An Accident Detection and Classification System Using Internet of Things and Machine Learning towards Smart City

Daily traffic accidents increase annually, causing a significant number of death and disability cases. Most of fatalities occur because of the late response to these emergency cases. The time after the traumatic injury is called the golden hour, where providing essential medical and surgical aid at that time increases the probability of saving human lives by one-third an average. Thus, the focus of this paper was to develop a system based on IoT for accident detection and classification. The system detects and classifies vehicle accidents based on severity level and reports the essential information about the accident to emergency services providers. The system consists of a microcontroller, GPS, and a group of sensors to determine different physical parameters related to vehicle motion. In addition, different types of machine learning classifiers were examined with the developed system to determine the most accurate classifier for the system. The classifiers are the Gaussian Mixture Model (GMM), Naive-Bayes Tree (NB), Decision Tree (DT), and Classification and Regression Trees (CART). The implementation of the system showed that GMM and CART models were better in terms of precision and recall. It was also shown that the severity of accidents depends mainly on the g-force value and fire occurrence.

Role of imaging in early diagnosis of acute ischemic stroke: a literature review

Stroke is a serious health condition that is responsible for more than 5% of total deaths. Near 20% of patients experiencing stroke die every year, resulting in the stroke being at the top of the list of preventable causes of death. Once an acute stroke is suspected, a golden hour of less than an hour is available to prevent the undesirable consequences. Since neuroimaging is mandatory in the diagnosis of stroke, the proper use of neuroimaging could help saving time and planning the right treatment for the patient. Some of the available imaging methods help us with rapid results, while others benefit us from a more accurate diagnosis. Hereby, we aim to provide a clinical review of the advantages and disadvantages of different available neuroimaging methods in approaching acute stroke to help clinicians choose the best method according to the settings.

Sepsis in der prähospitalen Notfallmedizin

Zusammenfassung Hintergrund Die Sepsis ist eine notfallmedizinische Herausforderung – denn diese lebensbedrohliche Organdysfunktion, verursacht durch eine dysregulierte Wirtsantwort auf eine Infektion, präsentiert sich in vielfältiger Ausprägung und wird deshalb häufig erst zu spät erkannt. Fragestellung Die kürzlich publizierten „surviving sepsis campaign“-Guidelines und die deutsche S3-Leitlinie geben Empfehlungen zur Diagnostik und Therapie der Sepsis im intrahospitalen bzw. intensivmedizinischen Setting, gehen jedoch nicht explizit auf den Bereich der prähospitalen Notfallmedizin ein. Ziel der Arbeit ist es, die Evidenzlage im Hinblick auf die prähospitale Versorgung von Patienten mit Verdacht auf Sepsis herauszuarbeiten und daraus Handlungsoptionen für den Notarzt- und Rettungsdienst abzuleiten. Diskussion Die Therapie der Sepsis und des septischen Schocks wird in Bündeln zusammengefasst, wobei das erste idealerweise innerhalb der ersten Stunde abgeschlossen sein soll – analog zum Konzept der „golden hour“ bei anderen notfallmedizinischen Entitäten wie der Traumaversorgung. Die prähospitale Therapie fokussiert sich auf die Sicherung der Vitalparameter gemäß ABCDE-Schema, wobei insbesondere der Volumentherapie ein hoher Stellenwert zukommt. Die weiteren Maßnahmen des „1 h bundle“, wie Laktatmessung, Gewinnung mikrobiologischer Proben und Beginn einer antiinfektiven Therapie, sind regelhaft erst in der Klinik möglich. Ziel ist eine schnellstmögliche Fokussanierung, wofür die Auswahl und Vorabinformation einer geeigneten Zielklinik zur Initiierung und Bahnung der weiteren klinischen Diagnostik- und Behandlungspfade, eine strukturierte und gezielte Übergabe sowie regelmäßige Fortbildung erforderlich sind.

Ranger O Low Titer (ROLO): Whole Blood Transfusion for Forward Deployed Units

ABSTRACT First-time use of Ranger O Low Titer (ROLO) blood and implementation of a forward-walking blood bank using predetermined donors proved essential in the survival of a 33-year-old active duty soldier following a complex blast injury during combat operations. The patient sustained significant bone, soft tissue, and vascular damage and continued to deteriorate despite resuscitation with cold-stored whole blood (WB). Only after utilizing the ROLO battle drill and transfusing with fresh WB was the patient able to be stabilized and evacuated. In this case report, we discuss how ROLO walking blood bank takes the next step in aiding resuscitation, providing smaller, forward-deployed units with blood resupply without the administrative burden of storage, particularly in resource-scarce environments. We provide an overview of WB and contrast its use to that of component therapy. In conjunction with the Golden Hour, ROLO can be incorporated as the standard damage control resuscitation to reduce the risks of noncompressible hemorrhage. By taking precautionary steps in the pre-deployment setting, ROLO offers an invaluable alternative to conventional resuscitation.

Major trauma

This chapter discusses the management of major trauma. Trauma is the leading cause of death in the first four decades of life, and every minute, more than nine people die from injuries and violence. Trimodal distribution of death implies death from injury occurs in one of three time periods: first peak (within seconds to minutes), second peak (within minutes to several hours), and third peak (after several days to weeks). The ‘golden hour’ refers to the period when medical care can make the maximum impact on death and disability. A systematic, rapid initial assessment is essential and this includes preparation, triage, primary survey (ABCDE), resuscitation, secondary survey, continued monitoring, and reevaluation and definitive care. The chapter then looks at the advanced trauma life support (ATLS) system. It also considers thoracic injuries, abdominal trauma, vascular injuries, and head injuries.

Impact of a “Brain Protection Bundle” in Reducing Severe Intraventricular Hemorrhage in Preterm Infants <30 Weeks GA: A Retrospective Single Centre Study

Background: despite advances in perinatal care, periventricular/intraventricular hemorrhage (IVH) continues to remain high in neonatal intensive care units (NICUs) worldwide. Studies have demonstrated the benefits of implementing interventions during the antenatal period, stabilization after birth (golden hour management) and postnatally in the first 72 h to reduce the incidence of IVH. Objective: to compare the incidence of severe intraventricular hemorrhage (IVH ≥ Grade III) before and after implementation of a “brain protection bundle” in preterm infants <30 weeks GA. Study design: a pre- and post-implementation retrospective cohort study to compare the incidence of severe IVH following execution of a “brain protection bundle for the first 72 h from 2015 to 2018. Demographics, management practices at birth and in the NICU, cranial ultrasound results and short-term morbidities were compared. Results: a total of 189 and 215 infants were included in the pre- and post-implementation phase, respectively. No difference in the incidence of severe IVH (6.9% vs. 9.8%, p = 0.37) was observed on the first cranial scan performed after 72 h of age. Conclusion: the implementation of a “brain protection bundle” was not effective in reducing the incidence of severe IVH within the first 72 h of life in our centre.