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Sample records for radiation mass casualties

  1. Some considerations for mass casualty management in radiation emergencies.

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

    Radiation emergencies are rather new to humankind, as compared to other types of emergencies such as earthquakes, floods, or hurricanes. Fortunately, they are rare, but because of that, planning for response to large-scale radiation emergencies is least understood. Along with the specific technical aspects of response to radiation emergencies, there are some general guiding principles of responding to mass casualty events of any nature, as identified by the World Health Organization in its 2007 manual for mass casualty management systems. The paper brings forward such general considerations as applicable to radiation mass casualty events, including (1) clear lines of communication; (2) scalability of approach; (3) whole-of-health approach; (4) knowledge based approach; and (5) multisectoral approach. Additionally, some key considerations of planning for mass casualty management systems are discussed, namely, health systems surge capacity and networking, risk and resources mapping, and others. PMID:20445382

  2. The Internet's role in a biodosimetric response to a radiation mass casualty event.

    PubMed

    Sugarman, S L; Livingston, G K; Stricklin, D L; Abbott, M G; Wilkins, R C; Romm, H; Oestreicher, U; Yoshida, M A; Miura, T; Moquet, J E; Di Giorgio, M; Ferrarotto, C; Gross, G A; Christiansen, M E; Hart, C L; Christensen, D M

    2014-05-01

    Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet. PMID:24667387

  3. Radiation Injury Treatment Network (RITN): Healthcare professionals preparing for a mass casualty radiological or nuclear incident

    PubMed Central

    ROSS, JOEL R.; CASE, CULLEN; CONFER, DENNIS; WEISDORF, DANIEL J.; WEINSTOCK, DAVID; KRAWISZ, ROBERT; CHUTE, JOHN; WILHAUK, JULIE; NAVARRO, WILLIS; HARTZMAN, ROBERT; COLEMAN, C. NORMAN; HATCHETT, RICHARD; CHAO, NELSON

    2011-01-01

    Purpose To describe the history, composition, and activities of the Radiation Injury Treatment Network (RITN). The Radiation Injury Treatment Network® is a cooperative effort of the National Marrow Donor Program and the American Society for Blood and Marrow Transplantation. The goals of RITN are to educate hematologists, oncologists, and stem cell transplant practitioners about their potential involvement in the response to a radiation incident and provide treatment expertise. Injuries to the marrow system readily occur when a victim is exposed to ionising radiation. This focus therefore leverages the expertise of these specialists who are accustomed to providing the intensive supportive care required by patients with a suppressed marrow function. Following a radiological incident, RITN centres may be asked to: Accept patient transfers to their institutions; provide treatment expertise to practitioners caring for victims at other centres; travel to other centres to provide medical expertise; or provide data on victims treated at their centres. Moving forward, it is crucial that we develop a coordinated interdisciplinary approach in planning for and responding to radiological and nuclear incidents. The ongoing efforts of radiation biologists, radiation oncologists, and health physicists can and should complement the efforts of RITN and government agencies. Conclusion RITN serves as a vital partner in preparedness and response efforts for potential radiological and nuclear incidents. PMID:21801106

  4. The hematologist and radiation casualties.

    PubMed

    Dainiak, Nicholas; Waselenko, Jamie K; Armitage, James O; MacVittie, Thomas J; Farese, Ann M

    2003-01-01

    Since the terrorist attack of September 11, 2001, preparation by the health care system for an act of terrorism has been mandated by leaders of governments. Scenarios for terrorist acts involving radioactive material have been identified, and approaches to management (based on past experience from atomic weapons detonations and radiation accidents) have been developed. Because of their experience in managing patients with profound cytopenia and/or marrow aplasia, hematologists will be asked to play a significant role in evaluating and treating victims of mass accidental or deliberate exposure to radiation. This review provides a framework for understanding how radiation levels are quantified, how radiation alters the function of hematopoietic (and nonhematopoietic) cells and tissues, and how victims receiving a significant radiation dose can be identified and managed. In Section I, Dr. Nicholas Dainiak reviews four components of the Acute Radiation Syndrome: the hematopoietic, neurovascular, gastrointestinal and cutaneous subsyndromes. Clinical signs and symptoms are discussed for exposed individuals at the time of initial presentation (the prodromal phase) and during their course of disease (the manifest illness). In Section II, he presents clinical and laboratory methods to assess radiation doses, including time to onset and severity of vomiting, rate of decline in absolute blood lymphocyte count and the appearance of chromosome aberrations such as dicentrics and ring forms. Potential scenarios of a radiation terrorist event are reviewed, and methods for initial clinical assessment, triage, and early management of the acute radiation syndrome and its component subsyndromes are summarized. In Section III, Dr. Jamie Waselenko reviews the hematopoietic syndrome, and presents guidelines for the use of cytokine therapy, antibiotics, and supportive care that have been developed by the Strategic National Pharmaceutical Stockpile Working Group. Results of preclinical and

  5. Game-based mass casualty burn training.

    PubMed

    Kurenov, Sergei N; Cance, William W; Noel, Ben; Mozingo, David W

    2009-01-01

    An interactive, video game-based training module, Burn Center, was developed to simulate the real-life emergency events of a mass casualty disaster scenario, involving in 40 victims.The game contains two components - triage and resuscitation. The goal of the triage game is to correctly stabilize, sort, tag and transport burn victims during a mass casualty event at a busy theme park. After complete the triage component, the player will then take on the role of a burn care provider, balancing the clinical needs of multiple burn patients through a 36-hour resuscitation period, using familiar computer-simulated hospital devices. Once complete, players of Burn Center will come away with applicable skills and knowledge of burn care, for both field triage and initial resuscitation of the burn patients. PMID:19377134

  6. Oxygen supplies during a mass casualty situation.

    PubMed

    Ritz, Ray H; Previtera, Joseph E

    2008-02-01

    Mass casualty and pandemic events pose a substantial challenge to the resources available in our current health care system. The ability to provide adequate oxygen therapy is one of the systems that could be out-stripped in certain conditions. Natural disasters can disrupt manufacturing or delivery, and pandemic events can increase consumption beyond the available supply. Patients may require manual resuscitation, basic oxygen therapy, or positive-pressure ventilation during these scenarios. Available sources of oxygen include bulk liquid oxygen systems, compressed gas cylinders, portable liquid oxygen (LOX) systems, and oxygen concentrators. The last two are available in a variety of configurations, which include personal and home systems that are suitable for individual patients, and larger systems that can provide oxygen to multiple patients or entire institutions. Bulk oxygen systems are robust and are probably sustainable during periods of high consumption, but are at risk if manufacturing or delivery is disrupted. Compressed gas cylinders offer support during temporary periods of need but are not a solution for extended periods of therapy. Personal oxygen concentrators and LOX systems are limited in their application during mass casualty scenarios. Large-capacity oxygen concentrators and LOX systems may effectively provide support to alternative care sites or larger institutions. They may also be appropriate selections for governmental emergency-response scenarios. Careful consideration of the strengths and limitations of each of these options can reduce the impact of a mass casualty event. PMID:18218152

  7. Public experiences of mass casualty decontamination.

    PubMed

    Carter, Holly; Drury, John; Rubin, G James; Williams, Richard; Amlôt, Richard

    2012-09-01

    In this article, we analyze feedback from simulated casualties who took part in field exercises involving mass decontamination, to gain an understanding of how responder communication can affect people's experiences of and compliance with decontamination. We analyzed questionnaire data gathered from 402 volunteers using the framework approach, to provide an insight into the public's experiences of decontamination and how these experiences are shaped by the actions of emergency responders. Factors that affected casualties' experiences of the decontamination process included the need for greater practical information and better communication from responders, and the need for privacy. Results support previous findings from small-scale incidents that involved decontamination in showing that participants wanted better communication from responders during the process of decontamination, including more practical information, and that the failure of responders to communicate effectively with members of the public led to anxiety about the decontamination process. The similarity between the findings from the exercises described in this article and previous research into real incidents involving decontamination suggests that field exercises provide a useful way to examine the effect of responder communication strategies on the public's experiences of decontamination. Future exercises should examine in more detail the effect of various communication strategies on the public's experiences of decontamination. This will facilitate the development of evidence-based communication strategies intended to reduce anxiety about decontamination and increase compliance among members of the public during real-life incidents that involve mass decontamination. PMID:22823588

  8. Mass casualty incidents - time to engage.

    PubMed

    Ben-Ishay, Offir; Mitaritonno, Michele; Catena, Fausto; Sartelli, Massimo; Ansaloni, Luca; Kluger, Yoram

    2016-01-01

    Mass casualty incident continues to overwhelm medical systems worldwide. Preparedness for an MCI is a crucial requisite for the injured better outcome. The World Society of Emergency Surgery initiated a survey in regard to its senior member's personal and institutional preparedness for MCI. The results here in presented indicate that WSES should engage in a formatted and structured preparedness course for medical institutions and individuals."By all appearances it seems to be just another normal Saturday morning in the emergency department (ED). Patients occupy thirty out of the sixty beds; some awaits discharge, some awaits admission to the hospital. All of a sudden the squeaky voice of the red phone is tearing the air, the hard metal voice on the line is reporting of an explosion in the nearby train station, estimated number of casualties is 80. You ask for their estimated time of arrival, when you hear the first sirens of ambulances parking out of the ED; no answer was needed. PMID:26848306

  9. Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data

    PubMed Central

    Egan, Joseph R.; Amlôt, Richard

    2012-01-01

    In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS). The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing) of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit. PMID:23202768

  10. Ultrasound applications in mass casualties and extreme environments.

    PubMed

    Ma, O John; Norvell, Jeffrey G; Subramanian, Srikala

    2007-05-01

    A mass-casualty incident is one in which the number of patients with injuries exceeds the available medical resources to care for them in a timely manner. In such a situation, the numerous advantages of ultrasonography make it an ideal triage tool for helping clinicians rapidly screen patients. Experiences during the 1988 Armenian earthquake and the 1999 Turkish earthquake demonstrated the proficiency of ultrasound in providing rapid clinical data to the physicians caring for the mass-casualty patients. Wireless and satellite transmission of ultrasound images also has been shown to be feasible and may be applied to mass-casualty situations. In addition, ultrasound applications have been demonstrated to aid in the diagnosis of various conditions, including pneumothorax, in the International Space Station. Ultrasound's portability, reproducibility, accuracy, and ease of use will make it an important diagnostic instrument for future space missions. PMID:17446788

  11. Planning for a Mass Casualty Incident in Arkansas Schools

    ERIC Educational Resources Information Center

    Patterson, Harry; Liggin, Rebecca; Shirm, Steve; Nation, Brian; Dick, Rhonda

    2005-01-01

    School preparedness includes the possibility of a natural disaster, but recent events also confirm a need for preparedness and prevention efforts for intentional mass casualty incidents (MCIs). This survey examined the preparedness for the prevention and response for MCIs at public schools in Arkansas. This survey demonstrated that most school…

  12. Development and Validation of a Mass Casualty Conceptual Model

    PubMed Central

    Culley, Joan M.; Effken, Judith A.

    2012-01-01

    Purpose To develop and validate a conceptual model that provides a framework for the development and evaluation of information systems for mass casualty events. Design The model was designed based on extant literature and existing theoretical models. A purposeful sample of 18 experts validated the model. Open-ended questions, as well as a 7-point Likert scale, were used to measure expert consensus on the importance of each construct and its relationship in the model and the usefulness of the model to future research. Methods Computer-mediated applications were used to facilitate a modified Delphi technique through which a panel of experts provided validation for the conceptual model. Rounds of questions continued until consensus was reached, as measured by an interquartile range (no more than 1 scale point for each item); stability (change in the distribution of responses less than 15% between rounds); and percent agreement (70% or greater) for indicator questions. Findings Two rounds of the Delphi process were needed to satisfy the criteria for consensus or stability related to the constructs, relationships, and indicators in the model. The panel reached consensus or sufficient stability to retain all 10 constructs, 9 relationships, and 39 of 44 indicators. Experts viewed the model as useful (mean of 5.3 on a 7-point scale). Conclusions Validation of the model provides the first step in understanding the context in which mass casualty events take place and identifying variables that impact outcomes of care. Clinical Relevance This study provides a foundation for understanding the complexity of mass casualty care, the roles that nurses play in mass casualty events, and factors that must be considered in designing and evaluating information-communication systems to support effective triage under these conditions. PMID:20487188

  13. Assessment of Hospital Pharmacy Preparedness for Mass Casualty Events

    PubMed Central

    Awad, Nadia I.; Cocchio, Craig

    2015-01-01

    Objectives: To assess the preparedness of hospital pharmacies in New Jersey to provide pharmaceutical services in mass casualty scenarios. Methods: An electronic cross-sectional survey was developed to assess the general knowledge of available resources and attitudes toward the preparedness of the pharmacy department. Results: Out of 60 invitations to participate, 18 surveys (30%) were completed. Respondents practiced at community hospitals (12, 66.6%) with no trauma center designation (11, 67.4%) that served more than 500 licensed beds (five, 29.4%). Six respondents (35.3%) indicated that 75,000 to 100,000 patients visited their emergency departments annually. Seventeen sites (94.4%) reported the existence of an institutional disaster preparedness protocol; 10 (55.5%) indicated that there is a specific plan for the pharmacy department. Most respondents (10, 55.5%) were unsure whether their hospitals had an adequate supply of analgesics, rapid sequence intubation agents, vasopressors, antiemetics, respiratory medications, ophthalmics, oral antimicrobials, and chemical-weapon-specific antidotes. Five (27.7%) agreed that the pharmacy disaster plan included processes to ensure care for patients already hospitalized, and four (22.2%) agreed that the quantity of medication was adequate to treat patients and hospital employees if necessary. Medication stock and quantities were determined based on national or international guidelines at three (16.6%) institutions surveyed. Conclusion: This survey demonstrates a lack of general consensus regarding hospital pharmacy preparedness for mass casualty scenarios despite individualized institutional protocols for disaster preparedness. Standardized recommendations from government and/or professional pharmacy organizations should be developed to guide the preparation of hospital pharmacy departments for mass casualty scenarios. PMID:25859121

  14. A mass casualty incident involving children and chemical decontamination.

    PubMed

    Timm, Nathan; Reeves, Scott

    2007-01-01

    Mass casualty incidents involving contaminated children are a rare but ever-present possibility. In this article we outline one such event that resulted in 53 pediatric patients and 3 adults presenting to the emergency department of a children's hospital for decontamination and treatment. We pay special attention to the training that allowed this responses to occur. We also outline the institutional response with emphasis on incident command, communication, and resource utilization. Specific lessons learned are explored in detail. Finally, we set forth a series of recommendations to assist other institutions should they be called upon to care for and decontaminate pediatric patients. PMID:17517363

  15. Mass casualty care in an expeditionary environment: developing local knowledge and expertise in context.

    PubMed

    De Jong, Marla J; Benner, Richard; Benner, Patricia; Richard, Maggie L; Kenny, Deborah J; Kelley, Patricia; Bingham, Mona; Debisette, Annette Tyree

    2010-01-01

    To discover new experience-based clinical and care delivery knowledge learned in the Iraq and Afghanistan combat zones, 107 Air Force, Army, and Navy nurses were interviewed. Eight areas of experiential knowledge were identified in the new care delivery system that featured rapid transport, early trauma and surgical care, and expeditious aeromedical evacuation: (1) organizing for mass casualties, (2) uncertainty about incoming casualties, (3) developing systems to track patients, (4) resource utilization, (5) ripple effects of a mass casualty event, (6) enlarging the scope of nursing practice, (7) operating medical facilities under attack, and (8) nurse emotions related to mass casualties. PMID:20234239

  16. [Mass maritime casualty incidents in German waters: structures and resources].

    PubMed

    Castan, J; Paschen, H-R; Wirtz, S; Dörges, V; Wenderoth, S; Peters, J; Blunk, Y; Bielstein, A; Kerner, T

    2012-07-01

    The Central Command for Maritime Emergencies was founded in Germany in 2003 triggered by the fire on board of the cargo ship "Pallas" in 1998. Its mission is to coordinate and direct measures at or above state level in maritime emergency situations in the North Sea and the Baltic Sea. A special task in this case is to provide firefighting and medical care. To face these challenges at sea emergency doctors and firemen have been specially trained. This form of organization provides a concept to counter mass casualty incidents and peril situations at sea. Since the foundation of the Central Command for Maritime Emergencies there have been 5 operations for firefighting units and 4 for medical response teams. Assignments and structure of the Central Command for Maritime Emergencies are unique in Europe. PMID:22699223

  17. Mass Casualty Incident Primary Triage Methods in China

    PubMed Central

    Chen, Jin-Hong; Yang, Jun; Yang, Yu; Zheng, Jing-Chen

    2015-01-01

    Objective: To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China. Data Sources: Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/), and China Earthquake Information (http://www.csi.ac.cn/). Study Selection: We included studies associated with mass casualty events related to China, the PT applied in China, guidelines and standards, and application and development of the carding PT method in China. Results: From 3976 potentially relevant articles, 22 met the inclusion criteria, 20 Chinese, and 2 English. These articles included 13 case reports, 3 retrospective analyses of MCI, two methods introductions, three national or sectoral criteria, and one simulated field testing and validation. There were a total of 19 kinds of MCI PT methods that have been reported in China from 1950 to 2014. In addition, there were 15 kinds of PT methods reported in the literature from the instance of the application. Conclusions: The national and sectoral current triage criteria are developed mainly for earthquake relief. Classification is not clear. Vague criteria (especially between moderate and severe injuries) operability are not practical. There are no triage methods and research for children and special populations. There is no data and evidence supported triage method. We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real, practical, and efficient PT method. PMID:26415807

  18. Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica

    PubMed Central

    Mills, Christopher N.; Mills, Gregory H.

    2011-01-01

    Antarctica is one of the most remote regions on Earth. Mass casualty incident (MCI) responses in Antarctica are prone to complications from multiple environmental and operational challenges. This review of the current status of MCI risks and response strategies for Antarctica focuses on aeromedical evacuation, a critical component of many possible MCI scenarios. Extreme cold and weather, a lack of medical resources and a multitude of disparate international bases all exert unique demands on MCI response planning. Increasing cruise ship traffic is also escalating the risk of MCI occurrence. To be successful, MCI response must be well coordinated and undertaken by trained rescuers, especially in the setting of Antarctica. Helicopter rescue or aeromedical evacuation of victims to off-continent facilities may be necessary. Currently, military forces have the greatest capacity for mass air evacuation. Specific risks that are likely to occur include structure collapses, vehicle incapacitations, vehicle crashes and fires. All of these events pose concomitant risks of hypothermia among both victims and rescuers. Antarctica’s unique environment requires flexible yet robust MCI response planning among the many entities in operation on the continent. PMID:21691470

  19. Mass casualty incident response and aeromedical evacuation in antarctica.

    PubMed

    Mills, Christopher N; Mills, Gregory H

    2011-02-01

    Antarctica is one of the most remote regions on Earth. Mass casualty incident (MCI) responses in Antarctica are prone to complications from multiple environmental and operational challenges. This review of the current status of MCI risks and response strategies for Antarctica focuses on aeromedical evacuation, a critical component of many possible MCI scenarios. Extreme cold and weather, a lack of medical resources and a multitude of disparate international bases all exert unique demands on MCI response planning. Increasing cruise ship traffic is also escalating the risk of MCI occurrence. To be successful, MCI response must be well coordinated and undertaken by trained rescuers, especially in the setting of Antarctica. Helicopter rescue or aeromedical evacuation of victims to off-continent facilities may be necessary. Currently, military forces have the greatest capacity for mass air evacuation. Specific risks that are likely to occur include structure collapses, vehicle incapacitations, vehicle crashes and fires. All of these events pose concomitant risks of hypothermia among both victims and rescuers. Antarctica's unique environment requires flexible yet robust MCI response planning among the many entities in operation on the continent. PMID:21691470

  20. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project.

    PubMed

    Baker, David J; Murray, Virginia S G; Carli, Pierre A

    2013-01-01

    The European Union (EU) Mass Casualties and Health (MASH) project that ran between 2008 and 2010 was designed to study the management of mass casualties from chemical and radiological releases and associated health implications. One area of study for this project concerned arrangements within EU Member States for the management of mass casualties following a chemical release. This was undertaken via a confidential online questionnaire that was sent to selected points of contact throughout the EU. Responses were obtained from 18 states from respondents holding senior positions in chemical planning and incident response. Information gathered shows a lack of uniformity within the EU about the organization of responses to chemical releases and the provision of medical care. This article presents the overall findings of the study demonstrating differences between countries on planning and organization, decontamination, prehospital emergency medical responses, clinical diagnoses, and therapy and aftercare. Although there may be an understandable reluctance from national respondents to share information on security and other grounds, the findings, nevertheless, revealed substantial differences between current planning and operational responses within the EU states for the management of mass chemical casualties. The existing international networks for response to radiation incidents are not yet matched by equivalent networks for chemical responses yet sufficient information was available from the study to identify potential deficiencies, identify common casualty management pathways, and to make recommendations for future operations within the EU. Improvements in awareness and training and the application of modern information and communications will help to remedy this situation. Specialized advanced life support and other medical care for chemical casualties appear lacking in some countries. A program of specialized training and action are required to apply the findings

  1. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice.

    PubMed

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Amlôt, Richard; Larner, Joanne; Matar, Hazem; Chilcott, Robert P

    2016-01-01

    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the "ladder-pipe system" for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination. PMID:27442794

  2. Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents

    PubMed Central

    Ramesh, Aruna C.; Kumar, S.

    2010-01-01

    In a mass casualty situation due to chemical, biological, radiological, or nuclear (CBRN) event, triage is absolutely required for categorizing the casualties in accordance with medical care priorities. Dealing with a CBRN event always starts at the local level. Even before the detection and analysis of agents can be undertaken, zoning, triage, decontamination, and treatment should be initiated promptly. While applying the triage system, the available medical resources and maximal utilization of medical assets should be taken into consideration by experienced triage officers who are most familiar with the natural course of the injury presented and have detailed information on medical assets. There are several triage systems that can be applied to CBRN casualties. With no one standardized system globally or nationally available, it is important for deploying a triage and decontamination system which is easy to follow and flexible to the available medical resources, casualty number, and severity of injury. PMID:21829319

  3. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    PubMed

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate. PMID:25915603

  4. Carbamate poisoning: treatment recommendations in the setting of a mass casualties event.

    PubMed

    Rosman, Yossi; Makarovsky, Igor; Bentur, Yedidia; Shrot, Shai; Dushnistky, Tsvika; Krivoy, Amir

    2009-11-01

    The threat of using chemical compounds by terrorists as weapons of mass casualties has been a rising concern in recent years. Carbamates, a group of reversible acetylcholinesterase inhibitors, could be potentially involved in such toxic mass casualty events because they can cause cholinergic crisis that could lead to fatality, similar to that of organophosphate poisoning. The medical management of carbamate poisoning consists of supportive measures and specific antidotal treatment, that is, the anticholinergic compound atropine. The administration of oximes, acetylcholinesterase reactivators, in carbamate poisoning is controversial because of the potential toxicity of oximes in conjunction with carbamate especially in the case of the carbamate--"carbaryl" poisoning. However, recent data suggest that this concern may be unwarranted. In this article, we review the current data regarding the pros and cons of using oximes against carbamates poisoning in a mass casualties event scenario. We also propose a new decision-making algorithm for the medical first responders in a mass casualties event suspected to be caused by a cholinergic substance (organophosphate or carbamate). According to this algorithm, treatment should consist of atropine and oxime regardless of the exact toxic compound involved. We speculate that in a mass casualties event, the benefits of using oximes outweigh the low level of potential risk. PMID:19931761

  5. Panel 2.5: mass-casualty management and hospital care.

    PubMed

    Borra, Agostino; Perez, Luis Jorge; Min, Tin; Puavilai, Wilai; Seo, Norimasa; Tipsunthonsak, Nakhon

    2005-01-01

    This is a summary of the presentations and discussion of Panel 2.5, Mass-Casualty Management and Hospital Care of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to mass-casualty management and hospital care as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) recommendations; and (3) conclusions. Subsections of the conclusion section include: (1) lessons learned; (2) what was done well?; and (3) what could have been done better?. PMID:16496625

  6. Assessment of Biodosimetry Methods for a Mass-Casualty Radiological Incident: Medical Response and Management Considerations

    PubMed Central

    Sullivan, Julie M.; Prasanna, Pataje G. S.; Grace, Marcy B.; Wathen, Lynne; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman

    2013-01-01

    Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual’s radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual’s dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a stand-alone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, we reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point. PMID:24162058

  7. Portable ultrasonography in mass casualty incidents: The CAVEAT examination

    PubMed Central

    Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; Bahner, David P; Whitmill, Melissa L; Dean, Anthony J

    2010-01-01

    Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings. PMID:22474622

  8. Effect of Hospital Staff Surge Capacity on Preparedness for a Conventional Mass Casualty Event

    PubMed Central

    Welzel, Tyson B.; Koenig, Kristi L.; Bey, Tareg; Visser, Errol

    2010-01-01

    Objectives: To assess current medical staffing levels within the Hospital Referral System in the City of Cape Town Metropolitan Municipality, South Africa, and analyze the surge capacity needs to prepare for the potential of a conventional mass casualty incident during a planned mass gathering. Methods: Query of all available medical databases of both state employees and private medical personnel within the greater Cape Town area to determine current staffing levels and distribution of personnel across public and private domains. Analysis of the adequacy of available staff to manage a mass casualty incident. Results: There are 594 advanced pre-hospital personnel in Cape Town (17/100,000 population) and 142 basic pre-hospital personnel (4.6/100,000). The total number of hospital and clinic-based medical practitioners is 3097 (88.6/100,000), consisting of 1914 general physicians; 54.7/100,000 and 1183 specialist physicians; 33.8/100,000. Vacancy rates for all medical practitioners range from 23.5% to 25.5%. This includes: nursing post vacancies (26%), basic emergency care practitioners (39.3%), advanced emergency care personnel (66.8%), pharmacy assistants (42.6%), and pharmacists (33.1%). Conclusion: There are sufficient numbers and types of personnel to provide the expected ordinary healthcare needs at mass gathering sites in Cape Town; however, qualified staff are likely insufficient to manage a concurrent mass casualty event. Considering that adequate correctly skilled and trained staff form the backbone of disaster surge capacity, it appears that Cape Town is currently under resourced to manage a mass casualty event. With the increasing size and frequency of mass gathering events worldwide, adequate disaster surge capacity is an issue of global relevance. PMID:20823971

  9. Army nurses' knowledge base for determining triage categories in a mass casualty.

    PubMed

    Robison, Jennifer L

    2002-10-01

    The timing, location, and participants in a mass casualty scenario cannot be predicted. Nurses may be involved in performing triage, yet there is no published documentation of military nurses' ability to triage. A prospective design was used to describe 82 Army nurses' knowledge base related to designating triage categories for patients during a mass causality, examining the relationships among their education and experience as evaluated by The Darnall Mass Casualty Triage Test and Demographic Data Form. The most significant areas associated with higher scores on the Triage Test were: completion of Advanced Cardiac Life Support, advanced certification as a Certified Registered Nurse Anesthetists, Certified Emergency Nurse, or Critical Care Registered Nurse, and attendance to the Medical Management of Nuclear Weapons Course. An improved average score for nurses overall was also noted when compared with previous work with the Darnall MASCAL Triage Test. PMID:12392246

  10. Adolescent epidemic hysteria presenting as a mass casualty, toxic exposure incident

    SciTech Connect

    Selden, B.S.

    1989-08-01

    Discussed is a case of explosive epidemic hysteria presenting as a mass casualty, toxic inhalation incident. Fifteen adolescent female students were triaged from a school of 700 persons exposed to sewer gas and arrived simultaneously at the emergency department complaining of a variety of nonspecific symptoms without physical findings. These symptoms quickly remitted with reassurance and dispersion of the group. Factors important in the recognition and treatment of epidemic hysteria are presented.

  11. Resource planning for ambulance services in mass casualty incidents: a DES-based policy model.

    PubMed

    Rauner, Marion S; Schaffhauser-Linzatti, Michaela M; Niessner, Helmut

    2012-09-01

    Due to an increasing number of mass casualty incidents, which are generally complex and unique in nature, we suggest that decision makers consider operations research-based policy models to help prepare emergency staff for improved planning and scheduling at the emergency site. We thus develop a discrete-event simulation policy model, which is currently being applied by disaster-responsive ambulance services in Austria. By evaluating realistic scenarios, our policy model is shown to enhance the scheduling and outcomes at operative and online levels. The proposed scenarios range from small, simple, and urban to rather large, complex, remote mass casualty emergencies. Furthermore, the organization of an advanced medical post can be improved on a strategic level to increase rescue quality, including enhanced survival of injured victims. In particular, we consider a realistic mass casualty incident at a brewery relative to other exemplary disasters. Based on a variety of such situations, we derive general policy implications at both the macro (e.g., strategic rescue policy) and micro (e.g., operative and online scheduling strategies at the emergency site) levels. PMID:22653522

  12. K-plan for patient repatriation after mass casualty events abroad.

    PubMed

    Duchateau, François-Xavier; Verner, Laurent

    2012-01-01

    In addition to requests for individual aeromedical evacuation (AE), medical assistance companies also may respond to mass casualty incidents abroad. The purpose of this report was to evaluate the effectiveness of our primary casualty plan, based on experience involving a January 2010 bus crash in southern Egypt. The main evaluative criterion was time elapsed from the initial call until the return of victims to their home country. Three critically injured patients underwent an initial AE to Cairo for advanced trauma care. After stabilization, they arrived back in their home country 42 hours after the initial call. The remaining group of patients arrived 27 hours later, or a total of 69 hours after the first call. These findings suggest that the "K-Plan" standardized operating process may be effective for rapid and appropriate repatriation of numerous victims. Some specific issues, such as efficiently locating a large-capacity charter aircraft, require further improvement. PMID:22386102

  13. Mobilized progenitor cells as a bridging therapy for radiation casualties: a brief review of tocopherol succinate-based approaches.

    PubMed

    Singh, Vijay K; Singh, Pankaj K; Wise, Stephen Y; Seed, Thomas M

    2011-07-01

    Nuclear detonation through either military or terrorist action would most likely lead to a mass-casualty scenario involving victims with varying degrees of exposure to ionizing radiation. As a result of radiation injury to the hematopoietic system, victims would suffer from a lack of red blood cells that deliver oxygen, immune cells that detect and eliminate infectious agents, and blood platelets that promote blood clot formation. In part, these symptoms are generally referred to as acute radiation syndrome (ARS). While some victims of moderate to high levels of radiation will be beyond saving, most will have received enough radiation to injure but not kill their bone marrow cells completely. Such people will recover from their injuries but face a 30-60day period during which they cannot fully fight infections and are prone to uncontrolled bleeding and anemia. To keep them alive until their hematopoietic system recovers, they must receive supportive care. Recently, using experimental animal models of ARS, transfusion of myeloid progenitor cells have been tried as a bridging therapy for radiation-exposed animals. Such cells have been shown to be effective in protecting animals exposed to lethal doses of radiation. These myeloid progenitors (along with of other hematopoietic progenitor cell types) can be mobilized out of the bone marrow into the blood for the reconstitution of hematopoiesis. This review discusses various approaches to the mobilization of progenitors using different mobilizing agents, and their utility as a bridging therapy for radiation casualties. We suggest that α-tocopherol succinate (TS) is an optimal mobilizing agent for progenitors. The extent of progenitor mobilization TS elicits in experimental mice is comparable to clinically used drugs such as recombinant granulocyte-colony stimulating factor rhG-CSF/Neupogen® and the bicyclam AMD3100 (plerixafor/Mozobil); therefore, we propose that TS be considered for further translational development

  14. Clinical Framework and Medical Countermeasure Use During an Anthrax Mass-Casualty Incident.

    PubMed

    Bower, William A; Hendricks, Katherine; Pillai, Satish; Guarnizo, Julie; Meaney-Delman, Dana

    2015-12-01

    In 2014, CDC published updated guidelines for the prevention and treatment of anthrax (Hendricks KA, Wright ME, Shadomy SV, et al. Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults. Emerg Infect Dis 2014;20[2]. Available at http://wwwnc.cdc.gov/eid/article/20/2/13-0687_article.htm). These guidelines provided recommended best practices for the diagnosis and treatment of persons with naturally occurring or bioterrorism-related anthrax in conventional medical settings. An aerosolized release of Bacillus anthracis spores over densely populated areas could become a mass-casualty incident. To prepare for this possibility, the U.S. government has stockpiled equipment and therapeutics (known as medical countermeasures [MCMs]) for anthrax prevention and treatment. However, previously developed, publicly available clinical recommendations have not addressed the use of MCMs or clinical management during an anthrax mass-casualty incident, when the number of patients is likely to exceed the ability of the health care infrastructure to provide conventional standards of care and supplies of MCMs might be inadequate to meet the demand required. To address this gap, in 2013, CDC conducted a series of systematic reviews of the scientific literature on anthrax to identify evidence that could help clinicians and public health authorities set guidelines for intravenous antimicrobial and antitoxin use, diagnosis of anthrax meningitis, and management of common anthrax-specific complications in the setting of a mass-casualty incident. Evidence from these reviews was presented to professionals with expertise in anthrax, critical care, and disaster medicine during a series of workgroup meetings that were held from August 2013 through March 2014. In March 2014, a meeting was held at which 102 subject matter experts discussed the evidence and adapted the existing best practices guidance to a clinical use framework for the

  15. Autonomous mobile platform for enhanced situational awareness in Mass Casualty Incidents.

    PubMed

    Yang, Dongyi; Schafer, James; Wang, Sili; Ganz, Aura

    2014-01-01

    To enhance the efficiency of the search and rescue process of a Mass Casualty Incident, we introduce a low cost autonomous mobile platform. The mobile platform motion is controlled by an Android Smartphone mounted on a robot. The pictures and video captured by the Smartphone camera can significantly enhance the situational awareness of the incident commander leading to a more efficient search and rescue process. Moreover, the active RFID readers mounted on the mobile platform can improve the localization accuracy of victims in the disaster site in areas where the paramedics are not present, reducing the triage and evacuation time. PMID:25570104

  16. The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents.

    PubMed

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Garijo Gonzalo, Gracia; Martinez Monzon, Carlos; Pelaez Corres, Nieves; Rodriguez Soler, Alberto; Turegano Fuentes, Fernando

    2016-01-01

    This text describes the process of development of the new Spanish Prehospital Advanced Triage Method (META) and explain its main features and contribution to prehospital triage systems in mass casualty incidents. The triage META is based in the Advanced Trauma Life Support (ATLS) protocols, patient's anatomical injuries and mechanism of injury. It is a triage method with four stages including early identification of patients with severe trauma that would benefit from a rapid evacuation to a surgical facility and introduces a new patient flow by-passing the advanced medical post to improve evacuation. The stages of triage META are: I) Stabilization triage that classifies patients according to severity to set priorities for initial emergency treatment; II) Identifying patients requiring urgent surgical treatment, this is done at the same time than stage I and creates a new flow of patients with high priority for evacuation; III) Implementation of Advanced Trauma Life Support protocols to patients previously classified according to stablished priority; and IV) Evacuation triage, stablishing evacuation priorities in case of lacks of appropriate transport resources. The triage META is to be applied only by prehospital providers with advanced knowledge and training in advanced trauma life support care and has been designed to be implemented as prehospital procedure in mass casualty incidents (MCI). PMID:27130042

  17. Oral and Enteral Resuscitation of Burn Shock The Historical Record and Implications for Mass Casualty Care

    PubMed Central

    Kramer, George C.; Michell, Michael W.; Oliveira, Hermes; Brown, Tim La H.; Herndon, David; Baker, R. David; Muller, Michael

    2010-01-01

    In the aftermath of a mass disaster, standard care methods for treatment of burn injury will often not be available for all victims. A method of fluid resuscitation for burns that has largely been forgotten by contemporary burn experts is enteral resuscitation. We identified 12 studies with over 700 patients treated with enteral resuscitation, defined as drinking or gastric infusion of salt solutions, from the literature. These studies suggest that enteral resuscitation can be an effective treatment for burn shock under conditions in which the standard IV therapy is unavailable or delayed, such as in mass disasters and combat casualties. Enteral resuscitation of burn shock was effective in patients with moderate (10–40% TBSA) and in some patients with more severe injuries. The data suggests that some hypovolemic burn and trauma patients can be treated exclusively with enteral resuscitation, and others might benefit from enteral resuscitation as an initial alternative and a supplement to IV therapy. A complication of enteral resuscitation was vomiting, which occurred less in children and much less when therapy was initiated within the first postburn hour. Enteral resuscitation is contra-indicated when the patient is in “peripheral circulatory collapse”. The optimal enteral solution and regimen has not yet been defined, nor has its efficacy been tested against modern IV resuscitation. The oldest studies used glucose-free solutions of buffered isotonic and hypotonic saline. Studies that are more recent show benefit of adding glucose to electrolyte solutions similar to those used in the treatment of cholera. If IV therapy for mass casualty care is delayed due to logistical constraints, enteral resuscitation should be considered. PMID:20827301

  18. Oral and enteral resuscitation of burn shock the historical record and implications for mass casualty care.

    PubMed

    Kramer, George C; Michell, Michael W; Oliveira, Hermes; Brown, Tim La H; Herndon, David; Baker, R David; Muller, Michael

    2010-01-01

    In the aftermath of a mass disaster, standard care methods for treatment of burn injury will often not be available for all victims. A method of fluid resuscitation for burns that has largely been forgotten by contemporary burn experts is enteral resuscitation. We identified 12 studies with over 700 patients treated with enteral resuscitation, defined as drinking or gastric infusion of salt solutions, from the literature. These studies suggest that enteral resuscitation can be an effective treatment for burn shock under conditions in which the standard IV therapy is unavailable or delayed, such as in mass disasters and combat casualties. Enteral resuscitation of burn shock was effective in patients with moderate (10-40% TBSA) and in some patients with more severe injuries. The data suggests that some hypovolemic burn and trauma patients can be treated exclusively with enteral resuscitation, and others might benefit from enteral resuscitation as an initial alternative and a supplement to IV therapy. A complication of enteral resuscitation was vomiting, which occurred less in children and much less when therapy was initiated within the first postburn hour. Enteral resuscitation is contra-indicated when the patient is in "peripheral circulatory collapse". The optimal enteral solution and regimen has not yet been defined, nor has its efficacy been tested against modern IV resuscitation. The oldest studies used glucose-free solutions of buffered isotonic and hypotonic saline. Studies that are more recent show benefit of adding glucose to electrolyte solutions similar to those used in the treatment of cholera. If IV therapy for mass casualty care is delayed due to logistical constraints, enteral resuscitation should be considered. PMID:20827301

  19. MASCAL: RFID Tracking of Patients, Staff and Equipment to Enhance Hospital Response to Mass Casualty Events

    PubMed Central

    Fry, Emory A.; Lenert, Leslie A.

    2005-01-01

    Most medical facilities practice managing the large numbers of seriously injured patients expected during catastrophic events. As the demands on the healthcare team increase, however, the challenges faced by managers escalate, workflow bottlenecks develop and system capacity decreases. This paper describes MASCAL, an integrated software–hardware system designed to enhance management of resources at a hospital during a mass casualty situation. MASCAL uses active 802.11b asset tags to track patients, equipment and staff during the response to a disaster. The system integrates tag position information with data from personnel databases, medical information systems, registration applications and the US Navy’s TACMEDCS triage application in a custom visual disaster management environment. MASCAL includes interfaces for a hospital command center, local area managers (emergency room, operating suites, radiology, etc.) and registration personnel. MASCAL is an operational system undergoing functional evaluation at the Naval Medical Center, San Diego, CA. PMID:16779042

  20. Regional Variation in Causes of Injuries among Terrorism Victims for Mass Casualty Events

    PubMed Central

    Regens, James L.; Schultheiss, Amy; Mould, Nick

    2015-01-01

    The efficient allocation of medical resources to prepare for and respond to mass casualty events (MCEs) attributable to intentional acts of terrorism is a major challenge confronting disaster planners and emergency personnel. This research article examines variation in regional patterns in the causes of injures associated with 77,258 successful terrorist attacks that occurred between 1970 and 2013 involving the use of explosives, firearms, and/or incendiaries. The objective of this research is to estimate regional variation in the use of different conventional weapons in successful terrorist attacks in each world region on variation in injury cause distributions. Indeed, we find that the distributions of the number of injuries attributable to specific weapons types (i.e., by cause) vary greatly among the 13 world regions identified within the Global Terrorism Database. PMID:26347857

  1. Predeployment mass casualty and clinical trauma training for US Army forward surgical teams.

    PubMed

    Pereira, Bruno M T; Ryan, Mark L; Ogilvie, Michael P; Gomez-Rodriguez, Juan Carlos; McAndrew, Patrick; Garcia, George D; Proctor, Kenneth G

    2010-07-01

    Since the beginning of the program in 2002, 84 Forward Surgical Teams (FSTs) have rotated through the Army Trauma Training Center (ATTC) at the University of Miami/Ryder Trauma Center including all those deployed to Iraq and Afghanistan. The purpose of this study was to provide the latest updates of our experience with FSTs at the ATTC. Before deployment, each FST participates in a 2-week training rotation at the ATTC. The rotation is divided into 3 phases. Phase 1 is to refresh FST knowledge regarding the initial evaluation and management of the trauma patient. Phase 2 is the clinical phase and is conducted entirely at the Ryder Trauma Center. The training rotation culminates in phase 3, the Capstone exercise. During the Capstone portion of their training, the entire 20-person FST remains at the Ryder Trauma Center and is primarily responsible for the evaluation and resuscitation of all patients arriving over a 24-hour period. Subject awareness concerning their role within the team improved from 71% to 95%, indicating that functioning as a team in the context of the mass casualty training exercise along with clinical codes was beneficial. The clinical component of the rotation was considered by 47% to be the most valuable aspect of the training. Our experience strongly suggests that a multimodality approach is beneficial for preparing a team of individuals with minimal combat (or trauma) experience for the rigors of medical care and triage on the battlefield. The data provided by participants rotating through the ATTC show that through clinical exposure and simulation over a 2-week period, FST performance is optimized by defining provider roles and improving communication. The mass casualty training exercise is a vital component of predeployment training that participants feel is valuable in preparing them for the challenges that lay ahead. PMID:20613574

  2. Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001

    PubMed Central

    2013-01-01

    Background Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. Methodology We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Results Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Conclusion Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response. PMID:24164778

  3. Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

    PubMed

    Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia

    2015-02-01

    On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses. PMID:25544145

  4. Greetings: 50 years of Atomic Bomb Casualty Commission-Radiation Effects Research Foundation studies.

    PubMed

    Shigematsu, I

    1998-05-12

    The Atomic Bomb Casualty Commission was established in Hiroshima in 1947 and in Nagasaki in 1948 under the auspices of the U.S. National Academy of Sciences to initiate a long-term and comprehensive epidemiological and genetic study of the atomic bomb survivors. It was replaced in 1975 by the Radiation Effects Research Foundation which is a nonprofit Japanese foundation binationally managed and supported with equal funding by the governments of Japan and the United States. Thanks to the cooperation of the survivors and the contributions of a multitude of scientists, these studies flourish to this day in what must be the most successful long-term research collaboration between the two countries. Although these studies are necessarily limited to the effects of acute, whole-body, mixed gamma-neutron radiation from the atom bombs, their comprehensiveness and duration make them the most definitive descriptions of the late effects of radiation in humans. For this reason, the entire world relies heavily on these data to set radiation standards. As vital as the study results are, they still represent primarily the effects of radiation on older survivors. Another decade or two should correct this deficiency and allow us to measure definitively the human risk of heritable mutation from radiation. We look to the worldwide radiation and risk community as well as to the survivors who have contributed so much to what has been done already to accomplish this goal. PMID:9576897

  5. A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes.

    PubMed

    Tekin, Akin; Namias, Nicholas; O'Keeffe, Terence; Pizano, Louis; Lynn, Mauricio; Prater-Varas, Robin; Quintana, Olga Delia; Borges, Leda; Ishii, Mary; Lee, Seong; Lopez, Peter; Lessner-Eisenberg, Sharon; Alvarez, Angel; Ellison, Tom; Sapnas, Katherine; Lefton, Jennifer; Ward, Charles Gillon

    2005-03-01

    The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2-27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 per cent bums and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event; having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support

  6. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study

    PubMed Central

    2012-01-01

    Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS) regarding Thai military personnel injured in the mass casualty incident (MCI) April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR) of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%). These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%). A total of 18 patients (11.7%) had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS). However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04), abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P < 0.01), head & neck injury (adjusted OR = 13.8; 95% CI, 2.4-80.4; P < 0.01) and chest injury (adjusted OR = 9.9; 95% CI, 2.1-47.3; P < 0.01). Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future. PMID:22214518

  7. [National preparedness for biological mass casualty event: between the devil and the deep blue sea].

    PubMed

    Eldad, Arieh

    2002-05-01

    Species of plants and animals, as well as nations of human beings were extinguished throughout the prehistory and history of this planet. One of the possible explanations for this phenomenon is a large scale epidemic of viral, bacterial or fungal infections. One well-documented example was the smallpox epidemic among native Indians of South America following the European invasion. Deliberate dissemination of disease was used as a weapon during the Middle Ages when corpses of plague casualties were thrown over the walls and into the besieged towns. The Book of Kings II, of the Bible, in chapter 19 recalls the story of 185,000 soldiers of Sennacherib that died in one night, near the walls of Jerusalem. The possibility of causing mass casualty by dissemination of infectious disease has driven countries and terrorist organizations to produce and store large quantities of bacteria or viruses. The death of thousands in the USA on September 11, 2001, demonstrated that terror has no moral prohibitions, only technical limitations. Terror organizations will not hesitate to use weapons for mass destruction to kill many, and if only few will die, it will still serve the purpose of these evil organizations: to strew panic, to destroy normal life and to increase fear and instability. Any government that faces decisions about how to be better prepared against biological warfare is pushed between the devil and the deep blue sea. On the one hand: the better we will be prepared, equipped with antibiotics and vaccines--the more lives of casualties we will be able to save. Better public education will help to reduce the damage, but, on the other hand--in order to cause more people to make the effort to equip themselves or to refresh their protective kit--we will have to increase their level of concern. In order to improve the medical education of all members of the medical teams we will have to start a broad and intense campaign, thereby taking the risk of increasing stress in the

  8. Hospital management of mass radiological casualties: reassessing exposures from contaminated victims of an exploded radiological dispersal device.

    PubMed

    Smith, James M; Ansari, Armin; Harper, Frederick T

    2005-11-01

    One of the key issues in the aftermath of an exploded radiological dispersal device from a terrorist event is that of the contaminated victim and the concern among healthcare providers for the harmful exposures they may receive in treating patients, especially if the patient has not been thoroughly decontaminated. This is critically important in the event of mass casualties from a nuclear or radiological incident because of the essential rapidity of acute medical decisions and that those who have life- or limb-threatening injuries may have treatment unduly delayed by a decontamination process that may be unnecessary for protecting the health and safety of the patient or the healthcare provider. To estimate potential contamination of those exposed in a radiological dispersal device event, results were used from explosive aerosolization tests of surrogate radionuclides detonated with high explosives at the Sandia National Laboratories. Computer modeling was also used to assess radiation dose rates to surgical personnel treating patients with blast injuries who are contaminated with any of a variety of common radionuclides. It is demonstrated that exceptional but plausible cases may require special precautions by the healthcare provider, even while managing life-threatening injuries of a contaminated victim from a radiological dispersal device event. PMID:16217195

  9. Hospital management of mass radiological casualties : reassessing exposures from contaminated victims of an exploded radiological dispersal device (RDD).

    SciTech Connect

    Ansari, Armin; Harper, Frederick Taylor; Smith, James M.

    2005-04-01

    One of the key issues in the aftermath of an exploded radiological dispersal device from a terrorist event is that of the contaminated victim and the concern among healthcare providers for the harmful exposures they may receive in treating patients, especially if the patient has not been thoroughly decontaminated. This is critically important in the event of mass casualties from a nuclear or radiological incident because of the essential rapidity of acute medical decisions and that those who have life- or limb-threatening injuries may have treatment unduly delayed by a decontamination process that may be unnecessary for protecting the health and safety of the patient or the healthcare provider. To estimate potential contamination of those exposed in a radiological dispersal device event, results were used from explosive aerosolization tests of surrogate radionuclides detonated with high explosives at the Sandia National Laboratories. Computer modeling was also used to assess radiation dose rates to surgical personnel treating patients with blast injuries who are contaminated with any of a variety of common radionuclides. It is demonstrated that exceptional but plausible cases may require special precautions by the healthcare provider, even while managing life-threatening injuries of a contaminated victim from a radiological dispersal device event.

  10. Expedited electronic entry: a new way to manage mass-casualty radiology order workflow.

    PubMed

    Bookman, Kelly; Zane, Richard

    2013-08-01

    One of the important tenets of emergency preparedness is that planning for disaster response should resemble standard operating procedure whenever possible. Electronic order entry has become part of the standard operating procedures of most institutions but many of these systems are either too cumbersome for use during a surge or can even be rendered non-functional during a sudden patient surge such as a mass-casualty incident (MCI). Presented here is an experience with delayed radiology order entry during a recent MCI and the after action programming of the system based on this real experience. In response to the after action analysis of the MCI, a task force was assigned to solve the MCI radiology order entry problem and a solution to streamline disaster image ordering was devised. A "browse page" was created that lists every x-ray and every CT scan that might be needed in such an event with all required information defaulted to "Disaster." This created a way to order multiple images for any one patient, with 40% time saving over standard electronic order entry. This disaster radiology order entry solution is an example of the surge preparedness needed to promote patient safety and efficient care delivery as the widespread deployment of electronic health records and order entry continues across the United States. PMID:23731567

  11. Improving emergency medical dispatching with emphasis on mass-casualty incidents.

    PubMed

    Kleinoscheg, Gabriel; Burgsteiner, Harald; Bernroider, Martin; Kiechle, Günter; Obermayer, Maria

    2014-01-01

    Dispatching ambulances is a demanding and stressful task for dispatchers. This is especially true in case of mass-casualty incidents. Therefore, the aim of this work was to investigate if and to what extent the dispatch operation of the Red Cross Salzburg can be optimized on such occasions with a computerized system. The basic problem of a dynamic multi-vehicle Dial-a-Ride Problem with time windows was enhanced according to the requirements of the Red Cross Salzburg. The general objective was to minimize the total mileage covered by ambulances and the waiting time of patients. Furthermore, in case of emergencies suitable adaptions to a plan should be carried out automatically. Consequently, the problem is solved by using the Adaptive Large Neighborhood Search. Evaluation results indicate that the system outperforms a human dispatcher by between 2.5% and 36% within 1 minute of runtime concerning total costs. Moreover, the system's response time in case that a plan has to be updated is less than 1 minute on average. PMID:24825692

  12. Prehospital triage and communication performance in small mass casualty incidents: a gauge for disaster preparedness.

    PubMed

    Johnson, G A; Calkins, A

    1999-03-01

    Because of their infrequency, disasters are difficult to train for. Emergency prehospital personnel frequently participate in small mass casualty incidents (MCIs) (3 to 50 victims). This study sought to examine prehospital performance in small MCIs in areas that are frequently mismanaged in disasters. Prospective data from the resource physician and retrospective data from tape recorded prehospital conversations were collected for a 9-month period. Clinical patient data, patient demographics, emergency medical services squad characteristics, and triage information were recorded. Forty-five consecutive MCIs were studied. Most of these were motor vehicle accidents. Prehospital providers included paid providers, nonpaid providers, and air and ground transport. The mean number of victims first identified (4.6%) was greatly different than the mean number of victims eventually transported from a scene (7.1%). Most patients were treated at a level 1 trauma center. Frequent errors included having multiple communicators on site (38%), misidentifying the number of victims (56%), and having unclear information for the resource physician (43%). Only 38% of events had prehospital triage information that was deemed appropriate in total. These results show that scene and triage errors are frequent in MCIs of small scale. This information can be used to assay a system's readiness for disasters. PMID:10102314

  13. Roles of a helicopter emergency medical service in mass casualty incidents.

    PubMed

    Stohler, S A; Jacobs, L M; Gabram, S G

    1991-01-01

    The Connecticut helicopter emergency medical service (HEMS) has responded to 12 mass casualty incidents (MCI) in two years. Eight were drills and four were actual events. An MCI response plan was instituted prior to the onset of the HEMS program. All MCIs were reviewed to determine actual victims, knowledge of MCI prior to lift-off, and roles of the HEMS. The actual roles were compared with the pre-established roles. The four actual MCIs (building explosion, hotel fire, bus rollover and plane crash) were reviewed. Sixty-seven victims were involved. Prenotification occurred in one MCI. The roles of the HEMS in each MCI were: triage (n = 4), medical treatment (n = 4), transport (n = 3), augmented response (n = 1), and air surveillance (n = 0). The roles of HEMS response to MCI should be well-defined prior to an event. Air medical benefits include response within a large geographic area, highest level of prehospital medical care, identification of trauma receiving hospitals, and facilitation of transport. PMID:10108935

  14. Using baseline data to address the lack of hospital beds during mass-casualty incidents.

    PubMed

    Hadef, Hysham; Bartier, Jean-Claude; Delplancq, Herve; Dupeyron, Jean-Pierre

    2008-01-01

    The management of victims during mass-casualty incidents (MCIs) is improving. In many countries, physicians and paramedics are well-trained to manage these incidents. A problem that has been encountered during MCIs is the lack of adequate numbers of hospital beds to accommodate the injured. In Europe, hospitals are crowded. One solution for the lack of beds is the creation of baseline data systems that could be consulted by medical personnel in all European countries. A MCI never has occurred in northeastern Europe, but such an event remains a possibility. This paper describes how the use of SAGEC 67, a free-access, information database concerning the availability of beds should help the participating countries, initially France, Germany, and Switzerland, respond to a MCI by dispatching each patient to an appropriate hospital and informing their families and physicians using their own language. Baseline data for more than 20 countries, and for hospitals, especially those in Germany, Switzerland, and France, were collected. Information about the number of beds and their availability hour-by-hour was included. In the case of MCIs, the baseline data program is opened and automatically connects to all of the countries. In case of a necessary hospital evacuation, the required beds immediately are occupied in one of these three countries. Questions and conversations among medical staff or family members can be accomplished between hospitals through computer, secured-line chatting that automatically translates into appropriate language. During the patient evacuation phase of a MCI, respondents acknowledged that a combination of local, state, and private resources and international cooperation eventually would be needed to meet the demand. Patient evacuation is optimized through the use of SAGEC 67, a free baseline database. PMID:18935955

  15. Epidemiology of Emergency Medical Services-Assessed Mass Casualty Incidents according to Causes

    PubMed Central

    2016-01-01

    To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs’ epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved ≥ 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6–5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals’ resources. PMID:26955248

  16. Epidemiology of Emergency Medical Services-Assessed Mass Casualty Incidents according to Causes.

    PubMed

    Park, Ju Ok; Shin, Sang Do; Song, Kyoung Jun; Hong, Ki Jeong; Kim, Jungeun

    2016-03-01

    To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs' epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved ≥ 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6-5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals' resources. PMID:26955248

  17. A wireless first responder handheld device for rapid triage, patient assessment and documentation during mass casualty incidents.

    PubMed

    Killeen, James P; Chan, Theodore C; Buono, Colleen; Griswold, William G; Lenert, Leslie A

    2006-01-01

    Medical care at mass casualty incidents and disasters requires rapid patient triage and assessment, acute care and disposition often in the setting of overwhelming numbers of victims, limited time, and little resources. Current systems rely on a paper triage tag on which rescuers and medical providers mark the patient's triage status and record limited information on injuries and treatments administered in the field. In this manuscript, we describe the design, development and deployment of a wireless handheld device with an electronic medical record (EMR) for use by rescuers responding to mass casualty incidents (MCIs) and disasters. The components of this device, the WIISARD First Responder (WFR), includes a personal digital assistant (PDA) with 802.11 wireless transmission capabilities, microprocessor and non-volatile memory, and a unique EMR software that replicates the rapidity and ease of use of the standard paper triage tag. WFR also expands its functionality by recording real-time medical data electronically for simultaneous access by rescuers, mid-level providers and incident commanders on and off the disaster site. WFR is a part of the Wireless Information System for Medical Response in Disasters (WIISARD) architecture. PMID:17238377

  18. Clinical review: The role of the intensive care physician in mass casualty incidents: planning, organisation, and leadership

    PubMed Central

    Shirley, Peter J; Mandersloot, Gerlinde

    2008-01-01

    There is a long-standing, broad assumption that hospitals will ably receive and efficiently provide comprehensive care to victims following a mass casualty event. Unfortunately, the majority of medical major incident plans are insufficiently focused on strategies and procedures that extend beyond the pre-hospital and early-hospital phases of care. Recent events underscore two important lessons: (a) the role of intensive care specialists extends well beyond the intensive care unit during such events, and (b) non-intensive care hospital personnel must have the ability to provide basic critical care. The bombing of the London transport network, while highlighting some good practices in our major incident planning, also exposed weaknesses already described by others. Whilst this paper uses the events of the 7 July 2005 as its point of reference, the lessons learned and the changes incorporated in our planning have generic applications to mass casualty events. In the UK, the Department of Health convened an expert symposium in June 2007 to identify lessons learned from 7 July 2005 and disseminate them for the benefit of the wider medical community. The experiences of clinicians from critical care units in London made a large contribution to this process and are discussed in this paper. PMID:18492221

  19. Mass-casualty victim "surge" management. Preparing for bombings and blast-related injuries with possibility of hazardous materials exposure.

    PubMed

    Severance, Harry W

    2002-01-01

    Bombings and other blast-related events place severe demands on pre-hospital and in-hospital systems. The resulting surge of victims can overwhelm the resources of any facility not prepared for such an event. The September 11 terrorist attacks underscore the urgency of our need for preparedness. The challenges become even more daunting when there is possible hazmat exposure as well; this means that adequate and rapid disposition of victims is even more critical in order to avoid contamination of hospitals systems or whole communities. Federal agencies have been designated and federal mandates have been issued to address mass casualty events, but federal or even regional systems cannot respond in time to address the massive and immediate needs generated by an explosion. Local communities must take the lead in developing incident command systems for initial management of such events. Hospital and pre-hospital providers play a key role in such planning. Ultimate management and disposition of large numbers of casualties, especially if contaminated, cannot follow standard patient management protocols; new protocols are needed. To avoid a total, overwhelming break down of in-hospital resources, hospitals need to assume a lead role in addressing such issues in their local communities. PMID:12970967

  20. Scientific framework for research on disaster and mass casualty incident in Korea: building consensus using Delphi method.

    PubMed

    Kim, Chu Hyun; Park, Ju Ok; Park, Chang Bae; Kim, Seong Chun; Kim, Soo Jin; Hong, Ki Jeong

    2014-01-01

    We aimed to determine the scientific framework for research on disaster and mass casualty incident (MCI) in Korea, especially Korean terminology, feasible definition, and epidemiologic indices. The two staged policy Delphi method was performed by instructors of National Disaster Life Support (NDLS®) with the constructed questionnaire containing items based on the literature review. The first-stage survey was conducted by 11 experts through two rounds of survey for making issue and option. The second-stage survey was conducted by 35 experts for making a generalized group based consensus. Experts were selected among instructors of National Disaster Life Support Course. Through two staged Delphi survey experts made consensus: 1) the Korean terminology "jaenan" with "disaster" and "dajung-sonsang-sago" with "MCI"; 2) the feasible definition of "disaster" as the events that have an effect on one or more municipal local government area (city-county-district) or results in ≥ 10 of death or ≥ 50 injured victims; 3) the feasible definition of MCI as the events that result in ≥ 6 casualties including death; 4) essential 31 epidemiologic indices. Experts could determine the scientific framework in Korea for research on disaster medicine, considering the distinct characteristics of Korea and current research trends. PMID:24431916

  1. Engaging Active Bystanders in Mass Casualty Events and Other Life-Threatening Emergencies: A Pilot Training Course Demonstration.

    PubMed

    Smith, Tracey O; Baker, Susan D; Roberts, Kathryn; Payne, Skip A

    2016-04-01

    Emerging research indicates the critical role members of the public can play in saving lives and reducing morbidity at the scene in the immediate aftermath of a disaster. It is anticipated that with training, more members of the public will be ready and able to assist should they be present at mass casualty events or other circumstances in which there are serious injuries or potential loss of life. This article describes a training course developed by multiple federal and nonfederal partners aimed at preparing the public to become "active bystanders" followed by a pilot demonstration project conducted by Medical Reserve Corps Units. The outcomes of the project indicated that the training was comprehensive and appropriate for members of the public with little or no first aid knowledge. National availability of the "Becoming an Active Bystander" training course is currently being planned. PMID:26841861

  2. Book review of "The Ethics of Coercion in Mass Casualty Medicine" by Griffin Trotter MD, PhD

    PubMed Central

    Singh, Sonal

    2007-01-01

    Public health ethics is neither taught widely in medical schools or schools of public health in the US or around the world. It is not surprising that health care professionals are particularly challenged when faced with ethical questions which extend beyond safeguarding the interests of their individual patients to matters that affect overall public good. The perceived threat of terror after September 11 2007, the anthrax attacks and the Katrina debacle are recent circumstances which may result in coercion. These have piqued the interest of medical professionals and the general public on public health ethics. The Ethics of Coercion in Mass Casualty Medicine written by Griffin Trotter MD, PhD attempts to fill a timely void in this area by examining the ethics of coercion in times of public health disasters.

  3. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study

    PubMed Central

    2014-01-01

    Background Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. Methods A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item’s importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Results Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. Conclusions This study is the first to produce an expert consensus on the

  4. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model.

    PubMed

    Hrdina, Chad M; Coleman, C Norman; Bogucki, Sandy; Bader, Judith L; Hayhurst, Robert E; Forsha, Joseph D; Marcozzi, David; Yeskey, Kevin; Knebel, Ann R

    2009-01-01

    Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe perimeters are established, RTR sites should be determined in real-time that are based on the extent of destruction, environmental factors, residual radiation, available infrastructure, and transportation routes. Such RTR sites are divided into three types depending on their physical/situational relationship to the incident. The RTR1 sites are near the epicenter with residual radiation and include victims with blast injuries and other major traumatic injuries including radiation exposure; RTR2 sites are situated in relationship to the plume with varying amounts of residual radiation present, with most victims being ambulatory; and RTR3 sites are collection and transport sites with minimal or no radiation present or exposure risk and a victim population with a potential variety of injuries or radiation exposures. Medical Care sites are predetermined sites at which definitive medical care is given to those in immediate need of care. They include local/regional hospitals, medical centers, other

  5. Mass casualties and health care following the release of toxic chemicals or radioactive material--contribution of modern biotechnology.

    PubMed

    Göransson Nyberg, Ann; Stricklin, Daniela; Sellström, Åke

    2011-12-01

    Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons "at risk" of developing health problems, these technologies can aid in securing the unaffected or "worried well". We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking. PMID:22408587

  6. Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems.

    PubMed

    Matar, H; Larner, J; Kansagra, S; Atkinson, K L; Skamarauskas, J T; Amlot, R; Chilcott, R P

    2014-06-01

    The efficient removal of contaminants from the outer surfaces of the body can provide an effective means of reducing adverse health effects associated with incidents involving the accidental or deliberate release of hazardous materials. Showering with water is frequently used by first responders as a rapid method of mass casualty decontamination (MCD). However, there is a paucity of data on the generic effectiveness and safety of aqueous decontamination systems. To address these issues, we have developed a new in vitro skin diffusion cell system to model the conditions of a common MCD procedure ("ladder pipe system"). The new diffusion cell design incorporates a showering nozzle, an air sampling port for measurement of vapour loss and/aerosolisation, adjustable (horizontal to vertical) skin orientation and a circulating manifold system (to maintain a specified flow rate, temperature and pressure of shower water). The dermal absorption characteristics of several simulants (Invisible Red S, curcumin and methyl salicylate) measured with the new in vitro model were in good agreement with previous in vitro and in vivo studies. Moreover, these initial studies have indicated that whilst flow rate and water temperature are important factors for MCD, the presence of clothing during showering may (under certain circumstances) cause transfer and spreading of contaminants to the skin surface. PMID:24412538

  7. Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology

    PubMed Central

    Göransson Nyberg, Ann; Stricklin, Daniela; Sellström, Åke

    2011-01-01

    Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons “at risk” of developing health problems, these technologies can aid in securing the unaffected or “worried well”. We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking. PMID:22408587

  8. Mass casualty following unprecedented tornadic events in the Southeast: natural disaster outcomes at a Level I trauma center.

    PubMed

    Hartmann, Elizabeth H; Creel, Nathan; Lepard, Jacob; Maxwell, Robert A

    2012-07-01

    On April 27, 2011, an EF4 (enhanced Fujita scale) tornado struck a 48-mile path across northwest Georgia and southeast Tennessee. Traumatic injuries sustained during this tornado and others in one of the largest tornado outbreaks in history presented to the regional Level I trauma center, Erlanger Health System, in Chattanooga, TN. Patients were triaged per mass casualty protocols through an incident command center and triage officer. Medical staffing was increased to anticipate a large patient load. Records of patients admitted as a result of tornado-related injury were retrospectively reviewed and characterized by the injury patterns, demographics, procedures performed, length of stay, and complications. One hundred four adult patients were treated in the emergency department; of these, 28 (27%) patients required admission to the trauma service. Of those admitted, 16 (57%) were male with an age range of 21 to 87 years old and an average length of stay of 10.9 ± 11.8 days. Eleven (39%) patients required intensive care unit admissions. The most common injuries seen were those of soft tissue, bony fractures, and the chest. Interventions included tube thoracostomies, exploratory laparotomies, orthopedic fixations, soft tissue reconstructions, and craniotomy. All 28 patients admitted survived to discharge. Nineteen (68%) patients were discharged home, six (21%) went to a rehabilitation hospital, and three (11%) were transferred to skilled nursing facilities. Emergency preparedness and organization are key elements in effectively treating victims of natural disasters. Those victims who survive the initial tornadic event and present to a Level I trauma center have low mortality. Like in our experience, triage protocols need to be implemented to quickly and effectively manage mass injuries. PMID:22748536

  9. Mutation, radiation, and species survival: The genetics studies of the Atomic Bomb Casualty Commission in Hiroshima and Nagasaki, Japan

    SciTech Connect

    Lindee, M.S.

    1990-01-01

    This is an analysis of the work of the Atomic Bomb Casualty Commission, an American agency which studied the effects of radiation on survivors of the atomic bombings at Hiroshima and Nagasaki, Japan, 1947-1975. Funded by the U.S. Atomic Energy Commission and directed by the National Academy of Sciences-National Research Council, the ABCC was the largest and longest medical study of the estimated 300,000 survivors. The morphological genetics study dominated the ABCCs first decade. James Neel and his principal collaborator William J. Schull tracked more than 76,000 pregnancies. Their results (1956) suggested the bombs radiation had no detectable impact on the offspring of survivors. Though geneticists knew that radiation caused heritable mutations in experimental organisms such as Drosophila, and believed it caused mutations in humans, the Neel-Schull findings were not a surprise. The practical difficulties of the study, and the relatively small increase in abnormal births to be expected, made a finding of significant effects unlikely. The Neel-Schull approach reflected the scientific debate over genetic load, and the Muller-Dobzhansky classical-balance controversy. Yet the findings also reflected the post-war debate over atomic energy and weapons testing. Many extra-scientific forces militated against a finding of positive effects at Hiroshima and Nagasaki. Negative findings were consistent with the needs of the Atomic Energy Commission, the State Department and the U.S. military. This dissertation explores how both the scientific debate about genetic load, and the political debate about atmospheric weapons testing, shaped this complex epidemiological study.

  10. Dynamic 3D visual analytic tools: a method for maintaining situational awareness during high tempo warfare or mass casualty operations

    NASA Astrophysics Data System (ADS)

    Lizotte, Todd E.

    2010-04-01

    Maintaining Situational Awareness (SA) is crucial to the success of high tempo operations, such as war fighting and mass casualty events (bioterrorism, natural disasters). Modern computer and software applications attempt to provide command and control manager's situational awareness via the collection, integration, interrogation and display of vast amounts of analytic data in real-time from a multitude of data sources and formats [1]. At what point does the data volume and displays begin to erode the hierarchical distributive intelligence, command and control structure of the operation taking place? In many cases, people tasked with making decisions, have insufficient experience in SA of high tempo operations and become overwhelmed easily as vast amounts of data begin to be displayed in real-time as an operation unfolds. In these situations, where data is plentiful and the relevance of the data changes rapidly, there is a chance for individuals to target fixate on those data sources they are most familiar. If these individuals fall into this type of pitfall, they will exclude other data that might be just as important to the success of the operation. To counter these issues, it is important that the computer and software applications provide a means for prompting its users to take notice of adverse conditions or trends that are critical to the operation. This paper will discuss a new method of displaying data called a Crisis ViewTM, that monitors critical variables that are dynamically changing and allows preset thresholds to be created to prompt the user when decisions need to be made and when adverse or positive trends are detected. The new method will be explained in basic terms, with examples of its attributes and how it can be implemented.

  11. Developing and organizing a trauma system and mass casualty management: some useful observations from the israeli trauma model.

    PubMed

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  12. Developing and Organizing a Trauma System and Mass Casualty Management: Some Useful Observations from the Israeli Trauma Model

    PubMed Central

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  13. The Boston Marathon Bombings Mass Casualty Incident: One Emergency Department's Information Systems Challenges and Opportunities.

    PubMed

    Landman, Adam; Teich, Jonathan M; Pruitt, Peter; Moore, Samantha E; Theriault, Jennifer; Dorisca, Elizabeth; Harris, Sheila; Crim, Heidi; Lurie, Nicole; Goralnick, Eric

    2015-07-01

    Emergency department (ED) information systems are designed to support efficient and safe emergency care. These same systems often play a critical role in disasters to facilitate real-time situation awareness, information management, and communication. In this article, we describe one ED's experiences with ED information systems during the April 2013 Boston Marathon bombings. During postevent debriefings, staff shared that our ED information systems and workflow did not optimally support this incident; we found challenges with our unidentified patient naming convention, real-time situational awareness of patient location, and documentation of assessments, orders, and procedures. As a result, before our next mass gathering event, we changed our unidentified patient naming convention to more clearly distinguish multiple, simultaneous, unidentified patients. We also made changes to the disaster registration workflow and enhanced roles and responsibilities for updating electronic systems. Health systems should conduct disaster drills using their ED information systems to identify inefficiencies before an actual incident. ED information systems may require enhancements to better support disasters. Newer technologies, such as radiofrequency identification, could further improve disaster information management and communication but require careful evaluation and implementation into daily ED workflow. PMID:24997562

  14. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    PubMed Central

    2009-01-01

    Background Hospitals have a critically important role in the management of mass causality incidents (MCI), yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%), pelvic injuries (11.5%), thoracic injuries (5.0%) and major amputations (3.1%). The mean cut to suture time was 130 min (IQR 65-165 min). Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00), ISS ≥ 35 (OR 2,94), hemoglobin level ≤ 8 mg/dL (OR 1,40), pulse rate on hospital admission < 40 or > 120/min (OR 1,39), blood pressure on hospital admission < 90 mmHg (OR 1,35), prehospital infusion volume ≥ 2000 ml (OR 1,34), GCS ≤ 8 (OR 1,32) and anisocoria (OR 1,28) on-scene. Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI. PMID:20149987

  15. [Organizational problems of disaster victim identification in mass casualties as exemplified by Tu 154-M and Airbus A310 passenger plane crashes].

    PubMed

    Volkov, A V; Kolkutin, V V; Klevno, V A; Shkol'nikov, B V; Kornienko, I V

    2008-01-01

    Managerial experience is described that was gained during the large-scale work on victim identification following mass casualties in the Tu 154-M and Airbus A310 passenger plane crashes. The authors emphasize the necessity to set up a specialized agency of constant readiness meeting modern requirements for the implementation of a system of measures for personality identification. This agency must incorporate relevant departments of the Ministries of Health, Defense, and Emergency Situations as well as investigative authorities and other organizations. PMID:19048869

  16. The grave is wide: the Hibakusha of Hiroshima and Nagasaki and the legacy of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation.

    PubMed

    O'Malley, Gerald F

    2016-07-01

    Following the atomic bomb attacks on Japan in 1945, scientists from the United States and Japan joined together to study the Hibakusha - the bomb affected people in what was advertised as a bipartisan and cooperative effort. In reality, despite the best efforts of some very dedicated and earnest scientists, the early years of the collaboration were characterized by political friction, censorship, controversy, tension, hostility, and racism. The 70-year history, scientific output and cultural impact of the Atomic Bomb Casualty Commission and the Radiation Effects Research Foundation are described in the context of the development of Occupied Japan. PMID:27158765

  17. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs

    PubMed Central

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G.; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean- René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

    2015-01-01

    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative’s Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident. PMID:26635995

  18. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs.

    PubMed

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean-René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

    2015-01-01

    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative's Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident. PMID:26635995

  19. Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire*

    PubMed Central

    Shen, Wei-feng; Jiang, Li-bing; Jiang, Guan-yu; Zhang, Mao; Ma, Yue-feng; He, Xiao-jun

    2014-01-01

    Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: ‘mass casualty incident’, ‘MCI’, ‘research method’, ‘Wenchuan’, ‘earthquake’, ‘research paradigm’, ‘science of surge’, ‘surge’, ‘surge capacity’, and ‘vulnerability’. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the

  20. Challenges of major incident management when excess resources are allocated: experiences from a mass casualty incident after roof collapse of a military command center.

    PubMed

    Romundstad, Luis; Sundnes, Knut Ole; Pillgram-Larsen, Johan; Røste, Geir K; Gilbert, Mads

    2004-01-01

    During a military exercise in northern Norway in March 2000, the snow-laden roof of a command center collapsed with 76 persons inside. Twenty-five persons were entrapped and/or buried under snow masses. There were three deaths. Seven patients had serious injuries, three had moderate injuries, and 16 had minor injuries. A military Convalescence Camp that had been set up in a Sports Hall 125 meters from the scene was reorganized as a causality clearing station. Officers from the Convalescence Camp initially organized search and rescue. In all, 417 persons took part in the rescue work with 36 ambulances, 17 helicopters, three ambulance airplanes and one transport plane available. Two ambulances, five helicopters and one transport aircraft were used. Four patients were evacuated to a civilian hospital and six to a field hospital. The stretcher and treatment teams initially could have been more effectively organized. As resources were ample, this was a mass casualty, not a disaster. Firm incident command prevented the influx of excess resources. PMID:15506256

  1. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions.

    PubMed

    Burkle, Frederick M

    2002-05-01

    The threat of a BT event has catalyzed serious reflection on the troublesome issues that come with event management and triage. Such reflection has had the effect of multiplying the efforts to find solutions to what could become a catastrophic public health disaster. Management options are becoming more robust, as are reliable detection devices and rapid access to stockpiled antibiotics and vaccines. There is much to be done, however, especially in the organizing, warehousing, and granting/exercising authority for resource allocations. The introduction of these new options should encourage one to believe that, in time, evolving standards of care will make it possible to rethink the currently unthinkable consequences. Unfortunately the cost of such preparedness is high and out of reach of most governments. Most of the developing world has neither the will nor the means to plan for BT events and remains overwhelmed with basic public health concerns (i.e., water, food, sanitation, shelter) that must take priority. Therefore, developed countries will be expected to respond using international exogenous resources to mitigate the effects of such a disaster. As a result, the state capacity of the effected government will be severely compromised. If triage and management of casualties is further compromised, terrorists will have met their goals. One could argue that health sciences will continue for decades to play catch up with the advanced technology driving potential bioagent weaponry. If one lesson was learned from the review of the former Soviet Union's biological weapons program, it is that the unthinkable remains an option to terrorists who have comparable expertise. It is crucial to develop realistic strategies for a BT event. Triage planning (the process of establishing criteria for health care prioritization) permits society to see cases in the context of diverse moral perspectives, limited resources, and compelling health care demands. This includes a competent

  2. Medical response of a physician and two nurses to the mass-casualty event resulting in the Phi Phi Islands from the tsunami.

    PubMed

    Ammartyothin, Surasak; Ashkenasi, Issac; Schwartz, Dagan; Leiba, Adi; Nakash, Guy; Pelts, Rami; Goldberg, Avishay; Bar-Dayan, Yaron

    2006-01-01

    The Phi Phi Islands are isolated islands located about one hour by ship from the mainland in Krabi province of Thailand. There is a small medical facility where the director is the one physician that provides care to residents and tourists. This small medical facility faced an enormous mass casualty incident due to the 2004 Tsunami. The hospital was damaged by the Tsunami wave and was not functional, one crew member died and another was injured. Medical care and evacuation posed a unique problem in the Phi Phi Islands due to remoteness, limited medical resources, lack of effective communication with the main land and the large number of victims. An alternative medical facility was located in a nearby hotel. The crew included the medical director, two nurses, two additional staff members, 10 local volunteers, and hotel staff members. The medical crew had to treat 600-700 casualties in 24 hours. Most of the victims were mildly injured, but approximately 100 (15%) of the victims could not walk due to their injuries. The medical director, made a conscious decision to initially treat only circulation ("C") problems, by controlling external hemorrhages. This decision was driven by the lack of equipment and personnel to deal with airway ("A") and breathing ("B") problems. In the post-disaster debriefing, the Phi Phi Island hospital physician noted five major lessons concerning disaster management in such extreme situation in a small facility located in a remote area: (1) effective resistant communication facilities must be ensured; (2) clear, simple "evacuation plans" should be made in advance; (3) plans should be made to ensure automatic reinforcement of remote areas with evacuation vehicles, medical equipment and medical personnel; (4) efficient cooperation with medical volunteers must be planned and drilled; and (5) every team member of such a hospital must participate in an educational program and periodic drills should be done to improve the disaster and emergency

  3. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan.

    PubMed

    Berger, Ferco H; Körner, Markus; Bernstein, Mark P; Sodickson, Aaron D; Beenen, Ludo F; McLaughlin, Patrick D; Kool, Digna R; Bilow, Ronald M

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs. PMID:26781837

  4. Clinical guidelines for responding to chemical, biological, radiological, nuclear and trauma/burn mass casualty incidents: Quick reference guides for emergency department staff.

    PubMed

    Albanese, Joseph; Burich, David; Smith, Deborah; Hayes, Lynn; Paturas, James; Tomassoni, Anthony

    The word 'DISASTER' may be used as a mnemonic for listing the critical elements of emergency response. The National Disaster Life Support Education Foundation's (NDLSEC) DISASTER paradigm emphasises out-of-hospital emergency response and includes the following elements: (1) detect; (2) incident command system; (3) security and safety; (4) assessment; (5) support; (6) triage and treatment; (7) evacuate; and (8) recovery. This paper describes how the DISASTER paradigm was used to create a series of clinical guidelines to assist the preparedness effort of hospitals for mitigating chemical, biological, radiological, nuclear incidents or explosive devices resulting in trauma/burn mass casualty incidents (MCIs) and their initial response to these events. Descriptive information was obtained from observations and records associated with this project. The information contributed by a group of subject matter experts in disaster medicine, at the Yale New Haven Health System Center for Emergency Preparedness and Disaster Response was used to author the clinical guidelines. Akin to the paradigm developed by the NDLSEC for conducting on-scene activities, the clinical guidelines use the letters in the word 'disaster' as a mnemonic for recalling the main elements required for mitigating MCIs in the hospital emergency department. PMID:25416374

  5. Incidence and Mortality Rates of Disasters and Mass Casualty Incidents in Korea: A Population-Based Cross-Sectional Study, 2000-2009

    PubMed Central

    Kim, Soo Jin; Shin, Sang Do; Lee, Seung Chul; Park, Ju Ok; Sung, Joohon

    2013-01-01

    The objective of study was to evaluate the incidence and mortality rates of disasters and mass casualty incidents (MCIs) over the past 10 yr in the administrative system of Korea administrative system and to examine their relationship with population characteristics. This was a population-based cross-sectional study. We calculated the nationwide incidence, as well as the crude mortality and injury incidence rates, of disasters and MCIs. The data were collected from the administrative database of the National Emergency Management Agency (NEMA) and from provincial fire departments from January 2000 to December 2009. A total of 47,169 events were collected from the NEMA administrative database. Of these events, 115 and 3,079 cases were defined as disasters and MCIs that occurred in Korea, respectively. The incidence of technical disasters/MCIs was approximately 12.7 times greater than that of natural disasters/MCIs. Over the past 10 yr, the crude mortality rates for disasters and MCIs were 2.36 deaths per 100,000 persons and 6.78 deaths per 100,000 persons, respectively. The crude injury incidence rates for disasters and MCIs were 25.47 injuries per 100,000 persons and 152 injuries per 100,000 persons, respectively. The incidence and mortality of disasters/MCIs in Korea seem to be low compared to that of trend around the world. PMID:23678255

  6. Tsunami Casualty Model

    NASA Astrophysics Data System (ADS)

    Yeh, H.

    2007-12-01

    More than 4500 deaths by tsunamis were recorded in the decade of 1990. For example, the 1992 Flores Tsunami in Indonesia took away at least 1712 lives, and more than 2182 people were victimized by the 1998 Papua New Guinea Tsunami. Such staggering death toll has been totally overshadowed by the 2004 Indian Ocean Tsunami that claimed more than 220,000 lives. Unlike hurricanes that are often evaluated by economic losses, death count is the primary measure for tsunami hazard. It is partly because tsunamis kill more people owing to its short lead- time for warning. Although exact death tallies are not available for most of the tsunami events, there exist gender and age discriminations in tsunami casualties. Significant gender difference in the victims of the 2004 Indian Ocean Tsunami was attributed to women's social norms and role behavior, as well as cultural bias toward women's inability to swim. Here we develop a rational casualty model based on humans' limit to withstand the tsunami flows. The application to simple tsunami runup cases demonstrates that biological and physiological disadvantages also make a significant difference in casualty rate. It further demonstrates that the gender and age discriminations in casualties become most pronounced when tsunami is marginally strong and the difference tends to diminish as tsunami strength increases.

  7. MACRAD: A mass analysis code for radiators

    SciTech Connect

    Gallup, D.R.

    1988-01-01

    A computer code to estimate and optimize the mass of heat pipe radiators (MACRAD) is currently under development. A parametric approach is used in MACRAD, which allows the user to optimize radiator mass based on heat pipe length, length to diameter ratio, vapor to wick radius, radiator redundancy, etc. Full consideration of the heat pipe operating parameters, material properties, and shielding requirements is included in the code. Preliminary results obtained with MACRAD are discussed.

  8. Radiologic diagnosis of explosion casualties.

    PubMed

    Eastridge, Brian J; Blackbourne, Lorne; Wade, Charles E; Holcomb, John B

    2008-01-01

    The threat of terrorist events on domestic soil remains an ever-present risk. Despite the notoriety of unconventional weapons, the mainstay in the armament of the terrorist organization is the conventional explosive. Conventional explosives are easily weaponized and readily obtainable, and the recipes are widely available over the Internet. According to the US Department of State and the Federal Bureau of Investigation, over one half of the global terrorist events involve explosions, averaging two explosive events per day worldwide in 2005 (Terrorism Research Center. Available at www.terrorism.com. Accessed April 1, 2007). The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads, published by the Institute of Medicine, states that explosions were the most common cause of injuries associated with terrorism (Institute of Medicine Report: The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads. Washington DC: National Academic Press, 2007). Explosive events have the potential to inflict numerous casualties with multiple injuries. The complexity of this scenario is exacerbated by the fact that few providers or medical facilities have experience with mass casualty events in which human and material resources can be rapidly overwhelmed. Care of explosive-related injury is based on same principles as that of standard trauma management paradigms. The basic difference between explosion-related injury and other injury mechanisms are the number of patients and multiplicity of injuries, which require a higher allocation of resources. With this caveat, the appropriate utilization of radiology resources has the potential to impact in-hospital diagnosis and triage and is an essential element in optimizing the management of the explosive-injured patients. PMID:19069034

  9. Predictive models of radiative neutrino masses

    NASA Astrophysics Data System (ADS)

    Julio, J.

    2016-06-01

    We discuss two models of radiative neutrino mass generation. The first model features one-loop Zee model with Z4 symmetry. The second model is the two-loop neutrino mass model with singly- and doubly-charged scalars. These two models fit neutrino oscillation data well and predict some interesting rates for lepton flavor violation processes.

  10. Radiative neutrino mass, dark matter, and leptogenesis

    SciTech Connect

    Gu Peihong; Sarkar, Utpal

    2008-05-15

    We propose an extension of the standard model, in which neutrinos are Dirac particles and their tiny masses originate from a one-loop radiative diagram. The new fields required by the neutrino mass generation also accommodate the explanation for the matter-antimatter asymmetry and dark matter in the Universe.

  11. Radiation Monitoring for the Masses.

    PubMed

    Wagner, Eric; Sorom, Rich; Wiles, Linda

    2016-01-01

    In response to the Fukushima-Daiichi incident, many commercial vendors have produced applications and equipment targeted at the average member of the public in order to enable them to make radiation measurements themselves at little to no cost. The authors have evaluated a small selection of these items in order to validate their performance when exposed to a calibrated 137Cs dose rate irradiator. The products fall into two primary categories: the first using the CMOS from the camera on ubiquitous smartphones and the second using an accessory that performs the radiation measurement. Presented here are the performance data of a selection and recommendations on how to interpret the produced values. PMID:26606063

  12. Solids mass flow indication with radiation

    DOEpatents

    Macko, Joseph E.; Estriplet, Isnard

    1985-06-04

    Method and apparatus for indicating mass flow of a solid particulate material through a rotary feeder. A radiation source and detector are positioned in a manner whereby radiation flux is directed through, and attenuated by, particulate material contained in rotating pockets. A Cesium-137 gamma source can be mounted within the shaft of the feeder, and one or more detectors can be mounted outside of the feeder housing. The detected signal is indicative of the mass of particulate material contained within a given pocket rotating within the feeder.

  13. The simplest models of radiative neutrino mass

    NASA Astrophysics Data System (ADS)

    Law, Sandy S. C.; McDonald, Kristian L.

    2014-04-01

    The complexity of radiative neutrino-mass models can be judged by: (i) whether they require the imposition of ad hoc symmetries, (ii) the number of new multiplets they introduce and (iii) the number of arbitrary parameters that appear. Considering models that do not employ new symmetries, the simplest models have two new multiplets and a minimal number of new parameters. With this in mind, we search for the simplest models of radiative neutrino mass. We are led to two models, containing a real scalar triplet and a charged scalar doublet (respectively), in addition to the charged singlet scalar considered by Zee [h+ (1, 1, 2)]. These models are essentially simplified versions of the Zee model and appear to be the simplest models of radiative neutrino mass. However, despite successfully generating nonzero masses, present-day data is sufficient to rule these simple models out. The Zee and Zee-Babu models therefore remain as the simplest viable models. Moving beyond the minimal cases, we find a new model of two-loop masses that employs the charged doublet Φ (1, 2, 3) and the doubly-charged scalar k++ (1, 1, 4). This is the sole remaining model that employs only three new noncolored multiplets.

  14. Flavour dependent gauged radiative neutrino mass model

    NASA Astrophysics Data System (ADS)

    Baek, Seungwon; Okada, Hiroshi; Yagyu, Kei

    2015-04-01

    We propose a one-loop induced radiative neutrino mass model with anomaly free flavour dependent gauge symmetry: μ minus τ symmetry U(1) μ- τ . A neutrino mass matrix satisfying current experimental data can be obtained by introducing a weak isospin singlet scalar boson that breaks U(1) μ- τ symmetry, an inert doublet scalar field, and three right-handed neutrinos in addition to the fields in the standard model. We find that a characteristic structure appears in the neutrino mass matrix: two-zero texture form which predicts three non-zero neutrino masses and three non-zero CP-phases from five well measured experimental inputs of two squared mass differences and three mixing angles. Furthermore, it is clarified that only the inverted mass hierarchy is allowed in our model. In a favored parameter set from the neutrino sector, the discrepancy in the muon anomalous magnetic moment between the experimental data and the the standard model prediction can be explained by the additional neutral gauge boson loop contribution with mass of order 100 MeV and new gauge coupling of order 10-3.

  15. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related casualties are reported in accordance with 46 CFR 197.484 and 197.486. ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Diving casualties. 146.40...

  16. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related casualties are reported in accordance with 46 CFR 197.484 and 197.486. ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Diving casualties. 146.40...

  17. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related casualties are reported in accordance with 46 CFR 197.484 and 197.486. ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Diving casualties. 146.40...

  18. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related casualties are reported in accordance with 46 CFR 197.484 and 197.486. ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Diving casualties. 146.40...

  19. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related casualties are reported in accordance with 46 CFR 197.484 and 197.486. ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Diving casualties. 146.40...

  20. Predictive model of radiative neutrino masses

    NASA Astrophysics Data System (ADS)

    Babu, K. S.; Julio, J.

    2014-03-01

    We present a simple and predictive model of radiative neutrino masses. It is a special case of the Zee model which introduces two Higgs doublets and a charged singlet. We impose a family-dependent Z4 symmetry acting on the leptons, which reduces the number of parameters describing neutrino oscillations to four. A variety of predictions follow: the hierarchy of neutrino masses must be inverted; the lightest neutrino mass is extremely small and calculable; one of the neutrino mixing angles is determined in terms of the other two; the phase parameters take CP-conserving values with δCP=π; and the effective mass in neutrinoless double beta decay lies in a narrow range, mββ=(17.6-18.5) meV. The ratio of vacuum expectation values of the two Higgs doublets, tanβ, is determined to be either 1.9 or 0.19 from neutrino oscillation data. Flavor-conserving and flavor-changing couplings of the Higgs doublets are also determined from neutrino data. The nonstandard neutral Higgs bosons, if they are moderately heavy, would decay dominantly into μ and τ with prescribed branching ratios. Observable rates for the decays μ →eγ and τ→3μ are predicted if these scalars have masses in the range of 150-500 GeV.

  1. New development in radiative neutrino mass generation

    NASA Astrophysics Data System (ADS)

    Julio

    2014-10-01

    We present a simple and predictive model of radiative neutrino masses. It is a special case of the Zee model with a family-dependent Z4 symmetry acting on the leptons. A variety of predictions follow: The hierarchy of neutrino masses must be inverted; the lightest neutrino mass is extremely small and calculable; one of the neutrino mixing angles is determined in terms of the other two; the phase parameters take CP-conserving values with δCP = π and the effective mass in neutrinoless double beta decay lies in a narrow range, mββ =(17.6-18.5) meV. The ratio of vacuum expectation values of the two Higgs doublets, tan β, is determined to be either 1.9 or 0.19 from neutrino oscillation data. Flavor-conserving and flavor-changing couplings of the Higgs doublets are also determined from neutrino data. The non-standard neutral Higgs bosons, if they are moderately heavy, decay significantly into μ and τ with prescribed branching ratios. Observable rates for the decays μ → eγ and τ → 3μ are predicted if these scalars have masses in the range of 150-500 GeV.

  2. Child pedestrian casualties and deprivation.

    PubMed

    Green, James; Muir, Helen; Maher, Mike

    2011-05-01

    The existence of an association between child pedestrian accidents and socio-economic deprivation in Great Britain is well established. The factors driving this association are complex and difficult to isolate. This study uses accident prediction models to investigate the links between child pedestrian casualties and a range of environmental and socio-economic factors commonly linked to deprived areas and people. Separate models are constructed relating to the areas in which the children become casualties, and the areas in which the children reside. Significant socio-economic factors include: single-parenthood, reliance on income support, and crime; and environmental factors include domestic garden area, junction density and pedestrian and vehicular flow density. The study found that factors pertaining to the local environment were more prevalent in the models considering accident locations, whilst socio-economic factors were of greater influence in the residency model. PMID:21376859

  3. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  4. Radiation Design of Ion Mass Spectrometers

    NASA Technical Reports Server (NTRS)

    Sittler, Ed; Cooper, John; Christian, Eric; Moore, Tom; Sturner, Steve; Paschalidis, Nick

    2011-01-01

    In the harsh radiation environment of Jupiter and with the JUpiter ICy moon Explorer (JUICE) mission including two Europa flybys where local intensities are approx. 150 krad/month behind 100 mils of Al shielding, so background from penetrating radiation can be a serious issue for detectors inside an Ion Mass Spectrometer (IMS). This can especially be important for minor ion detection designs. Detectors of choice for time-of-flight (TOF) designs are microchannel plates (MCP) and some designs may include solid state detectors (SSD). The standard approach is to use shielding designs so background event rates are low enough that the detector max rates and lifetimes are first not exceeded and then the more stringent requirement that the desired measurement can successfully be made (i.e., desired signal is sufficiently greater than background noise after background subtraction is made). GEANT codes are typically used along with various electronic techniques, but such designs need to know how the detectors will respond to the simulated primary and secondary radiations produced within the instrument. We will be presenting some preliminary measurements made on the response of MCPs to energetic electrons (20 ke V to 1400 ke V) using a Miniature TOF (MTOF) device and the High Energy Facility at Goddard Space Flight Center which has a Van de Graaff accelerator.

  5. An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2000-2007 Light-Duty Vehicles

    SciTech Connect

    Wenzel, Tom

    2012-08-01

    NHTSA recently completed a logistic regression analysis (Kahane 2012) updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data for 2002 to 2008 involving MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and a category for all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.

  6. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident means— (a) Any casualty or accident involving...

  7. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident means— (a) Any casualty or accident involving...

  8. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  9. Contribution of forensic autopsy to scene reconstruction in mass fire casualties: a case of alleged arson on a floor consisting of small compartments in a building.

    PubMed

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Maeda, Hitoshi

    2015-01-01

    A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a 'private video parlor' consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (<20% of body surface) in most victims, except for three victims found between the entrance and the estimated fire-outbreak site; thus, identification was completed without difficulty, supported by DNA analysis. Blood carboxyhemoglobin saturation (COHb) was higher for victims found dead in the inner area. Blood cyanide levels were sublethal, moderately correlated to COHb, but were higher in victims found around the estimated fire-outbreak site. There was no evidence of thinner, alcohol or drug abuse, or an attack of disease as a possible cause of an accidental fire outbreak. These observations contribute to evidence-based reconstruction of the fire disaster, and suggest how deaths could have been prevented by appropriate disaster measures. PMID:25311374

  10. Human casualties in earthquakes: modelling and mitigation

    USGS Publications Warehouse

    Spence, R.J.S.; So, E.K.M.

    2011-01-01

    Earthquake risk modelling is needed for the planning of post-event emergency operations, for the development of insurance schemes, for the planning of mitigation measures in the existing building stock, and for the development of appropriate building regulations; in all of these applications estimates of casualty numbers are essential. But there are many questions about casualty estimation which are still poorly understood. These questions relate to the causes and nature of the injuries and deaths, and the extent to which they can be quantified. This paper looks at the evidence on these questions from recent studies. It then reviews casualty estimation models available, and finally compares the performance of some casualty models in making rapid post-event casualty estimates in recent earthquakes.

  11. Predicting casualties implied by TIPs

    NASA Astrophysics Data System (ADS)

    Trendafiloski, G.; Wyss, M.; Wyss, B. M.

    2009-12-01

    When an earthquake is predicted, forecast, or expected with a higher than normal probability, losses are implied. We estimated the casualties (fatalities plus injured) that should be expected if earthquakes in TIPs (locations of Temporarily Increased Probability of earthquakes) defined by Kossobokov et al. (2009) should occur. We classified the predictions of losses into the categories red (more than 400 fatalities or more than 1,000 injured), yellow (between 100 and 400 fatalities), green (fewer than 100 fatalities), and gray (undetermined). TIPs in Central Chile, the Philippines, Papua, and Taiwan are in the red class, TIPs in Southern Sumatra, Nicaragua, Vanatu, and Honshu in the yellow class, and TIPs in Tonga, Loyalty Islands, Vanatu, S. Sandwich Islands, Banda Sea, and the Kuriles, are classified as green. TIPs where the losses depend moderately on the assumed point of major energy release were classified as yellow; TIPs such as in the Talaud Islands and in Tonga, where the losses depend very strongly on the location of the epicenter, were classified as gray. The accuracy of loss estimates after earthquakes with known hypocenter and magnitude are affected by uncertainties in transmission and soil properties, the composition of the building stock, the population present, and the method by which the numbers of casualties are calculated. In the case of TIPs, uncertainties in magnitude and location are added, thus we calculate losses for a range of these two parameters. Therefore, our calculations can only be considered order of magnitude estimates. Nevertheless, our predictions can come to within a factor of two of the observed numbers, as in the case of the M7.6 earthquake of October 2005 in Pakistan that resulted in 85,000 fatalities (Wyss, 2005). In subduction zones, the geometrical relationship between the earthquake source capable of a great earthquake and the population is clear because there is only one major fault plane available, thus the epicentral

  12. CBRNE TC3: A Hybrid Approach to Casualty Care in the CBRNE Environment.

    PubMed

    Strain, John W

    2013-01-01

    The implementation of Tactical Combat Casualty Care (TCCC) guidelines for the Operation Enduring Freedom and Operation Iraqi Freedom contingency operations has dramatically reduced preventable combat deaths. A study of these principles and their application to medical treatment in the chemical, biological, radiological, nuclear, and high-yield explosives (CBRNE), weapons of mass destruction (WMD) environment is presented as a potential readiness and force multiplier for units engaged in this area of operations. Preparing medical operators for support of WMD sampling and mitigation missions requires extensive preventive medicine and post-exposure and downrange trauma threat preparedness. Training and equipping CBRN operators with treatment skills and appropriate interventional material requires pre-implementation planning specific to WMD threats (e.g., anthrax, radiation, organophosphates, and contaminated trauma). A scenario-based study reveals the tactics, techniques, and procedures for training, resourcing, and fielding the CBRN operator of the future. PMID:23817878

  13. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty. (a) Immediately after the addressing of...

  14. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  15. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  16. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  17. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty. (a) Immediately after the addressing of...

  18. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  19. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  20. 19 CFR 158.27 - Accidental fire or other casualty.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Accidental fire or other casualty. 158.27 Section... Casualty, Loss, or Theft While in Customs Custody § 158.27 Accidental fire or other casualty. In the case of injury or destruction by accidental fire or other casualty, the following evidence shall...

  1. 19 CFR 158.27 - Accidental fire or other casualty.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Accidental fire or other casualty. 158.27 Section... Casualty, Loss, or Theft While in Customs Custody § 158.27 Accidental fire or other casualty. In the case of injury or destruction by accidental fire or other casualty, the following evidence shall...

  2. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  3. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Report of casualty or accident. 173.55 Section 173.55 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or...

  4. 46 CFR 28.80 - Report of casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... accordance with paragraph (c) of this section, as soon as possible after the casualty, to the underwriter of... involved in the casualty; and (13) The monetary amount paid for an injury or a death. (d) A casualty to a... the casualty involves any of the following. (1) Loss of life. (2) An injury that requires...

  5. Understanding combat casualty care statistics.

    PubMed

    Holcomb, John B; Stansbury, Lynn G; Champion, Howard R; Wade, Charles; Bellamy, Ronald F

    2006-02-01

    Maintaining good hospital records during military conflicts can provide medical personnel and researchers with feedback to rapidly adjust treatment strategies and improve outcomes. But to convert the resulting raw data into meaningful conclusions requires clear terminology and well thought out equations, utilizing consistent numerators and denominators. Our objective was to arrive at terminology and equations that would produce the best insight into the effectiveness of care at different stages of treatment, either pre or post medical treatment facility care. We first clarified three essential terms: 1) the case fatality rate (CFR) as percentage of fatalities among all wounded; 2) killed in action (KIA) as percentage of immediate deaths among all seriously injured (not returning to duty); and 3) died of wounds (DOW) as percentage of deaths following admission to a medical treatment facility among all seriously injured (not returning to duty). These equations were then applied consistently across data from the WWII, Vietnam and the current Global War on Terrorism. Using this clear set of definitions we used the equations to ask two basic questions: What is the overall lethality of the battlefield? How effective is combat casualty care? To answer these questions with current data, the three services have collaboratively created a joint theater trauma registry (JTTR), cataloging all the serious injuries, procedures, and outcomes for the current war. These definitions and equations, consistently applied to the JTTR, will allow meaningful comparisons and help direct future research and appropriate application of personnel. PMID:16508502

  6. LDEF geometry/mass model for radiation analyses

    NASA Technical Reports Server (NTRS)

    Colborn, B. L.; Armstrong, T. W.

    1992-01-01

    A three-dimensional geometry/mass model of LDEF is under development for ionizing radiation analyses. This model, together with ray tracing algorithms, is being programmed for use both as a stand alone code in determining three-dimensional shielding distributions at dosimetry locations and as a geometry module that can be interfaced with radiation transport codes.

  7. Hubble induced mass in radiation-dominated universe

    NASA Astrophysics Data System (ADS)

    Kawasaki, Masahiro; Takesako, Tomohiro

    2012-05-01

    We reconsider the effective mass of a scalar field which interact with visible sector via Planck-suppressed coupling in supergravity framework. We focus on the radiation-dominated (RD) era after inflation. In this era, the effective mass is given by thermal average of interaction terms. To make our analysis clear, we rely on Kadanoff-Baym equations to evaluate the thermal average. We find that, in RD era, a scalar field acquires the effective mass of the order of H.

  8. Rapid Analysis of Mass Distribution of Radiation Shielding

    NASA Technical Reports Server (NTRS)

    Zapp, Edward

    2007-01-01

    Radiation Shielding Evaluation Toolset (RADSET) is a computer program that rapidly calculates the spatial distribution of mass of an arbitrary structure for use in ray-tracing analysis of the radiation-shielding properties of the structure. RADSET was written to be used in conjunction with unmodified commercial computer-aided design (CAD) software that provides access to data on the structure and generates selected three-dimensional-appearing views of the structure. RADSET obtains raw geometric, material, and mass data on the structure from the CAD software. From these data, RADSET calculates the distribution(s) of the masses of specific materials about any user-specified point(s). The results of these mass-distribution calculations are imported back into the CAD computing environment, wherein the radiation-shielding calculations are performed.

  9. Simulated casualties and medics for emergency training.

    PubMed

    Chi, D M; Kokkevis, E; Ogunyemi, O; Bindiganavale, R; Hollick, M J; Clarke, J R; Webber, B L; Badler, N I

    1997-01-01

    The MediSim system extends virtual environment technology to allow medical personnel to interact with and train on simulated casualties. The casualty model employs a three-dimensional animated human body that displays appropriate physical and behavioral responses to injury and/or treatment. Medical corpsmen behaviors were developed to allow the actions of simulated medical personnel to conform to both military practice and medical protocols during patient assessment and stabilization. A trainee may initiate medic actions through a mouse and menu interface; a VR interface has also been created by Stansfield's research group at Sandia National Labs. PMID:10168943

  10. 46 CFR 122.260 - Reports of potential vessel casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Marine Casualties and Voyage Records § 122.260 Reports of potential vessel casualty. (a) An owner... district rescue coordination center (RCC) cognizant over the area in which the vessel was last...

  11. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  12. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  13. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  14. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  15. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  16. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  17. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  18. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  19. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  20. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  1. Searching for radiative neutrino mass generation at the LHC

    NASA Astrophysics Data System (ADS)

    Volkas, Raymond R.

    2015-04-01

    In this talk (talk given at the International Conference on Massive Neutrinos, Singapore, 9-13 February 2015), I describe the general characteristics of radiative neutrino mass models that can be probed at the LHC. I then cover the specific constraints on a new, explicit model of this type.

  2. Optimal shield mass distribution for space radiation protection

    NASA Technical Reports Server (NTRS)

    Billings, M. P.

    1972-01-01

    Computational methods have been developed and successfully used for determining the optimum distribution of space radiation shielding on geometrically complex space vehicles. These methods have been incorporated in computer program SWORD for dose evaluation in complex geometry, and iteratively calculating the optimum distribution for (minimum) shield mass satisfying multiple acute and protected dose constraints associated with each of several body organs.

  3. Consistency of WIMP Dark Matter as radiative neutrino mass messenger

    NASA Astrophysics Data System (ADS)

    Merle, Alexander; Platscher, Moritz; Rojas, Nicolás; Valle, José W. F.; Vicente, Avelino

    2016-07-01

    The scotogenic scenario provides an attractive approach to both Dark Matter and neutrino mass generation, in which the same symmetry that stabilises Dark Matter also ensures the radiative seesaw origin of neutrino mass. However the simplest scenario may suffer from inconsistencies arising from the spontaneous breaking of the underlying ℤ 2 symmetry. Here we show that the singlet-triplet extension of the simplest model naturally avoids this problem due to the presence of scalar triplets neutral under the ℤ 2 which affect the evolution of the couplings in the scalar sector. The scenario offers good prospects for direct WIMP Dark Matter detection through the nuclear recoil method.

  4. Hospital preparedness for possible nonconventional casualties: an Israeli experience.

    PubMed

    Schreiber, Shaul; Yoeli, Naomi; Paz, Gedalia; Barbash, Gabriel I; Varssano, David; Fertel, Nurit; Hassner, Avi; Drory, Margalit; Halpern, Pinchas

    2004-01-01

    Since 9/11, hospitals and health authorities have been preparing medical response in case of various mass terror attacks. The experience of Tel Aviv Sourasky Medical Center in treating suicide-bombing mass casualties served, in the time leading up to the war in Iraq, as a platform for launching a preparedness program for possible attacks with biological and chemical agents of mass destruction. Adapting Quarantelli's criteria on disaster mitigation to the "microinfrastructure" of the hospital, and including human behavior experts, we attempted to foster an interactive emergency management process that would deal with contingencies stemming from the potential hazards of chemical and biological (CB) weapons. The main objective of our work was to encourage an organization-wide communication network that could effectively address the contingent hazards unique to this unprecedented situation. A stratified assessment of needs, identification of unique dangers to first responders, and assignment of team-training sessions paved the way for program development. Empowerment through leadership and resilience training was introduced to emergency team leaders of all disciplines. Focal subject matters included proactive planning, problem-solving, informal horizontal and vertical communication, and coping through stress-management techniques. The outcome of this process was manifested in an "operation and people" orientation supporting a more effective and compatible emergency management. The aim of article is to describe this process and to point toward the need for a broad-spectrum view in such circumstances. Unlike military units, the civilian hospital staff at risk, expected to deal with CB casualties, requires adequate personal consideration to enable effective functioning. Issues remain to be addressed in the future. We believe that collaboration and sharing of knowledge, information, and expertise beyond the medical realm is imperative in assisting hospitals to expedite

  5. The Tactical Combat Casualty Care Casualty Card TCCC Guidelines ? Proposed Change 1301.

    PubMed

    Kotwal, Russ S; Butler, Frank K; Montgomery, Harold R; Brunstetter, Tyson J; Diaz, George Y; Kirkpatrick, James W; Summers, Nancy L; Shackelford, Stacy A; Holcomb, John B; Bailey, Jeffrey A

    2013-01-01

    Optimizing trauma care delivery is paramount to saving lives on the battlefield. During the past decade of conflict, trauma care performance improvement at combat support hospitals and forward surgical teams in Afghanistan and Iraq has increased through Joint Trauma System and DoD Trauma Registry data collection, analysis, and rapid evidence-based adjustments to clinical practice guidelines. Although casualties have benefitted greatly from a trauma system and registry that improves hospital care, still lacking is a comprehensive and integrated system for data collection and analysis to improve performance at the prehospital level of care. Tactical Combat Casualty Care (TCCC) based casualty cards, TCCC after action reports, and unit-based prehospital trauma registries need to be implemented globally and linked to the DoD Trauma Registry in a seamless manner that will optimize prehospital trauma care delivery. PMID:23877773

  6. Radiative fermion masses in local D-brane models

    NASA Astrophysics Data System (ADS)

    Burgess, C. P.; Krippendorf, Sven; Maharana, Anshuman; Quevedo, Fernando

    2011-05-01

    In the context of D-brane model building, we present a realistic framework for generating fermion masses that are forbidden by global symmetries. We show that the string theoretical Large volume scenario circumvents the standard lore that fermion masses generated by loop effects are too small in generic gravity mediated scenarios. We argue that the fact that in toric singularity models, the up quark masses have always a zero eigenvalue, corresponding to the lightest generation, is due to the presence of approximate global symmetries that we explicitly identify in del Pezzo singularities. These symmetries are broken by global effects and therefore proportional to inverse powers of the volume. We estimate the generic size of radiative corrections to fermion masses in different phenomenological manifestations of the Large volume scenario. Concrete realizations in terms of flavor violating soft-terms are estimated and contrasted with current bounds on flavour changing neutral currents. Contributions from generic extra Higgs-like fields set bounds on their masses close to the GUT scale to produce realistic fermion masses.

  7. Field deployable EEG monitor for nerve agent casualties.

    PubMed

    McDonnall, Daniel; Hiatt, Scott; Yatsenko, Dimitri; Guillory, K Shane

    2009-01-01

    Early recognition and aggressive management of seizure activity is important in the treatment of patients with nerve agent exposure. However, these patients can experience non-convulsive seizures that are difficult to identify without EEG monitoring. In this paper, we discuss the development and testing of a low-cost, field-deployable device that records and displays patient EEG trends over time. The device is optimized for early levels of care for military and mass casualty patients until they can be relocated to medical facilities with more comprehensive monitoring. The device also records pulse oximetry and acceleration information, and patient data are available for later analysis and improvement of treatment protocols. PMID:19964118

  8. Optimization of NTP System Truss to Reduce Radiation Shield Mass

    NASA Technical Reports Server (NTRS)

    Scharber, Luke L.; Kharofa, Adam; Caffrey, Jarvis A.

    2016-01-01

    The benefits of nuclear thermal propulsion are numerous and relevant to the current NASA mission goals involving but not limited to the crewed missions to mars and the moon. They do however also present new and unique challenges to the design and logistics of launching/operating spacecraft. One of these challenges, relevant to this discussion, is the significant mass of the shielding which is required to ensure an acceptable radiation environment for the spacecraft and crew. Efforts to reduce shielding mass are difficult to accomplish from material and geometric design points of the shield itself, however by increasing the distance between the nuclear engines and the main body of the spacecraft the required mass of the shielding is lessened considerably. The mass can be reduced significantly per unit length, though any additional mass added by the structure to create this distance serves to offset those savings, thus the design of a lightweight structure is ideal. The challenges of designing the truss are bounded by several limiting factors including; the loading conditions, the capabilities of the launch vehicle, and achieving the ideal truss length when factoring for the overall mass reduced. Determining the overall set of mass values for a truss of varying length is difficult since to maintain an optimally designed truss the geometry of the truss or its members must change. Thus the relation between truss mass and length for these loading scenarios is not linear, and instead has relation determined by the truss design. In order to establish a mass versus length trend for various truss designs to compare with the mass saved from the shield versus length, optimization software was used to find optimal geometric properties that still met the design requirements at established lengths. By solving for optimal designs at various lengths, mass trends could be determined. The initial design findings show a clear benefit to extending the engines as far from the main

  9. Mass growth of the first stars under radiative feedback

    NASA Astrophysics Data System (ADS)

    Stacy, Athena; Greif, Thomas H.; Bromm, Volker

    2012-09-01

    We perform 3-D cosmological simulations to examine the growth of metal-free, Population III (Pop III) stars under radiative feedback. We trace the evolution of gas and dark matter until the formation of the first minihalo, and follow the collapse of the minihalo's gas up to densities of n = 1012cm-3. We then implement the sink particle method while modeling the effect of Lyman-Werner (LW) and ionizing radiation emitted by the initial protostar over the next 5000 yr. A disk assembles around the first protostar, and radiative feedback does not prevent further fragmentation of the disk to form multiple Pop III stars. Feedback leads to heating of the dense gas to several thousand Kelvin, and this warm region expands outward at the gas sound speed. Once this region extends to the size of the disk, the disk mass declines while the accretion rate onto the protostars is reduced by an order of magnitude. The main sink will approach an asymptotic value of 30 Msolar by the time it reaches the main sequence. Such unexpectedly low Pop III masses may have important consequences for the occurrence of pair-instability supernovae in the early Universe as well as the Pop III chemical signature in the oldest stars observable today.

  10. Analysis of driver casualty risk for different work zone types.

    PubMed

    Weng, Jinxian; Meng, Qiang

    2011-09-01

    Using driver casualty data from the Fatality Analysis Report System, this study examines driver casualty risk and investigates the risk contributing factors in the construction, maintenance and utility work zones. The multiple t-tests results show that the driver casualty risk is statistically different depending on the work zone type. Moreover, construction work zones have the largest driver casualty risk, followed by maintenance and utility work zones. Three separate logistic regression models are developed to predict driver casualty risk for the three work zone types because of their unique features. Finally, the effects of risk factors on driver casualty risk for each work zone type are examined and compared. For all three work zone types, five significant risk factors including road alignment, truck involvement, most harmful event, vehicle age and notification time are associated with increased driver casualty risk while traffic control devices and restraint use are associated with reduced driver casualty risk. However, one finding is that three risk factors (light condition, gender and day of week) exhibit opposing effects on the driver casualty risk in different types of work zones. This may largely be due to different work zone features and driver behavior in different types of work zones. PMID:21658509

  11. How to Explain the Non-Zero Mass of Electromagnetic Radiation Consisting of Zero-Mass Photons

    ERIC Educational Resources Information Center

    Gabovich, Alexander M.; Gabovich, Nadezhda A.

    2007-01-01

    The mass of electromagnetic radiation in a cavity is considered using the correct relativistic approach based on the concept of a scalar mass not dependent on the particle (system) velocity. It is shown that due to the non-additivity of mass in the special theory of relativity the ensemble of chaotically propagating mass-less photons in the cavity…

  12. Radiative and Kinetic Feedback by Low-Mass Primordial Stars

    NASA Astrophysics Data System (ADS)

    Whalen, Daniel; Hueckstaedt, Robert M.; McConkie, Thomas O.

    2010-03-01

    Ionizing UV radiation and supernova (SN) flows amidst clustered minihalos at high redshift regulated the rise of the first stellar populations in the universe. Previous studies have addressed the effects of very massive primordial stars on the collapse of nearby halos into new stars, but the absence of the odd-even nucleosynthetic signature of pair-instability SNe in ancient metal-poor stars suggests that Population III stars may have been less than 100 M sun. We extend our earlier survey of local UV feedback on star formation to 25-80 M sun stars and include kinetic feedback by SNe for 25-40 M sun stars. We find radiative feedback to be relatively uniform over this mass range, primarily because the larger fluxes of more massive stars are offset by their shorter lifetimes. Our models demonstrate that prior to the rise of global UV backgrounds, Lyman-Werner (LW) photons from nearby stars cannot prevent halos from forming new stars. These calculations also reveal that violent dynamical instabilities can erupt in the UV radiation front enveloping a primordial halo, but that they ultimately have no effect on the formation of a star. Finally, our simulations suggest that relic H II regions surrounding partially evaporated halos may expel LW backgrounds at lower redshifts, allowing stars to form that were previously suppressed. We provide fits to radiative and kinetic feedback on star formation for use in both semianalytic models and numerical simulations.

  13. Gauge U(1) dark symmetry and radiative light fermion masses

    NASA Astrophysics Data System (ADS)

    Kownacki, Corey; Ma, Ernest

    2016-09-01

    A gauge U (1) family symmetry is proposed, spanning the quarks and leptons as well as particles of the dark sector. The breaking of U (1) to Z2 divides the two sectors and generates one-loop radiative masses for the first two families of quarks and leptons, as well as all three neutrinos. We study the phenomenological implications of this new connection between family symmetry and dark matter. In particular, a scalar or pseudoscalar particle associated with this U (1) breaking may be identified with the 750 GeV diphoton resonance recently observed at the Large Hadron Collider (LHC).

  14. Radiative neutrino mass generation from WIMP dark matter

    NASA Astrophysics Data System (ADS)

    Lineros, Roberto A.

    2016-05-01

    The minimal seesaw extension of the Standard Model requires two electroweak singlet fermions in order to accommodate the neutrino oscillation parameters at tree level. Here we consider a next to minimal extension where light neutrino masses are generated radiatively by two electroweak fermions: one singlet and one triplet under SU(2). These should be odd under a parity symmetry and their mixing gives rise to a stable weakly interactive massive particle dark matter candidate. For mass in the GeV-TeV range, it reproduces the correct relic density, and provides an observable signal in nuclear recoil direct detection experiments. The fermion triplet component of the dark matter has gauge interactions, making it also detectable at present and near future collider experiments.

  15. Radiation Injury Treatment Network®: Preparedness Through a Coalition of Cancer Centers.

    PubMed

    Case, Cullen

    2016-08-01

    This article provides an overview of Radiation Injury Treatment Network® (RITN), its preparedness activities and capabilities, including training and educating over 11,500 hospital staff, coordinating over 500 exercises, developing treatment guidelines, developing standard operating procedures, and being recognized by the U.S. federal government as a national response asset. The RITN provides comprehensive evaluation and treatment for victims with marrow toxic injuries. Many of the casualties from the detonation of an improvised nuclear device (IND) (a.k.a. terrorist nuclear bomb) with only radiation injuries will be salvageable; however, they would require outpatient and/or inpatient care. Recognizing this, the U.S. National Marrow Donor Program (NMDP), U.S. Navy, and American Society for Blood and Marrow Transplantation (ASBMT) collaboratively developed RITN, which comprises medical centers with expertise in the management of bone marrow failure. The medical community will undoubtedly be taxed by the resulting medical surge from an IND despite the well-defined United States emergency medical system, the National Disaster Medical System; however, one area that is unique for radiological disasters is the care for casualties with acute radiation syndrome. Hematologists and oncologists purposefully expose their cancer patients to high doses of radiation and toxic chemicals for chemotherapy as they treat their patients, resulting in symptoms not unlike casualties with exposure to ionizing radiation from a radiological disaster. This makes the staff from cancer centers ideal for the specialized care that will be required for thousands of casualties following a mass casualty radiological incident. The RITN is a model for how a collaborative effort can fill a readiness gap-through its network of 76 hospitals, blood donor centers, and cord blood banks, the RITN is preparing to provide outpatient care and specialized supportive care to up to 63,000 radiological casualties

  16. Noninvasive detection of weapons of mass destruction using terahertz radiation

    NASA Astrophysics Data System (ADS)

    Campbell, Matthew B.; Heilweil, Edwin J.

    2003-08-01

    The growing and immediate threat of biological and chemical weapons has placed urgency on the development of chemical and biological warfare agent (CWA/BWA) screening devices. Specifically, the ability to detect CWA/BWA prior to deployment is paramount to mitigating the threat without exposing individuals to its effects. SPARTA, Inc. and NIST are currently investigating the feasibility of using far-infrared radiation, or terahertz (THz, 1 THz = 1012 Hz) radiation, to non-invasively detect biological and chemical agents, explosives and drugs/narcotics inside sealed containers. Small-to-medium sized molecules (3-100 atoms) in gas, liquid and solid phases consistently exhibit identifiable spectral features in the far-IR portion of the spectrum. Many compounds associated with weapons of mass destruction are made up of molecules of this size. The THz portion of the spectrum lies between visible light and radio waves, allowing for partial transmission of 0.3-10.0 THz (30-1000 μm, 10-330 cm-1) light through most common materials. Therefore, transmission measurements of THz light can potentially be used to non-invasively detect the presence of CWA/BWA, explosives and drugs in the pathway of a THz radiation beam.

  17. 46 CFR 197.484 - Notice of casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... GENERAL PROVISIONS Commercial Diving Operations Records § 197.484 Notice of casualty. (a) In addition to the requirements of subpart 4.05 of this chapter and 33 CFR 146.30, the person-in-charge shall notify the Officer-in-Charge, Marine Inspection, as soon as possible after a diving casualty occurs, if...

  18. The Casualty Actuarial Society: Helping Universities Train Future Actuaries

    ERIC Educational Resources Information Center

    Boa, J. Michael; Gorvett, Rick

    2014-01-01

    The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

  19. 46 CFR 197.484 - Notice of casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... GENERAL PROVISIONS Commercial Diving Operations Records § 197.484 Notice of casualty. (a) In addition to the requirements of subpart 4.05 of this chapter and 33 CFR 146.30, the person-in-charge shall notify the Officer-in-Charge, Marine Inspection, as soon as possible after a diving casualty occurs, if...

  20. 46 CFR 197.484 - Notice of casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... GENERAL PROVISIONS Commercial Diving Operations Records § 197.484 Notice of casualty. (a) In addition to the requirements of subpart 4.05 of this chapter and 33 CFR 146.30, the person-in-charge shall notify the Officer-in-Charge, Marine Inspection, as soon as possible after a diving casualty occurs, if...

  1. 46 CFR 197.484 - Notice of casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... the requirements of subpart 4.05 of this chapter and 33 CFR 146.30, the person-in-charge shall notify... casualty involves any of the following: (1) Loss of life. (2) Diving-related injury to any person causing... casualty including presumed cause. (6) Nature and extent of the injury to persons. (c) The notice...

  2. 33 CFR 146.35 - Written report of casualty.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reporting requirements of 46 CFR 4.05-12. (b) The written report required by paragraph (a) of this section...) Describes the casualty, including the date and time; (3) Describes the nature and extent of injury to...-2692 for casualties resulting in property damage, personnel injury, or loss of life. (c) If filed...

  3. 46 CFR 197.484 - Notice of casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... the requirements of subpart 4.05 of this chapter and 33 CFR 146.30, the person-in-charge shall notify... casualty involves any of the following: (1) Loss of life. (2) Diving-related injury to any person causing... casualty including presumed cause. (6) Nature and extent of the injury to persons. (c) The notice...

  4. 46 CFR 109.415 - Retention of records after casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Retention of records after casualty. 109.415 Section 109.415 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS OPERATIONS Reports, Notifications, and Records Reports and Notifications § 109.415 Retention of records after casualty. (a) The owner,...

  5. 46 CFR 109.415 - Retention of records after casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....415 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS... casualty. (a) The owner, agent, master, or person in charge of a unit for which a report of casualty is... Charge, Marine Inspection, that records need not be retained on board. (b) The records which must...

  6. 26 CFR 1.165-7 - Casualty losses.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 2 2014-04-01 2014-04-01 false Casualty losses. 1.165-7 Section 1.165-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.165-7 Casualty...

  7. 26 CFR 1.165-7 - Casualty losses.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 2 2012-04-01 2012-04-01 false Casualty losses. 1.165-7 Section 1.165-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.165-7 Casualty...

  8. 26 CFR 1.165-7 - Casualty losses.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Casualty losses. 1.165-7 Section 1.165-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.165-7 Casualty...

  9. 26 CFR 1.165-7 - Casualty losses.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 2 2011-04-01 2011-04-01 false Casualty losses. 1.165-7 Section 1.165-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.165-7 Casualty...

  10. 26 CFR 1.165-7 - Casualty losses.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 2 2013-04-01 2013-04-01 false Casualty losses. 1.165-7 Section 1.165-7 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.165-7 Casualty...

  11. Rotating, radiating mass imbedded in a de Sitter universe

    SciTech Connect

    Hadley, R.H.

    1991-01-01

    This study presents a new solution to the Einstein field equations for a rotating, radiating mass imbedded in a de Sitter universe, the Kerr de Sitter-Vaidya or KDV line element. Solutions presented were precursers to the new solution. One of these, the Vaidya-Mallett or VM metric is used as a starting point to derive the KDV metric by a method called complexification. The mathematical framework for the KDV metric is the Newman-Penrose formalism, a powerful tool that provides insight into the various properties of the space-time geometry and optical properties of the radiation field. Using this formalism, the metric can be expressed in tetrad form and the Newman-Penrose spin coefficient equations solved for tetrad components of the trace-free Ricci tensor, Ricci scalar, Maxwell tensor, and Weyl tensor. Using the tetrad components of the Weyl tensor, the Petrov type for the gravitational and electromagnetic fields are found. The new solution is shown to be a solution to the Einstein-Maxwell equations for a particular choice of energy-momentum tensor which is studied in detail.

  12. ON THE MASS RADIATED BY COALESCING BLACK HOLE BINARIES

    SciTech Connect

    Barausse, E.; Morozova, V.; Rezzolla, L.

    2012-10-10

    We derive an analytic phenomenological expression that predicts the final mass of the black hole (BH) remnant resulting from the merger of a generic binary system of BHs on quasi-circular orbits. Besides recovering the correct test-particle limit for extreme mass-ratio binaries, our formula reproduces well the results of all the numerical-relativity simulations published so far, both when applied at separations of a few gravitational radii and when applied at separations of tens of thousands of gravitational radii. These validations make our formula a useful tool in a variety of contexts ranging from gravitational-wave (GW) physics to cosmology. As representative examples, we first illustrate how it can be used to decrease the phase error of the effective-one-body waveforms during the ringdown phase. Second, we show that, when combined with the recently computed self-force correction to the binding energy of nonspinning BH binaries, it provides an estimate of the energy emitted during the merger and ringdown. Finally, we use it to calculate the energy radiated in GWs by massive BH binaries as a function of redshift, using different models for the seeds of the BH population.

  13. Operation Castle Cascade: managing multiple casualties from a simulated chemical weapons attack.

    PubMed

    Siegel, David; Younggren, Bradley N; Ness, Brian; Kvool, Valerie

    2003-05-01

    In the wake of the recent terrorist attack on the United States, there is an ever-increasing need for the defense against weapons of mass destruction. The use of explosive devices in combination with chemical agents could result in a community disaster with multiple traumatic and medical injuries. Military medical personnel may be the first called upon due to their unique training and equipment. Operation Castle Cascade was a large-scale exercise on a military instillation involving the apprehension of hostages and detonation of an explosive device containing dimethyl sulfate. We will provide details on the medical management of 50 patients with simulated chemical and traumatic injuries. Issues relating to on-site chemical identification, triage, decontamination, treatment, casualty collection, and transportation of casualties are addressed in this article. PMID:12775167

  14. Fast migration of low-mass planets in radiative discs

    NASA Astrophysics Data System (ADS)

    Pierens, A.

    2015-12-01

    Low-mass planets are known to undergo Type I migration and this process must have played a key role during the evolution of planetary systems. Analytical formulae for the disc torque have been derived assuming that the planet evolves on a fixed circular orbit. However, recent work has shown that in isothermal discs, a migrating protoplanet may also experience dynamical corotation torques that scale with the planet drift rate. The aim of this study is to examine whether dynamical corotation torques can also affect the migration of low-mass planets in non-isothermal discs. We performed 2D radiative hydrodynamical simulations to examine the orbital evolution outcome of migrating protoplanets as a function of disc mass. We find that a protoplanet can enter a fast migration regime when it migrates in the direction set by the entropy-related horseshoe drag and when the Toomre stability parameter is less than a threshold value below which the horseshoe region contracts into a tadpole-like region. In that case, an underdense trapped region appears near the planet, with an entropy excess compared to the ambient disc. If the viscosity and thermal diffusivity are small enough so that the entropy excess is conserved during migration, the planet then experiences strong corotation torques arising from the material flowing across the planet orbit. During fast migration, we observe that a protoplanet can pass through the zero-torque line predicted by static torques. We also find that fast migration may help in disrupting the mean-motion resonances that are formed by convergent migration of embryos.

  15. 33 CFR 146.35 - Written report of casualty.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... reporting requirements of 46 CFR 4.05-12. (b) The written report required by paragraph (a) of this section... casualty; (5) Gives the name, address, and phone number of persons involved in or witnessing the...

  16. 33 CFR 146.35 - Written report of casualty.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reporting requirements of 46 CFR 4.05-12. (b) The written report required by paragraph (a) of this section... casualty; (5) Gives the name, address, and phone number of persons involved in or witnessing the...

  17. 46 CFR 185.260 - Reports of potential vessel casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... (UNDER 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.260 Reports of potential... imperiled: (1) The Coast Guard district rescue coordination center (RCC) cognizant over the area in...

  18. 46 CFR 197.488 - Retention of records after casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  19. 46 CFR 197.488 - Retention of records after casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  20. 46 CFR 197.488 - Retention of records after casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  1. 46 CFR 197.488 - Retention of records after casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  2. 46 CFR 197.488 - Retention of records after casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... casualty is made under § 197.484 shall retain all records onboard that are maintained on the vessel or... until advised by the Officer-in-Charge, Marine Inspection, that records need not be retained onboard....

  3. Closing in on minimal dark matter and radiative neutrino masses

    NASA Astrophysics Data System (ADS)

    Sierra, D. Aristizabal; Simoes, C.; Wegman, D.

    2016-06-01

    We study one-loop radiative neutrino mass models in which one of the beyond-the-standard model fields is either a hypercharge-zero fermion quintet (minimal dark matter) or a hypercharge-zero scalar septet. By systematically classifying all possible one-loop such models we identify various processes that render the neutral component of these representations (dark matter) cosmologically unstable. Thus, our findings show that these scenarios are in general not reconcilable with dark matter stability unless tiny couplings or additional ad hoc symmetries are assumed, in contrast to minimal dark matter models where stability is entirely due to the standard model gauge symmetry. For some variants based on higher-order loops we find that α2 reaches a Landau pole at rather low scales, a couple orders of magnitude from the characteristic scale of the model itself. Thus, we argue that some of these variations although consistent with dark matter stability and phenomenological constraints are hard to reconcile with perturbativity criteria.

  4. Radiation disasters: role of the BMT team.

    PubMed

    Confer, Dennis L; Weisdorf, Daniel; Weinstock, David; Case, Cullen; Chao, Nelson

    2012-01-01

    Bone marrow transplant (BMT) teams do not generally consider themselves to be emergency responders. But the bone marrow is the most radiosensitive organ in the body, and early changes in peripheral blood counts remain the best indicator of major total-body radiation exposures. Following a mass casualty incident, such as that occasioned by a nuclear detonation, BMT teams should expect that they will be called upon for their expertise in managing severe myelosuppression. Numerous resources, including the Radiation Injury Treatment Network, are available to assist BMT teams in planning for such a role. PMID:22226106

  5. Impact of radiation hardness and operating temperatures of silicon carbide electronics on space power system mass

    NASA Astrophysics Data System (ADS)

    Juhasz, Albert J.; Tew, Roy C.; Schwarze, Gene E.

    1999-01-01

    The effect of silicon carbide (SiC) electronics operating temperatures on Power Management and Distribution (PMAD), or Power Conditioning (PC), subsystem radiator size and mass requirements was evaluated for three power output levels (100 kWe, 1 MWe, and 10 MWe) for near term technology (i.e. 1500 K turbine inlet temperature) Closed Cycle Gas Turbine (CCGT) power systems with a High Temperature Gas Reactor (HTGR) heat source. The study was conducted for assumed PC radiator temperatures ranging from 370 to 845 K and for three scenarios of electrical energy to heat conversion levels which needed to be rejected to space by means of the PC radiator. In addition, during part of the study the radiation hardness of the PC electronics was varied at a fixed separation distance to estimate its effect on the mass of the instrument rated reactor shadow shield. With both the PC radiator and the conical shadow shield representing major components of the overall power system the influence of the above on total power system mass was also determined. As expected, results show that the greatest actual mass savings achieved by the use of SiC electronics occur with high capacity power systems. Moreover, raising the PC radiator temperature above 600 K yields only small additional system mass savings. The effect of increased radiation hardness on total system mass is to reduce system mass by virtue of lowering the shield mass.

  6. Impact of Radiation Hardness and Operating Temperatures of Silicon Carbide Electronics on Space Power System Mass

    NASA Technical Reports Server (NTRS)

    Juhasz, Albert J.; Tew, Roy C.; Schwarze, Gene E.

    1998-01-01

    The effect of silicon carbide (SiC) electronics operating temperatures on Power Management and Distribution (PMAD), or Power Conditioning (PC), subsystem radiator size and mass requirements was evaluated for three power output levels (100 kW(e) , 1 MW(e), and 10 MW(e)) for near term technology ( i.e. 1500 K turbine inlet temperature) Closed Cycle Gas Turbine (CCGT) power systems with a High Temperature Gas Reactor (HTGR) heat source. The study was conducted for assumed PC radiator temperatures ranging from 370 to 845 K and for three scenarios of electrical energy to heat conversion levels which needed to be rejected to space by means of the PC radiator. In addition, during part of the study the radiation hardness of the PC electronics was varied at a fixed separation distance to estimate its effect on the mass of the instrument rated reactor shadow shield. With both the PC radiator and the conical shadow shield representing major components of the overall power system the influence of the above on total power system mass was also determined. As expected, results show that the greatest actual mass savings achieved by the use of SiC electronics occur with high capacity power systems. Moreover, raising the PC radiator temperature above 600 K yields only small additional system mass savings. The effect of increased radiation hardness on total system mass is to reduce system mass by virtue of lowering the shield mass.

  7. 'Wellbeing': a collateral casualty of modernity?

    PubMed

    Carlisle, Sandra; Henderson, Gregor; Hanlon, Phil W

    2009-11-01

    In the now vast empirical and theoretical literature on wellbeing knowledge of the subject is provided mainly by psychology and economics, where understanding of the concept are framed in very different ways. We briefly rehearse these, before turning to some important critical points which can be made about this burgeoning research industry, including the tight connections between the meanings of the concept with the moral value systems of particular 'modern' societies. We then argue that both the 'science' of wellbeing and its critique are, despite their diversity, re-connected by and subsumed within the emerging environmental critique of modern consumer society. This places concerns for individual and social wellbeing within the broader context of global human problems and planetary wellbeing. A growing number of thinkers now suggest that Western society and culture are dominated by materialistic and individualistic values, made manifest at the political and social levels through the unending pursuit of economic growth, and at the individual level by the seemingly endless quest for consumer goods, regardless of global implications such as broader environmental harms. The escalating growth of such values is associated with a growing sense of individual alienation, social fragmentation and civic disengagement and with the decline of more spiritual, moral and ethical aspects of life. Taken together, these multiple discourses suggest that wellbeing can be understood as a collateral casualty of the economic, social and cultural changes associated with late modernity. However, increasing concerns for the environment have the potential to counter some of these trends, and in so doing could also contribute to our wellbeing as individuals and as social beings in a finite world. PMID:19765875

  8. Data quality for situational awareness during mass-casualty events.

    PubMed

    Demchak, Barry; Griswold, William G; Lenert, Leslie A

    2007-01-01

    Incident Command systems often achieve situational awareness through manual paper-tracking systems. Such systems often produce high latencies and in-complete data, resulting in inefficient and ineffective resource deployment. WIISARD (Wireless Internet Information System for Medical Response in Disasters) collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to incident commanders. Yet, the introduction of IT into a disaster setting is not problem-free. Notably, system component failures can delay the delivery of data. The type and extent of a failure can have varying effects on the usefulness of information displays. We describe a small, coherent set of customizble information overlays to address this problem, and we discuss reactions to these displays by medical commanders. PMID:18693821

  9. Investigation of Advanced Resonant-Mass Gravitational Radiation Detectors

    NASA Astrophysics Data System (ADS)

    Zhou, Zhiqing

    1994-01-01

    The sensitivity of resonant-mass gravitational radiation detectors depends on both the antenna cross-section and the detector noise. The cross-section is determined by the sound velocity VS and density rho of the antenna material, as well as the antenna geometry. The principal detector noise sources are thermal Nyquist noise and noise due to the readout electromechanical amplifier. The cross-section is proportional to rho V_sp{S}{5} for a given frequency and antenna geometry while the thermal noise is inversely proportional to the antenna's mechanical quality factor Q for a given temperature. Materials with high VS could, in principle, provide about a hundred-fold increase in the antenna cross -section as compared to current generation detectors. In this dissertation we report the results of measurements of the temperature-dependent mechanical losses in several suitable high sound velocity materials. The results show that the signal-to-noise ratios of detectors made of these materials could be improved by a factor of 15 to 100 at 4 K as compared to current detectors with aluminum antennas. A spherical gravitational wave antenna is very promising for gravitational wave astronomy because of its large cross-section, isotropic sky coverage, and the capability it can provide for determining the wave direction. In this dissertation several aspects of spherical detectors, including the eigenfunctions and eigenfrequencies of the normal-modes of an elastic sphere, the energy cross-section, and the response functions that are used to obtain the noise-free solution to the inverse problem are discussed. Using the maximum likelihood estimation method the inverse problem in the presence of noise is solved. We also determine the false-alarm probability and the detection probability for a network of spherical detectors and estimate the detectable event rates for supernovae core collapses and binary coalescences. Six identical cylindrical detectors, with a suitable arrangement of

  10. Traffic accidents involving fatigue driving and their extent of casualties.

    PubMed

    Zhang, Guangnan; Yau, Kelvin K W; Zhang, Xun; Li, Yanyan

    2016-02-01

    The rapid progress of motorization has increased the number of traffic-related casualties. Although fatigue driving is a major cause of traffic accidents, the public remains not rather aware of its potential harmfulness. Fatigue driving has been termed as a "silent killer." Thus, a thorough study of traffic accidents and the risk factors associated with fatigue-related casualties is of utmost importance. In this study, we analyze traffic accident data for the period 2006-2010 in Guangdong Province, China. The study data were extracted from the traffic accident database of China's Public Security Department. A logistic regression model is used to assess the effect of driver characteristics, type of vehicles, road conditions, and environmental factors on fatigue-related traffic accident occurrence and severity. On the one hand, male drivers, trucks, driving during midnight to dawn, and morning rush hours are identified as risk factors of fatigue-related crashes but do not necessarily result in severe casualties. Driving at night without street-lights contributes to fatigue-related crashes and severe casualties. On the other hand, while factors such as less experienced drivers, unsafe vehicle status, slippery roads, driving at night with street-lights, and weekends do not have significant effect on fatigue-related crashes, yet accidents associated with these factors are likely to have severe casualties. The empirical results of the present study have important policy implications on the reduction of fatigue-related crashes as well as their severity. PMID:26625173

  11. Implications for modeling casualty sustainment during peacekeeping operations.

    PubMed

    Blood, Christopher G; Zhang, Jinjin; Walker, G Jay

    2002-10-01

    Projections of the casualties expected during peacekeeping operations allow medical planners to assess in advance the medical resources needed to support such operations. Data detailing fatalities incurred in previous peacekeeping operations were extracted from several U.N. sources. From these data, rates of killed-in-action were computed for the deployed forces. One hundred eighty-eight peacekeeping incidents in which casualties were sustained were also examined to derive wounded-in-action rates. The estimated mean wounded-in-action rate for these operations was 3.16 per 1,000 strength per year; the estimated wounded-in-action rate for individual operations ranged from 0.49 to 12.50. There were an average of 3.8 wounded and 0.86 killed in the 188 casualty incidents examined. Thirty-eight percent of the wounds were described as serious. The casualty incidence derived in this study can provide a basis for estimating the casualties likely in future peacekeeping operations. PMID:12392258

  12. [Model and enlightenment from rescue of August 2nd Kunshan explosion casualty].

    PubMed

    Tan, Q; Qiu, H B; Sun, B W; Shen, Y M; Nie, L J; Zhang, H W

    2016-01-01

    On August 2nd, 2014, a massive dust explosion occurred in a factory of Kunshan, resulting in a mass casualty involving 185 burn patients. They were transported to 20 medical institutions in Jiangsu province and Shanghai. More than one thousand of medical personnel of our country participated in this emergency rescue, and satisfactory results were achieved. In this paper, the characteristics of this accident were analyzed, the positive effects of interdisciplinary cooperation were affirmed, and the contingency plan, rescue process and pattern, and reserve, organization and management of talents during this rescue process were reviewed retrospectively. PMID:27426066

  13. Effect of radiator position and mass flux on the dryer room heat transfer rate

    NASA Astrophysics Data System (ADS)

    Mirmanto, M.; Sulistyowati, E. D.; Okariawan, I. D. K.

    A room radiator as usually used in cold countries, is actually able to be used as a heat source to dry goods, especially in the rainy season where the sun seldom shines due to much rain and cloud. Experiments to investigate effects of radiator position and mass flux on heat transfer rate were performed. This study is to determine the best position of the radiator and the optimum mass flux. The radiator used was a finned radiator made of copper pipes and aluminum fins with an overall dimension of 220 mm × 50 mm × 310 mm. The prototype room was constructed using plywood and wood frame with an overall size of 1000 mm × 1000 mm × 1000 mm. The working fluid was heated water flowing inside the radiator and air circulating naturally inside the prototype room. The nominal mass fluxes employed were 800, 900 and 1000 kg/m2 s. The water was kept at 80 °C at the radiator entrance, while the initial air temperature inside the prototype room was 30 °C. Three positions of the radiator were examined. The results show that the effect of the mass flux on the forced and free convection heat transfer rate is insignificant but the radiator position strongly affects the heat transfer rate for both forced and free convection.

  14. The Role of Mass Spectrometry-Based Metabolomics in Medical Countermeasures Against Radiation

    PubMed Central

    Patterson, Andrew D.; Lanz, Christian; Gonzalez, Frank J.; Idle, Jeffrey R.

    2013-01-01

    Radiation metabolomics can be defined as the global profiling of biological fluids to uncover latent, endogenous small molecules whose concentrations change in a dose-response manner following exposure to ionizing radiation. In response to the potential threat of nuclear or radiological terrorism, the Center for High-Throughput Minimally Invasive Radiation Biodosimetry (CMCR) was established to develop field-deployable biodosimeters based, in principle, on rapid analysis by mass spectrometry of readily and easily obtainable biofluids. In this review, we briefly summarize radiation biology and key events related to actual and potential nuclear disasters, discuss the important contributions the field of mass spectrometry has made to the field of radiation metabolomics, and summarize current discovery efforts to use mass spectrometry-based metabolomics to identify dose-responsive urinary constituents, and ultimately to build and deploy a noninvasive high-throughput biodosimeter. PMID:19890938

  15. Radiative Corrections to the Neutron Star Mass Inferred from QPO Frequencies

    NASA Astrophysics Data System (ADS)

    Abramowicz, M. A.; Kluźniak, W.; Yu, W.

    2011-12-01

    The frequencies of kHz QPOs are widely interpreted as being indicative of the values of characteristic frequencies related to orbital motion around neutron stars, e.g., the radial epicyclic frequency. In regions directly exposed to the radiation from the luminous neutron star these frequencies change with the luminosity. Including radiative corrections will change the neutron star mass value inferred from the QPO frequencies. Radiative forces may also be behind the puzzling phenomenon of parallel tracks.

  16. 46 CFR 4.05-10 - Written report of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Written report of marine casualty. 4.05-10 Section 4.05-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-10 Written report of...

  17. 46 CFR 4.05-5 - Substance of marine casualty notice.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Substance of marine casualty notice. 4.05-5 Section 4.05-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-5 Substance of...

  18. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  19. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  20. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-25...

  1. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  2. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine Casualty Investigations § 4.40-25...

  3. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  4. 33 CFR 174.107 - Contents of casualty or accident report form.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Contents of casualty or accident... System Requirements § 174.107 Contents of casualty or accident report form. Each form for reporting a vessel casualty or accident must contain the information required in § 173.57 of this chapter....

  5. 46 CFR 4.05-10 - Written report of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Written report of marine casualty. 4.05-10 Section 4.05-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-10 Written report of...

  6. 46 CFR 4.05-5 - Substance of marine casualty notice.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Substance of marine casualty notice. 4.05-5 Section 4.05-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-5 Substance of...

  7. 46 CFR 4.05-10 - Written report of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Written report of marine casualty. 4.05-10 Section 4.05-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-10 Written report of...

  8. 46 CFR 4.05-10 - Written report of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Written report of marine casualty. 4.05-10 Section 4.05-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-10 Written report of...

  9. 46 CFR 4.05-5 - Substance of marine casualty notice.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Substance of marine casualty notice. 4.05-5 Section 4.05-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-5 Substance of...

  10. 46 CFR 4.05-5 - Substance of marine casualty notice.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Substance of marine casualty notice. 4.05-5 Section 4.05-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-5 Substance of...

  11. 46 CFR 4.05-5 - Substance of marine casualty notice.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Substance of marine casualty notice. 4.05-5 Section 4.05-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-5 Substance of...

  12. 46 CFR 4.05-10 - Written report of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Written report of marine casualty. 4.05-10 Section 4.05-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-10 Written report of...

  13. 46 CFR 185.220 - Records of a voyage resulting in a marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Records of a voyage resulting in a marine casualty. 185.220 Section 185.220 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.220 Records of a voyage resulting in a marine casualty....

  14. 46 CFR 185.220 - Records of a voyage resulting in a marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Records of a voyage resulting in a marine casualty. 185.220 Section 185.220 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.220 Records of a voyage resulting in a marine casualty....

  15. 46 CFR 196.07-1 - Notice and reporting of casualty and voyage records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... RESEARCH VESSELS OPERATIONS Notice and Reporting of Casualty and Voyage Records § 196.07-1 Notice and reporting of casualty and voyage records. The requirements for providing notice and reporting of marine... 46 Shipping 7 2010-10-01 2010-10-01 false Notice and reporting of casualty and voyage records....

  16. 33 CFR 174.107 - Contents of casualty or accident report form.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Contents of casualty or accident... System Requirements § 174.107 Contents of casualty or accident report form. Each form for reporting a vessel casualty or accident must contain the information required in § 173.57 of this chapter....

  17. Predictive model for radiatively induced neutrino masses and mixings with dark matter.

    PubMed

    Gustafsson, Michael; No, Jose M; Rivera, Maximiliano A

    2013-05-24

    A minimal extension of the standard model to naturally generate small neutrino masses and provide a dark matter candidate is proposed. The dark matter particle is part of a new scalar doublet field that plays a crucial role in radiatively generating neutrino masses. The symmetry that stabilizes the dark matter also suppresses neutrino masses to appear first at three-loop level. Without the need of right-handed neutrinos or other very heavy new fields, this offers an attractive explanation of the hierarchy between the electroweak and neutrino mass scales. The model has distinct verifiable predictions for the neutrino masses, flavor mixing angles, colliders, and dark matter signals. PMID:23745861

  18. 46 CFR 197.486 - Written report of casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... STANDARDS GENERAL PROVISIONS Commercial Diving Operations Records § 197.486 Written report of casualty. The... occurs, as follows: (a) On Form CG-2692, when the diving installation is on a vessel. (b) Using a written report, in narrative form, when the diving installation is on a facility. The written report must...

  19. 46 CFR 197.486 - Written report of casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... STANDARDS GENERAL PROVISIONS Commercial Diving Operations Records § 197.486 Written report of casualty. The... occurs, as follows: (a) On Form CG-2692, when the diving installation is on a vessel. (b) Using a written report, in narrative form, when the diving installation is on a facility. The written report must...

  20. 46 CFR 197.486 - Written report of casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... STANDARDS GENERAL PROVISIONS Commercial Diving Operations Records § 197.486 Written report of casualty. The... occurs, as follows: (a) On Form CG-2692, when the diving installation is on a vessel. (b) Using a written report, in narrative form, when the diving installation is on a facility. The written report must...

  1. 46 CFR 197.486 - Written report of casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STANDARDS GENERAL PROVISIONS Commercial Diving Operations Records § 197.486 Written report of casualty. The... occurs, as follows: (a) On Form CG-2692, when the diving installation is on a vessel. (b) Using a written report, in narrative form, when the diving installation is on a facility. The written report must...

  2. 46 CFR 197.486 - Written report of casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STANDARDS GENERAL PROVISIONS Commercial Diving Operations Records § 197.486 Written report of casualty. The... occurs, as follows: (a) On Form CG-2692, when the diving installation is on a vessel. (b) Using a written report, in narrative form, when the diving installation is on a facility. The written report must...

  3. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 122... 46 Shipping 4 2014-10-01 2014-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS...

  4. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Notice given as required by 33 CFR 160.215 satisfies the requirement of this section if the marine casualty involves a hazardous condition as defined by 33 CFR 160.204. (c) Except as otherwise required... by paragraph (a)(8) of this section, a report made pursuant to 33 CFR 153.203, 40 CFR 117.21, or...

  5. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 122... 46 Shipping 4 2011-10-01 2011-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS...

  6. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Notice given as required by 33 CFR 160.215 satisfies the requirement of this section if the marine casualty involves a hazardous condition as defined by 33 CFR 160.203. (c) Except as otherwise required... by paragraph (a)(8) of this section, a report made pursuant to 33 CFR 153.203, 40 CFR 117.21, or...

  7. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 122... 46 Shipping 4 2013-10-01 2013-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS...

  8. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Administration (OSHA) in 29 Code of Federal Regulations (CFR) part 1904. (c) Notice given as required by § 122... 46 Shipping 4 2010-10-01 2010-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS...

  9. Battlefield Documentation of Tactical Combat Casualty Care in Afghanistan.

    PubMed

    Robinson, John B; Smith, Michael P; Gross, Kirby R; Sauer, Samual W; Geracci, James J; Day, Charlie D; Kotwal, Russ S

    2016-01-01

    Performance improvement is reliant on information and data, as you cannot improve what you do not measure. The US military went to war in 2001 without an integrated trauma care system to collect and analyze combat casualty care data. By 2006, the conflict in Afghanistan began appreciating the capture and consolidation of hospital care documentation into the Department of Defense Trauma Registry. In contrast, a paucity of documentation has existed for prehospital or tactical combat casualty care (TCCC). Using the 75th Ranger casualty documentation model established in 2005, the Joint Trauma System developed a casualty data collection system for prehospital care using the TCCC Card, the TCCC After Action Report (AAR), and the Prehospital Trauma Registry. In 2013, this system was mandated for use by US forces in Afghanistan. The Joint Trauma System also created and deployed a prehospital team to be an integral part of the Joint Theater Trauma System in Afghanistan. This prehospital team provided prehospital training and facilitated prehospital data capture. Described and analyzed in this report are prehospital data captured in Afghanistan from 2013 to 2014 using the TCCC Card and the TCCC AAR. PMID:27215873

  10. Primary Casualty Reception Ship: the hospital within--Operation Granby.

    PubMed

    Dewar, E P

    1992-01-01

    As the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RFA Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO). In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed. Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services. The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA. One hundred and five patients were treated of which 78 were returned to duty. Argu as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US. PMID:1460595

  11. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Notice given as required by 33 CFR 160.215 satisfies the requirement of this section if the marine casualty involves a hazardous condition as defined by 33 CFR 160.204. (c) Except as otherwise required... by paragraph (a)(8) of this section, a report made pursuant to 33 CFR 153.203, 40 CFR 117.21, or...

  12. 46 CFR 169.807 - Notice of casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... to mariners, radiograms sent and received, the radio log, and crew, sailing school...

  13. 46 CFR 169.807 - Notice of casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... to mariners, radiograms sent and received, the radio log, and crew, sailing school...

  14. 46 CFR 169.807 - Notice of casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... to mariners, radiograms sent and received, the radio log, and crew, sailing school...

  15. 46 CFR 169.807 - Notice of casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... to mariners, radiograms sent and received, the radio log, and crew, sailing school...

  16. 46 CFR 169.807 - Notice of casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Notice of casualty. 169.807 Section 169.807 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS... to mariners, radiograms sent and received, the radio log, and crew, sailing school...

  17. Testing radiative neutrino mass models at the LHC

    NASA Astrophysics Data System (ADS)

    Cai, Yi; Clarke, Jackson D.; Schmidt, Michael A.; Volkas, Raymond R.

    2015-02-01

    The Large Hadron Collider provides us new opportunities to search for the origin of neutrino mass. Beyond the minimal see-saw models a plethora of models exist which realise neutrino mass at tree- or loop-level, and it is important to be sure that these possibilities are satisfactorily covered by searches. The purpose of this paper is to advance a systematic approach to this problem. Majorana neutrino mass models can be organised by SM-gauge-invariant operators which violate lepton number by two units. In this paper we write down the minimal ultraviolet completions for all of the mass-dimension 7 operators. We predict vector-like quarks, vector-like leptons, scalar leptoquarks, a charged scalar, a scalar doublet, and a scalar quadruplet, whose properties are constrained by neutrino oscillation data. A detailed collider study is presented for and completions with a vector-like quark and a leptoquark . The existing LHC limits extracted from searches for vector-like fermions and sbottoms/stops are m χ ≳ 620 GeV and m ϕ ≳ 600 GeV.

  18. Effects of anisotropic conduction and heat pipe interaction on minimum mass space radiators

    NASA Technical Reports Server (NTRS)

    Baker, Karl W.; Lund, Kurt O.

    1991-01-01

    Equations are formulated for the two dimensional, anisotropic conduction of heat in space radiator fins. The transverse temperature field was obtained by the integral method, and the axial field by numerical integration. A shape factor, defined for the axial boundary condition, simplifies the analysis and renders the results applicable to general heat pipe/conduction fin interface designs. The thermal results are summarized in terms of the fin efficiency, a radiation/axial conductance number, and a transverse conductance surface Biot number. These relations, together with those for mass distribution between fins and heat pipes, were used in predicting the minimum radiator mass for fixed thermal properties and fin efficiency. This mass is found to decrease monotonically with increasing fin conductivity. Sensitivities of the minimum mass designs to the problem parameters are determined.

  19. Mass model of the LDEF satellite spacecraft and experiments for ionizing radiation analyses.

    PubMed

    Colborn, B L; Armstrong, T W

    1996-11-01

    A three-dimensional (3D) mass model of the LDEF spacecraft and selected experiments has been developed to allow the influence of material shielding on ionizing radiation measurements and analyses to be determined accurately. This computer model has been applied in a stand-alone mode to provide 3D shielding distributions around radiation dosimeters to aid data interpretation, and has been interfaced with radiation transport codes for a variety of different types of radiation predictions. This paper summarizes the methodology used, the level of detail incorporated, and some example model applications. PMID:11540514

  20. Verifiable associated processes from radiative lepton masses with dark matter

    NASA Astrophysics Data System (ADS)

    Fraser, Sean; Ma, Ernest; Zakeri, Mohammadreza

    2016-06-01

    If leptons do not couple directly to the one Higgs doublet of the standard model of particle interactions, they must still do so somehow indirectly to acquire mass, as proposed recently in several models where it happens in one loop through dark matter. We analyze the important consequences of this scenario in a specific model, including Higgs decay, muon anomalous magnetic moment, μ →e γ , μ →e e e , and the proposed dark sector.

  1. Coupled Fluids-Radiation Analysis of a High-Mass Mars Entry Vehicle

    NASA Technical Reports Server (NTRS)

    Palmer, Grant; Allen, Gary; Tang, Chun; Brown, Jim

    2011-01-01

    The NEQAIR line-by-line radiation code has been incorporated into the DPLR Navier-Stokes flow solver such that the NEQAIR subroutines are now callable functions of DPLR. The coupled DPLR-NEQAIR code was applied to compute the convective and radiative heating rates over high-mass Mars entry vehicles. Two vehicle geometries were considered - a 15 m diameter 70-degree sphere cone configuration and a slender, mid-L/D vehicle with a diameter of 5 m called an Ellipsled. The entry masses ranged from 100 to 165 metric tons. Solutions were generated for entry velocities ranging from 6.5 to 9.1 km/s. The coupled fluids-radiation solutions were performed at the peak heating location along trajectories generated by the Traj trajectory analysis code. The impact of fluids-radiation coupling is a function of the level of radiative heating and the freestream density and velocity. For the high-mass Mars vehicles examined in this study, coupling effects were greatest for entry velocities above 8.5 km/s where the surface radiative heating was reduced by up 17%. Generally speaking, the Ellipsled geometry experiences a lower peak radiative heating rate but a higher peak turbulent convective heating rate than the MSL-based vehicle.

  2. A NEW MECHANISM FOR MASS ACCRETION UNDER RADIATION PRESSURE IN MASSIVE STAR FORMATION

    SciTech Connect

    Tanaka, Kei E. I.; Nakamoto, Taishi

    2010-05-01

    During the formation of a massive star, strong radiation pressure from the central star acts on the dust sublimation front and tends to halt the accretion flow. To overcome this strong radiation pressure, it has been considered that a strong ram pressure produced by a high-mass accretion rate of 10{sup -3} M{sub sun} yr{sup -1} or more is needed. We reinvestigated the necessary condition to overcome the radiation pressure and found a new mechanism for overcoming it. Accumulated mass in a stagnant flow near the dust sublimation front helps the mass accretion by its weight. This mechanism relaxes the condition for the massive star formation. We call this mechanism the 'OMOSHI effect', where OMOSHI is an acronym for 'One Mechanism for Overcoming Stellar High radiation pressure by weIght'. Additionally, in Japanese, OMOSHI is a noun meaning a weight that is put on something to prevent it from moving. We investigate the generation of the OMOSHI effect using local one-dimensional radiation hydrodynamics simulations. The radiation pressure and the gravitational force are connected through the gas pressure, and to sum up, the radiation pressure is balanced or overcome by the gravitational force. We also discuss the global structure and temporal variation of the accretion flow.

  3. A New Mechanism for Mass Accretion Under Radiation Pressure in Massive Star Formation

    NASA Astrophysics Data System (ADS)

    Tanaka, Kei E. I.; Nakamoto, Taishi

    2010-05-01

    During the formation of a massive star, strong radiation pressure from the central star acts on the dust sublimation front and tends to halt the accretion flow. To overcome this strong radiation pressure, it has been considered that a strong ram pressure produced by a high-mass accretion rate of 10-3 M sun yr-1 or more is needed. We reinvestigated the necessary condition to overcome the radiation pressure and found a new mechanism for overcoming it. Accumulated mass in a stagnant flow near the dust sublimation front helps the mass accretion by its weight. This mechanism relaxes the condition for the massive star formation. We call this mechanism the "OMOSHI effect," where OMOSHI is an acronym for "One Mechanism for Overcoming Stellar High radiation pressure by weIght." Additionally, in Japanese, OMOSHI is a noun meaning a weight that is put on something to prevent it from moving. We investigate the generation of the OMOSHI effect using local one-dimensional radiation hydrodynamics simulations. The radiation pressure and the gravitational force are connected through the gas pressure, and to sum up, the radiation pressure is balanced or overcome by the gravitational force. We also discuss the global structure and temporal variation of the accretion flow.

  4. Pre-Hawking radiation may allow for reconstruction of the mass distribution of the collapsing object

    NASA Astrophysics Data System (ADS)

    Dai, De-Chang; Stojkovic, Dejan

    2016-07-01

    Hawking radiation explicitly depends only on the black hole's total mass, charge and angular momentum. It is therefore generally believed that one cannot reconstruct the information about the initial mass distribution of an object that made the black hole. However, instead of looking at radiation from a static black hole, we can study the whole time-dependent process of the gravitational collapse, and pre-Hawking radiation which is excited because of the time-dependent metric. We compare radiation emitted by a single collapsing shell with that emitted by two concentric shells of the equivalent total mass. We calculate the gravitational trajectory and the momentum energy tensor. We show that the flux of energy emitted during the collapse by a single shell is significantly different from the flux emitted by two concentric shells of the equivalent total mass. When the static black hole is formed, the fluxes become indistinguishable. This implies that an observer studying the flux of particles from a collapsing object could in principle reconstruct information not only about the total mass of the collapsing object, but also about the mass distribution.

  5. Radiative PQ breaking and the Higgs boson mass

    NASA Astrophysics Data System (ADS)

    D'Eramo, Francesco; Hall, Lawrence J.; Pappadopulo, Duccio

    2015-06-01

    The small and negative value of the Standard Model Higgs quartic coupling at high scales can be understood in terms of anthropic selection on a landscape where large and negative values are favored: most universes have a very short-lived electroweak vacuum and typical observers are in universes close to the corresponding metastability boundary. We provide a simple example of such a landscape with a Peccei-Quinn symmetry breaking scale generated through dimensional transmutation and supersymmetry softly broken at an intermediate scale. Large and negative contributions to the Higgs quartic are typically generated on integrating out the saxion field. Cancellations among these contributions are forced by the anthropic requirement of a sufficiently long-lived electroweak vacuum, determining the multiverse distribution for the Higgs quartic in a similar way to that of the cosmological constant. This leads to a statistical prediction of the Higgs boson mass that, for a wide range of parameters, yields the observed value within the 1σ statistical uncertainty of ˜ 5 GeV originating from the multiverse distribution. The strong CP problem is solved and single-component axion dark matter is predicted, with an abundance that can be understood from environmental selection. A more general setting for the Higgs mass prediction is discussed.

  6. Management of Crush Syndrome Casualties after Disasters

    PubMed Central

    Sever, Mehmet Sukru; Vanholder, Raymond

    2011-01-01

    After direct impact of the trauma, crush syndrome is the second most frequent cause of death after mass disasters. However, since crush syndrome is quite rare in daily practice, mistakes are frequent in the treatment of these cases. This paper summarizes the etiopathogenesis of traumatic rhabdomyolysis and of crush syndrome-based acute kidney injury. The clinical and laboratory features, prophylaxis, and treatment of crush cases are described as well. The importance of early and energetic fluid resuscitation is underlined for prophylaxis of acute kidney injury. Since there is chaos, and an overwhelming number of victims, logistic drawbacks create a specific problem in the treatment of crush victims after mass disasters. Potential solutions for logistic hurdles and disaster preparedness scenarios have also been provided in this review article. PMID:23908797

  7. Integration of Tactical Emergency Casualty Care Into the National Tactical Emergency Medical Support Competency Domains.

    PubMed

    Pennardt, Andre; Kamin, Rich; Llewellyn, Craig; Shapiro, Geoff; Carmona, Philip A; Schwartz, Richard B

    2016-01-01

    Tactical emergency medical support (TEMS) is a critical component of the out-of-hospital response to domestic high-threat incidents such as hostage scenarios, warrant service, active shooter or violent incidents, terrorist attacks, and other intentional mass casualty-producing acts. From its grass-roots inception in the form of medical support of select law enforcement special weapons and tactics (SWAT) units in the 1980s, the TEMS subspecialty of prehospital care has rapidly grown and evolved over the past 40 years. The National TEMS Initiative and Council (NTIC) competencies and training objectives are the only published recommendations of their kind and offer the opportunity for national standardization of TEMS training programs and a future accreditation process. Building on the previous work of the NTIC and the creation of acknowledged competency domains for TEMS and the acknowledged civilian translation of TCCC by the Committee for Tactical Emergency Casualty Care (C-TECC), the Joint Review Committee (JRC) has created an opportunity to bring forward the work in a form that could be operationally useful in an all-hazards and whole of community format. PMID:27450605

  8. OMOSHI Effect: A New Mechanism for Mass Accretion under the Radiation Pressure in Massive Star Formation

    NASA Astrophysics Data System (ADS)

    Tanaka, Kei; Nakamoto, Taishi

    2009-08-01

    In a massive-star formation process, a high-mass accretion rate is considered to be needed to overcome the strong radiation pressure at the dust sublimation front. We examined the accretion structure near the dust sublimation front and found a new mechanism to overcome this radiation pressure. The weight of the accumulated mass in a stagnant flow near the dust sublimation front helps with the mass accretion. We call this mechanism the ``OMOSHI effect,'' where OMOSHI is an acronym for ``One Mechanism for Overcoming Stellar High radiation pressure by weight.'' OMOSHI is also a Japanese noun meaning a weight that is put on something to prevent it from moving. This mechanism relaxes the condition for the massive star formation.

  9. Radiative Feedback from Primordial Protostars and Final Mass of the First Stars

    NASA Technical Reports Server (NTRS)

    Hosokawa, Takashi; Omukai, Kazuyuki; Yoshida, Naoki; Yorke, Harold W.

    2012-01-01

    In this contribution, we review our efforts toward understanding the typical mass-scale of primordial stars. Our direct numerical simulations show that, in both of Population III.1 and III.2 cases, strong UV stellar radiative feedback terminatesmass accretion onto a protostar.AnHII region formed around the protostar very dynamically expands throughout the gas accreting envelope, which cuts off the gas supply to a circumstellar disk. The disk is exposed to the stellar UV radiation and loses its mass by photoevaporation. The derived final masses are 43 Stellar Mass and 17 Stellar Mass in our fiducial Population III.1 and III.2 cases. Much more massive stars should form in other exceptional conditions. In atomic-cooling halos where H2 molecules are dissociated, for instance, a protostar grows via very rapid mass accretion with the rates M* approx. 0.1 - 1 Stellar Mass/yr. Our newstellar evolution calculations show that the protostar significantly inflates and never contracts to reach the ZAMS stage in this case. Such the "supergiant protostars" have very low UV luminosity, which results in weak radiative feedback against the accretion flow. In the early universe, supermassive stars formed through this process might provide massive seeds of supermassive black holes.

  10. Leptogenesis, radiative neutrino masses and inert Higgs triplet dark matter

    NASA Astrophysics Data System (ADS)

    Lu, Wen-Bin; Gu, Pei-Hong

    2016-05-01

    We extend the standard model by three types of inert fields including Majorana fermion singlets/triplets, real Higgs singlets/triplets and leptonic Higgs doublets. In the presence of a softly broken lepton number and an exactly conserved Z2 discrete symmetry, these inert fields together can mediate a one-loop diagram for a Majorana neutrino mass generation. The heavier inert fields can decay to realize a successful leptogenesis while the lightest inert field can provide a stable dark matter candidate. As an example, we demonstrate the leptogenesis by the inert Higgs doublet decays. We also perform a systematic study on the inert Higgs triplet dark matter scenario where the interference between the gauge and Higgs portal interactions can significantly affect the dark matter properties.