Search results for: emergency room

Authors: Donna Erika E. De Jesus

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Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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Authors: Chongtham Jiten, Radhapiyari Laishram, K. Chandramani Singh

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Alkaline niobate (Na_0.5K_0.5)NbO₃ ceramic system has attracted major attention in view of its potential for replacing the highly toxic but superior lead zirconate titanate (PZT) system for piezoelectric applications. Recently, a more detailed study of this system reveals that the ferroelectric and piezoelectric properties are optimized in the Li- and V-modified system having the composition (K_0.485Na_0.5Li_0.015)(Nb_0.98V_0.02)O₃. In the present work, we further study the pyroelectric behaviour of this composition along with another doped with Mn⁴⁺. So, (K_0.485Na_0.5Li_0.015)(Nb_0.98V_0.02)O₃ + x MnO₂ (x = 0, and 0.01 wt. %) ceramic compositions were synthesized by conventional ceramic processing route. X-ray diffraction study reveals that both the undoped and Mn⁴⁺-doped ceramic samples prepared crystallize into a perovskite structure having orthorhombic symmetry. Dielectric study indicates that Mn⁴⁺ doping has little effect on both the Curie temperature (T_c) and tetragonal-orthorhombic phase transition temperature (T_ot). The bulk density, room-temperature dielectric constant (ε_RT), and room-c The room-temperature coercive field (E_c) is observed to be lower in Mn⁴⁺ doped sample. The detailed analysis of the P-E hysteresis loops over the range of temperature from about room temperature to T_ot points out that enhanced ferroelectric properties exist in this temperature range with better thermal stability for the Mn⁴⁺ doped ceramic. The study reveals that small traces of Mn⁴⁺ can modify (K_0.485Na_0.5Li_0.015)(Nb_0.98V_0.02)O₃ system so as to improve its ferroelectric properties with good thermal stability over a wide range of temperature.

Keywords: ceramics, dielectric properties, ferroelectric properties, lead-free, sintering, thermal stability

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Authors: Amirreza Niktash, B. P. Huynh

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A windcatcher is a structure fitted on the roof of a building for providing natural ventilation by using wind power; it exhausts the inside stale air to the outside and supplies the outside fresh air into the interior space of the building working by pressure difference between outside and inside of the building and using ventilation principles of passive stacks and wind tower, respectively. In this paper, the effect of different heights of inlet/outlets’ ducts of a two-sided windcatcher on the flow rate, flow velocity and flow pattern through a three-dimensional room fitted with the windcatcher are investigated and analysed by using RANS CFD technique and applying standard K-ε turbulence model via a commercial computational fluid dynamics (CFD) software package. The achieved results show that the inlet/outlet ducts height strongly affects flow rate, flow velocity and flow pattern especially in the living area of the room when the wind velocity is not too low. The results are confirmed by the experimental test for constructed scaled model in the laboratory and it develops the two-sided windcatcher’s performance in ventilation applications.

Keywords: CFD, RANS, ventilation, windcatcher

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Authors: Sarmin, S., Ologuin, R.S.

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Background: Rapid population growth and land constraints in Singapore results in a possible situation in which we face a higher number of casualties and lack of operational space in healthcare facilities during disasters and HAZMAT events, collectively known as Civil Emergencies. This creates a need for available working space within hospital grounds to be amphibious or multi-functional, to ensure the institution’s capability to respond efficiently to Civil Emergencies. The Emergency Department (ED) mitigates this issue by converting the Ambulance Assembly Area used during peacetime into an Open Decontamination Facility (ODF) during Civil Emergency Response, for decontamination of casualties before they proceed to treatment areas into Ambulance Assembly Area used during peacetime. Aims: To effectively operationalize the Open Decontamination Facility (ODF) through the reduction of manual handling. Methods: From past experiences on Civil Emergency exercises, it was labor-intensive for staff to set up the Open Decontamination Facility (ODF). Manual handling to set up the Decontamination lanes by bringing down the curtains and supply of water was required to be turned on. Conclusion: The effectiveness of the design construction of an Open Decontamination Facility (ODF) is based on the use of automation of bringing down the curtains on the various lanes. The use of control panels for water supply to decontaminate patients. Safety within the ODF was considered with the installation of panic buttons, intercom for staff communication, and perimeter curtains were installed with stability arm to manage the condition with high wind velocity.

Keywords: civil emergencies, disaster, emergency department, Hazmat

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Authors: A. Belmokhtar, A. Yahiaoui, A. Benyoucef, M. Belbachir

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We reported the synthesis and characterization of nanocomposite poly (4,4’ methylenedianiline) via chemical polymerization of monomers 4,4’ methylenedianiline by ammonium persulfate (APS) at room temperature catalyzed by Maghnite-H+. A facile method was demonstrated to grow poly (4,4’ methylenedianiline) nanocomposite, which was carried out by mixing Ammonium Persulfate (APS) aqueous and 4,4’ methylenedianiline solution in the presence of Maghnite-H+ at room temperature The effect of amount of catalyst and time on the polymerization yield of the polymers was studied. Structure was confirmed by elemental analysis, UV vis, RMN-1H, and voltammetry cyclique.

Keywords: charaterization, maghnite-h+, polymerization, poly (4, 4’ methylenedianiline)

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Authors: Hasan Farahneh

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Smart asset management along roadsides and in deserted areas is a topic of deprived attention. We find most of the work in emergency reporting services in intelligent transportation systems (ITS) and rural areas but not much in asset reporting. Currently, available asset management mechanisms are based on scheduled maintenance and do not effectively report any emergency situation in a timely manner. This paper is the continuation of our previous work, in which we proposed the usage of Foglets and VLC link between smart vehicles and road side assets. In this paper, we propose a hybrid communication system for asset management and emergency reporting architecture for smart transportation. We incorporate Foglets along with visible light communication (VLC) and radio frequency (RF) communication. We present the channel model and parameters of a hybrid model to support an intelligent transportation system (ITS) system. Simulations show high improvement in the system performance in terms of communication range and received data. We present a comparative analysis of a hybrid ITS system.

Keywords: Internet of Things, Foglets, VLC, RF, smart vehicle, roadside asset management

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Syaza Bt. Saifuddin, Rashidi Bin Othman, Muhammad Hafizuddin Akmal Bin Md Hashim, Ismail Bin Jasmani, Noor Hanita Bt. Abdul Majid

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This paper illustrates the background of various concepts, approaches, terminologies used to describe the basic framework of an Islamic Hotel Room design. This paper reviews the theoretical views in establishing a suitable and optimum environment for Muslim as well as non-Muslim guests in hotel rooms while according to shariah. It involves a few research methodologies that requires the researcher to study on a few characteristics needed to create more efficient rooms in terms of social interaction, economic growth and other tolerable elements. This paper intends on revealing the elements that are vital and may contribute for hotels in achieving a more conclusive research on space planning for hotel rooms focusing on the shariah and Muslim guests. Malaysia is an Islamic country and has billion of tourists coming over for business and recreational purposes. Therefore, having a righteous environment that best suit this target user is important in terms of generating the economy as well as providing a better understanding to the community on the benefits of applying these qualities in a conventional resort design.

Keywords: design, Islam, room, shariah compliant hotel

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Authors: Behcet Al, Şener Cindoruk, Suat Zengin, Mehmet Murat Oktay, Mehmet Mustafa Sunar, Hatice Eroglu, Cuma Yildirim

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Objective: In present study we aimed to investigate the chronic drug use due to chronic diseases in patients admitted to emergency department. Materials-Methods: 144 patients who applied to emergency department (ED) of medicine school of Gaziantep University between June 2013 and September 2013 with chronic diseases and use chronic drugs were included. Information about drugs used by patients were recorded. Results: Of patients, half were male, half were female, and the mean age was 58 years. The first three common diseases were diabetes mellitus, hypertension and coronary artery diseases. Of patients, %79.2 knew their illness. Fifty patients began to use drug within three months, 36 patient began to use within the last one year. While 42 patients brought all of their drugs with themselves, 17 patients brought along a portion of drugs. While three patients stopped their medication completely, 125 patients received medication on a regular basis. Fifty-two patient described the drugs with names, 13 patients described with their colors, 3 patients described by grammes, 45 patients described with the size of the tablet and 13 patients could not describe the drugs. Ninety-two patients explained which kind of drugs were used for each diseases, 17 patient explained partly, and 35 patients had no idea. Hundred patients received medication by themselves, 44 patients medications were giving by their relatives and med carers. Of medications, 140 were written by doctors directly, three medication were given by pharmacist; and one patient bought the drug by himself. For 11 patients the drugs were not harmonious to their diseases. Fifty-one patients admitted to the ED two times within last week, and 73 admitted two times within last month. Conclusion: The majority of patients with chronic diseases and use chronic drugs know their diseases and use the drugs in order, but do not have enough information about their medication.

Keywords: chronic disease, drug use, emergency department, medication

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Authors: Dong Zhao

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Even though the recent claim of room temperature superconductivity by LK-99 was confirmed an unsuccessful attempt, this work reawakened people’s century striving to get applicable superconductors with Tc of room temperature or higher and under ambient pressure. One of the efforts was focusing on exploring the thorium salts. This is because certain thorium compounds revealed an unusual property of having both high electrical conductivity and diamagnetism or the so-called “coexistence of high electrical conductivity and diamagnetism.” It is well known that this property of the coexistence of high electrical conductivity and diamagnetism is held by superconductors because of the electron pairings. Consequently, the likelihood for these thorium compounds to have superconducting properties becomes great. However, as a surprise, these thorium salts possess this property at room temperature and atmosphere pressure. This gives rise to solid evidence for these thorium compounds to be room-temperature superconductors without a need for external pressure. Among these thorium compound superconductors claimed in that work, thorium di-iodide (ThI₂) is a unique one and has received comprehensive discussion. ThI₂ was synthesized and structurally analyzed by the single crystal diffraction method in the 1960s. Its special property of coexistence of high electrical conductivity and diamagnetism was revealed. Because of this unique property, a special molecular configuration was sketched. Except for an ordinary oxidation of +2 for the thorium cation, the thorium’s oxidation state in ThI₂ is +4. According to the experimental results, ThI₂‘s actual molecular configuration was determined as an unusual one of [Th4+(e-)2](I-)2. This means that the ThI₂ salt’s cation is composed of a [Th4+(e-)2]2+ cation core. In other words, the cation of ThI₂ is constructed by combining an oxidation state +4 of the thorium atom and a pair of electrons or an electron lone pair located on the thorium atom. This combination of the thorium atom and the electron lone pair leads to an oxidation state +2 for the [Th4+(e-)2]2+ cation core. This special construction of the thorium cation is very distinctive, which is believed to be the factor that grants ThI₂ the room temperature superconductivity. Actually, the key for ThI₂ to become a room-temperature superconductor is this characteristic electron lone pair residing on the thorium atom along with the formation of a network constructed by the thorium atoms. This network specializes in a way that allows the electron lone pairs to hop over it and, thus, to generate the supercurrent. This work will discuss, in detail, the special electrical and magnetic properties of ThI₂ as well as its structural features at ambient conditions. The exploration of how the electron pairing in combination with the structurally specialized network works together to bring ThI₂ into a superconducting state. From the experimental results, strong evidence has definitely pointed out that the ThI₂ should be a superconductor, at least at room temperature and under atmosphere pressure.

Keywords: co-existence of high electrical conductivity and diamagnetism, electron lone pair, room temperature superconductor, special molecular configuration of thorium di-iodide ThI₂

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Authors: Sharib Ahmed, Mansoor Rafi, Kamran Ali Awan, Faraz Khaskhali, Amir Maqbool, Altaf Hashmi

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Medical linear accelerators (LINAC’s) used in radiotherapy treatments produce undesired neutrons when they are operated at energies above 8 MeV, both in electron and photon configuration. Neutrons are produced by high-energy photons and electrons through electronuclear (e, n) a photonuclear giant dipole resonance (GDR) reactions. These reactions occurs when incoming photon or electron incident through the various materials of target, flattening filter, collimators, and other shielding components in LINAC’s structure. These neutrons may reach directly to the patient, or they may interact with the surrounding materials until they become thermalized. A work has been set up to study the effect of different parameter on the production of neutron around the room by photonuclear reactions induced by photons above ~8 MeV. One of the commercial available neutron detector (Ludlum Model 42-31H Neutron Detector) is used for the detection of thermal and fast neutrons (0.025 eV to approximately 12 MeV) inside and outside of the treatment room. Measurements were performed for different field sizes at 100 cm source to surface distance (SSD) of detector, at different distances from the isocenter and at the place of primary and secondary walls. Other measurements were performed at door and treatment console for the potential radiation safety concerns of the therapists who must walk in and out of the room for the treatments. Exposures have taken place from Elekta Synergy® linear accelerators for two different energies (10 MV and 18 MV) for a given 200 MU’s and dose rate of 600 MU per minute. Results indicates that neutron doses at 100 cm SSD depend on accelerator characteristics means jaw settings as jaws are made of high atomic number material so provides significant interaction of photons to produce neutrons, while doses at the place of larger distance from isocenter are strongly influenced by the treatment room geometry and backscattering from the walls cause a greater doses as compare to dose at 100 cm distance from isocenter. In the treatment room the ambient dose equivalent due to photons produced during decay of activation nuclei varies from 4.22 mSv.h−1 to 13.2 mSv.h−1 (at isocenter),6.21 mSv.h−1 to 29.2 mSv.h−1 (primary wall) and 8.73 mSv.h−1 to 37.2 mSv.h−1 (secondary wall) for 10 and 18 MV respectively. The ambient dose equivalent for neutrons at door is 5 μSv.h−1 to 2 μSv.h−1 while at treatment console room it is 2 μSv.h−1 to 0 μSv.h−1 for 10 and 18 MV respectively which shows that a 2 m thick and 5m longer concrete maze provides sufficient shielding for neutron at door as well as at treatment console for 10 and 18 MV photons.

Keywords: equivalent doses, neutron contamination, neutron detector, photon energy

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Authors: J. R. Wang, S. W. Chen, Y. Chiang, W. S. Hsu, J. H. Yang, Y. S. Tseng, C. Shih

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In this research, the HABIT analysis methodology was established for Maanshan nuclear power plant (NPP). The Final Safety Analysis Report (FSAR), reports, and other data were used in this study. To evaluate the control room habitability under the CO₂ storage burst, the HABIT methodology was used to perform this analysis. The HABIT result was below the R.G. 1.78 failure criteria. This indicates that Maanshan NPP habitability can be maintained. Additionally, the sensitivity study of the parameters (wind speed, atmospheric stability classification, air temperature, and control room intake flow rate) was also performed in this research.

Keywords: PWR, HABIT, Habitability, Maanshan

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Authors: Y. Chiang, W. Y. Li, J. R. Wang, S. W. Chen, W. S. Hsu, J. H. Yang, Y. S. Tseng, C. Shih

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In this research, the HABIT code was used to estimate the concentration under the CO₂ and H₂SO₄ storage burst conditions for Kuosheng nuclear power plant (NPP). The Final Safety Analysis Report (FSAR) and reports were used in this research. In addition, to evaluate the control room habitability for these cases, the HABIT analysis results were compared with the R.G. 1.78 failure criteria. The comparison results show that the HABIT results are below the criteria. Additionally, some sensitivity studies (stability classification, wind speed and control room intake rate) were performed in this study.

Keywords: BWR, HABIT, habitability, Kuosheng

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Authors: Agnetha Schuchardt, Jennifer Hartmann, Laura Schulte, Roman Peperhove, Lars Gerhold

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If critical infrastructures fail, even for a short period of time, it can have significant negative consequences for the affected population. This is especially true for the food sector that is strongly interlinked with other sectors like the power supply. A blackout could lead to several cities being without food supply for numerous days, simply because cash register systems do no longer work properly. Following the public opinion, securing the food supply in emergencies is considered a task of the state, however, in the German context, the key players are private enterprises and private households. Both are not aware of their responsibility and both cannot be forced to take any preventive measures prior to an emergency. This problem became evident to officials and politicians so that the law covering food security was revised in order to include private stakeholders into mitigation processes. The paper will present a scientific review of governmental and regulatory literature. The focus is the inclusion of the food industry through a law reform and the challenges that still exist. Together with legal experts, an analysis of regulations will be presented that explains the development of the law reform concerning food security and emergency storage in Germany. The main findings are that the existing public food emergency storage is out-dated, insufficient and too expensive. The state is required to protect food as a critical infrastructure but does not have the capacities to live up to this role. Through a law reform in 2017, new structures should to established. The innovation was to include the private sector into the civil defense concept since it has the required knowledge and experience. But the food industry is still reluctant. Preventive measures do not serve economic purposes – on the contrary, they cost money. The paper will discuss respective examples like equipping supermarkets with emergency power supply or self-sufficient cash register systems and why the state is not willing to cover the costs of these measures, but neither is the economy. The biggest problem with the new law is that private enterprises can only be forced to support food security if the state of emergency has occurred already and not one minute earlier. The paper will cover two main results: the literature review and an expert workshop that will be conducted in summer 2018 with stakeholders from different parts of the food supply chain as well as officials of the public food emergency concept. The results from this participative process will be presented and recommendations will be offered that show how the private economy could be better included into a modern food emergency concept (e. g. tax reductions for stockpiling).

Keywords: critical infrastructure, disaster control, emergency food storage, food security, private economy, resilience

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Authors: Shah S. M. A., Aftab U.

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It is imperative in today’s world to get a real time information about different emergency situation occurred in the environment. Helicopters are mostly used to access places which are hard to access in emergencies like earthquake, floods, bridge failure or in any other disasters conditions. Use of helicopters are considered more costly to properly collect the data. Therefore a new technique has been introduced in this research to promptly collect data using drones. The drone designed in this research is based on trial and error experimental work with objective to construct an economical drone. Locally available material have been used for this purpose. And a mobile camera were also attached to prepare video during the flight. It was found that within very limited resources the result were quite successful.

Keywords: UAV, real time, camera, disasters

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Authors: Siyao Zhu, Yifang Xu

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After natural and man-made disasters, robots can bypass the danger, expedite the search, and acquire unprecedented situational awareness to design rescue plans. The hands-free requirement from the first responders excludes the use of tedious manual control and operation. In unknown, unstructured, and obstructed environments, natural-language-based supervision is not amenable for first responders to formulate, and is difficult for robots to understand. Brain-computer interface is a promising option to overcome the limitations. This study aims to test the feasibility of using electroencephalography (EEG) signals to decode human intentions and detect the level of consensus on robot-provided information. EEG signals were classified using machine-learning and deep-learning methods to discriminate search intentions and agreement perceptions. The results show that the average classification accuracy for intention recognition and consensus assessment is 67% and 72%, respectively, proving the potential of incorporating recognizable users’ bioelectrical responses into advanced robot-assisted systems for emergency response.

Keywords: consensus assessment, electroencephalogram, emergency response, human-robot collaboration, intention recognition, search and rescue

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Authors: Okan Cakir, Ibrahim Arziman, Derya Can, Mete Erkencigil, Murat Durusu, S. Mehmet Yasar

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Introduction: Burn injuries from different types and ways commonly seen in emergency departments, approach and treatment varies from outpatient treatment to critical care unit. We wanted to mention a rare burn injury cause of air conditioner refrigerant. Case report: A 22-year-old case admitted to emergency department with a complaint of left hand burn injury and pain. In his history, he said that an accident was occurred before 30 minutes from admission while he had been trying to repair the air conditioner. Air conditioner refrigerant suddenly had erupted from its tank and burned his hand. In physical examination of extremities, second-degree burn bullae on the left hand on second and third proximal phalanx, between first and second phalanx palmar side and on hypothenar region and on third and fourth proximal phalanx and also hyperemia from hand to wrist were seen. There was no motor and sensorial deficiency. As a treatment, local silver sulfadiazine applied to the burn area and analgesic prescribed. The case called for the clinical follow-up to the plastic surgery department. Conclusion: The clinician should take a comprehensive and careful anamnesis for suitable and right management and treatment as in this case in which as well as rare and occurs different way.

Keywords: air conditioner refrigerant, burn, emergency department, rare

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Authors: Ramovatar, Neeraj Panwar

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Lead free Ba₀.₉₈Ca₀.₀₂SnxTi₁₋ₓO₃ (x = 0.01 and 0.05 mole %) ferroelectric ceramics have been synthesized by the solid-state reaction method with sintering at 1400 °C for 2 h. The room temperature x-ray diffraction (XRD) patterns identified the tetragonal phase for x = 0.01 composition whereas co-existence of tetragonal and orthorhombic phases for x =0.05 composition. Raman spectroscopy results corroborated with the XRD results at room temperature. The maximum dielectric properties (ɛm ~ 8591, tanδ ~ 0.018) were obtained for the compound with x = 0.01 at 5 kHz. Further, the tetragonal to cubic (TC) transition temperature was observed at 122 °C and 102 °C for the ceramics with x =0.01 and x = 0.05, respectively. The temperature dependent P-E loops also revealed the existence of TC at these particular temperature values. The energy storage density (Ed) of both compounds was calculated from room temperature P – E loops at an applied electric field of 20 kV/cm. The maximum Ed ~ 224 kJ/m³ was achieved for the sample with x = 0.01 as compared to 164 kJ/m³ for the x =0.05 composition. The value of Ed is comparable to other BaTiO₃ based lead free ferroelectric systems. Impedance spectroscopy analysis exhibited the bulk and grain boundary contributions above 300 °C under the frequency range 100 Hz to 1 MHz. The above properties make these ceramics suitable for energy storage devices.

Keywords: dielectric properties, energy storage properties, impedance spectroscopy, lead free ceramics

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Authors: S. M. C. Kelly, A. Hargreaves, S. Hargreaves

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Introduction: The Can’t intubate, Can’t ventilate emergency scenario is one which has been shown to be managed badly in the past. Reasons identified included gaps in knowledge of the procedure and the emergency equipment used. We aimed to show an increase in confidence amongst anesthetists and operating department practitioners in the technique following a short tea trolley style teaching intervention. Methods: We carried out the teaching on a one-to-one basis. Two Anaesthetists visited each operating theatre during normal working days. One carried out the teaching session and one took over the intra‐operative care of the patient, releasing the listed anaesthetist for a short teaching session. The teaching was delivered to mixture of students and healthcare professionals, both anaesthetists and anaesthetic practitioners. The equipment includes a trolley, an airway manikin, size 10 scalpel, bougie and size 6.0 tracheal tube. The educator discussed the equipment, performed a demonstration and observed the participants performing the procedure. We asked each person to fill out a pre and post teaching questionnaire, stating their confidence with the procedure. Results: The teaching was delivered to 63 participants in total, which included 21 consultant anaesthetists, 23 trainee doctors and 19 anaesthetic practitioners. The teaching sessions lasted on average 9 minutes (range 5– 15 minutes). All participants reported an increase in confidence in both the equipment and technique in front of neck access. Anaesthetic practitioners reported the greatest increase in confidence (53%), with trainee anaesthetists reporting 27% increase and consultant anaesthetists 22%. Overall, confidence in the performance of emergency front of neck access increased by 31% after the teaching session. Discussion: Short ‘Trolley style’ teaching improves confidence in the equipment and technique used for the emergency front of neck access. This is true for students and for consultant anaesthetists. This teaching style is quick with minimal running costs and is relevant for all anesthetic departments.

Keywords: airway teaching, can't intubate can't ventilate, cricothyroidotomy, front-of-neck

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Authors: Kai Chun Yang, Shao-Wen Chen, Jong-Rong Wang, Chunkuan Shih, Jung-Hua Yang, Hsiung-Chih Chen, Wen-Sheng Hsu

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In this study, we build RADionuclide Transport, Removal And Dose Estimation/Symbolic Nuclear Analysis Package (SNAP/RADTRAD) model of Kuosheng Nuclear Power Plant which is based on the Final Safety Evaluation Report (FSAR) and other data of Kuosheng Nuclear Power Plant. It is used to estimate the radiation dose of the Exclusion Area Boundary (EAB), the Low Population Zone (LPZ), and the control room following ‘release from the containment’ case in Loss Of Coolant Accident (LOCA). The RADTRAD analysis result shows that the evaluation dose at EAB, LPZ, and the control room are close to the FSAR data, and all of the doses are lower than the regulatory limits. At last, we do a sensitivity analysis and observe that the evaluation doses increase as the intake rate of the control room increases.

Keywords: RADTRAD, radionuclide transport, removal and dose estimation, snap, symbolic nuclear analysis package, boiling water reactor, NPP, kuosheng

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Authors: Umberto Platini

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This paper analyses the role of government fragmentation as predictor of the use of emergency decrees in parliamentary democracies. In particular, it focuses on the relationship between ideological divisiveness within cabinets and the choice by executives to issue emergency decrees rather initiating ordinary legislative procedures. A Bayesian multilevel analysis conducted on the population of government-initiated legislation in Italy between 1996 and 2018 finds significant evidence that those legislative proposals which are further away from the ideological centre of gravity of the executive are around three times more likely to be issued as emergency decrees. Likewise, legislative projects regulating more contentious policy areas are significantly more likely to be issued by decree. However, for more contentious issues the importance of ideological distance as a predictor diminishes. This evidence suggests that cabinets prefer decrees to ordinary legislative procedures when they expect that the bargaining environment in Parliament is more hostile. These results persist regardless of the fluctuations of the political-economic cycle. Their robustness is also tested against a battery of controls and against fixed effects both at the government level and at the legislature level.

Keywords: Bayesian multilevel logit models, executive action, executive decrees, ideology, legislative studies, polarization

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Authors: Zayd Parekh, Amish Prasad, Baraa Souman

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Postural orthostatic tachycardia syndrome (POTS) is characterized by orthostatic intolerance due to an exaggerated tachycardia in response to standing upright. This exaggerated orthostatic tachycardia is defined as the heart rate (HR) rising 30 beats above a baseline value while supine or seated within ten minutes. The tachycardia can lead to symptoms of orthostatic intolerance such as palpitations, lightheadedness, exercise intolerance, fatigue, and anxiety. POTS can go undiagnosed for many years due to its similarities with other cardiac and psychiatric conditions and nonspecific presentation, making it crucial to raise awareness for it in the medical field. The following case study discusses a 30-year-old female who was evaluated in the emergency room several times before being referred to the clinic for POTS. An overview of what tests are performed with this patient is also provided, highlighting the diagnostic work-up for POTS and the process of ruling out other differentials being considered. Finally, the epidemiology, the various theories regarding its pathophysiology, the diagnostic process, and pharmacological and non-pharmacological management for POTS are reviewed.

Keywords: orthostatic intolerance, postural orthostatic tachycardia syndrome, syncope, tachycardia

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Authors: Jadwiga Klukow, Anna Ksykiewicz-Dorota

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An analysis of the distribution of nurses’ working time constitutes vital information for the management in planning employment. The objective of the study was to analyze the distribution of nurses’ working time in an emergency department. The study was conducted in an emergency department of a teaching hospital in Lublin, in Southeast Poland. The catalogue of activities performed by nurses was compiled by means of continuous observation. Identified activities were classified into four groups: Direct care, indirect care, coordination of work in the department and personal activities. Distribution of nurses’ working time was determined by work sampling observation (Tippett) at random intervals. The research project was approved by the Research Ethics Committee by the Medical University of Lublin (Protocol 0254/113/2010). On average, nurses spent 31% of their working time on direct care, 47% on indirect care, 12% on coordinating work in the department and 10% on personal activities. The most frequently performed direct care tasks were diagnostic activities – 29.23% and treatment-related activities – 27.69%. The study has provided information on the complexity of performed activities and utilization of nurses’ working time. Enhancing the effectiveness of nursing actions requires working out a strategy for improved management of the time nurses spent at work. Increasing the involvement of auxiliary staff and optimizing communication processes within the team may lead to reduction of the time devoted to indirect care for the benefit of direct care.

Keywords: emergency nurses, nursing care, workload, work sampling

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Authors: Masih Nikgou

Abstract:

ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Woo Young Jung, Sung Min Park, Ho Young Son, Viriyavudh Sim

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This study presents a way to reduce earthquake damage and emergency rehabilitation of critical structures such as schools, high-tech factories, and hospitals due to strong ground motions associated with climate changes. Regarding recent trend, a strong earthquake causes serious damage to critical structures and then the critical structure might be influenced by sequence aftershocks (or tsunami) due to fault plane adjustments. Therefore, in order to improve seismic performance of critical structures, retrofitted or strengthening study of the structures under aftershocks sequence after emergency rehabilitation of the structures subjected to strong earthquakes is widely carried out. Consequently, this study used composite material for emergency rehabilitation of the structure rather than concrete and steel materials because of high strength and stiffness, lightweight, rapid manufacturing, and dynamic performance. Also, this study was to develop or improve the seismic performance or seismic retrofit of critical structures subjected to strong ground motions and earthquake aftershocks, by utilizing GFRP-Corrugated Infill Panels (GCIP).

Keywords: aftershock, composite material, GFRP, infill panel

Procedia PDF Downloads 307

Authors: Laxman Budhathoki, Lal Bahadur Shrestha, K. C. Laxman

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Hundreds of people are being lost their life by flood disaster in Nepal every year. Community-based disaster management committee has formed to formulate the disaster management plan including the component of EWS like EWS tower, rain gauge station, flood gauge station, culverts, boats, ropes, life jackets, a communication mechanism, emergency shelter, Spur, dykes, dam, evacuation route, emergency dry food management etc. Now EWS become a successful tool to decrease the human casualty from 13 to 0 every year in Rapti River of Chitwan District.

Keywords: disaster risk reduction, early warning system, flood, participatory approach

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Authors: Nakache Radouane, M. Boukelloul, M. Fredj

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Method room and pillar sizes are key factors for safe mining and their recovery in open-stop mining. This method is advantageous due to its simplicity and requirement of little information to be used. It is probably the most representative method among the total load approach methods although it also remains a safe design method. Using a finite element software (PLAXIS 3D), analyses were carried out with an elasto-plastic model and comparisons were made with methods based on the total load approach. The results were presented as the optimization for improving the ore recovery rate while maintaining a safe working environment.

Keywords: room and pillar, mining, total load approach, elasto-plastic

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Authors: A. Anbu Raj, V. Mugendiren

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Sheet metal forming is a vital manufacturing process used in automobile, aerospace, agricultural industries, etc. Incremental forming is a promising process providing a short and inexpensive way of forming complex three-dimensional parts without using die. The aim of this research is to study the forming behaviour of AA 5052, Aluminium Alloy, using incremental forming and also to study the FLD of cone shape AA 5052 Aluminium Alloy at room temperature and various annealing temperature. Initially the surface roughness and wall thickness through incremental forming on AA 5052 Aluminium Alloy sheet at room temperature is optimized by controlling the effects of forming parameters. The central composite design (CCD) was utilized to plan the experiment. The step depth, feed rate, and spindle speed were considered as input parameters in this study. The surface roughness and wall thickness were used as output response. The process performances such as average thickness and surface roughness were evaluated. The optimized results are taken for minimum surface roughness and maximum wall thickness. The optimal results are determined based on response surface methodology and the analysis of variance. Formability Limit Diagram is constructed on AA 5052 Aluminium Alloy at room temperature and various annealing temperature by using optimized process parameters from the response surface methodology. The cone has higher formability than the square pyramid and higher wall thickness distribution. Finally the FLD on cone shape and square pyramid shape at room temperature and the various annealing temperature is compared experimentally and simulated with Abaqus software.

Keywords: incremental forming, response surface methodology, optimization, wall thickness, surface roughness

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Authors: Bidzina Matsaberidze

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It is known that, in emergency situations, multi-attribute group decision-making (MAGDM) models are characterized by insufficient objective data and a lack of time to respond to the task. Evidence theory is an effective tool for describing such incomplete information in decision-making models when the expert and his knowledge are involved in the estimations of the MAGDM parameters. We consider an emergency decision-making model, where expert assessments on humanitarian aid from distribution centers (HADC) are represented in q-rung ortho-pair fuzzy numbers, and the data structure is described within the data body theory. Based on focal probability construction and experts’ evaluations, an objective function-distribution centers’ selection ranking index is constructed. Our approach for solving the constructed bicriteria partitioning problem consists of two phases. In the first phase, based on the covering’s matrix, we generate a matrix, the columns of which allow us to find all possible partitionings of the HADCs with the service centers. Some constraints are also taken into consideration while generating the matrix. In the second phase, based on the matrix and using our exact algorithm, we find the partitionings -allocations of the HADCs to the centers- which correspond to the Pareto-optimal solutions. For an illustration of the obtained results, a numerical example is given for the facility location-selection problem.

Keywords: emergency MAGDM, q-rung orthopair fuzzy sets, evidence theory, HADC, facility location problem, multi-objective combinatorial optimization problem, Pareto-optimal solutions

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Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

Abstract:

This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

Procedia PDF Downloads 167