Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

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

2016-08-09

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

Mass-casualty events at schools: a national preparedness survey.

Science.gov (United States)

Graham, James; Shirm, Steve; Liggin, Rebecca; Aitken, Mary E; Dick, Rhonda

2006-01-01

Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.

Basic Disaster Life Support (BDLS) Training Improves First Responder Confidence to Face Mass-Casualty Incidents in Thailand.

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Kuhls, Deborah A; Chestovich, Paul J; Coule, Phillip; Carrison, Dale M; Chua, Charleston M; Wora-Urai, Nopadol; Kanchanarin, Tavatchai

2017-10-01

Medical response to mass-casualty incidents (MCIs) requires specialized training and preparation. Basic Disaster Life Support (BDLS) is a course designed to prepare health care workers for a MCI. The purpose of this study was to evaluate the confidence of health care professionals in Thailand to face a MCI after participating in a BDLS course. Basic Disaster Life Support was taught to health care professionals in Thailand in July 2008. Demographics and medical experience were recorded, and participants rated their confidence before and after the course using a five-point Likert scale in 11 pertinent MCI categories. Survey results were compiled and compared with PBasic Disaster Life Support significantly improves confidence to respond to MCI situations, but nurses and active duty military benefit the most from the course. Future courses should focus on these groups to prepare for MCIs. Kuhls DA , Chestovich PJ , Coule P , Carrison DM , Chua CM , Wora-Urai N , Kanchanarin T . Basic Disaster Life Support (BDLS) training improves first responder confidence to face mass-casualty incidents in Thailand. Prehosp Disaster Med. 2017;32(5):492-500 .

Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

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Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

2012-02-01

In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

Management of the mass casualty from the 2001 Jos crisis

African Journals Online (AJOL)

2012-11-04

Nov 4, 2012 ... The complex nature of natural and man‑made disasters poses multidisciplinary ... system [Figure 1] to mobilize staff from outside the hospital. Management of the mass ..... warning before casualties arrived. Transportation to ...

Mass Casualty Decontamination in a Chemical or Radiological/ Nuclear Incident: Further Guiding Principles

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

2016-01-01

This short report presents a response to an article written by Cibulsky et al. (2016). The paper by Cibulsky et al. presents a useful and timely overview of the evidence surrounding the technical and operational aspects of mass casualty decontamination. It identifies three priority targets for future research, the third of which is how casualties' needs can be met in ways that best support compliance with and effectiveness of casualty decontamination. While further investigation into behavioural, communication and privacy issues during mass decontamination is warranted, there is now a substantial body of research in this area which is not considered in detail in the succinct summary provided by Cibulsky et al. (2016). In this short report, we summarise the available evidence around likely public behaviour during mass decontamination, effective communication strategies, and potential issues resulting from a lack of privacy. Our intention is to help further focus the research needs in this area and highlight topics on which more research is needed. PMID:27790381

How will military/civilian coordination work for reception of mass casualties from overseas?

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Mackenzie, Colin; Donohue, John; Wasylina, Philip; Cullum, Woodrow; Hu, Peter; Lam, David M

2009-01-01

In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed "surge" capacity of Maryland NDMS Hospitals. Three tabletop exercises and a functional exercise were performed using a simulated, overseas, military mass-casualty event. The first tabletop exercise was with military and civilian NMDS partners. The second tested the revised NDMS activation plan. The third exercised the Authorities of State Emergency Medical System and Walter Reed Army Medical Center Directors of Emergency Medicine over Maryland NDMS hospitals, and their Medical Mutual Aid Agreement. The functional exercise used Homeland Security Exercise Evaluation Program tools to evaluate reception, triage, staging, and transportation of 160 notional patients (including 20 live, moulaged "patients") and one canine. The first tabletop exercise identified deficiencies in operational protocols for military/civilian mass-casualty reception, triage, treatment, and problems with sharing a Unified Command. The second found improvements in the revised NDMS activation plan. The third informed expectations for NDMS hospitals. In the functional exercise, all notional patients were received, triaged, dispatched, and accounted in military and five civilian hospitals within two hours. The canine revealed deficiencies in companion/military animal reception, holding, treatment, and evacuation. Three working groups were suggested: (1) to ensure 100% compliance with triage tags, patient accountability, and return of equipment used in mass casualty events and exercises; (2) to investigate making information technology and imaging networks available for Emergency Operation Centers and Incident Command; and (3) to establish NDMS

Management of the mass casualty from the 2001 Jos crisis

African Journals Online (AJOL)

2012-11-04

Nov 4, 2012 ... Management of Jos crisis mass casualty. 437. Nigerian Journal of ... operating and admission registers and their case notes retrieved from the .... of young males in our study was because these were the rioters in the first ...

Red Tides: Mass casualty and whole blood at sea Red Tides.

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Miller, Benjamin T; Lin, Andrew H; Clark, Susan C; Cap, Andrew P; Dubose, Joseph J

2018-02-13

The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP). The blood supply can be augmented with WFWB collected from a "walking blood bank" (WBB). Following a helicopter crash, six patients were transported by MV-22 Osprey to the USS Bataan. Patient 1 had a pelvic fracture, was managed with a pelvic binder, and received 4 units of pRBC, 2 units of FFP, and 6 units of WFWB. Patient 2, with a comminuted tibia and fibula fracture, underwent lower extremity four-compartment fasciotomy, and received 4 units of WFWB. Patient 3 underwent several procedures, including left anterior thoracotomy, aortic cross-clamping, exploratory laparotomy, small bowel resection, and tracheostomy. He received 8 units of pRBC, 8 units of FFP, and 28 units of WFWB. Patients 4 and 5 had suspected spine injuries and were managed non-operatively. Patient 6, with open tibia and fibula fractures, underwent lower extremity four-compartment fasciotomy with tibia external fixation and received 1 unit of WFWB. All patients survived aeromedical evacuation to a Role 4 medical facility and subsequent transfer to local hospitals. Maritime military mass casualty incidents are challenging, but the U.S. Navy's casualty-receiving ships are ready to perform RDCR at sea. Activation of the ship's WBB to transfuse WFWB is essential for hemostatic resuscitations afloat. V STUDY TYPE: Case series.

Review of On-Scene Management of Mass-Casualty Attacks

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Annelie Holgersson

2016-02-01

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

Importance of banked tissues in the management of mass nuclear casualties

International Nuclear Information System (INIS)

Singh, Rita; Bhatnagar, P.K.

2009-01-01

Nuclear detonations are the most devastating of the weapons of mass destruction. There will be large number of casualties on detonation of nuclear weapon. Biological tissues like bone, skin, amniotic membrane and other soft tissues can be used for repair or reconstruction of the injured part of the body. Tissues from human donor can be processed and banked for orthopaedic, spinal, trauma and other surgical procedures. Radiation technology is used to sterilize the tissues to make them safe for clinical use. This paper highlights the importance of such banked tissues in the management of the casualties. (author)

Scalable patients tracking framework for mass casualty incidents.

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Yu, Xunyi; Ganz, Aura

2011-01-01

We introduce a system that tracks patients in a Mass Casualty Incident (MCI) using active RFID triage tags and mobile anchor points (DM-tracks) carried by the paramedics. The system does not involve any fixed deployment of the localization devices while maintaining a low cost triage tag. The localization accuracy is comparable to GPS systems without incurring the cost of providing a GPS based device to every patient in the disaster scene.

Emergency response to mass casualty incidents in Lebanon.

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El Sayed, Mazen J

2013-08-01

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

Patient distribution in a mass casualty event of an airplane crash

NARCIS (Netherlands)

Postma, Ingri L. E.; Weel, Hanneke; Heetveld, Martin J.; van der Zande, Ineke; Bijlsma, Taco S.; Bloemers, Frank W.; Goslings, J. Carel

2013-01-01

Difficulties have been reported in the patient distribution during Mass Casualty Incidents. In this study we analysed the regional patient distribution protocol (PDP) and the actual patient distribution after the 2009 Turkish Airlines crash near Amsterdam. Analysis of the patient distribution of 126

Management of the mass casualty from the 2001 Jos crisis | Ozoilo ...

African Journals Online (AJOL)

Background: We report our experience in the hospital management of mass casualty following the Jos civil crisis of 2001. Materials and Methods: Aretrospective analysis of the records of patients managed in the Jos civil crisis of September 2001, in Plateau State, Nigeria. Information extracted included demographic data of ...

Mass casualty drill in a local hospital | Ardill | Nigerian Journal of ...

African Journals Online (AJOL)

The stated goals of the mass casualty drill were as follows: evaluate the performance of the hospital staff at every cadre, the communication systems, the adequacy of hospital supplies and equipment and provide immediate feedback to the staff for their educational benefit and improved future performance. The Consultant ...

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis.

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Schauer, Steven G; April, Michael D; Simon, Erica; Maddry, Joseph K; Carter, Robert; Delorenzo, Robert A

2017-08-01

Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines. Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR). These cases were identified as part of a research study evaluating Tactical Combat Casualty Care (TCCC) guidelines. Cases that were designated as or associated with denoted MASCAL events were included. Data Fifty subjects were identified during the course of this project. Explosives were the most common cause of injuries. There was a wide range of vital signs. Tourniquet placement and pressure dressings were the most common interventions, followed by analgesia administration. Oral transmucosal fentanyl citrate (OTFC) was the most common parenteral analgesic drug administered. Most were evacuated as "routine." Follow-up data were available for 36 of the subjects and 97% were discharged alive. The most common prehospital interventions were tourniquet and pressure dressing hemorrhage control, along with pain medication administration. Larger data sets are needed to guide development of MASCAL in-theater clinical practice guidelines. Schauer SG , April MD , Simon E , Maddry JK , Carter R III , Delorenzo RA . Prehospital interventions during mass-casualty events in Afghanistan: a case analysis. Prehosp Disaster Med. 2017;32(4):465-468.

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

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Turner, Conor D. A.; Lockey, David J.; Rehn, Marius

2016-01-01

Background Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future p...

Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.

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Luigi Ingrassia, Pier; Ragazzoni, Luca; Carenzo, Luca; Colombo, Davide; Ripoll Gallardo, Alba; Della Corte, Francesco

2015-04-01

This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session. Fifty-six students in their last year of medical school were randomized into two groups (A and B). The same scenario, a car accident, was developed identically on the two simulation methodologies: virtual reality and live simulation. On day 1, group A was exposed to the live scenario and group B was exposed to the virtual reality scenario, aiming to triage 10 victims. On day 2, all students attended a 2-h lecture on mass casualty triage, specifically the START triage method. On day 3, groups A and B were crossed over. The groups' abilities to perform mass casualty triage in terms of triage accuracy, intervention correctness, and speed in the scenarios were assessed. Triage and lifesaving treatment scores were assessed equally by virtual reality and live simulation on day 1 and on day 3. Both simulation methodologies detected an improvement in triage accuracy and treatment correctness from day 1 to day 3 (PVirtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills.

Pre-hospital management of mass casualty civilian shootings: a systematic literature review.

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Turner, Conor D A; Lockey, David J; Rehn, Marius

2016-11-08

Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice. Systematic literature searches of PubMed, Cochrane Database of Systematic Reviews and Scopus were conducted in conjunction with simple searches of non-indexed databases; Web of Science, OpenDOAR and Evidence Search. The searches were last carried out on 20 April 2016 and only identified those papers published after the 1 January 1980. Included documents had to contain descriptions, discussions or experiences of the pre-hospital management of civilian mass shootings. From the 494 identified manuscripts, 73 were selected on abstract and title and after full text reading 47 were selected for inclusion in analysis. The search yielded reports of 17 mass shooting events, the majority from the USA with additions from France, Norway, the UK and Kenya. Between 1994 and 2015 the shooting of 1649 people with 578 deaths at 17 separate events are described. Quality appraisal demonstrated considerable heterogeneity in reporting and revealed limited data on mass shootings globally. Key themes were identified to improve future practice: tactical emergency medical support may harmonise inner cordon interventions, a need for inter-service education on effective haemorrhage control, the value of senior triage operators and the need for regular mass casualty incident simulation.

Systematic review of strategies to manage and allocate scarce resources during mass casualty events.

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Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Pillemer, Francesca; Waxman, Daniel A; Moore, Melinda; Hansen, Cynthia K; Knebel, Ann R; Ricciardi, Richard; Kellermann, Arthur L

2013-06-01

Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of

Research issues in preparedness for mass casualty events, disaster, war, and terrorism.

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Hinton Walker, Patricia; Garmon Bibb, Sandra C; Elberson, Karen L

2005-09-01

This article provides a perspective on the types of research questions that might be explored and strategies used in relation to disaster,terrorism, and mass casualty events. Research is addressed in the context of three areas of focus: issues related to the health care provider; issues affecting the patient, individual, family, and community; and issues related to the health care system.

Developing a Mass Casualty Surge Capacity Protocol for Emergency Medical Services to Use for Patient Distribution.

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Shartar, Samuel E; Moore, Brooks L; Wood, Lori M

2017-12-01

Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care. Working with hospitals within the region, we refined emergency department surge capacity for MCIs and developed a prepopulated tool for EMS providers to use to distribute higher-acuity casualties to trauma centers and lower-acuity casualties to nontrauma hospitals. A mechanism to remove a hospital from the list of available resources, if it is overwhelmed with patients who self-transport to the location, also was put into place. The number of critically injured survivors from an MCI has proven to be consistent, averaging 7% to 10%. Moving critically injured patients to level 1 trauma centers can result in a 25% reduction in mortality, when compared with care at nontrauma hospitals. US cities face major gaps in the surge capacity needed to manage an MCI. Sixty percent of "walking wounded" casualties self-transport to the closest hospital(s) to the incident. Directing critically ill patients to designated trauma centers has the potential to reduce mortality associated with the event. When applied to MCI responses, damage-control principles reduce resource utilization and optimize surge capacity. A universal system for mass casualty triage was identified and incorporated into the region's EMS. Flagship regional coordinating hospitals were designated

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

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

2007-01-01

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

Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001.

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Ozoilo, Kenneth N; Pam, Ishaya C; Yiltok, Simon J; Ramyil, Alice V; Nwadiaro, Hyacinth C

2013-10-28

Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response.

Intraosseous vascular access in disasters and mass casualty events: A review of the literature.

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Burgert, James M

2016-01-01

The intraosseous (IO) route of vascular access has been increasingly used to administer resuscitative fluids and drugs to patients in whom reliable intravenous (IV) access could not be rapidly or easily obtained. It is unknown that to what extent the IO route has been used to gain vascular access during disasters and mass casualty events. The purpose of this review was to examine the existing literature to answer the research question, "What is the utility of the IO route compared to other routes for establishing vascular access in patients resulting from disasters and mass casualty events?" Keyword-based online database search of PubMed, CINAHL, and the Cochrane Database of Systematic Reviews. University-based academic research cell. Included evidence were randomized and nonrandomized trials, systematic reviews with and without meta-analysis, case series, and case reports. Excluded evidence included narrative reviews and expert opinion. Not applicable. Of 297 evidence sources located, 22 met inclusion criteria. Located evidence was organized into four categories including chemical agent poisoning, IO placement, while wearing chemical protective clothing (PPE), military trauma, and infectious disease outbreak. Evidence indicates that the IO route of infusion is pharmacokinetically equal to the IV route and superior to the intramuscular (IM) and endotracheal routes for the administration of antidotal drugs in animal models of chemical agent poisoning while wearing full chemical PPE. The IO route is superior to the IM route for antidote administration during hypovolemic shock. Civilian casualties of explosive attacks and mass shootings would likely benefit from expanded use of the IO route and military resuscitation strategies. The IO route is useful for fluid resuscitation in the management of diarrheal and hemorrhagic infectious disease outbreaks.

[Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

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Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

2017-02-01

Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

Population and energy elasticity of tornado casualties

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Fricker, Tyler; Elsner, James B.; Jagger, Thomas H.

2017-04-01

Tornadoes are capable of catastrophic destruction and mass casualties, but there are yet no estimates of how sensitive the number of casualties are to changes in the number of people in harm's way or to changes in tornado energy. Here the relationship between tornado casualties (deaths and injuries), population, and energy dissipation is quantified using the economic concept of "elasticity." Records of casualties from individual tornadoes over the period 2007-2015 are fit to a regression model. The coefficient on the population term (population elasticity) indicates that a doubling in population increases the casualty rate by 21% [(17, 24)%, 95% credible interval]. The coefficient on the energy term (energy elasticity) indicates that a doubling in energy dissipation leads to a 33% [(30, 35)%, 95% credible interval] increase in the casualty rate. The difference in elasticity values show that on average, changes in energy dissipation have been relatively more important in explaining tornado casualties than changes in population. Assuming no changes in warning effectiveness or mitigation efforts, these elasticity estimates can be used to project changes in casualties given the known population trends and possible trends in tornado activity.

Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study.

Science.gov (United States)

Duncan, Edward A S; Colver, Keith; Dougall, Nadine; Swingler, Kevin; Stephenson, John; Abhyankar, Purva

2014-02-22

Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item's importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. This study is the first to produce an expert consensus on the items and quantities of clinical equipment

MiRTE: Mixed Reality Triage and Evacuation game for Mass Casualty information systems design, testing and training.

Science.gov (United States)

Yu, Xunyi; Ganz, Aura

2011-01-01

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

Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

Science.gov (United States)

Timler, Dariusz; Bogusiak, Katarzyna; Kasielska-Trojan, Anna; Neskoromna-Jędrzejczak, Aneta; Gałązkowski, Robert; Szarpak, Łukasz

2016-02-01

The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

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

Energy Technology Data Exchange (ETDEWEB)

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

2009-08-15

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

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

International Nuclear Information System (INIS)

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

2009-01-01

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

The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks.

Science.gov (United States)

Pan, Chih-Long; Lin, Chih-Hao; Lin, Yan-Ren; Wen, Hsin-Yu; Wen, Jet-Chau

2018-02-02

Due to the increasing number of natural and man-made disasters, mass casualty incidents occur more often than ever before. As a result, health care providers need to adapt in order to cope with the overwhelming patient surge. To ensure quality and safety in health care, accurate information in pandemic disease control, death reduction, and health quality promotion should be highlighted. However, obtaining precise information in real time is an enormous challenge to all researchers of the field. In this paper, innovative strategies are presented to develop a sound information network using the concept of "witness sensors." To overcome the reliability and quality limitations of information obtained through social media, researchers must focus on developing solutions that secure the authenticity of social media messages, especially for matters related to health. To address this challenge, we introduce a novel concept based on the two elements of "witness" and "sensor." Witness sensors can be key players designated to minimize limitations to quality of information and to distinguish fact from fiction during critical events. In order to enhance health communication practices and deliver valid information to end users, the education and management of witness sensors should be further investigated, especially for implementation during mass casualty incidents and epidemic outbreaks. ©Chih-Long Pan, Chih-Hao Lin, Yan-Ren Lin, Hsin-Yu Wen, Jet-Chau Wen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2018.

Triage in mass casualty situations

African Journals Online (AJOL)

A recent Oxfam report highlights a four-fold increase in the occurrence of ... A disaster, by definition, overwhelms the response capacity of the community. However ... or the location of the incident in such a place that it warrants the response of ...

Management of the mass casualty from the 2001 Jos crisis.

Science.gov (United States)

Ozoilo, K N; Kidmas, A T; Nwadiaro, H C; Iya, D; Onche, I I; Misauno, M A; Sule, A Z; Yiltok, S J; Uba, A F; Ramyil, V M; Dakum, N K; Ugwu, B T

2014-01-01

We report our experience in the hospital management of mass casualty following the Jos civil crisis of 2001. A retrospective analysis of the records of patients managed in the Jos civil crisis of September 2001, in Plateau State, Nigeria. Information extracted included demographic data of patients, mechanisms of injury, nature and site of injury, treatment modalities and outcome of care. A total of 463 crisis victims presented over a 5 day period. Out of these, the records of 389 (84.0%) were available and analyzed. There were 348 (89.5%) males and 41 females (10.5%) aged between 3 weeks and 70 years, with a median age of 26 years. Most common mechanisms of injury were gunshot in 176 patients (45.2%) and blunt injuries from clubs and sticks in 140 patients (36.0%). Debridement with or without suturing was the most common surgical procedure, performed in 128 patients (33%) followed by exploratory laparotomy in 27 (6.9%) patients. Complications were documented in 55 patients (14.1%) and there were 16 hospital deaths (4.1% mortality). Challenges included exhaustion of supplies, poor communication and security threats both within the hospital and outside. Most patients reaching the hospital alive had injuries that did not require lifesaving interventions. Institutional preparedness plan would enable the hospital to have an organized approach to care, with better chances of success. More effective means of containing crises should be employed to reduce the attendant casualty rate.

Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

Science.gov (United States)

Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

2017-07-01

Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

Science.gov (United States)

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

2015-02-01

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

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

Science.gov (United States)

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

2012-04-01

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

Optimization of Nonambulant Mass Casualty Decontamination Protocols as Part of an Initial or Specialist Operational Response to Chemical Incidents.

Science.gov (United States)

Chilcott, Robert P; Mitchell, Hannah; Matar, Hazem

2018-05-30

The UK's Initial Operational Response (IOR) is a new process for improving the survival of multiple casualties following a chemical, biological, radiological or nuclear incident. Whilst the introduction of IOR represents a patient-focused response for ambulant casualties, there is currently no provision for disrobe and dry decontamination of nonambulant casualties. Moreover, the current specialist operational response (SOR) protocol for nonambulant casualty decontamination (also referred to as "clinical decontamination") has not been subject to rigorous evaluation or development. Therefore, the aim of this study was to confirm the effectiveness of putatively optimized dry (IOR) and wet (SOR) protocols for nonambulant decontamination in human volunteers. Dry and wet decontamination protocols were objectively evaluated using human volunteers. Decontamination effectiveness was quantified by liquid chromatography-mass spectrometry analysis of the recovery of a chemical warfare agent simulant (methylsalicylate) from skin and hair of volunteers, with whole-body fluorescence imaging to quantify the skin distribution of residual simulant. Both the dry and wet decontamination processes were rapid (3 and 4 min, respectively) and were effective in removing simulant from the hair and skin of volunteers, with no observable adverse effects related to skin surface spreading of contaminant. Further studies are required to assess the combined effectiveness of dry and wet decontamination under more realistic conditions and to develop appropriate operational procedures that ensure the safety of first responders.

Managing the surge in demand for blood following mass casualty events: Early automatic restocking may preserve red cell supply.

Science.gov (United States)

Glasgow, Simon; Vasilakis, Christos; Perkins, Zane; Brundage, Susan; Tai, Nigel; Brohi, Karim

2016-07-01

Traumatic hemorrhage is a leading preventable cause of mortality following mass casualty events (MCEs). Improving outcomes requires adequate in-hospital provision of high-volume red blood cell (RBC) transfusions. This study investigated strategies for optimizing RBC provision to casualties in MCEs using simulation modeling. A computerized simulation model of a UK major trauma center (TC) transfusion system was developed. The model used input data from past MCEs and civilian and military trauma registries. We simulated the effect of varying on-shelf RBC stock hold and the timing of externally restocking RBC supplies on TC treatment capacity across increasing loads of priority one (P1) and two (P2) casualties from an event. Thirty-five thousand simulations were performed. A casualty load of 20 P1s and P2s under standard TC RBC stock conditions left 35% (95% confidence interval, 32-38%) of P1s and 7% (4-10%) of P2s inadequately treated for hemorrhage. Additionally, exhaustion of type O emergency RBC stocks (a surrogate for reaching surge capacity) occurred in a median of 10 hours (IQR, 5 to >12 hours). Doubling casualty load increased this to 60% (57-63%) and 30% (26-34%), respectively, with capacity reached in 2 hours (1-3 hours). The model identified a minimum requirement of 12 U of on-shelf RBCs per P1/P2 casualty received to prevent surge capacity being reached. Restocking supplies in an MCE versus greater permanent on-shelf RBC stock holds was considered at increasing hourly intervals. T-test analysis showed no difference between stock hold versus supply restocking with regard to overall outcomes for MCEs up to 80 P1s and P2s in size (p < 0.05), provided the restock occurred within 6 hours. Even limited-sized MCEs threaten to overwhelm TC transfusion systems. An early-automated push approach to restocking RBCs initiated by central suppliers can produce equivocal outcomes compared with holding excess stock permanently at TCs. Therapeutic/care management study

Design of a model to predict surge capacity bottlenecks for burn mass casualties at a large academic medical center.

Science.gov (United States)

Abir, Mahshid; Davis, Matthew M; Sankar, Pratap; Wong, Andrew C; Wang, Stewart C

2013-02-01

To design and test a model to predict surge capacity bottlenecks at a large academic medical center in response to a mass-casualty incident (MCI) involving multiple burn victims. Using the simulation software ProModel, a model of patient flow and anticipated resource use, according to principles of disaster management, was developed based upon historical data from the University Hospital of the University of Michigan Health System. Model inputs included: (a) age and weight distribution for casualties, and distribution of size and depth of burns; (b) rate of arrival of casualties to the hospital, and triage to ward or critical care settings; (c) eligibility for early discharge of non-MCI inpatients at time of MCI; (d) baseline occupancy of intensive care unit (ICU), surgical step-down, and ward; (e) staff availability-number of physicians, nurses, and respiratory therapists, and the expected ratio of each group to patients; (f) floor and operating room resources-anticipating the need for mechanical ventilators, burn care and surgical resources, blood products, and intravenous fluids; (g) average hospital length of stay and mortality rate for patients with inhalation injury and different size burns; and (h) average number of times that different size burns undergo surgery. Key model outputs include time to bottleneck for each limiting resource and average waiting time to hospital bed availability. Given base-case model assumptions (including 100 mass casualties with an inter-arrival rate to the hospital of one patient every three minutes), hospital utilization is constrained within the first 120 minutes to 21 casualties, due to the limited number of beds. The first bottleneck is attributable to exhausting critical care beds, followed by floor beds. Given this limitation in number of patients, the temporal order of the ensuing bottlenecks is as follows: Lactated Ringer's solution (4 h), silver sulfadiazine/Silvadene (6 h), albumin (48 h), thrombin topical (72 h), type

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

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

2014-10-01

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

Radiation protection - Performance criteria for laboratories performing cytogenetic triage for assessment of mass casualties in radiological or nuclear emergencies - General principles and application to dicentric assay

International Nuclear Information System (INIS)

2008-01-01

The potential for nuclear and radiological emergencies involving mass casualties from accidental or malicious acts or terrorism requires generic procedures for emergency dose assessment to help the development of medical response capabilities. A mass-casualties incident is defined here as an event that exceeds the local medical resources. Biological dosimetry, based on cytogenetic analysis using the dicentric assay, typically applied for accidental dose assessment, has been defined in ISO 19238. Cytogenetic triage is the use of chromosome damage to evaluate and assess approximately and rapidly radiation doses received by individuals in order to supplement the clinical categorization of casualties. This International Standard focuses on the use of the dicentric assay for rapid cytogenetic triage involving mass-casualty incidents. The primary purpose of this International Standard is to provide a guideline to all laboratories in order to perform the dicentric-bioassay - cytogenetic triage for dose assessment using documented and validated procedures. Secondly, it can facilitate the application of cytogenetic biodosimetry networks to permit comparison of results obtained in different laboratories. Finally, it is expected that laboratories newly commissioned to carry out the cytogenetic triage conform to this International Standard in order to perform the triage reproducibly and accurately. This International Standard is written in the form of procedures to adopt for dicentric-bioassay - cytogenetic triage biological dosimetry for overexposures involving mass radiological casualties. The criteria required for such measurements usually depend on the application of the results: medical management when appropriate, radiation-protection management, record keeping and medical/legal requirements. For example, selected cases can be analysed to produce a more accurate evaluation of high partial-body exposure; secondly, doses can be estimated for persons exposed below the

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

NARCIS (Netherlands)

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

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

Drones at the service for training on mass casualty incident

Science.gov (United States)

Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo

2017-01-01

Abstract Mass casualty incidents (MCI) are characterized by a large number of victims with respect to the resources available. In this study, we aimed to analyze the changes produced in the self-perception of students who were able to visualize aerial views of a simulation of a MCI. A simulation study, mixed method, was performed to compare the results from an ad hoc questionnaire. The 35 students from the Emergency Nursing Master from the UCAM completed a questionnaire before and after watching an MCI video with 40 victims in which they had participated. The main variable measured was the change in self-perception (CSP). The CSP occurred in 80% (28/35) of the students (P = .001). Students improved their individual (P = .001) and group (P = .006) scores. They also described that their personal performance had better results than the group performance (P = .047). The main conclusion of this study is that drones could lead to CSP and appraisal of the MCI simulation participants. PMID:28658106

[Treatment strategies for mass casualty incidents and terrorist attacks in trauma and vascular surgery : Presentation of a treatment concept].

Science.gov (United States)

Friemert, B; Franke, A; Bieler, D; Achatz, A; Hinck, D; Engelhardt, M

2017-10-01

The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs. terrorist attack MCI= dynamic situation) and the different security positions (rescue services vs. police services). This article is concerned with question of which changes in the surgical treatment of patients are made necessary by these new challenges. In this case it is necessary that physicians are familiar with the different injury patterns, whereby priority must be given to gunshot and explosion (blast) injuries. Furthermore, altered strategic and tactical approaches (damage control surgery vs. tactical abbreviated surgical care) are necessary to ensure survival for as many victims of terrorist attacks as possible and also to achieve the best possible functional results. It is only possible to successfully counter these new challenges by changing the mindset in the treatment of terrorist MCI compared to MCI incidents. An essential component of this mindset is the acquisition of a maximum of flexibility. This article would like to make a contribution to this problem.

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

NARCIS (Netherlands)

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

2016-01-01

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

Integrating Urban Infrastructure and Health System Impact Modeling for Disasters and Mass-Casualty Events

Science.gov (United States)

Balbus, J. M.; Kirsch, T.; Mitrani-Reiser, J.

2017-12-01

Over recent decades, natural disasters and mass-casualty events in United States have repeatedly revealed the serious consequences of health care facility vulnerability and the subsequent ability to deliver care for the affected people. Advances in predictive modeling and vulnerability assessment for health care facility failure, integrated infrastructure, and extreme weather events have now enabled a more rigorous scientific approach to evaluating health care system vulnerability and assessing impacts of natural and human disasters as well as the value of specific interventions. Concurrent advances in computing capacity also allow, for the first time, full integration of these multiple individual models, along with the modeling of population behaviors and mass casualty responses during a disaster. A team of federal and academic investigators led by the National Center for Disaster Medicine and Public Health (NCDMPH) is develoing a platform for integrating extreme event forecasts, health risk/impact assessment and population simulations, critical infrastructure (electrical, water, transportation, communication) impact and response models, health care facility-specific vulnerability and failure assessments, and health system/patient flow responses. The integration of these models is intended to develop much greater understanding of critical tipping points in the vulnerability of health systems during natural and human disasters and build an evidence base for specific interventions. Development of such a modeling platform will greatly facilitate the assessment of potential concurrent or sequential catastrophic events, such as a terrorism act following a severe heat wave or hurricane. This presentation will highlight the development of this modeling platform as well as applications not just for the US health system, but also for international science-based disaster risk reduction efforts, such as the Sendai Framework and the WHO SMART hospital project.

A better START for low-acuity victims: data-driven refinement of mass casualty triage.

Science.gov (United States)

Cross, Keith P; Petry, Michael J; Cicero, Mark X

2015-01-01

Methods currently used to triage patients from mass casualty events have a sparse evidence basis. The objective of this project was to assess gaps of the widely used Simple Triage and Rapid Transport (START) algorithm using a large database when it is used to triage low-acuity patients. Subsequently, we developed and tested evidenced-based improvements to START. Using the National Trauma Database (NTDB), a large set of trauma victims were assigned START triage levels, which were then compared to recorded patient mortality outcomes using area under the receiver-operator curve (AUC). Subjects assigned to the "Minor/Green" level who nevertheless died prior to hospital discharge were considered mistriaged. Recursive partitioning identified factors associated with of these mistriaged patients. These factors were then used to develop candidate START models of improved triage, whose overall performance was then re-evaluated using data from the NTDB. This process of evaluating performance, identifying errors, and further adjusting candidate models was repeated iteratively. The study included 322,162 subjects assigned to "Minor/Green" of which 2,046 died before hospital discharge. Age was the primary predictor of under-triage by START. Candidate models which re-assigned patients from the "Minor/Green" triage level to the "Delayed/Yellow" triage level based on age (either for patients >60 or >75), reduced mortality in the "Minor/Green" group from 0.6% to 0.1% and 0.3%, respectively. These candidate START models also showed net improvement in the AUC for predicting mortality overall and in select subgroups. In this research model using trauma registry data, most START under-triage errors occurred in elderly patients. Overall START accuracy was improved by placing elderly but otherwise minimally injured-mass casualty victims into a higher risk triage level. Alternatively, such patients would be candidates for closer monitoring at the scene or expedited transport ahead of other

An Interprofessional Approach to Continuing Education With Mass Casualty Simulation: Planning and Execution.

Science.gov (United States)

Saber, Deborah A; Strout, Kelley; Caruso, Lisa Swanson; Ingwell-Spolan, Charlene; Koplovsky, Aiden

2017-10-01

Many natural and man-made disasters require the assistance from teams of health care professionals. Knowing that continuing education about disaster simulation training is essential to nursing students, nurses, and emergency first responders (e.g., emergency medical technicians, firefighters, police officers), a university in the northeastern United States planned and implemented an interprofessional mass casualty incident (MCI) disaster simulation using the Project Management Body of Knowledge (PMBOK) management framework. The school of nursing and University Volunteer Ambulance Corps (UVAC) worked together to simulate a bus crash with disaster victim actors to provide continued education for community first responders and train nursing students on the MCI process. This article explains the simulation activity, planning process, and achieved outcomes. J Contin Educ Nurs. 2017;48(10):447-453. Copyright 2017, SLACK Incorporated.

Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

Science.gov (United States)

Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

2016-04-01

Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience. © 2016 AABB.

Civilian casualties of Iraqi ballistic missile attack to

Directory of Open Access Journals (Sweden)

Khaji Ali

2012-06-01

Full Text Available 【Abstract】Objective: To determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war. Methods: Data were extracted from the Army Staff Headquarters based on daily reports of Iranian army units during the war. Results: During 52 days, Tehran was stroked by 118 Al-Hussein missiles (a modified version of Scud missile. Eighty-six missiles landed in populated areas. During Iraqi missile attacks, 422 civilians died and 1 579 injured (4.9 deaths and 18.3 injuries per missile. During 52 days, 8.1 of the civilians died and 30.4 injured daily. Of the cases that died, 101 persons (24% were excluded due to the lack of information. Among the remainders, 179 (55.8% were male and 142 (44.2% were female. The mean age of the victims was 25.3 years±19.9 years. Our results show that the high accuracy of modified Scud missiles landed in crowded ar-eas is the major cause of high mortality in Tehran. The pres-ence of suitable warning system and shelters could reduce civilian casualties. Conclusion: The awareness and readiness of civilian defense forces, rescue services and all medical facilities for dealing with mass casualties caused by ballistic missile at-tacks are necessary. Key words: Mortality; War; Mass casualty incidents; Wounds and injuries

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

Science.gov (United States)

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

2018-01-01

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

Mass casualty incidents: are NHS staff prepared? An audit of one NHS foundation trust.

Science.gov (United States)

Milkhu, C S; Howell, D C J; Glynne, P A; Raptis, D; Booth, H L; Langmead, L; Datta, V K

2008-09-01

Lack of knowledge of an NHS trust's major incident policies by clinical staff may result in poorly coordinated responses during a mass casualty incident (MCI). To audit knowledge of the major incident policy by clinical staff working in a central London major acute NHS trust designated to receive casualties on a 24-h basis during a MCI. A 12-question proforma was distributed to 307 nursing and medical staff in the hospital, designed to assess their knowledge of the major incident policy. Completed proformas were collected over a 2-month period between December 2006 and February 2007. A reply rate of 34% was obtained, with a reasonable representation from all disciplines ranging from nurses to consultants. Despite only 41% having read the policy in full, 70% knew the correct immediate action to take if informed of major incident activation. 76% knew the correct stand-down procedure. 56% knew the correct reporting point but less than 25% knew that an action card system was utilised. Nurses had significantly (p<0.01) more awareness of the policy than doctors. In view of the heightened terrorist threat in London, knowledge of major incident policy is essential. The high percentage of positive responses relating to immediate and stand-down actions reflects the rolling trust-wide MCI education programme and the organisational memory of the trust following several previous MCI in the capital. There is still scope for an improvement in awareness, however, particularly concerning knowledge of action cards, which are now displayed routinely throughout clinical areas and will be incorporated into induction packs.

Role of radiology in the study and identification of casualty victims

International Nuclear Information System (INIS)

Lichtenstein, J.E.; Madewell, J.E.

1982-01-01

Radiology is assuming an increasingly important role in the investigation of casualty victims. Radiographic screening for foreign bodies, personal effects, dental and surgical artifacts and occult skeletal injury has long been an established technique in forensic medicine. Positive radiographic identification of the victims by comparison with antemortem films and records in a more recent, important development. Large scale radiographic investigations may require improvised facilities posing unaccustomed technical and logistical problems. Radiologic experience gained from aviation accident investigation is found to apply in other casualty situations as well as in individual fatality investigations. Radiologic data may aid determination of the cause of incidents, resulting in improved safety procedures and design, as well as serving humanitarian and forensic functions. (orig.)

Primary Identification Methods and their Effectiveness in Mass Disaster Situations: A Literature Review

Directory of Open Access Journals (Sweden)

Naiara M. Gaglietti

2017-06-01

Full Text Available Mass disasters generally result in an elevated number of casualties that need identification. The primary identification methods listed by INTERPOL (DNA, fingerprint and forensic dentistry have a very important role in helping and speeding up the victim identification process. The present study sought to report mass destruction cases found in the literature published from 2005 to 2015 that have used the primary human identification methods. This study has been done as a literature review using the keywords: disasters, natural disasters, disaster victims, and human identification in a total of 16 selected papers and 13 listed disasters. It has been concluded that the primary identification methods are capable and efficient to perform a safe and satisfactory identification of mass disasters victims, used both separately or in combination.

Drones at the service for training on mass casualty incident: A simulation study.

Science.gov (United States)

Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo

2017-06-01

Mass casualty incidents (MCI) are characterized by a large number of victims with respect to the resources available. In this study, we aimed to analyze the changes produced in the self-perception of students who were able to visualize aerial views of a simulation of a MCI. A simulation study, mixed method, was performed to compare the results from an ad hoc questionnaire. The 35 students from the Emergency Nursing Master from the UCAM completed a questionnaire before and after watching an MCI video with 40 victims in which they had participated. The main variable measured was the change in self-perception (CSP). The CSP occurred in 80% (28/35) of the students (P = .001). Students improved their individual (P = .001) and group (P = .006) scores. They also described that their personal performance had better results than the group performance (P = .047). The main conclusion of this study is that drones could lead to CSP and appraisal of the MCI simulation participants.

Tsunami Casualty Model

Science.gov (United States)

Yeh, H.

2007-12-01

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

[National preparedness for biological mass casualty event: between the devil and the deep blue sea].

Science.gov (United States)

Eldad, Arieh

2002-05-01

Species of plants and animals, as well as nations of human beings were extinguished throughout the prehistory and history of this planet. One of the possible explanations for this phenomenon is a large scale epidemic of viral, bacterial or fungal infections. One well-documented example was the smallpox epidemic among native Indians of South America following the European invasion. Deliberate dissemination of disease was used as a weapon during the Middle Ages when corpses of plague casualties were thrown over the walls and into the besieged towns. The Book of Kings II, of the Bible, in chapter 19 recalls the story of 185,000 soldiers of Sennacherib that died in one night, near the walls of Jerusalem. The possibility of causing mass casualty by dissemination of infectious disease has driven countries and terrorist organizations to produce and store large quantities of bacteria or viruses. The death of thousands in the USA on September 11, 2001, demonstrated that terror has no moral prohibitions, only technical limitations. Terror organizations will not hesitate to use weapons for mass destruction to kill many, and if only few will die, it will still serve the purpose of these evil organizations: to strew panic, to destroy normal life and to increase fear and instability. Any government that faces decisions about how to be better prepared against biological warfare is pushed between the devil and the deep blue sea. On the one hand: the better we will be prepared, equipped with antibiotics and vaccines--the more lives of casualties we will be able to save. Better public education will help to reduce the damage, but, on the other hand--in order to cause more people to make the effort to equip themselves or to refresh their protective kit--we will have to increase their level of concern. In order to improve the medical education of all members of the medical teams we will have to start a broad and intense campaign, thereby taking the risk of increasing stress in the

Human casualties in earthquakes: Modelling and mitigation

Science.gov (United States)

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

2011-01-01

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

Nuclear and radiological risk: contaminated mass casualties in the hospital

International Nuclear Information System (INIS)

Telion, C.; Lejay, M.; Carli, P.

2006-01-01

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

Allocation of scarce resources during mass casualty events.

Science.gov (United States)

Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Waxman, Daniel A; Pillemer, Francesca; Carey, Christine; Moore, Melinda; Karir, Veena; Johnson, Tiffani J; Iyer, Neema; Hu, Jianhui; Shanman, Roberta; Larkin, Jody Wozar; Timmer, Martha; Motala, Aneesa; Perry, Tanja R; Newberry, Sydne; Kellermann, Arthur L

2012-06-01

This systematic review sought to identify the best available evidence regarding strategies for allocating scarce resources during mass casualty events (MCEs). Specifically, the review addresses the following questions: (1) What strategies are available to policymakers to optimize the allocation of scarce resources during MCEs? (2) What strategies are available to providers to optimize the allocation of scarce resources during MCEs? (3) What are the public's key perceptions and concerns regarding the implementation of strategies to allocate scarce resources during MCEs? (4) What methods are available to engage providers in discussions regarding the development and implementation of strategies to allocate scarce resources during MCEs? We searched Medline, Scopus, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Global Health, Web of Science®, and the Cochrane Database of Systematic Reviews from 1990 through 2011. To identify relevant non-peer-reviewed reports, we searched the New York Academy of Medicine's Grey Literature Report. We also reviewed relevant State and Federal plans, peer-reviewed reports and papers by nongovernmental organizations, and consensus statements published by professional societies. We included both English- and foreign-language studies. Our review included studies that evaluated tested strategies in real-world MCEs as well as strategies tested in drills, exercises, or computer simulations, all of which included a comparison group. We reviewed separately studies that lacked a comparison group but nonetheless evaluated promising strategies. We also identified consensus recommendations developed by professional societies or government panels. We reviewed existing State plans to examine the current state of planning for scarce resource allocation during MCEs. Two investigators independently reviewed each article, abstracted data, and assessed study quality. We considered 5,716 reports for this comparative effectiveness

Marine Casualty and Pollution Data for Researchers

Data.gov (United States)

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

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

Science.gov (United States)

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

2017-01-01

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

Ship Engine Room Casualty Analysis by Using Decision Tree Method

Directory of Open Access Journals (Sweden)

Ömür Yaşar SAATÇİOĞLU

2017-03-01

Full Text Available Ships may encounter undesirable conditions during operations. In consequence of a casualty, fire, explosion, flooding, grounding, injury even death may occur. Besides, these results can be avoidable with precautions and preventive operating processes. In maritime transportation, casualties depend on various factors. These were listed as misuse of the engine equipment and tools, defective machinery or equipment, inadequacy of operational procedure and measure of safety and force majeure effects. Casualty reports which were published in Australia, New Zealand, United Kingdom, Canada and United States until 2015 were examined and the probable causes and consequences of casualties were determined with their occurrence percentages. In this study, 89 marine investigation reports regarding engine room casualties were analyzed. Casualty factors were analyzed with their frequency percentages and also their main causes were constructed. This study aims to investigate engine room based casualties, frequency of each casualty type and main causes by using decision tree method.

Do lower income areas have more pedestrian casualties?

Science.gov (United States)

Noland, Robert B; Klein, Nicholas J; Tulach, Nicholas K

2013-10-01

Pedestrian and motor vehicle casualties are analyzed for the State of New Jersey with the objective of determining how the income of an area may be associated with casualties. We develop a maximum-likelihood negative binomial model to examine how various spatially defined variables, including road, income, and vehicle ownership, may be associated with casualties using census block-group level data. Due to suspected spatial correlation in the data we also employ a conditional autoregressive Bayesian model using Markov Chain Monte Carlo simulation, implemented with Crimestat software. Results suggest that spatial correlation is an issue as some variables are not statistically significant in the spatial model. We find that both pedestrian and motor vehicle casualties are greater in lower income block groups. Both are also associated with less household vehicle ownership, which is not surprising for pedestrian casualties, but is a surprising result for motor vehicle casualties. Controls for various road categories provide expected relationships. Individual level data is further examined to determine relationships between the location of a crash victim and their residence zip code, and this largely confirms a residual effect associated with both lower income individuals and lower income areas. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

2013-08-01

sounds of high-pressure gas leaking and the creaking or popping of expanding and failing metal containers. As previous events have demonstrated, it...different triage categories, affix a commercially available triage tag to each casualty. They are perforated for easy ripping . The bottom-most color of...pupil dilation, and cloudy consciousness. The person may be unable to walk or move his/her arms and legs and may curl up into a fetal position

26 CFR 1.165-7 - Casualty losses.

Science.gov (United States)

2010-04-01

... where damage by casualty has occurred to a building and ornamental or fruit trees used in a trade or business, the decrease in value shall be measured by taking the building and trees into account separately... building and trees. (ii) In determining a casualty loss involving real property and improvements thereon...

Triage Simulation in a Virtual Environment

NARCIS (Netherlands)

Dumay, A.C.M.

1995-01-01

Triage is the assessment of physical conditions of casualties with limited support of staff and equipment. The critical factor in handling a mass casualty situation is time. The focus is on the quick and accurate assessment of the physical conditions of casualties and the application of life-saving

Infant with a foreign body bronchus: a fishy situation!

African Journals Online (AJOL)

which gave him brief respite. However, his situation deteriorated and he was referred to our center, as the suspicion of a foreign body in the bronchus was high by then and the referring physician had become concerned. After a detailed clinical examination in our casualty, we suspected that he might have aspirated a small ...

Analysis of performance and stress caused by a simulation of a mass casualty incident.

Science.gov (United States)

Nieto Fernández-Pacheco, Antonio; Castro Delgado, Rafael; Arcos González, Pedro; Navarro Fernández, José Luis; Cerón Madrigal, José Joaquín; Juguera Rodriguez, Laura; Perez Alonso, Nuria; Armero-Barranco, David; Lidon López Iborra, María; Damian, Escribano Tortosa; Pardo Rios, Manuel

2018-03-01

To determine the stress that is potentially produced in professional health workers due to a mass casualty incident (MCI) simulated exercise, and its relation to prior academic training and the role played in the simulation. Observational study of stress in a MCI. For this work, two MCI drills comprised of 40 victims each were conducted. Two randomized groups of 36 students each were created: Master's Students Group (MSG) and Undergraduate Student Group (USG). The role performed by each student (triage or sectorization) was assessed. The stress level was determined by prior and subsequent measurements of alpha-amylase (αA), HR, SBP and DBP. The percentage of victims that were correctly triaged was 88.6%, 91.84% for MSG and 83.76% for the USG (p=0.004). The basal αA was 97,107.50±72,182.67IU/L and the subsequent αA was 136,195.55±90,176.46±IU/L (pperformed the triage and those who performed sectorization but there were no differences between undergraduate and Masters' students. Conducting a simulated exercise caused stress in personnel involved in the MCI, with a greater impact on participants who performed triage, although it was not influenced by their prior academic level. The stress level in our case did not affect or determine the performance of acquired skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway.

Science.gov (United States)

Young, Victoria Solveig; Eggesbø, Heidi B; Gaarder, Christine; Næss, Pål Aksel; Enden, Tone

2017-07-01

To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. Nine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff. Plain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected. • Minimum acceptable care (MAC) should replace normal routines in mass casualty incidents. • MAC implied reduced use of imaging in the emergency department (ED). • CT in ED was restricted to suspected severe head injuries during MAC. • The radiologist should cancel all non-head CTs in the ED during MAC.

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

International Nuclear Information System (INIS)

Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F.; Prasanna, P.G.S.

2007-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2007-07-15

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

Triage and Treatment of Combined Injury in Mass Casualty Situations

Science.gov (United States)

1996-11-01

NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT UU 18. NUMBER OF PAGES 21 19a. NAME OF...within 24-48 hours after CI. Antiemetic drugs, such as Ondansetron, Granisetron , Dimetcarb or Dixaphen, are useful for nausea and vomiting removal

The 43rd Infantry Division: Unit Cohesion and Neuropsychiatric Casualties

National Research Council Canada - National Science Library

Fuschak, K

1999-01-01

..., The Solomon Islands, from July to September 1943. The study explores the multiple causes of these casualties, to include ignorance of lessons learned regarding neuropsychiatric casualties in World War I, general unpreparedness, poor training...

VIRTUAL REALITY FOR MANAGEMENT OF SITUATIONAL AWARENESS DURING GLOBAL MASS GATHERINGS

Directory of Open Access Journals (Sweden)

A. S. Karsakov

2017-01-01

Full Text Available This paper presents a training technology for staff of mass events for development of action skills in large gatherings of people, including crowd dynamic management and actions in extreme situations caused by the panic. The technology is based on the multi-agent model of crowd dynamic with dynamically re-computable navigation fields. We implemented the software system that provides a collaborative and distributed process of training activities in the virtual reality environment. The following characteristics of the developed software system available from experimental studies were analyzed: computational intensity of simulations, scalability of rendering system and reactivity of the final system when rendering computationally intensive scenes. The proposed models and infrastructure for training through collaborative immersion in the virtual reality can improve situational awareness of events staff prior to the event. The developed technology is a unique tool for improving the quality and safety of disposable and unique events involving the broad masses of people, including unfunded by retrospective experience mass gatherings. Developed technology was tested within the Kumbh Mela festival in Ujjain, India.

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

Directory of Open Access Journals (Sweden)

Nick Kassouf

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

The Casualty Actuarial Society: Helping Universities Train Future Actuaries

Science.gov (United States)

Boa, J. Michael; Gorvett, Rick

2014-01-01

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

Five years after the accident, whiplash casualties still have poorer quality of life in the physical domain than other mildly injured casualties: analysis of the ESPARR cohort.

Science.gov (United States)

Tournier, Charlène; Hours, Martine; Charnay, Pierrette; Chossegros, Laetitia; Tardy, Hélène

2016-01-05

This study aims to compare health status and quality of life five years after a road accident between casualties with whiplash versus other mild injuries, to compare evolution of quality of life at 1 and 5 years after the accident, and to explore the relation between initial injury (whiplash vs. other) and quality of life. The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 167 casualties with "pure" whiplash and a population of 185 casualties with other mild injuries (MAIS-1). All subjects with lesions classified as cervical contusion (AIS code 310402) or neck sprain (AIS code 640278) were considered as whiplash casualties. Diagnosis was made by physicians, at the outset of hospital care, based on interview, clinical findings and X-ray. Whiplash injuries were then classified following the Quebec classification (grades 1 and 2). Quality of life was assessed on the WHOQoL-Bref questionnaire. Correlations between explanatory variables and quality of life were explored by Poisson regression and variance analysis. Between 1 and 5 years, global QoL improved for both whiplash and non-whiplash casualties; but, considering the two whiplash groups separately, improvement in grade 2 was much less than in grade 1. At 5 years, grade-2 whiplash casualties were more dissatisfied with their health (39.4%; p whiplash (24.3%) or grade-1 whiplash casualties (27.0%). Deteriorated quality of life in the mental, social and environmental domains was mainly related to psychological and socioeconomic factors for both whiplash and other mildly injured road-accident casualties. While PTSD was a major factor for the physical domain, whiplash remained a predictive factor after adjustment on PTSD; unsatisfactory health at 5 years, with deteriorated quality of life in the physical domain, was observed specifically in the whiplash group, pain playing a predominant intermediate role. Deteriorated quality of life in the physical domain

Survey of trauma registry data on tourniquet use in pediatric war casualties.

Science.gov (United States)

Kragh, John F; Cooper, Arthur; Aden, James K; Dubick, Michael A; Baer, David G; Wade, Charles E; Blackbourne, Lorne H

2012-12-01

Previously, we reported on the use of emergency tourniquets to stop bleeding in war casualties, but virtually all the data were from adults. Because no pediatric-specific cohort of casualties receiving emergency tourniquets existed, we aimed to fill knowledge gaps on the care and outcomes of this group by surveying data from a trauma registry to refine device designs and clinical training. A retrospective review of data from a trauma registry yielded an observational cohort of 88 pediatric casualties at US military hospitals in theater on whom tourniquets were used from May 17, 2003, to December 25, 2009. Of the 88 casualties in the study group, 72 were male and 16 were female patients. Ages averaged 11 years (median, 11 years; range, 4-17 years). There were 7 dead and 81 survivor outcomes for a trauma survival rate of 93%. Survivor and dead casualties were similar in all independent variables measured except hospital stay duration (median, 5 days and 1 day, respectively). Six casualties (7%) had neither extremity nor external injury in that they had no lesion indicating tourniquet use. The survival rate of the present study's casualties is similar to that of 3 recent large nonpediatric-specific studies. Although current emergency tourniquets were ostensibly designed for modern adult soldiers, tourniquet makers, perhaps unknowingly, produced tourniquets that fit children. The rate of unindicated tourniquets, 7%, implied that potential users need better diagnostic training. Level 4; case series, therapeutic study.

[In-hospital management of victims of chemical weapons of mass destruction].

Science.gov (United States)

Barelli, Alessandro; Gargano, Flavio; Proietti, Rodolfo

2005-01-01

Emergency situations caused by chemical weapons of mass destruction add a new dimension of risk to those handling and treating casualties. The fundamental difference between a hazardous materials incident and conventional emergencies is the potential for risk from contamination to health care professionals, patients, equipment and facilities of the Emergency Department. Accurate and specific guidance is needed to describe the procedures to be followed by emergency medical personnel to safely care for a patient, as well as to protect equipment and people. This review is designed to familiarize readers with the concepts, terminology and key operational considerations that affect the in-hospital management of incidents by chemical weapons.

Benefits of multidisciplinary collaboration for earthquake casualty estimation models: recent case studies

Science.gov (United States)

So, E.

2010-12-01

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

Three years experience with forward-site mass casualty triage-, evacuation-, operating room-, ICU-, and radiography-enabled disaster vehicles: development of usage strategies from drills and deployments.

Science.gov (United States)

Griffiths, Jane L; Kirby, Neil R; Waterson, James A

2014-01-01

Delineation of the advantages and problems related to the use of forward-site operating room-, Intensive Care Unit (ICU)-, radiography-, and mass casualty-enabled disaster vehicles for site evacuation, patient stabilization, and triage. The vehicles discussed have six ventilated ICU spaces, two ORs, on-site radiography, 21 intermediate acuity spaces with stretchers, and 54 seated minor acuity spaces. Each space has piped oxygen with an independent vehicle-loaded supply. The vehicles are operated by the Dubai Corporate Ambulance Services. Their support hospital is the main trauma center for the Emirate of Dubai and provides the vehicles' surgical, intensivist, anesthesia, and nursing staff. The disaster vehicles have been deployed 264 times in the last 5 years (these figures do not include deployments for drills). Introducing this new service required extensive initial planning and ongoing analysis of the performance of the disaster vehicles that offer ambulance services and receiving hospitals a large array of possibilities in terms of triage, stabilization of priority I and II patients, and management of priority III patients. In both drills and in disasters, the vehicles were valuable in forward triage and stabilization and in the transport of large numbers of priority III patients. This has avoided the depletion of emergency transport available for priority I and II patients. The successful utilization of disaster vehicles requires seamless cooperation between the hospital staffing the vehicles and the ambulance service deploying them. They are particularly effective during preplanned deployments to high-risk situations. These vehicles also potentially provide self-sufficient refuges for forward teams in hostile environments.

Transfusion-Associated Microchimerism in Combat Casualties

National Research Council Canada - National Science Library

Dunne, James R; Lee, Tzong-Hae; Burns, Christopher; Cardo, Lisa J; Curry, Kathleen; Busch, Michael P

2007-01-01

...) in civilian trauma patients receiving allogenic red blood cell (RBC) transfusions. We explored the incidence of TA-MC in combat casualties receiving FrWB compared with patients receiving standard stored RBC transfusions. Methods...

Traffic accidents involving fatigue driving and their extent of casualties.

Science.gov (United States)

Zhang, Guangnan; Yau, Kelvin K W; Zhang, Xun; Li, Yanyan

2016-02-01

The rapid progress of motorization has increased the number of traffic-related casualties. Although fatigue driving is a major cause of traffic accidents, the public remains not rather aware of its potential harmfulness. Fatigue driving has been termed as a "silent killer." Thus, a thorough study of traffic accidents and the risk factors associated with fatigue-related casualties is of utmost importance. In this study, we analyze traffic accident data for the period 2006-2010 in Guangdong Province, China. The study data were extracted from the traffic accident database of China's Public Security Department. A logistic regression model is used to assess the effect of driver characteristics, type of vehicles, road conditions, and environmental factors on fatigue-related traffic accident occurrence and severity. On the one hand, male drivers, trucks, driving during midnight to dawn, and morning rush hours are identified as risk factors of fatigue-related crashes but do not necessarily result in severe casualties. Driving at night without street-lights contributes to fatigue-related crashes and severe casualties. On the other hand, while factors such as less experienced drivers, unsafe vehicle status, slippery roads, driving at night with street-lights, and weekends do not have significant effect on fatigue-related crashes, yet accidents associated with these factors are likely to have severe casualties. The empirical results of the present study have important policy implications on the reduction of fatigue-related crashes as well as their severity. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI)--a case report].

Science.gov (United States)

Gałazkowski, Robert; Wejnarski, Arkadiusz; Baumberg, Ignacy; Świeżewski, Stanisław; Timler, Dariusz

2014-01-01

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

Casualty Risk From Tornadoes in the United States is Highest in Urbanized Areas Across the Mid South

Science.gov (United States)

Fricker, T.; Elsner, J.

2017-12-01

Risk factors for tornado casualties are well known. Less understood is how and to what degree these determinants, after controlling for strength and urban density, vary spatially and temporally. Here we fit models to casualty counts from all casualty-producing tornadoes since 1995 in order to quantify the interactions between urbanization and energy on casualty rates. Results from the models show that the more urbanized areas of the Mid South are substantively and significantly more vulnerable to casualties from tornadoes than elsewhere in the country. Casualty rates are significantly higher on the weekend for tornadoes in this region. Night and day casualty rates are similar regardless of where they occur. Higher vulnerability to casualties from tornadoes occurring in more urbanized areas correspond significantly with greater percentages of elderly people. Many of the micro cities in the Mid South are threatened by tornadoes annually and this threat might potentially be exacerbated by climate change.

A numerical simulation strategy on occupant evacuation behaviors and casualty prediction in a building during earthquakes

Science.gov (United States)

Li, Shuang; Yu, Xiaohui; Zhang, Yanjuan; Zhai, Changhai

2018-01-01

Casualty prediction in a building during earthquakes benefits to implement the economic loss estimation in the performance-based earthquake engineering methodology. Although after-earthquake observations reveal that the evacuation has effects on the quantity of occupant casualties during earthquakes, few current studies consider occupant movements in the building in casualty prediction procedures. To bridge this knowledge gap, a numerical simulation method using refined cellular automata model is presented, which can describe various occupant dynamic behaviors and building dimensions. The simulation on the occupant evacuation is verified by a recorded evacuation process from a school classroom in real-life 2013 Ya'an earthquake in China. The occupant casualties in the building under earthquakes are evaluated by coupling the building collapse process simulation by finite element method, the occupant evacuation simulation, and the casualty occurrence criteria with time and space synchronization. A case study of casualty prediction in a building during an earthquake is provided to demonstrate the effect of occupant movements on casualty prediction.

Manual estimation of fallout casualties. Final report

International Nuclear Information System (INIS)

Gant, K.S.; Haaland, C.M.

1978-08-01

A method is described for enabling Emergency Operating Centers (EOCs) to estimate nuclear fallout casualties (fatalities and injuries) during and after nuclear attack without the aid of computers. This method is compatible with the current manual method for estimating initial weapons effects. The new technique requires that the EOCs have information on nuclear detonations and upper wind conditions and that they have maps, a protractor, map overlay material, grease pencils, worksheets, and pencils. In addition, they will need two tables of data and a fallout casualty (FC) template, all supplied in this report. Five steps are involved in the estimation of fallout casualties for an area: sketching fallout wind streamlines on a map overlay; plotting locations of nuclear detonations and their fallout streamlines; measuring crosswind and upwind distances to detonation points from the point of interest; reading radiation exposure tables and summing the contributions from different weapons to obtain the exposure at that point; and using the FC template with the protection factor profile for the area to estimate fatalities and injuries. The tables of radiation exposure are based on a modified Weapons Systems Evaluation Group-10 (WSEG-10) fallout model. The table of county protection factor profiles (PFPs) assumes a Community Shelter Plan (CSP) posture

Hospital management of mass radiological casualties: reassessing exposures from contaminated victims of an exploded radiological dispersal device (RDD)

International Nuclear Information System (INIS)

Ansari, Armin; Harper, Frederick Taylor; Smith, James M.

2005-01-01

One of the key issues in the aftermath of an exploded radiological dispersal device from a terrorist event is that of the contaminated victim and the concern among healthcare providers for the harmful exposures they may receive in treating patients, especially if the patient has not been thoroughly decontaminated. This is critically important in the event of mass casualties from a nuclear or radiological incident because of the essential rapidity of acute medical decisions and that those who have life- or limb-threatening injuries may have treatment unduly delayed by a decontamination process that may be unnecessary for protecting the health and safety of the patient or the healthcare provider. To estimate potential contamination of those exposed in a radiological dispersal device event, results were used from explosive aerosolization tests of surrogate radionuclides detonated with high explosives at the Sandia National Laboratories. Computer modeling was also used to assess radiation dose rates to surgical personnel treating patients with blast injuries who are contaminated with any of a variety of common radionuclides. It is demonstrated that exceptional but plausible cases may require special precautions by the healthcare provider, even while managing life-threatening injuries of a contaminated victim from a radiological dispersal device event.

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

Directory of Open Access Journals (Sweden)

Robert Gałązkowski

2014-04-01

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

Casualties and threshold effects

International Nuclear Information System (INIS)

Mays, C.W.; National Cancer Inst., Bethesda

1988-01-01

Radiation effects like cancer are denoted as casualties. Other radiation effects occur almost in everyone when the radiation dose is sufficiently high. One then speaks of radiation effects with a threshold dose. In this article the author puts his doubt about this classification of radiation effects. He argues that some effects of exposure to radiation do not fit in this classification. (H.W.). 19 refs.; 2 figs.; 1 tab

Occupational safety data and casualty rates for the uranium fuel cycle

International Nuclear Information System (INIS)

O'Donnell, F.R.; Hoy, H.C.

1981-10-01

Occupational casualty (injuries, illnesses, fatalities, and lost workdays) and production data are presented and used to calculate occupational casualty incidence rates for technologies that make up the uranium fuel cycle, including: mining, milling, conversion, and enrichment of uranium; fabrication of reactor fuel; transportation of uranium and fuel elements; generation of electric power; and transmission of electric power. Each technology is treated in a separate chapter. All data sources are referenced. All steps used to calculate normalized occupational casualty incidence rates from the data are presented. Rates given include fatalities, serious cases, and lost workdays per 100 man-years worked, per 10 12 Btu of energy output, and per other appropriate units of output

Yale and the Atomic Bomb Casualty Commission

International Nuclear Information System (INIS)

Bowers, J.Z.

1983-01-01

This is a description, based largely on personal discussions, of the contributions of men from the Yale University School of Medicine to the saga of the immediate and long-term studies on the medical effects of the atomic bombs at Hiroshima and Nagasaki. They played key roles in the immediate studies of bomb effects, in the creation of long-term studies of delayed effects, and in elevating the Atomic Bomb Casualty Commission after 1955 to a position of excellence in its studies and relations with the Japanese. The accumulation of the information presented in this paper derives from research for the preparation of the history of the Atomic Bomb Casualty Commission. In 1975, the commission was passed to Japanese leadership as the Radiation Effects Research Foundation

Westinghouse GOCO conduct of casualty drills

International Nuclear Information System (INIS)

Ames, C.P.

1996-02-01

Purpose of this document is to provide Westinghouse Government Owned Contractor Operated (GOCO) Facilities with information that can be used to implement or improve drill programs. Elements of this guide are highly recommended for use when implementing a new drill program or when assessing an existing program. Casualty drills focus on response to abnormal conditions presenting a hazard to personnel, environment, or equipment; they are distinct from Emergency Response Exercises in which the training emphasis is on site, field office, and emergency management team interaction. The DOE documents which require team training and conducting drills in nuclear facilities and should be used as guidance in non-nuclear facilities are: DOE 5480.19 (Chapter 1 of Attachment I) and DOE 5480.20 (Chapter 1, paragraphs 7 a. and d. of continuing training). Casualty drills should be an integral part of the qualification and training program at every DOE facility

Estimating shaking-induced casualties and building damage for global earthquake events: a proposed modelling approach

Science.gov (United States)

So, Emily; Spence, Robin

2013-01-01

Recent earthquakes such as the Haiti earthquake of 12 January 2010 and the Qinghai earthquake on 14 April 2010 have highlighted the importance of rapid estimation of casualties after the event for humanitarian response. Both of these events resulted in surprisingly high death tolls, casualties and survivors made homeless. In the Mw = 7.0 Haiti earthquake, over 200,000 people perished with more than 300,000 reported injuries and 2 million made homeless. The Mw = 6.9 earthquake in Qinghai resulted in over 2,000 deaths with a further 11,000 people with serious or moderate injuries and 100,000 people have been left homeless in this mountainous region of China. In such events relief efforts can be significantly benefitted by the availability of rapid estimation and mapping of expected casualties. This paper contributes to ongoing global efforts to estimate probable earthquake casualties very rapidly after an earthquake has taken place. The analysis uses the assembled empirical damage and casualty data in the Cambridge Earthquake Impacts Database (CEQID) and explores data by event and across events to test the relationships of building and fatality distributions to the main explanatory variables of building type, building damage level and earthquake intensity. The prototype global casualty estimation model described here uses a semi-empirical approach that estimates damage rates for different classes of buildings present in the local building stock, and then relates fatality rates to the damage rates of each class of buildings. This approach accounts for the effect of the very different types of buildings (by climatic zone, urban or rural location, culture, income level etc), on casualties. The resulting casualty parameters were tested against the overall casualty data from several historical earthquakes in CEQID; a reasonable fit was found.

The 2004 Fitts Lecture: Current Perspective on Combat Casualty Care

Science.gov (United States)

2005-07-01

deliver this lecture, I actually wondered whether he had called the wrong number. Dr. Basil Pruitt described Dr. William P. Fitts in his 1992 Fitts Lecture...in our ability to care for injured casualties in a deployed setting. Dr. Basil Pruitt eloquently described the interaction between the AAST and...ation ( ABA ) verified burn centers (Fig. 3) in proximity to the USAF hubs.11 We anticipated between 500 and 2,500 burn casualties and created a

Role of cytogenetic biodosimetry in meeting the needs of a mass casualty radiological/nuclear event

International Nuclear Information System (INIS)

Balajee, A.S.; Dainiak, N.

2016-01-01

Radiological/nuclear (R/N) terrorism constitutes a potential threat to all nations that can result in significant morbidity and mortality among hundreds of thousands individuals. In addition to the timing and severity of clinical signs and symptoms, individual radiation dose informs risk assessment and mitigation of radiation-associated injuries. The 'gold standard' for individual whole-body radiation dosimetry is the dicentric chromosome assay. The Cytogenetics Biodosimetry Laboratory at REAC/TS is a WHO Collaborating Centre and member of IAEA's RANET that employs DCA, as well as fluorescence in situ hybridization, premature chromosome condensation, and micronuclei assays to assess radiation dose. The quality of dose estimates and standard operating procedures for DCA at REAC/TS have been validated in multiple inter-comparison studies involving CBLs in Asia, Europe, North America and South America. DCA is scalable to meet the needs of a mass casualty R/N incident. The CBL at REAC/TS has made seminal contributions to augment surge capacity for DCA and develop CBLs worldwide through initiatives such as modification of 'Share Point' in 2010 to transmit images of metaphases for simultaneous telescoring; (2) development of an on-line training program for metaphase scoring; (3) proactive participation as a WCC to create ISO standards; and (4) guidance of regulatory agencies to monitor quality of results and SOPs. The precision of dose estimates by DCA can be vastly improved by using a universal calibration curve. With this view, REAC/TS has organized a collaboration with CBLs at Health Canada and Yale University to construct and validate a common calibration curve for gamma rays

Bird casualties and wind turbines near the Kreekrak sluices of Zeeland

International Nuclear Information System (INIS)

Musters, C.J.M.; Noordervliet, M.A.W.; Ter Keurs, W.J.

1995-03-01

The impact of wind turbines on birds was investigated for an estuary, situated near the North Sea coast in the Dutch province of Zeeland, with large amount of bird migration. Five 250 kW, three-bladed 25m, 40 rpm turbines were installed on the western side of a dike. The distance between the turbines is 125 m. Since 1 April 1990 the turbines have been in action almost continuously. The study on the title subject was set up to investigate the number of bird casualties caused by the five wind turbines near the sluices of Kreekrak and the number that may be expected to be caused by a total of 20 turbines. The study also focused on the number of casualties among rare birds in relation to those among the common birds as a result of the wind turbines in the Kreekrak area. An area of 125 x 125 m around each wind turbine, consisting partly of land and partly of water, was searched for dead birds every other day during a period of one year (28 April 1990 - 29 April 1991). During this one-year period, the bodies of 26 birds of 17 different species were found; six birds were certainly or almost certainly killed by the turbines. In three other cases, the birds may have died because of the turbines, while in the case of eight birds, it was not possible to determine the cause of death. The remaining nine birds were not killed by the wind turbines. The annual number of bird victims expected following the installation of 20 wind turbines was estimated at a minimum of 7 and a maximum of 142. For each species a correlation was found between the number of victims and the estimated number of visitors to the area. This suggests that the rare species among the birds were not excessively endangered by the turbines. The number of bird casualties per turbine was low in comparison with the results of other Dutch investigations. On the basis of these results, it is concluded that there is no reason to advise against increasing the number of wind turbines near the sluices of Kreekrak to 20. 3

The Casualty Network System Capstone Project

Science.gov (United States)

2012-12-01

described by the Watts and Strogatz model (Watts & Strogatz , 1998). Based on the Watts and Strogatz model, the AF can be viewed as a small world...chemical casualties handbook (Vol. 7). Fort Detrick, MD: U.S. Government Printing Office. Watts, Duncan, & Strogatz , Steven (1998). Collective dynamics of

Integration of Tactical Emergency Casualty Care Into the National Tactical Emergency Medical Support Competency Domains.

Science.gov (United States)

Pennardt, Andre; Callaway, David W; Kamin, Rich; Llewellyn, Craig; Shapiro, Geoff; Carmona, Philip A; Schwartz, Richard B

2016-01-01

Tactical emergency medical support (TEMS) is a critical component of the out-of-hospital response to domestic high-threat incidents such as hostage scenarios, warrant service, active shooter or violent incidents, terrorist attacks, and other intentional mass casualty-producing acts. From its grass-roots inception in the form of medical support of select law enforcement special weapons and tactics (SWAT) units in the 1980s, the TEMS subspecialty of prehospital care has rapidly grown and evolved over the past 40 years. The National TEMS Initiative and Council (NTIC) competencies and training objectives are the only published recommendations of their kind and offer the opportunity for national standardization of TEMS training programs and a future accreditation process. Building on the previous work of the NTIC and the creation of acknowledged competency domains for TEMS and the acknowledged civilian translation of TCCC by the Committee for Tactical Emergency Casualty Care (C-TECC), the Joint Review Committee (JRC) has created an opportunity to bring forward the work in a form that could be operationally useful in an all-hazards and whole of community format. 2016.

19 CFR 158.21 - Allowance in duties for casualty, loss, or theft while in Customs custody.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Allowance in duties for casualty, loss, or theft... LOST, DAMAGED, ABANDONED, OR EXPORTED Casualty, Loss, or Theft While in Customs Custody § 158.21 Allowance in duties for casualty, loss, or theft while in Customs custody. Section 563(a), Tariff Act of...

46 CFR 122.220 - Records of a voyage resulting in a marine casualty.

Science.gov (United States)

2010-10-01

....220 Section 122.220 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER... OPERATIONS Marine Casualties and Voyage Records § 122.220 Records of a voyage resulting in a marine casualty... custody thereof, shall make these records available upon request, to a duly authorized investigating...

War casualties: recent trends in evacuation, triage and the golden hour

International Nuclear Information System (INIS)

Safdar, C. A.

2010-01-01

Prompt medical treatment and early evacuation is the goal of military medicine in the battlefield. 'Triage' is a process of sorting the casualties according to the severity of injury and the prioritization of treatment. In trauma management 'Golden Hour' is the first sixty minutes or so after injury; this emphasizes that the chances of the victim's survival are the greatest if definitive care is given as early as possible. Our evacuation protocols follow the triage but the time to treatment is beyond sixty minutes. Many Armies have developed evacuation systems which allow the casualty to be seen within this specified time. This has been achieved by streamlining the evacuation chain, extensive incorporation of air transport and training of paramedics in advanced life support measures. In line with the modern trends we need to modernize our own system of casualty evacuation and treatment. (author)

Net-bottom Cage Inserts for Water Bird Casualties

Directory of Open Access Journals (Sweden)

Jackie Belle

2017-10-01

Full Text Available My Bright Idea is a net-bottomed cage insert, which is used to support pelagic avian casualties. The idea was designed and modified by the International Bird Rescue in California (Bird Rescue.

Effects of ship casualties on reactor safety and marine reactor design

International Nuclear Information System (INIS)

Agena, H.H.

1978-01-01

Ship casualties such as collision, grounding, fire and explosions, leakage and partial flooding may severely impair the safety of the nuclear reactor plant and result in nuclear hazards to the crew and the environment. Engineered safeguards are being discussed for protection against such consequences: manoeuvrability, structural (passive) collision and fire protection, protection against external fires and pressure waves, after heat transmission in case of a casualty, and after heat transmission out off the sunk wreck. Existing requirements will be discussed, shortly

Casualties of peace: an analysis of casualties admitted to the intensive care unit during the negotiation of the comprehensive Colombian process of peace.

Science.gov (United States)

Ordoñez, Carlos A; Manzano-Nunez, Ramiro; Naranjo, Maria Paula; Foianini, Esteban; Cevallos, Cecibel; Londoño, Maria Alejandra; Sanchez Ortiz, Alvaro I; García, Alberto F; Moore, Ernest E

2018-01-01

After 52 years of war in 2012, the Colombian government began the negotiation of a process of peace, and by November 2012, a truce was agreed. We sought to analyze casualties who were admitted to the intensive care unit (ICU) before and during the period of the negotiation of the comprehensive Colombian process of peace. Retrospective study of hostile casualties admitted to the ICU at a Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (November 2012-December 2016). Patients were compared with respect to time periods. Four hundred forty-eight male patients were admitted to the emergency room. Of these, 94 required ICU care. Sixty-five casualties presented before the truce and 29 during the negotiation period. Median injury severity score was significantly higher before the truce. Furthermore, the odds of presenting with severe trauma (ISS > 15) were significantly higher before the truce (OR, 5.4; (95% CI, 2.0-14.2); p  < 0.01). There was a gradual decrease in the admissions to the ICU, and the performance of medical and operative procedures during the period observed. We describe a series of war casualties that required ICU care in a period of peace negotiation. Despite our limitations, our study presents a decline in the occurrence, severity, and consequences of war injuries probably as a result in part of the negotiation of the process of peace. The hysteresis of these results should only be interpreted for their implications in the understanding of the peace-health relationship and must not be overinterpreted and used for any political end.

Investigating the Relationship Between Drone Warfare and Civilian Casualties in Gaza

Directory of Open Access Journals (Sweden)

Dr. Ann Rogers

2014-12-01

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

46 CFR 28.80 - Report of casualty.

Science.gov (United States)

2010-10-01

... GUARD, DEPARTMENT OF HOMELAND SECURITY UNINSPECTED VESSELS REQUIREMENTS FOR COMMERCIAL FISHING INDUSTRY... routine duties. (3) Loss of a vessel. (4) Damage to or by a vessel, its cargo, apparel or gear, except for... industry vessel must submit a report of each casualty involving that vessel to an organization listed in...

46 CFR 122.210 - Alcohol or drug use by individuals directly involved in casualties.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Alcohol or drug use by individuals directly involved in... PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.210 Alcohol or drug use by individuals... alcohol or drug use by individuals directly involved in the casualty. (b) The owner, agent, master, or...

The use of analgesia in mountain rescue casualties with moderate or severe pain.

Science.gov (United States)

Ellerton, John Alexander; Greene, Mike; Paal, Peter

2013-06-01

To assess the effectiveness of analgesia used in mountain rescue (MR) in casualties with moderate or severe pain. To determine if a verbal numeric pain score is practical in this environment. To describe the analgesic strategies used by MR. Prospective, descriptive study. Fifty-one MR teams in England and Wales. The study period was 1 September 2008 to 31 August 2010. 92 MR casualties with a pain scoreof 4/10 or greater. 38% of casualties achieved a pain reduction of 50% or greater in their initial score at 15 min and 60.2% had achieved this at handover. The initial pain score was 8 (median), reducing to 5 at 15 min and 3 at handover. The mean pain reduction was 2.5 ± 2.4 at 15 min and 3.9 ± 2.5 at handover. 80 casualties (87%) were treated with an opioid and seven had two different opioids administered. Seven main strategies were identified in which the principal agent was entonox, intramuscular opioid, oral analgesia, fentanyl lozenge, intranasal or intravenous opioid. The choice of strategy varied with the skills of the casualty carer. Pain should be assessed using a pain score. When possible, intravenous opioid is the gold standard to achieve early and continuing pain control in patients with moderate or severe pain. Entonox and oral analgesics, as sole agents, have limited use in moderate or severe pain. Intranasal opioid and fentanyl lozenge are effective, and appropriate in MR. Research priorities include bioavailability in different environmental conditions and patient's satisfaction with their pain management.

One year after mild injury: comparison of health status and quality of life between casualties with whiplash versus other injuries

OpenAIRE

HOURS, Martine; KHATI, Inès; CHARNAY, Pierrette; CHOSSEGROS, Laetitia; TARDY, Hélène; TOURNIER, Charlène; PERRINE, Anne-Laure; LUAUTE, Jacques; LAUMON, Bernard

2014-01-01

Objectives: To compare health status, family and occupational impact and quality of life one year after an accident between casualties with whiplash versus other mild injuries, and to explore the relation between initial injury (whiplash vs. other) and quality of life. Design: Prospective cohort study. Subjects: The study used data from the ESPARR cohort (a representative cohort of road accident casualties) and included 173 casualties with 'pure' whiplash and a population of 207 casualties wi...

Vulnerability Situations associated with Flash Flood Casualties in the United States

Science.gov (United States)

Terti, G.; Ruin, I.; Anquetin, S.; Gourley, J. J.

2015-12-01

In the United States (U.S.) flash flooding (FF hereafter) is one of the leading cause of weather-related deaths. Because FF events can be distinguished from riverine floods by their fast response to rainfall and resulting impacts signature, analyzing FF-specific impact datasets seems a good way to identify the juxtaposition of social and physical circumstances leading to those impacts. This communication focuses on conceptual and methodological developments allowing testing hypotheses on FF-specific vulnerability factors through the analysis of human impact datasets. We hypothesize that the intersection of the spatio-temporal context of the FF phenomena with the distribution of people and their characteristics across space and time reveals various paths of vulnerability through the expression of different accidents' circumstances (i.e., vehicle-related, inside buildings, open-air, campsites). We argue that vulnerability and the resulting impacts vary dynamically throughout the day according to the location/situation under concern. In order to test FF-specific contextual vulnerability factors at the scale of the continental US, 1075 fatalities reported between 1996 and 2014 in the Storm Data publication of the U.S. National Climatic Data Center (NCDC) are analyzed to statistically explore the timing, the duration and the location of the FF event, and the age and gender of the victims and the circumstance (i.e. location/activity) of their death. In this objective, a re-classification of the individual fatality circumstances and a discretization of the time in qualitative time-steps are performed to obtain possible trends and patterns in the occurrence of fatalities in certain circumstances and time (e.g., day vs night). The findings highlight the importance of situation-specific assessment of FF fatalities to guide the development of FF-specific vulnerability and impacts prediction modeling. Such analysis can provide valuable knowledge when the National Weather

Preliminary quantitative assessment of earthquake casualties and damages

DEFF Research Database (Denmark)

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

2005-01-01

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

Marine Information for Safety and Law Enforcement (MISLE) Casualty and Pollution Incidents, Guam, 2015, US Coast Guard

Data.gov (United States)

U.S. Environmental Protection Agency — The Marine Casualty and Pollution Data files provide details about marine casualty and pollution incidents investigated by Coast Guard Offices throughout the United...

Analyzing the Effects of Urban Combat on Daily Casualty Rates

National Research Council Canada - National Science Library

Yazilitas, Hakan

2004-01-01

.... The available data set contains measurements about the battles like initial strengths, daily casualties, terrain, front width, linear density, attacker's and defender's country, and armor losses...

Provenancing of unidentified World War II casualties: Application of strontium and oxygen isotope analysis in tooth enamel.

Science.gov (United States)

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

2015-01-01

In 2010 and 2012 two sets of unidentified human remains of two World War II soldiers were recovered in the area where the 1944-1945 Kapelsche Veer bridgehead battle took place in The Netherlands. Soldiers of four Allied nations: British Royal Marine Commandos, Free Norwegian Commandos, Free Poles and Canadians, fought against the German Army in this battle. The identification of these two casualties could not be achieved using dental record information of DNA analysis. The dental records of Missing in Action soldiers of the Allied nations did not match with the dental records of the two casualties. A DNA profile was determined for the casualty found in 2010, but no match was found. Due to the lack of information on the identification of the casualties provided by routine methods, an isotope study was conducted in teeth from the soldiers to constrain their provenance. The isotope study concluded that the tooth enamel isotope composition for both casualties matched with an origin from the United Kingdom. For one of the casualties a probable origin from the United Kingdom was confirmed, after the isotope study was conducted, by the recognition of a characteristic belt buckle derived from a Royal Marine money belt, only issued to British Royal Marines, found with the remains of the soldier. Copyright © 2014 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

Military Medical Revolution: Prehospital Combat Casualty Care

Science.gov (United States)

2012-01-01

systems Anesthesia Antisepsis/sanitation (Lister, Pasteur , Koch) Nursing care (Nightingale) World War I and World War II Antibiotics Blood...to preserve the life of casualties in critical conditions. TACEVAC includes evacuation by both designat- ed medical (MEDEVAC) mobility assets and...military experience in Somalia, Afghanistan, and Iraq revitalized the concept of treating hemorrhage with plas- ma to preserve coagulation system

46 CFR 4.05-12 - Alcohol or drug use by individuals directly involved in casualties.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Alcohol or drug use by individuals directly involved in... § 4.05-12 Alcohol or drug use by individuals directly involved in casualties. (a) For each marine... evidence of alcohol or drug use by individuals directly involved in the casualty. (b) The marine employer...

Israeli hospital preparedness for terrorism-related multiple casualty incidents: can the surge capacity and injury severity distribution be better predicted?

Science.gov (United States)

Kosashvili, Yona; Aharonson-Daniel, L; Daniel, Limor A; Peleg, Kobi; Horowitz, Ariel; Laor, Danny; Blumenfeld, Amir

2009-07-01

The incidence of large-scale urban attacks on civilian populations has significantly increased across the globe over the past decade. These incidents often result in Hospital Multiple Casualty Incidents (HMCI), which are very challenging to hospital teams. 15 years ago the Emergency and Disaster Medicine Division in the Israeli Ministry of Health defined a key of 20 percent of each hospital's bed capacity as its readiness for multiple casualties. Half of those casualties are expected to require immediate medical treatment. This study was performed to evaluate the efficacy of the current readiness guidelines based on the epidemiology of encountered HMCIs. A retrospective study of HMCIs was recorded in the Israeli Defense Force (IDF) home front command and the Israeli National Trauma Registry (ITR) between November 2000 and June 2003. An HMCI is defined by the Emergency and Disaster Medicine Division in the Israeli Ministry of Health as >or=10 casualties or >or=4 suffering from injuries with an ISS>or=16 arriving to a single hospital. The study includes a total of 32 attacks, resulting in 62 HMCIs and 1292 casualties. The mean number of arriving casualties to a single hospital was 20.8+/-13.3 (range 4-56, median 16.5). In 95% of the HMCIs the casualty load was concept may improve the utilisation of national emergency health resources both in the preparation phase and on real time.

49 CFR 1242.41 - Other and casualties and insurance (accounts XX-26-99 and 50-26-00).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Other and casualties and insurance (accounts XX-26... RAILROADS 1 Operating Expenses-Equipment § 1242.41 Other and casualties and insurance (accounts XX-26-99 and... administration (account XX-26-01). freight cars ...

49 CFR 1242.65 - Other and casualties and insurance (accounts XX-51-99 and 50-51-00).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Other and casualties and insurance (accounts XX-51... RAILROADS 1 Operating Expenses-Transportation § 1242.65 Other and casualties and insurance (accounts XX-51... separation of administration (account XX-51-01). yard operations ...

[A new age of mass casuality education? : The InSitu project: realistic training in virtual reality environments].

Science.gov (United States)

Lorenz, D; Armbruster, W; Vogelgesang, C; Hoffmann, H; Pattar, A; Schmidt, D; Volk, T; Kubulus, D

2016-09-01

Chief emergency physicians are regarded as an important element in the care of the injured and sick following mass casualty accidents. Their education is very theoretical; practical content in contrast often falls short. Limitations are usually the very high costs of realistic (large-scale) exercises, poor reproducibility of the scenarios, and poor corresponding results. To substantially improve the educational level because of the complexity of mass casualty accidents, modified training concepts are required that teach the not only the theoretical but above all the practical skills considerably more intensively than at present. Modern training concepts should make it possible for the learner to realistically simulate decision processes. This article examines how interactive virtual environments are applicable for the education of emergency personnel and how they could be designed. Virtual simulation and training environments offer the possibility of simulating complex situations in an adequately realistic manner. The so-called virtual reality (VR) used in this context is an interface technology that enables free interaction in addition to a stereoscopic and spatial representation of virtual large-scale emergencies in a virtual environment. Variables in scenarios such as the weather, the number wounded, and the availability of resources, can be changed at any time. The trainees are able to practice the procedures in many virtual accident scenes and act them out repeatedly, thereby testing the different variants. With the aid of the "InSitu" project, it is possible to train in a virtual reality with realistically reproduced accident situations. These integrated, interactive training environments can depict very complex situations on a scale of 1:1. Because of the highly developed interactivity, the trainees can feel as if they are a direct part of the accident scene and therefore identify much more with the virtual world than is possible with desktop systems

Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK'S Initial Operational Response (IOR.

Directory of Open Access Journals (Sweden)

Richard Amlôt

Full Text Available Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an "Initial Operational Response" by (1 identifying an appropriate method for performing improvised skin decontamination and (2 providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads. The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate removed from each volunteer's forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and

Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK'S Initial Operational Response (IOR).

Science.gov (United States)

Amlôt, Richard; Carter, Holly; Riddle, Lorna; Larner, Joanne; Chilcott, Robert P

2017-01-01

Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an "Initial Operational Response" by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer's forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions, improvised

A Dynamic Optimization Method of Indoor Fire Evacuation Route Based on Real-time Situation Awareness

Directory of Open Access Journals (Sweden)

DING Yulin

2016-12-01

Full Text Available How to provide safe and effective evacuation routes is an important safeguard to correctly guide evacuation and reduce the casualties during the fire situation rapidly evolving in complex indoor environment. The traditional static path finding method is difficult to adjust the path adaptively according to the changing fire situation, which lead to the evacuation decision-making blindness and hysteresis. This paper proposes a dynamic method which can dynamically optimize the indoor evacuation routes based on the real-time situation awareness. According to the real-time perception of fire situation parameters and the changing indoor environment information, the evacuation route is optimized dynamically. The integrated representation of multisource indoor fire monitoring sensor observations oriented fire emergency evacuation is presented at first, real-time fire threat situation information inside building is then extracted from the observation data of multi-source sensors, which is used to constrain the dynamical optimization of the topology of the evacuation route. Finally, the simulation experiments prove that this method can improve the accuracy and efficiency of indoor evacuation routing.

CitizenAID.

Science.gov (United States)

2017-01-25

CitizenAID is an easy-to-use app that informs users how to provide care in mass casualty situations, including shootings, knife attacks and bomb incidents. The authors are well known and respected specialists in trauma care and disaster management.

Optimization of Lyophilized Plasma for Use in Combat Casualties

Science.gov (United States)

2016-03-01

ratio of NS infused at a rate of 165 ml/min, minus any given during the controlled hemorrhage to induce acidosis and coagulopathy. This reflects...antioxidant effect suggesting the potential to reduce acute respiratory distress syndrome and multiple organ failure in combat casualties. This model

Prevalence of alcohol among nonfatally injured road accident casualties in two level III trauma centers in northern Ghana.

Science.gov (United States)

Damsere-Derry, James; Palk, Gavan; King, Mark

2018-02-17

Alcohol use is pervasive among motorists on the road in Ghana; however, we do not know the extent to which this behavior is implicated in road accidents in this country. The main objective of this research was to establish the prevalence of alcohol in the blood of nonfatally injured casualties in the emergency departments (EDs) in northern Ghana. Participants were injured road traffic crash victims, namely, pedestrians, cyclists, motorcyclists, and drivers seeking treatment at an ED. The study sites were 2 level III trauma centers located in Wa and Bolgatanga. Participants were screened for alcohol followed by breath tests for positive participants using breathalyzers. Two hundred and sixty-two accident victims visited EDs, 58% of whom were in Wa. Among the victims, 41% were hospitalized and 57% experienced slight injuries. The vast majority (76%) of the casualties were motorcyclists, 13% were pedestrians, 8% were cyclists, and 2% were drivers. Casualties who had detectable alcohol in their blood were predominantly vulnerable road users. In all, 34% of participants had detectable blood alcohol concentrations (BACs) and the mean BAC for all casualties who tested positive and could give definitive BACs was 0.2265 (226 mg/dl). The prevalence of alcohol use was 53% among cyclists, 34% among motorcyclists, 21% among pedestrians, and 17% among drivers. Male casualties were more likely to test positive for alcohol than females. In addition, the prevalence of alcohol was significantly higher among injured casualties in Bolgatanga compared to Wa. There was a high prevalence of alcohol use among nonfatally injured casualties in northern Ghana and injury severity increased with BAC. AUDIT screening in the hospital, alcohol consumption guideline, road safety education with an emphasis on minimizing or eliminating alcohol consumption, and enhanced enforcement of the BAC limit among motorists are recommended.

49 CFR 1242.72 - Other and casualties and insurance (accounts XX-52-99 and 50-52-00).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Other and casualties and insurance (accounts XX-52... RAILROADS 1 Operating Expenses-Transportation § 1242.72 Other and casualties and insurance (accounts XX-52... separation of administration (account XX-52-01). train and yard operations common ...

49 CFR 1242.82 - Other and casualties and insurance (accounts XX-55-99 and 50-55-00).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Other and casualties and insurance (accounts XX-55... RAILROADS 1 Operating Expenses-Transportation § 1242.82 Other and casualties and insurance (accounts XX-55... separation of administration (account XX-55-01). Operating Expenses general and administration ...

49 CFR 1242.54 - Other and casualties and insurance (accounts XX-27-99 and 50-27-00).

Science.gov (United States)

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Other and casualties and insurance (accounts XX-27... RAILROADS 1 Operating Expenses-Equipment § 1242.54 Other and casualties and insurance (accounts XX-27-99 and... administration (account XX-27-01). Operating Expenses—Transportation train operations ...

Casualty data analysis of the world merchant fleet for reported fire and explosion incidents resulting in marine pollution

Science.gov (United States)

1995-02-01

World wide merchant vessel fire and explosion data were analyzed to determine the contribution of these casualties to the marine pollution problem. The source of information is the Lloyd's Casualty Information System Data Base. The major findings of ...

A survey of the practice of nurses' skills in Wenchuan earthquake disaster sites: implications for disaster training.

Science.gov (United States)

Yin, Huahua; He, Haiyan; Arbon, Paul; Zhu, Jingci

2011-10-01

To determine nursing skills most relevant for nurses participating in disaster response medical teams; make recommendations to enhance training of nurses who will be first responders to a disaster site; to improve the capacity of nurses to prepare and respond to severe natural disasters. Worldwide, nurses play a key role in disaster response teams at disaster sites. They are often not prepared for the challenges of dealing with mass casualties; little research exists into what basic nursing skills are required by nurses who are first responders to a disaster situation. This study assessed the most relevant disaster nursing skills of first responder nurses at the 2008 Wenchuan earthquake disaster site. Data were collected in China in 2008 using a self-designed questionnaire, with 24 participants who had been part of the medical teams that were dispatched to the disaster sites. The top three skills essential for nurses were: intravenous insertion; observation and monitoring; mass casualty triage. The three most frequently used skills were: debridement and dressing; observation and monitoring; intravenous insertion. The three skills performed most proficiently were: intravenous insertion; observation and monitoring; urethral catheterization. The top three ranking skills most important for training were: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling. The core nursing skills for disaster response training are: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling; observation and monitoring; mass casualty triage; controlling specific infection; psychological crisis intervention; cardiopulmonary resuscitation; debridement and dressing; central venous catheter insertion; patient care recording. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR)

Science.gov (United States)

Riddle, Lorna; Larner, Joanne

2017-01-01

Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an “Initial Operational Response” by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer’s forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions

The Internet's role in a biodosimetric response to a radiation mass casualty event.

Science.gov (United States)

Sugarman, S L; Livingston, G K; Stricklin, D L; Abbott, M G; Wilkins, R C; Romm, H; Oestreicher, U; Yoshida, M A; Miura, T; Moquet, J E; Di Giorgio, M; Ferrarotto, C; Gross, G A; Christiansen, M E; Hart, C L; Christensen, D M

2014-05-01

Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet.

The Effect of a Golden Hour Policy on the Morbidity and Mortality of Combat Casualties.

Science.gov (United States)

Kotwal, Russ S; Howard, Jeffrey T; Orman, Jean A; Tarpey, Bruce W; Bailey, Jeffrey A; Champion, Howard R; Mabry, Robert L; Holcomb, John B; Gross, Kirby R

2016-01-01

The term golden hour was coined to encourage urgency of trauma care. In 2009, Secretary of Defense Robert M. Gates mandated prehospital helicopter transport of critically injured combat casualties in 60 minutes or less. To compare morbidity and mortality outcomes for casualties before vs after the mandate and for those who underwent prehospital helicopter transport in 60 minutes or less vs more than 60 minutes. A retrospective descriptive analysis of battlefield data examined 21,089 US military casualties that occurred during the Afghanistan conflict from September 11, 2001, to March 31, 2014. Analysis was conducted from September 1, 2014, to January 21, 2015. Data for all casualties were analyzed according to whether they occurred before or after the mandate. Detailed data for those who underwent prehospital helicopter transport were analyzed according to whether they occurred before or after the mandate and whether they occurred in 60 minutes or less vs more than 60 minutes. Casualties with minor wounds were excluded. Mortality and morbidity outcomes and treatment capability-related variables were compared. For the total casualty population, the percentage killed in action (16.0% [386 of 2411] vs 9.9% [964 of 9755]; P mean injury severity score, 17.3; mortality, 10.1% [457 of 4542]) with detailed data, there was a decrease in median transport time after the mandate (90 min vs 43 min; P < .001) and an increase in missions achieving prehospital helicopter transport in 60 minutes or less (24.8% [181 of 731] vs 75.2% [2867 of 3811]; P < .001). When adjusted for injury severity score and time period, the percentage killed in action was lower for those critically injured who received a blood transfusion (6.8% [40 of 589] vs 51.0% [249 of 488]; P < .001) and were transported in 60 minutes or less (25.7% [205 of 799] vs 30.2% [84 of 278]; P < .01), while the percentage died of wounds was lower among those critically injured initially treated by combat

Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia

Directory of Open Access Journals (Sweden)

Abdullah A. Bin Shalhoub

2017-03-01

Full Text Available Objectives: To identify and describe the hospital disaster preparedness (HDP in major private hospitals in Riyadh, Saudi Arabia. Methods: This is an observational cross-sectional survey study performed in Riyadh city, Saudi Arabia between December 2015 and April 2016. Thirteen major private hospitals in Riyadh with more than 100 beds capacity were included in this investigation. Results: The 13 hospitals had HDP plan and reported to have an HDP committee. In 12 (92.3% hospitals, the HDP covered both internal and external disasters and HDP was available in every department of the hospital. There were agreements with other hospitals to accept patients during disasters in 9 facilities (69.2% while 4 (30.8% did not have such agreement. None of the hospitals conducted any unannounced exercises in previous year. Conclusion: Most of the weaknesses were apparent particularly in the education, training and monitoring of the hospital staff to the preparedness for disaster emergency occasion. Few hospitals had conducted an exercise with casualties, few had drilled evacuation of staff and patients in the last 12 months, and none had any unannounced exercise in the last year.

Computer aid in rescue organisation on site in case of catastrophic situation on nuclear plant

International Nuclear Information System (INIS)

Teissier, M.

1992-01-01

The rescue organisation in case of catastrophic situation is based on known principles: creation of medical buffer structures between hazard spot where injured people are being collected and rear hospitals, triage of victims as urgent casualties. We will propose computer aid in order to value the time used to prepare and evacuate all the victims from the site, knowing inventory of available means, waiting periods and lengths of intervention, types and number of victims. Thus, it is possible to optimize the former organisation, qualitatively and quantitatively to improve efficiency in rescuing operations. (author)

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

Science.gov (United States)

2015-09-01

untreated casualty estimate, AMedP-7.5 uses the Injury Profile to deter- mine the final outcome for each Injury Profile cohort. For a treated casualty...materially from that of an HD burn. Large, single coalescent blisters with sharply defined margins are filled with cloudy and opales - cent fluid, and the

Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace.

Science.gov (United States)

Ordoñez, Carlos A; Manzano Nunez, Ramiro; Parra, Michael W; Herrera, Juan Pablo; Naranjo, Maria Paula; Escobar, Sara Sofia; Badiel, Marisol; Morales, Monica; Cevallos, Cecibel; Bayona, Juan G; Sanchez, Alvaro Ignacio; Puyana, Juan Carlos; García, Alberto F

2017-12-30

Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods. A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered. We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.

Casualties Produced by Impact and Related Topics of People Survivability in a Direct Effects Environment

Science.gov (United States)

1974-08-01

Effects Environment". Lt was per- formed for the Defer se Civil Preparedness Agency under Contract DAHiC20-73-C-0196. rhe study was initiated on Hay...rough examin-ation of field daca , i.e., detailed survey data of existing buildings. The rvJson for this is that in order to be generally applicabli...debris under the action of blast winds. These can inteiracL with people located in their paths producing impact casualtie.s. People locaced in basements

Relation between both oxidative and metabolic-osmotic cell damages and initial injury severity in bombing casualties

Directory of Open Access Journals (Sweden)

Vučeljić Marina

2006-01-01

Full Text Available Background/Aim. We have recently reported the development of oxidative cell damages in bombing casualties within a very early period after the initial injury. The aim of this study, was to investigate malondialdehyde (MDA, as an indicator of lipid peroxidation, and osmolal gap (OG, as a good indicator of metabolic cell damages and to assess their relationship with the initial severity of the injury in bombing casualties. Methods. The study included the males (n = 52, injured during the bombing with the Injury Severity Score (ISS ranging from 3 to 66. The whole group of casualties was devided into a group of less severely (ISS < 25, n = 24 and a group of severely (ISS ≥ 26, n = 28 injured males. The uninjured volunteers (n = 10 were the controls. Osmolality, MDA, sodium, glucose, urea, creatinine, total bilirubin and total protein levels were measured in the venous blood, sampled daily, within a ten-day period. Results. In both groups of casualties, MDA and OG levels increased, total protein levels decreased, while other parameters were within the control limits. MDA alterations correlated with ISS (r = 0.414, p < 0.01, while a statistically significant correlation between OG and ISS was not obtained. Interestingly, in spite of some differences in MDA and OG trends, at the end of the examined period they were at the similar level in both groups. Conclusion. The initial oxidative damages of the cellular membrane with intracellular metabolic disorders contributed to the gradual development of metabolic-osmotic damages of cells, which, consequently caused the OG increase. In the bombing casualties, oxidative cell damages were dependent on the initial injury severity, while metabolic-osmotic cell damages were not.

[HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

Science.gov (United States)

Ronen, Ohad; Assadi, Nidal; Sela, Eyal

2017-05-01

For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

26 CFR 20.2054-1 - Deduction for losses from casualties or theft.

Science.gov (United States)

2010-04-01

... (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Taxable Estate... during the settlement of the estate arising from fires, storms, shipwrecks, or other casualties, or from...

Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway

International Nuclear Information System (INIS)

Young, Victoria Solveig; Eggesboe, Heidi B.; Enden, Tone; Gaarder, Christine; Naess, Paal Aksel

2017-01-01

To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. Nine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff. Plain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected. (orig.)

Radiology response in the emergency department during a mass casualty incident: a retrospective study of the two terrorist attacks on 22 July 2011 in Norway

Energy Technology Data Exchange (ETDEWEB)

Young, Victoria Solveig; Eggesboe, Heidi B.; Enden, Tone [Oslo University Hospital, Division of Radiology and Nuclear Medicine, Oslo (Norway); Gaarder, Christine [Oslo University Hospital, Department of Traumatology, Oslo (Norway); Naess, Paal Aksel [Oslo University Hospital, Department of Traumatology, Oslo (Norway); Oslo University Hospital, Department of Paediatric Surgery, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Faculty of Medicine, Oslo (Norway)

2017-07-15

To describe the use of radiology in the emergency department (ED) in a trauma centre during a mass casualty incident, using a minimum acceptable care (MAC) strategy in which CT was restricted to potentially severe head injuries. We retrospectively studied the initial use of imaging on patients triaged to the trauma centre following the twin terrorist attacks in Norway on 22 July 2011. Nine patients from the explosion and 15 from the shooting were included. Fourteen patients had an Injury Severity Score >15. During the first 15 h, 22/24 patients underwent imaging in the ED. All 15 gunshot patients had plain films taken in the ED, compared to three from the explosion. A CT was performed in 18/24 patients; ten of these were completed in the ED and included five non-head CTs, the latter representing deviations from the MAC strategy. No CT referrals were delayed or declined. Mobilisation of radiology personnel resulted in a tripling of the staff. Plain film and CT capacity was never exceeded despite deviations from the MAC strategy. An updated disaster management plan will require the radiologist to cancel non-head CTs performed in the ED until no additional MCI patients are expected. (orig.)

The Need for Situational Awareness in a CBRNE Attack

Directory of Open Access Journals (Sweden)

Jordan Nelms

2011-02-01

Full Text Available Six years before the terrorist attacks on the World Trade Center and the Pentagon, and eight years before the United States went to war with Saddam Hussein for his alleged concealment of chemical and biological weapons caches, Japan's Tokyo subway was struck by one of the most vicious terror attacks in modern history.  The 1995 Sarin terrorist attack represents an important case study for post-9/11 emergency managers because it highlights the key issues first responders and public health officials face when confronted with a CBRNE ('C'hemical, 'B'iological, 'R'adiological, 'N'uclear, 'E'xplosive mass-casualty attack.

Challenges facing the veterinary profession in Ireland: 3. emergency and casualty slaughter certification.

Science.gov (United States)

Magalhães-Sant'Ana, Manuel; More, Simon J; Morton, David B; Hanlon, Alison J

2017-01-01

Veterinarians are faced with significant conflicts of interest when issuing certificates for the transport and slaughter of acutely injured and casualty livestock. In a recent Policy Delphi study, emergency and casualty slaughter certification was a key concern identified by veterinary professionals in Ireland. In this case study (the third in a series of three resulting from a research workshop exploring challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and the on-farm use of veterinary antimicrobials), we aim to provide a value-based reflection on the constraints and opportunities for best practice in emergency and casualty slaughter certification in Ireland. Using a qualitative focus group approach, this study gathered evidence from relevant stakeholders, namely a representative from the regulatory body, local authority veterinarians with research experience in emergency slaughter, an animal welfare research scientist, official veterinarians from the competent authority, a private veterinary practitioner, and a member of a farming organisation. Results revealed a conflict between the responsibility of private veterinary practitioners (PVPs) to safeguard the welfare of acutely injured bovines on-farm and the client's commercial concerns. As a consequence, some PVPs may feel under pressure to certify, for example, an acutely injured animal for casualty slaughter instead of recommending either on-farm emergency slaughter or disposal by the knackery service. Among Official Veterinarians, there are concerns about the pressure within processing plants to accept acutely injured livestock as casualty animals. Confusion pertaining to legislation and definition of fitness to travel also contribute to these dilemmas. Conflicts of interest arise due to the gap between governance and provision to facilitate on-farm emergency slaughter of livestock. Increased availability and acceptance of on

Daily variation in natural disaster casualties: information flows, safety, and opportunity costs in tornado versus hurricane strikes.

Science.gov (United States)

Zahran, Sammy; Tavani, Daniele; Weiler, Stephan

2013-07-01

Casualties from natural disasters may depend on the day of the week they strike. With data from the Spatial Hazard Events and Losses Database for the United States (SHELDUS), daily variation in hurricane and tornado casualties from 5,043 tornado and 2,455 hurricane time/place events is analyzed. Hurricane forecasts provide at-risk populations with considerable lead time. Such lead time allows strategic behavior in choosing protective measures under hurricane threat; opportunity costs in terms of lost income are higher during weekdays than during weekends. On the other hand, the lead time provided by tornadoes is near zero; hence tornados generate no opportunity costs. Tornado casualties are related to risk information flows, which are higher during workdays than during leisure periods, and are related to sheltering-in-place opportunities, which are better in permanent buildings like businesses and schools. Consistent with theoretical expectations, random effects negative binomial regression results indicate that tornado events occurring on the workdays of Monday through Thursday are significantly less lethal than tornados that occur on weekends. In direct contrast, and also consistent with theory, the expected count of hurricane casualties increases significantly with weekday occurrences. The policy implications of observed daily variation in tornado and hurricane events are considered. © 2012 Society for Risk Analysis.

The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war.

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Beck-Razi, Nira; Fischer, Doron; Michaelson, Moshe; Engel, Ahuva; Gaitini, Diana

2007-09-01

The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict. The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate. Two-hundred eighty-one physically injured patients, 215 soldiers (76.5%) and 66 civilians (23.5%), were admitted. Focused assessment with sonography for trauma was performed in 102 casualties suspected to have an abdominal injury. Sixty-eight underwent computed tomography (CT); 12 underwent laparotomy; and 28 were kept under clinical observation alone. We compared FAST results against CT, laparotomy, and clinical observation records. Focused assessment with sonography for trauma results were positive in 17 casualties and negative in 85. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FAST were 75%, 97.6%, 88.2%, 94.1%, and 93.1%, respectively. A strong correlation between FAST and CT results, laparotomy, and clinical observation was obtained (P war conflict-related MCI, FAST enabled immediate triage of casualties to laparotomy, CT, or clinical observation. Because of its moderate sensitivity, a negative FAST result with strong clinical suspicion demands further evaluation, especially in an MCI.

Job Stress and Coping in Army Casualty Operations Workers

Science.gov (United States)

1991-01-14

informing survivors, and 2) a masculine culture that denies socioemotional aspects of policework (Hall, 1982; Hendricks, 1984; Eth, 1987). Casualty...assistance environment, requiring a degree of 42 socioemotional investment, social supports of some nature are useful. Overall, the work atmosphere at COC is...in child- protective service workers. _ fly Service Review, 31-44. 52 Hendricks, J.E. (1984). Death notification: The theory and practice of informing

Challenges to Improving Combat Casualty Survivability on the Battlefield

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2015-01-01

Rescue Medic in Mogadishu , Somalia, and Special Forces battalion surgeon during Operation Enduring Freedom. He is currently the Director of the Military...the CoTCCC, an organization born outside the traditional military medical establishment, exposes a void in ownership and expertise in battle - field...serve as bat- talion surgeons responsible for the resuscitation of battle casualties in the battalion aid station. This is reminiscent of how

Retrospection. Uranium mining Wismut und the legal casualty insurance

International Nuclear Information System (INIS)

Breuer, Joachim

2015-01-01

Although the Wismut uranium mining company in the former DDR had 600.000 employees, the company was not mentioned in the contract on the German reunification. The expenses for the health consequences imposed manifold challenges to the legal casualty insurance. The question of responsibility, the conservation, digitalization and evaluation of data concerning the personnel and health information, partially handwritten is a tremendous amount of work.

A third-party casualty risk model for unmanned aircraft system operations

International Nuclear Information System (INIS)

Melnyk, Richard; Schrage, Daniel; Volovoi, Vitali; Jimenez, Hernando

2014-01-01

Unmanned Aircraft System (UAS) integration into the National Airspace System (NAS) is an important goal of many members of the Aerospace community including stakeholders such as the military, law enforcement and potential civil users of UAS. However, integration efforts have remained relatively limited due to safety concerns. Due to the nature of UAS, safety predictions must look beyond the system itself and take the operating environment into account. A framework that can link UAS reliability and physical characteristics to the effects on the bystander population is required. This study proposes using a Target Level of Safety approach and an event tree format, populated with data from existing studies that share characteristics of UAS crashes to enable casualty prediction for UAS operations. - Highlights: • A framework for predicting bystander casualties caused by UAS mishaps. • A method to facilitate UAS integration by linking system reliability to system safety. • A tool to help develop UAS certification standards

Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers

International Nuclear Information System (INIS)

Coleman, Liz; Piper, Keith

2009-01-01

Aim: To assess how accurately and confidently casualty officers, nurse practitioners and radiographers, practicing within the emergency department (ED), recognize and describe radiographic trauma within an image test bank of 20 appendicular radiographs. Method: The participants consisted of 7 casualty officers, 13 nurse practitioners and 18 radiographers. All 20 radiographic examinations selected for the image test bank had been acquired following trauma and included some subtle, yet clinically significant abnormalities. The test bank score (maximum 40 marks), sensitivity and specificity percentages were calculated against an agreed radiological diagnosis (reference standard). Alternative Free-response Receiver Operating Characteristic (AFROC) analysis was used to assess the overall performance of the diagnostic accuracy of these professional groups. The variation in performance between each group was measured using the analysis of variance (ANOVA) test, to identify any statistical significant differences in the performance in interpretation between these groups. The relationship between the participants' perceived image interpretation accuracy during clinical practice and the actual accuracy of their image test bank score was examined using Pearson's Correlation Coefficient (r). Results: The results revealed that the radiographers gained the highest mean test bank score (28.5/40; 71%). This score was statistically higher than the mean test bank scores attained by the participating nurse practitioners (21/40; 53%) and casualty officers (21.5/40; 54%), with p < 0.01 and p = 0.02, respectively. When compared with each other, the scores from these latter groups showed no significant difference (p = 0.91). The mean 'area under the curve' (AUC) value achieved by the radiographers was also significantly higher (p < 0.01) in comparison to the AUC values demonstrated by the nurse practitioners and casualty officers, whose results, when compared, showed no significant

Conflict Without Casualties: Non-Lethal Weapons in Irregular Warfare

Science.gov (United States)

2007-09-01

the body,” and the Geneva Protocol of 1925, bans the use of chemical and biological weapons .11 On 8 April 1975, President Ford issued Executive...E Funding – PE 63851M) (accessed 15 December 2006). The American Journal of Bioethics . “Medical Ethics and Non-Lethal Weapons .” Bioethics.net...CASUALTIES: NON-LETHAL WEAPONS IN IRREGULAR WARFARE by Richard L. Scott September 2007 Thesis Advisor: Robert McNab Second Reader

Psychosocial considerations for mass decontamination

International Nuclear Information System (INIS)

Lemyre, L.; Johnson, C.; Corneil, W.

2010-01-01

Mass exposure to explosions, infectious agents, food-borne illnesses, chemicals or radiological materials may require mass decontamination that have critical psychosocial implications for the public and for both traditional and non-traditional responders in terms of impact and of response. Five main issues are common to mass decontamination events: (i) perception, (ii) somatisation, (iii) media role and communication, (iv) information sharing, (v) behavioural guidance and (vi) organisational issues. Empirical evidence is drawn from a number of cases, including Chernobyl; Goiania, Brazil; the sarin gas attack in Tokyo; the anthrax attacks in the USA; Three Mile Island; and by features of the 2003 severe acute respiratory syndrome pandemic. In this paper, a common platform for mass casualty management is explored and suggestions for mass interventions are proposed across the complete event timeline, from pre-event threat and warning stages through to the impact and reconstruction phases. Implication for responders, health care and emergency infrastructure, public behaviour, screening processes, risk communication and media management are described. (authors)

Eating Order: A 13-Week Trust Model Class for Dieting Casualties

Science.gov (United States)

Jackson, Elizabeth G.

2008-01-01

Chronic dieting distorts eating behaviors and causes weight escalation. Desperation about losing weight results in pursuit of extreme weight loss measures. Instead of offering yet another diet, nutrition educators can teach chronic dieters (dieting casualties) to develop eating competence. Eating Order, a 13-week class for chronic dieters based on…

Personal protection during resuscitation of casualties contaminated with chemical or biological warfare agents--a survey of medical first responders.

Science.gov (United States)

Brinker, Andrea; Prior, Kate; Schumacher, Jan

2009-01-01

The threat of mass casualties caused by an unconventional terrorist attack is a challenge for the public health system, with special implications for emergency medicine, anesthesia, and intensive care. Advanced life support of patients injured by chemical or biological warfare agents requires an adequate level of personal protection. The aim of this study was to evaluate the personal protection knowledge of emergency physicians and anesthetists who would be at the frontline of the initial health response to a chemical/biological warfare agent incident. After institutional review board approval, knowledge of personal protection measures among emergency medicine (n = 28) and anesthetics (n = 47) specialty registrars in the South Thames Region of the United Kingdom was surveyed using a standardized questionnaire. Participants were asked for the recommended level of personal protection if a chemical/biological warfare agent(s) casualty required advanced life support in the designated hospital resuscitation area. The best awareness within both groups was regarding severe acute respiratory syndrome, and fair knowledge was found regarding anthrax, plague, Ebola, and smallpox. In both groups, knowledge about personal protection requirements against chemical warfare agents was limited. Knowledge about personal protection measures for biological agents was acceptable, but was limited for chemical warfare agents. The results highlight the need to improve training and education regarding personal protection measures for medical first receivers.

Death on the battlefield (2001-2011): implications for the future of combat casualty care.

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Eastridge, Brian J; Mabry, Robert L; Seguin, Peter; Cantrell, Joyce; Tops, Terrill; Uribe, Paul; Mallett, Olga; Zubko, Tamara; Oetjen-Gerdes, Lynne; Rasmussen, Todd E; Butler, Frank K; Kotwal, Russ S; Kotwal, Russell S; Holcomb, John B; Wade, Charles; Champion, Howard; Lawnick, Mimi; Moores, Leon; Blackbourne, Lorne H

2012-12-01

Critical evaluation of all aspects of combat casualty care, including mortality, with a special focus on the incidence and causes of potentially preventable deaths among US combat fatalities, is central to identifying gaps in knowledge, training, equipment, and execution of battlefield trauma care. The impetus to produce this analysis was to develop a comprehensive perspective of battlefield death, concentrating on deaths that occurred in the pre-medical treatment facility (pre-MTF) environment. The Armed Forces Medical Examiner Service Mortality Surveillance Division was used to identify Operation Iraqi Freedom and Operation Enduring Freedom combat casualties from October 2001 to June 2011 who died from injury in the deployed environment. The autopsy records, perimortem records, photographs on file, and Mortality Trauma Registry of the Armed Forces Medical Examiner Service were used to compile mechanism of injury, cause of injury, medical intervention performed, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) on all lethal injuries. All data were used by the expert panel for the conduct of the potential for injury survivability assessment of this study. For the study interval between October 2001 and June 2011, 4,596 battlefield fatalities were reviewed and analyzed. The stratification of mortality demonstrated that 87.3% of all injury mortality occurred in the pre-MTF environment. Of the pre-MTF deaths, 75.7% (n = 3,040) were classified as nonsurvivable, and 24.3% (n = 976) were deemed potentially survivable (PS). The injury/physiologic focus of PS acute mortality was largely associated with hemorrhage (90.9%). The site of lethal hemorrhage was truncal (67.3%), followed by junctional (19.2%) and peripheral-extremity (13.5%) hemorrhage. Most battlefield casualties died of their injuries before ever reaching a surgeon. As most pre-MTF deaths are nonsurvivable, mitigation strategies to impact outcomes in this population need to be directed

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

Directory of Open Access Journals (Sweden)

Marla B. Keenan

2013-06-01

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

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

Science.gov (United States)

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

2009-06-01

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research

Internet-accessible radiographic database of Vietnam War casualties for medical student education.

Science.gov (United States)

Critchley, Eric P; Smirniotopoulos, James G

2003-04-01

The purpose of this study was to determine the feasibility of archiving radiographic images from Vietnam era conflict casualties into a personal computer-based electronic database of text and images and displaying the data using an Internet-accessible database for preservation and educational purposes. Thirty-two patient cases were selected at random from a pool of 1,000 autopsy reports in which radiographs were available. A total of 74 radiographs from these cases were digitized using a commercial image scanner and then uploaded into an Internet accessible database. The quality of the digitized images was assessed by administering an image-based test to a group of 12 medical students. No statistically significant (p > 0.05) differences were found between test scores when using the original radiographs versus using the digitized radiographs on the Internet-accessible database. An Internet-accessible database is capable of effectively archiving Vietnam era casualty radiographs for educational purposes.

Strategy Of Attrition: Why General Westmoreland Failed In 1967

Science.gov (United States)

2016-05-26

assault on South Vietnamese regulars at Xa Tan Hung resulted in...with forty-six wounded. To complicate the situation, civilian casualties continued to mass. During the attack at Xa Tan Hung, the Viet Cong wounded...Ronald H. Advice And Support: The Early. Years, 1941-1960. Washington, DC: Center of Military History,1985. Taleb, Nassim Nicholas . Antifragile: Things

Modification of Measures of Acute Kidney Injury to Risk Stratify Combat Casualties

Science.gov (United States)

2017-08-26

REPORT TYPE 08/26/2017 Poster 4. TJTLE AND SUBTITLE t\\.1odification of l’vfeasures,of Acute Kidney Injury to Risk Stratify Cotnbat Casualties 6...profiles and potential future conflicts , identifying acute kidney injury (AKI) early can help us determine the need for rapidity of evacuation

Earthquake casualty models within the USGS Prompt Assessment of Global Earthquakes for Response (PAGER) system

Science.gov (United States)

Jaiswal, Kishor; Wald, David J.; Earle, Paul S.; Porter, Keith A.; Hearne, Mike

2011-01-01

Since the launch of the USGS’s Prompt Assessment of Global Earthquakes for Response (PAGER) system in fall of 2007, the time needed for the U.S. Geological Survey (USGS) to determine and comprehend the scope of any major earthquake disaster anywhere in the world has been dramatically reduced to less than 30 min. PAGER alerts consist of estimated shaking hazard from the ShakeMap system, estimates of population exposure at various shaking intensities, and a list of the most severely shaken cities in the epicentral area. These estimates help government, scientific, and relief agencies to guide their responses in the immediate aftermath of a significant earthquake. To account for wide variability and uncertainty associated with inventory, structural vulnerability and casualty data, PAGER employs three different global earthquake fatality/loss computation models. This article describes the development of the models and demonstrates the loss estimation capability for earthquakes that have occurred since 2007. The empirical model relies on country-specific earthquake loss data from past earthquakes and makes use of calibrated casualty rates for future prediction. The semi-empirical and analytical models are engineering-based and rely on complex datasets including building inventories, time-dependent population distributions within different occupancies, the vulnerability of regional building stocks, and casualty rates given structural collapse.

Tracking the daily availability of burn beds for national emergencies.

Science.gov (United States)

Barillo, David J; Jordan, Marion H; Jocz, Richard J; Nye, Donna; Cancio, Leopoldo C; Holcomb, John B

2005-01-01

Medical planning for Operation Iraqi Freedom included predictive models of expected number of burn casualties. In all but the best-case scenario, casualty estimates exceeded the capacity of the only Department of Defense burn center. Examination of existing federal-civilian disaster plans for military hospital augmentation revealed that bed availability data were neither timely nor accurate. Recognizing the need for accurate knowledge of burn bed availability, the Department of Defense requested assistance from the American Burn Association (ABA). Directors of burn centers in the United States were queried for interest in participation in a mass casualty plan to provide overflow burn bed capacity. A list of 70 participating burn centers was devised based upon proximity to planned military embarkation points. A computer tracking program was developed. Daily automated e-mail messages requesting bed status were sent to burn center directors at 6 am Central time with responses requested before 11 am. The collated list of national overflow burn bed capacity was e-mailed each day to the ABA Central Office and to federal and military agencies involved with burn patient triage and transportation. Once automated, this task required only 1-2 hours a day. Available burn-bed lists were generated daily between March 17 and May 2, 2003 and then every other day until May 9, 2003. A total of 2151 responses were received (mean, 43 burn centers per day). A system to track daily nationwide burn bed availability was successfully implemented. Although intended for military conflict, this system is equally applicable to civilian mass casualty situations. We advocate adoption of this or a similar bed tracking system by the ABA for use during burn mass casualty incidents.

[Disasters and emergency situations: what have we learned from the past to prepare for the future?].

Science.gov (United States)

Peleg, Kobi

2010-07-01

Israel has gained extensive experience in the mass casuaLty field, especially from dealing with terrorism events. This special issue of "Harefuah" includes articles that describe and analyze several aspects and approaches related to mass casualty event (MCE) preparedness and response strategies, based on Israel's experience. Feigenberg reports that Magen David Adom (MDA) was able to evacuate all urgent injuries during an MCE from the site to a hospital in 28 minutes, on average. Of the MCE casualties, 71% were evacuated directly to level 1 trauma centers. Rafalowski notes that the ability of MDA to implement organizational and operational Learning processes close to the time of the incident, as well as their modular operational approach, which allows flexibility in responding to simultaneous events, are probably among the reasons that have helped MDA reach a high Level of success in dealing with MCEs. Analysis of terrorism injury data demonstrates that these injuries, suffered by both children and adults, are characterized by increased complexity, with higher severity, higher in-patient mortality rates, and significantly greater use of precious hospital resources such as intensive care, operating rooms, CT, and days of hospitalization. Extensive experience dealing with MCEs has brought managerial insights to the entire health system, for instance in the hospitalization system and clinical management of injuries. In her article, Adini defines five major components for assessing the Israeli health system in emergencies. Shasha's article discusses the principles of hospital preparedness while working under fire. The importance of this subject has in recent years helped bring a more academic approach to emergency and disaster management in the world and in Israel, as enacted at Tel Aviv University's Multidisciplinary Master's Program in Emergency and Disaster Management, and also in other universities that focus on specific disciplines. In summary, achieving

Evaluating the Joint Theater Trauma Registry as a data source to benchmark casualty care.

Science.gov (United States)

O'Connell, Karen M; Littleton-Kearney, Marguerite T; Bridges, Elizabeth; Bibb, Sandra C

2012-05-01

Just as data from civilian trauma registries have been used to benchmark and evaluate civilian trauma care, data contained within the Joint Theater Trauma Registry (JTTR) present a unique opportunity to benchmark combat care. Using the iterative steps of the benchmarking process, we evaluated data in the JTTR for suitability and established benchmarks for 24-hour mortality in casualties with polytrauma and a moderate or severe blunt traumatic brain injury (TBI). Mortality at 24 hours was greatest in those with polytrauma and a severe blunt TBI. No mortality was seen in casualties with polytrauma and a moderate blunt TBI. Secondary insults after TBI, especially hypothermia and hypoxemia, increased the odds of 24-hour mortality. Data contained in the JTTR were found to be suitable for establishing benchmarks. JTTR data may be useful in establishing benchmarks for other outcomes and types of combat injuries.

United States Army Rangers in Somalia: An Analysis of Combat Casualties on an Urban Battlefield

National Research Council Canada - National Science Library

Mabry, Robert L; Holcomb, John B; Baker, Andrew M; Cloonan, Clifford C; Uhorchak, John M; Perkins, Denver E; Canfield, Anthony J; Hagmann, John H

2000-01-01

.... From July 1998 to March 1999 data were collected for a retrospective analysis of all combat casualties sustained by United States military forces in Mogadishu, Somalia, on October 3 and 4, 1993...

Testing the START Triage Protocol: Can It Improve the Ability of Nonmedical Personnel to Better Triage Patients During Disasters and Mass Casualties Incidents ?

Science.gov (United States)

Badiali, Stefano; Giugni, Aimone; Marcis, Lucia

2017-06-01

START (Simple Triage and Rapid Treatment) triage is a tool that is available even to nonmedical rescue personnel in case of a disaster or mass casualty incident (MCI). In Italy, no data are available on whether application of the START protocol could improve patient outcomes during a disaster or MCI. We aimed to address whether "last-minute" START training of nonmedical personnel during a disaster or MCI would result in more effective triage of patients. In this case-control study, 400 nonmedical ambulance crew members were randomly assigned to a non-START or a START group (200 per group). The START group received last-minute START training. Each group examined 6000 patients, obtained from the Emergo Train System (ETS Italy, Bologna, Italy) victims database, and assigned patients a triage code (black-red-yellow-green) along with a reason for the assignment. Each rescuer triaged 30 patients within a 30-minute time frame. Results were analyzed according to Fisher's exact test for a P valueSTART group completed the evaluations in 15 minutes, whereas the non-START group took 30 minutes. The START group correctly triaged 94.2% of their patients, as opposed to 59.83% of the non-START group (PSTART group versus 13.67% and 26.5% for the non-START group. The non-START group had 458 "preventable deaths" on 6000 cases because of incorrect triage, whereas the START group had 91. Even a "last-minute" training on the START triage protocol allows nonmedical personnel to better identify and triage the victims of a disaster or MCI, resulting in more effective and efficient medical intervention. (Disaster Med Public Health Preparedness. 2017;11:305-309).

46 CFR 185.220 - Records of a voyage resulting in a marine casualty.

Science.gov (United States)

2010-10-01

....220 Section 185.220 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.220 Records of a... officer, or person responsible for the custody thereof, shall make these records available upon request...

On-ground casualty risk reduction by structural design for demise

Science.gov (United States)

Lemmens, Stijn; Funke, Quirin; Krag, Holger

2015-06-01

In recent years, awareness concerning the on-ground risk posed by un-controlled re-entering space systems has increased. On average over the past decade, an object with mass above 800 kg re-enters every week from which only a few, e.g. ESA's GOCE in 2013 and NASA's UARS in 2011, appeared prominent in international media. Space agencies and nations have discussed requirements to limit the on-ground risk for future missions. To meet the requirements, the amount of debris falling back on Earth has to be limited in number, mass and size. Design for demise (D4D) refers to all measures taken in the design of a space object to increase the potential for demise of the object and its components during re-entry. SCARAB (Spacecraft Atmospheric Re-entry and Break-Up) is ESA's high-fidelity tool which analyses the thermal and structural effects of atmospheric re-entry on spacecraft with a finite-element approach. For this study, a model of a representative satellite is developed in SCARAB to serve as test-bed for D4D analyses on a structural level. The model is used as starting point for different D4D approaches based on increasing the exposure of the satellite components to the aero-thermal environment, as a way to speed up the demise. Statistical bootstrapping is applied to the resulting on-ground fragment lists in order to compare the different re-entry scenarios and to determine the uncertainties of the results. Moreover, the bootstrap results can be used to analyse the casualty risk estimator from a theoretical point of view. The risk reductions for the analysed D4D techniques are presented with respect to the reference scenario for the modelled representative satellite.

Blood transfusion is associated with infection and increased resource utilization in combat casualties.

Science.gov (United States)

Dunne, James R; Riddle, Mark S; Danko, Janine; Hayden, Rich; Petersen, Kyle

2006-07-01

Combat casualty care has made significant advances in recent years, including administration of blood products in far-forward locations. However, recent studies have shown blood transfusion to be a significant risk factor for infection and increased resource utilization in critically injured patients. We therefore sought to investigate the incidence of blood transfusion and its association with infection and resource utilization in combat casualties. Prospective data were collected and retrospectively reviewed on 210 critically injured patients admitted to the USNS Comfort over a 7-week period during the 2003 assault phase of Operation Iraqi Freedom. Patients were stratified by age, gender, and injury severity score (ISS). Multivariate regression analyses were used to assess blood transfusion and hematocrit (HCT) as independent risk factors for infection and intensive care unit (ICU) admission controlling for age, gender, and ISS. The study cohort had a mean age of 30 +/- 2 years, a mean ISS of 14 +/- 3, 84 per cent were male, and 88 per cent sustained penetrating trauma. Blood transfusion was required in 44 per cent (n = 93) of the study cohort. Transfused patients had a higher ISS (18 +/- 4 vs. 10 +/- 3, P transfused. Patients receiving blood transfusion had an increased infection rate (69% vs. 18%, P transfused and nontransfused patients. Multivariate binomial regression analysis identified blood transfusion and HCT as independent risk factors for infection (P blood transfusion as an independent risk factor for ICU admission (P blood transfusion. Blood transfusion is an independent risk factor for infection and increased resource utilization. Therefore, consideration should be given to the use of alternative blood substitutes and recombinant human erythropoietin in the treatment and management of combat casualties.

75 FR 38188 - Surety Companies Acceptable on Federal Bonds-Termination: Stonebridge Casualty Insurance Company

Science.gov (United States)

2010-07-01

... should be accepted from this company, and bonds that are continuous in nature should not be renewed. The... DEPARTMENT OF THE TREASURY Fiscal Service [NAIC 10952] Surety Companies Acceptable on Federal Bonds--Termination: Stonebridge Casualty Insurance Company AGENCY: Financial Management Service, Fiscal...

Popliteal artery repair in massively transfused military trauma casualties: a pursuit to save life and limb.

Science.gov (United States)

Fox, Charles J; Perkins, Jeremy G; Kragh, John F; Singh, Niten N; Patel, Bhavin; Ficke, James R

2010-07-01

Popliteal artery war wounds can bleed severely and historically have high rates of amputation associated with ligation (72%) and repair (32%). More than before, casualties are now surviving the initial medical evacuation and presenting with severely injured limbs that prompt immediate limb salvage decisions in the midst of life-saving maneuvers. A modern analysis of current results may show important changes because previous limb salvage strategies were limited by the resuscitation and surgical techniques of their eras. Because exact comparisons between wars are difficult, the objective of this study was to calculate a worst-case (a pulseless, fractured limb with massive hemorrhage from popliteal artery injury) amputation-free survival rate for the most severely wounded soldiers undergoing immediate reconstruction to save both life and limb. We performed a retrospective study of trauma casualties admitted to the combat support hospital at Ibn Sina Hospital in Baghdad, Iraq, between 2003 and 2007. US military casualties requiring a massive transfusion (> or = 10 blood units transfused within 24 hours of injury) were identified. We extracted data on the subset of casualties with a penetrating supra or infrageniculate popliteal arterial vascular injury. Demographics, injury mechanism, Injury Severity Score, tourniquet use, physiologic parameters, damage control adjuncts, surgical repair techniques, operative time, and outcomes (all-cause 30-day mortality, amputation rates, limb salvage failure, and graft patency) were investigated. Forty-six massively transfused male casualties, median age 24 years (range, 19-54 years; mean Injury Severity Score, 19 +/- 8.0), underwent immediate orthopedic stabilization and vascular reconstruction. There was one early death. The median operative time for the vascular repairs was 217 minutes (range, 94-630 minutes) and included all damage control procedures. Combined arterial and venous injuries occurred in 17 (37%). Ligation was

Mathematical models for estimating earthquake casualties and damage cost through regression analysis using matrices

International Nuclear Information System (INIS)

Urrutia, J D; Bautista, L A; Baccay, E B

2014-01-01

The aim of this study was to develop mathematical models for estimating earthquake casualties such as death, number of injured persons, affected families and total cost of damage. To quantify the direct damages from earthquakes to human beings and properties given the magnitude, intensity, depth of focus, location of epicentre and time duration, the regression models were made. The researchers formulated models through regression analysis using matrices and used α = 0.01. The study considered thirty destructive earthquakes that hit the Philippines from the inclusive years 1968 to 2012. Relevant data about these said earthquakes were obtained from Philippine Institute of Volcanology and Seismology. Data on damages and casualties were gathered from the records of National Disaster Risk Reduction and Management Council. This study will be of great value in emergency planning, initiating and updating programs for earthquake hazard reduction in the Philippines, which is an earthquake-prone country.

The capacity, capabilities and needs of the who BioDoseNet member laboratories

International Nuclear Information System (INIS)

Maznyk, N. A.; Wilkins, R. C.; Carr, Z.; Lloyd, D. C.

2012-01-01

Bio-dosimetry is an essential tool for providing timely assessments of radiation exposure, particularly when physical dosimetry is unavailable or unreliable. For mass-casualty events involving public exposure to ionising radiation, it is paramount to rapidly provide this dose information for medical management of casualties. The dicentric chromosome assay is currently the most reliable accepted method for bio-dosimetry; however, in a mass-casualty scenario, the throughput of this assay will be challenged by its time-consuming nature and the specific expertise required. To address this limitation, many countries have established expertise in cytogenetic bio-dosimetry and started developing surge capabilities through setting up regional networks to deal with emergency situations. To capitalise on this growing expertise and organise it into an internationally coordinated laboratory network, the World Health Organization has created and launched a global bio-dosimetry network (BioDoseNet). In order to determine the existing capacity of BioDoseNet member laboratories, including their expertise and in vivo experience, involvement in national and international activities, problems, needs and prospects, an in-depth survey was conducted. These survey results provide significant information on the current state of emergency cytogenetic bio-dosimetry capabilities around the world. (authors)

Relative device stability of anterior versus axillary needle decompression for tension pneumothorax during casualty movement: Preliminary analysis of a human cadaver model.

Science.gov (United States)

Leatherman, Matthew L; Held, Jenny M; Fluke, Laura M; McEvoy, Christian S; Inaba, Kenji; Grabo, Daniel; Martin, Matthew J; Earley, Angela S; Ricca, Robert L; Polk, Travis M

2017-07-01

Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current prehospital standard of care for tPTX is immediate decompression with a 14-gauge 8-cm angiocatheter; however, failure rates may be as high as 17% to 60%. Alternative devices, such as 10-gauge angiocatheter, modified Veress needle, and laparoscopic trocar, have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement. Seven soft-embalmed cadavers were intubated and mechanically ventilated. Chest wall thickness was measured at the second intercostal space at the midclavicular line (2MCL) and the fifth intercostal space along the anterior axillary line (5AAL). CO2 insufflation created a PTX, and needle decompression was then performed with a randomized device. Insertional depth was measured between hub and skin before and after simulated casualty transport. Thoracoscopy was used to evaluate for intrapleural placement and/or injury during insertion and after movement. Cadaver demographics, device displacement, device dislodgment, and injuries were recorded. Three decompressions were performed at each site (2MCL/5AAL), totaling 12 events per cadaver. Eighty-four decompressions were performed. Average cadaver age was 59 years, and body mass index was 24 kg/m. The CWT varied between cadavers because of subcutaneous emphysema, but the average was 39 mm at the 2MCL and 31 mm at the 5AAL. Following movement, the 2MCL site was more likely to become dislodged than the 5AAL (67% vs. 17%, p = 0.001). Median displacement also differed between 2MCL and 5AAL (23 vs. 2 mm, p = 0.001). No significant differences were noted in dislodgement or displacement between devices. Five minor lung injuries were noted at the 5AAL position. Preliminary results from this human cadaver study suggest the 5AAL position is a more stable and reliable location

Protective measures while treating CWA casualties

International Nuclear Information System (INIS)

Medema, J.

2009-01-01

When Chemical Warfare agent casualties are brought into a medical facility they are usually decontaminated before receiving treatment. The decontamination can range from simply undressing to complex entry/exit procedures for a collective protection medical shelter. It is expected that the decontamination has reduced the contamination to such a degree that there is no more hazard for the medical personnel from emanating CWA vapors. However there is quite some evidence that this is usually not the case and additional protective measures are required in order to have the medical staff operating unhindered and not endangered by albeit low but still hazardous CWA vapor concentrations that at the end of the day would have adverse effects on the capabilities of the medical staff. In the paper some simple but effective means will be described that will reduce the exposure of the medical staff to.(author)

Commercial Cleaning Products for Chemical Decontamination: A Scoping Study

Science.gov (United States)

2014-05-01

and may injure human skin without dilution), although this approach is less favoured in a mass casualty decontamination situation than soap and water...commercial cleaning products, full strength K-O-K® liquid bleach (5.25% aqueous solution of NaOCl), dish-washing detergent Cascade® with Extra...Bleach Action Gel, OxiClean® Versatile Stain Remover Powder, and ZEP® Industrial Purple liquid cleaner (proprietary caustic cleaner containing

Rhabdomyolysis among critically ill combat casualties: Associations with acute kidney injury and mortality.

Science.gov (United States)

Stewart, Ian J; Faulk, Tarra I; Sosnov, Jonathan A; Clemens, Michael S; Elterman, Joel; Ross, James D; Howard, Jeffrey T; Fang, Raymond; Zonies, David H; Chung, Kevin K

2016-03-01

Rhabdomyolysis has been associated with poor outcomes in patients with traumatic injury, especially in the setting of acute kidney injury (AKI). However, rhabdomyolysis has not been systematically examined in a large cohort of combat casualties injured in the wars in Iraq and Afghanistan. We conducted a retrospective study of casualties injured during combat operations in Iraq and Afghanistan who were initially admitted to the intensive care unit from February 1, 2002, to February 1, 2011. Information on age, sex, Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), mechanism of injury, shock index, creatine kinase, and serum creatinine were collected. These variables were examined via multivariate logistic and Cox regression analyses to determine factors independently associated with rhabdomyolysis, AKI, and death. Of 6,011 admissions identified, a total of 2,109 patients met inclusion criteria and were included for analysis. Rhabdomyolysis, defined as creatine kinase greater than 5,000 U/L, was present in 656 subjects (31.1%). Risk factors for rhabdomyolysis identified on multivariable analysis included injuries to the abdomen and extremities, increased ISS, male sex, explosive mechanism of injury, and shock index greater than 0.9. After adjustment, patients with rhabdomyolysis had a greater than twofold increase in the odds of AKI. In the analysis for mortality, rhabdomyolysis was significantly associated with death until AKI was added, at which point it lost statistical significance. We found that rhabdomyolysis is associated with the development of AKI in combat casualties. While rhabdomyolysis was strongly associated with mortality on the univariate model and in conjunction with both ISS and age, it was not associated with mortality after the inclusion of AKI. This suggests that the effect of rhabdomyolysis on mortality may be mediated by AKI. Prognostic and epidemiologic study, level III.

The influence of car registration year on driver casualty rates in Great Britain.

Science.gov (United States)

Broughton, Jeremy

2012-03-01

A previous paper analysed data from the British national road accident reporting system to investigate the influence upon car driver casualty rates of the general type of car being driven and its year of first registration. A statistical model was fitted to accident data from 2001 to 2005, and this paper updates the principal results using accident data from 2003 to 2007. Attention focuses upon the role of year of first registration since this allows the influence of developments in car design upon occupant casualty numbers to be evaluated. Three additional topics are also examined with these accident data. Changes over time in frontal and side impacts are compared. Changes in the combined risk for the two drivers involved in a car-car collision are investigated, being the net result of changes in secondary safety and aggressivity. Finally, the results of the new model relating to occupant protection are related to an index that had been developed previously to analyse changes over time in the secondary safety of the car fleet. Copyright © 2011 Elsevier Ltd. All rights reserved.

Triage Decision Trees and Triage Protocols: Changing Strategies for Medical Rescue in Civilian Mass Casualty Situations.

Science.gov (United States)

1984-02-06

capacity loads. o Passenger instruction in the use of and the design of escape and floatation gear are grossly inadequate. o Hazards change with weather...triage, Canad Anesth Soc J., 27(3) May 80, p. 201 * 52. Cope 0. and Moore F.D., The redistribution of body water in the fluid therapy of the burned

The state of US trauma systems: public perceptions versus reality--implications for US response to terrorism and mass casualty events.

Science.gov (United States)

Champion, Howard R; Mabee, Marcia S; Meredith, J Wayne

2006-12-01

not been made a national priority. Trauma systems must be adequately developed and supported to fulfill the public's expectation to receive the best possible care if seriously injured, and to ensure readiness for mass casualty and terrorist incidents.

The pros and cons of vaious optical media for the soldier's interfacility radiographic record (SIRR) in the combat casualty care system

International Nuclear Information System (INIS)

Kerlin, B.D.; Johnson, W.P.

1989-01-01

Ongoing research and evaluation projects sponsored by the Army Medical Research and Development Command are leading towards filmless radiography in the combat casualty care system of the 1990s. With the elimination of film, the question arises as to the most appropriate medium for archiving and transporting X-ray images and related patient data with the wounded between facilities. This paper considers the pros and cons of the various candidate media in relation to their specifications, availability, and appropriateness under simulated combat casualty care conditions

The Pros And Cons Of Various Optical Media For The Soldier's Interfacility Radiographic Record (SIRR) In The Combat Casualty Care System

Science.gov (United States)

Kerlin, Barbara D.; Johnson, William P.

1989-05-01

Ongoing research and evaluation projects sponsored by the Army Medical Research and Development Command are leading towards filmless radiography in the combat casualty care system of the 1990s. With the elimination of film, the question arises as to the most appropriate medium for archiving and transporting x-ray images and related patient data with the wounded between facilities. This paper considers the pros and cons of the various candidate media in relation to their specifications, availability, and appropriateness under simulated combat casualty care conditions.

Analysis of the Causes of Maritime Casualties

Directory of Open Access Journals (Sweden)

Jelenko Švetak

2003-01-01

Full Text Available A survey of total loss accidents in merchant shipping over aperiod of 30 years shows that these can be arranged in the followingorder: stranding, fire, water-leaks, gales and collision;other accidents are also taken into consideration. The analysisconsiders ships over 500 GT of different flags, plying any routeof navigation.Initially, a sample of 500 merchant ships- of different typesand tonnage- and under 15 different flags is analyzed to determineage and type of ship, and the causes of accidents.In the second analysis, the same 15 flags are considered,but now over a wider range on a sample totalling 1,500 merchantships. The results of both analyses are compared. It isshown that all collisions together with gale amount to 25% ofmaritime casualty returns -in the total loss lists- while strandingand collision take more than 40% of the toll.

A Descriptive Analysis of Tactical Casualty Care Interventions Performed by Law Enforcement Personnel in the State of Wisconsin, 2010-2015.

Science.gov (United States)

Stiles, Chad M; Cook, Christopher; Sztajnkrycer, Matthew D

2017-06-01

Introduction Based upon military experience, law enforcement has developed guidelines for medical care during high-threat conditions. The purpose of the current study was to provide a descriptive analysis of reported outcomes of law enforcement medical interventions. This was a descriptive analysis of a convenience sample of cases submitted to the Wisconsin Tactical Medicine Initiative (Wisconsin USA), after the provision of successful patient care, between January 2010 and December 2015. The study was reviewed by the Mayo Foundation Institutional Review Board (Rochester, Minnesota USA) and deemed exempt. Nineteen agencies submitted information during the study period. Of the 56 episodes of care reported, four (7.1%) cases involved care provided to injured officers while 52 (92.9%) involved care to injured civilians, including suspects. In at least two cases, on-going threats existed during the provision of medical care to an injured civilian. Law enforcement rendered care prior to Emergency Medical Services (EMS) arrival in all but two cases. The current case series demonstrates the life-saving potential for law enforcement personnel trained and equipped under current Tactical Combat Casualty Care (TCCC)/ Committee on Tactical Emergency Casualty Care (C-TECC) tactical casualty care guidelines. Although originally developed to save the lives of wounded combat personnel, in the civilian sector, the training appears more likely to save victims rather than law enforcement personnel. Stiles CM , Cook C , Sztajnkrycer MD . A descriptive analysis of tactical casualty care interventions performed by law enforcement personnel in the State of Wisconsin, 2010-2015. Prehosp Disaster Med. 2017;32(3):284-288.

Rotorcraft Use in Disaster Relief and Mass Casualty Incidents - Case Studies

Science.gov (United States)

1990-06-01

Disaster Relief and Mass 6. Performing Organization Code C asuallty Incidents- C ase Studies 8._P rfo minOr ani ati nR porNo 7. Author (s) 8...disaster planning process; and 3) produce a color video tape promoting the need for and the use of rotorcraft and heliports in disaster relief. 17...disaster prepaLedness ageicies for use in the integration of local helicopter assets into the disaster planning process; and 3) produce a color video tape

46 CFR 185.210 - Alcohol or drug use by individuals directly involved in casualties.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Alcohol or drug use by individuals directly involved in... whether there is any evidence of alcohol or drug use by individuals directly involved in the casualty. (b... evidence of drug or alcohol use, or evidence of intoxication, has been obtained; and (2) Specifies the...

27 CFR 25.282 - Beer lost by fire, theft, casualty, or act of God.

Science.gov (United States)

2010-04-01

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

A Serious Game for Massive Training and Assessment of French Soldiers Involved in Forward Combat Casualty Care (3D-SC1): Development and Deployment.

Science.gov (United States)

Pasquier, Pierre; Mérat, Stéphane; Malgras, Brice; Petit, Ludovic; Queran, Xavier; Bay, Christian; Boutonnet, Mathieu; Jault, Patrick; Ausset, Sylvain; Auroy, Yves; Perez, Jean Paul; Tesnière, Antoine; Pons, François; Mignon, Alexandre

2016-05-18

The French Military Health Service has standardized its military prehospital care policy in a ''Sauvetage au Combat'' (SC) program (Forward Combat Casualty Care). A major part of the SC training program relies on simulations, which are challenging and costly when dealing with more than 80,000 soldiers. In 2014, the French Military Health Service decided to develop and deploy 3D-SC1, a serious game (SG) intended to train and assess soldiers managing the early steps of SC. The purpose of this paper is to describe the creation and production of 3D-SC1 and to present its deployment. A group of 10 experts and the Paris Descartes University Medical Simulation Department spin-off, Medusims, coproduced 3D-SC1. Medusims are virtual medical experiences using 3D real-time videogame technology (creation of an environment and avatars in different scenarios) designed for educational purposes (training and assessment) to simulate medical situations. These virtual situations have been created based on real cases and tested on mannequins by experts. Trainees are asked to manage specific situations according to best practices recommended by SC, and receive a score and a personalized feedback regarding their performance. The scenario simulated in the SG is an attack on a patrol of 3 soldiers with an improvised explosive device explosion as a result of which one soldier dies, one soldier is slightly stunned, and the third soldier experiences a leg amputation and other injuries. This scenario was first tested with mannequins in military simulation centers, before being transformed into a virtual 3D real-time scenario using a multi-support, multi-operating system platform, Unity. Processes of gamification and scoring were applied, with 2 levels of difficulty. A personalized debriefing was integrated at the end of the simulations. The design and production of the SG took 9 months. The deployment, performed in 3 months, has reached 84 of 96 (88%) French Army units, with a total of 818

Spatial-temporal patterns in Mediterranean carnivore road casualties: Consequences for mitigation

Science.gov (United States)

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

2009-01-01

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

Neonatal and pediatric regionalized systems in pediatric emergency mass critical care.

Science.gov (United States)

Barfield, Wanda D; Krug, Steven E; Kanter, Robert K; Gausche-Hill, Marianne; Brantley, Mary D; Chung, Sarita; Kissoon, Niranjan

2011-11-01

Improved health outcomes are associated with neonatal and pediatric critical care in well-organized, cohesive, regionalized systems that are prepared to support and rehabilitate critically ill victims of a mass casualty event. However, present systems lack adequate surge capacity for neonatal and pediatric mass critical care. In this document, we outline the present reality and suggest alternative approaches. In May 2008, the Task Force for Mass Critical Care published guidance on provision of mass critical care to adults. Acknowledging that the critical care needs of children during disasters were unaddressed by this effort, a 17-member Steering Committee, assembled by the Oak Ridge Institute for Science and Education with guidance from members of the American Academy of Pediatrics, convened in April 2009 to determine priority topic areas for pediatric emergency mass critical care recommendations.Steering Committee members established subcommittees by topic area and performed literature reviews of MEDLINE and Ovid databases. The Steering Committee produced draft outlines through consensus-based study of the literature and convened October 6-7, 2009, in New York, NY, to review and revise each outline. Eight draft documents were subsequently developed from the revised outlines as well as through searches of MEDLINE updated through March 2010.The Pediatric Emergency Mass Critical Care Task Force, composed of 36 experts from diverse public health, medical, and disaster response fields, convened in Atlanta, GA, on March 29-30, 2010. Feedback on each manuscript was compiled and the Steering Committee revised each document to reflect expert input in addition to the most current medical literature. States and regions (facilitated by federal partners) should review current emergency operations and devise appropriate plans to address the population-based needs of infants and children in large-scale disasters. Action at the state, regional, and federal levels should address

Special involuntary conversion situations involving timberland

Science.gov (United States)

William C. Siegal

2001-01-01

If standing timber is destroyed or stolen, or if forest land is condemned for public use, the owner may be entitled to take a deduction on his or her income tax return. These types of losses are called involuntary conversions. In previous National Woodlands articles I've discussed in detail casualty losses, which represent the major type of timber involuntary...

Disaster metrics: quantitative benchmarking of hospital surge capacity in trauma-related multiple casualty events.

Science.gov (United States)

Bayram, Jamil D; Zuabi, Shawki; Subbarao, Italo

2011-06-01

Hospital surge capacity in multiple casualty events (MCE) is the core of hospital medical response, and an integral part of the total medical capacity of the community affected. To date, however, there has been no consensus regarding the definition or quantification of hospital surge capacity. The first objective of this study was to quantitatively benchmark the various components of hospital surge capacity pertaining to the care of critically and moderately injured patients in trauma-related MCE. The second objective was to illustrate the applications of those quantitative parameters in local, regional, national, and international disaster planning; in the distribution of patients to various hospitals by prehospital medical services; and in the decision-making process for ambulance diversion. A 2-step approach was adopted in the methodology of this study. First, an extensive literature search was performed, followed by mathematical modeling. Quantitative studies on hospital surge capacity for trauma injuries were used as the framework for our model. The North Atlantic Treaty Organization triage categories (T1-T4) were used in the modeling process for simplicity purposes. Hospital Acute Care Surge Capacity (HACSC) was defined as the maximum number of critical (T1) and moderate (T2) casualties a hospital can adequately care for per hour, after recruiting all possible additional medical assets. HACSC was modeled to be equal to the number of emergency department beds (#EDB), divided by the emergency department time (EDT); HACSC = #EDB/EDT. In trauma-related MCE, the EDT was quantitatively benchmarked to be 2.5 (hours). Because most of the critical and moderate casualties arrive at hospitals within a 6-hour period requiring admission (by definition), the hospital bed surge capacity must match the HACSC at 6 hours to ensure coordinated care, and it was mathematically benchmarked to be 18% of the staffed hospital bed capacity. Defining and quantitatively benchmarking the

Is the Australian hospital system adequately prepared for terrorism?

Science.gov (United States)

Rosenfeld, Jeffrey V; Fitzgerald, Mark; Kossmann, Thomas; Pearce, Andrew; Joseph, Anthony; Joseph, Andrew; Tan, Gim; Gardner, Michele; Shapira, Shmuel

Australian hospitals need to be prepared to deal with mass casualties from terrorist strikes, including bomb blasts and chemical, biological and radiation injury. Injuries from bomb explosions are more severe than those commonly seen in Australian hospitals. In disasters involving mass casualties in urban areas, many of the injured make their own way to hospital, often arriving before the more seriously injured casualties. Major hospitals in Australia should plan for large numbers of undifferentiated and potentially contaminated casualties arriving with minimal warning. It is critical that experienced and trained senior medical officers perform the triage of casualties in emergency departments, with frequent reassessment to detect missed injuries (especially pulmonary blast injury). Hospitals require well developed standard operating procedures for mass casualty events, reinforced by regular drills. Preparing for a major event includes training staff in major incident management, setting up an operational/control unit, nominating key personnel, ensuring there is an efficient intra-hospital communication system, and enhancing links with other emergency services and hospitals.

Management of High-Velocity Injuries of the Head and Neck.

Science.gov (United States)

Majors, Jacob S; Brennan, Joseph; Holt, G Richard

2017-11-01

Trauma centers must prepare to manage high-velocity injuries resulting from a mass casualty incidents as global terrorism becomes a greater concern and an increasing risk. The most recent conflicts in Iraq and Afghanistan have significantly improved understanding of battlefield trauma and how to appropriately address these injures. This article applies combat surgery experience to civilian situations, outlines the physiology and kinetics of high-velocity injuries, and reviews applicable triage and management strategies. Published by Elsevier Inc.

Nurses' requirements for relief and casualty support in disasters: a qualitative study.

Science.gov (United States)

Nekooei Moghaddam, Mahmoud; Saeed, Sara; Khanjani, Narges; Arab, Mansour

2014-04-01

Nurses are among the most important groups engaged in casualty support, regardless of the cause, and they are one of the largest care groups involved in disasters. Consequently, these workers should gain proper support and skills to enable effective, timely, responsible and ethical emergency responses. In this study, we investigated the needs of nurses for proper casualty support in disasters, to facilitate better planning for disaster management. This was a qualitative content analysis study. Interviews were performed with 23 nurses, at educational hospitals and the Faculty of Nursing at Kerman Medical University, who had a minimum of five years working experience and assisted in an earthquake disaster. Intensity and snowball sampling were performed. Data was collected through semi-structured interviews. Interviews were transcribed and coded into main themes and subthemes. Four major themes emerged from the data; 1) psychological support, 2) appropriate clinical skills education, 3) appropriate disaster management, supervision and programming, and 4) the establishment of ready for action groups and emergency sites. The participants' comments highlighted the necessity of training nurses for special skills including emotion management, triage and crush syndrome, and to support nurses' families, provide security, and act according to predefined programs in disasters. There are a wide range of requirements for disaster aid. Proper aid worker selection, frequent and continuous administration of workshops and drills, and cooperation and alignment of different governmental and private organizations are among the suggested initiatives.

Now and Then: Combat Casualty Care Policies for Operation Iraqi Freedom and Operation Enduring Freedom Compared With Those of Vietnam

National Research Council Canada - National Science Library

Cordts, Paul R; Brosch, Laura A; Holcomb, John B

2008-01-01

Between December 2004 and June 2007, 13 key Operation Iraqi Freedom/ Operation Enduring Freedom combat casualty care policies were published to inform medical practice in the combat theater of operations...

Minimizing casualties in biological and chemical threats (war and terrorism): the importance of information to the public in a prevention program.

Science.gov (United States)

Noy, Shabtai

2004-01-01

The most effective means of defending against biological or chemical warfare, whether in war or as a result of terror, is the use of primary prevention. The main goal of such a prevention program is to minimize the human loss by reducing the number of casualties (fatalities, physical wounds, and psychological injury). A secondary objective is to prevent the widespread sense of helplessness in the general population. These two aims complement each other. The more the public is active in defending itself, rather than viewing itself as helpless, the lesser the expected number of casualties of any kind. In order to achieve these two goals, educating the civilian population about risk factors and pointing out appropriate defensive strategies is critical. In the absence of an effective prevention program and active participation by the public, there is a high risk for massive numbers of physical and psychological casualties. An essential ingredient of any preventive program, which ultimately may determine the success or failure of all other protective actions, is early, gradual dissemination of information and guidance to the public, so that citizens can become active participants in the program. The public needs to be given information concerning the nature of the threat and effective methods of coping with it, should an unconventional attack occur. Lack of such adaptive behavior (such as wearing protective gear) is likely to bring about vast numbers of physical and psychological casualties. These large numbers may burden the medical, political, and public safety systems beyond their ability to manage. Failure to provide reasonable prevention and effective interventions can lead to a destruction of the social and emotional fabric of individuals and the society. Furthermore, inadequate preparation, education, and communication can result in the development of damaging mistrust of the political and military leadership, disintegration of social and political structures

Using the Design for Demise Philosophy to Reduce Casualty Risk Due to Reentering Spacecraft

Science.gov (United States)

Kelley, R. L.

2012-01-01

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

[Travel time and distances to Norwegian out-of-hours casualty clinics].

Science.gov (United States)

Raknes, Guttorm; Morken, Tone; Hunskår, Steinar

2014-11-01

Geographical factors have an impact on the utilisation of out-of-hours services. In this study we have investigated the travel distance to out-of-hours casualty clinics in Norwegian municipalities in 2011 and the number of municipalities covered by the proposed recommendations for secondary on-call arrangements due to long distances. We estimated the average maximum travel times and distances in Norwegian municipalities using a postcode-based method. Separate analyses were performed for municipalities with a single, permanently located casualty clinic. Altogether 417 out of 430 municipalities were included. We present the median value of the maximum travel times and distances for the included municipalities. The median maximum average travel distance for the municipalities was 19 km. The median maximum average travel time was 22 minutes. In 40 of the municipalities (10 %) the median maximum average travel time exceeded 60 minutes, and in 97 municipalities (23 %) the median maximum average travel time exceeded 40 minutes. The population of these groups comprised 2 % and 5 % of the country's total population respectively. For municipalities with permanent emergency facilities(N = 316), the median average flight time 16 minutes and median average distance 13 km.. In many municipalities, the inhabitants have a long average journey to out-of-hours emergency health services, but seen as a whole, the inhabitants of these municipalities account for a very small proportion of the Norwegian population. The results indicate that the proposed recommendations for secondary on-call duty based on long distances apply to only a small number of inhabitants. The recommendations should therefore be adjusted and reformulated to become more relevant.

Slope Failure Prediction and Early Warning Awareness Education for Reducing Landslides Casualty in Malaysia

Science.gov (United States)

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

2015-12-01

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

The prefect facing emergency situation

International Nuclear Information System (INIS)

Masse, H.

2006-01-01

In the field of emergency procedures regarding the protection of life, property and the environment, the 'prefet' of a department is the only public authority both representative of the state and accountable. In France laws and regulations have been in recent years revised in order to modernize emergency situations management. The 'prefet' of the Drome 'department', Henri MASSE, presents a summary of recent developments and explains how his services are organised in order to be able to handle emergency situations. He also focuses on his experience of handling the specific difficulties of nuclear risks, his department sheltering numerous nuclear facilities: EURODIF Pierrelatte nuclear fuel enrichment plant, EDF Tricastin nuclear power plant, AREVA Valence FBFC nuclear fuel manufacturing unit, etc. (author)

[Traffic casualties and injuries: a problem of costs, too. A Swiss survey].

Science.gov (United States)

Martinoli, S; Quadri, B; Casabianca, A

1993-01-01

Based on an epidemiological observation in Ticino 1985, following statement is possible: in Switzerland every year 900 people dye in traffic casualties. Many victims of tragic accidents get lifetime disabled. Direct and indirect costs of traffic injuries are yearly 3 billions of swiss francs. Only a small percentage (6%) is devoted to medical treatment. The most part is due to compensation of income, disability with its allocations and lost productivity. Among "avoidable" deaths, traffic victims are an essential portion because the are young. More efforts should be undertaken to lower road mortality because she erodes the swiss population pyramid in a significant manner.

The Impact of 10 Years of War on Combat Casualty Care Research: A Citation Analysis

Science.gov (United States)

2012-01-01

Crommett JW, et al. Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training. J Trauma. 2002;52:1078Y1085...transection model to compare nine hemostatic dressings. They concluded that the use of a zeolite hemostatic agent controlled hemorrhage and significantly...review of the scientific literature published during this period can be used to evaluate the research on combat casualty care conducted during the recent

Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident.

Science.gov (United States)

Lee, James S; Franc, Jeffrey M

2015-08-01

A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise. Hypothesis/Problem It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone. Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes. There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar

High Reliability Organization and Applicability to the Battlefield to Reduce Errors Associated with Combat Casualty Care

Science.gov (United States)

2016-06-10

use different terminology depending on which sister service they are from. Every service has various medical capabilities for each role of medical ... Medical Errors, Combat Casualty Care, Culture of Safety 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...Army) AE Adverse event AHRQ Agency for Healthcare Research and Quality AHS Army Health System AMEDD Army Medical Department CPQ Clinical Practice

Retrospection. Uranium mining Wismut und the legal casualty insurance; Erinnerungen. Uranerzbergbau Wismut und die gesetzliche Unfallversicherung

Energy Technology Data Exchange (ETDEWEB)

Breuer, Joachim [Deutsche Gesetzliche Unfallversicherung (DGUV), Berlin (Germany)

2015-07-01

Although the Wismut uranium mining company in the former DDR had 600.000 employees, the company was not mentioned in the contract on the German reunification. The expenses for the health consequences imposed manifold challenges to the legal casualty insurance. The question of responsibility, the conservation, digitalization and evaluation of data concerning the personnel and health information, partially handwritten is a tremendous amount of work.

Offender and offense characteristics of a nonrandom sample of mass murderers.

Science.gov (United States)

Hempel, A G; Meloy, J R; Richards, T C

1999-01-01

A nonrandom sample (N = 30) of mass murderers in the United States and Canada during the past 50 years was studied. Data suggest that such individuals are single or divorced males in their fourth decade of life with various Axis I paranoid and/or depressive conditions and Axis II personality traits and disorders, usually Clusters A and B. The mass murder is precipitated by a major loss related to employment or relationship. A warrior mentality suffuses the planning and attack behavior of the subject, and greater deaths and higher casualty rates are significantly more likely if the perpetrator is psychotic at the time of the offense. Alcohol plays a very minor role. A large proportion of subjects will convey their central motivation in a psychological abstract, a phrase or sentence yelled with great emotion at the beginning of the mass murder; but in our study sample, only 20 percent directly threatened their victims before the offense. Death by suicide or at the hands of others is the usual outcome for the mass murderer.

Management of Open Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02.

Science.gov (United States)

Butler, Frank K; Dubose, Joseph J; Otten, Edward J; Bennett, Donald R; Gerhardt, Robert T; Kheirabadi, Bijan S; Gross, Kriby R; Cap, Andrew P; Littlejohn, Lanny F; Edgar, Erin P; Shackelford, Stacy A; Blackbourne, Lorne H; Kotwal, Russ S; Holcomb, John B; Bailey, Jeffrey A

2013-01-01

During the recent United States Central Command (USCENTCOM) and Joint Trauma System (JTS) assessment of prehospital trauma care in Afghanistan, the deployed director of the Joint Theater Trauma System (JTTS), CAPT Donald R. Bennett, questioned why TCCC recommends treating a nonlethal injury (open pneumothorax) with an intervention (a nonvented chest seal) that could produce a lethal condition (tension pneumothorax). New research from the U.S. Army Institute of Surgical Research (USAISR) has found that, in a model of open pneumothorax treated with a chest seal in which increments of air were added to the pleural space to simulate an air leak from an injured lung, use of a vented chest seal prevented the subsequent development of a tension pneumothorax, whereas use of a nonvented chest seal did not. The updated TCCC Guideline for the battlefield management of open pneumothorax is: ?All open and/ or sucking chest wounds should be treated by immediately applying a vented chest seal to cover the defect. If a vente chest seal is not available, use a non-vented chest seal. Monitor the casualty for the potential development of a subsequent tension pneumothorax. If the casualty develops increasing hypoxia, respiratory distress, or hypotension and a tension pneumothorax is suspected, treat by burping or removing the dressing or by needle decompression.? This recommendation was approved by the required two-thirds majority of the Committee on TCCC in June 2013. 2013.

Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries

Science.gov (United States)

2017-11-13

Airway Final Report: Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries...Consumer Style Comparison Table of Suction Pump Devices ............................. 103 Appendix H – Web Links for Images for Consumer- Style ...0022 pg. 6 Executive Summary Suction is a critical component of airway management , which is the second leading cause of preventable

Shaken but prepared: Analysis of disaster response at an academic medical centre following the Boston Marathon bombings.

Science.gov (United States)

Osgood, Robert; Scanlon, Courtney; Jotwani, Rohan; Rodkey, Daniel; Arshanskiy, Maria; Salem, Deeb

Over the last decade, there has been a rise in the number of mass casualty incidences (MCIs) and their subsequent effect on hospital systems. While there has been much discussion over improving procedures to treat victims of MCIs, there has not been a thorough, systems-based analysis concerning the costs incurred by hospitals during such events. Here the authors examine the history of the Hospital Incident Command Center and how its evolution at Tufts Medical Center helped mitigate the damage following the Boston Marathon Bombings. Tufts' unique variations to the Hospital Incident Command Center include strategic communication hierarchies and a 'zero cost centre' financial system which both provided for a quick and adaptive response. Operating in collaboration with the Conference of Boston Teaching Hospitals encouraged coordination and preparation during emergency situations such as mass casualty events. The direct and indirect effects on Tufts Medical Center stemming from the Boston Marathon Bombings were analysed. Tufts MC treated 36 victims immediately following the MCI. The estimated total cost during the week of April 15 to April 19, 2013 was $776,051. The cost was primarily comprised of lost revenue from cancelled outpatient and inpatient hospital services, as well as expenses incurred due to overtime pay, salary expenses, PPE kits and hospitality services. Finally, the authors examine ways to reduce the future costs during emergency situations through increasing communication with employees, understanding the source of all direct expenses, and mitigating excess risk by developing partnerships with other hospital systems.

[Fatal incidents by crowd crush during mass events. (Un)preventable phenomenon?].

Science.gov (United States)

Wagner, U; Fälker, A; Wenzel, V

2013-01-01

Crowd crushes with dozens or even hundreds of casualties have occurred several times at the Hajj in Saudi Arabia and also in soccer stadiums in Western Europe. As fatal accidents after human stampedes during mass events occur very rarely and are usually accompanied by many years of criminal court proceedings in order to identify underlying responsible mechanisms and culprits, it is very difficult to draw conclusions and formulate precautions from an emergency medical point of view. This study analyzed a fatal crowd crush which occurred on 4 December 1999 following the "Air & Style" snowboard contest with approximately 22,000 people attending in the Bergisel stadium in Innsbruck, Austria. Firstly, focused interviews were conducted with professional rescuers, police and physicians and secondly publicly available court records dealing with this incident in the district court of Innsbruck, Austria were analyzed. During the snowboard contest 87 emergency medical technicians, 6 emergency physicians, 1 leading emergency physician, 21 policemen and 140 security personnel were present. Following the accident additionally some 100 emergency medical technicians, 36 emergency medical service vehicles and 4 physician-staffed emergency medical service vehicles responded to the scene. The deadly crowd crush resulting in 6 fatalities, 4 patients still in a vegetative state and 38 injured, was due to a severe crowd accumulation at one stadium exit, which was not recognized and dispersed in time. Construction of the exit in line with darkness, steep slope and slippery surface contributed adversely to this dangerous situation, although panic did not occur at any time. Unfortunately, there is no patent remedy to completely prevent fatal accidents by a crowd crush at mass events. If planning is initiated early, sufficient material and personnel reserves are kept in reserve and despite conflicting interests of the organizers, the host community, security, police and emergency medical

The casualty chain inventory: a new scale for measuring peritraumatic responses: a cross-sectional study

Directory of Open Access Journals (Sweden)

Sandvik Leiv

2011-05-01

Full Text Available Abstract Background Peritraumatic psychological- and sensory impressions in victims of civilian accidents are only partly understood. This study scrutinizes the level and duration of perceived psychological threat at scene of injury as well as in hospital (the casualty chain measured by the Casualty Chain Inventory (CCI. The purpose of the study was to assess and validate the CCI, and to examine the correlations between the new instrument and stress responses measured by the Impact of Event Scale (IES and the Post-traumatic Stress Scale-10 (PTSS-10 Methods Three hundred and fifteen injured, conscious, hospitalised patients were assessed with a self-report questionnaire. The CCI consists of eight items including sensory impressions and well-known psychological responses to trauma. Results The internal consistency of the CCI was solid (Cronbach's alpha: .83-.85. A factor analysis revealed two components, "perception" and "dissociation". The instrument correlates significantly with the Impact of Event Scale (r = 0.47 - 0.54 and the Posttraumatic Stress Scale-10 (r = 0.32 - 0.50. The explained variance is high both at the scene of injury (61% and in the hospital (65%. Dissociation and perception either used as a two-factor solution or as a sum score measured in the hospital, gave the strongest prediction for later psychological distress. Conclusions The CCI appears to be a useful screening instrument for, at an early state, identifying patients hospitalized after a physical incident at risk for subsequent psychological distress.

Plastic Surgery Response in Natural Disasters.

Science.gov (United States)

Chung, Susan; Zimmerman, Amanda; Gaviria, Andres; Dayicioglu, Deniz

2015-06-01

Disasters cause untold damage and are often unpredictable; however, with proper preparation, these events can be better managed. The initial response has the greatest impact on the overall success of the relief effort. A well-trained multidisciplinary network of providers is necessary to ensure coordinated care for the victims of these mass casualty disasters. As members of this network of providers, plastic surgeons have the ability to efficiently address injuries sustained in mass casualty disasters and are a valuable member of the relief effort. The skill set of plastic surgeons includes techniques that can address injuries sustained in large-scale emergencies, such as the management of soft-tissue injury, tissue viability, facial fractures, and extremity salvage. An approach to disaster relief, the types of disasters encountered, the management of injuries related to mass casualty disasters, the role of plastic surgeons in the relief effort, and resource management are discussed. In order to improve preparedness in future mass casualty disasters, plastic surgeons should receive training during residency regarding the utilization of plastic surgery knowledge in the disaster setting.

Physiologic Waveform Analysis for Early Detection of Hemorrhage during Transport and Higher Echelon Medical Care of Combat Casualties

Science.gov (United States)

2014-03-01

area under the curve (ROC AUC ) values. (ROC AUC values range from 0 and 1 and indicate the probability of correct detection/discrimination...training set of the human LBNP data. Values are receiver operating characteristic area under the curves (ROC AUCs ) comparing the relative SV change...detection of hemorrhage is crucial for managing combat casualties. However, mean arterial blood pressure (ABP) and other vital signs are late indicators of

A comparative study of depression, anxiety, stress and their relationships with smoking pattern in caregivers of patients of casualty and outpatient departments

Directory of Open Access Journals (Sweden)

Purushottam

2016-01-01

Full Text Available Background: Smoking is prohibited in India at all the public places including hospital premises, but people with habit of smoking are not able to abide the rules strictly. Somehow, level of dependence and stress along with other psychological variables like anxiety and depression play key roles in smoking in the hospital premises. Methodology: Present study aimed to know the level of dependence and other psychological variables like depression, anxiety, and stress in the caregivers of patients of casualty and outpatients departments. Seventy five participants were recruited purposively from the hospital premises. The Fagerström Test for Nicotine Dependence and the Depression Anxiety Stress Scales (DASS- Hindi were administered. Result: Participants reported nicotine dependence was associated with psychological variables like mild to moderate level of depression, anxiety, and stress. Caregivers of casualty patients were having high level of stress than caregivers of outpatients. Conclusion: It can be concluded that psychological variables play a significant role in nicotine dependence.

Problems associated with the organization and planning of medical aid for radiation accident casualties

International Nuclear Information System (INIS)

Jammet, H.P.

1977-01-01

Problems associated with the organization and planning of medical treatment for radiation accident casualties are considered for different types of radiation accident: whole-body or partial irradiation, external or internal contamination and small or large numbers of cases. The problems posed are ones of competence, urgency and capacity; on the diagnostic side there is the problem of evaluating the exposure or contamination and assessing the resultant damage, while on the treatment side the questions of first aid, conventional treatment and specialized treatment have to be considered. The solutions envisaged involve organization at the local and national levels and planning of medical treatment by skilled, multidisciplinary medical teams. (author)

Statistical aspects of the program of the Atomic Bomb Casualty Commission

Energy Technology Data Exchange (ETDEWEB)

Beebe, G W

1961-02-24

The Atomic Bomb Casualty Commission (ABCC) is a medical research institute in Hiroshima and Nagasaki devoted to long term study of the late effects of nuclear radiation upon man. The work draws its great interest from the paucity of existing information on the effect of radiation on man; from the unique radiation experience of the atomic bomb survivors; from the increasing utilization of nuclear energy in modern technology; and from humanitarian concern for the survivors of the bombs. The ABCC program provides the statistician with an important opportunity to apply the tools and concepts of statistics, for the inferences to be drawn are largely statistical inferences growing out of the comparison of samples defined as to radiation exposure. The work is of international as well as statistical interest by virtue of its subject matter and as a meeting-ground for statisticians trained in different countries.

PRE-HOSPITAL EMERGENCY CARE IN SWEDEN

Directory of Open Access Journals (Sweden)

Ulf BJÖRNSTIG

2004-01-01

In Sweden (9 million inhabitants, a sparsely populated country with sometimes long transportation distances to the nearest trauma hospital, 800 ambulances, 7 ambulance helicopters and 3–5 fixed wing ambulance aircraft are the available transport resources. In case of a mass casualty or disaster situation, inside or outside the country, a governmental project (Swedish National Medevac aims to convert a passenger aircraft from Scandinavian Airlines System (SAS to a qualified medical resource for long distance transport, with capacity to nurse six intensive care patients and an additional 6–20 lieing or seated patients during transport.

From Cholera to Burns: A Role for Oral Rehydration Therapy

Science.gov (United States)

Green, W.B.; Asuku, M.E.; Feldman, M.; Makam, R.; Noppenberger, D.; Price, L.A.; Prosciak, M.; van Loon, I.N.

2011-01-01

According to the practice guidelines of the American Burn Association on burn shock resuscitation, intravenous (IV) fluid therapy is the standard of care for the replacement of fluid and electrolyte losses in burn injury of ≥20% of the total body surface area. However, in mass burn casualties, IV fluid resuscitation may be delayed or unavailable. Oral rehydration therapy (ORT), which has been shown to be highly effective in the treatment of dehydration in epidemics of cholera, could be an alternate way to replace fluid losses in burns. A prospective case series of three patients was carried out as an initial step to establish whether oral Ceralyte®90 could replace fluid losses requiring IV fluid therapy in thermal injury. The requirement of the continuing IV fluid therapy was reduced by an average of 58% in the first 24 hours after the injury (range 37-78%). ORT may be a feasible alternative to IV fluid therapy in the resuscitation of burns. It could also potentially save many lives in mass casualty situations or in resource-poor settings where IV fluid therapy is not immediately available. Further studies are needed to assess the efficacy of this treatment and to determine whether the present formulations of ORT for cholera need modification. PMID:22283039

A markov decision process model for the optimal dispatch of military medical evacuation assets.

Science.gov (United States)

Keneally, Sean K; Robbins, Matthew J; Lunday, Brian J

2016-06-01

We develop a Markov decision process (MDP) model to examine aerial military medical evacuation (MEDEVAC) dispatch policies in a combat environment. The problem of deciding which aeromedical asset to dispatch to each service request is complicated by the threat conditions at the service locations and the priority class of each casualty event. We assume requests for MEDEVAC support arrive sequentially, with the location and the priority of each casualty known upon initiation of the request. The United States military uses a 9-line MEDEVAC request system to classify casualties as being one of three priority levels: urgent, priority, and routine. Multiple casualties can be present at a single casualty event, with the highest priority casualty determining the priority level for the casualty event. Moreover, an armed escort may be required depending on the threat level indicated by the 9-line MEDEVAC request. The proposed MDP model indicates how to optimally dispatch MEDEVAC helicopters to casualty events in order to maximize steady-state system utility. The utility gained from servicing a specific request depends on the number of casualties, the priority class for each of the casualties, and the locations of both the servicing ambulatory helicopter and casualty event. Instances of the dispatching problem are solved using a relative value iteration dynamic programming algorithm. Computational examples are used to investigate optimal dispatch policies under different threat situations and armed escort delays; the examples are based on combat scenarios in which United States Army MEDEVAC units support ground operations in Afghanistan.

The role of the medical examiner in mass casualty situations with special reference to the Alfred P. Murrah Building bombing.

Science.gov (United States)

Jordan, F B

1999-04-01

To describe the events that shaped the investigation by the Oklahoma Office of the Chief Medical Examiner with regard to the terrorist bombing of the Alfred P. Murrah Federal Building in Oklahoma City in 1995 and to provide lessons learned for reinforcement and future planning. All persons known to have been killed by the blast. Standard forensic techniques with regard to crime scene investigation, documentation, body identification and cause of death determinations were followed. Fatality injury and related evidence documentation. A total of 168 people died principally from secondary and tertiary injuries caused by projectiles, victim displacement, and crushing. Emphasis is placed on the methods of operation required to find, remove, identify, and determine cause of death in these individuals. Simultaneously, evidence must be identified and preserved in a homicide investigation of this type. Close cooperation must exist among multiple varied agencies and disciplines to accomplish the task and to prepare for subsequent analysis and courtroom testimony required by the criminal justice system. Terrorism, both foreign and domestic, is a current fact and will be a problem in many forms in the 21st century. No one is immune. The key to success is to plan ahead and be aware of available resources. Preplanning for short comings and difficult issues, and most importantly, relying on team work will allow future participants to successfully meet and complete the challenge. The investigation developed detailed injury data and mechanisms that were available for subsequent judicial proceedings and for in-depth epidemiological studies spearheaded by the Injury Prevention Service of the Oklahoma State Department of Health.

Neutrino mass experiments

International Nuclear Information System (INIS)

Robertson, R.G.H.

1989-01-01

The current status of the experimental search for neutrino mass is reviewed, with emphasis on direct kinematic methods. Simpson and Hime report finding new evidence for a 17-keV neutrino in the β decay of 3 H and 35 S. The situation concerning the electron neutrino mass as measured in tritium beta decay has not changed significantly in the last two years. We discuss the ''model independent'' lower limit of 17 eV obtained by the ITEP group in light of existing data on the 3 H-- 3 He mass difference. 42 refs., 1 fig., 1 tab

Emergency situations; Les situations d'urgence

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-07-01

The nuclear activities are exercised so as to prevent the accidents. They are subjected to a rule whom application is controlled by the Asn. The risk of grave accident is so limited to a very low level of probability. He cannot be however completely pushed aside. The expression ' radiological emergency situation ' indicates a situation which ensues from an incident or of an accident risking to lead to an emission of radioactive materials or a level of radioactivity susceptible to strike a blow at the public health. The term ' nuclear crisis ' is used for the events which can lead to a radiological emergency situation on a nuclear basic installation or during a transport of radioactive materials. The preparation and the management of emergency situations, that they are of natural, accidental or terrorist origin, became a major concern of our society. We propose you of to know more about it in this file. (N.C.)

Semiannual Report to the Congress. April 1, 2012 - September 30, 2012

Science.gov (United States)

2012-10-01

Killeen, Texas, restaurant frequented by military members with the intent to inflict mass casualties and to shoot anyone fleeing the building after...the explosive devices inside a Killeen, Texas, restaurant frequented by military members with the intent to inflict mass casualties...” APRIL 1...compensation cap; $1.3 million of out-of-period worker’s compensation costs; and a $2.0 million upward adjustment for actual franchise taxes in excess of

Accurate Gene Expression-Based Biodosimetry Using a Minimal Set of Human Gene Transcripts

Energy Technology Data Exchange (ETDEWEB)

Tucker, James D., E-mail: jtucker@biology.biosci.wayne.edu [Department of Biological Sciences, Wayne State University, Detroit, Michigan (United States); Joiner, Michael C. [Department of Radiation Oncology, Wayne State University, Detroit, Michigan (United States); Thomas, Robert A.; Grever, William E.; Bakhmutsky, Marina V. [Department of Biological Sciences, Wayne State University, Detroit, Michigan (United States); Chinkhota, Chantelle N.; Smolinski, Joseph M. [Department of Electrical and Computer Engineering, Wayne State University, Detroit, Michigan (United States); Divine, George W. [Department of Public Health Sciences, Henry Ford Hospital, Detroit, Michigan (United States); Auner, Gregory W. [Department of Electrical and Computer Engineering, Wayne State University, Detroit, Michigan (United States)

2014-03-15

Purpose: Rapid and reliable methods for conducting biological dosimetry are a necessity in the event of a large-scale nuclear event. Conventional biodosimetry methods lack the speed, portability, ease of use, and low cost required for triaging numerous victims. Here we address this need by showing that polymerase chain reaction (PCR) on a small number of gene transcripts can provide accurate and rapid dosimetry. The low cost and relative ease of PCR compared with existing dosimetry methods suggest that this approach may be useful in mass-casualty triage situations. Methods and Materials: Human peripheral blood from 60 adult donors was acutely exposed to cobalt-60 gamma rays at doses of 0 (control) to 10 Gy. mRNA expression levels of 121 selected genes were obtained 0.5, 1, and 2 days after exposure by reverse-transcriptase real-time PCR. Optimal dosimetry at each time point was obtained by stepwise regression of dose received against individual gene transcript expression levels. Results: Only 3 to 4 different gene transcripts, ASTN2, CDKN1A, GDF15, and ATM, are needed to explain ≥0.87 of the variance (R{sup 2}). Receiver-operator characteristics, a measure of sensitivity and specificity, of 0.98 for these statistical models were achieved at each time point. Conclusions: The actual and predicted radiation doses agree very closely up to 6 Gy. Dosimetry at 8 and 10 Gy shows some effect of saturation, thereby slightly diminishing the ability to quantify higher exposures. Analyses of these gene transcripts may be advantageous for use in a field-portable device designed to assess exposures in mass casualty situations or in clinical radiation emergencies.

Econometric analysis of the changing effects in wind strength and significant wave height on the probability of casualty in shipping.

Science.gov (United States)

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

2011-05-01

This study uses econometric models to measure the effect of significant wave height and wind strength on the probability of casualty and tests whether these effects changed. While both effects are in particular relevant for stability and strength calculations of vessels, it is also helpful for the development of ship construction standards in general to counteract increased risk resulting from changing oceanographic conditions. The authors analyzed a unique dataset of 3.2 million observations from 20,729 individual vessels in the North Atlantic and Arctic regions gathered during the period 1979-2007. The results show that although there is a seasonal pattern in the probability of casualty especially during the winter months, the effect of wind strength and significant wave height do not follow the same seasonal pattern. Additionally, over time, significant wave height shows an increasing effect in January, March, May and October while wind strength shows a decreasing effect, especially in January, March and May. The models can be used to simulate relationships and help understand the relationships. This is of particular interest to naval architects and ship designers as well as multilateral agencies such as the International Maritime Organization (IMO) that establish global standards in ship design and construction. Copyright © 2011 Elsevier Ltd. All rights reserved.

Limit on mass differences in the Weinberg model

NARCIS (Netherlands)

Veltman, M.J.G.

1977-01-01

Within the Weinberg model mass differences between members of a multiplet generate further mass differences between the neutral and charged vector bosons. The experimental situation on the Weinberg model leads to an upper limit of about 800 GeV on mass differences within a multiplet. No limit on the

A Descriptive Study of Military Nurse Practitioners’ Practice Settings and Clinical Practice Activities

Science.gov (United States)

1996-05-01

staff inservice, hernia exams, mass casualty triage, nutrition counseling , pelvic exams, pap smears, school physicals, testicular examination...1 Supervising 1 Wet preps 4 Community assessment 1 Cervical biopsies 7 Tympanograms 1 Note. N Frequency of response. Summary Role Theory employs...smears I I ( J billing I I ( I pelvic exams I I ( J computer data entry I I ( I rectal exams I I I J mass casualty triage I I ( I hernia exams I I

Radio-contaminated casualties treatment: an unusual application of technical shelters used on the Ile Longue site

International Nuclear Information System (INIS)

Laroche, P.; Rousset, J.; Abiliou, R.; Roe, H.; Berthelot, B.; Lemaire, L.

2002-01-01

While the radio-contaminated casualties treatment center (CTBRC) of the military hospital of Brest is reconstructed an unusual structure has been built on the Ile Longue site. Technical shelters (ETM) of the French military health service have been put together in order to constitute the CTBRC/ETM. This structure is adapted to the necessities of the nuclear site of Brest. First we explain the organization of the medical intervention in case of a nuclear accident; then we describe the functions of the CTBRC. People from hospital and medical teams of the nuclear oceanic French forces (FOST) take part in utilization, maintenance, training according to a particular protocol. (author)

Manipulating the Geometric Computer-aided Design of the Operational Requirements-based Casualty Assessment Model within BRL-CAD

Science.gov (United States)

2018-03-30

aided Design of the Operational Requirements-based Casualty Assessment Model within BRL-CAD 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ...upper_arm_r.s upper_arm_r.s-bool r upper_leg_l.r - lower_leg_l.s-bool r upper_leg_r.r - lower_leg_r.s-bool r upper_arm_r.r - lower_arm_r.s-bool r ...upper_arm_l.r - lower_arm_l.s-bool r pelvis.r - hip_l.s-bool - hip_r.s-bool - upper_leg_l.s-bool - upper_leg_r.s-bool r thorax.r - shoulder_l.s-bool

Substernal Thyroid Masses

Directory of Open Access Journals (Sweden)

Mohamed A.H. Regal

2010-10-01

Full Text Available A thyroid mass, most often a non toxic colloid goiter or occasionally an adenoma, is not an unusual finding below the level of the thoracic inlet.1 In 1992 Creswell and Wells estimated that these tumors comprise 5.8% of all mediastinal lesions.1 There is no standard definition for thyroid glands extending below the thoracic inlet, but such masses descend from their original cervical location for more than 2 or 3 cm below the thoracic inlet, and are not truly primary tumors of the mediastinum. They preserve the connection between the thoracic and cervical portion and receive their blood supply from the neck.2,3 In 1940, the seminal report of Wakeley and Mulvany divided intrathoracic thyroid masses into 3 types; (1”Small substernal extension” of a mainly cervical mass, (2 “Partial” intrathoracic, in which the major portion of the mass is situated within the thorax, and (3”Complete” in which all of the mass lies within the thoracic cavity.

40 years of terrorist bombings - A meta-analysis of the casualty and injury profile.

Science.gov (United States)

Edwards, D S; McMenemy, L; Stapley, S A; Patel, H D L; Clasper, J C

2016-03-01

Terrorists have used the explosive device successfully globally, with their effects extending beyond the resulting injuries. Suicide bombings, in particular, are being increasingly deployed due to the devastating effect of a combination of high lethality and target accuracy. The aim of this study was to identify trends and analyse the demographics and casualty figures of terrorist bombings worldwide. Analysis of the Global Terrorism Database (GTD) and a PubMed/Embase literature search (keywords "terrorist", and/or "suicide", and/or "bombing") from 1970 to 2014 was performed. 58,095 terrorist explosions worldwide were identified in the GTD. 5.08% were suicide bombings. Incidents per year are increasing (Pprofile of survivors to guide the immediate response by the medical services and the workload in the coming days. Copyright © 2016 Elsevier Ltd. All rights reserved.

Situated Transgressiveness

DEFF Research Database (Denmark)

Muhr, Sara Louise; Sullivan, Katie Rose; Rich, Craig

2016-01-01

conversations within queer theory, transgender and organization studies by highlighting how situated contexts mediate the political potential of queer bodies at work. By developing the concept ‘situated transgressiveness’, this article challenges notions of transgender as a stable, ideal disruptive category......This study investigates the lived experience of one transwoman, Claire, a public advocate and a manager with client services responsibilities. We examine Claire's story in order to discuss how situated contexts, such as different roles, locales and interactions, shape the way she experiences...

Modeling the Motion of an Increasing Mass System

Science.gov (United States)

Kunkel, William; Harrington, Randal

2010-01-01

Problems on the dynamics of changing mass systems often call for the more general form of Newton's second law Fnet = dp/dt. These problems usually involve situations where the mass of the system decreases, such as in rocket propulsion. In contrast, this experiment examines a system where the mass "increases" at a constant rate and the net force…

49 CFR 1242.33 - Other expenses and casualties and insurance (accounts XX-17-99, XX-18-99, XX-19-99, 50-17-00, 50...

Science.gov (United States)

2010-10-01

... (accounts XX-17-99, XX-18-99, XX-19-99, 50-17-00, 50-18-00, and 50-19-00). 1242.33 Section 1242.33....33 Other expenses and casualties and insurance (accounts XX-17-99, XX-18-99, XX-19-99, 50-17-00, 50... separation of administrative—other (account XX-19-06). Operating Expenses—Equipment locomotives ...

Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu Pandemic: Thwarting Potential Disasters in the Bud

Directory of Open Access Journals (Sweden)

Rajesh Arora

2011-01-01

Full Text Available The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations.

NATO Allied Medical Publication 7.5 (AMedP 7.5) NATO Planning Guide for the Estimation of CBRN Casualties

Science.gov (United States)

2016-12-01

PROMULGATION [ Date ] 1. The enclosed Allied Medical Publication AMedP-7.5, NATO Planning Guide for the Estimation of CBRN Casualties, which has been... radioisotopes modeled are 60Co, 90Sr, 99Mo, 125I, 131I, 137Cs, 192Ir, 226Ra, 238Pu, 241Am, 252Cf. 2) Whole-body irradiation (from cloudshine, groundshine,9... Earth Shelter 16.67 66.67 Exposed/Dismounted 1.00 1.00 Foxhole (nuclear only)† 3.00 10.00 Masonry Building 8.33 6.67 Multi-Story Brick Building 1.33

Assessing Operational Situations

DEFF Research Database (Denmark)

Zhang, Xinxin

In spite of the high level of automation commonly applied to today’s engineering system, humans’ skill and knowledge still plays a central role in the systems’ daily operation, critical decision making, and accident management. The complexity of the engineered system poses great challenge for human...... operators to perceive and understand the operational situation. The research domain of situation awareness approaches the operational challenges from the human cognition perspective while the presented thesis aims at supporting situation assessment from the system perspective. The thesis has reviewed...... different perspectives on situation awareness in the human factor studies and uses the knowledge reflectively for system representation and analysis. The human cognitive activities during complex plant operation and how they perceive a situation and what kind of knowledge has to be established in the human...

Emergency situations

International Nuclear Information System (INIS)

2007-01-01

The nuclear activities are exercised so as to prevent the accidents. They are subjected to a rule whom application is controlled by the Asn. The risk of grave accident is so limited to a very low level of probability. He cannot be however completely pushed aside. The expression ' radiological emergency situation ' indicates a situation which ensues from an incident or of an accident risking to lead to an emission of radioactive materials or a level of radioactivity susceptible to strike a blow at the public health. The term ' nuclear crisis ' is used for the events which can lead to a radiological emergency situation on a nuclear basic installation or during a transport of radioactive materials. The preparation and the management of emergency situations, that they are of natural, accidental or terrorist origin, became a major concern of our society. We propose you of to know more about it in this file. (N.C.)

Fire Situations and Prevention Measures of residential building

Directory of Open Access Journals (Sweden)

Zhou Baixia

2017-01-01

Full Text Available The proportion of residential building is the largest in all buildings. With the development of urbanization, residential building fires are at high momentum. The paper lists the residential building fires and the number of casualties’ proportion to total fires from 2011 to 2014, analyzing the high incidence causes of the fires and casualties and putting forward suggestions and countermeasures including carrying out fire safety education to improve the fire safety awareness of residents, fulfilling responsibility to enhancing fire safety management capabilities, perfecting fire apparatus to develop fire safety environment and enhancing public awareness of fire safety, equipping evacuation equipments to promote response ability to deal with disasters etc.

High-throughput microfluidics automated cytogenetic processing for effectively lowering biological process time and aid triage during radiation accidents

International Nuclear Information System (INIS)

Ramakumar, Adarsh

2016-01-01

Nuclear or radiation mass casualties require individual, rapid, and accurate dose-based triage of exposed subjects for cytokine therapy and supportive care, to save life. Radiation mass casualties will demand high-throughput individual diagnostic dose assessment for medical management of exposed subjects. Cytogenetic techniques are widely used for triage and definitive radiation biodosimetry. Prototype platform to demonstrate high-throughput microfluidic micro incubation to support the logistics of sample in miniaturized incubators from the site of accident to analytical labs has been developed. Efforts have been made, both at the level of developing concepts and advanced system for higher throughput in processing the samples and also implementing better and efficient methods of logistics leading to performance of lab-on-chip analyses. Automated high-throughput platform with automated feature extraction, storage, cross platform data linkage, cross platform validation and inclusion of multi-parametric biomarker approaches will provide the first generation high-throughput platform systems for effective medical management, particularly during radiation mass casualty events

Epidemiology and antimicrobial susceptibilities of wound isolates of obligate anaerobes from combat casualties.

Science.gov (United States)

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

2016-02-01

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

Improving PAGER's real-time earthquake casualty and loss estimation toolkit: a challenge

Science.gov (United States)

Jaiswal, K.S.; Wald, D.J.

2012-01-01

We describe the on-going developments of PAGER’s loss estimation models, and discuss value-added web content that can be generated related to exposure, damage and loss outputs for a variety of PAGER users. These developments include identifying vulnerable building types in any given area, estimating earthquake-induced damage and loss statistics by building type, and developing visualization aids that help locate areas of concern for improving post-earthquake response efforts. While detailed exposure and damage information is highly useful and desirable, significant improvements are still necessary in order to improve underlying building stock and vulnerability data at a global scale. Existing efforts with the GEM’s GED4GEM and GVC consortia will help achieve some of these objectives. This will benefit PAGER especially in regions where PAGER’s empirical model is less-well constrained; there, the semi-empirical and analytical models will provide robust estimates of damage and losses. Finally, we outline some of the challenges associated with rapid casualty and loss estimation that we experienced while responding to recent large earthquakes worldwide.

Mass-Gathering Medical Care in Electronic Dance Music Festivals.

Science.gov (United States)

FitzGibbon, Kathleen M; Nable, Jose V; Ayd, Benjamin; Lawner, Benjamin J; Comer, Angela C; Lichenstein, Richard; Levy, Matthew J; Seaman, Kevin G; Bussey, Ian

2017-10-01

Introduction Electronic dance music (EDM) festivals represent a unique subset of mass-gathering events with limited guidance through literature or legislation to guide mass-gathering medical care at these events. Hypothesis/Problem Electronic dance music festivals pose unique challenges with increased patient encounters and heightened patient acuity under-estimated by current validated casualty predication models. This was a retrospective review of three separate EDM festivals with analysis of patient encounters and patient transport rates. Data obtained were inserted into the predictive Arbon and Hartman models to determine estimated patient presentation rate and patient transport rates. The Arbon model under-predicted the number of patient encounters and the number of patient transports for all three festivals, while the Hartman model under-predicted the number of patient encounters at one festival and over-predicted the number of encounters at the other two festivals. The Hartman model over-predicted patient transport rates for two of the three festivals. Electronic dance music festivals often involve distinct challenges and current predictive models are inaccurate for planning these events. The formation of a cohesive incident action plan will assist in addressing these challenges and lead to the collection of more uniform data metrics. FitzGibbon KM , Nable JV , Ayd B , Lawner BJ , Comer AC , Lichenstein R , Levy MJ , Seaman KG , Bussey I . Mass-gathering medical care in electronic dance music festivals. Prehosp Disaster Med. 2017;32(5):563-567.

Blast overpressure and fallout radiation dose models for casualty assessment and other purposes. Rev. ed.

International Nuclear Information System (INIS)

Bentley, P.R.

1981-12-01

The determination of blast overpressures and fallout radiation doses at points on a sufficiently fine grid, for any part or for the whole of the UK, and for any postulated attack, is an essential element in the systematic assessment of casualties, the estimation of numbers of homeless, and the evaluation of life-saving measures generally. Models are described which provide the required blast and dose values and which are intended to supersede existing models which were introduced in 1971. The factors which affect blast and, more particularly, dose values are discussed, and the way in which various factors are modelled is described. The models are incorporated into separate computer programs which are described, the outputs of which are stored on magnetic tape for subsequent use as required. (author)

The Role Of The Media In The Political Culture Of Russia: The Current Situation

OpenAIRE

Анна Леонидовна Кочурова

2014-01-01

The article is devoted to the analysis of the characteristics and activities of mass media as an institution of political culture, which should be aimed at raising citizens' awareness and capacity objective to organize information exchange between Government and citizens. Considered social acuteness and urgency of this problem, the main functions of the MASS MEDIA, a trend increase in the role and impact of the MEDIA on the current political situation in Russia.

Vulnerability of populations and the urban health care systems to nuclear weapon attack – examples from four American cities

Directory of Open Access Journals (Sweden)

Dallas Cham E

2007-02-01

Full Text Available Abstract Background The threat posed by the use of weapons of mass destruction (WMD within the United States has grown significantly in recent years, focusing attention on the medical and public health disaster capabilities of the nation in a large scale crisis. While the hundreds of thousands or millions of casualties resulting from a nuclear weapon would, in and of itself, overwhelm our current medical response capabilities, the response dilemma is further exacerbated in that these resources themselves would be significantly at risk. There are many limitations on the resources needed for mass casualty management, such as access to sufficient hospital beds including specialized beds for burn victims, respiration and supportive therapy, pharmaceutical intervention, and mass decontamination. Results The effects of 20 kiloton and 550 kiloton nuclear detonations on high priority target cities are presented for New York City, Chicago, Washington D.C. and Atlanta. Thermal, blast and radiation effects are described, and affected populations are calculated using 2000 block level census data. Weapons of 100 Kts and up are primarily incendiary or radiation weapons, able to cause burns and start fires at distances greater than they can significantly damage buildings, and to poison populations through radiation injuries well downwind in the case of surface detonations. With weapons below 100 Kts, blast effects tend to be stronger than primary thermal effects from surface bursts. From the point of view of medical casualty treatment and administrative response, there is an ominous pattern where these fatalities and casualties geographically fall in relation to the location of hospital and administrative facilities. It is demonstrated that a staggering number of the main hospitals, trauma centers, and other medical assets are likely to be in the fatality plume, rendering them essentially inoperable in a crisis. Conclusion Among the consequences of this

Medical treatment of radiation injuries-Current US status

Energy Technology Data Exchange (ETDEWEB)

Jarrett, D.G. [OSA - CBD and CDP, 3050 Defense Pentagon, Room 3C257, Washington, DC 20301-3050 (United States)], E-mail: david.jarrett@us.army.mil; Sedlak, R.G.; Dickerson, W.E. [Uniformed Services University, Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bethesda, MD 20889-5603 (United States); Reeves, G.I. [Northrop Grumman IT, 8211 Terminal Road, Lorton, VA 22079-1421 (United States)

2007-07-15

A nuclear incident or major release of radioactive materials likely would result in vast numbers of patients, many of whom would require novel therapy. Fortunately, the numbers of radiation victims in the United States (USA) have been limited to date. If a mass-casualty situation occurs, there will be a need to perform rapid, accurate dose estimates and to provide appropriate medications and other treatment to ameliorate radiation injury. The medical management of radiation injury is complex. Radiation injury may include acute radiation sickness (ARS) from external and/or internal radiation exposure, internal organ damage from incorporated radioactive isotopes, and cutaneous injury. Human and animal data have shown that optimal medical care may nearly double the survivable dose of ionizing radiation. Current treatment strategies for radiation injuries are discussed with concentration on the medical management of the hematopoietic syndrome. In addition, priority areas for continuing and future research into both acute deterministic injuries and also long-term stochastic sequelae of radiation exposure have been identified. There are several near-term novel therapies that appear to offer excellent prognosis for radiation casualties, and these are also described.

Future Naval Concepts -- Crew Reductions through Improved Damage Control Communications (FNC-CRIDCC)

National Research Council Canada - National Science Library

Street, Thomas T; Williams, Frederick W; Cooper, L. S; Halloway, III, Kenneth E; Rininger, Michael; Miller, Charles; Shirley, Bradley; Genovese, Samuel; Showalter, David; Zak, Stephen

2007-01-01

The object of the Damage Control (DC) Triad program was to develop a Damage Control Communications system, which would be damage tolerant and remain operable in casualty situations where DC communications are vital...

Characteristics of human - sloth bear (Melursus ursinus) encounters and the resulting human casualties in the Kanha-Pench corridor, Madhya Pradesh, India

OpenAIRE

Dhamorikar, Aniruddha H.; Mehta, Prakash; Bargali, Harendra; Gore, Kedar

2017-01-01

Sloth bears (Melursus ursinus) caused the highest number of human deaths between 2001 and 2015 and ranked second compared to other wild animals in causing human casualties in the Kanha-Pench corridor area. We studied the patterns of sloth bear attacks in the region to understand the reasons for conflict. We interviewed 166 victims of sloth bear attacks which occurred between 2004 and 2016 and found that most attacks occurred in forests (81%), with the greatest number of those (42%) occurring ...

Situational Method Engineering

OpenAIRE

Henderson-Sellers, Brian; Ralyte, Jolita; Par, Agerfalk; Rossi, Matti

2014-01-01

While previously available methodologies for software – like those published in the early days of object technology – claimed to be appropriate for every conceivable project, situational method engineering (SME) acknowledges that most projects typically have individual characteristics and situations. Thus, finding the most effective methodology for a particular project needs specific tailoring to that situation. Such a tailored software development methodology needs to take into account all t...

Situational method engineering

CERN Document Server

Henderson-Sellers, Brian; Ågerfalk, Pär J; Rossi, Matti

2014-01-01

While previously available methodologies for software ? like those published in the early days of object technology ? claimed to be appropriate for every conceivable project, situational method engineering (SME) acknowledges that most projects typically have individual characteristics and situations. Thus, finding the most effective methodology for a particular project needs specific tailoring to that situation. Such a tailored software development methodology needs to take into account all the bits and pieces needed for an organization to develop software, including the software process, the

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

International Nuclear Information System (INIS)

Tagawa, Masuko

1996-01-01

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

METHODOLOGICAL ELEMENTS OF SITUATIONAL ANALYSIS

Directory of Open Access Journals (Sweden)

Tetyana KOVALCHUK

2016-07-01

Full Text Available The article deals with the investigation of theoretical and methodological principles of situational analysis. The necessity of situational analysis is proved in modern conditions. The notion “situational analysis” is determined. We have concluded that situational analysis is a continuous system study which purpose is to identify dangerous situation signs, to evaluate comprehensively such signs influenced by a system of objective and subjective factors, to search for motivated targeted actions used to eliminate adverse effects of the exposure of the system to the situation now and in the future and to develop the managerial actions needed to bring the system back to norm. It is developed a methodological approach to the situational analysis, its goal is substantiated, proved the expediency of diagnostic, evaluative and searching functions in the process of situational analysis. The basic methodological elements of the situational analysis are grounded. The substantiation of the principal methodological elements of system analysis will enable the analyst to develop adaptive methods able to take into account the peculiar features of a unique object which is a situation that has emerged in a complex system, to diagnose such situation and subject it to system and in-depth analysis, to identify risks opportunities, to make timely management decisions as required by a particular period.

Intraosseous Administration of Antidotes in the Chemical Weapons Victim - An Alternative to the Intravenous Route

International Nuclear Information System (INIS)

Borron, S. W.; Arias, J. C.

2007-01-01

Hazardous materials paradigms call for definitive treatment of chemical victims to begin in the 'warm zone' during decontamination. This delay may result in lethal outcomes, particularly in the case of multiple victims, where rescue may be delayed due to insufficient numbers of rescue teams. It is virtually impossible for rescuers in full protective gear to establish intravenous lines. In recent years, significant advances have been made in intraosseous (IO) infusion devices. An IO device developed in our institution, the EZ-IO, is very easily placed by rescuers in typical work uniforms. IO placement takes longer while in protective gear, but is feasible. The IO is equivalent to an intravenous line, allowing more rapid administration of antidotes in the event of chemical mass casualties. Antidotes not amenable to intramuscular administration and even those often given IM may be more effective given IO. IO administration has the following possible advantages over intravenous or intramuscular antidote administration: 1. Drugs administered IO reach the vascular system virtually instantaneously. 2. IO administration may be performed in protective clothing and could theoretically be employed while awaiting rescue. 3. IO administration may be preferred over intravenous administration in the warm zone. In summary, IO administration of antidotes should be further evaluated for use in chemical disasters. The ease and speed of placement, ready access to the vascular tree, and potential for earlier intervention make it a potentially ideal means of vascular access and antidotal administration in the mass casualty situation. (author)

Situational Leadership

OpenAIRE

Süttö, Marián

2016-01-01

This thesis is focused on field of leadership, particularly situational leadership model by Hersey and Blanchard. Thesis is mostly theoretical framework aimed to offer the possibility for reader to get overview in leadership issues. Theoretical framework of the thesis is focused on leadership definition, the most important leadership theories in the past, and especially to situational leadership approach. The focus of this thesis is to get detailed insight in this model and therefore offer in...

Interactive Purchasing Situations

NARCIS (Netherlands)

Groote Schaarsberg, M.; Borm, P.E.M.; Hamers, H.J.M.; Reijnierse, J.H.

2012-01-01

Abstract: This paper introduces a new class of interactive cooperative purchasing situations and provides an explicit alternative characterization of the nucleolus of cooperative games, which offers an alternative to Kohlberg (1971). In our cooperative purchasing situation, the unit price of a

Selection, follow-up, and analysis in the Atomic Bomb Casualty Commission Study

International Nuclear Information System (INIS)

Jablon, S.

1985-01-01

More is known about ionizing radiation as a cause of human cancer than about any other carcinogen. Most of this knowledge is derived from the studies conducted by the Atomic Bomb Casualty Commission and Radiation Effects Research Foundation on about 100,000 Japanese survivors of the atomic bombing in 1945. The importance of these studies is based on the large size of the exposed population and the fact that individual estimates of radiation dose were possible. These factors and the combined excellence of the centralized vital statistics reporting and population registration systems in Japan have made feasible the continuing longitudinal studies of cancer mortality by site in relation to radiation dose over a span of more than 30 years. Excellent voluntary cooperation by the survivors has enabled the continuation of a biennial physical examination program which has made possible the acquisition of blood for studies of radiation-induced chromosomal aberrations and mutations at the level of specific genes. Similarly, with the cooperation of local universities, hospitals, and physicians, tumor and tissue registries necessary for the study of cancer incidence have been developed. An autopsy pathology program has enabled study of the accuracy of cause of death certification

Mass Poverty in Nigeria: Cultural Bases, Causes and Remedies ...

African Journals Online (AJOL)

Apart from these, mass poverty in Nigeria, is tacitly encouraged by the government whose various policies and programmes have been tailored to further impoverish the masses. The widespread poverty in Nigeria is webbed around a culture that situates people and their offsprings in a particular social strata and engenders ...

Two Balls' Collision of Mass Ratio 3:1

Science.gov (United States)

Ogawara, Yasuo; Hull, Michael M.

2018-04-01

Students will sometimes ask why momentum and kinetic energy concepts are both necessary. When physics teachers demonstrate situations that require both an understanding of kinetic energy and momentum, a favorite is Newton's cradle, or a comparable demonstration of two balls of equal mass hitting each other. However, in addition to the case of two balls of equal mass, if a ball hits another ball of three times the mass with equal speed, the results are also interesting, and, like the equal-mass demonstration, both kinetic energy and momentum are critical for understanding the motion.

Massive gravity with mass term in three dimensions

International Nuclear Information System (INIS)

Nakasone, Masashi; Oda, Ichiro

2009-01-01

We analyze the effect of the Pauli-Fierz mass term on a recently established, new massive gravity theory in three space-time dimensions. We show that the Pauli-Fierz mass term makes the new massive gravity theory nonunitary. Moreover, although we add the gravitational Chern-Simons term to this model, the situation remains unchanged and the theory stays nonunitary despite that the structure of the graviton propagator is greatly changed. Thus, the Pauli-Fierz mass term is not allowed to coexist with mass-generating higher-derivative terms in the new massive gravity.

Dynamics of Situation Definition

Science.gov (United States)

Park, Dongseop; Moro, Yuji

2006-01-01

Situation definition is the process and product of actors' interpretive activities toward a given situation. By reviewing a number of psychological studies conducted in experimental settings, we found that the studies have only explicated a part of the situation definition process and have neglected its dynamic aspects. We need to focus on the…

Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

Science.gov (United States)

2017-10-01

AWARD NUMBER: W81XWH-15-2-0072 TITLE: Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in...Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS 5b. GRANT NUMBER W81XWH-15...Figure 4. Mitochondrial activity is mostly preserved on the animals that were supported with ventilator devices and mesenchymal stem cells . Using a

Hydration status of Greco-Roman wrestlers in an authentic precompetition situation.

Science.gov (United States)

Ööpik, Vahur; Timpmann, Saima; Burk, Andres; Hannus, Innar

2013-06-01

We assessed the urinary indexes of hydration status of Greco-Roman wrestlers in an authentic precompetition situation at the time of official weigh-in (OWI). A total of 51 of 89 wrestlers competing in the Estonian Championship in 2009 donated a urine sample. Questionnaire responses revealed that 27 wrestlers (body mass losers (BMLs)) reduced body mass before the competition, whereas 24 wrestlers (those who do not lose body mass (n-BMLs)) did not. In 42 wrestlers, values of urine specific gravity ≥1.020 and urine osmolality ≥700 mOsmol·kg(-1) revealed a hypohydrated status. The prevalence of hypohydration in the BMLs (96%) was higher than in the n-BMLs (67%) (χ(2) = 7.68; p 1.030) was 5.3 times greater (χ(2) = 8.32; p OWI. The prevalence of hypohydration and serious hypohydration is especially high among wrestlers who are accustomed to reducing body mass before competition. These results suggest that an effective rehydration strategy is needed for Olympic-style wrestlers, and that changes in wrestling rules should be considered to reduce the prevalence of harmful body mass management behaviours.

Understanding the Effects of Blast Wave on the Intracranial Pressure and Traumatic Brain Injury in Rodents and Humans Using Experimental Shock Tube and Numerical Simulations

Science.gov (United States)

2014-07-01

populated ( train stations) region or in public events (Boston marathon ) to inflict maximum civilian casualties [15, 17]. Figure 2.2: Percentage of...and understand the biomechanical loading experienced by the animal at different placement locations along the tube in order to recreate field loading...Boston Marathon and mass-casualty events. New England journal of medicine, 2013. 368(21): p. 1958-1960. 16. Wilson, C. Improvised explosive devices

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

Science.gov (United States)

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

2018-02-15

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

Features of microscopic pedestrian movement in a panic situation based on cellular automata model

Science.gov (United States)

Ibrahim, Najihah; Hassan, Fadratul Hafinaz

2017-10-01

Pedestrian movement is the one of the subset for the crowd management under simulation objective. During panic situation, pedestrian usually will create a microscopic movement that lead towards the self-organization. During self-organizing, the behavioral and physical factors had caused the mass effect on the pedestrian movement. The basic CA model will create a movement path for each pedestrian over a time step. However, due to the factors immerge, the CA model needs some enhancement that will establish a real simulation state. Hence, this concept paper will discuss on the enhanced features of CA model for microscopic pedestrian movement during panic situation for a better pedestrian simulation.

Knowledge-based driver assistance systems traffic situation description and situation feature relevance

CERN Document Server

Huelsen, Michael

2014-01-01

The comprehension of a traffic situation plays a major role in driving a vehicle. Interpretable information forms a basis for future projection, decision making and action performing, such as navigating, maneuvering and driving control. Michael Huelsen provides an ontology-based generic traffic situation description capable of supplying various advanced driver assistance systems with relevant information about the current traffic situation of a vehicle and its environment. These systems are enabled to perform reasonable actions and approach visionary goals such as injury and accident free driv

Situational simulations in interactive video

Energy Technology Data Exchange (ETDEWEB)

Smith, L.J.

1991-07-01

The Westinghouse Hanford Company Advanced Training Technologies section is using situational simulations in several Interactive Video training courses. Two applications of situational simulations will be discussed. In the first, used in the Hanford General Employee Training course, the student evaluates employee's actions in simulations of possible workplace situations. In the second, used in the Criticality Safety course, students must follow well-defined procedures to complete tasks. Design and incorporation of situational simulations will be discussed. 3 refs.

Situational simulations in interactive video

International Nuclear Information System (INIS)

Smith, L.J.

1991-07-01

The Westinghouse Hanford Company Advanced Training Technologies section is using situational simulations in several Interactive Video training courses. Two applications of situational simulations will be discussed. In the first, used in the Hanford General Employee Training course, the student evaluates employee's actions in simulations of possible workplace situations. In the second, used in the Criticality Safety course, students must follow well-defined procedures to complete tasks. Design and incorporation of situational simulations will be discussed. 3 refs

Fake signals caused by heavy-mass motions near a sensitive spherical gravitational wave antenna

International Nuclear Information System (INIS)

Lobo, Alberto; Cerdonio, Massimo; Montero, Alvaro

2002-01-01

In this paper we analyse in quantitative detail the effect of a moving mass on a spherical gravitational wave detector. This applies to situations where heavy traffic or similar disturbances occur near the GW antenna. Such disturbances result in quadrupole tidal stresses in the antenna mass, and they therefore precisely fake a real gravitational signal. The study shows that there are always characteristic frequencies, depending on the motion of the external masses, at which the fake signals are most intense. It however appears that, even at those frequencies, fake signals should be orders of magnitude below the sensitivity curve of an optimized detector, in likely realistic situations

Extending injury prevention methodology to chemical terrorism preparedness: the Haddon Matrix and sarin.

Science.gov (United States)

Varney, Shawn; Hirshon, Jon Mark; Dischinger, Patricia; Mackenzie, Colin

2006-01-01

The Haddon Matrix offers a classic epidemiological model for studying injury prevention. This methodology places the public health concepts of agent, host, and environment within the three sequential phases of an injury-producing incident-pre-event, event, and postevent. This study uses this methodology to illustrate how it could be applied in systematically preparing for a mass casualty disaster such as an unconventional sarin attack in a major urban setting. Nineteen city, state, federal, and military agencies responded to the Haddon Matrix chemical terrorism preparedness exercise and offered feedback in the data review session. Four injury prevention strategies (education, engineering, enforcement, and economics) were applied to the individual factors and event phases of the Haddon Matrix. The majority of factors identified in all phases were modifiable, primarily through educational interventions focused on individual healthcare providers and first responders. The Haddon Matrix provides a viable means of studying an unconventional problem, allowing for the identification of modifiable factors to decrease the type and severity of injuries following a mass casualty disaster such as a sarin release. This strategy could be successfully incorporated into disaster planning for other weapons attacks that could potentially cause mass casualties.

Surgical resource utilization in urban terrorist bombing: a computer simulation.

Science.gov (United States)

Hirshberg, A; Stein, M; Walden, R

1999-09-01

The objective of this study was to analyze the utilization of surgical staff and facilities during an urban terrorist bombing incident. A discrete-event computer model of the emergency room and related hospital facilities was constructed and implemented, based on cumulated data from 12 urban terrorist bombing incidents in Israel. The simulation predicts that the admitting capacity of the hospital depends primarily on the number of available surgeons and defines an optimal staff profile for surgeons, residents, and trauma nurses. The major bottlenecks in the flow of critical casualties are the shock rooms and the computed tomographic scanner but not the operating rooms. The simulation also defines the number of reinforcement staff needed to treat noncritical casualties and shows that radiology is the major obstacle to the flow of these patients. Computer simulation is an important new tool for the optimization of surgical service elements for a multiple-casualty situation.

Problem situations in management activity

OpenAIRE

N.A. DUBINKO

2009-01-01

This article reviews contemporary methodological and theoretical approaches to the problem situations in management activity. Revealed and analyzed the types of problem situations managers dealing with in their activity. Rank correlation of problem situations shows distinctions depending on management work experience. Revealed gender distinctions in the managers' ideas of management problems.

An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2003-2010 Light-Duty Vehicles

Energy Technology Data Exchange (ETDEWEB)

Wenzel, Tom P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2018-01-05

The Department of Energy’s (DOE) Vehicle Technologies Office funds research on development of technologies to improve the fuel economy of both light- and heavy-duty vehicles, including advanced combustion systems, improved batteries and electric drive systems, and new lightweight materials. Of these approaches to increase fuel economy and reduce fuel consumption, reducing vehicle mass through more extensive use of strong lightweight materials is perhaps the easiest and least expensive method; however, there is a concern that reducing vehicle mass may lead to more fatalities. Lawrence Berkeley National Laboratory (LBNL) has conducted several analyses to better understand the relationship between vehicle mass, size and safety, in order to ameliorate concerns that down-weighting vehicles will inherently lead to more fatalities. These analyses include recreating the regression analyses conducted by the National Highway Traffic Safety Administration (NHTSA) that estimate the relationship between mass reduction and U.S. societal fatality risk per vehicle mile of travel (VMT), while holding vehicle size (i.e. footprint, wheelbase times track width) constant; these analyses are referred to as LBNL Phase 1 analysis. In addition, LBNL has conducted additional analysis of the relationship between mass and the two components of risk per VMT, crash frequency (crashes per VMT) and risk once a crash has occurred (risk per crash); these analyses are referred to as LBNL Phase 2 analysis.

A scan for models with realistic fermion mass patterns

International Nuclear Information System (INIS)

Bijnens, J.; Wetterich, C.

1986-03-01

We consider models which have no small Yukawa couplings unrelated to symmetry. This situation is generic in higher dimensional unification where Yukawa couplings are predicted to have strength similar to the gauge couplings. Generations have then to be differentiated by symmetry properties and the structure of fermion mass matrices is given in terms of quantum numbers alone. We scan possible symmetries leading to realistic mass matrices. (orig.)

Energy situation - Forth quarter 2016. Energy situation October 2016; Energy situation November 2016; Energy situation December 2016

International Nuclear Information System (INIS)

Guggemos, Fabien; Misak, Evelyne; Mombel, David; Moreau, Sylvain

2017-02-01

This publication presents, first, a quarterly report of the French energy situation: primary energy consumption, energy independence and CO_2 emissions, national production, imports, exports, energy costs, average and spot prices. Data are presented separately for solid mineral fuels, petroleum products, natural gas and electricity. Month-to-month details are summarized in a second part, in the form of tables and graphs

Energy situation - First quarter 2017. Energy situation January 2017; Energy situation February 2017; Energy situation March 2017

International Nuclear Information System (INIS)

Guggemos, Fabien; Misak, Evelyne; Mombel, David; Moreau, Sylvain

2017-05-01

This publication presents, first, a quarterly report of the French energy situation: primary energy consumption, energy independence and CO_2 emissions, national production, imports, exports, energy costs, average and spot prices. Data are presented separately for solid mineral fuels, petroleum products, natural gas and electricity. Month-to-month details are summarized in a second part, in the form of tables and graphs

Situational theory of leadership.

Science.gov (United States)

Waller, D J; Smith, S R; Warnock, J T

1989-11-01

The situational theory of leadership and the LEAD instruments for determining leadership style are explained, and the application of the situational leadership theory to the process of planning for and implementing organizational change is described. Early studies of leadership style identified two basic leadership styles: the task-oriented autocratic style and the relationship-oriented democratic style. Subsequent research found that most leaders exhibited one of four combinations of task and relationship behaviors. The situational leadership theory holds that the difference between the effectiveness and ineffectiveness of the four leadership styles is the appropriateness of the leader's behavior to the particular situation in which it is used. The task maturity of the individual or group being led must also be accounted for; follower readiness is defined in terms of the capacity to set high but attainable goals, willingness or ability to accept responsibility, and possession of the necessary education or experience for a specific task. A person's leadership style, range, and adaptability can be determined from the LEADSelf and LEADOther questionnaires. By applying the principles of the situational leadership theory and adapting their managerial styles to specific tasks and levels of follower maturity, the authors were successful in implementing 24-hour pharmacokinetic dosing services provided by staff pharmacists with little previous experience in clinical services. The situational leadership model enables a leader to identify a task, set goals, determine the task maturity of the individual or group, select an appropriate leadership style, and modify the style as change occurs. Pharmacy managers can use this model when implementing clinical pharmacy services.

Hardships and personal strategies of Vietnam War nurses.

Science.gov (United States)

Scannell-Desch, E A

2000-08-01

This study describes hardships faced in Vietnam and personal strategies used to deal with these hardships as defined by 24 female military nurses who served during the war. Purposive sampling was used, and data were generated using four core questions and in-depth interviews. The research methodology was phenomenology, incorporating data analysis procedures of Colaizzi, Lincoln and Guba, and Van Manen. Eight hardship and nine personal strategy themes were identified. This study found that caring for young, severely injured, and disfigured soldiers was a significant hardship and that nurses struggled with the moral dilemmas inherent in mass casualty situations, triage policies, and the practice of returning recovered soldiers to combat. Most nurses relied on personally proven and familiar strategies to reduce or buffer the effects of emotional hardships, whereas some discovered and used new strategies.

Situative Space Tracking within Smart Environments

DEFF Research Database (Denmark)

Surie, Dipak; Jäckel, Florian; Janlert, Lars-Erik

2010-01-01

This paper describes our efforts in modeling and tracking a human agent’s situation based on his/her possibilities to perceive and act upon objects (both physical and virtual) within smart environments. A Situative Space Model is proposed. WLAN signal-strength-based situative space tracking syste......-laboratory smart home environment where a global precision of 83.4% and a global recall of 88.6% were obtained.......This paper describes our efforts in modeling and tracking a human agent’s situation based on his/her possibilities to perceive and act upon objects (both physical and virtual) within smart environments. A Situative Space Model is proposed. WLAN signal-strength-based situative space tracking system...

Design and evaluation of a wireless electronic health records system for field care in mass casualty settings.

Science.gov (United States)

Lenert, L A; Kirsh, D; Griswold, W G; Buono, C; Lyon, J; Rao, R; Chan, T C

2011-01-01

There is growing interest in the use of technology to enhance the tracking and quality of clinical information available for patients in disaster settings. This paper describes the design and evaluation of the Wireless Internet Information System for Medical Response in Disasters (WIISARD). WIISARD combined advanced networking technology with electronic triage tags that reported victims' position and recorded medical information, with wireless pulse-oximeters that monitored patient vital signs, and a wireless electronic medical record (EMR) for disaster care. The EMR system included WiFi handheld devices with barcode scanners (used by front-line responders) and computer tablets with role-tailored software (used by managers of the triage, treatment, transport and medical communications teams). An additional software system provided situational awareness for the incident commander. The WIISARD system was evaluated in a large-scale simulation exercise designed for training first responders. A randomized trial was overlaid on this exercise with 100 simulated victims, 50 in a control pathway (paper-based), and 50 in completely electronic WIISARD pathway. All patients in the electronic pathway were cared for within the WIISARD system without paper-based workarounds. WIISARD reduced the rate of the missing and/or duplicated patient identifiers (0% vs 47%, pwireless EMR systems for care of the victims of disasters would be complex to develop but potentially feasible to build and deploy, and likely to improve the quality of information available for the delivery of care during disasters.

Developing and Organizing a Trauma System and Mass Casualty ...

African Journals Online (AJOL)

If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader. To download the PDF, click the Download link ...

Mass casualty response in the 2008 Mumbai terrorist attacks.

Science.gov (United States)

Roy, Nobhojit; Kapil, Vikas; Subbarao, Italo; Ashkenazi, Isaac

2011-12-01

The November 26-29, 2008, terrorist attacks on Mumbai were unique in its international media attention, multiple strategies of attack, and the disproportionate national fear they triggered. Everyone was a target: random members of the general population, iconic targets, and foreigners alike were under attack by the terrorists. A retrospective, descriptive study of the distribution of terror victims to various city hospitals, critical radius, surge capacity, and the nature of specialized medical interventions was gathered through police, legal reports, and interviews with key informants. Among the 172 killed and 304 injured people, about four-fifths were men (average age, 33 years) and 12% were foreign nationals. The case-fatality ratio for this event was 2.75:1, and the mortality rate among those who were critically injured was 12%. A total of 38.5% of patients arriving at the hospitals required major surgical intervention. Emergency surgical operations were mainly orthopedic (external fixation for compound fractures) and general surgical interventions (abdominal explorations for penetrating bullet/shrapnel injuries). The use of heavy-duty automatic weapons, explosives, hostages, and arson in these terrorist attacks alerts us to new challenges to medical counterterrorism response. The need for building central medical control for a coordinated response and for strengthening public hospital capacity are lessons learned for future attacks. These particular terrorist attacks had global consequences, in terms of increased security checks and alerts for and fears of further similar "Mumbai-style" attacks. The resilience of the citizens of Mumbai is a critical measure of the long-term effects of terror attacks.

Development of a Mass Casualty Triage Performance Assessment Tool

Science.gov (United States)

2015-02-01

CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON Cindy Underwood a. REPORT Unlimited b. ABSTRACT...describing the victim’s physical state; a list of tasks that must be carried out in order to treat the victim and correctly determine the victim’s triage...have nonmedical personnel practice proper techniques for transporting patients, including the loading, carrying , and unloading of litters

Mass casualties of radiation injuries after nuclear weapon explosion

International Nuclear Information System (INIS)

Messerschmidt, O.

1980-01-01

Burns, mechanical lesions, radiation injuries as well as combinations of these types of injuries as a consequence of a nuclear explosion demand different basic lines of triage. The lack of a suitable physical dosimetry is a special problem for the evaluation of radiation injuries. While in cases of wounds and burns treatment, like surgery, is recommended to take place early, for example, within hours or days after those injuries, treatment of radiation victims is necessary only in the stage of severe haematologic changes including disturbances of coagulation and occurrence of high fever which appears after one or two weeks subsequent to exposure. The lack of medical personnel and medical equipment result in even a worse prognosis for the various injuries than in peace time accidents. (orig.) [de

Developing and Organizing a Trauma System and Mass Casualty ...

African Journals Online (AJOL)

Annals of Medical and Health Sciences Research | Jan-Mar 2013 | Vol 3 | Issue 1 |. 85. Address for ... the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel ... There was also a special session on artistic ... run policy is employed by the trauma response team that is.

The mass media and nuclear energy in the U.S

International Nuclear Information System (INIS)

Roche, C.

1994-01-01

The author discusses some problems of mass media of the United States connected with covering issues of nuclear power development, and makes some recommendations to improve the situation in this field

Possible radiation injury at Koeberg Nuclear Power Station

International Nuclear Information System (INIS)

Van Rensburg, L.C.J.; De Villiers, B.; Van Zyl, C.J.

1986-01-01

Any injured patient from Koeberg Nuclear Power Station will be treated in the conventional manner as an acute surgical emergency; this has priority over decontamination. The ideal situation is decontamination at Koeberg before ambulance transferral to the Tygerberg Radiation Casualty Facility, but if this is not possible or complete, decontamination can be accomplished by a trained team in the unit. Teamwork is the essence at the place of injury, during transfer, in the decontamination area, in the operating theatre and during the postoperative phase. No surgical management is appropriate or complete without the very necessary guidance and advice from a physicist and the Advisory Group for Radiation Casualties

A Situational Maintenance Model

DEFF Research Database (Denmark)

Luxhoj, James T.; Thorsteinsson, Uffe; Riis, Jens Ove

1997-01-01

An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance.......An overview of trend in maintenance management and presentation of a situational model and an analytical tools for identification of managerial efforts in maintenance....

Agent Based Modeling and Simulation of Pedestrian Crowds In Panic Situations

KAUST Repository

Alrashed, Mohammed

2016-11-01

The increasing occurrence of panic stampedes during mass events has motivated studying the impact of panic on crowd dynamics and the simulation of pedestrian flows in panic situations. The lack of understanding of panic stampedes still causes hundreds of fatalities each year, not to mention the scarce methodical studies of panic behavior capable of envisaging such crowd dynamics. Under those circumstances, there are thousands of fatalities and twice that many of injuries every year caused be crowd stampede worldwide, despite the tremendous efforts of crowd control and massive numbers of safekeeping forces. Pedestrian crowd dynamics are generally predictable in high-density crowds where pedestrians cannot move freely and thus gives rise to self-propelling interactions between pedestrians. Although every pedestrian has personal preferences, the motion dynamics can be modeled as a social force in such crowds. These forces are representations of internal preferences and objectives to perform certain actions or movements. The corresponding forces can be controlled for each individual to represent a different variety of behaviors that can be associated with panic situations such as escaping danger, clustering, and pushing. In this thesis, we use an agent-based model of pedestrian behavior in panic situations to predict the collective human behavior in such crowd dynamics. The proposed simulations suggests a practical way to alleviate fatalities and minimize the evacuation time in panic situations. Moreover, we introduce contagious panic and pushing behavior, resulting in a more realistic crowd dynamics model. The proposed methodology describes the intensity and spread of panic for each individual as a function of distances between pedestrians.

Twelve cases of multiple myeloma in Nagasaki (especially seven atomic bombing casualty cases). [In Japanese

Energy Technology Data Exchange (ETDEWEB)

Ichimaru, M; Yasuhi, S; Ouchuru, S

1963-12-01

Since 1958, there have been 12 cases of multiple myeloma in Nagasaki, and among them were 7 cases representing atomic bombing casualties, with 3 cases being with 2 km distance from the hypocenter. The age of onset was between 51 and 69 years, and the sex ratio was 8:4, it occurring mostly in males. Symptoms were predominantly low back pain and chest pain caused by the bone changes in 8 cases. Two cases complained of general malaise and palpitation which resulted from anemia. One developed persistent epistaris, and another complained of diplopia caused by the paralysis of the oculomotor nerve. Peripheral blood in all cases showed anemia, 9 with hyperchromic and 3 with normochromic or hypochromic anemia. Low platelet counts were seen in 3 cases. All showed leukopenia. All cases showed typical ..gamma..-globulin change with a myeloma peak, and in 4 cases showed an increase of ..beta..-globulin. Bence-Jones proteinuria was present in 5 cases. Average course was 1 year 4 months. Among complications, myeloma nephrosis, aplastic anemia, and pneumonia were the most important ones.

Radiation protection measures applied during the autopsies on the casualties of the Goiania accident

International Nuclear Information System (INIS)

Martins, N.S.F.; Silva, L.H.C.; Rosa, R.

1998-01-01

The most seriously affected casualties of the radiological accident caused by the opening of a 137 Cs source capsule in Goiania were treated at the Marcilio Dias Naval Hospital (HNMD) in Rio de Janeiro in the period from October to December 1987. Four of the injured died in October. The autopsies were performed at this institution. Due to the external and internal contamination presented by these victims, specific radiation protection procedures were adopted to enable the medical team to perform their duties. The radiation protection staff, under the co-ordination of technicians of the Brazilian Nuclear Energy Commission (CNEN), were responsible for the preparation of the autopsy room and for advising the professionals on duty during these events. The radiation protection staff took specific measures to prevent the spread of contamination throughout the hospital, the contamination of persons attending the autopsies and to minimize any radiation dose to the medical and professional team. The measures aimed at personal control and the preparation of the autopsy room are described as well as the radiation protection steps applied in connection with the performance of the autopsies, the emplacement of the bodies into the coffins and their transport back to Goiania. (author)

Laterally situated sinus pericranii

International Nuclear Information System (INIS)

Koshu, K.; Takahashi, S.

1981-01-01

Sinus pericranii has been reported to be situated usually along the midline. Two cases of laterally situated sinus pericranii are presented. Venous blood was obtained by puncturing the tumors directly. Injection of contrast medium into the tumors demonstrated a communication between the tumors and the intracranial venous sinuses through marked diploic veins. (orig.)

All in a day's work – variability in person-situation interactions in daily life situations

DEFF Research Database (Denmark)

Jensen, Lasse Meinert

effect of persons’ situational concerns and intentions upon fluctuations in quality of experience. This paper will argue that the combination of findings (a) and (b) goes against the interpretation that persons merely “react” to situational features, and instead points to how subjective and agentic...... features of the person shape experience by way of guiding the person’s interaction with the situations of everyday life....

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

Science.gov (United States)

Matsumura, Janice

2004-01-01

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

Atomic weight versus atomic mass controversy

International Nuclear Information System (INIS)

Holden, N.E.

1985-01-01

A problem for the Atomic Weights Commission for the past decade has been the controversial battle over the names ''atomic weight'' and ''atomic mass''. The Commission has considered the arguments on both sides over the years and it appears that this meeting will see more of the same discussion taking place. In this paper, I review the situation and offer some alternatives

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

Science.gov (United States)

Raknes, Guttorm; Hunskaar, Steinar

2014-01-01

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

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

Directory of Open Access Journals (Sweden)

Guttorm Raknes

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

The application of transportation models in emergency situations: Example of a hypothetical city

Directory of Open Access Journals (Sweden)

Antić Jovana Z.

2015-01-01

Full Text Available Emergency situations, where mass evacuation of people is present, are serious problem that is difficult to resolve. Such events have become more frequent in recent years. The transportation network is a key part of the infrastructure when it comes to events with disastrous consequences, because a large population of people must be effectively evacuated from densely populated urban areas. Therefore, requirements during an evacuation process are made in a relatively short period of time, and available capacity of the road network has become the main resource to be efficiently utilized in order to shorten the time required for evacuation. By using transportation model, the paper presents the simulation of the traffic in a situation when there is a need to evacuate large numbers of people, in order to propose measures that could be efficiently used.

Triage and first care of casualties after radiological incidents; Triage en eerste opvang van slachtoffers na radiologische incidenten

Energy Technology Data Exchange (ETDEWEB)

De Groot, R.; Van Zoelen, G.A.; Van Riel, A.J.H.P.; Leenders, M.E.C.

2010-11-15

The RIVM has prepared an overview of the necessary measures for the first care of casualties of incidents with radiological material, starting at the location of the incident until the hospital. Different groups of casualties are discerned, for which specific measures are necessary to minimise health risk. Subsequently flowcharts are set up for the evaluation, selection and first care of these casualties with concomitant measures. The flowcharts indicate which persons should be directly transported to the hospital and which persons can be sent home after monitoring and, if necessary, removal of radioactive material, for example contaminated clothing (decontamination). Furthermore, there is attention for the persons that are not exposed, but are worried. In time of an incident the flowcharts can be adapted and refined according to the specific nature of the incident. The report is written on request of the 'Medical Planning and Preparedness Office (GHOR)', by order of the Ministry of Health, Welfare and Sport. The report describes the consequences of incidents with a 'dirty bomb' and a hidden radioactive source. A 'dirty bomb' is a conventional explosive that will spread radioactive material after detonation. People in the direct surroundings of the explosion can be perilously injured. They can also become contaminated by scattered shards and radioactive material. During an incident with a hidden (intact) radioactive source, the radioactive material will not spread, because it is located at a specific site. The report also presents a flowchart for these incidents. The report supplies information to explain the flowcharts. The appendices give background information on radioactivity and ionising radiation and the health risks after exposure. Also references are provided to relevant national and international guidelines and handbooks. [Dutch] Het RIVM heeft in kaart gebracht welke maatregelen nodig zijn om slachtoffers op te vangen van

U.S. Strategy for Bioterrorism Emergency Medical Preparedness and Response

National Research Council Canada - National Science Library

Lugo, Angel

2003-01-01

... diseases and mass casualty dangers. The 2002 National Strategy for Homeland Security includes numerous emergency preparedness and response initiatives as part of the overall homeland security strategy...

Typical synoptic situations and their impacts on the wintertime air pollution in the Guanzhong basin, China

Directory of Open Access Journals (Sweden)

N. Bei

2016-06-01

Full Text Available Rapid industrialization and urbanization have caused severe air pollution in the Guanzhong basin, northwestern China, with heavy haze events occurring frequently in recent winters. Using the NCEP reanalysis data, the large-scale synoptic situations influencing the Guanzhong basin during wintertime of 2013 are categorized into six types to evaluate the contribution of synoptic situations to the air pollution, including “north-low”, “southwest-trough”, “southeast-high”, “transition”, “southeast-trough”, and “inland-high”. The FLEXPART model has been utilized to demonstrate the corresponding pollutant transport patterns for the typical synoptic situations in the basin. Except for “southwest-trough” and “southeast-high” (defined as favorable synoptic situations, the other four synoptic conditions (defined as unfavorable synoptic situations generally facilitate the accumulation of air pollutants, causing heavy air pollution in the basin. In association with the measurement of PM2.5 (particulate matter with aerodynamic diameter less than 2.5 µm in the basin, the unfavorable synoptic situations correspond to high PM2.5 mass concentrations or poor air quality and vice versa. The same analysis has also been applied to winters of 2008–2012, which shows that the basin was mainly influenced by the unfavorable synoptic situations during wintertime leading to poor air quality. The WRF-CHEM model has further been applied to simulate the selected 6 days representing the typical synoptic situations during the wintertime of 2013, and the results generally show a good agreement between the modeled distributions and variations of PM2.5 and the corresponding synoptic situations, demonstrating reasonable classification for the synoptic situations in the basin. Detailed meteorological conditions, such as temperature inversion, low-level horizontal wind speed, and planetary boundary layer, all contribute to heavy air pollution

Situating Engagement

DEFF Research Database (Denmark)

Korn, Matthias

Our mobile phone is with us at all times. Habitually, we pick it up in the morning and carry it around on our daily routes and routines. Increasingly, we use it to locate ourselves and the things and people around us. With ubiquitous computing, technology is moving into the very fabric of our....... First, situationally appropriate forms of engagement that align well with citizens’ own conceptions are necessary in order to provide relevance and meaning of issues in the moment. Second, situated engagement requires a technological setup which facilitates the co-location of people, place...... with sophisticated prototypes in the wild. It proposes walkshops as a technique for collaborative exploration within actual outdoor environments and the use of field trials as part of an iterative design process in order to look ahead toward use practices that are still in the making....

Managing and engineering in complex situations

CERN Document Server

Sousa-Poza, Andres

2013-01-01

With so many terms available to define the same thing, it would seem nearly irresponsible to introduce yet another term (complex situation) to describe a phenomenological state of such as a system. However, a complex situation infers both a broader meaning and imposes a different perspective. Complex in this context is dependent on understanding and reality rather than observer and knowledge.   Situation imposes a gestalt that cannot be characterized within a singular perspective that relegates paradox to a superior/subordinate hierarchy. This also infers that complex situation has no monotonic definition or each definition is by default incomplete. Therefore the perennial derivations for systems such as complex systems, system of systems, federation of systems is no longer a sufficient descriptor for complex situation.  Ergo system and its genealogy lack the constitution to define complex situations. The books' intent is to explore this pathology through a series of papers written by authors that work in ...

The Committee of the Chiefs of Military Medical Services in NATO (COMEDS) and Its Relation to RTO/HFM Panel

Science.gov (United States)

2004-09-01

technically in the underdog situation. It obviously has made it crucial to “win the media war”. Media coverage now has a dramatic effect on public opinion...Ever more effective body armour reduces fatal casualty numbers but increases significantly the medical challenge to save the survivor’s limbs. As a

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

Directory of Open Access Journals (Sweden)

Huber-Wagner S

2009-12-01

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

Medical management after indoor fires: A review

NARCIS (Netherlands)

Welling, L.; van Harten, S. M.; Patka, P.; Bierens, J. J. L. M.; Boers, M.; Luitse, J. S. K.; Mackie, D. P.; Trouwborst, A.; Gouma, D. J.; Kreis, R. W.

2005-01-01

Fires involving mass burn casualties require extreme efforts and flexibility from the regular health care system. The cafe fire in Volendam, which occurred shortly after midnight on the first of January 2001, resulted in the worst indoor mass burns incident in Dutch history. During the extensive

Constraints on constituent quark masses from potential models

International Nuclear Information System (INIS)

Silvestre-Brac, B.

1998-01-01

Starting from reasonable hypotheses, the magnetic moments for the baryons are revisited dat the light of general space wave functions. They allow to put very severe bounds on the quark masses as derived from usual potential models. The experimental situation cannot be explained in the framework of such models. (author)

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Shooter and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as Advocates ... Board of Governors Advisory Councils Statements of the College Statements of the College ...

Your Lung Operation: After Your Operation

Medline Plus

Full Text Available ... Shooter and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as Advocates ... Board of Governors Advisory Councils Statements of the College Statements of the College ...

Your Lung Operation: After Your Operation

Medline Plus

Full Text Available ... Asked Questions Resources Educational Resources Educational Resources E-Learning ... Primers and Compendiums Strategies to Enhance Survival in Active Shooter and Intentional Mass Casualty Events Surgeons and ...

Ostomy Home Skills Program

Medline Plus

Full Text Available ... Asked Questions Resources Educational Resources Educational Resources E-Learning ... Primers and Compendiums Strategies to Enhance Survival in Active Shooter and Intentional Mass Casualty Events Surgeons and ...

Learning situation models in a smart home.

Science.gov (United States)

Brdiczka, Oliver; Crowley, James L; Reignier, Patrick

2009-02-01

This paper addresses the problem of learning situation models for providing context-aware services. Context for modeling human behavior in a smart environment is represented by a situation model describing environment, users, and their activities. A framework for acquiring and evolving different layers of a situation model in a smart environment is proposed. Different learning methods are presented as part of this framework: role detection per entity, unsupervised extraction of situations from multimodal data, supervised learning of situation representations, and evolution of a predefined situation model with feedback. The situation model serves as frame and support for the different methods, permitting to stay in an intuitive declarative framework. The proposed methods have been integrated into a whole system for smart home environment. The implementation is detailed, and two evaluations are conducted in the smart home environment. The obtained results validate the proposed approach.

Situating beyond the social

DEFF Research Database (Denmark)

Soffer, Ann Katrine Bønnelykke

2016-01-01

Situated learning serves as an analytical framework for learning in a community of practice and has been widely used to understand the learning process that is entailed in becoming a nurse. Yet in this paper, the difficulties encountered with the original notion of situated learning once...... framework. I suggest the notion of multi-configured learning, which captures the heterogeneity and materiality encountered during ethnographic fieldwork at a Danish nursing school....

Direct measurements of neutrino mass

International Nuclear Information System (INIS)

Robertson, R.G.H.

1991-01-01

Some recent developments in the experimental search for neutrino mass are discussed. New data from Los Alamos on the electron neutrino mass as measured in tritium beta decay give an upper limit of 9.3 eV at the 95% confidence level. This result is not consistent with the long-standing ITEP result of 26(5) eV within a ''model-independent'' range of 17 to 40 eV. It now appears that the electron neutrino is not sufficiently massive to close the universe by itself. Hime and Jelley report finding new evidence for a 17-keV neutrino in the Β decay of 35 S and 63 Ni. Many other experiments are being reported and the situation is still unresolved. 56 refs., 1 fig., 3 tabs

The Internet's effect on personality traits: An important casualty of the "Internet addiction" paradigm.

Science.gov (United States)

Aboujaoude, Elias

2017-03-01

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

Planning as situated design

DEFF Research Database (Denmark)

Axel, Erik

It is common to associate situated activity with concrete, craftlike or manual activity here and now and to reserve theoretical and abstract thinking for activities like theoretical experimentation and systematic planning. Much work has gone into demonstrating that these activities are concrete...... and situated, too. In this presentation it will be argued that the investigation of systematic planning as conflictual cooperation will help us see that situated activity is not only based on the present conditions, but also relates them to events spread out in time and space, thereby opening up for another...... understanding of theoretical thinking. Some material from the empirical research project developed with Klaus Nielsen on the design and engineering of a house will be presented. On this basis a conception of planning will be unfolded. It will be understood differently from the way it is understood...

Barriers and Factors Affecting Personal Protective Equipment Usage ...

African Journals Online (AJOL)

ADMIN

However compliance to it by HCWs has remained poor even in high-risk clinical situation. The objective of this study was to identify and describe the factors that influence a HCWs' decision to wear .... necrotizing fasciitis, osteomyelitis, abscesses, urosepsis etc are admitted. Casualty, burns .... J Tuberc Lung Dis. 2017 Mar 1 ...

Medical Management of Radiological Casualties Handbook. First Edition

Science.gov (United States)

1999-12-01

fear reac- tions. Use of oral prophylactic antiemetics, such as granisetron (Kytril®) and ondansetron (Zofran®), may be indicated in situations where...clothing should be carefully removed, placed in marked plastic bags, and re-Imoved to a secure location within a contaminated area. Bare skin and hair...the treatment area (i.e., wind blows from the clean treatment area to the dirty decontamination area). Key Principles • Wind direction " Security of the

Performance of intact and partially degraded concrete barriers in limiting mass transport

International Nuclear Information System (INIS)

Walton, J.C.

1992-06-01

Mass transport through concrete barriers and release rate from concrete vaults are quantitatively evaluated. The thorny issue of appropriate diffusion coefficients for use in performance assessment calculations is covered, with no ultimate solution found. Release from monolithic concrete vaults composed of concrete waste forms is estimated with a semi-analytical solution. A parametric study illustrates the importance of different parameters on release. A second situation of importance is the role of a concrete shell or vault placed around typical waste forms in limiting mass transport. In both situations, the primary factor controlling concrete performance is cracks. The implications of leaching behavior on likely groundwater concentrations is examined. Frequently, lower groundwater concentrations can be expected in the absence of engineered covers that reduce infiltration

The Justice of Preventive War

National Research Council Canada - National Science Library

Stephenson, Henry

2004-01-01

In response to the 9/11 attacks and continuing threats of mass-casualty terrorism, the United States has adopted a new security strategy that emphasizes anticipatory actions, including preventive war...

How to lead complex situations

DEFF Research Database (Denmark)

Hansen, Michael Pingel

2013-01-01

The military leader is experiencing increasingly more complex situations, whether it is as leader in a foreign combat environment or in the home-based public administration. Complex situations like these call for a special set of managerial responses and a special way of leading organisations...

“Creative Industries” Strategies in Soviet Lithuania: Packages of Mass Consumption Goods

Directory of Open Access Journals (Sweden)

Eglė Jaškūnienė

2015-07-01

Full Text Available The article explores the Soviet mechanism of including the creative potentials into formation of economical and ideological policy strategies. Research aims to examine, how mass media and culture theories of Walter Benjamin, Frankfurt school and British Culture studies reflect the situation of mass culture in Soviet system. Case study is based on Lithuanian package design of 1960–1970s.

Resonance scattering of Rayleigh waves by a mass defect

International Nuclear Information System (INIS)

Croitoru, M.; Grecu, D.

1978-06-01

The resonance scattering of an incident Rayleigh wave by a mass defect extending over a small cylindrical region situated in the surface of a semi-infinite isotropic, elastic medium is investigated by means of the Green's function method. The form of the differential cross-section for the scattering into different channels exhibits a strong resonance phenomenon at two frequencies. The expression of the resonance frequencies as well as of the corresponding widths depends on the relative change in mass density. The main assumption that the wavelengths of incoming and scattered wave are large compared to the defect dimension implies a large relative mass-density change. (author)

Fluid-Structure Interaction Analysis of Parachute Finite Mass Inflation

Directory of Open Access Journals (Sweden)

Xinglong Gao

2016-01-01

Full Text Available Parachute inflation is coupled with sophisticated fluid-structure interaction (FSI and flight mechanic behaviors in a finite mass situation. During opening, the canopy often experiences the largest deformation and loading. To predict the opening phase of a parachute, a computational FSI model for the inflation of a parachute, with slots on its canopy fabric, is developed using the arbitrary Lagrangian-Euler coupling penalty method. In a finite mass situation, the fluid around the parachute typically has an unsteady flow; therefore, a more complex opening phase and FSI dynamics of a parachute are investigated. Navier-Stokes (N-S equations for uncompressible flow are solved using an explicit central difference method. The three-dimensional visualization of canopy deformation as well as the evolution of dropping velocity and overload is obtained and compared with the experimental results. This technique could be further applied in the airdrop test of a parachute for true prediction of the inflation characteristics.

SPEECH TACTICS IN MASS MEDIA DISCOURSE

Directory of Open Access Journals (Sweden)

Olena Kaptiurova

2014-06-01

Full Text Available The article deals with the basic speech tactics used in mass media discourse. It has been stated that such tactics as contact establishment and speech interaction termination, yielding up initiative or its preserving are compulsory for the communicative situation of a talk show. Language personalities of television talk shows anchors and linguistic ways of the interview organisation are stressed. The material is amply illustrated with relevant examples.

Deep situationality

DEFF Research Database (Denmark)

Matejskova, Tatiana

2014-01-01

as a Slovak national with immigration experi- ence, a nominal outsider to both the country of research, Germany, and its immigrant subjects, the post-Soviet Russian-speaking migrants. Focusing on the production of time-spaces of proximity as a deeply situational process, I stress in particular the un...

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

Science.gov (United States)

O'Malley, Gerald F

2016-07-01

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

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

Directory of Open Access Journals (Sweden)

Alicia Rodríguez-Martos

2005-02-01

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

Digital map and situation surface: a team-oriented multidisplay workspace for network enabled situation analysis

Science.gov (United States)

Peinsipp-Byma, E.; Geisler, Jürgen; Bader, Thomas

2009-05-01

System concepts for network enabled image-based ISR (intelligence, surveillance, reconnaissance) is the major mission of Fraunhofer IITB's applied research in the area of defence and security solutions. For the TechDemo08 as part of the NATO CNAD POW Defence against terrorism Fraunhofer IITB advanced a new multi display concept to handle the shear amount and high complexity of ISR data acquired by networked, distributed surveillance systems with the objective to support the generation of a common situation picture. Amount and Complexity of ISR data demands an innovative man-machine interface concept for humans to deal with it. The IITB's concept is the Digital Map & Situation Surface. This concept offers to the user a coherent multi display environment combining a horizontal surface for the situation overview from the bird's eye view, an attached vertical display for collateral information and so-called foveatablets as personalized magic lenses in order to obtain high resolved and role-specific information about a focused areaof- interest and to interact with it. In the context of TechDemo08 the Digital Map & Situation Surface served as workspace for team-based situation visualization and analysis. Multiple sea- and landside surveillance components were connected to the system.

Study of mass consciousnessand its dynamics in sociologic research

Directory of Open Access Journals (Sweden)

S. V. Khobta

2017-01-01

Full Text Available The article is dedicated to analysis of the approaches used to study mass consciousness and the methods of their dynamics research. The two following approaches are reviewed: aggregative and group. The author shows that the study of the dynamics of mass consciousness in the modern day science is performed via computer modeling applying agent-oriented models and mass surveys of public opinion. Special attention is given to the concept of mass consciousness according to B. Grushin, where the mass consciousness is analyzed as a complex phenomenon according to its structure and the formation process. It is further analyzed what this particular concept is able to provide for the mass consciousness studies in the times of crises, similar to the situation of the military conflict at the East. It is then proven that the dialectic approach should be used as the basis for the mass consciousness studies adjusted for the interaction dynamics between the individual and collective, spontaneous and the institutionalized inside the collective consciousness. The mass consciousness is a complex structural formation, both heterogeneous and syncretical. Inside this structure one must distinguish between the layers that differ in depth and mobility and pay attention to its various conditions. The layers represent different worldviews, where, depending on the situation, scientific, religious or mystical images of the world can be actualized along with their ideological, moral and aesthetic precepts. These can cross, merge or coexist without contradicting each other and get actualized to a different extent. Besides the aforementioned the mass consciousness serves as a carrier of different kinds of deep, hard to change formations, such as «historical/collective memory», memlexes as well as superficial, most actualized forms, such as mems. It has «public/formal», socially accepted, and «private/real» levels that manifest themselves, in particular, in the forms of

The relationship between basal blood pressure and body mass ...

African Journals Online (AJOL)

Background: In contrast to the situation in developed countries, very few studies have been done on blood pressure (BP) determinants among Nigerian adolescents. Aim: To evaluate the relationship between basal BP and body mass index (BMI) in a group of healthy Nigerian secondary school students. Methods: This was ...

Measurement of mass and isotopic fission yields for heavy fission products with the LOHENGRIN mass spectrometer

International Nuclear Information System (INIS)

Bail, A.

2009-05-01

In spite of the huge amount of fission yield data available in different libraries, more accurate values are still needed for nuclear energy applications and to improve our understanding of the fission process. Thus measurements of fission yields were performed at the mass spectrometer Lohengrin at the Institut Laue-Langevin in Grenoble, France. The mass separator Lohengrin is situated at the research reactor of the institute and permits the placement of an actinide layer in a high thermal neutron flux. It separates fragments according to their atomic mass, kinetic energy and ionic charge state by the action of magnetic and electric fields. Coupled to a high resolution ionization chamber the experiment was used to investigate the mass and isotopic yields of the light mass region. Almost all fission yields of isotopes from Th to Cf have been measured at Lohengrin with this method. To complete and improve the nuclear data libraries, these measurements have been extended in this work to the heavy mass region for the reactions 235 U(n th ,f), 239 Pu(n th ,f) and 241 Pu(n th ,f). For these higher masses an isotopic separation is no longer possible. So, a new method was undertaken with the reaction 239 Pu(n th ,f) to determine the isotopic yields by spectrometry. These experiments have allowed to reduce considerably the uncertainties. Moreover the ionic charge state and kinetic energy distributions were specifically studied and have shown, among others, nanosecond isomers for some masses. (author)

Population is the main driver of war group size and conflict casualties.

Science.gov (United States)

Oka, Rahul C; Kissel, Marc; Golitko, Mark; Sheridan, Susan Guise; Kim, Nam C; Fuentes, Agustín

2017-12-26

The proportions of individuals involved in intergroup coalitional conflict, measured by war group size (W), conflict casualties (C), and overall group conflict deaths (G), have declined with respect to growing populations, implying that states are less violent than small-scale societies. We argue that these trends are better explained by scaling laws shared by both past and contemporary societies regardless of social organization, where group population (P) directly determines W and indirectly determines C and G. W is shown to be a power law function of P with scaling exponent X [demographic conflict investment (DCI)]. C is shown to be a power law function of W with scaling exponent Y [conflict lethality (CL)]. G is shown to be a power law function of P with scaling exponent Z [group conflict mortality (GCM)]. Results show that, while W/P and G/P decrease as expected with increasing P, C/W increases with growing W. Small-scale societies show higher but more variance in DCI and CL than contemporary states. We find no significant differences in DCI or CL between small-scale societies and contemporary states undergoing drafts or conflict, after accounting for variance and scale. We calculate relative measures of DCI and CL applicable to all societies that can be tracked over time for one or multiple actors. In light of the recent global emergence of populist, nationalist, and sectarian violence, our comparison-focused approach to DCI and CL will enable better models and analysis of the landscapes of violence in the 21st century. Copyright © 2017 the Author(s). Published by PNAS.

Mass imbalances in EPANET water-quality simulations

Energy Technology Data Exchange (ETDEWEB)

Davis, Michael J.; Janke, Robert; Taxon, Thomas N.

2018-04-06

EPANET is widely employed to simulate water quality in water distribution systems. However, the time-driven simulation approach used to determine concentrations of water-quality constituents provides accurate results, in general, only for small water-quality time steps; use of an adequately short time step may not be feasible. Overly long time steps can yield errors in concentrations and result in situations in which constituent mass is not conserved. Mass may not be conserved even when EPANET gives no errors or warnings. This paper explains how such imbalances can occur and provides examples of such cases; it also presents a preliminary event-driven approach that conserves mass with a water-quality time step that is as long as the hydraulic time step. Results obtained using the current approach converge, or tend to converge, to those obtained using the new approach as the water-quality time step decreases. Improving the water-quality routing algorithm used in EPANET could eliminate mass imbalances and related errors in estimated concentrations.

Advanced Situation Awareness Technologies, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Advanced Situation Awareness Technologies (ASAT) will facilitate exploration of the moon surface, and other planetary bodies. ASAT will create an Advanced Situation...

A Comparative Analysis and Prediction of Traffic Accident Causalities in the Sultanate of Oman using Artificial Neural Networks and Statistical methods

Directory of Open Access Journals (Sweden)

Galal A. Ali

1998-12-01

Full Text Available Traffic accidents are among the major causes of death in the Sultanate of Oman This is particularly the case in the age group of I6 to 25. Studies indicate that, in spite of Oman's high population-per-vehicle ratio, its fatality rate per l0,000 vehicles is one of the highest in the world. This alarming Situation underlines the importance of analyzing traffic accident data and predicting accident casualties. Such steps will lead to understanding the underlying causes of traffic accidents, and thereby to devise appropriate measures to reduce the number of car accidents and enhance safety standards. In this paper, a comparative study of car accident casualties in Oman was undertaken. Artificial Neural Networks (ANNs were used to analyze the data and make predictions of the number of accident casualties. The results were compared with those obtained from the analysis and predictions by regression techniques. Both approaches attempted to model accident casualties using historical  data on related factors, such as population, number of cars on the road and so on, covering the period from I976 to 1994. Forecasts for the years 1995 to 2000 were made using ANNs and regression equations. The results from ANNs provided the best fit for the data. However, it was found that ANNs gave lower forecasts relative to those obtained by the regression methods used, indicating that ANNs are suitable for interpolation but their use for extrapolation may be limited. Nevertheless, the study showed that ANNs provide a potentially powerful tool in analyzing and forecasting traffic accidents and casualties.

Challenges in war-related thoracic injury faced by French military surgeons in Afghanistan (2009-2013).

Science.gov (United States)

de Lesquen, Henri; Beranger, Fabien; Berbis, Julie; Boddaert, Guillaume; Poichotte, Antoine; Pons, Francois; Avaro, Jean-Philippe

2016-09-01

This study reports the challenges faced by French military surgeons in the management of thoracic injury during the latest Afghanistan war. From January 2009 to April 2013, all of the civilian, French and Coalition casualties admitted to French NATO Combat Support Hospital situated on Kabul were prospectively recorded in the French Military Health Service Registry (OPEX(®)). Only penetrating and blunt thoracic trauma patients were retrospectively included. Eighty-nine casualties were included who were mainly civilian (61%) and men (94%) with a mean age of 27.9 years old. Surgeons dealt with polytraumas (78%), severe injuries (mean Injury Severity Score=39.2) and penetrating wounds (96%) due to explosion in 37%, gunshot in 53% and stabbing in 9%. Most of casualties were first observed or drained (n=56). In this non-operative group more than 40% of casualties needed further actions. In the operative group, Damage Control Thoracotomy (n=22) was performed to stop ongoing bleeding and air leakage and Emergency Department Thoracotomy (n=11) for agonal patient. Casualties suffered from hemothorax (60%), pneumothorax (39%), diaphragmatic (37%), lung (35%), heart or great vessels (20%) injuries. The main actions were diaphragmatic sutures (n=25), lung resections (wedge n=6, lobectomy n=4) and haemostasis (intercostal artery ligation n=3, heart injury repairs n=5, great vessels injury repairs n=5). Overall mortality was 11%. The rate of subsequent surgery was 34%. The analysis of the OPEX(®) registry reflects the thoracic surgical challenges of general (visceral) surgeons serving in combat environment during the latest Afghanistan War. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emergency situations in SMEs : Are entrepreneurs prepared?

NARCIS (Netherlands)

Kleijn, E.; Montfort, van K.; Masurel, E.

2012-01-01

The article examines how entrepreneurs prepare for emergency situations in small and medium-sized enterprises (SMEs) in the Netherlands. It identifies the characteristics of SMEs and the theory related to emergency situations and the preparations for such situations. It also provides a detailed

Realistic Safe-Separation Distance Determination for Mass Fire Hazards

Science.gov (United States)

2013-03-25

amidships tossed the upper decks back, curled and flattened like a banana peel as indicated in Figure 5. Sections of the Liberte were hurled outward...powders are based on nitrocellulose alone (typically an ether- alcohol colloid of nitrocellulose). Double-based powders have both nitrocellulose and...during the Cold War and details were, and still are, hard to get . For example, several articles mentioned casualties but do not give numbers. http

Normalization and Personalization of Learning Situation: NPLS

Directory of Open Access Journals (Sweden)

Mounia Abik

2009-06-01

Full Text Available The personalization of learning is a major pedagogical challenge solicited by pedagogues and didacts. There are several projects about the production of personalizable learning situations such as Reload-LDE and Alfanet. These projects are interested in producing new standardized and personalizable learning situations. However, on the Web, an important number of learning situations exist. These situations are rich in information but don't consider all the characteristics of participants taking part in the learning, nor their technical environments. In this paper we suggest a help system that can transform an existing learning situation to another structure standardized and personalizable depending on the context of learning personalization that we have defined.

Situational leadership and persons with disabilities.

Science.gov (United States)

Cubero, Christopher G

2007-01-01

Does situational leadership style impact workers with disabilities? Situational leadership as a model and style of organizational management is defined. With a concentration on workers with disabilities, employer and employee perceptions of the workplace environment are analyzed as a contributing factor to the choice of leadership styles. Leadership style and its potential impact on workers with disabilities are included. Advantages of situational leadership style as an organizational model for managers that matches the intricate needs of workers with disabilities are argued. Methods for increasing awareness of the needs of persons with disabilities in the workplace and improving leadership models are discussed. Implications and potential outcomes for workers with disabilities based on the use of situational leadership by managers are discussed.

Ethiopia - energy situation 1983/84

Energy Technology Data Exchange (ETDEWEB)

1985-01-01

After a few short remarks on the energy situation, the most important figures referring to the production and consumption of electricity, petroleum, and petroleum products from 1978 to 1982 are compared in tabular form. The situation on the energy market, especially the petroleum and natural gas market, is described. Finally, some figures concerning the foreign trade are given.

Transit safety & security statistics & analysis 2002 annual report (formerly SAMIS)

Science.gov (United States)

2004-12-01

The Transit Safety & Security Statistics & Analysis 2002 Annual Report (formerly SAMIS) is a compilation and analysis of mass transit accident, casualty, and crime statistics reported under the Federal Transit Administrations (FTAs) National Tr...

Transit safety & security statistics & analysis 2003 annual report (formerly SAMIS)

Science.gov (United States)

2005-12-01

The Transit Safety & Security Statistics & Analysis 2003 Annual Report (formerly SAMIS) is a compilation and analysis of mass transit accident, casualty, and crime statistics reported under the Federal Transit Administrations (FTAs) National Tr...

Factors affecting the organization and management of emergency ...

African Journals Online (AJOL)

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

Conversion disorder and mass psychogenic illness in child neurology.

Science.gov (United States)

Mink, Jonathan W

2013-11-01

A common problem faced by neurologists is the existence of disorders that present with neurological symptoms but do not have identifiable neurological bases. Conversion disorder is the most common of these disorders. In some situations, members of a cohesive social group will develop the same or similar symptoms. This review discusses conversion disorder in children, with an emphasis on function movement disorders. It also reviews a recent occurrence of mass psychogenic illness in New York State with discussion of the key features of mass psychogenic illness. © 2013 New York Academy of Sciences.

School and Situated Knowledge: Travel or Tourism?

Science.gov (United States)

Damarin, Suzanne K.

1993-01-01

Examines issues related to situated cognition and learning, both in the classroom and in the world. Topics discussed include educational theories; the situated nature of knowledge; the perception of experts; and the role of technology in situated learning, including virtual reality, hypertext, and telecommunications. (26 references) (LRW)

Experience in the management of the mass casualty from the ...

African Journals Online (AJOL)

2015-09-21

Sep 21, 2015 ... mainly from road traffic collisions[5] until September 9,. 2001,[6,7] when ... highlighted, analyzed, and possible solutions proffered. Other areas that .... incidence of exhaustion of supplies, drugs, blood, or other consumables.

A large-scale mass casualty simulation to develop the non-technical skills medical students require for collaborative teamwork.

Science.gov (United States)

Jorm, Christine; Roberts, Chris; Lim, Renee; Roper, Josephine; Skinner, Clare; Robertson, Jeremy; Gentilcore, Stacey; Osomanski, Adam

2016-03-08

There is little research on large-scale complex health care simulations designed to facilitate student learning of non-technical skills in a team-working environment. We evaluated the acceptability and effectiveness of a novel natural disaster simulation that enabled medical students to demonstrate their achievement of the non-technical skills of collaboration, negotiation and communication. In a mixed methods approach, survey data were available from 117 students and a thematic analysis undertaken of both student qualitative comments and tutor observer participation data. Ninety three per cent of students found the activity engaging for their learning. Three themes emerged from the qualitative data: the impact of fidelity on student learning, reflexivity on the importance of non-technical skills in clinical care, and opportunities for collaborative teamwork. Physical fidelity was sufficient for good levels of student engagement, as was sociological fidelity. We demonstrated the effectiveness of the simulation in allowing students to reflect upon and evidence their acquisition of skills in collaboration, negotiation and communication, as well as situational awareness and attending to their emotions. Students readily identified emerging learning opportunities though critical reflection. The scenarios challenged students to work together collaboratively to solve clinical problems, using a range of resources including interacting with clinical experts. A large class teaching activity, framed as a simulation of a natural disaster is an acceptable and effective activity for medical students to develop the non-technical skills of collaboration, negotiation and communication, which are essential to team working. The design could be of value in medical schools in disaster prone areas, including within low resource countries, and as a feasible intervention for learning the non-technical skills that are needed for patient safety.

21 CFR 290.10 - Definition of emergency situation.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Definition of emergency situation. 290.10 Section...) DRUGS: GENERAL CONTROLLED DRUGS General Provisions § 290.10 Definition of emergency situation. For the... Controlled Substances Act, the term emergency situation means those situations in which the prescribing...

Crisis Situations in Engineering Product Development

DEFF Research Database (Denmark)

Muenzberg, Christopher; Hammer, Jens; Brem, Alexander

2016-01-01

approaches reduce the problem identification time and increase the efficiency of crisis management. The goal of this research is to identify methods which are able to support the crisis management process successfully. Therefore, a literature-based analysis of developing methods, especially TRIZ is conducted......Crisis situations are special situations during the development process. They are characterized by time and handling pressure. Therefore, it is necessary to identify and apply a methodical problem solving approach to overcome these situations. Due to their prescriptive character, problem solving...

Role of clinical indications of bone mass measurement with bi-photonic X-ray absorptiometry. Interet et indications cliniques des mesures de masse osseuse par absorptiometrie biphotonique a rayons X

Energy Technology Data Exchange (ETDEWEB)

Anon.

Bone densitometry by precise, reliable and non-traumatic methods such as X-ray bi-phonon absorptiometry, is the only way to predict osteoporosis fractures risks. The whole epidemiological studies establish that bone mass loss and osteoporosis risk are directly linked. The measurement of the bone mass is the basis of osteoporosis prevention for elderly women, and of other clinical situations. This paper gives, by a critical analysis of available data, advantages and limits of bone mass measurements by X-ray bi-phonon absorptiometry, and essential clinical indications. (A.B.). 181 refs.

Operational guidance for radiation emergency response organisations in Europe for using bio-dosimetric tools developed in EU MULTIBIODOSE project

International Nuclear Information System (INIS)

Jaworska, Alicja; Ainsbury, Elizabeth A.; Rothkamm, Kai; Fattibene, Paola; Lindholm, Carita; Oestreicher, Ursula; Romm, Horst; Thierens, Hubert; Vral, Anne; Trompier, Francois; Voisin, Philippe; Woda, Clemens; Wojcik, Andrzej

2015-01-01

In the event of a large-scale radiological emergency, the triage of individuals according to their degree of exposure forms an important initial step of the accident management. Although clinical signs and symptoms of a serious exposure may be used for radiological triage, they are not necessarily radiation specific and can lead to a false diagnosis. Biodosimetry is a method based on the analysis of radiation-induced changes in cells of the human body or in portable electronic devices and enables the unequivocal identification of exposed people who should receive medical treatment. The MULTIBIODOSE (MBD) consortium developed and validated several bio-dosimetric assays and adapted and tested them as tools for biological dose assessment in a mass-casualty event. Different bio-dosimetric assays were validated against the 'gold standard' of biological dosimetry-the dicentric assay. The assays were harmonised in such a way that, in an emergency situation, they can be run in parallel in a network of European laboratories. The aim of this guidance is to give a concise overview of the developed bio-dosimetric tools as well as how and when they can be used in an emergency situation. (authors)

A one-dimensional model of resonances with a delta barrier and mass jump

International Nuclear Information System (INIS)

Alvarez, J.J.; Gadella, M.; Heras, F.J.H.; Nieto, L.M.

2009-01-01

In this Letter, we present a one-dimensional model that includes a hard core at the origin, a Dirac delta barrier at a point in the positive semiaxis and a mass jump at the same point. We study the effect of this mass jump in the behavior of the resonances of the model. We obtain an infinite number of resonances for this situation, showing that for the case of a mass jump the imaginary part of the resonance poles tend to a fixed value depending on the quotient of masses, and demonstrate that none of these resonances is degenerated.

Situation Awareness with Systems of Systems

NARCIS (Netherlands)

Laar, P. van de; Tretmans, J.; Borth, M.

2013-01-01

This book discusses various aspects, challenges, and solutions for developing systems-of-systems for situation awareness, using applications in the domain of maritime safety and security. Topics include advanced, multi-objective visualization methods for situation awareness, stochastic outlier

Learning Situations in Nursing Education: A Concept Analysis.

Science.gov (United States)

Shahsavari, Hooman; Zare, Zahra; Parsa-Yekta, Zohreh; Griffiths, Pauline; Vaismoradi, Mojtaba

2018-02-01

The nursing student requires opportunities to learn within authentic contexts so as to enable safe and competent practice. One strategy to facilitate such learning is the creation of learning situations. A lack of studies on the learning situation in nursing and other health care fields has resulted in insufficient knowledge of the characteristics of the learning situation, its antecedents, and consequences. Nurse educators need to have comprehensive and practical knowledge of the definition and characteristics of the learning situation so as to enable their students to achieve enhanced learning outcomes. The aim of this study was to clarify the concept of the learning situation as it relates to the education of nurses and improve understanding of its characteristics, antecedents, and consequences. The Bonis method of concept analysis, as derived from the Rodgers' evolutionary method, provided the framework for analysis. Data collection and analysis were undertaken in two phases: "interdisciplinary" and "intra-disciplinary." The data source was a search of the literature, encompassing nursing and allied health care professions, published from 1975 to 2016. No agreement on the conceptual phenomenon was discovered in the international literature. The concept of a learning situation was used generally in two ways and thus classified into the themes of: "formal/informal learning situation" and "biologic/nonbiologic learning situation." Antecedents to the creation of a learning situation included personal and environmental factors. The characteristics of a learning situation were described in terms of being complex, dynamic, and offering potential and effective learning opportunities. Consequences of the learning situation included enhancement of the students' learning, professionalization, and socialization into the professional role. The nurse educator, when considering the application of the concept of a learning situation in their educational planning, must

Two Balls' Collision of Mass Ratio 3:1

Science.gov (United States)

Ogawara, Yasuo; Hull, Michael M.

2018-01-01

Students will sometimes ask why momentum and kinetic energy concepts are both necessary. When physics teachers demonstrate situations that require both an understanding of kinetic energy and momentum, a favorite is Newton's cradle, or a comparable demonstration of two balls of equal mass hitting each other. However, in addition to the case of two…

Zur wirtschaftlichen Situation georgischer Landwirtschaftsbetriebe

OpenAIRE

Schulze, Eberhard; Tillack, Peter; Mosashwili, Nodar

2003-01-01

Dieser Forschungsbericht beinhaltet die Ergebnisse einer Untersuchung von 200 Familienbetrieben im Osten Georgiens im Distrikt Sighnagi in der Kakheti-Region Ende 2001/Anfang 2002. Sie dienten dem Ziel, Erkenntnisse über die wirtschaftliche Situation georgischer Familienbetriebe sowie zum Teil der sozialen Situation in Bauernfamilien nach zehn Jahren Transformationsprozess in der Landwirtschaft zu gewinnen. Die Untersuchungen schlossen die Befragung der Betriebsleiter nach dem Alter, der Daue...

Biphasic cuirass ventilation is better than bag-valve mask ventilation for resuscitation following organophosphate poisoning

Directory of Open Access Journals (Sweden)

Ilan Gur

2015-01-01

Conclusions: The noninvasive, easy-to-operate Biphasic Cuirass Ventilation device was effective in reducing OP-induced mortality and might be advantageous in an organophosphate mass casualty event. This finding should be validated in further investigations.

Minimalistic Neutrino Mass Model

CERN Document Server

De Gouvêa, A; Gouvea, Andre de

2001-01-01

We consider the simplest model which solves the solar and atmospheric neutrino puzzles, in the sense that it contains the smallest amount of beyond the Standard Model ingredients. The solar neutrino data is accounted for by Planck-mass effects while the atmospheric neutrino anomaly is due to the existence of a single right-handed neutrino at an intermediate mass scale between 10^9 GeV and 10^14 GeV. Even though the neutrino mixing angles are not exactly predicted, they can be naturally large, which agrees well with the current experimental situation. Furthermore, the amount of lepton asymmetry produced in the early universe by the decay of the right-handed neutrino is very predictive and may be enough to explain the current baryon-to-photon ratio if the right-handed neutrinos are produced out of thermal equilibrium. One definitive test for the model is the search for anomalous seasonal effects at Borexino.

Coherent Network Optimizing of Rail-Based Urban Mass Transit

Directory of Open Access Journals (Sweden)

Ying Zhang

2012-01-01

Full Text Available An efficient public transport is more than ever a crucial factor when it comes to the quality of life and competitiveness of many cities and regions in Asia. In recent years, the rail-based urban mass transit has been regarded as one of the key means to overcoming the great challenges in Chinese megacities. The purpose of this study is going to develop a coherent network optimizing for rail-based urban mass transit to find the best alternatives for the user and to demonstrate how to meet sustainable development needs and to match the enormous capacity requirements simultaneously. This paper presents an introduction to the current situation of the important lines, and transfer points in the metro system Shanghai. The insufficient aspects are analyzed and evaluated; while the optimizing ideas and measurements are developed and concreted. A group of examples are used to illustrate the approach. The whole study could be used for the latest reference for other megacities which have to be confronted with the similar situations and processes with enormous dynamic travel and transport demands.

An assessment of mass burn incineration costs

International Nuclear Information System (INIS)

Fox, M.R.; Scutter, J.N.; Sutton, A.M.

1993-01-01

This study comprises the third and final part of a cost assessment exercise of waste-to-energy options. The specific objectives of this particular study were: to determine the capital and operating costs of three generic types of mass burn waste-to-energy systems, for waste inputs of 200,000 and 400,000 t/y of municipal solid waste (MSW); to verify the mass and energy balances of the systems; to develop a computer cost model to manipulate the data as required; to carry out sensitivity checks on the computer model of changes to key parameters; and to conduct the study in a manner approximating as closely as possible to a real commercial situation. (author)

Expected hazards and hospital beds in host cities of the 2014 FIFA World Cup in Brazil

Directory of Open Access Journals (Sweden)

Elaine Silva Miranda

Full Text Available Planning for mass gatherings involves health system preparedness based on an understanding of natural and technological hazards identified through prior risk assessment. We present the expected hazards reported by health administrators of the host cities for the 2014 FIFA World Cup in Brazil and discuss the hazards considering minimal available public hospital beds in the 12 cities at the time of the event. Four different groups of respondents were interviewed: pharmaceutical service administrators and overall health administrators at both the municipal and hospital levels. The hospital bed occupancy rate was calculated, based on the Brazilian Health Informatics Department (DATASUS. The number of surplus beds was calculated using parameters from the literature regarding surge and mass casualty needs and number of unoccupied beds. In all groups, physical injuries ranked first, followed by emerging and endemic diseases. Baseline occupancy rates were high (95%CI: 0.93-2.19 in all 12 cities. Total shortage, considering all the cities, ranged from -47,670 (for surges to -60,569 beds (for mass casualties. The study can contribute to discussions on mass-gathering preparedness.

Personality-situation transactions from adolescence to old age.

Science.gov (United States)

Wrzus, Cornelia; Wagner, Gert G; Riediger, Michaela

2016-05-01

People presumably choose and create their daily environments according to their personality. Prior research shows that, for example, more extraverted people engage more often in social situations, and more conscientious people engage more often in work-related activities compared with less extraverted or less conscientious people, respectively. The current study examined such personality-situation transactions in people's daily life. Based on the assumption that older people know themselves and their personality better than younger people, we investigated whether momentary and proximate personality-situation associations (i.e., changing from 1 type of situation into another) increase with older age. Three-hundred and 78 people aged 14 to 82 years described their Big Five traits and took part in a 3-week experience-sampling phase. Using mobile-phone based assessments in daily life, participants reported on average 55 times on their momentary situation. Multilevel modeling results showed that personality-situation associations varied with the age of participants. Some of the "established" personality-situation associations, such as for extraversion and time spent with friends or conscientiousness and time spent with work activities, were only observed in adolescence and young adulthood. In contrast, other personality-situation associations appeared only in late adulthood, such as for openness and time spent with friends. Yet most personality-situation associations did not vary significantly with people's age. In addition, personality traits predicted maintaining or entering personality-congruent situations. The latter results point to the active role of personality in shaping one's environment. The findings imply that some personality-situation transactions may be largely similarly across the life span. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Determinants of Critical Infrastructure Resources

Directory of Open Access Journals (Sweden)

Ostrowska Teresa

2017-12-01

Full Text Available This article is devoted to the issue of how resources are interpreted in the form of technology reactors that, as a result of unexpected circumstances, turn into pyramidal or avalanche threat dynamics. Counteracting such catastrophic, terrorist, or war situations cannot begin in the face of mass casualties or significant material losses that will require reconstruction and the work of many generations. The decisive factor is the correct long-term operation and management of the economy. The starting point of this article is the concept of resource and structural-functional relationships of resources and all their possible interpretations consistent with the functionalities they play in the human environment, human aggregates, and whole nations. The aim is to draw the reader's attention to the importance (semiotics of qualitative specifications and dynamically changing determinants contained in the material and structural-functional properties of the resources and their channel (information communication.

Spacio-temporal situation assessment for mobile robots

DEFF Research Database (Denmark)

Beck, Anders Billesø; Risager, Claus; Andersen, Nils Axel

2011-01-01

chains are used to model the situation states and sequence, where stream clustering is used for state matching and dealing with noise. In experiments using simulated and real data, we show that we are able to learn a situation sequence for a mobile robot passing through a narrow passage. After learning......In this paper, we present a framework for situation modeling and assessment for mobile robot applications. We consider situations as data patterns that characterize unique circumstances for the robot, and represented not only by the data but also its temporal and spacial sequence. Dynamic Markov...

A lightning multiple casualty incident in Sequoia and Kings Canyon National Parks.

Science.gov (United States)

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

2015-03-01

Multiple casualty incidents (MCIs) are uncommon in remote wilderness settings. This is a case report of a lightning strike on a Boy Scout troop hiking through Sequoia and Kings Canyon National Parks (SEKI), in which the lightning storm hindered rescue efforts. The purpose of this study was to review the response to a lightning-caused MCI in a wilderness setting, address lightning injury as it relates to field management, and discuss evacuation options in inclement weather incidents occurring in remote locations. An analysis of SEKI search and rescue data and a review of current literature were performed. A lightning strike at 10,600 feet elevation in the Sierra Nevada Mountains affected a party of 5 adults and 7 Boy Scouts (age range 12 to 17 years old). Resources mobilized for the rescue included 5 helicopters, 2 ambulances, 2 hospitals, and 15 field and 14 logistical support personnel. The incident was managed from strike to scene clearance in 4 hours and 20 minutes. There were 2 fatalities, 1 on scene and 1 in the hospital. Storm conditions complicated on-scene communication and evacuation efforts. Exposure to ongoing lightning and a remote wilderness location affected both victims and rescuers in a lightning MCI. Helicopters, the main vehicles of wilderness rescue in SEKI, can be limited by weather, daylight, and terrain. Redundancies in communication systems are vital for episodes of radio failure. Reverse triage should be implemented in lightning injury MCIs. Education of both wilderness travelers and rescuers regarding these issues should be pursued. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Biomechanical Analysis of Defensive Cutting Actions During Game Situations: Six Cases in Collegiate Soccer Competitions

Directory of Open Access Journals (Sweden)

Sasaki Shogo

2015-06-01

Full Text Available The strengths of interpersonal dyads formed by the attacker and defender in one-on-one situations are crucial for performance in team ball sports such as soccer. The purpose of this study was to analyze the kinematics of one-on-one defensive movements in soccer competitions, and determine the relationships between lower limb kinematics and the center of mass translation during cutting actions. Six defensive scenes in which a player was responding to an offender’s dribble attack were selected for analysis. To reconstruct the three-dimensional kinematics of the players, we used a photogrammetric model-based image-matching technique. The hip and knee kinematics were calculated from the matched skeleton model. In addition, the center of mass height was expressed as a ratio of each participant’s body height. The relationships between the center of mass height and the kinematics were determined by the Pearson’s product-moment correlation coefficient. The normalized center of mass height at initial contact was correlated with the vertical center of mass displacement (r = 0.832, p = 0.040 and hip flexion angle at initial contact (r = −0.823, p = 0.044. This suggests that the lower center of mass at initial contact is an important factor to reduce the downwards vertical center of mass translation during defensive cutting actions, and that this is executed primarily through hip flexion. It is therefore recommended that players land with an adequately flexed hip at initial contact during one-on-one cutting actions to minimize the vertical center of mass excursion.

Fission, critical mass and safety-a historical review

International Nuclear Information System (INIS)

Meggitt, Geoff

2006-01-01

Since the discovery of fission, the notion of a chain reaction in a critical mass releasing massive amounts of energy has haunted physicists. The possibility of a bomb or a reactor prompted much of the early work on determining a critical mass, but the need to avoid an accidental critical excursion during processing or transport of fissile material drove much that took place subsequently. Because of the variety of possible situations that might arise, it took some time to develop adequate theoretical tools for criticality safety and the early assessments were based on direct experiment. Some extension of these experiments to closely similar situations proved possible, but it was not until the 1960s that theoretical methods (and computers to run them) developed enough for them to become reliable assessment tools. Validating such theoretical methods remained a concern, but by the end of the century they formed the backbone of criticality safety assessment. This paper traces the evolution of these methods, principally in the UK and USA, and summarises some related work concerned with the nature of criticality accidents and their radiological consequences. It also indicates how the results have been communicated and used in ensuring nuclear safety. (review)

Topological sources of soliton mass and supersymmetry breaking

Science.gov (United States)

Haas, Patrick A.

2018-06-01

We derive the Smarr formulae for two five-dimensional solutions of supergravity, which are asymptotically ; in particular, one has a magnetic ‘bolt’ in its center, and one is a two-center solution. We show for both spacetimes that supersymmetry—and so the BPS-bound—is broken by the holonomy and how each topological feature of a space-like hypersurface enters Smarr’s mass formula, with emphasis on the ones that give rise to the stated violation of the BPS-bound. In this light, we question if any violating extra-mass term in a spacetime with such asymptotics is only evident in the ADM mass while the Komar mass per se ‘tries’ to preserve BPS. Finally, we derive the cohomological fluxes for each situation and examine in a more general fashion how the breaking of supersymmetry—and so the BPS-bound violation—is associated with their topologies. In the second (and more complicated) scenario, we especially focus on the compact cycle linking the centers, and the contribution of non-vanishing bulk terms in the mass formula to the breaking of supersymmetry.

A simple method for improving predictions of nuclear masses

International Nuclear Information System (INIS)

Yamada, Masami; Tsuchiya, Susumu; Tachibana, Takahiro

1991-01-01

The formula for atomic masses which exactly conforms to all nuclides does not exist in reality and cannot be anticipated for the time being hereafter. At present the masses of many nuclides are known experimentally with good accuracy, but the values of whichever mass formulas are more or less different from those experimental values except small number of accidental coincidence. Under such situation, for forecasting the mass of an unknown nuclide, how is it cleverly done ? Generally speaking, to take the value itself of a mass formula seems not the best means. It may be better to take the difference of the values of a mass formula and experiment for the nuclide close to that to be forecast in consideration and to correct the forecast value of the mass formula. In this report, the simple method for this correction is proposed. The formula which connects between two extreme cases, the difference between a true mass and the value of a mass formula is the sum of proton part and neutron part, and the difference distributes randomly around zero, was proposed. The procedure for its concrete application is explained. This method can be applied to other physical quantities than mass, for example the half life of beta decay. (K.I.)

Mass transport in propagating patterns of convection

International Nuclear Information System (INIS)

Moses, E.; Steinberg, V.

1988-01-01

Recent studies of propagating waves in an oscillatory convection of binary mixtures arise questions about transport properties of this flow. Optical visualization of a field of refraction index due to a shadowgraph technique gives information on the temperature and concentration fields. However, experimental observation of rolls propagating along the cell as travelling waves (TW) does not necessarily imply that mass is transferred hydrodynamically by the convective motion along the cell. One of the possibilities discussed, e.g., is that TW observed is only a phase propagation. The traditional examples of such situations come from the domain of linear, superposition-oriented physics. Acoustic waves transfer momentum and energy, but do not cause the mass to make excursions for their equilibrium point that are larger than the oscillation amplitude. In the case of nonlinear physics we were aware that small amplitude surface waves cause only small oscillatory motion round the equilibrium point, while larger amplitudes can cause the mass to start moving in the direction of the TW. This paper discussed the different possibilities of mass transfer by TW. 27 refs., 20 figs

Browse Title Index

African Journals Online (AJOL)

Items 101 - 144 of 144 ... ... Reducing Morbidity and Mortality from Unsafe Abortion in Nigeria, Abstract ... Vol 4, No 1 (2003): Mental Health, Revisiting the National Mental Health ... Road Traffic crashes: problems of mass casualty management in ...

Ostomy Home Skills Program

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Full Text Available ... on Health Care Reform Medicare Physician Payment Medical Liability Reform Opioids and Surgical Care GME and Workforce ... and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as Advocates Surgeons and Bundled Payment Models ...

Ostomy Home Skills Program

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Full Text Available ... to Enhance Survival in Active Shooter and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

Your Lung Operation: After Your Operation

Medline Plus

Full Text Available ... to Enhance Survival in Active Shooter and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

The France energy situation; La situation energetique de la France

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

This analysis of the french energy situation provides information and key data on some key facts about the energy in France, the France energy supply and demand, the major principles of energy policy, the challenges of french energy policy and the DGEMP (general directorate for energy and raw materials). (A.L.B.)

Modeling of Communication in a Computational Situation Assessment Model

International Nuclear Information System (INIS)

Lee, Hyun Chul; Seong, Poong Hyun

2009-01-01

Operators in nuclear power plants have to acquire information from human system interfaces (HSIs) and the environment in order to create, update, and confirm their understanding of a plant state, or situation awareness, because failures of situation assessment may result in wrong decisions for process control and finally errors of commission in nuclear power plants. Quantitative or prescriptive models to predict operator's situation assessment in a situation, the results of situation assessment, provide many benefits such as HSI design solutions, human performance data, and human reliability. Unfortunately, a few computational situation assessment models for NPP operators have been proposed and those insufficiently embed human cognitive characteristics. Thus we proposed a new computational situation assessment model of nuclear power plant operators. The proposed model incorporating significant cognitive factors uses a Bayesian belief network (BBN) as model architecture. It is believed that communication between nuclear power plant operators affects operators' situation assessment and its result, situation awareness. We tried to verify that the proposed model represent the effects of communication on situation assessment. As the result, the proposed model succeeded in representing the operators' behavior and this paper shows the details

Infographics as Eye Candy: Review of World War II in Numbers: An Infographic Guide to the Conflict, Its Conduct, and Its Casualties by Peter Doyle (2013

Directory of Open Access Journals (Sweden)

Joel Best

2016-01-01

Full Text Available Peter Doyle. World War II in Numbers: An Infographic Guide to the Conflict, Its Conduct, and Its Casualties, illustrated by Lindsey Johns (Buffalo NY: Firefly Books, 2013. 224 pp. ISBN: 177085195X. Doyle’s book contains dozens of graphs of statistical data dealing with World War II. Many of these graphs are visually striking. However, they often violate fundamental graphing principles, in that they distort quantitative relationships, use unidentified scales, and often make it difficult to compare quantities. Graphic software makes it easy to create imaginative images, but these can fail to communicate the very information that is the graph’s purpose.

14 CFR 99.5 - Emergency situations.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Emergency situations. 99.5 Section 99.5 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SECURITY CONTROL OF AIR TRAFFIC General § 99.5 Emergency situations. In an...

An exploration of the applicability of situational segmentation in the health care market: development of a situational taxonomy.

Science.gov (United States)

Gehrt, K C; Pinto, M B

1990-01-01

Competition in the health care market has intensified in recent years. Health care providers are increasingly adopting innovative marketing techniques to secure their positions in the marketplace. This paper examines an innovative marketing technique, situational segmentation, and assesses its applicability to the health care market. Situational segmentation has proven useful in many consumer goods markets but has received little attention in the context of health care marketing. A two-stage research process is used to develop a taxonomy of situational factors pertinent to health care choice. In stage one, focus group interviews are used to gather information which is instrumental to questionnaire development. In stage two, the responses of 151 subjects to a 51 item questionnaire are factor analyzed. The results demonstrate that situational segmentation is a viable strategy in the health care market.

[Support psychotherapy in traumatic situations].

Science.gov (United States)

Pérez-Sales, Pau; Vázquez Valverde, Carmelo

2003-12-01

It seems that a certain consensus exists to speak about a traumatic situation as an experience which is made up of a threat on the physical or psychological integrity of a person and against which one responds with fear, desperation and intensive horror. Different psychological phenomena are involved with the manner through which a human being confronts his/her past. In particular, the response to traumatic situations, mourning, and blame share their characteristic of being an irreversible living reality related to facts, loss or past impacts and it is necessary to integrate these in one's life in order to advance; these comprise a triangle frequently coexisting and interconnected. Aid for these three situations has, therefore, as common elements, two premises: an active task is required by the person who suffers this situation; this person must, in some form, desire to move ahead. One can not toil in mourning, in a traumatic experience, or in a life of blame if these have a positive symbolic value for this person; for example, mourning as a manner not to treason the dead person by forgetting that person, the reliving a trauma as an attempt to provide some sense to the actions which occurred, or blame as a desire to not forget an error or as a final punishment of this active task; the final objective of this active task is not usually to forget but to integrate in order to live. If a person does not perceive this clearly, this person may not become actively involved in the task to overcome a traumatic situation and to move ahead, nor will that person accept that a person who tries to help questions this person's realities or experiences.

Exploring schema-driven differences in situation awareness between road users: an on-road study of driver, cyclist and motorcyclist situation awareness.

Science.gov (United States)

Salmon, Paul M; Lenne, Michael G; Walker, Guy H; Stanton, Neville A; Filtness, Ashleigh

2014-01-01

Collisions between different road users make a substantial contribution to road trauma. Although evidence suggests that different road users interpret the same road situations differently, it is not clear how road users' situation awareness differs, nor is it clear which differences might lead to conflicts. This article presents the findings from an on-road study conducted to examine driver, motorcyclist and cyclist situation awareness in different road environments. The findings suggest that, in addition to minor differences in the structure of different road users' situation awareness (i.e. amount of information and how it is integrated), the actual content of situation awareness in terms of road user schemata, the resulting interaction with the world and the information underpinning situation awareness is markedly different. Further examination indicates that the differences are likely to be compatible along arterial roads, shopping strips and at roundabouts, but that they may create conflicts between different road users at intersections. Interventions designed to support compatible situation awareness and behaviour between different road users are discussed.

SPECIFICITY OF SELF-PRESERVATION MOTIVATION IN EXTREME SITUATION

Directory of Open Access Journals (Sweden)

Ekaterina Anatolevna Karacheva

2015-02-01

Full Text Available The article presents the results of the study motivation of self-preservation in an extreme situation. Usually extreme situation unfold from the point of view of functioning, health, high negative level mental stress and tension. The extreme situation is the situation of human activity to which man acts, carrying out certain activities. The article provides an overview of russian and foreign authors dealing with this problem. Theoretical models of motivation of self-preservation Z. Freud, A. Maslow, G. Murray, M. Magomed-Eminov. The study explores the leading motivation in an extreme situation and analyzed the levels of motivation of self-preservation. The study was conducted in the Afghan veterans, using a method of unfinished sentences and other. Identified two levels of motivation of self-preservation: individual and personal. Revealed that the motivation of self-preservation is the leading motivation in an extreme situation.

Conservation of Mass and Preservation of Positivity with Ensemble-Type Kalman Filter Algorithms

Science.gov (United States)

Janjic, Tijana; Mclaughlin, Dennis; Cohn, Stephen E.; Verlaan, Martin

2014-01-01

This paper considers the incorporation of constraints to enforce physically based conservation laws in the ensemble Kalman filter. In particular, constraints are used to ensure that the ensemble members and the ensemble mean conserve mass and remain nonnegative through measurement updates. In certain situations filtering algorithms such as the ensemble Kalman filter (EnKF) and ensemble transform Kalman filter (ETKF) yield updated ensembles that conserve mass but are negative, even though the actual states must be nonnegative. In such situations if negative values are set to zero, or a log transform is introduced, the total mass will not be conserved. In this study, mass and positivity are both preserved by formulating the filter update as a set of quadratic programming problems that incorporate non-negativity constraints. Simple numerical experiments indicate that this approach can have a significant positive impact on the posterior ensemble distribution, giving results that are more physically plausible both for individual ensemble members and for the ensemble mean. In two examples, an update that includes a non-negativity constraint is able to properly describe the transport of a sharp feature (e.g., a triangle or cone). A number of implementation questions still need to be addressed, particularly the need to develop a computationally efficient quadratic programming update for large ensemble.

Pedagogical and conflict situations of teacher of physical training

Directory of Open Access Journals (Sweden)

Pechko O.M.

2011-02-01

Full Text Available The article reveals the essence of pedagogical and conflict situations between teacher and student. Considered ways of solving and preventing pedagogical and conflict situations in school. Principal reasons of conflict situations are selected, situations of activity, conduct and relations. The receptions of influence of teacher of physical culture are separated on personality of schoolchildren. It is well-proven that the profession of teacher of physical culture supposes possibility of conflict situations.

The layperson in emergency situations

OpenAIRE

Pergola, AM; Araujo, IEM

2008-01-01

The layperson's qualification to provide early care in emergency situations and basic life support (BLS) is fundamental to save lives and prevent sequels. The objective was to identify the level of knowledge of lay people about approaching an emergency victim. Structured interviews in non-technical language were used with a 385-subject sample, average age 35.4 (+/- 14.55) years, with more than 50% having a high school or university education. Over 55% of these observed situations with loss of...

Prospects for improved detection of chemical, biological, radiological, and nuclear threats

Energy Technology Data Exchange (ETDEWEB)

Wuest, Craig R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Hart, Brad [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Slezak, Thomas R. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2012-07-31

Acquisition and use of Chemical, Biological, Radiological, and Nuclear (CBRN) weapons continue to be a major focus of concern form the security apparatus of nation states because of their potential for mass casualties when used by a determined adversary.

Situation awareness with systems of systems

CERN Document Server

Tretmans, Jan; Borth, Michael

2013-01-01

This book discusses various aspects, challenges, and solutions for developing systems-of-systems for situation awareness, using applications in the domain of maritime safety and security.  Topics include advanced, multi-objective visualization methods for situation awareness, stochastic outlier selection, rule-based anomaly detection, an ontology-based event model for semantic reasoning, new methods for semi-automatic generation of adapters bridging communication gaps, security policies for systems-of-systems, trust assessment, and methods to deal with the dynamics of systems-of-systems in run-time monitoring, testing, and diagnosis. Architectural considerations for designing information-centric systems-of-systems such as situation awareness systems, and an integrated demonstrator implementing many of the investigated aspects, complete the book.

Project management in crisis situations

Directory of Open Access Journals (Sweden)

Agnieszka Goździewska-Nowicka

2017-05-01

Full Text Available In today’s methodologies of project management attention is increasingly paid to the crises-related issues. Modern economy and the turbulent environment cause that an emergingcrisis can pose a serious threat to the implementation of any undertaking. This article focuses on the presentation of the conditions and causes of crisis situations, the essence of projects, and their effective management. The major objective of the paper, however, is to demonstrate how companies implementing projects cope with the occurrence of a crisis situation.

Cyber defense and situational awareness

CERN Document Server

Kott, Alexander; Erbacher, Robert F

2015-01-01

This book is the first publication to give a comprehensive, structured treatment to the important topic of situational awareness in cyber defense. It presents the subject in a logical, consistent, continuous discourse, covering key topics such as formation of cyber situational awareness, visualization and human factors, automated learning and inference, use of ontologies and metrics, predicting and assessing impact of cyber attacks, and achieving resilience of cyber and physical mission. Chapters include case studies, recent research results and practical insights described specifically for th

Direct measurements of neutrino masses

Energy Technology Data Exchange (ETDEWEB)

Holzschuh, E [Zurich Univ. (Switzerland). Inst. fuer Physik

1996-11-01

The direct measurements have so far given no indication for a nonzero (positive) mass of any of the three known neutrinos. The experiments measuring the tau and the muon neutrino are good shape. The tritium experiments are in an unfortunate situation. It is unclear to me whether the problems are experimental or theoretical or a combination of both. The electronic final states distribution have been calculated, but the results have never been tested experimentally. The most important question to be answered is about the validity of the sudden approximation. (author) 9 figs., 2 tabs., 16 refs.

HMC algorithm with multiple time scale integration and mass preconditioning

Science.gov (United States)

Urbach, C.; Jansen, K.; Shindler, A.; Wenger, U.

2006-01-01

We present a variant of the HMC algorithm with mass preconditioning (Hasenbusch acceleration) and multiple time scale integration. We have tested this variant for standard Wilson fermions at β=5.6 and at pion masses ranging from 380 to 680 MeV. We show that in this situation its performance is comparable to the recently proposed HMC variant with domain decomposition as preconditioner. We give an update of the "Berlin Wall" figure, comparing the performance of our variant of the HMC algorithm to other published performance data. Advantages of the HMC algorithm with mass preconditioning and multiple time scale integration are that it is straightforward to implement and can be used in combination with a wide variety of lattice Dirac operators.

CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

OpenAIRE

Maria-Madalina SALOMIA

2012-01-01

In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space. From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups tha...

CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

Directory of Open Access Journals (Sweden)

Maria-Madalina, Salomia

2012-01-01

Full Text Available In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space.From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups that present opinions, knowledge and divergent interests such as:managers, investors, financial creditors, commercial creditors, clients, suppliers, employees, the government and its institutions, bankers, financial analysts, the public, the business community and other entities who base themselves on the objectivity and integrity of the financial situations audited.

When API Mass Spectrometry Meets Super Atmospheric Pressure Ion Sources

Science.gov (United States)

Chen, Lee Chuin

2015-01-01

In a tutorial paper on the application of free-jet technique for API-MS, John Fenn mentioned that “…for a number of years and a number of reasons, it has been found advantageous in many situations to carry out the ionization process in gas at pressures up to 1000 Torr or more” (Int. J. Mass Spectrom. 200: 459–478, 2000). In fact, the first ESI mass spectrometer constructed by Yamashita and Fenn had a counter-flow curtain gas source at 1050 Torr (ca. 1.4 atm) to sweep away the neutral (J. Phys. Chem. 88: 4451–4459, 1984). For gaseous ionization using electrospray plume, theoretical analysis also shows that “super-atmospheric operation would be more preferable in space-charge-limited situations.”(Int. J. Mass Spectrom. 300: 182–193, 2011). However, electrospray and the corona-based chemical ion source (APCI) in most commercial instrument are basically operated under an atmospheric pressure ambient, perhaps out of the concern of safety, convenience and simplicity in maintenance. Running the ion source at pressure much higher than 1 atm is not so common, but had been done by a number of groups as well as in our laboratory. A brief review on these ion sources will be given in this paper. PMID:26819912

Laboratory analysis of CBRN-substances: Stakeholder networks as clue to higher CBRN resilience in Europe

NARCIS (Netherlands)

Plamboeck, A.H.; Stöven, S.; Duarte Davidson, R.; Fykse, E.M.; Griffiths, M.; Nieuwenhuizen, M.S.; Rivier, C.; Schans, M.J. van der

2016-01-01

The threat of terrorists using CBRN agents continues to pose a risk of mass casualties and severe disruption of societal functions in Europe. Standardisation of crisis management activities is one important step towards effective national and international interoperability and increased resilience.

Twisted mass, overlap and Creutz fermions. Cut-off effects at tree-level of perturbation theory

International Nuclear Information System (INIS)

Cichy, K.; Kujawa, A.; Jansen, K.; Shindler, A.

2008-02-01

We study cutoff effects at tree-level of perturbation theory for maximally twisted mass Wilson, overlap and the recently proposed Creutz fermions. We demonstrate that all three kind of lattice fermions exhibit the expected O(a 2 ) scaling behaviour in the lattice spacing. In addition, the sizes of these cutoff effects are comparable for the three kinds of lattice fermions considered here. Furthermore, we analyze situations when twisted mass fermions are not exactly at maximal twist and when overlap fermions are studied in comparison to twisted mass fermions when the quark masses are not matched. (orig.)

Les Médias de Masse au Service de la Communication de Guerre

Directory of Open Access Journals (Sweden)

Serrano, Yeny

2008-09-01

Full Text Available Cet article propose une réflexion autour de la question Comment lesmédias de masse informent-ils les citoyens à propos d'une confrontation armée et quelles variables interviennent dans la mis-e en discours d'une guerre par les médias? Nous faisons l'hypothèse que ce travail informatif est déterminé non seulement par des variables propres aux médias mais aussi par les contraintes propres à une situation de guerre. Cette hypothèse, qui semblerait a priori évidente, met l'accent sur le fait que la production de l'information, en situation de guerre, ne dépend pas exclusivement des intentions et du travail des professionnels de l'information. En effet, de nombreuses contraintes militaires et stratégiques entrent en contradiction avec les principes de "neutralité", d"impartialité", etc. défendus par les médias de masse et leurs professionnels.

EFFECT OF TUNE MASS DAMPER (TMD) ON HIGHRISE BUILDING SUBJECTEDTO LATERAL LOADS

OpenAIRE

Prof. Syed Farroqh Anwar; Mr.Noor Mohammed; Syed Zeeshan Ali

2017-01-01

Strong earthquakes have occurred in many countries and have caused many problems including casualties, economic loss, destruction of infrastructures, and even leaking of radioactive materials. Therefore, earthquake resistant design and reinforcement of existing structures have become increasingly more important due to increasing probability of strong earthquakes. Especially, a higher level of earthquake resistance is required for infrastructures and industrial facilities as it has been shown ...

About Stressful Situations

Science.gov (United States)

... make a new friend — plus catch up in social studies. Get support. Find someone to talk to about your situation. Ask for help or advice. Be with people who believe in you, make you laugh, and help you feel good about yourself. Sometimes just a listening ear helps a lot. It helps you know ...

Actinides analysis in emergency situation by on-line coupling between a calix[6]arene-based chromatography column and an Inductively Coupled Plasma-Mass Spectrometer

International Nuclear Information System (INIS)

Baghdadi, Sarah

2015-01-01

In the event of a nuclear crisis, involving actinides (U, Pu, Am) it is important to have fast analysis methods available in order to identify people that could be contaminated. Usually, they are performed in urine or faeces. Even though, analytical methods used with alpha detection are reliable they are lengthy and tedious to set up. This work consisted in developing an on-line coupling method between a calix[6]arene-based chromatography column and an inductively coupled plasma mass spectrometer (ICP-MS). To do so, a speciation study of actinides in mineralised urine was developed to understand the chemical equilibria happening during the actinides extraction. A protocol was elaborated to extract simultaneously all three actinides at pH = 5, then co-elute them with 0.25 mol.L -1 H 3 PO 4 . Recovery was 56 %, 74 % and 85 % for U, Pu and Am respectively. The column was then coupled to the ICP-MS. A parameter study helped defining mineralisation duration, extraction and elution flow-rates. It was then possible to propose an on-line coupling system allowing reaching detection limits lower than 0.5 mBq.L-1 for 238 U and 243 Am and lower than 5 mBq.L -1 for 239 Pu and 241 Am, for analysis duration lower than 6 hours. These analytical performances show the interest of this technique for a use in a nuclear crisis situation. (author)

Mass carbon monoxide poisoning at an ice-hockey game: initial approach and long-term follow-up.

Science.gov (United States)

Mortelmans, Luc J M; Populaire, Jacques; Desruelles, Didier; Sabbe, Marc B

2013-12-01

A mass carbon monoxide (CO) intoxication during an ice-hockey game is described. Two hundred and thirty-five patients were seen in different hospitals, 88 of them the same night at the nearby emergency department. To evaluate long-term implications and to identify relevant indicators, a follow-up study was organized 1 year after the incident. Apart from the file data from the emergency departments, a 1-year follow-up mailing was sent to all patients. One hundred and ninety-one patients returned their questionnaire (86%). The mean age of the patients was 28 years, with 61% men. The mean carboxyhaemoglobin (COHb) was 9.9%. COHb levels were significantly higher for individuals on the ice (referee, players and maintenance personnel). There was a significant relationship with the initial presence of dizziness, fatigue and the COHb level. Headache, abdominal pain, nausea and vomiting were not significantly related to the COHb levels. The relationship between symptoms and CO level, however, should be interpreted with caution as there was a wide range between exposure and blood tests. 5.2% of patients had residual complaints, all including headache, with a significant higher incidence with high COHb levels. Only two patients had an abnormal neurological control (one slightly disturbed electroencephalography and one persistent encephalopathic complaint). Work incapacity was also significantly related to COHb levels. CO mass poisonings remain a risk in indoor sporting events. Although it causes an acute mass casualty incident, it is limited in time and delayed problems are scarce. Symptomatology is a poor tool for triage. The best prevention is the use of nonmineral energy sources such as for example electricity.

Computer Simulation as a Tool for Assessing Decision-Making in Pandemic Influenza Response Training

Directory of Open Access Journals (Sweden)

James M Leaming

2013-05-01

Full Text Available Introduction: We sought to develop and test a computer-based, interactive simulation of a hypothetical pandemic influenza outbreak. Fidelity was enhanced with integrated video and branching decision trees, built upon the 2007 federal planning assumptions. We conducted a before-and-after study of the simulation effectiveness to assess the simulations’ ability to assess participants’ beliefs regarding their own hospitals’ mass casualty incident preparedness.Methods: Development: Using a Delphi process, we finalized a simulation that serves up a minimum of over 50 key decisions to 6 role-players on networked laptops in a conference area. The simulation played out an 8-week scenario, beginning with pre-incident decisions. Testing: Role-players and trainees (N=155 were facilitated to make decisions during the pandemic. Because decision responses vary, the simulation plays out differently, and a casualty counter quantifies hypothetical losses. The facilitator reviews and critiques key factors for casualty control, including effective communications, working with external organizations, development of internal policies and procedures, maintaining supplies and services, technical infrastructure support, public relations and training. Pre- and post-survey data were compared on trainees.Results: Post-simulation trainees indicated a greater likelihood of needing to improve their organization in terms of communications, mass casualty incident planning, public information and training. Participants also recognized which key factors required immediate attention at their own home facilities.Conclusion: The use of a computer-simulation was effective in providing a facilitated environment for determining the perception of preparedness, evaluating general preparedness concepts and introduced participants to critical decisions involved in handling a regional pandemic influenza surge. [West J Emerg Med. 2013;14(3:236–242.

The situation of nuclear energy in the USA

International Nuclear Information System (INIS)

Barthelt, K.

1984-01-01

Owing to the fact that peaceful utilization of nuclear energy receives much coverage in the mass media, at party congresses and lately even in respectable journals in a way characterized by much emotional commitment and little factual knowledge, there is a danger of transferring the situation in the USA too easily to the Federal Republic of Germany along with all those well-known arguments. In the article, the author points out the differences between the continent USA and the comparatively small country Federal Republic of Germany reading the conclusion that any sweeping comparison of both countries is misleading so, too, in energy supply. In detail, there is a brief overview on the historical development of nuclear power utilization in the USA, a discussion of the reasons for cancelling/shutting-down nuclear power plants in the USA, an analysis of the effects of modified demand predictions on power station construction and of funding problems as well as an investigation into the profitability of nuclear energy in the USA. (orig./UA) [de

France energy situation

International Nuclear Information System (INIS)

1991-01-01

The monthly (May 1991) energy situation analysis in France is presented: the energy consumption rise is lowered and especially, oil imports have fallen from -3.1 pc; natural gas imports and domestic electric power production have risen. The energy import dependence rate have very slightly risen, around 50 pc. Diagrams for 1989, 1990, 1991 are presented [fr

Mass Action and Conservation of Current

Directory of Open Access Journals (Sweden)

Eisenberg Robert S.

2016-10-01

Full Text Available The law of mass action does not force a series of chemical reactions to have the same current flow everywhere. Interruption of far-away current does not stop current everywhere in a series of chemical reactions (analyzed according to the law of mass action, and so does not obey Maxwell’s equations. An additional constraint and equation is needed to enforce global continuity of current. The additional constraint is introduced in this paper in the special case that the chemical reaction describes spatial movement through narrow channels. In that case, a fully consistent treatment is possible using different models of charge movement. The general case must be dealt with by variational methods that enforce consistency of all the physical laws involved. Violations of current continuity arise away from equilibrium, when current flows, and the law of mass action is applied to a non-equilibrium situation, different from the systems considered when the law was originally derived. Device design in the chemical world is difficult because simple laws are not obeyed in that way. Rate constants of the law of mass action are found experimentally to change from one set of conditions to another. The law of mass action is not robust in most cases and cannot serve the same role that circuit models do in our electrical technology. Robust models and device designs in the chemical world will not be possible until continuity of current is embedded in a generalization of the law of mass action using a consistent variational model of energy and dissipation.

Understanding situation awareness and its importance in patient safety.

Science.gov (United States)

Gluyas, Heather; Harris, Sarah-Jane

2016-04-20

Situation awareness describes an individual's perception, comprehension and subsequent projection of what is going on in the environment around them. The concept of situation awareness sits within the group of non-technical skills that include teamwork, communication and managing hierarchical lines of communication. The importance of non-technical skills has been recognised in safety-critical industries such as aviation, the military, nuclear, and oil and gas. However, health care has been slow to embrace the role of non-technical skills such as situation awareness in improving outcomes and minimising the risk of error. This article explores the concept of situation awareness and the cognitive processes involved in maintaining it. In addition, factors that lead to a loss of situation awareness and strategies to improve situation awareness are discussed.

Can teamwork and situational awareness (SA) in ED resuscitations be improved with a technological cognitive aid? Design and a pilot study of a team situation display.

Science.gov (United States)

Parush, A; Mastoras, G; Bhandari, A; Momtahan, K; Day, K; Weitzman, B; Sohmer, B; Cwinn, A; Hamstra, S J; Calder, L

2017-12-01

Effective teamwork in ED resuscitations, including information sharing and situational awareness, could be degraded. Technological cognitive aids can facilitate effective teamwork. This study focused on the design of an ED situation display and pilot test its influence on teamwork and situational awareness during simulated resuscitation scenarios. The display design consisted of a central area showing the critical dynamic parameters of the interventions with an events time-line below it. Static information was placed at the sides of the display. We pilot tested whether the situation display could lead to higher scores on the Clinical Teamwork Scale (CTS), improved scores on a context-specific Situational Awareness Global Assessment Technique (SAGAT) tool, and team communication patterns that reflect teamwork and situational awareness. Resuscitation teamwork, as measured by the CTS, was overall better with the presence of the situation display as compared with no situation display. Team members discussed interventions more with the situation display compared with not having the situation display. Situational awareness was better with the situation display only in the trauma scenario. The situation display could be more effective for certain ED team members and in certain cases. Overall, this pilot study implies that a situation display could facilitate better teamwork and team communication in the resuscitation event. Copyright © 2017 Elsevier Inc. All rights reserved.

Representing and reasoning about program in situation calculus

Science.gov (United States)

Yang, Bo; Zhang, Ming-yi; Wu, Mao-nian; Xie, Gang

2011-12-01

Situation calculus is an expressive tool for modeling dynamical system in artificial intelligence, changes in a dynamical world is represented naturally by the notions of action, situation and fluent in situation calculus. Program can be viewed as a discrete dynamical system, so it is possible to model program with situation calculus. To model program written in a smaller core programming language CL, notion of fluent is expanded for representing value of expression. Together with some functions returning concerned objects from expressions, a basic action theory of CL programming is constructed. Under such a theory, some properties of program, such as correctness and termination can be reasoned about.

Assessment of left ventricular mass in sequential studies with cine MR imaging

International Nuclear Information System (INIS)

Tomei, E.; Semelka, R.; Wagner, S.; Mayo, J.; Chatterjee, K.; Parmley, W.W.; O'Sullivan, M.; Wolfe, C.L.; Caputo, G.; Higgins, C.B.

1989-01-01

The aim of this study was to measure left ventricular (LV) mass in 11 healthy volunteers, 10 patients with dilated cardiomyopathy, and eight patients with LV hypertrophy (LVH), using two sequential studies to compare the characteristics of LV mass in the same subject and in different clinical situations. All subjects underwent short- axis cine MR imaging at 1.5 T. Each subject had two separate studies: the healthy volunteers within 6 months and those with cardiac disease within 1 week. Measurements (both end- systolic and end-diastolic) included LV mass, LV mass index, and wall thickness. LV mass was substantially increased in both DCM and LVH. The interstudy variability for end- systolic and end-diastolic mass was 5.2% and 3.8%, respectively, for healthy volunteers, 5.2% and 4.0% for LVH, and 3.8% and 6.1% for DCM. The low variability indicates the reproducibility of this technique in sequential studies when no change is expected

Situational Script Management of Business Processes with Changeable Structure

OpenAIRE

Chaliy, Sergey; Chala, Oksana

2008-01-01

In the presented work the problem of management business-processes with changeable structure is considered and situational based approach to its decision is offered. The approach is based on situational model of management business-process according to which process is represented as a set of situations. The script defining necessary actions is connected with each situation. Management of process is carried out by means of the rules formalizing functional requirements to processes.

A Century of Progress in Molecular Mass Spectrometry

Science.gov (United States)

McLafferty, Fred W.

2011-07-01

The first mass spectrum of a molecule was measured by J.J. Thomson in 1910. Mass spectrometry (MS) soon became crucial to the study of isotopes and atomic weights and to the development of atomic weapons for World War II. Its notable applications to molecules began with the quantitative analysis of light hydrocarbons during World War II. When I joined the Dow Chemical Company in 1950, MS was not favored by organic chemists. This situation improved only with an increased understanding of gaseous ion chemistry, which was obtained through the use of extensive reference data. Gas chromatography-MS was developed in 1956, and tandem MS was first used a decade later. In neutralization-reionization MS, an unusual, unstable species is prepared by ion-beam neutralization and characterized by reionization. Electrospray ionization of a protein mixture produces its corresponding ionized molecules. In top-down proteomics, ions from an individual component can be mass separated and subjected to collision-activated and electron-capture dissociation to provide extensive sequence information.

Inheritance of Properties in NTU Communication Situations

NARCIS (Netherlands)

Hendrickx, R.L.P.

2002-01-01

In this paper we consider communication situations in which utility is nontransferable. We compare this model with the more familiar model of transferable utility communication situations and point out an odd feature of the latter. We mainly focus on the inheritance of properties of the underlying

Towards ontology-driven situation-aware disaster management

NARCIS (Netherlands)

Moreira, João; Ferreira Pires, Luis; van Sinderen, Marten J.; Dockhorn Costa, P.

2015-01-01

Over the last years, numerous ICT applications with mechanisms to detect situations have been developed to support disaster management (DM), which is a field of a great societal and economic importance. Those applications are termed situation-aware (SA) because they try, in near real-time, to

Global earthquake casualties due to secondary effects: A quantitative analysis for improving rapid loss analyses

Science.gov (United States)

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

2010-01-01

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

TIER competency-based training course for the first receivers of CBRN casualties: a European perspective.

Science.gov (United States)

Djalali, Ahmadreza; Della Corte, Francesco; Segond, Frederique; Metzger, Marie-Helene; Gabilly, Laurent; Grieger, Fiene; Larrucea, Xabier; Violi, Christian; Lopez, Cédric; Arnod-Prin, Philippe; Ingrassia, Pier L

2017-10-01

Education and training are key elements of health system preparedness vis-à-vis chemical, biological, radiological and nuclear (CBRN) emergencies. Medical respondents need sufficient knowledge and skills to manage the human impact of CBRN events. The current study was designed to determine which competencies are needed by hospital staff when responding to CBRN emergencies, define educational needs to develop these competencies, and implement a suitable delivery method. This study was carried out from September 2014 to February 2015, using a three-step modified Delphi method. On the basis of international experiences, publications, and experts' consensus, core competencies for hospital staff - as CBRN casualty receivers - were determined, and training curricula and delivery methods were defined. The course consists of 10 domains. These are as follows: threat identification; health effects of CBRN agents; planning; hospital incident command system; information management; safety, personal protective equipment and decontamination; medical management; essential resources; psychological support; and ethical considerations. Expected competencies for each domain were defined. A blended approach was chosen. By identifying a set of core competencies, this study aimed to provide the specific knowledge and skills required by medical staff to respond to CRBN emergencies. A blended approach may be a suitable delivery method, allowing medical staff to attend the same training sessions despite different time zones and locations. The study output provides a CBRN training scheme that may be adapted and used at the European Union level.

Narrative Construction, Social Perceptions, and the Situation Model.

Science.gov (United States)

Costabile, Kristi A

2016-05-01

The present investigation examined how three salient features of narrative thinking (situation model construction, linguistic concreteness, and perspective-taking) influenced the social inference process. Results of four experiments indicated that compared with those given other objectives, perceivers given narrative objectives were: (a) more likely to make situation rather than trait attributions for observed behaviors (Experiment 1), (b) less likely to make implicit trait inferences (Experiment 2), and (c) less likely to rely on behavior valence when making evaluative judgments (Experiment 4). Linguistic analyses indicated that narrative construction consistently entailed the creation of situation models of events and linguistic concreteness, but only situation model creation mediated the relationship between narrative and inferences. Experiment 3 confirmed the mediating role of situation models: Perceivers with narrative objectives made trait inferences only when behaviors were inconsistent with contextual information. The role of these core narrative features on social perceptions is discussed. © 2016 by the Society for Personality and Social Psychology, Inc.

77 FR 52746 - Medical Countermeasures for a Burn Mass Casualty Incident

Science.gov (United States)

2012-08-30

... Building 1 where routine security check procedures will be performed. For parking and security information... telephone number. Those without Internet access should contact Suzanne Schwartz to register (see Contact... Internet at http://www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/default.htm . (Select this...

Bomb blast mass casualty incidents: initial triage and management of injuries.

Science.gov (United States)

Goh, S H

2009-01-01

Bomb blast injuries are no longer confined to battlefields. With the ever present threat of terrorism, we should always be prepared for bomb blasts. Bomb blast injuries tend to affect air-containing organs more, as the blast wave tends to exert a shearing force on air-tissue interfaces. Commonly-injured organs include the tympanic membranes, the sinuses, the lungs and the bowel. Of these, blast lung injury is the most challenging to treat. The clinical picture is a mix of acute respiratory distress syndrome and air embolism, and the institution of positive pressure ventilation in the presence of low venous pressures could cause systemic arterial air embolism. The presence of a tympanic membrane perforation is not a reliable indicator of the presence of a blast injury in the other air-containing organs elsewhere. Radiological imaging of the head, chest and abdomen help with the early identification of blast lung injury, head injury, abdominal injury, eye and sinus injuries, as well as any penetration by foreign bodies. In addition, it must be borne in mind that bomb blasts could also be used to disperse radiological and chemical agents.

Situational Analysis and Engineering Work Practices

DEFF Research Database (Denmark)

Buch, Anders; Andersen, Vibeke

2013-01-01

boundaries in order to investigate the dynamics of cultural reproduction in expert work practices. The paper will propose a new research agenda that – inspired by George Marcus’ multi-sited ethnographic methodology (Marcus 1998) and Adele Clarke’s situational analysis (Clarke 2005) – analyze (and contrasts...... of analysis and allowing the situation to be scalable. Likewise, it aspires to overcome the widespread dualism of ‘text’ and ‘con-text’ that pervades contemporary social science methods. We will argue that expert work practices – although reproduced and enacted in local settings – are also enactments......Studies of work practices of scientists and engineers inspired by Science and Technology Studies (STS) provide new material for a richer understanding of expert cultures and expert work practices. However, the specific and strictly situated focus of many of these studies threatens to limit...

Representing Operational Modes for Situation Awareness

DEFF Research Database (Denmark)

Kirchhübel, Denis; Lind, Morten; Ravn, Ole

2017-01-01

reasonable reactions to abnormal situations. Intelligent computational support tools can make the operator's task easier, but they require knowledge about the overall system in form of some model. While tools used for fault-tolerant control design based on physical principles and relations are valuable tools...... for designing robust systems, the models become too complex when considering the interactions on a plant-wide level. The alarm systems meant to support human operators in the diagnosis of the plant-wide situation on the other hand fail regularly in situations where these interactions of systems lead to many...... the interconnected systems can be inferred and alarm floods can potentially be reduced to their root-cause. However, the desired behaviour of a complex system changes due to operating procedures that require more than one physical and functional configuration. In this paper a consistent representation of possible...

A improved Network Security Situation Awareness Model

Directory of Open Access Journals (Sweden)

Li Fangwei

2015-08-01

Full Text Available In order to reflect the situation of network security assessment performance fully and accurately, a new network security situation awareness model based on information fusion was proposed. Network security situation is the result of fusion three aspects evaluation. In terms of attack, to improve the accuracy of evaluation, a situation assessment method of DDoS attack based on the information of data packet was proposed. In terms of vulnerability, a improved Common Vulnerability Scoring System (CVSS was raised and maked the assessment more comprehensive. In terms of node weights, the method of calculating the combined weights and optimizing the result by Sequence Quadratic Program (SQP algorithm which reduced the uncertainty of fusion was raised. To verify the validity and necessity of the method, a testing platform was built and used to test through evaluating 2000 DAPRA data sets. Experiments show that the method can improve the accuracy of evaluation results.

Situated learning and interacting with/through technologies

DEFF Research Database (Denmark)

Raudaskoski, Pirkko Liisa

2006-01-01

There is a growing interest within social and humanistic sciences towards understanding practice theoretically and analytically. Lave and Wenger’s concept “situated learning” describes the process of newcomers moving toward full participation in a community. Wenger later refined his approach in h...... practices. The interdisciplinary interaction analysis (IA) is suggested as the best way to study the various aspects of situated learning in technology-intensive interactions.......There is a growing interest within social and humanistic sciences towards understanding practice theoretically and analytically. Lave and Wenger’s concept “situated learning” describes the process of newcomers moving toward full participation in a community. Wenger later refined his approach in his...... book ‘Communities of practice: Learning, meaning and identity’. Situated learning is equalled with social order: instead of understanding learning as a separate practice from everyday life, learning is seen as a more mundane phenomenon. It is sometimes difficult to operationalize Lave and Wenger...

Diagnostic orientation in control of disturbance situations

International Nuclear Information System (INIS)

Hukki, K.; Norros, L.

1993-01-01

The object of the study is diagnostic judgement in the control of dynamic processes. The starting point was the known difficulty process operators have in utilizing knowledge of process dynamics in disturbance situations that require both diagnostic and prognostic actions. A model of the diagnostic judgement process as a construction of coherent interpretation of the situation is outlined, and comprehensive data from simulated disturbance handling by 6 crews of a PWR type nuclear power plant was analysed. The phase of analysis included evaluation of the adequacy of task performance, utilization of available process information, and evaluation of the interpretation of disturbance situations. The results suggest that a functional orientation towards task performance allows a more coherent and comprehensive interpretation of the situation and more adequate task performance. Coherence of interpretation seems to be reflected in a higher subjective certainty compared with crews with an incoherent interpretation. (author). 15 refs, 2 figs, 2 tabs

Continuous measures of situation awareness and workload

International Nuclear Information System (INIS)

Droeivoldsmo, Asgeir; Skraaning, Gyrd jr.; Sverrbo, Mona; Dalen, Joergen; Grimstad, Tone; Andresen, Gisle

1998-03-01

This report presents methods for continuous measures for Situation Awareness and Workload. The objective has been to identify, develop and test the new measures, and compare them to instruments that require interruptions of scenarios. The new measures are: (1) the Visual Indicator of Situation Awareness (VISA); where Situation Awareness is scored from predefined areas of visual interest critical for solving scenarios. Visual monitoring of areas was recorded by eye-movement tracking. (2) Workload scores reflected by Extended Dwell Time (EDT) and the operator Activity Level. EDT was calculated from eye-movement data files, and the activity level was estimated from simulator logs. Using experimental data from the 1996 CASH NRC Alarm study and the 1997 Human Error Analysis Project/ Human-Centred Automation study, the new measurement techniques have been tested and evaluated on a preliminary basis. The results showed promising relationships between the new continuous measures of situation awareness and workload, and established instruments based upon scenario interruptions. (author)

The Situated Nature of Preschool Children's Conflict Strategies

OpenAIRE

Thornberg, Robert

2006-01-01

The purpose of this study was to examine whether the peer conflict strategies of preschool children are situated and therefore vary across different conflict situations. Hypothetical conflict interviews were administered through a series of puppet shows. Participants were 178 preschool children. Results indicate that preschool children's conflict management skills are situated in peer conflict, because their strategies are to a greater or lesser degree influenced by the opponent's strategies....

A Critical Systems Metamethodology for Problem Situation Structuring

OpenAIRE

Slavica P. Petrovic

2012-01-01

The increasing complexity and diversity of management problem situations in organizations, as well as the increasing variety of theories, methodologies, methods, techniques, and models that can be employed in problem situation structuring and solving, must be considered as relevant aspects of management process in contemporary circumstances. Creative holism in management problem situations in organizations is enabled by means of Critical Systems Thinking (CST) as well as Critical Systems Prac...

Recognition of risk situations based on endoscopic instrument tracking and knowledge based situation modeling

Science.gov (United States)

Speidel, Stefanie; Sudra, Gunther; Senemaud, Julien; Drentschew, Maximilian; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

2008-03-01

Minimally invasive surgery has gained significantly in importance over the last decade due to the numerous advantages on patient-side. The surgeon has to adapt special operation-techniques and deal with difficulties like the complex hand-eye coordination, limited field of view and restricted mobility. To alleviate these constraints we propose to enhance the surgeon's capabilities by providing a context-aware assistance using augmented reality (AR) techniques. In order to generate a context-aware assistance it is necessary to recognize the current state of the intervention using intraoperatively gained sensor data and a model of the surgical intervention. In this paper we present the recognition of risk situations, the system warns the surgeon if an instrument gets too close to a risk structure. The context-aware assistance system starts with an image-based analysis to retrieve information from the endoscopic images. This information is classified and a semantic description is generated. The description is used to recognize the current state and launch an appropriate AR visualization. In detail we present an automatic vision-based instrument tracking to obtain the positions of the instruments. Situation recognition is performed using a knowledge representation based on a description logic system. Two augmented reality visualization programs are realized to warn the surgeon if a risk situation occurs.

Cooperative Games arising from Information Sharing Situations

NARCIS (Netherlands)

Brânzei, R.; Tijs, S.H.; Timmer, J.B.

2000-01-01

Relations are established between information sharing (IS) situations and IS-games on one hand and information collecting (IC) situations and IC-games on the other hand. It is shown that IC-games can be obtained as convex combinations of so-called local games. Properties are described which IC-games

Situational Influences on Reactions to Observed Violence.

Science.gov (United States)

Berkowitz, Leonard

1986-01-01

Examines data on what situational factors influence people's desire to view violent television programming. Surveys research on the effects on viewer's behavior of the presence of other observers, the nature of the available target, situational features operating as retrieval cues, the viewers' interpretations of the violent scenes, and the…

Management by Grid Principles or Situationalism: Which?

Science.gov (United States)

Blake, Robert R.; Mouton, Jane S.

1981-01-01

Attempts to resolve the leadership theory controversy between situationalism and the one-best-way approach. Indicates the validity of the latter and the lack of predictive value of the former. Results indicated administrators chose the 9,9 alternative and rejected situationally prescribed answers, reflecting a management by principles (behavioral…

GAMBIT : Integrated Programme of Road Safety Improvement in Poland : some observations about the road safety situation in Poland, about the structure of the GAMBIT programme and about programme components.

NARCIS (Netherlands)

Wegman, F.C.M.

1996-01-01

The GAMBIT team produced a draft version of the final GAMBIT report. This report discusses this draft. It is explained in the report why there has been an increase in the number of road accident casualties in Poland in recent years. A politically sanctioned National Road Safety Plan can make a

Operational guidance for radiation emergency response organisations in Europe for using biodosimetric tools developed in EU MULTIBIODOSE project.

Science.gov (United States)

Jaworska, Alicja; Ainsbury, Elizabeth A; Fattibene, Paola; Lindholm, Carita; Oestreicher, Ursula; Rothkamm, Kai; Romm, Horst; Thierens, Hubert; Trompier, Francois; Voisin, Philippe; Vral, Anne; Woda, Clemens; Wojcik, Andrzej

2015-04-01

In the event of a large-scale radiological emergency, the triage of individuals according to their degree of exposure forms an important initial step of the accident management. Although clinical signs and symptoms of a serious exposure may be used for radiological triage, they are not necessarily radiation specific and can lead to a false diagnosis. Biodosimetry is a method based on the analysis of radiation-induced changes in cells of the human body or in portable electronic devices and enables the unequivocal identification of exposed people who should receive medical treatment. The MULTIBIODOSE (MBD) consortium developed and validated several biodosimetric assays and adapted and tested them as tools for biological dose assessment in a mass-casualty event. Different biodosimetric assays were validated against the 'gold standard' of biological dosimetry-the dicentric assay. The assays were harmonised in such a way that, in an emergency situation, they can be run in parallel in a network of European laboratories. The aim of this guidance is to give a concise overview of the developed biodosimetric tools as well as how and when they can be used in an emergency situation. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Towards an ethical theory in disaster situations.

Science.gov (United States)

Mallia, Pierre

2015-02-01

Health Care professionals working in disaster situations have to face urgent choices which diverge from their normal deontological ethos and are more utilitarian. Such is the triage system used to choose whom to treat. Instead of entering a crisis these professionals should be thought that ethics is not harmonizable to all situations and that there are situations in which saving as many lives as possible mean sacrificing others. This calls for defining a perimeter zone in which such choices occur, and a time frame (a space-time niche) in which it ought to be considered ethical and legitimate to use such value laden choices.

6 CFR 25.5 - Obligations of seller.

Science.gov (United States)

2010-01-01

... liability insurance required, the Under Secretary may consider any factor, including, but not limited to... liability insurance offered on the world market; (vi) Data and history regarding mass casualty losses; (vii... price of the product, and the possible consequences thereof for development, production, or deployment...

Fundamental situations in teaching biology: The case of parthenogenesis

Directory of Open Access Journals (Sweden)

Robert Evans

2012-06-01

Full Text Available This theoretical paper considers the notion of fundamental situation in the sense of Brousseau’s theory of didactical situations. It introduces some precise elements of this theory in which a teacher provides an environment for student work that aims to enable students, through constructive inquiry, to acquire well defined pieces of scientific knowledge. Situations become fundamental if they not only allow, but force students to construct the target knowledge. A classical example from mathematics is presented, where the target knowledge is a theorem of plane geometry presented as a puzzle. Then a new fundamental situation in biology is described for parthenogenetic reproduction, which has recently turned out to occur in Komodo dragons. An explicit demand to generate and test hypotheses that could explain the given example of dragon reproduction, using authentic DNA data, is given to students. The paper concludes with an analysis of the extent to which this fundamental situation in biology is authentic to the theory of didactical situations.

A situational approach to the measurement of safety culture

International Nuclear Information System (INIS)

Semmer, N.; Regennass, A.

1997-01-01

Values and social norms are the main target of most approaches to the study of safety culture and many existing survey methodologies directly ask for these norms and values. However, a number of considerations point to the dangers of limiting the evaluation of safety culture to the analysis of these responses. Therefore the necessity is stressed to also consider how actual situations activate norms and behaviours. This relates to the fact that in any given situation both aspects of the appraisal of reality are present: the objective definition of the situation and its personal evaluation. The latter not only reflects the ''official'' norms and values but also ''basic underlying assumptions''. The situational approach introduced in this paper confronts people with situations which contain a dilemma with conflicting social norms and where various costs and benefits are associated with different types of behaviour. In addition, the prerequisites and limitations of the situational approach are discussed. (author). 9 refs, 1 fig

Energy situation november 2002

International Nuclear Information System (INIS)

2002-12-01

The monthly situation analysis in France is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

Energy situation August 2002

International Nuclear Information System (INIS)

2002-09-01

The monthly situation analysis in France is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

Existential vulnerability: toward a psychopathology of limit situations.

Science.gov (United States)

Fuchs, Thomas

2013-01-01

Jaspers' concept of limit situations seems particularly appropriate not only to elucidate outstanding existential situations in general, but also basic preconditions for the occurrence of mental disorders. For this purpose, the concept is first explained in Jaspers' sense and then related to an 'existential vulnerability' of mentally ill persons that makes them experience even inconspicuous events as distressing limit situations. In such situations, an otherwise hidden fundamental condition of existence becomes manifest for them, e.g. the fragility of one's own body, the inevitability of freedom, or the finiteness of life. This fundamental condition is found unbearable and, as a reaction, gives rise to mental illness. This concept of existential vulnerability is illustrated by some psychopathological examples. © 2013 S. Karger AG, Basel.

Perceptions and attitudes of students of mass communication toward mental illness in Nigerian Tertiary Institution

OpenAIRE

Lateef Olutoyin Oluwole; Adetunji Obadeji; Mobolaji Usman Dada

2016-01-01

Background: The power of the modern mass media is not limited to its ability to communicate information and entertain but derives primarily from its ability to define situations, thereby enabling it to construct social reality. Stigma is related to negative stereotyping and prejudicial attitudes that in turn lead to discriminatory practices. Aims: The study sought to know the perceptions of and attitudes of mass communication students towards mental illness and the mentally ill. Settings and ...

Situational Awareness and Logistics Division

Data.gov (United States)

Federal Laboratory Consortium — Volpe's Situational Awareness and Logistics Division researches, develops, implements, and analyzes advanced systems to protect, enhance, and ensure resilienceof the...

Investigating Situational Interest in Primary Science Lessons

Science.gov (United States)

Loukomies, Anni; Juuti, Kalle; Lavonen, Jari

2015-01-01

Pupils' interest has been one of the major concerns in science education research because it can be seen as a gateway to more personalised forms of interest and motivation. However, methods to investigate situational interest in science teaching and learning are not broadly examined. This study compares the pupils' observed situational interest…

Practicing discernment: pastoral care in crisis situations.

Science.gov (United States)

Landes, Scott D

2010-01-01

This article correlates a particular experience of providing pastoral care for a person in a crisis situation with a particular understanding of the practice of pastoral care. Through engaging in correlative practical theology, it highlights the need for practicing discernment when providing pastoral care for persons utilizing narratives to work through crisis situations.

A Goal-Function Approach to Analysis of Control Situations

DEFF Research Database (Denmark)

Lind, Morten

2010-01-01

The concept of situations plays a central role in all theories of meaning and context. and serve to frame or group events and other occurrences into coherent meaningful wholes. Situations are typed, may be interconnected and organized into higher level structures. In operation of industrial...... processes situations should identify operational aspects relevant for control agent’s decision making in plant supervision and control. Control situations can be understood as recurrent and interconnected patterns of control with important implications for control and HMI design. Goal-Function approaches...

The Farm Credit Situation: Implications for Agricultural Policy.

Science.gov (United States)

Bullock, J. Bruce

1986-01-01

Examines issues regarding current farm finance situation from a public policy perspective: origins and causes of current situation, available policy options for dealing with the problems, and impacts of policy options. (NEC)

Hippocampal frequency shifts in different behavioural situations

NARCIS (Netherlands)

Kamp, A.; Lopes da Silva, F.H.; Storm van Leeuwen, W.

1971-01-01

Electrical activity of the dog's hippocampus was recorded in (a) an operant behaviour situation, and (b) a field situation by a radio-telemetering system. The dominant frequency of the theta rhythm shifted consistently from 4–5 c/sec to 6–7 c/sec when a dog (a) withdrew from a pedal after being

FOSTERING AND DEVELOPMENT OF MULTICULTURALISM VIA SITUATIVE VOCABULARIES

Directory of Open Access Journals (Sweden)

О В Львова

2017-12-01

Full Text Available The search for ways and means of fostering and development of multiculturalism is now of great importance for the world community. Situational vocabulary was previously proposed by the author as an ICT tool for fostering and development of communicative competence in foreign language. They contain lexical structures used in specific communicative situations, as well as modern ICT tools (blogs, chats, forums, mail, etc. to supplement already gained data and to discuss the ways and situations of use of various linguistic constructions or meanings of the words. Further study of the possibilities and ways of application of the instrument showed that students are not able to choose a relevant form for certain situations, or they lack or do not know the appropriate words and expressions, both in native and in a foreign language. In addition, the incorrect use of certain words or expressions in the situation may be regarded by representatives of other cultures as rude or disrespectful. The peculiarity of the method offered by the author is based on the idea of using situational vocabularies for gaining information and study of various linguistic and cultural aspects of the host country and other countries. In addition, the interaction in the familiar for learners ICT space motivates them and increase the effectiveness of such activities.

Applicability of hybrid linear ion trap-high resolution mass spectrometry and quadrupole-linear ion trap-mass spectrometry for mycotoxin analysis in baby food.

Science.gov (United States)

Rubert, Josep; James, Kevin J; Mañes, Jordi; Soler, Carla

2012-02-03

Recent developments in mass spectrometers have created a paradoxical situation; different mass spectrometers are available, each of them with their specific strengths and drawbacks. Hybrid instruments try to unify several advantages in one instrument. In this study two of wide-used hybrid instruments were compared: hybrid quadrupole-linear ion trap-mass spectrometry (QTRAP®) and the hybrid linear ion trap-high resolution mass spectrometry (LTQ-Orbitrap®). Both instruments were applied to detect the presence of 18 selected mycotoxins in baby food. Analytical parameters were validated according to 2002/657/CE. Limits of quantification (LOQs) obtained by QTRAP® instrument ranged from 0.45 to 45 μg kg⁻¹ while lower limits of quantification (LLOQs) values were obtained by LTQ-Orbitrap®: 7-70 μg kg⁻¹. The correlation coefficients (r) in both cases were upper than 0.989. These values highlighted that both instruments were complementary for the analysis of mycotoxin in baby food; while QTRAP® reached best sensitivity and selectivity, LTQ-Orbitrap® allowed the identification of non-target and unknowns compounds. Copyright © 2011 Elsevier B.V. All rights reserved.

Radiation. Basics, influences, contamination situation, and countermeasures

International Nuclear Information System (INIS)

Baba, Mamoru; Nomura, Kiyoshi

2012-01-01

Fukushima Daiichi Nuclear Accident resulted in the contamination of a large area, and by now the situation of contamination and exposure has gradually clarified, and a lot of information has been being accumulated. Toward reconstruction of Fukushima prefecture from the current circumstance that the residents still live under continuing fear, this article discusses how to clarify the current situation and deal with the contamination, which the residents are concerned about. First, radiation, basic properties of radiation, and so on are introduced. Regarding the influence on human bodies, the mechanism and the degree of influence by radiation, especially on children, women, and pregnant women are explained. Next, regarding the measurements of radiation and radioactivity, the properties of measurement methods and the detectors are explained. Regarding the current situation of contamination and exposure, mainly addressing the area around Koriyama city, various topics are covered including: (1) situation of contamination and radiation monitoring, (2) countermeasures for radioactivity contamination, (3) internal exposure dose, (4) exposed dose from water and food, as well as (5) safety standards. (S.K.)

Conflict Resolution Automation and Pilot Situation Awareness

Science.gov (United States)

Dao, Arik-Quang V.; Brandt, Summer L.; Bacon, Paige; Kraut, Josh; Nguyen, Jimmy; Minakata, Katsumi; Raza, Hamzah; Rozovski, David; Johnson, Walter W.

2010-01-01

This study compared pilot situation awareness across three traffic management concepts. The Concepts varied in terms of the allocation of traffic avoidance responsibility between the pilot on the flight deck, the air traffic controllers, and a conflict resolution automation system. In Concept 1, the flight deck was equipped with conflict resolution tools that enable them to fully handle the responsibility of weather avoidance and maintaining separation between ownship and surrounding traffic. In Concept 2, pilots were not responsible for traffic separation, but were provided tools for weather and traffic avoidance. In Concept 3, flight deck tools allowed pilots to deviate for weather, but conflict detection tools were disabled. In this concept pilots were dependent on ground based automation for conflict detection and resolution. Situation awareness of the pilots was measured using online probes. Results showed that individual situation awareness was highest in Concept 1, where the pilots were most engaged, and lowest in Concept 3, where automation was heavily used. These findings suggest that for conflict resolution tasks, situation awareness is improved when pilots remain in the decision-making loop.

Enriching Mental Health Mobile Assessment and Intervention with Situation Awareness.

Science.gov (United States)

Soares Teles, Ariel; Rocha, Artur; José da Silva E Silva, Francisco; Correia Lopes, João; O'Sullivan, Donal; Van de Ven, Pepijn; Endler, Markus

2017-01-10

Current mobile devices allow the execution of sophisticated applications with the capacity for identifying the user situation, which can be helpful in treatments of mental disorders. In this paper, we present SituMan , a solution that provides situation awareness to MoodBuster , an ecological momentary assessment and intervention mobile application used to request self-assessments from patients in depression treatments. SituMan has a fuzzy inference engine to identify patient situations using context data gathered from the sensors embedded in mobile devices. Situations are specified jointly by the patient and mental health professional, and they can represent the patient's daily routine (e.g., "studying", "at work", "working out"). MoodBuster requests mental status self-assessments from patients at adequate moments using situation awareness. In addition, SituMan saves and displays patient situations in a summary, delivering them for consultation by mental health professionals. A first experimental evaluation was performed to assess the user satisfaction with the approaches to define and identify situations. This experiment showed that SituMan was well evaluated in both criteria. A second experiment was performed to assess the accuracy of the fuzzy engine to infer situations. Results from the second experiment showed that the fuzzy inference engine has a good accuracy to identify situations.

Enriching Mental Health Mobile Assessment and Intervention with Situation Awareness

Directory of Open Access Journals (Sweden)

Ariel Soares Teles

2017-01-01

Full Text Available Current mobile devices allow the execution of sophisticated applications with the capacity for identifying the user situation, which can be helpful in treatments of mental disorders. In this paper, we present SituMan, a solution that provides situation awareness to MoodBuster, an ecological momentary assessment and intervention mobile application used to request self-assessments from patients in depression treatments. SituMan has a fuzzy inference engine to identify patient situations using context data gathered from the sensors embedded in mobile devices. Situations are specified jointly by the patient and mental health professional, and they can represent the patient’s daily routine (e.g., “studying”, “at work”, “working out”. MoodBuster requests mental status self-assessments from patients at adequate moments using situation awareness. In addition, SituMan saves and displays patient situations in a summary, delivering them for consultation by mental health professionals. A first experimental evaluation was performed to assess the user satisfaction with the approaches to define and identify situations. This experiment showed that SituMan was well evaluated in both criteria. A second experiment was performed to assess the accuracy of the fuzzy engine to infer situations. Results from the second experiment showed that the fuzzy inference engine has a good accuracy to identify situations.

Caricatural Imagery in the Mass Media. Research Report, Vol. 9, No. 2.

Science.gov (United States)

Streicher, Lawrence H.

Caricature and its distortion of reality as developed in the mass press are discussed in relation to the appearance of caricatural elements in other media, such as radio and television. High frequency of appearances of these distorted roles and situations might lead to viewers' perceptual rigidity in typing of characters in general, but might have…

The situational interest of undergraduate students in zoophysiology

DEFF Research Database (Denmark)

Dohn, Niels Bonderup; Madsen, Peter Teglberg; Malte, H.

2009-01-01

Situational interest has been identified as an important motivational variable that has an impact on students' academic performances, yet little is known about how the specific variable of the learning environment might trigger students' situational interest. The purpose of this study...... of the faculty and should be considered when planning instruction. By focusing on the enhancement of situational interest in physiology lessons, faculty members can find ways to foster students' involvement in specific content areas and increase levels of academic motivation...

Risk Analysis for Environmental Health Triage

International Nuclear Information System (INIS)

Bogen, K T

2005-01-01

The Homeland Security Act mandates development of a national, risk-based system to support planning for, response to and recovery from emergency situations involving large-scale toxic exposures. To prepare for and manage consequences effectively, planners and responders need not only to identify zones of potentially elevated individual risk, but also to predict expected casualties. Emergency response support systems now define ''consequences'' by mapping areas in which toxic chemical concentrations do or may exceed Acute Exposure Guideline Levels (AEGLs) or similar guidelines. However, because AEGLs do not estimate expected risks, current unqualified claims that such maps support consequence management are misleading. Intentionally protective, AEGLs incorporate various safety/uncertainty factors depending on scope and quality of chemical-specific toxicity data. Some of these factors are irrelevant, and others need to be modified, whenever resource constraints or exposure-scenario complexities require responders to make critical trade-off (triage) decisions in order to minimize expected casualties. AEGL-exceedance zones cannot consistently be aggregated, compared, or used to calculate expected casualties, and so may seriously misguide emergency response triage decisions. Methods and tools well established and readily available to support environmental health protection are not yet developed for chemically related environmental health triage. Effective triage decisions involving chemical risks require a new assessment approach that focuses on best estimates of likely casualties, rather than on upper plausible bounds of individual risk. If risk-based consequence management is to become a reality, federal agencies tasked with supporting emergency response must actively coordinate to foster new methods that can support effective environmental health triage

Big data for space situation awareness

Science.gov (United States)

Blasch, Erik; Pugh, Mark; Sheaff, Carolyn; Raquepas, Joe; Rocci, Peter

2017-05-01

Recent advances in big data (BD) have focused research on the volume, velocity, veracity, and variety of data. These developments enable new opportunities in information management, visualization, machine learning, and information fusion that have potential implications for space situational awareness (SSA). In this paper, we explore some of these BD trends as applicable for SSA towards enhancing the space operating picture. The BD developments could increase in measures of performance and measures of effectiveness for future management of the space environment. The global SSA influences include resident space object (RSO) tracking and characterization, cyber protection, remote sensing, and information management. The local satellite awareness can benefit from space weather, health monitoring, and spectrum management for situation space understanding. One area in big data of importance to SSA is value - getting the correct data/information at the right time, which corresponds to SSA visualization for the operator. A SSA big data example is presented supporting disaster relief for space situation awareness, assessment, and understanding.

Situation awareness system for Canada

Science.gov (United States)

Hill, Andrew

1999-07-01

Situation awareness encompasses a knowledge of orders, plans and current knowledge of friendly force actions. Knowing where you are and being able to transmit that information in near real-time to other friendly forces provides the ability to exercise precise command and control over those forces. With respect to current command and control using voice methods, between 40 percent and 60 percent of Combat Net Radio traffic relates to location reporting of some sort. Commanders at Battle Group and below spend, on average, 40 percent of their total time performing position and navigation related functions. The need to rapidly transfer own force location information throughout a force and to process the received information quickly, accurately and reliably provides the rationale for the requirement for an automated situation awareness system. This paper describes the Situation Awareness System (SAS) being developed by Computing Devices Canada for the Canadian Department of National Defence as a component of the Position Determination and Navigation for Land Forces program. The SAS is being integrated with the Iris Tactical Command, Control, Communications System, which is also being developed by Computing Devices. The SAS software provides a core operating environment onto which command and control functionality can be easily added to produce general and specialist battlefield management systems.

Energy situation, January 2006

International Nuclear Information System (INIS)

2006-03-01

The monthly energy situation analysis in France, at January 2006, is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

Energy situation november 2005

International Nuclear Information System (INIS)

2005-12-01

The monthly energy situation analysis in France at November 2005 is presented. Statistics are given for energy consumption, demand, import and export. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

Energy situation July 2004

International Nuclear Information System (INIS)

2004-08-01

The monthly energy situation in France at july 2004 is presented. Statistics are given on energy accounting, imports, exports, energy prices. A special attention is given to the primary energy, the solid fuels, the petroleum products, the natural gas and the electric power. (A.L.B.)

Turning Chaos into Order : Preparedness, Concepts and Lessons Learned in Disaster Medicine

NARCIS (Netherlands)

Haverkort, J. J Mark

2016-01-01

Optimal care for a sudden, unexpected large number of victims from a mass casualty incident (MCI) is demanding and challenging for every healthcare system. It requires paradigm shift from regular trauma care. Instead of focusing on the individual patient with unlimited resources the focus of care

75 FR 39437 - Optimizing the Security of Biological Select Agents and Toxins in the United States

Science.gov (United States)

2010-07-08

... agents and toxins with the potential to pose a severe threat to public health and safety, animal and... mass casualties or devastating effects to the economy, critical infrastructure, or public confidence... establishment of appropriate practices for physical security and cyber security for facilities that possess Tier...

Rural casualty crashes on the Kings Highway: A new approach for road safety studies.

Science.gov (United States)

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

2016-10-01

This paper will consider the contribution that changes in road geometry and driver visual information make to the incidence and distribution of road casualties in different driving environments. This relationship will be explored specifically for the Kings Highway, a major arterial road connecting Queanbeyan with coastal southern New South Wales, Australia. It introduces and suggests a new empirical approach of plotting crashes with road segmentation, calculating sinuosity indices and grades as key features of road geometry, and critical visual points as a behavioural component of road curvature, within a GIS context. It is an approach that might be used when detailed road geometry data is not available. The visualisation and segmentation approach in this research might be used for summarising crash rates and road geometry factors, and for comparing day/night and eastbound/westbound driving conditions. The results suggest some early interpretations for detailed road safety studies that might be considered at local or national levels. The rate of crashes increases according to changes in road geometry factors during the day and for eastbound travel. This is not the case for night driving where the incidence of crashes is similar on both straight and curved roads segments due to the headlight effect and limited background visual field. Crash clusters at day-time may be due to the stronger effect of road geometry (e.g. combination of curvature and vertical grade) on driver behaviour travelling eastbound. The outcomes suggest that it might be essential to consider the effect of environmental factors in any road safety and crash analysis studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

Disadvantageous Situation of Retail Investors in Equity Crowdfunding

Institute of Scientific and Technical Information of China (English)

Shuanglong Wan

2017-01-01

This essay focuses on the onerous situation of retail investors in the proliferating equity crowdfunding. It points out and explains in detail four aspects of situation: insufficient information, misleading information, weak bargaining power and low liqui

Nuclear situation in Japan; La situation du nucleaire au Japon

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-07-01

This analysis takes stock on the nuclear situation in Japan. It discusses the ambitious equipment program in collaboration with the France, the destabilization of the japanese nuclear industry following the accidents and the energy policy evolutions. It presents the projects of the japanese nuclear industry: the Monju reactor restart, the Pluthermal project, the reprocessing power plant of Rokkasho Mura, the new reactors, the russian weapons dismantling, the ITER site selection and the buy out of Westinghouse by Toshiba. (A.L.B.)

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

Directory of Open Access Journals (Sweden)

K Asish

2016-01-01

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

Developing disaster management modules: a collaborative approach.

Science.gov (United States)

Douglas, Valerie

Disasters, whether natural or human induced, can strike when least expected. The events of 9/11 in the US, the 7/7 bombings in the UK, and the anthrax incident in the US on 10th October 2001 indicate that there is a need to have a nursing workforce who is able to respond effectively to mass casualty events and incidents involving chemical, biological, radiological and nuclear substances. Multi-agency collaboration is one of the fundamental principles of disaster preparedness and response. It was therefore necessary to take a similar multi-agency collaborative approach to develop modules on the management of mass casualty events and incidents involving hazardous substances. The modules are offered to registered nurses and registered paramedics. They can be taken independently or as part of a BSc in nursing or health pathway, on a part-time basis. Since the commencement of the modules in September 2004, registered paramedics and registered nurses who work in a wide range of specialties have accessed them.