Data Mining and Visualization of Grid-Based City Emergency System

A cluster analyzing algorithm based on grids is introduced in this paper,which is applied to data mining in the city emergency system. In the previous applications, data mining was based on the method of analyzing points and lines, which was not efficient enough in dealing with the geographic information in units of police areas. The proposed algorithm maps an event set stored as a point set to a grid unit set, utilizes the cluster algorithm based on grids to find out all the clusters, and shows the results in the method of visualization. The algorithm performs well when dealing with high dimensional data sets and immense data. It is suitable for the data mining based on geogra-(phic) information system and is supportive to decision-makings in the city emergency system.

Location Determination Of Optimal Emergency System For Hurricane Disaster Based On Mathematical Modeling

This article first introduces the current research status of space optical communication,and gives a brief overview of the development and application prospects of space optical communication,explaining its important research significance.Then,the working principle of ATP in space optical communication system is studied,the mathematical model of ATP control system is established according to the actual needs,and the ATP control system design of space optical communication is designed.By selecting appropriate motors and gyroscopes as the actuators and detection elements of the system,substituting the actual parameters for simulation analysis,and correcting and verifying the results,some useful results are obtained.The simulation results show the rationality and effectiveness of the ATP design scheme.

Analysis of Drone Fleet Type and Quantity for Medical Package Distribution in Emergency System

In order to cope with the disasters caused by the worst hurricane in Puerto Rico in 2017,it is necessary to build an emergency system to reduce the losses.An emergency system should include the location of ISO standard dry cargo containers and the distribution of emergency medical packages.This paper discusses the distribution of emergency medical package.Based on the above location results of ISO standard dry cargo container,taking the demand of disaster areas not exceed its supply into consideration and considering the timeliness and weak economy,a multi-objective mixed integer programming model is constructed on the premise of minimum transportation time and cost.It is determined that the drone fleet consists of four B,one C and one F drones.Through the optimization model,the distribution plan of emergency medical packages is formulated.

Artificial Intelligence Based Meteorological Parameter Forecasting for Optimizing Response of Nuclear Emergency Decision Support System

This paper presents a novel artificial intelligence (AI) based approach to predict crucial meteorological parameters such as temperature,pressure,and wind speed,typically calculated from computationally intensive weather research and forecasting (WRF) model.Accurate meteorological data is indispensable for simulating the release of radioactive effluents,especially in dispersion modeling for nuclear emergency decision support systems.Simulation of meteorological conditions during nuclear emergencies using the conventional WRF model is very complex and time-consuming.Therefore,a new artificial neural network (ANN) based technique was proposed as a viable alternative for meteorological prediction.A multi-input multi-output neural network was trained using historical site-specific meteorological data to forecast the meteorological parameters.Comprehensive evaluation of this technique was conducted to test its performance in forecasting various parameters including atmospheric pressure,temperature,and wind speed components in both East-West and North-South directions.The performance of developed network was evaluated on an unknown dataset,and acquired results are within the acceptable range for all meteorological parameters.Results show that ANNs possess the capability to forecast meteorological parameters,such as temperature and pressure,at multiple spatial locations within a grid with high accuracy,utilizing input data from a single station.However,accuracy is slightly compromised when predicting wind speed components.Root mean square error (RMSE) was utilized to report the accuracy of predicted results,with values of 1.453℃for temperature,77 Pa for predicted pressure,1.058 m/s for the wind speed of U-component and 0.959 m/s for the wind speed of V-component.In conclusion,this approach offers a precise,efficient,and wellinformed method for administrative decision-making during nuclear emergencies.

Deep Learning-Based Control System Design for Emergency Vehicles through Intersections

This paper addresses the challenge of integrating priority passage for emergency vehicles with optimal intersection control in modern urban traffic. It proposes an innovative strategy based on deep learning to enable emergency vehicles to pass through intersections efficiently and safely. The research aims to develop a deep learning model that utilizes intersection violation monitoring cameras to identify emergency vehicles in real time. This system adjusts traffic signals to ensure the rapid passage of emergency vehicles while simultaneously optimizing the overall efficiency of the traffic system. In this study, OpenCV is used in combination with Convolutional Neural Networks (CNN) and Recurrent Neural Networks (RNN) to jointly complete complex image processing and analysis tasks, to realize the purpose of fast travel of emergency vehicles. At the end of this study, the principle of the You Only Look Once (YOLO) algorithm can be used to design a website and a mobile phone application (app) to enable private vehicles with emergency needs to realize emergency passage through the application, which is also of great significance to improve the overall level of urban traffic management, reduce traffic congestion and promote the development of related technologies.

Coordinated restoration optimization of power-gas integrated energy system with mobile emergency sources

In an integrated energy system(IES) composed of multiple subsystems, energy coupling causes an energy supply blockage or shutdown in one subsystem, thereby affecting the energy flow distribution optimization of other subsystems.The energy supply should be globally optimized during the IES energy supply restoration process to produce the highest restoration net income. Mobile emergency sources can be quickly and flexibly connected to supply energy after an energy outage to ensure a reliable supply to the system, which adds complexity to the decision. This study focuses on a powergas IES with mobile emergency sources and analyzes the coupling relationship between the gas distribution system and the power distribution system in terms of sources, networks, and loads, and the influence of mobile emergency source transportation. The influence of the transient process caused by the restoration operation of the gas distribution system on the power distribution system is also discussed. An optimization model for power-gas IES restoration was established with the objective of maximizing the net income. The coordinated restoration optimization decision-making process was also built to realize the decoupling iteration of the power-gas IES, including system status recognition, mobile emergency source dispatching optimization, gas-to-power gas flow optimization, and parallel intra-partition restoration scheme optimization for both the power and gas distribution systems. A simulation test power-gas IES consisting of an 81-node medium-voltage power distribution network, an 89-node medium-pressure gas distribution network, and four mobile emergency sources was constructed. The simulation analysis verified the efficiency of the proposed coordinated restoration optimization method.

Low-temperature characteristicsof rubbers and performance testsof type 120 emergencyvalve diaphragms

Purpose–The type 120 emergency valve is an essential braking component of railway freight trains,butcorresponding diaphragms consisting of natural rubber(NR)and chloroprene rubber(CR)exhibit insufficientaging resistance and low-temperature resistance,respectively.In order to develop type 120 emergency valverubber diaphragms with long-life and high-performance,low-temperatureresistant CR and NR were processed.Design/methodology/approach–The physical properties of the low-temperature-resistant CR and NRwere tested by low-temperature stretching,dynamic mechanical analysis,differential scanning calorimetryand thermogravimetric analysis.Single-valve and single-vehicle tests of type 120 emergency valves werecarried out for emergency diaphragms consisting of NR and CR.Findings–The low-temperature-resistant CR and NR exhibited excellent physical properties.The elasticityand low-temperature resistance of NR were superior to those of CR,whereas the mechanical properties of thetwo rubbers were similar in the temperature range of 0℃–150℃.The NR and CR emergency diaphragms metthe requirements of the single-valve test.In the low-temperature single-vehicle test,only the low-temperaturesensitivity test of the NR emergency diaphragm met the requirements.Originality/value–The innovation of this study is that it provides valuable data and experience for futuredevelopment of type 120 valve rubber diaphragms.

Earthquake Emergency Response System of High-speed Railway by Least Square Method

This paper studies the Least Square Method to define high-speed railway(HSR) earthquake risk and solve the problem of its emergency response mechanism. Based on the construction of a monitoring system for HSR earthquake emergency response, the technical operational procedures for HSR seismic emergency response are proposed. The quantity, scale, and location of HSR earthquake emergency response mechanism are defined, and the corresponding emergency response system is built. In particular, the earthquake emergency response system can conduct real-time continuous dynamic monitoring of seismic activity along the railway. When earthquake occurs, the intensity of the ground motion is detected by the system. When the earthquake monitoring value reaches the earthquake alarm threshold, it will send an alarm signal to the dispatch center, and the emergency power supply will be forced to cut off. The earthquake emergency response system will continue to monitor the follow-up ground motion acceleration. The system provides the operation scheduling center with a basis for train operation control to resume operation after stopping. The monitoring result of the system reduces the disaster, and the secondary disaster is caused by the earthquake. This paper improves the HSR response mechanism in detecting earthquake disasters. The result improves the ability of HSR to deal with earthquake disasters, and reduces casualties and economic and property loss caused by earthquake disasters.

Prediction of sepsis within 24 hours at the triage stage in emergency departments using machine learning

BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to fi nd a light-weight,convenient prediction method through machine learning.METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation.RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the fi ve most important features were acuity,arrival transportation,age,shock index,and respiratory rate.CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.

Mega-Constellations Based TT&C Resource Sharing: Keep Reliable Aeronautical Communication in an Emergency

With the development of the transportation industry, the effective guidance of aircraft in an emergency to prevent catastrophic accidents remains one of the top safety concerns. Undoubtedly, operational status data of the aircraft play an important role in the judgment and command of the Operational Control Center(OCC). However, how to transmit various operational status data from abnormal aircraft back to the OCC in an emergency is still an open problem. In this paper, we propose a novel Telemetry, Tracking,and Command(TT&C) architecture named Collaborative TT&C(CoTT&C) based on mega-constellation to solve such a problem. CoTT&C allows each satellite to help the abnormal aircraft by sharing TT&C resources when needed, realizing real-time and reliable aeronautical communication in an emergency. Specifically, we design a dynamic resource sharing mechanism for CoTT&C and model the mechanism as a single-leader-multi-follower Stackelberg game. Further, we give an unique Nash Equilibrium(NE) of the game as a closed form. Simulation results demonstrate that the proposed resource sharing mechanism is effective, incentive compatible, fair, and reciprocal. We hope that our findings can shed some light for future research on aeronautical communications in an emergency.

Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong Kong.The primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED presentation.Using c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time points.RESULTS:We analyzed 601 patients,of whom 166(27.6%)developed sepsis.NEWS2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary outcome.However,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),respectively.The discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time point.CONCLUSION:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

Innovative pathways allow safe discharge of mild acute pancreatitis from the emergency room

Acute pancreatitis(AP)is a leading cause of gastrointestinal-related hospitalizations in the United States,resulting in 300000 admissions per year with an estimated cost of over$2.6 billion annually.The severity of AP is determined by the presence of pancreatic complications and end-organ damage.While moderate/severe pancreatitis can be associated with significant morbidity and mortality,the majority of patients have a mild presentation with an uncomplicated course and mortality rate of less than 2%.Despite favorable outcomes,the majority of mild AP patients are admitted,contributing to healthcare cost and burden.In this Editorial we review the performance of an emergency department(ED)pathway for patients with mild AP at a tertiary care center with the goal of reducing hospitalizations,resource utilization,and costs after several years of implementation of the pathway.We discuss the clinical course and outcomes of mild AP patients enrolled in the pathway who were successfully discharged from the ED compared to those who were admitted to the hospital,and identify predictors of successful ED discharge to select patients who can potentially be triaged to the pathway.We conclude that by implementing innovative clinical pathways which are established and reproducible,selected AP patients can be safely discharged from the ED,reducing hospitalizations and healthcare costs,without compromising clinical outcomes.We also identify a subset of patients most likely to succeed in this pathway.

Resilience assessment and optimization method of city road network in the post-earthquake emergency period

The post-earthquake emergency period,which is a sensitive time segment just after an event,mainly focuses on saving life and restoring social order.To improve the seismic resilience of city road networks,a resilience evaluation method used in the post-earthquake emergency period is proposed.The road seismic damage index of a city road network can consider the influence of roads,bridges and buildings along the roads,etc.on road capacity after an earthquake.A function index for a city road network is developed,which reflects the connectivity,redundancy,traffic demand and traffic function of the network.An optimization model for improving the road repair order in the post-earthquake emergency period is also developed according to the resilience evaluation,to enable decision support for city emergency management and achieve the best seismic resilience of the city road network.The optimization model is applied to a city road network and the results illustrate the feasibility of the resilience evaluation and optimization method for a city road network in the post-earthquake emergency period.

Risk factors for postpartum posttraumatic stress disorder after emergency admission

BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.

Consideration of the influence of supports in modeling the electromagnetic fields of 25 kV traction networks under emergency conditions

Single-phase 25 kV traction networks of electrified alternating current(AC)railways create electromagnetic fields(EMFs)with significant levels of intensity.The most intense magnetic fields occur when short circuits exist between the contact wire and rails or ground.Despite the short duration of exposure,they can adversely affect electronic devices and induce significant voltages in adjacent power lines,which is dangerous for operating personnel.Although numerous investigations have focused on modeling the EMF of traction networks and power lines,the challenge of determining the three-dimensional electromagnetic fields near metal supports during the flow of a short-circuit current through them is yet to be resolved.In this case,the field has a complex spatial structure that significantly complicates the calculations of intensities.This study proposes a methodology,algorithms,software,and digital models for determining the EMF in the described emergency scenarios.During the modeling process,the objects being studied were represented by segments of thin wires to analyze the distribution of the electric charge and calculate the intensities of the electric and magnetic fields.This approach was implemented in the Fazonord software,and the modeling results show a substantial increase in EMF levels close to the support,with a noticeable decrease in the levels as the distance from it increases.The procedure implemented in the commercial software Fazonord is universal and can be used to determine electromagnetic fields at any electrical power facility that includes live parts of limited length.Based on the proposed procedure,the EMF near the supports of overhead power lines and traction networks of various designs could be determined,the EMF levels at substations can be calculated,and the influence of metal structures located near traction networks,such as pedestrian crossings at railway stations,can be considered.

Trends in oxycodone and oxycodone-containing analgesics administration for back pain in emergency departments in the USA(2007–2018)

BACKGROUND:To describe trends in oxycodone and oxycodone-containing analgesic prescribing for the treatment of back pain among adults in emergency departments(EDs) in the USA from 2007 to 2018.METHODS:Data were gathered from the National Hospital Ambulatory Medical Care Survey(NHAMCS) from 2007 to 2018.The study population included individuals of all ages presenting to USA EDs.The NHAMCS reasons for visit and oxycodone drug ID codes were used to isolate patients with back pain.The main outcome was the proportion of oxycodone and oxycodone-containing analgesics prescribed for back pain in the EDs over the specified time period.RESULTS:There was a relative decrease in the overall administration of oxycodone for back pain in the EDs by 62.3% from 2007(244,000 visits) to 2018(92,000 visits).The proportion of ED patients prescribed with oxycodone-containing analgesics for back pain increased among patients aged 45 years and older(from 43.8% to 57.6%),female patients(from 54.5% to 62.0%),black patients(from 22.5% to 30.4%),and Hispanic/Latino patients(from 9.4% to 19.6%).Oxycodone/acetaminophen was most prescribed and accounted for 90.2% of all oxycodone-containing analgesics in 2007,with a decrease to 68.5% in 2018.Pure oxycodone was the second most prescribed medication,accounting for 6.1% in 2007 and 31.5% in 2018.CONCLUSION:The overall number of oxycodone-containing analgesics decreased significantly from 2007 to 2018.However,that number trended upward in 45-year-old and older,female,black,or Hispanic/Latino patients from 2007 to 2018.The total amount of pure oxycodone increased significantly from 2007 to 2008.

Short-term effects of low-level PM_(2.5),PM_(10),O_(3),and tropical meteorological conditions on emergency department visits for respiratory diseases in Haikou,China

Objective:To assess the correlation between atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City.Methods:Daily data on atmospheric pollutants,meteorological factors,and emergency department visits for respiratory diseases in Haikou City from 2018 to 2021 were collected.The Spearman rank correlation test was used to analyze the correlation,and a distributed lag non-linear model was employed to analyze the health effects and lag impacts of environmental factors.Subgroup analyses were conducted based on sex and age.Results:According to the criteria of International Classification of Diseases(ICD-10:J00-J99),a total of 221913 cases were included,accounting for 21.3%of the total emergency department visits in Haikou City.For every 1℃increase in temperature,the risk of emergency department visits increased by 1.029%(95%CI 1.016%-1.042%).Relative humidity greater than 80%reduced the risk of visits,while higher atmospheric pressure(>1010 hpa)also decreased the likelihood of daily emergency department visits.Higher concentrations of PM_(2.5)(30-50μg/m^(3)),PM10(>60μg/m^(3)),and O_(3)(75-125μg/m^(3))were associated with increased visits.Higher temperatures(>25℃)have a greater impact on females and children aged 0-14 years,while males are more sensitive to low atmospheric pressure.Individuals aged 65 and above exhibited increased sensitivity to O_(3)concentration,and the effects of PM2.5,PM10,and O_(3)are more pronounced in individuals over 14 years old.Conclusions:Short-term exposure to high temperatures,particulate matter pollutants(PM_(2.5)and PM_(10)),and ozone(O_(3))is associated with increased emergency department visits for respiratory diseases.

Ultrasonic enhancement of persulfate oxidation system governs emerging pollutants decontamination

Emerging contaminants (ECs) are widely present in aquatic environments, posing potential risks to both ecosystems and human health. Theultrasound-assisted persulfate oxidation process has attracted considerable attention in the degradation of ECs due to its ability to generate bothsulfate radicals and cavitation effects, enhancing degradation effects. In this paper, the principle of ultrasonic synergistic Fenton-like oxidationsystem for degrading organic pollutants was reviewed, divided into homogeneous system, non-homogeneous system, and single-atom system toexplore the synergistic effect of ultrasound-enhanced persulfate technology in three aspects, and the effects of environmental factors such asultrasonic frequency and power, system pH, temperature, and initial oxidant concentration on the system's decontamination performance werediscussed. Finally, future research on ultrasonically activated persulfate technology is summarized and prospected.

Management of obstructed colorectal carcinoma in an emergency setting:An update

Colorectal carcinoma is common,particularly on the left side.In 20%of patients,obstruction and ileus may be the first clinical manifestations of a carcinoma that has advanced(stage II,III or even IV).Diagnosis is based on clinical presentation,plain abdominal radiogram,computed tomography(CT),CT colonography and positron emission tomography/CT.The best management strategy in terms of short-term operative or interventional and long-term oncological outcomes re-mains unknown.For the most common left-sided obstruction,the first choice should be either emergency surgery or endoscopic decompression by self-expen-dable metal stents or tubes.The operative plan should be either one-stage or two-stage resection.One-stage resection with on-table bowel decompression and irrigation can be accompanied or not accompanied by proximal defunctioning stoma(colostomy or ileostomy).Primary anastomosis is more convenient but has increased risks of anastomotic leakage and morbidity.Two-stage resection(Hart-mann’s procedure)is safer and the most widely used despite temporally affecting quality of life.Damage control surgery in high-risk frail patients is less frequently performed since it can be successfully substituted with endoscopic stenting or tubing.For the less common right-sided obstruction,one-stage surgical resection is more beneficial than endoscopic decompression.The role of minimally invasive surgery(laparoscopic or robotic)is a subject of debate.Emergency laparoscopic-assisted management is advantageous to some extent but requires much expertise due to inherent difficulties in dissecting the distended colon and the risk of rup-ture and subsequent septic complications.The decompressing stent as a bridge to elective surgery more substantially decreases the risks of morbidity and mortality than emergency surgery for decompression and has equivalent medium-term overall survival and disease-free survival rates.Its combination with neoadjuvant chemotherapy or radiation may have a positive effect on long-term oncological outcomes.Management plans are crucial and must be individualized to better fit each case.Core Tip:Acute obstruction is common in patients with more advanced colorectal carcinoma and may be the first manifestation mainly of left-sided obstruction and in elderly individuals.Emergency decompression is mandatory.Emergency surgical resection and primary anastomosis accompanied or not accompanied by proximal defunctioning stoma must be the first treatment choice for fit patients under 70 years.Hartmann’s two-stage procedure,although more preferable,must be the second alternative choice.Emergency endoscopic self-expendable metal stents must be preferred in unfit patients as a bridge to surgery and for palliative treatment in all inoperable cases.However,these basic management principles constitute a general direction.Decision-making is important and should be individualized.

Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.