Evolution of a mass casualty drill design team: A program evaluation

Introduction: The number of mass casualty incidents (MCIs) is increasing. While many healthcare systems have not experienced an MCI, the need for preparedness is ever present. The unique challenges of MCI preparedness require the use of simulation, which has been found to be an effective model for training in medical environments.Objective: To determine common discussion points when a multidisciplinary team designed and implemented in situ MCI simulation drills to enhance our emergency preparedness plan.Design: This was a retrospective qualitative evaluation of the multidisciplinary mass casualty drill design team’s weekly meeting minutes documents. These documents provided insight into the evolution of a mass casualty drill design team and the advancement of our emergency response plan. Results: Continuous discussions surrounding resource restraints helped to inform the emergenceof the three themes, which were “Staff,” “Space,” and “Stuff.” These three themes were further broken down into different subthemes, but there was a continued focus on resource scarcity.Conclusions: Our results indicate the use of an MCI drill design team and in situ simulations assisted in better understanding of how hospital departments struggled with resource scarcity and provided opportunities to strengthen the emergency preparedness response plan. Incorporating a multidisciplinary mass casualty drill design team helped to ensure different perspectives and department needs were acknowledged and addressed through the in situ simulation trainings.

Effects of the technique and drill design used during the osteotomy on the thermal and histological stimulation

The objective of our in vivo study was to compare the effects of the osteotomy on the thermal alterations, the bone healing and count of polymorphonuclear cells, comparing the drill design (cylindrical or conical) using continuous or intermittent movement. Twelve rabbits were used, which were made four osteotomies (n = 2 per tibia) to simulate the surgical drilling sequence for the installation of a dental implant at 8 mm of length and regular diameter. Four groups were proposed: group G1, cylindrical drill with continuous movement; group G2, cylindrical drill with intermittent movement; group G3, conical drill with continuous movement; and, group G4, conical drill with intermittent movement. Thermal mean variation was 6.91 ± 1.4 °C in group 1, 4.30 ± 1.3 °C in group 2, 2.78 ± 0.6 °C in group 3, and 2.77 ± 0.7 °C in group 4. Whereas the mean area of new bone formation was 1.00 ± 0.3 mm2 in group 1, 1.48 ± 0.3 mm2 in group 2, 2.20 ± 0.4 mm2 in group 3, and 2.43 ± 0.4 mm2in group 4. The mean count of polymorphonuclear cells, in the group 1 was 62.4 ± 5.9 cells, group 2 was 50.7 ± 4.2 cells, group 3 was 44.4 ± 3.7 cells, and group 4 was 42.4 ± 3.7 cells. The conical drill sequence produced a significantly smaller increase in temperature during both techniques (continuous and intermittent), more effective new bone formation and a smaller number of polymorphonuclear cells. During the osteotomy for the installation of implants, the professional must take to consider the drill design to perform a less traumatic surgical technique, which can improve and facilitate the healing of peri-implant tissues.

Development of a New Drill Design to Improve the Temperature Control during the Osteotomy for Dental Implants: A Comparative In Vitro Analysis

The present in vitro study evaluated a new drill design to improve the temperature control during the osteotomies for dental implant installation, comparing with two drill designs that use conventional external irrigation. Three blocks of synthetic cortical bone were used for osteotomy procedures. Three groups were created: control group 1 (Con1), where a conical multiple drill system with a conventional external irrigation system was used; control group 2 (Con2), where a single bur with a conventional external irrigation system was used; and, test group (Test), where the new single bur (turbo drill) with a new irrigation system was used. Twenty osteotomies were made without irrigation and with intense irrigation, for each group. A thermocouple was used to measure the temperature produced during the osteotomies. The measured temperature were: 28.9 ± 1.68 °C for group Con1; 27.5 ± 1.32 °C for group Con2; 26.3 ± 1.28 °C for group Test. Whereas, the measured temperatures with irrigation were: 23.1 ± 1.27 °C for group Con1; 21.7 ± 1.36 °C for group Con2; 19.4 ± 1.29 °C for group Test. The single drill with a new design for improving the irrigation and temperature control, in comparison with the drill designs with conventional external irrigation.

Development of the Third Generation of the Dual-Reciprocating Drill

The dual-reciprocating drill (DRD) is a low-mass alternative to traditional drilling techniques biologically inspired by the wood wasp ovipositor, which is used to drill into wood in order to lay its eggs. The DRD reciprocates two halves lined with backwards-facing teeth, enabling it to generate traction forces that reduce the required overhead penetration force. While previous research has focused on experimental testing of the drill’s operational and design parameters, numerical simulation techniques are being developed to allow the rapid testing of multiple designs, complementing and informing experimental testing campaigns. The latest DRD design iteration integrated a novel internal actuation mechanism and demonstrated the benefits of adding controlled lateral movements. This paper presents an exploration of how bit morphology affects drilling performance and a preliminary study of discrete element method (DEM) simulations for modelling DRD interactions in regolith. These have shown how regolith grain size and microscopic behaviour significantly affects the performance of different drill designs, and demonstrated how customisable drills can exploit the properties of various substrates. Two system prototypes are also being developed for the DRD’s third generation, each utilising novel actuation and sampling mechanisms. A final drill design will then be deployed from a planetary rover and perform the first DRD drilling and sampling operation.

Evacuation characteristics of preschool children through bottlenecks

Pedestrian movement through bottlenecks have been widely studied from various aspects to understand the effects of bottlenecks on the pedestrian flow. However, few attentions have been paid to the movement characteristics of preschool children, who show obvious differences behaviour compared to adults due to the poor balance and understanding of danger especial under emergencies. In this study, we focus on the evacuation characteristics of preschool children through bottlenecks with laboratory experiments. From all the experiment, we do not observe clear lane formation process from the trajectories diagrams. It is found that the first arrive first out principle does not work in the situation with competition. Compared to adults, children are more likely to fall and hard to be controlled during movement, which is very dangerous in emergencies. The highest speed for the preschool children can beyond 3 m/s and is depend on the location in the crowd for each individual. For a given number of evacuees, the total evacuation time firstly decreases a linear with the increasing the bottleneck width and then keeps a constant if nobody falls down during the movement. Falling down of children will increase the evacuation time incredibly. The findings will be beneficial for the evacuation drill design in kindergarten as well as the facility design for young children.