This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in ...This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in servicing accident victims. This is useful for developing means of saving the lives of accident victims in the Federal Fapital City (FCC). The data used comprised of Nigerian Sat II 2013 multispectral imagery (5 m multispectral and 2.5 m Panchromatic) of FCC obtained from the National Space Research and Development Agency (NARSDA), coordinates of seventy (70) accident black spots, five (5) zebra points and sixteen (16) emergency health care facilities obtained from Federal Road Safety Commission (FRSC). ArcGIS 10.0 software was used to display, visualize, identify and extract features from the imagery, and create maps from different layers of the spatial data, choose colors and symbols, create buffer zones, analyze spatial relationships, and design map layouts. Purposeful sampling method was adopted to administer 99 questionnaires to accident victims in the hospitals within the FCC. The spatial data were used to determine the time of rescue, type of rescue and coverage time of rescue operation. The statistical data were used to assess the spatio-temporal distribution of accidents and determine the level of response by the rescue teams. The results show that accident victims have adequate access to health facilities but inadequate access to zebra points, and passers-by have more effective accident response than the government action agencies. Specific points for the creation of additional zebra points were identified through buffering, and the creation of sustainable Good Samaritan programs and training for community persons in first aid were suggested. Meanwhile, further research to determine the impact of time of rescue, type of rescue and category of hospital on the accident victims was suggested.展开更多
Water pollution accidents such as chemical spill and toxicants leach have become a serious issue in the world, which brings great threats to the aquatic ecosystem and drinking water safety. To detect unknown pollution...Water pollution accidents such as chemical spill and toxicants leach have become a serious issue in the world, which brings great threats to the aquatic ecosystem and drinking water safety. To detect unknown pollutions in time and take proper emergency actions, this study developed a system which integrated an online intelligent water quality monitoring device with a high efficient water quality model. The device is based on water quality probes and biological sensors which use fish motion as indicator. The numerical model is a combination of Euler and Lagrangian approaches. Finite element method is applied to simulate the flow field in an unstructured grid, and the pollutant be- haviours are traced through particle tracking. Oracle is used to manage the basic and monitoring data, and ArcSDE as well as ArclMS technologies are applied to make the system WebGIS-based so as to improve the data receiving and dispatching efficiency. The developed system has been successfully operated in Douhe Reservoir and Taihu Lake, China, where drinking water intakes are installed. It is seen from the applications that the online intelligent water qual- ity monitoring and emergency support system can be of great support to emergency management.展开更多
It has been revealed that prolonged shelter life caused by Fukushima Daiichi Nuclear Power Station accident in conjunction with the Great East Japan Earthquake influences sleep and mental health of the residents, and ...It has been revealed that prolonged shelter life caused by Fukushima Daiichi Nuclear Power Station accident in conjunction with the Great East Japan Earthquake influences sleep and mental health of the residents, and therefore its influence on their physical and emotional health has become a concern. Therefore, in this study, the authors aimed at clarifying actual situations of sleep and stress of middle age males living in shelters for a long period in each of emergency temporary houses and post-earthquake public houses. For 5 males who moved from emergency temporary houses to post-earthquake public houses, their objective and subjective sleep states were measured with Actigraph and PSQI, respectively. Furthermore, their objective and subjective stresses were measured with saliva stress biomarkers and GHQ28, respectively. Their data were analyzed by paired t-test. As result, in comparison between the life in the emergency temporary houses and post-earthquake public houses, significant variation was not recognized in their objective sleep states and saliva stress biomarkers though their subjective sleep and subjective stress were significantly worsened after moving to the post-earthquake public houses.展开更多
Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Da...Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Data were collected in a large, Hong Kong, government hospital over an eighteen-month period. Recipients included 281 patients, 150 medical staff members, and 44 relatives of patients. Results: Interventions with patients and their family members centered on crisis management, diagnostic assessment, psychoeducation, and consultations regarding long-term adjustment to medical infirmities. The majority of staff members sought consultations regarding work related stress such as burnout symptoms and coping with vicarious trauma experiences. Frequency tables provide information on utilization of specific services while case vignettes contextualize psychological interventions. Conclusion: There are many potential benefits of psychological service for AED patients and staff.展开更多
Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst...Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.展开更多
Objective:To determine the clinical and epidemiological features of pelvic fracture patients presenting to the Emergency Department.Methods:This prospective observational study was conducted in a tertiary care center ...Objective:To determine the clinical and epidemiological features of pelvic fracture patients presenting to the Emergency Department.Methods:This prospective observational study was conducted in a tertiary care center in south India.Causes of injury,types of pelvic fractures,the associated injuries,and outcome at the time of discharge were recorded.Results:A total of 140 patients were included in this study.Most patients were classified as type A(n=62),followed by type B(n=48)and type C(n=30).A total of 112 patients were injured due to road traffic accidents,followed by a fall from a height(n=23)and a fall from a heavy object(n=5).Most subjects had facial injuries(n=99,70.7%),followed by head injuries(n=51,36.4%).Five percent of the patients were expired,12%left against medical advice,and 83%were discharged.Conclusions:The incidence of pelvic fractures presenting to the Emergency Department is relatively high in India.Road traffic accidents are the primary cause of pelvic fractures and associated facial and head injuries.The outcomes demonstrate the need for improved prevention strategies and comprehensive management protocols to reduce mortality.展开更多
This study aimed at determining the spatial patterns of Road Traffic Crash (RTC) black spots, Federal Road Safety Commission (FRSC) zebra points and emergency health care facilities in Federal Capital City (FCC). The ...This study aimed at determining the spatial patterns of Road Traffic Crash (RTC) black spots, Federal Road Safety Commission (FRSC) zebra points and emergency health care facilities in Federal Capital City (FCC). The aim was to provide stakeholders with information that will aid their understanding of accident prone locations and accessible rescue possibilities for accident victims on the roads in FCT. GPS Map 76S Mark (GARMIN) was used to locate and pick coordinates of data in the study area. A total of 16 possible emergency health care facilities, seventy (70) RTC black spots and Five Zebra point locations were obtained from FRSC. ArcGIS 10.0 was used to compute the data by plotting the coordinates to produce maps of the spatial relationship and to carry out Nearest Neighbour Analysis (NNA). The result was further used to determine the spatial patterns of RTC black spots as well as patterns of the emergency facilities. Generally, the result shows that the spatial trend is turning towards dispersion. However, there is less than 1% likelihood that the dispersed patterns could be the result of random chance. It was recommended that, the Federal Road Safety Commission should be staffed with trained professionals that can be responsible for accident data surveillance and analysis using geospatial techniques.展开更多
The thorium molten salt reactor–liquid fuel(TMSR-LF1) has inherent safety features. The accident occurrence possibility and their consequences are much lower for the TMSR-LF1 than that of traditional reactors.Based o...The thorium molten salt reactor–liquid fuel(TMSR-LF1) has inherent safety features. The accident occurrence possibility and their consequences are much lower for the TMSR-LF1 than that of traditional reactors.Based on accident analysis, the maximum credible accident and the radioactive source terms of the TMSR-LF1 were first estimated. Then, the total effective dose of the maximum credible accident was calculated. Based on calculations, the cover gas flow rate can significantly affect the radiation consequences of the maximum credible accident when it changes from 0 to 10 L/min. If no cover gas is flowing, a site-area emergency would be required within the range of 50–73 m from the reactor. In the case of cover gas flow, only an abnormal notification and an alert two emergency class would be required within the range of 50 m.展开更多
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
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
The countermeasures are the actions that should be taken, after the occurrence of a nuclear accident to protect the public against the associated risks. These actions may be represented by sheltering, evacuation, dist...The countermeasures are the actions that should be taken, after the occurrence of a nuclear accident to protect the public against the associated risks. These actions may be represented by sheltering, evacuation, distribution of stable iodine tablets and/or relocation. This study represents a comprehensive probabilistic study to investigate the role of the adoption of the countermeasures in case of a hypothetical accident of type LOCA for nuclear power plant of PWR (1000 Mw). The effective doses in different organs, short and long health effects, and the associated risks are calculated with and without countermeasures. In addition, the overall costs of the accident and the costs of countermeasures are estimated which represent our first trials to know how much the proposed accident cost. The results showed that, the area around the site requires early and late countermeasures action after the accident especially in the downwind sectors. For late countermeasures, the duration time of relocation ranged from about two to 10 years. The adoption of the countermeasures increases the costs of emergency plan by 40% but reduces the risk associated the accident.展开更多
Trauma is one of the most common surgical emergencies admitted in the acute care departments of hospitals in Guinea, West Africa. We carried a study to assess the epidemiological pattern and clinical care of neurotrau...Trauma is one of the most common surgical emergencies admitted in the acute care departments of hospitals in Guinea, West Africa. We carried a study to assess the epidemiological pattern and clinical care of neurotrauma in the emergency department of the Kindia regional hospital, a rural secondary hospital catering to the needs of western Guinea and nearby districts. Data were prospectively collected from December 2019 to March 2020 after receiving the required hospital authorization and informed consent from the patients or relatives. We recorded two hundred cases of neurotraumas (64.5% of traumatic brain injury cases and 14.5% of spinal cord injury). Neurotraumas represented 17.7% of all admitted patients in the department in the study period. The mean age was 25.34 ± 16.73, and the age range 16 to 30 was the most affected. The predominance was male, with a sex ratio of 3.43. Motor Vehicle Accident was the leading cause 68.5%, and 73.2% of them involved a motorcycle. Motorcycle-to-motorcycle collision was responsible for more than a third of neurotraumas. We classified the majority of the cases as mild and low risk neurotrauma representing 62.08%. All patients benefited from medical treatment, and 30.7% of patients received surgical treatment for associated abdominal, orthopedic, and minor procedures for scalp dilacerations. No patient was referred to a Neurosurgery department, and all living patients were discharged home during the study period with minimal disability. The mortality was 16.3%. Our results could be biased by the lack of interhospital networking and the fact that severe traumatic brain-injured patient dies before seeking medical attention.展开更多
Abrupt air pollution accidents can endanger people’s health and destroy the local ecological environment.The appropriate emergency response can minimize the harmful effects of accidents and protect people’s lives an...Abrupt air pollution accidents can endanger people’s health and destroy the local ecological environment.The appropriate emergency response can minimize the harmful effects of accidents and protect people’s lives and property.This paper provides an overview of the key emergency response technologies for abrupt air pollution accidents around the globe with emphasis on the major achievements that China has obtained in recent years.With decades of effort,China has made significant progress in emergency monitoring technologies and equipment,source estimation technologies,pollutant dispersion simulation technologies and others.Many effective domestic emergency monitoring instruments(e.g.,portable DOAS/FT-IR systems,portable FID/PID systems,portable GC-MS systems,scanning imaging remote sensing systems,and emergency monitoring vehicles)had been developed which can meet the demands for routine emergency response activities.A monitoring layout technique combining air dispersion simulation,fuzzy comprehensive evaluation,and a post-optimality analysis was proposed to identify the optimal monitoring layout scheme under the constraints of limited monitoring resources.Multiple source estimation technologies,including the forward method and the inversion method,have been established and evaluated under various scenarios.Multi-scale dynamic pollution dispersion simulation systems with high temporal and spatial resolution were further developed.A comprehensive emergency response platform integrating database support,source estimation,monitoring schemes,fast monitoring of pollutants,pollution predictions and risk assessment was developed based on the technical idea of"source identification-model simulation-environmental monitoring"dynamic interactive feedback.It is expected that the emergency response capability for abrupt air pollution accidents will gradually improve in China.展开更多
BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY Thi...BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY This case report describes the rare situation wherein a surgeon inadvertently detached the inflatable tube of an endotracheal tube during a tonsillectomy,and positive pressure ventilation could not be provided.While reintubation may increase the risk of respiratory tract infection and aspiration,patients with a difficult airway might die due to apnea.The best treatment method is to optimize the damaged tracheal tube junction to avoid secondary intubation and ensure patient safety.An intravenous needle and cannula were used to repair the damaged gap in the current case.Following the repair,the anesthesia machine showed no indication of low tidal volume,and there was no deflation of the endotracheal tube cuff.Subsequently,the patient was transferred to the postanesthesia recovery room,and the tracheal tube was removed with satisfactory results.CONCLUSION Using an intravenous needle to repair a break in the inflatable tube surrounding an endotracheal tube is safe and reliable.展开更多
Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the t...Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the treatment database of the Emergency Center. The period January 2009 to December 2012 has been considered for this research. The aim of this study is to assess the prevalence of fatal road traffic accidents in Pristine, Kosovo, and describe their determinants. The number of injured in traffic accidents who have sought emergency medical assistance in the Emergency Center from January 2009 to December 2012 is increasing significantly. It is concluded that except reasons mentioned above and among others, there also are the following factors: enormous increase of number of persons equipped with driving license, driving speeds above limits which are considered to be the primary cause of the road traffic accidents. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.展开更多
With the development of metropolitan regions and the appearance of urban agglomerations, cities have been more closely related. For the restricted emergency rescue resource in a single city, it has become more and mor...With the development of metropolitan regions and the appearance of urban agglomerations, cities have been more closely related. For the restricted emergency rescue resource in a single city, it has become more and more imminent for the demand of the intercity collaborative resistance to major accident, so as to improve the protection capacity of urban security. In order to find an effective intercity, emergency rescue collaborative system, this paper introduces the concept and analysis method of ecosystem theory into intercity emergency, rescue. Based on the analysis of the formation-process of emergency rescue individual, population and community: a throe-level intercity emergency rescue collaborative system is constructed according to the characteristics of dynamics and structure of intercity emergency rescue ecosystem then the collaboration mechanism of information, resource and process in the interceity emergency rescue ecosystem is also studied in this paper; so as to offer available strategy and method for the ecosystem theory applied to intercity, emergency rescue. Through the studies of intereity emergency rescue ecosystem. it illuminates that the proposed emergency system can not Only cope with the major accident more timely and effectively but also integrate the intercity information resources and emergency rescue resource and process optimization.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
文摘This paper studied the spatial accessibility of emergency facilities to road accident victims in Federal Capital City to determine the sufficiency of existing emergency health care facilities and rescue facilities in servicing accident victims. This is useful for developing means of saving the lives of accident victims in the Federal Fapital City (FCC). The data used comprised of Nigerian Sat II 2013 multispectral imagery (5 m multispectral and 2.5 m Panchromatic) of FCC obtained from the National Space Research and Development Agency (NARSDA), coordinates of seventy (70) accident black spots, five (5) zebra points and sixteen (16) emergency health care facilities obtained from Federal Road Safety Commission (FRSC). ArcGIS 10.0 software was used to display, visualize, identify and extract features from the imagery, and create maps from different layers of the spatial data, choose colors and symbols, create buffer zones, analyze spatial relationships, and design map layouts. Purposeful sampling method was adopted to administer 99 questionnaires to accident victims in the hospitals within the FCC. The spatial data were used to determine the time of rescue, type of rescue and coverage time of rescue operation. The statistical data were used to assess the spatio-temporal distribution of accidents and determine the level of response by the rescue teams. The results show that accident victims have adequate access to health facilities but inadequate access to zebra points, and passers-by have more effective accident response than the government action agencies. Specific points for the creation of additional zebra points were identified through buffering, and the creation of sustainable Good Samaritan programs and training for community persons in first aid were suggested. Meanwhile, further research to determine the impact of time of rescue, type of rescue and category of hospital on the accident victims was suggested.
基金National High-Tech R&D Program of China ("863" Program,No.2009AA06A418)
文摘Water pollution accidents such as chemical spill and toxicants leach have become a serious issue in the world, which brings great threats to the aquatic ecosystem and drinking water safety. To detect unknown pollutions in time and take proper emergency actions, this study developed a system which integrated an online intelligent water quality monitoring device with a high efficient water quality model. The device is based on water quality probes and biological sensors which use fish motion as indicator. The numerical model is a combination of Euler and Lagrangian approaches. Finite element method is applied to simulate the flow field in an unstructured grid, and the pollutant be- haviours are traced through particle tracking. Oracle is used to manage the basic and monitoring data, and ArcSDE as well as ArclMS technologies are applied to make the system WebGIS-based so as to improve the data receiving and dispatching efficiency. The developed system has been successfully operated in Douhe Reservoir and Taihu Lake, China, where drinking water intakes are installed. It is seen from the applications that the online intelligent water qual- ity monitoring and emergency support system can be of great support to emergency management.
文摘It has been revealed that prolonged shelter life caused by Fukushima Daiichi Nuclear Power Station accident in conjunction with the Great East Japan Earthquake influences sleep and mental health of the residents, and therefore its influence on their physical and emotional health has become a concern. Therefore, in this study, the authors aimed at clarifying actual situations of sleep and stress of middle age males living in shelters for a long period in each of emergency temporary houses and post-earthquake public houses. For 5 males who moved from emergency temporary houses to post-earthquake public houses, their objective and subjective sleep states were measured with Actigraph and PSQI, respectively. Furthermore, their objective and subjective stresses were measured with saliva stress biomarkers and GHQ28, respectively. Their data were analyzed by paired t-test. As result, in comparison between the life in the emergency temporary houses and post-earthquake public houses, significant variation was not recognized in their objective sleep states and saliva stress biomarkers though their subjective sleep and subjective stress were significantly worsened after moving to the post-earthquake public houses.
文摘Study Aim: Descriptions of the direct services of a psychologist (i.e. clinical psychology intern) in an accident and emergency department (AED) are provided as a new and rare area of professional practice. Method: Data were collected in a large, Hong Kong, government hospital over an eighteen-month period. Recipients included 281 patients, 150 medical staff members, and 44 relatives of patients. Results: Interventions with patients and their family members centered on crisis management, diagnostic assessment, psychoeducation, and consultations regarding long-term adjustment to medical infirmities. The majority of staff members sought consultations regarding work related stress such as burnout symptoms and coping with vicarious trauma experiences. Frequency tables provide information on utilization of specific services while case vignettes contextualize psychological interventions. Conclusion: There are many potential benefits of psychological service for AED patients and staff.
文摘Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.
文摘Objective:To determine the clinical and epidemiological features of pelvic fracture patients presenting to the Emergency Department.Methods:This prospective observational study was conducted in a tertiary care center in south India.Causes of injury,types of pelvic fractures,the associated injuries,and outcome at the time of discharge were recorded.Results:A total of 140 patients were included in this study.Most patients were classified as type A(n=62),followed by type B(n=48)and type C(n=30).A total of 112 patients were injured due to road traffic accidents,followed by a fall from a height(n=23)and a fall from a heavy object(n=5).Most subjects had facial injuries(n=99,70.7%),followed by head injuries(n=51,36.4%).Five percent of the patients were expired,12%left against medical advice,and 83%were discharged.Conclusions:The incidence of pelvic fractures presenting to the Emergency Department is relatively high in India.Road traffic accidents are the primary cause of pelvic fractures and associated facial and head injuries.The outcomes demonstrate the need for improved prevention strategies and comprehensive management protocols to reduce mortality.
文摘This study aimed at determining the spatial patterns of Road Traffic Crash (RTC) black spots, Federal Road Safety Commission (FRSC) zebra points and emergency health care facilities in Federal Capital City (FCC). The aim was to provide stakeholders with information that will aid their understanding of accident prone locations and accessible rescue possibilities for accident victims on the roads in FCT. GPS Map 76S Mark (GARMIN) was used to locate and pick coordinates of data in the study area. A total of 16 possible emergency health care facilities, seventy (70) RTC black spots and Five Zebra point locations were obtained from FRSC. ArcGIS 10.0 was used to compute the data by plotting the coordinates to produce maps of the spatial relationship and to carry out Nearest Neighbour Analysis (NNA). The result was further used to determine the spatial patterns of RTC black spots as well as patterns of the emergency facilities. Generally, the result shows that the spatial trend is turning towards dispersion. However, there is less than 1% likelihood that the dispersed patterns could be the result of random chance. It was recommended that, the Federal Road Safety Commission should be staffed with trained professionals that can be responsible for accident data surveillance and analysis using geospatial techniques.
文摘The thorium molten salt reactor–liquid fuel(TMSR-LF1) has inherent safety features. The accident occurrence possibility and their consequences are much lower for the TMSR-LF1 than that of traditional reactors.Based on accident analysis, the maximum credible accident and the radioactive source terms of the TMSR-LF1 were first estimated. Then, the total effective dose of the maximum credible accident was calculated. Based on calculations, the cover gas flow rate can significantly affect the radiation consequences of the maximum credible accident when it changes from 0 to 10 L/min. If no cover gas is flowing, a site-area emergency would be required within the range of 50–73 m from the reactor. In the case of cover gas flow, only an abnormal notification and an alert two emergency class would be required within the range of 50 m.
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.
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The countermeasures are the actions that should be taken, after the occurrence of a nuclear accident to protect the public against the associated risks. These actions may be represented by sheltering, evacuation, distribution of stable iodine tablets and/or relocation. This study represents a comprehensive probabilistic study to investigate the role of the adoption of the countermeasures in case of a hypothetical accident of type LOCA for nuclear power plant of PWR (1000 Mw). The effective doses in different organs, short and long health effects, and the associated risks are calculated with and without countermeasures. In addition, the overall costs of the accident and the costs of countermeasures are estimated which represent our first trials to know how much the proposed accident cost. The results showed that, the area around the site requires early and late countermeasures action after the accident especially in the downwind sectors. For late countermeasures, the duration time of relocation ranged from about two to 10 years. The adoption of the countermeasures increases the costs of emergency plan by 40% but reduces the risk associated the accident.
文摘Trauma is one of the most common surgical emergencies admitted in the acute care departments of hospitals in Guinea, West Africa. We carried a study to assess the epidemiological pattern and clinical care of neurotrauma in the emergency department of the Kindia regional hospital, a rural secondary hospital catering to the needs of western Guinea and nearby districts. Data were prospectively collected from December 2019 to March 2020 after receiving the required hospital authorization and informed consent from the patients or relatives. We recorded two hundred cases of neurotraumas (64.5% of traumatic brain injury cases and 14.5% of spinal cord injury). Neurotraumas represented 17.7% of all admitted patients in the department in the study period. The mean age was 25.34 ± 16.73, and the age range 16 to 30 was the most affected. The predominance was male, with a sex ratio of 3.43. Motor Vehicle Accident was the leading cause 68.5%, and 73.2% of them involved a motorcycle. Motorcycle-to-motorcycle collision was responsible for more than a third of neurotraumas. We classified the majority of the cases as mild and low risk neurotrauma representing 62.08%. All patients benefited from medical treatment, and 30.7% of patients received surgical treatment for associated abdominal, orthopedic, and minor procedures for scalp dilacerations. No patient was referred to a Neurosurgery department, and all living patients were discharged home during the study period with minimal disability. The mortality was 16.3%. Our results could be biased by the lack of interhospital networking and the fact that severe traumatic brain-injured patient dies before seeking medical attention.
基金supported by the National Key Research and Development Program of China(No.2017YFC0209900)Beijing Nova Program from Beijing Municipal Science&Technology Commission(No.Z201100006820098)the Youth Science and Technology Talents Support Program(2020)by Anhui Association for Science and Technology(No.RCTJ202002)。
文摘Abrupt air pollution accidents can endanger people’s health and destroy the local ecological environment.The appropriate emergency response can minimize the harmful effects of accidents and protect people’s lives and property.This paper provides an overview of the key emergency response technologies for abrupt air pollution accidents around the globe with emphasis on the major achievements that China has obtained in recent years.With decades of effort,China has made significant progress in emergency monitoring technologies and equipment,source estimation technologies,pollutant dispersion simulation technologies and others.Many effective domestic emergency monitoring instruments(e.g.,portable DOAS/FT-IR systems,portable FID/PID systems,portable GC-MS systems,scanning imaging remote sensing systems,and emergency monitoring vehicles)had been developed which can meet the demands for routine emergency response activities.A monitoring layout technique combining air dispersion simulation,fuzzy comprehensive evaluation,and a post-optimality analysis was proposed to identify the optimal monitoring layout scheme under the constraints of limited monitoring resources.Multiple source estimation technologies,including the forward method and the inversion method,have been established and evaluated under various scenarios.Multi-scale dynamic pollution dispersion simulation systems with high temporal and spatial resolution were further developed.A comprehensive emergency response platform integrating database support,source estimation,monitoring schemes,fast monitoring of pollutants,pollution predictions and risk assessment was developed based on the technical idea of"source identification-model simulation-environmental monitoring"dynamic interactive feedback.It is expected that the emergency response capability for abrupt air pollution accidents will gradually improve in China.
文摘BACKGROUND During the perianesthesia period,emergency situations threatening the life and safety of patients can occur at any time.When dealing with some emergencies,occasional confusion is inevitable.CASE SUMMARY This case report describes the rare situation wherein a surgeon inadvertently detached the inflatable tube of an endotracheal tube during a tonsillectomy,and positive pressure ventilation could not be provided.While reintubation may increase the risk of respiratory tract infection and aspiration,patients with a difficult airway might die due to apnea.The best treatment method is to optimize the damaged tracheal tube junction to avoid secondary intubation and ensure patient safety.An intravenous needle and cannula were used to repair the damaged gap in the current case.Following the repair,the anesthesia machine showed no indication of low tidal volume,and there was no deflation of the endotracheal tube cuff.Subsequently,the patient was transferred to the postanesthesia recovery room,and the tracheal tube was removed with satisfactory results.CONCLUSION Using an intravenous needle to repair a break in the inflatable tube surrounding an endotracheal tube is safe and reliable.
文摘Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the treatment database of the Emergency Center. The period January 2009 to December 2012 has been considered for this research. The aim of this study is to assess the prevalence of fatal road traffic accidents in Pristine, Kosovo, and describe their determinants. The number of injured in traffic accidents who have sought emergency medical assistance in the Emergency Center from January 2009 to December 2012 is increasing significantly. It is concluded that except reasons mentioned above and among others, there also are the following factors: enormous increase of number of persons equipped with driving license, driving speeds above limits which are considered to be the primary cause of the road traffic accidents. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.
基金supported by National Natural Science Foundation of China (Grant No.70671021)National Social Science Fund of China (Grant No.06BZZ019)Emergency Rescue Decision-Making Mechanism of Outsize Accidents in Nanjing (Grant No.200702011)
文摘With the development of metropolitan regions and the appearance of urban agglomerations, cities have been more closely related. For the restricted emergency rescue resource in a single city, it has become more and more imminent for the demand of the intercity collaborative resistance to major accident, so as to improve the protection capacity of urban security. In order to find an effective intercity, emergency rescue collaborative system, this paper introduces the concept and analysis method of ecosystem theory into intercity emergency, rescue. Based on the analysis of the formation-process of emergency rescue individual, population and community: a throe-level intercity emergency rescue collaborative system is constructed according to the characteristics of dynamics and structure of intercity emergency rescue ecosystem then the collaboration mechanism of information, resource and process in the interceity emergency rescue ecosystem is also studied in this paper; so as to offer available strategy and method for the ecosystem theory applied to intercity, emergency rescue. Through the studies of intereity emergency rescue ecosystem. it illuminates that the proposed emergency system can not Only cope with the major accident more timely and effectively but also integrate the intercity information resources and emergency rescue resource and process optimization.
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.