Analysis of the Effect of Humanistic Care in the Process of Pre-Hospital Emergency Care

Objective:To explore the effectiveness of humanistic care in pre-hospital emergency care.Methods:From April 2020 to January 2021,80 pre-hospital emergency patients were studied.The patients were randomly divided into two groups:a control group(n=40),which received conventional care,and an experimental group(n=40),which received humanistic care.The effects of nursing care and psychological state were compared between the two groups.Results:The experimental group showed better nursing outcomes and a more positive psychological state compared to the control group(P<0.05).Conclusion:Humanistic care in pre-hospital emergency settings is more effective in reducing patients’anxiety and depression,enhancing the operational abilities and service attitudes of nursing staff,and increasing the emergency success rate.

Applying Network Flow Optimization Techniques to Improve Relief Goods Transport Strategies under Emergency Situation

Given the seriously damaged emergency situation occurring after a large-scale natural disaster, a critical and important problem that needs to be solved urgently is how to distribute the necessary relief goods, such as drinking water, food, and medicine, to the damaged area and how to transport them corresponding to the actual supply and demand situation as quickly as possible. The existing infrastructure, such as traffic roads, bridges, buildings, and other facilities, may suffer from severe damage. Assuming uncertainty related with each road segment’s availability, we formulate a transshipment network flow optimization problem under various types of uncertain situations. In order to express the uncertainty regarding the availability of each road segment, we apply the Monte Carlo simulation technique to generate random networks following certain probability distribution conditions. Then, we solve the model to obtain an optimal transport strategy for the relief goods. Thus, we try to implement a necessary and desirable response strategy for managing emergency cases caused by, for example, various natural disasters. Our modeling approach was then applied to the actual road network in Sumatra Island in Indonesia in 2009, when a disastrous earthquake occurred to develop effective and efficient public policies for emergency situations.

Calculation of railway transport capacity in an emergency based on Markov process

A method is proposed to calculate the railway transport capacity in an emergency to support the dispatching work of control centers. The effect of an emergency on section transport capacity is analyzed and the basic method to calculate the transport capacity is presented. The results show that the situation-changing process in emergency is actually a Markov process. The calculation rule is presented based on division of the time segment during which the emergency lasts. The algorithm is designed to calculate the transport capacity of each time segment. The pessimistic strategy and the fuzzy strategy are proposed to determine the computing value of the transport capacity of each time segment, to satisfy the calculating requirements in different occasions. Our study shows that the method is reasonable and practical and the method can be embedded in the train dispatching system to support the operation work in an emergency.

Current pre-hospital traumatic brain injury management in China

BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

Overview of the Shenzhen Emergency Medical Service Call Pattern

BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACKGROUND：In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS：Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized ＇paramedic＇ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized.CONCLUSION：The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.

Feasibility study of emergency intervention for vascular injury outside the hospital

Background: Minimally invasive surgery in the field of traumatic vascular injury diagnosis and treatment has achieved good results. This study was designed to determine whether pre-hospital emergency intervention is feasible for vascular injury in a field intervention cabin under the condition of war or a disaster site.Methods: Different types of animal experiments of vascular injury intervention were performed in a field intervention cabin. Treatment capacity was evaluated by data collection, including duration of surgery, clinical evaluation, image clarity, and equipment handling. Environmental adaptability and mobility were evaluated by maneuverability and long-distance mobility.Results: A total of 56 surgeries(7 types) were performed in the field intervention cabin. Digital subtraction angiography(DSA) had good imaging performance. A total of 4800 km of long-distance mobility was performed, and all the equipment operated normally without any equipment failure. We participated in the medical service maneuver twice. The cabin unfolded and worked properly. There was no equipment damage during the medical service maneuver.Conclusion: Use of a field intervention cabin under the conditions of war or disaster is feasible for pre-hospital emergency intervention of vascular injury.

Optimization of Urban Rail Transportation in Emerging Countries Using Operational Research Techniques

Rail systems are gradually becoming the most desirable form of transit infrastructure around the world, partly because they are becoming more environmentally friendly compared with airplanes and automobiles. This paper examines the place of emerging countries in this move of implementing modern rail system that will eventually enhance the realization of a low-carbon society. Network model, transportation model and linear programming algorithms are used to model the present urban rail transport system in Nigeria, as an emerging country, in order to optimize it. Operational research methods, including simplex method and MODI, with the aids of computer software (excel solver and LIP solver) were adopted to solve the resulting models. The results showed that optimization of rail transport system will not only reduce carbon emission but also bring about economic development which is required for the eradication of prevalent poverty in these emerging countries.

A New Type of Flat Vehicle for Emergency Patient Transfer

The utility model discloses a new type of flat vehicle for emergency patient transfer, comprising a support frame, a bed board, an infusion stand and a transfer assembly;the transfer assembly comprises a trapezoidal base fixed on the upper part of the support frame, and a trapezoid mounted on the bottom or side of the bed board. A sliding sleeve, a limit pin, a fixing cylinder and a spring;the trapezoidal sliding sleeve is matched on the trapezoidal base, a pin shaft hole is arranged on the trapezoidal base, the fixing cylinder is fixed on the trapezoidal sliding sleeve, and the limit pin is sleeved in the fixing cylinder, The bottom of the limit pin protrudes from the trapezoidal sliding sleeve, and the upper part is provided with a traction rod;the spring is sleeved on the traction rod, and a limiting plate is arranged at intervals on both sides of the trapezoidal base, and the limiting plate is wrapped in the trapezoidal sliding sleeve. The outer end: by setting the transfer component, the bed board is allowed to be fixed, slid and completely disengaged from the support frame, which is convenient for transferring the bed board together with the patient on it during the patient transfer process. It provides convenience for medical staff.

Characteristics of Decision-Making by Family Members When Older Adults Are Hospitalized in Emergency Cases with Life-Threatening Conditions

Aim: This study aims to elucidate decision-making characteristics based on interviews with family members with experience in having to select treatments for older adult patients who have been hospitalized following emergency transport to the hospital. Design: Semi-structured interviews were conducted with 10 individuals with experience in surrogate decision-making for an older adult family member. Methods: The recorded interview data were transcribed verbatim, divided into minimum semantic units, and coded. Next, categories and subcategories were abstracted. A comparison was made with the conceptual constructs of a previous study that examined decision-making by families in a life-threatening crisis. Results: Four categories were extracted from 489 antecedents, 370 attributes, and 388 consequences. One new category was abstracted for each of: 1) antecedents: observing abnormalities and responding, while being worried about death;2) attributes: deliberating on the patient prognosis, the relationship with the patient, and what they believe the patient would want;and 3) consequences: continuing support during convalescence. It is desirable to provide support based on the characteristics of families of older adults, including considering the psychological burden on the families who make surrogate decisions, and also the burden of subsequent caregiving because it is not and in the present environment has not been common for patients to express their wishes beforehand.

上海市标准化非急救医疗转运服务规范的确立及应用

目的 分析上海市非急救医疗转运现存问题及行业标准制定过程,为建立标准化非急救医疗转运服务规范提供参考。方法 回顾我国非急救医疗转运发展历程,分析现阶段非急救医疗转运问题,建立非急救医疗转运团体标准,并进行推广,满足患者非急救医疗转运需求,提供以患者为中心的医疗服务。结果 成功制定了上海市非急救医疗转运的行业标准并应用推广,提升了医疗转运效率。结论 非急救医疗转运是院前急救的补充,有助于缓解院前急救压力,提高医疗转运效率。

多船型多种类应急物资水陆联运调度算例分析

建立多品类应急物资在跨城综合运输路径的优化模型,并根据货船在港口之间的往返运输情形设计港口货船调度模块,在此基础上,融合粒子群算法解决物资在各运输阶段对中转节点选择的问题。通过设置两种不同型号货船的仿真计算对比试验,优化结果分析,验证本文所提出算法的有效性,为应急灾害的运输决策问题提供行之有效的解决方案。

泸定6.8级地震公路抢通保通方案

2022年9月5日,四川泸定发生6.8级地震,公路沿线诱发了大量的地质灾害,造成多处公路损坏或断道,极大地影响了抗震救灾工作。快速摸清震区公路网的受损情况和抢通保通难度,对震后救援至关重要。为此,对震区公路受损情况进行调查,会同地方交通部门完成公路的抢通保通任务。调查发现了507处受损点,公路灾害以崩塌滑坡为主,占总灾害的90%以上。公路灾害具有数量多、规模小、连片分布的特点,公路震害与地震烈度正相关,与断层距离、河流距离负相关。在不利因子组合下,公路震害程度明显加剧,局部位置的公路受损率可达到92.5%。在抢通保通阶段,利用龙头石及大岗山电站的库区水运资源,快速建立5处码头,建立起通往震中的生命通道,让应急队伍快速进入灾区,让伤员第一时间运送出来;灾后交通网的重建充分利用水运资源,不追求道路等级与路线指标,公路重建以提高公路的抗灾能力及韧性为目标。

供需协调视角下城市应急救援可达性评估--以郑州“7·20”特大暴雨为例

日益频繁的特大暴雨对城市造成愈加严重的影响,亟须关注应急救援需求的变化特征以及与之对应的应急救援可达性水平,以此提升城市应急救援的动态响应能力。以郑州市中心城区为例,通过社交媒体数据识别求救点和道路阻碍点,分析“7·20”特大暴雨背景下应急救援需求的时空分布特征。基于供需协调的视角,利用高斯两步移动搜寻法评估城市应急救援可达性。研究结果表明,应急救援需求具有动态集聚分布特征,同时应急救援可达性存在供需错位。最后,从完善应急救援通道网络、建立应急救援可达性智能评估平台、优化应急救援资源的空间布局三方面提出优化策略。

急诊科危重症患者院内转运不良事件的风险预测模型构建

目的分析急诊科危重症患者院内转运不良事件风险因素,构建风险预测模型。方法采用方便抽样法选取2021年10月至2023年2月某院急诊科进行院内转运的870例危重症患者的临床资料,采用单因素和多因素Logistic回归分析建立风险预测模型,以受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under curve,AUC)评价模型预测效果。结果英国国家早期预警评分(national early warning score,NEWS)、血氧饱和度、急诊B超、血管活性药物、机械通气是急诊科危重症患者发生病情不良事件的独立风险因素;血氧饱和度、携氧装置、Ⅲ类管路、护工参与转运是技术不良事件的独立风险因素(均P<0.05)。AUC分别为0.813,0.756。结论构建的急诊科危重症患者院内转运不良事件风险预测模型具有一定的参考价值。

大客流场景下地铁电扶梯故障的乘客疏散

地铁车站客流量大、疏散路线复杂、地下空间有限,一旦发生突发事件而乘客未得到及时疏导,易造成人员恐慌,引发严重安全事故和财产损失.因此,基于安全疏散的地铁车站客流调控,对确保乘客安全出行,维持地铁系统运营具有重要作用.基于社会力模型,以深圳地铁1号线车公庙站为例,运用仿真软件AnyLogic建立地铁车站大客流场景下的疏散模型,从微观角度模拟分析了叠加电扶梯故障突发事件对客流疏散的影响,对比实际调查的高峰期站台容纳量数据,突出大客流场景研究的重要性.通过仿真实验证明突发事件发生时平均分配疏散客流措施效果更佳,将原目的地为拥挤处电扶梯的乘客引导至其他电扶梯虽然会造成部分乘客走行距离的增加,但疏散速率会提升,高峰时期能够提升46.51%,大客流场景下能够提升93.26%.在大客流疏散背景下,叠加不同位置的电扶梯故障假设情景,分类讨论具体的客流平均分配方案,通过仿真实验定量确定各情景下的最佳客流分配方案,为地铁运营部门制定疏散预案提供参考.

2020年我国运输航空公司突发公共卫生事件应急管理能力调查

目的了解我国运输航空公司突发公共卫生事件应急管理能力现况。方法采用方便抽样的横断面研究,收集73家运输航空公司2020年突发公共卫生事件应对的组织资源、应急预案、培训和演练等应急能力现况,使用n(%)进行统计学描述,使用卡方检验和Fisher确切概率法比较不同地区、空勤人员规模航空公司间应急管理能力差异。结果组织资源方面,航空公司应急防控部门设置率、专职人员配置率、信息系统设置率分别为100.0%(73/73)、52.1%(38/73)、26.0%(19/73);应急预案制定率为91.8%(67/73),其中85.1%(57/67)的航空公司在2020年更新了预案;34.3%(25/73)的航空公司每年培训次数≤1次,培训评价反馈(45.2%,33/73)和人员定期考核(52.1%,38/73)等评估与改进手段较少使用;每年组织开展应急演练的航空公司占71.2%(52/73),12.3%(9/73)的航空公司参加地方应急演练,61.6%(45/73)设置了演练评价反馈制度与手段。应急演练评价反馈率存在地区差异(χ^(2)=6.43,P=0.040),东部地区航空公司应急演练评价反馈率高于中部及东北地区(χ^(2)=5.83,P=0.016)。空勤人员数量多、航班量大的航空公司应急专职人员配备率较高(P<0.05)。结论航空公司应急部门设置、应急预案制定率高,均具备一定的突发公共卫生事件应急管理能力,但在应急预案更新、专业人才配备和培养、常态化应急培训演练等方面仍需进一步加强和完善。

基于循证的护理安全信息风险预警体系的构建与实证:急诊科危重患者转运风险评估指标体系

目的:构建急诊科危重患者转运风险评估指标体系,为预防急诊科危重患者转运风险、形成急诊科危重患者转运风险应对策略提供客观依据,为临床提供更全面、便捷的评估工具。方法:通过文献回顾及小组讨论法初步构建转运风险评估指标体系框架,2023年7~8月采用德尔菲法进行2轮专家函询,对指标体系内容进行修改与完善,并运用层次分析法计算权重。结果:本研究共进行了2轮专家函询,问卷回收率分别是95.5%、100.0%,专家权威系数为0.874,专家意见的协调系数分别为0.189、0.223(P<0.05);最终形成的急诊科危重患者转运风险评估指标体系包括2个一级指标、8个二级指标及26个三级指标。结论:本研究构建的急诊科危重患者转运风险评估指标体系科学、可靠,为更全面地评估患者转运风险、护航急诊科危重患者转运安全提供一定的理论基础,可为形成急诊科危重患者转运风险预警模型及应对策略提供参考依据。

城市交通新基建网络建设展望——目标、内涵与路径

建设世界一流的交通基础设施体系已上升成为国家战略,对城市交通而言,从传统基础设施迈向新型基础设施(以下简称“新基建”)是高质量发展的必然选择。探讨了城市交通新基建网络建设的目标、内涵与路径,强调新基建不等同于抛弃传统价值,仍需紧密围绕服务于人的需求、组织城市高效运行、引领生态战略落地、筑牢网络韧性防线、与新业态同频共振、提升行业管理效能等目标推动建设。从设施-运输-信息-能源四网融合、物理-数字-社会三元空间融合、为设施“规-建-养-运”全面赋能、建立全息认知-全视角评估-全场景推演-全要素调控闭环4个维度出发,解析城市交通新基建网络的构建与运行内涵并展望其发展的未来形态。最后,从规划编制方法与技术创新、新基建网络智能体构建、城市交通基础设施与能源跨网融合角度探讨新时期城市交通的发展路径。

考虑交通网络不确定性及SESS与MESS空间配合的分布式储能防灾应急规划

为在大规模停电后提供紧急电力支持,提出一种考虑交通网络不确定性及固定储能系统(SESS)和移动储能系统(MESS)空间配合的分布式储能(DES)防灾应急规划方法。基于正态分布区间数,建立通行时间不确定的MESS调度交通网络模型,提出考虑SESS与MESS空间配合效应的联合应急供电策略。采用机会约束描述交通网络不确定性,构建考虑供电可靠性最优的DES选址定容模型。将机会约束转换为确定性等价类,针对DES防灾应急系统多个供电可靠性衡量指标间的冗余问题,提出基于规格化法平面约束法的多目标优化求解方法。采用改进的IEEE 30节点系统及交通网络进行验证,结果表明所提方法能够实现多区域最优配置,验证了SESS与MESS的空间配合效应,并反映了交通网络不确定性对规划结果的影响。