[Fibrinolysis and acute stroke in maritime search and rescue medical evacuation].

PubMed

Lambert, R; Cabardis, S; Valance, J; Borge, E; Ducassé, J-L; Arzalier, J-J

2008-03-01

Medical management of a female passenger with acute stroke aboard a cruise ship at the sea allowed a fast evacuation towards a stroke unit by an helicopter staffed with an emergency medical doctor. Fibrinolysis begun in a short delay after magnetic resonance imaging.

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Helicopter hospital emergency medical....271 Helicopter hospital emergency medical evacuation service (HEMES). (a) No certificate holder may... certificate holder may assign a helicopter flight crewmember, and no flight crewmember may accept an...

A Markov Decision Process Model for the Optimal Dispatch of Military Medical Evacuation Assets

DTIC Science & Technology

2014-03-27

further background on MEDEVAC and provides a review of pertinent literature . Section 3 provides a de- scription of the problem for which we develop our...best medical evacuation system possible, for those who follow in your footsteps . Special thanks goes to my wife and two children for their...order to generate the computational results necessary to make this paper a success. Lastly, I would like to thank the US Army Medical Evacuation

An example of extreme cardiology: chest pain on the high seas and helicoptered medical evacuations: the French Navy experience.

PubMed

Vinsonneau, Ulric; Cavel, Christiane; Bombert, Christophe; Lely, Laurent; Paleiron, Nicolas; Vergez-Larrouget, Claude; Cornily, Jean-Christophe; Castellant, Philippe; Gilard, Martine; Paule, Paule; Bronstein, Jean-Ariel

2012-10-01

Medicalized high sea rescue is very different from prehospital medical evacuation. It requires specifically trained medical teams because the difficulties are marine, aerial, and medically related. The French Navy provides medical evacuations by helicopter on the Atlantic coast, up to 320 km offshore and under all weather conditions. The epidemiology of acute chest pain in the high seas has been poorly described. Therefore, in this retrospective study, we aimed to assess the prevalence and constraints found in the management of these emergencies. From January 1, 2000, to April 30, 2009, 286 medical evacuations by helicopter were performed, 132 of which were due to traumatological emergencies, and 154 to medical emergencies. Acute chest pain, with 36 missions, was the leading cause of medical evacuation. All evacuated patients were men who were either professional sailors or ferry passengers. The median age was 48 years (range, 26-79). The most common prehospital diagnosis was coronary chest pain in 23 patients (64%), including 11 patients with acute coronary syndrome with ST-segment elevation. Thirty-two patients were airlifted by helicopter. All patients benefited from monitoring, electrocardiogram, peripheral venous catheter, and medical management as soon as the technical conditions allowed it. Copyright © 2012 Elsevier Inc. All rights reserved.

Disaster-Driven Evacuation and Medication Loss: a Systematic Literature Review

PubMed Central

Ochi, Sae; Hodgson, Susan; Landeg, Owen; Mayner, Lidia; Murray, Virginia

2014-01-01

AIM: The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards. METHOD: The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review. RESULTS: All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees. DISCUSSION: This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have

48 CFR 728.307-70 - Medical Evacuation (MEDEVAC) Services (MAR 1993).

Code of Federal Regulations, 2011 CFR

2011-10-01

... FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-70 Medical Evacuation (MEDEVAC) Services (MAR 1993). The Contracting Officer shall insert the clause at 752.228-70 in all contracts which require performance by contractor employees overseas. [59 FR...

48 CFR 728.307-70 - Medical Evacuation (MEDEVAC) Services (MAR 1993).

Code of Federal Regulations, 2010 CFR

2010-10-01

... FOR INTERNATIONAL DEVELOPMENT GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 728.307-70 Medical Evacuation (MEDEVAC) Services (MAR 1993). The Contracting Officer shall insert the clause at 752.228-70 in all contracts which require performance by contractor employees overseas. [59 FR...

Medical relief activities, medical resourcing, and inpatient evacuation conducted by Nippon Medical School due to the Fukushima Daiichi Nuclear Power Plant accident following the Great East Japan Earthquake 2011.

PubMed

Koyama, Atsushi; Fuse, Akira; Hagiwara, Jun; Matsumoto, Gaku; Shiraishi, Shinichiro; Masuno, Tomohiko; Miyauchi, Masato; Kawai, Makoto; Yokota, Hiroyuki

2011-01-01

On March 11, 2011, after the Great East Japan Earthquake and tsunami, the government declared a nuclear emergency following damage to the Fukushima Daiichi Nuclear Power Plant. A second hydrogen explosion occurred on March 14 at the plant's No. 3 reactor and injured 11 people. At that time the prime minister urged people living 20 to 30 km from the Daiichi plant to stay indoors. Under these circumstances, many residents of Iwaki City, which was largely outside the 30-km zone, left the city, making it difficult to get supplies to the remaining residents. The only transportation route open for supplies and medical resources was roads, and many drivers feared the rumor that the city was contaminated by radioactive materials and, so, refused to go there. Nippon Medical School (NMS) heard that medical resources were running short at Iwaki Kyoritsu Hospital, which requested water, medications, food, fuel (gasoline), medical support, and the evacuation of 300 inpatients. As a first step, NMS decided to evaluate the situation at the hospital and, on March 16, the director of the NMS Advanced Emergency Center visited the hospital and helped provide triage for about 200 patients. Critically ill patients receiving ventilatory support were given priority for evacuation because they would be most at risk of not being able to evacuate should the Japanese government order an immediate evacuation of the city. We tried to evacuate the inpatients via an official framework, such as the Disaster Medical Assistance Team (DMAT), but DMAT could not support this mission because this hospital was not within the 30-km evacuation zone. Moreover, the Iwaki City government could not support the evacuation efforts because they were fearful of the rumor that Iwaki was contaminated by radioactive material. Ultimately, we realized that we had to conduct the mission ourselves and, so, contacted our colleagues in the Tokyo metropolitan area to prepare enough hospital beds. We evacuated 15 patients

Air medical evacuations from a developing world conflict zone.

PubMed

Low, Adam; Vadera, Bettina

2011-01-01

Somalia has been without effective government for close to two decades, with more than 1 million people internally displaced. The political unrest persists, with United Nations-backed African Union peacekeeping forces supporting the Transitional National government of Sharif Ahmed, struggling to maintain control of central Mogadishu from Islamist extremist groups, such as the reportedly Al-Qaeda-backed Al-Shabab. The African Union force of 5,000 troops is predominantly of Ugandan and Burundian origin, making up the African Mission in Somalia (AMISOM) effort. However, its mandate is limited to operations only in Mogadishu, and it is unauthorized to actively pursue insurgents. As with other ongoing high-profile conflicts, African Union troops face an enemy that blends into the civilian populace, fighting with a lethal mixture of improvised explosive devices and suicide bombers. Copyright © 2011 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

International Organization for Migration: experience on the need for medical evacuation of refugees during the Kosovo crisis in 1999.

PubMed

Szilard, Istvan; Cserti, Arpad; Hoxha, Ruhija; Gorbacheva, Olga; O'Rourke, Thomas

2002-04-01

The International Organization for Migration (IOM) developed and implemented a three-month project entitled Priority Medical Screening of Kosovar Refugees in Macedonia, within the Humanitarian Evacuation Program (HEP) for Kosovar refugees from FR Yugoslavia, which was adopted in May 1999. The project was based on an agreement with the office of United Nations High Commission for Refugees (UNHCR) and comprised the entry of registration data of refugees with medical condition (Priority Medical Database), and classification (Priority Medical Screening) and medical evacuation of refugees (Priority Medical Evacuation) in Macedonia. To realize the Priority Medical Screening project plan, IOM developed and set up a Medical Database linked to IOM/UNHCR HEP database, recruited and trained a four-member data entry team, worked out and set up a referral system for medical cases from the refugee camps, and established and staffed medical contact office for refugees in Skopje and Tetovo. Furthermore, it organized and staffed a mobile medical screening team, developed and implemented the system and criteria for the classification of referred medical cases, continuously registered and classified the incoming medical reports, contacted regularly the national delegates and referred to them the medically prioritized cases asking for acceptance and evacuation, and co-operated and continuously exchanged the information with UNHCR Medical Co-ordination and HEP team. Within the timeframe of the project, 1,032 medical cases were successfully evacuated for medical treatment to 25 host countries throughout the world. IOM found that those refugees suffering from health problems, who at the time of the termination of the program were still in Macedonia and had not been assisted by the project, were not likely to have been priority one cases, whose health problems could be solved only in a third country. The majority of these vulnerable people needed social rather than medical care and

Medical evacuation for unrecognized abdominal wall pain: a case series.

PubMed

Msonda, Hapu T; Laczek, Jeffrey T

2015-05-01

Chronic abdominal pain is a frequently encountered complaint in the primary care setting. The abdominal wall is the etiology of this pain in 10 to 30% of all cases of chronic abdominal pain. Abdominal cutaneous nerve entrapment at the lateral border of the rectus abdominis muscle has been attributed as a cause of this pain. In the military health care system, patients with unexplained abdominal pain are often transferred to military treatment facilities via the Military Medical Evacuation (MEDEVAC) system. We present two cases of patients who transferred via MEDEVAC to our facility for evaluation and treatment of chronic abdominal pain. Both patients had previously undergone extensive laboratory evaluation, imaging, and invasive procedures, such as esophagogastroduodenoscopy before transfer. Upon arrival, history and physical examinations suggested an abdominal wall source to their pain, and both patients experienced alleviation of their abdominal wall pain with lidocaine and corticosteroid injection. This case series highlights the need for military physicians to be aware of abdominal wall pain. Early diagnosis of abdominal cutaneous nerve entrapment syndrome by eliciting Carnett's sign will limit symptom chronicity, avoid unnecessary testing, and even prevent medical evacuation. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Mass aeromedical evacuation of patients in an emergency: experience following the 2010 Yushu earthquake.

PubMed

Liu, Xu; Liu, Yuan; Zhang, Lulu; Liang, Wannian; Zhu, Zenghong; Shen, Yan; Kang, Peng; Liu, Zhipeng

2013-12-01

On April 14, 2010, a catastrophic earthquake hit Yushu, China, causing 2698 deaths and 12,135 injuries. A large number of patients were evacuated by air to hospitals in unaffected areas for specialty treatment. To investigate the overall process and details of patients' aeromedical evacuation (AE) after the Yushu earthquake. The study was an observational, retrospective investigation conducted in December 2010 in Qinghai province. Information was gathered from Yushu Batang airport, the Ministry of Health, the Health Department of Qinghai Province, and rear echelon hospitals in five provinces. A total of 2796 patients were evacuated by 152 separate flights from Yushu. The number of AE patients reached a peak (55.8%) within 72 h after the earthquake. Of the total 2796 patients, 2533 were admitted to rear echelon hospitals. This number included 2111 (83.3%) with earthquake-related trauma, 422 (26.7%) with non-traumatic diseases, and 166 (6.6%) with acute mountain sickness. No accident or medical error was reported during the evacuation process. The aircraft used for AE included IL-76 transport aircraft from the Air Force, Airbus A-319s from civil aviation, and MI-17 helicopters from Army aviation. According to our investigation, the need for professional AE training was great (83.7%). In addition, almost all participants (99.3%) agreed that the aircraft needed to be improved for the purpose of AE. Aeromedical evacuation of a large number of patients after major disasters in remote areas can be done safely and effectively; however, problems such as a lack of suitable AE aircraft and medical equipment, as well as insufficient professional medical training in AE, were revealed after the Yushu earthquake. Copyright © 2013 Elsevier Inc. All rights reserved.

21 CFR 876.4370 - Gastroenterology-urology evacuator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology evacuator. 876.4370... (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4370 Gastroenterology-urology evacuator. (a) Identification. A gastroenterology-urology evacuator is a device used to remove...

Evacuation performance evaluation tool.

PubMed

Farra, Sharon; Miller, Elaine T; Gneuhs, Matthew; Timm, Nathan; Li, Gengxin; Simon, Ashley; Brady, Whittney

2016-01-01

Hospitals conduct evacuation exercises to improve performance during emergency events. An essential aspect in this process is the creation of reliable and valid evaluation tools. The objective of this article is to describe the development and implications of a disaster evacuation performance tool that measures one portion of the very complex process of evacuation. Through the application of the Delphi technique and DeVellis's framework, disaster and neonatal experts provided input in developing this performance evaluation tool. Following development, content validity and reliability of this tool were assessed. Large pediatric hospital and medical center in the Midwest. The tool was pilot tested with an administrative, medical, and nursing leadership group and then implemented with a group of 68 healthcare workers during a disaster exercise of a neonatal intensive care unit (NICU). The tool has demonstrated high content validity with a scale validity index of 0.979 and inter-rater reliability G coefficient (0.984, 95% CI: 0.948-0.9952). The Delphi process based on the conceptual framework of DeVellis yielded a psychometrically sound evacuation performance evaluation tool for a NICU.

[Towards the problem of necessity to reduce the medical evacuation stages in conditions of local wars and armed conflicts].

PubMed

Gaĭdar, B V; Ivantsov, V A; Sidel'nikov, V O; Rusev, I T; Madaĭ, D Iu; Kokoev, V G; Zinov'ev, E V; Mutalibov, M M

2004-06-01

The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid.

Evacuation Priorities in Mass Casualty Terror-Related Events

PubMed Central

Einav, Sharon; Feigenberg, Zvi; Weissman, Charles; Zaichik, Daniel; Caspi, Guy; Kotler, Doron; Freund, Herbert R.

2004-01-01

Objective: To assess evacuation priorities during terror-related mass casualty incidents (MCIs) and their implications for hospital organization/contingency planning. Summary Background Data: Trauma guidelines recommend evacuation of critically injured patients to Level I trauma centers. The recent MCIs in Israel offered an opportunity to study the impositions placed on a prehospital emergency medical service (EMS) regarding evacuation priorities in these circumstances. Methods: A retrospective analysis of medical evacuations from MCIs (29.9.2000–31.9.2002) performed by the Israeli National EMS rescue teams. Results: Thirty-three MCIs yielded data on 1156 casualties. Only 57% (506) of the 1123 available and mobilized ambulances were needed to provide 612 evacuations. Rescue teams arrived on scene within <5 minutes and evacuated the last urgent casualty within 15–20 minutes. The majority of non-urgent and urgent patients were transported to medical centers close to the event. Less than half of the urgent casualties were evacuated to more distant trauma centers. Independent variables predicting evacuation to a trauma center were its being the hospital closest to the event (OR 249.2, P < 0.001), evacuation within <10 minutes of the event (OR 9.3, P = 0.003), and having an urgent patient on the ambulance (OR 5.6, P < 0.001). Conclusions: Hospitals nearby terror-induced MCIs play a major role in trauma patient care. Thus, all hospitals should be included in contingency plans for MCIs. Further research into the implications of evacuation of the most severely injured casualties to the nearest hospital while evacuating all other casualties to various hospitals in the area is needed. The challenges posed by terror-induced MCIs require consideration of a paradigm shift in trauma care. PMID:15075645

[Aeromedical evacuation of critically ill patients in developing countries A retrospective study on 244 patients in Djibouti].

PubMed

Bordes, J; Loheas, D; Benois, A

2015-01-01

The pratice of intensive care in Africa is marked by a wide variety of health care delivery. Only a few centers offer specialized intensive care units, as cardiac or neurological units. That may explain the need for aeromedical evacuations for patients whose condition exceeds local capacity. Our objective was to assess whether the proportion of patients admitted to intensive care and evacuated had increased between 1997 and 2013 in a developing country, Djibouti. We examined the activity register of Bouffard Hospital intensive care unit in Djibouti to determine the number and characteristics of patients evacuated by air ambulance during a 16 years period. From January 1997 to December 2013, a total of 244 patients were evacuated. The evacuation rate was 5.74ù of the patients admitted to the entire duration of the study. The rate of patients evacuated was not different between 1997 and 2013 (5,69ù versus 8,33ù respectively, p = 0,269). However, the rate of djiboutian evacuated patients was statistically different between 1997 and 2013 (0,96ù versus 4,46ù, p = 0,02). The main causes were severe trauma injuries, cardiovascular diseases and neurological diseases. The aeromedical evacuation of a critically ill patient in a developing country is a process requiring heavy logistics and depending on the medical skills available in the area, and financial resources that can be implemented for the patient. Our study shows that medical evacuations in favor of Djiboutian patients are marginal but are increasing over the past decade.

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

21 CFR 888.4220 - Cement monomer vapor evacuator.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cement monomer vapor evacuator. 888.4220 Section... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4220 Cement monomer vapor evacuator. (a) Identification. A cement monomer vapor evacuator is a device intended for use during surgery to contain or remove...

Evacuation decisions in a chemical air pollution incident: cross sectional survey

PubMed Central

Kinra, S; Lewendon, G; Nelder, R; Herriott, N; Mohan, R; Hort, M; Harrison, S; Murray, V

2005-01-01

Objective To compare the health outcomes in sheltered and evacuated populations after a chemical incident in a plastics factory. Design Cross sectional survey. Setting Urban area in southwest England. Participants 1750 residents from the area exposed to the chemical smoke, of which 472 were evacuated and the remaining 1278 were advised to shelter indoors. Main outcome measure Number of adverse health symptoms. A case was defined by the presence of four or more symptoms. Main results 1096 residents (63%; 299 evacuated, 797 sheltered) provided data for analyses. The mean symptom score and proportion of cases were higher in evacuated people than in the sheltered population (evacuated: symptom score 1.9, cases 19.7% (n = 59); sheltered: symptom score 1.0, cases 9.5% (n = 76); P < 0.001 for both). The difference between the two groups attenuated markedly at the end of two weeks from the start of the incident. The two main modifiable risk factors for the odds of becoming a case were evacuation (odds ratio 2.5, 95% confidence interval 1.7 to 3.8) and direct exposure to smoke for more than two hours on the first day of the incident (2.0, 1.7 to 2.3). The distance of residence from the factory or level of exposure before intervention (first six hours) had little effect on the odds of a person becoming a case. Conclusions Sheltering may have been a better protective action than evacuation in this chemical incident, which is consistent with the prevailing expert view. Although this study has limitations, it is based on a real event. Evacuations carry their own risks and resource implications; increased awareness may help to reduce unnecessary evacuations in the future. PMID:15976419

US EPA Base Study Standard Operating Procedure for Sampling Volatile Organic Compounds in Indoor Air Using Evacuated Canisters

EPA Pesticide Factsheets

The objective of this procedure is to collect a representative sample of air containing volatile organic compound (VOC) contaminants present in an indoor environment using an evacuated canister, and to subsequently analyze the concentration of VOCs, as selected by EPA.

Evacuation support system for improved medical documentation and information flow in the field.

PubMed

Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

2008-02-01

Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

Aeromedical evacuation using an aircraft transit isolator of a patient with Lassa fever.

PubMed

Lotz, Eric; Raffin, Hervé

2012-05-01

Lassa fever is a viral hemorrhagic fever only present in West Africa. The mortality rate is 1% and may reach 15% among hospitalized patients. Transmission between humans is mostly due to direct contact with infected body fluids. Aeromedical evacuation of patients with viral hemorrhagic fevers (such as Lassa fever) demands strict isolation measures. Only a few cases of such evacuations have been reported in the literature during the last 40 yr. The use of an aircraft transit isolator device could be helpful. We report the aeromedical evacuation of a confirmed Lassa fever patient from Sierra Leone to Sweden with a dedicated air ambulance using an aircraft transit isolator. The patient was a 30-yr-old physician working for a nonprofit organization. The patient contracted the disease working with infected hospitalized patients. The duration of the mission between activation and arrival at the Swedish hospital was 36 h, which is within the World Health Organization recommendations. Evacuation of patients with potentially lethal contagious infections is possible, but only with strict isolation measures. Specific protective equipment and isolator are mandatory. Medical and technical crews performing such evacuations should be trained in proper equipment use and the isolator should first be used with a low-risk patient to create minimal risk transport conditions.

Haughton-Mars Project/NASA 2006 Lunar Medical Contingency Simulation: Equipment and Methods for Medical Evacuation of an Injured Crewmember

NASA Technical Reports Server (NTRS)

Chappell, S. P.; Scheuring, R. A.; Jones, J. A.; Lee, P.; Comtois, J. M.; Chase, T.; Gernhardt M.; Wilkinson, N.

2007-01-01

Introduction: Achieving NASA's Space Exploration Vision scientific objectives will require human access into cratered and uneven terrain for the purpose of sample acquisition to assess geological, and perhaps even biological features and experiments. Operational risk management is critical to safely conduct the anticipated tasks. This strategy, along with associated contingency plans, will be a driver of EVA system requirements. Therefore, a medical contingency EVA scenario was performed with the Haughton-Mars Project/NASA to develop belay and medical evacuation techniques for exploration and rescue respectively. Methods: A rescue system to allow two rescuer astronauts to evacuate one in incapacitated astronaut was evaluated. The systems main components were a hard-bottomed rescue litter, hand-operated winch, rope, ground picket anchors, and a rover-winch attachment adapter. Evaluation was performed on 15-25deg slopes of dirt with embedded rock. The winch was anchored either by adapter to the rover or by pickets hammered into the ground. The litter was pulled over the surface by rope attached to the winch. Results: The rescue system was utilized effectively to extract the injured astronaut up a slope and to a waiting rover for transport to a simulated habitat for advanced medical care, although several challenges to implementation were identified and overcome. Rotational stabilization of the winch was found to be important to get maximize mechanical advantage from the extraction system. Discussion: Further research and testing needs to be performed to be able to fully consider synergies with the other Exploration surface systems, in conducting contingency operations. Structural attachment points on the surface EVA suits may be critical to assist in incapacitated evacuation. Such attach points could be helpful in microgravity incapacitated crewmember transport as well. Wheeled utility carts or wheels that may be attachable to a litter may also aid in extraction and

Organisational framework and outputs of International medical evacuation in Guinea: A need for change.

PubMed

Guilavogui, Timothé; Camara, Alioune; Diallo, Elhadj Marouf; Koïvogui, Akoï; Barry, Aminatou; Zoumanigui, Koligna; Diallo, Alpha Ahmadou; Delamou, Alexandre; Koulibaly, Moussa

2018-02-15

The study aims to describe the organizational framework of International Medical Evacuation (IME), the profile of persons evacuated, and the associated cost of IME in Guinea. This was a descriptive study of IME policy in Guinea. We described the politico-structural organization of IME and the profile of patient accessing IME through the Ministry of Health (MOH: 2001-2015) and through the National Social Security Fund (NSSF: 2011-2015). From 1958 to 1992 since the health system was restricted, the country negotiated the free medical treatment with Socialist countries. Since 1992, a medical assistance line was included in the sector budgets, and IME was officially managed by the MOH and with a parallel system existing at the NSSF. With an average cost of US $34 251 per case, cardiovascular diseases (20%), Traumatology/Orthopedic diseases (20%), and Neurologic/neurosurgery diseases (12.5%) have motivated more than half of 2445 IME supported by the MOH between 2001 and 2015. With a diagnostic exploration (38.7%) as main motivation, the majority of the IMEs (80.0%) endorsed by the NSSF (2011-2015) concerned their employees/workers or those of the NSSF's supervisory ministry and their families. Despite a strict regulatory framework, the emergence and sustainability of parallel IME systems in other departments with different procedures than MOH's procedure represent a major weakness/deficiency. The new prospects for the free medical treatment of state employees could eventually lead to an effective correction of this structural failure if efficiently managed. Copyright © 2018 John Wiley & Sons, Ltd.

Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series.

PubMed

Dindart, Jean-Michel; Peyrouset, Olivier; Palich, Romain; Bing, Abdoul; Kojan, Richard; Barbe, Solenne; Harouna, Souley; Blackwell, Nikki

2017-03-11

We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N'Zerekore, Guinea to the Treatment Centre for Carers run by the medical corps of the French army in Conakry, the capital of Guinea, which was established on 17 January 2015 and closed on 7 July 2015. In total more than 500 HWs have died from EVD since the epidemic began. This mortality has had significant effects on the ability of local services to respond appropriately to the disaster. The HWs were transported by air in the "Human Stretcher Transit Isolator-Total Containment (Oxford) Limited" (HSTI-TCOL) negative pressure isolation pod. Medical evacuation of patients with suspected, potentially fatal, infectious diseases is feasible with the use of a light isolator for patients without critical dysfunctions.

[Roles and functions of military flight nursing: aeromedical evacuation].

PubMed

Lee, Chun-Lan; Hsiao, Yun-Chien; Chen, Chao-Yen

2012-06-01

Evacuating the injured is an important part of disaster medicine. Aircraft provide timely access to distant and remote areas and, in an emergency, can evacuate sick or injured individuals in such areas quickly and safely for critical treatment elsewhere. Aeromedical evacuation (AE) comprises the two categories of fixed-wing ambulance service and helicopter emergency medical service (HEMS). Each aims to accomplish unique objectives. In Taiwan, the Second Taiwan Strait Crisis in 1958 established the unique role and functions of medical flight nursing. Significant knowledge and experience has been accumulated in the field since that time in such areas as the effects of high altitude environments on individuals and equipment; physiological, psychological, social and spiritual factors that affect the injured and / or response team members; and emergency care delivery techniques. All have been essential elements in the development and delivery of comprehensive medical flight nurse training. Medical flight nursing belongs in a special professional category, as nurses must master knowledge on general and special-case casualty evacuation procedures, relevant instruments and equipment, triage, in-flight medical care, and aircraft loading requirements related to transporting the sick and injured. The internationalization of medical care has opened the potential to expand medical flight nursing roles and functions into disaster nursing. Although military considerations continue to frame medical flight nursing training and preparation today, the authors feel that creating strategic alliances with disaster nursing specialists and organizations overseas is a future developmental direction for Taiwan's medical flight nursing sector worth formal consideration.

Patient-driven resource planning of a health care facility evacuation.

PubMed

Petinaux, Bruno; Yadav, Kabir

2013-04-01

The evacuation of a health care facility is a complex undertaking, especially if done in an immediate fashion, ie, within minutes. Patient factors, such as continuous medical care needs, mobility, and comprehension, will affect the efficiency of the evacuation and translate into evacuation resource needs. Prior evacuation resource estimates are 30 years old. Utilizing a cross-sectional survey of charge nurses of the clinical units in an urban, academic, adult trauma health care facility (HCF), the evacuation needs of hospitalized patients were assessed periodically over a two-year period. Survey data were collected on 2,050 patients. Units with patients having low continuous medical care needs during an emergency evacuation were the postpartum, psychiatry, rehabilitation medicine, surgical, and preoperative anesthesia care units, the Emergency Department, and Labor and Delivery Department (with the exception of patients in Stage II labor). Units with patients having high continuous medical care needs during an evacuation included the neonatal and adult intensive care units, special procedures unit, and operating and post-anesthesia care units. With the exception of the neonate group, 908 (47%) of the patients would be able to walk out of the facility, 492 (25.5%) would require a wheelchair, and 530 (27.5%) would require a stretcher to exit the HCF. A total of 1,639 patients (84.9%) were deemed able to comprehend the need to evacuate and to follow directions; the remainder were sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of the 248 adult intensive care unit patients were too ill to survive an evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping the case was not considered to be safe. Heath care facilities can utilize the results of this study to model their anticipated resource requirements for an emergency evacuation. This will permit the Incident Management Team to mobilize the necessary resources both within

Evacuate or Shelter-in-place? The Role of Corporate Memory and Political Environment in Hospital-evacuation Decision Making.

PubMed

Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Kranke, Derrick; Dobalian, Aram

2015-06-01

Hospital-evacuation decisions are rarely straightforward in protracted advance-warning events. Previous work provides little insight into the decision-making process around evacuation. This study was conducted to identify factors that most heavily influenced the decisions to evacuate the US Department of Veterans Affairs (VA) New York Harbor Healthcare System's (NYHHS; New York USA) Manhattan Campus before Hurricane Irene in 2011 and before Superstorm Sandy in 2012. Semi-structured interviews with 11 senior leaders were conducted on the processes and factors that influenced the evacuation decisions prior to each event. The most influential factor in the decision to evacuate the Manhattan Campus before Hurricane Irene was New York City's (NYC's) hospital-evacuation mandate. As a federal facility, the Manhattan VA medical center (VAMC) was exempt from the city's order, but decision makers felt compelled to comply. In the case of Superstorm Sandy, corporate memory of a similar 1992 storm that crippled the Manhattan facility drove the decision to evacuate before the storm hit. Results suggest that hospital-evacuation decisions are confounded by political considerations and are influenced by past disaster experience. Greater shared situational awareness among at-risk hospitals, along with a more coordinated approach to evacuation decision making, could reduce pressure on hospitals to make these high-stakes decisions. Systematic mechanisms for collecting, documenting, and sharing lessons learned from past disasters are sorely needed at the institutional, local, and national levels.

Analysis of the causes of medical evacuation of injured and sick soldiers of the Polish Military Contingent in the Islamic State of Afghanistan taking part in International Security Assistance Force operations.

PubMed

Ziemba, Radosław

2012-04-01

Military casualties in Afghanistan arise in part from climatic and natural conditions that are difficult for European soldiers to endure, as well as from intense guerrilla combat with mass use of IEDs (improvised explosive devices), thus posing numerous and diverse medical problems requiring evacuation to the home country. A search of the literature revealed no comprehensive studies of the causes of medical evacuation from this theater of operations. This article is a review of medical reports of the Polish Military Contingent taking part in Operation Enduring Freedom during the period from 01 January 2010 to 31 December 2011, including an analysis of causes of all ROLE 4 medical evacuations (to the military base in Germany or to the home country). As many as 565 (5.49%) of the total of 10 294 contingent soldiers were evacuated during the analyzed period. Of these, 29% of evacuation cases were due to combat injuries, 23% to complications of respiratory tract infection, 11% to mental health problems, 11% to chronic neuralgias, 12% to complications of acute gastrointestinal infections, 4% to non-combat injuries, 3% to dental and maxillofacial problems, 2% to dermatological problems and 2% to leishmaniasis. The remaining causes included chronic organic/systemic diseases manifested during service. The main causes of medical evacuations to the home country were the consequences of combat injuries, mainly due to IED attacks. Appropriate diagnosis and early treatment of infections is also an important problem in the face of a significant number of complications resulting in evacuation of soldiers to their home country.

Medical evacuations in the oil and gas industry: a retrospective review with implications for future evacuation and preventative strategies.

PubMed

Toner, Sharyn; Andrée Wiltens, Derkje H; Berg, Johannes; Williams, Hector; Klein, Susan; Marshall, Simon; Nerwich, Neil; Copeland, Ryan

2017-05-01

Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken. A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted. Employee records and Human Resource data were used as a denominator for the population. Analogous Medevac data from specific locations were used to compare patterns of diagnoses. A total of 130 Medevacs were conducted during the study period, resulting in a Medevac rate of 4 per 1000 of population with 16 per 1000 for females and 3 per 1000 for males, respectively. The youngest and oldest age-groups required Medevacs in larger proportions. The evacuation rates were highest for countries classified as 'high' or 'extreme risk'. The most frequent diagnostic categories for Medevac were: trauma, digestive, musculoskeletal, cardiac and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to Medevac. This study uniquely provides a benchmark Medevac rate (4 per 1000) for EEs and FBTs and demonstrates that Medevac rates are highest from countries identified as 'high risk'; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for Medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travellers, and the application of

Distance Learning Methodologies. TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES).

ERIC Educational Resources Information Center

Bloomquist, Carroll R.

The TRANSCOM (Transportation Command) Regulating Command and Control Evacuation System (TRAC2ES), which applies state-of-the-art technology to manage global medical regulating (matching patients to clinical availability) and medical evacuation processes, will be installed at all Department of Defense medical locations globally. A combination of…

The Urgent Need for a Comprehensive, Fully Integrated, Joint Intra-Theater Aeromedical Evacuation System

DTIC Science & Technology

2017-04-06

future demands for intra-theater AE for all services and coalition partners in accordance with DoD Directive 5100.01 and the SECDEF’s Memorandum for... demand signal for AE assets approximately doubled. In 2009, the Medical Evacuation Proponency Directorate at Fort Rucker, AL conducted an...Analysis (TAA), but the Army only possessed 38 Air Ambulance Companies in its force structure to meet all of DoD’s AE demands .9 These results included nine

The Bali bombing: civilian aeromedical evacuation.

PubMed

Tran, Minh D; Garner, Alan A; Morrison, Ion; Sharley, Peter H; Griggs, William M; Xavier, Colin

2003-10-06

After the Bali bombing on 12 October 2002, many injured Australians required evacuation to Darwin, and then to burns units around Australia. Many patients were evacuated from Denpasar by Qantas, with assistance from staff of civilian medical retrieval services. The transport of patients from Darwin to specialist burns units involved a coordinated response of civilian and military services. Some issues in responding to such disasters were identified, and a national coordinating network could improve future responses.

The evacuation of cairns hospitals due to severe tropical cyclone Yasi.

PubMed

Little, Mark; Stone, Theona; Stone, Richard; Burns, Jan; Reeves, Jim; Cullen, Paul; Humble, Ian; Finn, Emmeline; Aitken, Peter; Elcock, Mark; Gillard, Noel

2012-09-01

On February 2, 2011, Tropical Cyclone Yasi, the largest cyclone to cross the Australian coast and a system the size of Hurricane Katrina, threatened the city of Cairns. As a result, the Cairns Base Hospital (CBH) and Cairns Private Hospital (CPH) were both evacuated, the hospitals were closed, and an alternate emergency medical center was established in a sports stadium 15 km from the Cairns central business district. This article describes the events around the evacuation of 356 patients, staff, and relatives to Brisbane (approximately 1,700 km away by road), closure of the hospitals, and the provision of a temporary emergency medical center for 28 hours during the height of the cyclone. Our experience highlights the need for adequate and exercised hospital evacuation plans; the need for clear command and control with identified decision-makers; early decision-making on when to evacuate; having good communication systems with redundancy; ensuring that patients are adequately identified and tracked and have their medications and notes; ensuring adequate staff, medications, and oxygen for holding patients; and planning in detail the alternate medical facility safety and its role, function, and equipment. © 2012 by the Society for Academic Emergency Medicine.

Fluid Transient Analysis during Priming of Evacuated Line

NASA Technical Reports Server (NTRS)

Bandyopadhyay, Alak; Majumdar, Alok K.; Holt, Kimberley

2017-01-01

Water hammer analysis in pipe lines, in particularly during priming into evacuated lines is important for the design of spacecraft and other in-space application. In the current study, a finite volume network flow analysis code is used for modeling three different geometrical configurations: the first two being straight pipe, one with atmospheric air and other with evacuated line, and the third case is a representation of a complex flow network system. The numerical results show very good agreement qualitatively and quantitatively with measured data available in the literature. The peak pressure and impact time in case of straight pipe priming in evacuated line shows excellent agreement.

A review of computer evacuation models and their data needs.

DOT National Transportation Integrated Search

1994-05-01

This document reviews the history and current status of computer models of the evacuation of an airliner cabin. Basic concepts upon which evacuation models are based are discussed, followed by a review of the Civil Aerospace Medical Institute s effor...

Diagnoses and factors associated with medical evacuation and return to duty among nonmilitary personnel participating in military operations in Iraq and Afghanistan

PubMed Central

Cohen, Steven P.; Brown, Charlie; Kurihara, Connie; Plunkett, Anthony; Nguyen, Conner; Strassels, Scott A.

2011-01-01

Background Nonmilitary personnel play an increasingly critical role in modern wars. Stark differences exist between the demographic characteristics, training and missions of military and nonmilitary members. We examined the differences in types of injury and rates of returning to duty among nonmilitary and military personnel participating in military operations in Iraq and Afghanistan. Methods We collected data for nonmilitary personnel medically evacuated from military operations in Iraq and Afghanistan between 2004 and 2007. We compared injury categories and return-to-duty rates in this group with previously published data for military personnel and identified factors associated with return to duty. Results Of the 2155 medically evacuated nonmilitary personnel, 74.7% did not return to duty. War-related injuries in this group accounted for 25.6% of the evacuations, the most common causes being combat-related injuries (55.4%) and musculoskeletal/spinal injuries (22.9%). Among individuals with non–war-related injuries, musculoskeletal injuries accounted for 17.8% of evacuations. Diagnoses associated with the highest return-to-duty rates in the group of nonmilitary personnel were psychiatric diagnoses (15.6%) among those with war-related injuries and noncardiac chest or abdominal pain (44.0%) among those with non–war-related injuries. Compared with military personnel, nonmilitary personnel with war-related injuries were less likely to return to duty (4.4% v. 5.9%, p = 0.001) but more likely to return to duty after non–war-related injuries (32.5% v. 30.7%, p = 0.001). Interpretation Compared with military personnel, nonmilitary personnel were more likely to be evacuated with non–war-related injuries but more likely to return to duty after such injuries. For evacuations because of war-related injuries, this trend was reversed. PMID:21324873

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

38 CFR 17.58 - Evacuation of community nursing homes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... nursing homes. 17.58 Section 17.58 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.58 Evacuation of community nursing homes. When veterans are evacuated from a community nursing home as the result of an emergency, they may be relocated...

Deployment Surveillance Report: Traumatic Brain Injury Identified from Hospitalization and Air Evacuation Records - Army, 2004-2009

DTIC Science & Technology

2012-10-17

7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Army Institute of Public Health U.S. Army Public Health Command Aberdeen Proving Ground, Maryland...21010-5403 8. PERFORMING ORGANIZATION REPORT NUMBER 12-HF-0F7E-09 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) None 10. SPONSOR...Hospitalized Air Evacuated n % n % American football 17 28.8 9 25.7 Combatives/boxing/wrestling 10 16.9 8 22.9 Basketball 13 22.0 5 14.3 Baseball/ softball 8

Pedestrian evacuation at the subway station under fire

NASA Astrophysics Data System (ADS)

Xiao-Xia, Yang; Hai-Rong, Dong; Xiu-Ming, Yao; Xu-Bin, Sun

2016-04-01

With the development of urban rail transit, ensuring the safe evacuation of pedestrians at subway stations has become an important issue in the case of an emergency such as a fire. This paper chooses the platform of line 4 at the Beijing Xuanwumen subway station to study the emergency evacuation process under fire. Based on the established platform, effects of the fire dynamics, different initial pedestrian densities, and positions of fire on evacuation are investigated. According to simulation results, it is found that the fire increases the air temperature and the smoke density, and decreases pedestrians’ visibility and walking velocity. Also, there is a critical initial density at the platform if achieving a safe evacuation within the required 6 minutes. Furthermore, different positions of fire set in this paper have little difference on crowd evacuation if the fire is not large enough. The suggestions provided in this paper are helpful for the subway operators to prevent major casualties. Project supported by the National Natural Science Foundation of China (Grant Nos. 61322307 and 61233001).

Modeling Evacuation of a Hospital without Electric Power.

PubMed

Vugrin, Eric D; Verzi, Stephen J; Finley, Patrick D; Turnquist, Mark A; Griffin, Anne R; Ricci, Karen A; Wyte-Lake, Tamar

2015-06-01

Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital's primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital's ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model's ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing.

Prospective data, experience, and lessons learned at a surgically augmented brigade medical company (Level II+) during the 2007 Iraq surge.

PubMed

Lesho, Emil

2011-07-01

Provide data and experience at a surgically augmented brigade medical support company during the Iraq surge for future deployments. Data were prospectively aggregated. Eight thousand and eighty-three patients consisting of 52% coalition military, 19% U.S. military, and 29% U.S. or local civilians were evaluated. Ninety-four percent had disease nonbattle injuries and 4% had battle injuries. Ninety-five percent returned to duty, 2.5% admitted, 2% evacuated, and < 1% died of wounds. Total occupied bed days were 416. Predominate trauma and surgical conditions included burns, explosive injury, extremity trauma, and predominate medical conditions included infections, musculoskeletal injuries, and mental health issues. One hundred and fifty-eight air evacuations were required (80% trauma and 20% medical). Challenges included lack of mental health providers, cardiac and chronic medications, and exercise electrocardiogram capability. Without physical therapists, experienced nurses, and ancillary medical care, approximately 1500 more air evacuations would have been required, and return-to-duty would have been significantly delayed for approximately 300 patients.

Evacuation of a Tertiary Neonatal Centre: Lessons from the 2016 Kumamoto Earthquakes

PubMed Central

Iwata, Osuke; Kawase, Akihiko; Iwai, Masanori; Wada, Kazuko

2017-01-01

Background Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. Objective The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters. Methods Background variables including clinical risk scores and timing/destination of transportation were compared between infants, who subsequently were transferred to destinations outside of Kumamoto Prefecture, and their peers. Results All but 1 of the infants were successfully evacuated from their NICU within 8 h. One very-low-birth-weight infant developed moderate hypothermia following transportation. Fourteen infants were transferred to NICUs outside of Kumamoto Prefecture, which was associated with the diagnosis of congenital heart disease, dependence on respiratory support, higher risk scores, and longer elapsed time from the decision to departure. There was difficulty in arranging helicopter transportation because the coordination office of the Disaster Medical Assistance Team had requisitioned most air/ground ambulances and only helped arrange ground transportations for 13 low-risk infants. Transportation for all 10 high-risk infants (risk scores greater than or equal to the upper quartile) was arranged by local/neighbour NICUs. Conclusions Although the overall evacuation process was satisfactory, potential risks of relying on the adult-based emergency transportation system were highlighted. A better system needs to be developed urgently to put appropriate priority on vulnerable infants. PMID:28437783

Evacuation of a Tertiary Neonatal Centre: Lessons from the 2016 Kumamoto Earthquakes.

PubMed

Iwata, Osuke; Kawase, Akihiko; Iwai, Masanori; Wada, Kazuko

2017-01-01

Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters. Background variables including clinical risk scores and timing/destination of transportation were compared between infants, who subsequently were transferred to destinations outside of Kumamoto Prefecture, and their peers. All but 1 of the infants were successfully evacuated from their NICU within 8 h. One very-low-birth-weight infant developed moderate hypothermia following transportation. Fourteen infants were transferred to NICUs outside of Kumamoto Prefecture, which was associated with the diagnosis of congenital heart disease, dependence on respiratory support, higher risk scores, and longer elapsed time from the decision to departure. There was difficulty in arranging helicopter transportation because the coordination office of the Disaster Medical Assistance Team had requisitioned most air/ground ambulances and only helped arrange ground transportations for 13 low-risk infants. Transportation for all 10 high-risk infants (risk scores greater than or equal to the upper quartile) was arranged by local/neighbour NICUs. Although the overall evacuation process was satisfactory, potential risks of relying on the adult-based emergency transportation system were highlighted. A better system needs to be developed urgently to put appropriate priority on vulnerable infants. © 2017 S. Karger AG, Basel.

Central Dental Evacuation Systems.

DTIC Science & Technology

1982-05-01

handpiece . Inlets to this system are required throughout the dental facility for all disciplines of patient treatment where coolant and irrigation liquids...speed air turbine dental handpiece is used and for practically all other procedures in the practice of modern dentistry. Performance and reliability...AD-AI16 653 SCHOOL OF AEROSPACE MEDICINE BROOKS AFR TX F/G 6/5 CENTRAL DENTAL EVACUATION SYSTEMS.(U) MAY 52 J M POWELL, J M YOUNG UNCLASSIFIED SAM-TR

Is there one optimal medical treatment and evacuation chain for all situations: "scoop-and-run" or "stay-and-play".

PubMed

Hoejenbos, Maarten J J; McManus, John; Hodgetts, Timothy

2008-01-01

In 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one "golden" treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization. A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion. Using the different experiences and the outcome of the discussions, it was concluded that there is not one "golden" medical emergency system, there are no "golden" timelines, and no "golden" skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems. The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.

Considerations for the head-injured air-evacuated patient: a case report of frontal sinus fracture and review of the literature.

PubMed

Helling, Eric; McKinlay, Alex J

2005-07-01

Head and neck injuries are not uncommon in combat environments and may be increasing due to survivable injuries from the use of kevlar helmets and body armor. With the current capability of rapid evacuation from the battlefield, acutely injured patients with frontal sinus injuries may undergo further barometric challenges. Proper care during transport can prevent the occurrence of secondary injury (increased intracranial pressure, tension pneumocephalus) that would complicate the patient's management at the next level of care. Management principles (importance of low-level flight/pressurized cabin, preflight use of decongestants, avoidance of valsalva, and ability to manage complications either procedurally or by landing) are reviewed. In addition, we propose a simple mechanism for pressure equilibration of a compromised frontal sinus during air evacuation using an angiocatheter placed through the wound before closure.

Management of pneumothorax in cattle by continuous-flow evacuation.

PubMed

Peek, Simon E; Slack, J A; McGuirk, Sheila M

2003-01-01

Pneumothorax in cattle can develop subsequent to acute or chronic pulmonary disease, and if unresolved may lead to respiratory distress and death due to hypoxia and compression and collapse of cardiac and thoracic great vessels. Therapeutic evacuation of free air within the pleural space can provide acute relief and improve chances of survival. This article descibes the adaptation and use of a continuous flow evacuation device to resolve pneumothorax in 3 cattle with pneumothorax associated with infectious lower airway disease.

GPSS computer simulation of aircraft passenger emergency evacuations.

DOT National Transportation Integrated Search

1978-06-01

The costs of civil air transport emergency evacuation demonstrations using human subjects have risen as seating capacities of these aircraft have increased. Repeated tests further increase the costs and also the risks of injuries to participants. A m...

Prospective use of unmanned aerial vehicles for military medical evacuation in future conflicts.

PubMed

Handford, Charles; Reeves, F; Parker, P

2018-03-09

In order to continue to deliver outstanding medical care on the battlefield, the UK Defence Medical Services must continue to adapt, overcome and actively embrace change. One potential area is the rapid proliferation and sophistication of automated and remote systems such as unmanned aerial vehicles (UAVs). UAVs are already used to deliver blood to remote military locations in Afghanistan and defibrillators to those that need them in the USA and Sweden. An area of future opportunity would be to facilitate rapid evacuation of wounded personnel from high intensity, high threat, remote and austere areas directly to specialist care. Such a capability would reduce threat to human life while allowing rapid extraction of casualties from high risk or inaccessible environments straight back to Role 3 care, all of which in these situations is either not possible or carries too much risk using conventional aerial assets. The article aims to highlight a potential future capability, stimulate debate and reflection, all of which is essential for innovation and future organisational development. The potential uses and benefits of UAVs are highlighted including both the challenges and rewards of utilising UAVs for casualty evacuation. Key benefits are reduced risk to human life, cost, ability to insert into areas conventional aircraft cannot and the rapidity of transfer. Challenges are likely to be airspace management, decisions on appropriate level of care to deliver during transit and ultimately user acceptability. The article also highlights that in order to maximise our ability to exploit new technologies, all arms and trades within the military must be involved in collective research and development. Furthermore, sensible corroboration with private companies will further enhance our ability to acquire products that best serve our needs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use

Laboratory evaluation of 10 heat and moisture exchangers using simulated aeromedical evacuation conditions.

PubMed

Suliman, Huda S; Fecura, Stephen E; Baskin, Jonathan; Kalns, John E

2011-06-01

Heat and moisture exchangers (HMEs) are used for airway humidification in mechanically ventilated patients and have been evaluated only under hospital conditions. U.S. Air Force aeromedical evacuation transports are performed under rugged conditions further complicated by the cold and dry environment in military aircrafts, and HMEs are used to provide airway humidification for patients. This study evaluated 10 commercial HMEs using a test system that simulated aeromedical evacuation conditions. Although the American National Standards Institute recommends inspired air to be at an absolute humidity value of > or = 30 mg/L for mechanically ventilated patients, the highest absolute humidity by any HME was approximately 20 mg/L. Although none of the HMEs were able to maintain a temperature high enough to achieve the humidity standard of the American National Standards Institute, the clinical significance of this standard may be less important than the relative humidity maintained in the respired air, especially on evacuation flights of short duration.

Air Force Medical Service > Resources > Suicide Prevention

Science.gov Websites

Air Force Medical Service Air Force Medical Service Join the Air Force Home Your Healthcare Healthy Videos MHS Genesis AFMS Priorities Trusted Care Vision Air Force Medical Home Full Spectrum Medical ) Air Force EFMP Who is an EFM? Who must enroll? EFMP-Medical EFMP-M Objectives Family Criteria EFMP-M

Intra-community implications of implementing multiple tsunami-evacuation zones in Alameda, California

USGS Publications Warehouse

Peters, Jeff; Wood, Nathan J.; Wilson, Rick; Miller, Kevin

2016-01-01

Tsunami-evacuation planning in coastal communities is typically based on maximum evacuation zones for a single scenario or a composite of sources; however, this approach may over-evacuate a community and overly disrupt the local economy and strain emergency-service resources. To minimize the potential for future over-evacuations, multiple evacuation zones based on arrival time and inundation extent are being developed for California coastal communities. We use the coastal city of Alameda, California (USA), as a case study to explore population and evacuation implications associated with multiple tsunami-evacuation zones. We use geospatial analyses to estimate the number and type of people in each tsunami-evacuation zone and anisotropic pedestrian evacuation models to estimate pedestrian travel time out of each zone. Results demonstrate that there are tens of thousands of individuals in tsunami-evacuation zones on the two main islands of Alameda, but they will likely have sufficient time to evacuate before wave arrival. Quality of life could be impacted by the high number of government offices, schools, day-care centers, and medical offices in certain evacuation zones and by potentially high population density at one identified safe area after an evacuation. Multi-jurisdictional evacuation planning may be warranted, given that many at-risk individuals may need to evacuate to neighboring jurisdictions. The use of maximum evacuation zones for local tsunami sources may be warranted given the limited amount of available time to confidently recommend smaller zones which would result in fewer evacuees; however, this approach may also result in over-evacuation and the incorrect perception that successful evacuations are unlikely.

The effects of wearing Passenger Protective Breathing Equipment on evacuation times through type III and type IV emergency aircraft exits in clear air and smoke.

DOT National Transportation Integrated Search

1989-11-01

The effects of Passenger Protective Breathing Equipment (PPBE) on the time required for simulated emergency evacuations through Type III and Type IV overwing aircraft exits were studied in two quasi-independent experiments, one in clear air and anoth...

Air ambulance medical transport advertising and marketing.

PubMed

2011-01-01

The National Association of EMS Physicians (NAEMSP), the American College of Emergency Physicians (ACEP), the Air Medical Physician Association (AMPA), the Association of Air Medical Services (AAMS), and the National Association of State EMS Officials (NASEMSO) believe that patient care and outcomes are optimized by using air medical transport services that are licensed air ambulance providers with robust physician medical director oversight and ongoing quality assessment and review. Only air ambulance medical transport services with these credentials should advertise/market themselves as air ambulance services.

The Incidence of Fever in US Critical Care Air Transport Team Combat Trauma Patients Evacuated from the Theater between March 2009 and March 2010

DTIC Science & Technology

2013-11-01

THE INCIDENCE OF FEVER IN US CRITICAL CARE AIR TRANSPORT TEAM COMBAT TRAUMA PATIENTS EVACUATED FROM THE THEATER BETWEEN MARCH 2009 AND MARCH 2010...Critical Care Air Transport Teams (CCATTs). Fever after trauma is correlated with surgical complications and infection. The purposes of this study are...248 trauma patients met the inclusion criteria, and 101 trauma patients (40%) had fever . The mean age was 28 years, and 98% of patients were men. The

Rebuilding the Trust: Independent Review Group Report on Rehabilitative Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center

DTIC Science & Technology

2007-04-11

conditions and administrative hurdles and failed to place proper priority on solutions. • A smooth integration is lacking for transition into a joint Walter...accounts the evolution of rapid joint battlefield medical response, rapid evacuation with intensive care, quality air transportation, and unsurpassed...and increased survival is the result of more efficient joint medical response on the battlefield and medical tactics, techniques and procedures that

Increased flight surgeon role in military aeromedical evacuation.

PubMed

Lyons, T J; Connor, S B

1995-10-01

Physicians were involved in the development of aeromedical evacuation (medevac) and flight surgeons flew as crewmembers on the first U.S. military medevac flights. However, since World War II flight surgeons have not been routinely assigned to operational medevac units. The aeromedical literature addressing the role of physicians in medevac is controversial. Recent contingencies involving the U.S. Air Force (USAF) have required the augmentation of medevac units with flight surgeons. Beginning in 1992, the United States Air Forces Europe (USAFE) assigned three flight surgeons to the medevac squadron. Between 2 February 1993 and 24 March 1994 USAFE moved 241 patients on 29 missions out of the former Yugoslavia--most of these missions had a flight surgeon on the crew. Because advance medical information on the status of these patients is often nonexistent, the presence of a physician on the crew proved life-saving in some instances. In peacetime operations, there has been a recent trend in the European theater for the USAF to move more unstable patients. Dedicated medevac flight surgeons have proven to have the specific experience and training to perform effectively in the role of in-flight medical attendant. In addition, they are effective in negotiating with referring physicians about the urgency of movement, required equipment, the need for medical attendants, etc. These flight surgeons also provide medical coverage of transiting patients in the Aeromedical Staging Flight (ASF), thus providing needed continuity in the medevac system. Dedicated medevac flight surgeons fill a unique and valuable role in medevac systems. Agencies with medevac units should consider assigning flight surgeons to these units.

Evacuation of the ICU

PubMed Central

Niven, Alexander S.; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V.; Christian, Michael D.; Grissom, Colin K.; Christian, Michael D.; Devereaux, Asha V.; Dichter, Jeffrey R.; Kissoon, Niranjan; Rubinson, Lewis; Amundson, Dennis; Anderson, Michael R.; Balk, Robert; Barfield, Wanda D.; Bartz, Martha; Benditt, Josh; Beninati, William; Berkowitz, Kenneth A.; Daugherty Biddison, Lee; Braner, Dana; Branson, Richard D; Burkle, Frederick M.; Cairns, Bruce A.; Carr, Brendan G.; Courtney, Brooke; DeDecker, Lisa D.; De Jong, Marla J.; Dominguez-Cherit, Guillermo; Dries, David; Einav, Sharon; Erstad, Brian L.; Etienne, Mill; Fagbuyi, Daniel B.; Fang, Ray; Feldman, Henry; Garzon, Hernando; Geiling, James; Gomersall, Charles D.; Grissom, Colin K.; Hanfling, Dan; Hick, John L.; Hodge, James G.; Hupert, Nathaniel; Ingbar, David; Kanter, Robert K.; King, Mary A.; Kuhnley, Robert N.; Lawler, James; Leung, Sharon; Levy, Deborah A.; Lim, Matthew L.; Livinski, Alicia; Luyckx, Valerie; Marcozzi, David; Medina, Justine; Miramontes, David A.; Mutter, Ryan; Niven, Alexander S.; Penn, Matthew S.; Pepe, Paul E.; Powell, Tia; Prezant, David; Reed, Mary Jane; Rich, Preston; Rodriquez, Dario; Roxland, Beth E.; Sarani, Babak; Shah, Umair A.; Skippen, Peter; Sprung, Charles L.; Subbarao, Italo; Talmor, Daniel; Toner, Eric S.; Tosh, Pritish K.; Upperman, Jeffrey S.; Uyeki, Timothy M.; Weireter, Leonard J.; West, T. Eoin; Wilgis, John; Ornelas, Joe; McBride, Deborah; Reid, David; Baez, Amado; Baldisseri, Marie; Blumenstock, James S.; Cooper, Art; Ellender, Tim; Helminiak, Clare; Jimenez, Edgar; Krug, Steve; Lamana, Joe; Masur, Henry; Mathivha, L. Rudo; Osterholm, Michael T.; Reynolds, H. Neal; Sandrock, Christian; Sprecher, Armand; Tillyard, Andrew; White, Douglas; Wise, Robert; Yeskey, Kevin

2014-01-01

BACKGROUND: Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS: The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee’s methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS: Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. CONCLUSIONS: Successful ICU evacuation during a disaster requires

Heat Transfar Properties of Flat-Panel Evacuated Porous Insrlators

NASA Astrophysics Data System (ADS)

Yoneno, Hirosyi; Yamamoto, Ryoichi

Flat Panel evacuated porous insulators have been produced by filling powder or fiber (such as perlite powder, diatomaceous earth powder, silica aerogel powder, g lass fiber and ceramic fiber) in film-like laminated plastic container and by evacuating to form vacuum in it is interior. Heat transfer properties of these evacuated insulators have been studied under various conditions (such as particle diameter, surface area, packing density, solid volume fraction and void dimension). The apparent mean thermal conductivity has been measured for the boundary surface temperature at cold face temperature 13°C and hot face temperature 35°. The effect of air pressure ranging from 1 Pa to one atomosphere (105 Pa) was examined. The results were as follows. (1) For each powder the apparent mean thermal conductivity decreases with decreasing residual air pressure, and at very low pressure bellow 1 -103 Pa the conductivity becomes indeqendent of pressure. The thermal conductivity at 1.3Pa is 0.0053 W/mK for perlite powder, 0.0048W/mK for diatomaceous earth powder, 0.0043 W/mK for silica aerogel powder and 0.0029W/mK for glass fiber. (2) With decreasing particle size, the apparent mean thermal conductivity is constant independent of residual air pressure in higher pressure region. It is that void dimension continues to decrease with particle size and the mean free path of air becomes comparable with void dimension. (3) In the range of minor solid volume fraction, the apparent mean thermal conductivity at very low precreases with decreasing particle size. This shows the thermal contact resistance of the solid particle increases with decreasing particle size.

Nursing home evacuation plans.

PubMed

Castle, Nicholas G

2008-07-01

I examined evacuation plans from 2134 nursing homes and analyzed national data to determine the types of nursing homes cited for deficiencies in their evacuation plans. Evacuation plans were assessed according to criteria developed by an expert panel funded by the Office of the Inspector General. Deficiency citations came from the Online Survey, Certification, and Recording database, collected from 1997 to 2005. Four specific citations, for written emergency plans, staff training, written evacuation plans, and fire drills, were examined with multivariate logistic regression. Most plans had water supply provisions (96%). Only 31% specified an evacuation route. The rate of citations was relatively stable throughout the study period: each year approximately 0.6% of facilities were found to be deficient in written emergency plans, 2.1% in staff training, 1.2% in written evacuation plans, and 7.9% in fire drills. Some nursing homes need more specific evacuation plans. Water supply was the most and evacuation routes were the least well-addressed areas.

Tsunami evacuation simulation considering differences in evacuation means depending on the household attribute

NASA Astrophysics Data System (ADS)

Sugiki, Nao; Hirata, Yoshiki; Matsuo, Kojiro

2017-10-01

Large scale earthquakes occur frequently in Japan in recent years. In the Great East Japan Earthquake that occurred in 2011 and caused major damage, more than 90% of the dead were due to the tsunami. The speed of evacuation is important in considering evacuation at the time of the attack of the tsunami, especially the elderly evacuation speed is assumed to be slower than non-elderly people. Elderly people may have different means of evacuation and speed depending on the composition of the households to which they belong because of the different possibilities of riding in families' driven cars. However, a simulation taking such a difference of evacuation into consideration has not been conducted. The purpose of this study is to conduct a tsunami evacuation simulation in consideration of evacuation measures and speed depending on the type of households belonging to in the tsunami inundation area of Toyohashi city, Japan. In order to conduct the tsunami evacuation simulation considering the household type, detailed data on individual households is necessary. However, it is difficult to obtain from aggregated data such as National Census. Therefore, detailed data on individual households is created by using the household micro data estimation system developed by Sugiki et al. [1]. Evacuation simulation is performed by shortest path search using Esri's ArcGIS Network Analyst's OD cost matrix analysis. The elderly people who cannot complete evacuation by the time of the arrival of the tsunami were found from evacuation simulation results assuming evacuation measures available for each household attribute to which the evacuees belong.

Measuring US Army medical evacuation: Metrics for performance improvement.

PubMed

Galvagno, Samuel M; Mabry, Robert L; Maddry, Joseph; Kharod, Chetan U; Walrath, Benjamin D; Powell, Elizabeth; Shackelford, Stacy

2018-01-01

The US Army medical evacuation (MEDEVAC) community has maintained a reputation for high levels of success in transporting casualties from the point of injury to definitive care. This work served as a demonstration project to advance a model of quality assurance surveillance and medical direction for prehospital MEDEVAC providers within the Joint Trauma System. A retrospective interrupted time series analysis using prospectively collected data was performed as a process improvement project. Records were reviewed during two distinct periods: 2009 and 2014 to 2015. MEDEVAC records were matched to outcomes data available in the Department of Defense Trauma Registry. Abstracted deidentified data were reviewed for specific outcomes, procedures, and processes of care. Descriptive statistics were applied as appropriate. A total of 1,008 patients were included in this study. Nine quality assurance metrics were assessed. These metrics were: airway management, management of hypoxemia, compliance with a blood transfusion protocol, interventions for hypotensive patients, quality of battlefield analgesia, temperature measurement and interventions, proportion of traumatic brain injury (TBI) patients with hypoxemia and/or hypotension, proportion of traumatic brain injury patients with an appropriate assessment, and proportion of missing data. Overall survival in the subset of patients with outcomes data available in the Department of Defense Trauma Registry was 97.5%. The data analyzed for this study suggest overall high compliance with established tactical combat casualty care guidelines. In the present study, nearly 7% of patients had at least one documented oxygen saturation of less than 90%, and 13% of these patients had no documentation of any intervention for hypoxemia, indicating a need for training focus on airway management for hypoxemia. Advances in battlefield analgesia continued to evolve over the period when data for this study was collected. Given the inherent high

Lessons learned from the total evacuation of a hospital after the 2016 Kumamoto Earthquake.

PubMed

Yanagawa, Youichi; Kondo, Hisayoshi; Okawa, Takashi; Ochi, Fumio

The 2016 Kumamoto Earthquakes were a series of earthquakes that included a foreshock earthquake (magnitude 6.2) on April 14 and a main shock (magnitude 7.0) on April 16, 2016. A number of hospitals in Kumamoto were severely damaged by the two major earthquakes and required total evacuation. The authors retrospectively analyzed the activity data of the Disaster Medical Assistance Teams using the Emergency Medical Information System records to investigate the cases in which the total evacuation of a hospital was attempted following the 2016 Kumamoto Earthquake. Total evacuation was attempted at 17 hospitals. The evacuation of one of these hospitals was canceled. Most of the hospital buildings were more than 20 years old. The danger of collapse was the most frequent reason for evacuation. Various transportation methods were employed, some of which involved the Japan Ground Self-Defense Force; no preventable deaths occurred during transportation. The hospitals must now be renovated to improve their earthquake resistance. The coordinated and combined use of military and civilian resources is beneficial and can significantly reduce human suffering in large-scale disasters.

Factors Affecting Hurricane Evacuation Intentions.

PubMed

Lazo, Jeffrey K; Bostrom, Ann; Morss, Rebecca E; Demuth, Julie L; Lazrus, Heather

2015-10-01

Protective actions for hurricane threats are a function of the environmental and information context; individual and household characteristics, including cultural worldviews, past hurricane experiences, and risk perceptions; and motivations and barriers to actions. Using survey data from the Miami-Dade and Houston-Galveston areas, we regress individuals' stated evacuation intentions on these factors in two information conditions: (1) seeing a forecast that a hurricane will hit one's area, and (2) receiving an evacuation order. In both information conditions having an evacuation plan, wanting to keep one's family safe, and viewing one's home as vulnerable to wind damage predict increased evacuation intentions. Some predictors of evacuation intentions differ between locations; for example, Florida respondents with more egalitarian worldviews are more likely to evacuate under both information conditions, and Florida respondents with more individualist worldviews are less likely to evacuate under an evacuation order, but worldview was not significantly associated with evacuation intention for Texas respondents. Differences by information condition also emerge, including: (1) evacuation intentions decrease with age in the evacuation order condition but increase with age in the saw forecast condition, and (2) evacuation intention in the evacuation order condition increases among those who rely on public sources of information on hurricane threats, whereas in the saw forecast condition evacuation intention increases among those who rely on personal sources. Results reinforce the value of focusing hurricane information efforts on evacuation plans and residential vulnerability and suggest avenues for future research on how hurricane contexts shape decision making. © 2015 Society for Risk Analysis.

Injury patterns in clashes between citizens and security forces during forced evacuation.

PubMed

Schwartz, D; Bar-Dayan, Y

2008-10-01

Clashes between state security forces and civilian populations can lead to mass casualty incidents (MCI), challenging emergency medical service (EMS) systems, hospitals and medical management systems. In January 2006, clashes erupted between Israeli security forces and settlers, around the forced evacuation of the Amona outpost. Data collected during the events and in subsequent formal debriefings were processed to identify the specifics of an MCI caused by forced evacuation. Pre-event preparedness, time and types of injuries encountered were evaluated among evacuated civilians and security forces members, their transport to hospitals, care received and follow-up. The event is described according to DISAST-CIR methodology. Data were entered on MS Excel (2003) and analysis was carried out using SPSS version 12. 4000 police personnel (backed by army forces) clashed for 12 h with approximately 5000 settlers. 229 injured (174 settlers and 55 security personnel) were cared for at six receiving hospitals. A total of 16 were evacuated by aeromedical evacuation, including one severely head-injured policeman. Settlers used sticks, stones and cement blocks, whereas police used mounted riders, batons and shields. Head injuries were the most common injuries among settlers (50%), whereas extremity injuries dominated among security forces members (72.7%). Large-scale clashes between state security forces and citizens may cause numerous injuries, even if firearms and explosives are not used. Despite the fact that almost all injuries were mild, the incident burdened local medical teams, EMS and Jerusalem hospitals. A predominance of head injuries was found among injured settlers and extremity injuries among injured security forces.

Evacuation of Intensive Care Units During Disaster: Learning From the Hurricane Sandy Experience.

PubMed

King, Mary A; Dorfman, Molly V; Einav, Sharon; Niven, Alex S; Kissoon, Niranjan; Grissom, Colin K

2016-02-01

Data on best practices for evacuating an intensive care unit (ICU) during a disaster are limited. The impact of Hurricane Sandy on New York City area hospitals provided a unique opportunity to learn from the experience of ICU providers about their preparedness, perspective, roles, and activities. We conducted a cross-sectional survey of nurses, respiratory therapists, and physicians who played direct roles during the Hurricane Sandy ICU evacuations. Sixty-eight health care professionals from 4 evacuating hospitals completed surveys (35% ICU nurses, 21% respiratory therapists, 25% physicians-in-training, and 13% attending physicians). Only 21% had participated in an ICU evacuation drill in the past 2 years and 28% had prior training or real-life experience. Processes were inconsistent for patient prioritization, tracking, transport medications, and transport care. Respondents identified communication (43%) as the key barrier to effective evacuation. The equipment considered most helpful included flashlights (24%), transport sleds (21%), and oxygen tanks and respiratory therapy supplies (19%). An evacuation wish list included walkie-talkies/phones (26%), lighting/electricity (18%), flashlights (10%), and portable ventilators and suction (16%). ICU providers who evacuated critically ill patients during Hurricane Sandy had little prior knowledge of evacuation processes or vertical evacuation experience. The weakest links in the patient evacuation process were communication and the availability of practical tools. Incorporating ICU providers into hospital evacuation planning and training, developing standard evacuation communication processes and tools, and collecting a uniform dataset among all evacuating hospitals could better inform critical care evacuation in the future.

21 CFR 880.5045 - Medical recirculating air cleaner.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Medical recirculating air cleaner. 880.5045... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating air cleaner is a device used to remove particles from the air for medical purposes. The device may...

21 CFR 880.5045 - Medical recirculating air cleaner.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical recirculating air cleaner. 880.5045... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating air cleaner is a device used to remove particles from the air for medical purposes. The device may...

21 CFR 880.5045 - Medical recirculating air cleaner.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical recirculating air cleaner. 880.5045... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating air cleaner is a device used to remove particles from the air for medical purposes. The device may...

Health ramifications of the Gush Katif evacuation.

PubMed

Kory, Ronen; Carney, Alon; Naimer, Sody

2013-03-01

Following the 2005 evacuation of Gush Katif, a community of Jewish settlements located in the greater Gaza Strip, many evacuees reported a deterioration in their health status. To determine if and to what degree the evacuation of Gush Katif caused a worsening in the health status of the evacuees. In this retrospective cohort study we assessed the medical records of 2962 evacuees for changes in prevalence of diabetes, hypertension and ischemic heart disease in the period beginning 1 year before and ending 5 years after the evacuation. The findings were compared to those for the general israeli population. A questionnaire was distributed to 64 individuals to assess lifestyle and social change. An increase in diabetes and hypertension was found in men aged 45-64. The prevalence of diabetes mellitus in the 45-54 male group rose from 8.7% in 2004 to 12.6% in 2007 to 18.7% in 2010; in the 55-64 age group it rose from 24.6% in 2004 to 29.9% in 2007 to 32.9% in 2010. Hypertension in 45-64 year old men rose from 27.1% in 2004 to 35.12% in 2010. The increases in diabetes were significant and higher than those in the general population. The increases in hypertension were of similar magnitude. The prevalence of heart disease did not change and is similar to that in the general population. The questionnaire sample showed an increase in depression and overweight. The Gush Katif evacuation appears to be associated with increased morbidity of chronic disease. This may be attributed to any of several mechanisms, with unemployment, depression, inactivity and overweight playing significant roles. Preventive medical interventions and measures should be employed to screen and treat this population which underwent a major stressful event and as a result seem at greater risk than their peers.

21 CFR 880.6500 - Medical ultraviolet air purifier.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Medical ultraviolet air purifier. 880.6500 Section... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by exposure...

21 CFR 880.6500 - Medical ultraviolet air purifier.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical ultraviolet air purifier. 880.6500 Section... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by exposure...

21 CFR 880.6500 - Medical ultraviolet air purifier.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical ultraviolet air purifier. 880.6500 Section... Miscellaneous Devices § 880.6500 Medical ultraviolet air purifier. (a) Identification. A medical ultraviolet air purifier is a device intended for medical purposes that is used to destroy bacteria in the air by exposure...

Feasibility of negative pressure wound therapy during intercontinental aeromedical evacuation of combat casualties.

PubMed

Fang, Raymond; Dorlac, Warren C; Flaherty, Stephen F; Tuman, Caroline; Cain, Steven M; Popey, Tracy L C; Villard, Douglas R; Aydelotte, Jayson D; Dunne, James R; Anderson, Adam M; Powell, Elisha T

2010-07-01

The objective of this study was to assess the feasibility of utilizing negative pressure wound therapy (NPWT) for the treatment of wartime soft-tissue wounds during intercontinental aeromedical evacuation. Attempts to use NPWT during early phases of overseas contingency operations resulted in occasional vacuum system failures and potentially contributed to wound complications. These anecdotal episodes led to a perception that NPWT during aeromedical evacuation carried a high risk of wound complications and limited its use. As a result, NPWT was not frequently applied in the management of soft-tissue wounds before US casualty arrival in the continental United States (CONUS) for wounds sustained in the combat theaters. Concurrently, early NPWT on the traumatic wounds of host nation casualties not requiring aeromedical evacuation seemed to provide many benefits typically associated with the therapy such as decreased infection rates, earlier wound closure, and improved pain management. On a daily basis, study investigators reviewed the trauma in-patient census at Landstuhl Regional Medical Center, Germany, to identify patient candidates with soft-tissue extremity or torso wounds that required packing. Patient demographics, injuries, and previous wound treatments were recorded. Surgeons inspected wounds in the operating room and applied a NPWT dressing if deemed appropriate. NPWT was continued throughout the remainder of the patient's hospitalization and also during aeromedical evacuation to CONUS. A study investigator escorted the patient during aeromedical evacuation to educate the flight crews, to record the impact on crew workload, and to troubleshoot the system if necessary. Thirty enrolled patients with 41 separate wounds flew from Germany to CONUS with a portable NPWT system (VAC Freedom System; Kinetic Concepts Incorporated, San Antonio, TX). All 30 patients arrived at the destination facilities with intact and functional systems. No significant in

Initial multicenter technical experience with the Apollo device for minimally invasive intracerebral hematoma evacuation.

PubMed

Spiotta, Alejandro M; Fiorella, David; Vargas, Jan; Khalessi, Alexander; Hoit, Dan; Arthur, Adam; Lena, Jonathan; Turk, Aquilla S; Chaudry, M Imran; Gutman, Frederick; Davis, Raphael; Chesler, David A; Turner, Raymond D

2015-06-01

No conventional surgical intervention has been shown to improve outcomes for patients with spontaneous intracerebral hemorrhage (ICH) compared with medical management. We report the initial multicenter experience with a novel technique for the minimally invasive evacuation of ICH using the Penumbra Apollo system (Penumbra Inc, Alameda, California). Institutional databases were queried to perform a retrospective analysis of all patients who underwent ICH evacuation with the Apollo system from May 2014 to September 2014 at 4 centers (Medical University of South Carolina, Stony Brook University, University of California at San Diego, and Semmes-Murphy Clinic). Cases were performed either in the neurointerventional suite, operating room, or in a hybrid operating room/angiography suite. Twenty-nine patients (15 female; mean age, 62 ± 12.6 years) underwent the minimally invasive evacuation of ICH. Six of these parenchymal hemorrhages had an additional intraventricular hemorrhage component. The mean volume of ICH was 45.4 ± 30.8 mL, which decreased to 21.8 ± 23.6 mL after evacuation (mean, 54.1 ± 39.1% reduction; P < .001). Two complications directly attributed to the evacuation attempt were encountered (6.9%). The mortality rate was 13.8% (n = 4). Minimally invasive evacuation of ICH and intraventricular hemorrhage can be achieved with the Apollo system. Future work will be required to determine which subset of patients are most likely to benefit from this promising technology.

The Pedestrian Evacuation Analyst: geographic information systems software for modeling hazard evacuation potential

USGS Publications Warehouse

Jones, Jeanne M.; Ng, Peter; Wood, Nathan J.

2014-01-01

Recent disasters such as the 2011 Tohoku, Japan, earthquake and tsunami; the 2013 Colorado floods; and the 2014 Oso, Washington, mudslide have raised awareness of catastrophic, sudden-onset hazards that arrive within minutes of the events that trigger them, such as local earthquakes or landslides. Due to the limited amount of time between generation and arrival of sudden-onset hazards, evacuations are typically self-initiated, on foot, and across the landscape (Wood and Schmidtlein, 2012). Although evacuation to naturally occurring high ground may be feasible in some vulnerable communities, evacuation modeling has demonstrated that other communities may require vertical-evacuation structures within a hazard zone, such as berms or buildings, if at-risk individuals are to survive some types of sudden-onset hazards (Wood and Schmidtlein, 2013). Researchers use both static least-cost-distance (LCD) and dynamic agent-based models to assess the pedestrian evacuation potential of vulnerable communities. Although both types of models help to understand the evacuation landscape, LCD models provide a more general overview that is independent of population distributions, which may be difficult to quantify given the dynamic spatial and temporal nature of populations (Wood and Schmidtlein, 2012). Recent LCD efforts related to local tsunami threats have focused on an anisotropic (directionally dependent) path distance modeling approach that incorporates travel directionality, multiple travel speed assumptions, and cost surfaces that reflect variations in slope and land cover (Wood and Schmidtlein, 2012, 2013). The Pedestrian Evacuation Analyst software implements this anisotropic path-distance approach for pedestrian evacuation from sudden-onset hazards, with a particular focus at this time on local tsunami threats. The model estimates evacuation potential based on elevation, direction of movement, land cover, and travel speed and creates a map showing travel times to safety (a

Air Medical Evacuations From the German North Sea Wind Farm Bard Offshore 1: Traumatic Injuries, Acute Diseases, and Rescue Process Times (2011-2013).

PubMed

Dethleff, Dirk; Weinrich, Nils; Kowald, Birgitt; Hory, Dorothea; Franz, Rüdiger; Nielsen, Maja Verena; Seide, Klaus; Jürgens, Christian; Stuhr, Markus

2016-01-01

Our purpose was 2-fold: 1) to show emergency-related traumatic injury and acute disease patterns and 2) to evaluate air rescue process times in a remotely located German offshore wind farm. Optimally, this will support methodologies to reduce offshore help time (time from the incoming emergency call until offshore arrival of the helicopter). The type and severity of traumatic injuries and acute diseases were retrospectively analyzed for 39 air medevacs from August 2011 to December 2013, and the process times of air rescue missions were evaluated in detail. Forty-nine percent of the medevacs were related to traumatic injuries, whereas 41% were associated with acute diseases and 10% remained unclear. Cardiovascular and gastrointestinal disorders accounted for 90% of internal medical cases. About 69% of the trauma was related to contusions, lacerations, and cuts. The main body regions injured were limbs (∼59%) and head (∼32%). The total rescue time until arrival at the destination facility averaged 175.3 minutes (standard deviation = 54.4 minutes). The mean helicopter offshore arrival time was 106.9 minutes (standard deviation = 57.4 minutes) after the incoming emergency call. In 64% of the medevacs, the helicopter arrived on scene within a help time of 90 minutes. A reduction of help time (≤ 60 minutes) for time-critical severe trauma and acute diseases may be anticipated through rapid and focused medical and logistic decision-making processes by the onshore dispatch center combined with professional, qualified, and well-trained flight and rescue personnel. Copyright © 2016 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Factors associated with high-rise evacuation: qualitative results from the World Trade Center Evacuation Study.

PubMed

Gershon, Robyn R M; Qureshi, Kristine A; Rubin, Marcie S; Raveis, Victoria H

2007-01-01

Due to the fact that most high-rise structures (i.e., >75 feet high, or eight to ten stories) are constructed with extensive and redundant fire safety features, current fire safety procedures typically only involve limited evacuation during minor to moderate fire emergencies. Therefore, full-scale evacuation of high-rise buildings is highly unusual and consequently, little is known about how readily and rapidly high-rise structures can be evacuated fully. Factors that either facilitate or inhibit the evacuation process remain under-studied. This paper presents results from the qualitative phase of the World Trade Center Evacuation Study, a three-year, five-phase study designed to improve our understanding of the individual, organizational, and environmental factors that helped or hindered evacuation from the World Trade Center (WTC) Towers 1 and 2, on 11 September 2001. Qualitative data from semi-structured, in-depth interviews and focus groups involving WTC evacuees were collected and analyzed. On the individual level, factors that affected evacuation included perception of risk (formed largely by sensory cues), preparedness training, degree of familiarity with the building, physical condition, health status, and footwear. Individual behavior also was affected by group behavior and leadership. At the organizational level, evacuation was affected by worksite preparedness planning, including the training and education of building occupants, and risk communication. The environmental conditions affecting evacuation included smoke, flames, debris, general condition and degree of crowdedness on staircases, and communication infrastructure systems (e.g., public address, landline, cellular and fire warden's telephones). Various factors at the individual, organizational, and environmental levels were identified that affected evacuation. Interventions that address the barriers to evacuation may improve the full-scale evacuation of other high-rise buildings under extreme

Diagnoses and Factors Associated With Medical Evacuation and Return to Duty for Service Members Participating in Operation Iraqi Freedom or Operation Enduring Freedom: A Prospective Cohort Study

DTIC Science & Technology

2010-01-23

effect of non-battle-related injuries and disease on military readiness. Funding John P Murtha Neuroscience and Pain Institute, and US Army Regional...doctor visits and medical evacuation.5,6 To achieve optimum use of medical resources and effectively plan military operations, medical and...Operation Iraqi Freedom who returned to duty increased substantially from a low of 8% in 2004 to 37% in 2007, an effect partly attributable to the

ICU fire evacuation preparedness in London: a cross-sectional study.

PubMed

Murphy, G R F; Foot, C

2011-05-01

Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. A cross-sectional survey of all 50 adult and paediatric ICUs within the London Postgraduate Deanery was conducted; neonatal units were excluded. The senior nurse at each unit was asked to complete a 90-question structured questionnaire, covering unit patient characteristics, design, equipment, training, and their evacuation plan. Thirty-five of 50 (70%) responded within 2 months of the study. Significant weaknesses were reported in unit design, equipment, and planning. Unit design was compromised by inadequate fire doors (20%), ventilation cut-outs (17%), and escape routes (up to 60%). The ability to evacuate multiple patients simultaneously may be limited by a lack of portable monitoring equipment (49% of beds) and emergency drug supplies (20% of beds). Evacuation plans were often limited in their scope (96% expected to remain on their floor; 14% had plans to obtain medications after evacuation), and not rehearsed (60%). Staff training, while well provided for permanent staff, is less so for temporary staff (34%). Forward planning for an urgent evacuation can be improved.

Evacuation of Pets During Disasters: A Public Health Intervention to Increase Resilience.

PubMed

Chadwin, Robin

2017-09-01

During a disaster, many pet owners want to evacuate their pets with them, only to find that evacuation and sheltering options are limited or nonexistent. This disregard for companion animal welfare during a disaster can have public health consequences. Pet owners may be stranded at home, unwilling to leave their pets behind. Others refuse evacuation orders or attempt to reenter evacuation sites illegally to rescue their animals. Psychopathologies such as grief, depression, and posttraumatic stress disorder are associated with pet abandonment during an evacuation. Health care workers may refuse to work if their animals are in danger, leaving medical facilities understaffed during crises. Zoonotic disease risk increases when pets are abandoned or left to roam, where they are more likely to encounter infected wildlife or unowned animals than they would if they were safely sheltered with their owners. These sequelae are not unique to the United States, nor to wealthy countries. Emergency planning for companion animals during disasters is a global need in communities with a significant pet population, and will increase resilience and improve public health.

Which groups of patients benefit from helicopter evacuation?

PubMed

Hotvedt, R; Kristiansen, I S; Førde, O H; Thoner, J; Almdahl, S M; Bjørsvik, G; Berge, L; Magnus, A C; Mamen, K; Sparr, T; Ytre-Arne, K

1996-05-18

The evacuation of emergency cases by air, usually by helicopter, is controversial because of the cost of the programme, the possibility of an accident (especially in an urban area), and unproven benefit. But such evacuations cannot be studied by a random intervention (eg, air versus ground ambulance). We used an expert-panel approach to estimate the health outcome for patients transferred by emergency helicopter compared with the potential outcome if they had gone by surface ambulance. The helicopter programme is based at the University Hospital of Tromsø in northern Norway. 370 case-reports of helicopter evacuation from rural areas were screened by anaesthetists for routine and case-specific data. Two expert panels assessed the cases for potential additional health benefit arising from the fact of helicopter evacuation. The panels used a modified Delphi technique to reach consensus in life-years gained. One panel met for cases aged under 15 and pregnant women, the other for older cases. 240 of the 370 cases were male (65%); the age range for both sexes was 0-86 years. The most common diagnosis for the 55 cases aged under 15 was infection (49%); in older patients, cardiovascular disease dominated (50%). Trauma accounted for just under a fifth of cases in both groups. On average, the patients arrived 69 min (range 0-615) earlier in hospital than if they had gone by ground transport. For 283 cases, the initial screening by the anaesthetists indicated no additional benefit compared with that obtainable by ground-ambulance transport. The main reason was that no treatment was given during the flight or early on in hospital that could not have been given otherwise. 90 cases entered the expert panel system. Of these 90, 49 cases were judged to have received no additional benefit. This left 41 (11% of the total of 370 evacuated) who were judged to have benefited, gaining 290.6 life-years. 96% of the total number of life-years gained was achieved in nine patients, six of

Prehospital injury severity of children evacuated by helicopters from combat zones: a retrospective report.

PubMed

Samuel, Nir; Hirschhorn, Gil; Chen, Jacob; Steiner, Ivan P; Shavit, Itai

2013-03-01

In Israel, the Airborne Rescue and Evacuation Unit (AREU) provides prehospital trauma care in times of peace and during times of armed conflict. In peacetime, the AREU transports children who were involved in motor vehicle collisions (MVC) and those who fall off cliffs (FOC). During armed conflict, the AREU evacuates children who sustain firearm injuries (FI) from the fighting zones. To report on prehospital injury severity of children who were evacuated by the AREU from combat zones. A retrospective comparative analysis was conducted on indicators of prehospital injury severity for patients who had MVC, FOC, and FI. It included the National Advisory Committee for Aeronautics (NACA) score, the Glasgow Coma Scale (GCS) score on scene, and the number of procedures performed by emergency medical personnel and by the AREU air-crew. From January 2003 to December 2009, 36 MVC, 25 FOC, and 17 FI children were transported from the scene by the AREU. Five patients were dead at the scene: 1 (2.8%) MVC, 1 (4%) FOC, and 3 (17.6%) FI. Two (11.7%) FI patients were dead on arrival at the hospital. MVC, FOC, and FI patients had mean (±SD) NACA scores of 4.4 ± 1.2, 3.6 ± 1.2, and 5 ± 0.7, respectively. Mean (±SD) GCS scores were 8.9 ± 5.6, 13.6 ± 4, and 6.9 ± 5.3, respectively. Life support interventions were required by 29 (80.6%) MVC, 3 (12%) FOC, and 15 (88.2%) FI patients. In the prehospital setting, children evacuated from combat zones were more severely injured than children who were transported from the scene during peacetime. Copyright © 2013 Elsevier Inc. All rights reserved.

Pedestrian evacuation modeling to reduce vehicle use for distant tsunami evacuations in Hawaiʻi

USGS Publications Warehouse

Wood, Nathan J.; Jones, Jamie; Peters, Jeff; Richards, Kevin

2018-01-01

Tsunami waves that arrive hours after generation elsewhere pose logistical challenges to emergency managers due to the perceived abundance of time and inclination of evacuees to use vehicles. We use coastal communities on the island of Oʻahu (Hawaiʻi, USA) to demonstrate regional evacuation modeling that can identify where successful pedestrian-based evacuations are plausible and where vehicle use could be discouraged. The island of Oʻahu has two tsunami-evacuation zones (standard and extreme), which provides the opportunity to examine if recommended travel modes vary based on zone. Geospatial path distance models are applied to estimate population exposure as a function of pedestrian travel time and speed out of evacuation zones. The use of the extreme zone triples the number of residents, employees, and facilities serving at-risk populations that would be encouraged to evacuate and slightly reduces the percentage of residents (98–76%) that could evacuate in less than 15 min at a plausible speed (with similar percentages for employees). Areas with lengthy evacuations are concentrated in the North Shore region for the standard zone but found all around the Oʻahu coastline for the extreme zone. The use of the extreme zone results in a 26% increase in the number of hotel visitors that would be encouraged to evacuate, and a 76% increase in the number of them that may require more than 15 min. Modeling can identify where pedestrian evacuations are plausible; however, there are logistical and behavioral issues that warrant attention before localized evacuation procedures may be realistic.

Societal acceptance of unnecessary evacuation

NASA Astrophysics Data System (ADS)

McCaughey, Jamie W.; Mundzir, Ibnu; Patt, Anthony; Rosemary, Rizanna; Safrina, Lely; Mahdi, Saiful; Daly, Patrick

2017-04-01

Uncertainties in forecasting extreme events force an unavoidable tradeoff between false alarms and misses. The appropriate balance depends on the level of societal acceptance of unnecessary evacuations, but there has been little empirical research on this. Intuitively it may seem that an unnecessary evacuation would make people less likely to evacuate again in the future, but our study finds no support for this intuition. Using new quantitative (n=800) and qualitative evidence, we examine individual- and household-level evacuation decisions in response to the strong 11-Apr-2012 earthquake in Aceh, Indonesia. This earthquake did not produce a tsunami, but the population had previously experienced the devastating 2004 tsunami. In our sample, the vast majority of people (86%) evacuated in the 2012 earthquake, and nearly all (94%) say they would evacuate again if a similar earthquake happened in the future. Self-reported level of fear at the moment of the 2012 earthquake explains more of the variance in evacuation decisions and intentions than does a combination of perceived tsunami risk and perceived efficacy of evacuation modeled on protection motivation theory. These findings suggest that the appropriate balance between false alarms and misses may be highly context-specific. Investigating this in each context would make an important contribution to the effectiveness of early-warning systems.

Analysis of evacuations from areas of operation to the Spanish Role 4 medical treatment facility (2008-2013).

PubMed

Navarro Suay, Ricardo; Tamburri Bariain, Rafael; Gutiérrez Ortega, Carlos; Hernández Abadía de Barbará, Alberto; López Soberón, Edurne; Rodríguez Moro, Carlos

2014-01-01

Since 1987, the Spanish Armed Forces have deployed their troops in a multitude of conflicts and natural disasters worldwide. The Spanish Military Medical Corps has the ability to deploy Role 1, Role 2, and one Role 3 medical treatment facilities. It also has a Role 4 in operation, the "Gómez Ulla" Central Hospital of Defense, in Madrid. The aim of this study is to describe the type of Spanish casualties evacuated from different areas of operation to the Role 4 from 2008 to 2013. A retrospective, cross-sectional study was performed on a sample of 232 patients. Among these, 211 (91%) were noncombat casualties: 126 because of illness, 53 because of an accident, and 32 because of sports injuries. The remaining 21 (9%) were combat casualties: 11 from improvised explosive devices and 10 from gunfire. Afghanistan, followed by Lebanon, is the operational area where most evacuees originate. The authors consider it essential that the Spanish Armed Forces rely on a Role 4 medical treatment facility as part of their medical support to international operations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

Can cooperative behaviors promote evacuation efficiency?

NASA Astrophysics Data System (ADS)

Cheng, Yuan; Zheng, Xiaoping

2018-02-01

This study aims to get insight into the question whether cooperative behaviors can promote the evacuation efficiency during an evacuation process. In this work, cooperative behaviors and evacuation efficiency have been examined in detail by using a cellular automata model with behavioral extension. The simulation results show that moderate cooperative behaviors can result in the highest evacuation efficiency. It is found that in a mixture of cooperative and competitive individuals, more cooperative people will lead to relatively high evacuation efficiency, and the larger subgroup will play a leading role. This work can also provide some new insights for the study of cooperative behaviors and evacuation efficiency which can be a scientific decision-making basis for emergency response involving large-scale crowd evacuation in emergencies.

Audit of the effectiveness of command and control arrangements for medical evacuation of seriously ill or injured casualties in southern Afghanistan 2007.

PubMed

Cordell, R F; Cooney, M S; Beijer, D

2008-12-01

The effectiveness of the command and control of medical evacuation by helicopter (MEDEVAC) of casualties sustained in southern Afghanistan each month from 1 May to 31 July 2007 was audited. In this period 762 casualties of all categories were evacuated to International Security Assistance Force (ISAF) field hospital facilities under the direction of Operations and medical staff of NATO Regional Command (South) (RC-S). The criterion for the audit was the time taken from notification in the RC-S Combined Joint Operations Centre (CJOC) until the helicopter landed ("Wheels Down") at the destination field hospital's helicopter landing site. The standard to be met was 90 minutes for all "9-liner" Category A (URGENT) and Category B (URGENT - surgical) cases (in hospital within 2 hours of wounding) allowing for time from injury to first notification in the CJOC, and time from landing to transfer to the Emergency Department (30 minutes together) at the designated destination hospital. Those that did not meet this target were assessed in order to review their outcome and to identify means for improving performance. Analysis of evacuation times for all missions each month from May to July revealed that three quarters of A and B category missions met the 90 minute target. No adverse outcome resulted from those which did not meet this target, reasons for which included distance (more than 30 minutes flying time each way), delay in securing a hostile landing site, delay in obtaining sufficient information, incorrect categorization of the casualty's priority, and on one occasion, an overmatch of assets available at that time. No casualties died who were recoverable. Comparison with data from the two previous RC-S rotations (prior to 1 May 07) showed an improvement in mean response time, but little change in median response on the rotation of RC-S staff on 1 May 07. The major change that had occurred on this rotation was to move the medical operations staff into the CJOC. The

Air medical transportation in India: Our experience.

PubMed

Khurana, Himanshu; Mehta, Yatin; Dubey, Sunil

2016-01-01

Long distance air travel for medical needs is on the increase worldwide. The condition of some patients necessitates specially modified aircraft, and monitoring and interventions during transport by trained medical personnel. This article presents our experience in domestic and international interhospital air medical transportation from January 2010 to January 2014. Hospital records of all air medical transportation undertaken to the institute during the period were analyzed for demographics, primary etiology, and events during transport. 586 patients, 453 (77.3%) males and 133 (22.6%) females of ages 46.7 ± 12.6 years and 53.4 ± 9.7 years were transported by us to the institute. It took 3030 flying hours with an average of 474 ± 72 min for each mission. The most common indication for transport was cardiovascular diseases in 210 (35.8%) and central nervous system disease in 120 (20.4%) cases. The overall complication rate was 5.3% There was no transport related mortality. Cardiac and central nervous system ailments are the most common indication for air medical transportation. These patients may need attention and interventions as any critical patient in the hospital but in a difficult environment lacking space and help. Air medical transport carries no more risk than ground transportation.

The documentation of pain management during aeromedical evacuation missions.

PubMed

Lamb, Di

2010-06-01

Modern warfare has generated a significant increase in blast injuries, which demand careful management during planning and while undertaking air transfer. Pain management following multiple injuries can be challenging even when a patient is cared for in a stationary health care setting; this is further complicated by the additional stressors of flight. This article describes health care governance initiatives implemented by the Aeromedical Evacuation Squadron, based at Royal Air Force (RAF), United Kingdom. It focuses on quality and performance improvements via a program of clinical-effectiveness auditing. Copyright (c) 2010. Published by Elsevier Inc.

Shuttle abort landing site emergency medical services

NASA Technical Reports Server (NTRS)

Mckenas, David K.; Jennings, Richard T.

1991-01-01

NASA and DOD studies of medical-planning and logistical problems are reviewed as applicable to providing emergency medical care at remote transoceanic abort landing (TAL) sites. Two options are analyzed including a modified surgical response team and a combination physician/medical technician team. The two concepts are examined in terms of cost-effectiveness, specific types of medical support such as blood procurement, and search-and-rescue requirements. It is found that the physician/technician team is more economically efficient, and the description of the concept permits the development of an effective TAL-site astronaut medical-support system. A balance is struck between the competing problems of cost and medical capability by planning for on-scene medical stabilization and air evacuation to DOD tertiary medical centers.

Routes to effective evacuation planning primer series : evacuating populations with special needs.

DOT National Transportation Integrated Search

2009-04-01

Evacuation operations are conducted under the authority of, and based on decisions by, local and state authorities. The purpose of this primer, Evacuating Populations with Special Needs, is to provide local and state emergency managers, government of...

Air medical transportation in India: Our experience

PubMed Central

Khurana, Himanshu; Mehta, Yatin; Dubey, Sunil

2016-01-01

Background and Aims: Long distance air travel for medical needs is on the increase worldwide. The condition of some patients necessitates specially modified aircraft, and monitoring and interventions during transport by trained medical personnel. This article presents our experience in domestic and international interhospital air medical transportation from January 2010 to January 2014. Material and Methods: Hospital records of all air medical transportation undertaken to the institute during the period were analyzed for demographics, primary etiology, and events during transport. Results: 586 patients, 453 (77.3%) males and 133 (22.6%) females of ages 46.7 ± 12.6 years and 53.4 ± 9.7 years were transported by us to the institute. It took 3030 flying hours with an average of 474 ± 72 min for each mission. The most common indication for transport was cardiovascular diseases in 210 (35.8%) and central nervous system disease in 120 (20.4%) cases. The overall complication rate was 5.3% There was no transport related mortality. Conclusion: Cardiac and central nervous system ailments are the most common indication for air medical transportation. These patients may need attention and interventions as any critical patient in the hospital but in a difficult environment lacking space and help. Air medical transport carries no more risk than ground transportation. PMID:27625486

Variations in population exposure and evacuation potential to multiple tsunami evacuation phases on Alameda and Bay Farm Islands, California

NASA Astrophysics Data System (ADS)

Peters, J.

2015-12-01

Planning for a tsunami evacuation is challenging for California communities due to the variety of earthquake sources that could generate a tsunami. A maximum tsunami inundation zone is currently the basis for all tsunami evacuations in California, although an Evacuation Playbook consisting of specific event-based evacuation phases relating to flooding severity is in development. We chose to investigate the Evacuation Playbook approach for the island community of Alameda, CA since past reports estimated a significant difference in numbers of residents in the maximum inundation zone when compared to an event-based inundation zone. In order to recognize variations in the types of residents and businesses within each phase, a population exposure analysis was conducted for each of the four Alameda evacuation phases. A pedestrian evacuation analysis using an anisotropic, path distance model was also conducted to understand the time it would take for populations to reach high ground by foot. Initial results suggest that the two islands of the City of Alameda have different situations when it comes to the four tsunami evacuation phases. Pedestrian evacuation results suggest that Bay Farm Island would have more success evacuating by vehicle due to limited nearby high ground for pedestrians to reach safety. Therefore, agent-based traffic simulation software was used to model vehicle evacuation off Bay Farm Island. Initial results show that Alameda Island could face challenges evacuating numerous boat docks and a large beach for phases 1 and 2, whereas Bay Farm Island is unaffected at these phases but might be challenged with evacuating by vehicle for phases 3 and maximum due to congestion on limited egress routes. A better understanding of the population exposure within each tsunami Evacuation Playbook phase and the time it would take to evacuate out of each phase by foot or vehicle will help emergency managers implement the evacuation phases during an actual tsunami event.

Ultra-Scale Computing for Emergency Evacuation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhaduri, Budhendra L; Nutaro, James J; Liu, Cheng

2010-01-01

Emergency evacuations are carried out in anticipation of a disaster such as hurricane landfall or flooding, and in response to a disaster that strikes without a warning. Existing emergency evacuation modeling and simulation tools are primarily designed for evacuation planning and are of limited value in operational support for real time evacuation management. In order to align with desktop computing, these models reduce the data and computational complexities through simple approximations and representations of real network conditions and traffic behaviors, which rarely represent real-world scenarios. With the emergence of high resolution physiographic, demographic, and socioeconomic data and supercomputing platforms, itmore » is possible to develop micro-simulation based emergency evacuation models that can foster development of novel algorithms for human behavior and traffic assignments, and can simulate evacuation of millions of people over a large geographic area. However, such advances in evacuation modeling and simulations demand computational capacity beyond the desktop scales and can be supported by high performance computing platforms. This paper explores the motivation and feasibility of ultra-scale computing for increasing the speed of high resolution emergency evacuation simulations.« less

Pedestrian Evacuation Analysis for Tsunami Hazards

NASA Astrophysics Data System (ADS)

Jones, J. M.; Ng, P.; Wood, N. J.

2014-12-01

Recent catastrophic tsunamis in the last decade, as well as the 50th anniversary of the 1964 Alaskan event, have heightened awareness of the threats these natural hazards present to large and increasing coastal populations. For communities located close to the earthquake epicenter that generated the tsunami, strong shaking may also cause significant infrastructure damage, impacting the road network and hampering evacuation. There may also be insufficient time between the earthquake and first wave arrival to rely on a coordinated evacuation, leaving at-risk populations to self-evacuate on foot and across the landscape. Emergency managers evaluating these coastal risks need tools to assess the evacuation potential of low-lying areas in order to discuss mitigation options, which may include vertical evacuation structures to provide local safe havens in vulnerable communities. The U.S. Geological Survey has developed the Pedestrian Evacuation Analyst software tool for use by researchers and emergency managers to assist in the assessment of a community's evacuation potential by modeling travel times across the landscape and producing both maps of travel times and charts of population counts with corresponding times. The tool uses an anisotropic (directionally dependent) least cost distance model to estimate evacuation potential and allows for the variation of travel speed to measure its effect on travel time. The effectiveness of vertical evacuation structures on evacuation time can also be evaluated and compared with metrics such as travel time maps showing each structure in place and graphs displaying the percentage change in population exposure for each structure against the baseline. Using the tool, travel time maps and at-risk population counts have been generated for some coastal communities of the U.S. Pacific Northwest and Alaska. The tool can also be used to provide valuable decision support for tsunami vertical evacuation siting.

Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy.

PubMed

McGinty, Meghan D; Burke, Thomas A; Resnick, Beth; Barnett, Daniel J; Smith, Katherine C; Rutkow, Lainie

Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make

[Emergency and disaster response in critical care unit in the Mexican Social Security Institute: triage and evacuation].

PubMed

Echevarría-Zuno, Santiago; Cruz-Vega, Felipe; Elizondo-Argueta, Sandra; Martínez Valdés, Everardo; Franco-Bey, Rubén; Méndez-Sánchez, Luis Miguel

2013-01-01

Providing medical assistance in emergencies and disaster in advance makes the need to maintain Medical Units functional despite the disturbing phenomenon that confronts the community, but conflict occurs when the Medical Unit needs support and needs to be evacuated, especially when the evacuation of patients in a Critical Care Unit is required. In world literature there is little on this topic, and what is there usually focuses on the conversion of areas and increased ability to care for mass casualties, but not about how to evacuate if necessary, and when a wrong decision can have fatal consequences. That is why the Mexican Social Security Institute gave the task of examining these problems to a working group composed of specialists of the Institute. The purpose was to evaluate and establish a method for performing a protocol in the removal of patients and considering always to safeguard both staff and patients and maintain the quality of care.

21 CFR 880.5045 - Medical recirculating air cleaner.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Medical recirculating air cleaner. 880.5045 Section 880.5045 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating...

21 CFR 880.5045 - Medical recirculating air cleaner.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Medical recirculating air cleaner. 880.5045 Section 880.5045 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Therapeutic Devices § 880.5045 Medical recirculating air cleaner. (a) Identification. A medical recirculating...

Exposure to Environmental Air Manganese and Medication ...

EPA Pesticide Factsheets

Manganese (Mn) is an essential element with natural low levels found in water, food, and air, but due to industrialized processes, both workplace and the environmental exposures to Mn have increased. Recently, environmental studies have reported physical and mental health problems associated with air-Mn exposure, but medical record reviews for exposed residents are rare in the literature. When medical records and clinical testing are unavailable, examination of residents’ prescribed medication use may be used as a surrogate of health effects associated with Mn. We examined medication use among adult Ohio residents in two towns with elevated air-Mn (n=185) and one unexposed control town (n=90). Study participants recorded medication use in a health questionnaire and brought their currently prescribed medication, over-the-counter and supplement lists to their interview. Two physicians (family and psychiatric medicine) reviewed the provided medication list and developed medical categories associated with the medications used. The exposed (E) and control (C) groups were compared on the established 12 medication and 1 supplement categories using chi-square tests. The significant medication categories were further analyzed using hierarchical binomial logistic regression adjusting for education, personal income, and years of residency. The two groups were primarily white (E:94.6%; C:96.7%) but differed on education (E:13.8; C:15.2 years), residence length in their re

Predictions of vacuum loss of evacuated vials from initial air leak rates.

PubMed

Prisco, Michael R; Ochoa, Jorge A; Yardimci, Atif M

2013-08-01

Container closure integrity is a critical factor for maintaining product sterility and stability. Therefore, closure systems (found in vials, syringes, and cartridges) are designed to provide a seal between rubber stoppers and glass containers. To ensure that the contained product has maintained its sterility and stability at the time of deployment, the seal must remain intact within acceptable limits. To this end, a mathematical model has been developed to describe vacuum loss in evacuated drug vials. The model computes equivalent leak diameter corresponding to initial air leak rate as well as vacuum loss as a function of time and vial size. The theory accounts for three flow regimes that may be encountered. Initial leak rates from 10(-8) to 10(3) sccm (standard cubic centimeters per minute) were investigated for vials ranging from 1 to 100 mL. Corresponding leak diameters of 0.25-173 μm were predicted. The time for a vial to lose half of its vacuum, the T50 value, ranged from many years at the lowest leak rates and largest vials, to fractions of a second at the highest leak rates and smallest vials. These results may be used to determine what level of initial vacuum leak is acceptable for a given product. Copyright © 2013 Wiley Periodicals, Inc.

Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma

DTIC Science & Technology

2016-02-01

changes in ambient conditions such as cabin pressure and temperature could potentially have detrimental effects on the already vulnerable brain. There...during simulated long-range aero-medical evacuation has adverse effects on brain blood flow and tissue oxygenation , as well as lung function in swine...is a dearth of knowledge about the effects of long range aero-medical evacuation on injured organs, as well as an emerging published database

A single center's experience with the bedside subdural evacuating port system: a useful alternative to traditional methods for chronic subdural hematoma evacuation.

PubMed

Safain, Mina; Roguski, Marie; Antoniou, Alexander; Schirmer, Clemens M; Schirmer, Clemens S; Malek, Adel M; Riesenburger, Ron

2013-03-01

Object The traditional methods for managing symptomatic chronic subdural hematoma (SDH) include evacuation via a bur hole or craniotomy, both with or without drain placement. Because chronic SDH frequently occurs in elderly patients with multiple comorbidities, the bedside approach afforded by the subdural evacuating port system (SEPS) is an attractive alternative method that is performed under local anesthesia and conscious sedation. The goal of this study was to evaluate the radiographic and clinical outcomes of SEPS as compared with traditional methods. Methods A prospectively maintained database of 23 chronic SDHs treated by bur hole or craniotomy and of 23 chronic SDHs treated by SEPS drainage at Tufts Medical Center was compiled, and a retrospective chart review was performed. Information regarding demographics, comorbidities, presenting symptoms, and outcome was collected. The volume of SDH before and after treatment was semiautomatically measured using imaging software. Results There was no significant difference in initial SDH volume (94.5 cm(3) vs 112.6 cm(3), respectively; p = 0.25) or final SDH volume (31.9 cm(3) vs 28.2 cm(3), respectively; p = 0.65) between SEPS drainage and traditional methods. In addition, there was no difference in mortality (4.3% vs 9.1%, respectively; p = 0.61), length of stay (11 days vs 9.1 days, respectively; p = 0.48), or stability of subdural evacuation (94.1% vs 83.3%, respectively; p = 0.60) for the SEPS and traditional groups at an average follow-up of 12 and 15 weeks, respectively. Only 2 of 23 SDHs treated by SEPS required further treatment by bur hole or craniotomy due to inadequate evacuation of subdural blood. Conclusions The SEPS is a safe and effective alternative to traditional methods of evacuation of chronic SDHs and should be considered in patients presenting with a symptomatic chronic SDH.

Traffic evacuation time under nonhomogeneous conditions.

PubMed

Fazio, Joseph; Shetkar, Rohan; Mathew, Tom V

2017-06-01

During many manmade and natural crises such as terrorist threats, floods, hazardous chemical and gas leaks, emergency personnel need to estimate the time in which people can evacuate from the affected urban area. Knowing an estimated evacuation time for a given crisis, emergency personnel can plan and prepare accordingly with the understanding that the actual evacuation time will take longer. Given the urban area to be evacuated, street widths exiting the area's perimeter, the area's population density, average vehicle occupancy, transport mode share and crawl speed, an estimation of traffic evacuation time can be derived. Peak-hour traffic data collected at three, midblock, Mumbai sites of varying geometric features and traffic composition were used in calibrating a model that estimates peak-hour traffic flow rates. Model validation revealed a correlation coefficient of +0.98 between observed and predicted peak-hour flow rates. A methodology is developed that estimates traffic evacuation time using the model.

Global Optimization of Emergency Evacuation Assignments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Han, Lee; Yuan, Fang; Chin, Shih-Miao

2006-01-01

Conventional emergency evacuation plans often assign evacuees to fixed routes or destinations based mainly on geographic proximity. Such approaches can be inefficient if the roads are congested, blocked, or otherwise dangerous because of the emergency. By not constraining evacuees to prespecified destinations, a one-destination evacuation approach provides flexibility in the optimization process. We present a framework for the simultaneous optimization of evacuation-traffic distribution and assignment. Based on the one-destination evacuation concept, we can obtain the optimal destination and route assignment by solving a one-destination traffic-assignment problem on a modified network representation. In a county-wide, large-scale evacuation case study, the one-destinationmore » model yields substantial improvement over the conventional approach, with the overall evacuation time reduced by more than 60 percent. More importantly, emergency planners can easily implement this framework by instructing evacuees to go to destinations that the one-destination optimization process selects.« less

Impact of Anemia in Critically Ill Burned Casualties Evacuated From Combat Theater via US Military Critical Care Air Transport Teams.

PubMed

Hamilton, Joshua A; Mora, Alejandra G; Chung, Kevin K; Bebarta, Vikhyat S

2015-08-01

US military Critical Care Air Transport Teams (CCATT) transport critically ill burn patients out of theater. Blood transfusion may incur adverse effects, and studies report lower hemoglobin (Hgb) value may be safe for critically ill patients. There are no studies evaluating the optimal Hgb value for critically ill burn patients prior to CCATT evacuation. The aim of the study was to determine if critically ill burn casualties with an Hgb of 10 g/dL or less, transported via CCATT, have similar clinical outcomes at 30 days as compared with patients with an Hgb of greater than 10 g/dL. We conducted an institutional review board-approved retrospective cohort study involving patients transported via CCATT. We separated our study population into two cohorts based on Hgb levels at the time of theater evacuation: Hgb ≤10 g/dL or Hgb ≥10 g/dL. We compared demographics, injury description, physiologic parameters, and clinical outcomes. Of the 140 subjects enrolled, 29 were Hgb ≤10, and 111 were Hgb ≥10. Both groups were similar in age and percent total body surface area burned. Those Hgb ≤10 had a higher injury severity score (34 ± 19.8 vs. 25 ± 16.9, P = 0.02) and were more likely to have additional trauma (50% vs. 25%, P = 0.04). Modeling revealed no persistent differences in mortality, and other clinical outcomes measured. Critical Care Air Transport Teams transport of critically ill burn patients with an Hgb of 10 g/dL or less had no significant differences in complications or mortality as compared with patients with an Hgb of greater than 10 g/dL. In this study, lower hemoglobin levels did not confer greater risk for worse outcomes.

A method of emotion contagion for crowd evacuation

NASA Astrophysics Data System (ADS)

Cao, Mengxiao; Zhang, Guijuan; Wang, Mengsi; Lu, Dianjie; Liu, Hong

2017-10-01

The current evacuation model does not consider the impact of emotion and personality on crowd evacuation. Thus, there is large difference between evacuation results and the real-life behavior of the crowd. In order to generate more realistic crowd evacuation results, we present a method of emotion contagion for crowd evacuation. First, we combine OCEAN (Openness, Extroversion, Agreeableness, Neuroticism, Conscientiousness) model and SIS (Susceptible Infected Susceptible) model to construct the P-SIS (Personalized SIS) emotional contagion model. The P-SIS model shows the diversity of individuals in crowd effectively. Second, we couple the P-SIS model with the social force model to simulate emotional contagion on crowd evacuation. Finally, the photo-realistic rendering method is employed to obtain the animation of crowd evacuation. Experimental results show that our method can simulate crowd evacuation realistically and has guiding significance for crowd evacuation in the emergency circumstances.

Study on Earthquake Emergency Evacuation Drill Trainer Development

NASA Astrophysics Data System (ADS)

ChangJiang, L.

2016-12-01

With the improvement of China's urbanization, to ensure people survive the earthquake needs scientific routine emergency evacuation drills. Drawing on cellular automaton, shortest path algorithm and collision avoidance, we designed a model of earthquake emergency evacuation drill for school scenes. Based on this model, we made simulation software for earthquake emergency evacuation drill. The software is able to perform the simulation of earthquake emergency evacuation drill by building spatial structural model and selecting the information of people's location grounds on actual conditions of constructions. Based on the data of simulation, we can operate drilling in the same building. RFID technology could be used here for drill data collection which read personal information and send it to the evacuation simulation software via WIFI. Then the simulation software would contrast simulative data with the information of actual evacuation process, such as evacuation time, evacuation path, congestion nodes and so on. In the end, it would provide a contrastive analysis report to report assessment result and optimum proposal. We hope the earthquake emergency evacuation drill software and trainer can provide overall process disposal concept for earthquake emergency evacuation drill in assembly occupancies. The trainer can make the earthquake emergency evacuation more orderly, efficient, reasonable and scientific to fulfill the increase in coping capacity of urban hazard.

Aeromedical evacuation of injured hikers in Hong Kong

PubMed Central

Wong, Tai Wai; Lau, Ping Fat; Lau, Chor Chiu

2010-01-01

BACKGROUND: Hiking is a very popular sport in Hong Kong. Serious injuries can sometimes occur in the remote areas not accessible to roads. Aeromedical evacuation service is run by the Government Flying Service (GFS) with emergency physicians and nurses as volunteers in Hong Kong. In this paper we describe the profile and outcome of injured hikers rescued by the GFS. METHODS: In this retrospective review, nature of the complaints, medical team composition, vital signs, clinical assessment and diagnosis on site were collected from the GFS medical record. Demographic data, final diagnoses and outcomes of the patients were retrieved from emergency department (ED) and hospital discharge records. RESULTS: A total of 275 cases were recruited for the 3-year period from January 2003 to December 2005. The mean age of the group was 39 years (range 1-83) with more males (159, 58%) than females. Heat illnesses, injuries and medical problems each constituted about one third of the cases. Lower limb injuries accounted for nearly half of the injuries. About 30% of the rescued hikers did not register to be seen at the ED. Only 48 hikers (17.5%) required admission and four were admitted to intensive/coronary care units for heat stroke and acute coronary syndrome. Five cases of pre-hospital cardiac arrest were recorded. CONCLUSION: Most hikers evacuated by the GFS did not suffer from serious conditions. GFS should still be prepared for the occasional cases that require advanced life support. PMID:25214963

KAMEDO Report No. 92: Evacuation of Swedes from Lebanon--observational studies in connection with the war in Lebanon in summer 2006.

PubMed

Kulling, Per; Sigurdsson, Susannah; Hamberger, Bertil

2008-01-01

A large-scale armed conflict between Hezbollah and Israel in July 2006 caused the evacuation of a large number of Swedish residents from Lebanon. This report describes the evacuation throughout its various stages. Swedish authorities were prepared for an event of this type from the experience of the 2004 Asian tsunami disaster. Lessons learned from the management and medical care during the evacuations are presented in this report.

Evacuating populations with special needs

DOT National Transportation Integrated Search

2009-04-01

Evacuation operations are conducted under the authority of, and based on decisions by, local and state authorities. The purpose of this primer, Evacuating Populations with Special Needs, is to provide local and state emergency managers, government of...

AsMA Medical Guidelines for Air Travel: Fitness to Fly and Medical Clearances.

PubMed

Thibeault, Claude; Evans, Anthony D; Dowdall, Nigel P

2015-07-01

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Not everyone is fit to travel by air and physicians should advise their patients accordingly. They should review the passenger's medical condition, giving special consideration to the dosage and timing of any medications, contagiousness, and the need for special assistance during travel. In general, an individual with an unstable medical condition should not fly; cabin altitude, duration of exposure, and altitude of the destination airport are all considerations when recommending a passenger for flight.

NUclear EVacuation Analysis Code (NUEVAC) : a tool for evaluation of sheltering and evacuation responses following urban nuclear detonations.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoshimura, Ann S.; Brandt, Larry D.

2009-11-01

The NUclear EVacuation Analysis Code (NUEVAC) has been developed by Sandia National Laboratories to support the analysis of shelter-evacuate (S-E) strategies following an urban nuclear detonation. This tool can model a range of behaviors, including complex evacuation timing and path selection, as well as various sheltering or mixed evacuation and sheltering strategies. The calculations are based on externally generated, high resolution fallout deposition and plume data. Scenario setup and calculation outputs make extensive use of graphics and interactive features. This software is designed primarily to produce quantitative evaluations of nuclear detonation response options. However, the outputs have also proven usefulmore » in the communication of technical insights concerning shelter-evacuate tradeoffs to urban planning or response personnel.« less

Thoracoscopic evacuation of retained post-traumatic hemothorax.

PubMed

Ahmad, Tanveer; Ahmed, Syed Waqar; Soomro, Niaz Hussain; Sheikh, Khalil Ahmed

2013-03-01

Post-traumatic retained hemothorax is a major risk factor for empyema thoracis leading to prolonged hospitalization, entrapped lung and a need for decortication. VATS (Video Assisted Thoracoscopy) for retained hemothorax shortens the duration of chest tube drainage and length of stay. From December 2004 to July 2009, 110 consecutive patients underwent VATS for retained or clotted hemothoraces at the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi. Majority of the patients were males (n = 91; 82.7%). Sixty-five patients (59.1%) underwent VATS within 6 days and 45 patients (40.9%) between 7 - 14 days of injury. In 8 patients (7.3%) VATS was abandoned for thoracotomy. Post VATS full lung expansion was achieved in 87 patients (79.0) with complete evacuation of hemothorax. Chest tubes were removed within the first week in 100 patients (90.9%). In hemodynamically stable patients, VATS is a safe, reliable and effective technique for the evacuation of retained hemothorax. Early intervention within 6 days of injury avoids the need for a thoracotomy and is associated with a better short and long-term outcome.

Preparedness in Long-Term Care: A Novel Approach to Address Gaps in Evacuation Tracking.

PubMed

Prot, Emilie Y; Clements, Bruce

2017-02-01

With an aging population, the number of elderly individuals residing in long-term care (LTC) facilities will continue to grow and pose unique challenges to disaster preparedness and response. With this rapidly growing vulnerable population, it becomes imperative to identify enhanced and novel preparedness strategies and measures. LTC residents not only have complicated medical needs, including the timing of dispensing multiple medications, but frequently have cognitive and mobility deficits as well. In nearly every major disaster, elderly populations have suffered disproportionate morbidity and mortality. This is often due to elderly evacuees getting overlooked in the chaos of an initial response. Instituting measures to rapidly recognize this population in a crowd during an evacuation will reduce their risk. This commentary reviews the LTC facility evacuation challenges of the 2013 explosion of the West Fertilizer Company plant in West, Texas, and offers a novel solution of mandating the wearing of pink vests by all nursing home residents in case of an evacuation. The pink vests quickly alert disaster rescue and response workers of LTC residents with special needs. (Disaster Med Public Health Preparedness. 2017;11:28-30).

Epidural Hematoma Complication after Rapid Chronic Subdural Hematoma Evacuation: A Case Report

PubMed Central

Akpinar, Aykut; Ucler, Necati; Erdogan, Uzay; Yucetas, Cem Seyho

2015-01-01

Patient: Male, 41 Final Diagnosis: Healty Symptoms: Headache Medication: — Clinical Procedure: Chronic subdural hematoma Specialty: Neurosurgery Objective: Diagnostic/therapeutic accidents Background: Chronic subdural hematoma generally occurs in the elderly. After chronic subdural hematoma evacuation surgery, the development of epidural hematoma is a very rare entity. Case Report: We report the case of a 41-year-old man with an epidural hematoma complication after chronic subdural hematoma evacuation. Under general anesthesia, the patient underwent a large craniotomy with closed system drainage performed to treat the chronic subdural hematoma. After chronic subdural hematoma evacuation, there was epidural leakage on the following day. Conclusions: Although trauma is the most common risk factor in young CSDH patients, some other predisposing factors may exist. Intracranial hypotension can cause EDH. Craniotomy and drainage surgery can usually resolve the problem. Because of rapid dynamic intracranial changes, epidural leakages can occur. A large craniotomy flap and silicone drainage in the operation area are key safety points for neurosurgeons and hydration is essential. PMID:26147957

[The use of the new loads of expendable medical supplies by the medical service of the Armed Forces].

PubMed

Miroshnichenko, Iu V; Bunin, S A; Grebeniuk, A N; Kononov, V N; Sidorov, D A

2014-09-01

The new loads of expendable medical supplies adopted by the Armed Forces of the Russian Federation and included into regulating documents are the most important elements of the authorized equipment system. Nine loads of expendable medical supplies, combined into two classification groups, are provided for the medical service. The use of these loads improves the effectiveness of medical supply for all stages of medical evacuation, medical continuity during medical and evacuation procedures and allows to deliver medical aid to patients on the basis of modern and innovative medical technologies.

In Vitro Evaluation of Evacuated Blood Collection Tubes as a Closed-Suction Surgical Drain Reservoir.

PubMed

Heiser, Brian; Okrasinski, E B; Murray, Rebecca; McCord, Kelly

The initial negative pressures of evacuated blood collection tubes (EBCT) and their in vitro performance as a rigid closed-suction surgical drain (CSSD) reservoir has not been evaluated in the scientific literature despite being described in both human and veterinary texts and journals. The initial negative pressures of EBCT sized 3, 6, 10, and 15 mL were measured and the stability of the system monitored. The pressure-to-volume curve as either air or water was added and maximal filling volumes were measured. Evacuated blood collection tubes beyond the manufacture's expiration date were evaluated for initial negative pressures and maximal filling volumes. Initial negative pressure ranged from -214 mm Hg to -528 mm Hg for EBCT within the manufacturer's expiration date. Different pressure-to-volume curves were found for air versus water. Optimal negative pressures of CSSD are debated in the literature. Drain purpose and type of exudates are factors that should be considered when deciding which EBCT size to implement. Evacuated blood collection tubes have a range of negative pressures and pressure-to-volume curves similar to previously evaluated CSSD rigid reservoirs. Proper drain management and using EBCT within labeled expiration date are important to ensure that expected negative pressures are generated.

The significance of a small, level-3 'semi evacuation' hospital in a terrorist attack in a nearby town.

PubMed

Pinkert, Moshe; Leiba, Adi; Zaltsman, Eilon; Erez, Onn; Blumenfeld, Amir; Avinoam, Shkolnick; Laor, Daniel; Schwartz, Dagan; Goldberg, Avishay; Levi, Yehezkel; Bar-Dayan, Yaron

2007-09-01

Terrorist attacks can occur in remote areas causing mass-casualty incidents MCIs far away from level-1 trauma centres. This study draws lessons from an MCI pertaining to the management of primary and secondary evacuation and the operational mode practiced. Data was collected from formal debriefings during and after the event, and the medical response, interactions and main outcomes analysed using Disastrous Incidents Systematic Analysis through Components, Interactions and Results (DISAST-CIR) methodology. A total of 112 people were evacuated from the scene-66 to the nearby level 3 Laniado hospital, including the eight critically and severely injured patients. Laniado hospital was instructed to act as an evacuation hospital but the flow of patients ended rapidly and it was decided to admit moderately injured victims. We introduce a novel concept of a 'semi-evacuation hospital'. This mode of operation should be selected for small-scale events in which the evacuation hospital has hospitalization capacity and is not geographically isolated. We suggest that level-3 hospitals in remote areas should be prepared and drilled to work in semi-evacuation mode during MCIs.

Effects of evacuation assistant’s leading behavior on the evacuation efficiency: Information transmission approach

NASA Astrophysics Data System (ADS)

Wang, Xiao-Lu; Guo, Wei; Zheng, Xiao-Ping

2015-07-01

Evacuation assistants are expected to spread the escape route information and lead evacuees toward the exit as quickly as possible. Their leading behavior influences the evacuees’ movement directly, which is confirmed to be a decisive factor of the evacuation efficiency. The transmission process of escape information and its function on the evacuees’ movement are accurately presented by the proposed extended dynamic communication field model. For evacuation assistants and evacuees, their sensitivity parameter of static floor field (SFF), , and , are fully discussed. The simulation results indicate that the appropriate is associated with the maximum of evacuees. The optimal combinations of and were found to reach the highest evacuation efficiency. There also exists an optimal value for evacuation assistants’ information transmission radius. Project supported by the National Basic Research Program of China (Grant No. 2011CB706900), the National Natural Science Foundation of China (Grant Nos. 71225007 and 71203006), the National Key Technology Research and Development Program of the Ministry of Science and Technology of China (Grant No. 2012BAK13B06), the Humanities and Social Sciences Project of the Ministry of Education of China (Grant Nos. 10YJA630221 and 12YJCZH023), and the Beijing Philosophy and Social Sciences Planning Project of the Twelfth Five-Year Plan, China (Grant Nos. 12JGC090 and 12JGC098).

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

46 CFR 116.520 - Emergency evacuation plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency evacuation plan. 116.520 Section 116.520... ARRANGEMENT Escape and Embarkation Station Requirements § 116.520 Emergency evacuation plan. The owner or managing operator shall prepare an evacuation plan that must: (a) Identify possible casualties involving...

Experimental study on occupant evacuation in narrow seat aisle

NASA Astrophysics Data System (ADS)

Huang, Shenshi; Lu, Shouxiang; Lo, Siuming; Li, Changhai; Guo, Yafei

2018-07-01

Narrow seat aisle is an important area in the train car interior due to the large passenger population, however evacuation therein has not gained enough concerns. In this experimental study, the occupant evacuation of the narrow seat aisle area is investigated, with the aisle width of 0.4-0.6 m and the evacuation direction of forward and backward. The evacuation behaviors are analyzed based on the video record, and the discussion is carried out in the aspect of evacuation time, crowdedness, evacuation order, and aisle conflicts. The result shows that with the increasing aisle width, total evacuation time and the average specific evacuation rate decrease. The aisle is crowded for some time, with a large linear occupant densities. The evacuation order of each occupant is mainly related to the seat position. Moreover, it is found that the aisle conflicts can be well described by Burstedde's model. This study gives a useful benchmark for evacuation simulation of narrow seat aisle, and provides reference to safety design of seat area in train cars.

Tsunami evacuation buildings and evacuation planning in Banda Aceh, Indonesia.

PubMed

Yuzal, Hendri; Kim, Karl; Pant, Pradip; Yamashita, Eric

Indonesia, a country of more than 17,000 islands, is exposed to many hazards. A magnitude 9.1 earthquake struck off the coast of Sumatra, Indonesia, on December 26, 2004. It triggered a series of tsunami waves that spread across the Indian Ocean causing damage in 11 countries. Banda Aceh, the capital city of Aceh Province, was among the most damaged. More than 31,000 people were killed. At the time, there were no early warning systems nor evacuation buildings that could provide safe refuge for residents. Since then, four tsunami evacuation buildings (TEBs) have been constructed in the Meuraxa subdistrict of Banda Aceh. Based on analysis of evacuation routes and travel times, the capacity of existing TEBs is examined. Existing TEBs would not be able to shelter all of the at-risk population. In this study, additional buildings and locations for TEBs are proposed and residents are assigned to the closest TEBs. While TEBs may be part of a larger system of tsunami mitigation efforts, other strategies and approaches need to be considered. In addition to TEBs, robust detection, warning and alert systems, land use planning, training, exercises, and other preparedness strategies are essential to tsunami risk reduction.

Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional Management Oversight

DTIC Science & Technology

2015-09-24

No. DODIG-2015-179 S E P T E M B E R 2 4 , 2 0 1 5 Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional...us at www.dodig.mil Results in Brief Delinquent Medical Service Accounts at David Grant Air Force...Force Medical Center (DGMC) properly managed delinquent accounts over 180 days by effectively transferring the debt to the appropriate debt collection

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

30 CFR 57.4361 - Underground evacuation drills.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Underground evacuation drills. 57.4361 Section... Prevention and Control Firefighting Procedures/alarms/drills § 57.4361 Underground evacuation drills. (a) At least once every six months, mine evacuation drills shall be held to assess the ability of all persons...

Necessity of guides in pedestrian emergency evacuation

NASA Astrophysics Data System (ADS)

Yang, Xiaoxia; Dong, Hairong; Yao, Xiuming; Sun, Xubin; Wang, Qianling; Zhou, Min

2016-01-01

The role of guide who is in charge of leading pedestrians to evacuate in the case of emergency plays a critical role for the uninformed people. This paper first investigates the influence of mass behavior on evacuation dynamics and mainly focuses on the guided evacuation dynamics. In the extended crowd model proposed in this paper, individualistic behavior, herding behavior and environment influence are all considered for pedestrians who are not informed by the guide. According to the simulation results, herding behavior makes more pedestrians evacuate from the room in the same period of time. Besides, guided crowd demonstrates the same behavior of group dynamics which is characterized by gathering, conflicts and balance. Moreover, simulation results indicate guides with appropriate initial positions and quantity are more conducive to evacuation under a moderate initial density of pedestrians.

AsMA Medical Guidelines for Air Travel: In-Flight Medical Care.

PubMed

Thibeault, Claude; Evans, Anthony D; Pettyjohn, Frank S; Alves, Paulo M

2015-06-01

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. All airlines are required to provide first aid training for cabin crew, and the crew are responsible for managing any in-flight medical events. There are also regulatory requirements for the carriage of first aid and medical kits. AsMA has developed recommendations for first aid kits, emergency medical kits, and universal precaution kits.

Air Conditioner Charging. Automotive Mechanics. Air Conditioning. Instructor's Guide [and] Student Guide.

ERIC Educational Resources Information Center

Spignesi, B.

This instructional package, one in a series of individualized instructional units on automobile air conditioning, consists of a student guide and an instructor guide dealing with air conditioning charging. Covered in the module are checking the air conditioning system for leaks, checking and adding refrigerant oil as needed, evacuating the system,…

Lithium battery fires: implications for air medical transport.

PubMed

Thomas, Frank; Mills, Gordon; Howe, Robert; Zobell, Jim

2012-01-01

Lithium-ion batteries provide more power and longer life to electronic medical devices, with the benefits of reduced size and weight. It is no wonder medical device manufacturers are designing these batteries into their products. Lithium batteries are found in cell phones, electronic tablets, computers, and portable medical devices such as ventilators, intravenous pumps, pacemakers, incubators, and ventricular assist devices. Yet, if improperly handled, lithium batteries can pose a serious fire threat to air medical transport personnel. Specifically, this article discusses how lithium-ion batteries work, the fire danger associated with them, preventive measures to reduce the likelihood of a lithium battery fire, and emergency procedures that should be performed in that event. Copyright © 2012 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Characteristics of nontrauma scene flights for air medical transport.

PubMed

Krebs, Margaret G; Fletcher, Erica N; Werman, Howard; McKenzie, Lara B

2014-01-01

Little is known about the use of air medical transport for patients with medical, rather than traumatic, emergencies. This study describes the practices of air transport programs, with respect to nontrauma scene responses, in several areas throughout the United States and Canada. A descriptive, retrospective study was conducted of all nontrauma scene flights from 2008 and 2009. Flight information and patient demographic data were collected from 5 air transport programs. Descriptive statistics were used to examine indications for transport, Glasgow Coma Scale Scores, and loaded miles traveled. A total of 1,785 nontrauma scene flights were evaluated. The percentage of scene flights contributed by nontraumatic emergencies varied between programs, ranging from 0% to 44.3%. The most common indication for transport was cardiac, nonST-segment elevation myocardial infarction (22.9%). Cardiac arrest was the indication for transport in 2.5% of flights. One air transport program reported a high percentage (49.4) of neurologic, stroke, flights. The use of air transport for nontraumatic emergencies varied considerably between various air transport programs and regions. More research is needed to evaluate which nontraumatic emergencies benefit from air transport. National guidelines regarding the use of air transport for nontraumatic emergencies are needed. Copyright © 2014 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Optimal nonimaging integrated evacuated solar collector

NASA Astrophysics Data System (ADS)

Garrison, John D.; Duff, W. S.; O'Gallagher, Joseph J.; Winston, Roland

1993-11-01

A non imaging integrated evacuated solar collector for solar thermal energy collection is discussed which has the lower portion of the tubular glass vacuum enveloped shaped and inside surface mirrored to optimally concentrate sunlight onto an absorber tube in the vacuum. This design uses vacuum to eliminate heat loss from the absorber surface by conduction and convection of air, soda lime glass for the vacuum envelope material to lower cost, optimal non imaging concentration integrated with the glass vacuum envelope to lower cost and improve solar energy collection, and a selective absorber for the absorbing surface which has high absorptance and low emittance to lower heat loss by radiation and improve energy collection efficiency. This leads to a very low heat loss collector with high optical collection efficiency, which can operate at temperatures up to the order of 250 degree(s)C with good efficiency while being lower in cost than current evacuated solar collectors. Cost estimates are presented which indicate a cost for this solar collector system which can be competitive with the cost of fossil fuel heat energy sources when the collector system is produced in sufficient volume. Non imaging concentration, which reduces cost while improving performance, and which allows efficient solar energy collection without tracking the sun, is a key element in this solar collector design.

Non-battle injuries among U.S. Army soldiers deployed to Afghanistan and Iraq, 2001-2013.

PubMed

Patel, Avni A; Hauret, Keith G; Taylor, Bonnie J; Jones, Bruce H

2017-02-01

Many non-battle injuries among deployed soldiers are due to occupational-related tasks. Given that non-battle injuries are a significant cause of morbidity and mortality, occupational safety and health are of great concern to the military. Some of the leading causes of non-battle injuries in the military are also common in non-military occupational settings. Nationally, falls and motor-vehicle accidents are leading causes of non-fatal occupational injuries in the civilian workforce. The objective of this research is to identify the leading causes, types, and anatomic locations of non-fatal non-battle injuries in Afghanistan and Iraq. Non-battle injuries were identified from medical air evacuation records. Causes of air evacuated injuries were identified and coded using the diagnosis and narrative patient history in the air evacuation records. Descriptive statistics were used to report the air evacuated non-battle injury rates, causes, injury types, and anatomic locations. Between 2001 and 2013, there were 68,349 medical air evacuations from Afghanistan and Iraq. Non-battle injuries accounted for 31% of air evacuations from Afghanistan and 34% from Iraq. These injuries were the leading diagnosis category for air evacuations. The three leading causes of injury for Afghanistan and Iraq, respectively, were sports/physical training (23% and 24%), falls/jumps (19% and 16%), and military vehicle-related accidents (8% and 11%). The leading injury types were fractures (21%), overuse pain and inflammation (16%), and dislocations (11%). Given that over 30% of medical evacuations of soldiers result from non-battle injuries, prevention of such conditions would substantially enhance military readiness during combat. Copyright © 2016 National Safety Council and Elsevier Ltd. All rights reserved.

Research on Evacuation Based on Social Force Model

NASA Astrophysics Data System (ADS)

Liu, W.; Deng, Z.; Li, W.; Lin, J.

2017-09-01

Crowded centers always cause personnel casualties in evacuation operations. Stampede events often occur by hit, squeeze and crush due to panic. It is of vital important to alleviate such situation. With the deepening of personnel evacuation research, more and more researchers are committed to study individual behaviors and self-organization phenomenon in evacuation process. The study mainly includes: 1, enrich the social force model from different facets such as visual, psychological, external force to descript more realistic evacuation; 2, research on causes and effects of self - organization phenomenon. In this paper, we focus on disorder motion that occurs in the crowded indoor publics, especially the narrow channel and safety exits and other special arteries. We put forward the improved social force model to depict pedestrians' behaviors, an orderly speed-stratification evacuation method to solve disorder problem, and shape-changed export to alleviate congestion. The result of this work shows an improvement of evacuation efficiency by 19.5 %. Guiding pedestrians' direction to slow down the influence of social forces has a guidance function in improving the efficiency of indoor emergency evacuation.

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 133.145... LIFESAVING SYSTEMS Requirements for All OSVs § 133.145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each marine evacuation...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

46 CFR 199.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 199.145....145 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system... from the marine evacuation system platform by a person either in the liferaft or on the platform; (4...

[The standardization of medical care and the training of medical personnel].

PubMed

Korbut, V B; Tyts, V V; Boĭshenko, V A

1997-09-01

The medical specialist training at all levels (medical orderly, doctor's assistant, general practitioner, doctors) should be based on the medical care standards. Preliminary studies in the field of military medicine standards have demonstrated that the medical service of the Armed Forces of Russia needs medical resources' standards, structure and organization standards, technology standards. Military medical service resources' standards should reflect the requisitions for: all medical specialists' qualification, equipment and material for medical set-ups, field medical systems, drugs, etc. Standards for structures and organization should include requisitions for: command and control systems in military formations' and task forces' medical services and their information support; health-care and evacuation functions, sanitary control and anti-epidemic measures and personnel health protection. Technology standards development could improve and regulate the health care procedures in the process of evacuation. Standards' development will help to solve the problem of the data-base for the military medicine education system and medical research.

Using highways during notice evacuations operations.

DOT National Transportation Integrated Search

2006-12-01

Evacuations may involve hundreds or hundreds of thousands of people. regardless of the numbers, in each and every instance, the transportation network plays a key role in evacuating people out of harms way. recognizing the unique challenges posed ...

Task Force on Emergency Evacuation of Transport Airplanes. Volume 2. Supporting Documentation.

DTIC Science & Technology

1986-07-01

P.O. Box 604 Trinidaa, West Indies Rick Cremer Acting Manager, Frederic Diamond Air Carrier Branch President Federal Aviation Apeiron Technology...Lynch Transport Canada Further, to insure the availability of trained personnel to provide leadership in the event of an accident of an aircraft having...66-26A. -3- conmmendably in achieving evacuations within reasonable times while providingy calm ana etfective leadership , It was found that escape

The introduction of new critical care equipment into the aeromedical evacuation service of the Royal Air Force.

PubMed

Lamb, Di

2003-04-01

Changing world events over recent years and an increasingly complex patient casemix have led to a review of the equipment used by the Aeromedical Evacuation Squadron of the Royal Air Force. The initial special purpose aeromedical equipment (SPAME) project was completed in 2001 with the new equipment being brought into service in August of the same year. The project incorporated long term planning for replacing the equipment along with its rapidly developing technology, especially with that used for the care of the critically ill. An intensive training programme was simultaneously introduced to support the deployment of this new technology. Critical care teams comprise a consultant anaesthetist, a critical care nurse, a flight nurse attendant (paramedic) and a technician, all of whom attend courses designed specifically to accommodate their role within the team.A considerable amount of work has been undertaken by a dedicated team to ensure this project became a reality and which has resulted in the provision of care to meet the needs of any casualty, anywhere in the world, being achieved using the latest technology proportionate to any hospital-based ICU.

Predictive value of impaired evacuation at proctography in diagnosing anismus.

PubMed

Halligan, S; Malouf, A; Bartram, C I; Marshall, M; Hollings, N; Kamm, M A

2001-09-01

We aimed to determine the positive predictive value of impaired evacuation during evacuation proctography for the subsequent diagnosis of anismus. Thirty-one adults with signs of impaired evacuation (defined as the inability to evacuate two thirds of a 120 mL contrast enema within 30 sec) during evacuation proctography underwent subsequent anorectal physiologic testing for anismus. A physiologic diagnosis of anismus was based on a typical clinical history of the condition combined with impaired rectal balloon expulsion or abnormal surface electromyogram. Twenty-eight (90%) of the 31 patients with impaired proctographic evacuation were found to have anismus at subsequent physiologic testing. Among the 28 were all 10 patients who evacuated no contrast medium and all 11 patients with inadequate pelvic floor descent, giving evacuation proctography a positive predictive value of 90% for the diagnosis of anismus. A prominent puborectal impression was seen in only three subjects during proctography, one of whom subsequently showed no physiologic sign of anismus. Impaired evacuation during evacuation proctography is highly predictive for diagnosis of anismus.

Intrarectal pressures and balloon expulsion related to evacuation proctography.

PubMed Central

Halligan, S; Thomas, J; Bartram, C

1995-01-01

Seventy four patients with constipation were examined by standard evacuation proctography and then attempted to expel a small, non-deformable rectal balloon, connected to a pressure transducer to measure intrarectal pressure. Simultaneous imaging related the intrarectal position of the balloon to rectal deformity. Inability to expel the balloon was associated proctographically with prolonged evacuation, incomplete evacuation, reduced anal canal diameter, and acute anorectal angulation during evacuation. The presence and size of rectocoele or intussusception was unrelated to voiding of paste or balloon. An independent linear combination of pelvic floor descent and evacuation time on proctography correctly predicted maximum intrarectal pressure in 74% of cases. No patient with both prolonged evacuation and reduced pelvic floor descent on proctography could void the balloon, as maximum intrarectal pressure was reduced in this group. A prolonged evacuation time on proctography, in combination with reduced pelvic floor descent, suggests defecatory disorder may be caused by inability to raise intrarectal pressure. A diagnosis of anismus should not be made on proctography solely on the basis of incomplete/prolonged evacuation, as this may simply reflect inadequate straining. PMID:7672656

Evacuation of institutionalized and specialized populations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vogt, B.M.

The purpose of this research was to assess the needs of organizations caring for institutional and specialized populations when faced with a threat or hazard requiring an evacuation. Individuals within specialized populations are unlike other victims of disaster because of their inherent dependency on organizational care givers and require different management strategies on the part of organizations and agencies in an evacuation. The research sought to identify those aspects of coping strategies that have been used successfully to manage an emergency evacuation. To identify special populations that have evacuated from institutions and similar facilities over a four-year period, a computerizedmore » search was conducted of media accounts describing such events. The search yielded a total of 1024 accounts from which four major subgroups were identified: nursing homes and related care facilities, hospitals, educational institutions, and correctional facilities. A miscellaneous group including housing for the elderly, apartments and other building complexes, workplaces and factories, public facilities, and places occupied by transient populations, such as transportation units and recreational facilities, could be used for future study. Among the factors found to affect evacuations were the extent of organizational resources (such as the number of staff or other individuals available at the time of the event), the type and number of clientele, and such community characteristics as population density. The study focuses on selected organizational characteristics of health care facilities (nursing homes and related care facilities and hospitals) which have recently experienced either a partial or complete evacuation of their facilities. 165 refs., 13 tabs.« less

Optimizing Medical Kits for Spaceflight

NASA Technical Reports Server (NTRS)

Keenan, A. B,; Foy, Millennia; Myers, G.

2014-01-01

The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulation outcomes describing the impact of medical events on the mission may be used to optimize the allocation of resources in medical kits. Efficient allocation of medical resources, subject to certain mass and volume constraints, is crucial to ensuring the best outcomes of in-flight medical events. We implement a new approach to this medical kit optimization problem. METHODS We frame medical kit optimization as a modified knapsack problem and implement an algorithm utilizing a dynamic programming technique. Using this algorithm, optimized medical kits were generated for 3 different mission scenarios with the goal of minimizing the probability of evacuation and maximizing the Crew Health Index (CHI) for each mission subject to mass and volume constraints. Simulation outcomes using these kits were also compared to outcomes using kits optimized..RESULTS The optimized medical kits generated by the algorithm described here resulted in predicted mission outcomes more closely approached the unlimited-resource scenario for Crew Health Index (CHI) than the implementation in under all optimization priorities. Furthermore, the approach described here improves upon in reducing evacuation when the optimization priority is minimizing the probability of evacuation. CONCLUSIONS This algorithm provides an efficient, effective means to objectively allocate medical resources for spaceflight missions using the Integrated Medical Model.

Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma

DTIC Science & Technology

2015-02-01

of Combat Casualties in a Swine Polytrauma PRINCIPAL INVESTIGATOR: Richard McCarron, PhD CONTRACTING ORGANIZATION: Henry M. Jackson Foundation for the...Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma 5a. CONTRACT NUMBER...of neurotrauma and polytrauma . We plan to investigate the effects of aero-medical evacuation on neurophysiology and lung function in swine models of

Crowd evacuation model based on bacterial foraging algorithm

NASA Astrophysics Data System (ADS)

Shibiao, Mu; Zhijun, Chen

To understand crowd evacuation, a model based on a bacterial foraging algorithm (BFA) is proposed in this paper. Considering dynamic and static factors, the probability of pedestrian movement is established using cellular automata. In addition, given walking and queue times, a target optimization function is built. At the same time, a BFA is used to optimize the objective function. Finally, through real and simulation experiments, the relationship between the parameters of evacuation time, exit width, pedestrian density, and average evacuation speed is analyzed. The results show that the model can effectively describe a real evacuation.

Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees.

PubMed

Nomura, Shuhei; Blangiardo, Marta; Tsubokura, Masaharu; Nishikawa, Yoshitaka; Gilmour, Stuart; Kami, Masahiro; Hodgson, Susan

2016-01-01

Considering the health impacts of evacuation is fundamental to disaster planning especially for vulnerable elderly populations; however, evacuation-related mortality risks have not been well-investigated. We conducted an analysis to compare survival of evacuated and non-evacuated residents of elderly care facilities, following the Great East Japan Earthquake and subsequent Fukushima Dai-ichi nuclear power plant incident on 11th March 2011. To assess associations between evacuation and mortality after the Fukushima nuclear incident; and to present discussion points on disaster planning, with reference to vulnerable elderly populations. The study population comprised 1,215 residents admitted to seven elderly care facilities located 20-40km from the nuclear plant in the five years before the incident. Demographic and clinical characteristics were obtained from medical records. Evacuation histories were tracked until mid 2013. Main outcome measures are hazard ratios in evacuees versus non-evacuees using random-effects Cox proportional hazards models, and pre- and post-disaster survival probabilities and relative mortality incidence. Experiencing the disasters did not have a significant influence on mortality (hazard ratio 1.10, 95% confidence interval: 0.84-1.43). Evacuation was associated with 1.82 times higher mortality (95% confidence interval: 1.22-2.70) after adjusting for confounders, with the initial evacuation from the original facility associated with 3.37 times higher mortality risk (95% confidence interval: 1.66-6.81) than non evacuation. The government should consider updating its requirements for emergency planning for elderly facilities and ensure that, in a disaster setting, these facilities have the capacity and support to shelter in place for at least sufficient time to adequately prepare initial evacuation. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma Model

DTIC Science & Technology

2014-02-01

Chamber construction has been completed and swine experiments have been initiated. The NMRC Center for Hypobaric Experimentation, Simulation and...Aeromedical evacuation, en-route care, hypobaric conditions, hypobaric chamber, swine model 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...diminished morbidity and mortality among combat casualties. However, not much is known about the effects of long range aero-medical evacuation in hypobaric

Guidelines for hurricane evacuation signing and markings

DOT National Transportation Integrated Search

2007-12-01

Based on focus group input and surveys of motorists who have recent hurricane evacuation experience, researchers developed guidelines for various hurricane evacuation signs and markings, including route signs, contraflow signs, emergency shoulder lan...

[Papers Presented at the American Medical Association's Air Pollution Medical Research Conference (New Orleans, Louisiana, October 5-7, 1970).

ERIC Educational Resources Information Center

American Medical Association, Chicago, IL.

This is a collection of twenty speeches presented at the American Medical Association's Air Pollution Medical Conference, October 5-7, 1970. Speeches included: Air Pollution Control: The Physician's Role; Air Pollution Problems in Nuclear Power Development; Airway Resistance and Collateral Ventilation; Asbestos Air Pollution in Urban Areas;…

Suction evacuation of hemothorax: A prospective study.

PubMed

Savage, Stephanie A; Cibulas, George A; Ward, Tyler A; Davis, Corinne A; Croce, Martin A; Zarzaur, Ben L

2016-07-01

Although tube thoracostomy is a common procedure after thoracic trauma, incomplete evacuation of fluid places the patient at risk for retained hemothorax. As little as 300 to 500 cm of blood may result in the need for an additional thoracostomy tube or, in more severe cases, lung entrapment and empyema. We hypothesized that suction evacuation of the thoracic cavity before tube placement would decrease the incidence of late complications. Patients requiring tube thoracostomy within 96 hours of admission were prospectively identified and underwent suction evacuation of the pleural space (SEPS) before tube placement. These patients were compared to historical controls without suction evacuation. Demographics, admission vital signs, laboratory values, details of chest tube placement, and outcomes were collected on all patients. Multivariable logistic regression was used to compare outcomes between groups. A total of 199 patients were identified, consisting of 100 retrospective controls and 99 SEPS patients. There were no differences in age, sex, admission injury severity score or chest abbreviated injury score, admission laboratory values or vital signs, or hospital length of stay. Mean (SD) volume of hemothorax in SEPS patients was 220 (297) cm; with only 48% having a volume greater than 100 cm at the time of tube placement. Three patients developed empyema, and 19 demonstrated retained blood; there was no difference between SEPS and control patients. Suction evacuation of the pleural space was significantly protective against recurrent pneumothorax after chest tube removal (odds ratio, 0.332; 95% confidence interval, 0.148-0.745). Preemptive suction evacuation of the thoracic cavity did not have a significant impact on subsequent development of retained hemothorax or empyema. Suction evacuation of the pleural space significantly decreased incidence of recurrent pneumothorax after thoracostomy removal. Although the mechanism is unclear, such a benefit may make this

[Medical care for the burnt in modern local military conflicts].

PubMed

Sidel'nikov, V O; Paramonov, B A; Tatarin, S N

2002-07-01

The article is devoted to the experience of treatment of the servicemen who burned during the hostilities in Afghanistan (1979-1989), Tadjikistan (1992-1994) and in Republic of Chechnya (1994-2996). Medical care rendered in 18,921 cases of burns and combined trauma (the burn prevailed) is analyzed: 1201--in Afghanistan, 205--in Tadjikistan and 415--in Republic of Chechnya. In the structure of sanitary losses of surgical character the burned persons constituted 2.5% in Afghanistan, 7.0%--in Tadjikistan and 3.9%--in Republic of Chechnya. The most effective was the medical-evacuation system in Afghanistan. The optimal medical-evacuation system during the local armed conflicts and wars is the evacuation consisted of two stages: first medical aid--specialized medical care.

Condition for dust evacuation from the first galaxies

NASA Astrophysics Data System (ADS)

Fukushima, Hajime; Yajima, Hidenobu; Omukai, Kazuyuki

2018-06-01

Dust enables low-mass stars to form from low-metallicity gas by inducing fragmentation of clouds via cooling by thermal emission. Dust may, however, be evacuated from star-forming clouds due to the radiation force from massive stars. We study here the condition for dust evacuation by comparing the dust evacuation time with the time of cloud destruction due to either expansion of H II regions or supernovae. The cloud destruction time has a weak dependence on cloud radius, while the dust evacuation time is shorter for a cloud with a smaller radius. Dust evacuation, thus, occurs in compact star-forming clouds whose column density is NH ≃ 1024-1026 cm-2. The critical halo mass above which dust evacuation occurs is lower for higher formation red shift, e.g. ˜109 M⊙ at red shift z ˜ 3 and ˜107 M⊙ at z ˜ 9. In addition, the metallicity of the gas should be less than ˜10-2 Z⊙, otherwise attenuation by dust reduces the radiation force significantly. From the dust-evacuated gas, massive stars are likely to form, even with a metallicity above ˜10-5 Z⊙, the critical value for low-mass star formation due to dust cooling. This can explain the dearth of ultra-metal-poor stars with a metallicity lower than ˜10-4 Z⊙.

Comparison of calculation and simulation of evacuation in real buildings

NASA Astrophysics Data System (ADS)

Szénay, Martin; Lopušniak, Martin

2018-03-01

Each building must meet requirements for safe evacuation in order to prevent casualties. Therefore methods for evaluation of evacuation are used when designing buildings. In the paper, calculation methods were tested on three real buildings. The testing used methods of evacuation time calculation pursuant to Slovak standards and evacuation time calculation using the buildingExodus simulation software. If calculation methods have been suitably selected taking into account the nature of evacuation and at the same time if correct values of parameters were entered, we will be able to obtain almost identical times of evacuation in comparison with real results obtained from simulation. The difference can range from 1% to 27%.

Casualty Evacuation Delay and Outcomes

DTIC Science & Technology

2003-01-01

consequences of delay in therapy on wounded individuals. The contractor was charged with studying the effect of delay on evacuation on outcome of...process. 3 There are a remarkably small proportion of patient diagnoses and states in which time has an effect on outcome . This is because the vast...emphasis on estimating the effect of delayed evacuation on injury outcome and means to mitigating such effects . Since some of the Specific Aims were

Modeling hurricane evacuation traffic : testing the gravity and intervening opportunity models as models of destination choice in hurricane evacuation.

DOT National Transportation Integrated Search

2008-03-01

The objectives of this study are to test whether the Gravity and Intervening Opportunity Models (IOM) can successfully reproduce aggregate evacuation destination choice observed in evacuation behavior from Hurricane Floyd, compare the performance of ...

Modeling pedestrian evacuation with guiders based on a multi-grid model

NASA Astrophysics Data System (ADS)

Cao, Shuchao; Song, Weiguo; Lv, Wei

2016-02-01

Pedestrian evacuation with guidance is investigated by a multi-grid model in this paper. The effects of guider type, guider number, guider distribution and guidance strategy on evacuation are discussed. From the analysis of simulation results, it is found that the identified guiders are more beneficial to evacuation because they can be distinguished easily by pedestrians during evacuation; The optimal guider number exists in view of the human cost and can be obtained in our model; The uniform distribution of guiders covers more area in the room and makes evacuation efficient; Evacuation guidance is more effective when the speed of guider is about 75% of herding pedestrian's speed in our simulation scenario; The performance of evacuation guidance strategy considering both distance and occupant number is the best when compared to other strategies; The coordination and cooperation between guiders are very important and necessary to facilitate the evacuation. The study may be useful for understanding the importance of guidance in evacuation and developing efficient evacuation strategy for management under emergency.

3D Building Evacuation Route Modelling and Visualization

NASA Astrophysics Data System (ADS)

Chan, W.; Armenakis, C.

2014-11-01

The most common building evacuation approach currently applied is to have evacuation routes planned prior to these emergency events. These routes are usually the shortest and most practical path from each building room to the closest exit. The problem with this approach is that it is not adaptive. It is not responsively configurable relative to the type, intensity, or location of the emergency risk. Moreover, it does not provide any information to the affected persons or to the emergency responders while not allowing for the review of simulated hazard scenarios and alternative evacuation routes. In this paper we address two main tasks. The first is the modelling of the spatial risk caused by a hazardous event leading to choosing the optimal evacuation route for a set of options. The second is to generate a 3D visual representation of the model output. A multicriteria decision making (MCDM) approach is used to model the risk aiming at finding the optimal evacuation route. This is achieved by using the analytical hierarchy process (AHP) on the criteria describing the different alternative evacuation routes. The best route is then chosen to be the alternative with the least cost. The 3D visual representation of the model displays the building, the surrounding environment, the evacuee's location, the hazard location, the risk areas and the optimal evacuation pathway to the target safety location. The work has been performed using ESRI's ArcGIS. Using the developed models, the user can input the location of the hazard and the location of the evacuee. The system then determines the optimum evacuation route and displays it in 3D.

Development of the Japanese National Disaster Medical System and Experiences during the Great East Japan Earthquake

PubMed Central

Homma, Masato

2015-01-01

After the Great Hanshin-Awaji Earthquake in 1995, the Japanese national disaster medical system (NDMS) was developed. It mainly consists of four components, namely, a disaster base hospital, an emergency medical information system, a disaster medical assistance team (DMAT), and national aeromedical evacuation (AE). The NDMS was tested for the first time in a real disaster situation during the Great East Japan Earthquake in 2011. Two airports and one base were appointed as DMAT gathering places, and approximately 393 DMAT members divided into 78 teams were transported by Japan Air Self-Defense Force (JASDF) aircrafts to two AE staging bases the following day. Staging care units were installed at Hanamaki Airport, Fukushima Airport, and the Japan Ground Self-Defense Force Camp Kasuminome, and 69, 14 and 24 DMAT teams were placed at those locations, respectively. In total, 19 patients were evacuated using JASDF fixed-wing aircraft. Important issues requiring attention became clear through the experiences of the Great East Japan Earthquake and will be discussed in this paper. PMID:26306054

Managed traffic evacuation using distributed sensor processing

NASA Astrophysics Data System (ADS)

Ramuhalli, Pradeep; Biswas, Subir

2005-05-01

This paper presents an integrated sensor network and distributed event processing architecture for managed in-building traffic evacuation during natural and human-caused disasters, including earthquakes, fire and biological/chemical terrorist attacks. The proposed wireless sensor network protocols and distributed event processing mechanisms offer a new distributed paradigm for improving reliability in building evacuation and disaster management. The networking component of the system is constructed using distributed wireless sensors for measuring environmental parameters such as temperature, humidity, and detecting unusual events such as smoke, structural failures, vibration, biological/chemical or nuclear agents. Distributed event processing algorithms will be executed by these sensor nodes to detect the propagation pattern of the disaster and to measure the concentration and activity of human traffic in different parts of the building. Based on this information, dynamic evacuation decisions are taken for maximizing the evacuation speed and minimizing unwanted incidents such as human exposure to harmful agents and stampedes near exits. A set of audio-visual indicators and actuators are used for aiding the automated evacuation process. In this paper we develop integrated protocols, algorithms and their simulation models for the proposed sensor networking and the distributed event processing framework. Also, efficient harnessing of the individually low, but collectively massive, processing abilities of the sensor nodes is a powerful concept behind our proposed distributed event processing algorithms. Results obtained through simulation in this paper are used for a detailed characterization of the proposed evacuation management system and its associated algorithmic components.

To Evacuate or Shelter in Place: Implications of Universal Hurricane Evacuation Policies on Nursing Home Residents

PubMed Central

Dosa, David; Hyer, Kathryn; Thomas, Kali; Swaminathan, Shailender; Feng, Zhanlian; Brown, Lisa; Mor, Vincent

2011-01-01

Objective To examine the differential morbidity/mortality associated with evacuation versus sheltering in place for nursing home (NH) residents exposed to the 4 most recent Gulf-hurricanes Methods Observational study using Medicare claims, and NH data sources. We compared the differential mortality/morbidity for long-stay residents exposed to 4 recent hurricanes (Katrina, Rita, Gustav, and Ike) relative to those residing at the same NHs over the same time periods during the prior 2 non-hurricane years as a control. Using an instrumental variable analysis, we then evaluated the independent effect of evacuation on outcomes at 90 days. Results Among 36,389 NH residents exposed to a storm, the 30 and 90 day mortality/hospitalization rates increased compared to non-hurricane control years. There were a cumulative total of 277 extra deaths and 872 extra hospitalizations at 30 days. At 90 days, 579 extra deaths and 544 extra hospitalizations were observed. Using the instrumental variable analysis, evacuation increased the probability of death at 90 days from 2.7-5.3% and hospitalization by 1.8-8.3%, independent of other factors. Conclusion Among residents exposed to hurricanes, evacuation significantly exacerbated subsequent morbidity/mortality. PMID:21885350

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Marine evacuation system launching arrangements. 108.545... DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching arrangements. (a) Arrangements. Each marine evacuation system must have the following arrangements: (1) Each...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... associated liferafts. Inflatable liferafts used in conjunction with the marine evacuation system must be stowed as follows: (1) Each inflatable liferaft used in conjunction with the marine evacuation system... platform. (2) Each inflatable liferaft used in conjunction with the marine evacuation system must be...

3 Echo: concept of operations for early care and evacuation of victims of mass violence.

PubMed

Autrey, Allen W; Hick, John L; Bramer, Kurtis; Berndt, Jeremy; Bundt, Jonathan

2014-08-01

This report describes the successful use of a simple 3-phase approach that guides the initial 30 minutes of a response to blast and active shooter events with casualties: Enter, Evaluate, and Evacuate (3 Echo) in a mass-shooting event occurring in Minneapolis, Minnesota USA, on September 27, 2012. Early coordination between law enforcement (LE) and rescue was emphasized, including establishment of unified command, a common operating picture, determination of evacuation corridors, swift victim evaluation, basic treatment, and rapid evacuation utilizing an approach developed collaboratively over the four years prior to the event. Field implementation of 3 Echo requires multi-disciplinary (Emergency Medical Services (EMS), fire and LE) training to optimize performance. This report details the mass-shooting event, the framework created to support the response, and also describes important aspects of the concepts of operation and curriculum evolved through years of collaboration between multiple disciplines to arrive at unprecedented EMS transport times in response to the event.

Evacuation transportation management : task five : operational concept.

DOT National Transportation Integrated Search

2009-06-26

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Evacuation transportation management. Task five, Operational concept

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Optimization and Planning of Emergency Evacuation Routes Considering Traffic Control

PubMed Central

Zhang, Lijun; Wang, Zhaohua

2014-01-01

Emergencies, especially major ones, happen fast, randomly, as well as unpredictably, and generally will bring great harm to people's life and the economy. Therefore, governments and lots of professionals devote themselves to taking effective measures and providing optimal evacuation plans. This paper establishes two different emergency evacuation models on the basis of the maximum flow model (MFM) and the minimum-cost maximum flow model (MC-MFM), and proposes corresponding algorithms for the evacuation from one source node to one designated destination (one-to-one evacuation). Ulteriorly, we extend our evaluation model from one source node to many designated destinations (one-to-many evacuation). At last, we make case analysis of evacuation optimization and planning in Beijing, and obtain the desired evacuation routes and effective traffic control measures from the perspective of sufficiency and practicability. Both analytical and numerical results support that our models are feasible and practical. PMID:24991636

46 CFR 133.145 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... liferafts. Inflatable liferafts used in conjunction with the marine evacuation system must be stowed as follows: (1) Each inflatable liferaft used in conjunction with the marine evacuation system must be close.... (2) Each inflatable liferaft used in conjunction with the marine evacuation system must be capable of...

An Integrated Approach to Modeling Evacuation Behavior

DOT National Transportation Integrated Search

2011-02-01

A spate of recent hurricanes and other natural disasters have drawn a lot of attention to the evacuation decision of individuals. Here we focus on evacuation models that incorporate two economic phenomena that seem to be increasingly important in exp...

Evacuation Preparedness in the Event of Fire in Intensive Care Units in Sweden: More is Needed.

PubMed

Löfqvist, Erika; Oskarsson, Åsa; Brändström, Helge; Vuorio, Alpo; Haney, Michael

2017-06-01

Introduction Hospitals, including intensive care units (ICUs), can be subject to threat from fire and require urgent evacuation. Hypothesis The hypothesis was that the current preparedness for ICU evacuation for fire in the national public hospital system in a wealthy country was very good, using Sweden as model. An already validated questionnaire for this purpose was adapted to national/local circumstances and translated into Swedish. It aimed to elicit information concerning fire response planning, personnel education, training, and exercises. Questionnaire results (yes/no answers) were collected and answers collated to assess grouped responses. Frequencies of responses were determined. While a written hospital plan for fire response and evacuation was noted by all responders, personnel familiarity with the plan was less frequent. Deficiencies were reported concerning all categories: lack of written fire response plan for ICU, lack of personnel education in this, and lack of practical exercises to practice urgent evacuation in the event of fire. These findings were interpreted as an indication of risk for worse consequences for patients in the event of fire and ICU evacuation among the hospitals in the country that was assessed, despite clear regulations and requirements for these. The exact reasons for this lack of compliance with existing laws was not clear, though there are many possible explanations. To remedy this, more attention is needed concerning recognizing risk related to lack of preparedness. Where there exists a goal of high-quality work in the ICU, this should include general leadership and medical staff preparedness in the event of urgent ICU evacuation. Löfqvist E , Oskarsson A , Brändström H , Vuorio A , Haney M . Evacuation preparedness in the event of fire in intensive care units in Sweden: more is needed. Prehosp Disaster Med. 2017;32(3):317-320.

Pedestrian flow-path modeling to support tsunami-evacuation planning

NASA Astrophysics Data System (ADS)

Wood, N. J.; Jones, J. M.; Schmidtlein, M.

2015-12-01

Near-field tsunami hazards are credible threats to many coastal communities throughout the world. Along the U.S. Pacific Northwest coast, low-lying areas could be inundated by a series of catastrophic tsunamis potentially arriving in a matter of minutes following a Cascadia subduction zone (CSZ) earthquake. We developed a geospatial-modeling method for characterizing pedestrian-evacuation flow paths and evacuation basins to support evacuation and relief planning efforts for coastal communities in this region. We demonstrate this approach using the coastal communities of Aberdeen, Hoquiam, and Cosmopolis in southwestern Grays Harbor County, Washington (USA), where previous research suggests approximately 20,500 people (99% of the residents in tsunami-hazard zones) will likely have enough time to evacuate before tsunami-wave arrival. Geospatial, anisotropic, path distance models were developed to map the most efficient pedestrian paths to higher ground from locations within the tsunami-hazard zone. This information was then used to identify evacuation basins, outlining neighborhoods sharing a common evacuation pathway to safety. We then estimated the number of people traveling along designated evacuation pathways and arriving at pre-determined safe assembly areas, helping determine shelter demand and relief support (e.g., for elderly individuals or tourists). Finally, we assessed which paths may become inaccessible due to earthquake-induced ground failures, a factor which may impact an individual's success in reaching safe ground. The presentation will include a discussion of the implications of our analysis for developing more comprehensive coastal community tsunami-evacuation planning strategies worldwide.

Lessons learned from the 2010 evacuations at Merapi volcano

NASA Astrophysics Data System (ADS)

Mei, Estuning Tyas Wulan; Lavigne, Franck; Picquout, Adrien; de Bélizal, Edouard; Brunstein, Daniel; Grancher, Delphine; Sartohadi, Junun; Cholik, Noer; Vidal, Céline

2013-07-01

The rapid onset and large magnitude of the 2010 eruption of Merapi posed significant challenges for evacuations and resulted in a peak number of almost 400,000 Internally Displaced Persons (IDPs). A pre-existing hazard map and an evacuation plan based on the relatively small magnitude of previous eruptions of the 20th century were utilized by emergency officials during the initial phase of the eruption (25 October-3 November, 2010). However, when the magnitude of the eruption increased greatly on 3-5 November 2010, the initial evacuation plan had to be abandoned as danger zones were expanded rapidly and the scale and pace of the evacuation increased dramatically. Fortunately, orders to evacuate were communicated quickly through a variety of communication methods and as a result many thousands of lives were saved. However, there were also problems that resulted from this rapid and larger-than-expected evacuation; and there were lessons learned that can improve future mass evacuations at Merapi and other volcanoes. We analyzed the results of 1969 questionnaires and conducted a series of interviews with community leaders and emergency officials. Results were compiled for periods both during and after the 2010 eruption. Our results show that: (1) trust in the Indonesian government and volcanologists was very high after the eruption; (2) multiple modes of communication were used to relay warnings and evacuation orders; (3) 50% to 70% of IDPs returned to the danger zone during the crisis despite evacuation orders; (4) preparation before the eruption was critical to the successes and included improvements to roads and education programs, (5) public education about hazards and evacuation protocols before the eruption was focused in the perceived highest danger zone where it was effective yet, confusion and loss of life in other areas demonstrated that education programs in all hazard zones are needed to prepare for larger-than-normal eruptions, and (6) improvements in

Minimally invasive evacuation of intraventricular hemorrhage with the Apollo vibration/suction device.

PubMed

Tan, Lee A; Lopes, Demetrius K; Munoz, Lorenzo F; Shah, Yojan; Bhabad, Sudeep; Jhaveri, Miral; Moftakhar, Roham

2016-05-01

Intraventricular hemorrhages (IVH) can occur as a consequence of spontaneous intracerebral hemorrhage, aneurysm rupture, arteriovenous malformation hemorrhage, trauma, or coagulopathy. IVH is a known risk factor for poor clinical outcome with up to 80% mortality. The current standard treatment strategy for IVH consists of the placement of an external ventricular drain. We report our early experience with using the Apollo suction/vibration aspiration system (Penumbra, Alameda, CA, USA) for minimally invasive evacuation of IVH with a review of the pertinent literature. Medical records of patients with IVH who were admitted to Rush University Medical Center, USA, from July to November 2014 were queried from the electronic database. Patients with Graeb Scores (GS) >6 were selected for minimally invasive IVH evacuation with the Apollo aspiration system. Patient demographics, pre- and post-operative GS, pre- and post-operative modified Graeb Score (mGS), as well procedure related complications were analyzed and recorded. A total of eight patients (five men) were identified during the study period. The average age was 55.5years. The mean GS was 9.6 pre-operatively and decreased to 4.9 post-operatively (p=0.0002). The mean mGS was 22.9 pre-operatively and decreased to 11.4 post-operatively (p=0.0001). Most of the IVH reduction occurred in the frontal horn and atrium of the lateral ventricle, as well the third ventricle. One (1/8) procedure-related complication occurred consisted of a tract hemorrhage. The Apollo system can be used for minimally invasive IVH evacuation to achieve significant blood clot volume reduction with minimal procedure-related complication. Copyright © 2016. Published by Elsevier Ltd.

Effect of vacuum spine board immobilization on incidence of pressure ulcers during evacuation of military casualties from theater.

PubMed

Mok, James M; Jackson, Keith L; Fang, Raymond; Freedman, Brett A

2013-12-01

In the summer of 2009, the vacuum spine board (VSB) was designated by the US Air Force as the preferred method of external spinal immobilization during aeromedical transport of patients with suspected unstable thoracolumbar spine fractures. One purported advantage of the VSB is that, by distributing weight over a larger surface area, it decreases the risk of skin pressure ulceration. To examine whether the rate of pressure ulcers has changed since the introduction of the VSB. Retrospective cohorts. Injured US service members undergoing spinal immobilization during evacuation from the Iraq and Afghanistan theaters to Landstuhl, Germany. Presence and stage of pressure ulceration, and deterioration in neurologic status. Records of the initial 60 patients medically evacuated on the VSB to Landstuhl Regional Medical Center were retrospectively analyzed for patient demographics, injury characteristics, and incidence of pressure injury. The incidence of pressure ulcers after the use of VSB was compared with that in a historical control consisting of 30 patients with unstable spinal injuries evacuated before the introduction of the VSB. No sources of external funding were used for this investigation. The combined cohort had a mean age of 28.8 years and mean Injury Severity Score (ISS) of 20.63 and comprised 96% men. Most injury mechanisms were blunt (58%). The rate of neurological injury was 19%. There were no cases of progressive neurological deficit or deformity in either cohort. In the VSB group, using a broad definition of pressure ulcer, incidence was 13 of 60 patients (22%). Using a strict definition, incidence was eight of 60 (13%): five Stage I and three Stage II. In the non-VSB group, incidence of pressure ulcers was three of 30 (10%), using either definition, all Stage II. Difference in incidence between the groups was not statistically significant. Intubated patients had a significantly higher incidence of pressure ulcers. Both the VSB and historic means (non

A microcomputer based traffic evacuation modeling system for emergency planning application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rathi, A.K.

1994-12-01

Vehicular evacuation is one of the major and often preferred protective action options available for emergency management in a real or anticipated disaster. Computer simulation models of evacuation traffic flow are used to estimate the time required for the affected populations to evacuate to safer areas, to evaluate effectiveness of vehicular evacuations as a protective action option. and to develop comprehensive evacuation plans when required. Following a review of the past efforts to simulate traffic flow during emergency evacuations, an overview of the key features in Version 2.0 of the Oak Ridge Evacuation Modeling System (OREMS) are presented in thismore » paper. OREMS is a microcomputer-based model developed to simulate traffic flow during regional emergency evacuations. OREMS integrates a state-of-the-art dynamic traffic flow and simulation model with advanced data editing and output display programs operating under a MS-Windows environment.« less

Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study.

PubMed

Santavirta, Torsten; Santavirta, Nina; Betancourt, Theresa S; Gilman, Stephen E

2015-01-05

To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Cohort study. National child evacuation scheme in Finland during the second world war. Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n = 45,463; women: n = 22,021; men: n = 23,442). Evacuees in the sample were identified from war time government records. Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). The Finnish evacuation policy was not associated with an increased overall risk of admission to hospital

Microbiological contamination of compressed air used in dentistry: an investigation.

PubMed

Conte, M; Lynch, R M; Robson, M G

2001-11-01

The purpose of this preliminary investigation was twofold: 1) to examine the possibility of cross-contamination between a dental-evacuation system and the compressed air used in dental operatories and 2) to capture and identify the most common microflora in the compressed-air supply. The investigation used swab, water, and air sampling that was designed to track microorganisms from the evacuation system, through the air of the mechanical room, into the compressed-air system, and back to the patient. Samples taken in the vacuum system, the air space in the mechanical room, and the compressed-air storage tank had significantly higher total concentrations of bacteria than the outside air sampled. Samples of the compressed air returning to the operatory were found to match the outside air sample in total bacteria. It was concluded that the air dryer may have played a significant role in the elimination of microorganisms from the dental compressed-air supply.

The Use of the Integrated Medical Model for Forecasting and Mitigating Medical Risks for a Near-Earth Asteroid Mission

NASA Technical Reports Server (NTRS)

Kerstman, Eric; Saile, Lynn; Freire de Carvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

2011-01-01

Introduction The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission managers and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight. Methods Stochastic computational methods are used to forecast probability distributions of medical events, crew health metrics, medical resource utilization, and probability estimates of medical evacuation and loss of crew life. The IMM can also optimize medical kits within the constraints of mass and volume for specified missions. The IMM was used to forecast medical evacuation and loss of crew life probabilities, as well as crew health metrics for a near-earth asteroid (NEA) mission. An optimized medical kit for this mission was proposed based on the IMM simulation. Discussion The IMM can provide information to the space program regarding medical risks, including crew medical impairment, medical evacuation and loss of crew life. This information is valuable to mission managers and the space medicine community in assessing risk and developing mitigation strategies. Exploration missions such as NEA missions will have significant mass and volume constraints applied to the medical system. Appropriate allocation of medical resources will be critical to mission success. The IMM capability of optimizing medical systems based on specific crew and mission profiles will be advantageous to medical system designers. Conclusion The IMM is a decision support tool that can provide estimates of the impact of medical events on human space flight missions, such as crew impairment, evacuation, and loss of crew life. It can be used to support the development of mitigation strategies and to propose optimized medical systems for specified space flight missions. Learning Objectives The audience will learn how an evidence-based decision support tool can be

Selfishness- and Selflessness-based models of pedestrian room evacuation

NASA Astrophysics Data System (ADS)

Song, Xiao; Ma, Liang; Ma, Yaofei; Yang, Chen; Ji, Hang

2016-04-01

Some pedestrian evacuation studies have employed game strategy to deal with moving conflicts involving two or three pedestrians. However, most of these have simply presented game strategies for pedestrians without analyzing the reasons why they choose to defect or cooperate. We believe that selfish and selfless behaviors are two main factors that should be considered in evacuation. In addition to these behaviors, human emotions such as sympathy and behaviors such as vying were also taken into account to investigate their impacts on pedestrians' strategies. Moreover, an essential objective factor, the building design factor of door width was tested and analyzed. Experimental results showed that the sense of self leads to more defectors and a longer evacuation time. However, sympathy does some good, leading to more cooperators and a shorter evacuation time. Moreover, the exit door width is an essential factor of the evacuation efficiency. When the width was less than 6 cells in a rectangular room with a size greater than 50 × 50, the evacuation time greatly decreased when the width increased. However, this effect was less obvious when the width increased.

Analyzing communication errors in an air medical transport service.

PubMed

Dalto, Joseph D; Weir, Charlene; Thomas, Frank

2013-01-01

Poor communication can result in adverse events. Presently, no standards exist for classifying and analyzing air medical communication errors. This study sought to determine the frequency and types of communication errors reported within an air medical quality and safety assurance reporting system. Of 825 quality assurance reports submitted in 2009, 278 were randomly selected and analyzed for communication errors. Each communication error was classified and mapped to Clark's communication level hierarchy (ie, levels 1-4). Descriptive statistics were performed, and comparisons were evaluated using chi-square analysis. Sixty-four communication errors were identified in 58 reports (21% of 278). Of the 64 identified communication errors, only 18 (28%) were classified by the staff to be communication errors. Communication errors occurred most often at level 1 (n = 42/64, 66%) followed by level 4 (21/64, 33%). Level 2 and 3 communication failures were rare (, 1%). Communication errors were found in a fifth of quality and safety assurance reports. The reporting staff identified less than a third of these errors. Nearly all communication errors (99%) occurred at either the lowest level of communication (level 1, 66%) or the highest level (level 4, 33%). An air medical communication ontology is necessary to improve the recognition and analysis of communication errors. Copyright © 2013 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Dual effects of pedestrian density on emergency evacuation

NASA Astrophysics Data System (ADS)

Ma, Yi; Lee, Eric Wai Ming; Yuen, Richard Kwok Kit

2017-02-01

This paper investigates the effect of the pedestrian density in building on the evacuation dynamic with simulation method. In the simulations, both the visibility in building and the exit limit of building are taken into account. The simulation results show that the effect of the pedestrian density in building on the evacuation dynamics is dual. On the one hand, when the visibility in building is very large, the increased pedestrian density plays a negative effect. On the other hand, when the visibility in building is very small, the increased pedestrian density can play a positive effect. The simulation results also show that when both the exit width and visibility are very small, the varying of evacuation time with regard to the pedestrian density is non-monotonous and presents a U-shaped tendency. That is, in this case, too large or too small pedestrian density in building is disadvantageous to the evacuation process. Our findings provide a new insight about the effect of the pedestrian density in building on the evacuation dynamic.

Enhancing resource coordination for multi-modal evacuation planning.

DOT National Transportation Integrated Search

2013-01-01

This research project seeks to increase knowledge about coordinating effective multi-modal evacuation for disasters. It does so by identifying, evaluating, and assessing : current transportation management approaches for multi-modal evacuation planni...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

14 CFR 121.570 - Airplane evacuation capability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Airplane evacuation capability. 121.570... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.570 Airplane evacuation capability. (a) No person may cause an airplane carrying passengers to be moved on the surface, take off, or...

Air medical transport: what the family wants to know.

PubMed

Fultz, J H; McKee, J L; Zalaznik, F R; Kidd, P S

1993-01-01

The needs of family members of intensive care unit patients are well-documented, but there is little published about the specific needs of family members of air medical patients. This study was devised to identify family member's information needs regarding air medical transport. Using a descriptive correlational design, 100 family members of air medical patients completed a 14-item Likert-format questionnaire. Each item addressed an information need and asked how important the information was to the family member and how much of this information they received. The information needs most frequently ranked as very important related to the patient's condition, the patient's admitting unit at the receiving hospital, and being able to see the patient prior to flight. Information most frequently received by the family related to the patient's condition. Flight crews need to be cognizant of families' needs and develop ways to improve communication with the family to meet those needs.

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

30 CFR 57.4363 - Underground evacuation instruction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and evacuation plans and procedures and fire warning signals in effect at the mine. (b) Whenever a change is made in escape and evacuation plans and procedures for any area of the mine, all persons... NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Fire...

Hurricane Sandy Evacuation Among World Trade Center Health Registry Enrollees in New York City.

PubMed

Brown, Shakara; Gargano, Lisa M; Parton, Hilary; Caramanica, Kimberly; Farfel, Mark R; Stellman, Steven D; Brackbill, Robert M

2016-06-01

Timely evacuation is vital for reducing adverse outcomes during disasters. This study examined factors associated with evacuation and evacuation timing during Hurricane Sandy among World Trade Center Health Registry (Registry) enrollees. The study sample included 1162 adults who resided in New York City's evacuation zone A during Hurricane Sandy who completed the Registry's Hurricane Sandy substudy in 2013. Factors assessed included zone awareness, prior evacuation experience, community cohesion, emergency preparedness, and poor physical health. Prevalence estimates and multiple logistic regression models of evacuation at any time and evacuation before Hurricane Sandy were created. Among respondents who evacuated for Hurricane Sandy (51%), 24% had evacuated before the storm. In adjusted analyses, those more likely to evacuate knew they resided in an evacuation zone, had evacuated during Hurricane Irene, or reported pre-Sandy community cohesion. Evacuation was less likely among those who reported being prepared for an emergency. For evacuation timing, evacuation before Hurricane Sandy was less likely among those with pets and those who reported 14 or more poor physical health days. Higher evacuation rates were observed for respondents seemingly more informed and who lived in neighborhoods with greater social capital. Improved disaster messaging that amplifies these factors may increase adherence with evacuation warnings. (Disaster Med Public Health Preparedness. 2016;10:411-419).

Uncertainty in a spatial evacuation model

NASA Astrophysics Data System (ADS)

Mohd Ibrahim, Azhar; Venkat, Ibrahim; Wilde, Philippe De

2017-08-01

Pedestrian movements in crowd motion can be perceived in terms of agents who basically exhibit patient or impatient behavior. We model crowd motion subject to exit congestion under uncertainty conditions in a continuous space and compare the proposed model via simulations with the classical social force model. During a typical emergency evacuation scenario, agents might not be able to perceive with certainty the strategies of opponents (other agents) owing to the dynamic changes entailed by the neighborhood of opponents. In such uncertain scenarios, agents will try to update their strategy based on their own rules or their intrinsic behavior. We study risk seeking, risk averse and risk neutral behaviors of such agents via certain game theory notions. We found that risk averse agents tend to achieve faster evacuation time whenever the time delay in conflicts appears to be longer. The results of our simulations also comply with previous work and conform to the fact that evacuation time of agents becomes shorter once mutual cooperation among agents is achieved. Although the impatient strategy appears to be the rational strategy that might lead to faster evacuation times, our study scientifically shows that the more the agents are impatient, the slower is the egress time.

Behavioral effects in room evacuation models

NASA Astrophysics Data System (ADS)

Dossetti, V.; Bouzat, S.; Kuperman, M. N.

2017-08-01

In this work we study a model for the evacuation of pedestrians from an enclosure considering a continuous space substrate and discrete time. We analyze the influence of behavioral features that affect the use of the empty space, that can be linked to the attitudes or characters of the pedestrians. We study how the interaction of different behavioral profiles affects the needed time to evacuate completely a room and the occurrence of clogging. We find that neither fully egotistic nor fully cooperative attitudes are optimal from the point of view of the crowd. In contrast, intermediate behaviors provide lower evacuation times. This leads us to identify some phenomena closely analogous to the faster-is-slower effect. The proposed model allows for distinguishing between the role of the attitudes in the search for empty space and the attitudes in the conflicts.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

NASA Astrophysics Data System (ADS)

Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

2014-11-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

NASA Astrophysics Data System (ADS)

Fraser, S. A.; Wood, N. J.; Johnston, D. M.; Leonard, G. S.; Greening, P. D.; Rossetto, T.

2014-06-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate evacuation departure time or assumed a common departure time for all exposed population. In this paper, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The model is demonstrated for a case study of local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb-level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds can approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios.

Variable population exposure and distributed travel speeds in least-cost tsunami evacuation modelling

USGS Publications Warehouse

Fraser, Stuart A.; Wood, Nathan J.; Johnston, David A.; Leonard, Graham S.; Greening, Paul D.; Rossetto, Tiziana

2014-01-01

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.

Application of Catastrophe Risk Modelling to Evacuation Public Policy

NASA Astrophysics Data System (ADS)

Woo, G.

2009-04-01

The decision by civic authorities to evacuate an area threatened by a natural hazard is especially fraught when the population in harm's way is extremely large, and where there is considerable uncertainty in the spatial footprint, scale, and strike time of a hazard event. Traditionally viewed as a hazard forecasting issue, civil authorities turn to scientists for advice on a potentially imminent dangerous event. However, the level of scientific confidence varies enormously from one peril and crisis situation to another. With superior observational data, meteorological and hydrological hazards are generally better forecast than geological hazards. But even with Atlantic hurricanes, the track and intensity of a hurricane can change significantly within a few hours. This complicated and delayed the decision to call an evacuation of New Orleans when threatened by Hurricane Katrina, and would present a severe dilemma if a major hurricane were appearing to head for New York. Evacuation needs to be perceived as a risk issue, requiring the expertise of catastrophe risk modellers as well as geoscientists. Faced with evidence of a great earthquake in the Indian Ocean in December 2004, seismologists were reluctant to give a tsunami warning without more direct sea observations. Yet, from a risk perspective, the risk to coastal populations would have warranted attempts at tsunami warning, even though there was significant uncertainty in the hazard forecast, and chance of a false alarm. A systematic coherent risk-based framework for evacuation decision-making exists, which weighs the advantages of an evacuation call against the disadvantages. Implicitly and qualitatively, such a cost-benefit analysis is undertaken by civic authorities whenever an evacuation is considered. With the progress in catastrophe risk modelling, such an analysis can be made explicit and quantitative, providing a transparent audit trail for the decision process. A stochastic event set, the core of a

Pedestrian collective motion in competitive room evacuation.

PubMed

Garcimartín, A; Pastor, J M; Martín-Gómez, C; Parisi, D; Zuriguel, I

2017-09-07

When a sizable number of people evacuate a room, if the door is not large enough, an accumulation of pedestrians in front of the exit may take place. This is the cause of emerging collective phenomena where the density is believed to be the key variable determining the pedestrian dynamics. Here, we show that when sustained contact among the individuals exists, density is not enough to describe the evacuation, and propose that at least another variable -such as the kinetic stress- is required. We recorded evacuation drills with different degrees of competitiveness where the individuals are allowed to moderately push each other in their way out. We obtain the density, velocity and kinetic stress fields over time, showing that competitiveness strongly affects them and evidencing patterns which have been never observed in previous (low pressure) evacuation experiments. For the highest competitiveness scenario, we detect the development of sudden collective motions. These movements are related to a notable increase of the kinetic stress and a reduction of the velocity towards the door, but do not depend on the density.

Analysis of community tsunami evacuation time: An overview

NASA Astrophysics Data System (ADS)

Yunarto, Y.; Sari, A. M.

2018-02-01

Tsunami in Indonesia is defined as local tsunami due to its occurrences which are within a distance of 200 km from the epicenter of the earthquake. A local tsunami can be caused by an earthquake, landslide, or volcanic eruption. Tsunami arrival time in Indonesia is generally between 10-60 minutes. As the estimated time of the tsunami waves to reach the coast is 30 minutes after the earthquake, the community should go to the vertical or horizontal evacuation in less than 30 minutes. In an evacuation, the city frequently does the evacuation after obtaining official directions from the authorities. Otherwise, they perform an independent evacuation without correct instructions from the authorities. Both of these ways have several strengths and limitations. This study analyzes these methods regarding time as well as the number of people expected to be saved.

Performance analysis of a solar still coupled with evacuated heat pipes

NASA Astrophysics Data System (ADS)

Pramod, B. V. N.; Prudhvi Raj, J.; Krishnan, S. S. Hari; Kotebavi, Vinod

2018-02-01

In developing countries the need for better quality drinking water is increasing steadily. We can overcome this need by using solar energy for desalination purpose. This process includes fabrication and analysis of a pyramid type solar still coupled with evacuated heat pipes. This experiment using evacuated heat pipes are carried in mainly three modes namely 1) Still alone 2) Using heat pipe with evacuated tubes 3)Using evacuated heat pipe. For this work single basin pyramid type solar still with 1m2 basin area is fabricated. Black stones and Black paint are utilised in solar still to increase evaporation rate of water in basin. The heat pipe’s evaporator section is placed inside evacuated tube and the heat pipe’s condenser section is connected directly to the pyramid type solar still’s lower portion. The output of distillate water from still with evacuated heat pipe is found to be 40% more than the still using only evacuated tubes.

The critical care air transport program.

PubMed

Beninati, William; Meyer, Michael T; Carter, Todd E

2008-07-01

The critical care air transport team program is a component of the U.S. Air Force Aeromedical Evacuation system. A critical care air transport team consists of a critical care physician, critical care nurse, and respiratory therapist along with the supplies and equipment to operate a portable intensive care unit within a cargo aircraft. This capability was developed to support rapidly mobile surgical teams with high capability for damage control resuscitation and limited capacity for postresuscitation care. The critical care air transport team permits rapid evacuation of stabilizing casualties to a higher level of care. The aeromedical environment presents important challenges for the delivery of critical care. All equipment must be tested for safety and effectiveness in this environment before use in flight. The team members must integrate the current standards of care with the limitation imposed by stresses of flight on their patient. The critical care air transport team capability has been used successfully in a range of settings from transport within the United States, to disaster response, to support of casualties in combat.

Computer simulation-based framework for transportation evacuation in major trip generator.

DOT National Transportation Integrated Search

2009-01-01

Since emergencies including both natural disasters and man-made incidents, are happening more and more : frequently, evacuation, especially transportation evacuation, is becoming a hot research focus in recent years. : Currently, transportation evacu...

Modeling and assessment of civil aircraft evacuation based on finer-grid

NASA Astrophysics Data System (ADS)

Fang, Zhi-Ming; Lv, Wei; Jiang, Li-Xue; Xu, Qing-Feng; Song, Wei-Guo

2016-04-01

Studying civil aircraft emergency evacuation process by using computer model is an effective way. In this study, the evacuation of Airbus A380 is simulated using a Finer-Grid Civil Aircraft Evacuation (FGCAE) model. In this model, the effect of seat area and others on escape process and pedestrian's "hesitation" before leaving exits are considered, and an optimized rule of exit choice is defined. Simulations reproduce typical characteristics of aircraft evacuation, such as the movement synchronization between adjacent pedestrians, route choice and so on, and indicate that evacuation efficiency will be determined by pedestrian's "preference" and "hesitation". Based on the model, an assessment procedure of aircraft evacuation safety is presented. The assessment and comparison with the actual evacuation test demonstrate that the available exit setting of "one exit from each exit pair" used by practical demonstration test is not the worst scenario. The half exits of one end of the cabin are all unavailable is the worst one, that should be paid more attention to, and even be adopted in the certification test. The model and method presented in this study could be useful for assessing, validating and improving the evacuation performance of aircraft.

Optimization-based decision support to assist in logistics planning for hospital evacuations.

PubMed

Glick, Roger; Bish, Douglas R; Agca, Esra

2013-01-01

The evacuation of the hospital is a very complex process and evacuation planning is an important part of a hospital's emergency management plan. There are numerous factors that affect the evacuation plan including the nature of threat, availability of resources and staff the characteristics of the evacuee population, and risk to patients and staff. The safety and health of patients is of fundamental importance, but safely moving patients to alternative care facilities while under threat is a very challenging task. This article describes the logistical issues and complexities involved in planning and execution of hospital evacuations. Furthermore, this article provides examples of how optimization-based decision support tools can help evacuation planners to better plan for complex evacuations by providing real-world solutions to various evacuation scenarios.

Unaccompanied evacuation and adult mortality: evaluating the finnish policy of evacuating children to foster care during World War II.

PubMed

Santavirta, Torsten

2014-09-01

I examined associations between evacuation of Finnish children to temporary foster care in Sweden during World War II and all-cause mortality between ages 38 and 78 years. I used a Cox proportional hazards model to estimate mortality risk according to whether the individual was evacuated during childhood or not. I used within-sibling analysis to control for all unobserved socioeconomic and genetic characteristics shared among siblings. Individual-level data for Finnish cohorts born in 1933 to 1944 were derived from wartime government records, Finnish census data from 1950 and 1970, and death cause registry from 1971 to 2011. I found no statistically significant association between evacuation and all-cause mortality when all exposed individuals were included in the analysis. However, subgroup analysis showed that men evacuated before age 4 years had a 1.31 higher mortality risk (95% confidence interval = 1.01, 1.69) than their nonevacuated counterparts. In the aggregate, individuals do not have elevated mortality risk as a consequence of foster care during early childhood owing to the onset of sudden external shocks (e.g., wars).

Does Non-Compliance with Route/Destination Assignment Compromise Evacuation Efficiency?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yuan, Fang; Han, Lee; Chin, Shih-Miao

2007-01-01

This paper documents studies of two real-world network evacuation cases, each with a different, but proven, simulation software package. The purpose of these studies was to examine whether the rate of evacuees' compliance with predetermined route/destination assignments would have an impact on the efficiency of evacuation operations. Results from both cases suggest that a rate of less than 100% compliance does not compromise evacuation efficiency. In fact, although this is counter-intuitive, evacuation efficiency would actually improve as a result of "sensible" non-compliance on the part of the evacuees. A closer observation of the results revealed that the somewhat unexpected improvementmore » results from a reduction in congestion along designated evacuation routes as evacuees spread out to less prominent parallel streets and other non-congested outbound routes. This suggests that by being limited by the zone-to-zone and one-to-one assignment framework, conventional evacuation plans may have fallen short of providing the most efficient guidance to evacuees. To address this issue, some systematic means, perhaps simulation-based, should be performed to assess the zone partitions, route designations, and destination assignments in existing evacuation plans. Thus, evacuation planning with route/destination assignments based on origin zones may be flawed and may deserve reconsideration. After all, once en route, where an evacuee is coming from is of far less consequence than where he or she is going.« less

Medical oxygen and air travel.

PubMed

Lyznicki, J M; Williams, M A; Deitchman, S D; Howe, J P

2000-08-01

This report responds to a resolution that asked the American Medical Association (AMA) to take action to improve airport and airline accommodations for passengers requiring medical oxygen. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that commercial air travel exposes passengers to altitude-related hypoxia and gas expansion, which may cause some passengers to experience significant symptoms and medical complications during flight. Medical guidelines are available to help physicians evaluate and counsel potential passengers who are at increased risk of inflight hypoxemia. Supplemental oxygen may be needed for some passengers to maintain adequate tissue oxygenation and prevent hypoxemic complications. For safety and security reasons, federal regulations prohibit travelers from using their own portable oxygen system onboard commercial aircraft. Many U.S. airlines supply medical oxygen for use during flight but policies and procedures vary. Oxygen-dependent passengers must make additional arrangements for the use of supplemental oxygen in airports. Uniform standards are needed to specify procedures and equipment for the use of medical oxygen in airports and aboard commercial aircraft. Revision of federal regulations should be considered to accommodate oxygen-dependent passengers and permit them to have an uninterrupted source of oxygen from departure to destination.

Prolonged Hypobaria during Aeromedical Evacuation and the Effects on Traumatic Brain Injury

DTIC Science & Technology

2016-01-28

from theatre to Landstuhl Regional Medical Center and subsequently to the United States. Although it is assumed that rapid evacuation to higher levels...removed from the skull, and those designated for electron microscopy were subjected to secondary fixation in a mixture of 4% paraformaldehyde and 1...Cleared, SAF/PA, Case #2016-0437, 28 Sep 2016. of the quadrants (southwest) 14 inches from the side wall . Each rat was subjected to four trials to locate

Status Report on Medical Materiel Items Tested and Evaluated for Use in the USAF Aeromedical Evacuation System.

DTIC Science & Technology

1986-06-01

P.O. Box 2007 3101 E. Alejo Rd. Palm Springs, CA 92262 Telephone: (619) 327-1571 Date Evaluated June 1979 Summary The BABYbird Ventilator, Model 5900...air. Procurement Manufacturer 15 Product and Manufacturer Infant AIRbird Resuscitator Medical Products Oivision/3M P.O. Box 2007 3101 E. Alejo Rd. Palm...Silicone Bag Medical Products Division/3M P.O. Box 20073101 E. Alejo Rd Palm Springs, CA 92262 Telephone: (619) 327-1571 Date Evaluated July 1978 Sumary

Injuries occurring in medical students during international medical rotations: a strategy toward maximizing safety.

PubMed

Galvin, Shannon; Robertson, Russell; Hargarten, Stephen

2012-06-01

The number of medical students traveling to nations outside the United States is steadily increasing. The Association of American Medical Colleges graduation questionnaire notes an increase from 2,838 students in 2001 to 3,799 students in 2009, the last year for which information is available. The risk of having any type of illness during international travel approaches 50%. Up to 19% of students will seek medical care on their return to the United States for illnesses. Most illnesses are benign and self limited. However, when deaths do occur, the leading causes are motor vehicle crashes and drownings. If air medical evacuation occurs, the most likely cause is an injury event. The authors review the literature to determine the risk of and type of illnesses and injuries suffered by travelers while overseas, especially medical volunteers. We describe the major categories of illness and injury risk and propose reasonable risk reduction and prevention strategies for prevention for injury, a relatively neglected area. We recommend that medical schools provide pre-travel training that includes injury prevention so that students are prepared not only for illness prevention but also for injury prevention. A focus on injury prevention, especially from motor vehicle crashes and drowning, is warranted given their role in causing death and serious injury to traveling students.

A literature review of air medical work hazards and pregnancy.

PubMed

Van Dyke, Patricia

2010-01-01

An increased percentage of miscarriages among coworkers at one air medical transport company in 2008 prompted a literature review of selected hazards relevant to the profession of rotor wing air medical flight crew. Because of a lack of known research specific to this population, relevant studies from 1990 to 2008 were chosen to investigate pregnancy risks associated with exposure to vibration, jet fuel, noise, altitude, and fatigue in other occupations. Findings were summarized and recommendations made for future research.

Sensitivity of tsunami evacuation modeling to direction and land cover assumptions

USGS Publications Warehouse

Schmidtlein, Mathew C.; Wood, Nathan J.

2015-01-01

Although anisotropic least-cost-distance (LCD) modeling is becoming a common tool for estimating pedestrian-evacuation travel times out of tsunami hazard zones, there has been insufficient attention paid to understanding model sensitivity behind the estimates. To support tsunami risk-reduction planning, we explore two aspects of LCD modeling as it applies to pedestrian evacuations and use the coastal community of Seward, Alaska, as our case study. First, we explore the sensitivity of modeling to the direction of movement by comparing standard safety-to-hazard evacuation times to hazard-to-safety evacuation times for a sample of 3985 points in Seward's tsunami-hazard zone. Safety-to-hazard evacuation times slightly overestimated hazard-to-safety evacuation times but the strong relationship to the hazard-to-safety evacuation times, slightly conservative bias, and shorter processing times of the safety-to-hazard approach make it the preferred approach. Second, we explore how variations in land cover speed conservation values (SCVs) influence model performance using a Monte Carlo approach with one thousand sets of land cover SCVs. The LCD model was relatively robust to changes in land cover SCVs with the magnitude of local model sensitivity greatest in areas with higher evacuation times or with wetland or shore land cover types, where model results may slightly underestimate travel times. This study demonstrates that emergency managers should be concerned not only with populations in locations with evacuation times greater than wave arrival times, but also with populations with evacuation times lower than but close to expected wave arrival times, particularly if they are required to cross wetlands or beaches.

Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts

PubMed Central

Cherry, Nicola; Haynes, Whitney

2017-01-01

Background: Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. Methods: People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire. Results: Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms (n = 17) and mental ill health (n = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health (n = 8) and respiratory symptoms (n = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety (p = 0.01) and depression (p = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work. Interpretation: Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees. PMID:28819065

Effects of the Fort McMurray wildfires on the health of evacuated workers: follow-up of 2 cohorts.

PubMed

Cherry, Nicola; Haynes, Whitney

2017-08-15

Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire. Of the 129 participants, 109 were in the Fort McMurray area on May 3. Thirty-seven (33.9%) of the participants who were in Fort McMurray on May 3 reported a health condition, including respiratory symptoms ( n = 17) and mental ill health ( n = 17), immediately after the fire. At follow-up, a mean of 102 days after the fire, 11 participants (10.1%) reported a fire-related health condition, including mental ill health ( n = 8) and respiratory symptoms ( n = 2). There was no difference before and after the fire in use of alcohol, cigarettes, recreational drugs or medication. One in 4 participants (32 [24.6%]) had not worked since the fire, and fewer than half (58 [44.6%]) had returned to Fort McMurray. Of the 90 participants evacuated, 15 (16.7%) had scores indicative of moderate or severe anxiety or depression on the Hospital Anxiety and Depression Scale. Those evacuated had significantly higher mean anxiety ( p = 0.01) and depression ( p = 0.04) scores than those not evacuated. Regression modelling showed that anxiety scores were higher for women, with longer time since the fire and with evacuation to a motel. Depression scores were higher for women and with financial loss because of lack of work. Although evacuation was associated with higher anxiety and depression scores, persisting ill health was not widespread at early follow-up after the fire. Although these results are encouraging, these "healthy worker" results cannot be generalized to all evacuees. Copyright 2017, Joule Inc. or its licensors.

Solid evacuated microspheres of hydrogen

DOEpatents

Turnbull, Robert J.; Foster, Christopher A.; Hendricks, Charles D.

1982-01-01

A method is provided for producing solid, evacuated microspheres comprised of hydrogen. The spheres are produced by forming a jet of liquid hydrogen and exciting mechanical waves on the jet of appropriate frequency so that the jet breaks up into drops with a bubble formed in each drop by cavitation. The drops are exposed to a pressure less than the vapor pressure of the liquid hydrogen so that the bubble which is formed within each drop expands. The drops which contain bubbles are exposed to an environment having a pressure just below the triple point of liquid hydrogen and they thereby freeze giving solid, evacuated spheres of hydrogen.

Effect of authority figures for pedestrian evacuation at metro stations

NASA Astrophysics Data System (ADS)

Song, Xiao; Zhang, Zenghui; Peng, Gongzhuang; Shi, Guoqiang

2017-01-01

Most pedestrian evacuation literatures are about routing algorithm, human intelligence and behavior etc. Few works studied how to fully explore the function of authority/security figures, who know more of the environment by simply being there every day. To evaluate the effect of authority figure (AF) in complex buildings, this paper fully investigates the AF related factors that may influence the evacuation effect of crowd, such as the number and locations of AFs, their spread of direction, calming effect and distribution strategies etc. Social force based modeling and simulation results show that these factors of AFs play important roles in evacuation efficiency, which means fewer AFs with right guiding strategy can have good evacuation performance. For our case study, Zhichun Avenue station, the conclusion is that deployment of four AFs is a good choice to achieve relatively high evacuation performance yet save cost.

Simulation of pedestrian crowds’ evacuation in a huge transit terminal subway station

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran; Hao, Xinpeng; Deng, Baoshun

2012-11-01

As modernized urban rail transportation, subways are playing an important role in transiting large passenger flows. Passengers are in high density within the subway during rush hours. The casualty and injury will be tremendous if an accident occurs, such as a fire. Hence, enough attention should be paid on pedestrian crowds’ evacuation in a subway. In this paper, simulation of the process of pedestrian crowds’ evacuation from a huge transit terminal subway station is conducted. The evacuation process in different cases is conducted by using an agent-based model. Effects of occupant density, exit width and automatic fare gates on evacuation time are studied in detail. It is found that, with the increase of the occupant density, the evacuation efficiency would decline. There is a linear relationship between occupant density and evacuation time. Different occupant densities correspond to different critical exit widths. However, the existence of the automatic fare gates has little effect on evacuation time and tendency. The current results of this study will be helpful in guiding evacuation designs of huge underground spaces.

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 10, October 2009

DTIC Science & Technology

2009-10-01

Iraqi Freedom, active component, U.S.Armed Forces ____________________________________2 Medical evacuation for suspected breast cancer , active and...Suspected Breast Cancer , Active and Reserve Components, U.S. Armed Forces, January 2002-June 2009 Deployment health” activities enable the Armed Forces to...members medically evacuated from Iraq or Afghanistan since 2002 with a diagnosis of a breast lump, breast cancer or other breast disorders. The

Analyzing evacuation versus shelter-in-place strategies after a terrorist nuclear detonation.

PubMed

Wein, Lawrence M; Choi, Youngsoo; Denuit, Sylvie

2010-09-01

We superimpose a radiation fallout model onto a traffic flow model to assess the evacuation versus shelter-in-place decisions after the daytime ground-level detonation of a 10-kt improvised nuclear device in Washington, DC. In our model, ≈ 80k people are killed by the prompt effects of blast, burn, and radiation. Of the ≈ 360k survivors without access to a vehicle, 42.6k would die if they immediately self-evacuated on foot. Sheltering above ground would save several thousand of these lives and sheltering in a basement (or near the middle of a large building) would save of them. Among survivors of the prompt effects with access to a vehicle, the number of deaths depends on the fraction of people who shelter in a basement rather than self-evacuate in their vehicle: 23.1k people die if 90% shelter in a basement and 54.6k die if 10% shelter. Sheltering above ground saves approximately half as many lives as sheltering in a basement. The details related to delayed (i.e., organized) evacuation, search and rescue, decontamination, and situational awareness (via, e.g., telecommunications) have very little impact on the number of casualties. Although antibiotics and transfusion support have the potential to save ≈ 10k lives (and the number of lives saved from medical care increases with the fraction of people who shelter in basements), the logistical challenge appears to be well beyond current response capabilities. Taken together, our results suggest that the government should initiate an aggressive outreach program to educate citizens and the private sector about the importance of sheltering in place in a basement for at least 12 hours after a terrorist nuclear detonation. © 2010 Society for Risk Analysis.

Performance optimization of evacuated tube collector for solar cooling of a house in hot climate

NASA Astrophysics Data System (ADS)

Ghoneim, Adel A.

2018-02-01

Evacuating the space connecting cover and absorber significantly improves evacuated tube collector (ETC) performance. So, ETCs are progressively utilised all over the world. The main goal of current study is to explore ETC thermal efficiency in hot and severe climate like Kuwait weather conditions. A collector test facility was installed to record ETC thermal performance for one-year period. An extensively developed model for ETCs is presented, employing complete optical and thermal assessment. This study analyses separately optics and heat transfer in the evacuated tubes, allowing the analysis to be extended to different configurations. The predictions obtained are in agreement with experimental. The optimum collector parameters (collector tube length and diameter, mass flow rate and collector tilt angle) are determined. The present results indicate that the optimum tube length is 1.5 m, as at this length a significant improvement is achieved in efficiency for different tube diameters studied. Finally, the heat generated from ETCs is used for solar cooling of a house. Results of the simulation of cooling system indicate that an ETC of area 54 m2, tilt angle of 25° and storage tank volume of 2.1 m3 provides 80% of air-conditioning demand in a house located in Kuwait.

MEDICAL ASPECTS OF COMMERCIAL JET AIR TRAVEL

PubMed Central

Leeds, M. Frederick

1959-01-01

Jet aircraft will further enhance the medically safe and comfortable transportation of persons with disease. Experience in military medicine, substantiated by civilian commercial air travel experience, has already proved that transportation of sick or disabled persons in propeller-driven planes is essentially benign. Certain restrictions are necessary regarding carriage of sick passengers on commercial aircraft whether jet-propelled or of propeller type. These restrictions are primarily related to the comfort of fellow passengers and to the nonmedical environment of commercial airliners rather than to any risk of air travel per se. PMID:13638839

Empirical study on social groups in pedestrian evacuation dynamics

NASA Astrophysics Data System (ADS)

von Krüchten, Cornelia; Schadschneider, Andreas

2017-06-01

Pedestrian crowds often include social groups, i.e. pedestrians that walk together because of social relationships. They show characteristic configurations and influence the dynamics of the entire crowd. In order to investigate the impact of social groups on evacuations we performed an empirical study with pupils. Several evacuation runs with groups of different sizes and different interactions were performed. New group parameters are introduced which allow to describe the dynamics of the groups and the configuration of the group members quantitatively. The analysis shows a possible decrease of evacuation times for large groups due to self-ordering effects. Social groups can be approximated as ellipses that orientate along their direction of motion. Furthermore, explicitly cooperative behaviour among group members leads to a stronger aggregation of group members and an intermittent way of evacuation.

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

30 CFR 77.1101 - Escape and evacuation; plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Fire Protection § 77.1101 Escape and evacuation; plan. (a) Before September 30, 1971, each operator of... event of a fire. (b) All employees shall be instructed on current escape and evacuation plans, fire alarm signals, and applicable procedures to be followed in case of fire. (c) Plans for escape and...

Developing a database for pedestrians' earthquake emergency evacuation in indoor scenarios.

PubMed

Zhou, Junxue; Li, Sha; Nie, Gaozhong; Fan, Xiwei; Tan, Jinxian; Li, Huayue; Pang, Xiaoke

2018-01-01

With the booming development of evacuation simulation software, developing an extensive database in indoor scenarios for evacuation models is imperative. In this paper, we conduct a qualitative and quantitative analysis of the collected videotapes and aim to provide a complete and unitary database of pedestrians' earthquake emergency response behaviors in indoor scenarios, including human-environment interactions. Using the qualitative analysis method, we extract keyword groups and keywords that code the response modes of pedestrians and construct a general decision flowchart using chronological organization. Using the quantitative analysis method, we analyze data on the delay time, evacuation speed, evacuation route and emergency exit choices. Furthermore, we study the effect of classroom layout on emergency evacuation. The database for indoor scenarios provides reliable input parameters and allows the construction of real and effective constraints for use in software and mathematical models. The database can also be used to validate the accuracy of evacuation models.

Facilitating emergency hospital evacuation through uniform discharge criteria.

PubMed

Sandra, Keret; Meital, Nahari; Ofer, Merin; Limor, Aharonson-Daniel; Sara, Goldberg; Bruria, Adini

2017-05-01

Though hospitals' operational continuity is crucial, full institutional evacuation may at times be unavoidable. The study's objective was to establish criteria for discharge of patients during complete emergency evacuation and compare scope of patients suitable for discharge pre/post implementation of criteria. Standards for patient discharge during an evacuation were developed based on literature and disaster managers. The standards were reviewed in a two-round Delphi process. All hospitals in Israel were requested to identify inpatients' that could be released home during institutional evacuation. Potential discharges were compared in 2013-2014, before and after formulation of discharge criteria. Consensus exceeding 80% was obtained for four out of five criteria after two Delphi cycles. Average projected discharge rate before and after formulation of criteria was 34.2% and 42.9%, respectively (p<0.001). Variance in potential dischargeable patients was 31-fold less in 2014 than in 2013 (MST=8,452 versus MST=264,366, respectively; p<0.001). Differences were found between small, medium and large hospitals in mean rate of dischargeable patients: 52.1%, 41.5% and 42.2%, respectively (p=0.001). The study's findings enable to forecast the extent of patients that may be released home during full emergency evacuation of a hospital; thereby facilitating preparedness of contingency plans. Copyright © 2016 Elsevier Inc. All rights reserved.

Who evacuates when hurricanes approach? The role of risk, information, and location.

PubMed

Stein, Robert M; Dueñas-Osorio, Leonardo; Subramanian, Devika

2010-01-01

This article offers an expanded perspective on evacuation decision making during severe weather. In particular, this work focuses on uncovering determinants of individual evacuation decisions. We draw on a survey conducted in 2005 of residents in the eight-county Houston metropolitan area after Hurricane Rita made landfall on September 24, 2005. We find that evacuation decisions are influenced by a heterogeneous set of parameters, including perceived risk from wind, influence of media and neighbors, and awareness of evacuation zone, that are often at variance with one of the primary measures of risk used by public officials to order or recommend an evacuation (i.e., storm surge). We further find that perceived risk and its influence on evacuation behavior is a local phenomenon more readily communicated by and among individuals who share the same geography, as is the case with residents living inside and outside official risk areas. Who evacuates and why is partially dependent on where one lives because perceptions of risk are not uniformly shared across the area threatened by an approaching hurricane and the same sources and content of information do not have the same effect on evacuation behavior. Hence, efforts to persuade residential populations about risk and when, where, and how to evacuate or shelter in place should originate in the neighborhood rather than emanating from blanket statements from the media or public officials. Our findings also raise important policy questions (included in the discussion section) that require further study and consideration by those responsible with organizing and implementing evacuation plans.

Agent-based Modeling with MATSim for Hazards Evacuation Planning

NASA Astrophysics Data System (ADS)

Jones, J. M.; Ng, P.; Henry, K.; Peters, J.; Wood, N. J.

2015-12-01

Hazard evacuation planning requires robust modeling tools and techniques, such as least cost distance or agent-based modeling, to gain an understanding of a community's potential to reach safety before event (e.g. tsunami) arrival. Least cost distance modeling provides a static view of the evacuation landscape with an estimate of travel times to safety from each location in the hazard space. With this information, practitioners can assess a community's overall ability for timely evacuation. More information may be needed if evacuee congestion creates bottlenecks in the flow patterns. Dynamic movement patterns are best explored with agent-based models that simulate movement of and interaction between individual agents as evacuees through the hazard space, reacting to potential congestion areas along the evacuation route. The multi-agent transport simulation model MATSim is an agent-based modeling framework that can be applied to hazard evacuation planning. Developed jointly by universities in Switzerland and Germany, MATSim is open-source software written in Java and freely available for modification or enhancement. We successfully used MATSim to illustrate tsunami evacuation challenges in two island communities in California, USA, that are impacted by limited escape routes. However, working with MATSim's data preparation, simulation, and visualization modules in an integrated development environment requires a significant investment of time to develop the software expertise to link the modules and run a simulation. To facilitate our evacuation research, we packaged the MATSim modules into a single application tailored to the needs of the hazards community. By exposing the modeling parameters of interest to researchers in an intuitive user interface and hiding the software complexities, we bring agent-based modeling closer to practitioners and provide access to the powerful visual and analytic information that this modeling can provide.

The Impact of Transport Time on Outcomes Following Evacuation from Point of Injury

DTIC Science & Technology

2017-06-16

FROM: 59 MDW/SGVU SUBJECT: Professional Presentation Approval 1. Your paper, entitled The Impact of Transport Time on Outcomes Following Evacuation from...mail) that your presentation was given. At that time , we will need the date (month, day and year) along with the location of your presentation. It is...Congratulations, and thank you for your efforts and time . Your contributions are vital to the medical mission. We look forward to assisting you in your future

[Organization of medical support for troops, defending Leningrad and the people of the blockaded city].

PubMed

Shelepov, A M; Kryuchkov, O A

2015-03-01

The data on the composition of forces of medical services and organization of medical-evacuation support for troops defending the blockaded Leningrad are presented. The information about the health losses among the population of Leningrad as a result of bombing, shelling and disease is given. Extremely high rates of morbidity and mortality in residents were associated with hunger, hypothermia and emotional stress. The clinical picture of some diseases has different peculiarities because of alimentary dystrophy background. The city health service suffered huge losses: 482 medical institutions were destroyed, only about 300 people from 1.5 thousand of medical personnel in 1942 saved working capability. The health care service of the local air defense played an essential role in delivery of medical aid. The contribution of civil and military health workers in saving residents lives in the blockaded Leningrad was appreciated.

Evacuation transportation management : task four: interview and survey results.

DOT National Transportation Integrated Search

2006-06-26

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

Evacuation transportation management. Task four, Interview and survey results

DOT National Transportation Integrated Search

2006-01-01

Much of what is known about evacuations is based on preparations for incidents, such as hurricanes, for which there is advance warning. With advance warning, evacuations can be planned and managed using procedures and systems that have been developed...

[New possibilities in emergency medical transportation and emergency services of Polish Medical Air Rescue].

PubMed

Gałazkowski, Robert

2010-01-01

In Poland, two types of medical services are accomplished by the Medical Air Rescue (MAR) operating all over the country: emergency transport from the incident scene to hospital and inter-hospital transport. Helicopters or planes are used for this purpose. In 2009, helicopters performed 4359 flights to incidents and 1537 inter-hospital transports whereas planes performed 589 inter-hospital ambulance and 196 rescue flights. MAR operates from 17 bases of the Helicopter Emergency Medical Service (HEMS) and one airbase. Helicopters are mainly used when medical transport is emergent, within the operational region of a given base whereas planes when the distance between the present and target airports exceeds 250 km. In 2008, new modern aircraft were introduced to HEMS-helicopters EC 135. They fulfil all requirements of air transport regulations and are adjusted to visual (VFR) and instrumental (IFR) flights rules, at day and night. The medical cabin of EC 135 is ergonomic and functional considering the majority of rescue activities under life-saving circumstances. It is equipped with ventilator, defibrillator, infusion pumps etc. Defibrillators have 12-lead ECG, E(T)CO2, SpO2, NIBP, and IBP modules. Transport ventilators can work in a variety of ventilation modes including CMV, SIMV, SVV, BILEVEL, PCV, ASB, PPV and CPAP. The purchase of helicopters with modern avionic and medical configuration ensures high quality services of MAR for many years to come.

Pathways toward a low cost evacuated collector system

NASA Astrophysics Data System (ADS)

Hull, J. R.; Schertz, W. W.; Allen, J. W.; Ogallagher, J. J.; Winston, R.

The goal of widespread use of solar thermal collectors will only be achieved when they are proven to be economically superior to competing energy sources. Evacuated tubular collectors appear to have the potential to achieve this goal. An advanced evacuated collector using nonimaging concentration under development at the University of Chicago and Argonne can achieve a 50% seasonal efficiency at heat delivery temperatures in excess of 170C. The same collector has an optical efficiency so that low temperature performance is also excellent. In this advanced collector design all of the critical components are enclosed in the vacuum, and the collector has an inherently long lifetime. The current cost of evacuated systems is too high, mainly because the volume of production has been too low to realize economies of mass production. It appears that certain design features of evacuated collectors can be changed (e.g., use of heat pipe absorbers) so as to introduce new system design and market strategy options that can reduce the balance of system cost.

A computer simulation of aircraft evacuation with fire

NASA Technical Reports Server (NTRS)

Middleton, V. E.

1983-01-01

A computer simulation was developed to assess passenger survival during the post-crash evacuation of a transport category aircraft when fire is a major threat. The computer code, FIREVAC, computes individual passenger exit paths and times to exit, taking into account delays and congestion caused by the interaction among the passengers and changing cabin conditions. Simple models for the physiological effects of the toxic cabin atmosphere are included with provision for including more sophisticated models as they become available. Both wide-body and standard-body aircraft may be simulated. Passenger characteristics are assigned stochastically from experimentally derived distributions. Results of simulations of evacuation trials and hypothetical evacuations under fire conditions are presented.

Emergency evacuation study for the Greater Jackson Area : evacuation traffic from New Orleans.

DOT National Transportation Integrated Search

2011-05-21

In response to both natural and man-made disasters, more and more emergency evacuation plans have been put : forward and consistently aims to move a large disaster affected population through a highway network towards safer : areas as quickly and eff...

Modeling hurricane evacuation traffic : development of a time-dependent hurricane evacuation demand model.

DOT National Transportation Integrated Search

2008-04-01

The objective of this research is to develop alternative time-dependent travel demand models of hurricane evacuation travel and to compare the performance of these models with each other and with the state-of-the-practice models in current use. Speci...

A microcomputer based traffic evacuation modeling system for emergency planning application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rathi, A.K.

1995-12-31

The US Army stockpiles unitary chemical weapons, both as bulk chemicals and as munitions, at eight major sites in the United States. The continued storage and disposal of the chemical stockpile has the potential for accidental releases of toxic gases that could escape the installation boundaries and pose a threat to the civilian population in the vicinity. Vehicular evacuation is one of the major and often preferred protective action options available for emergency management in a real or anticipated disaster. Computer simulation models of evacuation traffic flow are used to estimate the time required for the affected populations to evacuatemore » to safer areas, to evaluate effectiveness of vehicular evacuations as a protective action option, and to develop comprehensive evacuation plans when required. Following a review of the past efforts to simulate traffic flow during emergency evacuations, an overview of the key features in Version 2.0 of the Oak Ridge Evacuation Modeling System (OREMS) are presented in this paper. OREMS is a microcomputer-based model developed to simulate traffic flow during regional emergency evacuations. OREMS integrates a state-of-the-art dynamic traffic flow and simulation model with advanced data editing and output display programs operating under a MS-Windows environment.« less

Getting out of harm's way - evacuation from tsunamis

USGS Publications Warehouse

Jones, Jeanne M.; Wood, Nathan J.; Gordon, Leslie C.

2015-01-01

Maps of travel time can be used by emergency managers and community planners to identify where to focus evacuation training and tsunami education. The tool can also be used to examine the potential benefits of vertical-evacuation structures, which are buildings or berms designed to provide a local high ground in low-lying areas of the hazard zone. 

A spatiotemporal optimization model for the evacuation of the population exposed to flood hazard

NASA Astrophysics Data System (ADS)

Alaeddine, H.; Serrhini, K.; Maizia, M.

2015-03-01

Managing the crisis caused by natural disasters, and especially by floods, requires the development of effective evacuation systems. An effective evacuation system must take into account certain constraints, including those related to traffic network, accessibility, human resources and material equipment (vehicles, collecting points, etc.). The main objective of this work is to provide assistance to technical services and rescue forces in terms of accessibility by offering itineraries relating to rescue and evacuation of people and property. We consider in this paper the evacuation of an urban area of medium size exposed to the hazard of flood. In case of inundation, most people will be evacuated using their own vehicles. Two evacuation types are addressed in this paper: (1) a preventive evacuation based on a flood forecasting system and (2) an evacuation during the disaster based on flooding scenarios. The two study sites on which the developed evacuation model is applied are the Tours valley (Fr, 37), which is protected by a set of dikes (preventive evacuation), and the Gien valley (Fr, 45), which benefits from a low rate of flooding (evacuation before and during the disaster). Our goal is to construct, for each of these two sites, a chronological evacuation plan, i.e., computing for each individual the departure date and the path to reach the assembly point (also called shelter) according to a priority list established for this purpose. The evacuation plan must avoid the congestion on the road network. Here we present a spatiotemporal optimization model (STOM) dedicated to the evacuation of the population exposed to natural disasters and more specifically to flood risk.

Initial management of hospital evacuations caused by Hurricane Rita: a systematic investigation.

PubMed

Downey, Erin L; Andress, Knox; Schultz, Carl H

2013-06-01

Hurricanes remain a major threat to hospitals throughout the world. The authors attempted to identify the planning areas that impact hospital management of evacuations and the challenges faced when sheltering-in-place. This observational, retrospective cohort study examined acute care institutions from one hospital system impacted by Hurricane Rita in 2005. Investigators used a standardized survey instrument and interview process, previously used in the hospital evacuation context, to examine hospitals' initial internal situational awareness and subsequent decision making that resulted in evacuation due to Hurricane Rita. Participants from each hospital included representatives from senior leadership and clinical and nonclinical staff that comprised the Incident Management Team (IMT). The main measured outcomes were responses to 95 questions contained in the survey. Seven of ten eligible hospitals participated in the study. All facilities evacuated the sickest patients first. The most significant factors prompting evacuation were the issuing of mandatory evacuation orders, storm dynamics (category, projected path, storm surge), and loss of regional communications. Hospitals that sheltered-in-place experienced staff shortages, interruptions to electrical power, and loss of water supplies. Three fully-evacuated institutions experienced understaffing of 40%-60%, and four hospitals sustained depressed staffing levels for over four weeks. Five hospitals lost electricity for a mean of 4.8 days (range .5-11 days). All facilities continued to receive patients to their Emergency Departments (EDs) while conducting their own evacuation. Hospital EDs should plan for continuous patient arrival during evacuation. Emergency Operation Plans (EOPs) that anticipate challenges associated with evacuation will help to maximize initial decision making and management during a crisis situation. Hospitals that shelter-in-place face critical shortages and must provide independent patient

A Study of Flood Evacuation Center Using GIS and Remote Sensing Technique

NASA Astrophysics Data System (ADS)

Mustaffa, A. A.; Rosli, M. F.; Abustan, M. S.; Adib, R.; Rosli, M. I.; Masiri, K.; Saifullizan, B.

2016-07-01

This research demonstrated the use of Remote Sensing technique and GIS to determine the suitability of an evacuation center. This study was conducted in Batu Pahat areas that always hit by a series of flood. The data of Digital Elevation Model (DEM) was obtained by ASTER database that has been used to delineate extract contour line and elevation. Landsat 8 image was used for classification purposes such as land use map. Remote Sensing incorporate with GIS techniques was used to determined the suitability location of the evacuation center from contour map of flood affected areas in Batu Pahat. GIS will calculate the elevation of the area and information about the country of the area, the road access and percentage of the affected area. The flood affected area map may provide the suitability of the flood evacuation center during the several levels of flood. The suitability of evacuation centers can be determined based on several criteria and the existing data of the evacuation center will be analysed. From the analysis among 16 evacuation center listed, there are only 8 evacuation center suitable for the usage during emergency situation. The suitability analysis was based on the location and the road access of the evacuation center toward the flood affected area. There are 10 new locations with suitable criteria of evacuation center proposed on the study area to facilitate the process of rescue and evacuating flood victims to much safer and suitable locations. The results of this study will help in decision making processes and indirectly will help organization such as fire-fighter and the Department of Social Welfare in their work. Thus, this study can contribute more towards the society.

Utilization of emergency medical kits by air carriers.

DOT National Transportation Integrated Search

1991-03-01

The Department of Transportation Emergency Medical Equipment Requirements Rule of January 9, 1986, mandated a period of 24 months (August 1986 - July 1988) during which all air carriers flying under Federal Aviation Regulation, Part 121, would monito...

Agent-based Large-Scale Emergency Evacuation Using Real-Time Open Government Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Wei; Liu, Cheng; Bhaduri, Budhendra L

The open government initiatives have provided tremendous data resources for the transportation system and emergency services in urban areas. This paper proposes a traffic simulation framework using high temporal resolution demographic data and real time open government data for evacuation planning and operation. A comparison study using real-world data in Seattle, Washington is conducted to evaluate the framework accuracy and evacuation efficiency. The successful simulations of selected area prove the concept to take advantage open government data, open source data, and high resolution demographic data in emergency management domain. There are two aspects of parameters considered in this study: usermore » equilibrium (UE) conditions of traffic assignment model (simple Non-UE vs. iterative UE) and data temporal resolution (Daytime vs. Nighttime). Evacuation arrival rate, average travel time, and computation time are adopted as Measure of Effectiveness (MOE) for evacuation performance analysis. The temporal resolution of demographic data has significant impacts on urban transportation dynamics during evacuation scenarios. Better evacuation performance estimation can be approached by integrating both Non-UE and UE scenarios. The new framework shows flexibility in implementing different evacuation strategies and accuracy in evacuation performance. The use of this framework can be explored to day-to-day traffic assignment to support daily traffic operations.« less

Simulating the effects of social networks on a population's hurricane evacuation participation

NASA Astrophysics Data System (ADS)

Widener, Michael J.; Horner, Mark W.; Metcalf, Sara S.

2013-04-01

Scientists have noted that recent shifts in the earth's climate have resulted in more extreme weather events, like stronger hurricanes. Such powerful storms disrupt societal function and result in a tremendous number of casualties, as demonstrated by recent hurricane experience in the US Planning for and facilitating evacuations of populations forecast to be impacted by hurricanes is perhaps the most effective strategy for reducing risk. A potentially important yet relatively unexplored facet of people's evacuation decision-making involves the interpersonal communication processes that affect whether at-risk residents decide to evacuate. While previous research has suggested that word-of-mouth effects are limited, data supporting these assertions were collected prior to the widespread adoption of digital social media technologies. This paper argues that the influence of social network effects on evacuation decisions should be revisited given the potential of new social media for impacting and augmenting information dispersion through real-time interpersonal communication. Using geographic data within an agent-based model of hurricane evacuation in Bay County, Florida, we examine how various types of social networks influence participation in evacuation. It is found that strategies for encouraging evacuation should consider the social networks influencing individuals during extreme events, as it can be used to increase the number of evacuating residents.

A Method for Formulizing Disaster Evacuation Demand Curves Based on SI Model

PubMed Central

Song, Yulei; Yan, Xuedong

2016-01-01

The prediction of evacuation demand curves is a crucial step in the disaster evacuation plan making, which directly affects the performance of the disaster evacuation. In this paper, we discuss the factors influencing individual evacuation decision making (whether and when to leave) and summarize them into four kinds: individual characteristics, social influence, geographic location, and warning degree. In the view of social contagion of decision making, a method based on Susceptible-Infective (SI) model is proposed to formulize the disaster evacuation demand curves to address both social influence and other factors’ effects. The disaster event of the “Tianjin Explosions” is used as a case study to illustrate the modeling results influenced by the four factors and perform the sensitivity analyses of the key parameters of the model. Some interesting phenomena are found and discussed, which is meaningful for authorities to make specific evacuation plans. For example, due to the lower social influence in isolated communities, extra actions might be taken to accelerate evacuation process in those communities. PMID:27735875

Experiment and modeling of paired effect on evacuation from a three-dimensional space

NASA Astrophysics Data System (ADS)

Jun, Hu; Huijun, Sun; Juan, Wei; Xiaodan, Chen; Lei, You; Musong, Gu

2014-10-01

A novel three-dimensional cellular automata evacuation model was proposed based on stairs factor for paired effect and variety velocities in pedestrian evacuation. In the model pedestrians' moving probability of target position at the next moment was defined based on distance profit and repulsive force profit, and evacuation strategy was elaborated in detail through analyzing variety velocities and repulsive phenomenon in moving process. At last, experiments with the simulation platform were conducted to study the relationships of evacuation time, average velocity and pedestrian velocity. The results showed that when the ratio of single pedestrian was higher in the system, the shortest route strategy was good for improving evacuation efficiency; in turn, if ratio of paired pedestrians was higher, it is good for improving evacuation efficiency to adopt strategy that avoided conflicts, and priority should be given to scattered evacuation.

Tsunami Evacuation Plan for the City of Tangier-Morocco

NASA Astrophysics Data System (ADS)

Benchekroun, Sabah; Omira, Rachid; Baptista, Maria Ana; Arbi Toto, El

2016-04-01

Tsunami evacuation plan is an important tool to mitigate the tsunami impact. It is the most efficient way to save human lives, well before the waves reach the threatened coastal area, by providing evacuation routes and appropriate shelters. In this study, we propose a tsunami evacuation plan for the city of Tangier-Morocco. This plan is designed considering the tsunami threat from the tsunamigenic sources located in the SW Iberia Margin and using the inundation maps of the worst case to define the limit of flooding area. The evacuation plan is elaborated through modelling the required time for the threatened coastal population to reach the shelters. Results of this study will be useful for decision makers and local authorities in preventing the community resiliency for tsunami hazard. This work received funding from collaborative project ASTARTE - Assessment Strategy and Risk Reduction for Tsunamis in Europe Grant 603839, FP7.

Evacuation and Community Shelters

MedlinePlus

... cleaning solution − Emergency preparedness kit − Clothing and bedding − Car keys If local officials haven’t advised an immediate evacuation, take these steps to protect your home before you leave: − Turn off electricity at the main fuse or breaker and turn ...

Evacuate and backfill apparatus and method

DOEpatents

Oakley, David J.; Groves, Oliver J.

1985-01-01

An apparatus and method for treatment of hollow articles by evacuating existing gas or gases therefrom and purging or backfilling the articles with a second gas such as helium. The apparatus includes a sealed enclosure having an article storage drum mounted therein. A multiplicity of such articles are fed singly into the enclosure and loaded into radial slots formed in the drum. The enclosure is successively evacuated and purged with helium to replace the existing gas in the articles with helium. The purged articles are then discharged singly from the drum and transported out of the enclosure.

Evacuate and backfill apparatus and method

DOEpatents

Oakley, D.J.; Groves, O.J.

1984-06-27

An apparatus and method as described for treatment of hollow articles by evacuating existing gas or gases therefrom and purging or backfilling the articles with a second gas such as helium. The apparatus includes a sealed enclosure having an article storage drum mounted therein. A multiplicity of such articles are fed singly into the enclosure and loaded into radial slots formed in the drum. The enclosure is successively evacuated and purged with helium to replace the existing gas in the articles with helium. The purged articles are then discharged singly from the drum and transported out of the enclosure.

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

46 CFR 108.545 - Marine evacuation system launching arrangements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Marine evacuation system launching arrangements. 108.545 Section 108.545 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS DESIGN AND EQUIPMENT Lifesaving Equipment § 108.545 Marine evacuation system launching...

Modeling hurricane evacuation traffic : evaluation of freeway contraflow evacuation initiation and termination point configurations.

DOT National Transportation Integrated Search

2010-06-01

Over the last five years, the departments of transportation in 12 coastal states threatened by hurricanes have developed plans for the implementation of contraflow traffic operations on freeways during evacuations. Contraflow involves the use of one ...

A new device for evacuating air from the cardiac chambers.

PubMed Central

Zhong, B T

1993-01-01

A new device has been developed to provide complete de-airing of the heart after cardiopulmonary bypass. The apparatus consists of a special aspiration needle threaded to the bottom of a transparent bulb. A 1-way flutter valve is mounted at the top of the bulb, which creates a vacuum when the bulb is squeezed. This device has been used in 4 adults and 2 children, for both congenital and acquired heart disease. Preliminary results have shown that this device's active suctioning of air results in effective removal of air from the cardiac chambers; the transparent bulb enables the surgeon to visually determine that the de-airing procedure is complete. PMID:8219828

[Medical Problems in Air Travel from a General Practitioner’s Perspective].

PubMed

Stutz, Andreas; Ensslin, Angela

2016-07-06

As travel by air increases, so does the number of passengers with chronic or acute medical issues. To evaluate fitness for air travel, it is necessary to consider the impact of the altered atmospheric surroundings in an airplane on the current illness to avoid a worsening of health conditions or even an emergency. As first medical contact person, the general practitioner will define supportive measures together with the patient and discuss these with the Medical Service of the airline for implementation. After a thorough evaluation, most patients will be classified fit to fly. Furthermore, a pre-travel consultation should address necessary vaccinations and information on infectious diseases.

Evacuating damaged and destroyed buildings on 9/11: behavioral and structural barriers.

PubMed

Groeger, Justina L; Stellman, Steven D; Kravitt, Alexandra; Brackbill, Robert M

2013-12-01

Evacuation of the World Trade Center (WTC) twin towers and surrounding buildings damaged in the September 11, 2001 attacks provides a unique opportunity to study factors that affect emergency evacuation of high rise buildings. Problem The goal of this study is to understand the extent to which structural and behavioral barriers and limitations of personal mobility affected evacuation by occupants of affected buildings on September 11, 2001. This analysis included 5,023 civilian, adult enrollees within the World Trade Center Health Registry who evacuated the two World Trade Center towers and over 30 other Lower Manhattan buildings that were damaged or destroyed on September 11, 2001. Multinomial logistic regression was used to predict total evacuation time (<30 to ≤60 minutes, >1 hour to <2 hours relative to ≤30 minutes) in relation to number of infrastructure barriers and number of behavioral barriers, adjusted for demographic and other factors. A higher percentage of evacuees reported encountering at least one behavioral barrier (84.9%) than reported at least one infrastructure barrier (51.9%). This pattern was consistent in all buildings except WTC 1, the first building attacked, where >90% of evacuees reported encountering both types of barriers. Smoke and poor lighting were the most frequently-reported structural barriers. Extreme crowding, lack of communication with officials, and being surrounded by panicked crowds were the most frequently-reported behavioral barriers. Multivariate analyses showed evacuation time to be independently associated with the number of each type of barrier as well as gender (longer times for women), but not with the floor from which evacuation began. After adjustment, personal mobility impairment was not associated with increased evacuation time. Because most high-rise buildings have unique designs, infrastructure factors tend to be less predictable than behavioral factors, but both need to be considered in developing emergency

Suicide Rates in Evacuation Areas After the Fukushima Daiichi Nuclear Disaster.

PubMed

Orui, Masatsugu; Suzuki, Yuriko; Maeda, Masaharu; Yasumura, Seiji

2018-04-05

Associations between nuclear disasters and suicide have been examined to a limited extent. To clarify the suicide rates in evacuation areas after the nuclear disaster in Fukushima, which occurred in March 2011. This descriptive study used monthly data from vital statistics between March 2009 and December 2015. Suicide rates in areas to which evacuation orders had been issued, requiring across-the-board, compulsory evacuation of residents from the entire or part of municipalities, were obtained and compared with the national average. Male suicide rates in evacuation areas increased significantly immediately after the disaster, and then began to increase again 4 years after the disaster. Female suicide rates declined slightly during the first year and then increased significantly over the subsequent 3-year period. Moreover, male rates in areas where evacuation orders were issued for the total area declined over the course of approximately 2 years, but then began to increase thereafter. Analysis by age revealed postdisaster male rates in evacuation areas decreased for those aged 50-69 years and increased for those aged ≤ 29 years and ≥ 70 years. The number of suicides among females and the female population in the evacuation area was small. Our findings suggest the need to keep in mind that, when providing post-disaster mental health services, suicide rates can eventually increase even if they initially decrease.

Beat-the-wave evacuation mapping for tsunami hazards in Seaside, Oregon, USA

USGS Publications Warehouse

Priest, George R.; Stimely, Laura; Wood, Nathan J.; Madin, Ian; Watzig, Rudie

2016-01-01

Previous pedestrian evacuation modeling for tsunamis has not considered variable wave arrival times or critical junctures (e.g., bridges), nor does it effectively communicate multiple evacuee travel speeds. We summarize an approach that identifies evacuation corridors, recognizes variable wave arrival times, and produces a map of minimum pedestrian travel speeds to reach safety, termed a “beat-the-wave” (BTW) evacuation analysis. We demonstrate the improved approach by evaluating difficulty of pedestrian evacuation of Seaside, Oregon, for a local tsunami generated by a Cascadia subduction zone earthquake. We establish evacuation paths by calculating the least cost distance (LCD) to safety for every grid cell in a tsunami-hazard zone using geospatial, anisotropic path distance algorithms. Minimum BTW speed to safety on LCD paths is calculated for every grid cell by dividing surface distance from that cell to safety by the tsunami arrival time at safety. We evaluated three scenarios of evacuation difficulty: (1) all bridges are intact with a 5-minute evacuation delay from the start of earthquake, (2) only retrofitted bridges are considered intact with a 5-minute delay, and (3) only retrofitted bridges are considered intact with a 10-minute delay. BTW maps also take into account critical evacuation points along complex shorelines (e.g., peninsulas, bridges over shore-parallel estuaries) where evacuees could be caught by tsunami waves. The BTW map is able to communicate multiple pedestrian travel speeds, which are typically visualized by multiple maps with current LCD-based mapping practices. Results demonstrate that evacuation of Seaside is problematic seaward of the shore-parallel waterways for those with any limitations on mobility. Tsunami vertical-evacuation refuges or additional pedestrian bridges may be effective ways of reducing loss of life seaward of these waterways.

Tsunami evacuation analysis, modelling and planning: application to the coastal area of El Salvador

NASA Astrophysics Data System (ADS)

Gonzalez-Riancho, Pino; Aguirre-Ayerbe, Ignacio; Aniel-Quiroga, Iñigo; Abad Herrero, Sheila; González Rodriguez, Mauricio; Larreynaga, Jeniffer; Gavidia, Francisco; Quetzalcoalt Gutiérrez, Omar; Álvarez-Gómez, Jose Antonio; Medina Santamaría, Raúl

2014-05-01

Advances in the understanding and prediction of tsunami impacts allow the development of risk reduction strategies for tsunami-prone areas. Conducting adequate tsunami risk assessments is essential, as the hazard, vulnerability and risk assessment results allow the identification of adequate, site-specific and vulnerability-oriented risk management options, with the formulation of a tsunami evacuation plan being one of the main expected results. An evacuation plan requires the analysis of the territory and an evaluation of the relevant elements (hazard, population, evacuation routes, and shelters), the modelling of the evacuation, and the proposal of alternatives for those communities located in areas with limited opportunities for evacuation. Evacuation plans, which are developed by the responsible authorities and decision makers, would benefit from a clear and straightforward connection between the scientific and technical information from tsunami risk assessments and the subsequent risk reduction options. Scientifically-based evacuation plans would translate into benefits for the society in terms of mortality reduction. This work presents a comprehensive framework for the formulation of tsunami evacuation plans based on tsunami vulnerability assessment and evacuation modelling. This framework considers (i) the hazard aspects (tsunami flooding characteristics and arrival time), (ii) the characteristics of the exposed area (people, shelters and road network), (iii) the current tsunami warning procedures and timing, (iv) the time needed to evacuate the population, and (v) the identification of measures to improve the evacuation process, such as the potential location for vertical evacuation shelters and alternative routes. The proposed methodological framework aims to bridge the gap between risk assessment and risk management in terms of tsunami evacuation, as it allows for an estimation of the degree of evacuation success of specific management options, as well as

An Analysis of the Populations of the Air Force's Medical and Professional Officer Corps.

PubMed

Keating, Edward G; Massey, Hugh G; Mele, Judith D; Mundell, Benjamin F

2012-01-01

Since the advent of the all-volunteer force, one of the foremost personnel challenges of the U.S. Air Force has been recruiting and retaining an adequate number of medical and professional officers in the Air Force's seven medical and professional officer corps: the Biomedical Sciences Corps (BSC), the Chaplain Corps, the Dental Corps, the Judge Advocate General (JAG) Corps (attorneys), the Medical Corps (physicians), the Medical Service Corps (MSC), and the Nurse Corps. For each of these corps, there are highly similar jobs in the private sector, so attracting and retaining these corps' officers is a constant challenge. This article analyzes all seven Air Force medical and professional officer corps and their relative statuses with regard to end strengths, accession levels, promotion flow, and attrition since the late 1970s. The authors find that recent accession and retention trends have been most adverse in the Air Force's Nurse Corps, while the MSC and the JAG Corps appear to have the most stable populations.

Deployment Injury Surveillance Summary, U.S. Army Operation Iraqi Freedom/Operation Enduring Freedom Calendar Year 2009

DTIC Science & Technology

2012-03-01

injury diagnosis for injuries resulting in out-of-CENTCOM air evacuation. Inflammation and Pain (Overuse) Joint Derangement Joint Derangement...c) The most common types of musculoskeletal conditions leading to medical air evacuation were inflammation and pain (overuse) (42 percent...spine (19 percent), strains/sprains/rupture to the lower leg and/or knee (9 percent), and inflammation and pain (overuse) involving the shoulder (9

Modeling hurricane evacuation traffic : evaluation of freeway contraflow evacuation initiation and termination point configurations.

DOT National Transportation Integrated Search

2006-06-01

Over the last 5 years, the Departments of Transportation in 12 coastal states threatened by hurricanes have developed plans for the implementation of contraflow traffic operations on freeways during evacuations. Contraflow involves the use of one or ...

Numerical Simulation of Evacuation Process in Malaysia By Using Distinct-Element-Method Based Multi-Agent Model

NASA Astrophysics Data System (ADS)

Abustan, M. S.; Rahman, N. A.; Gotoh, H.; Harada, E.; Talib, S. H. A.

2016-07-01

In Malaysia, not many researches on crowd evacuation simulation had been reported. Hence, the development of numerical crowd evacuation process by taking into account people behavioral patterns and psychological characteristics is crucial in Malaysia. On the other hand, tsunami disaster began to gain attention of Malaysian citizens after the 2004 Indian Ocean Tsunami that need quick evacuation process. In relation to the above circumstances, we have conducted simulations of tsunami evacuation process at the Miami Beach of Penang Island by using Distinct Element Method (DEM)-based crowd behavior simulator. The main objectives are to investigate and reproduce current conditions of evacuation process at the said locations under different hypothetical scenarios for the efficiency study of the evacuation. The sim-1 is initial condition of evacuation planning while sim-2 as improvement of evacuation planning by adding new evacuation area. From the simulation result, sim-2 have a shorter time of evacuation process compared to the sim-1. The evacuation time recuded 53 second. The effect of the additional evacuation place is confirmed from decreasing of the evacuation completion time. Simultaneously, the numerical simulation may be promoted as an effective tool in studying crowd evacuation process.

Digestive tract evacuation in northern squawfish (Ptychocheilus oregonensis)

USGS Publications Warehouse

Beyer, J.M.; Lucchetti, G.; Gray, G.

1988-01-01

Digestive tract evacuation in northern squawfish (Ptychocheilus oregonensis) (170–1900 g) was studied in fish allowed to feed voluntarily on salmon (4–70 g) at three water temperatures (10, 15, and 20 °C). Squawfish were sacrificed at 1- or 2-h intervals until evacuation approximated 90%. Amount of food evacuated for a given time interval increased approximately three times as the temperature was increased and as the prey weight was increased and two times as the predator weight was increased. The 90% emptying time (ET90) decreased by about two thirds as the temperature doubled and by about one half as the predator weight increased 10 times, but approximately doubled when the prey weight increased 4 times. Two-fish meals (17–20 g each, 35–39 g total) were evacuated more slowly than meals of one fish weighing 17–20 g, but at the same rate as meals of one fish weighing 35–40 g. Equations derived are easily applied to a wide range of water temperatures, prey weights, and predator weights.

Low-cost evacuated-tube solar collector

NASA Astrophysics Data System (ADS)

1981-02-01

A prototype design for an evacuated tube air cooled solar collector module was completed. A product cost study, based on the production of 60,000 of the prototype modules per year (approx. 1,000,000 square feet annually), estimates that the module as shipped would have a cost at inventory of $7.09 to $7.40 per square foot of aperture. Computer programs were developed to predict the optical and thermal performane of the module. Antireflective coatings (porous aluminum oxide) formed by spraying or dipping were demonstrated but degraded more rapidly when exposed to a high humidity ambient acid etched films. A selective black chromium oxide multi-layered graded film was vapor deposited which had an absorptivity of about 0.9 and an emissivity of 0.03. When the film was heated to temperatures of 4000 C in a gettered vacuum for as little as 24 hours, however, irreversible changes took place both between and within coating layers which resulted in alpha decreasing to about 0.73 and epsilon increasing to 0.14.

Evacuation and rescue in automated guideway transit. Volume 2 : guidebook

DOT National Transportation Integrated Search

1979-12-01

Evacuation and rescue are significant problems in all transportation systems. : Serious injuries and loss of life can result from situations in which inadequate : means of evacuating and rescuing passengers exist. In conventional transporlation : sys...

Evacuation and Rescue in Automated Guideway Transit : Volume 2. Guidebook.

DOT National Transportation Integrated Search

1979-12-01

Evacuation and rescue are significant problems in all transportation systems. Serious injuries and loss of life can result from situations in which inadequate means of evacuating and rescuing passengers exist. In conventional transporlation systems, ...

14 CFR 125.189 - Demonstration of emergency evacuation procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the emergency evacuation procedures for each type and model of airplane with a seating of more than 44... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Demonstration of emergency evacuation procedures. 125.189 Section 125.189 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...

Personalized Alert Notifications and Evacuation Routes in Indoor Environments

PubMed Central

Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

2012-01-01

The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

Spatial memory enhances the evacuation efficiency of virtual pedestrians under poor visibility condition

NASA Astrophysics Data System (ADS)

Ma, Yi; Lee, Eric Wai Ming; Shi, Meng; Kwok Kit Yuen, Richard

2018-03-01

Spatial memory is a critical navigation support tool for disoriented evacuees during evacuation under adverse environmental conditions such as dark or smoky conditions. Owing to the complexity of memory, it is challenging to understand the effect of spatial memory on pedestrian evacuation quantitatively. In this study, we propose a simple method to quantitatively represent the evacueeʼs spatial memory about the emergency exit, model the evacuation of pedestrians under the guidance of the spatial memory, and investigate the effect of the evacueeʼs spatial memory on the evacuation from theoretical and physical perspectives. The result shows that (i) a good memory can significantly assist the evacuation of pedestrians under poor visibility conditions, and the evacuation can always succeed when the degree of the memory exceeds a threshold (\\varphi > 0.5); (ii) the effect of memory is superior to that of “follow-the-crowd” under the same environmental conditions; (iii) in the case of multiple exits, the difference in the degree of the memory between evacuees has a significant effect (the greater the difference, the faster the evacuation) for the evacuation under poor visibility conditions. Our study provides a new quantitative insight into the effect of spatial memory on crowd evacuation under poor visibility conditions. Project supported by the Research Grants Council of the Hong Kong Special Administrative Region, China (Grant No. 11203615).

Leveraging Twitter to gauge evacuation compliance: Spatiotemporal analysis of Hurricane Matthew

PubMed Central

Martín, Yago; Cutter, Susan L.

2017-01-01

Hurricane Matthew was the deadliest Atlantic storm since Katrina in 2005 and prompted one of the largest recent hurricane evacuations along the Southeastern coast of the United States. The storm and its projected landfall triggered a massive social media reaction. Using Twitter data, this paper examines the spatiotemporal variability in social media response and develops a novel approach to leverage geotagged tweets to assess the evacuation responses of residents. The approach involves the retrieval of tweets from the Twitter Stream, the creation and filtering of different datasets, and the statistical and spatial processing and treatment to extract, plot and map the results. As expected, peak Twitter response was reached during the pre-impact and preparedness phase, and decreased abruptly after the passage of the storm. A comparison between two time periods—pre-evacuation (October 2th-4th) and post-evacuation (October 7th-9th)—indicates that 54% of Twitter users moved away from the coast to a safer location, with observed differences by state on the timing of the evacuation. A specific sub-state analysis of South Carolina illustrated overall compliance with evacuation orders and detailed information on the timing of departure from the coast as well as the destination location. These findings advance the use of big data and citizen-as-sensor approaches for public safety issues, providing an effective and near real-time alternative for measuring compliance with evacuation orders. PMID:28753667

Leveraging Twitter to gauge evacuation compliance: Spatiotemporal analysis of Hurricane Matthew.

PubMed

Martín, Yago; Li, Zhenlong; Cutter, Susan L

2017-01-01

Hurricane Matthew was the deadliest Atlantic storm since Katrina in 2005 and prompted one of the largest recent hurricane evacuations along the Southeastern coast of the United States. The storm and its projected landfall triggered a massive social media reaction. Using Twitter data, this paper examines the spatiotemporal variability in social media response and develops a novel approach to leverage geotagged tweets to assess the evacuation responses of residents. The approach involves the retrieval of tweets from the Twitter Stream, the creation and filtering of different datasets, and the statistical and spatial processing and treatment to extract, plot and map the results. As expected, peak Twitter response was reached during the pre-impact and preparedness phase, and decreased abruptly after the passage of the storm. A comparison between two time periods-pre-evacuation (October 2th-4th) and post-evacuation (October 7th-9th)-indicates that 54% of Twitter users moved away from the coast to a safer location, with observed differences by state on the timing of the evacuation. A specific sub-state analysis of South Carolina illustrated overall compliance with evacuation orders and detailed information on the timing of departure from the coast as well as the destination location. These findings advance the use of big data and citizen-as-sensor approaches for public safety issues, providing an effective and near real-time alternative for measuring compliance with evacuation orders.

An Evaluation of Infrastructure for Tsunami Evacuation in Padang, West Sumatra, Indonesia (Invited)

NASA Astrophysics Data System (ADS)

Cedillos, V.; Canney, N.; Deierlein, G.; Diposaptono, S.; Geist, E. L.; Henderson, S.; Ismail, F.; Jachowski, N.; McAdoo, B. G.; Muhari, A.; Natawidjaja, D. H.; Sieh, K. E.; Toth, J.; Tucker, B. E.; Wood, K.

2009-12-01

Padang has one of the world’s highest tsunami risks due to its high hazard, vulnerable terrain and population density. The current strategy to prepare for tsunamis in Padang is focused on developing early warning systems, planning evacuation routes, conducting evacuation drills, and raising local awareness. Although these are all necessary, they are insufficient. Padang’s proximity to the Sunda Trench and flat terrain make reaching safe ground impossible for much of the population. The natural warning in Padang - a strong earthquake that lasts over a minute - will be the first indicator of a potential tsunami. People will have about 30 minutes after the earthquake to reach safe ground. It is estimated that roughly 50,000 people in Padang will be unable to evacuate in that time. Given these conditions, other means to prepare for the expected tsunami must be developed. With this motivation, GeoHazards International and Stanford University’s Chapter of Engineers for a Sustainable World partnered with Indonesian organizations - Andalas University and Tsunami Alert Community in Padang, Laboratory for Earth Hazards, and the Ministry of Marine Affairs and Fisheries - in an effort to evaluate the need for and feasibility of tsunami evacuation infrastructure in Padang. Tsunami evacuation infrastructure can include earthquake-resistant bridges and evacuation structures that rise above the maximum tsunami water level, and can withstand the expected earthquake and tsunami forces. The choices for evacuation structures vary widely - new and existing buildings, evacuation towers, soil berms, elevated highways and pedestrian overpasses. This interdisciplinary project conducted a course at Stanford University, undertook several field investigations, and concluded that: (1) tsunami evacuation structures and bridges are essential to protect the people in Padang, (2) there is a need for a more thorough engineering-based evaluation than conducted to-date of the suitability of

Impacts of high resolution data on traveler compliance levels in emergency evacuation simulations

DOE PAGES

Lu, Wei; Han, Lee D.; Liu, Cheng; ...

2016-05-05

In this article, we conducted a comparison study of evacuation assignment based on Traffic Analysis Zones (TAZ) and high resolution LandScan USA Population Cells (LPC) with detailed real world roads network. A platform for evacuation modeling built on high resolution population distribution data and activity-based microscopic traffic simulation was proposed. This platform can be extended to any cities in the world. The results indicated that evacuee compliance behavior affects evacuation efficiency with traditional TAZ assignment, but it did not significantly compromise the performance with high resolution LPC assignment. The TAZ assignment also underestimated the real travel time during evacuation. Thismore » suggests that high data resolution can improve the accuracy of traffic modeling and simulation. The evacuation manager should consider more diverse assignment during emergency evacuation to avoid congestions.« less

External factors impacting hospital evacuations caused by Hurricane Rita: the role of situational awareness.

PubMed

Downey, Erin L; Andress, Knox; Schultz, Carl H

2013-06-01

The 2005 Gulf Coast hurricane season was one of the most costly and deadly in US history. Hurricane Rita stressed hospitals and led to multiple, simultaneous evacuations. This study systematically identified community factors associated with patient movement out of seven hospitals evacuated during Hurricane Rita. This study represents the second of two systematic, observational, and retrospective investigations of seven acute care hospitals that reported off-site evacuations due to Hurricane Rita. Participants from each hospital included decision makers that comprised the Incident Management Team (IMT). Investigators applied a standardized interview process designed to assess evacuation factors related to external situational awareness of community activities during facility evacuation due to hurricanes. The measured outcomes were responses to 95 questions within six sections of the survey instrument. Investigators identified two factors that significantly impacted hospital IMT decision making: (1) incident characteristics affecting a facility's internal resources and challenges; and (2) incident characteristics affecting a facility's external evacuation activities. This article summarizes the latter and reports the following critical decision making points: (1) Emergency Operations Plans (EOP) were activated an average of 85 hours (3 days, 13 hours) prior to Hurricane Rita's landfall; (2) the decision to evacuate the hospital was made an average of 30 hours (1 day, 6 hours) from activation of the EOP; and (3) the implementation of the evacuation process took an average of 22 hours. Coordination of patient evacuations was most complicated by transportation deficits (the most significant of the 11 identified problem areas) and a lack of situational awareness of community response activities. All evacuation activities and subsequent evacuation times were negatively impacted by an overall lack of understanding on the part of hospital staff and the IMT regarding how to

Study of Tranexamic Acid During Air Medical Prehospital Transport Trial (STAAMP trial)

DTIC Science & Technology

2015-10-01

AWARD NUMBER: W81XWH-13-2-0080 TITLE: Study of Tranexamic Acid During Air Medical Prehospital Transport Trial (STAAMP trial) PRINCIPAL INVESTIGATOR...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Study of Tranexamic Acid During Air Medical Prehospital Transport Trial (STAAMP trial) 5b. GRANT NUMBER W81XWH...IRB approval regarding changes to the protocol language. 15. SUBJECT TERMS Prehospital; Tranexamic acid 16. SECURITY CLASSIFICATION OF: 17. LIMITATION

A spatio-temporel optimization model for the evacuation of the population exposed to natural disasters

NASA Astrophysics Data System (ADS)

Alaeddine, H.; Serrhini, K.; Maïzia, M.; Néron, E.

2015-01-01

The importance of managing the crisis caused by natural disasters, and especially by flood, requires the development of an effective evacuation systems. An effective evacuation system must take into account certain constraints, including those related to network traffic, accessibility, human resources and material equipment (vehicles, collecting points, etc.). The main objective of this work is to provide assistance to technical services and rescue forces in terms of accessibility by offering itineraries relating to rescue and evacuation of people and property. We consider in this paper the evacuation of an urban area of medium size exposed to the hazard of flood. In case of inundation, most people will be evacuated using their own vehicles. Two evacuation types are addressed in this paper, (1) a preventive evacuation based on a flood forecasting system and (2) an evacuation during the disaster based on flooding scenarios. The two study sites on which the evacuation model developed is applied are the valley of Tours (Fr, 37) which is protected by a set of dikes (preventive evacuation) and the valley of Gien (Fr, 45) which benefits of a low rate of flooding (evacuation before and during the disaster). Our goal is to construct, for each of these two sites, a chronological evacuation plan i.e. computing for each individual the departure date and the path to reach the assembly point (also called shelter) associated according to a priorities list established for this purpose. Evacuation plan must avoid the congestion on the road network. Here we present a Spatio-Temporal Optimization Model (STOM) dedicated to the evacuation of the population exposed to natural disasters and more specifically to flood risk.

Evacuation simulation with consideration of obstacle removal and using game theory

NASA Astrophysics Data System (ADS)

Lin, Guan-Wen; Wong, Sai-Keung

2018-06-01

In this paper, we integrate a cellular automaton model with game theory to simulate crowd evacuation from a room with consideration of obstacle removal. The room has one or more exits, one of which is blocked by obstacles. The obstacles at the exit can be removed by volunteers. We investigate the cooperative and defective behaviors of pedestrians during evacuation. The yielder game and volunteer's dilemma game are employed to resolve interpedestrian conflict. An anticipation floor field is proposed to guide the pedestrians to avoid obstacles that are being removed. We conducted experiments to determine how a variety of conditions affect overall crowd evacuation and volunteer evacuation times. The conditions were the start time of obstacle removal, number of obstacles, placement of obstacles, time spent in obstacle removal, strength of the anticipation floor field, and obstacle visibility distance. We demonstrate how reciprocity can be achieved among pedestrians and increases the efficiency of the entire evacuation process.

Making Multi-Level Tsunami Evacuation Playbooks Operational in California and Hawaii

NASA Astrophysics Data System (ADS)

Wilson, R. I.; Peterson, D.; Fryer, G. J.; Miller, K.; Nicolini, T.; Popham, C.; Richards, K.; Whitmore, P.; Wood, N. J.

2016-12-01

In the aftermath of the 2010 Chile, 2011 Japan, and 2012 Haida Gwaii tsunamis in California and Hawaii, coastal emergency managers requested that state and federal tsunami programs investigate providing more detailed information about the flood potential and recommended evacuation for distant-source tsunamis well ahead of their arrival time. Evacuation "Playbooks" for tsunamis of variable sizes and source locations have been developed for some communities in the two states, providing secondary options to an all or nothing approach for evacuation. Playbooks have been finalized for nearly 70% of the coastal communities in California, and have been drafted for evaluation by the communities of Honolulu and Hilo in Hawaii. A key component to determining a recommended level of evacuation during a distant-source tsunami and making the Playbooks operational has been the development of the "FASTER" approach, an acronym for factors that influence the tsunami flood hazard for a community: Forecast Amplitude, Storm, Tides, Error in forecast, and the Run-up potential. Within the first couple hours after a tsunami is generated, the FASTER flood elevation value will be computed and used to select the appropriate minimum tsunami phase evacuation "Playbook" for use by the coastal communities. The states of California and Hawaii, the tsunami warning centers, and local weather service offices are working together to deliver recommendations on the appropriate evacuation Playbook plans for communities to use prior to the arrival of a distant-source tsunami. These partners are working closely with individual communities on developing conservative and consistent protocols on the use of the Playbooks. Playbooks help provide a scientifically-based, minimum response for small- to moderate-size tsunamis which could reduce the potential for over-evacuation of hundreds of thousands of people and save hundreds of millions of dollars in evacuation costs for communities and businesses.

Clarifying evacuation options through fire behavior and traffic modeling

Treesearch

Carol L. Rice; Ronny J. Coleman; Mike Price

2011-01-01

Communities are becoming increasingly concerned with the variety of choices related to wildfire evacuation. We used ArcView with Network Analyst to evaluate the different options for evacuations during wildfire in a case study community. We tested overlaying fire growth patterns with the road network and population characteristics to determine recommendations for...

A Simple Evacuation Modeling and Simulation Tool for First Responders

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koch, Daniel B; Payne, Patricia W

2015-01-01

Although modeling and simulation of mass evacuations during a natural or man-made disaster is an on-going and vigorous area of study, tool adoption by front-line first responders is uneven. Some of the factors that account for this situation include cost and complexity of the software. For several years, Oak Ridge National Laboratory has been actively developing the free Incident Management Preparedness and Coordination Toolkit (IMPACT) to address these issues. One of the components of IMPACT is a multi-agent simulation module for area-based and path-based evacuations. The user interface is designed so that anyone familiar with typical computer drawing tools canmore » quickly author a geospatially-correct evacuation visualization suitable for table-top exercises. Since IMPACT is designed for use in the field where network communications may not be available, quick on-site evacuation alternatives can be evaluated to keep pace with a fluid threat situation. Realism is enhanced by incorporating collision avoidance into the simulation. Statistics are gathered as the simulation unfolds, including most importantly time-to-evacuate, to help first responders choose the best course of action.« less

The effect of overwing hatch placement on evacuation from smaller transport aircraft.

PubMed

Wilson, Rebecca L; Muir, Helen C

2010-02-01

Overwing exits are installed on a number of smaller transport aircraft. With a traditional overwing exit, once released, the hatch is not attached to the fuselage and will fall into the cabin. To operate, the hatch has to be brought inwards, manoeuvred and placed in a location where it does not obstruct egress. Accidents and experimental studies have shown that the hatch is not always disposed of into an appropriate location. Evacuation trials from a smaller transport aircraft cabin were conducted. The placement of the exit hatch was manipulated. The results indicated that hatch placement had a significant effect on passenger evacuation rates from a smaller transport aircraft, with the internal placement tested resulting in slower evacuation rates. The study has highlighted the importance of operators disposing of the hatch into a location whereby it does not impede egress. One way to ensure this would be the installation of an automatically disposed hatch. Statement of Relevance: It is important that all occupants can evacuate an aircraft rapidly if required. The influence of overwing hatch placement on evacuation from smaller transport aircraft was addressed Evacuation trials concluded that an inappropriately placed hatch can negatively influence evacuation rates. Improvements to exit design and passenger education were suggested.

A Global System for Transportation Simulation and Visualization in Emergency Evacuation Scenarios

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lu, Wei; Liu, Cheng; Thomas, Neil

2015-01-01

Simulation-based studies are frequently used for evacuation planning and decision making processes. Given the transportation systems complexity and data availability, most evacuation simulation models focus on certain geographic areas. With routine improvement of OpenStreetMap road networks and LandScanTM global population distribution data, we present WWEE, a uniform system for world-wide emergency evacuation simulations. WWEE uses unified data structure for simulation inputs. It also integrates a super-node trip distribution model as the default simulation parameter to improve the system computational performance. Two levels of visualization tools are implemented for evacuation performance analysis, including link-based macroscopic visualization and vehicle-based microscopic visualization. Formore » left-hand and right-hand traffic patterns in different countries, the authors propose a mirror technique to experiment with both scenarios without significantly changing traffic simulation models. Ten cities in US, Europe, Middle East, and Asia are modeled for demonstration. With default traffic simulation models for fast and easy-to-use evacuation estimation and visualization, WWEE also retains the capability of interactive operation for users to adopt customized traffic simulation models. For the first time, WWEE provides a unified platform for global evacuation researchers to estimate and visualize their strategies performance of transportation systems under evacuation scenarios.« less

Using highways during evacuation operations for events with advance notice

DOT National Transportation Integrated Search

2006-12-01

This document constitutes the first of a primer series titled 'Routes to Effective Evacuation planning' and covers the use of the highway system during evacuation operations when advance planning is possible [...] This is a basic-level guide on condu...

Providing emergency medical care to offshore oil and gas platforms in the Gulf of Mexico using telemedicine

NASA Astrophysics Data System (ADS)

Bouabene, Anis

2002-08-01

UTMB is developing with industrial partners the "24/7 telemedicine triage project" to provide emergency medical care to offshore oil and gas rigs and platforms in the Gulf of Mexico. The oil and gas industry is second only to the US department of defense in the number of employees stationed in remote areas. Providing medical care to such populations is logistically complex and expensive. In addition, emergency evacuation is often time-consuming and poses risks for both patients and medical crews. By utilizing high-resolution videoconferencing technology, through a satellite communication, patient visits will be conducted in real time and will provide more informed decisions about the need for more extensive treatment, thereby reducing unnecessary evacuations. In addition, patients who require evacuation will receive a higher standard of care while waiting for transport to a medical facility. UTMB physicians report that 39% of all patients from offshore facilities treated in the emergency department, could have been successfully treated through telemedicine without being evacuated to a hospital. The telemedicine project will employ standard procedures for medical triage, in which patients are directed to appropriate medical experts based on their symptoms or type of injury.

Displacement of the underserved: medical needs of Hurricane Katrina evacuees in West Virginia.

PubMed

Ridenour, Marilyn L; Cummings, Kristin J; Sinclair, Julie R; Bixler, Danae

2007-05-01

On August 29, 2005 Hurricane Katrina struck Louisiana, Mississippi, and Alabama. During the aftermath of the storm, hurricane victims were evacuated to over 1,000 evacuation centers in 27 states. Three-hundred and twenty-three evacuees from 220 households were provided housing, food, and medical care at an evacuation center in West Virginia. A needs assessment followed to identify current needs of the evacuees. One-hundred and sixty-four evacuees were interviewed. Twenty-five percent reported an acute illness, while 46% reported having at least one chronic medical condition. The greatest need reported was for dental care (57%), followed by eyeglasses (34%), dentures (28%), and medical services (25%). Two weeks after the hurricane, the basic needs of food, shelter, and hygiene were met. The assessment identified and led to a successful response regarding the ongoing need for durable medical equipment (dentures and eyeglasses), as well as dental care.

Elementary students' evacuation route choice in a classroom: A questionnaire-based method

NASA Astrophysics Data System (ADS)

Chen, Liang; Tang, Tie-Qiao; Huang, Hai-Jun; Song, Ziqi

2018-02-01

Children evacuation is a critical but challenging issue. Unfortunately, existing researches fail to effectively describe children evacuation, which is likely due to the lack of experimental and empirical data. In this paper, a questionnaire-based experiment was conducted with children aged 8-12 years to study children route choice behavior during evacuation from in a classroom with two exits. 173 effective questionnaires were collected and the corresponding data were analyzed. From the statistical results, we obtained the following findings: (1) position, congestion, group behavior, and backtracking behavior have significant effects on children route choice during evacuation; (2) age only affects children backtracking behavior, and (3) no prominent effects based on gender and guidance were observed. The above findings may help engineers design some effective evacuation strategies for children.

Transperineal ultrasound compared to evacuation proctography for diagnosing enteroceles and intussusceptions.

PubMed

Weemhoff, M; Kluivers, K B; Govaert, B; Evers, J L H; Kessels, A G H; Baeten, C G

2013-03-01

This study concerns the level of agreement between transperineal ultrasound and evacuation proctography for diagnosing enteroceles and intussusceptions. In a prospective observational study, 50 consecutive women who were planned to have an evacuation proctography underwent transperineal ultrasound too. Sensitivity, specificity, positive (PPV) and negative predictive value, as well as the positive and negative likelihood ratio of transperineal ultrasound were assessed in comparison to evacuation proctography. To determine the interobserver agreement of transperineal ultrasound, the quadratic weighted kappa was calculated. Furthermore, receiver operating characteristic curves were generated to show the diagnostic capability of transperineal ultrasound. For diagnosing intussusceptions (PPV 1.00), a positive finding on transperineal ultrasound was predictive of an abnormal evacuation proctography. Sensitivity of transperineal ultrasound was poor for intussusceptions (0.25). For diagnosing enteroceles, the positive likelihood ratio was 2.10 and the negative likelihood ratio, 0.85. There are many false-positive findings of enteroceles on ultrasonography (PPV 0.29). The interobserver agreement of the two ultrasonographers assessed as the quadratic weighted kappa of diagnosing enteroceles was 0.44 and that of diagnosing intussusceptions was 0.23. An intussusception on ultrasound is predictive of an abnormal evacuation proctography. For diagnosing enteroceles, the diagnostic quality of transperineal ultrasound was limited compared to evacuation proctography.

Postoperative pain after haemorrhoidectomy: role of impaired evacuation.

PubMed

Puigdollers, A; Cisternas, D; Azpiroz, F

2011-08-01

We hypothesized that obstructive defaecation is associated with more postoperative pain after haemorrhoidectomy. Fifty patients with grade IV haemorrhoids were included in a prospective study. Impaired evacuation was defined as the inability to evacuate a rectal balloon. Perianal sensitivity was evaluated by means of an algometer, and anxiety and depression were assessed by the hospital anxiety and depression (HAD) scale. Over the first 10 days after a Milligan-Morgan haemorrhoidectomy, the following parameters were measured on daily questionnaires: pain (associated with and unrelated to defaecation by means of visual analogue scales), number of bowel movements, faecal consistency and analgesic requirement on demand (tramadol 50 mg p.o., number of doses). Results are expressed as median and interquartile range or mean ± SE. Patients with impaired evacuation (14 women, eight men; age range 28-61 years) experienced more postoperative pain than patients with nonimpaired evacuation (eight women, 20 men; age range 24-70 years): 3.2 (2.1) vs 2.1 (1.8) defaecatory pain, respectively (P = 0.045), and 2.4 (2.3) vs 1.7 (2.3) nondefecatory pain, respectively (P = 0.048). There was no difference between the groups regarding stool consistency, number of bowel movements [12.5 (7.3) vs 15.5 (7.2), respectively; NS] and analgesic requirement [1.0 (6.1) vs 1.0 (5.2) extra doses on demand, respectively; NS] during the 10 postoperative days. No differences related to age, sex, HAD scores or perianal sensitivity were found. Impaired anal evacuation is predictive of postoperative pain after haemorrhoidectomy. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Community disruptions and business costs for distant tsunami evacuations using maximum versus scenario-based zones

USGS Publications Warehouse

Wood, Nathan J.; Wilson, Rick I.; Ratliff, Jamie L.; Peters, Jeff; MacMullan, Ed; Krebs, Tessa; Shoaf, Kimberley; Miller, Kevin

2017-01-01

Well-executed evacuations are key to minimizing loss of life from tsunamis, yet they also disrupt communities and business productivity in the process. Most coastal communities implement evacuations based on a previously delineated maximum-inundation zone that integrates zones from multiple tsunami sources. To support consistent evacuation planning that protects lives but attempts to minimize community disruptions, we explore the implications of scenario-based evacuation procedures and use the California (USA) coastline as our case study. We focus on the land in coastal communities that is in maximum-evacuation zones, but is not expected to be flooded by a tsunami generated by a Chilean earthquake scenario. Results suggest that a scenario-based evacuation could greatly reduce the number of residents and employees that would be advised to evacuate for 24–36 h (178,646 and 159,271 fewer individuals, respectively) and these reductions are concentrated primarily in three counties for this scenario. Private evacuation spending is estimated to be greater than public expenditures for operating shelters in the area of potential over-evacuations ($13 million compared to $1 million for a 1.5-day evacuation). Short-term disruption costs for businesses in the area of potential over-evacuation are approximately $122 million for a 1.5-day evacuation, with one-third of this cost associated with manufacturing, suggesting that some disruption costs may be recouped over time with increased short-term production. There are many businesses and organizations in this area that contain individuals with limited mobility or access and functional needs that may have substantial evacuation challenges. This study demonstrates and discusses the difficulties of tsunami-evacuation decision-making for relatively small to moderate events faced by emergency managers, not only in California but in coastal communities throughout the world.

Long-term outcomes of patients evacuated from hospitals near the Fukushima Daiichi nuclear power plant after the Great East Japan Earthquake.

PubMed

Igarashi, Yutaka; Tagami, Takashi; Hagiwara, Jun; Kanaya, Takahiro; Kido, Norihiro; Omura, Mariko; Tosa, Ryoichi; Yokota, Hiroyuki

2018-01-01

After the accident of the Fukushima Daiichi nuclear power plant due to the Great East Japan Earthquake in March 2011, the Japanese government issued a mandatory evacuation order for people living within a 20 km radius of the nuclear power plant. The aim of the current study was to investigate long-term outcomes of these patients and identify factors related to mortality. Patients who were evacuated from hospitals near the Fukushima Daiichi nuclear power plant to the Aizu Chuo Hospital from 15 to 26 March, 2011 were included in this study. The following data were collected from medical records: age, sex, activities of daily life, hospital they were admitted in at the time of earthquake, distance between the facility and the nuclear power plant, reasons of evacuation and number of transfers. The patient outcomes were collected from medical records and/or investigated on the telephone in January 2012. A total of 97 patients (28 men and 69 women) were transferred from 10 hospitals via ambulances or buses. No patients died or experienced exacerbation during transfer. Median age of the patients was 86 years. Of the total, 36 patients were not able to obey commands, 44 were bed-ridden and 61 were unable to sustain themselves via oral intake of food. Among 86 patients who were followed-up, 41 (48%) died at the end of 2011. Multiple-regression analysis showed that non-oral intake [Hazard Ratio (HR): 6.07, 95% Confidence interval (CI): 1.94-19.0] and male sex [HR: 8.35, 95% CI: 2.14-32.5] had significant impact on mortality. This study found that 48% of the evacuated patients died 9 months after the earthquake and they had significantly higher mortality rate than the nursing home residents. Non-oral intake and male sex had significant impact on mortality. These patients should be considered as especially vulnerable in case of hospital evacuation.

A study on evacuation time from lecture halls in Faculty of Engineering, Universiti Putra Malaysia

NASA Astrophysics Data System (ADS)

Othman, W. N. A. W.; Tohir, M. Z. M.

2018-04-01

An evacuation situation in any building involves many risks. The geometry of building and high potential of occupant load may affect the efficiency of evacuation process. Although fire safety rules and regulations exist, they remain insufficient to guarantee the safety of all building occupants and do not prevent the dramatic events to be repeated. The main objective of this project is to investigate the relationship between the movement time, travel speed and occupant density during a series of evacuation drills specifically for lecture halls. Generally, this study emphasizes on the movement of crowd within a limited space and includes the aspects of human behaviour. A series of trial evacuations were conducted in selected lecture halls at Faculty of Engineering, Universiti Putra Malaysia with the aim of collecting actual data for numerical analysis. The numerical data obtained during trial evacuations were used to determine the evacuation time, crowd movement and behaviour during evacuation process particularly for lecture halls. The evacuation time and number of occupants exiting from each exit were recorded. Video camera was used to record and observe the movement behaviour of occupants during evacuations. EvacuatioNZ was used to simulate the trials evacuations of DK 5 and the results predicted were compared with experimental data. EvacuatioNZ was also used to predict the evacuation time and the flow of occupants exiting from each door for DK 4 and DK 8.

Quantitative comparison between crowd models for evacuation planning and evaluation

NASA Astrophysics Data System (ADS)

Viswanathan, Vaisagh; Lee, Chong Eu; Lees, Michael Harold; Cheong, Siew Ann; Sloot, Peter M. A.

2014-02-01

Crowd simulation is rapidly becoming a standard tool for evacuation planning and evaluation. However, the many crowd models in the literature are structurally different, and few have been rigorously calibrated against real-world egress data, especially in emergency situations. In this paper we describe a procedure to quantitatively compare different crowd models or between models and real-world data. We simulated three models: (1) the lattice gas model, (2) the social force model, and (3) the RVO2 model, and obtained the distributions of six observables: (1) evacuation time, (2) zoned evacuation time, (3) passage density, (4) total distance traveled, (5) inconvenience, and (6) flow rate. We then used the DISTATIS procedure to compute the compromise matrix of statistical distances between the three models. Projecting the three models onto the first two principal components of the compromise matrix, we find the lattice gas and RVO2 models are similar in terms of the evacuation time, passage density, and flow rates, whereas the social force and RVO2 models are similar in terms of the total distance traveled. Most importantly, we find that the zoned evacuation times of the three models to be very different from each other. Thus we propose to use this variable, if it can be measured, as the key test between different models, and also between models and the real world. Finally, we compared the model flow rates against the flow rate of an emergency evacuation during the May 2008 Sichuan earthquake, and found the social force model agrees best with this real data.

AsMA Medical Guidelines for Air Travel: Reported In-Flight Medical Events and Death.

PubMed

Thibeault, Claude; Evans, Anthony D

2015-06-01

Medical Guidelines for Airline Travel provide information that enables healthcare providers to properly advise patients who plan to travel by air. Although there are no publicly available databases providing information on the number of in-flight medical emergencies, the few studies published in the literature indicate that they are uncommon. Minor illnesses such as near-fainting, dizziness, and hyperventilation occur more frequently. However, serious illnesses, such as seizures and myocardial infarction, also occur. In-flight deaths are also rare.

Evacuation dynamic and exit optimization of a supermarket based on particle swarm optimization

NASA Astrophysics Data System (ADS)

Li, Lin; Yu, Zhonghai; Chen, Yang

2014-12-01

A modified particle swarm optimization algorithm is proposed in this paper to investigate the dynamic of pedestrian evacuation from a fire in a public building-a supermarket with multiple exits and configurations of counters. Two distinctive evacuation behaviours featured by the shortest-path strategy and the following-up strategy are simulated in the model, accounting for different categories of age and sex of the pedestrians along with the impact of the fire, including gases, heat and smoke. To examine the relationship among the progress of the overall evacuation and the layout and configuration of the site, a series of simulations are conducted in various settings: without a fire and with a fire at different locations. Those experiments reveal a general pattern of two-phase evacuation, i.e., a steep section and a flat section, in addition to the impact of the presence of multiple exits on the evacuation along with the geographic locations of the exits. For the study site, our simulations indicated the deficiency of the configuration and the current layout of this site in the process of evacuation and verified the availability of proposed solutions to resolve the deficiency. More specifically, for improvement of the effectiveness of the evacuation from the site, adding an exit between Exit 6 and Exit 7 and expanding the corridor at the right side of Exit 7 would significantly reduce the evacuation time.

Effect of form of obstacle on speed of crowd evacuation

NASA Astrophysics Data System (ADS)

Yano, Ryosuke

2018-03-01

This paper investigates the effect of the form of an obstacle on the time that a crowd takes to evacuate a room, using a toy model. Pedestrians are modeled as active soft matter moving toward a point with intended velocities. An obstacle is placed in front of the exit, and it has one of four shapes: a cylindrical column, a triangular prism, a quadratic prism, or a diamond prism. Numerical results indicate that the evacuation-completion time depends on the shape of the obstacle. Obstacles with a circular cylinder (C.C.) shape yield the shortest evacuation-completion time in the proposed model.

Stoma management in a tropical country: colostomy irrigation versus natural evacuation.

PubMed

Leong, A F; Yunos, A B

1999-11-01

People with ostomies in Singapore were initially resistant to colostomy irrigation. This study, a prospective crossover study of 26 patients who underwent abdominoperineal resection, compared colostomy irrigation with the natural evacuation method. During the colostomy-irrigation phase of the study, all 26 patients reported an improvement in continence and fewer problems with sleep, sex, and skin complications compared to the natural-evacuation phase. The study also found a reduction in monthly expenses with colostomy irrigation compared to natural evacuation. Patient satisfaction scores were also superior during the colostomy-irrigation phase. This difference in satisfaction scores was less marked in those who were more than 1-year postsurgery than in those who were less than 1-year postsurgery. The difference in satisfaction between colostomy irrigation and natural evacuation scores was statistically significant in the group that was less than 1-year postsurgery, but not in the group that was more than 1-year postsurgery. The study concluded that colostomy irrigation after abdominoperineal resection is superior to natural evacuation in terms of cost and patient satisfaction and should be introduced soon after surgery.

The Effects of Evacuation on Nursing Home Residents With Dementia

PubMed Central

Brown, Lisa M.; Dosa, David M.; Thomas, Kali; Hyer, Kathryn; Feng, Zhanlian; Mor, Vincent

2013-01-01

Background In response to the hurricane-related deaths of nursing home residents, there has been a steady increase in the number of facilities that evacuate under storm threat. This study examined the effects of evacuation during Hurricane Gustav on residents who were cognitively impaired. Methods Nursing homes in counties located in the path of Hurricane Gustav were identified. The Minimum Data Set resident assessment files were merged with the Centers for Medicare enrollment file to determine date of death for residents in identified facilities. Difference-in-differences analyses were conducted adjusting for residents’ demographic characteristics and acuity. Results The dataset included 21,255 residents living in 119 at risk nursing homes over three years of observation. Relative to the two years before the storm, there was a 2.8 percent increase in death at 30 days and a 3.9 percent increase in death at 90 days for residents with severe dementia who evacuated for Hurricane Gustav, controlling for resident demographics and acuity. Conclusions The findings of this research reveal the deleterious effects of evacuation on residents with severe dementia. Interventions need to be developed and tested to determine the best methods for protecting this at risk population when there are no other options than to evacuate the facility. PMID:22930698

Fluid Line Evacuation and Freezing Experiments for Digital Radiator Concept

NASA Technical Reports Server (NTRS)

Berisford, Daniel F.; Birur, Gajanana C.; Miller, Jennifer R.; Sunada, Eric T.; Ganapathi, Gani B.; Stephan, Ryan; Johnson, Mark

2011-01-01

The digital radiator technology is one of three variable heat rejection technologies being investigated for future human-rated NASA missions. The digital radiator concept is based on a mechanically pumped fluid loop with parallel tubes carrying coolant to reject heat from the radiator surface. A series of valves actuate to start and stop fluid flow to di erent combinations of tubes, in order to vary the heat rejection capability of the radiator by a factor of 10 or more. When the flow in a particular leg is stopped, the fluid temperature drops and the fluid can freeze, causing damage or preventing flow from restarting. For this reason, the liquid in a stopped leg must be partially or fully evacuated upon shutdown. One of the challenges facing fluid evacuation from closed tubes arises from the vapor generated during pumping to low pressure, which can cause pump cavitation and incomplete evacuation. Here we present a series of laboratory experiments demonstrating fluid evacuation techniques to overcome these challenges by applying heat and pumping to partial vacuum. Also presented are results from qualitative testing of the freezing characteristics of several different candidate fluids, which demonstrate significant di erences in freezing properties, and give insight to the evacuation process.

People's Risk Recognition Preceding Evacuation and Its Role in Demand Modeling and Planning.

PubMed

Urata, Junji; Pel, Adam J

2018-05-01

Evacuation planning and management involves estimating the travel demand in the event that such action is required. This is usually done as a function of people's decision to evacuate, which we show is strongly linked to their risk awareness. We use an empirical data set, which shows tsunami evacuation behavior, to demonstrate that risk recognition is not synonymous with objective risk, but is instead determined by a combination of factors including risk education, information, and sociodemographics, and that it changes dynamically over time. Based on these findings, we formulate an ordered logit model to describe risk recognition combined with a latent class model to describe evacuation choices. Our proposed evacuation choice model along with a risk recognition class can evaluate quantitatively the influence of disaster mitigation measures, risk education, and risk information. The results obtained from the risk recognition model show that risk information has a greater impact in the sense that people recognize their high risk. The results of the evacuation choice model show that people who are unaware of their risk take a longer time to evacuate. © 2017 Society for Risk Analysis.

Application of fire and evacuation models in evaluation of fire safety in railway tunnels

NASA Astrophysics Data System (ADS)

Cábová, Kamila; Apeltauer, Tomáš; Okřinová, Petra; Wald, František

2017-09-01

The paper describes an application of numerical simulation of fire dynamics and evacuation of people in a tunnel. The software tool Fire Dynamics Simulator is used to simulate temperature resolution and development of smoke in a railway tunnel. Comparing to temperature curves which are usually used in the design stage results of the model show that the numerical model gives lower temperature of hot smoke layer. Outputs of the numerical simulation of fire also enable to improve models of evacuation of people during fires in tunnels. In the presented study the calculated high of smoke layer in the tunnel is in 10 min after the fire ignition lower than the level of 2.2 m which is considered as the maximal limit for safe evacuation. Simulation of the evacuation process in bigger scale together with fire dynamics can provide very valuable information about important security conditions like Available Safe Evacuation Time (ASET) vs Required Safe Evacuation Time (RSET). On given example in software EXODUS the paper summarizes selected results of evacuation model which should be in mind of a designer when preparing an evacuation plan.

An indoor augmented reality mobile application for simulation of building evacuation

NASA Astrophysics Data System (ADS)

Sharma, Sharad; Jerripothula, Shanmukha

2015-03-01

Augmented Reality enables people to remain connected with the physical environment they are in, and invites them to look at the world from new and alternative perspectives. There has been an increasing interest in emergency evacuation applications for mobile devices. Nearly all the smart phones these days are Wi-Fi and GPS enabled. In this paper, we propose a novel emergency evacuation system that will help people to safely evacuate a building in case of an emergency situation. It will further enhance knowledge and understanding of where the exits are in the building and safety evacuation procedures. We have applied mobile augmented reality (mobile AR) to create an application with Unity 3D gaming engine. We show how the mobile AR application is able to display a 3D model of the building and animation of people evacuation using markers and web camera. The system gives a visual representation of a building in 3D space, allowing people to see where exits are in the building through the use of a smart phone or tablets. Pilot studies were conducted with the system showing its partial success and demonstrated the effectiveness of the application in emergency evacuation. Our computer vision methods give good results when the markers are closer to the camera, but accuracy decreases when the markers are far away from the camera.

Developing Tsunami Evacuation Plans, Maps, And Procedures: Pilot Project in Central America

NASA Astrophysics Data System (ADS)

Arcos, N. P.; Kong, L. S. L.; Arcas, D.; Aliaga, B.; Coetzee, D.; Leonard, J.

2015-12-01

In the End-to-End tsunami warning chain, once a forecast is provided and a warning alert issued, communities must know what to do and where to go. The 'where to' answer would be reliable and practical community-level tsunami evacuation maps. Following the Exercise Pacific Wave 2011, a questionnaire was sent to the 46 Member States of Pacific Tsunami Warning System (PTWS). The results revealed over 42 percent of Member States lacked tsunami mass coastal evacuation plans. Additionally, a significant gap in mapping was exposed as over 55 percent of Member States lacked tsunami evacuation maps, routes, signs and assembly points. Thereby, a significant portion of countries in the Pacific lack appropriate tsunami planning and mapping for their at-risk coastal communities. While a variety of tools exist to establish tsunami inundation areas, these are inconsistent while a methodology has not been developed to assist countries develop tsunami evacuation maps, plans, and procedures. The International Tsunami Information Center (ITIC) and partners is leading a Pilot Project in Honduras demonstrating that globally standardized tools and methodologies can be applied by a country, with minimal tsunami warning and mitigation resources, towards the determination of tsunami inundation areas and subsequently community-owned tsunami evacuation maps and plans for at-risk communities. The Pilot involves a 1- to 2-year long process centered on a series of linked tsunami training workshops on: evacuation planning, evacuation map development, inundation modeling and map creation, tsunami warning & emergency response Standard Operating Procedures (SOPs), and conducting tsunami exercises (including evacuation). The Pilot's completion is capped with a UNESCO/IOC document so that other countries can replicate the process in their tsunami-prone communities.

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami

USGS Publications Warehouse

Apatu, Emma J. I.; Gregg, Chris E.; Wood, Nathan J.; Wang, Liang

2016-01-01

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 Mw 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis.

Mass and Volume Optimization of Space Flight Medical Kits

NASA Technical Reports Server (NTRS)

Keenan, A. B.; Foy, Millennia Hope; Myers, Jerry

2014-01-01

Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success

Was the Risk from Nursing-Home Evacuation after the Fukushima Accident Higher than the Radiation Risk?

PubMed

Murakami, Michio; Ono, Kyoko; Tsubokura, Masaharu; Nomura, Shuhei; Oikawa, Tomoyoshi; Oka, Tosihiro; Kami, Masahiro; Oki, Taikan

2015-01-01

After the 2011 accident at the Fukushima Daiichi nuclear power plant, nursing-home residents and staff were evacuated voluntarily from damaged areas to avoid radiation exposure. Unfortunately, the evacuation resulted in increased mortalities among nursing home residents. We assessed the risk trade-off between evacuation and radiation for 191 residents and 184 staff at three nursing homes by using the same detriment indicator, namely loss of life expectancy (LLE), under four scenarios, i.e. "rapid evacuation (in accordance with the actual situation; i.e. evacuation on 22 March)," "deliberate evacuation (i.e. evacuation on 20 June)," "20-mSv exposure," and "100-mSv exposure." The LLE from evacuation-related mortality among nursing home residents was assessed with survival probability data from nursing homes in the city of Minamisoma and the city of Soma. The LLE from radiation mortality was calculated from the estimated age-specific mortality rates from leukemia and all solid cancers based on the additional effective doses and the survival probabilities. The total LLE of residents due to evacuation-related risks in rapid evacuation was 11,000 persons-d-much higher than the total LLEs of residents and staff due to radiation in the other scenarios (27, 1100, and 5800 persons-d for deliberate evacuation, 20 mSv-exposure, and 100 mSv-exposure, respectively). The latitude for reducing evacuation risks among nursing home residents is surprisingly large. Evacuation regulation and planning should therefore be well balanced with the trade-offs against radiation risks. This is the first quantitative assessment of the risk trade-off between radiation exposure and evacuation after a nuclear power plant accident.

Population evacuations in industrial accidents: a review of the literature about four major events.

PubMed

Soffer, Yechiel; Schwartz, Dagan; Goldberg, Avishay; Henenfeld, Maxim; Bar-Dayan, Yaron

2008-01-01

This article reviews the literature describing four chemical and nuclear accidents and the lessons learned from each regarding the evacuation of civilian populations. Evacuation may save lives however, if poorly orchestrated, it may cause serious problems. For example, an inaccurate assessment of danger may lead to the evacuation of the same population twice, as the area requiring evacuation becomes larger than originally expected. Evacuation programs should focus on the vulnerable components of the populations, such as the elderly, children, and the disabled, and also should include plans for the care of pets and other animals. Training programs for civilians living near industrial centers and other high-risk areas should be considered. Finally, pre-event planning and preparation can improve the evacuation process and prevent panic behavior, and thus result in fewer casualties.

[Evacuation plan of an intensive care unit: a new quality indicator?].

PubMed

Sánchez-Palacios, M; Lorenzo Torrent, R; Santana-Cabrera, L; Martín García, J A; Campos, S G; Carrasco de Miguel, V

2010-04-01

The intensive care units must be prepared for a possible disaster, whether internal or external, in case it becomes necessary to evacuate the in-patients. They must have an Emergency and Self-protection Plan that includes the patient evacuation criteria and this must be known by all the personnel who work in the service. For that reason, the patients must be triaged, based on their attention priorities, according to their survival possibilities. Having an evacuation, known by all the personnel and updated by means of the performance of periodic drills, should be included as a quality indicator that must be met, since this would achieve better attention to the patient in case of a disaster situation requiring the evacuation of the ICU. Copyright 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

[PTSD-positive screening and factors influencing the mental state in victims evacuated/ not evacuated from Wenchuan earthquake area within 1 month].

PubMed

Gao, Xueping; Luo, Xingwei

2009-06-01

To explore posttraumatic stress disorder (PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month. The 3 groups included 235 victims who were not evacuated from Shifang territory (the incident scene, Group A), 44 victims who were evacuated to Second Xiangya Hospital (the wounded, Group B) and 36 relatives (the relatives, Group C). The mental state of all subjects was evaluated by Impact of Event Scale-Revised (IES-R) and other tools. (1) One month after the disaster, and the positive rate of PTSD screening in these survivors was 35.56%, the positive rate in women was significantly higher than that in men (chi(2)=16.27,P<0.001). The positive rate of PTSD screening in Group A, Group B and Group C was 39.15%, 31.82%, and 16.67%, respectively, with significant difference (chi(2)(mh)=5.243,P<0.05). Among the three groups which met the diagnosis criterion of PTSD symptoms, the scores for "numbness/avoidance symptom"and "excessive arousing symptom"in Group A were significantly higher than those in Group B and C (P<0.01). (2) The scores for "anxiety"and "depression"and "psychosomatic"symptoms in Group A and Group B were significantly higher than those in Group C (P<0.05). (3) Gender, place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms. One month after the earthquake, the victims suffered psychologically. PTSD symptoms, anxiety and depression symptoms were their major mental problems, more attention to especially women victims. The protection factors include dispersing victims to the secure place as soon as possible, expanding and strengthening society support. Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.

Modeling hurricane evacuation traffic : a mobile real-time traffic counter for monitoring hurricane evacuation traffic conditions.

DOT National Transportation Integrated Search

2006-04-01

In this research report, an investigation was conducted to identify a suitable traffic monitoring device for collecting traffic data during actual emergency evacuation conditions that may result from hurricanes in Louisiana. The study reviewed thorou...

Tsunami evacuation mathematical model for the city of Padang

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kusdiantara, R.; Hadianti, R.; Badri Kusuma, M. S.

2012-05-22

Tsunami is a series of wave trains which travels with high speed on the sea surface. This traveling wave is caused by the displacement of a large volume of water after the occurrence of an underwater earthquake or volcano eruptions. The speed of tsunami decreases when it reaches the sea shore along with the increase of its amplitudes. Two large tsunamis had occurred in the last decades in Indonesia with huge casualties and large damages. Indonesian Tsunami Early Warning System has been installed along the west coast of Sumatra. This early warning system will give about 10-15 minutes to evacuatemore » people from high risk regions to the safe areas. Here in this paper, a mathematical model for Tsunami evacuation is presented with the city of Padang as a study case. In the model, the safe areas are chosen from the existing and selected high rise buildings, low risk region with relatively high altitude and (proposed to be built) a flyover ring road. Each gathering points are located in the radius of approximately 1 km from the ring road. The model is formulated as an optimization problem with the total normalized evacuation time as the objective function. The constraints consist of maximum allowable evacuation time in each route, maximum capacity of each safe area, and the number of people to be evacuated. The optimization problem is solved numerically using linear programming method with Matlab. Numerical results are shown for various evacuation scenarios for the city of Padang.« less

Air bearing vacuum seal assembly

DOEpatents

Booth, Rex

1978-01-01

An air bearing vacuum seal assembly capable of rotating at the speed of several thousand revolutions per minute using an air cushion to prevent the rotating and stationary parts from touching, and a two stage differential pumping arrangement to maintain the pressure gradient between the air cushion and the vacuum so that the leak rate into the vacuum is, for example, less than 1 .times. 10.sup.-4 Pa m.sup.3 /s. The air bearing vacuum seal has particular application for mounting rotating targets to an evacuated accelerator beam tube for bombardment of the targets with high-power charged particle beams in vacuum.

SCALING AN URBAN EMERGENCY EVACUATION FRAMEWORK: CHALLENGES AND PRACTICES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Karthik, Rajasekar; Lu, Wei

2014-01-01

Critical infrastructure disruption, caused by severe weather events, natural disasters, terrorist attacks, etc., has significant impacts on urban transportation systems. We built a computational framework to simulate urban transportation systems under critical infrastructure disruption in order to aid real-time emergency evacuation. This framework will use large scale datasets to provide a scalable tool for emergency planning and management. Our framework, World-Wide Emergency Evacuation (WWEE), integrates population distribution and urban infrastructure networks to model travel demand in emergency situations at global level. Also, a computational model of agent-based traffic simulation is used to provide an optimal evacuation plan for traffic operationmore » purpose [1]. In addition, our framework provides a web-based high resolution visualization tool for emergency evacuation modelers and practitioners. We have successfully tested our framework with scenarios in both United States (Alexandria, VA) and Europe (Berlin, Germany) [2]. However, there are still some major drawbacks for scaling this framework to handle big data workloads in real time. On our back-end, lack of proper infrastructure limits us in ability to process large amounts of data, run the simulation efficiently and quickly, and provide fast retrieval and serving of data. On the front-end, the visualization performance of microscopic evacuation results is still not efficient enough due to high volume data communication between server and client. We are addressing these drawbacks by using cloud computing and next-generation web technologies, namely Node.js, NoSQL, WebGL, Open Layers 3 and HTML5 technologies. We will describe briefly about each one and how we are using and leveraging these technologies to provide an efficient tool for emergency management organizations. Our early experimentation demonstrates that using above technologies is a promising approach to build a scalable and high

Household evacuation characteristics in American Samoa during the 2009 Samoa Islands tsunami.

PubMed

Apatu, Emma J I; Gregg, Chris E; Wood, Nathan J; Wang, Liang

2016-10-01

Tsunamis represent significant threats to human life and development in coastal communities. This quantitative study examines the influence of household characteristics on evacuation actions taken by 211 respondents in American Samoa who were at their homes during the 29 September 2009 Mw 8.1 Samoa Islands earthquake and tsunami disaster. Multiple logistic regression analysis of survey data was used to examine the association between evacuation and various household factors. Findings show that increases in distance to shoreline were associated with a slightly decreased likelihood of evacuation, whereas households reporting higher income had an increased probability of evacuation. The response in American Samoa was an effective one, with only 34 fatalities in a tsunami that reached shore in as little as 15 minutes. Consequently, future research should implement more qualitative study designs to identify event and cultural specific determinants of household evacuation behaviour to local tsunamis. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Study on queueing behavior in pedestrian evacuation by extended cellular automata model

NASA Astrophysics Data System (ADS)

Hu, Jun; You, Lei; Zhang, Hong; Wei, Juan; Guo, Yangyong

2018-01-01

This paper proposes a pedestrian evacuation model for effective simulation of evacuation efficiency based on extended cellular automata. In the model, pedestrians' momentary transition probability to a target position is defined in terms of the floor field and queueing time, and the critical time is defined as the waiting time threshold in a queue. Queueing time and critical time are derived using Fractal Brownian Motion through analysis of pedestrian arrival characteristics. Simulations using the platform and actual evacuations were conducted to study the relationships among system evacuation time, average system velocity, pedestrian density, flow rate, and critical time. The results demonstrate that at low pedestrian density, evacuation efficiency can be improved through adoption of the shortest route strategy, and critical time has an inverse relationship with average system velocity. Conversely, at higher pedestrian densities, it is better to adopt the shortest queueing time strategy, and critical time is inversely related to flow rate.

Analysis of sheltering and evacuation strategies for an urban nuclear detonation scenario.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoshimura, Ann S.; Brandt, Larry D.

2009-05-01

Development of an effective strategy for shelter and evacuation is among the most important planning tasks in preparation for response to a low yield, nuclear detonation in an urban area. This study examines shelter-evacuate policies and effectiveness focusing on a 10 kt scenario in Los Angeles. The goal is to provide technical insights that can support development of urban response plans. Results indicate that extended shelter-in-place can offer the most robust protection when high quality shelter exists. Where less effective shelter is available and the fallout radiation intensity level is high, informed evacuation at the appropriate time can substantially reducemore » the overall dose to personnel. However, uncertainties in the characteristics of the fallout region and in the exit route can make evacuation a risky strategy. Analyses indicate that only a relatively small fraction of the total urban population may experience significant dose reduction benefits from even a well-informed evacuation plan.« less

An interval-parameter mixed integer multi-objective programming for environment-oriented evacuation management

NASA Astrophysics Data System (ADS)

Wu, C. Z.; Huang, G. H.; Yan, X. P.; Cai, Y. P.; Li, Y. P.

2010-05-01

Large crowds are increasingly common at political, social, economic, cultural and sports events in urban areas. This has led to attention on the management of evacuations under such situations. In this study, we optimise an approximation method for vehicle allocation and route planning in case of an evacuation. This method, based on an interval-parameter multi-objective optimisation model, has potential for use in a flexible decision support system for evacuation management. The modeling solutions are obtained by sequentially solving two sub-models corresponding to lower- and upper-bounds for the desired objective function value. The interval solutions are feasible and stable in the given decision space, and this may reduce the negative effects of uncertainty, thereby improving decision makers' estimates under different conditions. The resulting model can be used for a systematic analysis of the complex relationships among evacuation time, cost and environmental considerations. The results of a case study used to validate the proposed model show that the model does generate useful solutions for planning evacuation management and practices. Furthermore, these results are useful for evacuation planners, not only in making vehicle allocation decisions but also for providing insight into the tradeoffs among evacuation time, environmental considerations and economic objectives.

Risk for intracranial pressure increase related to enclosed air in post-craniotomy patients during air ambulance transport: a retrospective cohort study with simulation.

PubMed

Brändström, Helge; Sundelin, Anna; Hoseason, Daniela; Sundström, Nina; Birgander, Richard; Johansson, Göran; Winsö, Ola; Koskinen, Lars-Owe; Haney, Michael

2017-05-12

Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to observed intracranial air volumes, hypothetical sea level pre-transport ICP, and different potential flight levels and cabin pressures. A cohort of consecutive subdural hematoma evacuation patients from one University Medical Centre was assessed with post-operative intracranial air volume measurements by computed tomography. Intracranial pressure changes related to estimated intracranial air volume effects of changing atmospheric pressure (simulating flight and cabin pressure changes up to 8000 ft) were simulated using an established model for intracranial pressure and volume relations. Approximately one third of the cohort had post-operative intracranial air. Of these, approximately one third had intracranial air volumes less than 11 ml. The simulation estimated that the expected changes in intracranial pressure during 'flight' would not result in intracranial hypertension. For intracranial air volumes above 11 ml, the simulation suggested that it was possible that intracranial hypertension could develop 'inflight' related to cabin pressure drop. Depending on the pre-flight intracranial pressure and air volume, this could occur quite early during the assent phase in the flight profile. DISCUSSION: These findings support the idea that there should be radiographic verification of the presence or absence of intracranial air after craniotomy for patients planned for long distance air transport. Very small amounts of air are clinically inconsequential. Otherwise, air transport with maintained ground-level cabin pressure should be a priority for these patients.

Emergency communications for evacuation (EVAC) in New Orleans impact assessment report.

DOT National Transportation Integrated Search

2015-05-01

This document constitutes the Impact Assessment Report for Emergency Communications for Evacuation (EVAC) in New Orleans. Response, Emergency Staging and Communications, Uniform Management, and Evacuation (R.E.S.C.U.M.E.) is a bundle of applications ...

Automatic smoke evacuation in laparoscopic surgery: a simplified method for objective evaluation.

PubMed

Takahashi, Hidekazu; Yamasaki, Makoto; Hirota, Masashi; Miyazaki, Yasuaki; Moon, Jeong Ho; Souma, Yoshihito; Mori, Masaki; Doki, Yuichiro; Nakajima, Kiyokazu

2013-08-01

Although its theoretical usefulness has been reported, the true value of automatic smoke evacuation system in laparoscopic surgery remains unknown. This is mainly due to the lack of objective evaluation. The purpose of this study was to determine the efficacy of the automatic smoke evacuator in laparoscopic surgery, by real-time objective evaluation system using an industrial smoke-detection device. Six pigs were used in this study. Three surgical ports were placed and electrosurgical smoke was generated in a standard fashion, using either a high-frequency electrosurgical unit (HF-ESU) or laparosonic coagulating shears (LCS). The smoke was evacuated immediately in the evacuation group but not in the control nonevacuation group. The laparoscopic field-of-view was subjectively evaluated by ten independent surgeons. The composition of the surgical smoke was analyzed by mass spectrometry. The residual smoke in the abdominal cavity was aspirated manually into a smoke tester, and stains on a filter paper were image captured, digitized, and semiquantified. Subjective evaluation indicated superior field-of-view in the evacuation group, compared with the control, at 15 s after activation of the HF-ESU (P < 0.05). The smoke comprised various chemical compounds, including known carcinogens. The estimated volume of intra-abdominal residual smoke after activation of HF-ESU was significantly lower in the evacuation group (47.4 ± 16.6) than the control (76.7 ± 2.4, P = 0.0018). Only marginal amount of surgical smoke was detected in both groups after LCS when the tissue pad was free from burnt tissue deposits. However, the amount was significantly lower in the evacuation group (21.3 ± 10.7) than the control (75 ± 39.9, P = 0.044) when the tissue pad contained tissue sludge. Automatic smoke evacuation provides better field-of-view and reduces the risk of exposure to harmful compounds.

An optimization design for evacuation planning based on fuzzy credibility theory and genetic algorithm

NASA Astrophysics Data System (ADS)

Zhang, D.; Zhang, W. Y.

2017-08-01

Evacuation planning is an important activity in disaster management. It has to be planned in advance due to the unpredictable occurrence of disasters. It is necessary that the evacuation plans are as close as possible to the real evacuation work. However, the evacuation plan is extremely challenging because of the inherent uncertainty of the required information. There is a kind of vehicle routing problem based on the public traffic evacuation. In this paper, the demand for each evacuation set point is a fuzzy number, and each routing selection of the point is based on the fuzzy credibility preference index. This paper proposes an approximate optimal solution for this problem by the genetic algorithm based on the fuzzy reliability theory. Finally, the algorithm is applied to an optimization model, and the experiment result shows that the algorithm is effective.

Early waning and evacuation from Tsunami, volcano, flood and other hazards

NASA Astrophysics Data System (ADS)

Sugimoto, M.

2012-12-01

In reconsideration of the great sacrifice among the people, evacuation calls for evacuation through Japan Meteorological Agency (JMA), local governments and Medias have been drastically changed after the 2011 Tohoku tsunami in Japan. One of example is that JMA changed from forecasted concrete figure of tsunami height to one of 3 levels of tsunami height. A data shows the border between life and death is just 2 minutes of earlier evacuation in case of the 2011 tsunami. It shows how importance for communities to prompt early evacuation for survivals. However, the 2011 Tohoku tsunami revealed there is no reliable trigger to prompt early evacuation to people in case of blackout under disasters, excluding effective education. The warning call was still complicated situations in Japan in July 2012. The 2012 Northern Kyusyu downpours was at worst around 110 millimeters an hour and casualties 30 in Japan. JMA learned from the last tsunami. In this time JMA informed to local governments as a waning call "Unexpected severe rains" to local governments. However, local governments did not notice the call from JMA in the same as usual informed way. One of the local government said "We were very busy for preparing for staffs. We looked at the necessary information of the water levels of rivers and flood prevention under emergent situation" (NHK 2012). This case shows JMA's evacuation calls from upstream to midstream of local government and downstream of communities started, however upstream calls have not engaged with midstream and communities yet. Calls of early warning from upstream is still a self-centered idea for both midstream and downstream. Finally JMA could not convey a crisis mentality to local government. The head of Oarai town independently decided to use the different warning call "Order townspersons to evacuate immediately" in Ibaraki prefecture, Japan from the other municipalities in 2011 though there was not such a manuals calls in Japan. This risk communication

The National Disaster Medical System

NASA Technical Reports Server (NTRS)

Reutershan, Thomas P.

1991-01-01

The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

Reflection on Lessons Learned: An Analysis of the Adverse Outcomes Observed During the Hurricane Rita Evacuation.

PubMed

Baker, Karen

2018-02-01

In September 2005, nearly 3.7 million people evacuated the Texas coastline in advance of Hurricane Rita's landfall, making the event the largest emergency evacuation in US history. The Rita evacuation underscored the importance of planning for domestic mass-evacuation events, as the evacuation itself led to over 100 of the at least 119 deaths attributed to the storm. In the days preceding Rita's landfall, several cascading, interrelated circumstances precipitated such adverse outcomes. This article explores the series of events leading up to the evacuation's poor outcomes, the response following Rita to amend evacuation plans, and how Texas successfully implemented these changes during later storms to achieve better outcomes. (Disaster Med Public Health Preparedness. 2018;12:115-120).

Optimal layout design of obstacles for panic evacuation using differential evolution

NASA Astrophysics Data System (ADS)

Zhao, Yongxiang; Li, Meifang; Lu, Xin; Tian, Lijun; Yu, Zhiyong; Huang, Kai; Wang, Yana; Li, Ting

2017-01-01

To improve the pedestrian outflow in panic situations by suitably placing an obstacle in front of the exit, it is vital to understand the physical mechanism behind the evacuation efficiency enhancement. In this paper, a robust differential evolution is firstly employed to optimize the geometrical parameters of different shaped obstacles in order to achieve an optimal evacuation efficiency. Moreover, it is found that all the geometrical parameters of obstacles could markedly influence the evacuation efficiency of pedestrians, and the best way for achieving an optimal pedestrian outflow is to slightly shift the obstacle from the center of the exit which is consistent with findings of extant literature. Most importantly, by analyzing the profiles of density, velocity and specific flow, as well as the spatial distribution of crowd pressure, we have proven that placing an obstacle in panic situations does not reduce or absorb the pressure in the region of exit, on the contrary, promotes the pressure to a much higher level, hence the physical mechanism behind the evacuation efficiency enhancement is not a pressure decrease in the region of exit, but a significant reduction of high density region by effective separation in space which finally causes the increasing of escape speed and evacuation outflow. Finally, it is clearly demonstrated that the panel-like obstacle is considerably more robust and stable than the pillar-like obstacle to guarantee the enhancement of evacuation efficiency under different initial pedestrian distributions, different initial crowd densities as well as different desired velocities.

New York Chapter History of Military Medicine Award. U.S. Army medical helicopters in the Korean War.

PubMed

Driscoll, R S

2001-04-01

Medical evacuation helicopters are taken for granted in today's military. However, the first use of helicopters for this purpose in the Korean War was not done intentionally but as a result of the necessity of moving patients rapidly over difficult Korean terrain and of the early ebbing of the main battle line. The objective of this essay is to increase the historical awareness of military medical evacuation helicopters in the Korean War during this 50th anniversary year. By describing the many challenges and experiences encountered in implementing the use of helicopters for evacuation, the reader will appreciate how a technology developed for another use helped in the success of evacuating nearly 22,000 patients while contributing to establishing a mortality rate of wounded of 2.4%. The preparation to write this essay included archival research of historical reports, records, and oral histories from the archives of the U.S. Army Center for Military History. Additionally, a search of journal articles written during and after the Korean War was conducted. The result is a comprehensive description of the use of medical evacuation helicopters in the Korean War.

The use of consumer-satisfaction surveys by an air medical program.

PubMed

Hanzely, D; Higgins, B; Popil, V

1993-07-01

Surveys were distributed to referring and receiving hospitals or to EMS agencies that used the air medical service. The respondents were asked to evaluate the dispatcher's, pilot's and flight crew's professionalism and courteousness on a Likert scale and through written comments. Phase 1 of the survey distribution was discontinued after problems were encountered due to the distribution process. Phase 2 consisted of the air medical program mailing surveys directly to the referring and receiving facilities or to the EMS agencies. In terms of courteousness and professionalism, 90% of the respondents' answers fell within the strongly agree to neutral range. Questions regarding pilots and dispatchers were often left unanswered. Two areas were identified as needing further work on the part of the medical flight crew: follow-up with referring hospitals on patient outcome and identification of flight physicians vs. flight nurses.

The Fort McMurray, Alberta wildfires: Emergency and recovery management of healthcare services.

PubMed

Matear, David

2017-01-01

One of the largest wildfires in Canadian history raged through northern Alberta in May to July 2016, and prompted the largest emergency air evacuation in Canadian history. Central to the challenges were the evacuation of a regional hospital, and the emergency and recovery management associated with healthcare services. This paper describes multiple phases of emergency and recovery management, which employed and adapted the Incident Command System to healthcare services. There were no injuries reported throughout the medical evacuation and recovery of medical services. The leadership and management of healthcare services achieved the goals of evacuating patients and staff effectively, supporting emergency first responders and the re-entry of the population to Fort McMurray.

Endoscopic Evacuation of Basal Ganglia Hematoma: Surgical Technique, Outcome, and Learning Curve.

PubMed

Ma, Lichao; Hou, Yuanzheng; Zhu, Ruyuan; Chen, Xiaolei

2017-05-01

Minimally invasive endoscopic hematoma evacuation is a promising treatment option for intracerebral hemorrhage. However, the technique still needs improvement. We report our clinical experience of using this technique to evacuate deep-seated basal ganglia hematomas. The frontal approach was used in most patients. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale, hematoma evacuation rate, 30-day mortality, and long-term outcome defined by the modified Rankin Scale were analyzed retrospectively. The surgical duration per milliliter of clot (DPM) was calculated. The learning curve for this technique was determined based on the relation between the DPM and evacuation rate per the number of cases experienced. A total of 24 patients were enrolled. The evacuation rate was 87% ± 10%. The average Glasgow Coma Scale score recovered from 8 to 13 after surgery. Twenty-one patients had follow-up data. The follow-up time was 13 ± 6 months. The 30-day mortality after surgery was zero. Forty-eight percent of patients (10/21) achieved a favorable outcome. The DPM (P = 0.92) and evacuation rate (P = 0.64) did not change substantially with the number of cases experienced. Endoscopic port surgery for hematoma evacuation via the frontal approach is a safe surgical option for deep-seated basal ganglia hematomas. This technique is minimally invasive and may be helpful to provide better long-term outcomes for selected patients. For neurosurgeons, the learning curve for this technique is steep, which implies that the skills needed for our technique can be easily acquired. Copyright © 2017 Elsevier Inc. All rights reserved.

Evacuation Criteria after A Nuclear Accident: A Personal Perspective

PubMed Central

Wilson, Richard

2012-01-01

In any decision involving radiation a risk-risk or risk-benefit comparison should be done. This can be either explicit or implicit. When the adverse effect of an alternate action is less than the planned action, such as medical use of X rays or nuclear power in ordinary operation, the comparison is simple. But in this paper I argue that with the situation faced by the Japanese in Fukushima, the assumption that the risk of an alternate action is small is false. The risks of unnecessary evacuation exceeded the risk of radiation cancers hypothetically produced by staying in place. This was not realized by those that had to make a decision within hours. This realization suggests important changes, worldwide, in the guidelines for radiation protection in accident situations. PMID:23304100

The Mapping of Temporary Evacuation Site (TES) and Tsunami Evacuation Route in North Pagai Island, Mentawai Islands Regency - Indonesia

NASA Astrophysics Data System (ADS)

Putra, Aprizon; Mutmainah, Herdiana

2016-11-01

Mentawai Islands Regency, especially north Pagai island, suffered two earthquakes on April 15 2016. The local government in cooperation with the relevant parties had tried to minimize casualties before the disaster or during the disaster by making an evacuation route to the TES. The purpose of this study was to the mapping of TES and tsunami evacuation route using the approach of Geographic Information Systems (GIS) for disaster mitigation of tsunami-potential earthquake in north Pagai island.The research was conducted at 3 locations in the coast of Sikakap village, 4 locations in the coast of Taikako village, 3 locations in the coast of Silabu village, 7 locations in the coast of Saumanganya village, and 3 locations in the coast of Matobe village. The effort taken was to evacuate people to the TES with an average distance of 372.62 m from the beach. The results showed that the feasibility of TES that could accommodate residents, among others, were in the hills behind Sikakap Port, Taikako Silaoinan hills, the hills near the Mapinang Silabu village chief's office and Mapinang hills, Gulukguluk Saumanganya and Panatarat Matobe hills.

Pilot fatigue survey: exploring fatigue factors in air medical operations.

PubMed

Gregory, Kevin B; Winn, William; Johnson, Kent; Rosekind, Mark R

2010-01-01

Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations. A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management. Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules. Over 84% of the pilots reported that fatigue had affected their flight performance; less than 28% reported "nodding off" during flight. More than 90% reported a separate work site "rest" room with a bed available. Over 90% reported no company policies restricting on-duty sleep. Approximately half of the pilots reported getting 4 hours or more sleep during a typical night shift. Approximately half reported that sleep inertia had never compromised flight safety. Over 90% reported that it was better to sleep during the night and overcome sleep inertia if necessary. Survey results reflected practices that can mitigate the degrading effects of fatigue, including the availability of designated work-site sleep rooms. As demands continue to evolve, the need remains for sustained efforts to address fatigue-related risks in the air medical transport industry. This includes further study of sleep inertia issues and the need for alertness management programs. Copyright © 2010 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

Optimal control of diarrhea transmission in a flood evacuation zone

NASA Astrophysics Data System (ADS)

Erwina, N.; Aldila, D.; Soewono, E.

2014-03-01

Evacuation of residents and diarrhea disease outbreak in evacuation zone have become serious problem that frequently happened during flood periods. Limited clean water supply and infrastructure in evacuation zone contribute to a critical spread of diarrhea. Transmission of diarrhea disease can be reduced by controlling clean water supply and treating diarrhea patients properly. These treatments require significant amount of budget, which may not be fulfilled in the fields. In his paper, transmission of diarrhea disease in evacuation zone using SIRS model is presented as control optimum problem with clean water supply and rate of treated patients as input controls. Existence and stability of equilibrium points and sensitivity analysis are investigated analytically for constant input controls. Optimum clean water supply and rate of treatment are found using optimum control technique. Optimal results for transmission of diarrhea and the corresponding controls during the period of observation are simulated numerically. The optimum result shows that transmission of diarrhea disease can be controlled with proper combination of water supply and rate of treatment within allowable budget.

Considering culture in evacuation planning and consequence management.

PubMed

Bergeron, Wayne P

2015-01-01

Because culture profoundly affects human behavior, it is important that emergency management decision makers from both government and the private sector who will be involved in the management of evacuation operations build cultural considerations into their planning, preparations, education, and training from the very beginning. Preparation in this regard ensures that when the crisis hits, the response efforts undertaken will at a minimum not disregard culture or make situations worse because of a lack of cultural understanding and optimally will use the consideration of culture to frame the most effective response possible to ultimately save lives and relieve suffering. Whether it is recognizing that in some cultures the decision to comply with evacuation advice and orders will be made by a matriarch or patriarch of the family, or that the ability of an entire extended family unit to remain together in the evacuation process will be the key to compliance, culture may be the pivotal factor in a successful outcome. It is these (and many more) small cultural considerations and an overall understanding of the effect that culture has on behavior that can enhance the overall effectiveness of a culturally aware organization involved in the management of evacuation operations and emergency response. Hopefully, this initial work begins a deeper discussion and evaluation of cultural aspects both concerning the populations and cultures impacted by events, but just as importantly, the cultures and cultural understanding of the responding organizations.

A novel grid-based mesoscopic model for evacuation dynamics

NASA Astrophysics Data System (ADS)

Shi, Meng; Lee, Eric Wai Ming; Ma, Yi

2018-05-01

This study presents a novel grid-based mesoscopic model for evacuation dynamics. In this model, the evacuation space is discretised into larger cells than those used in microscopic models. This approach directly computes the dynamic changes crowd densities in cells over the course of an evacuation. The density flow is driven by the density-speed correlation. The computation is faster than in traditional cellular automata evacuation models which determine density by computing the movements of each pedestrian. To demonstrate the feasibility of this model, we apply it to a series of practical scenarios and conduct a parameter sensitivity study of the effect of changes in time step δ. The simulation results show that within the valid range of δ, changing δ has only a minor impact on the simulation. The model also makes it possible to directly acquire key information such as bottleneck areas from a time-varied dynamic density map, even when a relatively large time step is adopted. We use the commercial software AnyLogic to evaluate the model. The result shows that the mesoscopic model is more efficient than the microscopic model and provides more in-situ details (e.g., pedestrian movement pattern) than the macroscopic models.

An oxymoron of long-term care-Sheltering-in-place during an evacuation: A literature review of the best practices of evacuation and sheltering-in-place for long-term care facilities.

PubMed

Baxter, Megan

Long-term care facilities (LTCFs) are defined as residential facilities that are home to elderly patrons who are no longer able to live independently. These facilities require comprehensive emergency planning to provide the best response to the threat of a disaster for their residents. However, LTCFs are often overlooked in disaster planning, leaving them to work independently to create suitable arrangements in the event of a disaster. This article examines the literature on evacuating and compares it to the literature on sheltering-in-place for LTCFs. Conclusions regarding best practices are also provided. A literature review and Internet search were completed in July 2016. Information was entered onto a spreadsheet listing the key points of each article, which was reviewed for emerging themes. Out of the 399 acquired articles and grey literature found during the research portion of this article, 30 were deemed pertinent, 22 of which appear in this article. All included articles were peer reviewed. Themes emerging from these articles include the persistent absence of research into the best practices for LTCFs during emergencies and the difficulties of evacuating and sheltering-in-place with frail populations. While there is no one right answer for all scenarios, sheltering-in-place appears to be the default safe option for those in LTCFs-with the assumption that the facility has taken steps toward preparation, such as purchasing generators and securing enough food, water, and medical supplies to sustain the residents, staff, and families of both for 7 days. Additionally, a LTCF needs to devise contingency plans for evacuation if necessary, to be fully prepared for a catastrophic event.

Enhancing evacuation plans with a situation awareness system based on end-user knowledge provision.

PubMed

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-06-24

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating.

Enhancing Evacuation Plans with a Situation Awareness System Based on End-User Knowledge Provision

PubMed Central

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-01-01

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating. PMID:24961212

Visitors’ awareness of the tsunami evacuation plan in Pasar Raya Padang, Indonesia

NASA Astrophysics Data System (ADS)

Kemal, B. M.; Yosritzal; Purnawan; Putra, H.

2018-04-01

This paper presents an investigation into the visitors’ awareness of the tsunami evacuation plan at Pasar Raya Padang, a traditional market at the central business district of Padang City, Indonesia. This study has been motivated by the fact that Pasar Raya Padang is the largest traditional market in West Sumatera and visited by many visitors from various origins. Pasar Raya Padang is chosen because it is located at a tsunami prone area, but local government managed to keep businesses in the area running and attract visitors. The awareness of the people in the market would be crucial to increase the possibility to safe their life during an evacuation. As much as 500 respondents were interviewed during daytime in the market. The study found that most of the visitors are not aware of the tsunami evacuation plan in the area. Local government is suggested to develop standard procedure for the evacuation, to place more sign and make it more visible for most of the visitors and do evacuation simulations periodically.

Experimental study and numerical simulation of evacuation from a dormitory

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran; Zhou, Ning; Mei, Sen; Tian, Zhenguo

2012-11-01

The evacuation process of students from a dormitory is investigated by both experiment and modeling. We investigate the video record of pedestrian movement in a dormitory, and find some typical characteristics of evacuation, including continuous pedestrian flow, mass behavior and so on. Based on the experimental observation, we found that simulation results considering pre-movement time are closer to the experimental results. With the model considering pre-movement time, we simulate the evacuation process and compare the simulation results with the experimental results, and find that they agree with each other closely. The crowd massing phenomenon is conducted in this paper. It is found that different crowd massing phenomena will emerge due to different desired velocities. The crowd massing phenomenon could be more serious with the increase of the desired velocity. In this study, we also found the faster-is-slower effect. When the positive effect produced by increasing the desired velocity is not sufficient for making up for its negative effect, the phenomenon of the greater the desired velocity the longer the time required for evacuation will emerge. From the video record, it can be observed that the mass behavior is obvious during the evacuation process. And the mass phenomenon could also be found in simulation. The results obtained from our study are also suitable to all these buildings in which both living and resting areas occupy the majority space, such as dormitories, residential buildings, hotels (restaurants) and so on.

Anal gas evacuation and colonic microbiota in patients with flatulence: effect of diet.

PubMed

Manichanh, Chaysavanh; Eck, Anat; Varela, Encarna; Roca, Joaquim; Clemente, José C; González, Antonio; Knights, Dan; Knight, Rob; Estrella, Sandra; Hernandez, Carlos; Guyonnet, Denis; Accarino, Anna; Santos, Javier; Malagelada, Juan-R; Guarner, Francisco; Azpiroz, Fernando

2014-03-01

To characterise the influence of diet on abdominal symptoms, anal gas evacuation, intestinal gas distribution and colonic microbiota in patients complaining of flatulence. Patients complaining of flatulence (n=30) and healthy subjects (n=20) were instructed to follow their usual diet for 3 days (basal phase) and to consume a high-flatulogenic diet for another 3 days (challenge phase). During basal phase, patients recorded more abdominal symptoms than healthy subjects in daily questionnaires (5.8±0.3 vs 0.4±0.2 mean discomfort/pain score, respectively; p=<0.0001) and more gas evacuations by an event marker (21.9±2.8 vs 7.4±1.0 daytime evacuations, respectively; p=0.0001), without differences in the volume of gas evacuated after a standard meal (262±22 and 265±25 mL, respectively). On flatulogenic diet, both groups recorded more abdominal symptoms (7.9±0.3 and 2.8±0.4 discomfort/pain, respectively), number of gas evacuations (44.4±5.3 and 21.7±2.9 daytime evacuations, respectively) and had more gas production (656±52 and 673±78 mL, respectively; p<0.05 vs basal diet for all). When challenged with flatulogenic diet, patients' microbiota developed instability in composition, exhibiting variations in the main phyla and reduction of microbial diversity, whereas healthy subjects' microbiota were stable. Taxa from Bacteroides fragilis or Bilophila wadsworthia correlated with number of gas evacuations or volume of gas evacuated, respectively. Patients complaining of flatulence have a poor tolerance of intestinal gas, which is associated with instability of the microbial ecosystem.

Reducing the oxygen concentration of gases delivered from anaesthetic machines unadapted for medical air

PubMed Central

Clutton, R. E.; Schoeffmann, G.; Chesnil, M.; Gregson, R.; Reed, F.; Lawson, H.; Eddleston, M.

2014-01-01

High fractional concentrations of inspired oxygen (FiO2) delivered over prolonged periods produce characteristic histological changes in the lungs and airway of exposed animals. Modern medical anaesthetic machines are adapted to deliver medical air (FiO2=0.21) for the purpose of reducing FiO2; anaesthetic machines designed for the veterinary market have not been so adapted. Two inexpensive modifications that allow medical air to be added to the gas flow from veterinary anaesthetic machines are described. The advantages and disadvantages of each modification are discussed. PMID:21862470

Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

PubMed

Lawford, Karen M; Giles, Audrey R; Bourgeault, Ivy L

2018-02-10

Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg. To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba. Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance. The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives. There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly

28 CFR 0.154 - Advance and evacuation payments and special allowances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Advance and evacuation payments and... Advance and evacuation payments and special allowances. The Director of the Federal Bureau of... Marshals Service, and the Director of the Office of Justice Assistance, Research and Statistics, as to...

Transit evacuation planning : two case studies.

DOT National Transportation Integrated Search

2010-06-01

This project addresses the emergency transit evacuation of individuals without personal vehicles or the : means to acquire them during extreme coastal events. It is a joint effort of the University Transportation : Center for Alabama (UTCA) and the C...

Intelligent Exit-Selection Behaviors during a Room Evacuation

NASA Astrophysics Data System (ADS)

Zarita, Zainuddin; Lim Eng, Aik

2012-01-01

A modified version of the existing cellular automata (CA) model is proposed to simulate an evacuation procedure in a classroom with and without obstacles. Based on the numerous literature on the implementation of CA in modeling evacuation motions, it is notable that most of the published studies do not take into account the pedestrian's ability to select the exit route in their models. To resolve these issues, we develop a CA model incorporating a probabilistic neural network for determining the decision-making ability of the pedestrians, and simulate an exit-selection phenomenon in the simulation. Intelligent exit-selection behavior is observed in our model. From the simulation results, it is observed that occupants tend to select the exit closest to them when the density is low, but if the density is high they will go to an alternative exit so as to avoid a long wait. This reflects the fact that occupants may not fully utilize multiple exits during evacuation. The improvement in our proposed model is valuable for further study and for upgrading the safety aspects of building designs.

Pedestrians’ behavior in emergency evacuation: Modeling and simulation

NASA Astrophysics Data System (ADS)

Wang, Lei; Zheng, Jie-Hui; Zhang, Xiao-Shuang; Zhang, Jian-Lin; Wang, Qiu-Zhen; Zhang, Qian

2016-11-01

The social force model has been widely used to simulate pedestrian evacuation by analyzing attractive, repulsive, driving, and fluctuating forces among pedestrians. Many researchers have improved its limitations in simulating behaviors of large-scale population. This study modifies the well-accepted social force model by considering the impacts of interaction among companions and further develops a comprehensive model by combining that with a multi-exit utility function. Then numerical simulations of evacuations based on the comprehensive model are implemented in the waiting hall of the Wulin Square Subway Station in Hangzhou, China. The results provide safety thresholds of pedestrian density and panic levels in different operation situations. In spite of the operation situation and the panic level, a larger friend-group size results in lower evacuation efficiency. Our study makes important contributions to building a comprehensive multi-exit social force model and to applying it to actual scenarios, which produces data to facilitate decision making in contingency plans and emergency treatment. Project supported by the National Natural Science Foundation of China (Grant No. 71471163).

Modified social force model based on information transmission toward crowd evacuation simulation

NASA Astrophysics Data System (ADS)

Han, Yanbin; Liu, Hong

2017-03-01

In this paper, the information transmission mechanism is introduced into the social force model to simulate pedestrian behavior in an emergency, especially when most pedestrians are unfamiliar with the evacuation environment. This modified model includes a collision avoidance strategy and an information transmission model that considers information loss. The former is used to avoid collision among pedestrians in a simulation, whereas the latter mainly describes how pedestrians obtain and choose directions appropriate to them. Simulation results show that pedestrians can obtain the correct moving direction through information transmission mechanism and that the modified model can simulate actual pedestrian behavior during an emergency evacuation. Moreover, we have drawn four conclusions to improve evacuation based on the simulation results; and these conclusions greatly contribute in optimizing a number of efficient emergency evacuation schemes for large public places.

A cellular automaton model for evacuation flow using game theory

NASA Astrophysics Data System (ADS)

Guan, Junbiao; Wang, Kaihua; Chen, Fangyue

2016-11-01

Game theory serves as a good tool to explore crowd dynamic conflicts during evacuation processes. The purpose of this study is to simulate the complicated interaction behavior among the conflicting pedestrians in an evacuation flow. Two types of pedestrians, namely, defectors and cooperators, are considered, and two important factors including fear index and cost coefficient are taken into account. By combining the snowdrift game theory with a cellular automaton (CA) model, it is shown that the increase of fear index and cost coefficient will lengthen the evacuation time, which is more apparent for large values of cost coefficient. Meanwhile, it is found that the defectors to cooperators ratio could always tend to consistent states despite different values of parameters, largely owing to self-organization effects.

A Time-Aware Routing Map for Indoor Evacuation †

PubMed Central

Zhao, Haifeng; Winter, Stephan

2016-01-01

Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making. PMID:26797610

Emergency Responses and Health Consequences after the Fukushima Accident; Evacuation and Relocation.

PubMed

Hasegawa, A; Ohira, T; Maeda, M; Yasumura, S; Tanigawa, K

2016-04-01

The Fukushima accident was a compounding disaster following the strong earthquake and huge tsunami. The direct health effects of radiation were relatively well controlled considering the severity of the accident, not only among emergency workers but also residents. Other serious health issues include deaths during evacuation, collapse of the radiation emergency medical system, increased mortality among displaced elderly people and public healthcare issues in Fukushima residents. The Fukushima mental health and lifestyle survey disclosed that the Fukushima accident caused severe psychological distress in the residents from evacuation zones. In addition to psychiatric and mental health problems, there are lifestyle-related problems such as an increase proportion of those overweight, an increased prevalence of hypertension, diabetes mellitus and dyslipidaemia and changes in health-related behaviours among evacuees; all of which may lead to an increased cardiovascular disease risk in the future. The effects of a major nuclear accident on societies are diverse and enduring. The countermeasures should include disaster management, long-term general public health services, mental and psychological care, behavioural and societal support, in addition to efforts to mitigate the health effects attributable to radiation. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Spatial modelling for tsunami evacuation route in Parangtritis Village

NASA Astrophysics Data System (ADS)

Juniansah, A.; Tyas, B. I.; Tama, G. C.; Febriani, K. R.; Farda, N. M.

2018-04-01

Tsunami is a series of huge sea waves that commonly occurs because of the oceanic plate movement or tectonic activity under the sea. As a sudden hazard, the tsunami has damaged many people over the years. Parangtritis village is one of high tsunami hazard risk area in Indonesia which needs an effective tsunami risk reduction. This study aims are modelling a tsunami susceptibility map, existing assembly points evaluation, and suggesting effective evacuation routes. The susceptibility map was created using ALOS PALSAR DEM and surface roughness coefficient. The method of tsunami modelling employed inundation model developed by Berryman (2006). The results are used to determine new assembly points based on the Sentinel 2A imagery and to determine the most effective evacuation route by using network analyst. This model can be used to create detailed scale of evacuation route, but unrepresentative for assembly point that far from road network.

Disentangling the Impact of Social Groups on Response Times and Movement Dynamics in Evacuations

PubMed Central

Bode, Nikolai W. F.; Holl, Stefan; Mehner, Wolfgang; Seyfried, Armin

2015-01-01

Crowd evacuations are paradigmatic examples for collective behaviour, as interactions between individuals lead to the overall movement dynamics. Approaches assuming that all individuals interact in the same way have significantly improved our understanding of pedestrian crowd evacuations. However, this scenario is unlikely, as many pedestrians move in social groups that are based on friendship or kinship. We test how the presence of social groups affects the egress time of individuals and crowds in a representative crowd evacuation experiment. Our results suggest that the presence of social groups increases egress times and that this is largely due to differences at two stages of evacuations. First, individuals in social groups take longer to show a movement response at the start of evacuations, and, second, they take longer to move into the vicinity of the exits once they have started to move towards them. Surprisingly, there are no discernible time differences between the movement of independent individuals and individuals in groups directly in front of the exits. We explain these results and discuss their implications. Our findings elucidate behavioural differences between independent individuals and social groups in evacuations. Such insights are crucial for the control of crowd evacuations and for planning mass events. PMID:25785603

21 CFR 882.5850 - Implanted spinal cord stimulator for bladder evacuation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Implanted spinal cord stimulator for bladder evacuation. 882.5850 Section 882.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5850 Implanted spinal cord stimulator for bladder evacuation. (a) Identification. An implanted spinal...

21 CFR 882.5850 - Implanted spinal cord stimulator for bladder evacuation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted spinal cord stimulator for bladder evacuation. 882.5850 Section 882.5850 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....5850 Implanted spinal cord stimulator for bladder evacuation. (a) Identification. An implanted spinal...

Game-Based Evacuation Drill Using Augmented Reality and Head-Mounted Display

ERIC Educational Resources Information Center

Kawai, Junya; Mitsuhara, Hiroyuki; Shishibori, Masami

2016-01-01

Purpose: Evacuation drills should be more realistic and interactive. Focusing on situational and audio-visual realities and scenario-based interactivity, the authors have developed a game-based evacuation drill (GBED) system that presents augmented reality (AR) materials on tablet computers. The paper's current research purpose is to improve…

Evacuated FM08 Fuses Carry a Sustained Arc in a Bus over 75 VDC

NASA Technical Reports Server (NTRS)

Leidecker, Henning; Slonaker, J.

1999-01-01

The FM08 style fuse is specified to interrupt an overcurrent of up to 300 A in a bus of up to 125 VDC, but this applies only when its barrel is filled with air. When placed into a space-grade vacuum, the FM08 style fuse exhausts its air within a year. Then, the probability of an enduring arc is high for all ratings when the bus is above 75 VDC, and the overcurrent is large. The arc endures until something else interrupts the current. The fuse can violently eject metal vapor or other material during the sustained arcing. The evacuated FM08 does not develop a sustained arc when interrupted in a bus of 38 VDC or less, at least when there is little inductance in the circuit. This is consistent with its successful use in many spacecraft having buses in the range 24 to 36 volts.

Air medical referring customer satisfaction: a valuable insight.

PubMed

Fultz, J H; Coyle, C B; Reynolds, P W

1998-01-01

To remain competitive and survive, air medical programs must have a mechanism for obtaining customer feedback, especially when alternate transport options are available. The goal of this survey was to examine the air medical service's performance as perceived by customers requesting the transport. Surveys were mailed to 400 referring customers who had contact with the flight crew during the transition of patient care. The survey consisted of 16 statements evaluating the service by using a 4-point Likert scale, three demographic questions, one statement evaluating overall satisfaction, and two open-ended questions for comments or suggestions. Two hundred forty-four surveys were returned for a 61% responses rate. Results indicated referring customers are satisfied with the service provided Written comments and suggestions were divided into two categories, positive comments and suggestions for improvement. Three common themes were identified within the suggestions for improvement: crew rapport, communications, and operations. Suggested improvements were evaluated, and selected strategies were incorporated into program operation. Customer feedback furnishes valuable insight into their needs and perception of a service. Comments and suggestions for improvement can promote critical inquiry into service operation and provide a catalyst for improvement.

Development of Helicopter Capabilities in the U.S. Army During the Korean and Vietnam Wars

DTIC Science & Technology

2016-06-10

capacity, cost, vulnerability and complexity of design comparing to fixed- wind capability. However, helicopters had their unbeatable advantage... wires , rescuing of downed pilots and casualty 23 Horn, 66. 24 Ibid., 75. 23 evacuation...missions: air transportation, medical evacuation, wire laying, reconnaissance, artillery spotting, messenger service and many others. In case of both

"Operation Workload" : a study of passenger energy expenditure during an emergency evacuation.

DOT National Transportation Integrated Search

1989-03-01

In an earlier study at the Civil Aeromedical Institute, workloads were determined for passengers during an emergency evacuation. The evacuation tests were conducted in an orderly manner and were suggested as representative of a moderate workload. The...

Tsunami evacuation plans for future megathrust earthquakes in Padang, Indonesia, considering stochastic earthquake scenarios

NASA Astrophysics Data System (ADS)

Muhammad, Ario; Goda, Katsuichiro; Alexander, Nicholas A.; Kongko, Widjo; Muhari, Abdul

2017-12-01

This study develops tsunami evacuation plans in Padang, Indonesia, using a stochastic tsunami simulation method. The stochastic results are based on multiple earthquake scenarios for different magnitudes (Mw 8.5, 8.75, and 9.0) that reflect asperity characteristics of the 1797 historical event in the same region. The generation of the earthquake scenarios involves probabilistic models of earthquake source parameters and stochastic synthesis of earthquake slip distributions. In total, 300 source models are generated to produce comprehensive tsunami evacuation plans in Padang. The tsunami hazard assessment results show that Padang may face significant tsunamis causing the maximum tsunami inundation height and depth of 15 and 10 m, respectively. A comprehensive tsunami evacuation plan - including horizontal evacuation area maps, assessment of temporary shelters considering the impact due to ground shaking and tsunami, and integrated horizontal-vertical evacuation time maps - has been developed based on the stochastic tsunami simulation results. The developed evacuation plans highlight that comprehensive mitigation policies can be produced from the stochastic tsunami simulation for future tsunamigenic events.

How to simulate pedestrian behaviors in seismic evacuation for vulnerability reduction of existing buildings

NASA Astrophysics Data System (ADS)

Quagliarini, Enrico; Bernardini, Gabriele; D'Orazio, Marco

2017-07-01

Understanding and representing how individuals behave in earthquake emergencies would be essentially to assess the impact of vulnerability reduction strategies on existing buildings in seismic areas. In fact, interactions between individuals and the scenario (modified by the earthquake occurrence) are really important in order to understand the possible additional risks for people, especially during the evacuation phase. The current approach is based on "qualitative" aspects, in order to define best practice guidelines for Civil Protection and populations. On the contrary, a "quantitative" description of human response and evacuation motion in similar conditions is urgently needed. Hence, this work defines the rules for pedestrians' earthquake evacuation in urban scenarios, by taking advantages of previous results of real-world evacuation analyses. In particular, motion laws for pedestrians is defined by modifying the Social Force model equation. The proposed model could be used for evaluating individuals' evacuation process and so for defining operative strategies for interferences reduction in critical urban fabric parts (e.g.: interventions on particular buildings, evacuation strategies definition, city parts projects).

Agent-based evacuation simulation for spatial allocation assessment of urban shelters

NASA Astrophysics Data System (ADS)

Yu, Jia; Wen, Jiahong; Jiang, Yong

2015-12-01

The construction of urban shelters is one of the most important work in urban planning and disaster prevention. The spatial allocation assessment is a fundamental pre-step for spatial location-allocation of urban shelters. This paper introduces a new method which makes use of agent-based technology to implement evacuation simulation so as to conduct dynamic spatial allocation assessment of urban shelters. The method can not only accomplish traditional geospatial evaluation for urban shelters, but also simulate the evacuation process of the residents to shelters. The advantage of utilizing this method lies into three aspects: (1) the evacuation time of each citizen from a residential building to the shelter can be estimated more reasonably; (2) the total evacuation time of all the residents in a region is able to be obtained; (3) the road congestions in evacuation in sheltering can be detected so as to take precautionary measures to prevent potential risks. In this study, three types of agents are designed: shelter agents, government agents and resident agents. Shelter agents select specified land uses as shelter candidates for different disasters. Government agents delimitate the service area of each shelter, in other words, regulate which shelter a person should take, in accordance with the administrative boundaries and road distance between the person's position and the location of the shelter. Resident agents have a series of attributes, such as ages, positions, walking speeds, and so on. They also have several behaviors, such as reducing speed when walking in the crowd, helping old people and children, and so on. Integrating these three types of agents which are correlated with each other, evacuation procedures can be simulated and dynamic allocation assessment of shelters will be achieved. A case study in Jing'an District, Shanghai, China, was conducted to demonstrate the feasibility of the method. A scenario of earthquake disaster which occurs in nighttime

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

5 CFR 550.409 - Evacuation payments during a pandemic health crisis.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Evacuation payments during a pandemic... during a pandemic health crisis. (a) An agency may order one or more employees to evacuate from their... the employee) during a pandemic health crisis without regard to whether the agency and the employee...

Integrating supply and demand aspects of transportation for mass evacuation under disasters.

DOT National Transportation Integrated Search

2009-10-15

This study seeks to address real-time operational needs in the context of the evacuation response problem by providing a capability to dynamically route vehicles under evacuation, thereby being responsive to the actual conditions unfolding in real-ti...

Influences of exit and stair conditions on human evacuation in a dormitory

NASA Astrophysics Data System (ADS)

Lei, Wenjun; Li, Angui; Gao, Ran; Wang, Xiaowei

2012-12-01

Evacuation processes of students are investigated by experiment and simulation. The experiment is performed for students evacuating from a dormitory with an exit and stairs. FDS+Evac is proposed to simulate the exit and stair dynamics of occupant evacuation. Concerning the exit and stair widths, we put forward some useful standpoints. Good agreement is achieved between the predicted results and experimental results. With the increase of exit width, a significant stratification phenomenon will be found in flow rate. Stratification phenomenon is that two different stable flow rates will emerge during the evacuation. And the flow rate curve looks like a ladder. The larger the exit width, the earlier the stratification phenomenon appears. When exit width is more than 2.0 m, the flow rate of each exit width is divided into two stable stages, and the evacuation times show almost no change. The judgment that the existence of stairs causes flow stratification is reasonable. By changing the width of the stairs, we proved that judgment. The smaller the width of BC, the earlier the stratification appears. We found that scenario 5 is the most adverse circumstance. Those results are helpful in performance-based design of buildings.

Evacuation of the ICU: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

King, Mary A; Niven, Alexander S; Beninati, William; Fang, Ray; Einav, Sharon; Rubinson, Lewis; Kissoon, Niranjan; Devereaux, Asha V; Christian, Michael D; Grissom, Colin K

2014-10-01

Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. The Evacuation and Mobilization topic panel used the American College of Chest Physicians (CHEST) Guidelines Oversight Committee's methodology to develop seven key questions for which specific literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. Based on current best evidence, we provide 13 suggestions outlining a systematic approach to prepare for and execute an effective ICU evacuation during a disaster. Interhospital and intrahospital collaboration and functional ICU communication are critical for success. Pre-event planning and preparation are required for a no-notice evacuation. A Critical Care Team Leader must be designated within the Hospital Incident Command System. A three-stage ICU Evacuation Timeline, including (1) no immediate threat, (2) evacuation threat, and (3) evacuation implementation, should be used. Detailed suggestions on ICU evacuation, including regional planning, evacuation drills, patient transport preparation and equipment, patient prioritization and distribution for evacuation, patient information and tracking, and federal and international evacuation assistance systems, are also provided. Successful ICU evacuation during a disaster requires active preparation, participation

The role of the defaecating pouchogram in the assessment of evacuation difficulty after restorative proctocolectomy and pouch-anal anastomosis.

PubMed

Stellingwerf, M E; Maeda, Y; Patel, U; Vaizey, C J; Warusavitarne, J; Bemelman, W A; Clark, S K

2016-08-01

Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not well understood. We aimed to evaluate the role of defaecating pouchography in an attempt to assess the mechanism of evacuation difficulty in pouch patients. All RPC patients who had had a defaecating pouchogram for evacuation difficulty at one hospital between 2006 and 2014 were retrospectively reviewed. The findings and features were correlated with the symptoms. Demographic, clinical and radiological variables were analysed. Eighty-seven [55 (63%) female] patients aged 47.6 ± 12.5 years (mean standard ± SD) were identified. Thirty-five had a mechanical outlet obstruction and 52 had no identified mechanical cause to explain the evacuation difficulty. The mean age of these 52 [33 (63%) female] patients was 48.2 ± 13 years. Of these 52 patients, significantly more used anti-diarrhoeal medication (P = 0.029), complained of a high frequency of defaecation (P = 0.005), experienced a longer time to the initiation of defaecation (P = 0.049) and underwent pouchoscopy (P = 0.003). Biofeedback appeared to improve the symptoms in 7 of 16 patients with a nonmechanical defaecatory difficulty. The most common findings on defaecating pouchography included residual barium of more than 33% after an attempted evacuation (46%, n = 24), slow evacuation (35%, n = 18) and mucosal irregularity (33%, n = 17). Correlation between radiological features and symptoms showed a statistically significant relationship between straining, anal pain, incontinence and urgency with patterns of anismus or pelvic floor descent or weakness seen on the defaecating pouchogram. Symptoms of incomplete evacuation, difficulty in the initiation of defaecation, high defaecatory frequency and

Comparison of the effects of voluntary termination of pregnancy and uterine evacuation for medical reasons on female sexual function.

PubMed

Dundar, B; Dilbaz, B; Karadag, B

2016-04-01

A wide spectrum of emotions are experienced during abortion, including anxiety, sadness and grief, guilt, pessimism about future pregnancies, disturbed self-perception and loss of confidence in intimate relationships. This study aimed to compare the short-term effects of legal voluntary termination of pregnancy with uterine evacuation for medical reasons on female sexual function. The study group was comprised of 50 patients admitted to the Family Planning Clinic for legal voluntary termination of pregnancy <10 weeks of gestation, and the control group was comprised of 50 patients who underwent manual vacuum aspiration of the products of conception for medical reasons (e.g. inevitable abortion, incomplete abortion, fetal abnormality and teratogenic drug use). Female sexual function in the two groups was evaluated using the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). GRISS scores immediately before and 3 months after termination of pregnancy were compared within each group and between the two groups. Mean total GRISS scores before and after termination of pregnancy were 5.33 and 8.12 in the study group, and 6.02 and 6.4 in the control group, respectively (p<0.05). The increase in GRISS scores for both groups indicated deterioration in sexual function (p=0.000 and p=0.016, respectively). Three months after termination of pregnancy, the total GRISS score was significantly higher in the study group compared with the control group (8.12 vs 6.4, p<0.05). Female sexual dysfunction is a complicated concept that is affected by multiple factors over a woman's lifetime. It is important to consider female sexual function as a part of reproductive health, with a close relationship with contraception. As such, patients should receive counselling about sexual function and contraception as part of comprehensive abortion care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prototype Tsunami Evacuation Park in Padang, West Sumatra, Indonesia

NASA Astrophysics Data System (ADS)

Tucker, B. E.; Cedillos, V.; Deierlein, G.; Di Mauro, M.; Kornberg, K.

2012-12-01

Padang, Indonesia, a city of some 900,000 people, half of whom live close to the coast and within a five-meter elevation above sea level, has one of the highest tsunami risks in the world due to its close offshore thrust-fault seismic hazard, flat terrain and dense population. There is a high probability that a tsunami will strike the shores of Padang, flooding half of the area of the city, within the next 30 years. If that tsunami occurred today, it is estimated that several hundred thousand people would die, as they could not reach safe ground in the ~30 minute interval between the earthquake's occurrence and the tsunami's arrival. Padang's needs have been amply demonstrated: after earthquakes in 2007, 2009, 2011 and 2012, citizens, thinking that those earthquakes might cause a tsunami, tried to evacuate in cars and motorbikes, which created traffic jams, and most could not reach safe ground in 30 minutes. Since 2008, GeoHazards International (GHI) and Stanford University have studied a range of options for improving this situation, including ways to accelerate evacuation to high ground with pedestrian bridges and widened roads, and means of "vertical" evacuation in multi-story buildings, mosques, pedestrian overpasses, and Tsunami Evacuation Parks (TEPs), which are man-made hills with recreation facilities on top. TEPs proved most practical and cost-effective for Padang, given the available budget, technology and time. The Earth Observatory Singapore (EOS) developed an agent-based model that simulates pedestrian and vehicular evacuation to assess tsunami risk and risk reduction interventions in Southeast Asia. EOS applied this model to analyze the effectiveness in Padang of TEPs over other tsunami risk management approaches in terms of evacuation times and the number of people saved. The model shows that only ~24,000 people (20% of the total population) in the northern part of Padang can reach safe ground within 30 minutes, if people evacuate using cars and

Wildfire evacuation and its alternatives: perspectives from four United States' communities

Treesearch

Sarah McCaffrey; Alan Rhodes; Melanie Stidham

2015-01-01

Recent years have seen growing interest within the United States fire management community in exploring alternatives to the standard approach of evacuating entire populations that are threatened by a wildfire. There has been particular interest in what can be learned from the Australian approach, whereby residents choose whether or not to evacuate under the '...

Why Don't People Evacuate When Nature Threatens?

NASA Astrophysics Data System (ADS)

Thompson, K. J.; Broad, K.; Meyer, R.; Orlove, B. S.

2011-12-01

Why do so many Southern Californians fail to evacuate when warned that winter storms have critically raised the risk of a debris flow in their neighborhoods? Have they perhaps not seen or heeded news coverage of past debris flow events? Are they unaware that recent fires made the hillsides above them more prone to gravity-driven processes? Do they think they can wait to start their cars until they can actually see the flow coming? Or have they merely experienced too many "false alarms" in past years, and no longer put much stock in the judgment of public officials or the ability of scientists to judge debris flow risk? In preparation for a simulation study that will place decision makers in a virtual house in the California foothills during a winter storm event, we explore the reasons that people do and do not evacuate in the face of potential debris flows. Working in collaboration with the USGS Multi-Hazards Demonstration Project for Southern California, we are surveying hundreds of local residents, from debris-flow prone areas and from elsewhere in the state, to establish their baseline knowledge (and misconceptions) about, attitudes toward, information use regarding, and experience with debris flows. Initial interviews with residents of recently hit neighborhoods give qualitative data suggesting that false-alarm effects and underestimation of risk are driving factors; these surveys will provide quantitative evidence to extend those findings. We will discuss the results of this survey in the context of a comprehensive body of psychology research that seeks to explain why people frequently appear to ignore or discount hazard warnings: neglecting to insure their homes and crops (Kunreuther, 1984), failing to evacuate in the face of storms and fires (Baker, 1991; Packham, 1995), and (barring a recent, vivid event) showing little support for measures that would manage or mitigate future hazards (Kunreuther, 2006a, 2006b; Weber, 2006). We will also consider the

Safe Emergency Evacuation From Tall Structures

NASA Technical Reports Server (NTRS)

Stephan, E. S.

1984-01-01

Emergency egress system allows people to be evacuated quickly from tall structures. New emergency system applicable to rescues from fires in tall hotels and other buildings. System consists of basket on slide wire. Basket descends by gravity on sloped slide wire staked to ground.

A fuzzy Bayesian network approach to quantify the human behaviour during an evacuation

NASA Astrophysics Data System (ADS)

Ramli, Nurulhuda; Ghani, Noraida Abdul; Ahmad, Nazihah

2016-06-01

Bayesian Network (BN) has been regarded as a successful representation of inter-relationship of factors affecting human behavior during an emergency. This paper is an extension of earlier work of quantifying the variables involved in the BN model of human behavior during an evacuation using a well-known direct probability elicitation technique. To overcome judgment bias and reduce the expert's burden in providing precise probability values, a new approach for the elicitation technique is required. This study proposes a new fuzzy BN approach for quantifying human behavior during an evacuation. Three major phases of methodology are involved, namely 1) development of qualitative model representing human factors during an evacuation, 2) quantification of BN model using fuzzy probability and 3) inferencing and interpreting the BN result. A case study of three inter-dependencies of human evacuation factors such as danger assessment ability, information about the threat and stressful conditions are used to illustrate the application of the proposed method. This approach will serve as an alternative to the conventional probability elicitation technique in understanding the human behavior during an evacuation.

Civilians under fire: evacuation behaviour in north Israel during the Second Lebanon War.

PubMed

Gidron, David; Peleg, Kobi; Jaffe, Dena; Shenhar, Gili

2010-10-01

This paper seeks to understand evacuation behaviour in a case of spontaneous evacuation. During the Second Lebanon War of 2006, more than one-third of residents in north Israel spontaneously evacuated--the remainder stayed in situ. Using a telephone survey of 665 respondents residing in north Israel, we were able to characterise the behaviour of evacuees and non-evacuees. The main reasons cited for evacuating were fear of injury to self or family, the effect on children, inability to remain in a protective space, and family pressure. The main reasons cited for remaining at home were no suitable alternative, did not perceive a high level of danger, had to go to work, and there is no place like home. There were no significant differences with regard to most socio-demographic characteristics of the population. These findings should aid emergency managers in preparing the population for a future emergency and in engaging in effective dialogue with the population during an emergency on the evacuation option. © 2010 The Author(s). Journal compilation © Overseas Development Institute, 2010.

High-energy metal air batteries

DOEpatents

Zhang, Ji-Guang; Xiao, Jie; Xu, Wu; Wang, Deyu; Williford, Ralph E.; Liu, Jun

2014-07-01

Disclosed herein are embodiments of lithium/air batteries and methods of making and using the same. Certain embodiments are pouch-cell batteries encased within an oxygen-permeable membrane packaging material that is less than 2% of the total battery weight. Some embodiments include a hybrid air electrode comprising carbon and an ion insertion material, wherein the mass ratio of ion insertion material to carbon is 0.2 to 0.8. The air electrode may include hydrophobic, porous fibers. In particular embodiments, the air electrode is soaked with an electrolyte comprising one or more solvents including dimethyl ether, and the dimethyl ether subsequently is evacuated from the soaked electrode. In other embodiments, the electrolyte comprises 10-20% crown ether by weight.

High-energy metal air batteries

DOEpatents

Zhang, Ji-Guang; Xiao, Jie; Xu, Wu; Wang, Deyu; Williford, Ralph E.; Liu, Jun

2013-07-09

Disclosed herein are embodiments of lithium/air batteries and methods of making and using the same. Certain embodiments are pouch-cell batteries encased within an oxygen-permeable membrane packaging material that is less than 2% of the total battery weight. Some embodiments include a hybrid air electrode comprising carbon and an ion insertion material, wherein the mass ratio of ion insertion material to carbon is 0.2 to 0.8. The air electrode may include hydrophobic, porous fibers. In particular embodiments, the air electrode is soaked with an electrolyte comprising one or more solvents including dimethyl ether, and the dimethyl ether subsequently is evacuated from the soaked electrode. In other embodiments, the electrolyte comprises 10-20% crown ether by weight.

Army Air Ambulance Blood Product Program in the Combat Zone and Challenges to Best Practices.

PubMed

Powell-Dunford, Nicole; Quesada, Jose F; Gross, Kirby R; Shackelford, Stacy A

2016-08-01

Identify challenges and best practices in the development of an austere air ambulance transfusion program. A search of PubMed using combinations of the key terms 'prehospital,' 'blood product,' 'red blood cells,' 'damage control resuscitation,' 'transfusion,' 'air ambulance,' 'medical evacuation,' and 'medevac' yielded 196 articles for further analysis, with 14 articles suitable for addressing the background of prehospital transfusion within a helicopter. Retrospective analysis of unclassified briefs, after action reports, and procedures was also undertaken along with interview of subject matter experts. The initial series of 15 transfusions were discussed telephonically among flight crew, trauma surgeons, and lab specialists. Review of Joint Theater System data was readily available for 84 U.S. Army air ambulance transfusions between May-December 2012, with December marking the redeployment of the 25(th) Combat Aviation Brigade. Standardized implementation enabled safe blood product administration for 84 causalities from May-December 2012 without blood product shortage, expiration, or transfusion reaction. Challenges included developing transfusion competency, achieving high quality blood support, countering the potential for anti-U.S. sentiment, and diversity in coalition transfusion practices. Blood product administration aboard the air ambulance is logistically complex, requiring blood bank integration. Repetitive training enabled emergency medical technicians (EMTs) with basic medical training to safely perform transfusion in accordance with clinical operating guidelines. In the austere environment, logistic factors are significant challenges and political sensitivities are important considerations. Best practices may facilitate new en route transfusion programs. Powell-Dunford N, Quesada JF, Gross KR, Shackelford SA. Army air ambulance blood product program in the combat zone and challenges to best practices. Aerosp Med Hum Perform. 2016; 87(8):728-734.

Prioritizing Medical Resources for Exploration Missions

NASA Technical Reports Server (NTRS)

Shah, R. V.; Kerstman, E. L.

2015-01-01

Long duration missions beyond low Earth orbit introduce new constraints to the medical system. Factors such as the inability to evacuate to Earth in a timely manner, communication delay, limitations in available medical equipment, and the clinical background of the crew will all have an impact on the assessment and treatment of medical conditions. The Exploration Medical Capability (ExMC) Element of NASAs Human Research Program seeks to improve the way the element derives its mitigation strategies for the risk of "Unacceptable Health and Mission Outcomes Due to Limitation of In-flight Medical Capabilities."

A Participatory Agent-Based Simulation for Indoor Evacuation Supported by Google Glass.

PubMed

Sánchez, Jesús M; Carrera, Álvaro; Iglesias, Carlos Á; Serrano, Emilio

2016-08-24

Indoor evacuation systems are needed for rescue and safety management. One of the challenges is to provide users with personalized evacuation routes in real time. To this end, this project aims at exploring the possibilities of Google Glass technology for participatory multiagent indoor evacuation simulations. Participatory multiagent simulation combines scenario-guided agents and humans equipped with Google Glass that coexist in a shared virtual space and jointly perform simulations. The paper proposes an architecture for participatory multiagent simulation in order to combine devices (Google Glass and/or smartphones) with an agent-based social simulator and indoor tracking services.

A Participatory Agent-Based Simulation for Indoor Evacuation Supported by Google Glass

PubMed Central

Sánchez, Jesús M.; Carrera, Álvaro; Iglesias, Carlos Á.; Serrano, Emilio

2016-01-01

Indoor evacuation systems are needed for rescue and safety management. One of the challenges is to provide users with personalized evacuation routes in real time. To this end, this project aims at exploring the possibilities of Google Glass technology for participatory multiagent indoor evacuation simulations. Participatory multiagent simulation combines scenario-guided agents and humans equipped with Google Glass that coexist in a shared virtual space and jointly perform simulations. The paper proposes an architecture for participatory multiagent simulation in order to combine devices (Google Glass and/or smartphones) with an agent-based social simulator and indoor tracking services. PMID:27563911

A comparison of the nursing home evacuation experience between hurricanes katrina (2005) and gustav (2008).

PubMed

Blanchard, Gary; Dosa, David

2009-11-01

One of the tragic legacies of Hurricane Katrina was the loss of life among Louisiana (LA) nursing home (NH) residents. Katrina revealed a staggering lack of emergency preparation and understanding of how to safely evacuate frail populations. Three years later, LA braced for Hurricane Gustav, a storm heralded to rival Katrina's power. Although its magnitude of destruction ultimately paled to Katrina, the warnings and predicted path preceding Gustav yielded a process of NH evacuations similar to Katrina. The goal of this article was to ascertain whether NH administrative directors (ADs) felt more prepared to evacuate before Gustav. In 2006, Dosa et al(5) (J Am Med Dir Assoc, 3/07), interviewed 20 NH ADs by qualitative telephone survey to evaluate their lessons learned from Katrina. Administrators at these 20 participating nursing homes were contacted and asked to participate in a follow-up survey to compare hurricane preparedness between 2005 and 2008. Specifically, ADs were asked if they evacuated before Gustav, their destination, and about logistical issues with evacuation (eg, transportation, injuries). ADs were asked to rate their confidence with state assistance, hurricane transportation, and evacuation preparedness on a 10-point scale (10=most confident) and compare their preparedness to Katrina. Sixteen of the 20 NHs that participated in 2006 agreed to be surveyed-11 of whom held the same position before Katrina. Unlike Katrina, when only 45% evacuated before the storm, all 16 NHs evacuated before Gustav (56% to another NH and 46% to a church, gym, college, or other facility). Overall, ADs rated their confidence in preparedness for Gustav as a mean of 8.3 (range 5 to 10) compared with a mean of 5.4 (range 3 to 8) for Katrina, a 54% improvement. Of the 11 ADs employed pre-Katrina, 73% reported improved collaboration with the state and 55% noted improved transportation. Nevertheless, 7 ADs noted significant logistical problems during evacuation (mostly

The long-term impact of war experiences and evacuation on people who were children during World War Two.

PubMed

Waugh, Melinda J; Robbins, Ian; Davies, Stephen; Feigenbaum, Janet

2007-03-01

During World War Two 1.9 million people were evacuated from British cities where the risk of bombing was perceived to be highest. 1.5 million of these were children who, often unaccompanied, were sent to live with strangers. Two hundred and forty-five people who were evacuated as children were compared with 96 of similar age who did not experience evacuation. Within this self-selected sample, significant numbers of the evacuees were found to have experienced abuse and neglect. Pre-evacuation abuse made continued abuse likely during evacuation, while abuse during evacuation led to children being more likely to continue to be abused on their return home. Abuse during evacuation led to increased scores on the Impact of Event Scale and General Health Questionnaire, and to insecure attachment patterns. The role of evacuation and abuse in the maintenance of long-term psychological problems is discussed.

U.S. Army Deployment Injury Surveillance Summary Calendar Year 2008. 1 January 2008 - 31 December 2008

DTIC Science & Technology

2009-09-15

region affected. In 2008, 831 NBI-related musculoskeletal conditions required medical air evacuation. Inflammation and Pain (Overuse) Joint...evacuation were inflammation and pain (overuse) (56 percent), joint derangement (16 percent), and strains/sprains/rupture (13 percent). The spine/back...extremities (14 percent). The leading specific injury-related musculoskeletal conditions were inflammation and pain (overuse) involving the lumbar

Fleeing The Storm(s): An Examination of Evacuation Behavior During Florida’s 2004 Hurricane Season

PubMed Central

SMITH, STANLEY K.; MCCARTY, CHRIS

2009-01-01

The 2004 hurricane season was the worst in Florida’s history, with four hurricanes causing at least 47 deaths and some $45 billion in damages. To collect information on the demographic impact of those hurricanes, we surveyed households throughout the state and in the local areas that sustained the greatest damage. We estimate that one-quarter of Florida’s population evacuated prior to at least one hurricane; in some areas, well over one-half of the residents evacuated at least once, and many evacuated several times. Most evacuees stayed with family or friends and were away from home for only a few days. Using logistic regression analysis, we found that the strength of the hurricane and the vulnerability of the housing unit had the greatest impact on evacuation behavior; additionally, several demographic variables had significant effects on the probability of evacuating and the choice of evacuation lodging (family/friends, public shelters, or hotels/motels). With continued population growth in coastal areas and the apparent increase in hurricane activity caused by global warming, threats posed by hurricanes are rising in the United States and throughout the world. We believe the present study will help government officials plan more effectively for future hurricane evacuations. PMID:19348112

Understanding and managing disaster evacuation on a transportation network.

PubMed

Lambert, James H; Parlak, Ayse I; Zhou, Qian; Miller, John S; Fontaine, Michael D; Guterbock, Thomas M; Clements, Janet L; Thekdi, Shital A

2013-01-01

Uncertain population behaviors in a regional emergency could potentially harm the performance of the region's transportation system and subsequent evacuation effort. The integration of behavioral survey data with travel demand modeling enables an assessment of transportation system performance and the identification of operational and public health countermeasures. This paper analyzes transportation system demand and system performance for emergency management in three disaster scenarios. A two-step methodology first estimates the number of trips evacuating the region, thereby capturing behavioral aspects in a scientifically defensible manner based on survey results, and second, assigns these trips to a regional highway network, using geographic information systems software, thereby making the methodology transferable to other locations. Performance measures are generated for each scenario including maps of volume-to-capacity ratios, geographic contours of evacuation time from the center of the region, and link-specific metrics such as weighted average speed and traffic volume. The methods are demonstrated on a 600 segment transportation network in Washington, DC (USA) and are applied to three scenarios involving attacks from radiological dispersion devices (e.g., dirty bombs). The results suggests that: (1) a single detonation would degrade transportation system performance two to three times more than that which occurs during a typical weekday afternoon peak hour, (2) volume on several critical arterials within the network would exceed capacity in the represented scenarios, and (3) resulting travel times to reach intended destinations imply that un-aided evacuation is impractical. These results assist decisions made by two categories of emergency responders: (1) transportation managers who provide traveler information and who make operational adjustments to improve the network (e.g., signal retiming) and (2) public health officials who maintain shelters, food and