Search results for: emergency and disaster response

Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

Procedia PDF Downloads 134

Authors: Arif Almutairi, Monjur Mourshed

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Due to varying geographical and tectonic factors, the region of Saudi Arabia has been subjected to numerous natural and man-made maritime disasters during the last two decades. Natural maritime disasters, such as cyclones and tsunamis, have been recorded in coastal areas of the Indian Ocean (including the Arabian Sea and the Gulf of Aden). Therefore, the Indian Ocean is widely recognised as the potential source of future destructive natural disasters that could affect Saudi Arabia’s coastline. Meanwhile, man-made maritime disasters, such as those arising from piracy and oil pollution, are located in the Red Sea and the Arabian Gulf, which are key locations for oil export and transportation between Asia and Europe. This paper provides a brief overview of maritime disasters surrounding Saudi Arabia’s coastline in order to classify them by frequency of occurrence and location, and discuss their future impact the region. Results show that the Arabian Gulf will be more vulnerable to natural maritime disasters because of its location, whereas the Red Sea is more vulnerable to man-made maritime disasters, as it is the key location for transportation between Asia and Europe. The results also show that with the aid of proper classification, effective disaster management can reduce the consequences of maritime disasters.

Keywords: disaster classification, maritime disaster, natural disasters, man-made disasters

Procedia PDF Downloads 189

Authors: S. M. Amin Hosseini, Oriol Pons, Carmen Mendoza Arroyo, Albert de la Fuente

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In the aftermath of a natural disaster, the major challenge most cities and societies face, regardless of their diverse level of prosperity, is to provide temporary housing (TH) for the displaced population (DP). However, the features of TH, which have been applied in previous recovery programs, greatly varied from case to case. This situation demonstrates that providing temporary accommodation for DP in a short period time and usually in great numbers is complicated in terms of satisfying all the beneficiaries’ needs, regardless of the societies’ welfare levels. Furthermore, when previously used strategies are applied to different areas, the chosen strategies are most likely destined to fail, unless the strategies are context and culturally based. Therefore, as the population of disaster-prone cities are increasing, decision-makers need a platform to help to determine all the factors, which caused the outcomes of the prior programs. To this end, this paper aims to assess the problems, requirements, limitations, potential responses, chosen strategies, and their outcomes, in order to determine the main elements that have influenced the TH process. In this regard, and in order to determine a customizable strategy, this study analyses the TH programs of five different cases as: Marmara earthquake, 1999; Bam earthquake, 2003; Aceh earthquake and tsunami, 2004; Hurricane Katrina, 2005; and, L’Aquila earthquake, 2009. The research results demonstrate that the main vertexes of TH are: (1) local characteristics, including local potential and affected population features, (2) TH properties, which needs to be considered in four phases: planning, provision/construction, operation, and second life, and (3) natural hazards impacts, which embraces intensity and type. Accordingly, this study offers decision-makers the opportunity to discover the main vertexes, their subsets, interactions, and the relation between strategies and outcomes based on the local conditions of each case. Consequently, authorities may acquire the capability to design a customizable method in the face of complicated post-disaster housing in the wake of future natural disasters.

Keywords: post-disaster temporary accommodation, urban resilience, natural disaster, local characteristic

Procedia PDF Downloads 243

Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

Procedia PDF Downloads 233

Authors: Oussama Derdous, Lakhdar Djemili, Hamza Bouchahed

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The consequences of a dam breach can be devastating; both in terms of lives lost and damaged infrastructure and property. Hydraulic modeling provides a clear picture of the possible consequences of partial or complete failure of a dam, which is the key to carry out emergency planning and conduct reliable risk assessments. In this paper, the MIKE11 model developed by the Danish Hydrologic Institute (DHI) was used to simulate the flood wave propagation associated with a potential failure analysis failure of Zardezas dam located in the city of Skikda in the North East of Algeria. MIKE11 results including inundation maps and the representative channel/valley cross-sections depicting flow depth and maximal flow velocities showed that Zardezas reservoir presents a significant risk to downstream areas in the event of a dam failure. These results can be used as the basis of the development of an Emergency Action Plan (EAP).The main objective of this plan is to predict the appropriate steps to avoid or at least decrease the consequences of unexpected failure of Zardezas dam.

Keywords: MIKE11, dam break, inundation maps, emergency action plan

Procedia PDF Downloads 463

Authors: Repaul Kanji, Rajat Agrawal

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In this era where issues like climate change and disasters are the topics of discussion at national and international forums, it is very often that humanity questions the causative role of corporates in such events. It is beyond any doubt that rapid industrialisation and development has taken a toll in the form of climate change and even disasters, in some case. Thus, demanding to fulfill a corporate's responsibilities in the form of rescue and relief in times of disaster, rehabilitation and even mitigation and preparedness to adapt to the oncoming changes is obvious. But how can the responsibilities of the corporates be channelised to ensure all this, i.e., develop a resilient society? More than that, which factors, when emphasised upon, can lead to the holistic development of the society. To answer this query, an extensive literature review was done to identify several enablers like legislations of a nation, the role of brand and reputation, ease of doing Corporate Social Responsibility, mission and vision of an organisation, religion and culture, etc. as a tool for building disaster resilience. A questionnaire survey, interviews with experts and academicians followed by interpretive structural modelling (ISM) were used to construct a multi-hierarchy model depicting the contextual relationship among the identified enablers. The study revealed that culture and religion are the most powerful driver, which affects other enablers either directly or indirectly. Taking cognisance of the fact that an idea of separation between religion and workplace (business) resides subconsciously within the society, the study tries to interpret the outcome of the ISM through the lenses of past researches (The Integrating Box) and explores how it can be leveraged to build a resilient society.

Keywords: corporate social responsibility, interpretive structural modelling, disaster resilience and risk reduction, the integration box (TIB)

Procedia PDF Downloads 209

Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

Procedia PDF Downloads 205

Authors: Stephen Verderber

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The World Health Organization (WHO) calls for research and development on ecologically sustainable, resilient structures capable of effectively responding to disaster events globally, in response to climate change, politically based diasporas, earthquakes, and other adverse events upending the rhythms of everyday life globally. By 2050, nearly 80% of the world’s population will reside in coastal zones, and this, coupled with the increasingly dire impacts of climate change, constitute a recipe for further chaos and disruption, and in light of these events, architects have yet to rise up to meet the challenge. In the arena of healthcare, rapidly deployable clinics and field hospitals can provide immediate assistance in medically underserved disaster strike zones. Transportable facilities offer multiple advantages over conventional, fixed-site hospitals, as lightweight, comparatively unencumbered alternatives. These attributes have been proven repeatedly in 20th century vehicular and tent-based structures deployed in frontline combat theaters and in prior natural disasters. Prefab transportable clinics and trauma centers recently responded adroitly to medical emergencies in the aftermath of the Haitian (2010) and Ecuadorian (2016) earthquakes, and in North American post-hurricane relief efforts (2017) while architects continue to be castigated by their engineer colleagues as chronically poor first responders. Architecturally based portable structures for healthcare currently include Redeployable Health Centers (RHCs), Redeployable Trauma Centers (RTCs), and Permanent Modular Installations (PMIs). Five tectonic variants within this typology have recently been operationalized in the field: 1. Vehicular-based Nomadics: Prefab modules installed on a truck chassis with interior compartments dropped in prior to final assembly. Alternately, a two-component apparatus is preferred, with a truck cab pulling a modular medical unit, with independent transiting component; 2. Tent and Pneumatic Systems: Tent/yurt precursors and inflatable systems lightweight and responsive to topographically challenging terrain and diverse climates; 3. Containerized Systems: The standard modular intermodal-shipping container affords structural strength, resiliency in difficult transiting conditions, and can be densely close-packed and these can be custom-built or hold flat-pack systems; 4. Flat-Packs and Pop-Up Systems: These kit-of-part assemblies are shipped in standardized or specially-designed ISO containers; and 5. Hybrid Systems: These consist of composite facilities representing a synthesis of mobile vehicular components and/or tent or shipping containers, fused with conventional or pneumatically activated tent systems. Hybrids are advantageous in many installation contexts from an aesthetic, fabrication, and transiting perspective. Advantages/disadvantages of various modular systems are comparatively examined, followed by presentation of a compendium of 80 evidence (research)-based planning and design considerations addressing site/context, transiting and commissioning, triage, decontamination/intake, diagnostic and treatment, facility tectonics, and administration/total environment. The benefits of offsite pre-manufactured fabrication are examined, as is anticipated growth in international demand for transportable healthcare facilities to meet the challenges posed by accelerating global climate change and global conflicts. This investigation into rapid response facilities for pre and post-disaster zones is drawn from a recent book by the author, the first on architecture on this topic (Innovations in Transportable Healthcare Architecture).

Keywords: disaster mitigation, rapid response healthcare architecture, offsite prefabrication

Procedia PDF Downloads 118

Authors: Mane Varosyan, Diana Tumanyan, Agnesa Martirosyan

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There are many catastrophic events that end with dire consequences, and to avoid them, people should be well-armed with the necessary information about these situations. During the last years, Serious Games have increasingly gained popularity for training people for different types of emergencies. The major discussed problem is the usage of gamification in education. Moreover, it is mandatory to understand how and what kind of gamified e-learning modules promote engagement. As the theme is emergency, we also find out people’s behavior for creating the final approach. Our proposed solution is an educational video game, “EZZRA”.

Keywords: gamification, education, emergency, serious games, game design, virtual reality, digitalisation

Procedia PDF Downloads 75

Authors: Ezgi Şendil

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Information extracted from social media has received great attention since it has become an effective alternative for collecting people’s opinions and emotions based on specific experiences in a faster and easier way. The paper aims to put data in a meaningful way to analyze users’ posts and get a result in terms of the experiences and opinions of the users during and after natural disasters. The posts collected from Reddit are classified into nine different categories, including injured/dead people, infrastructure and utility damage, missing/found people, donation needs/offers, caution/advice, and emotional support, identified by using labelled Twitter data and four different machine learning (ML) classifiers.

Keywords: disaster, NLP, postdisaster management, sentiment analysis

Procedia PDF Downloads 75

Authors: Yuxiao Jiang, Lingjun Meng, Mengyu Zhan, Lichunyi Zhang, Yingxia Yun

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On August 8th of 2015, a serious explosion occurred in Binhai New Area of Tianjin. This explosion led to the suspension of Tianjin-Binhai Light Rail Line 9 which was an important transportation mean connecting the old and new urban areas and the suspension causes inconvenience to commuters traveling from Tianjin to Binhai or Binhai to Tianjin and residents living by Line 9. On this regard, this paper intends to give suggestions on how to develop multi-mode transportation system rapidly and effectively after a disaster and tackle with the problems in terms of transportation infrastructure facilities. The paper proposes the idea of traffic resilience which refers to the city’s ability to restore its transportation system and reduce risks when the transportation system is destroyed by a disaster. By doing questionnaire research, on the spot study and collecting data from the internet, a GIS model is established so as to analyze the alternative traffic means used by different types of residents and study the transportation supply and demand. The result shows that along the Line 9, there is a larger demand for alternative traffic means in the place which is nearer to the downtown area. Also, the distribution of bus stations is more reasonable in the place nearer to downtown area, however, the traffic speed in the area is slower. Based on traffic resilience, the paper raises strategies to develop post-disaster multi-mode transportation system such as establishing traffic management mechanism timely and effectively, building multi-mode traffic networks, improving intelligent traffic systems and so on.

Keywords: traffic resilience, multi-mode transportation system, public traffic, transportation demand

Procedia PDF Downloads 347

Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

Procedia PDF Downloads 224

Authors: Chaiyaporn Yuksen

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Backgroud: Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). Method: The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. Result: 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times Conclusion: The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: clinical prediction score, SVT, recurrence, emergency department

Procedia PDF Downloads 155

Authors: Kateryna Kulyk

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Anti-corruption education is an integral element of the corruption prevention mechanism of any state. Effective implementation of anti-corruption policy is impossible without awareness-raising activities. Information campaigns should target different social groups and aim to reduce tolerance to any form of corruption. Today, Ukraine and Lithuania have all the necessary infrastructure to actively work in this direction. Anti-corruption measures and building a society resistant to corruption are particularly important in the context of martial law in Ukraine and the state of emergency in Lithuania, as these conditions increase the risks of corrupt practices. To implement this area of activity, it is recommended to actively involve all state and local authorities, business representatives, non-governmental organisations, and all interested citizens. As of today, educational institutions, specialised anti-corruption bodies, and the public are already involved in this process. The purpose of the research is to draw public attention to the need and importance of obtaining basic knowledge on combating and preventing corruption, even in a state of emergency or martial law. This topic remains relevant even during the period of a state of emergency or martial law, as the risk of corrupt practices increases during these periods. The study is based on a comprehensive analysis of the anti-corruption policies of Ukraine and Lithuania, sociological research, and our own survey of anti-corruption experts. Legislation, reports of anti-corruption bodies and civil society organisations were analysed. We also conducted an anonymous survey of 13 anti-corruption experts on the most important anti-corruption measures in the countries studied. The main contribution of the research is to draw attention to the problem of low awareness of the population of countries about the importance of anti-corruption education as one of the necessary conditions for reducing corruption practices.

Keywords: corruption, prevention and combating of corruption, education, anti-corruption education, martial law, state of emergency

Procedia PDF Downloads 35

Authors: Peng Li, Er-xiang Song

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Numerical analysis of longitudinal tunnel seismic response due to spatial variation of earthquake ground motion is an important issue that cannot be ignored in the design and safety evaluation of tunnel structures. In this paper, numerical methods for analysis of tunnel longitudinal response under asynchronous seismic wave is extensively studied, including the improvement of the 1D time-domain finite element method, three dimensional numerical simulation technique for the site asynchronous earthquake response as well as the 3-D soil-tunnel structure interaction analysis. The study outcome will be beneficial to aid further research on the nonlinear meticulous numerical analysis and seismic response mechanism of tunnel structures under asynchronous earthquake motion.

Keywords: asynchronous input, longitudinal seismic response, tunnel structure, numerical simulation, traveling wave effect

Procedia PDF Downloads 437

Authors: Daniel Y. Abebe, Jaehyouk Choi

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From the past earthquake events, many people get hurt at the exit while they are trying to go out of the buildings because of the exit doors are unable to be opened. The door is not opened because it deviates from its the original position. The aim of this research is to develop and evaluate a new type safety door that keeps the door frame in its original position or keeps its edge angles perpendicular during and post-earthquake. The proposed door is composed of three components: outer frame joined to the wall, inner frame (door frame) and circular hollow section connected to the inner and outer frame which is used as seismic energy dissipating device.

Keywords: safety-door, earthquake disaster, low yield point steel, passive energy dissipating device, FE analysis

Procedia PDF Downloads 526

Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

Procedia PDF Downloads 376

Authors: B. P. G. Figueira, I. C. Pinto, D. Ferro, F. C. M. Zacharias

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The absenteeism at work constitutes in a temporary absence of labor functions resulting from various reasons, bringing damage to production, increasing costs of care and overburdening other workers, has its principal cause due to illness, often due exposure to several risks in the workplace. This study aims to know, identify and analyze the types and causes of absenteeism, such as the frequency at which it occurs by professional category, for employment contract and days not worked in Emergency Care Public in a city in the interior of São Paulo. We conducted exploratory and descriptive study with a quantitative approach, with nursing professionals, after selection of inclusion criteria was reached a universe of 208 subjects, the data collected are for the years from 2010-2013. Research has shown that the professional category of nursing assistant had 88,11% of total absenteeism, absenteeism lasting 1 day was the with the highest frequency, the women were responsible for 74,80% of absenteeism disease. It was concluded that absenteeism shall be monitored to plan control actions, establishing better political for the management of human resources, because it can be an aggravating factor in the quality of care.

Keywords: absenteeism; nursing; emergency medical services, human resource

Procedia PDF Downloads 326

Authors: Sima Ajami, Batool Akbari

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Background: Radio frequency identification (RFID) system has been successfully applied to the areas of manufacturing, supply chain, agriculture, transportation, healthcare, and services. The RFID is already used to track and trace the victims in a disaster situation. Data can be collected in real time and be immediately available to emergency personnel and saves time by the RFID. Objectives: The aim of this study was, first, to identify stakeholders and customers for rescuing earthquake victims, second, to list key internal and external factors to use RFID to track earthquake victims, finally, to assess SWOT for rescuers' viewpoint. Materials and Methods: This study was an applied and analytical study. The study population included scholars, experts, planners, policy makers and rescuers in the "red crescent society of Isfahan province", "disaster management Isfahan province", "maintenance and operation department of Isfahan", "fire and safety services organization of Isfahan municipality", and "medical emergencies and disaster management center of Isfahan". After that, researchers held a workshop to teach participants about RFID and its usages in tracking earthquake victims. In the meanwhile of the workshop, participants identified, listed, and weighed key internal factors (strengths and weaknesses; SW) and external factors (opportunities and threats; OT) to use RFID in tracking earthquake victims. Therefore, participants put weigh strengths, weaknesses, opportunities, and threats (SWOT) and their weighted scales were calculated. Then, participants' opinions about this issue were assessed. Finally, according to the SWOT matrix, strategies to solve the weaknesses, problems, challenges, and threats through opportunities and strengths were proposed by participants. Results: The SWOT analysis showed that the total weighted score for internal and external factors were 3.91 (Internal Factor Evaluation) and 3.31 (External Factor Evaluation) respectively. Therefore, it was in a quadrant SO strategies cell in the SWOT analysis matrix and aggressive strategies were resulted. Organizations, scholars, experts, planners, policy makers and rescue workers should plan to use RFID technology in order to save more victims and manage their life. Conclusions: Researchers suppose to apply SO strategies and use a firm’s internal strength to take advantage of external opportunities. It is suggested, policy maker should plan to use the most developed technologies to save earthquake victims and deliver the easiest service to them. To do this, education, informing, and encouraging rescuers to use these technologies is essential. Originality/ Value: This study was a research paper that showed how RFID can be useful to track victims in earthquake.

Keywords: frequency identification system, strength, weakness, earthquake, victim

Procedia PDF Downloads 322

Authors: Marshal D. Kafle, Jun H. Kim, Hyun W. Been, Kyoung M. Min

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Fluid viscous damping systems are well suited for many air vehicles subjected to shock and vibration. These damping system work with the principle of viscous fluid throttling through the orifice to create huge pressure difference between compression and rebound chamber and obtain the required damping force. One application of such systems is its use in aircraft door system to counteract the door’s velocity and safely stop it. In exigency situations like crash or emergency landing where the door doesn’t open easily, possibly due to unusually tilting of fuselage or some obstacles or intrusion of debris obstruction to move the parts of the door, such system can be combined with other systems to provide needed force to forcefully open the door and also securely stop it simultaneously within the required time i.e.less than 8seconds. In the present study, a hydraulic system called snubber along with other systems like actuator, gas bottle assembly which together known as emergency power assist system (EPAS) is designed, built and experimentally studied to check the magnitude of angular velocity, damping force and time required to effectively open the door. Whenever needed, the gas pressure from the bottle is released to actuate the actuator and at the same time pull the snubber’s piston to operate the emergency opening of the door. Such EPAS installed in the suspension arm of the aircraft door is studied explicitly changing parameters like orifice size, oil level, oil viscosity and bypass valve gap and its spring of the snubber at varying temperature to generate the optimum design case. Comparative analysis of the EPAS at several cases is done and conclusions are made. It is found that during emergency condition, the systemopening time and angular velocity, when snubber with 0.3mm piston and shaft orifice and bypass valve gap of 0.5 mm with its original spring is used,shows significant improvement over the old ones.

Keywords: aircraft door damper, bypass valve, emergency power assist system, hydraulic damper, oil viscosity

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Authors: Volkan Isbuga, Joman M. Mahmood, Ali Firat Cabalar

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This study presents the site response analysis of mica-sand mixtures available in certain parts of the world including Izmir, a highly populated city and located in a seismically active region in western part of Turkey. We performed site response analyses by employing SHAKE, an equivalent linear approach, for the micaceous soil deposits consisting of layers with different amount of mica contents and thicknesses. Dynamic behavior of micaceous sands such as shear modulus reduction and damping ratio curves are input for the ground response analyses. Micaceous sands exhibit a unique dynamic response under a scenario earthquake with a magnitude of Mw=6. Results showed that higher amount of mica caused higher spectral accelerations.

Keywords: micaceous sands, site response, equivalent linear approach, SHAKE

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

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Authors: Ayesha Akbar

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Public service delivery has witnessed a significant improvement with the integration of information communication technology (ICT). It not only improves management structure with advanced technology for surveillance of service delivery but also provides evidence for informed decisions and policy. Pakistan’s public sector organizations have not been able to produce some good results to ensure service delivery. Notwithstanding, some of the public sector organizations in Pakistan has diffused modern technology and proved their credence by providing better service delivery standards. These good indicators provide sound basis to integrate technology in public sector organizations and shift of policy towards evidence based policy making. Rescue-1122 is a public sector organization which provides emergency services and proved to be a successful model for the provision of service delivery to save human lives and to ensure human development in Pakistan. The information about the organization has been received by employing qualitative research methodology. The information is broadly based on primary and secondary sources which includes Rescue-1122 website, official reports of organizations; UNDP (United Nation Development Program), WHO (World Health Organization) and by conducting 10 in-depth interviews with the high administrative staff of organizations who work in the Lahore offices. The information received has been incorporated with the study for the better understanding of the organization and their management procedures. Rescue-1122 represents a successful model in delivering the services in an efficient way to deal with the disaster management. The management of Rescue has strategized the policies and procedures in such a way to develop a comprehensive model with the integration of technology. This model provides efficient service delivery as well as maintains the standards of the organization. The service delivery model of rescue-1122 works on two fronts; front-office interface and the back-office interface. Back-office defines the procedures of operations and assures the compliance of the staff whereas, front-office equipped with the latest technology and good infrastructure handles the emergency calls. Both ends are integrated with satellite based vehicle tracking, wireless system, fleet monitoring system and IP camera which monitors every move of the staff to provide better services and to pinpoint the distortions in the services. The standard time of reaching to the emergency spot is 7 minutes, and during entertaining the case; driver‘s behavior, traffic volume and the technical assistance being provided to the emergency case is being monitored by front-office. Then the whole information get uploaded to the main dashboard of Lahore headquarter from the provincial offices. The latest technology is being materialized by Rescue-1122 for delivering the efficient services, investigating the flaws; if found, and to develop data to make informed decision making. The other public sector organizations of Pakistan can also develop such models to integrate technology for improving service delivery and to develop evidence for informed decisions and policy making.

Keywords: data, e-governance, evidence, policy

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Authors: R. Ueda

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Today global society is seeking resilient partnership in local organizations and individuals, which realizes multi-stakeholders relationship. Although it is proposed by modern global framework of sustainable development, it is conceivable that such affiliation can be found out in the traditional local community in Japan, and that traditional spirit is tacitly sustaining in modern context of disaster mitigation in society and economy. Then this research is aiming to clarify and analyze implication for the global world by actual case studies. Regional and urban resilience is the ability of multi-stakeholders to cooperate flexibly and to adapt in response to changes in the circumstances caused by disasters, but there are various conflicts affecting coordination of disaster relief measures. These conflicts arise not only from a lack of communication and an insufficient network, but also from the difficulty to jointly draw common context from fragmented information. This is because of the weakness of our modern engineering which focuses on maintenance and restoration of individual systems. Here local ‘circles’ holistically includes local community and interacts periodically. Focusing on examples of resilient organizations and wisdom created in communities, what can be seen throughout history is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. And the wisdom of a solid and autonomous disaster prevention formed by the historical community called’ Waju’ – an area surrounded by circle embankment to protect the settlement from flood – lives on in government efforts of the coastal industrial island of today. Industrial company there collaborates to create a circle including common evacuation space, road access improvement and infrastructure recovery. These days, people here adopts new interface technology. Large-scale AR- Augmented Reality for more than hundred people is expressing detailed hazard by tsunami and liquefaction. Common experiences of the major disaster space and circle of mutual discussion are enforcing resilience. Collaboration spirit lies in the center of circle. A consistent key point is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. This writer believes that both self-governing human organizations and the societal implementation of technical systems are necessary. Infrastructure should be autonomously instituted by associations of companies and other entities in industrial areas for working closely with local governments. To develop advanced disaster prevention and multi-stakeholder collaboration, partnerships among industry, government, academia and citizens are important.

Keywords: industrial recovery, multi-sakeholders, traditional culture, user experience, Waju

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Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: Jiri Barta

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This paper deals with the prevention and management of emergencies. It focuses on the protection of assets of the critical infrastructure entities that are important to preventing, preparing for and management of emergencies and crisis situations. The paper defines assets and specifies their use and place in the process of crisis management and planning. Critical assets that are protected from the negative effects of emergency or crisis situation we can use in crisis management and response. This basic rule applies mainly to the substantial assets used in the protection of critical infrastructure processes.

Keywords: asset, continuity, critical infrastructure, crisis management process

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Authors: Abdullah Alsaeed

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Virtualized computing and cloud computing infrastructures are no longer fuzz or marketing term. They are a core reality in today’s corporate Information Technology (IT) organizations. Hence, developing an effective and efficient methodologies for data backup and data recovery is required more than any time. The purpose of data backup and recovery techniques are to assist the organizations to strategize the business continuity and disaster recovery approaches. In order to accomplish this strategic objective, a variety of mechanism were proposed in the recent years. This research paper will explore and examine the latest techniques and solutions to provide data backup and restoration for the cloud computing platforms.

Keywords: data backup, data recovery, cloud computing, business continuity, disaster recovery, cost-effective, data encryption.

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Authors: Israel Ropo Orimoloye, Johanes A. Belle, Olusola Adeyemi, Olusola O. Ololade

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With more than 100,000 orbits during the past 20 years, Terra has significantly improved our knowledge of the Earth's climate and its implications on societies and ecosystems of human activity and natural disasters, including drought events. With Terra instrument's performance and the free distribution of its products, this study utilised Terra MOD13Q1 satellite data to assess drought disaster events and its spatiotemporal patterns over the Free State Province of South Africa between 2001 and 2019 for summer, autumn, winter, and spring seasons. The study also used high-resolution downscaled climate change projections under three representative concentration pathways (RCP). Three future periods comprising the short (the 2030s), medium (2040s), and long term (2050s) compared to the current period are analysed to understand the potential magnitude of projected climate change-related drought. The study revealed that the year 2001 and 2016 witnessed extreme drought conditions where the drought index is between 0 and 20% across the entire province during summer, while the year 2003, 2004, 2007, and 2015 observed severe drought conditions across the region with variation from one part to the another. The result shows that from -24.5 to -25.5 latitude, the area witnessed a decrease in precipitation (80 to 120mm) across the time slice and an increase in the latitude -26° to -28° S for summer seasons, which is more prominent in the year 2041 to 2050. This study emphasizes the strong spatio-environmental impacts within the province and highlights the associated factors that characterise high drought stress risk, especially on the environment and ecosystems. This study contributes to a disaster risk framework to identify areas for specific research and adaptation activities on drought disaster risk and for environmental planning in the study area, which is characterised by both rural and urban contexts, to address climate change-related drought impacts.

Keywords: remote sensing, drought disaster, climate scenario, assessment

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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