scholarly journals (P2-40) Patient Allocation to Hospitals During Mass-Casualty Incidents

2011 ◽  
Vol 26 (S1) ◽  
pp. s148-s149 ◽  
Author(s):  
K. Ruettger ◽  
W. Lenz
Keyword(s):  
Emergency Response ◽  
Operations Management ◽  
Low Frequency ◽  
Working Hours ◽  
Cost Effective ◽  
Mass Casualty ◽  
Rescue Service ◽  
Hospital Facility ◽  
State Register ◽  
Helicopter Landing

Due to the limited resources of specialized hospital departments, the allocation of patients to different hospitals according to severity is an extraordinarily complex and time-critical problem. The emergency capacity was determined for all medical centers (n = 135) in the State of Hessen, Germany, for patients of various triage categories (red, yellow, green) during normal working hours, and during weekends and nights and included logistic specifications of a potential helicopter landing. These data were entered into a state register. Using the data from the “acute-care-register”, a Ticket System was developed that allows operations management to assign patients according to the severity of their condition, urgency, and specialization requirements (e.g., neurosurgery, ophthalmology, pediatrics) to a hospital without exceeding the admission and/or treatment capacity of the hospital/facility. During a non-critical period, the order of allocations depending on the distance from the clinic is planned in advance so that no further modifications are necessary during the acute intervention phase of an emergency response. Additional notification of hospital capacities for severe casualties provided during the emergency response can be easily and immediately supplemented. Due to the relatively low frequency of such emergency responses, a cost-effective concept that is easily adaptable to the respective fields of application was decided upon. The system is a sticker set customized for the respective rescue teams. The sets will be carried permanently in the rescue equipment by the organization manager of the rescue service team. The equipment is not dependent on electronic components. The cost per sticker set is approximately US$50. Keeping track of the patient allocations is assured.

scholarly journals (P2-9) Patient Allocation to Hospitals During Mass-Casualty Incidents

2011 ◽  
Vol 26 (S1) ◽  
pp. s138-s138 ◽  
Author(s):  
K. Ruettger ◽  
W. Lenz
Keyword(s):  
Emergency Response ◽  
Operations Management ◽  
Low Frequency ◽  
Working Hours ◽  
Cost Effective ◽  
Mass Casualty ◽  
Rescue Service ◽  
Hospital Facility ◽  
State Register ◽  
Helicopter Landing

Due to the limited resources of specialized hospital departments, the allocation of patients to different hospitals according to the severity of their condition is an extraordinarily complex and time-critical problem. The emergency capacity was determined for all medical centers (n = 135) in the State of Hessen, for patients of the various hospitalization triage categories (red, yellow, green), for normal working hours, for weekends and nights, including logistic specifications of a potential helicopter landing. This data was entered into a state register. Using the data from the “acute-care-register”, a Ticket System was developed that allows the operations management to assign patients according to the severity of their condition, urgency and necessary specialization (e.g., neurosurgery, ophthalmology, pediatrics) to a hospital without exceeding the admission and/or treatment capacity of the hospital/facility. During a non-critical period, the order of allocations depending on the distance of the clinic to the site of the emergency is planned in advance so that no further modifications are necessary during the acute intervention phase of an emergency response. Additional notification of hospital capacities for severe casualties provided during the emergency response can be easily and immediately supplemented. Due to the relatively low frequency of such emergency responses, a cost-effective concept that is easily adaptable to the respective fields of application has been discovered. The system is a sticker set customized for the respective rescue teams. The sets will be carried permanently in the rescue equipment by the organization manager of the rescue service team. The equipment is not dependent on electronic components. The cost per sticker set is approximately US$50. Keeping track of the patient allocations is assured.

Postexposure Interventions to Prevent Infection With HBV, HCV, or HIV, and Tetanus in People Wounded During Bombings and Other Mass Casualty Events—United States, 2008: Recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness

2008 ◽  
Vol 2 (3) ◽  
pp. 150-165 ◽  
Author(s):  
Louisa E. Chapman ◽  
Ernest E. Sullivent ◽  
Lisa A. Grohskopf ◽  
Elise M. Beltrami ◽  
Joseph F. Perz ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Emergency Response ◽  
Mass Casualty ◽  
Acute Injury ◽  
Mass Casualties ◽  
Public Health Preparedness ◽  
Mass Casualty Event ◽  
Public Health Officials ◽  
Centers For Disease Control

ABSTRACTPeople wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

scholarly journals New collaborations in daily emergency response

2015 ◽  
Vol 4 (2) ◽  
pp. 177-193 ◽  
Author(s):  
Åsa Weinholt ◽  
Tobias Andersson Granberg
Keyword(s):  
Home Care ◽  
Emergency Response ◽  
Situational Awareness ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Content Type ◽  
Rescue Service ◽  
Security Officers ◽  
Important Benefit ◽  
Home Care Nurses

Purpose – The purpose of this paper is to analyse costs and benefits from new collaborations in daily emergency response and to demonstrate how cost-benefit analysis (CBA) can be used for evaluating effects from these kinds of collaborations. Design/methodology/approach – CBA is used to evaluate two collaborations. The cases are: security officers that respond to fire and rescue service (FRS) calls; and home care nurses that assist the FRSs when they respond to urgent medical calls. Interviews, public documents and incident reports have been used as sources of data. Findings – Most costs are relatively straightforward to estimate. More difficult to estimate are the turn-out costs, including the services that cannot be performed when the new actors take on new assignments. One important benefit from these kinds of collaborations is reduced response time. Other benefits include increased situational awareness and improved preventive work in Case 1, as well as improved working conditions for the traditional resources and increased medical competence in Case 2. The analysis indicate that the case with the security officers most likely was socially beneficial, while the case with the home care nurses at the time of the study was not. Originality/value – The authors provide a thorough description and analysis of two interesting new ways of performing daily emergency response. Furthermore, the authors depict how CBA can be used to structure the analysis and evaluation of new initiatives in emergence services and how it can be used for identifying improvement potential. The authors also identify and discuss what is needed in terms of documentation as well as research, for it to be possible to improve the quantitative analysis of these kinds of initiatives.

Science-based solutions on the development of instructions for an emergency response plan for open-pit mines

2020 ◽  
pp. 84-98
Author(s):  
S. S. Kobylkin ◽  
A. S. Kobylkin ◽  
S. V. Balovtsev ◽  
A. R. Kharisov
Keyword(s):  
Emergency Response ◽  
Russian Federation ◽  
Initial Period ◽  
Open Pit ◽  
Open Pit Mining ◽  
Open Pit Mines ◽  
Rescue Service ◽  
Emergency Response Plan ◽  
The Russian Federation ◽  
Response Plan

At present, in the Russian Federation there are no legislatively approved recommendations on the procedure, structure and requirements for the design of an emergency response plan for coal open-pit mines. Therefore, the development of this document at the mining enterprises is carried out independently, coordinating it with emergency response services serving the hazardous production facility. The absence of regulatory documents forces the enterprise management to make decisions on the structure of the document, forms and its content. This can lead to errors in conducting mine rescue operations when attracting additional forces and means from other units of rescue units. The relevance of creating a single document for everyone to draw up a plan for the elimination of accidents at sections has been repeatedly noted at production meetings with the participation of scientists, specialists from surveillance services and representatives of rescue units. In order to increase the emergency preparedness of enterprises, on the basis of studies of the current regulatory documentation of Rostechnadzor, the EMERCOM of the Russian Federation, Mines Rescue Service and scientific literature, an algorithm was developed for compiling submarines for coal open-pit mines. The analysis of accidents at the coal open-pit mines of the country made it possible to create a list of types of accidents encountered. Based on this, instructions have been developed for the actions of all workers in the mine for the initial period in the event of an accident. Taking into account the existing standard forms for coal mines, the developed document forms for open pits were developed, this will make it possible to unify emergency rescue operations regarding the preparation of documents. Scientifically sound solutions can be used to develop a plan for the elimination of accidents in the future at all mining enterprises engaged in open mining. The results of the work expand knowledge in the field of safety of coal open pit mining.

The First Multilateral Well in Eastern Siberia on the Separated Oil Reservoirs

2021 ◽  
Author(s):  
Ruslan Fanisovich Gataullin ◽  
Stanislav Evgen’evich Ter-Saakov ◽  
Evgenij Vladimirovich Nikulin ◽  
Dmitriy Pavlovich Stifeev ◽  
Alexey Vyacheslavovich Filatov
Keyword(s):  
Low Frequency ◽  
Cost Effective ◽  
Drill String ◽  
Hole Drilling ◽  
Drill Bit ◽  
Eastern Siberia ◽  
Water Contact ◽  
Bottom Hole ◽  
Drilling Technology ◽  
Equipment Failures

Abstract This article describes engineering and technology solutions developed to successfully construct unconventional and unique horizontal well at the field of Eastern Siberia targeted to two isolated formations with an option to shut-off top Botuobinsky horizon after gas breakthrough and produce oil from underlying Ulakhansky bed further on. As oil-water contact in the lower part of Ulakhansky horizon makes fracturing the well inexpedient, multi hole drilling technology was implemented enabling drainage of the reserves that are far from the main borehole. The main objective of this well is to deplete Botuobinsky horizon subsequently shutting it off and continuing to recover petroleum reserves from Ulakhansky pay zone. Constructing such well is cost-effective, as it requires drilling only one intermediate casing interval instead of two. Accumulated experience of drilling and completing multi hole wells was used to ensure successful well construction; also, geological and stratigraphic data as well as possible complications while drilling Botuobunsky and Ulakhansky formations were analyzed in-depth. The following appliances were selected to meet the objective: –Bottom-hole equipment enabling drilling abrasive formations under conditions of high vibrations;–Special line of drill bits to ensure high ROP and successful sidetracking without additional tripping;–RSS with 152.4 mm drill bit. The goal set by the operating company was achieved through multi-faceted approach to performing the task, efficient cooperation of engineering technical services and continuous monitoring of output data while drilling. All that combined delivered the results listed below: –Sidetracks were carried out in an open horizontal hole without cement plugs and additional tripping for drill bit or BHA.–Minimized bottom-hole equipment failures under condition of increased high-frequency vibrations from bit while drilling hard formations due to implementation of modular PDM with data-transmitting channel.–Minimized bottom-hole equipment failures under condition of increased low-frequency vibrations from drill string with Hard Bending due to improved BHA design and optimized drilling parameters selection.–Liner was effectively run to Botuobinsky and Ulakhansky reservoirs with an option to shut-off the former after depletion and gas breakthrough. This well is the first one targeted at two isolated formations in East Siberia.

scholarly journals Cardiac Autonomic Modulation during on-Call Duty under Working Hours Restriction

2020 ◽  
Vol 17 (3) ◽  
pp. 1118
Author(s):  
Jien-Wen Chien ◽  
Chung-Yen Chen ◽  
Sheng-Hsuan Lin ◽  
Shih-Wen Lin ◽  
Yu-Hsuan Lin
Keyword(s):  
High Stress ◽  
Low Frequency ◽  
Working Hours ◽  
Autonomic Modulation ◽  
Long Working Hours ◽  
Resident Physicians ◽  
Sympathetic Modulation ◽  
And Shifts ◽  
Low Frequency Power ◽  
Frequency Power

Background: Medical residency is a time of high stress and long working hours, which increase the risk of cardiovascular disease. This study aimed to investigate the autonomic modulation of resident physicians throughout the on-call duty cycle. Methods: Spectral analysis of heart rate variability (HRV) was used to compute cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%, and the ratio of LF and HF, LF/HF) of 18 residents for a consecutive 4-day cycle. Results: Male residents show reduced cardiac sympathetic modulation (i.e., higher LF/HF and LF%) than the female interns. Medical residents’ cardiac parasympathetic modulation (i.e., HF) significantly increased on the first and the second post-call day compared with the pre-call day. In contrast, LF% was significantly decreased on the first and the second post-call day compared with the pre-call day. Similarly, LF/HF was significantly decreased on the second post-call day compared with the pre-call day. LF/HF significantly decreased on the first post-call day and on the second post-call day from on-call duty. Conclusion: The guideline that limits workweeks to 80 h and shifts to 28 h resulted in reduced sympathetic modulation and increased parasympathetic modulation during the two days following on-call duty.

Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland

2018 ◽  
Vol 13 (02) ◽  
pp. 243-255 ◽  
Author(s):  
Tener Goodwin Veenema ◽  
Fiona Boland ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Zena Moore ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Response ◽  
Large Scale ◽  
Mass Casualty ◽  
Republic Of Ireland ◽  
Emergency Responders ◽  
Mass Casualty Event ◽  
Service Readiness ◽  
The Republic ◽  
Professional Disciplines

ABSTRACTObjectiveUltimately, a country’s capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland.MethodsA cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland. Data collection was achieved using the Qualtrics® Research Suite. Descriptive statistics and appropriate tests of comparison between professional disciplines were conducted using Stata 13.ResultsA total of 385 respondents, registered nurses (43.4%), paramedics (37.9%), medical doctors (10.1%), and administrators/managers (8.6%), participated in the study. In general, a level of knowledge of MCEs and knowledge of clinical response activities and self-assessed clinical competence varied drastically across many aspects of the survey. Knowledge and confidence also varied across professional disciplines (P<0.05) with nurses, in general, reporting the least knowledge and/or confidence.ConclusionsThe results demonstrate that serious deficits exist in HCP knowledge, skills, and self-perceived abilities to participate in a large-scale MCE. Results also suggest a poor knowledge base of existing major emergency response plans. (Disaster Med Public Health Preparedness. 2019;13:243–255)

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