with practical guidance for medical emergency preparedness and response, describing the tasks and actions of different members of the national, regional or local medical infrastructure in accordance with international standards. This document provides generic response procedures for medical personnel responding to different types of radiation emergencies and at the different stages of the emergency response (at the scene of the emergency, pre-hospital, hospital), and during the early post-emergency stage (about 1-2 months afterwards).

Role of first responder's training in the management of nuclear and radiological emergencies

International Nuclear Information System (INIS)

Nagarajan, V.; Sankhla, Rajesh; Verma, R.K.

2008-01-01

Consequent to the terrorist attacks on WTC in USA and other similar terrorist attacks worldwide, there has been increasing public concern regarding the use of radioactive materials in a malevolent act. As the radioactive sources are widely used in the industries, terrorists may have access to these facilities and obtain the radioactive material suitable for making Radioactive Dispersal Device (RDD) often called as dirty bomb. Response to nuclear or radiological emergency may involve highly specialized agencies or technical experts. Hence well-coordinated arrangements must be integrated with those required for any other conventional emergencies. During radiological emergencies, emergency service personnel are expected to play a major role in the early response. Though these personnel are well equipped and trained in tackling the normal emergencies it is essential to train them to deal with the radiological emergencies due to inherent characteristics of radioactivity. For the effective management of radiological emergencies, these first responders are required to be trained in such a way that they understand the concept of radiation protection. This objective can be achieved by using a typical training module consisting of interactive class room lectures, practical sessions to use the instruments and handling of radioactive sources, demonstration of radiation protection practices, exhibition of all radiation survey instruments and protective equipment etc., display of various posters and RDD Emergency Exercise. (author)

32 CFR 989.34 - Special and emergency procedures.

Science.gov (United States)

2010-07-01

... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.34 Special and emergency procedures. (a... regulations or this part. If possible, promptly notify HQ USAF/A7CI, for SAF/IEE coordination and CEQ.... Coordination in this instance must take place as soon as practicable. [64 FR 38129, July 15, 1999, as amended...

Guidelines for the preparation of emergency operating procedures. Resolution of comments on NUREG-0799

International Nuclear Information System (INIS)

1982-08-01

The purpose of this document is to identify the elements necessary for utilities to prepare and implement a program of Emergency Operating Procedures (EOPs) for use by control room personnel to assist in mitigating the consequences of a broad range of accidents and multiple equipment failures. This document applies only to the EOPs so designated; it does not address emergency preparedness or emergency planning. It also represents the resolution of comments on NUREG-0799, Draft Criteria for Preparation of Emergency Operating Procedures

Global teaching and training initiatives for emerging cohort studies

Directory of Open Access Journals (Sweden)

Jessica K. Paulus

2012-09-01

Full Text Available A striking disparity exists across the globe, with essentially no large-scale longitudinal studies ongoing in regions that will be significantly affected by the oncoming non-communicable disease epidemic. The successful implementation of cohort studies in most low-resource research environments presents unique challenges that may be aided by coordinated training programs. Leaders of emerging cohort studies attending the First World Cohort Integration Workshop were surveyed about training priorities, unmet needs and potential cross-cohort solutions to these barriers through an electronic pre-workshop questionnaire and focus groups. Cohort studies representing India, Mexico, Nigeria, South Africa, Sweden, Tanzania and Uganda described similar training needs, including on-the-job training, data analysis software instruction, and database and bio-bank management. A lack of funding and protected time for training activities were commonly identified constraints. Proposed solutions include a collaborative cross-cohort teaching platform with web-based content and interactive teaching methods for a range of research personnel. An international network for research mentorship and idea exchange, and modifying the graduate thesis structure were also identified as key initiatives. Cross-cohort integrated educational initiatives will efficiently meet shared needs, catalyze the development of emerging cohorts, speed closure of the global disparity in cohort research, and may fortify scientific capacity development in low-resource settings.

The impact of emergency obstetric care training in Somaliland, Somalia.

Science.gov (United States)

Ameh, Charles; Adegoke, Adetoro; Hofman, Jan; Ismail, Fouzia M; Ahmed, Fatuma M; van den Broek, Nynke

2012-06-01

To provide and evaluate in-service training in "Life Saving Skills - Emergency Obstetric and Newborn Care" in order to improve the availability of emergency obstetric care (EmOC) in Somaliland. In total, 222 healthcare providers (HCPs) were trained between January 2007 and December 2009. A before-after study was conducted using quantitative and qualitative methods to evaluate trainee reaction and change in knowledge, skills, and behavior, in addition to functionality of healthcare facilities, during and immediately after training, and at 3 and 6 months post-training. The HCPs reacted positively to the training, with a significant improvement in 50% of knowledge and 100% of skills modules assessed. The HCPs reported improved confidence in providing EmOC. Basic and comprehensive EmOC healthcare facilities provided 100% of expected signal functions-compared with 43% and 56%, respectively, at baseline-with trained midwives performing skills usually performed by medical doctors. Lack of drugs, supplies, medical equipment, and supportive policy were identified as barriers that could contribute to nonuse of new skills and knowledge acquired. The training impacted positively on the availability and quality of EmOC and resulted in "up-skilling" of midwives. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Directory of Open Access Journals (Sweden)

Scheffer Gert J

2010-03-01

Full Text Available Abstract Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS and a Helicopter Emergency Medical Service (HEMS for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training

DEFF Research Database (Denmark)

Nayahangan, L J; Konge, L; Schroeder, T V

2017-01-01

to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved...... eliminated, resulting in a final prioritised list of 19 technical procedures. Conclusion A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons......Objectives and background Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of “learning by doing.” This change has established simulation...

Estimating the operator's performance time of emergency procedural tasks based on a task complexity measure

International Nuclear Information System (INIS)

Jung, Won Dae; Park, Jink Yun

2012-01-01

It is important to understand the amount of time required to execute an emergency procedural task in a high-stress situation for managing human performance under emergencies in a nuclear power plant. However, the time to execute an emergency procedural task is highly dependent upon expert judgment due to the lack of actual data. This paper proposes an analytical method to estimate the operator's performance time (OPT) of a procedural task, which is based on a measure of the task complexity (TACOM). The proposed method for estimating an OPT is an equation that uses the TACOM as a variable, and the OPT of a procedural task can be calculated if its relevant TACOM score is available. The validity of the proposed equation is demonstrated by comparing the estimated OPTs with the observed OPTs for emergency procedural tasks in a steam generator tube rupture scenario.

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)

Training for the medical response in radiological emergency experiences and results

International Nuclear Information System (INIS)

Cardenas Herrera, J.; Lopez Forteza, Y.

2003-01-01

The use of the nuclear techniques int he social practice confers a special imporatnce to the relative aspects to the safety of the practices and radiationsources, for what the implementation of efficient programs of radiation protection constitutes a priority. However in spite of the will before expressed, regrettably radiological situations happen accidental assocaited to multiple causes taht suggest the creation of response capacities to intervention before these fortuitous facts. The experiences accumulated in the last decades related with accidental exposures have evidenced the convenience of having properly qualified human resources for the Medical Response in Radiological Emergencies. The training in the medical aspects of the radiological emergencies acquires a singular character. In such a sense when valuing the national situation put onof manifest deficiences as for the training in medical aspects of the radiological emergencies that advised the development of training programs in such aspects for the different response groups linked to the topic. After identified the training necessities and the scope of the same ones, the contents of the training program were elaborated. The program has as general purpose the invigoration of the capacity of the medical response in front of accidental radiological situations, by means of actions that they bear to prepare groups of medical response in the handling of people accident victims and to the identification of potentials,accidental scenarios, as well as of the necessary resources to confront them. The program content approaches theoretical and paractical aspects to the medical aspect to radiological emergencies. The program include the different topics about fundamental of physical biological to radiation protection, radiation protection during exposure of radiological accidents, medical care for overexposed or contaminated persons, drill, exercises and concludes with designation of a strategy as preparation and

Information behavior and workplace procedures: The case of emergency-department triage

DEFF Research Database (Denmark)

Hertzum, Morten

In workplace contexts the performance of many information tasks is prescribed in procedures. Knowledge of the relationship between workplace procedures and actors’ real information behavior is important to understanding information behavior. We explore this relationship by looking at how emergency...... clinicians’ information behavior relates to clinical triage guidelines....

American National Standard: for radiological emergency-preparedness exercises for nuclear power plants

International Nuclear Information System (INIS)

Anon.

1979-01-01

The development of emergency plans and procedures should provide for testing and evaluating the emergency response organization and decision making processes. To test and evaluate emergency plans and procedures, realistic scenarios should be used for drills or exercises. Emergency exercises are training activities that require a substantial effort to plan and coordinate effectively. The exercise trains personnel who would be expected to participate in the emergency response. Emergency exercises should be conducted as realistically as possible. Insofar as possible, the participants should not be notified in advance except where necessary to assure that the exercise will not cause injuries or property damage. A real emergency will naturally impart stress on emergency response personnel and their organizations. Exercises should be designed to duplicate this sense of stress insofar as practical. An important element of testing the emergency response is to ensure that provisions have been made for observation, evaluation, and critiquing each exercise. These evaluations and critiques should be used to improve and revise emergency plans and procedures where required

Cooperative approach to training for radiological emergency preparedness and response in Southeast Asia

International Nuclear Information System (INIS)

Bus, John; Popp, Andrew; Holland, Brian; Murray, Allan

2011-01-01

The paper describes the collaborative and systematic approach to training for nuclear and radiological emergency preparedness and response and the outcomes of this work with ANSTO's Southeast Asian counterparts, particularly in the Philippines. The standards and criteria being applied are discussed, along with the methods, design and conduct of workshops, table-top and field exercises. The following elements of this training will be presented: (a) identifying the priority areas for training through needs analysis;(b) strengthening individual profesional expertise through a structured approach to training; and (c) enhancing individual Agency and National nuclear and radiological emergency preparedness and response arrangements and capabilities. Whilst the work is motivated by nuclear security concerns, the implications for effective and sustainable emergency response to any nuclear or radiological incidents are noted. (author)

A Comparison of Three Covert Assertion Training Procedures.

Science.gov (United States)

Twentyman, Craig T.; And Others

1980-01-01

Assessed the effectiveness of covert modification procedures in an assertion training program. All treatment groups were superior to the control in behavioral ratings of assertiveness during the posttest in those situations that had been employed previously in treatment; two were superior in those that had not been used, providing evidence of…

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)

Characteristics of training and motivation of physicians working in emergency medicine

Directory of Open Access Journals (Sweden)

Gilson Soares Feitosa-Filho

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

Variability in the Use of Simulation for Procedural Training in Radiology Residency: Opportunities for Improvement.

Science.gov (United States)

Matalon, Shanna A; Chikarmane, Sona A; Yeh, Eren D; Smith, Stacy E; Mayo-Smith, William W; Giess, Catherine S

2018-03-19

Increased attention to quality and safety has led to a re-evaluation of the classic apprenticeship model for procedural training. Many have proposed simulation as a supplementary teaching tool. The purpose of this study was to assess radiology resident exposure to procedural training and procedural simulation. An IRB-exempt online survey was distributed to current radiology residents in the United States by e-mail. Survey results were summarized using frequency and percentages. Chi-square tests were used for statistical analysis where appropriate. A total of 353 current residents completed the survey. 37% (n = 129/353) of respondents had never used procedure simulation. Of the residents who had used simulation, most did not do so until after having already performed procedures on patients (59%, n = 132/223). The presence of a dedicated simulation center was reported by over half of residents (56%, n = 196/353) and was associated with prior simulation experience (P = 0.007). Residents who had not had procedural simulation were somewhat likely or highly likely (3 and 4 on a 4-point Likert-scale) to participate if it were available (81%, n = 104/129). Simulation training was associated with higher comfort levels in performing procedures (P simulation training is associated with higher comfort levels when performing procedures, there is variable use in radiology resident training and its use is not currently optimized. Given the increased emphasis on patient safety, these results suggest the need to increase procedural simulation use during residency, including an earlier introduction to simulation before patient exposure. Copyright © 2018 Elsevier Inc. All rights reserved.

Virtual reality bronchoscopy simulation: a revolution in procedural training.

Science.gov (United States)

Colt, H G; Crawford, S W; Galbraith, O

2001-10-01

In the airline industry, training is costly and operator error must be avoided. Therefore, virtual reality (VR) is routinely used to learn manual and technical skills through simulation before pilots assume flight responsibilities. In the field of medicine, manual and technical skills must also be acquired to competently perform invasive procedures such as flexible fiberoptic bronchoscopy (FFB). Until recently, training in FFB and other endoscopic procedures has occurred on the job in real patients. We hypothesized that novice trainees using a VR skill center could rapidly acquire basic skills, and that results would compare favorably with those of senior trainees trained in the conventional manner. We prospectively studied five novice bronchoscopists entering a pulmonary and critical care medicine training program. They were taught to perform inspection flexible bronchoscopy using a VR bronchoscopy skill center; dexterity, speed, and accuracy were tested using the skill center and an inanimate airway model before and after 4 h of group instruction and 4 h of individual unsupervised practice. Results were compared to those of a control group of four skilled physicians who had performed at least 200 bronchoscopies during 2 years of training. Student's t tests were used to compare mean scores of study and control groups for the inanimate model and VR bronchoscopy simulator. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired two-sample t tests were used. Novices significantly improved their dexterity and accuracy in both models. They missed fewer segments after training than before training, and had fewer contacts with the bronchial wall. There was no statistically significant improvement in speed or total time spent not visualizing airway anatomy. After training, novice performance equaled or surpassed that of the skilled physicians. Novices performed

EM Talk: communication skills training for emergency medicine patients with serious illness.

Science.gov (United States)

Grudzen, Corita R; Emlet, Lillian L; Kuntz, Joanne; Shreves, Ashley; Zimny, Erin; Gang, Maureen; Schaulis, Monique; Schmidt, Scott; Isaacs, Eric; Arnold, Robert

2016-06-01

The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians can reinforce advance care plans and ensure the hospital care provided matches the patient's values. Despite their importance in care at the end of life, emergency physicians have received little training on how to talk to seriously ill patients and their families about goals of care. To expand communication skills training to emergency medicine, we developed a programme to give emergency medicine physicians the ability to empathically deliver serious news and to talk about goals of care. We have built on lessons from prior studies to design an intervention employing the most effective pedagogical techniques, including the use of simulated patients/families, role-playing and small group learning with constructive feedback from master clinicians. Here, we describe our evidence-based communication skills training course EM Talk using simulation, reflective feedback and deliberate practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

Science.gov (United States)

Perry, Jeffrey J; Snider, Carolyn E; Artz, Jennifer D; Stiell, Ian G; Shaeri, Sedigheh; McLeod, Shelley; Le Sage, Natalie; Hohl, Corinne; Calder, Lisa A; Vaillancourt, Christian; Holroyd, Brian; Hollander, Judd E; Morrison, Laurie J

2015-05-01

We sought to 1) identify best practices for training and mentoring clinician researchers, 2) characterize facilitators and barriers for Canadian emergency medicine researchers, and 3) develop pragmatic recommendations to improve and standardize emergency medicine postgraduate research training programs to build research capacity. We performed a systematic review of MEDLINE and Embase using search terms relevant to emergency medicine research fellowship/graduate training. We conducted an email survey of all Canadian emergency physician researchers. The Society for Academic Emergency Medicine (SAEM) research fellowship program was analysed, and other similar international programs were sought. An expert panel reviewed these data and presented recommendations at the Canadian Association of Emergency Physicians (CAEP) 2014 Academic Symposium. We refined our recommendations based on feedback received. Of 1,246 potentially relevant citations, we included 10 articles. We identified five key themes: 1) creating training opportunities; 2) ensuring adequate protected time; 3) salary support; 4) infrastructure; and 5) mentorship. Our survey achieved a 72% (67/93) response rate. From these responses, 42 (63%) consider themselves clinical researchers (i.e., spend a significant proportion of their career conducting research). The single largest constraint to conducting research was funding. Factors felt to be positive contributors to a clinical research career included salary support, research training (including an advanced graduate degree), mentorship, and infrastructure. The SAEM research fellowship was the only emergency medicine research fellowship program identified. This 2-year program requires approval of both the teaching centre and each applying fellow. This program requires training in 15 core competencies, manuscript preparation, and submission of a large grant to a national peer-review funding organization. We recommend that the CAEP Academic Section create a

A National Needs Assessment to Identify Technical Procedures in Vascular Surgery for Simulation Based Training.

Science.gov (United States)

Nayahangan, L J; Konge, L; Schroeder, T V; Paltved, C; Lindorff-Larsen, K G; Nielsen, B U; Eiberg, J P

2017-04-01

Practical skills training in vascular surgery is facing challenges because of an increased number of endovascular procedures and fewer open procedures, as well as a move away from the traditional principle of "learning by doing." This change has established simulation as a cornerstone in providing trainees with the necessary skills and competences. However, the development of simulation based programs often evolves based on available resources and equipment, reflecting convenience rather than a systematic educational plan. The objective of the present study was to perform a national needs assessment to identify the technical procedures that should be integrated in a simulation based curriculum. A national needs assessment using a Delphi process was initiated by engaging 33 predefined key persons in vascular surgery. Round 1 was a brainstorming phase to identify technical procedures that vascular surgeons should learn. Round 2 was a survey that used a needs assessment formula to explore the frequency of procedures, the number of surgeons performing each procedure, risk and/or discomfort, and feasibility for simulation based training. Round 3 involved elimination and ranking of procedures. The response rate for round 1 was 70%, with 36 procedures identified. Round 2 had a 76% response rate and resulted in a preliminary prioritised list after exploring the need for simulation based training. Round 3 had an 85% response rate; 17 procedures were eliminated, resulting in a final prioritised list of 19 technical procedures. A national needs assessment using a standardised Delphi method identified a list of procedures that are highly suitable and may provide the basis for future simulation based training programs for vascular surgeons in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

28 CFR 65.82 - Procedure for requesting a Presidential determination of an immigration emergency.

Science.gov (United States)

2010-07-01

... determination of an immigration emergency. 65.82 Section 65.82 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.82 Procedure for requesting a Presidential determination of an immigration emergency. (a) The President may make a...

Emergency public information procedures for nuclear plants

International Nuclear Information System (INIS)

Anon.

1979-01-01

As a result of the accident at Three Mile Island on March 28, 1979, increased emphasis has been placed on the public information capabilities of utility companies, and particularly their crisis public information procedures. A special industry task force was assigned to develop a generic model for a utility crisis public information plan. This report has been prepared not as a literal emergency plan for a utility, but as a generic check-off list of items and procedures that a utility should consider as a part of its own plan. Because of considerable variations in service areas, utility organization, and other factors, specific approaches may vary from utility to utility. The approaches cited here are generic suggestions that would help lead to an industrywide ability to inform the public, quickly and accurately, about non-routine events that it would consider of importance

Analysis of emergency response procedures and air traffic accidents ...

African Journals Online (AJOL)

Incessant air transport accidents have been a source of concern to stakeholders and aviation experts in Nigeria, yet the response and process has not been adequately appraised. This study attempts an evaluation of the emergency response procedures in the aviation industry with particular focus on Murtala Muhammed ...

The Use of Simulators for Training In-Flight and Emergency Procedures,

Science.gov (United States)

1980-06-01

statistical differences in performance between the two groups were found. Creelman (39) reported that students trained in the SNJ Link with a contact landing...isl . Project No. NM 00-5.7.01. Pensacola, FL: U.S. Naval School of Aviation MTdTici7US.Nval Air station, March 1952. 39. Creelman , J. A. Evaluation of

Development and evaluation of a leadership training program for public health emergency response: results from a Chinese study

Directory of Open Access Journals (Sweden)

Xu Yihua

2008-10-01

Full Text Available Abstract Background Since the 9/11 attack and severe acute respiratory syndrome (SARS, the development of qualified and able public health leaders has become a new urgency in building the infrastructure needed to address public health emergencies. Although previous studies have reported that the training of individual leaders is an important approach, the systemic and scientific training model need further improvement and development. The purpose of this study was to develop, deliver, and evaluate a participatory leadership training program for emergency response. Methods Forty-one public health leaders (N = 41 from five provinces completed the entire emergency preparedness training program in China. The program was evaluated by anonymous questionnaires and semi-structured interviews held prior to training, immediately post-training and 12-month after training (Follow-up. Results The emergency preparedness training resulted in positive shifts in knowledge, self-assessment of skills for public health leaders. More than ninety-five percent of participants reported that the training model was scientific and feasible. Moreover, the response of participants in the program to the avian influenza outbreak, as well as the planned evaluations for this leadership training program, further demonstrated both the successful approaches and methods and the positive impact of this integrated leadership training initiative. Conclusion The emergency preparedness training program met its aims and objectives satisfactorily, and improved the emergency capability of public health leaders. This suggests that the leadership training model was effective and feasible in improving the emergency preparedness capability.

Cadaver-based training is superior to simulation training for cricothyrotomy and tube thoracostomy.

Science.gov (United States)

Takayesu, James Kimo; Peak, David; Stearns, Dana

2017-02-01

Emergency medicine (EM) training mandates that residents be able to competently perform low-frequency critical procedures upon graduation. Simulation is the main method of training in addition to clinical patient care. Access to cadaver-based training is limited due to cost and availability. The relative fidelity and perceived value of cadaver-based simulation training is unknown. This pilot study sought to describe the relative value of cadaver training compared to simulation for cricothyrotomy and tube thoracostomy. To perform a pilot study to assess whether there is a significant difference in fidelity and educational experience of cadaver-based training compared to simulation training. To understand how important this difference is in training residents in low-frequency procedures. Twenty-two senior EM residents (PGY3 and 4) who had completed standard simulation training on cricothyrotomy and tube thoracostomy participated in a formalin-fixed cadaver training program. Participants were surveyed on the relative fidelity of the training using a 100 point visual analogue scale (VAS) with 100 defined as equal to performing the procedure on a real patient. Respondents were also asked to estimate how much the cadaveric training improved the comfort level with performing the procedures on a scale between 0 and 100 %. Open-response feedback was also collected. The response rate was 100 % (22/22). The average fidelity of the cadaver versus simulation training was 79.9 ± 7.0 vs. 34.7 ± 13.4 for cricothyrotomy (p Cadaver-based training provides superior landmark and tissue fidelity compared to simulation training and may be a valuable addition to EM residency training for certain low-frequency procedures.

An interactive simulation-based education system for BWR emergency, procedure guidelines

Energy Technology Data Exchange (ETDEWEB)

Tanikawa, Naoshi; Shida, Touichi [Hitachi Ltd (Japan). Hitachi Works; Ujita, Hiroshi; Yokota, Takeshi; Kato, Kanji [Hitachi Ltd, (Japan). Energy Research Lab.

1994-12-31

When applying EPGs (Emergency Procedure Guidelines), an operator decides the operational procedure by predicting the change of parameters from the plant status, because EPGs are described in a symptom style for emergency conditions. Technical knowledge of the plant behavior and its operation are necessary for operator to understand the EPGs. An interactive simulation-based education system, EPG-ICAI (Intelligent Computer Assisted Instruction), has been developed for BWR plant operators to acquire the knowledge of EPGs. EPG-ICAI is designed to realize an effective education by the step-by-step study by using an interactive real time simulator and an individual education by applying an intelligent tutoring function. (orig.) (2 refs., 7 figs., 1 tab.).

An interactive simulation-based education system for BWR emergency, procedure guidelines

International Nuclear Information System (INIS)

Tanikawa, Naoshi; Shida, Touichi; Ujita, Hiroshi; Yokota, Takeshi; Kato, Kanji

1994-01-01

When applying EPGs (Emergency Procedure Guidelines), an operator decides the operational procedure by predicting the change of parameters from the plant status, because EPGs are described in a symptom style for emergency conditions. Technical knowledge of the plant behavior and its operation are necessary for operator to understand the EPGs. An interactive simulation-based education system, EPG-ICAI (Intelligent Computer Assisted Instruction), has been developed for BWR plant operators to acquire the knowledge of EPGs. EPG-ICAI is designed to realize an effective education by the step-by-step study by using an interactive real time simulator and an individual education by applying an intelligent tutoring function. (orig.) (2 refs., 7 figs., 1 tab.)

Student tutors for hands-on training in focused emergency echocardiography – a randomized controlled trial

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Kühl Matthias

2012-10-01

Full Text Available Abstract Background Focused emergency echocardiography performed by non-cardiologists has been shown to be feasible and effective in emergency situations. During resuscitation a short focused emergency echocardiography has been shown to narrow down potential differential diagnoses and to improve patient survival. Quite a large proportion of physicians are eligible to learn focused emergency echocardiography. Training in focused emergency echocardiography usually comprises a lecture, hands-on trainings in very small groups, and a practice phase. There is a shortage of experienced echocardiographers who can supervise the second step, the hands-on training. We thus investigated whether student tutors can perform the hands-on training for focused emergency echocardiography. Methods A total of 30 volunteer 4th and 5th year students were randomly assigned to a twelve-hour basic echocardiography course comprising a lecture followed by a hands-on training in small groups taught either by an expert cardiographer (EC or by a student tutor (ST. Using a pre-post-design, the students were evaluated by an OSCE. The students had to generate two still frames with the apical five-chamber view and the parasternal long axis in five minutes and to correctly mark twelve anatomical cardiac structures. Two blinded expert cardiographers rated the students’ performance using a standardized checklist. Students could achieve a maximum of 25 points. Results Both groups showed significant improvement after the training (p Conclusions Hands-on training by student tutors led to a significant gain in echocardiography skills, although inferior to teaching by an expert cardiographer.

Training for Three Wars Ago: Antiquated C-130H Pilot Training

Science.gov (United States)

2015-10-01

negotiations between President Carter and Raoul Cédras halted the combat invasion of Haiti, and the aircraft heading to Haiti were recalled .12 Middle...accomplished within a period, to equally spreading the training burden over more time allowing lessons learned and muscle memory to develop from more consistent...cost squadron level trainer that allows for advanced mission rehearsal , threat awareness training, aircraft system refreshers, emergency procedure

BWR emergency procedure guidelines

International Nuclear Information System (INIS)

Post, J.S.; Karner, E.F.; Stratman, R.A.

1984-01-01

This chapter describes plans for dealing with reactor accidents developed by the Boiling Water Reactor (BWR) Owners' Group in response to post-Three Mile Island US NRC requirements. The devised Emergency Procedure Guidelines (EPGs), applicable to all BWRs, are symptom-based rather than event-based. According to the EPGs, the operator does not need to identify what event is occurring in the plant in order to decide what action to take, but need only observe the symptoms (values and trends of key control parameters) which exist and take appropriate action to control these symptoms. The original objective was to provide reactor operator guidance in responding to a small break loss-of-coolant accident (LOCA), but subsequent revisions have included other types of reactor accidents. Topics considered include the reactor pressure vessel (RPV) control guideline, the primary containment control guideline, the secondary containment control guideline, the radioactivity release control guideline, multiple failures vs. the design basis, safe limits vs. technical specifications, the technical status, licensing, and implementation. The EPGs are based upon maintaining both adequate core cooling and primary containment integrity

[Preparation of sedation-analgesia procedures in spanish paediatric emergency departments: A descriptive study].

Science.gov (United States)

Míguez Navarro, Concepción; Oikonomopoulou, Niki; Lorente Romero, Jorge; Vázquez López, Paula

2017-07-24

The objective of this study was to describe the current practice regarding the preparation of the sedation-analgesia (SA) procedures performed in the paediatric emergency centres in Spain. A multicentre, observational and prospective analytical study was carried out on the SA procedures that were performed on children under 18 years-old in 18 paediatric emergency departments between February 2015 and January 2016. A total of 658 SA procedures were registered in 18 hospitals of Spain, most of them to children older than 24 months. The type of the procedure was: simple analgesia in 57 (8.6%), sedation in 44 (6.7%), SA for a not very painful procedure in 275 (41.8%), and SA for a very painful procedure in 282 (42.9%). Informed consent was requested in 98.6% of the cases. The written form was more frequently preferred in the group of patients that received SA for a very painful procedure (76.6%) in comparison to a painful procedure or to simple analgesia (62.9% and 54.4%, respectively, P<.001). The staff that most frequently performed the SA procedures were the paediatricians of the emergency departments (64.3%), followed by Paediatrics Residents (30.7%). The most frequent reasons for the SA were traumatological (35.9%) and surgical (28.4%). Fasting was observed in 81% of the cases. More than two-thirds (67.3%, n=480) children were monitored, the majority (95.8%) of them using pulse oximetry. The pharmacological strategy used was the administration of one drug in 443 (67.3%) of the cases, mostly nitrous oxide, and a combination of drugs in 215 (32.7%), especially midazolam/ketamine (46.9%). The majority of the SA procedures analysed in this study have been carried out correctly and prepared in accordance with the current guidelines. Copyright © 2017. Publicado por Elsevier España, S.L.U.

An Automatic Identification Procedure to Promote the use of FES-Cycling Training for Hemiparetic Patients

Directory of Open Access Journals (Sweden)

Emilia Ambrosini

2014-01-01

Full Text Available Cycling induced by Functional Electrical Stimulation (FES training currently requires a manual setting of different parameters, which is a time-consuming and scarcely repeatable procedure. We proposed an automatic procedure for setting session-specific parameters optimized for hemiparetic patients. This procedure consisted of the identification of the stimulation strategy as the angular ranges during which FES drove the motion, the comparison between the identified strategy and the physiological muscular activation strategy, and the setting of the pulse amplitude and duration of each stimulated muscle. Preliminary trials on 10 healthy volunteers helped define the procedure. Feasibility tests on 8 hemiparetic patients (5 stroke, 3 traumatic brain injury were performed. The procedure maximized the motor output within the tolerance constraint, identified a biomimetic strategy in 6 patients, and always lasted less than 5 minutes. Its reasonable duration and automatic nature make the procedure usable at the beginning of every training session, potentially enhancing the performance of FES-cycling training.

Conference attendance does not correlate with emergency medicine residency in-training examination scores.

Science.gov (United States)

Gene Hern, H; Wills, Charlotte; Alter, Harrison; Bowman, Steven H; Katz, Eric; Shayne, Philip; Vahidnia, Farnaz

2009-12-01

The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. This was a multi-center retrospective cohort study using conference attendance data and examination results from residents in four large county EM residency training programs. Longitudinal multi-level models, adjusting for training site, U.S. Medical Licensing Examination (USMLE) Step 1 score, and sex were used to explore the relationship between conference attendance and in-training examination scores according to year of training. Each year of training was studied, as well as the overall effect of mean attendance as it related to examination score. Four training sites reported data on 405 residents during 2002 to 2008; 386 residents had sufficient data to analyze. In the multi-level longitudinal models, attendance at conference was not a significant predictor of in-training percentile score (coefficient = 0.005, 95% confidence interval [CI] = -0.053 to 0.063, p = 0.87). Score on the USMLE Step 1 examination was a strong predictor of ITE score (coefficient = 0.186, 95% CI = 0.155 to 0.217; p ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance. (c) 2009 by the Society for Academic Emergency Medicine.

Flowchart-format emergency operating procedures-strengths and weaknesses

International Nuclear Information System (INIS)

Barnes, V.E.; Bongarra, J.P. Jr.

1989-01-01

An increasing number of nuclear power plant licensees are converting their text-format emergency operating procedures (EOPs) to flowcharts. Findings of a recent study of the flowchart-format EOPs indicate that the flowchart format appears to solve several significant usability problems associated with text-format EOPs, but also introduces other types of usability concerns. This paper discusses some of the strengths and weaknesses of the flowchart format for presenting EOPs

Training and exercises of the Emergency Response Team at the Los Alamos Plutonium Facility

International Nuclear Information System (INIS)

Yearwood, D.D.

1988-01-01

The Los Alamos National Laboratory Plutonium Facility has an active Emergency Response Team. The Emergency Response Team is composed of members of the operating and support groups within the Plutonium Facility. In addition to their initial indoctrination, the members are trained and certified in first-aid, CPR, fire and rescue, and the use of self-contained-breathing-apparatus. Training exercises, drills, are conducted once a month. The drills consist of scenarios which require the Emergency Response Team to apply CPR and/or first aid. The drills are performed in the Plutonium Facility, they are video taped, then reviewed and critiqued by site personnel. Through training and effective drills and the Emergency Response Team can efficiently respond to any credible accident which may occur at the Plutonium Facility. 3 tabs

Functional design criteria for the Hazardous Materials Management and Emergency Response (HAMMER) Training Center. Revision 1

International Nuclear Information System (INIS)

Sato, P.K.

1995-01-01

Within the United States, there are few hands-on training centers capable of providing integrated technical training within a practical application environment. Currently, there are no training facilities that offer both radioactive and chemical hazardous response training. There are no hands-on training centers that provide training for both hazardous material operations and emergency response that also operate as a partnership between organized labor, state agencies, tribes, and local emergency responders within the US Department of Energy (DOE) complex. Available facilities appear grossly inadequate for training the thousands of people at Hanford, and throughout the Pacific Northwest, who are required to qualify under nationally-mandated requirements. It is estimated that 4,000 workers at the Hanford Site alone need hands-on training. Throughout the Pacific Northwest, the potential target audience would be over 30,000 public sector emergency response personnel, as well as another 10,000 clean-up workers represented by organized labor. The HAMMER Training Center will be an interagency-sponsored training center. It will be designed, built, and operated to ensure that clean-up workers, fire fighters, and public sector management and emergency response personnel are trained to handle accidental spills of hazardous materials. Training will cover wastes at clean-up sites, and in jurisdictions along the transportation corridors, to effectively protect human life, property, and the environment

Safe introduction of new procedures and emerging technologies in surgery: education, credentialing, and privileging.

Science.gov (United States)

Sachdeva, Ajit K; Russell, Thomas R

2007-08-01

Ongoing horizon scanning is needed to identify new procedures and emerging technologies that should be evaluated for introduction into surgical practice. Following evidence-based evaluation, if a new modality is found ready for adoption in practice, surgeons need education in the safe and effective use of the new modality. The educational experience should include structured teaching and learning, verification of new knowledge and skills, preceptoring or proctoring, and monitoring of outcomes. Credentialing and privileging to perform a new procedure or use an emerging technology should be based on evaluation of knowledge and skills and outcomes of surgical care, and not merely on the numbers of procedures performed. Education of the surgical team is also essential. The entire process involving education, verification of knowledge and skills, credentialing, and privileging must be transparent. Patients need to play a central role in making informed decisions regarding their care that involves use of a new procedure or an emerging technology, and they should participate actively in their perioperative care.

Effects of Computer-Based Training on Procedural Modifications to Standard Functional Analyses

Science.gov (United States)

Schnell, Lauren K.; Sidener, Tina M.; DeBar, Ruth M.; Vladescu, Jason C.; Kahng, SungWoo

2018-01-01

Few studies have evaluated methods for training decision-making when functional analysis data are undifferentiated. The current study evaluated computer-based training to teach 20 graduate students to arrange functional analysis conditions, analyze functional analysis data, and implement procedural modifications. Participants were exposed to…

Media and public relation. Part of emergency planning

International Nuclear Information System (INIS)

Jurkovic, I.A.; Debrecin, N.; Feretic, D.; Skanata, D.

2000-01-01

In the event of an emergency, media relation should be considered as one of the most important functions in emergency management. Individuals should be trained to be able to provide factual information to the media and the citizens during nuclear emergencies. Media can be also acquainted with the scope, ways and means of providing information related to nuclear emergencies during the predefined and regular media training or workshops, or as a part of regular training routine of involved organizations and institutions. This paper is through various approaches trying to present one of the possible ways that media and public relation can be treated during the emergencies and inside the developed emergency plans and procedures. It also represents an idea, based on the authors' experience, on a way in which things can be organized in the Croatian Technical Support Center when it comes to the media/public relation issue. (author)

Development and application of emergency operating procedures for nuclear power plants

International Nuclear Information System (INIS)

Lin Chengge

1990-01-01

The development and application of emergency operating procedures (EOPs) is an important measure to assure the operational safety for nuclear power plants. Event-oriented, symptom-, function- and state-oriented EOPs with their structures, interfaces, development procedures and practical application are described. The ideas and approach can be available for the preparation of EOPs for nuclear power plants which are going to be in service

Emergency Physician Awareness of Prehospital Procedures and Medications

Directory of Open Access Journals (Sweden)

Rachel Waldron

2014-07-01

Full Text Available Introduction: Maintaining patient safety during transition from prehospital to emergency department (ED care depends on effective handoff communication between providers. We sought to determine emergency physicians’ (EP knowledge of the care provided by paramedics in terms of both procedures and medications, and whether the use of a verbal report improved physician accuracy. Methods: We conducted a 2-phase observational survey of a convenience sample of EPs in an urban, academic ED. In this large ED paramedics have no direct contact with physicians for non-critical patients, giving their report instead to the triage nurse. In Phase 1, paramedics gave verbal report to the triage nurse only. In Phase 2, a research assistant (RA stationed in triage listened to this report and then repeated it back verbatim to the EPs caring for the patient. The RA then queried the EPs 90 minutes later regarding their patients’ prehospital procedures and medications. We compared the accuracy of these 2 reporting methods. Results: There were 163 surveys completed in Phase 1 and 116 in Phase 2. The oral report had no effect on EP awareness that the patient had been brought in by ambulance (86% in Phase 1 and 85% in Phase 2. The oral report did improve EP awareness of prehospital procedures, from 16% in Phase 1 to 45% in Phase 2, OR=4.28 (2.5-7.5. EPs were able to correctly identify all oral medications in 18% of Phase 1 cases and 47% of Phase 2 cases, and all IV medications in 42% of Phase 1 cases and 50% of Phase 2 cases. The verbal report led to a mild improvement in physician awareness of oral medications given, OR=4.0 (1.09-14.5, and no improvement in physician awareness of IV medications given, OR=1.33 (0.15-11.35. Using a composite score of procedures plus oral plus IV medications, physicians had all three categories correct in 15% of Phase 1 and 39% of Phase 2 cases (p<0.0001. Conclusion: EPs in our ED were unaware of many prehospital procedures and

Verifying the buildingEXODUS through an emergency response procedure (ERP) exercise at an underground intervention shaft

Science.gov (United States)

Tajedi, Noor Aqilah A.; Sukor, Nur Sabahiah A.; Ismail, Mohd Ashraf M.; Shamsudin, Shahrul A.

2017-10-01

An Emergency Response Plan (ERP) is an essential safety procedure that needs to be taken into account for railway operations, especially for underground railway networks. Several parameters need to be taken into consideration in planning an ERP such as the design of tunnels and intervention shafts, and operation procedures for underground transportation systems. Therefore, the purpose of this paper is to observe and analyse the Emergency Response Procedure (ERP) exercise for the underground train network at the LRT Kelana Jaya Line. The exercise was conducted at one of the underground intervention shaft exits, where the height of the staircase from the bottom floor to the upper floor was 24.59 metres. Four cameras were located at selected levels of the shaft, and 71 participants were assigned for the evacuation exercise. The participants were tagged with a number at the front and back of their safety vests. Ten respondents were randomly selected to give details of their height and weight and, at the same time, they had to self-record the time taken for them to evacuate from the bottom to the top of the shaft. The video footages that were taken during the ERP were analysed, and the data were used for the verification process on the buildingEXODUS simulation software. It was found that the results of the ERP experiment were significantly similar to the simulation results, thereby successfully verifying the simulation. This verification process was important to ensure that the results of the simulation were in accordance with the real situation. Therefore, a further evacuation analysis made use of the results from this verification.

Optimal training design for procedural motor skills: a review and application to laparoscopic surgery

NARCIS (Netherlands)

Spruit, E.N.; Band, G.P.H.; Hamming, J.F.; Ridderinkhof, K.R.

2014-01-01

This literature review covers the choices to consider in training complex procedural, perceptual and motor skills. In particular, we focus on laparoscopic surgery. An overview is provided of important training factors modulating the acquisition, durability, transfer, and efficiency of trained

Hybrid Decision-making Method for Emergency Response System of Unattended Train Operation Metro

Directory of Open Access Journals (Sweden)

Bobo Zhao

2016-04-01

Full Text Available Suitable selection of the emergency alternatives is a critical issue in emergency response system of Unattended Train Operation (UTO metro system of China. However, there is no available method for dispatcher group in Operating Control Center (OCC to evaluate the decision under emergency situation. It was found that the emergency decision making in UTO metro system is relative with the preferences and the importance of multi-dispatcher in emergency. Regarding these factors, this paper presents a hybrid method to determinate the priority weights of emergency alternatives, which aggregates the preference matrix by constructing the emergency response task model based on the Weighted Ordered Weighted Averaging (WOWA operator. This calculation approach derives the importance weights depending on the dispatcher emergency tasks and integrates it into the Ordered Weighted Averaging (OWA operator weights based on a fuzzy membership relation. A case from train fire is given to demonstrate the feasibility and practicability of the proposed methods for Group Multi-Criteria Decision Making (GMCDM in emergency management of UTO metro system. The innovation of this research is paving the way for a systematic emergency decision-making solution which connects the automatic metro emergency response system with the GMCDM theory.

Skin resurfacing procedures: new and emerging options

Directory of Open Access Journals (Sweden)

Loesch MM

2014-08-01

Full Text Available Mathew M Loesch,1 Ally-Khan Somani,1 Melanie M Kingsley,1 Jeffrey B Travers,1–3 Dan F Spandau1,41Department of Dermatology, 2Department of Pharmacology and Toxicology, 3Department of Pediatrics, 4Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USAAbstract: The demand for skin resurfacing and rejuvenating procedures has progressively increased in the last decade and has sparked several advances within the skin resurfacing field that promote faster healing while minimizing downtime and side effects for patients. Several technological and procedural skin resurfacing developments are being integrated into clinical practices today allowing clinicians to treat a broader range of patients' skin types and pathologies than in years past, with noteworthy outcomes. This article will discuss some emerging and developing resurfacing therapies and treatments that are present today and soon to be available.Keywords: rejuvenation, wounding, non-melanoma skin cancer, therapy

A 'mixed reality' simulator concept for future Medical Emergency Response Team training.

Science.gov (United States)

Stone, Robert J; Guest, R; Mahoney, P; Lamb, D; Gibson, C

2017-08-01

The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook 's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on 'mixed reality' technologies-in effect the 'blending' of real-world objects of training relevance with virtual reality reconstructions of operational contexts. 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/.

Procedures and Collaborative Information Seeking: A Study of Emergency Departments

DEFF Research Database (Denmark)

Hertzum, Morten; Reddy, Madhu

2015-01-01

Information seeking is a central and inherently collaborative activity in the emergency department (ED) which is the common entry point to hospitals for nearly all acute patients. In this paper, we investigate how ED clinicians’ collabo-rative information seeking (CIS) is shaped by the procedures...

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

Science.gov (United States)

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

General Employee Training Live, Course 15503

Energy Technology Data Exchange (ETDEWEB)

Gabel, Daniel Glen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hughes, Heather [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-08-25

This training at Los Alamos National Laboratory contains the following sections: Introduction to the Laboratory, Institutional Quality Assurance, Facilities, Policies, Procedures, and Other Requirements, Safety Expectations, Worker Protection: Occupational Safety and Health, Industrial Hygiene and Safety, Lockout/Tagout, General Employee Radiological Training, Fire Protection, Security, Emergency Operations, Occupational Health, and Environment.

Developing site-specific interactive environmental management tools: An exciting method of communicating training, procedures, and other information

Energy Technology Data Exchange (ETDEWEB)

Jaeckels, J.M.

1999-07-01

Environmental managers are faced with numerous programs that must be communicated throughout their organizations. Among these are regulatory training programs, internal environmental policy, regulatory guidance/procedures and internal guidance/procedures. Traditional methods of delivering this type of information are typically confined to written materials and classroom training. There are many challenges faced by environmental managers with these traditional approaches including: determining if recipients of written plans or procedures are reading and comprehending the information; scheduling training sessions to reach all affected people across multiple schedules/shifts; and maintaining adequate training records. In addition, current trends toward performance-based or competency-based training requires a more consistent method of measuring and documenting performance. The use of interactive computer applications to present training or procedural information is a new and exciting tool for delivering environmental information to employees. Site-specific pictures, text, sound, and even video can be combined with multimedia software to create informative and highly interactive applications. Some of the applications that can be produced include integrated environmental training, educational pieces, and interactive environmental procedures. They can be executed from a CD-ROM, hard drive, network or a company Intranet. Collectively, the authors refer to these as interactive environmental management tools (IEMTs). This paper focuses on site-specific, interactive training as an example of an IEMT. Interactive training not only delivers a highly effective message, but can also be designed to focus on site-specific environmental issues that are unique to each company. Interactive training also lends itself well to automated record keeping functions and to reaching all affected employees.

Medical intervention in radiological emergencies, formation and training; Intervencion medica en emergencias radiologicas, formacion y adiestramiento

Energy Technology Data Exchange (ETDEWEB)

Cardenas H, J. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba)]. e-mail: cardenas@cphr.edu.cu

2006-07-01

The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

An expert system-based aid for analysis of Emergency Operating Procedures in NPPs

International Nuclear Information System (INIS)

Jakubowski, Z.; Beraha, D.

1996-01-01

Emergency Operating Procedures (EOPs) generally and an accident management (AM) particularly play a significant part in the safety philosophy on NPPs since many years. A better methodology for development and validation of EOPs is desired. A prototype of an Emergency Operating Procedures Analysis System (EOPAS), which has been developed at GRS, is presented in the paper. The hardware configuration and software organisation of the system is briefly reviewed. The main components of the system such as the knowledge base of an expert system and the engineering simulator are described. (author)

Implementing blended learning in emergency airway management training: a randomized controlled trial.

Science.gov (United States)

Kho, Madeleine Huei Tze; Chew, Keng Sheng; Azhar, Muhaimin Noor; Hamzah, Mohd Lotfi; Chuah, Kee Man; Bustam, Aida; Chan, Hiang Chuan

2018-01-15

While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training. A single-center prospective randomised controlled trial involving 30 doctors from Sarawak General Hospital, Malaysia was conducted from September 2016 to February 2017 to compare the effectiveness of BL versus F2FL for emergency airway management training. Participants in the BL arm were given a period of 12 days to go through the online materials in a learning management system while those in the F2FL arm attended a-day of face-to-face lectures (8 h). Participants from both arms then attended a day of hands-on session consisting of simulation skills training with airway manikins. Pre- and post-tests in knowledge and practical skills were administered. E-learning experience and the perception towards BL among participants in the BL arm were also assessed. Significant improvements in post-test scores as compared to pre-test scores were noted for participants in both BL and F2FL arms for knowledge, practical, and total scores. The degree of increment between the BL group and the F2FL arms for all categories were not significantly different (total scores: 35 marks, inter-quartile range (IQR) 15.0 - 41.0 vs. 31 marks, IQR 24.0 - 41.0, p = 0.690; theory scores: 18 marks, IQR 9 - 24 vs. 19 marks, IQR 15 - 20, p = 0.992; practical scores: 11 marks, IQR 5 -18 vs. 10 marks, IQR 9 - 20, p = 0.461 respectively). The overall perception towards BL was positive. Blended learning is as effective as face-to-face learning for emergency airway management training

Training Librarians for 21st Century Repository Services: Emerging Trends

Directory of Open Access Journals (Sweden)

Helen Emasealu

2016-05-01

Full Text Available The paper reviewed the emerging roles of the 21st century librarians, charged with the responsibility to manage repository services across libraries in present-day information technology environment. Librarians need to be trained and empowered with requisite skills and knowledge needed for successful management of the ICT driven repository initiatives that the 21st century demands. Literature was reviewed on the roles and responsibilities of librarians, training needs and opportunities, career path and recruitment of librarians, and community support necessary for effective and efficient implementation and management of repository initiatives. This entails the ability to comprehend trends and change patterns which are essential for providing research focused and user-friendly models in open repository services that are based on thorough analytical understanding of the challenges of emerging trends. To achieve this requires the training and retraining of librarians to reposition them as information specialists in their career path. The role of the library as an integral part of its social environment is to educate the community about the existence of an open repository by building partnership with community-oriented research centres through seminars, workshops, symposium, training, and awareness programmes. The study recommends that librarians should strategize and collaborate with researchers to make open repository an essential research tool.

Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

Science.gov (United States)

Vigneswaran, Yalini; Ujiki, Michael B

2015-01-01

Peroral endoscopic myotomy (POEM) is an emerging minimally invasive procedure for the treatment of achalasia. Due to the improvements in endoscopic technology and techniques, this procedure allows for submucosal tunneling to safely endoscopically create a myotomy across the hypertensive lower esophageal sphincter. In the hands of skilled operators and experienced centers, the most common complications of this procedure are related to insufflation and accumulation of gas in the chest and abdominal cavities with relatively low risks of devastating complications such as perforation or delayed bleeding. Several centers worldwide have demonstrated the feasibility of this procedure in not only early achalasia but also other indications such as redo myotomy, sigmoid esophagus and spastic esophagus. Short-term outcomes have showed great clinical efficacy comparable to laparoscopic Heller myotomy (LHM). Concerns related to postoperative gastroesophageal reflux remain, however several groups have demonstrated comparable clinical and objective measures of reflux to LHM. Although long-term outcomes are necessary to better understand durability of the procedure, POEM appears to be a promising new procedure. PMID:26468336

Tool-use training in a species of rodent: the emergence of an optimal motor strategy and functional understanding.

Directory of Open Access Journals (Sweden)

Kazuo Okanoya

Full Text Available BACKGROUND: Tool use is defined as the manipulation of an inanimate object to change the position or form of a separate object. The expansion of cognitive niches and tool-use capabilities probably stimulated each other in hominid evolution. To understand the causes of cognitive expansion in humans, we need to know the behavioral and neural basis of tool use. Although a wide range of animals exhibit tool use in nature, most studies have focused on primates and birds on behavioral or psychological levels and did not directly address questions of which neural modifications contributed to the emergence of tool use. To investigate such questions, an animal model suitable for cellular and molecular manipulations is needed. METHODOLOGY/PRINCIPAL FINDINGS: We demonstrated for the first time that rodents can be trained to use tools. Through a step-by-step training procedure, we trained degus (Octodon degus to use a rake-like tool with their forelimbs to retrieve otherwise out-of-reach rewards. Eventually, they mastered effective use of the tool, moving it in an elegant trajectory. After the degus were well trained, probe tests that examined whether they showed functional understanding of the tool were performed. Degus did not hesitate to use tools of different size, colors, and shapes, but were reluctant to use the tool with a raised nonfunctional blade. Thus, degus understood the functional and physical properties of the tool after extensive training. CONCLUSIONS/SIGNIFICANCE: Our findings suggest that tool use is not a specific faculty resulting from higher intelligence, but is a specific combination of more general cognitive faculties. Studying the brains and behaviors of trained rodents can provide insights into how higher cognitive functions might be broken down into more general faculties, and also what cellular and molecular mechanisms are involved in the emergence of such cognitive functions.

Training student pharmacists to administer emergency pediatric influenza vaccine: A comparison of traditional vs. just-in-time training.

Science.gov (United States)

Terriff, Colleen M; McKeirnan, Kimberly

2017-07-01

This study compared traditional training (TT) and just-in-time training (JITT) of P3 student pharmacists regarding interest, confidence, and comfort pre- and post-training (primary objective); and assessment and administration competency (secondary objective) during a simulated influenza vaccination clinic. Student pharmacists were randomized 1:1 to receive either TT or JITT, completed pre- and post-training surveys assessing interest, confidence and comfort; and evaluated on performance during a simulated emergency infant vaccination. An infant manikin simulated a child <1 year of age, and an actor role-played the mother. All students received a briefing about the simulated mass vaccination prior to their performance assessment. Survey differences between groups were analyzed by ANOVA. The competency assessment was analyzed by a Chi-square or Fisher's exact test for individual steps and Student t-test for mean scores. Pre-training interest was high and maintained post-training. Pre-training confidence and comfort levels were low and improved in both groups. Mean competency scores were comparable between the TT and JITT groups. Comparing groups, TT students more commonly missed proper injection site selection and care; while JITT missed distracting the infant and administration documentation. JITT for student pharmacists to learn skills required to immunize infants elicits similar outcomes (interest, confidence, comfort, and administration competency) as TT for emergency pediatric influenza vaccination. Copyright © 2017 Elsevier Inc. All rights reserved.

EMERGENCY VICTIM CARE AND RESCUE, TEXTBOOK FOR SQUADMEN.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

DESIGNED FOR TRAINING EMERGENCY SQUAD PERSONNEL IN RESCUE PROCEDURES AND VICTIM CARE BEYOND BASIC FIRST AID, THIS TEXTBOOK WAS DEVELOPED BY A COMMITTEE OF SQUADMEN, DOCTORS, NURSES, FIREMEN, AND STATE TRADE AND INDUSTRIAL PERSONNEL TO BE USED IN ADULT TRAINING CLASSES OF FULL-TIME OR VOLUNTEER SQUADMEN. THE INSTRUCTIONAL MATERIAL INCLUDES 26…

Development of emergency response training focusing on non-technical skills. (1) Development and Trial of 'TAIKAN Training'

International Nuclear Information System (INIS)

Hikono, Masaru; Matsui, Yuko; Kanayama, Masaki

2017-01-01

Since the Great East Japan Earthquake of 2011, there have been increasing calls for developing the leadership capabilities of managers who are in charge of command and control of the on-site emergency response center at nuclear power plants. Training programs to improve non-technical skills are being developed and introduced. The authors developed an active learning exercise 'TAIKAN Training' that can be repeatedly performed on-site, targeting on-site commander teams in charge of the initial response in an emergency situation. The exercise forms the core element of a non-technical skills training curriculum. This paper outlines the developed exercise, evaluates the stress on the participants caused by the exercise, and identifies any issues before actually introducing it to a site. (author)

PRONTO training for obstetric and neonatal emergencies in Mexico.

Science.gov (United States)

Walker, Dilys M; Cohen, Susanna R; Estrada, Fatima; Monterroso, Marcia E; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer O

2012-02-01

To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator. A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation. Four elements were assessed: acceptability; feasibility and rating; institutional goal achievement; teamwork improvement; and knowledge and self-efficacy. The program was rated highly both by trainees and by non-trainees who completed a survey and interview. Hospital goals identified by participants in the module I strategic-planning sessions were achieved for 65% of goals in 3 months. Teamwork, knowledge, and self-efficacy scores improved. PRONTO brings simulation training to low-resource settings and can empower interprofessional teams to respond more effectively within their institutional limitations to emergencies involving women and newborns. Further study is warranted to evaluate the potential impact of the program on obstetric and neonatal outcome. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Human Factors in Training - Space Medicine Proficiency Training

Science.gov (United States)

Connell, Erin; Arsintescu, Lucia

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1

Current level of training, experience and perceptions of emergency physicians as expert witnesses: a pilot study.

Science.gov (United States)

Cunningham, Nicola Y; Weiland, Tracey J

2009-12-01

The objective of the present study was to determine emergency physicians' training, experience and perceptions as expert witnesses. Emergency physicians of an adult tertiary referral and teaching hospital participated in a pilot survey regarding their experiences in report writing and in court as expert witnesses. The 28-item survey also examined the amount of formalized forensic medical teaching that emergency physicians had received during their training. Of the participants, 41% (95% CI 21.6-64.1; 7/17) had never received any undergraduate or postgraduate training in forensic medicine, 11/17 (65%, 95% CI 41.2-82.8) had provided a written expert opinion for court, and 12/17 (71%, 95% CI 46.6-87.0) had attended court as an expert witness. All participants considered themselves 'skilled in attending an emergency resuscitation', whereas 3/13 (23%, 95% CI 7.5-50.9) considered themselves 'skilled in attending a courtroom trial'. Nearly 90% (95% CI 64.7-98.0; 15/17) thought that medical evidence training should be a requirement of emergency speciality training. The most commonly preferred forms of medical evidence training were mock court sessions (76%, 95% CI 52.2-91.0; 13/17) and forensic workshops (76%, 95% CI 52.2-91.0; 13/17). From 10 non-technical skills required of an EP, 'appearing in court as an expert witness' was perceived to be the second most difficult skill by most respondents. Emergency physicians in this pilot study have limited training for the role of expert witness and see it as one of the most difficult non-technical skills they have to perform. Further research is required regarding the current and future scope of forensic training.

Identifying and training non-technical skills of nuclear emergency response teams

International Nuclear Information System (INIS)

Crichton, M.T.; Flin, R.

2004-01-01

Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams

Identifying and training non-technical skills of nuclear emergency response teams

Energy Technology Data Exchange (ETDEWEB)

Crichton, M.T. E-mail: m.crichton@abdn.ac.uk; Flin, R

2004-08-01

Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams.

Health Code Number (HCN) Development Procedure

Energy Technology Data Exchange (ETDEWEB)

Petrocchi, Rocky; Craig, Douglas K.; Bond, Jayne-Anne; Trott, Donna M.; Yu, Xiao-Ying

2013-09-01

This report provides the detailed description of health code numbers (HCNs) and the procedure of how each HCN is assigned. It contains many guidelines and rationales of HCNs. HCNs are used in the chemical mixture methodology (CMM), a method recommended by the department of energy (DOE) for assessing health effects as a result of exposures to airborne aerosols in an emergency. The procedure is a useful tool for proficient HCN code developers. Intense training and quality assurance with qualified HCN developers are required before an individual comprehends the procedure to develop HCNs for DOE.

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.

Analysis of Transportation Alternatives for Ejection Seat Training

OpenAIRE

Gambel, Ray; Lundy, David; Murphy, William; Southmost Consulting

2011-01-01

EMBA Project Report EXECUTIVE SUMMARY Student Military Aviators who complete primary flight training at Training Wing FOUR and select jets for their advanced training track will require Naval Aviation Survival Training Program (NASTP) Class 1 training until the T-6B replaces the T-34C as the primary flight training aircraft. This Class 1 training instructs students in ejection seat equipment and procedures for emergency egress of their new aircraft. Of the eight available Aviation Survi...

Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

Science.gov (United States)

Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

2013-06-01

There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

Operating procedures for emergency situations in EDF PWR plants

International Nuclear Information System (INIS)

Depond, G.; Resse, L.

1992-01-01

Analysis of incidents and accidents occurring at French and foreign power plants - particularly the TMI accident - and the commissioning of many units in France, as well as tests on simulators, have all demonstrated that an improvement of safety in nuclear power units depends largely on the improvement of the man-machine interface and particularly of emergency operating procedures (EOP). EDF has taken numerous actions in this direction, especially since 1979. First of all, in improving the classical approach based on event-oriented procedures: Rewriting of initial accident operating procedures with regard to their technical contents their form, and the organization of the operating team (procedures I and A); Extension of initial procedures into areas at the limits of design basis and beyond the design basis limits (procedures H). Nevertheless, this approach is subject to several weaknesses. Dependence on a precise initial diagnosis, impossibility to take into account all the conceivable accidental situations, discrepancies between the predicted pattern and the reality. These drawbacks of the event approach have led us to revise the technical conception of the EOPs, and to develop a new approach based on a continuous monitoring of the physical states of the plant and the ability to define a relationship between the physical state of the plant and the operator actions. (author). 4 figs

Procedural Headache Medicine in Neurology Residency Training: A Survey of US Program Directors.

Science.gov (United States)

Robbins, Matthew S; Robertson, Carrie E; Ailani, Jessica; Levin, Morris; Friedman, Deborah I; Dodick, David W

2016-01-01

To survey neurology residency program directors (PDs) on trainee exposure, supervision, and credentialing in procedures widely utilized in headache medicine. Clinic-based procedures have assumed a prominent role in headache therapy. Headache fellows obtain procedural competence, but reliance on fellowship-trained neurologists cannot match the population eligible for treatments. The inclusion of educational modules and mechanisms for credentialing trainees pursuing procedural competence in residency curricula at individual programs is not known. A web-based survey of US neurology residency PDs was designed by the American Headache Society (AHS) procedural special interest section in collaboration with AHS and American Academy of Neurology's Headache and Facial Pain section leadership. The survey addressed exposure, training, and credentialing in: (1) onabotulinumtoxinA (onabotA) injections, (2) extracranial peripheral nerve blocks (PNBs), and (3) trigger point injections (TPIs). Fifty-five PDs (42.6%) completed the survey. Compared to noncompleters, survey completers were more likely to feature headache fellowships at their institutions (38.2% vs 10.8%, P=0.0002). High exposure (onabotA=90.9%, PNBs=80.0%, TPIs=70.9%) usually featured hands-on patient instruction (66.2%) and lectures (55.7%). Supervised performance rates were high (onabotA=65.5%, PNBs=60.0%, TPIs=52.7%), usually in continuity clinic (60.0%) or headache elective (50.9%). Headache specialists (69.1%) or general neurology (32.7%) faculty most commonly trained residents. Formal credentialing was uncommon (16.4-18.2%), mostly by documenting supervised procedures (25.5%). Only 27.3% of programs permitted trainees to perform procedures independently. Most PDs felt procedural exposure (80.0-90.9%) and competence (50.9-56.4%) by all trainees was important. Resident exposure to procedures for headache is high, but credentialing mechanisms, while desired by most PDs, are not generally in place. Implementation

Astronaut training plans and training facilities in Japan; Uchu hikoshi tanjo eno michi (kunren to kunren setsubi)

Energy Technology Data Exchange (ETDEWEB)

Harada, C. [National Space Development Agency of Japan, Tokyo (Japan)

1999-10-05

Introduced are the training of astronauts for duties aboard a space shuttle, training provided by NASDA (National Space Development Agency of Japan), and training facilities. The astronaut candidate training course involves space science, space medicine, ocean science, and others, in addition to flight training aboard the T-38 jet trainer, emergency procedure training, shuttle system training, weightlessness training aboard the KC-135 jet plane on a ballistic flight, and SCUBA training. After candidates are named to serve aboard the space shuttle, they are to undergo training related to the shuttle system, emergency exit, adaptation to the surroundings, and the space laboratory system. As for ISS (international space station), astronauts will have to construct the station, and to stay there for a long time operating and maintaining the station and manipulating various experimental apparatuses. The astronaut training process in Japan covers approximately four years, including candidate training, advanced training, and mission dependent training. The training facilities include a weightless environment test system, low-pressure environment adaptation training system, etc., available at NASDA's Tsukuba Space Center. (NEDO)

A national survey of prevalence of cardiopulmonary resuscitation training and knowledge of the emergency number in Ireland.

LENUS (Irish Health Repository)

Jennings, S

2009-07-06

AIM: The aim of this survey was to establish prevalence of cardiopulmonary resuscitation (CPR) training within the last 5 years and reasons preventing training and initiation of CPR in Ireland as well as awareness of the emergency numbers. METHODS: An in-home omnibus survey was undertaken in 2008 with quota sampling reflecting the age, gender, social class and geography of Ireland. RESULTS: Of the 974 respondents, 23.5% had undergone CPR training in the previous 5 years with lower social class and age 65 years and older significantly less likely to be trained. The workplace was both a major source of awareness as well as training for those trained. In the untrained group lack of awareness of the need for CPR training was the most significant reason for non-training. Cost was not cited as a barrier. 88.9% of people gave a correct emergency number with geographical variation. Notably, the European emergency number 112 was not well known. CONCLUSION: Previous Irish and American population targets for CPR training have been surpassed in Ireland in 2008. New internationally agreed targets are now required. Meanwhile older people and those in lower socio-economic groups should be targeted for training. Awareness of at least one emergency number is very high in Ireland. Some geographical variation was found and this should be studied further.

Simulation training for medical emergencies in the dental setting using an inexpensive software application.

Science.gov (United States)

Kishimoto, N; Mukai, N; Honda, Y; Hirata, Y; Tanaka, M; Momota, Y

2017-11-09

Every dental provider needs to be educated about medical emergencies to provide safe dental care. Simulation training is available with simulators such as advanced life support manikins and robot patients. However, the purchase and development costs of these simulators are high. We have developed a simulation training course on medical emergencies using an inexpensive software application. The purpose of this study was to evaluate the educational effectiveness of this course. Fifty-one dental providers participated in this study from December 2014 to March 2015. Medical simulation software was used to simulate a patient's vital signs. We evaluated participants' ability to diagnose and treat vasovagal syncope or anaphylaxis with an evaluation sheet and conducted a questionnaire before and after the scenario-based simulation training. The median evaluation sheet score for vasovagal syncope increased significantly from 7/9 before to 9/9 after simulation training. The median score for anaphylaxis also increased significantly from 8/12 to 12/12 (P simulation training. This simulation course improved participants' ability to diagnose and treat medical emergencies and improved their confidence. This course can be offered inexpensively using a software application. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The development of a quantitative measure for the complexity of emergency tasks stipulated in emergency operating procedures of nuclear power plants

International Nuclear Information System (INIS)

Park, Jin Kyun; Jung, Won Dea

2006-11-01

Previous studies have continuously pointed out that human performance is a decisive factor affecting the safety of complicated process systems. Subsequently, as the result of extensive efforts, it has been revealed that the provision of procedures is one of the most effective countermeasures, especially if human operators have to carry out their tasks under a very stressful environment. That is, since good procedures are helpful to not only enhance the performance of human operators but also the reduction of the possibility of a human error through stipulating detailed tasks to be done by human operators. Ironically, it has been emphasized that the performance of human operators could be impaired due to complicated procedures, because procedures directly govern the physical as well as cognitive behavior of human operators by institutionalizing detailed actions. Therefore, it is a prerequisite to develop a systematic framework that properly evaluate the complexity of tasks described in procedures. For this reason, a measure called TACOM (Task Complexity) that can quantify the complexity of emergency tasks described in the emergency operating procedures (EOPs) of NPPs has been developed. In this report, a technical background as well as practical steps to quantify the complexity of tasks were presented with a series of studies that were conducted to ensure the validity of the TACOM measure. As a result of validation studies, since it is shown that the TACOM measure seem to properly quantify the complexity of emergency tasks, it is desirable that the TACOM measure plays an important role in improving the performance of human operators

The development of a quantitative measure for the complexity of emergency tasks stipulated in emergency operating procedures of nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Park, Jin Kyun; Jung, Won Dea

2006-11-15

Previous studies have continuously pointed out that human performance is a decisive factor affecting the safety of complicated process systems. Subsequently, as the result of extensive efforts, it has been revealed that the provision of procedures is one of the most effective countermeasures, especially if human operators have to carry out their tasks under a very stressful environment. That is, since good procedures are helpful to not only enhance the performance of human operators but also the reduction of the possibility of a human error through stipulating detailed tasks to be done by human operators. Ironically, it has been emphasized that the performance of human operators could be impaired due to complicated procedures, because procedures directly govern the physical as well as cognitive behavior of human operators by institutionalizing detailed actions. Therefore, it is a prerequisite to develop a systematic framework that properly evaluate the complexity of tasks described in procedures. For this reason, a measure called TACOM (Task Complexity) that can quantify the complexity of emergency tasks described in the emergency operating procedures (EOPs) of NPPs has been developed. In this report, a technical background as well as practical steps to quantify the complexity of tasks were presented with a series of studies that were conducted to ensure the validity of the TACOM measure. As a result of validation studies, since it is shown that the TACOM measure seem to properly quantify the complexity of emergency tasks, it is desirable that the TACOM measure plays an important role in improving the performance of human operators.

Emerging technologies in education and training: applications for the laboratory animal science community.

Science.gov (United States)

Ketelhut, Diane Jass; Niemi, Steven M

2007-01-01

This article examines several new and exciting communication technologies. Many of the technologies were developed by the entertainment industry; however, other industries are adopting and modifying them for their own needs. These new technologies allow people to collaborate across distance and time and to learn in simulated work contexts. The article explores the potential utility of these technologies for advancing laboratory animal care and use through better education and training. Descriptions include emerging technologies such as augmented reality and multi-user virtual environments, which offer new approaches with different capabilities. Augmented reality interfaces, characterized by the use of handheld computers to infuse the virtual world into the real one, result in deeply immersive simulations. In these simulations, users can access virtual resources and communicate with real and virtual participants. Multi-user virtual environments enable multiple participants to simultaneously access computer-based three-dimensional virtual spaces, called "worlds," and to interact with digital tools. They allow for authentic experiences that promote collaboration, mentoring, and communication. Because individuals may learn or train differently, it is advantageous to combine the capabilities of these technologies and applications with more traditional methods to increase the number of students who are served by using current methods alone. The use of these technologies in animal care and use programs can create detailed training and education environments that allow students to learn the procedures more effectively, teachers to assess their progress more objectively, and researchers to gain insights into animal care.

A production system for computerized emergency procedures tracking

International Nuclear Information System (INIS)

Petrick, W.; Ng, K.; Stuart, C.; Cain, D.

1988-01-01

This paper describes a methodology used to implement a computerized Emergency Operating Procedures (EOP) tracking system based on artificial intelligence (AI) technologies. In AI parlance, the system is a production system in which the knowledge representation is a set of productions (IF-THEN rules) which are interpreted by an inference engine or rule interpreter. The inference engine looks for pattern matches in the rule premises which lead to a conclusion. This inferred conclusion is subsequently used in further pattern matches. By separating the knowledge representation from the inference engine, the system can readily accommodate changes to the written procedures. The system is written in the C language and is co-resident on the same computer as the Safety Parameter Display System (SPDS). The plant EOPs have been written in about 250 rules which are evaluated in less than one second using about 10-20% of the CPU. The conclusions are available to multiple users within seconds after a parameter value changes. The benefits achieved with this production rule system include compatibility with the written procedures used as the knowledge source, compatibility with control room instrumentation, compatibility with the SPDS, realtime performance, and efficient computer usage

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.)

Effectiveness of a multidevice 3D virtual environment application to train car service maintenance procedures

NARCIS (Netherlands)

Borsci, Simone; Lawson, Glyn; Jha, Bhavna; Burges, Mark; Salanitri, Davide

2016-01-01

This paper reports a study which demonstrates the advantages of using virtual-reality-based systems for training automotive assembly tasks. Sixty participants were randomly assigned to one of the following three training experiences to learn a car service procedure: (1) observational training

Guidelines for the presentation of emergency operating procedures using advanced information technology

International Nuclear Information System (INIS)

Green, M.; Hollnagel, E.; Niwa, Yuji

1994-01-01

New methods of information presentation and interface design are changing the conditions for work in the modern NPP control room. One area receiving considerable attention is that of Emergency Operating Procedures (EOP). Conventionally such procedures are presented using hard copy manuals; however, development in IT means that there are new opportunities for the computerization of such procedures. This paper reports on the development of human factors guidelines for the computerized presentation of EOPs. After identifying the principle stages in the transition from procedures as documents to fully automated procedures, computerised procedure presentation is briefly discussed. Guidelines for the presentation of such procedures are outlined starting with the high level goals for guidelines themselves. Such goals also constitute the criteria against which the computerized procedures are measured during implementation. Six dimensions describing computerized procedure presentation are presented and two are explore in more detail by identifying points along each dimension that characterize different levels of IT sophistication. (author). 8 refs, 1 tab

Radiological emergency preparedness arrangements in the European Commission

International Nuclear Information System (INIS)

Tanner, V.

2002-01-01

The purpose of this paper is to give an overview of the different procedures established within the European Commission, which are relevant to radiological emergency planning and response. Although emergency preparedness is a national responsibility within the European Union, the Commission has clearly defined operational tasks in terms of emergency information exchange and community foodstuff regulations. In addition the Commission promotes research programmes and training courses in the field

Development of emergency response training program for on-site commanders (1)

International Nuclear Information System (INIS)

Hikono, Masaru; Matsui, Yuko; Kanayama, Masaki

2017-01-01

Since the Great East Japan Earthquake of 2011, there have been increasing calls for developing the leadership capabilities of managers who are in charge of command and control of the on-site emergency response center at nuclear power plants. Training programs to improve non-technical skills are being developed and introduced. The authors developed an active learning exercise that can be repeatedly performed on-site, targeting on-site commander teams in charge of the initial response in an emergency situation. The exercise forms the core element of a non-technical skills training curriculum. This paper outlines the developed exercise, evaluates the stress on the participants caused by the exercise, and identifies any issues before actually introducing it to a site. (author)

Manpower development for safe operation of nuclear power plant. China. Emergency operating procedures. Activity: 5.1.4-Task-11. Technical report

International Nuclear Information System (INIS)

Walsh, L.A.

1994-01-01

This report covers the period of engagement from July 11, 1994 through July 22, 1994. The events and topics of discussion are as follows: History of Emergency Operating Procedure EOP Development; Emergency Operating Procedures (Event Based, Critical Safe Function Status Trees and Functional Recovery Response Procedures); Transition from Emergency Operating Procedures to Severe Accident Management Guidelines

General surgery residents' perception of robot-assisted procedures during surgical training.

Science.gov (United States)

Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

2015-01-01

With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases would replace conventional laparoscopic surgery in the future. This study illustrates that although the most residents

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 5. CPR, Oxygen Therapy. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the fifth in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains two sections covering the following course content; cardiopulmonary resuscitation (CPR) (including artificial ventilation, foreign body obstructions, adjunctive equipment and special techniques, artificial…

Development of procedure for emergency response in the case of combined disaster

International Nuclear Information System (INIS)

2012-01-01

It has been discussed that there were many differences to international standards and the delay for prior planning implementation of nuclear emergency preparedness. Based on this points, since fiscal year 2011, the framework for execution of the precautionary action etc. in consideration of the international standard to the Guide 'Emergency Preparedness for Nuclear Facilities' has been implemented by NSC (Nuclear Safety Commission) of Japan. On the other hand, it was clarified that there would be many problems for decision making strategies of protective actions at the nuclear disaster (combined disaster) when the natural disasters such as earthquakes and tsunamis, the flood, the heavy snow, and the large-scale fire, etc. occurred, and implementation of criteria and procedure for protective action execution through the experience with protective actions after the East Japan large-scale earthquake. The problem arrangements and data preparations to develop the emergency protective action procedure for the emergency preparedness manuals corresponding to the combined disasters are scheduled to be executed in this study for three years from the fiscal year 2011 based on the experience and the finding in the East Japan large-scale earthquake. Development and verification of the method of Evacuation Time Estimate (ETE) at the combined disaster are executed in this year. (author)

Nontrauma emergency surgery: optimal case mix for general surgery and acute care surgery training.

Science.gov (United States)

Cherry-Bukowiec, Jill R; Miller, Barbra S; Doherty, Gerard M; Brunsvold, Melissa E; Hemmila, Mark R; Park, Pauline K; Raghavendran, Krishnan; Sihler, Kristen C; Wahl, Wendy L; Wang, Stewart C; Napolitano, Lena M

2011-11-01

To examine the case mix and patient characteristics and outcomes of the nontrauma emergency (NTE) service in an academic Division of Acute Care Surgery. An NTE service (attending, chief resident, postgraduate year-3 and postgraduate year-2 residents, and two physician assistants) was created in July 2005 for all urgent and emergent inpatient and emergency department general surgery patient consults and admissions. An NTE database was created with prospective data collection of all NTE admissions initiated from November 1, 2007. Prospective data were collected by a dedicated trauma registrar and Acute Physiology and Chronic Health Evaluation-intensive care unit (ICU) coordinator daily. NTE case mix and ICU characteristics were reviewed for the 2-year time period January 1, 2008, through December 31, 2009. During the same time period, trauma operative cases and procedures were examined and compared with the NTE case mix. Thousand seven hundred eight patients were admitted to the NTE service during this time period (789 in 2008 and 910 in 2009). Surgical intervention was required in 70% of patients admitted to the NTE service. Exploratory laparotomy or laparoscopy was performed in 449 NTE patients, comprising 37% of all surgical procedures. In comparison, only 118 trauma patients (5.9% of admissions) required a major laparotomy or thoracotomy during the same time period. Acuity of illness of NTE patients was high, with a significant portion (13%) of NTE patients requiring ICU admission. NTE patients had higher admission Acute Physiology and Chronic Health Evaluation III scores [61.2 vs. 58.8 (2008); 58.2 vs. 55.8 (2009)], increased mortality [(9.71% vs. 4.89% (2008); 6.78% vs. 5.16% (2009)], and increased readmission rates (15.5% vs. 7.4%) compared with the total surgical ICU (SICU) admissions. In an era of declining operative caseload in trauma, the NTE service provides ample opportunity for complex general surgery decision making and operative procedures for

Preparedness of public authorities for emergencies at nuclear power plants

International Nuclear Information System (INIS)

1982-01-01

The safety guide lays down the requirements for the establishment of suitable procedures to be followed in the event of an emergency situation at a nuclear power plant. Many of the procedures would also be applicable at other nuclear facilities such as fuel manufacturing plants, irradiated fuel processing plants and the like. The guide defines reponsibilities for emergency planning, organization and action, protective measures to be taken, information and instruction of the public, training and cooperation across boundaries

Cephalopod biology and care, a COST FA1301 (CephsInAction) training school: anaesthesia and scientific procedures.

Science.gov (United States)

Lopes, Vanessa M; Sampaio, Eduardo; Roumbedakis, Katina; Tanaka, Nobuaki K; Carulla, Lucía; Gambús, Guillermo; Woo, Theodosia; Martins, Catarina P P; Penicaud, Virginie; Gibbings, Colette; Eberle, Jessica; Tedesco, Perla; Fernández, Isabel; Rodríguez-González, Tania; Imperadore, Pamela; Ponte, Giovanna; Fiorito, Graziano

2017-09-01

Cephalopods are the sole invertebrates included in the list of regulated species following the Directive 2010/63/EU. According to the Directive, achieving competence through adequate training is a requisite for people having a role in the different functions (article 23) as such carrying out procedures on animals, designing procedures and projects, taking care of animals, killing animals. Cephalopod Biology and Care Training Program is specifically designed to comply with the requirements of the "working document on the development of a common education and training framework to fulfil the requirements under the Directive 2010/63/EU". The training event occurred at the ICM-CSIC in Barcelona (Spain) where people coming from Europe, America and Asia were instructed on how to cope with regulations for the use of cephalopod molluscs for scientific purposes. The training encompasses discussion on the guidelines for the use and care of animals and their welfare with particular reference to procedures that may be of interest for neuroscience. Intensive discussion has been carried out during the training sessions with focus on behavioural studies and paradigms, welfare assessment, levels of severity of scientific procedures, animal care, handling, transport, individual identification and marking, substance administration, anaesthesia, analgesia and humane killing.

The information needs of patients receiving procedural sedation in a hospital emergency department.

Science.gov (United States)

Revell, Sue; Searle, Judy; Thompson, Shona

2017-07-01

This research investigated the information needs of patients receiving ED procedural sedation to determine the best format to consistently deliver key information in a way acceptable to all involved. Of particular interest was the question concerning patients' need for receiving written information. A descriptive exploratory study gathered qualitative data through face-to-face interviews and focus groups involving patients, nurses and medical staff. Individual interviews were conducted with eight adult patients following procedural sedation. They identified very few gaps in terms of specific information they needed pertaining to procedural sedation and rejected the need for receiving information in a written format. Their information needs related to a central concern for safety and trust. Focus groups, reflecting on the findings from patients, were conducted with five ED nurses and four emergency medicine consultants/registrars who regularly provided procedural sedation. Themes that emerged from the analysis of data from all three groups identified the issues concerning patient information needs as being: competence and efficiency of staff; explanations of procedures and progress; support person presence; and medico-legal issues. The research confirms that the quality of the patient's ED experience, specifically related to procedural sedation, is enhanced by ED staff, especially nurses, providing them with ongoing and repeated verbal information relevant to their circumstances. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preliminary Investigation of Time Remaining Display on the Computer-based Emergency Operating Procedure

Science.gov (United States)

Suryono, T. J.; Gofuku, A.

2018-02-01

One of the important thing in the mitigation of accidents in nuclear power plant accidents is time management. The accidents should be resolved as soon as possible in order to prevent the core melting and the release of radioactive material to the environment. In this case, operators should follow the emergency operating procedure related with the accident, in step by step order and in allowable time. Nowadays, the advanced main control rooms are equipped with computer-based procedures (CBPs) which is make it easier for operators to do their tasks of monitoring and controlling the reactor. However, most of the CBPs do not include the time remaining display feature which informs operators of time available for them to execute procedure steps and warns them if the they reach the time limit. Furthermore, the feature will increase the awareness of operators about their current situation in the procedure. This paper investigates this issue. The simplified of emergency operating procedure (EOP) of steam generator tube rupture (SGTR) accident of PWR plant is applied. In addition, the sequence of actions on each step of the procedure is modelled using multilevel flow modelling (MFM) and influenced propagation rule. The prediction of action time on each step is acquired based on similar case accidents and the Support Vector Regression. The derived time will be processed and then displayed on a CBP user interface.

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

Science.gov (United States)

Chapman, Dane M.; And Others

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

Generic procedures for medical response during a nuclear or radiological emergency. Emergency preparedness and response

International Nuclear Information System (INIS)

2005-04-01

The aim of this publication is to serve as a practical resource for planning the medical response to a nuclear or radiological emergency. It fulfils in part functions assigned to the IAEA under Article 5.a(ii) of the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency (Assistance Convention), namely, to collect and disseminate to States Parties and Member States information concerning methodologies, techniques and available results of research relating to such emergencies. Effective medical response is a necessary component of the overall response to nuclear or radiological (radiation) emergencies. In general, the medical response may represent a difficult challenge for the authorities due to the complexity of the situation, often requiring specialized expertise, and special organizational arrangements and materials. To be effective, adequate planning and preparedness are needed. This manual, if implemented, should help to contribute to coherent international response. The manual provides the practical tools and generic procedures for use by emergency medical personnel during an emergency situation. It also provides guidance to be used at the stage of preparedness for development of medical response capabilities. The manual also addresses mass casualty emergencies resulting from malicious acts involving radioactive material. This part was supported by the Nuclear Security Fund. The manual was developed based on a number of assumptions about national and local capabilities. Therefore, it must be reviewed and revised as part of the planning process to match the potential accidents, threats, local conditions and other unique characteristics of the facility where it may be used

Astronaut Scott Parazynski during egress training

Science.gov (United States)

1994-01-01

Astronaut Scott E. Parazynski looks at fellow STS-66 mission specialist Joseph R. Tanner, (foreground) during a rehearsal of procedures to be followed during the launch and entry phases of their scheduled November 1994 flight. This rehearsal, held in the crew compartment trainer (CCT) of JSC's Shuttle mockup and integration laboratory, was followed by a training session on emergency egress procedures.

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

Techniques for preparing flowchart-format emergency operating procedures: Background (Sections 1.0-9.0)

International Nuclear Information System (INIS)

Barnes, V.E.; Moore, C.J.; Wieringa, D.R.; Isakson, C.S.; Kono, B.K.; Gruel, R.L.

1989-01-01

This two-volume report describes the activities, findings, and recommendations of a project entitled ''Techniques for Presenting Flowchart-Format Emergency Operating Procedures.'' The project team surveyed the literature pertaining to flowcharts, reviewed existing flowchart emergency operating procedures (EOPs), interviewed consultants who produced flowcharts, and interviewed reactor operator licensing examiners about the use of flowcharts in nuclear power plants. This document, and Volume 1 of this report, discusses the use of flowchart-format EOPs in nuclear power plants and presents issue to be addressed in the design and implementation of flowchart EOPs. 66 refs., 76 figs., 2 tabs

Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

Directory of Open Access Journals (Sweden)

Tsagkaraki Petroula A

2009-01-01

Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

Training to handle unexpected events

International Nuclear Information System (INIS)

Hamlin, K.W.

1987-01-01

The importance of conducting hands-on training to deal with complex situations is well recognized. Since most utilities now own or have ordered their own control room simulators, access to simulator training facilities has improved greatly. Most utilities now have a control room shift rotation that includes a dedicated training shift. The opportunities for practicing operational control over unexpected and off-normal events are just beginning to be recognized. Areas that are being enhanced include teamwork training, diagnostics training, expanded simulator training programs, improvements in simulator instructor training, emergency procedures training, and training on the use of probabilistic risk assessment studies. All these efforts are aimed at the goal of improving the plant staff's ability to cope with unexpected and off-normal events

Evaluating the effect of emergency residency training on productivity in the emergency department.

Science.gov (United States)

Henning, Daniel J; McGillicuddy, Daniel C; Sanchez, Leon D

2013-09-01

Resident productivity, defined as patients seen per unit time, is one measure that is used to assess the performance and educational progress of residents in the emergency department (ED). One published study suggested that emergency residency training (EM) does not improve productivity compared with that in other specialties, including internal medicine (IM). This study assesses how EM and IM trainees perform in the ED and illustrates how resident productivity changes through the academic year. A retrospective review of attending physicians and residents working 8-h shifts in the higher acuity zone of a large-volume, tertiary, academic health care center was performed for July 2009, October 2009, January 2010, and April 2010. The total number of patients seen primarily and admitted during each shift was recorded. ED volume was approximated by the number of patients seen by the attending physician, and acuity was approximated by admission rate. A mixed model regression assessed the impact of year and type of residency training (e.g., EM1, EM2, IM1, and IM2), ED volume, and acuity on resident productivity (number of patients per shift). The study was granted waiver of informed consent by our institutional review board. We reviewed 936 shifts. After adjusting for acuity and ED volume, the EM1 group had a significant increase in patients per shift over the year, from 6.11 in July to 10.3 in April (p increased productivity significantly. The first EM training year leads to a significant change in productivity that separates EM from IM residents. This contradicts the previous assertion that non-EM residents have the same productivity as EM residents in the ED. Copyright © 2013 Elsevier Inc. All rights reserved.

An empirical investigation of operator performance in cognitively demanding simulated emergencies

International Nuclear Information System (INIS)

Roth, E.M.; Mumaw, R.J.; Lewis, P.M.

1994-07-01

This report documents the results of an empirical study of nuclear power plant operator performance in cognitively demanding simulated emergencies. During emergencies operators follow highly prescriptive written procedures. The objectives of the study were to understand and document what role higher-level cognitive activities such as diagnosis, or more generally 'situation assessment', play in guiding operator performance, given that operators utilize procedures in responding to the events. The study examined crew performance in variants of two emergencies: (1) an Interfacing System Loss of Coolant Accident and (2) a Loss of Heat Sink scenario. Data on operator performance were collected using training simulators at two plant sites. Up to 11 crews from each plant participated in each of two simulated emergencies for a total of 38 cases. Crew performance was videotaped and partial transcripts were produced and analyzed. The results revealed a number of instances where higher-level cognitive activities such as situation assessment and response planning enabled crews to handle aspects of the situation that were not fully addressed by the procedures. This report documents these cases and discusses their implications for the development and evaluation of training and control room aids, as well as for human reliability analyses

Creating Online Training for Procedures in Global Health with PEARLS (Procedural Education for Adaptation to Resource-Limited Settings).

Science.gov (United States)

Bensman, Rachel S; Slusher, Tina M; Butteris, Sabrina M; Pitt, Michael B; On Behalf Of The Sugar Pearls Investigators; Becker, Amanda; Desai, Brinda; George, Alisha; Hagen, Scott; Kiragu, Andrew; Johannsen, Ron; Miller, Kathleen; Rule, Amy; Webber, Sarah

2017-11-01

The authors describe a multiinstitutional collaborative project to address a gap in global health training by creating a free online platform to share a curriculum for performing procedures in resource-limited settings. This curriculum called PEARLS (Procedural Education for Adaptation to Resource-Limited Settings) consists of peer-reviewed instructional and demonstration videos describing modifications for performing common pediatric procedures in resource-limited settings. Adaptations range from the creation of a low-cost spacer for inhaled medications to a suction chamber for continued evacuation of a chest tube. By describing the collaborative process, we provide a model for educators in other fields to collate and disseminate procedural modifications adapted for their own specialty and location, ideally expanding this crowd-sourced curriculum to reach a wide audience of trainees and providers in global health.

40 CFR 240.209-3 - Recommended procedures: Operations.

Science.gov (United States)

2010-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c) Training in first aid practices and emergency procedures should be given all personnel. (d) Personal safety devices such as hard hats, gloves, safety glasses, and footwear should be provided for facility employees...

[The importance of simulation in team training on obstetric emergencies: results of the first phase of the national plan for continuous medical training].

Science.gov (United States)

Maio Matos, Francisco; Sousa Gomes, Andrea; Costa, Fernando Jorge; Santos Silva, Isabel; Carvalhas, Joana

2012-01-01

Obstetric emergencies are unexpected and random. The traditional model for medical training of these acute events has included lectures combined with sporadic clinical experiences, but this educational method has inherent limitations. Given the variety of manual skills that must be learned and high-risk environment, Obstetrics is uniquely suited for simulation. New technological educational tools provide an opportunity to learn and master technical skills needed in emergent situations as well as the opportunity to rehearse and learn from mistakes without risks to patients. The goals of this study are to assess which are the factors that trainees associate to human fallibility before and after clinical simulation based training; to compare the confidence level to solve emergent obstetric situations between interns and experts with up to 5 years of experience before and after training, and to determine the value that trainees give to simulation as a teaching tool on emergent events. 31 physicians participated at this course sessions. After the course, we verified changes in the factores that trainees associate to human fallibility, an increase in confidence level to solve emergent obstetric and an increase in the value that trainees give to simulation as a teaching tool.

A simulation-based training program improves emergency department staff communication.

Science.gov (United States)

Sweeney, Lynn A; Warren, Otis; Gardner, Liz; Rojek, Adam; Lindquist, David G

2014-01-01

The objectives of this study were to evaluate the effectiveness of Project CLEAR!, a novel simulation-based training program designed to instill Crew Resource Management (CRM) as the communication standard and to create a service-focused environment in the emergency department (ED) by standardizing the patient encounter. A survey-based study compared physicians' and nurses' perceptions of the quality of communication before and after the training program. Surveys were developed to measure ED staff perceptions of the quality of communication between staff members and with patients. Pretraining and posttraining survey results were compared. After the training program, survey scores improved significantly on questions that asked participants to rate the overall communication between staff members and between staff and patients. A simulation-based training program focusing on CRM and standardizing the patient encounter improves communication in the ED, both between staff members and between staff members and patients.

Development of a standardized training course for laparoscopic procedures using Delphi methodology.

Science.gov (United States)

Bethlehem, Martijn S; Kramp, Kelvin H; van Det, Marc J; ten Cate Hoedemaker, Henk O; Veeger, Nicolaas J G M; Pierie, Jean Pierre E N

2014-01-01

Content, evaluation, and certification of laparoscopic skills and procedure training lack uniformity among different hospitals in The Netherlands. Within the process of developing a new regional laparoscopic training curriculum, a uniform and transferrable curriculum was constructed for a series of laparoscopic procedures. The aim of this study was to determine regional expert consensus regarding the key steps for laparoscopic appendectomy and cholecystectomy using Delphi methodology. Lists of suggested key steps for laparoscopic appendectomy and cholecystectomy were created using surgical textbooks, available guidelines, and local practice. A total of 22 experts, working for teaching hospitals throughout the region, were asked to rate the suggested key steps for both procedures on a Likert scale from 1-5. Consensus was reached with Crohnbach's α ≥ 0.90. Of the 22 experts, 21 completed and returned the survey (95%). Data analysis already showed consensus after the first round of Delphi on the key steps for laparoscopic appendectomy (Crohnbach's α = 0.92) and laparoscopic cholecystectomy (Crohnbach's α = 0.90). After the second round, 15 proposed key steps for laparoscopic appendectomy and 30 proposed key steps for laparoscopic cholecystectomy were rated as important (≥4 by at least 80% of the expert panel). These key steps were used for the further development of the training curriculum. By using the Delphi methodology, regional consensus was reached on the key steps for laparoscopic appendectomy and cholecystectomy. These key steps are going to be used for standardized training and evaluation purposes in a new regional laparoscopic curriculum. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 3--Anatomy and Physiology. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the third in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains one section covering the following topics: general anatomical terms, the body cavities and contents, the integumentary system, the skeletal system, the muscular system, the nervous system, the respiratory…

An hypnotic suggestion: review of hypnosis for clinical emergency care.

Science.gov (United States)

Iserson, Kenneth V

2014-04-01

Hypnosis has been used in medicine for nearly 250 years. Yet, emergency clinicians rarely use it in emergency departments or prehospital settings. This review describes hypnosis, its historical use in medicine, several neurophysiologic studies of the procedure, its uses and potential uses in emergency care, and a simple technique for inducing hypnosis. It also discusses reasons why the technique has not been widely adopted, and suggests methods of increasing its use in emergency care, including some potential research areas. A limited number of clinical studies and case reports suggest that hypnosis may be effective in a wide variety of conditions applicable to emergency medical care. These include providing analgesia for existing pain (e.g., fractures, burns, and lacerations), providing analgesia and sedation for painful procedures (e.g., needle sticks, laceration repair, and fracture and joint reductions), reducing acute anxiety, increasing children's cooperation for procedures, facilitating the diagnosis and treatment of acute psychiatric conditions, and providing analgesia and anxiolysis for obstetric/gynecologic problems. Although it is safe, fast, and cost-effective, emergency clinicians rarely use hypnosis. This is due, in part, to the myths surrounding hypnosis and its association with alternative-complementary medicine. Genuine barriers to its increased clinical use include a lack of assured effectiveness and a lack of training and training requirements. Based on the results of further research, hypnosis could become a powerful and safe nonpharmacologic addition to the emergency clinician's armamentarium, with the potential to enhance patient care in emergency medicine, prehospital care, and remote medical settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Using Video Modeling with Voiceover Instruction Plus Feedback to Train Staff to Implement Direct Teaching Procedures.

Science.gov (United States)

Giannakakos, Antonia R; Vladescu, Jason C; Kisamore, April N; Reeve, Sharon A

2016-06-01

Direct teaching procedures are often an important part of early intensive behavioral intervention for consumers with autism spectrum disorder. In the present study, a video model with voiceover (VMVO) instruction plus feedback was evaluated to train three staff trainees to implement a most-to-least direct (MTL) teaching procedure. Probes for generalization were conducted with untrained direct teaching procedures (i.e., least-to-most, prompt delay) and with an actual consumer. The results indicated that VMVO plus feedback was effective in training the staff trainees to implement the MTL procedure. Although additional feedback was required for the staff trainees to show mastery of the untrained direct teaching procedures (i.e., least-to-most and prompt delay) and with an actual consumer, moderate to high levels of generalization were observed.

Medical Preparedness and Response for a Nuclear or Radiological Emergency. Training Materials

International Nuclear Information System (INIS)

2014-01-01

In almost all nuclear and radiological emergencies, local emergency services (e.g. local medical, law enforcement, and fire brigades) will have the most important role in the early response. Within hours, hospitals may also have an important role to play in the response at the local level. Since nuclear and radiological emergencies are rare, medical responders often have little or no experience in dealing with this type of emergency and inexperience may lead to an inadequate response. For this reason, training in medical preparedness and response for a nuclear or radiological emergency is an important aspect of preparedness and response activities. These materials are designed for use at a training course on medical preparedness and response for a nuclear or radiological emergency. They contain a wide range of lectures and supporting materials, which cover the basic topics and more specific areas of medical preparedness and response. Therefore, in planning their specific courses, organizers are encouraged to choose those lectures and supportive materials from the CD-ROM that best match their training priorities. Materials on the CD-ROM address the following areas: • Terrorism in Perspective; • Malicious Act Scenarios; • Providing Information to the Medical Community and the Public; • Medical Response to a Radiation Mass Casualty Event; • Handling of Contaminated Persons in Malicious Events; • Planning and Preparedness for Medical Response to Malicious Events with Radioactive Material; • Handling the Bodies of Decedents Contaminated with Radioactive Material; • Radiation Emergencies: Scope of the Problem; • Common Sources of Radiation; • Basic Concepts of Ionizing Radiation; • Basic Concepts of Radiation Protection; • Biological Effects of Ionizing Radiation – Basic Notions; • Basics of Radiopathology; • External Radioactive Contamination; • Internal Radioactive Contamination; • Acute Radiation Syndrome; • Cutaneous Radiation

First Response to Medical Emergency

International Nuclear Information System (INIS)

Manisah Saedon; Sarimah Mahat; Muhamad Nurfalah Karoji; Hasnul Nizam Osman

2015-01-01

Accident or medical emergencies, both minor and critical, occurs each day and can happen in any workplace. In any medical emergencies, time is a critical factor because the first person to arrive at the scene of an accident has a key role in the rescue of a victim. With the knowledge of some common medical procedures and emergency actions, this first responder can make a positive contribution to the welfare of the accident victim. In some cases, this contribution can make difference between life and death. Improper response to medical emergencies by an untrained person can result in worsen injuries or death. Therefore, first aids training are necessary to provide the information. (author)

Evaluating emergency ultrasound training in India

Directory of Open Access Journals (Sweden)

Gupta Amit

2010-01-01

Full Text Available Background : In countries with fully developed emergency medicine systems, emergency ultrasound (EUS plays an important role in the assessment and treatment of critically ill patients. Methods : The authors sought to introduce EUS to a group of doctors working in the emergency departments (EDs in India through an intensive 4-day adult and pediatric ultrasound course held at the Apex Trauma Center and EM division of the All India Institute of Medical Sciences in New Delhi. The workshop was evaluated with a survey questionnaire and a hands-on practical test. The questionnaire was designed to assess the current state of EUS in India′s EDs, and to identify potential barriers to the incorporation of EUS into current EM practice. The EUS course consisted of a general introductory didactic session followed by pediatric, abdominal and trauma, cardiothoracic, obstetrical and gynecologic, and vascular modules. Each module had a didactic session followed by hands-on applications with live models and/or simulators. A post-course survey questionnaire was given to the participants, and there was a practical test on the final day of the course. The ultrasound images taken by the participants were digitally recorded, and were subsequently graded for their accuracy by independent observers, residency, and/or fellowship trained in EUS. Results : There were a total of 42 participants who completed the workshop and took the practical examination; 32 participants filled in the course evaluation survey. Twenty-four (75% participants had no prior experience with EUS, 5 (16% had some experience, and 3 (9% had significant experience. During the practical examination, 38 of 42 participants (90% were able to identify Morison′s pouch on the focused abdominal sonography for trauma (FAST examination, and 32 (76% were able to obtain a parasternal long axis cardiac view and identify the left ventricle. The inferior vena cava was identified as it crosses the diaphragm into

Annual report of Nuclear Emergency Assistance and Training Center. April 1, 2008 - March 31, 2009

International Nuclear Information System (INIS)

Kanamori, Masashi; Hashimoto, Kazuichiro; Terunuma, Hiroshi; Ikeda, Takeshi; Ohmura, Akiko; Terakado, Naoya; Nagakura, Tomohiro; Fukumoto, Masahiro; Watanabe, Fumitaka; Yamamoto, Kazuya; Abe, Minako; Kikuchi, Masayuki; Sumiya, Akihiro; Matsusaka, Masaru

2009-09-01

When a nuclear emergency occurs in Japan, the Japan Atomic Energy Agency (JAEA) provides technical support to the National government, local governments, police, fire station and license holder etc. They are Designated Public Organizations conforming to the Basic Law on Emergency Preparedness and the Basic Plan for Disaster Countermeasures. The Nuclear Emergency Assistance and Training Center (NEAT) of JAEA provides a comprehensive range of technical support activities to an Off-Site Center in case of a nuclear emergency. Specifically, NEAT gives technical advice and information, provides for the dispatch of specialist as required, supplies emergency equipments and materials to the Joint Council of Nuclear Disaster Countermeasures, which meets at the Off-Site Center. NEAT provide various lectures and training course concerning nuclear disaster prevention for those personnel taking an active part in emergency response organizations at normal time. And NEAT researches on nuclear disaster prevention and also cooperate with international organizations. This annual report summarized the activities of JAEA/NEAT in the fiscal year 2008. (author)

Effects of imprint training procedure at birth on the reactions of foals at age six months.

Science.gov (United States)

Williams, J L; Friend, T H; Collins, M N; Toscano, M J; Sisto-Burt, A; Nevill, C H

2003-03-01

While imprint training procedures have been promoted in popular magazines, they have received limited scientific investigation. To determine the effects of a neonatal imprint training procedure on 6-month-old foals and to determine if any one session had a greater effect than others. Foals (n = 131) were divided into the following treatments: no imprint training, imprint training at birth, 12, 24 and 48 h after birth or imprint training only at birth, 12, 24, 48, or 72 h after birth. Foals then received minimal human handling until they were tested at 6 months. During training, time to complete exposure to the stimulus was significant for only 2 of 6 stimuli. Percentage change in baseline heart rate was significant for only 2 of 10 stimuli. These 4 effects were randomly spread across treatments. Neither the number of imprint training sessions (0, 1, or 4) nor the timing of imprint training sessions (none, birth, 12, 24, 48, or 72 h after birth) influenced the foal's behaviour at 6 months of age. In this study, imprint training did not result in better behaved, less reactive foals.

Provider volume and outcomes for abdominal aortic aneurysm repair, carotid endarterectomy, and lower extremity revascularization procedures.

LENUS (Irish Health Repository)

Killeen, Shane D

2012-02-03

BACKGROUND: Intuitively, vascular procedures performed by high-volume vascular subspecialists working at high-volume institutions should be associated with improved patient outcome. Although a large number of studies assess the relationship between volume and outcome, a single contemporary compilation of such studies is lacking. METHODS: A review of the English language literature was performed incorporating searches of the Medline, EMBASE, and Cochrane collaboration databases for abdominal aortic aneurysm repair (elective and emergent), carotid endarterectomy, and arterial lower limb procedures for any volume outcome relationship. Studies were included if they involved a patient cohort from 1980 onwards, were community or population based, and assessed health outcomes (mortality and morbidity) as a dependent variable and volume as an independent variable. RESULTS: We identified 74 relevant studies, and 54 were included. All showed either an inverse relationship of variable magnitude between provider volume and mortality, or no volume-outcome effect. The reduction in the risk-adjusted mortality rate (RAMR) for high-volume providers was 3% to 11% for elective abdominal aortic aneurysm (AAA) repair, 2.5 to 5% for emergent AAA repair, 0.7% to 4.7% carotid endarterectomy, and 0.3% to 0.9% for lower limb arterial bypass procedures. Subspeciality training also conferred a considerable morbidity and mortality benefit for emergent AAA repair, carotid endarterectomy, and lower limb arterial procedures. CONCLUSION: High-volume providers have significantly better outcomes for vascular procedures both in the elective and emergent setting. Subspeciality training also has a considerable impact. These data provide further evidence for the specialization of vascular services, whereby vascular procedures should generally be preformed by high-volume, speciality trained providers.

Astronaut Curtis L. Brown, Jr., pilot, works with his life raft during emergency bailout training

Science.gov (United States)

1996-01-01

STS-77 TRAINING VIEW --- Astronaut Curtis L. Brown, Jr., pilot, works with his life raft during emergency bailout training for crew members in the Johnson Space Centers (JSC) Weightless Environment Training Facility (WET-F). Brown will join five other astronauts for nine days aboard the Space Shuttle Endeavour next month.

Knowledge acquired during the implementation of the BWR emergency procedures tracking system

International Nuclear Information System (INIS)

Petrick, W.; Sun, B.K.H.; Naser, J.

1992-01-01

An Emergency Operating Procedures Tracking System (EOPTS) has been developed, installed and tested at Taiwan Power Company's Kuo Sheng BWR plant. The EOPTS is based on artificial intelligence methodologies to meet project objectives that could not be met using conventional techniques. The plant EOP's were encoded into a rule-based expert system developed specifically for this application. The EOPTS executes within the GE/ERFIS system to provide close integration with the plant SPDS. The initial EOPTS was implemented in the Kuo Sheng simulator to allow quantitative crew evaluations of the system. Statistical analysis techniques were used to demonstrate that the crews using the EOPTS showed faster responses, fewer errors, and more consistent actions than the crews using the EOP flowcharts. The knowledge acquired during the EOPTS project resulted in improved understanding of related areas such as the EPG'S, plant EOPS, man-machine interfaces, and simulator models for severe transients. These experiences will be used in the future to transfer the technology to US utilities with the objective to improve operator training of the plant EOPs during severe multiple failure transients. To this end, EPRI has developed a technology assessment package that is available to interested utilities. 9 refs., 1 fig

Generic procedures for monitoring in a nuclear or radiological emergency

International Nuclear Information System (INIS)

2005-03-01

This book is a Japanese version of the International Atomic Energy Agency (IAEA) publication (Report No., IAEA-TECDOC-1092, published in Vienna, 1999) of the same title. The translation of the original English into Japanese was done by the Department of Dose Assessment, Research Center for Radiation Emergency Medicine, National Institute of Radiological Sciences (NIRS). Since the Department was organized in addition to the Emergency Medicine Dept. in the Center in 2003 to establish a system for rapid and accurate dose assessment at emergent radiation exposure, the translation is thus a result of the department works, and is published with permission by IAEA as one of a series of NIRS Report (NIRS-M--179) for use in the country. The book is essentially a manual for providing technical requirements and procedures for radiation monitoring, environmental sampling and laboratory analyses for a nuclear or other radiological emergency. The contents are: Introduction, Outline of monitoring, Monitoring of outdoor radiation and contamination, Outdoor sampling, Gross alpha/beta measurement, Gamma spectrometry, Activation analyses, Basic data assessment, Work-sheets, Check-list for measuring equipments, Appendices, References, and others. (S.I.)

Peace Corps Stateside Teacher Training for Volunteers in Liberia. Volume I: Evaluation Report. Final Report.

Science.gov (United States)

PSI Associates, Inc., Washington, DC.

This report contains an evaluation of the Peace Corps stateside teacher training model for volunteers in Liberia. The first section lists recommendations stemming from the evaluation, concerning the pre-training questionnaire, deselection during training, emergency procedures, and the teacher training program. Section 2 describes the training…

Laparoscopy in major abdominal emergency surgery seems to be a safe procedure

DEFF Research Database (Denmark)

Nielsen, Liv Bjerre Juul; Tengberg, Line Toft; Bay-Nielsen, Morten

2017-01-01

INTRODUCTION: Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic...

A virtual reality system for the training of volunteers involved in health emergency situations.

Science.gov (United States)

De Leo, Gianluca; Ponder, Michal; Molet, Tom; Fato, Marco; Thalmann, Daniel; Magnenat-Thalmann, Nadia; Bermano, Francesco; Beltrame, Francesco

2003-06-01

In order to guarantee an effective and punctual medical intervention to injured people involved in health emergency situations, where usually both professional and non-professional health operators are involved, a fast and accurate treatment has to be carried out. In case of catastrophic or very critical situations, non-professional operators who did not receive proper training (volunteers are among them) could be affected by psychological inhibitions. Their performances could slow down in such way that would affect the quality of the treatment and increase both direct and indirect costs. Our virtual reality system that is currently in use at the health care emergency center of San Martino Hospital in Genoa, Italy, has been designed and developed to check health emergency operators' capabilities to adopt correct decision-making procedures, to make optimal use of new technological equipment and to overcome psychological barriers. Our system is composed of (1) a high-end simulation PC, whose main functions are execution of the main software module, rendering of 3D scenes in stereo mode, rendering of sound, and control of data transmission from/to VR devices; (2) a low-end control PC, which controls the VR simulation running on the simulation PC, manages medical emergency simulation scenarios, introduces unexpected events to the simulation and controls the simulation difficulty level; (3) a magnetic-based motion tracking device used for head and hand tracking; (4) a wireless pair of shutter glasses together with a cathode ray tube wall projector; and (5) a high-end surround sound system. The expected benefits have been verified through the design and implementation of controlled clinical trials.

Implementation of a Sustainable Training System for Emergency in Vietnam.

Science.gov (United States)

Kang, Sunjoo; Seo, Hyejin; Ho, Binh Duy; Nguyen, Phuong Thi Anh

2018-01-01

This study analyzed the project outcomes to share lessons regarding the development of an emergency medicine education system in Vietnam. Retrospective evaluation was implemented using project outcome indicators. A total of 13 training courses were administered, with the collaboration of international experts in Korea and Vietnam. A total of 23 kinds of emergency medicine education equipment were purchased, and a basic life support (BLS) and two advanced cardiac life support labs were remodeled to provide appropriate simulation training. Throughout the 2 years of the project, nine Vietnamese BLS instructors were approved by the Korea Association of Cardiopulmonary Resuscitation under American Heart Association. Results of evaluation by Korean international development experts were based on five criteria, provided by the Development Assistance Committee of the Organization for Economic Co-operation and Development, were excellent. Success factors were identified as partnership, ownership, commitment, government support, and global networking. Project indicators were all accomplished and received an excellent evaluation by external experts. For sustainable success, healthcare policy and legal regulation to promote high quality and safe service to the Vietnamese people are recommended.

A collaborative virtual environment for training of security agents in nuclear emergencies

Energy Technology Data Exchange (ETDEWEB)

Fernandes, Sara I.; Passos, Cláudio A.; Silva, Marcio H.; Carvalho, Paulo Victor R.; Legey, Ana Paula; Mol, Antonio Carlos; Machado, Daniel M.; Cotelli, André; Rocha, Tiago L., E-mail: mol@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Departamento de Realidade Virtual

2017-07-01

In face the recently observed security menaces related to terrorist actions and natural disasters, there is a need for a major qualification and training of the agents responsible for avoid any problems regarding to abnormal conditions. In the conventional training procedures, however, field simulations are associated to logistical and operational constraints regarded to the execution of the tests which can expose the user to risk. On the other hand, the use of virtual simulations provides an alternative to such limitations besides of promote the qualifying of professionals with a great reliability. For this reason, this paper proposes the development of a collaborative virtual environment that will be used to prepare the security agents on identifying individuals suspected of carrying radioactive materials. The development of the virtual environment consisted on modeling using Autodesk 3ds Max, where the scene itself and the scene objects were modeled besides the terrain creation and basic features programming using the Game Engine Unity 3D. In the Engine Game were included radiation detectors and avatars. The security agents were able to communicate to each other by means of auxiliary external tools like a headset software that makes possible the communication, coordination and cooperation required for an effective collaboration. Experimental tests of the virtual simulations were performed with the participation of CNEN radiological protection agents and collaborators. The tests have shown that the proposed method can contribute to improve the training results of the basic collaborative skills required for a CNEN agent in an emergency situation without the need to expose him to any kind of risk. In face of that, we hope that it can contribute to minimize the demand for qualified security professionals. (author)

A collaborative virtual environment for training of security agents in nuclear emergencies

International Nuclear Information System (INIS)

Fernandes, Sara I.; Passos, Cláudio A.; Silva, Marcio H.; Carvalho, Paulo Victor R.; Legey, Ana Paula; Mol, Antonio Carlos; Machado, Daniel M.; Cotelli, André; Rocha, Tiago L.

2017-01-01

In face the recently observed security menaces related to terrorist actions and natural disasters, there is a need for a major qualification and training of the agents responsible for avoid any problems regarding to abnormal conditions. In the conventional training procedures, however, field simulations are associated to logistical and operational constraints regarded to the execution of the tests which can expose the user to risk. On the other hand, the use of virtual simulations provides an alternative to such limitations besides of promote the qualifying of professionals with a great reliability. For this reason, this paper proposes the development of a collaborative virtual environment that will be used to prepare the security agents on identifying individuals suspected of carrying radioactive materials. The development of the virtual environment consisted on modeling using Autodesk 3ds Max, where the scene itself and the scene objects were modeled besides the terrain creation and basic features programming using the Game Engine Unity 3D. In the Engine Game were included radiation detectors and avatars. The security agents were able to communicate to each other by means of auxiliary external tools like a headset software that makes possible the communication, coordination and cooperation required for an effective collaboration. Experimental tests of the virtual simulations were performed with the participation of CNEN radiological protection agents and collaborators. The tests have shown that the proposed method can contribute to improve the training results of the basic collaborative skills required for a CNEN agent in an emergency situation without the need to expose him to any kind of risk. In face of that, we hope that it can contribute to minimize the demand for qualified security professionals. (author)

Training for the Future? A Case Study of Emerging Education, Training and Development Practitioners in the South African Clothing Manufacturing Industry

Science.gov (United States)

Jones, Barbara; Cooper, Linda; McMillan, Janice

2006-01-01

This article investigates how training instructors in the South African clothing industry were prepared for their roles as Education, Training and Development Practitioners (ETDPs) by a university adult education programme. The key focus is on how these emerging ETDPs experienced their changing roles, identities and approaches to teaching and the…

Astronaut Jean-Francois Clervoy in middeck during launch/entry training

Science.gov (United States)

1994-01-01

Wearing a training version of a partial pressure suit, Astronaut Jean-Francois Clervoy, STS-66 international mission specialist, secures himself on a collapsible seat on the middeck of a shuttle trainer during a rehearsal of procedures to be followed during launch and entry phases of the scheduled November flight of STS-66. This rehearsal, held in the crew compartment trainer (CCT) of JSC's Shuttle mockup and integration laboratory, was followed by a training session on emergency egress procedures.

Hazardous materials emergency response training program at Texas A ampersand M University

International Nuclear Information System (INIS)

Stirling, A.G.

1989-01-01

The Texas Engineering Extension Service (TEEX) as the engineering vocational training arm of the Texas A ampersand M University system has conducted oil-spill, hazardous-material, and related safety training for industry since 1976 and fire suppression training since 1931. In 1987 TEEX conducted training for some 66,000 persons, of which some 6000 were in hazardous-materials safety training and 22,000 in fire suppression or related fields. Various laws and regulations exist relative to employee training at an industrial facility, such as the Hazard Communication Act, the Resource Conservation and Recovery Act (RCRA), the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA or more commonly Superfund), the Community Right to Know Law, and the Superfund Amendments and Reauthorization Act (SARA), Titles I and III. The TEEX programs developed on the foundation emphasize the hands-on approach (60% field exercises) to provide a comprehensive training curriculum resulting in regulatory compliance, an effective emergency response capability, a prepared community, and a safe work environment

Simulation training for emergency obstetric and neonatal care in Senegal preliminary results.

Science.gov (United States)

Gueye, M; Moreira, P M; Faye-Dieme, M E; Ndiaye-Gueye, M D; Gassama, O; Kane-Gueye, S M; Diouf, A A; Niang, M M; Diadhiou, M; Diallo, M; Dieng, Y D; Ndiaye, O; Diouf, A; Moreau, J C

2017-06-01

To describe a new training approach for emergency obstetric and neonatal care (EmONC) introduced in Senegal to strengthen the skills of healthcare providers. The approach was based on skills training according to the so-called "humanist" method and on "lifesaving skills". Simulated practice took place in the classroom through 13 clinical stations summarizing the clinical skills needed for EmONC. Evaluation took place in all phases, and the results were recorded in a database to document the progress of each learner. This approach was used to train 432 providers in 10 months and to document the increase in each participants' technical achievements. The combination of training with the "learning by doing" model ensured that providers learned and mastered all EmONC skills and reduced the missed learning opportunities observed in former EmONC training sessions. Assessing the impact of training on EmONC indicators and introducing this learning modality in basic training are the two major challenges we currently face.

A study of advanced training technology: Emerging answers to tough questions

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-03-01

This study reports the result of an extensive nationwide review of military, private sector, and other federal agencies and organizations that are implementing a wide variety of advanced training technologies. This report classifies the general categories of advanced training technologies found and provides an overview of each, including specific types and examples. In addition, the research findings present an organizational model for training development linking overall organizational maturity to readiness to implement specific kinds of advanced training technologies. It also presents proposed methods for selecting media, describes the organizations and the data gathered, and provides a summary of implementation success at each organization. This study is organized as a set of five topics. Each topic raises a number of important questions and provides complete or emerging answers. For organizations who have made advanced training selections, this study is a resource to benchmark their success with other organizations who have made similar selections. For new or developing training organizations, this study will help plan their future technology selections by comparing their level of organizational maturity to the documented experiences of similar organizations.

NRC influences on nuclear training

International Nuclear Information System (INIS)

Hannon, J.N.

1987-01-01

NRC influences on utility training programs through prescriptive requirements and evaluation of industry self-initiatives are discussed. NRC regulation and industry initiatives are complimentary and in some instances industry initiatives are replacing NRC requirements. Controls and feedback mechanisms designed to enhance positive NRC influences and minimize or eliminate negative influences are discussed. Industry and NRC efforts to reach an acceptable mix between regulator oversight and self-initiatives by the industry are recognized. Problem areas for continued cooperation to enhance training and minimize conflicting signals to industry are discussed. These areas include: requalification examination scope and content, depth of training and examination on emergency procedures; improved learning objectives as the basis for training and examination, and severe accident training

Stimulus- and response-reinforcer contingencies in autoshaping, operant, classical, and omission training procedures in rats.

Science.gov (United States)

Atnip, G W

1977-07-01

Separate groups of rats received 500 trials of lever-press training under autoshaping (food delivery followed 10-second lever presentations, or occurred immediately following a response); operant conditioning (responding was necessary for food delivery); and classical conditioning (food followed lever presentations regardless of responding). Each group then received 500 trials on an omission procedure in which food was omitted on trials with a response. Another group received 1000 trials on the omission procedure, and a fifth group, random control, received 1000 uncorrelated presentations of lever and food. The autoshaping, operant, and classical groups reached high response levels by the end of initial training. Acquisition was fastest in the autoshaping group. Responding remained consistently low in the control group. The omission group responded at a level between the control group and the other three groups. During omission training, responding in these three groups declined to the omission-group level. During omission training, the rats continued contacting the lever frequently after lever pressing had declined. Response maintenance under omission training seems not to require topographic similarity between the response and reinforcer-elicited consummatory behaviors.

Comprehensive simulation-enhanced training curriculum for an advanced minimally invasive procedure: a randomized controlled trial.

Science.gov (United States)

Zevin, Boris; Dedy, Nicolas J; Bonrath, Esther M; Grantcharov, Teodor P

2017-05-01

There is no comprehensive simulation-enhanced training curriculum to address cognitive, psychomotor, and nontechnical skills for an advanced minimally invasive procedure. 1) To develop and provide evidence of validity for a comprehensive simulation-enhanced training (SET) curriculum for an advanced minimally invasive procedure; (2) to demonstrate transfer of acquired psychomotor skills from a simulation laboratory to live porcine model; and (3) to compare training outcomes of SET curriculum group and chief resident group. University. This prospective single-blinded, randomized, controlled trial allocated 20 intermediate-level surgery residents to receive either conventional training (control) or SET curriculum training (intervention). The SET curriculum consisted of cognitive, psychomotor, and nontechnical training modules. Psychomotor skills in a live anesthetized porcine model in the OR was the primary outcome. Knowledge of advanced minimally invasive and bariatric surgery and nontechnical skills in a simulated OR crisis scenario were the secondary outcomes. Residents in the SET curriculum group went on to perform a laparoscopic jejunojejunostomy in the OR. Cognitive, psychomotor, and nontechnical skills of SET curriculum group were also compared to a group of 12 chief surgery residents. SET curriculum group demonstrated superior psychomotor skills in a live porcine model (56 [47-62] versus 44 [38-53], Ppsychomotor skills in the live porcine model and in the OR in a human patient (56 [47-62] versus 63 [61-68]; P = .21). SET curriculum group demonstrated inferior knowledge (13 [11-15] versus 16 [14-16]; P<.05), equivalent psychomotor skill (63 [61-68] versus 68 [62-74]; P = .50), and superior nontechnical skills (41 [38-45] versus 34 [27-35], P<.01) compared with chief resident group. Completion of the SET curriculum resulted in superior training outcomes, compared with conventional surgery training. Implementation of the SET curriculum can standardize training

Planning, conduct and principal features of NPP emergency exercises in Switzerland

International Nuclear Information System (INIS)

Baggenstos, M.

1993-01-01

Emergency exercises for each NPP are required on a regular basis by the Swiss Nuclear Safety Inspectorate. The purpose of such exercises is to train the NPP staff and the on-site emergency organization in the application of the emergency procedures and the cooperation with off-site emergency teams and public authorities. The paper discusses the purpose of the emergency exercises and experiences made especially with bilateral exercises. The responsibilities for the preparation and execution of the different emergency exercises in Switzerland are explained

Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations

Science.gov (United States)

2013-01-01

Background Deaf and hard-of-hearing (Deaf/HH) individuals have been underserved before and during emergencies. This paper will assess Deaf/HH related emergency preparedness training needs for state emergency management agencies and deaf-serving community-based organizations (CBOs). Methods Four approaches were used: 1) a literature review; 2) results from 50 key informant (KI) interviews from state and territorial-level emergency management and public health agencies; 3) results from 14 KI interviews with deaf-serving CBOs in the San Francisco Bay Area; and 4) a pilot program evaluation of an emergency responder training serving the Deaf/HH in one urban community. Results Results from literature review and state and territorial level KIs indicate that there is a substantive gap in emergency preparedness training on serving Deaf/HH provided by state agencies. In addition, local KI interviews with 14 deaf-serving CBOs found gaps in training within deaf-serving CBOs. These gaps have implications for preparing for and responding to all-hazards emergencies including weather-related or earthquake-related natural disasters, terrorist attacks, and nuclear-chemical disasters. Conclusion Emergency preparedness trainings specific to responding to or promoting preparedness of the Deaf/HH is rare, even for state agency personnel, and frequently lack standardization, evaluation, or institutionalization in emergency management infrastructure. This has significant policy and research implications. Similarly, CBOs are not adequately trained to serve the needs of their constituents. PMID:23497178

Annual report of Nuclear Emergency Assistance and Training Center. April 1, 2006 - March 31, 2008

International Nuclear Information System (INIS)

2008-12-01

When a nuclear emergency occurs in Japan, the Japan Atomic Energy Agency (JAEA) provides technical support to the National government, local governments, police, fire station and license holder etc. They are Designated Public Organizations conforming to the Basic Law on Emergency Preparedness and the Basic Plan for Disaster Countermeasures. The Nuclear Emergency Assistance and Training Center (NEAT) of JAEA provides a comprehensive range of technical support activities to an off-site center in case of a nuclear emergency. Specifically, NEAT gives technical advice and information, provides for the dispatch of specialist as required, supplies emergency equipments and materials to the Joint Council of Nuclear Disaster Countermeasures, which meets at the off-site center. NEAT provide various lectures and training course concerning nuclear disaster prevention for those personnel taking an active part in emergency response organizations at normal time. And NEAT researches on nuclear disaster prevention and also cooperate with international organizations. This annual report summarized the activities of JAEA/NEAT in the fiscal year 2006 and 2007. (author)

Development of a virtual reality training system. An application to emergency response in radioactive materials transport

International Nuclear Information System (INIS)

Watabe, Naohito

2003-01-01

A virtual reality (VR) training system was developed for the purpose of confirming the applicability of virtual reality on training systems for emergency response of radioactive materials transport. This system has following features; 1) Accident scenarios were derived from an event tree analysis. 2) Instructors can edit the training scenario. 3) Three VR scenes were prepared: vehicle and equipment checks, vehicle travel on an expressway, and emergency response in a tunnel fire accident. 4) every action by users is recorded automatically. 5) Instructors and users hold briefing session after the training, and they can review and confirm the results with VR animation. 6) A support database is provided for the convenience of users. The applicability of the system was validated through some trial applications and demonstrations. (author)

Cytogenetic Dosimetry: Applications in Preparedness for and Response to Radiation Emergencies - Training Materials

International Nuclear Information System (INIS)

2013-01-01

These materials are designed for use at a four day training course on the application of cytogenetic dosimetry in preparedness for and response to radiation emergencies. They contain information on: (1) Basics of biological effects of ionizing radiation: Parts 1+2; (2) Basics of dosimetry; (3) dicentric assay; (4) Retrospective dosimetry by translocation analysis; (5) Premature chromosome condensation analysis; (6) Cytokinesis block micronucleus assay; (7) Applied statistics for biodosimetry; (8) Automatic analysis of chromosomal assays; (9) Biodosimetry in mass casualty events; (10) Safety of laboratory staff and quality programmes; (11) Examples of accident investigations; (12) Cytogenetic dose estimation in the criticality accident in Tokaimura; (13) Radiological accidents in Latin America; (14) Radiological accidents in Georgia. Additionally, the CD contains two working sessions with the reference materials for use and a standard training programme. This training course consists of lectures and work sessions that can easily be utilized by a State to build a basic capability in biodosimetry application in a nuclear or radiological emergency

[Out-of-hospital pediatric emergencies. Perception and assessment by emergency physicians].

Science.gov (United States)

Eich, C; Roessler, M; Timmermann, A; Heuer, J F; Gentkow, U; Albrecht, B; Russo, S G

2009-09-01

Out-of-hospital (OOH) pediatric emergencies have a relatively low prevalence. In Germany the vast majority of cases are attended by non-specialized emergency physicians (EPs) for whom these are not routine procedures. This may lead to insecurity and fear. However, it is unknown how EPs perceive and assess pediatric emergencies and how they could be better prepared for them. All active EPs (n=50) of the Department of Anaesthesiology, Emergency and Intensive Care Medicine at the University Medical Centre of Göttingen were presented with a structured questionnaire in order to evaluate their perception and assessment of OOH pediatric emergencies. The 43 participating EPs made highly detailed statements on the expected characteristics of OOH pediatric emergencies. Their confidence level grew with the children's age (pemergencies. They felt the greatest deficits were in the care of infrequent but life-threatening emergencies. Three educational groups can be differentiated: knowledge and skills to be gained with children in hospital, clinical experience from adult care also applicable in children and rare diagnoses and interventions to be trained with manikins or simulators.

Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training.

Science.gov (United States)

Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

2015-01-01

Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training

Directory of Open Access Journals (Sweden)

Ada Hindle

2015-01-01

Full Text Available Introduction. Web-based learning (WBL is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

Evaluation of staff cultural awareness before and after attending cultural awareness training in an Australian emergency department.

Science.gov (United States)

Chapman, Rose; Martin, Catherine; Smith, Tammy

2014-10-01

Cultural awareness of emergency department staff is important to ensure delivery of appropriate health care to people from all ethnic groups. Cultural awareness training has been found to increase knowledge about other cultures and is widely used as a means of educating staff, however, debate continues as to the effectiveness of these programs. To determine if an accredited cultural awareness training program affected emergency department staff knowledge, familiarity, attitude of and perception towards Australian Aboriginal and Torres Strait Islander people. One group pre-test and post-test intervention study compared the cultural awareness of 44 emergency department staff towards Aboriginal and Torres Strait Islander people before and after training. The cultural awareness training was delivered in six hours over three sessions and was taught by an accredited cultural awareness trainer. The cultural awareness training changed perception but did not affect attitude towards Aboriginal and Torres Strait Islander people in this group. Future strategies to improve staff cultural awareness need to be investigated, developed, implemented and evaluated. Copyright © 2013 Elsevier Ltd. All rights reserved.

Table-top trainings in radiation protection. Educational element or emergency planning?

International Nuclear Information System (INIS)

Stolar, A.

2009-01-01

Education plays an important role in emergency management to prepare members of all levels of management for the worst case scenario. The mission that organizations have to deal with, is based on the application of fundamental knowledge, accumulated know-how and knowledge of the intersections and abilities of the participating organizations. An effective, safe and resource-saving way to get effective help in preparing disasters are table-top trainings. What great warlords helped to win centuries ago, is now increasingly anchored on a statutory basis and introduced in the emergency planning. (orig.)

Investigation of a Reinforcement-Based Toilet Training Procedure for Children with Autism.

Science.gov (United States)

Cicero, Frank R.; Pfadt, Al

2002-01-01

This study evaluated the effectiveness of a reinforcement-based toilet training intervention with three children with autism. Procedures included positive reinforcement, graduated guidance, scheduled practice trials, and forward prompting. All three children reduced urination accidents to zero and learned to request bathroom use spontaneously…

The BWR [Boiling Water Reactor] Emergency Operating Procedures Tracking System (EOPTS): Evaluation by control-room operating crews

International Nuclear Information System (INIS)

Spurgin, A.J.; Orvis, D.D.; Spurgin, J.P.; Luna, C.J.

1990-05-01

This report presents the results of a project sponsored by the Electric Power Research Institute (EPRI) and Taiwan Power Company (TPC) and conducted by APG and TPC to perform evaluation of the Emergency Operating Procedures Tracking System (EOPTS). The EOPTS is an expert system employing artificial intelligence techniques developed by EPRI for Boiling Water Reactor (BWR) plants based on emergency operating procedures (EOPs). EOPTS is a computerized decision aid used to assist plant operators in efficient and reliable use of EOPs. The main objective of this project was to evaluate the EOPTS and determine how an operator aid of this type could noticeably improve the response time and the reliability of control room crews to multi-failure scenarios. A secondary objective was to collect data on how crew performance was affected. Experiments results indicate that the EOPTS measurably improves crew performance over crews using the EOP flow charts. Time-comparison measurements indicate that crews using the EOPTS perform required actions more quickly than do those using the flowcharts. The results indicate that crews using the EOPTS are not only faster and more consistent in their actions but make fewer errors. In addition, they have a higher likelihood of recovering from the errors that they do make. Use of the EOPTS in the control room should result in faster termination and mitigation of accidents and reduced risk of power plant operations. Recommendations are made towards possible applications of the EOPTS to operator training and evaluation, and for the applicability of the evaluation methodology developed for this project to the evaluation of similar operator aides. 17 refs., 14 figs., 14 tabs

Core Competencies or a Competent Core? A Scoping Review and Realist Synthesis of Invasive Bedside Procedural Skills Training in Internal Medicine.

Science.gov (United States)

Brydges, Ryan; Stroud, Lynfa; Wong, Brian M; Holmboe, Eric S; Imrie, Kevin; Hatala, Rose

2017-11-01

Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training. The authors systematically searched Medline, Embase, the Cochrane Library, and ERIC through April 2015. Studies were screened in three phases; all reviews were performed independently and in duplicate. The authors extracted information on learner and patient demographics, study design and methodological quality, and details of training interventions and measured outcomes. A three-step realist synthesis was performed to synthesize findings on each study's context, mechanism, and outcome, and to identify a foundational training model. From an initial 6,671 studies, 149 studies were further reduced to 67 (45%) reporting sufficient information for realist synthesis. Analysis yielded four types of procedural skills training interventions. There was relative consistency across contexts and significant differences in mechanisms and outcomes across the four intervention types. The medical procedural service was identified as an adaptable foundational training model. The observed heterogeneity in procedural skills training implies that programs are not consistently developing residents who are competent in core procedures. The findings suggest that researchers in education and quality improvement will need to collaborate to design training that develops a "competent core" of proceduralists using simulation and clinical rotations.

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.)

Working safely in gamma radiography. A training manual for industrial radiographers

International Nuclear Information System (INIS)

McGuire, S.A.; Peabody, C.A.

1982-09-01

This manual is designed for classroom training in working safely in industrial radiography using gamma sources. The purpose is to train radiographers' assistants to work safely as a qualified gamma radiographer. The contents cover the essentials of radiation, radiation protection, emergency procedures, gamma cameras, and biological effects of radiation

Astronaut Curtis Brown on flight deck mockup during training

Science.gov (United States)

1994-01-01

Astronaut Curtis L. Brown, STS-66 pilot, mans the pilot's station during a rehearsal of procedures to be followed during the launch and entry phases of their scheduled November 1994 flight. This rehearsal, held in the crew compartment trainer (CCT) of JSC's Shuttle mockup and integration laboratory, was followed by a training session on emergency egress procedures.

Augmented Reality as a Telemedicine Platform for Remote Procedural Training.

Science.gov (United States)

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-10-10

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor's hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers' perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

Augmented Reality as a Telemedicine Platform for Remote Procedural Training

Science.gov (United States)

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-01-01

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform. PMID:28994720

Augmented Reality as a Telemedicine Platform for Remote Procedural Training

Directory of Open Access Journals (Sweden)

Shiyao Wang

2017-10-01

Full Text Available Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER through mixed reality capture (MRC and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

40 CFR 265.16 - Personnel training.

Science.gov (United States)

2010-07-01

... hazardous waste man-age-ment procedures (including con-tin-gen-cy plan implementation) rel-e-vant to the... facility employees that receive emergency response training pursuant to Occupational Safety and Health... hazardous waste management, and the name of the employee filling each job; (2) A written job description for...

STS-54 Astronaut Crew Emergency Egress Training, Press Q&A, TCDT

Science.gov (United States)

1992-01-01

The crew of STS-54, Commander John H. Casper, Pilot Donald R. McMonagle, and Mission Specialists Mario Runco, Jr., Gregory J. Harbaugh, and Susan J. Helms, is seen during a question and answer session with the press and during the Terminal Countdown and Demonstration Test (TCDT), including Emergency Egress Training.

A Simulation Learning Approach to Training First Responders for Radiological Emergencies

International Nuclear Information System (INIS)

Sanders, Robert Lon; Rhodes, Graham S.

2007-01-01

This paper describes the application of simulation learning technology, popularized by the emerging serious games industry, for training first responders to properly act in the event of a radiological emergency. Using state-of-the-art video game production tools and runtime engines as an enabling technology, simulation learning combines interactive virtual worlds based on validated engineering models with engaging storylines and scenarios that invoke the emotional response-and the corresponding human stress level-that first responders would encounter during a real-world emergency. For the application discussed here, in addition to providing engaging instruction about the fundamentals of radiological environments and the proper usage of radiological equipment, simulation learning prepares first responders to perform effectively under high stress and enables them to practice in teams

Training of the IMIS-emergency mode by the German Meterological Service

International Nuclear Information System (INIS)

Steinkopff, Th.; Mirsch, M.; Dyck, W.

2003-01-01

Due to a set of general administrative regulations for the ''Integrated Measuring and Information System for the Monitoring of Radioactivity in the Environment'' the measuring programmes for the normal mode and the emergency mode have a different design. In case of an emergency the results of the meteorological prognosis and the measuring data provide a first input for the calculation of the dosis. The capability to change from normal mode to emergency mode without difficulties should therefore be guaranteed. Only continuously operated exercises give a tool to test the organisation and the working-procedures in an emergency mode. The integration of all the different working-units is documented in an emergency programme. In the frame of an exercise of three days in 2002 valuable results have been experienced. The exercise took into account real meteorological data. Requirements for the further optimization were the result of this exercise. (orig.)

Implementation of a Sustainable Training System for Emergency in Vietnam

Directory of Open Access Journals (Sweden)

Sunjoo Kang

2018-01-01

Full Text Available PurposeThis study analyzed the project outcomes to share lessons regarding the development of an emergency medicine education system in Vietnam.MethodsRetrospective evaluation was implemented using project outcome indicators.ResultsA total of 13 training courses were administered, with the collaboration of international experts in Korea and Vietnam. A total of 23 kinds of emergency medicine education equipment were purchased, and a basic life support (BLS and two advanced cardiac life support labs were remodeled to provide appropriate simulation training. Throughout the 2 years of the project, nine Vietnamese BLS instructors were approved by the Korea Association of Cardiopulmonary Resuscitation under American Heart Association. Results of evaluation by Korean international development experts were based on five criteria, provided by the Development Assistance Committee of the Organization for Economic Co-operation and Development, were excellent. Success factors were identified as partnership, ownership, commitment, government support, and global networking.ConclusionProject indicators were all accomplished and received an excellent evaluation by external experts. For sustainable success, healthcare policy and legal regulation to promote high quality and safe service to the Vietnamese people are recommended.

EDA-EMERGE : An FP7 initial training network to equip the next generation of young scientists with the skills to address the complexity of environmental contamination with emerging pollutants

NARCIS (Netherlands)

Brack, Werner; Govender, Selvan; Schulze, Tobias; Krauss, Martin; Hu, Meng; Muz, Melis; Hollender, Juliane; Schirmer, Kristin; Schollee, Jennifer; Hidasi, Anita; Slobodnik, Jaroslav; Rabova, Zuzana; Ait-Aissa, Selim; Sonavane, Manoj; Carere, Mario; Lamoree, Marja; Leonards, Pim; Tufi, Sara; Ouyang, Xiyu; Schriks, Merijn; Thomas, Kevin; De Almeida, Ana Catarina; Froment, Jean; Hammers-Wirtz, Monika; Ahel, Marijan; Koprivica, Sanja; Hollert, Henner; Seiler, Thomas Benjamin; Di Paolo, Carolina; Tindall, Andrew; Spirhanzlova, Petra

2013-01-01

The initial training network consortium novel tools in effect-directed analysis to support the identification and monitoring of emerging toxicants on a European scale (EDA-EMERGE) was formed in response to the seventh EU framework program call to train a new generation of young scientists (13 PhD

Epidemiologic comparison of injured high school basketball athletes reporting to emergency departments and the athletic training setting.

Science.gov (United States)

Fletcher, Erica N; McKenzie, Lara B; Comstock, R Dawn

2014-01-01

Basketball is a popular US high school sport with more than 1 million participants annually. To compare patterns of athletes with basketball-related injuries presenting to US emergency departments from 2005 through 2010 and the high school athletic training setting from the 2005-2011 seasons. Descriptive epidemiology study. Data from the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission and the High School Reporting Information Online database. Complex sample weights were used to calculate national estimates of basketball-related injuries for comparison. Adolescents from 13 to 19 years of age treated in US emergency departments for basketball-related injuries and athletes from 13 to 19 years of age from schools participating in High School Reporting Information Online who were injured while playing basketball. Nationally, an estimated 1,514,957 (95% confidence interval = 1,337,441, 1,692,474) athletes with basketball-related injuries reported to the emergency department and 1,064,551 (95% confidence interval = 1,055,482, 1,073,620) presented to the athletic training setting. Overall, the most frequent injuries seen in the emergency department were lacerations and fractures (injury proportion ratios [IPRs] = 3.45 and 1.72, respectively), whereas those seen in the athletic training setting were more commonly concussions and strains/sprains (IPRs = 2.23 and 1.19, respectively; all P values training setting (IPR = 1.18; all P values basketball players presenting for treatment in the emergency department and the athletic training setting. Understanding differences specific to clinical settings is crucial to grasping the full epidemiologic and clinical picture of sport-related injuries. Certified athletic trainers play an important role in identifying, assessing, and treating athletes with sport-related injuries who might otherwise present to clinical settings with higher costs, such as the emergency department.

Working safely in gamma radiography. A training manual for industrial radiographers

Energy Technology Data Exchange (ETDEWEB)

McGuire, S.A.; Peabody, C.A.

1982-09-01

This manual is designed for classroom training in working safely in industrial radiography using gamma sources. The purpose is to train radiographers' assistants to work safely as a qualified gamma radiographer. The contents cover the essentials of radiation, radiation protection, emergency procedures, gamma cameras, and biological effects of radiation. (ACR)

Annual report of Nuclear Emergency Assistance and Training Center. April 1, 2013 - March 31, 2014

International Nuclear Information System (INIS)

Sato, Takeshi; Muto, Shigeo; Akiyama, Kiyomitsu; Aoki, Kazufumi; Okamoto, Akiko; Kawakami, Takeshi; Kume, Nobuhide; Nakanishi, Chika; Koie, Masahiro; Kawamata, Hiroyuki; Nemotouchi, Toshimasa; Saito, Toru; Kato, Tadashi; Sumiya, Akio; Yamamoto, Kazuya; Sato, Sohei; Sumiya, Akihiro; Okuno, Hiroshi; Yoshida, Hiroshi; Kikuchi, Masayuki; Matsusaka, Masaru

2015-02-01

The Japan Atomic Energy Agency, which will be abbreviated as JAEA hereafter, was assigned as a designated public institution under the Disaster Countermeasures Basic Act and under the Armed Attack Situations Response Act. Based on these Acts, the JAEA has the responsibility of providing technical support to the national government and/or local governments in case of disaster responses or response in the event of a military attack, etc. In order to fulfill the tasks, the JAEA has established the Emergency Action Plan and the Civil Protection Action Plan. In case of a nuclear emergency, the Nuclear Emergency Assistance and Training Center (NEAT) dispatches specialists of JAEA, supplies the national government and local governments with emergency equipment and materials, and gives technical advice and information. In normal time, NEAT provides various exercises and training courses concerning nuclear disaster prevention to those personnel taking an active part in emergency response institutions of the national and local governments, police, fire fighters, self-defense forces, etc. in addition to the JAEA itself. The NEAT also researches nuclear disaster preparedness and response, and cooperates with international organizations. In the FY2013, the NEAT accomplished the following tasks: (1) Technical support activities as a designated public institution in cooperation with the national and local governments, etc. (2) Human resource development, exercise and training of nuclear emergency response personnel for the national and local governments, etc. (3) Researches on nuclear disaster preparedness and response, and sending useful information. (4) International contributions to Asian countries on nuclear disaster preparedness and response in collaboration with the international organizations. (author)

The Effectiveness of Group Training of Procedural Emotion Regulation Strategies in Cognitive Coping of Individuals Suffering Substance Abuse

Directory of Open Access Journals (Sweden)

ali ghaedniay jahromi

2015-02-01

Full Text Available Objective: The aim of this study was to examine the effectiveness of group training of procedural emotion regulation strategies in cognitive coping of individuals suffering substance abuse. Method: A quasi-experimental design along with pretest-posttest and control group was used for this study. Then, 16 patients suffering substance abuse were selected through convenience sampling and were randomly assigned to two control and experimental groups. The experimental group received 10 sessions of group training of procedural emotion regulation strategies while the control group received no treatment. Both groups before and after the treatment completed the Persian version of cognitive emotion regulation questionnaire (Hasani, 2011. Results: The results showed that group training of e procedural motion regulation strategies leads to a reduction in maladaptive strategies such as self-blame, rumination, catastrophizing, and other-blame and an increase in adaptive strategies such as refocus on planning, positive reappraisal, and perspective development. Conclusion: Training of procedural emotion regulation strategies via the reduction of maladaptive and increase of adaptive cognitive emotion regulation strategies can provide the opportunity for the improvement and non-return to substance abuse.

Virtual reality: emerging role of simulation training in vascular access.

Science.gov (United States)

Davidson, Ingemar J A; Lok, Charmaine; Dolmatch, Bart; Gallieni, Maurizio; Nolen, Billy; Pittiruti, Mauro; Ross, John; Slakey, Douglas

2012-11-01

Evolving new technologies in vascular access mandate increased attention to patient safety; an often overlooked yet valuable training tool is simulation. For the end-stage renal disease patient, simulation tools are effective for all aspects of creating access for peritoneal dialysis and hemodialysis. Based on aviation principles, known as crew resource management, we place equal emphasis on team training as individual training to improve interactions between team members and systems, cumulating in improved safety. Simulation allows for environmental control and standardized procedures, letting the trainee practice and correct mistakes without harm to patients, compared with traditional patient-based training. Vascular access simulators range from suture devices, to pressurized tunneled conduits for needle cannulation, to computer-based interventional simulators. Simulation training includes simulated case learning, root cause analysis of adverse outcomes, and continual update and refinement of concepts. Implementation of effective human to complex systems interaction in end-stage renal disease patients involves a change in institutional culture. Three concepts discussed in this article are as follows: (1) the need for user-friendly systems and technology to enhance performance, (2) the necessity for members to both train and work together as a team, and (3) the team assigned to use the system must test and practice it to a proficient level before safely using the system on patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Resource Conservation and Recovery Act (RCRA) new-employee training manual for the Operations Division RCRA personnel

Energy Technology Data Exchange (ETDEWEB)

Barkenbus, B.D.

1987-03-01

This manual has been prepared for the training of new employees who will work with RCRA hazardous waste management in the Operations Division. It will be taught by a person who is trained in hazardous waste regulations/procedures. It consists of nine modules. The topics of these modules are: RCRA Training, Hazardous Waste Regulations, Transportation Regulations, Hazardous Waste Management at ORNL, Chemical Hazards and Safety, Hazardous Waste Operations Training, Sampling of Hazardous Waste, Hazardous Waste Identification/Classification, and RCRA Contingency Plans and Emergency Procedures. The on-the-job training areas are identified in the modules. They are an integral part of training.

Three-year emergency medicine training program in The Netherlands: first evaluation from the residents' perspective.

Science.gov (United States)

Koning, Salomon Willem; Gaakeer, Menno Iskander; Veugelers, Rebekka

2013-07-26

The Netherlands' 3-year training in Emergency Medicine (EM) was formally approved and introduced in November 2008. To identify areas for improvement, we conducted the first evaluation of this curriculum from the residents' perspective. A questionnaire was composed on ten aspects of the curriculum. It contained multiple-choice, open and opinion questions; answers to the latter were classified using the Likert scale. The questionnaires were mailed to all enrolled residents. We mailed questionnaires to all 189 enrolled residents, and 105 responded (55.6%). Although they were satisfied with their training overall, 96.2% thought it was currently too short: 18.3% desired extension to 4 years, 76.0% to 5 and 1.9% to 6 years. Nevertheless, residents expected that they would function effectively as emergency physicians (EPs) after finishing their 3-year training program. Bedside teaching was assessed positively by 35.2%. All rotations were assessed positively, with the general practice rotation seen as contributing the least to the program. According to 43.7%, supervising EPs were available for consultation; 40.7% thought that, in a clinical capacity, the EP was sufficiently present during residents' shifts. When EPs were present, 82.5% found them to be easily accessible, and 66.6% viewed them as role models. In the Emergency Medicine Departments (EDs) with a higher number of EPs employed, residents tended to perceive better supervision and were more likely to see their EPs as role models. While residents were stimulated to do research, actual support and assistance needed to be improved. Although overall, the current training program was evaluated positively, the residents identified four areas for improvement: (1) in training hospitals, trained EPs should be present more continuously for clinical supervision; (2) bedside teaching should be improved, (3) scientific research should be facilitated more and (4) the training program should be extended.

Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.

Science.gov (United States)

Branzetti, Jeremy B; Adedipe, Adeyinka A; Gittinger, Matthew J; Rosenman, Elizabeth D; Brolliar, Sarah; Chipman, Anne K; Grand, James A; Fernandez, Rosemarie

2017-11-01

A subset of high-risk procedures present significant safety threats due to their (1) infrequent occurrence, (2) execution under time constraints and (3) immediate necessity for patient survival. A Just-in-Time (JIT) intervention could provide real-time bedside guidance to improve high-risk procedural performance and address procedural deficits associated with skill decay. To evaluate the impact of a novel JIT intervention on transvenous pacemaker (TVP) placement during a simulated patient event. This was a prospective, randomised controlled study to determine the effect of a JIT intervention on performance of TVP placement. Subjects included board-certified emergency medicine physicians from two hospitals. The JIT intervention consisted of a portable, bedside computer-based procedural adjunct. The primary outcome was performance during a simulated patient encounter requiring TVP placement, as assessed by trained raters using a technical skills checklist. Secondary outcomes included global performance ratings, time to TVP placement, number of critical omissions and System Usability Scale scores (intervention only). Groups were similar at baseline across all outcomes. Compared with the control group, the intervention group demonstrated statistically significant improvement in the technical checklist score (11.45 vs 23.44, p<0.001, Cohen's d effect size 4.64), the global rating scale (2.27 vs 4.54, p<0.001, Cohen's d effect size 3.76), and a statistically significant reduction in critical omissions (2.23 vs 0.68, p<0.001, Cohen's d effect size -1.86). The difference in time to procedural completion was not statistically significant between conditions (11.15 min vs 12.80 min, p=0.12, Cohen's d effect size 0.65). System Usability Scale scores demonstrated excellent usability. A JIT intervention improved procedure perfromance, suggesting a role for JIT interventions in rarely performed procedures. © Article author(s) (or their employer(s) unless otherwise stated in

Limitations of subjective cognitive load measures in simulation-based procedural training.

Science.gov (United States)

Naismith, Laura M; Cheung, Jeffrey J H; Ringsted, Charlotte; Cavalcanti, Rodrigo B

2015-08-01

The effective implementation of cognitive load theory (CLT) to optimise the instructional design of simulation-based training requires sensitive and reliable measures of cognitive load. This mixed-methods study assessed relationships between commonly used measures of total cognitive load and the extent to which these measures reflected participants' experiences of cognitive load in simulation-based procedural skills training. Two groups of medical residents (n = 38) completed three questionnaires after participating in simulation-based procedural skills training sessions: the Paas Cognitive Load Scale; the NASA Task Load Index (TLX), and a cognitive load component (CLC) questionnaire we developed to assess total cognitive load as the sum of intrinsic load (how complex the task is), extraneous load (how the task is presented) and germane load (how the learner processes the task for learning). We calculated Pearson's correlation coefficients to assess agreement among these instruments. Group interviews explored residents' perceptions about how the simulation sessions contributed to their total cognitive load. Interviews were audio-recorded, transcribed and subjected to qualitative content analysis. Total cognitive load scores differed significantly according to the instrument used to assess them. In particular, there was poor agreement between the Paas Scale and the TLX. Quantitative and qualitative findings supported intrinsic cognitive load as synonymous with mental effort (Paas Scale), mental demand (TLX) and task difficulty and complexity (CLC questionnaire). Additional qualitative themes relating to extraneous and germane cognitive loads were not reflected in any of the questionnaires. The Paas Scale, TLX and CLC questionnaire appear to be interchangeable as measures of intrinsic cognitive load, but not of total cognitive load. A more complete understanding of the sources of extraneous and germane cognitive loads in simulation-based training contexts is

Computer Simulation Model to Train Medical Personnel on Glucose Clamp Procedures.

Science.gov (United States)

Maghoul, Pooya; Boulet, Benoit; Tardif, Annie; Haidar, Ahmad

2017-10-01

A glucose clamp procedure is the most reliable way to quantify insulin pharmacokinetics and pharmacodynamics, but skilled and trained research personnel are required to frequently adjust the glucose infusion rate. A computer environment that simulates glucose clamp experiments can be used for efficient personnel training and development and testing of algorithms for automated glucose clamps. We built 17 virtual healthy subjects (mean age, 25±6 years; mean body mass index, 22.2±3 kg/m 2 ), each comprising a mathematical model of glucose regulation and a unique set of parameters. Each virtual subject simulates plasma glucose and insulin concentrations in response to intravenous insulin and glucose infusions. Each virtual subject provides a unique response, and its parameters were estimated from combined intravenous glucose tolerance test-hyperinsulinemic-euglycemic clamp data using the Bayesian approach. The virtual subjects were validated by comparing their simulated predictions against data from 12 healthy individuals who underwent a hyperglycemic glucose clamp procedure. Plasma glucose and insulin concentrations were predicted by the virtual subjects in response to glucose infusions determined by a trained research staff performing a simulated hyperglycemic clamp experiment. The total amount of glucose infusion was indifferent between the simulated and the real subjects (85±18 g vs. 83±23 g; p=NS) as well as plasma insulin levels (63±20 mU/L vs. 58±16 mU/L; p=NS). The virtual subjects can reliably predict glucose needs and plasma insulin profiles during hyperglycemic glucose clamp conditions. These virtual subjects can be used to train personnel to make glucose infusion adjustments during clamp experiments. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Health and Safety Procedures Manual for hazardous waste sites

Energy Technology Data Exchange (ETDEWEB)

Thate, J.E.

1992-09-01

The Oak Ridge National Laboratory Chemical Assessments Team (ORNL/CAT) has developed this Health and Safety Procedures Manual for the guidance, instruction, and protection of ORNL/CAT personnel expected to be involved in hazardous waste site assessments and remedial actions. This manual addresses general and site-specific concerns for protecting personnel, the general public, and the environment from any possible hazardous exposures. The components of this manual include: medical surveillance, guidance for determination and monitoring of hazards, personnel and training requirements, protective clothing and equipment requirements, procedures for controlling work functions, procedures for handling emergency response situations, decontamination procedures for personnel and equipment, associated legal requirements, and safe drilling practices.

Health Care Personnel’s Awareness, Attitudes and Implementations About Emergency Contraception and other Family Planning Procedures

Directory of Open Access Journals (Sweden)

Gül PINAR

2005-09-01

Full Text Available OBJECTIVE: The purpose of this study is to determine health care personnel’s awareness, attitudes and implementations about emergency contraception and other family planning procedures Design: 50 physicians and 100 nurses, who had accepted to participate in the questionnaire, Setting: Ankara Etlik Maternity Hospital Interventions: Questionnaire was performed amoung 50 physicians and 100 nurses, who had accepted to participate. In the questionnaire, in addition to questions developed by researchers which focus on sociodemographic backgrounds of the health care personnel, questions aiming at revealing awareness, attitudes and implementations about emergency contraception and other family planning procedures. Main outcome measures: Data were analyzed by SPSS. A x_ test was used and percent were determined. The threshold of significance was defined as p\tplanning procedures of the health care personnel.

The role of musical training in emergent and event-based timing

Directory of Open Access Journals (Sweden)

Lawrence eBaer

2013-05-01

Full Text Available Musical performance is thought to rely predominantly on event-based timing involving a clock-like neural process and an explicit internal representation of the time interval. Some aspects of musical performance may rely on emergent timing, which is established through the optimization of movement kinematics, and can be maintained without reference to any explicit representation of the time interval. We predicted that musical training would have its largest effect on event-based timing, supporting the dissociability of these timing processes and the dominance of event-based timing in musical performance. We compared 22 musicians and 17 non-musicians on the prototypical event-based timing task of finger tapping and on the typically emergently timed task of circle drawing. For each task, participants first responded in synchrony with a metronome (Paced and then responded at the same rate without the metronome (Unpaced. Analyses of the Unpaced phase revealed that non-musicians were more variable in their inter-response intervals for finger tapping compared to circle drawing. Musicians did not differ between the two tasks. Between groups, non-musicians were more variable than musicians for tapping but not for drawing. We were able to show that the differences were due to less timer variability in musicians on the tapping task. Correlational analyses of movement jerk and inter-response interval variability revealed a negative association for tapping and a positive association for drawing in non-musicians only. These results suggest that musical training affects temporal variability in tapping but not drawing. Additionally, musicians and non-musicians may be employing different movement strategies to maintain accurate timing in the two tasks. These findings add to our understanding of how musical training affects timing and support the dissociability of event-based and emergent timing modes.

Developments in the preparation of operating procedures for emergency conditions of nuclear power plants

International Nuclear Information System (INIS)

1985-06-01

In recent years a substantial effort has been devoted by the nuclear community to extend Emergency Operating Procedures (EOPs) to cover all conceivable events and to develop procedure formats that transmit the essential guidance to operators in an optimum way. The information given in this report is based upon the most recent developments in formulating and applying EOPs. It should therefore provide guidance to those involved in preparing or reviewing EOPs on the scope, technical basis, organization and format of such procedures. It also outlines the actions required to validate the adequacy and applicability of these procedures so that the correct operator actions are achieved. Examples are given to illustrate the developments in some Member States

Volcanic risk and tourism in southern Iceland: Implications for hazard, risk and emergency response education and training

Science.gov (United States)

Bird, Deanne K.; Gisladottir, Gudrun; Dominey-Howes, Dale

2010-01-01

This paper examines the relationship between volcanic risk and the tourism sector in southern Iceland and the complex challenge emergency management officials face in developing effective volcanic risk mitigation strategies. An early warning system and emergency response procedures were developed for communities surrounding Katla, the volcano underlying the Mýrdalsjökull ice cap. However, prior to and during the 2007 tourist season these mitigation efforts were not effectively communicated to stakeholders located in the tourist destination of Þórsmörk despite its location within the hazard zone of Katla. The hazard zone represents the potential extent of a catastrophic jökulhlaup (glacial outburst flood). Furthermore, volcanic risk mitigation efforts in Þórsmörk were based solely on information derived from physical investigations of volcanic hazards. They did not consider the human dimension of risk. In order to address this gap and provide support to current risk mitigation efforts, questionnaire surveys were used to investigate tourists' and tourism employees' hazard knowledge, risk perception, adoption of personal preparedness measures, predicted behaviour if faced with a Katla eruption and views on education. Results indicate that tourists lack hazard knowledge and they do not adopt preparedness measures to deal with the consequences of an eruption. Despite a high level of risk perception, tourism employees lack knowledge about the early warning system and emergency response procedures. Results show that tourists are positive about receiving information concerning Katla and its hazards and therefore, the reticence of tourism employees with respect to disseminating hazard information is unjustified. In order to improve the tourism sector's collective capacity to positively respond during a future eruption, recommendations are made to ensure adequate dissemination of hazard, risk and emergency response information. Most importantly education campaigns

Astronaut Scott Parazynski in hatch of CCT during training

Science.gov (United States)

1994-01-01

Astronaut Scott E. Parazynski, STS-66 mission specialist, poses near the hatchway of the crew compartment trainer (CCT) (out of frame) in JSC's Shuttle mockup and integration laboratory. Crew members were about to begin a rehearsal of procedures to be followed during the launch and entry phases of their flight. That rehearsal was followed by a training session on emergency egress procedures.

The training needs of Turkish emergency department personnel regarding intimate partner violence

Science.gov (United States)

Aksan, H Asli Davas; Aksu, Feride

2007-01-01

Background Violence against females is a widespread public health problem in Turkey and the lifetime prevalence of IPV ranges between 34 and 58.7%. Health care workers (HCW) sometimes have the unique opportunity and obligation to identify, treat, and educate females who are abused. The objective of this study was to evaluate the knowledge, attitudes, and experiences of the emergency department (ED) staff regarding intimate partner violence (IPV) at a large university hospital in Turkey. Methods A cross-sectional study was conducted in a large university hospital via questionnaire. The study population consisted of all the nurses and physicians who worked in the ED during a two month period (n = 215). The questionnaire response rate was 80.5% (41 nurses and 132 physicians). The main domains of the questionnaire were knowledge regarding the definition of IPV, clinical findings in victims of IPV, legal aspects of IPV, attitudes towards IPV, knowledge about the characteristics of IPV victims and abusers, and professional and personal experiences and training with respect to IPV. Results One-half of the study group were females, 76.3% were physicians, and 89.8% had no training on IPV. The majority of the nurses (89.5%) and physicians (71.1%) declared that they were aware of the clinical appearance of IPV. The mean of the knowledge scores on clinical knowledge were 8.84 ± 1.73 (range, 0–10) for acute conditions, and 4.51 ± 3.32 for chronic conditions. The mean of the knowledge score on legal procedures and the legal rights of the victims was 4.33 ± 1.66 (range, 0–7). At least one reason to justify physical violence was accepted by 69.0% of females and 84.7% of males, but more males than females tended to justify violence (chi square = 5.96; p = 0.015). However, both genders accepted that females who experienced physical violence should seek professional medical help. Conclusion The study participants' knowledge about IPV was rather low and a training program is

Examining the importance of incorporating emergency preparedness and disaster training core competencies into allied health curricula.

Science.gov (United States)

Curtis, Tammy

2015-01-01

Preparation for responding to emergency events that does not warrant outside help beyond the local community resources or responding to disaster events that is beyond the capabilities of the local community both require first responders and healthcare professionals to have interdisciplinary skills needed to function as a team for saving lives. To date, there is no core emergency preparedness and disaster planning competencies that have been standardized at all levels across the various allied health curricula disciplines. To identify if emergency preparedness and disaster training content are currently being taught in allied health program courses, to identify possible gaps within allied health curricula, and to explore the perceptions of allied health college educators for implementing emergency preparedness and disaster training core competencies into their existing curricula, if not already included. A quantitative Internet-based survey was conducted in 2013. Convenient sample. Fifty-one allied health college educators completed the survey. Descriptive statistics indicated that the majority of allied health college instructors do not currently teach emergency preparedness and disaster training core competency content within their current allied health discipline; however, their perceived level of importance for inclusion of the competencies was high. The results of this study supported the need for developing and establishing a basic national set of standardized core emergency preparedness and disaster planning competencies at all levels across various allied health curricula disciplines to ensure victims receive the best patient care and have the best possible chance of survival.

Early prototype assessment of a new virtual system for training procedural skills of automotive service operators: LARTE tool

NARCIS (Netherlands)

Borsci, Simone; Lawson, Glyn; Burgess, Mark; Jha, Bhavna; Kurosu, Masaaki

2015-01-01

The consortium of the Innovate UK funded Live Augmented Reality Training Environments (LARTE) project, composed of Jaguar Land Rover (JLR), Holovis International Ltd and The University of Nottingham, developed a new concept of a 3D multiplatform training system to train the procedural skills of

A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments

NARCIS (Netherlands)

van Lonkhuijzen, L.; Dijkman, A.; van Roosmalen, J.; Zeeman, G.; Scherpbier, A.

Background Training of healthcare workers can play an important role in improving quality of care, and reducing maternal and perinatal mortality and morbidity. Objectives To assess the effectiveness of training programmes aimed at improving emergency obstetric care in low-resource environments.

Guidelines for Induction and Intubation Sequence Fast in Emergency Service

OpenAIRE

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

2012-01-01

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

Managing Obstetric Emergencies and Trauma (MOET structured skills training in Armenia, utilising models and reality based scenarios

Directory of Open Access Journals (Sweden)

Israelyan Musheg

2002-05-01

Full Text Available Abstract Background Mortality rates in Western Europe have fallen significantly over the last 50 years. Maternal mortality now averages 10 maternal deaths per 100,000 live births but in some of the Newly Independent States of the former Soviet Union, the ratio is nearly 4 times higher. The availability of skilled attendants to prevent, detect and manage major obstetric complications may be the single most important factor in preventing maternal deaths. A modern, multidisciplinary, scenario and model based training programme has been established in the UK (Managing Obstetric Emergencies and Trauma (MOET and allows specialist obstetricians to learn or revise the undertaking of procedures using models, and to have their skills tested in scenarios. Methods Given the success of the MOET course in the UK, the organisers were keen to evaluate it in another setting (Armenia. Pre-course knowledge and practice questionnaires were administered. In an exploratory analysis, post-course results were compared to pre-course answers obtained by the same interviewer. Results All candidates showed an improvement in post-course scores. The range was far narrower afterwards (167–188 than before (85–129.5. In the individual score analysis only two scenarios showed a non-significant change (cord prolapse and breech delivery. Conclusion This paper demonstrates the reliability of the model based scenarios, with a highly significant improvement in obstetric emergency management. However, clinical audit will be required to measure the full impact of training by longer term follow up. Audit of delays, specific obstetric complications, referrals and near misses may all be amenable to review.

Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

International Nuclear Information System (INIS)

Park, Jinkyun; Jeong, Kwangsup; Jung, Wondea

2005-01-01

In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operators' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration

Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

Energy Technology Data Exchange (ETDEWEB)

Park, Jinkyun [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of)]. E-mail: kshpjk@kaeri.re.kr; Jeong, Kwangsup [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of); Jung, Wondea [Integrated Safety Assessment Division, Korea Atomic Energy Research Institute, P.O. Box 105, Duckjin-Dong, Yusong-Ku, Taejon 305-600 (Korea, Republic of)

2005-08-01

In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operators' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration.

Identifying cognitive complexity factors affecting the complexity of procedural steps in emergency operating procedures of a nuclear power plant

Energy Technology Data Exchange (ETDEWEB)

Jinkyun Park; Kwangsup Jeong; Wondea Jung [Korea Atomic Energy Research Institute, Taejon (Korea). Integrated Safety Assessment Division

2005-08-15

In complex systems such as a nuclear and chemical plant, it is well known that the provision of understandable procedures that allow operators to clarify what needs to be done and how to do it is one of the requisites to secure their safety. As a previous study in providing understandable procedures, the step complexity (SC) measure that can quantify the complexity of procedural steps in emergency operating procedures (EOPs) of a nuclear power plant (NPP) was suggested. However, the necessity of additional complexity factors that can consider a cognitive aspect in evaluating the complexity of procedural steps is raised. To this end, the comparisons between operator' performance data measured by the form of a step performance time with their behavior in carrying out the prescribed activities of procedural steps are conducted in this study. As a result, two kinds of complexity factors (the abstraction level of knowledge and the level of engineering decision) that could affect an operator's cognitive burden are identified. Although a well-designed experiment is indispensable for confirming the appropriateness of the additional complexity factors, it is strongly believed that the change of operators' performance data can be more authentically explained if the additional complexity factors are taken into consideration. (author)

Evaluation of Procedural Simulation as a Training and Assessment Tool in General Surgery

DEFF Research Database (Denmark)

Bjerrum, Flemming; Strandbygaard, Jeanett; Rosthøj, Susanne

2017-01-01

BACKGROUND: Laparoscopic appendectomy is a commonly performed surgical procedure, but few training models have been described for it. We examined a virtual reality module for practising a laparoscopic appendectomy. METHODS: A prospective cohort study with the following 3 groups of surgeons (n = 45...

Development of knowledge tests for multi-disciplinary emergency training

DEFF Research Database (Denmark)

Sorensen, J. L.; Thellesen, L.; Strandbygaard, J.

2015-01-01

and evaluating a multiple-choice question(MCQ) test for use in a multi-disciplinary training program inobstetric-anesthesia emergencies. Methods: A multi-disciplinary working committee with 12members representing six professional healthcare groups andanother 28 participants were involved. Recurrent revisions......, 40 out of originally50 items were included in the final MCQ test. The MCQ test wasable to distinguish between levels of competence, and good con-struct validity was indicated by a significant difference in the meanscore between consultants and first-year trainees, as well as betweenfirst...

Development of a VR training system of robotic peroral operation procedure for endoscopic surgery of digestive tracts

International Nuclear Information System (INIS)

Suzuki, Naoki; Hattori, Asaki; Tanoue, Kazuo; Ieiri, Satoshi; Konishi, Kozo; Tomikawa, Morimasa; Kenmotsu, Hajime; Hashizume, Makoto

2010-01-01

This report presents the development of a VR (virtual real) training system of robotic peroral operation procedure for endoscopic resection of gastric mucosa as the training is essential because the procedure differs from usual one hitherto. For VR operation space, used is reporters' sphere-filled organ model (SFM), which is deformed by and repels to, the outside force as a soft tissue rapidly in the real time. The deformation and repellence are computable. The SFM space is reconstructed to 3D of the inner environment of stomach using MRI data. The endoscope has, at the right and left side of its top, 2 arms of inner needle knife-equipped robotic forceps and is inserted perorally for operation. In VR, the forceps can grab the gastric mucosa, cut it with the knife to complete resection and carry the specimen out of the body. For the procedure training, the time required for hemostasis, bleeding volume, trace of the arms, intensity and direction of the outer force given are recorded, with which trainee's safety and degree of skill are evaluable in VR. Hydration step and clipping to close the wound are to be further added in the procedure. (T.T.)

Relational Discrimination by Pigeons in a Go/No-Go Procedure with Compound Stimuli: A Methodological Note

Science.gov (United States)

Campos, Heloisa Cursi; Debert, Paula; Barros, Romariz da Silva; McIlvane, William J.

2011-01-01

A go/no-go procedure with compound stimuli typically establishes emergent behavior that parallels in structure and typical outcome that of conventional tests for symmetric, transitive, and equivalence relations in normally capable adults. The present study employed a go/no-go compound stimulus procedure with pigeons. During training, pecks to…

Mental workload measurement for emergency operating procedures in digital nuclear power plants.

Science.gov (United States)

Gao, Qin; Wang, Yang; Song, Fei; Li, Zhizhong; Dong, Xiaolu

2013-01-01

Mental workload is a major consideration for the design of emergency operation procedures (EOPs) in nuclear power plants. Continuous and objective measures are desired. This paper compares seven mental workload measurement methods (pupil size, blink rate, blink duration, heart rate variability, parasympathetic/sympathetic ratio, total power and (Goals, Operations, Methods, and Section Rules)-(Keystroke Level Model) GOMS-KLM-based workload index) with regard to sensitivity, validity and intrusiveness. Eighteen participants performed two computerised EOPs of different complexity levels, and mental workload measures were collected during the experiment. The results show that the blink rate is sensitive to both the difference in the overall task complexity and changes in peak complexity within EOPs, that the error rate is sensitive to the level of arousal and correlate to the step error rate and that blink duration increases over the task period in both low and high complexity EOPs. Cardiac measures were able to distinguish tasks with different overall complexity. The intrusiveness of the physiological instruments is acceptable. Finally, the six physiological measures were integrated using group method of data handling to predict perceived overall mental workload. The study compared seven measures for evaluating the mental workload with emergency operation procedure in nuclear power plants. An experiment with simulated procedures was carried out, and the results show that eye response measures are useful for assessing temporal changes of workload whereas cardiac measures are useful for evaluating the overall workload.

Effects of a training workshop on suicide prevention among emergency room nurses.

Science.gov (United States)

Kishi, Yasuhiro; Otsuka, Kotaro; Akiyama, Keiko; Yamada, Tomoki; Sakamoto, Yumiko; Yanagisawa, Yaeko; Morimura, Hiroshi; Kawanishi, Chiaki; Higashioka, Hiroaki; Miyake, Yasushi; Thurber, Steven

2014-01-01

Suicide attempts are frequently encountered by emergency department nurses. Such encounters can potentially provide a foundation for secondary suicide prevention. The aim of the present investigation was to evaluate the effect of a 7-hr training program for emergency room nursing personnel in Japan. In all, 52 nurses completed the questionnaires before the workshop and 1 month after the workshop. The nurses' understanding of and willingness to care for suicidal patients positively changed. It is feasible to provide a 7-hr, relatively short, workshop on suicidal prevention aimed at emergency medical staff and to improve attitudes during a follow-up of 1 month. It is uncertain whether the positive attitudes of emergency nurses toward suicide and/or educational interventions could impact the outcomes of these interventions. Further studies are needed to address these important questions in this field.

Annual report of Nuclear Emergency Assistance and Training Center. April 1, 2010 - March 31, 2011

International Nuclear Information System (INIS)

Katagiri, Hiromi; Okuno, Hiroshi; Sawahata, Masayoshi; Ikeda, Takeshi; Sato, Sohei; Terakado, Naoya; Nagakura, Tomohiro; Nakanishi, Chika; Fukumoto, Masahiro; Yamamoto, Kazuya; Abe, Minako; Kawakami, Takeshi; Kikuchi, Masayuki; Sumiya, Akihiro; Matsusaka, Masaru

2011-12-01

When a nuclear emergency occurs in Japan, the Japan Atomic Energy Agency (JAEA) has the responsibility of providing technical support to the National government, local governments, police, fire station and license holders etc., because the JAEA is designated a Public Organization conforming to the Basic Law on Emergency Preparedness and the Basic Plan for Disaster Countermeasures. The Nuclear Emergency Assistance and Training Center (NEAT) of JAEA provides a comprehensive range of technical support activities to an Off-Site Center in case of a nuclear emergency. Specifically, NEAT gives technical advice and information, dispatch specialists as required, supplies emergency equipment and materials to the National Government and local governments. NEAT provides various lectures and training courses concerning nuclear disaster prevention for those personnel taking an active part in emergency response organizations at normal time. NEAT also researches on nuclear disaster prevention and cooperates with international organizations. Concerning about the assistance to the Accident of Fukushima No.1 Nuclear Power Station caused by the Great East Japan Earthquake at 11 March, 2011, JAEA assisted activities including environmental radiation monitoring, environmental radioactivity analyses, resident public consulting etc., with its full scale effort. NEAT served as the center of these supporting activities of JAEA. This annual report summarized these activities of JAEA/NEAT in the fiscal year 2010. (author)

Emergency operating procedures guidelines for pressurized water reactors - a progress report

International Nuclear Information System (INIS)

Lyon, W.C.

1984-01-01

Emergency Operating Procedures (EOPs) contain the instructions the operator will follow to control a nuclear plant whenever a condition exists that potentially jeopardizes the fuel cladding, the reactor coolant system (RCS) pressure boundary, or the containment. The EOPs are prepared from guidelines which contain the major operator instructions that will be in the EOPs. Guidelines have been prepared by owners' groups having Babcock and Wilcox (BandW), Combustion Engineering (CE), General Electric (GE), and Westinghouse (W) plants. These guidelines cover many aspects of full power operation. Future effort is anticipated to complete coverage of transient events, including severe accidents, all power conditions, and shutdown. This paper describes the philosophy which has guided NRC technical review of guidelines, progress achieved in providing comprehensive coverage of emergency conditions for PWRs, and anticipated future technical activities

Regulation of the State Office of Nuclear Safety No. 318/2002 of 13 June 2002 specifying details to ensure emergency preparedness of nuclear facilities and workplaces handling ionizing radiation sources, and requirements for the contents of internal emergency plans and emergency rules

International Nuclear Information System (INIS)

2002-01-01

The Regulation addresses the following issues: definition of a radiological event and interventions to be accomplished if a radiological event takes place; emergency preparedness; establishing a radiological event; assessment of a radiological event; warnings, notifications and alarms during a radiological event; intervention - management, procedures, instructions; radiological situation monitoring programme; provisions to restrict human exposure; health care provisions; documentation; informing the State Office of Nuclear Safety; personnel instructions and training; emergency preparedness inspection; internal emergency plan; emergency rules; and related issues. This Regulation supersedes Regulation No. 219/1997. (P.A.)

Matrix Training of Receptive Language Skills with a Toddler with Autism Spectrum Disorder: A Case Study

Science.gov (United States)

Curiel, Emily S. L.; Sainato, Diane M.; Goldstein, Howard

2016-01-01

Matrix training is a systematic teaching approach that can facilitate generalized language. Specific responses are taught that result in the emergence of untrained responses. This type of training facilitates the use of generalized language in children with autism spectrum disorder (ASD). This study used a matrix training procedure with a toddler…

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

Science.gov (United States)

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-07-22

The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.

How many training modalities are needed to obtain procedural confidence in intraosseous access?

DEFF Research Database (Denmark)

Hallas, Peter; Folkestad, Lars; Brabrand, Mikkel

2011-01-01

Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology...

The psychological effects of widespread emergencies and a first responder training course on a violent, developing community

Directory of Open Access Journals (Sweden)

Jared H. Sun

2011-12-01

Conclusion: Violence and emergencies are having a deep, negative impact on the psychology of the Cape Flats’ community members. First responder training is one intervention that can provide stress relief to the community, increase the likeliness community members will help each other during an emergency, and increase their confidence while helping. This was true even for those who were not trained voluntarily, and the more a trainee learned in the course the more likely they improved in initiative and confidence.

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.

Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians

Directory of Open Access Journals (Sweden)

Sanjeev Bhoi

2012-01-01

Full Text Available Background: Patients require procedural sedation and analgesia (PSA for the treatment of acute traumatic injuries. PSA has complications. Ultrasound (US guided peripheral nerve block is a safe alternative. Aim: Ultrasound guided nerve blocks for management of traumatic limb emergencies in Emergency Department (ED. Setting and Design: Prospective observational study conducted in ED. Materials and Methods: Patients above five years requiring analgesia for management of limb emergencies were recruited. Emergency Physicians trained in US guided nerve blocks performed the procedure. Statistical analysis: Effectiveness of pain control, using visual analogue scale was assessed at baseline and at 15 and 60 minutes after the procedure. Paired t test was used for comparison. Results: Fifty US guided nerve blocks were sciatic- 4 (8%, femoral-7 (14%, brachial- 29 (58%, median -6 (12%, and radial 2 (4% nerves. No patients required rescue PSA. Initial median VAS score was 9 (Inter Quartile Range [IQR] 7-10 and at 1 hour was 2(IQR 0-4. Median reduction in VAS score was 7.44 (IQR 8-10(75%, 1-2(25% (P=0.0001. Median procedure time was 9 minutes (IQR 3, 12 minutes and median time to reduction of pain was 5 minutes (IQR 1,15 minutes. No immediate or late complications noticed at 3 months. Conclusion: Ultrasound-guided nerve blocks can be safely and effectively performed for upper and lower limb emergencies by emergency physicians with adequate training.

Novice to expert practice via postprofessional athletic training education: a grounded theory.

Science.gov (United States)

Neibert, Peter J

2009-01-01

To discover the theoretic constructs that confirm, disconfirm, or extend the principles and their applications appropriate for National Athletic Trainers' Association (NATA)-accredited postprofessional athletic training education programs. Interviews at the 2003 NATA Annual Meeting & Clinical Symposia. Qualitative study using grounded theory procedures. Thirteen interviews were conducted with postprofessional graduates. Participants were purposefully selected based on theoretic sampling and availability. The transcribed interviews were analyzed using open coding, axial coding, and selective coding procedures. Member checks, reflective journaling, and triangulation were used to ensure trustworthiness. The participants' comments confirmed and extended the current principles of postprofessional athletic training education programs and offered additional suggestions for more effective practical applications. The emergence of this central category of novice to expert practice is a paramount finding. The tightly woven fabric of the 10 processes, when interlaced with one another, provides a strong tapestry supporting novice to expert practice via postprofessional athletic training education. The emergence of this theoretic position pushes postprofessional graduate athletic training education forward to the future for further investigation into the theoretic constructs of novice to expert practice.

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

Preparedness of fire safety in underground train station: Comparison between train operators in Malaysia with other operators from the developed countries

Science.gov (United States)

Tajedi, Noor Aqilah A.; Sukor, Nur Sabahiah A.; Ismail, Mohd Ashraf M.; Shamsudin, Shahrul A.

2017-10-01

The purpose of this paper is to compare the fire evacuation plan and preparation at the underground train stations in the different countries. The methodology for this study was using the extended questionnaire survey to investigate the Rapid Rail Sdn Bhd, Malaysia's fire safety plan and preparation at the underground train stations. There were four sections in the questionnaire which included (i) background of the respondents, (ii) the details on the train stations, safety instruction and fire evacuation exercises (iii) technical systems, installation and equipment at the underground stations and (iv) procedures and technical changes related to fire safety that had been applied by the operators. Previously, the respondents from the different train operator services in the developed countries had completed the questionnaires. This paper extends the response from the Rapid Rail Sdn Bhd to compare the emergency procedures and preparation for fire event with the developed countries. As a result, this study found that the equipment and facilities that provided at the underground train stations that operated by Rapid Rail are relevant for fire safety procedures and needs. The main advantage for Rapid Rail is the underground stations were designed with two or more entrances/exits that may perform better evacuation compare to one main entrance/exit train stations in the other developed countries.

Measuring cognitive load during procedural skills training with colonoscopy as an exemplar.

Science.gov (United States)

Sewell, Justin L; Boscardin, Christy K; Young, John Q; Ten Cate, Olle; O'Sullivan, Patricia S

2016-06-01

Few studies have investigated cognitive factors affecting learning of procedural skills in medical education. Cognitive load theory, which focuses on working memory, is highly relevant, but methods for measuring cognitive load during procedural training are not well understood. Using colonoscopy as an exemplar, we used cognitive load theory to develop a self-report instrument to measure three types of cognitive load (intrinsic, extraneous and germane load) and to provide evidence for instrument validity. We developed the instrument (the Cognitive Load Inventory for Colonoscopy [CLIC]) using a multi-step process. It included 19 items measuring three types of cognitive load, three global rating items and demographics. We then conducted a cross-sectional survey that was administered electronically to 1061 gastroenterology trainees in the USA. Participants completed the CLIC following a colonoscopy. The two study phases (exploratory and confirmatory) each lasted for 10 weeks during the 2014-2015 academic year. Exploratory factor analysis determined the most parsimonious factor structure; confirmatory factor analysis assessed model fit. Composite measures of intrinsic, extraneous and germane load were compared across years of training and with global rating items. A total of 477 (45.0%) invitees participated (116 in the exploratory study and 361 in the confirmatory study) in 154 (95.1%) training programmes. Demographics were similar to national data from the USA. The most parsimonious factor structure included three factors reflecting the three types of cognitive load. Confirmatory factor analysis verified that a three-factor model was the best fit. Intrinsic, extraneous and germane load items had high internal consistency (Cronbach's alpha 0.90, 0.87 and 0.96, respectively) and correlated as expected with year in training and global assessment of cognitive load. The CLIC measures three types of cognitive load during colonoscopy training. Evidence of validity is

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

OpenAIRE

Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby

2013-01-01

Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...

FEMA's purchase of a radiological training package: an avoidable disaster. Twenty-Third Report by the Committee on Government Operations, Ninety-Ninth Congress, First Session, House Report 99-367, November 12, 1985

International Nuclear Information System (INIS)

Anon.

1985-01-01

A congressional study of allegations against the Federal Emergency Management Agency (FEMA) management of a training program to prepare for a transportation emergency involving radioactive materials focused on contracting procedures. The study uncovered a lack of concern on the part of the agency in its response to committee inquiries and hearings. The findings fault FEMA for noncompetitive procurement, ignoring the advice of a scientific interagency, poor training and operating procedures, and other failures involving the Bradford training package. The committee recommends a thorough review of contracting procedures and an improved relationship with the radiological technical advisors

Decontamination of skin in emergency situation

International Nuclear Information System (INIS)

Harase, Chieko

1988-01-01

The report briefly discusses the organization of decontamination personnel and facilities to be used for decontamination in the event of an emergency, and outlines the author's experience in carrying out decontamination of the skin of tourists who came back to Japan after staying in Kiev at the time of the accident at Chernobyl (about 150 km away from Kiev). In Japan at present, no nuclear facilities seem to have sufficient personnel who are in charge of skin decontamination activities required in the event of an emergency, and emergency measures are generally limited to the development of emergency plans and implementation of drills. It is necessary to establish training courses for medical doctors and other medical personnel. Each plant has plans for skin decontamination procedures designed for professional workers in the plant. Plans should also be established for general people who might suffer skin decontamination in the event of an accident. What is the most important is to ease their anxiety about the contamination of their skin. The procedures, including washing and shampooing, used for the tourist returning from Kiev are described, and some problems encountered or expected to occur in similar cases are outlined and discussed. (Nogami, K.)

Emergency preparedness and its enhancement in Japan: From perspectives of infrastructure preparation, and exercise enhancement

International Nuclear Information System (INIS)

Funahashi, T.

2010-01-01

The organizational structure, procedures and infrastructures for the nuclear emergency response were established in Japan in the aftermath of the JCO accident and have been improved through exercises, drills and training. This paper overviews the infrastructure for the emergency response prepared by JNES and exercises implemented or supported by JNES for nuclear emergency preparedness. Approaches to feeding back exercise results are also addressed. (author)

Real-Time Simulation of Ship Impact for Crew Training

DEFF Research Database (Denmark)

Simonsen, Bo Cerup

2003-01-01

Real-time simulation of marine accidents and representation in a realistic, virtual environment may be an efficient way to train emergency procedures for ship?s crews and thus improve safety at sea. However, although various fast, simplified methods have been presented over the past decades...

Using an Individual Procedure Score Before and After the Advanced Surgical Skills Exposure for Trauma Course Training to Benchmark a Hemorrhage-Control Performance Metric.

Science.gov (United States)

Mackenzie, Colin F; Garofalo, Evan; Shackelford, Stacy; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Puche, Adam; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark

2015-01-01

Test with an individual procedure score (IPS) to assess whether an unpreserved cadaver trauma training course, including upper and lower limb vascular exposure, improves correct identification of surgical landmarks, underlying anatomy, and shortens time to vascular control. Prospective study of performance of 3 vascular exposure and control procedures (axillary, brachial, and femoral arteries) using IPS metrics by 2 colocated and trained evaluators before and after training with the Advanced Surgical Skills Exposure for Trauma (ASSET) course. IPS, including identification of anatomical landmarks, incisions, underlying structures, and time to completion of each procedure was compared before and after training using repeated measurement models. Audio-video instrumented cadaver laboratory at University of Maryland School of Medicine. A total of 41 second to sixth year surgical residents from surgical programs throughout Mid-Atlantic States who had not previously taken the ASSET course were enrolled, 40 completed the pre- and post-ASSET performance evaluations. After ASSET training, all components of IPS increased and time shortened for each of the 3 artery exposures. Procedure steps performed correctly increased 57%, anatomical knowledge increased 43% and skin incision to passage of a vessel loop twice around the correct vessel decreased by a mean of 2.5 minutes. An overall vascular trauma readiness index, a comprehensive IPS score for 3 procedures increased 28% with ASSET Training. Improved knowledge of surface landmarks and underlying anatomy is associated with increased IPS, faster procedures, more accurate incision placement, and successful vascular control. Structural recognition during specific procedural steps and anatomical knowledge were key points learned during the ASSET course. Such training may accelerate acquisition of specific trauma surgery skills to compensate for shortened training hours, infrequent exposure to major vascular injuries, or when just

Review of Flight Training Technology

Science.gov (United States)

1976-07-01

the cockpit. They might be used to train pilots in procedures to cope with NOE-altitude emergencies; howeve-r, a combination of cinematic simulation...airplanes. Although cockpit motion adds realism , thereby i-nproving pilot performanc, in the simulater Fedderqon, Vil; Guercio and Wall, i7?. Ince...operations. Light aircraft, part-task trainers, motion pictures and video tares, cinematic simulators, and digital teaching machines are among the

RCRA Personnel Training, Course 7488

Energy Technology Data Exchange (ETDEWEB)

Simpson, Lewis Edward [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-01-30

Federal and state regulations require hazardous and mixed waste facility workers at treatment and storage facilities (TSFs) and <90-day accumulation areas to be trained in hazardous and mixed waste management. This course will refamiliarize and update <90-day accumulation area workers, TSF workers, and supervisors of TSF workers regarding waste identification, pollution prevention, storage area requirements, emergency response procedures, and record-keeping requirements.

When simulated environments make the difference : the effectiveness of different types of training of car service procedures

NARCIS (Netherlands)

Borsci, Simone; Lawson, Glyn; Salanitri, Davide; Jha, Bhavna

2016-01-01

An empirical analysis was performed to compare the effectiveness of different approaches to training a set of procedural skills to a sample of novice trainees. Sixty-five participants were randomly assigned to one of the following three training groups: (1) learning-by-doing in a 3D desktop virtual

Procedural sedation and analgesia practices by emergency physicians in the Netherlands: a nationwide survey

NARCIS (Netherlands)

Kuypers, Maybritt I.; Smits, Gaël J. P.; Valkenet, Suzanne C.; Thijssen, Wendy A. M. H.; Plötz, Frans B.

2017-01-01

Several efforts have been made to assure and to improve the quality of procedural sedation and analgesia (PSA) performed by emergency physicians (EPs) in The Netherlands. This study investigated the current PSA practice and competences of EPs in both adult and paediatric patients. In particular, if

Good practices with respect to the development and use of nuclear power plant procedures

International Nuclear Information System (INIS)

1998-12-01

This technical publication is intended to provide information to nuclear power plant managers concerning good practices in respect to the development and use of NPP procedures. It is a part of an ongoing project on nuclear power plant instrumentation and control and is based on lessons learned from NPPs and utilities. The overall objective of this project is to provide systematic guidance on current and emerging instrumentation and control technologies including: protection and automation systems, control rooms, operator support systems, training simulators and human factors. It is intended to be applicable to NPPs in Member States that are in operation, under construction or being commissioned. The good practices described are consistent with the IAEA Safety Series recommendations with respect to the development and use of NPP procedures including the four categories: administrative procedures, operating procedures (normal, alarm response, abnormal and emergency procedures), maintenance and technical support procedures, and testing and surveillance procedures

A Virtual Emergency Telemedicine Serious Game in Medical Training: A Quantitative, Professional Feedback-Informed Evaluation Study.

Science.gov (United States)

Nicolaidou, Iolie; Antoniades, Athos; Constantinou, Riana; Marangos, Charis; Kyriacou, Efthyvoulos; Bamidis, Panagiotis; Dafli, Eleni; Pattichis, Constantinos S

2015-06-17

Serious games involving virtual patients in medical education can provide a controlled setting within which players can learn in an engaging way, while avoiding the risks associated with real patients. Moreover, serious games align with medical students' preferred learning styles. The Virtual Emergency TeleMedicine (VETM) game is a simulation-based game that was developed in collaboration with the mEducator Best Practice network in response to calls to integrate serious games in medical education and training. The VETM game makes use of data from an electrocardiogram to train practicing doctors, nurses, or medical students for problem-solving in real-life clinical scenarios through a telemedicine system and virtual patients. The study responds to two gaps: the limited number of games in emergency cardiology and the lack of evaluations by professionals. The objective of this study is a quantitative, professional feedback-informed evaluation of one scenario of VETM, involving cardiovascular complications. The study has the following research question: "What are professionals' perceptions of the potential of the Virtual Emergency Telemedicine game for training people involved in the assessment and management of emergency cases?" The evaluation of the VETM game was conducted with 90 professional ambulance crew nursing personnel specializing in the assessment and management of emergency cases. After collaboratively trying out one VETM scenario, participants individually completed an evaluation of the game (36 questions on a 5-point Likert scale) and provided written and verbal comments. The instrument assessed six dimensions of the game: (1) user interface, (2) difficulty level, (3) feedback, (4) educational value, (5) user engagement, and (6) terminology. Data sources of the study were 90 questionnaires, including written comments from 51 participants, 24 interviews with 55 participants, and 379 log files of their interaction with the game. Overall, the results were

Training review criteria and procedures

International Nuclear Information System (INIS)

1993-01-01

This document provides direction to NRC personnel for reviewing training programs at nuclear power plants to verify compliance with the requirements of 10 CFR 50. 120 and 10 CFR 55 as applicable. It describes the process for evaluating the effectiveness of training programs, provides aids for collection of information during interviews and observations, and provides criteria for evaluating the implementation of a systems approach to training. This document is not intended to have the effect of a regulation, it establishes no binding requirements or interpretations of NRC regulations. It is intended as guidance only

Emergency Response Capability Baseline Needs Assessment Compliance Assessment

Energy Technology Data Exchange (ETDEWEB)

Sharry, John A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2013-09-16

This document is the second of a two-part analysis of Emergency Response Capabilities of Lawrence Livermore National Laboratory. The first part, 2013 Baseline Needs Assessment Requirements Document established the minimum performance criteria necessary to meet mandatory requirements. This second part analyses the performance of Lawrence Livermore Laboratory Emergency Management Department to the contents of the Requirements Document. The document was prepared based on an extensive review of information contained in the 2009 BNA, the 2012 BNA document, a review of Emergency Planning Hazards Assessments, a review of building construction, occupancy, fire protection features, dispatch records, LLNL alarm system records, fire department training records, and fire department policies and procedures.

Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol.

Science.gov (United States)

Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

2016-05-18

The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. This systematic review addresses the following question: in underserviced populations and low-resource settings (P), does first aid or emergency care training or education for laypeople (I) confer any individual or community health benefit for emergency health conditions (O), in comparison with no training or other forms of education (C)? We restrict this review to studies reporting quantitatively measurable outcomes, and search 12 electronic bibliographic databases and grey literature sources. A team of expert content and methodology reviewers will conduct title and abstract screening and full-text review, using a custom-built online platform. Two investigators will independently extract methodological variables and outcomes related to patient-level morbidity and mortality and community-level effects on resilience or emergency care capacity. Two investigators will independently assess external validity, selection bias, performance bias, measurement bias, attrition bias and confounding. We will summarise the findings using a narrative approach to highlight similarities and differences between the gathered studies. Formal ethical approval is not required. The results will be disseminated through a peer-reviewed publication and knowledge translation strategy. CRD42014009685. 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/

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

Science.gov (United States)

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

Autogenic-feedback training improves pilot performance during emergency flying conditions

Science.gov (United States)

Kellar, Michael A.; Folen, Raymond A.; Cowings, Patricia S.; Toscano, William B.; Hisert, Glen L.

1994-01-01

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group comprised three pilots of HC-130 Hercules aircraft and four HH-65 Dolphin helicopter pilots; the control group comprised three pilots of HC-130's and six Dolphin helicopter pilots. During an initial flight, physiological data were recorded for each crew member and individual crew performance was rated by an instructor pilot. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic-Feedback Training (AFT). The remaining subjects received no training. During a second flight, treatment subjects showed significant improvement in performance, while controls did not improve. The results indicate that AFT management of high states of physiological arousal may improve pilot performance during emergency flying conditions.

An international fellowship training program in pediatric emergency medicine: establishing a new subspecialty in the Land of the Dragon.

Science.gov (United States)

Goldman, Ran D; Cheng, Adam; Jarvis, Anna; Keogh, Kelly; Lu, Guo-ping; Wang, Jian-she; Kissoon, Niranjan; Larson, Charles

2011-12-01

The health care system reform in the People's Republic of China has brought plans for establishment of a universal coverage for basic health services, including services for children. This effort demands significant change in health care planning. Pediatric emergency medicine (PEM) is not currently identified as a specialty in China, and emergency medicine systems suffer from lack of appropriate training.In 2006, the Centre for International Child Health and the Department of Pediatrics, British Columbia Children's Hospital, Vancouver, Canada, initiated a fellowship training program in PEM for pediatricians working in emergency departments or critical care settings with the Children's Hospital of Fudan University, China. The main objective was to upgrade the professional and clinical experience of emergency physicians practicing PEM and build PEM capacity throughout China by training the future trainers. After selecting trainees, the program included a structured curriculum over 2 years of training in China by Canadian and Australian PEM faculty and then practical exposure to PEM in Canada. All trainees underwent a structured evaluation after their final rotation in Canada. A total of 12 trainees completed the first 2 program cycles. The trainees considered the "overall rating of the training experience" as "excellent" (10/12) or "good" (2/12). All trainees considered the program as a relevant training to their practice and felt it will change their practice. They reported the program to be effective, with excellent complexity of content. Despite its current success, the program faces challenges in the development of the new subspecialty and ensuring its acceptance among other health care providers and decision makers. Identification and preparation of a capable training force to lead educational activities in China are daunting tasks. Time constraints, funding, and language barriers are other challenges. Future effort should be focused on improving and sustaining

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

Science.gov (United States)

Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren

2009-04-01

The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must

Factors associated with patient-reported procedural memory following emergency department procedural sedation with ketamine and propofol: A prospective cohort of 563 patients.

Science.gov (United States)

Greer, Andrew; Treston, Greg

2018-04-01

To describe the proportion of patients reporting procedural memory following procedural sedation and analgesia (PSA) with ketamine and propofol (KP) administered premixed together (ketofol) or individually (sequential KP) in ED attendees. Identify any clinical or demographic variables associated with procedural memory. This was a convenience sample of 563 patients who received KP PSA as per the departmental protocol. A standardised script was used to assess for procedural memory. This was categorised as 'any' and 'unpleasant' prior to discharge (immediate memory) and at telephone follow up (delayed memory). A total of 318 patients had sequential KP and 249 premixed 1:1 ketofol. For sequential KP compared to ketofol, the proportion reporting any memory was as follows: 3.5% versus 3.3% immediate, 4.4% versus 5.5% delayed and 5.4% versus 7.4% for the sum of these. For unpleasant memory, the proportion was as follows: 1.6% versus 2.9% immediate, 1.7% versus 4.7% delayed and 2.2% versus 6.9% all unpleasant memory (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.4-8.1). Memory was associated with male sex (OR 4, 95% CI 1.5-10.5), opiates (OR 3, 95% CI 1.7-7.5), a Wisconsin Sedation Scale score ≥3 (moderate sedation) (OR 4.3, 95% CI 1.1-18.2) and propofol dose 0.75 mg/kg (13% versus 3%) (OR 6, 95% CI 1.7-21). The ketofol group had 5% (95% CI 0.1-10) more respiratory events requiring intervention. Procedural memory was uncommon for both mix types; however, a greater proportion of the premixed ketofol group had unpleasant memory. Associations with sex, opiates, moderate sedation and propofol dose were identified, and respiratory adverse events were more common in the premixed ketofol group. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Protection of school children during a radiological emergency

International Nuclear Information System (INIS)

Brenner, W.B.; Johnson, F.C.; Goodkind, M.E.

1987-01-01

The protection of children during a radiological emergency is a potential concern that clearly transcends national boundaries and is therefore international in scope. Careful planning is needed to prevent independent actions on the part of school officials and parents that, although well intended, may lead to increased risks from radiation exposure, from traffic accidents, or from panic behavior. As part of its overall support for off-site emergency preparedness program, the Commonwealth Edison Company (CECo) has recently expanded the scope of planning for the protection of students in schools near its Quad Cities Nuclear Power Station in Cordova, Illinois. Working with off-site officials and with the assistance of emergency planners from Impell Corp., CECo has developed standard operating procedures (SOPs) to direct the emergency response activities for school administrators. These SOPs establish the chain of command for implementing protective actions and list alternative precautionary actions for a range of site conditions. In addition, during the development of these SOPs, CECo has had to address the following issues: interagency cooperation and consistency in approach; resource identification for transport, reception, registration, and communication; internal school procedures; and emergency preparedness training and exercising

Procedure for the training of workers of facilities of service of the trade retailer.

Directory of Open Access Journals (Sweden)

Tania Ivón Sosa Ibarra

2011-09-01

Full Text Available The benefit of the services transforms quickly. To improve this activity is vital to reach the excellence and a fundamental element is the human factor that should be motivated and highly qualified to satisfy the necessities of the clients, of there the importance of its superación. In this investigation a training procedure is designed for workers of facilities of service of the trade that it facilitates, starting from an appropriate detection of the training necessities, to execute actions to achieve an improvement in the benefit of the services. These transformations in the superación of the workers impact significantly in their conceptions, in order to achieve the formation of a professional of the sector from the much more competent and adjusted services to the demands that it demands the current moment. The procedure is feasible of applying in all the establishments of the commercial net and it contemplates four moments: diagnostic, projection, execution and the control. It constitutes a novel experience, to the being a proposal of change and innovation in the environment of the training and the benefit of the services in the sector of the trade and it can favor the development of work values.

The Emergency Action Plan of the Spanish Nuclear Safety Council (CSN)

International Nuclear Information System (INIS)

Calvin Cuarteto, M.; Camarma, J. R.; Martin Calvarro, J. M

2007-01-01

The Spanish Nuclear safety Council (CSN) has assigned by law among others the function to coordinate the measures of support and answer to nuclear emergency situations for all the aspects related with nuclear safety and radiological protection. Integrating and coordinating the different organisations public and private companies whose aid is necessary for the fulfilment of the functions attributed to the Regulatory Body. In order to suitable perform this function, CSN has equipped itself with an Emergency Action Plan that structures the response organization, establishes responsibility levels, incorporates basic performance procedures and includes capabilities to face the nuclear and radiological emergencies considering the external supports, resulting from the collaboration agreements with public institutions and private companies. To accomplish the above mentioned Emergency Action Plan, CSN has established and implanted a formation and training and re-training program for the organization response for emergencies and has update an operative centre (Emergency Room called Salem), equipped with infrastructures, tools and communication and operative systems that incorporate the more advanced technologies available to date. (Author)

Annual report of Nuclear Emergency Assistance and Training Center. April 1, 2011 - March 31, 2012

International Nuclear Information System (INIS)

Katagiri, Hiromi; Okuno, Hiroshi; Okamoto, Akiko; Ikeda, Takeshi; Tamura, Kenichi; Nagakura, Tomohiro; Nakanishi, Chika; Yamamoto, Kazuya; Abe, Minako; Sato, Sohei; Kawakami, Takeshi; Kikuchi, Masayuki; Sumiya, Akihiro; Matsusaka, Masaru

2012-08-01

When a nuclear emergency occurs in Japan, the Japan Atomic Energy Agency (JAEA) has the responsibility of providing technical support to the National government, local governments, police, fire stations and nuclear operators etc., because the JAEA has been designated as the Designated Public Institution under the Basic Act on Disaster Control Measures and the Act on Response to Armed Attack Situations, etc.. The Nuclear Emergency Assistance and Training Center (NEAT) of JAEA provides a comprehensive range of technical support activities to an Off-Site Center in case of a nuclear emergency. Specifically, NEAT gives technical advice and information, dispatches specialists as required, and supplies the National Government and local governments with emergency equipments and materials. NEAT provides various exercise and training courses concerning nuclear disaster prevention to those personnel taking an active part in emergency response organizations at normal times. NEAT also researches on nuclear disaster prevention and cooperates with international organizations. Concerning the assistance to the Accident at Fukushima Nuclear Power Station caused by the Great East Japan Earthquake on 11 March, 2011, JAEA has assisted activities including environmental radiation monitoring, environmental radioactivity analyses, and response to telephone inquiries from residents etc., with utmost effort. NEAT has served as the center of these supporting activities of JAEA. This annual report summarized these activities of JAEA/NEAT in the fiscal year 2011. (author)

Does Sexual Assault Nurse Examiner (SANE) Training Affect Attitudes of Emergency Department Nurses Toward Sexual Assault Survivors?

Science.gov (United States)

Nielson, Mary Hugo; Strong, Linda; Stewart, Julie G

2015-01-01

There are over 243,800 female sexual assaults in the United States annually. Of those who seek healthcare services after being sexually assaulted, 90% present to hospitals. Unfortunately, care and services for women who have been sexually assaulted are inconsistent. Increased burnout, frustration, and feelings of inadequacy can lead healthcare providers to exhibit personal biases or negative attitudes toward their patients. The Joint Commission, responsible for accreditation of healthcare organizations, has stated that nurses must provide competent care to all patients. Therefore, Sexual Assault Nurse Examiner (SANE) training needs to be available for emergency department (ED) nurses who care for patients who have been sexually assaulted. A survey using the Attitude Toward Rape Victims Scale was sent to 1503 ED nurses throughout the United States, from the Emergency Nursing Association's mailing list. The results of the survey showed that there was a significant difference in attitudes toward the patients between SANE-trained emergency nurses and those without training. This study also showed that 35.5% of hospitals represented by the respondents did not have SANE services available for adult patients who had been sexually assaulted, and furthermore, 85.5% of the respondents who cared for adult patients who had been sexually assaulted were not SANE trained. The negative attitudes held toward such patients as found in this study, coupled with a lack of training provides evidence that ED nurses may benefit from education related to appropriate treatment for patients who have been sexually assaulted. As evidence-based practice becomes the gold standard of care, ensuring that nurses are properly trained to care for all patients must be the goal.

Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years.

Science.gov (United States)

Caesar, Ulla; Karlsson, Jon; Hansson, Elisabeth

2018-01-01

Emergency surgery is unplanned by definition and patients are scheduled for surgery with minimal preparation. Some patients who have sustained emergency orthopaedic trauma or other conditions must be operated on immediately or within a few hours, while others can wait until the hospital's resources permit and/or the patients' health status has been optimised as needed. This may affect the prioritisation procedures for both emergency and elective surgery and might result in waiting lists, not only for planned procedures but also for emergencies. The main purpose of this retrospective, observational, single-centre study was to evaluate and describe for the number and reasons of delays, as well as waiting times in emergency orthopaedic surgery using data derived from the hospital's records and registers. All the emergency patients scheduled for emergency surgery whose procedures were rescheduled and delayed between 1 January 2007 and 31 December 2013 were studied. We found that 24% (8474) of the 36,017 patients scheduled for emergency surgeries were delayed and rescheduled at least once, some several times. Eighty per cent of these delays were due to organisational causes. Twenty-one per cent of all the delayed patients had surgery within 24 h, whilst 41% waited for more than 24 h, up to 3 days. A large number of the clinic's emergency orthopaedic procedures were rescheduled and delayed and the majority of the delays were related to organisational reasons. The results can be interpreted in two ways; first, organisational reasons are avoidable and the potential for improvement is great and, secondly and most importantly, the delays might negatively affect patient outcomes.

Methodology for determining the value of complexity parameter for emergency situation during driving of the train

Directory of Open Access Journals (Sweden)

O. M. Horobchenko

2015-12-01

Full Text Available Purpose. During development of intelligent control systems for locomotive there is a need in the evaluation of the current train situation in the terms of traffic safety. In order to estimate the probability of the development of various emergency situations in to the traffic accidents, it is necessary to determine their complexity. The purpose of this paper is to develop the methodology for determining the complexity of emergency situations during the locomotive operation. Methodology. To achieve this purpose the statistical material of traffic safety violations was accumulated. The causes of violations are divided into groups: technical factors, human factors and external influences. Using the theory of hybrid networks it was obtained a model that gives the output complexity parameter of the emergency situation. Network type: multilayer perceptron with hybrid neurons of the first layer and the sigmoid activation function. The methods of the probability theory were used for the analysis of the results. Findings. The approach to the formalization of manufacturing situations that can only be described linguistically was developed, that allowed to use them as input data to the model for emergency situation. It was established and proved that the exponent of complexity for emergency situation during driving the train is a random quantity and obeys to the normal distribution law. It was obtained the graph of the cumulative distribution function, which identified the areas for safe operation and an increased risk of accident. Originality. It was proposed theoretical basis for determining the complexity of emergency situations in the train work and received the maximum complexity value of emergency situations that can be admitted in the operating conditions. Practical value. Constant monitoring of this value allows not only respond to the threat of danger, but also getting it in numerical form and use it as one of the input parameters for the

Interdisciplinary Development of an Improved Emergency Department Procedural Work Surface Through Iterative Design and Use Testing in Simulated and Clinical Environments.

Science.gov (United States)

Zhang, Xiao C; Bermudez, Ana M; Reddy, Pranav M; Sarpatwari, Ravi R; Chheng, Darin B; Mezoian, Taylor J; Schwartz, Victoria R; Simmons, Quinneil J; Jay, Gregory D; Kobayashi, Leo

2017-03-01

surface and just-in-time training on its use when performing bedside procedures. Subjects completed the validated 10-point System Usability Scale postshift for the surface that they had used. The study protocol was approved by the institutional review board. Multiple prototypes and recursive design revisions resulted in a fully functional, portable, and durable bedside procedural surface that featured a stainless steel tray and intuitive hook-and-lock mechanisms for attachment to ED stretcher bed rails. Forty-two control and 40 experimental group subjects participated and completed questionnaires. The median System Usability Scale score (out of 100; higher scores associated with better usability) was 72.5 (interquartile range [IQR] 51.3 to 86.3) for the Mayo stand; the experimental surface was scored at 93.8 (IQR 84.4 to 97.5 for a difference in medians of 17.5 (95% confidence interval 10 to 27.5). Subjects reported several usability challenges with the Mayo stand; the experimental surface was reviewed as easy to use, simple, and functional. In accordance with experimental live environment deployment, questionnaire responses, and end-user suggestions, the project team finalized the design specification for the experimental procedural surface for open dissemination. An iterative, interdisciplinary approach was used to generate, evaluate, revise, and finalize the design specification for a new procedural surface that met all core end-user requirements. The final surface design was evaluated favorably on a validated usability tool against Mayo stands when use tested in simulated and live clinical settings. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses.

Science.gov (United States)

Edwards, Courtney; Jones, Jodi

2018-01-01

Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care. The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time. Administrative program development required creating a nursing practice statement, procedure guideline, operational plan, and competency validation. A training program comprising both didactic and hands-on training was developed and provided by emergency medicine physicians with formal ultrasound fellowship training. In determining whether the training program was adequate in preparing the student to place an ultrasound-guided PIV, 92.9% of students "agreed" or "strongly agreed." In having confidence in their ability to obtain an ultrasound guided PIV catheter placement, 35.7% of respondents "agreed" and 64.3% "strongly agreed." In finding it difficult to be successful in achieving ultrasound guided PIV catheter placement, 71.4% of students "strongly disagreed" and 14.3% "disagreed." All students (100%) felt it was a feasible task to train nurses to successfully place ultrasound-guided PIV catheters and 71.4% of students strongly support continuing to provide this training program and competency validation. Establishment of an effective didactic and hands-on training program resulted in emergency department nurses becoming competent in placement of ultrasound guided PIV catheters to provide optimal patient care. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Multidisciplinary team training in a simulation setting for acute abstetric emergencies : a systematic review

NARCIS (Netherlands)

Merién, A.E.R.; Ven, van de J.; Mol, B.W.J.; Houterman, S.; Oei, S.G.

2010-01-01

OBJECTIVE: To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. DATA SOURCES: We searched Medline, Embase, and the Cochrane Library from

Multidisciplinary Team Training in a Simulation Setting for Acute Obstetric Emergencies A Systematic Review

NARCIS (Netherlands)

Merién, A. E. R.; van de Ven, J.; Mol, B. W.; Houterman, S.; Oei, S. G.

2010-01-01

OBJECTIVE: To perform a systematic review of the literature on the effectiveness of multidisciplinary teamwork training in a simulation setting for the reduction of medical adverse outcomes in obstetric emergency situations. DATA SOURCES: We searched Medline, Embase, and the Cochrane Library from

State of emergency medicine in Azerbaijan.

Science.gov (United States)

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-04-01

There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the "specialty" model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. The Emergency Medicine Development Initiative (EMDI) of the International Medical Corps (IMC) was designed to improve the quality of emergency care in four pilot regional centers in Azerbaijan. The objective of this study was to assess the baseline emergency medical capacity of these four centers. EMDI staff conducted a four-part baseline survey in April 2006 to assess emergency care in Ganja (the second largest city in Azerbaijan), Kurdamir, Shamkir and Yevlakh. Data collection involved interviews with relevant personnel and a retrospective records review in each city. Pre-hospital: The number of ambulance teams per 10,000 inhabitants is below the number required by local regulations. On average, 45% of 27 medications and 37% of 17 pieces of critical equipment were available. Of the emergency procedures, 21% could be performed in the pre-hospital setting. In-hospital: Admission rates were near 100% for the admissions department-an area that is supposed to function as an emergency department would. On average 57% of 40 medications and 42% of 22 pieces of critical equipment were available. Of the emergency procedures, 62% could be performed in the in-hospital setting. The emergency medical system surveyed in Azerbaijan is inefficiently organized, under-financed, poorly equipped and lacks adequately trained staff. Reforms need to be directed towards achieving international standards, while adapting new models for service delivery into the existing framework and improving system capacity as highlighted by this baseline

Radiological Emergency Response Health and Safety Manual

Energy Technology Data Exchange (ETDEWEB)

D. R. Bowman

2001-05-01

This manual was created to provide health and safety (H&S) guidance for emergency response operations. The manual is organized in sections that define each aspect of H and S Management for emergency responses. The sections are as follows: Responsibilities; Health Physics; Industrial Hygiene; Safety; Environmental Compliance; Medical; and Record Maintenance. Each section gives guidance on the types of training expected for managers and responders, safety processes and procedures to be followed when performing work, and what is expected of managers and participants. Also included are generic forms that will be used to facilitate or document activities during an emergency response. These ensure consistency in creating useful real-time and archival records and help to prevent the loss or omission of information.

The Effects of Listener Training on the Emergence of Categorization and Speaker Behavior in Children with Autism

Science.gov (United States)

Kobari-Wright, Vissy V.; Miguel, Caio F.

2014-01-01

We evaluated the effects of listener training on the emergence of categorization and speaker behavior (i.e., tacts) using a nonconcurrent multiple baseline design. Four children with autism learned to select pictures given their dictated category names. We assessed whether they could match and tact pictures by category. After training, 3…

Relation between task complexity and variability of procedure progression during an emergency operation

International Nuclear Information System (INIS)

Kim, Yochan; Park, Jinkyun; Jung, Wondea

2013-01-01

Highlights: • The relation between task complexity and the variability of procedure progression was investigated. • The two quantitative measures, TACOM and VPP, were applied to this study. • The task complexity was positively related with the operator’s procedural variability. • The VPP measure can be useful for explaining the operator’s behaviors. - Abstract: In this study, the relation between task complexity and variability of procedure progression during an emergency operation was investigated by comparing the two quantitative measures. To this end, the TACOM measure and VPP measure were applied to evaluate the complexity of tasks and variability of procedure progression, respectively. The TACOM scores and VPP scores were obtained for 60 tasks in the OPERA database, and a correlation analysis between two measures and a multiple regression analysis between the sub-measures of the TACOM measure and VPP measure were conducted. The results showed that the TACOM measure is positively associated with the VPP measure, and the abstraction hierarchy complexity mainly affected the variability among the sub-measures of TACOM. From these findings, it was discussed that the task complexity is related to an operator’s procedural variability and VPP measure can be useful for explaining the operator’s behaviors

Training and training simulators for emergency situations in France

International Nuclear Information System (INIS)

Petit, G.

1990-01-01

The aim of this paper is to present principles and means set up by Electricite de France (E.D.F.) to provide the required tailor-made training. Today, recent advantages in computing capacities and software engineering along with the completion of Research and Development Training Division programs in the reactor safety (R+D) field (CATHARE, BETHSY..) give E.D.F. the opportunity to conceive and operate new tools for training which are described in the paper: RTGV-SEPIA: a simulator devoted to self training in SGTR field, thanks to a powerful expert system. SIPA: a 'generator of simulators' aiming at control and engineering studies and training, provided with a software able to give in real time a relevant description of complex topologies with diphasic flow patterns (up to a 12'' break in the primary coolant system of a reactor). (orig./DG) [de