ATTENTIVE ANAMNESIS IS FUNDAMENTAL IN EMERGENCY SERVICES: ELUSIVE UNUSUAL RADIOLOGIC APPEARANCES

Author(s):  
Duzgun Yildirim ◽  
Atilla Ersen ◽  
Baki Ekci ◽  
Cuneyt Tamam ◽  
Murat Eroglu ◽  
...  
Keyword(s):  
Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Musa Musa

This research was conducted to determine the Effectiveness of Jakarta Siaga 112 Emergency Services in Fire Management by UPT. Disaster Data & Information Center of BPBD DKI Jakarta Province by paying attention to aspects contained in the Effectiveness of the Jakarta Siaga Emergency Service Program 112. The research method was carried out with a case study method with data collection techniques using interview methods and document review. Interviews were conducted on 10 (ten) key informants, document review focused on documents related to the Jakarta Emergency Alert Service 112 Effectiveness research in Fire Management. The results showed that the Effectiveness of Jakarta Siaga 112 Emergency Services in Fire Management by UPT. The Center for Disaster Data & Information BPBD DKI Jakarta Province Its effectiveness is still low, due to the Implementation of Emergency Services Jakarta Standby 112 in Fire Management implemented by UPT. Disaster Data & Information Center of BPBD DKI Jakarta Province in terms of the Target Group Understanding of the Program, the Achievement of the Program Objectives aspects, and the Program Follow-up aspects. It is recommended to continue to disseminate this Emergency Service to the public, it is necessary to increase the firm commitment of the Head of 8 SKPD related to fire management so that all units play a role in accordance with the Standard Operating Procedures (SOPs) for Fire Management and the evaluation and follow-up of program services that are held periodically 3 once a month.Keywords: Effectiveness, Emergency Services, Fire Handling


2013 ◽  
Vol 1 (1) ◽  
pp. 16
Author(s):  
Mansur Kursad Erkuran ◽  
Arif Duran ◽  
Tarık Ocak ◽  
Mervan Bekdaş

2020 ◽  
Vol 89 ◽  
pp. 65-74
Author(s):  
A. G. Zavorotnyy ◽  

Introduction. Operation of radiation hazardous facilities is a reality of the modern world, and the future of the world economy is impossible without the development of nuclear and radiation technologies. At the same time, the widespread use of atomic energy puts forward an important and responsible task of ensuring the safety of the population and the environment in conditions of an increased risk of exposure to ionizing radiation and radioactive substances. In accordance with clause 3.2.1 of the "Radiation Safety Standards NRB-99/2009", the planned increased exposure of persons involved in emergency rescue operations related to the elimination of the consequences of radiation accidents is allowed for men, as a rule, over 30 years old only with their voluntary written consent, after informing about possible radiation doses and health risks. Increased exposure refers to exposure in excess of the basic dose limits under controlled (normal) operating conditions of radiation sources. Goals and objectives. The aim of the study is to increase the functionality of emergency services and fire and rescue subdivisions to perform tasks as intended in the elimination of radiation accidents. The tasks include the construction and substantiation of a model that allows converting the risks of deterministic effects into stochastic effects risks. Methods. When calculating the probability of output of stochastic and deterministic effects depending on the radiation dose and developing a threshold quadratic model, the least squares method and the probabilistic-statistical method were used. Results and discussion. The article shows that a linear non-threshold model of the interaction of radiation with matter greatly overestimates the risk of a stochastic effect emerging at doses of radiation. For example, this overestimation is 8,13 at a dose of D = 0,2 Sv/year. In this regard, a threshold quadratic model has been developed and proposed to be replaced by a threshold quadratic model, which makes it possible to increase the planned irradiation of personnel of emergency services and fire and rescue units during the elimination of radiation accidents in an effective dose from 0,2 Sv to 0,57 Sv, moreover, the probability of emergence of stochastic effects P2 = 0,0084 remains the same for both models. Conclusions. An increase in the maximum permissible dose of radiation for personnel of emergency services and fire and rescue units from 0,2 Sv/year to 0,5 Sv/year will make it possible to increase the functionality of the emergency services and fire and rescue units to perform tasks as intended by 2,5 times when elimination of radiation accidents. For example, the scope of rescue operations may be increased from 100 %, performed at a dose of D = 0,2 Sv/year, to 250 %, performed at a dose of D = 0,5 Sv/year. Key words: emergency services, fire and rescue units, radiation accidents, irradiation, linear no-threshold model, threshold quadratic model.


2020 ◽  
Author(s):  
Akmal Rustamov

The paper addresses the problem of increasing transportation safety due to usage of new possibilities provided by modern technologies. The proposed approach extends such systems as ERA-GLONASS and eCall via service network composition enabling not only transmitting additional information but also information fusion for defining required emergency means as well as planning for a whole emergency response operation. The main idea of the approach is to model the cyber physical human system components by sets of services representing them. The services are provided with the capability of self- contextualization to autonomously adapt their behaviors to the context of the car-driver system. The approach is illustrated via an accident emergency situation response scenario. “ERA-GLONASS” is the Russian state emergency response system for accidents, aimed at improving road safety and reducing the death rate from accidents by reducing the time for warning emergency services. In fact, this is a partially copied European e Call system with some differences in the data being transmitted and partly backward compatible with the European parent. The principle of the system is quite simple and logical: in the event of an accident, the module built into the car in fully automatic mode and without human intervention determines the severity of the accident, determines the vehicle’s location via GLONASS or GPS, establishes connection with the system infrastructure and in accordance with the protocol, transfers the necessary data on the accident (a certain distress signal). Having received the distress signal, the employee of the call center of the system operator should call the on-board device and find out what happened. If no one answers, send the received data to Sistema-112 and send it to the exact coordinates of the team of rescuers and doctors, and the last one to arrive at the place is given 20 minutes. And all this, I repeat, without the participation of a person: even if people caught in an accident will not be able to independently call emergency services, the data on the accident will still be transferred. In this work intended to add some information about applying system project in Uzbek Roads especially mountain regions like “Kamchik” pass. The Kamchik Pass is a high mountain pass at an elevation of 2.306 m above the sea level, located in the Qurama Mountains in eastern Uzbekistan and its length is about 88km.The road to reach the pass is asphalted, but there are rough sections where the asphalt has disappeared. It’s called A373. The old road over the pass was by passed by a tunnel built in 1999. On the horizon, the snow-capped peaks of the Fan Mountains come into view. The pass is located in the Fergana Valley between the Tashkent and Namangan Regions.


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