The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power ...The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power Plant (KNPP) as a function of the severity of the accident conditions. Special attention is paid to SAMG. It is described when the SAMG are used and at which conditions in a transition between the EOPs and the SAMG should be made. The Critical Safety Function Restoration Guidelines and their connections with SAMGs and EOPs are also discussed. The arrangement of SAMG is described in detail, since in the KNPP exist 2 types of SAMGs for Main Control Room (MCR) and for the Accident Management Centre (AMC) and they contain the same strategies, but they are different in format. Both types are symptom oriented procedures, but those for MCR are in 2-column-format with interconnections, whereas those for the AMC are developed in a logical manner and simplified for people, who take decisions. In the paper, they are also discussed the adopted strategies in existing SAMG that should be followed to recover from a damaged core condition and to prevent or mitigate the release of fission products. In the paper, they are also described a number of technical measures for management and mitigation of severe accidents, which are implemented in KNPP before and after the Fukushima accident. Many of them are common for WWER-1000 type of reactors, but some of them are unique and plant specific. This information can be useful for operators of other WWER type reactors or even PWR reactors.展开更多
Background: The aim was to evaluate safety aspects of patient-controlled sedation and analgesia (PCS) for extracorporeal shockwave lithotripsy (ESWL) and PCS to be handled by non-anaesthesiology doctors. Methods: Thir...Background: The aim was to evaluate safety aspects of patient-controlled sedation and analgesia (PCS) for extracorporeal shockwave lithotripsy (ESWL) and PCS to be handled by non-anaesthesiology doctors. Methods: Thirty-four ASA I-III patients used PCS with propofol and alfentanil for ESWL in this interventional study. Strict safety limits were defined regarding respiratory rate (RR), heart rate (HR), mean arterial blood pressure (MAP), oxygen saturation from pulse oximetry (SpO2), and transcutaneous partial pressures of oxygen (PtcO2) and carbon dioxide (PtcCO2). The patients' levels of consciousness was graded on a five-point scale and monitored with Bispectral Index (BIS). A nurse anaesthetist was supervising the procedure but was instructed to intervene only if safety limits were breached. No supplementary oxygen was given. Results: All patients responded to verbal stimuli during treatment. Cardiovascular stability was maintained, but respiratory variables were affected. Two patients with SpO2 2 ≥ 6.5 kPa). In 18 patients hypoxaemia was indicated as PtcO2 ≤ 8.0 kPa. All these 18 patients were given supplementary oxygen. There was no correlation between dose of drugs, age, weight or any vital variable. The 34 patients would use PCS again in the case of future treatment. Conclusions: During ESWL treatment PCS can be used with good patients’ satisfaction, and maintained cardiovascular stability, but PCS had an indisputable effect on pulmonary function with hypoxemia (resulting in need for supplementary oxygen) or hypercarbia. The person in charge of PCS must therefore be trained to perform according to the guidelines for sedation and/or analgesia by non-anaesthesiology doctors.展开更多
文摘The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power Plant (KNPP) as a function of the severity of the accident conditions. Special attention is paid to SAMG. It is described when the SAMG are used and at which conditions in a transition between the EOPs and the SAMG should be made. The Critical Safety Function Restoration Guidelines and their connections with SAMGs and EOPs are also discussed. The arrangement of SAMG is described in detail, since in the KNPP exist 2 types of SAMGs for Main Control Room (MCR) and for the Accident Management Centre (AMC) and they contain the same strategies, but they are different in format. Both types are symptom oriented procedures, but those for MCR are in 2-column-format with interconnections, whereas those for the AMC are developed in a logical manner and simplified for people, who take decisions. In the paper, they are also discussed the adopted strategies in existing SAMG that should be followed to recover from a damaged core condition and to prevent or mitigate the release of fission products. In the paper, they are also described a number of technical measures for management and mitigation of severe accidents, which are implemented in KNPP before and after the Fukushima accident. Many of them are common for WWER-1000 type of reactors, but some of them are unique and plant specific. This information can be useful for operators of other WWER type reactors or even PWR reactors.
文摘Background: The aim was to evaluate safety aspects of patient-controlled sedation and analgesia (PCS) for extracorporeal shockwave lithotripsy (ESWL) and PCS to be handled by non-anaesthesiology doctors. Methods: Thirty-four ASA I-III patients used PCS with propofol and alfentanil for ESWL in this interventional study. Strict safety limits were defined regarding respiratory rate (RR), heart rate (HR), mean arterial blood pressure (MAP), oxygen saturation from pulse oximetry (SpO2), and transcutaneous partial pressures of oxygen (PtcO2) and carbon dioxide (PtcCO2). The patients' levels of consciousness was graded on a five-point scale and monitored with Bispectral Index (BIS). A nurse anaesthetist was supervising the procedure but was instructed to intervene only if safety limits were breached. No supplementary oxygen was given. Results: All patients responded to verbal stimuli during treatment. Cardiovascular stability was maintained, but respiratory variables were affected. Two patients with SpO2 2 ≥ 6.5 kPa). In 18 patients hypoxaemia was indicated as PtcO2 ≤ 8.0 kPa. All these 18 patients were given supplementary oxygen. There was no correlation between dose of drugs, age, weight or any vital variable. The 34 patients would use PCS again in the case of future treatment. Conclusions: During ESWL treatment PCS can be used with good patients’ satisfaction, and maintained cardiovascular stability, but PCS had an indisputable effect on pulmonary function with hypoxemia (resulting in need for supplementary oxygen) or hypercarbia. The person in charge of PCS must therefore be trained to perform according to the guidelines for sedation and/or analgesia by non-anaesthesiology doctors.
