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Journal articles on the topic 'Medical rescue vehicle'
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1
Campagna, Sara, Alessio Conti, Valerio Dimonte, Marco Dalmasso, Michele Starnini, Maria Michela Gianino, and Alberto Borraccino. "Trends and Characteristics of Emergency Medical Services in Italy: A 5-Years Population-Based Registry Analysis." Healthcare 8, no. 4 (December 11, 2020): 551. http://dx.doi.org/10.3390/healthcare8040551.
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Background: Emergency Medical Services (EMS) plays a fundamental role in providing good quality healthcare services to citizens, as they are the first responders in distressing situations. Few studies have used available EMS data to investigate EMS call characteristics and subsequent responses. Methods: Data were extracted from the emergency registry for the period 2013–2017. This included call and rescue vehicle dispatch information. All relationships in analyses and differences in events proportion between 2013 and 2017 were tested against the Pearson’s Chi-Square with a 99% level of confidence. Results: Among the 2,120,838 emergency calls, operators dispatched at least one rescue vehicle for 1,494,855. There was an estimated overall incidence of 96 emergency calls and 75 rescue vehicles dispatched per 1000 inhabitants per year. Most calls were made by private citizens, during the daytime, and were made from home (63.8%); 31% of rescue vehicle dispatches were advanced emergency medical vehicles. The highest number of rescue vehicle dispatches ended at the emergency department (74.7%). Conclusions: Our data showed that, with some exception due to environmental differences, the highest proportion of incoming emergency calls is not acute or urgent and could be more effectively managed in other settings than in an Emergency Departments (ED). Better management of dispatch can reduce crowding and save hospital emergency departments time, personnel, and health system costs.
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Johnson, David R., W. Ann Maggiore, and David Ralph Davis. "A Method to Reduce Rural EMS Response Times." Prehospital and Disaster Medicine 6, no. 2 (June 1991): 143–47. http://dx.doi.org/10.1017/s1049023x00028260.
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AbstractProlonged EMS response times are a significant problem in rural areas. In this study, VHF radios and personal medical kits were placed in the private vehicles of rescue squad members. By coordinating the responses using radios, higher level EMTs were sent directly to the scene to initiate patient assessment and other procedures while others proceeded to an unstaffed station to pick up the rescue truck.Using this response system, EMTs arrived at the scene prior to the rescue vehicle on 30 of 35 calls (85.7%). In 25 of 35 calls (71.4%), the first person at the scene was at an advanced EMT level even though the majority of responses (56%) were made by Basic EMTs (p<0.001). The mean response time for EMTs using privately owned vehicles was 9±4 minutes (means±SD) compared with 16±9 minutes for the rescue truck (p<0.01). There also was a significant difference in response times between the privately owned vehicles and the rescue truck when the time between the receipt of the call and the initial acknowledgement of response was measured (1±1 minutes vs. 7±3 minutes; p<0.01).An effective EMS response can be made in rural areas by sending EMTs directly to a scene in private vehicles. Providing EMTs with VHF radios and personal medical kits enhances this response.
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Bai, Song, Bao-guo Yu, Yong-Zhong Zhang, Hui Ding, Zhou-wei Wu, Bin Fan, Hao-jun Fan, Shi-ke Hou, and Feng Chen. "Challenges of Treating Adenovirus Infection: Application of a Deployable Rapid-Assembly Shelter Hospital." Disaster Medicine and Public Health Preparedness 12, no. 1 (March 6, 2017): 109–14. http://dx.doi.org/10.1017/dmp.2016.187.
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AbstractThis article outlines the evolution of a rescue team in responding to adenovirus prevention with a deployable field hospital. The local governments mobilized a shelter hospital and a rescue team consisting of 59 members to assist with rescue and response efforts after an epidemic outbreak of adenovirus. We describe and evaluate the challenges of preparing for deployment, field hospital maintenance, treatment mode, and primary treatment methods. The field hospital established at the rescue scene consisted of a medical command vehicle, a computed tomography shelter, an X-ray shelter, a special laboratory shelter, an oxygen and electricity supply vehicle, and epidemic prevention and protection equipment. The rescue team comprised paramedics, physicians, X-ray technicians, respiratory therapists, and logistical personnel. In 22 days, more than 3000 patients with suspected adenovirus infection underwent initial examinations. All patients were properly treated, and no deaths occurred. After emergency measures were implemented, the spread of adenovirus was eventually controlled. An emergency involving infectious diseases in less-developed regions demands the rapid development of a field facility with specialized medical personnel when local hospital facilities are either unavailable or unusable. An appropriate and detailed prearranged action plan is important for infectious diseases prevention. (Disaster Med Public Health Preparedness. 2018;12:109–114)
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Harrison, Robert R., Kimball I. Maull, and C. Paul Boyan. "Vehicle Crash Rescue Skills and Residency Training in Emergency Medicine." Prehospital and Disaster Medicine 1, S1 (1985): 103–4. http://dx.doi.org/10.1017/s1049023x00043983.
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Recent advances in the resuscitation and stabilization skills of prehospital emergency care providers have done much to improve the quality of immediate care provided to suddenly ill or injured patients. Although much of the innovation and leadership in this area has been provided by emergency department physicians, most of them still lack an adequate appreciation of the circumstances under which these skills are executed. While many physicians participate in prehospital care teaching and evaluation of the system, most have not gained personal experience in those aspects of care foreign to hospital environment. They are particularly unacquainted with the intricacies of rescuing patients from automobile accidents and similar entrapments. It is not unusual, however, for an accident victim to spend half of the time required for the prehospital phase of emergency medical care undergoing extrication, and in many cases this must be done before full advanced life support measures may be initiated.
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Archana, Myaka. "Automatic Vehicle Accident Detection System." International Journal for Research in Applied Science and Engineering Technology 9, no. VI (June 30, 2021): 2975–79. http://dx.doi.org/10.22214/ijraset.2021.35670.
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The ascent of technology and infrastructure has created our lives easier. the appearance of technology has conjointly enhanced the traffic hazards and therefore the road accidents ensue ofttimes that causes immense loss of life and property owing to the poor emergency facilities. Our project can give AN optimum resolution to the present flinch. AN measuring device may be utilized in a automobile alarm application in order that dangerous driving may be detected. It may be used as a crash or change detector of the vehicle throughout and when crash. With signals from AN measuring device, a severe accident may be recognized. in step with this project once a vehicle meets with AN accident straight off vibration detector can notice the signal or if a automobile rolls over, and small electro system (MEMS) detector can notice the signal and sends it to ARM controller. Microcontroller sends the alert message through the GSM electronic equipment together with the situation to the police room or a rescue team. therefore the police will straight off trace the situation through GPS electronic equipment, when receiving the data. Then when orthodox the situation necessary action are going to be taken. If the person meets with a little accident or if there's no serious threat to any ones life, then the alert message may be terminated by the motive force by a switch provided so as to avoid wasting the dear time of the medical rescue team. This paper is helpful in police work the accident exactly by suggests that of each vibration detector and small electro system (MEMS) or measuring device. As there's a scope for future implementation we will add a wireless net cam for capturing the photographs which can facilitate in providing drivers help.
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Mulla, Christopher M., Stamatina Zavitsanou, Alejandro Jose Laguna Sanz, David Pober, Lauren Richardson, Pamela Walcott, Ipsa Arora, et al. "A Randomized, Placebo-Controlled Double-Blind Trial of a Closed-Loop Glucagon System for Postbariatric Hypoglycemia." Journal of Clinical Endocrinology & Metabolism 105, no. 4 (November 12, 2019): e1260-e1271. http://dx.doi.org/10.1210/clinem/dgz197.
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Abstract Background Postbariatric hypoglycemia (PBH) can threaten safety and reduce quality of life. Current therapies are incompletely effective. Methods Patients with PBH were enrolled in a double-blind, placebo-controlled, crossover trial to evaluate a closed-loop glucose-responsive automated glucagon delivery system designed to reduce severe hypoglycemia. A hypoglycemia detection and mitigation algorithm was embedded in the artificial pancreas system connected to a continuous glucose monitor (CGM, Dexcom) driving a patch infusion pump (Insulet) filled with liquid investigational glucagon (Xeris) or placebo (vehicle). Sensor/plasma glucose responses to mixed meal were assessed during 2 study visits. The system delivered up to 2 doses of study drug (300/150 μg glucagon or equal-volume vehicle) if triggered by the algorithm. Rescue dextrose was given for plasma glucose <55 mg/dL or neuroglycopenia. Results Twelve participants (11 females/1 male, age 52 ± 2, 8 ± 1 years postsurgery, mean ± SEM) completed all visits. Predictive hypoglycemia alerts prompted automated drug delivery postmeal, when sensor glucose was 114 ± 7 vs 121 ± 5 mg/dL (P = .39). Seven participants required rescue glucose after vehicle but not glucagon (P = .008). Five participants had severe hypoglycemia (<55 mg/dL) after vehicle but not glucagon (P = .03). Nadir plasma glucose was higher with glucagon vs vehicle (67 ± 3 vs 59 ± 2 mg/dL, P = .004). Plasma glucagon rose after glucagon delivery (1231 ± 187 vs 16 ± 1 pg/mL at 30 minutes, P = .001). No rebound hyperglycemia occurred. Transient infusion site discomfort was reported with both glucagon (n = 11/12) and vehicle (n = 10/12). No other adverse events were observed. Conclusion A CGM-guided closed-loop rescue system can detect imminent hypoglycemia and deliver glucagon, reducing severe hypoglycemia in PBH. Clinical Trials Registration NCT03255629
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Cardoso, Ricardo Galesso, Carina Fontana Francischini, Jorge Michel Ribera, Ricardo Vanzetto, and Gustavo Pereira Fraga. "Helicopter emergency medical rescue for the traumatized: experience in the metropolitan region of Campinas, Brazil." Revista do Colégio Brasileiro de Cirurgiões 41, no. 4 (August 2014): 236–44. http://dx.doi.org/10.1590/0100-69912014004003.
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OBJECTIVE: To analyze the profile of patients served by the air medical rescue system in the Metropolitan Region of Campinas, evaluating: triage and mobilization criteria; response time; on-site care and transport time; invasive procedures performed in the Pre-Hospital Care (PHC); severity of patients; morbidity and mortality.METHODS: We conducted a prospective, descriptive study in which we analyzed medical records of patients rescued between July 2010 and December 2012. During this period, 242 victims were taken to the HC-Unicamp. Of the 242 patients, 22 were excluded from the study.RESULTS: of the 220 cases evaluated, 173 (78.6%) were male, with a mean age of 32 years. Blunt trauma was the most prevalent (207 cases - 94.1%), motorcycle accidents being the most common mechanisms of injury (66 cases - 30%), followed by motor vehicle collisions (51 cases - 23.2%). The average response time was 10 ± 4 minutes and the averaged total pre-hospital time was 42 ± 11 minutes. The mean values of the trauma indices were: RTS = 6.2 ± 2.2; ISS = 19.2 ± 12.6; and TRISS = 0.78 ± 0.3. Tracheal intubation in the pre-hospital environment was performed in 77 cases (35%); 43 patients (19.5%) had RTS of 7.84 and ISSd"9, being classified as over-triaged. Of all patients admitted, the mortality was 15.9% (35 cases).CONCLUSION: studies of air medical rescue in Brazil are required due to the investments made in the pre-hospital care in a country without an organized trauma system. The high rate of over-triage found highlights the need to improve the triage and mobilization criteria.
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Fernandez, S. George, R. Palanisamy, and K. Vijayakumar. "GPS & GSM Based Accident Detection And Auto Intimation." Indonesian Journal of Electrical Engineering and Computer Science 11, no. 1 (July 1, 2018): 356. http://dx.doi.org/10.11591/ijeecs.v11.i1.pp356-361.
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<p>The high demand of automobiles has also increased the traffic hazards and the road accidents. Life of the people is under high risk. This is because of the lack of best emergency facilities available in our country. An automatic alarm device for vehicle accidents is introduced in this paper. This design is a system which can detect accidents in significantly less time and sends the basic information to first aid centre within a few seconds covering geographical coordinates, the time and angle in which a vehicle accident had occurred. This alert message is sent to the rescue team in a short time, which will help in saving the valuable lives. A Switch is also provided in order to terminate the sending of a message in rare case where there is no casualty, this can save the precious time of the medical rescue team. When the accident occurs the alert message is sent automatically to the rescue team and to the police station. The message is sent through the GSM module and the location of the accident is detected with the help of the GPS module. </p>
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Dr. A. Thomas Paul Roy, Dr. P. Gokulakrishnan, Dr S. Satheesbabu,. "Communication Assistance under Urban Vicinity in VANETs." Psychology and Education Journal 58, no. 1 (January 15, 2021): 4267–72. http://dx.doi.org/10.17762/pae.v58i1.1493.
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Vehicular Ad Hoc NETworks (VANET) has turn up as a stand to support intelligent vehicles communication, transport safety and performance.Road accidents and traffic congestion are the significant issues of metropolitan territories. In spite of the fact that endless arrangements are given for these issues, still there is no fitting answer for street mishap recognition. Likewise, because of the deferral in arriving at the emergency vehicle to the mishap area and accordingly the gridlock in the middle of the mishap area and clinic expands the probabilities of the passing of the person in question. Thus, it is needed to give handheld answer for the general public.This paper introduces a handheld solution to reduce the loss of life due to accidents and the time taken by the ambulance to reach the hospital. First, the proposed system finds out the road accidents automatically with the help of sensors in intelligent vehicles. Second, an alert is sent to all nearby hospitals after the road accident. This system maintains a database server which holds all hospital details in around the city. A GPS or GSM gadget in the concerned vehicle will send the area character of the mishap to the close by medical clinics through primary worker and afterward a rescue vehicle from very closest clinic is shipped off the mishap spot. Alongside these, there would be an effect of traffic inside the way of the emergency vehicle utilizing RF correspondence. This will limit the hour of ambulances to arrive at the clinic.Third, this system maintains another database for all kind of mechanical services. This system provides support to the roadsiders while the vehicle got breakdown or any other service issues in the vehicle. It also saves the time of the driver and unnecessary delay. Altogether, this system provides the appropriate handheld solution to the vehicle drivers and the society.
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Meng, Hao, Wasswa Shafik, S. Mojtaba Matinkhah, and Zubair Ahmad. "A 5G Beam Selection Machine Learning Algorithm for Unmanned Aerial Vehicle Applications." Wireless Communications and Mobile Computing 2020 (August 1, 2020): 1–16. http://dx.doi.org/10.1155/2020/1428968.
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The unmanned aerial vehicles (UAVs) emerged into a promising research trend within the recurrent year where current and future networks are to use enhanced connectivity in these digital immigrations in different fields like medical, communication, and search and rescue operations among others. The current technologies are using fixed base stations to operate onsite and off-site in the fixed position with its associated problems like poor connectivity. This open gate for the UAV technology is to be used as a mobile alternative to increase accessibility with fifth-generation (5G) connectivity that focuses on increased availability and connectivity. There has been less usage of wireless technologies in the medical field. This paper first presents a study on deep learning to medical field application in general and provides detailed steps that are involved in the multiarmed bandit (MAB) approach in solving the UAV biomedical engineering technology device and medical exploration to exploitation dilemma. The paper further presents a detailed description of the bandit network applicability to achieve close optimal performance and efficiency of medical engineered devices. The simulated results depicted that a multiarmed bandit problem approach can be applied in optimizing the performance of any medical networked device issue compared to the Thompson sampling, Bayesian algorithm, and ε-greedy algorithm. The results obtained further illustrated the optimized utilization of biomedical engineering technology systems achieving thus close optimal performance on the average period through deep learning of realistic medical situations.
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Goud, Varsha. "Vehicle Accident Automatic Detection and Remote Alarm Device." International Journal of Reconfigurable and Embedded Systems (IJRES) 1, no. 2 (July 1, 2012): 49. http://dx.doi.org/10.11591/ijres.v1.i2.pp49-54.
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<p>The Rapid growth of technology and infrastructure has made our lives more easy . The advent of technology has also increased the traffic hazards and the road accident take place frequently which causes huge loss of life and property because of the poor emergency facilities. Our project will provide an optimum solution to this draw back. An accelerometer can be used in a car alarm application so that dangerous driving can be detected . It can be used as a crash or rollover detector of the vehicle during and after a crash. With signals from an accelerometer, a severe accident can be recognized. According to this project when a vehicle meets with an accident immediately Vibration sensor will detect the signal or if a car rolls over, an Micro electro mechanical system(MEMS) sensor will detects the signal and sends it to ARM controller. Microcontroller sends the alert message through the GSM MODEM including the location to police control room or a rescue team. So the police can immediately trace the location through the GPS MODEM, after receiving the information. Then after conforming the location necessary action will be taken. If the person meets with a small accident or if there is no serious threat to anyone`s life, then the alert message can be terminated by the driver by a switch provided in order to avoid wasting the valuable time of the medical rescue team.</p> <p>This paper is useful in detecting the accident precisely by means of both vibration sensor and Micro electro Mechanical system(MEMS) or accelerometer. As there is a scope for improvement and as a future implementation we can add a wireless webcam for capturing the images which will help in providing driver`s assistance.</p> <p>Keywords - Accident ,Automatic Detection, Micro electro Mechanical system , Remote Alarm Device, Vehicle</p>
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Chen, Joy Iong-Zong, and S. Smys. "Construction of Black Box to Detect the Location of Road Mishap in Remote Area in the IoT Domain." June 2021 3, no. 2 (July 23, 2021): 131–46. http://dx.doi.org/10.36548/jtcsst.2021.2.005.
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In recent years, both developed and developing countries have witnessed an increase in the number of traffic accidents. Aside from a significant rise in the overall number of on-road commercial and non-commercial vehicles, advancements in transportation infrastructure and on-road technologies may result in road accidents, which generally result in high mortality. More than half of these fatalities are the result of delayed response by medical and rescue personnel. If an accident site receives quick medical treatment, an accident victim's chances of survival may improve considerably. Based on the IoT-based multiple-level vehicle environment, this study proposes a low-cost accident detection and alarm system. Vehicles are equipped with a "Black Box" board unit and an accident location identification module for the Global Positioning System (GPS), in addition to mechanical sensors (accelerometer, gyroscope) for accurate accident detection. This study has evaluated the proposed system with average packet delivery ratio (PDR) vs. relay nodes. Our simulation results have evaluated the evolution of relay nodes in the mobile / sensor node through internet gateway. It has also been demonstrated that the packet delivery ratio is inversely related to the incremental number of relay nodes.
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Khaliq, Kishwer Abdul, Omer Chughtai, Abdullah Shahwani, Amir Qayyum, and Jürgen Pannek. "Road Accidents Detection, Data Collection and Data Analysis Using V2X Communication and Edge/Cloud Computing." Electronics 8, no. 8 (August 14, 2019): 896. http://dx.doi.org/10.3390/electronics8080896.
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With the improvement in transportation infrastructure and in-vehicle technology in addition to a meteoric increase in the total number of commercial and non-commercial vehicles on the road, traffic accidents may occur, which usually cause a high death toll. More than half of these deaths occur due to a delayed response by medical care providers and rescue authorities. The chances of survival of an accident victim could increase drastically if immediate medical assistance is provided at an accident location. This work proposes a low-cost accident detection and notification system, which utilizes a multi-tier IoT-based vehicular environment; principally, it uses V2X Communication and Edge/Cloud computing. In this work, vehicles are equipped with an On-Board Unit (OBU) in addition to mechanical sensors (accelerometer, gyroscope) for reliable accident detection along with a Global Positioning System (GPS) module for identification of accident location. In addition to this, a camera module is implanted on the vehicle to capture the moment when an accident takes place. In order to facilitate inter-vehicle communication (IVC), OBU in each vehicle incorporates a wireless networking interface. Once an accident occurs, a vehicle detects it and generates an alert message. It then sends the message along with the accident location to an intermediate device, placed at the edge of the vehicular network, and therefore called an edge device. Upon receiving the notification, this edge device finds the nearest hospital and makes a request for an ambulance to be dispatched immediately. It also performs some preprocessing of data and effectively acts as a bridge between the sensors installed inside the vehicle and the distant server deployed in the cloud. A significant issue that the traffic authorities are currently facing is the real-time visualization of data obtained through such environments. Wireless interfaces are usually capable of forwarding real-time sensor data; however, this feature is not yet commercially available in the OBU of the vehicle; therefore, practical implementation is carried out using the Internet of things (IoT) in order to create a network among the vehicles, the edge node, and the central server. By performing analysis on the adequate acquired data of road accidents, the constructive plans of action can be devised that may limit the death toll. In order to assist the relevant authorities in performing wholesome analysis of refined and reliable data, a dynamic front-end visualization is proposed, which is hosted in the cloud. The generated charts and graphs help the personnel at relevant organizations to make appropriate decisions based on the conclusive analysis of processed and stored data.
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Liu, Ming, Dapeng Yang, and Fengxia Hao. "Optimization for the Locations of Ambulances under Two-Stage Life Rescue in the Emergency Medical Service: A Case Study in Shanghai, China." Mathematical Problems in Engineering 2017 (2017): 1–14. http://dx.doi.org/10.1155/2017/1830480.
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With the development of society, public resources for healthcare are increasingly inadequate to meet the demands for the services. Therefore, it is extremely important for policymakers to provide citizens with the most effective healthcare services within the limited available resources. In order to achieve positive effect rescue operations in the Emergency Medical Services (EMS) system, the problems including where to locate the ambulance facilities and how many ambulance vehicles should be allocated to the stations have become the focus of attention. In this paper, we study the problem based on the demand for EMS in Songjiang District, Shanghai, China, followed by the joint planning of Emergency Medical Services management, which typically consists of ambulance facility locations planning and patient’s assignment to hospitals. We proposed a modified Double Standard Model (DSM) to maximize the demand points covered at least two times within the minimum coverage criteria. The problem is solved by integer linear programming technique with the CPLEX software and we make a comparison between the solutions and the locations which exist in the emergency system used by the Songjiang emergency center. Our results show that the demand coverage rate and response time can be efficiently improved through relocating the current facilities without additional vehicle resources.
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Tamer, Aykut, Vincenzo Muscarello, Giuseppe Quaranta, and Pierangelo Masarati. "Cabin Layout Optimization for Vibration Hazard Reduction in Helicopter Emergency Medical Service." Aerospace 7, no. 5 (May 15, 2020): 59. http://dx.doi.org/10.3390/aerospace7050059.
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Helicopter Emergency and Medical Service (HEMS) vehicles require a specially configured cabin that supports the quick transport of a rescue team to the site of an emergency and return of patients back to a full capacity hospital, while sustaining the patients’ health using specifically designed, but otherwise state-of-the-art life-support equipment. The effectiveness and safety of the service may be challenged by the vibratory level, which could be improved by optimally positioning the affected subjects within the cabin. However, the bare dynamical response of the airframe can lead to erroneous evaluation of vibration performance, since pilots, crew, patients, and medical equipment dynamically interact with the helicopter through their interfaces with the structure. Therefore, layout optimization of a HEMS vehicle for low vibration requires the capability to efficiently analyze a large set of candidate coupled helicopter-interface-subject configurations, reaching a suitable trade-off between model detail and computational cost. This work presents an effective vibration rating of medical helicopters to support vibration hazard reduction by minimization of cabin interior accelerations. The tool is able to model high-fidelity rotorcraft aeroservoelasticity, easily connect formulations representing the dynamics of humans, equipment, and their interfaces, and calculate the vibration performance of the resulting coupled models. The approach is applied to a medium-weight helicopter to find its lowest vibration HEMS configuration. It is demonstrated that the optimal positioning of HEMS subjects can significantly reduce vibration hazard and improve operation safety, nearly as effectively as the application of vibration attenuation solutions with a fixed cabin layout.
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Li, Guanwu, Zheng Xu, Lingmi Hou, Xuefeng Li, Xin Li, Wei Yuan, Maki Polat, and Shixin Chang. "Differential effects of bisphenol A diglicydyl ether on bone quality and marrow adiposity in ovary-intact and ovariectomized rats." American Journal of Physiology-Endocrinology and Metabolism 311, no. 6 (December 1, 2016): E922—E927. http://dx.doi.org/10.1152/ajpendo.00267.2016.
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Bisphenol A diglycidyl ether (BADGE), a PPARγ2 antagonist, has been shown to inhibit marrow adipogenesis and promote bone formation in intact animals. We investigated the impact of BADGE on a new and more clinically relevant physiological model, the ovariectomized (OVX) rat model. Forty female Wistar rats were divided into four treatment groups for 12 wk ( n = 10/group): sham+vehicle, sham+BADGE, OVX+vehicle, and OVX+BADGE. Postmortem analyses included MRI, micro-CT, serological test, histomorphometry, biomechanical tests, RT-PCR, and Western blot. Overall, OVX induced a sequential marrow fat expansion accompanied by bone deterioration. Compared with OVX controls, BADGE reduced fat fraction of the distal femur by 36.3%, adipocyte density by 33.0%, adipocyte size by 28.6%, adipocyte volume percentage by 57.8%, and adipogenic markers PPARγ2 and C/EBPα by ∼50% in OVX rats. Similar results were observed in sham rats vs. vehicle. BADGE could promote bone quality in sham rats; however, BADGE did not significantly improve trabecular microarchitecture, biomechanical strength, and dynamic histomorphometric parameters except for trabecular separation in OVX rats. We concluded that early BADGE treatment at a dose of 30 mg/kg attenuates marrow adiposity in ovary-intact and OVX rats and stimulates bone formation in ovary-intact rats but does not significantly rescue bone quality in OVX rats.
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Jankov, Robert P., Kathrine L. Daniel, Shira Iny, Crystal Kantores, Julijana Ivanovska, Nadya Ben Fadel, and Amish Jain. "Sodium nitrite augments lung S-nitrosylation and reverses chronic hypoxic pulmonary hypertension in juvenile rats." American Journal of Physiology-Lung Cellular and Molecular Physiology 315, no. 5 (November 1, 2018): L742—L751. http://dx.doi.org/10.1152/ajplung.00184.2018.
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Deficient nitric oxide (NO) signaling plays a critical role in the pathogenesis of chronic neonatal pulmonary hypertension (PHT). Physiological NO signaling is regulated by S-nitrosothiols (SNOs), which act both as a reservoir for NO and as a reversible modulator of protein function. We have previously reported that therapy with inhaled NO (iNO) increased peroxynitrite-mediated nitration in the juvenile rat lung, although having minimal reversing effects on vascular remodeling. We hypothesized that sodium nitrite (NaNO2) would be superior to iNO in enhancing lung SNOs, thereby contributing to reversal of chronic hypoxic PHT. Rat pups were exposed to air or hypoxia (13% O2) from postnatal days 1 to 21. Dose-response prevention studies were conducted from days 1–21 to determine the optimal dose of NaNO2. Animals then received rescue therapy with daily subcutaneous NaNO2 (20 mg/kg), vehicle, or were continuously exposed to iNO (20 ppm) from days 14–21. Chronic PHT secondary to hypoxia was both prevented and reversed by treatment with NaNO2. Rescue NaNO2 increased lung NO and SNO contents to a greater extent than iNO, without causing nitration. Seven lung SNO proteins upregulated by treatment with NaNO2 were identified by multiplex tandem mass tag spectrometry, one of which was leukotriene A4 hydrolase (LTA4H). Rescue therapy with a LTA4H inhibitor, SC57461A (10 mg·kg−1·day−1 sc), partially reversed chronic hypoxic PHT. We conclude that NaNO2 was superior to iNO in increasing tissue NO and SNO generation and reversing chronic PHT, in part via upregulated SNO-LTA4H.
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McGuire-Wolfe, Christine. "Firefighters Fighting Germs - Evaluation of a Disinfecting Protocol for Use in the Fire Service." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s519—s520. http://dx.doi.org/10.1017/ice.2020.1202.
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Background: Pasco County Fire Rescue (PCFR) is a rapidly growing suburban fire department located in Florida. PCFR employs >500 firefighters (all cross-trained as either emergency medical technicians or paramedics) in 27 stations to provide both emergency medical services (EMS) and fire suppression response. Although multiple studies have established that pathogens are present in both apparatus and stations within the fire service, there is a knowledge gap regarding the effectiveness of cleaning and disinfecting protocols in this specific setting. Methods: In total, 65 high-touch surfaces in 11 vehicles (ambulances and engines) and common areas of 2 fire stations were swabbed before and after disinfection. Vehicle surfaces swabbed included seats, cabinet doors, door handles, stretchers, medical equipment, keyboard, steering wheels, shared headsets and hand rails. Inside the stations, the refrigerator handle, television remote, radio and alarm buttons, door handles, and locker handles were swabbed. Immediately following the initial swab collection, the surfaces were disinfected with hydrogen peroxide wipes and disinfectant cleaner sprayed through an electrostatic system. The same surfaces were then swabbed after disinfection. Colony-forming units (CFUs) were quantified using standard microbiological techniques by a third-party laboratory. Statistical analysis was performed on the resulting bacterial counts using Minitab version 18.1 software. Results: We detected statistically significant decreases in total bacteria, yeast, and mold counts following implementation of this disinfection protocol. The predisinfection mean of bacteria, yeast, and mold counts for all surfaces combined was reduced 96% after disinfection (from 254,637 CFU to 9,392 CFU). Conclusions: Cleaning and disinfection of surfaces in PCFR emergency vehicles and fire station common areas with the agents described above effectively reduced contamination with bacteria, yeast, and mold spores. The PCFR has implemented this disinfection protocol as a tool in eliminating EMS vehicles and the station environment as reservoirs of infection for patients, visitors, and firefighters. Future efforts will include assessing the impact of regular cleaning and disinfection on baseline levels of bacteria, yeast, and mold spores.Funding: This study was supported by Clorox.Disclosures: None
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Nancekievill, David. "On-Site Management and Treatment of Motor Car Racing Casualties." Prehospital and Disaster Medicine 1, no. 3 (1985): 326–29. http://dx.doi.org/10.1017/s1049023x00065997.
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In 1964, the medical team at motor car races consisted of 2 physicians, including the author, several first aid workers, and 2 nurses. Only one physician stood at the trackside and sophisticated equipment was non-existant. Nevertheless, it was possible to resuscitate drivers who had suffered a cardiac arrest at the moment of impact, by simple cardiopulmonary resuscitation (CPR). In 1965, the Grand Prix mobile hospital was added. This was a Juggernaut container lorry containing a well-equipped operating room and scrub up area. It was found to be of little use in the UK, although the idea behind it was well intentioned. The problem with the unit was one of mobility. It was certainly true that the hospital could be taken from London to Paris, but it was far too big to be driven from the car park to the injured driver at the side of the track. In 1968, theBritish Racing and Sports Car Club (BRSCC) introduced the first rescue unit. This short wheel base vehicle was presented to the club by Ford as a service to motor sport. It contained all necessary fire-fighting, cutting and medical equipment. It was to reach the scene of any accident within 3 minutes. In that way a driver whose heart had stopped at the moment of impact could be resuscitated before his brain suffered irreparable damage. Apart from firemen, the rescue unit carried a physician, usually an anaesthetist skilled in resuscitation. As a result, the standard of care around the circuit became standardized after the first few minutes.
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Hammond, Jeffrey, Gerardo A. Gomez, Ellen Fine, Jeanne Eckes, and Monica Castro. "The Non-Use of 9-1-1: Private Transport of Trauma Patients to a Trauma Center." Prehospital and Disaster Medicine 8, no. 1 (March 1993): 35–38. http://dx.doi.org/10.1017/s1049023x00039984.
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AbstractHypothesis:Privately transported, major trauma patients made up approximately 4% of the total trauma patients population at a major, regional trauma center which treats over 90% of all major trauma victims in the geographic area. This study was undertaken to evaluate the patient profile of those individuals who did not access 9-1-1 for transport to a trauma center, including their reasons for such non-use.Methods:Data on all major trauma occurring within Dade County, Florida, were collected by the county trauma registry.Results:In the last six months of 1989, 1,672 patients were entered into the trauma registry. One-thousand-six-hundred-thirteen (1,613) were transported by professional ground or air services, 59 by private vehicle. For those patients transported directly from the Emergency Department to the Operating Room, only 35% of private vehicle patients entered surgery within 90 minutes of presentation compared to 57% of those who gained access to the 9-1-1 system and used emergency medical services (EMS). One-half of those patients who did not use 9-1-1 did not have telephone access. Patient acuity was similar for those transported by private vehicle compared to those transported by basic or advanced life support units. Private vehicle transport often delayed patient triage and assessment. Thus, for a number of lower income patients, 9-1-1 access was difficult.Conclusion:Underestimation of the severity of the injury or fear of delay in rescue response were prominent reasons for non-use of 9-1-1. While educational efforts should concentrate on decreasing inappropriate 9-1-1 use for nonemergencies, the causes of underutilization should not be ignored.
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Blackburn, Michael L., Kikumi D. Ono-Moore, Hany F. Sobhi, and Sean H. Adams. "Carnitine palmitoyltransferase 2 knockout potentiates palmitate-induced insulin resistance in C2C12 myotubes." American Journal of Physiology-Endocrinology and Metabolism 319, no. 2 (August 1, 2020): E265—E275. http://dx.doi.org/10.1152/ajpendo.00515.2019.
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Saturated fatty acids (SFAs) are implicated in muscle inflammation/cell stress and insulin resistance, but the catalog of factors involved is incomplete. SFA derivatives that accumulate with mismatched FA availability and FA oxidation (FAO) are likely involved, and evidence has emerged that select acylcarnitines should be considered. To understand if excessive long-chain acylcarnitine accumulation and limited FAO associate with lipotoxicity, carnitine palmitoyltransferase 2 knockout C2C12 cells were generated (CPT2 KO). CPT2 KO was confirmed by Western blot, increased palmitoylcarnitine accumulation, and loss of FAO capacity. There was no effect of CPT2 KO on palmitic acid (PA) concentration-dependent increases in media IL-6 or adenylate kinase. PA at 200 and 500 µM did not trigger cell stress responses (phospho-Erk, -JNK, or -p38) above that of vehicle in WT or CPT2 KO cells. In contrast, loss of CPT2 exacerbated PA-induced insulin resistance (acute phospho-Akt; 10 or 100 nM insulin) by as much as ~50–96% compared with WT. Growing cells in carnitine-free media abolished differences between WT and CPT2 KO, but this did not fully rescue PA-induced insulin resistance. The results suggest that PA-induced insulin resistance stems in part from palmitoylcarnitine accumulation, further supporting the hypothesis that select acylcarnitines participate in cell signaling and, when in excess, can compromise cell function. Since carnitine-free conditions could not fully rescue insulin signaling, and CPT2 KO did not alter cell stress responses, the majority of PA-induced “lipotoxicity” in C2C12 myotubes cannot be attributed to palmitoylcarnitine alone.
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Powers, Jordan G., Andrew J. Monaghan, Arthur M. Cayette, David H. Bromwich, Ying-Hwa Kuo, and Kevin W. Manning. "Real-Time Mesoscale Modeling Over Antarctica: The Antarctic Mesoscale Prediction System*." Bulletin of the American Meteorological Society 84, no. 11 (November 1, 2003): 1533–46. http://dx.doi.org/10.1175/bams-84-11-1533.
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In support of the United States Antarctic Program (USAP), the National Center for Atmospheric Research and the Byrd Polar Research Center of The Ohio State University have created the Antarctic Mesoscale Prediction System (AMPS): an experimental, real-time mesoscale modeling system covering Antarctica. AMPS has been designed to serve flight forecasters at McMurdo Station, to support science and operations around the continent, and to be a vehicle for the development of physical parameterizations suitable for polar regions. Since 2000, AMPS has been producing high-resolution forecasts (grids to 3.3 km) with the “Polar MM5,” a version of the fifth-generation Pennsylvania State University-NCAR Mesoscale Model tuned for the polar atmosphere. Beyond its basic mission of serving the USAP flight forecasters at McMurdo, AMPS has assisted both in emergency operations to save lives and in programs to explore the extreme polar environment. The former have included a medical evacuation from the South Pole and a marine rescue from the continental margin. The latter have included scientific field campaigns and the daily activities of international Antarctic forecasters and researchers. The AMPS program has been a success in terms of advancing polar mesoscale NWP, serving critical logistical operations of the USAP, and, most visibly, assisting in emergency rescue missions to save lives. The history and performance of AMPS are described and the successes of this unique real-time mesoscale modeling system in crisis support are detailed.
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Jaslow, Sonia, David Jaslow, Derek Zecher, Ryan Synnestvedt, Nathaniel Zahustecher, Kevan Melly, and Ryan Overberger. "Deuce and a Half with a Twist: Repurposing Old Technology to Save Lives in Swiftwater Rescue during Urban and Small Stream Flash Flooding." Prehospital and Disaster Medicine 34, s1 (May 2019): s115. http://dx.doi.org/10.1017/s1049023x19002450.
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Introduction:Vehicles stranded in rising water account for the majority of swiftwater rescues (SWR) during urban and small stream flash flooding. Multiple simultaneous SWR incidents are commonplace during severe storms. Historically, SWR teams have pursued a “reach, throw, row, go” strategy. However, reach and throw attempts are usually futile. Boat operations and/or in-water rescue attempts can be technically complicated, time-consuming, and a drain on rescuer resources.Aim:To design an ideal SWR modality for use during urban and small stream roadway flooding.Methods:SWR objectives, strategy, and tactics were mapped against various transportation modalities to develop the safest solution for urban and small stream flood response.Results:High water vehicles (HWV), such as the “deuce and a half” 6 × 6 military truck, represent a new standard for SWR practicality and safety as they can reduce rescuer time in-water. HWVs are heavy and high enough to be stable on roadways in most flash flooding conditions. A properly designed emergency response package includes a fording kit, multi-directional floodlights for nighttime operations, public safety radios, and a siren that doubles as a public address system to coach victims as a rescue is initiated. Deployable ladders enable rescuer egress from and victim access to a covered lighted cargo bed that holds PPE, throw bags, and rescue rings; a deployable “boat in a bag” for victims who require ferrying; and a heated seating area where medical evaluation can be conducted while staying dry.Discussion:SWRs are dangerous resource-intensive incidents which account for more rescuer morbidity/mortality than all other technical rescue sub-types combined. These incidents will increase in frequency and severity worldwide due to climate change and overdevelopment. If rescue conditions are still tenable, HWVs are the most efficient and effective platform for conducting SWR from flooded roadways while decreasing safety risks to first responders and victims.
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Xu, Emily Z., Crystal Kantores, Julijana Ivanovska, Doreen Engelberts, Brian P. Kavanagh, Patrick J. McNamara, and Robert P. Jankov. "Rescue treatment with a Rho-kinase inhibitor normalizes right ventricular function and reverses remodeling in juvenile rats with chronic pulmonary hypertension." American Journal of Physiology-Heart and Circulatory Physiology 299, no. 6 (December 2010): H1854—H1864. http://dx.doi.org/10.1152/ajpheart.00595.2010.
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Chronic pulmonary hypertension in infancy and childhood is characterized by a fixed and progressive increase in pulmonary arterial pressure and resistance, pulmonary arterial remodeling, and right ventricular hypertrophy and systolic dysfunction. These abnormalities are replicated in neonatal rats chronically exposed to hypoxia from birth in which increased activity of Rho-kinase (ROCK) is critical to injury, as evidenced by preventive effects of ROCK inhibitors. Our objective in the present study was to examine the reversing effects of a late or rescue approach to treatment with a ROCK inhibitor on the pulmonary and cardiac manifestations of established chronic hypoxic pulmonary hypertension. Rat pups were exposed to air or hypoxia (13% O2) from postnatal day 1 and were treated with Y-27632 (15 mg/kg) or saline vehicle by twice daily subcutaneous injection commencing on day 14, for up to 7 days. Treatment with Y-27632 significantly attenuated right ventricular hypertrophy, reversed arterial wall remodeling, and completely normalized right ventricular systolic function in hypoxia-exposed animals. Reversal of arterial wall remodeling was accompanied by increased apoptosis and attenuated content of endothelin (ET)-1 and ETA receptors. Treatment of primary cultured juvenile rat pulmonary artery smooth muscle cells with Y-27632 attenuated serum-stimulated ROCK activity and proliferation and increased apoptosis. Smooth muscle apoptosis was also induced by short interfering RNA-mediated knockdown of ROCK-II, but not of ROCK-I. We conclude that sustained rescue treatment with a ROCK inhibitor reversed both the hemodynamic and structural abnormalities of chronic hypoxic pulmonary hypertension in juvenile rats and normalized right ventricular systolic function. Attenuated expression and activity of ET-1 and its A-type receptor on pulmonary arterial smooth muscle was a likely contributor to the stimulatory effects of ROCK inhibition on apoptosis. In addition, our data suggest that ROCK-II may be dominant in enhancing survival of pulmonary arterial smooth muscle.
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Novaro Mascarello, Laura, and Fulvia Quagliotti. "The civil use of small unmanned aerial systems (sUASs): operational and safety challenges." Aircraft Engineering and Aerospace Technology 89, no. 5 (September 4, 2017): 703–8. http://dx.doi.org/10.1108/aeat-01-2017-0014.
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Purpose In the past decades, both civil and military applications of small unmanned aerial systems (sUASs) have been on the rise. The sUASs guarantee the performance of dangerous, dull, duly and dirty missions, according to the 4D rule. The purpose of this study is to describe, some ethical, operational and safety challenges occur owing to the use of sUASs at over-crowded areas or in emergency scenarios. After an overview of the current sUAS regulations, some strategic configuration elements will be analysed to improve these systems and to define safe and inoffensive sUASs. Nevertheless, some problems have not been completely overcome. Design/methodology/approach The unmanned vehicles are nowadays applied for different kinds of applications. Search and rescue (S&R) missions; terrain surveillance and monitoring after natural disasters, such as earthquakes and landslides; and transportation of medical equipment and cartography are some examples of the most renowned and important civil missions of sUAS. In all these scenarios, some challenges could be encountered. First, the use of sUASs could compromise the privacy of unaware citizens who are in the area of application. Moreover, even if the unmanned vehicle works according to national and international regulations, there are some hazards both for the ground operators and for the population, because these sUASs could impact the human body after a flight failure. Findings In this paper, current principal regulations will be analysed, identifying some differences and discrepancies among them. Moreover, some considerations about the configuration elements are introduced to define the safe use of sUASs. Nevertheless, the privacy challenge is quite complicated to be overcome definitely. Originality/value Considering some challenges related to the civil applications of sUASs, new unmanned configurations could be developed to guarantee safety and data protection of unaware people.
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Zakrison, Tanya L., Nicholas Namias, Marc M. Grossman, David V. Shatz, Fahim Habib, Louis Pizano, Antonio Marttos, and Gabriel Ruiz. "The Rare Requirement of On-scene Extremity Amputations in the Entrapped Trauma Patient." Panamerican Journal of Trauma, Critical Care & Emergency Surgery 5, no. 2 (2016): 93–100. http://dx.doi.org/10.5005/jp-journals-10030-1151.
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ABSTRACT Objectives Entrapment of trauma patients in motor vehicle and other accidents is common. Frequently, Emergency Medical Services (EMS) personnel and firefighters are able to free the patient and initiate rapid transport to trauma centers. In rare circumstances, severe torso and extremity injuries combined with major entrapment may require complex rescue operations. These trauma patients spend the “Golden Hour” at the scene under difficult conditions. The objective of this review is to evaluate the role of the trauma surgeon leading the care at the scene of critically injured and entrapped trauma patients with possible need for surgical interventions. Materials and methods A 10-year review of all trauma surgeon to scene activations between 2005 and 2014 at the Ryder Trauma Center, an urban ACS Level 1 trauma center, was performed. An analysis of the trauma registry, individual cases, and surgical interventions was conducted. Results The University of Miami/Jackson Memorial Hospital (UM/JMH) Ryder Trauma Center and Miami Dade Fire Rescue have an established program in place for trauma surgeon to scene activations. During the study period, the on-call trauma surgeon was activated six times and traveled to the scene by air rescue helicopter four times, by ground in 1 case and in 1 case the patient expired before takeoff. One patient required on-scene amputation of an entrapped non-salvageable upper extremity. Two patients required on-scene amputation of bilateral lower mangled, entrapped extremities. One patient required a localized limb preserving surgical procedure to free him from entrapment. The incidence was 0.016% of 36,872 trauma alert activated patients evaluated at Ryder Trauma Center during the study period. Hemorrhagic shock, associated injuries, and long scene times were present in all patients. The survival of treated patients was 80%. Conclusion The need for on-scene amputations of nonsalvable extremities in entrapped trauma patients is rare. Experienced trauma surgeons should evaluate these patients and decide which interventions are necessary. All efforts should be made to salvage the limb. However, if the entrapped extremity appears nonsalvageable and the patient is in profound life-threatening shock requiring rapid transport, field amputation may be required. Policies, safety training and gear, supply kits, and partnerships with EMS are needed. How to cite this article Pust GD, Grossman MM, Shatz DV, Habib F, Pizano L, Zakrison TL, Marttos A, Ruiz G, Ginzburg E, Namias N. The Rare Requirement of On-scene Extremity Amputations in the Entrapped Trauma Patient. Panam J Trauma Crit Care Emerg Surg 2016;5(2):93-100.
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Khan, Faheem, Asim Ghaffar, Naeem Khan, and Sung Ho Cho. "An Overview of Signal Processing Techniques for Remote Health Monitoring Using Impulse Radio UWB Transceiver." Sensors 20, no. 9 (April 27, 2020): 2479. http://dx.doi.org/10.3390/s20092479.
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Non-invasive remote health monitoring plays a vital role in epidemiological situations such as SARS outbreak (2003), MERS (2015) and the recently ongoing outbreak of COVID-19 because it is extremely risky to get close to the patient due to the spread of contagious infections. Non-invasive monitoring is also extremely necessary in situations where it is difficult to use complicated wired connections, such as ECG monitoring for infants, burn victims or during rescue missions when people are buried during building collapses/earthquakes. Due to the unique characteristics such as higher penetration capabilities, extremely precise ranging, low power requirement, low cost, simple hardware and robustness to multipath interferences, Impulse Radio Ultra Wideband (IR-UWB) technology is appropriate for non-invasive medical applications. IR-UWB sensors detect the macro as well as micro movement inside the human body due to its fine range resolution. The two vital signs, i.e., respiration rate and heart rate, can be measured by IR-UWB radar by measuring the change in the magnitude of signal due to displacement caused by human lungs, heart during respiration and heart beating. This paper reviews recent advances in IR- UWB radar sensor design for healthcare, such as vital signs measurements of a stationary human, vitals of a non-stationary human, vital signs of people in a vehicle, through the wall vitals measurement, neonate’s health monitoring, fall detection, sleep monitoring and medical imaging. Although we have covered many topics related to health monitoring using IR-UWB, this paper is mainly focused on signal processing techniques for measurement of vital signs, i.e., respiration and heart rate monitoring.
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Lanzino, Giuseppe, Neal F. Kassell, Nicholas W. C. Dorsch, Alberto Pasqualin, Lennart Brandt, Peter Schmiedek, Laura L. Truskowski, Wayne M. Alves, and _. _. "Double-blind, randomized, vehicle-controlled study of high-dose tirilazad mesylate in women with aneurysmal subarachnoid hemorrhage. Part I. A cooperative study in Europe, Australia, New Zealand, and South Africa." Journal of Neurosurgery 90, no. 6 (June 1999): 1011–17. http://dx.doi.org/10.3171/jns.1999.90.6.1011.
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Object. Findings from previous multicenter clinical trials have suggested that tirilazad mesylate, a synthetic nonhormonal 21-aminosteroid, might be effective in preventing delayed cerebral ischemia following subarachnoid hemorrhage (SAH). This beneficial effect, however, was greater in males than females, possibly because of gender-related pharmacokinetic differences. The authors sought to assess the effects of administering a larger dose of tirilazad in women with SAH.Methods. To test the efficacy of a higher tirilazad mesylate dose in female patients, a prospective randomized, doubleblind, vehicle-controlled trial was conducted at 56 neurosurgical centers in Europe, Australia, New Zealand, and South Africa. Eight hundred nineteen patients were randomly assigned to receive either 15 mg/kg/day of tirilazad mesylate or a placebo containing the citrate vehicle. The two groups were similar in prognostic factors for delayed cerebral ischemia and overall outcome. High-dose tirilazad appeared to be well tolerated because no differences in the incidence of untoward medical events were noted between the two groups. Medical and surgical interventions were no different in the two treatment groups except for hyperdynamic therapy (intentional hypervolemia, induced hypertension, and/or hemodilution), which was more often used in the placebo-treated group to counteract symptomatic vasospasm (24% of patients given placebo compared with 18% of patients given tirilazad, p = 0.02).Mortality rates and overall outcome, assessed using the Glasgow Outcome Scale at 3 months post-SAH, were not different between the two groups, despite a significantly lower incidence of delayed cerebral ischemia in patients given tirilazad. Post hoc subgroup analysis by neurological grade also did not reveal significant differences in outcome, although a trend toward a lower mortality rate favoring the study drug was present in patients with neurological Grade IV and V at admission (32% compared with 37%). Symptomatic vasospasm occurred in 33.7% of the placebo-treated patients as opposed to 24.8% of the patients who were given tirilazad (p = 0.005). The severity of symptomatic vasospasm was also attenuated by administration of the study drug (severe symptomatic vasospasm was reported in 11% of the placebo-treated patients compared with 6% of patients in the tirilazad-treated group (p = 0.008). Clinical cerebral infarction from vasospasm was also reduced from 13% in the vehicle-treated group to 8% in the tirilazad-treated group (p < 0.04).Conclusions. The authors conclude that high-dose tirilazad mesylate is well tolerated in women with aneurysmal SAH. Although a significant reduction in the incidence of symptomatic vasospasm was observed in the treatment group, the primary end point (mortality rate at 3 months post-SAH) was not affected by the study drug. The use of other potentially effective rescue therapies (that is, hypervolemia, hemodilution, and induced hypertension) to counteract vasospasm may have been responsible for these contrasting observations between the two groups.
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Maslyakov, Vladimir Vladimirovich, Yurii Evlampievich Barachevskii, Ol'ga Nikolaevna Pavlova, Dmitrii Aleksandrovich Polikarpov, Aleksandr Vladimirovich Pimenov, Aleksei Gennadievich Proshin, and Anastasiya Aleksandrovna Pimenova. "Analysis of the results of rendering first aid in case of maxillofacial injuries suffered in road traffic accidents." Вопросы безопасности, no. 1 (January 2021): 20–27. http://dx.doi.org/10.25136/2409-7543.2021.1.35438.
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For achieving the set goal, the author conducted a retrospective research. The study involved the victims of road traffic accidents aged from 18 to 70 years, who suffered maxillofacial injuries; total of 150 victims over the period from 2010 to 2020. The selected topic is a pressing medical and social problem. It is observed that the number of close and open injuries received in road traffic accidents is roughly the same. However, the open injuries qualified as moderate and severe were determined in 45 (30%) cases. The data analysis indicates that in 30.7% of cases, first aid was rendered by bystanders and/or relatives of the victims, who do not have the necessary competence and knowledge for providing such aid; in another 19.3% of cases, first aid was rendered by operational services personnel (traffic police, fire and rescue divisions), who have the necessary knowledge and skills. The absence of necessary skills for rendering first aid to the victims of road traffic accident with such type of injury explains high percentage of mistakes, which amounted to 41.3%. At the same time, the operational services personnel demonstrated good results in rendering first aid; no mistakes were detected. The analysis of the common mistakes indicates the application of physical efforts in the process of removing victims from the vehicle; no special means while the victim's head was not fixated, which causes additional injuries. In six (4.0%) cases, the spoor condition of the victims was mistaken with comatose.
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Maslyakov, Vladimir Vladimirovich, Yurii Evlampievich Barachevskii, Ol'ga Nikolaevna Pavlova, Dmitrii Aleksandrovich Polikarpov, Aleksandr Vladimirovich Pimenov, Aleksei Gennadievich Proshin, and Anastasiya Aleksandrovna Pimenova. "Analysis of the results of rendering first aid in case of maxillofacial injuries suffered in road traffic accidents." Вопросы безопасности, no. 2 (February 2021): 20–27. http://dx.doi.org/10.25136/2409-7543.2021.2.35438.
Full textAbstract:
For achieving the set goal, the author conducted a retrospective research. The study involved the victims of road traffic accidents aged from 18 to 70 years, who suffered maxillofacial injuries; total of 150 victims over the period from 2010 to 2020. The selected topic is a pressing medical and social problem. It is observed that the number of close and open injuries received in road traffic accidents is roughly the same. However, the open injuries qualified as moderate and severe were determined in 45 (30%) cases. The data analysis indicates that in 30.7% of cases, first aid was rendered by bystanders and/or relatives of the victims, who do not have the necessary competence and knowledge for providing such aid; in another 19.3% of cases, first aid was rendered by operational services personnel (traffic police, fire and rescue divisions), who have the necessary knowledge and skills. The absence of necessary skills for rendering first aid to the victims of road traffic accident with such type of injury explains high percentage of mistakes, which amounted to 41.3%. At the same time, the operational services personnel demonstrated good results in rendering first aid; no mistakes were detected. The analysis of the common mistakes indicates the application of physical efforts in the process of removing victims from the vehicle; no special means while the victim's head was not fixated, which causes additional injuries. In six (4.0%) cases, the spoor condition of the victims was mistaken with comatose.
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Sefrin, P. "The Rendezvous System Using Emergency Doctors' Vehicles in the Federal Republic of Germany (FRG)." Prehospital and Disaster Medicine 1, S1 (1985): 145–47. http://dx.doi.org/10.1017/s1049023x00044204.
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In the Federal Republic of Germany, 1.2 million people per year get into a life-threatening situation from which they can be saved only by immediate medical assistance. Progress in intensive care therapy and the improved organization of rescue services have led to a greater number of doctors being available for first aid at the scene of the accident. The creation of an emergency medical service was designed to ensure medical treatment of emergency patients by medically qualified personnel. The Emergency Medical Service is defined as an organization within the framework of rescue services providing care for emergency patients. The emergency physician is trained and equipped particularly to recognize and treat life-threatening conditions. Through the rescue service, the physician can be taken to the scene of the accident by the quickest and shortest way. For this need, two systems have become established in the Federal Republic of Germany.
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Yu, Baoguo, Zhen Yang, Song Bai, Xuexian Shan, Qi Lv, Hui Ding, and Shike Hou. "Construction and Grouping of a Chinese People’s Armed Police Forces Provincial-Level Mobile Rescue Hospital System." Disaster Medicine and Public Health Preparedness 12, no. 4 (November 14, 2016): 502–6. http://dx.doi.org/10.1017/dmp.2016.110.
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AbstractIn recent years, with the increasingly frequent variety of large-scale disasters that have happened in China, the Chinese People’s Armed Police Forces (PAP) has undertaken increasingly frequent and diversified tasks, which has led to greater requirements for the construction of emergency medical rescue equipment. Therefore, as determined by the characteristics of the PAP’s tasks and based on the construction of special boxes and frame tent equipment, a new PAP mobile rescue hospital system was successfully developed, and all PAP provincial-level medical rescue teams have been equipped with this system. In the present article, we describe this mobile rescue hospital system, which is mainly composed of professional emergency vehicles, frame-type tents, and advanced medical equipment. The system has the following characteristics: significant integration, a fast response, flexibility, and practicability. The mobile rescue system is generally used as the army’s own health service support system and to provide certain emergency medical rescue services to disaster-stricken people. The successful construction and further application of this system have significance in terms of accelerating the response of rescue teams and the emergency treatment ability of the PAP’s provincial-level emergency medical rescue teams. (Disaster Med Public Health Preparedness. 2018;12:455–459)
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Han, Bing, Mingxing Hu, and Jialing Wang. "Site Selection for Pre-Hospital Emergency Stations Based on the Actual Spatiotemporal Demand: A Case Study of Nanjing City, China." ISPRS International Journal of Geo-Information 9, no. 10 (September 25, 2020): 559. http://dx.doi.org/10.3390/ijgi9100559.
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Rapid economic and social development has been accompanied by the occurrence of many major issues throughout the world. Specifically, there is an ever-increasing demand for emergent medical services among the public. In order to ensure timely responses to emergency demands, it is critical to reasonably configure the emergency stations. In general, emergency stations are mostly distributed according to the distribution of emergency demands and response time, which, however, fails to consider the negative impacts of randomly occurring emergency demands and traffic delays. In this study, first aid demands are combined with traffic states based on the spatiotemporal big data set covering model, which alleviates the negative impacts of randomly occurring first aid demands and traffic delay time on the planning of pre-hospital first aid stations. Moreover, the accuracy of the site selection model is improved, which meets the requirements that all randomly occurring simulated first aid demands can be approached within the target time under planning conditions and actual traffic constraints. Taking Nanjing City as an example, this study obtains multi-source big data, such as ambulance-carried GPS data from June 2018 to June 2019, Gaode Map-recorded traffic congestion data, and survey data of emergency rescue facilities. Basing on the processing and analysis of these data, it shows that first aid demands in Nanjing City are highly region-specific with high time delay. Various required factors are determined based on modeling and analysis, and the target time is agreed to be 8 min. The average vehicle speed on each road is calculated, accompanied by the establishment of an actual road network model. In this context, the transit time from the randomly distributed first aid stations to the hospital can be calculated, which are set to satisfy the model conditions so as to obtain the solution. Finally, such a solution is adjusted and verified according to the land-use situation. The results of this study, based on spatiotemporal big data, are expected to provide insights into improving the site selection model and enhancing efficiency while providing new technical methods.
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Patterson, Andrea M., Pratibha Singh, Hongge Li, Hui Lin Chua, Alexa Fisher, Carol Sampson, Artur Plett, Christie M. Orschell, and Louis M. Pelus. "Prostaglandin E2 Promotes Early Bone Marrow Reconstitution for Survival after Lethal Irradiation." Blood 128, no. 22 (December 2, 2016): 1481. http://dx.doi.org/10.1182/blood.v128.22.1481.1481.
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Abstract Introduction: High dose total body irradiation (TBI) causes severe damage to the hematopoietic system, resulting in ablation of both red and white blood cells and a high probability of infection, hemorrhage, and death. This is known as the hematopoietic syndrome of the acute radiation syndrome (HS-ARS). TBI is used therapeutically, and incidental exposure through nuclear accidents or radical terrorism is a current threat for which preparation is critical. Safe, effective, and pragmatic agents against HS-ARS are needed. We have identified prostaglandin E2 (PGE2) as a promising medical countermeasure to promote hematopoietic recovery and increase survival from lethal irradiation. Here, using the PGE2 analog 16,16-dimethyl PGE2 (dmPGE2), pre-irradiation dosing strategies were assessed in survival studies with an established mouse model of HS-ARS, and time course analyses were performed to elucidate the early cellular events associated with PGE2 radioprotection. Methods: C57BL/6 mice (n = 20/group) were exposed to LD70/30 (872 cGy) or LD90/30 (904 cGy) and treated with one of the following four dmPGE2 dosing strategies: a single dose of 35 μg at time -30 min, -1 hr, or -3 hr, or a double-dose of 20 μg each at time -45 min and -15 min pre-irradiation. Thirty-day survival was evaluated. The double-dose regimen was further utilized to assess cellular effects over time following LD70/30. Peripheral blood (PB) and bone marrow (BM) cells were harvested on days 1, 2, 4, 7, and 10 post-irradiation (n = 3/group/day). BM was analyzed by flow cytometry with immunostaining for surface markers (Sca-1, c-Kit, CD150, CD48 and blood cell lineage markers), cell cycle (Hoechst/PyroninY), and apoptosis (AnnexinV/7-AAD). PB differentials were assessed by a veterinary hematology analyzer. Results: All dmPGE2 regimens conferred 100% survival to mice receiving LD70/30, and all regimens provided a distinct survival advantage to mice receiving LD90/30 with the double-dose strategy conferring 100% survival at LD90/30. The double-dose was then chosen to assess cellular effects of dmPGE2 throughout the critical 10-day time period following LD70/30. Within the BM, marker-defined HSC numbers were significantly preserved by day 1 post-irradiation compared to vehicle controls, with a drop to vehicle levels observed on day 2 only. Cell cycling frequency among primitive hematopoietic cells was also conserved on day 1, decreased on day 2, then restored to non-irradiated control levels by days 7-10, while that of the unprotected mice remained significantly lower. Differentiated BM cells (lineage marker-positive) were substantially less apoptotic by day 2 and, in significant contrast to the untreated mice, returned to control levels of basal apoptosis by days 7-10. Overall BM cell populations were found to be largely replenished within one week as compared to the vehicle-treated mice, which remained significantly depressed. Further, 73-88% of detectable BM cells from the untreated mice were non-viable by day 4 post-irradiation based on sub-diploid DNA content and did not recover through day 10; dmPGE2-treated mice maintained significantly greater BM cell viability at each time point, returning to only 17-26% sub-diploid by day 7 (non-irradiated controls demonstrated ~5% sub-diploid DNA content). A corresponding effect on PB resulted in significant rescue from neutropenia, anemia, and thrombocytopenia by or before day 10. Conclusions: A single treatment with PGE2 prior to lethal irradiation can facilitate virtually complete survival, though a double treatment regimen may be most effective; further work will test whether this may be primarily due to the combined higher dose or to the altered timing. This PGE2-mediated survival involves early protection of both primitive and differentiated hematopoietic BM cells, affecting cell number, cell cycling, and apoptosis. Early hematopoietic BM recovery subsequently rescues PB components, facilitating ultimate survival. With further study, PGE2 may serve to provide an effective radioprotectant with the potential to safeguard patients undergoing TBI therapy, as well as military personnel and first responders, from the risk of radiation-associated mortality. Disclosures No relevant conflicts of interest to declare.
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Ruan, Junhu, Felix Chan, and Xiaofeng Zhao. "Re-Planning the Intermodal Transportation of Emergency Medical Supplies with Updated Transfer Centers." Sustainability 10, no. 8 (August 9, 2018): 2827. http://dx.doi.org/10.3390/su10082827.
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Helicopters and vehicles are often jointly used to transport key relief supplies and respond to disaster situations when supply nodes are far away from demand nodes or the key roads to affected areas are cut off. Emergency transfer centers (ETCs) are often changed due to secondary disasters and further rescue, so the extant intermodal transportation plan of helicopters and vehicles needs to be adjusted accordingly. Disruption management is used to re-plan emergency intermodal transportation with updated ETCs in this study. The basic idea of disruption management is to minimize the negative impact resulting from unexpected events. To measure the impact of updated ETCs on the extant plan, the authors consider three kinds of rescue participators, that is, supply recipients, rescue drivers, and transport schedulers, whose main concerns are supply arrival time, intermodal routes and transportation capacity, respectively. Based on the measurement, the authors develop a recovery model for minimizing the disturbance caused by the updated ETCs and design an improved genetic algorithm to generate solutions for the recovery model. Numerical experiments verify the effectiveness of this model and algorithm and discern that this disruption management method could produce recovery plans with shorter average waiting times, smaller disturbances for all the supply arrival times, intermodal routes and transportation capacity, and shorter running times. The comparison shows the advantage of this disruption management method over the rescheduling method.
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Gula, P. W., and E. M. Szafran. "(A265) Emergency Services In Catastrophic Flooding In Poland (2010 Experience)." Prehospital and Disaster Medicine 26, S1 (May 2011): s73. http://dx.doi.org/10.1017/s1049023x11002494.
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Emergency Services in catastrophic flooding in Poland (2010 experience) Przemyslaw Gula MD PhD, Edyta Szafran Institute for Emergency Medicine Flooding, Natural Disasters, Rescue Operations Between 17th May and 22nd June Poland faced one of the most catastrophic natural disasters in past 100 years history. The overall area of 779300 sq km. has been flooded. The flood affected several large municipalities. Nearly 270.000 people suffered the direct effects of the flood and 31000 were evacuated from their homes, 22 people were killed. Total number of 19000 buildings were destroyed or seriously damaged. Responding services were mainly the Fire and Rescue Service, Police, EMS, Military Units as well as supporting NGO's. The rescue and relief operation focused on evacuation, providing temporary shelter, water supply, establishing medical treatment and vaccination, providing public security. One of the challenges was the threat of evacuation of the hospitals in the affected areas. The total number of 80000 of rescue personnel and 15000 of military was involved in the rescue operation. The medical emergency operation included helicopter and boat evacuation, organization of field medical posts and secondary medical transfers. 43 helicopters and 1.000 vehicles were used. One of the problem was the collapse of the telephone network that affected the 112 Emergency Dispatch System. The out coming conclusions presented the high vulnerability of local medical systems on the effects of flooding. However the logistic support of Fire and Rescue and Military recourses can give quick compensation. The role of HEMS and SAR helicopters in providing evacuation and medical assistance is essential. Special emphasis should be made on providing the coordination of multiservice response and replacing the affected local communication systems. The main conclusion after flooding was the need of stronger integration of civil and military services, procedures, communication systems and compatibility of the equipment.
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Azimi, S., M. R. Delavar, and A. Rajabifard. "An optimized multi agent-based modeling of smart rescue operation." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLII-3/W4 (March 6, 2018): 93–100. http://dx.doi.org/10.5194/isprs-archives-xlii-3-w4-93-2018.
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<p><strong>Abstract.</strong> After the incidence of a disaster, a high demand for first-aid and a huge number of injured will emerge at the affected areas. In this paper, the optimum allocation of the medical assistance to the injured according to a multi-criteria decision making is performed by Multiplicatively Weighted Network Voronoi Diagram (MWNVD). For consideration of the allocation of the injured in the affected area to the appropriate hospitals using the MWNVD and decreasing the gap between the estimated and expected population in the MWNVDs, Particle Swarm Optimization (PSO) is applied to the MWNVDs.<br> This paper proposes a multi agent-based modeling for incorporating the allocation of the medical supplies to the injured according to the generated Voronoi Diagrams of the PSO-MWNVD, wayfinding of emergency vehicles based on the minimum travel distance and time as well as using smart city facilities to expedite the rescue operation. In the proposed model, considering the priority of the injured for receiving the medical assistance, information transfer about the condition of the injured to the hospitals prior to ambulance arrival for providing appropriate treatment, updating of emergency vehicles route based on the blocked streets and etc. are optimized.<br> The partial difference between the estimated and expected population for receiving the medical assistance in MWNVDs is computed as 37&thinsp;%, while the PSO-MWNVD decreased the mentioned difference to 6&thinsp;%. The relief operation time in the proposed model compared to another multi-agent rescue operation model, which uses MWNVD and does not have some facilities of the proposed model, is improved.</p>
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Mu, Haibo, Linzhong Liu, Yubo Song, and Na Wang. "Control Strategy of Signal Transition after Emergency Vehicle Signal Preemption." Discrete Dynamics in Nature and Society 2020 (January 27, 2020): 1–11. http://dx.doi.org/10.1155/2020/1382415.
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Emergency vehicle (EV) plays an important role in evacuations or rescues when emergencies occur. To insure that an EV can transfer people in danger to emergency shelters or medical assistance organizations as soon as possible, EV signal preemption (EVSP) strategy is usually adopted. After EV has passed through the intersection, traffic signal has to transfer back to normal signal timing scheme. This paper focuses on the control strategy of EV signal transitioning from EVSP back to normal operation. Considering both efficiency and fairness, the maximum vehicles passing through in per unit time during the transition period and the minimum difference between the maximum and the minimum queue length after transition are selected as objectives, and a multi-objective optimization model is presented. A nondominated sorting genetic algorithm II (NSGA-II) is designed to solve the optimization model and unique encoding and decoding methods are presented. The established model and designed algorithm are verified and the control effect is analyzed. Simulation results indicate that by adopting the control strategy obtained by the presented model, the number of vehicles passing through in per unit time during the transition period is increased and the difference of vehicle length in different directions is reduced significantly, from which we can conclude that the control method proposed in this paper has good performance.
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Jiang, Xiaobin, Ping Jiang, and Yuanshen Mao. "Performance of Modified Early Warning Score (MEWS) and Circulation, Respiration, Abdomen, Motor, and Speech (CRAMS) score in trauma severity and in-hospital mortality prediction in multiple trauma patients: a comparison study." PeerJ 7 (June 25, 2019): e7227. http://dx.doi.org/10.7717/peerj.7227.
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Background With an increasing number of motor vehicle crashes, there is an urgent need in emergency departments (EDs) to assess patients with multiple trauma quickly, easily, and reliably. Trauma severity can range from a minor to major threats to life or bodily function. In-hospital mortality and trauma severity prediction in such cases is crucial in the ED for the management of multiple trauma and improvement of the outcome of these patients. Previous studies have examined the performance of Modified Early Warning Score (MEWS) or Circulation, Respiration, Abdomen, Motor, and Speech (CRAMS) score based solely on mortality prediction or injury severity prediction. However, to the best of our knowledge, the performances of both scoring systems on in-hospital mortality and trauma severity prediction have not been compared previously. This retrospective study evaluated the value of MEWS and CRAMS score to predict in-hospital mortality and trauma severity in patients presenting to the ED with multiple traumatic injuries. Methods All study subjects were multiple trauma patients. Medical data of 1,127 patients were analyzed between January 2014 and April 2018. The MEWS and CRAMS score were calculated, and logistic regression and receiver operating characteristic curve analysis were conducted to investigate their performances regarding in-hospital mortality and trauma severity prediction. Results For in-hospital mortality prediction, the areas under the receiver operating characteristic curve (AUROCs) for MEWS and CRAMS score were 0.90 and 0.91, respectively, indicating that both of them were good in-hospital mortality predictors. Further, our study indicated that the CRAMS score performed better in trauma severity prediction, with an AUROC value of 0.84, which was higher than that of MEWS (AUROC = 0.77). For trauma severity prediction, the optimal cut-off value for MEWS was 2, while that of the CRAMS score was 8. Conclusions We found that both MEWS and CRAMS score can be used as predictors for trauma severity and in-hospital mortality for multiple trauma patients, but that CRAMS score was superior to MEWS for trauma severity prediction. CRAMS score should be prioritized in the prediction of trauma severity due to its excellence as a multiple trauma triage tool and potential contribution to rapid emergency rescue decisions.
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Braverman, BSc, RN, EMT-P, Ariel. "Unmanned aerial systems (UAS) in urban search and rescue-methodology, capacity development, and integration." Journal of Emergency Management 19, no. 1 (January 1, 2021): 33–38. http://dx.doi.org/10.5055/jem.0496.
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This paper’s purpose is to establish a methodological basis for using unmanned aerial vehicles (UAV) in urban search and rescue (USAR). Modern USAR operations involve the location, rescue (extrication), and initial medical stabilization of individuals trapped in confined spaces or places with complicated access, eg, high structures. As a part of the ongoing modernization process, this paper explores possible options for UAV utilization in USAR operations. Today, UAV are already taking part in support emergency operations all over the world, and possible forms of operation for UAV in USAR environment can be in two primary modes: on-site and logistic chain. The on-site mode includes various capabilities of multilayer UAV array, mostly based on enhanced visual capabilities to create situational awareness and to speed-up search and rescue (SAR) process including using nanodrones for entering into confined places, ventilation ducts, and underground sewer channels can give to rescue teams’ opportunities to have eyes within ruins even before initial clearing process. Cargo drones will be able to bring equipment directly to high floors or roadless areas in comparison to wheeled transportation. The advantages of cargo drones operation are the ability of autonomous flight based on GPS or homing beacon and ability to provide logistics supports without involving additional personnel and vehicles and with no dependence on road conditions.
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Dick, Wolfgang F. "Mobile Intensive Care Units." Prehospital and Disaster Medicine 1, S1 (1985): 139–40. http://dx.doi.org/10.1017/s1049023x00044162.
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Mobile intensive care units (MICU) will take care of all real emergency patients with presumed or proven disturbances of vital functions. These vehicles are equipped according to standardized criteria, and usually stationed at emergency hospitals. MICU's are accompanied by one rescue assistant, one emergency medical technician (EMT) and one physician.Eighty-five to 90% of the total number of emergency calls were primary emergency calls, where the emergency patient had to be treated at the scene; 10% to possibly 20% were emergency patients who had already received treatment by medical or paramedical personnel.
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Chartoff, Stanley E., and Joann M. Gren. "Survey of Iowa Emergency Medical Services on the Effects of the 1993 Floods." Prehospital and Disaster Medicine 12, no. 3 (September 1997): 37–41. http://dx.doi.org/10.1017/s1049023x00037626.
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AbstractIntroduction:From June through August 1993, extensive flooding in the Mississippi and Missouri River basins resulted in 50 deaths and 12 billion dollars [U.S.] in damages in nine Midwestern states. In Iowa (1990 population 2,777,000), the government declared all 99 counties Federal Disaster Areas. This study examines how this event impacted local emergency medical services (EMS).Methods:All 797 registered prehospital ambulance, rescue, and first-response companies in Iowa received survey questionnaires. Two follow-up mailings were provided for non-responders.Results:A total of 468 EMS companies (59%) returned completed questionnaires. The geographic distribution ofresponders and non-responders was similar. Of the companies responding, 132 (28%) reported an impact on their operations from the flood disaster. The most frequently reported operational changes included the use of non-traditional vehicles, providing aid to regions outside usual service areas, and involvement in non-medical rescue operations.Conclusion:A major flood provides unique challenges for emergency medical services. Cross-sectional surveys can identify areas of improvement for prehospital systems located in flood-prone areas. Results from this study provide a basis for constructing a more refined instrument to study future flood disasters.
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Gula, P. W., and E. M. Szafran. "(P1-30) Natural Disasters Challenge for Emergency and Rescue Services - Lessons Learned." Prehospital and Disaster Medicine 26, S1 (May 2011): s108. http://dx.doi.org/10.1017/s1049023x11003621.
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Natural disasters challenge for Emergency and Rescue Services- lessons learned Przemyslaw Gula MD PhD, Edyta Szafran Institute for Emergency Medicine. Krakow, Poland.In the period 2008–2010 Poland experienced series of natural disasters including 3 large scales flooding, 2 periods of extremely high snowfalls followed by low temperature periods and finally local flush flooding in different locations. The time of each disaster elapsed from several days up to 6 weeks. All of them had severe impact on local infrastructure by destroying road systems, communication as well as healthcare and fire brigade facilities. The rescue efforts required evacuation, Search and Rescue operations, providing medical care and shelter. The most problems occurred in following areas: - large scale evacuation - collapse of communication systems (including 112 dispatch) - inadequate number of specialized rescue equipment (helicopters, vehicles, boats, snowmobiles, etc.) - providing EMS in affected areas - necessity of evacuating hospitals. The lessons learned showed the need for following changes: - strong trans regional coordination in means of facilitation of utilizing civil protection and military recourses - unification of operative procedures for all actors of the response operation - improvement of communication systems and reducing their vulnerability on environmental factors - establishing regional crisis management and control centers, covering the emergency response activities in affected areas - need of large-scale use of HEMS as well as Police and military helicopters in natural disasters - need for better supply in specialized rescue equipment including recue motorboats, 4 wheels drive recue vehicles and ambulances, snowmobiles, quads in local response units. The main rule of commanding the entire operation is subsidiary. Local coordinating structures should be supported by regional and central governments by supplying necessary recourses. However the operational command should be unified and include all participating units and organizations.
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Dove, Dennis B., Louis R. M. DelGuercio, William M. Stahl, Leon D. Star, and Louis C. Abelson. "Airport Disaster Planning – New York City." Journal of the World Association for Emergency and Disaster Medicine 1, no. 2 (1985): 144. http://dx.doi.org/10.1017/s1049023x00065328.
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At the John F. Kennedy International Airport in New York City, disaster planning has been an integral part of the airport operations for the past 28 years. Through the Medical Office, emergency medical teams have been recruited from all ranks of airport personnel and trained in rescue and resuscitation. Following the crash of a commercial B 727 aircraft in 1976 and the resulting crippling traffic jams in the vicinity of the airport, a new concept was added to the disaster plan. This concept involves bringing the hospital, its facilities and its personnel to the scene.A new piece of equipment, known as a Mobile Emergency Hospital was designed from existing airport equipment, with the cooperation of the airlines, the operating authority of the airport, and other interested parties. Two such vehicles are now in constant readiness at the airport and together provide 12 monitored ICU beds, a 16-bed burn unit, 2 operating rooms and 72 other stretcher-beds to be used for the stabilization of critically ill patients prior to their transfer to an appropriate definitive care facility. A newer modularized version which incorporates these features, for use in any type disaster, is currently being developed. These mobile hospitals, together with two inflatable structures maintained at the airport, are supplemented by Mobile Emergency Rescue Vehicles (MERV vans) maintained at local hospitals by the Emergency Medical Service Systems (EMSS) of New York City. Together they provide the on-site Resuscitation and Stabilization Center in the event of a disaster.
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Polyakov, Aleksey Vasilievich, Vitaly Mikhailovich Usov, Boris Ivanovich Kryuchkov, Yu P. Chernyshev, and A. I. Motienko. "Innovative Solutions for Searching, Rescuing, and Rendering Assistance to Cosmonauts on the Forced Landing Place of the Descent Module Under Extreme Conditions of the Northern Climatic Zone." MANNED SPACEFLIGHT, no. 2(31) (June 4, 2019): 76–95. http://dx.doi.org/10.34131/msf.19.2.76-95.
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The paper considers new approaches to the use of unmanned aerial vehicles (UAVs) and associated technologies of emergency warning under extreme conditions of the northern climatic zones for expanding the search and rescue capabilities in case of the forced landing of the descent module (DM). The paper also analyzes the innovative solutions on the human protection against adverse environmental effects and the means for emergency medical care that are delivered to the landing place of the descent module and allow mitigating risks for surviving under unfavorable climatic conditions prior the evacuation operations begin.
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Waage, Agne, Bertil Hamberger, Tom Lundin, Björn-Ove Suserud, and Louis Riddez. "KAMEDO Report No. 84 Terrorist Attacks Against the World Trade Center, 11 September 2001." Prehospital and Disaster Medicine 21, no. 2 (April 2006): 129–31. http://dx.doi.org/10.1017/s1049023x00003526.
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AbstractOn 11 September 2001, two hijacked airplanes collided with the World Trade Center in New York. Both towers collapsed, spreading smoke and debris for miles. Rescue personnel arrived rapidly, but the collapse of the towers made the scene too dangerous for these teams to rescue all those trapped inside. Although this collapse was impossible to predict, fires occurring in skyscrapers can cause the structures to collapse. When a fire erupts in the upper levels of the building, it is even more difficult for those trapped inside to escape. Communications systems were shut down. In future incidents with large numbers of injured victims, the injured should be transported to hospitals by non-traditional medical transport vehicles (taxis, cars, etc.). If future disasters occur in the vicinity of a hospital, the most severely injured victims should go to the hospital instead of congregating at assembly points. These victims often are already at hospitals before substantial aid arrives at the assembly points. On-scene care must be documented, and easy-to-read triage tags should be used. Reserve power supplies in major cities should be maintained in preparation for emergencies. Both victims and rescue personnel are susceptible to post-traumatic, psychosocial reactions.
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Пичугин, Александр Иванович, Дмитрий Генрихович Мичудо, Николай Владимирович Навценя, Кирилл Юрьевич Яковенко, and Владимир Иванович Логинов. "On some conceptual directions for creating modern types and models of firerescue vehicles." Pozharnaia bezopasnost`, no. 2(99) (June 18, 2020): 70–78. http://dx.doi.org/10.37657/vniipo.2020.99.2.008.
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Рассмотрены направления деятельности отечественных предприятий по созданию различных типов и моделей пожарно-спасательных автомобилей (АПС) с начала ХХI века. Показана их доля в общем парке пожарных автомобилей (ПА). Определены приоритетные модели АПС по их главным параметрам: вместимости цистерны, базовому шасси, а также использованию других опций, расширяющих функциональные возможности АПС. Дано описание ряда конструкций АПС, представленных на крупнейшей международной выставке «Интершутц» (г. Ганновер), а также на международных салонах «Комплексная безопасность» (Москва). There are considered directions for creation of various fire and rescue vehicles (FRV) types and models of domestic production from the beginning of this century. An increase in their share in the total fire vehicles fleet is demonstrated. The number of FRV, presented at the largest International Exhibition INTERSCHUTZ (Hanover) as well as at INTEGRATED SAFETY & SECURITY EXHIBITIONs (Moscow), is described. The relevance of creation and production of new FRV models is determined by their multifunctionality during fire and rescue operations. Taking into account the expert survey between fire specialists of the Ministry of Emergency Situations of the Russian Federation and based on the main FRV parameter - tank capacity, base chassis, and the use of other options increasing the FRV functionality, there are defined the following priority FRV models: crane-manipulator unit, a device for compression foam supply, a hydroabrasive cutting device, a bulldozer blade device. There is presented a brief description of typical FRVs for the last 15-year period from the beginning of their production taking into account the conceptual proposals for their creation on various basic chassis: Ural (4 x 4), KamAZ (4 x 4), (4 x 4), (8 x 4); MAZ (4 x 2), IVECO AMT (4 x 4), (6 x 6) of foreign production: Mercedec-Benz Sprinter (4 x 2) and Fuso Canter (4 x 2), as well as with additional equipment: a medical module; with armoured elements and a blade; with crane manipulator
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McKnight, G., M. Palmer, and M. Khan. "The use of Unmanned Aerial Vehicles for CASEVAC in the future urban and littoral environments." Journal of The Royal Naval Medical Service 105, no. 1 (2019): 29–33. http://dx.doi.org/10.1136/jrnms-105-29.
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AbstractThe recent development of Unmanned Aerial Vehicles (UAVs) and their potential use for casualty evacuation (CASEVAC) has exciting implications for the United Kingdom Defence Medical Services (DMS). When compared to existing technology, the unique attributes of small size, increased manoeuvrability and lack of a human pilot would be extremely useful in congested and hazardous settings. There are ethical and practical considerations to be taken into account, but harnessing the full potential of this technology may improve the chances of survival from some battlefield injuries.UAVs could be of most benefit in a congested and complex battlespace, allowing evacuation of casualties from high risk environments. In addition to CASEVAC, a UAV could be used for critical care transfers, Search and Rescue (SAR) and Humanitarian And Disaster Relief (HADR) operations. Given the vast array of potential applications and a lower risk profile compared with current CASEVAC platforms, the DMS should actively monitor the development of UAV technology and plan ahead for integration within current doctrine.
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Karlsson, Sofia, Britt-Inger Saveman, and Lina Gyllencreutz. "Rescue Operations in Underground Mines: Caring for Patients in a Challenging Environment." Prehospital and Disaster Medicine 34, s1 (May 2019): s163—s164. http://dx.doi.org/10.1017/s1049023x19003728.
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Introduction:Major injury incidents in underground metalliferous and mineral mines are rare, but if, e.g., a major fire would occur, it is the emergency medical service (EMS) together with the mining company and rescue service who perform the rescue operation. Therefore it is important to develop safe and efficient rescue operation procedures for all the organizations involved, especially the EMS personnel.Aim:To examine EMS personnel’s perceptions and experiences regarding underground mining incidents.Method:Individual interviews were performed with 13 Swedish EMS personnel. The interviews were transcribed verbatim and analyzed with qualitative content analysis.Results:The theme “providing the same care in a difficult environment” emerged. Depending on the type of incident, the EMS personnel considered if the injured mining workers could be cared for either outside or in the mine in order to access and care for the injured mining workers as quickly as possible. The EMS personnel mentioned that it was difficult to make the decision if they should enter the mine or not due to the uncertainty of their safety. They also considered that it could be harder to accomplish the same level of care as in other incidents due to the difficult environment. In some instances, they cannot drive their ambulance vehicles into the mine, so they have to prioritize which equipment to bring as well as consider how to transport the patients.Discussion:The results identify some of the difficulties the EMS find challenging. Therefore the results could be used in finding solutions and making the EMS prepared for an effective and timely response for injured in underground mines.
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Steinbicker, Andrea U., Ashley J. Vonner, Chetana Sachidanandan, Lisa Lohmeyer, David T. Scadden, Randall T. Peterson, Kenneth D. Bloch, and Paul B. Yu. "Role of BMP Signaling In the Anemia of Chronic Disease." Blood 116, no. 21 (November 19, 2010): 2043. http://dx.doi.org/10.1182/blood.v116.21.2043.2043.
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Abstract Abstract 2043 Introduction: Anemia of chronic disease (ACD) describes anemia associated with diverse chronic inflammatory, infectious, or neoplastic processes. These conditions are frequently associated with increased circulating levels of inflammatory cytokines such as interleukin 6 (IL-6). IL-6 regulates expression of the hormone hepcidin, which inhibits the release of iron from hepatocytes, macrophages, and enterocytes into the circulation. In addition to IL-6, hepcidin gene expression is known to be transcriptionally regulated by bone morphogenetic protein (BMP) signaling. Hypothesis: We hypothesized that BMP signaling is required for the induction of hepcidin gene expression by IL-6 and plays a critical role in the pathogenesis of ACD. Methods: We used a turpentine-dependent model of ACD in mice. Mice were challenged with weekly subcutaneous injections of turpentine, which induces anemia in an IL-6 dependent manner. This model was studied to determine hepcidin gene expression and rescue ACD using BMP inhibition. Moreover, we examined hepcidin gene expression in zebrafish injected with Pseudomonas aeruginosa, and in transgenic zebrafish overexpressing human IL-6. The regulation of hepcidin gene expression was also studied in the human hepatocarcinoma cell line (HepG2). Results: Injections of mice with IL-6 (0.8 μg/g ip) increased hepatic hepcidin mRNA levels expression at 24 hours and decreased serum iron concentrations. Both effects were prevented by a small molecule BMP type I receptor kinase inhibitor, LDN-193189, or protein BMP antagonists. Weekly turpentine injections induced microcytic anemia after 3 weeks with a decrease in hemoglobin levels from 12.8±0.3 to 9.7±1.7 g/dL (*p<0.01). Concurrent treatment with LDN-193189 prevented turpentine-induced anemia and microcytosis (*p<0.01 for both). In mice challenged with turpentine for 6 weeks, treatment with LDN-193189, beginning after anemia was established at week 3, led to an increase in hemoglobin levels at week 6 (10.9±0.1 vs 9.5±0.2 g/dL, LDN193189 vs vehicle, respectively; *p<0.05). In zebrafish, microinjection with Pseudomonas aeruginosa or overexpression of human IL-6 induced hepatic hepcidin expression, an effect which was blocked by LDN-193189. Incubation of HepG2 cells with IL-6 (100 ng/ml) increased hepcidin mRNA levels 2 to 5 fold. Pretreatment with LDN-193189, or recombinant protein BMP antagonists such as noggin, abrogated the induction of hepcidin expression by IL-6. Incubation of HepG2 cells with BMP6 (2.5 to 10 ng/ml) modestly increased hepcidin mRNA levels. However, the combination of IL-6 and BMP6 synergistically increased hepcidin gene expression (*p<0.05). Conclusion: BMP signaling appears to play a critical role in the pathogenesis of anemia in a mouse ACD model. Our findings support the concept that BMP signaling is required for the induction of hepcidin gene expression by IL-6 in vitro and in vivo. Moreover, manipulation of BMP signaling represents a potentially novel therapeutic approach to the treatment of anemia associated with inflammation. Disclosures: Steinbicker: Deutsche Forschungsgemeinschaft DFG: Research Funding. Scadden:Fate Therapeutics: Consultancy, Equity Ownership, Patents & Royalties. Peterson:Massachusetts General Hospital Executive Committee on Research and NIDDK 1R01DK082971: Research Funding. Bloch:Massachusetts General Hospital Executive Committee on Research and NIDDK 1R01DK082971: Research Funding. Yu:Harvard Stem Cell Institute Seed Grant and the Howard Hughes Medical Institute Early Career Physician-Scientist Award: Honoraria, Research Funding; NHLBI 5K08HL079943: Research Funding.