After the Three Gorges Reservoir starts running, it can not only take into consideration the interest of departments such as flood control, power generation, water supply, and shipping, but also reduce or eliminate th...After the Three Gorges Reservoir starts running, it can not only take into consideration the interest of departments such as flood control, power generation, water supply, and shipping, but also reduce or eliminate the adverse effects of pollutants by discharge regulation. The evolution of pollutant plumes under different operation schemes of the Three Gorges Reservoir and three kinds of pollutant discharge types were calculated with the MIKE 21 AD software. The feasibility and effectiveness of the reservoir emergency operation when pollution accidents occur were investigated. The results indicate that the emergency operation produces significant effects on the instantaneous discharge type with lesser effects on the constant discharge type, the impact time is shortened, and the concentration of pollutant is reduced. Meanwhile, the results show that the larger the discharge is and the shorter the operation duration is, the more favorable the result is.展开更多
Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities u...Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.展开更多
Purpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’performance for emergent and urgent thoracic surgeries.Methods...Purpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’performance for emergent and urgent thoracic surgeries.Methods:With a homemade machine,animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage,urgent sternotomy,and emergent thoracotomy.Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models.Five operation teams from basic-level hospitals(group A)and five operation teams from level III hospitals(group B)were included to be trained and tested.Testing standards for the operations were established after thorough literature review,and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards.Tests were carried out after the training.Pre-and post-training performances were compared.Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.Results:Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%.After literature review,testing standards were established,and expert questionnaire results showed that the scientific score was 7.30±1.49,and the feasibility score was 7.50±0.89.Post-training performance was significantly higher in both group A and group B than pre-training performance.Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.Conclusions:Animal model-based simulation training established in the current study could improve the trainees’performance for emergent and urgent thoracic surgeries,especially of the surgical teams from basic-level hospitals.展开更多
With high stability,strong bearing capacity and other characteristics,multi-point leveling systems have been widely used in various industries.The mobile platform here uses a 12-point leveling system,which is mainly c...With high stability,strong bearing capacity and other characteristics,multi-point leveling systems have been widely used in various industries.The mobile platform here uses a 12-point leveling system,which is mainly composed of the mechanical transmission system of the supporting arm,a hydraulic drive system and an electrical control system.The leveling is realized through the proportional lifting of the arms in four quadrants.In order to ensure the smooth conduct of launch missions,emergency plans were made for the leveling system incase of failure of a single arm.展开更多
Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dens...Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002) Keywords World Trade Center (WTC) - terrorism - emergency response - emergency management - ground zero - remote sensing - emergency operations - disasters - geographic information systems (GIS) - satellite imagery - synthetic aperture radar (SAR) - light detection and ranging imagery (LIDAR)展开更多
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
Natural disasters not only result in financial loss but also the human lives. The failure of the existing buildings is one of the primary concerns for the damage to human lives. In order to plan a disaster free city p...Natural disasters not only result in financial loss but also the human lives. The failure of the existing buildings is one of the primary concerns for the damage to human lives. In order to plan a disaster free city proper planning of the buildings & infrastructure along with the associated information of non-spatial attributes are needed. The present paper highlights the application of satellite imagery for feature extraction and storing the associated database in GIS environment which is useful for decision making in real time disaster management. The complete methodology is elaborated with the help of a case study for earthquake risk assessment of Maharashtra Industrial Development Corporation (MIDC), Akola, Maharashtra, India region. For the better and precise work 0.5 m. resolution imagery is utilized for extracting the buildings & other infrastructure features. The structural and non-structural details of the buildings are stored as back end for possible vulnerability assessment, suitable planning and preparedness against the hazard. The extracted building features in the planned area have been given suitable weightages for Vulnerability Indexing. Based on suggested indexing approach possible retrofitting measures from the developed database can be recommended for the existing buildings in the proposed location of research. The proposed approach can further be extended for the entire infrastructure of the nation where the centralized data can be made available with Emergency Operation Centre for further planning & preparedness to make the nation disaster free.展开更多
The Westinghouse Nuclear Safety Advisory Letter NSAL-09-8 investigated the possibility of presence of vapor in RHR (residual heat removal) system in modes 3/4 LOCA (loss-of-coolant accident) conditions. This conce...The Westinghouse Nuclear Safety Advisory Letter NSAL-09-8 investigated the possibility of presence of vapor in RHR (residual heat removal) system in modes 3/4 LOCA (loss-of-coolant accident) conditions. This concerns the Westinghouse standard three-loops plant for which the RHR is the low pressure part of the St (safety injection). In some cases one or both RHR trains may become inoperable for SI function. As a response to this letter, Westinghouse Electric Belgium is providing RELAP5 analyzes for Westinghouse NSSS (nuclear steam supply system) European plants to assess the thermal hydraulic behavior of the RHR suction piping system for ECCS (emergency core cooling system) initiation events postulated to occur during startup/shutdown operations. Several concerns including condensation induced water hammer and voiding at the RHR pump have been investigated. As a conclusion, the analysis allowed to define the bounding hot leg temperature conditions under which both RHR trains remain safely operable. These bounding conditions are then implemented by the customer in their OPs (operating procedures) to achieve safe operations and successful accident management.展开更多
Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterect...Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterectomy.Results:The uterus was successfully removed and the bleeding was successfully stopped.It was transferred to the ICU under general anesthesia.Conclusion:For pregnant women with postpartum massive bleeding and hemorrhagic shock and diffuse intravascular coagulation(DIC),targeted surgical treatment and complete operating room emergency care are of great significance to save maternal lives.展开更多
Background: Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a restdt, the t...Background: Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a restdt, the trigger point of blood transtiision may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. Methods: From June 2013 to June 2014, patients were randomly divided into the experimental group (Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group) and the control group (control group). The between-group differences in the patients' demography and baseline inlbrmation, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell (RBC) transiiision standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. Results: During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of(34.8 ± 14.6) years. 50 tmderwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline inlbrmation. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transliision-related complications and mortality. Only tile POTTS-E group on the 1st postoperative day Hb was lower than group control, P 〈 0.05. POTTS-E group was totally (100%) conlbrmed to the requirements of the transfusion guideline to RBC inliision, which was higher than that of the control group (81.25%), P 〈 0.01.There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates ofallogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group (84.3%, 84.3%, and 96.8%) P 〈 0.05 or P 〈 0.01. Per capita consumption of intraoperative allogeneic RBC. total allogeneic RBC and total RBC were 0 (0, 3.0), 2.0 (0, 4.0), and 3.1 (0.81, 6.0) in POTTS-E groups were all lower than those of control group (4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]), P 〈 0.05 or P 〈 0.00 I. Conclusions: Peri-operative Transfilsion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is sate; Compared with doctor experience-based sub iective assessment, the scoring scheme was closer to patient physiological needs lbr transfusion and more reasonable: Utilization rate and the per capita consumption of RBC are obviously declined, which has clinical significance and is feasible. Based on the abovementioned three points, POTTS-E scores scheme is safe, reasonable, and practicable and has the value tbr carrying out multicenter and large sample clinical researches.展开更多
Background:Emergency Operations Center(EOC)is a place to provide response to public health emergencies.Chinese Center for Disease Control and Prevention(China CDC)'s EOC was officially established in 2016,which ha...Background:Emergency Operations Center(EOC)is a place to provide response to public health emergencies.Chinese Center for Disease Control and Prevention(China CDC)'s EOC was officially established in 2016,which has been the core department for the public health emergencies and risk response.In recent years,we have been continuously improving the function of EOC through many incidents.In the study,we hope to share the construction status,operation management experience of China CDC's EOC and the response process in the human avian influenza A(H7N9)outbreak.Main text:The China CDC's EOC mainly focus on building the five core elements including sites/places and facilities,information and data,plans and procedures,training and exercises,and logistics.Based on summarizing previous emergency respons巳the China CDC's EOC established its own incident management and the standardized response procedures.The event-specific data,context-specific data and event management data could be obtained through various source.The logistics department of the EOC also provides comprehensive support.The well-trained staff is another necessary conditions for its operation.Through sharing the response process of H7N9 outbreak,it further explains the EOC's functions in the five phases of outbreak response,such as the formulation of the incident response framework,monitoring,personnel dispatch and resource mobilization.Conclusions:The EOC con tributes to faster and more efficient responses during emergencies which en able a greater reduction in morbidity and mortality.Compared with the traditional incident response process,under the command and coordination of China CDC's EOC,each group involved in the response has a clearer goal,responsibilities and tasks at each stage.Meanwhile,each group also gave full play to its own expertise and advantages.As a whole,incident response tended to be more specialized and precise,which generally improves the efficiency of incident response.However,different countries and regions have different response processes to the events.We still suggested that appropriate emerge ncy operati on plan should be made according to the complexity of in cident response in the region when constructing response mechanism,through our experience.And the China CDC's EOC is still at growing and groping phase.展开更多
Cartographic communication and support within emergency management(EM)are complicated issues with changing demands according to the incident extent and phase of the EM cycle.Keeping in mind the specifics of each purpo...Cartographic communication and support within emergency management(EM)are complicated issues with changing demands according to the incident extent and phase of the EM cycle.Keeping in mind the specifics of each purpose,it is obvious that spatial data used for maps preparation and production must be differently visualized even for the same type of emergency incident(traffic accident,fire,and natural disaster).Context-based cartography is a promising methodology to deal with the changing demands of an operational EM center.An overview of cartographic communication is presented within the context of an operational EM center,activities of particular actors,and map use supporting the incident elimination.The authors of the paper respond to a series of questions,for example:what is the current cartographic support of operational EM in the Czech Republic in Digital Earth conditions?What possibilities are there to improve the cartographic communication?How can contextual cartographic services be implemented in a Web environment and how can the usability of results be tested?The paper gives several examples of the usage of cartographic technologies in map creation for various emergency situations.展开更多
基金supported by the Nonprofit Scientific Research Project of the Ministry of Water Resources of China (Grant No. 20081035)the National Fund for Major Projects of Water Pollution Control (Grant No. 2009ZX07104-006)
文摘After the Three Gorges Reservoir starts running, it can not only take into consideration the interest of departments such as flood control, power generation, water supply, and shipping, but also reduce or eliminate the adverse effects of pollutants by discharge regulation. The evolution of pollutant plumes under different operation schemes of the Three Gorges Reservoir and three kinds of pollutant discharge types were calculated with the MIKE 21 AD software. The feasibility and effectiveness of the reservoir emergency operation when pollution accidents occur were investigated. The results indicate that the emergency operation produces significant effects on the instantaneous discharge type with lesser effects on the constant discharge type, the impact time is shortened, and the concentration of pollutant is reduced. Meanwhile, the results show that the larger the discharge is and the shorter the operation duration is, the more favorable the result is.
基金supported by the National Natural ScienceFoundation of China (No. 72042014).
文摘Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.
基金Key logistics scientific project of the"Thirteenth Five Year Plan"of Medical Research of PLA(ALJ19J001)Key Clinical Innovation Project of Army Medical University and Xinqiao Hospital(CX2019JS107/2018JSLC0023)。
文摘Purpose:To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees’performance for emergent and urgent thoracic surgeries.Methods:With a homemade machine,animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage,urgent sternotomy,and emergent thoracotomy.Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models.Five operation teams from basic-level hospitals(group A)and five operation teams from level III hospitals(group B)were included to be trained and tested.Testing standards for the operations were established after thorough literature review,and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards.Tests were carried out after the training.Pre-and post-training performances were compared.Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.Results:Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%.After literature review,testing standards were established,and expert questionnaire results showed that the scientific score was 7.30±1.49,and the feasibility score was 7.50±0.89.Post-training performance was significantly higher in both group A and group B than pre-training performance.Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.Conclusions:Animal model-based simulation training established in the current study could improve the trainees’performance for emergent and urgent thoracic surgeries,especially of the surgical teams from basic-level hospitals.
文摘With high stability,strong bearing capacity and other characteristics,multi-point leveling systems have been widely used in various industries.The mobile platform here uses a 12-point leveling system,which is mainly composed of the mechanical transmission system of the supporting arm,a hydraulic drive system and an electrical control system.The leveling is realized through the proportional lifting of the arms in four quadrants.In order to ensure the smooth conduct of launch missions,emergency plans were made for the leveling system incase of failure of a single arm.
基金the Earthquake Engineering Research Centers Program of the National Science Foundation(NSF) under a Supplement to Award Number ECC-9701471 to the Multidisciplinary Center for Earthquake Engineering Research
文摘Remote sensing technology has been widely recognized for contributing to emergency response efforts after the World Trade Center attack on September 11th, 2001. The need to coordinate activities in the midst of a dense, yet relatively small area, made the combination of imagery and mapped data strategically useful. This paper reviews the role played by aerial photography, satellite imagery, and LIDAR data at Ground Zero. It examines how emergency managers utilized these datasets, and identifies significant problems that were encountered. It goes on to explore additional ways in which imagery could have been used, while presenting recommendations for more effective use in future disasters and Homeland Security applications. To plan adequately for future events, it was important to capture knowledge from individuals who responded to the World Trade Center attack. In recognition, interviews with key emergency management and geographic information system (GIS) personnel provide the basis of this paper. Successful techniques should not be forgotten, or serious problems dismissed. Although widely used after September 11th, it is important to recognize that with better planning, remote sensing and GIS could have played an even greater role. Together with a data acquisition timeline, an expanded discussion of these issues is available in the MCEER/NSF report “Emergency Response in the Wake of the World Trade Center Attack; The Remote Sensing Perspective” (Huyck and Adams, 2002) Keywords World Trade Center (WTC) - terrorism - emergency response - emergency management - ground zero - remote sensing - emergency operations - disasters - geographic information systems (GIS) - satellite imagery - synthetic aperture radar (SAR) - light detection and ranging imagery (LIDAR)
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Natural disasters not only result in financial loss but also the human lives. The failure of the existing buildings is one of the primary concerns for the damage to human lives. In order to plan a disaster free city proper planning of the buildings & infrastructure along with the associated information of non-spatial attributes are needed. The present paper highlights the application of satellite imagery for feature extraction and storing the associated database in GIS environment which is useful for decision making in real time disaster management. The complete methodology is elaborated with the help of a case study for earthquake risk assessment of Maharashtra Industrial Development Corporation (MIDC), Akola, Maharashtra, India region. For the better and precise work 0.5 m. resolution imagery is utilized for extracting the buildings & other infrastructure features. The structural and non-structural details of the buildings are stored as back end for possible vulnerability assessment, suitable planning and preparedness against the hazard. The extracted building features in the planned area have been given suitable weightages for Vulnerability Indexing. Based on suggested indexing approach possible retrofitting measures from the developed database can be recommended for the existing buildings in the proposed location of research. The proposed approach can further be extended for the entire infrastructure of the nation where the centralized data can be made available with Emergency Operation Centre for further planning & preparedness to make the nation disaster free.
文摘The Westinghouse Nuclear Safety Advisory Letter NSAL-09-8 investigated the possibility of presence of vapor in RHR (residual heat removal) system in modes 3/4 LOCA (loss-of-coolant accident) conditions. This concerns the Westinghouse standard three-loops plant for which the RHR is the low pressure part of the St (safety injection). In some cases one or both RHR trains may become inoperable for SI function. As a response to this letter, Westinghouse Electric Belgium is providing RELAP5 analyzes for Westinghouse NSSS (nuclear steam supply system) European plants to assess the thermal hydraulic behavior of the RHR suction piping system for ECCS (emergency core cooling system) initiation events postulated to occur during startup/shutdown operations. Several concerns including condensation induced water hammer and voiding at the RHR pump have been investigated. As a conclusion, the analysis allowed to define the bounding hot leg temperature conditions under which both RHR trains remain safely operable. These bounding conditions are then implemented by the customer in their OPs (operating procedures) to achieve safe operations and successful accident management.
文摘Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterectomy.Results:The uterus was successfully removed and the bleeding was successfully stopped.It was transferred to the ICU under general anesthesia.Conclusion:For pregnant women with postpartum massive bleeding and hemorrhagic shock and diffuse intravascular coagulation(DIC),targeted surgical treatment and complete operating room emergency care are of great significance to save maternal lives.
文摘Background: Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a restdt, the trigger point of blood transtiision may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future. Methods: From June 2013 to June 2014, patients were randomly divided into the experimental group (Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group) and the control group (control group). The between-group differences in the patients' demography and baseline inlbrmation, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell (RBC) transiiision standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed. Results: During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of(34.8 ± 14.6) years. 50 tmderwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline inlbrmation. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transliision-related complications and mortality. Only tile POTTS-E group on the 1st postoperative day Hb was lower than group control, P 〈 0.05. POTTS-E group was totally (100%) conlbrmed to the requirements of the transfusion guideline to RBC inliision, which was higher than that of the control group (81.25%), P 〈 0.01.There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates ofallogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group (84.3%, 84.3%, and 96.8%) P 〈 0.05 or P 〈 0.01. Per capita consumption of intraoperative allogeneic RBC. total allogeneic RBC and total RBC were 0 (0, 3.0), 2.0 (0, 4.0), and 3.1 (0.81, 6.0) in POTTS-E groups were all lower than those of control group (4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]), P 〈 0.05 or P 〈 0.00 I. Conclusions: Peri-operative Transfilsion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is sate; Compared with doctor experience-based sub iective assessment, the scoring scheme was closer to patient physiological needs lbr transfusion and more reasonable: Utilization rate and the per capita consumption of RBC are obviously declined, which has clinical significance and is feasible. Based on the abovementioned three points, POTTS-E scores scheme is safe, reasonable, and practicable and has the value tbr carrying out multicenter and large sample clinical researches.
基金This work was supported by National Key Research and Development Project(Grant No.2018YFC0809903-02)National Science and Technology Major Project of China(Grant Nos.2018ZX10101002-003,2018ZX10201-002-008-002).
文摘Background:Emergency Operations Center(EOC)is a place to provide response to public health emergencies.Chinese Center for Disease Control and Prevention(China CDC)'s EOC was officially established in 2016,which has been the core department for the public health emergencies and risk response.In recent years,we have been continuously improving the function of EOC through many incidents.In the study,we hope to share the construction status,operation management experience of China CDC's EOC and the response process in the human avian influenza A(H7N9)outbreak.Main text:The China CDC's EOC mainly focus on building the five core elements including sites/places and facilities,information and data,plans and procedures,training and exercises,and logistics.Based on summarizing previous emergency respons巳the China CDC's EOC established its own incident management and the standardized response procedures.The event-specific data,context-specific data and event management data could be obtained through various source.The logistics department of the EOC also provides comprehensive support.The well-trained staff is another necessary conditions for its operation.Through sharing the response process of H7N9 outbreak,it further explains the EOC's functions in the five phases of outbreak response,such as the formulation of the incident response framework,monitoring,personnel dispatch and resource mobilization.Conclusions:The EOC con tributes to faster and more efficient responses during emergencies which en able a greater reduction in morbidity and mortality.Compared with the traditional incident response process,under the command and coordination of China CDC's EOC,each group involved in the response has a clearer goal,responsibilities and tasks at each stage.Meanwhile,each group also gave full play to its own expertise and advantages.As a whole,incident response tended to be more specialized and precise,which generally improves the efficiency of incident response.However,different countries and regions have different response processes to the events.We still suggested that appropriate emerge ncy operati on plan should be made according to the complexity of in cident response in the region when constructing response mechanism,through our experience.And the China CDC's EOC is still at growing and groping phase.
基金The project(No.MSM0021622418)is supported by the Ministry of Education,Youth and Sports of the Czech Republic.Notes on contributors Karel Staněk has worked as an assistant。
文摘Cartographic communication and support within emergency management(EM)are complicated issues with changing demands according to the incident extent and phase of the EM cycle.Keeping in mind the specifics of each purpose,it is obvious that spatial data used for maps preparation and production must be differently visualized even for the same type of emergency incident(traffic accident,fire,and natural disaster).Context-based cartography is a promising methodology to deal with the changing demands of an operational EM center.An overview of cartographic communication is presented within the context of an operational EM center,activities of particular actors,and map use supporting the incident elimination.The authors of the paper respond to a series of questions,for example:what is the current cartographic support of operational EM in the Czech Republic in Digital Earth conditions?What possibilities are there to improve the cartographic communication?How can contextual cartographic services be implemented in a Web environment and how can the usability of results be tested?The paper gives several examples of the usage of cartographic technologies in map creation for various emergency situations.