Science.gov

Sample records for all-hazards emergency management

  1. All-Hazard Consequence Management Planning for the Water Sector: Preparedness, Emergency Response, and Recovery CIPAC Workshop

    DTIC Science & Technology

    2009-11-01

    can return to work after illness.  Establish policies for flexible worksite (e.g., telecommuting ) and flexible work hours (e.g., staggered shifts...S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Critical Infrastructure Partnership...Council (CIPAC) Working Group would like to acknowledge everyone who contributed to the development and finalization of All-Hazard Consequence

  2. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-04

    ... SECURITY Federal Emergency Management Agency All-Hazard Position Task Books for Type 3 Incident Management... comments. SUMMARY: The All-Hazard Position Task Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in the All-Hazard Incident Command System (ICS)...

  3. Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach

    ERIC Educational Resources Information Center

    Journal of American College Health, 2011

    2011-01-01

    This document, written collaboratively by members of ACHA's Emerging Public Health Threats and Emergency Response Coalition and Campus Safety and Violence Coalition, is designed to assist members of the college health community in planning for emergencies using an all-hazards approach. Its perspective is both macro and micro, beginning with a…

  4. Preparedness and emergency response research centers: using a public health systems approach to improve all-hazards preparedness and response.

    PubMed

    Leinhos, Mary; Qari, Shoukat H; Williams-Johnson, Mildred

    2014-01-01

    In 2008, at the request of the Centers for Disease Control and Prevention (CDC), the Institute of Medicine (IOM) prepared a report identifying knowledge gaps in public health systems preparedness and emergency response and recommending near-term priority research areas. In accordance with the Pandemic and All-Hazards Preparedness Act mandating new public health systems research for preparedness and emergency response, CDC provided competitive awards establishing nine Preparedness and Emergency Response Research Centers (PERRCs) in accredited U.S. schools of public health. The PERRCs conducted research in four IOM-recommended priority areas: (1) enhancing the usefulness of public health preparedness and response (PHPR) training, (2) creating and maintaining sustainable preparedness and response systems, (3) improving PHPR communications, and (4) identifying evaluation criteria and metrics to improve PHPR for all hazards. The PERRCs worked closely with state and local public health, community partners, and advisory committees to produce practice-relevant research findings. PERRC research has generated more than 130 peer-reviewed publications and nearly 80 practice and policy tools and recommendations with the potential to significantly enhance our nation's PHPR to all hazards and that highlight the need for further improvements in public health systems.

  5. 'All hazards approach' to disaster management: the role of information and knowledge management, Boyd's OODA Loop, and network-centricity.

    PubMed

    von Lubitz, Dag K J E; Beakley, James E; Patricelli, Frédéric

    2008-12-01

    The ever-increasing complexity of disasters demands utilisation of knowledge that exists outside domains traditionally drawn upon in disaster management. To be operationally useful, such knowledge must he extracted, combined with information generated by the disaster itself, and transformed into actionable knowledge. The process, though, is hampered by existing, business-oriented approaches to knowledge management, by technical issues related to access to relevant, multi-domain information/knowledge, and by executive decision-making processes based predominantly on historical knowledge. Consequently, as shown by many recent incidents, the management of large-scale (mega) disasters is often inefficient and exceedingly costly. This paper demonstrates that the integration of modified information and knowledge management into the concepts of network-centric operations and network-enabled capabilities, and the employment of Boyd's OODA (Observe, Orient, Decide, and Act) Loop-based decision-making in unpredictable and dynamically changing environments, may address some of these problems.

  6. 75 FR 16623 - Emergency Management for Higher Education Grant Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... their campus-based all-hazards emergency management planning efforts. We intend grant awards under these priorities and requirements to increase the capacity of IHEs to prevent/mitigate, prepare for, respond to... all-hazards emergency management planning efforts within the framework of the four phases of...

  7. The Benefits of Collaborative Processes for Establishing All Hazard Incident Management Teams in Urban Area Security Initiative Regions

    DTIC Science & Technology

    2013-09-01

    Metropolitan Medical Response System NAPA National Academy of Public Administration NIMS National Incident Management System NWCG National...Public Administration’s ( NAPA ) definition of partnership “as a mutually-beneficial and reciprocal relationship where entities share responsibilities...authority, and accountability for results.”51 NAPA defines collaboration as “joint work effort with shared responsibilities for mutually defined goals

  8. Improving the All-Hazards Homeland Security Enterprise Through the Use of an Emergency Management Intelligence Model

    DTIC Science & Technology

    2013-09-01

    as the inability of the EM community to swing the pendulum to the preparedness and mitigation phases. Intelligence, and the use of, is critical to...swing the EM pendulum from the reactive to the proactive. Borrowed from best practices in the current IC, and adapted to ensure a process that better...their Reverse 911 calling system; the software fails and none of the calls go through. Messages are pushed out to the public through various methods

  9. Compstat 2.0: An Innovative Police Strategic Management Plan That Facilitates Performance in the All Crimes and All Hazards Environment

    DTIC Science & Technology

    2011-03-01

    model that impede crime fighting effectiveness , and diminish public trust. The threats and challenges of the twenty-first century call for the...flaws, paradoxes and gaps in the model that impede crime fighting effectiveness , and diminish public trust. The threats and challenges of the twenty...becoming more complex. Increasing complexity demands new management practices that hone our effectiveness in perceiving and acting on the threats

  10. Federal Emergency Management Agency

    MedlinePlus

    ... Updates Emergency Management Agencies Emergency Management Institute El Niño Environmental Planning and Historic Preservation Program Exercise Fact ... Local, State, Tribal and Non-Profit Recovery Resources Region I Region II Region III Region IV Region ...

  11. Emergency Management Guide

    SciTech Connect

    Not Available

    1994-09-01

    This Emergency Management Guide provides guidance for the implementation of the requirements of the Department of Energy (DOE) Emergency Management System (EMS). The DOE EMS is established by DOE 5500.1B, EMERGENCY DEPARTMENT SYSTEM. The provisions of this guide specify neither policy nor responsibilities. It provides an acceptable approach to emergency planning activities at DOE facilities and sites. Other approaches may be used provided that they are approved by the cognizant Program Secretarial Officer (PSO), with the concurrence of the Director of Emergency Operations (DEO).

  12. Stennis all-hazards network adopted throughout NASA

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Stennis Space Center employees Mike McKinion (left), with Erica Lane Enterprises, and Luke Scianna, with the Jacobs Facility Operating Services Contract, monitor the facility and surrounding area on the 'all-hazards network' known as HazNet. The HazNet system at Stennis was developed by a local Mississippi company to help facilitate coordinated response during emergency and disaster situations. The system was installed in the new Emergency Operations Center built at Stennis before being implemented throughout NASA. HazNet was designed by NVision Solutions Inc. of Bay St. Louis, Miss., through NASA's Innovative Partnerships Program. In addition to being used at Stennis, it has been installed at other Gulf Coast communities to help coordinate response during emergencies and such natural disasters as hurricanes.

  13. Measuring healthcare preparedness: an all-hazards approach.

    PubMed

    Marcozzi, David E; Lurie, Nicole

    2012-10-25

    In a paper appearing in this issue, Adini, et al. describe a struggle familiar to many emergency planners-the challenge of planning for all scenarios. The authors contend that all-hazards, or capabilities-based planning, in which a set of core capabilities applicable to numerous types of events is developed, is a more efficient way to achieve general health care system emergency preparedness than scenario-based planning. Essentially, the core of what is necessary to plan for and respond to one kind of disaster (e.g. a biologic event) is also necessary for planning and responding to other types of disasters, allowing for improvements in planning and maximizing efficiencies. While Adini, et al. have advanced the science of health care emergency preparedness through their consideration of 490 measures to assess preparedness, a shorter set of validated preparedness measures would support the dual goals of accountability and improved outcomes and could provide the basis for determining which actions in the name of preparedness really matter.

  14. An All-Hazards Training Center for a Catastrophic Emergency

    DTIC Science & Technology

    2009-12-01

    reflect on and use their career experience to explore a wide range of strategic issues. To assure that the research conducted by Army War College...Stewart has more than 20 years experience in healthcare as a Respiratory Care Practitioner. He is a registered respiratory therapist and practiced in...on experience to respond to a WMD incident. There was no training curriculum for the original 10 Civil Support Teams (CSTs). The Pentagon rushed to

  15. Identifying the Emergency Management Profession.

    ERIC Educational Resources Information Center

    Chiesa, Adele M.

    1987-01-01

    In building an emergency management library collection within a training institution, technical data become secondary to identifying common goals, methods, and systems found at the federal, state, and local levels for responding to and planning for disasters and crises. These goals help identify emergency management skills public officials should…

  16. Emergency management logistics must become emergency supply chain management.

    PubMed

    Young, Richard R; Peterson, Matthew R

    2014-01-01

    Much has been written about how emergency management (EM) needs to look to the future regarding issues of resource management (monetary, human, and material). Constraints on budgets are ongoing and the staffing of emergency response activities is often difficult because volunteers have little to no training. The management of material resources has also been a challenge because 1) the categories of material vary by the type of emergency, 2) the necessary quantities of material are often not located near the ultimate point of need, and 3) the transportation assets are rarely available in the form and quantity required to allow timely and effective response. The logistics and resource management functions of EM (what we refer to as EM logistics) have been largely reactive, with little to no pre-event planning for potential demand. We applied the Supply Chain Operational Reference (SCOR) model to EM logistics in an effort to transform it to an integrated and scalable system of physical, information, and financial flows into which are woven the functions of sourcing, making, delivering, and returning, with an overarching planning function that transcends the organizational boundaries of participants. The result is emergency supply chain management, which embraces many more participants who share in a larger quantity of more useful information about the resources that need to be deployed when responding to and recovering from emergency events.

  17. Emergency Management Standards and Schools

    ERIC Educational Resources Information Center

    National Clearinghouse for Educational Facilities, 2009

    2009-01-01

    This publication discusses emergency management standards for school use and lists standards recommended by FEMA's National Incident Management System (NIMS). Schools are encouraged to review these standards carefully and to adopt, where applicable, those that meet their needs. The lists of standards, resources, and references contained herein…

  18. Emergency management of alveolar osteitis.

    PubMed

    Summers, Anthony

    2011-12-01

    Patients with urgent dental problems who present to emergency departments (EDs) during weekday office hours are usually referred to their dentists, often after being provided with analgesia. Outside these hours, however, ED professionals may have to provide treatment before referral. One dental emergency with which patients may present but of which ED staff are unlikely to have experience is alveolar osteitis, a painful condition that occurs usually after tooth extraction. This article defines alveolar osteitis and describes management in an ED.

  19. Development of national standardized all-hazard disaster core competencies for acute care physicians, nurses, and EMS professionals.

    PubMed

    Schultz, Carl H; Koenig, Kristi L; Whiteside, Mary; Murray, Rick

    2012-03-01

    The training of medical personnel to provide care for disaster victims is a priority for the physician community, the federal government, and society as a whole. Course development for such training guided by well-accepted standardized core competencies is lacking, however. This project identified a set of core competencies and performance objectives based on the knowledge, skills, and attitudes required by the specific target audience (emergency department nurses, emergency physicians, and out-of-hospital emergency medical services personnel) to ensure they can treat the injuries and illnesses experienced by victims of disasters regardless of cause. The core competencies provide a blueprint for the development or refinement of disaster training courses. This expert consensus project, supported by a grant from the Robert Wood Johnson Foundation, incorporated an all-hazard, comprehensive emergency management approach addressing every type of disaster to minimize the effect on the public's health. An instructional systems design process was used to guide the development of audience-appropriate competencies and performance objectives. Participants, representing multiple academic and provider organizations, used a modified Delphi approach to achieve consensus on recommendations. A framework of 19 content categories (domains), 19 core competencies, and more than 90 performance objectives was developed for acute medical care personnel to address the requirements of effective all-hazards disaster response. Creating disaster curricula and training based on the core competencies and performance objectives identified in this article will ensure that acute medical care personnel are prepared to treat patients and address associated ramifications/consequences during any catastrophic event.

  20. Airway management in emergency situations.

    PubMed

    Dörges, Volker

    2005-12-01

    Securing and monitoring the airway are among the key requirements of appropriate therapy in emergency patients. Failures to secure the airways can drastically increase morbidity and mortality of patients within a very short time. Therefore, the entire range of measures needed to secure the airway in an emergency, without intermediate ventilation and oxygenation, is limited to 30-40 seconds. Endotracheal intubation is often called the 'gold standard' for airway management in an emergency, but multiple failed intubation attempts do not result in maintaining oxygenation; instead, they endanger the patient by prolonging hypoxia and causing additional trauma to the upper airways. Thus, knowledge and availability of alternative procedures are also essential in every emergency setting. Given the great variety of techniques available, it is important to establish a well-planned, methodical protocol within the framework of an algorithm. This not only facilitates the preparation of equipment and the training of personnel, it also ensures efficient decision-making under time pressure. Most anaesthesia-related deaths are due to hypoxaemia when difficulty in securing the airway is encountered, especially in obstetrics during induction of anaesthesia for caesarean delivery. The most commonly occurring adverse respiratory events are failure to intubate, failure to recognize oesophageal intubation, and failure to ventilate. Thus, it is essential that every anaesthesiologist working on the labour and delivery ward is comfortable with the algorithm for the management of failed intubation. The algorithm for emergency airway management describing the sequence of various procedures has to be adapted to internal standards and to techniques that are available.

  1. Quantifying effectiveness in emergency management.

    PubMed

    Weaver, John Michael

    2014-01-01

    This study looked at the relationship between the Departments of Defense (DOD) and Homeland Security (DHS). Moreover, it reviewed the interface between their two subordinate organizations (Northern Command under DOD and the Federal Emergency Management Agency under DHS) with primacy over domestic disasters. Understanding the importance of intergovernmental relations (IGRs), the article dissected the interrelatedness of these organizations regarding hurricanes and the subsequent involvement of federal preparation and response efforts. The informal networked relationships were evaluated using regression analysis focusing on secondary sources of data and several variables. The vitality of collaborative networks is grounded in literature and has been espoused by Waugh and Streib in the world of emergency management; this study expanded on their premise.

  2. Management of gynecologic oncology emergencies

    SciTech Connect

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-08-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references.

  3. Bleeding varices: 1. Emergency management.

    PubMed Central

    Hanna, S S; Warren, W D; Galambos, J T; Millikan, W J

    1981-01-01

    The aim of the emergency management of bleeding varices is to stop the hemorrhage nonoperatively if possible, avoiding emergency shunt surgery, an operation that has a higher mortality than elective shunt surgery. Patients with an upper gastrointestinal hemorrhage should undergo endoscopy immediately to verify the diagnosis of bleeding varices. They can then be categorized according to whether they stop bleeding spontaneously (group 1), continue to bleed slowly (group 2) or continue to bleed rapidly (group 3). Group 1 patients are discussed in the second part of this two-part series. Group 2 patients are initially treated with vasopressin given intravenously; those who fail to respond should undergo emergency angiography and receive vasopressin intra-arterially. If this fails, patients at low surgical risk should undergo urgent shunt surgery; those at high risk do better with endoscopic sclerotherapy. Group 3 patients are also given an intravenous infusion of vasopressin. Patients at low surgical risk who continue to bleed then receive tamponade with a Sengstaken--Blakemore tube. If this fails, they undergo emergency creation of an H-shaped mesocaval shunt. Patients at high surgical risk who fail to respond to vasopressin given intravenously are next treated intra-arterially. If this fails they are given either endoscopic or transhepatic sclerotherapy. PMID:7006779

  4. Managing hypopituitarism in emergency departments.

    PubMed

    Welsh, Jeanette

    2015-10-01

    Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient's complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband.

  5. Hypertensive emergencies. Etiology and management.

    PubMed

    Tuncel, Meryem; Ram, Venkata C S

    2003-01-01

    Although systemic hypertension is a common clinical disorder, hypertensive emergencies are unusual in clinical practice. Situations that qualify as hypertensive emergencies include accelerated or malignant hypertension, hypertensive encephalopathy, acute left ventricular failure, acute aortic dissection, pheochromocytoma crisis, interaction between tyramine-containing foods or drugs and monoamine oxidase inhibitors, eclampsia, drug-induced hypertension and possibly intracranial hemorrhage. It is important to recognize these conditions since immediate lowering of systemic blood pressure is indicated. The diagnosis of hypertensive emergencies depends on the clinical manifestations rather than on the absolute level of the blood pressure. Depending on the target organ that is affected, the manifestations of hypertensive emergencies can be quite expressive, yet variable. Thus, the physician has to make the clinical diagnosis urgently in order to render appropriate therapy. Several parenteral drugs can quickly and effectively lower the blood pressure in hypertensive emergencies. Intravenous fenoldopam, a selective dopamine (DA1) receptor agonist, offers the advantage of improving renal blood flow and causing natriuresis. Intravenous nicardipine may be beneficial in reserving tissue perfusion in patients with ischemic disorders. Whereas trimethaphan camsilate is the drug of choice for managing acute aortic dissection, hydralazine remains the drug of choice for the treatment of eclampsia. The alpha-adrenoceptor, phentolamine, is useful in patients with pheochromocytoma crisis. Enalaprilat is the only ACE inhibitor available for parenteral use and may be particularly useful in treating hypertensive emergencies in patients with heart failure. However, ACE inhibitors may cause a precipitous fall in blood pressure in patients who are hypovolemic. Although useful as adjunctive therapy in hypertensive crises, diuretics should be used with caution in these patients because prior

  6. Information Systems Coordinate Emergency Management

    NASA Technical Reports Server (NTRS)

    2012-01-01

    The rescue crews have been searching for the woman for nearly a week. Hurricane Katrina devastated Hancock County, the southernmost point in Mississippi, and the woman had stayed through the storm in her beach house. There is little hope of finding her alive; the search teams know she is gone because the house is gone. Late at night in the art classroom of the school that is serving as the county s emergency operations center, Craig Harvey is discussing the search with the center s commander. Harvey is the Chief Operating Officer of a unique company called NVision Solutions Inc., based at NASA s Stennis Space Center in Bay St. Louis, only a couple of miles away. He and his entire staff have set up a volunteer operation in the art room, supporting the emergency management efforts using technology and capabilities the company developed through its NASA partnerships. As he talks to the commander, Harvey feels an idea taking shape that might lead them to the woman s location. Working with surface elevation data and hydrological principles, Harvey creates a map showing how the floodwaters from the storm would have flowed along the topography of the region around the woman s former home. Using the map, search crews find the woman s body in 15 minutes. Recovering individuals who have been lost is a sad reality of emergency management in the wake of a disaster like Hurricane Katrina in 2005. But the sooner answers can be provided, the sooner a community s overall recovery can take place. When damage is extensive, resources are scattered, and people are in dire need of food, shelter, and medical assistance, the speed and efficiency of emergency operations can be the key to limiting the impact of a disaster and speeding the process of recovery. And a key to quick and effective emergency planning and response is geographic information. With a host of Earth-observing satellites orbiting the globe at all times, NASA generates an unmatched wealth of data about our ever

  7. Social Media's New Role in Emergency Management

    SciTech Connect

    Ethan Huffman; Sara Prentice

    2008-03-01

    As technology continues to evolve, emergency management organizations must adapt to new ways of responding to the media and public. This paper examines a brief overview of social media's new role in emergency management. This includes definitions of social media, the benefits of utilizing social media, examples of social media being used and finally a discussion of how agencies, such as Department of Energy national laboratories, can begin including social media in their emergency management plans.

  8. Regulatory Information by Topic: Emergency Management

    EPA Pesticide Factsheets

    Regulatory information about emergencies, including chemical accident prevention, risk management plans (RMPs), chemical reporting, community right to know, and oil spills and hazardous substances releases.

  9. Helpful Hints for School Emergency Management: Emergency "Go-Kits"

    ERIC Educational Resources Information Center

    Hill, Tara

    2006-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The Office of Safe and Drug-Free Schools (OSDFS) encourages schools to consider emergency management in the context of its four phases: mitigation and prevention, preparedness, response, and recovery. The preparedness phase…

  10. Hazardous Materials Management System. A Guide for Local Emergency Managers.

    DTIC Science & Technology

    1981-07-01

    Office of Emergency Management 12240 N.E. Glisan, Portland, Oregon 97230 81 9 21 043 whom- son MCOEM 0779 July, 1981 Final Report HAZARDOUS MATERIALS...Emergency Management 12210 N. E. Glisan, Portland, Oregon 97230 FEMA REVIEW NOTICE "This report has been reviewed in the Federal Emergency Management Agency...Management Agency." SECURITY CLASSIFICATION OF ’.IS PAGE (When. Dot* f’Aor i . lb M INSTRUCTIONS REPORT DOCUENTATION PAGE BEOR COMPLETIORM I. REPORT NUMBER

  11. Emergency Response and Management Activities

    EPA Pesticide Factsheets

    This quarterly report, highlighting accomplishments over the past several months, showcases EPA’s unique emergency response capabilities through the use of cutting-edge technologies and innovative cleanup strategies.

  12. Applying business intelligence innovations to emergency management.

    PubMed

    Schlegelmilch, Jeffrey; Albanese, Joseph

    2014-01-01

    The use of business intelligence (BI) is common among corporations in the private sector to improve business decision making and create insights for competitive advantage. Increasingly, emergency management agencies are using tools and processes similar to BI systems. With a more thorough understanding of the principles of BI and its supporting technologies, and a careful comparison to the business model of emergency management, this paper seeks to provide insights into how lessons from the private sector can contribute to the development of effective and efficient emergency management BI utilisation.

  13. Helpful Hints for School Emergency Management: Steps for Developing a School Emergency Management Plan

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management:…

  14. Social media best practices in emergency management.

    PubMed

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

  15. Texas Emergency Resource Management. Volume I.

    DTIC Science & Technology

    1979-09-30

    and the transportation of essential supplies such as food and medical . FINDINGS 1. Basic operational concepts contain.d in the Texas Emer- gency...19. (Cont.) Economic Stabilization Health and Medical Petroleum, Gas and Solid Fuel Electric Power, Water Industrial Production Manpower...Government - State of Texas Emergency Resources Management Organization, Health and Medical , State to Local Government - State of Texas Emergency Resources

  16. Emergent management of scorpion sting.

    PubMed

    Kluz-Zawadzka, Jolanta; Hartman-Ksycińska, Anna; Lewandowski, Bogumił

    2014-01-01

    Scorpionism (syndrome of scorpion stings) is an important public health problem in many regions of the world, not only in tropics and subtropics. As scorpions may be unintentionally transported to any place in the world and keeping scorpions as pets is becoming more popular, scorpion stings occur also in Poland. Therefore, health professionals should have the knowledge on the management of scorpion stings. This article discusses a case who was stung by scorpion and proposes an algorithm of management with such patients.

  17. Emergency management of hyperemesis gravidarum.

    PubMed

    Summers, Anthony

    2012-07-01

    Most pregnant women experience morning sickness during the first 20 weeks of pregnancy. Often, the symptoms are mild, but recurring, nausea and vomiting; but the condition can also lead to dehydration, weight loss, electrolyte imbalance and blood volume depletion, and many women with more severe forms of the condition present to emergency departments. This article describes the presenting symptoms, causes of hyperemesis gravidarum, the associated clinical signs and complications, and the most common treatments offered.

  18. Framework for Real-Time All-Hazards Global Situational Awareness

    SciTech Connect

    Omitaomu, Olufemi A; Fernandez, Steven J; Bhaduri, Budhendra L

    2013-01-01

    Information systems play a pivotal role in emergency response by making consequence analysis models based on up-to-date data available to decision makers. While consequence analysis models have been used for years on local scales, their application on national and global scales has been constrained by lack of non-proprietary data. This chapter describes how this has changed using a framework for real-time all-hazards situational awareness called the Energy Awareness and Resiliency Standardized Services (EARSS) as an example. EARSS is a system of systems developed to collect non-proprietary data from diverse open content sources to develop a geodatabase of critical infrastructures all over the world. The EARSS system shows that it is feasible to provide global disaster alerts by producing valuable information such as texting messages about detected hazards, emailing reports about affected areas, estimating an expected number of impacted people and their demographic characteristics, identifying critical infrastructures that may be affected, and analyzing potential downstream effects. This information is provided in real-time to federal agencies and subscribers all over the world for decision making in humanitarian assistance and emergency response. The system also uses live streams of power outages, weather, and satellite surveillance data as events unfold. This, in turn, is combined with other public domain or open content information, such as media reports and postings on social networking websites, for complete coverage of the situation as events unfold. Working with up-to-date information from the EARSS system, emergency responders on the ground could pre-position their staff and resources, such as emergency generators and ice, where they are most needed.

  19. Texas Emergency Resource Management. Volume II.

    DTIC Science & Technology

    1979-09-30

    based on existing National and State plans. Urgent needs for resources that cannot be met from locally available supplies are reported to the...or his legal successor upon implementing crisis relocation of declaration of a national emergency for civil defense purposes by the President of the...mobilization, management and use of resources in crisis relocation situation or a nuclear emergency are set forth in the National Plan. b. State: In

  20. Hanford emergency management plan - release 15

    SciTech Connect

    CARPENTER, G.A.

    1999-07-19

    The Hanford emergency management plan for the US Department of Energy Richland, WA and Office of River Protection. The program was developed in accordance with DOE Orders as well as Federal and State regulations to protect workers and public health and safety.

  1. Special Population Planner for Emergency Management

    SciTech Connect

    2003-04-17

    The SPP is a tool for use by emergency management agencies in creating plans for possible events requiring their attention. It incorporates extensive data including those on special needs populations so that this segment of the population will be considered in general plans.

  2. Standardized emergency management system and response to a smallpox emergency.

    PubMed

    Kim-Farley, Robert J; Celentano, John T; Gunter, Carol; Jones, Jessica W; Stone, Rogelio A; Aller, Raymond D; Mascola, Laurene; Grigsby, Sharon F; Fielding, Jonathan E

    2003-01-01

    The smallpox virus is a high-priority, Category-A agent that poses a global, terrorism security risk because it: (1) easily can be disseminated and transmitted from person to person; (2) results in high mortality rates and has the potential for a major public health impact; (3) might cause public panic and social disruption; and (4) requires special action for public health preparedness. In recognition of this risk, the Los Angeles County Department of Health Services (LAC-DHS) developed the Smallpox Preparedness, Response, and Recovery Plan for LAC to prepare for the possibility of an outbreak of smallpox. A unique feature of the LAC-DHS plan is its explicit use of the Standardized Emergency Management System (SEMS) framework for detailing the functions needed to respond to a smallpox emergency. The SEMS includes the Incident Command System (ICS) structure (management, operations, planning/intelligence, logistics, and finance/administration), the mutual-aid system, and the multi/interagency coordination required during a smallpox emergency. Management for incident command includes setting objectives and priorities, information (risk communications), safety, and liaison. Operations includes control and containment of a smallpox outbreak including ring vaccination, mass vaccination, adverse events monitoring and assessment, management of confirmed and suspected smallpox cases, contact tracing, active surveillance teams and enhanced hospital-based surveillance, and decontamination. Planning/intelligence functions include developing the incident action plan, epidemiological investigation and analysis of smallpox cases, and epidemiological assessment of the vaccination coverage status of populations at risk. Logistics functions include receiving, handling, inventorying, and distributing smallpox vaccine and vaccination clinic supplies; personnel; transportation; communications; and health care of personnel. Finally, finance/administration functions include monitoring

  3. Using social media for disaster emergency management

    NASA Astrophysics Data System (ADS)

    Wang, Y. D.; Wang, T.; Ye, X. Y.; Zhu, J. Q.; Lee, J.

    2016-06-01

    Social media have become a universal phenomenon in our society (Wang et al., 2012). As a new data source, social media have been widely used in knowledge discovery in fields related to health (Jackson et al., 2014), human behaviour (Lee, 2014), social influence (Hong, 2013), and market analysis (Hanna et al., 2011). In this paper, we report a case study of the 2012 Beijing Rainstorm to investigate how emergency information was timely distributed using social media during emergency events. We present a classification and location model for social media text streams during emergency events. This model classifies social media text streams based on their topical contents. Integrated with a trend analysis, we show how Sina-Weibo fluctuated during emergency events. Using a spatial statistical analysis method, we found that the distribution patterns of Sina-Weibo were related to the emergency events but varied among different topics. This study helps us to better understand emergency events so that decision-makers can act on emergencies in a timely manner. In addition, this paper presents the tools, methods, and models developed in this study that can be used to work with text streams from social media in the context of disaster management.

  4. Barriers to managing TB in emergency departments.

    PubMed

    Morton, Rachel

    Improved management of tuberculosis is a key priority for Public Health England due to unacceptably high rates of the disease in the UK, particularly in London and other major cities. A survey of 20 staff in the acute medical unit at Queen Alexandra Hospital, Portsmouth, explored potential barriers to early TB detection and infection control in busy emergency departments. Low awareness and little familiarity with TB among many emergency admissions staff increased the likelihood of transmission from undiagnosed patients in crowded waiting areas. The study suggested regular updates on TB so staff could refresh their knowledge and awareness, and help improve TB detection and infection control.

  5. An Update on the Surgeons Scope and Depth of Practice to All Hazards Emergency Response

    DTIC Science & Technology

    2006-06-01

    anthrax, botulism, plague, smallpox, tularemia, and the viral hemorrhagic fevers (filoviruses, e.g. Ebola; arenaviruses , e.g. Lassa fever)8–22 that...Ebola, Marburg and arenaviruses e.g. Lassa, Machupo) Category B (second priority) Second highest priority agents include those that: Are

  6. Emergency department management of selected orthopedic injuries.

    PubMed

    Newton, Edward J; Love, John

    2007-08-01

    Rather than providing an encyclopedic review of extremity injuries, this article reviews selected serious injuries of the extremities that can be missed in the emergency department, either because they are relatively uncommon or because they are subtle in their clinical and radiographic presentation. They include injuries to the scapula, the shoulder, the forearm, the femur and hip, the knee, the tibia (which is the most common long bone fracture), and the ankle and foot. Their various causes include sports injuries, falls, and motor vehicle accidents. Several of these injuries can result in emergent complications or have time-dependent outcomes. Consequently, these injuries often must be managed by emergency physicians before specialist expertise becomes available.

  7. Emergency Management Computer-Aided Trainer (EMCAT)

    NASA Technical Reports Server (NTRS)

    Rodriguez, R. C.; Johnson, R. P.

    1986-01-01

    The Emergency Management Computer-Aided Trainer (EMCAT) developed by Essex Corporation or NASA and the Federal Emergency Management Administration's (FEMA) National Fire Academy (NFA) is described. It is a computer based training system for fire fighting personnel. A prototype EMCAT system was developed by NASA first using video tape images and then video disk images when the technology became available. The EMCAT system is meant to fill the training needs of the fire fighting community with affordable state-of-the-art technologies. An automated real time simulation of the fire situation was needed to replace the outdated manual training methods currently being used. In order to be successful, this simulator had to provide realism, be user friendly, be affordable, and support multiple scenarios. The EMCAT system meets these requirements and therefore represents an innovative training tool, not only for the fire fighting community, but also for the needs of other disciplines.

  8. Emergency Management. Functional Area Qualification Standard

    DTIC Science & Technology

    2004-01-01

    TS DOE– STD –1177-2004 January 2004 DOE STANDARD EMERGENCY MANAGEMENT FUNCTIONAL AREA QUALIFICATION STANDARD...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 DOE- STD -1177-2004 i This document has been reproduced directly from...Service, Springfield, VA 22161; (703) 605–6000. DOE- STD -1177-2004 ii APPROVAL The Federal Technical Capability Panel consists of senior U.S

  9. Computer Simulation for Emergency Incident Management

    SciTech Connect

    Brown, D L

    2004-12-03

    This report describes the findings and recommendations resulting from the Department of Homeland Security (DHS) Incident Management Simulation Workshop held by the DHS Advanced Scientific Computing Program in May 2004. This workshop brought senior representatives of the emergency response and incident-management communities together with modeling and simulation technologists from Department of Energy laboratories. The workshop provided an opportunity for incident responders to describe the nature and substance of the primary personnel roles in an incident response, to identify current and anticipated roles of modeling and simulation in support of incident response, and to begin a dialog between the incident response and simulation technology communities that will guide and inform planned modeling and simulation development for incident response. This report provides a summary of the discussions at the workshop as well as a summary of simulation capabilities that are relevant to incident-management training, and recommendations for the use of simulation in both incident management and in incident management training, based on the discussions at the workshop. In addition, the report discusses areas where further research and development will be required to support future needs in this area.

  10. Social Media in Emergency Management: Capability Assessment

    DTIC Science & Technology

    2014-05-01

    implementing an effective capability is resolving how to bridge the command-and- control , hierarchical culture of emergency management organizations to...intentionally left blank. ii DRDC-RDDC-2014-R16 Résumé …….. Les organismes de gestion des urgences et de première intervention de partout dans le...organismes de gestion des urgences n’ont pas encore pleinement adopté l’usage des médias sociaux. Dans le présent rapport, nous tentons de déterminer

  11. EMS incident management: emergency medical logistics.

    PubMed

    Maniscalco, P M; Christen, H T

    1999-01-01

    If you had to get x amount of supplies to point A or point B, or both, in 10 minutes, how would you do it? The answer lies in the following steps: 1. Develop a logistics plan. 2. Use emergency management as a partner agency for developing your logistics plan. 3. Implement a push logistics system by determining what supplies/medications and equipment are important. 4. Place mass casualty/disaster caches at key locations for rapid deployment. Have medication/fluid caches available at local hospitals. 5. Develop and implement command caches for key supervisors and managers. 6. Anticipate the logistics requirements of a terrorism/tactical violence event based on a community threat assessment. 7. Educate the public about preparing a BLS family disaster kit. 8. Test logistics capabilities at disaster exercises. 9. Budget for logistics needs. 10. Never underestimate the importance of logistics. When logistics support fails, the EMS system fails.

  12. Emergency medicine: an operations management view.

    PubMed

    Soremekun, Olan A; Terwiesch, Christian; Pines, Jesse M

    2011-12-01

    Operations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient-centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be "on the frontier," maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider.

  13. Emergency thoracic ultrasound and clinical risk management

    PubMed Central

    Interrigi, Maria Concetta; Trovato, Francesca M; Catalano, Daniela; Trovato, Guglielmo M

    2017-01-01

    Purpose Thoracic ultrasound (TUS) has been proposed as an easy-option replacement for chest X-ray (CXR) in emergency diagnosis of pneumonia, pleural effusion, and pneumothorax. We investigated CXR unforeseen diagnosis, subsequently investigated by TUS, considering its usefulness in clinical risk assessment and management and also assessing the sustainability of telementoring. Patients and methods This observational report includes a period of 6 months with proactive concurrent adjunctive TUS diagnosis telementoring, which was done using freely available smartphone applications for transfer of images and movies. Results Three hundred and seventy emergency TUS scans (excluding trauma patients) were performed and telementored. In 310 cases, no significant chest pathology was detected either by CXR, TUS, or the subsequent work-up; in 24 patients, there was full concordance between TUS and CXR (ten isolated pleural effusion; eleven pleural effusion with lung consolidations; and three lung consolidation without pleural effusion); in ten patients with lung consolidations, abnormalities identified by CXR were not detected by TUS. In 26 patients, only TUS diagnosis criteria of disease were present: in 19 patients, CXR was not diagnostic, ie, substantially negative, but TUS detected these conditions correctly, and these were later confirmed by computed tomography (CT). In seven patients, even if chest disease was identified by CXR, such diagnoses were significantly modified by ultrasound, and CT confirmed that TUS was more appropriate. The overall respective individual performances of CXR and TUS for the diagnosis of a pleural–pulmonary disease in emergency are good, with accuracy >95%. Conclusion About 20% of pneumonia cases were detectable only by CXR and 20% only by TUS and not by CXR; ie, about 40% of patients may have been misdiagnosed if, by chance, only one of the two tools had been used. The concurrent use of TUS and CXR increases the overall sensitivity and

  14. Emerging Technologies: Biosecurity and Consequence Management Implications

    NASA Astrophysics Data System (ADS)

    Perkins, Dana; Nordmann, Brian

    The natural outbreaks of disease and pandemics are transnational threats that create international challenges when detection and containment are not timely due to scarce human and material resources. Whether the cause of those outbreaks is natural or intentional in origin, the main goal of consequence management operations is to save lives. The consequence management process is a continuum of inter-connected phases such as planning, preparation, response, and recovery. The rapid advances of life sciences and the emergence of dual-use technologies such as synthetic biology and nanotechnology pose additional challenges in terms of planning for the unknown potential threats whether they may be synthetic microorganisms with unpredictable dissemination patterns or nanoscale-manipulated biological agents evading current detection capabilities. The US National Strategy for Countering Biological Threats is emphasizing prevention while continuing to support the national preparedness goals and response/recovery capabilities. The recent policies, guidelines, and recommendations on overhauling the biological risk management in the United States are a proactive stance to a rapidly changing global environment. They include optimization of the current oversight frameworks and active engagement of the industry and academia in order to reduce the risk that individuals with ill intent may exploit the commercial application of nucleic acid synthesis technology to access genetic material derived from or by encoding Biological Select Agents or Toxins. We are also actively seeking to increase our knowledge of health effects of various types of nanomaterials, and how to assess, control, and prevent harmful exposure, taking into consideration the numerous gaps that currently exist with regard to the distinct behavior of nanoparticles compared to the same chemical or material at "macro-scale". Fundamentally, a biological incident, whether it is of natural, accidental, or deliberate origin

  15. Critical asset and portfolio risk analysis: an all-hazards framework.

    PubMed

    Ayyub, Bilal M; McGill, William L; Kaminskiy, Mark

    2007-08-01

    This article develops a quantitative all-hazards framework for critical asset and portfolio risk analysis (CAPRA) that considers both natural and human-caused hazards. Following a discussion on the nature of security threats, the need for actionable risk assessments, and the distinction between asset and portfolio-level analysis, a general formula for all-hazards risk analysis is obtained that resembles the traditional model based on the notional product of consequence, vulnerability, and threat, though with clear meanings assigned to each parameter. Furthermore, a simple portfolio consequence model is presented that yields first-order estimates of interdependency effects following a successful attack on an asset. Moreover, depending on the needs of the decisions being made and available analytical resources, values for the parameters in this model can be obtained at a high level or through detailed systems analysis. Several illustrative examples of the CAPRA methodology are provided.

  16. Los Alamos National Laboratory emergency management plan. Revision 1

    SciTech Connect

    Ramsey, G.F.

    1998-07-15

    The Laboratory has developed this Emergency Management Plan (EMP) to assist in emergency planning, preparedness, and response to anticipated and actual emergencies. The Plan establishes guidance for ensuring safe Laboratory operation, protection of the environment, and safeguarding Department of Energy (DOE) property. Detailed information and specific instructions required by emergency response personnel to implement the EMP are contained in the Emergency Management Plan Implementing Procedure (EMPIP) document, which consists of individual EMPIPs. The EMP and EMPIPs may be used to assist in resolving emergencies including but not limited to fires, high-energy accidents, hazardous material releases (radioactive and nonradioactive), security incidents, transportation accidents, electrical accidents, and natural disasters.

  17. Emerging information management technologies and the future of disease management.

    PubMed

    Nobel, Jeremy J; Norman, Gordon K

    2003-01-01

    Disease management (DM) has become a widely accepted way to support care delivery in the chronically ill patient population. Patients enrolled in these programs have been shown to have better health, fewer complications and comorbidities, and lower health care costs. The development of advanced information management technologies is further enhancing the role DM plays in optimizing outcomes and cost-effectiveness in clinical care. These emerging information management technologies (EIMT) include advances in software, hardware, and networking, all of which share common impact attributes in their ability to improve cost-effectiveness of care, quality of care, and access to care. Specific examples include interactive websites with the ability to engage patients in the self-care management process, the embedding of biometric devices (digital scales, modem-enabled glucose meters in the home, blood pressure monitoring, etc.), workflow and care coordination programs that add intelligence via guideline-directed alerts and reminders to the delivery process, registries that include a summary of personal health data that can be used as a reference point for improved clinical decisions, and the systematic collection of aggregated, de-identified clinical, administrative, and cost data into comprehensive data sets to which predictive modeling analytic tools can be applied. By way of case example, we also present data from a controlled clinical trial utilizing EIMT in the form of home-based weight measurement using a digital scale and linkage to a care coordination center for the management of severe congestive heart failure. Outcome results on 85,515 patient-months of an aggregate commercial and Medicare continuously enrolled population demonstrated an average reduction of care utilization (hospitalization) of 57% and a reduction in related delivery cost (per member per year payments) of 55%. We conclude that EIMT have already begun to offer significant and quantifiable benefits

  18. Emergency medicine in pediatric dentistry: preparation and management.

    PubMed

    Malamed, Stanley F

    2003-10-01

    Medical emergencies can and do occur in the practice of dentistry. Although most emergencies take place in adults, serious problems can also develop in younger patients. The contemporary dentist must be prepared to manage expeditiously and effectively those few problems that do arise. Basic life support (as necessary) is all that is required to manage many emergency situations, with the addition of specific drug therapy in some others. Preparation of the office and staff includes basic life support (annually), pediatric advanced life support, development of an emergency team, consideration for emergency medical services, and the availability of emergency drugs and equipment with the ability to use these items effectively. As with the adult patient, effective management of pain (local anesthesia) and anxiety (behavioral management, conscious sedation) will minimize the development of medical emergencies.

  19. Quality assurance measurement for emergency management

    SciTech Connect

    Pawlowski, M.S.

    1993-12-31

    Under the Federal Civil Defense Act of 1950, as amended, the Federal Emergency Management Agency (FEMA) is charged with maintenance of a nationwide inventory of 4.3 million radiological instruments procured and granted by the federal government to state and local governments. These instruments are used by trained state Radiological Response Team Members, first responders, and critical workers to support the population from a national security or large-scale peacetime radiological disaster, e.g., Chernobyl, Three Mile Island, Satellite Reentry, etc. The inventory is maintained through a network of 100% federally funded state maintenance and calibration facilities, with overall technical guidance and standardization provided by the FEMA Radiological Instrumentation Test Facility. The system used to support maintenance and standardized calibration of the inventory consists of CDV-794 Radiation Calibrator (High Range), CDV-765 Model 2 Gamma Transfer Standard, CDV-790 Model 1 Calibrator (Low Range), and Dosimeter Transfer Standards. Past studies have indicated the {open_quotes}Readiness{close_quotes} and {open_quotes}Reliability{close_quotes} of the inventory to meet mission requirements based upon a standardized system of maintenance and calibration. FEMA has just initiated a new instrument Readiness and Reliability study with the State of Ohio Radiological Instrument Maintenance and Calibration Program to provide data to reassess the capability of the current inventory to support all types of peacetime and national security missions.

  20. Special event planning for the emergency manager.

    PubMed

    Gaynor, Peter T

    2009-11-01

    In the domain of emergency management and homeland security there is a lack of a formal planning process at the local level when it comes to special event planning. The unique nature of special event planning demands an understanding of the planning process for both traditional and non-traditional planning partners. This understanding will make certain that local governments apply due diligence when planning for the safety of the public. This paper offers a practical roadmap for planning at the local level. It will address those 'special events' that are beyond routine local events but not of a sufficient scale to be granted National Special Security Event status. Due to the infrequency of 'special events' in most communities, it is imperative that deliberate planning takes place. Upon conclusion, the reader will be able to construct a planning process tailored to the needs of their community, guide both traditional and non-traditional planning partners through the planning process, determine priorities, explore alternatives, plan for contingencies, conduct a confirmation brief, facilitate operations and assemble an after-action report and improvement plan.

  1. [Emergency treatment and management of anaphylaxis].

    PubMed

    Brockow, K; Ring, J

    2013-02-01

    Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. In anaphylaxis with primarily cardiovascular involvement, epinephrine is the treatment of choice and given together with volume substitution, oxygen, H(1)-antihistamines and corticosteroids. Obstruction of the airways is treated with intramuscular and inhaled epinephrine, or alternatively β(2)-sympathicomimetics, and oxygen. Abdominal or cutaneous involvement, such as generalized urticaria, usually can be treated with intravenous H(1)-antihistamines, glucocorticoids and surveillance. In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis.

  2. All Hazards Risk Assessment Transition Project: Report on Capability Assessment Management System (CAMS) Automation

    DTIC Science & Technology

    2014-04-01

    utilisés pour rassembler les exigences nécessaires à la mise au point du système de gestion de l’évaluation des capacités (Capability Assessment...comparaison et l’analyse des écarts et des exigences en matière de capacité à l’échelle du spectre de la gestion des urgences. 1 2 Table of...30 7.1.1.4 User Access Controls

  3. Action Guide for Emergency Management at Institutions of Higher Education

    ERIC Educational Resources Information Center

    Office of Safe and Drug-Free Schools, US Department of Education, 2010

    2010-01-01

    This "Action Guide for Emergency Management at Higher Education Institutions" has been developed to give higher education institutions a useful resource in the field of emergency management. It is intended for community colleges, four-year colleges and universities, graduate schools, and research institutions associated with higher education…

  4. Information management in the emergency department.

    PubMed

    Taylor, Todd B

    2004-02-01

    Information system planning for the ED is complex and new to emergency medicine, despite being used in other industries for many years. It has been estimated that less than 15% of EDs have comprehensive EDIS currently in place. The manner in which administration is approached in large part determines the success in obtaining appropriate institutional support for an EDIS. Active physician and nurse involvement is essential in the process if the new system is to be accepted at the user level. In the ED, large volumes of information are collected, collated,interpreted, and acted on immediately. Effective information management therefore is key to the successful operation of any ED. Although computerized information systems have tremendous potential for improving information management, such systems are often underused or implemented in such a way that they increase the workload on caregivers and staff. This is counter productive and should be avoided. In developing and implementing EDIS one should be careful not to automate poorly designed manual processes. Examples are ED tracking systems that require staff to manually relocate patients in the system. This task probably is completed only when the ED volume is low and "worked around" when the department is busy. Information from such a system is, therefore, flawed; at best useless and at worst counter productive. Alternatively, systems are available that can track patients automatically through the ED by way of infrared sensors similar to those used in baggage-tracking systems that have been in place in airports for years. In the automated (computerized) ED, we must have zero-fault-tolerant,enterprise-wide, hospital information networked systems that prevent unnecessary duplication of tasks, assist in tracking and entering data, and ultimately help analyze the information on a minute-to-minute basis. Such systems only reach their potential when they are fully integrated, including legacy systems, rather than stand

  5. Municipal resilience: A paradigm shift in emergency and continuity management.

    PubMed

    Solecki, Greg; Luchia, Mike

    More than a decade of emergency and continuity management vision was instrumental in providing the unprecedented level of response and recovery from the great flood of 2013. Earlier assessments, planning and validation promulgated development of corporate continuity, emergency and contingency plans along with tactical, strategic and recovery operations centres that all led to a reliable emergency management model that will continue to provide the backbone for municipal resilience.

  6. Establishing functional requirements for emergency management information systems

    SciTech Connect

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  7. Steps for Developing a School Emergency Management Plan. Helpful Hints for School Emergency Management. Volume 2, Issue 1

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    The U.S. Department of Education's Office of Safe and Drug-Free Schools strongly encourages schools and school districts to develop emergency management plans within the context of the four phases of emergency management: prevention, mitigation, preparedness, response and recovery. In addition, schools should collaborate closely with police, fire…

  8. Emergency inventory management for disasters--a review.

    PubMed

    Ozguven, Eren Erman; Ozbay, Kaan

    2014-01-01

    There has been a recent surge in the publication of academic literature examining various aspects of emergency inventory management for disasters. This article contains a timely literature review of these studies, beginning with an exposition of the characteristics of storage and delivery options for emergency supplies, with a particular emphasis on the differences between emergency inventories and conventional inventory management. Using a novel classification scheme and a comprehensive search of the inventory related literature, an overview of the emergency inventory management studies is also presented. Finally, based on this extensive review, a discussion is presented based on the critical issues and key findings related to the emergency inventory management field, and include suggestions for future research directions.

  9. The Emerging Phenomenon of Knowledge Management.

    ERIC Educational Resources Information Center

    Broadbent, Marianne

    1997-01-01

    Clarifies the meaning of knowledge management and gives examples of organizations that overtly practice it. Outlines four steps in knowledge management: (1) making knowledge visible; (2) building knowledge intensity; (3) building knowledge infrastructure; and (4) developing a knowledge culture. Discusses managing people as assets, librarians as…

  10. Emergency Preparedness--The Role of the School Nurse. Position Statement

    ERIC Educational Resources Information Center

    Cagginello, Joan B.; Clark, Sandra; Compton, Linda; Davis, Catherine; Healy, Marilyn; Hoffmann, Susan; Tuck, Christine M.

    2011-01-01

    It is the position of the National Association of School Nurses (NASN) that school nurses provide leadership in all phases of emergency preparedness and management and are a vital part of the school team that develops emergency response procedures for the school setting, using an all-hazards approach. The school nurse is a vital school…

  11. Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

    PubMed

    Carpenter, Christopher R; Platts-Mills, Timothy F

    2013-02-01

    Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care.

  12. Diagnosis and management of spinal cord emergencies.

    PubMed

    Flanagan, E P; Pittock, S J

    2017-01-01

    Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap. Neurologic deficits are often severe and may quickly become irreversible, highlighting the importance of early diagnosis and treatment. Emergent magnetic resonance imaging (MRI) of the entire spine is the imaging modality of choice for nontraumatic spinal cord emergencies and helps differentiate extramedullary compressive causes (e.g., epidural abscess, metastatic compression, epidural hematoma) from intramedullary etiologies (e.g., transverse myelitis, infectious myelitis, or spinal cord infarct). The MRI characteristics may give a clue to the diagnosis (e.g., flow voids dorsal to the cord in dural arteriovenous fistula). However, additional investigations (e.g., aquaporin-4-IgG) are often necessary to diagnose intramedullary etiologies and guide treatment. Emergency decompressive surgery is necessary for many extramedullary compressive causes, either alone or in combination with other treatments (e.g., radiation) and preoperative neurologic deficit is the best predictor of outcome.

  13. Managing Emerging Contaminant Risks: Plans & Progress

    DTIC Science & Technology

    2010-06-01

    Management Options (RMOs) approved…now underway or completed as Risk Management Actions (RMAs) – Beryllium, sulfur hexafluoride , hexavalent chromium...Award Acquisition, Technology and Logistics 5 EC Watch List  Tungsten alloys • Sodium Tungstate Tetrachloroethylene (PCE) Dioxin 1,4-dioxane...Chromium (Cr6+) Naphthalene …may move to watch list Beryllium (Be) Sulfur Hexafluoride (SF6) • Lead…added in Oct 09 Note: - Some risk management

  14. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal...

  15. SecureCore Security Architecture: Authority Mode and Emergency Management

    DTIC Science & Technology

    2007-10-16

    Dan C. Boger Department of Computer Science Interim Associate Provost and...Emergency Management 13 V. References [1] Boneh , D. and Franklin, M. “Identity based encryption from the Weil pairing.” SIAM J. of Computing, Vol. 32

  16. Increasing access and support for emergency management higher education programs.

    PubMed

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

  17. How do emergency managers use social media platforms?

    PubMed

    Bennett, DeeDee M

    2014-01-01

    Social media platforms are increasingly becoming a useful tool for victims, humanitarians, volunteers, and the general public to communicate during disasters. Research has shown that there are multiple advantages to using social media and the applicability of these platforms crosses several different types of disasters (human-caused, natural, and terrorist) here in the United States and abroad. However, some emergency management agencies have been reluctant to use social media as one of their many communications tools. In this study, the usefulness of social media for emergency management was examined over a 30-day period following a series of tornadoes. Using an observational approach, the public posts disseminated from an emergency management agency were analyzed to determine how two social media platforms were used. The findings show how emergency management agencies could leverage the connectedness of social media to reach victims and make unlikely partnerships.

  18. Challenges for lupus management in emerging countries.

    PubMed

    Tazi Mezalek, Zoubida; Bono, Wafaa

    2014-06-01

    In emerging countries, systemic lupus erythematosus (SLE) has been associated with several unfavorable outcomes including disease activity, damage accrual, work disability and mortality. Poor socioeconomic status (SES) and lack of access to healthcare, especially in medically underserved communities, may be responsible for many of the observed disparities. Diagnostic delay of SLE or for severe organ damages (renal involvement) have a negative impact on those adverse outcomes in lupus patients who either belong to minority groups or live in emerging countries. Longitudinal and observational prospective studies and registries may help to identify the factors that influence poor SLE outcomes in emerging countries. Infection is an important cause of mortality and morbidity in SLE, particularly in low SES patients and tuberculosis appears to be frequent in SLE patients living in endemic areas (mainly emerging countries). Thus, tuberculosis screening should be systematically performed and prophylaxis discussed for patients from these areas. SLE treatment in the developing world is restricted by the availability and cost of some immunosuppressive drugs. Moreover, poor adherence has been associated to bad outcomes in lupus patients with a higher risk of flares, morbidity, hospitalization, and poor renal prognosis. Low education and the lack of money are identified as the main barrier to improve lupus prognosis. Newer therapeutic agents and new protocols had contributed to improve survival in SLE. The use of corticoid-sparing agents (hydroxychloroquine, methotrexate, azathioprine and mycophenolate mofetif) is one of the most useful strategy; availability of inexpensive generics may help to optimize access to these medications.

  19. Recommendations for Emergency Management Planning for School Facilities.

    ERIC Educational Resources Information Center

    Texas Education Agency, Austin.

    Numerous events, such as hurricanes, floods, and tornadoes, constitute a natural disaster for public schools. Human-caused disasters include hazardous-material emergencies, civil riots, fires, and nuclear accidents. This document contains emergency-management planning guidelines, developed by the Texas Education Agency, to help local school…

  20. The Role of Spatial Information Systems in Environmental Emergency Management.

    ERIC Educational Resources Information Center

    Mondschein, Lawrence G.

    1994-01-01

    Reviews the use of spatial data and information technology by environmental managers and emergency responders. Discussion includes environmental legislation, the Toxic Chemical Release Inventory (TRI) database, public access to environmental information, information standardization problems, emergency response software development and a case study…

  1. MS ANTWERPEN: Emergency Management Training for Low-Risk Environments

    ERIC Educational Resources Information Center

    Strohschneider, Stefan; Gerdes, Jurgen

    2004-01-01

    Emergency management training programs have been developed mostly for trainees from high-risk environments such as aviation or the chemical industry. This article describes a training program for staff members from low-risk environments such as hospitals or hotels, where the awareness of potential dangers is usually low and emergency plans are…

  2. Federal Emergency Management Agency: An Organization Prepared

    DTIC Science & Technology

    2008-12-12

    time, FEMA continued its efforts and the Department of Housing and Urban Development (DHUD) made funds available for “ buyouts ” to encourage...many that has completely changed FEMA’s approach to disaster management. Today, FEMA is a learning and growing organization. This evolution from...management. FEMA is a better organization today than ever in their history but this improvement on the national level has come at the price of less

  3. Emergency management: Implementing a new strategy

    SciTech Connect

    Indelicato, G.

    1997-09-01

    Many of the problems resulting from a release incident stem from lack of preparation for such incidents; lack of control and coordination of the activities performed during the incident response; and mistaken assumptions regarding responsibility for the clean up. One unique approach to this type of situation addresses these and other issues thereby facilitating the primary objectives of cost control and incident closure. The Arrowhead Concept{reg_sign} to emergency response separates a release incident into two main phases: response phase and resolution phase. Each phase has three stages or activities. The response phase is the part of the incident that is typically performed under emergency conditions; it is urgent and fast-paced, with the need for a lot of decisions to be made without a lot of information. This phase is broken down into three concurrent activities: initial communication and coordination; release containment and control (abatement); and regulatory notification and negotiation.

  4. Emergency Management: A National Perspective. 1

    DTIC Science & Technology

    1989-06-01

    support. The one obvious exception was the Environmental Protection Agency (EPA) - created as a result of a great public groundswell and born and bred in...Hazard Reduction (1978) # 9 National Fire Prevention and Control # 7 Warning and Emergency Broadcast (t977) (Commerce)_______(1973) __ Same Devid Mcd...something of a small miracle that FEMA even survived, and that isn’t appreciated." In the face of great opposition to the very existence of the agency

  5. 77 FR 43100 - Privacy Act of 1974; Department of Homeland Security, Federal Emergency Management Agency-009...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-23

    ... Agency--2006--0002 National Emergency Management Information System (NEMIS)--Mitigation (MT) Electronic... of records titled, ``DHS/FEMA--2006--0002 National Emergency Management Information System (NEMIS... the process for reviewing information technology under the National Emergency Management...

  6. Architecture for a Generalized Emergency Management Software System

    SciTech Connect

    Hoza, Mark; Bower, John C.; Stoops, LaMar R.; Downing, Timothy R.; Carter, Richard J.; Millard, W. David

    2002-12-19

    The Federal Emergency Management Information System (FEMIS) was originally developed for the Chemical Stockpile Emergency Preparedness Program (CSEPP). It has evolved from a CSEPP-specific emergency management software system to a general-purpose system that supports multiple types of hazards. The latest step in the evolution is the adoption of a hazard analysis architecture that enables the incorporation of hazard models for each of the hazards such that the model is seamlessly incorporated into the FEMIS hazard analysis subsystem. This paper describes that new architecture.

  7. Approaches to emergency management teaching at the master's level.

    PubMed

    Alexander, David

    2013-01-01

    Training and education enable emergency managers to deal with complex situations, create durable networks of people with appropriate expertise, and ensure that knowledge is utilized to improve resilience in the face of disaster risk. Although there is a discrete literature on emergency management training, few attempts have been made to create an overview that discusses the key issues and proposes a standardized approach. This article examines the nature of training and education in emergency and disaster management. It analyzes the composition and requirements of courses at the master's degree level, which is considered to be the most appropriate tier for in-depth instruction in this field. This article defines "training" and "education" in the context of emergency management courses. It reviews the developing profile of the emergency manager in the light of training requirements. This article examines the question of whether emergency management is a branch of management science or whether it is something distinct and separate. Attention is given to the composition of a core curriculum and to the most appropriate pedagogical forms of delivering it. The article reviews the arguments for and against standardization of the curriculum and describes some of the pedagogical methods for delivering courses. Briefly, it considers the impact on training and education of new pedagogic methods based on information technology. It is concluded that the master's level is particularly suited to emergency and crisis management education, as it enables students to complement the in-depth knowledge they acquired in their disciplinary first degrees with a broader synthetic approach at the postgraduate level. Some measures of standardization of course offerings are desirable, in favor of creating a core curriculum that will ensure that essential core knowledge is imparted. Education and training in this field should include problem-solving approaches that enable students to learn

  8. Updating and Maintaining School Emergency Management Plans. Helpful Hints for School Emergency Management. Volume 2, Issue 3, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. Developing and implementing comprehensive, multi-hazard emergency management plans is an ongoing process that must be consistently reinforced and strengthened. Opportunities for reviewing, strengthening and updating…

  9. Acute Chest Pain: Emergency Evaluation and Management

    PubMed Central

    Walker, David M. C.

    1982-01-01

    Since cardiovascular and pulmonary disorders have significant morbidity and mortality, triage of patients who complain of chest pain is paramount. The less sophisticated the triage system, the more important the protocol should be to have these patients evaluated immediately. History and physical are still the most important diagnostic tools; information should be gathered from all available sources. Advanced cardiac life support training is most useful. Eight diagnostic classifications are described, together with the distinctions of onset, duration, location, radiation, precipitating and relieving factors, character and associated symptoms. The protocol for initial management is outlined, emphasizing coincident management wherever possible. Imagesp2005-a PMID:21286539

  10. Developing Higher Education Programs in Emergency Management: Ghana's Experience

    ERIC Educational Resources Information Center

    Yakubu, Mariama Bisongu

    2013-01-01

    Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…

  11. The Emerging Role of Women in Management: A Bibliography.

    ERIC Educational Resources Information Center

    Pask, Judith M., Comp.

    The role of women in management has become a topic of interest and importance during the last few years. This bibliography was compiled as a contribution to the Krannert Graduate School of Industrial Administration's seminar, The Emerging Role of Women in Management, held March 19, 1976. The materials included have been limited to those dealing…

  12. Managing mastitis in the emergency department.

    PubMed

    Summers, Anthony

    2011-10-01

    Mastitis is a common clinical condition and, although not exclusive to lactating mothers, most patients with the condition seen by clinical staff fall into this group. Between 3 and 33 per cent of lactating mothers experience an episode of mastitis (Academy of Breastfeeding Medicine 2008, Jahanfar et al 2009). Most of these mothers receive treatment from their midwives or GPs, but some attend EDs and require treatment for, and education about, the condition from emergency care staff, including nurse practitioners (NPs). This article describes mastitis and the various treatment measures, and aims to improve NPs' ability and confidence in recognising and treating the condition.

  13. Appraisal of Scientific Resources for Emergency Management.

    DTIC Science & Technology

    1983-09-01

    scientific, technical, and management skills. These included entomology , toxicology, public health, environmental impact analysis, economic analysis...Legionnaire’s Disease, Microbiology, chemical analysis & epidem- 1976 iology studies essential. 7. Medfly Controversy, 1981 Entomology , toxicology...Analytical 2. Inorganic 3. Organic 4. Physical 5. Nuclear 6. Forensic 7. Ordnance 8. Drugs 9. Narcotics 10. Chemical Warfare Agents 11. Insecticides

  14. Emerging Environmental Management Curricula in Minnesota

    ERIC Educational Resources Information Center

    Naylon, Michael J.

    1971-01-01

    Defined is the need for implementation of programs intended to restore and/or maintain wildlife populations on a self-renewing, self-sustaining basis. Development of environmental management concepts, understandings, activities, and lesson ideas is explained accompanied by schematic drawings. (BL)

  15. Emergency managers as change agents: recognizing the value of management, leadership, and strategic management in the disaster profession.

    PubMed

    Urby, Heriberto; McEntire, David A

    2015-01-01

    This article discusses the influence of management theory, some principles of leadership, four strategic management considerations, that are applied to emergency management, allow emergency managers to transform their followers, organizations, and communities at large. The authors argue that in the past there has been little recognition of the value, or application, of these three areas of emphasis in the disaster profession. Using more of these principles, emergency managers may transform into transformational change agents who make a difference in their followers' lives, who themselves transform other people and improve emergency management.

  16. Emergency department management of seizures in pediatric patients.

    PubMed

    Santillanes, Genevieve; Luc, Quyen

    2015-03-01

    Seizures account for 1% of all emergency department visits for children, and the etiologies range from benign to life-threatening. The challenge for emergency clinicians is to diagnose and treat the life-threatening causes of seizures while avoiding unnecessary radiation exposure and painful procedures in patients who are unlikely to have an emergent pathology. When treating patients in status epilepticus, emergency clinicians are also faced with the challenge of choosing anticonvulsant medications that will be efficacious while minimizing harmful side effects. Unfortunately, evidence to guide the evaluation and management of children presenting with new and breakthrough seizures and status epilepticus is limited. This review summarizes available evidence and guidelines on the diagnostic evaluation of first-time, breakthrough, and simple and complex febrile seizures. Management of seizures in neonates and seizures due to toxic ingestions is also reviewed.

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

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

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

  18. Managing marine disease emergencies in an era of rapid change

    PubMed Central

    Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B.; Dobson, Andy; Friedman, Carolyn S.; Froelich, Brett; Garren, Melissa; Gulland, Frances M. D.; Heron, Scott F.; Noble, Rachel T.; Revie, Crawford W.; Shields, Jeffrey D.; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C. Drew

    2016-01-01

    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. PMID:26880835

  19. Managing marine disease emergencies in an era of rapid change.

    PubMed

    Groner, Maya L; Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B; Dobson, Andy; Friedman, Carolyn S; Froelich, Brett; Garren, Melissa; Gulland, Frances M D; Heron, Scott F; Noble, Rachel T; Revie, Crawford W; Shields, Jeffrey D; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C Drew

    2016-03-05

    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require.

  20. A framework for modeling emerging diseases to inform management

    USGS Publications Warehouse

    Russell, Robin E.; Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan

    2017-01-01

    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

  1. A Framework for Modeling Emerging Diseases to Inform Management

    PubMed Central

    Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan H.C.

    2017-01-01

    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge. PMID:27983501

  2. CDC's Emergency Management Program activities - worldwide, 2003-2012.

    PubMed

    2013-09-06

    In 2003, recognizing the increasing frequency and complexity of disease outbreaks and disasters and a greater risk for terrorism, CDC established the Emergency Operations Center (EOC), bringing together CDC staff members who respond to public health emergencies to enhance communication and coordination. To complement the physical EOC environment, CDC implemented the Incident Management System (IMS), a staffing structure and set of standard operational protocols and services to support and monitor CDC program-led responses to complex public health emergencies. The EOC and IMS are key components of CDC's Emergency Management Program (EMP), which applies emergency management principles to public health practice. To enumerate activities conducted by the EMP during 2003-2012, CDC analyzed data from daily reports and activity logs. The results of this analysis determined that, during 2003-2012, the EMP fully activated the EOC and IMS on 55 occasions to support responses to infectious disease outbreaks, natural disasters, national security events (e.g., conventions, presidential addresses, and international summits), mass gatherings (e.g., large sports and social events), and man-made disasters. On 109 other occasions, the EMP was used to support emergency responses that did not require full EOC activation, and the EMP also conducted 30 exercises and drills. This report provides an overview of those 194 EMP activities.

  3. Business continuity management in emerging markets: the case of Jordan.

    PubMed

    Sawalha, Ihab H; Anchor, John R

    2012-01-01

    Despite their considerable growth in last few decades, emerging markets (EM) face numerous risks that have the potential to slow down or obstruct their development. Three main issues are discussed in this paper: first, the risks facing organisations operating in emerging markets and Jordan in particular; secondly, the role of business continuity management (BCM) in emerging markets; and thirdly, potential factors that underpin the role of BCM in emerging markets. These issues are significant, as they represent the role of BCM in highly dynamic and fast changing business environments. The paper provides a discussion of the significance of BCM in reducing or preventing risks facing organisations operating in emerging markets, especially those in Jordan.

  4. A Risk Management Architecture for Emergency Integrated Aircraft Control

    NASA Technical Reports Server (NTRS)

    McGlynn, Gregory E.; Litt, Jonathan S.; Lemon, Kimberly A.; Csank, Jeffrey T.

    2011-01-01

    Enhanced engine operation--operation that is beyond normal limits--has the potential to improve the adaptability and safety of aircraft in emergency situations. Intelligent use of enhanced engine operation to improve the handling qualities of the aircraft requires sophisticated risk estimation techniques and a risk management system that spans the flight and propulsion controllers. In this paper, an architecture that weighs the risks of the emergency and of possible engine performance enhancements to reduce overall risk to the aircraft is described. Two examples of emergency situations are presented to demonstrate the interaction between the flight and propulsion controllers to facilitate the enhanced operation.

  5. Management of cluster headache in the Emergency Department.

    PubMed

    Di Sabato, Francesco; Giacovazzo, Mario

    2005-09-01

    Although cluster headache (CH) is considered one of the most distinctive and painful primary headache disorders in clinical practice because of the brevity of each attack, its management is not always ergonomic or possible in the Emergency Department. In case of a previously competent diagnosis, the Emergency Department's team should send the patient to a headache centre where specialists in the management of CH can handle the pathology in the best way. In our headache centre we treat patients with CH attacks with a hyperbaric chamber, confirming the effectiveness of hyperbaric oxygen in CH patients.

  6. Handling Emergency Management in [an] Object Oriented Modeling Environment

    NASA Technical Reports Server (NTRS)

    Tokgoz, Berna Eren; Cakir, Volkan; Gheorghe, Adrian V.

    2010-01-01

    It has been understood that protection of a nation from extreme disasters is a challenging task. Impacts of extreme disasters on a nation's critical infrastructures, economy and society could be devastating. A protection plan itself would not be sufficient when a disaster strikes. Hence, there is a need for a holistic approach to establish more resilient infrastructures to withstand extreme disasters. A resilient infrastructure can be defined as a system or facility that is able to withstand damage, but if affected, can be readily and cost-effectively restored. The key issue to establish resilient infrastructures is to incorporate existing protection plans with comprehensive preparedness actions to respond, recover and restore as quickly as possible, and to minimize extreme disaster impacts. Although national organizations will respond to a disaster, extreme disasters need to be handled mostly by local emergency management departments. Since emergency management departments have to deal with complex systems, they have to have a manageable plan and efficient organizational structures to coordinate all these systems. A strong organizational structure is the key in responding fast before and during disasters, and recovering quickly after disasters. In this study, the entire emergency management is viewed as an enterprise and modelled through enterprise management approach. Managing an enterprise or a large complex system is a very challenging task. It is critical for an enterprise to respond to challenges in a timely manner with quick decision making. This study addresses the problem of handling emergency management at regional level in an object oriented modelling environment developed by use of TopEase software. Emergency Operation Plan of the City of Hampton, Virginia, has been incorporated into TopEase for analysis. The methodology used in this study has been supported by a case study on critical infrastructure resiliency in Hampton Roads.

  7. Managing aggression in the emergency department: promoting an interdisciplinary approach.

    PubMed

    Rintoul, Yvonne; Wynaden, Dianne; McGowan, Sunita

    2009-04-01

    Incidents of aggression are frequent occurrences in hospitals, particularly the emergency department. Aggression creates instability in the environment, impacts on patient care outcomes and leads to increased levels of stress in staff. Regular exposure to aggression in the workplace can have detrimental effects on health professionals' ongoing quality of life. The emergency department is a gateway to care and is heavily populated 24h a day. Therefore, it is essential that all health professionals are confident and well prepared to manage aggression. Based upon a review of the literature this paper outlines the causes of aggression and provides an interdisciplinary action plan for intervening with aggressive patients in the emergency department. The importance of interdisciplinary ownership and the well planned management of aggression are outlined. When well managed, the impact of aggression can be limited. Stability in the emergency department ensures that health professionals can be responsive to the community's needs for emergency care. This leads to the provision of effective and timely care and a stable work environment for all health professionals.

  8. Infant Trauma Management in the Emergency Department: An Emergency Medicine Simulation Exercise

    PubMed Central

    Mathieson, Sarah; Whalen, Desmond

    2015-01-01

    In a trauma situation, it is essential that emergency room physicians are able to think clearly, make decisions quickly and manage patients in a way consistent with their injuries. In order for emergency medicine residents to adequately develop the skills to deal with trauma situations, it is imperative that they have the opportunity to experience such scenarios in a controlled environment with aptly timed feedback. In the case of infant trauma, sensitivities have to be taken that are specific to pediatric medicine. The following describes a simulation session in which trainees were tasked with managing an infantile patient who had experienced a major trauma as a result of a single vehicle accident. The described simulation session utilized human patient simulators and was tailored to junior (year 1 and 2) emergency medicine residents. PMID:26487992

  9. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  10. EMERGING TECHNOLOGIES FOR THE MANAGEMENT AND UTILIZATION OF LANDFILL GAS

    EPA Science Inventory

    The report gives information on emerging technologies that are considered to be commercially available (Tier 1), currently undergoing research and development (Tier 2), or considered as potentially applicable (Tier 3) for the management of landfill gas (LFG) emissions or for the ...

  11. Emergency Management Instruction. Instructor's Guide for Grades 7-9.

    ERIC Educational Resources Information Center

    North Carolina State Div. of Emergency Management, Raleigh.

    Emergency Management education seeks to give students basic information about natural and man-made disasters, preparedness procedures, and survival techniques. The intent of this guide is to aid teachers in presenting disaster survival instruction in the junior high school grades. The materials are designed to supplement existing curricula, where…

  12. Emergency management and homeland security: Exploring the relationship.

    PubMed

    Kahan, Jerome H

    2015-01-01

    In the years after the 9/11 tragedy, the United States continues to face risks from all forms of major disasters, from potentially dangerous terrorist attacks to catastrophic acts of nature. Professionals in the fields of emergency management and homeland security have responsibilities for ensuring that all levels of government, urban areas and communities, nongovernmental organizations, businesses, and individual citizens are prepared to deal with such hazards though actions that reduce risks to lives and property. Regrettably, the overall efficiency and effectiveness of the nation's ability to deal with disasters is unnecessarily challenged by the absence of a common understanding on how these fields are related in the workforce and educational arenas. Complicating matters further is the fact that neither of these fields has developed agreed definitions. In many ways, homeland security and emergency management have come to represent two different worlds and cultures. These conditions can have a deleterious effect on preparedness planning for public and private stakeholders across the nation when coordinated responses among federal, state, and local activities are essential for dealing with consequential hazards. This article demonstrates that the fields of emergency management and homeland security share many responsibilities but are not identical in scope or skills. It argues that emergency management should be considered a critical subset of the far broader and more strategic field of homeland security. From analytically based conclusions, it recommends five steps that be taken to bring these fields closer together to benefit more from their synergist relationship as well as from their individual contributions.

  13. Seeking Accountability through State-Appointed Emergency District Management

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2013-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This article analyzes…

  14. Privacy Impact Assessment for the Emergency Management Portal

    EPA Pesticide Factsheets

    The Emergency Management Portal System collects cleanup site data, and personnel readiness data. Learn how this data will be collected in the system, how it will be used, access to the data, the purpose of data collection, and record retention policies.

  15. Optimising the management of pulmonary arterial hypertension patients: emergency treatments.

    PubMed

    Delcroix, M; Naeije, R

    2010-09-01

    Pulmonary arterial hypertension (PAH) is a rare and potentially fatal disease whose management is usually restricted to a few specialised centres. As patients do not necessarily live in the neighbourhood of these centres, daily care and emergencies have to be delegated to first and second lines. Treatment guidelines do not usually provide recommendations for acute emergency situations as evidence is scarce. This short review provides a description of our therapeutic protocols based on available data. A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described. Thereafter, based on an analysis of the reasons of death in the PAH population, a review of the main emergencies is provided. Cardiac arrest and resuscitation, decompensated right heart failure, respiratory failure, arrhythmia, pericardial effusion, haemoptysis, surgery and drug-related adverse events will be discussed successively. Case reports showing the precariousness of PAH patients will enforce our thesis of the need for optimal patient management organisation.

  16. Improving the safety of remote site emergency airway management.

    PubMed

    Wijesuriya, Julian; Brand, Jonathan

    2014-01-01

    Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations. The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist's responsibilities regarding checks and maintenance. Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources. Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications

  17. The application of supply chain management principles to emergency management logistics: An empirical study.

    PubMed

    Peterson, Matthew R; Young, Richard R; Gordon, Gary A

    2016-01-01

    Key elements of supply chain theory remain relevant to emergency management (EM) logistics activities. The Supply Chain Operations Reference model can also serve as a useful template for the planning, organizing, and execution of EM logistics. Through a series of case studies (developed through intensive survey of organizations and individuals responsible for EM), the authors identified the extent supply chain theory is being adopted and whether the theory was useful for emergency logistics managers. The authors found several drivers that influence the likelihood of an organization to implement elements of supply chain management: the frequency of events, organizational resources, population density, range of events, and severity of the disaster or emergency.

  18. Review article: Crisis resource management in emergency medicine.

    PubMed

    Carne, Belinda; Kennedy, Marcus; Gray, Tim

    2012-02-01

    Effective team management is a core element of expert practice in emergency medicine. Thus far, training in emergency medicine has focussed predominantly on proficiency in medical and technical skills, with emergency physicians acquiring these 'non-technical' skills in an ad hoc manner or by trial and error with varying levels of success. This paper describes a set of behaviours that, when practised in conjunction with medical and technical expertise, can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of an ED. Teaching and practice of these behaviours is now a core element of training and skills maintenance in other high-risk areas, such as aviation, and is becoming part of the routine training for anaesthetists. They address areas, such as communication, leadership, knowledge of environment, anticipation and planning, obtaining timely assistance, attention allocation and workload distribution. We outline the application of these behaviours in the speciality of emergency medicine, and suggest that the teaching and practice of crisis resource management principles should become part of the curriculum for training and credentialing of emergency medicine specialists.

  19. Management of constipation in the elderly: emerging therapeutic strategies.

    PubMed

    Kapoor, Shailendra

    2008-09-07

    A number of new, novel strategies for managing constipation in the elderly have emerged over the past few years. Prucalopride is one such new agent that is highly efficacious in managing chronic constipation. In fact, Camilleri et al in a recent study reported that the average number of bowel movements increased by at least one in nearly 47% of the patients who were administered a dose of 4 mg. Lubiprostone is another new agent recently approved by the FDA that shows efficacy in managing the symptoms of constipation. Neostigmine has also been successfully used for the management of recalcitrant constipation. Most of these studies have used subcutaneous neostigmine. Symbiotic yogurt containing components, such as Bifidobacterium and fructoligosaccharide, have also been recently shown to be highly effective in improving symptoms of constipation. Elderly patients especially those in hospices and nursing homes are often on opioids for pain management. Constipation secondary to opioid use is extremely common in nursing homes. Subcutaneous methylnaltrexone has recently been shown to be highly effective in the management of opioid-related constipation, and was recently approved by the FDA. Sacral nerve stimulation is another emerging strategy. A recent analysis by Mowatt et al supports the efficacy of this technique. Botulinum toxin is another agent that has already been successfully used for the management of chronic, refractory constipation in children and may be very effective for elderly constipation. Further larger studies are needed to confirm the findings noted in these studies. Constipation is clearly a major issue in the elderly and these new, emerging strategies will hopefully improve the quality of life and relieve the symptoms of constipation in this population.

  20. Hazardous Materials Management and Emergency Response training Center needs assessment

    SciTech Connect

    McGinnis, K.A.; Bolton, P.A.; Robinson, R.K.

    1993-09-01

    For the Hanford Site to provide high-quality training using simulated job-site situations to prepare the 4,000 Site workers and 500 emergency responders for known and unknown hazards a Hazardous Materials Management and Emergency Response Training Center is needed. The center will focus on providing classroom lecture as well as hands-on, realistic training. The establishment of the center will create a partnership among the US Department of Energy; its contractors; labor; local, state, and tribal governments; and Xavier and Tulane Universities of Louisiana. This report presents the background, history, need, benefits, and associated costs of the proposed center.

  1. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing

    PubMed Central

    Nellore, Kapileswar; Hancke, Gerhard P.

    2016-01-01

    Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC) protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC) with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2 simulation results

  2. Traffic Management for Emergency Vehicle Priority Based on Visual Sensing.

    PubMed

    Nellore, Kapileswar; Hancke, Gerhard P

    2016-11-10

    Vehicular traffic is endlessly increasing everywhere in the world and can cause terrible traffic congestion at intersections. Most of the traffic lights today feature a fixed green light sequence, therefore the green light sequence is determined without taking the presence of the emergency vehicles into account. Therefore, emergency vehicles such as ambulances, police cars, fire engines, etc. stuck in a traffic jam and delayed in reaching their destination can lead to loss of property and valuable lives. This paper presents an approach to schedule emergency vehicles in traffic. The approach combines the measurement of the distance between the emergency vehicle and an intersection using visual sensing methods, vehicle counting and time sensitive alert transmission within the sensor network. The distance between the emergency vehicle and the intersection is calculated for comparison using Euclidean distance, Manhattan distance and Canberra distance techniques. The experimental results have shown that the Euclidean distance outperforms other distance measurement techniques. Along with visual sensing techniques to collect emergency vehicle information, it is very important to have a Medium Access Control (MAC) protocol to deliver the emergency vehicle information to the Traffic Management Center (TMC) with less delay. Then only the emergency vehicle is quickly served and can reach the destination in time. In this paper, we have also investigated the MAC layer in WSNs to prioritize the emergency vehicle data and to reduce the transmission delay for emergency messages. We have modified the medium access procedure used in standard IEEE 802.11p with PE-MAC protocol, which is a new back off selection and contention window adjustment scheme to achieve low broadcast delay for emergency messages. A VANET model for the UTMS is developed and simulated in NS-2. The performance of the standard IEEE 802.11p and the proposed PE-MAC is analysed in detail. The NS-2 simulation results

  3. Wide Area Recovery and Resiliency Program (WARRP) Attachment 2 - All-Hazards Regional Recovery Framework Template

    DTIC Science & Technology

    2012-11-01

    the incident may be significant.  Palliative care will be established based on the needs of the incident.  Altered standards of care established...short-term and long-term housing o Comprehensive case management o Children’s stability within schools and child care settings o Home repairs or...Functions and the CBR Annexes. The process section discusses key activities. The FAQ section addresses such questions as: Why should our region care about

  4. GNSS-based network positioning technology for cooperative emergency management

    NASA Astrophysics Data System (ADS)

    Wu, Caicong; Chu, Tianxing; Tang, Anning; Su, Huaihong

    2009-06-01

    Personal digital assistant (PDA) with built-in GPS chip begins to be used for city management and emergency response management nowadays. The intelligent terminal can be used for event recording, multimedia (photo, audio, and video) capturing, wireless communication, GPS positioning and navigation. In the near future, PDA would take place of the vehicle GPS monitoring terminal to provide more functions and convenient. This article organizes the PDA of the same team for emergency response event into an integrated network through wireless communication so that each terminal can see each other on the map, including the vehicle GPS monitoring terminals. All of the terminals should send its GPS position and collected information to the emergency response center (ERC) through GPRS with a customized protocol. Then the center would create the socket connection to push the neighbors' location and common or special information to the others in the team according to the terminal's requirement and its authorities, and the leader or commander could send commands and messages to all of the underling members also. The GNSS based positioning and communication network organizes the dispersive emergency response personnel handheld with PDA and vehicles equipped with vehicle GPS monitoring terminal into an organic and cooperative network, each member in the network can see where its colleagues are, so as to seek for the help or support and exchange information in real time without calling which avoids exposure to the tracked objects. The Compass-1 satellite positioning and communication terminal is also used for personnel and vehicle positioning and message reporting. Altay is selected as the demonstration area. The prototype emergency management system is established for the local public security bureau and well validates the terminals and network function.

  5. Social Networking for Emergency Management and Public Safety

    SciTech Connect

    Lesperance, Ann M.; Olson, Jarrod; Godinez, Melanie A.

    2010-08-31

    On March 10, 2010 the workshop titled Social Networking for Emergency Management and Public Safety was held in Seattle, WA. The objective of this workshop was to showcase ways social media networking technologies can be used to support emergency management and public safety operations. The workshop highlighted the current state of social networking and where this dynamic engagement is heading, demonstrated some of the more commonly used technologies, highlighted case studies on how these tools have been used in a variety of jurisdictions and engaged the private sector on how these tools might serve as a conduit for two way communication between with the public sector to address regional recovery issues and decision making.

  6. [Care management: nurses' actions in a hospital emergency service].

    PubMed

    dos Santos, José Luís Guedes; Lima, Maria Alice Dias da Silva

    2011-12-01

    This study aimed to analyze care management actions performed by nurses in a hospital emergency service. This is a qualiative research of the case study type, carried out with nurses from the Emergency Service of a University Hospital in southern Brazil. The data were collected through participant observation and semi-structured interviews, and analyzed using thematic analysis. The results show nurses' actions in care planning, forecasting and provisioning of resources, supervision, leadership and training of the nursing team. In care planning, there is the execution of the nursing process and the control of the realization of laboratory and radiological tests. The actions of forecasting and provisioning of resources were: elaboration of the monthly schedule of employees, daily distribution of the staff and the management of material resources. Leadership encourages the planning of care, the coordination of the nursing staff and the delegation of activities.

  7. An information management and communications system for emergency operations

    SciTech Connect

    Gladden, C.A.; Doyle, J.F.

    1995-09-01

    In the mid 1980s the US Department of Energy (DOE) recognized the need to dramatically expand its Emergency Operations Centers to deal with the large variety of emergencies for which DOE has an obligation to manage, or provide technical support. This paper describes information management, display, and communications systems that have been implemented at the DOE Headquarters Forestall Operations Center (OC), DOE Operations Offices, and critical laboratory locations. Major elements of the system at the DOE Headquarters facility include computer control, information storage and retrieval, processing, Local Area Networks (LANs), videoconferencing, video display, and audio systems. These Headquarters systems are linked by Wide Area Networks (WANs) to similar systems at the Operations Office and critical Laboratory locations.

  8. [Management of maxillofacial injuries in an emergency unit: our experience].

    PubMed

    Famà, Fausto; Beccaria, Antonio; Malara, Consolato; Placanica, Pantaleone; Cucinotta, Francesco; Caruso, Antonino; Estollere, Concetta; Versace, Giuseppina; Latorre, Nadia; Foti, Donatella; Falzea, Roberto; De Ponte, Francesco; Gioffrè-Florio, Maria Antonietta

    2009-01-01

    Maxillofacial injuries are relatively frequent. These may be complicated by cranioencephalic injuries or large facial wounds. We report our experience with the initial management of these lesions in an emergency unit setting. In 2007, we observed 105 patients with maxillofacial injuries. Maxillofacial injuries were associated with cranio-encephalic injuries in 69 patients (65.7%) and with polytrauma in 31(29.5%), while in 5 cases (4.8%) they were isolated. The main causes of trauma were motorcycle accidents (60%). All patients were treated in accordance with the Advanced Trauma Life Support guidelines and assessed by computed tomography. No mortality was observed after diagnosis in the emergency unit or in the month following the trauma. Seventy-seven patients (73.3%) were admitted and 28 (26.7%) were treated and discharged. Accurate diagnosis and appropriate initial management yield good clinical outcomes with functional restoration and fewer aesthetic complications.

  9. Syncope: a review of emergency department management and disposition

    PubMed Central

    Patel, Pranjal R; Quinn, James V

    2015-01-01

    Syncope is defined as a transient loss of consciousness due to cerebral hypoperfusion with spontaneous return to baseline function without intervention. It is a common chief complaint of patients presenting to the emergency department. The differential diagnosis for syncope is broad and the management varies significantly depending on the underlying etiology. In the emergency department, determining the cause of a syncopal episode can be difficult. However, a thorough history and certain physical exam findings can assist in evaluating for life-threatening diagnoses. Risk-stratifying patients into low, moderate and high-risk groups can assist in medical decision making and help determine the patient’s disposition. Advancements in ambulatory monitoring have made it possible to obtain prolonged cardiac evaluations of patients in the outpatient setting. This review will focus on the diagnosis and management of the various types of syncope. PMID:27752576

  10. Disaster management and the emergency department: a framework for planning.

    PubMed

    Kim, Deborah H; Proctor, Pamela W; Amos, Linda K

    2002-03-01

    Recent changes in the Joint Commission Accrediting Hospital Organization (JCAHO) Environment of Care standards are forcing hospitals to revisit their disaster planning process. Emergency Management, a process that is familiar to municipal and industry planners is now part of hospital disaster planning. A framework for making the necessary changes to the hospital disaster plan is presented. Examples of tools that might be useful in the planning process are also included.

  11. Extreme Space Weather Impact: An Emergency Management Perspective

    NASA Astrophysics Data System (ADS)

    MacAlester, Mark H.; Murtagh, William

    2014-08-01

    In 2010, the Department of Homeland Security's Federal Emergency Management Agency (FEMA) partnered with the National Oceanic and Atmospheric Administration's Space Weather Prediction Center (SWPC) to investigate the potential for extreme space weather conditions to impact National Security/Emergency Preparedness communications—those communications vital to a functioning government and to emergency and disaster response—in the United States. Given the interdependencies of modern critical infrastructure, the initial systematic review of academic research on space weather effects on communications expanded to other critical infrastructure sectors, federal agencies, and private sector organizations. While the effort is ongoing, and despite uncertainties inherent with this hazard, FEMA and the SWPC did draw some conclusions. If electric power remains available, an extreme space weather event will result in the intermittent loss of HF and similar sky wave radio systems, minimal direct impact to public safety line-of-sight radio and commercial cellular services, a relatively small loss of satellite services as a percentage of the total satellite fleet, interference or intermittent loss of satellite communications and GPS navigation and timing signals, and no first-order impact to consumer electronic devices. Vulnerability of electric power to an extreme geomagnetic storm remains the primary concern from an emergency management perspective, but actual impact is not well understood at present. A discussion of potential impacts to infrastructure from the loss of electric power from any hazard is provided using the 2011 record tornado outbreak in Alabama as an example.

  12. Management of angioedema without urticaria in the emergency department.

    PubMed

    Pedrosa, Maria; Prieto-García, Alicia; Sala-Cunill, Anna

    2014-12-01

    Angioedema refers to a localized, transient swelling of the deep skin layers or the upper respiratory or gastrointestinal mucosa. It develops as a result of mainly two different vasoactive peptides, histamine or bradykinin. Pathophysiology, as well as treatment, is different in each case; nevertheless, the resulting signs and symptoms may be similar and difficult to distinguish. Angioedema may occur at any location. When the affected area involves the upper respiratory tract, both forms of angioedema can lead to an imminent upper airway obstruction and a life-threatening emergency. Emergency physicians must have a basic understanding of the pathophysiology underlying this process. Angioedema evaluation in the emergency department (ED) should aim to distinguish between histamine- and bradykinin-induced angioedema, in order to provide appropriate treatment to patients. However, diagnostic methods are not available at the ED setting, neither to confirm one mechanism or the other, nor to identify a cause. For this reason, the management of angioedema should rely on clinical data depending on the particular features of the episode and the patient in each case. The history-taking should be addressed to identify a possible etiology or triggering agent, recording complete information for an ulterior diagnostic study in the outpatient clinic. It is mandatory quickly to recognize and treat a potential life-threatening upper airway obstruction or anaphylaxis. This review focuses on the underlying mechanisms and management of histamine- and bradykinin-induced angioedema at the emergency department and provides an update on the currently available treatments.

  13. NNSA/NV Consequence Management Capabilities for Radiological Emergency Response

    SciTech Connect

    D. R. Bowman

    2002-10-01

    The U.S. Department of Energy's National Nuclear Security Administration Nevada Operations Office (NNSA/NV) provides an integrated Consequence Management (CM) response capability for the (NNSA) in the event of a radiological emergency. This encompasses planning, technical operations, and home team support. As the lead organization for CM planning and operations, NNSA/NV coordinates the response of the following assets during the planning and operational phases of a radiological accident or incident: (1) Predictive dispersion modeling through the Atmospheric Release Advisory Capability (ARAC) at Lawrence Livermore National Laboratory (LLNL) and the High Consequence Assessment Group at Sandia National Laboratories (SNL); (2) Regional radiological emergency assistance through the eight Radiological Assistance Program (RAP) regional response centers; (3) Medical advice and assistance through the Radiation Emergency Assistance Center/Training Site (REAC/TS) in Oak Ridge, Tennessee; (4) Aerial radiological mapping using the fixed-wing and rotor-wing aircraft of the Aerial Measuring System (AMS); (5) Consequence Management Planning Teams (CMPT) and Consequence Management Response Teams (CMRT) to provide CM field operations and command and control. Descriptions of the technical capabilities employed during planning and operations are given below for each of the elements comprising the integrated CM capability.

  14. Visualizing Diurnal Population Change in Urban Areas for Emergency Management

    SciTech Connect

    Kobayashi, Tetsuo; Medina, Richard M; Cova, Thomas

    2011-01-01

    There is an increasing need for a quick, simple method to represent diurnal population change in metropolitan areas for effective emergency management and risk analysis. Many geographic studies rely on decennial U.S. Census data that assume that urban populations are static in space and time. This has obvious limitations in the context of dynamic geographic problems. The U.S. Department of Transportation publishes population data at the transportation analysis zone level in fifteen-minute increments. This level of spatial and temporal detail allows for improved dynamic population modeling. This article presents a methodology for visualizing and analyzing diurnal population change for metropolitan areas based on this readily available data. Areal interpolation within a geographic information system is used to create twenty-four (one per hour) population surfaces for the larger metropolitan area of Salt Lake County, Utah. The resulting surfaces represent diurnal population change for an average workday and are easily combined to produce an animation that illustrates population dynamics throughout the day. A case study of using the method to visualize population distributions in an emergency management context is provided using two scenarios: a chemical release and a dirty bomb in Salt Lake County. This methodology can be used to address a wide variety of problems in emergency management.

  15. Coastal emergency managers' preferences for storm surge forecast communication.

    PubMed

    Morrow, Betty Hearn; Lazo, Jeffrey K

    2014-01-01

    Storm surge, the most deadly hazard associated with tropical and extratropical cyclones, is the basis for most evacuation decisions by authorities. One factor believed to be associated with evacuation noncompliance is a lack of understanding of storm surge. To address this problem, federal agencies responsible for cyclone forecasts are seeking more effective ways of communicating storm surge threat. To inform this process, they are engaging various partners in the forecast and warning process.This project focuses on emergency managers. Fifty-three emergency managers (EMs) from the Gulf and lower Atlantic coasts were surveyed to elicit their experience with, sources of, and preferences for storm surge information. The emergency managers-who are well seasoned in hurricane response and generally rate the surge risk in their coastal areas above average or extremely high-listed storm surge as their major concern with respect to hurricanes. They reported a general lack of public awareness about surge. Overall they support new ways to convey the potential danger to the public, including the issuance of separate storm surge watches and warnings, and the expression of surge heights using feet above ground level. These EMs would like more maps, graphics, and visual materials for use in communicating with the public. An important concern is the timing of surge forecasts-whether they receive them early enough to be useful in their evacuation decisions.

  16. What's in your all-hazards plan? In Boston they were prepared. Are you?

    PubMed

    Augustine, James J

    2013-05-01

    The best EMS major incident response program comes from excellent day-to-day delivery of care, combinbed with common sense preparedness and an excellent relationship with hospitals, law enforcement and regional public health officials. Expansion of a few physical assets, understanding the regional resources that can be utilized for major incidents, and routine use of an incident management system will lay the necessary groundwork for a major terrorist incident response. System leaders must consider the adaptation of triage efforts and response, with security and responder safety issues becoming an immediate consideration.

  17. Management of Complications Following Emergency and Elective Surgery for Diverticulitis

    PubMed Central

    Holmer, Christoph; Kreis, Martin E.

    2015-01-01

    Background The clinical spectrum of sigmoid diverticulitis (SD) varies from asymptomatic diverticulosis to symptomatic disease with potentially fatal complications. Sigmoid colectomy with restoration of continuity has been the prevailing modality for treating acute and recurrent SD, and is often performed as a laparoscopy-assisted procedure. For elective sigmoid colectomy, the postoperative morbidity rate is 15-20% whereas morbidity rates reach up to 30% in patients who undergo emergency surgery for perforated SD. Some of the more common and serious surgical complications after sigmoid colectomy are anastomotic leaks and peritonitis, wound infections, small bowel obstruction, postoperative bleeding, and injuries to the urinary tract structures. Regarding the management of complications, it makes no difference whether the complication is a result of an emergency or an elective procedure. Methods The present work gives an overview of the management of complications in the surgical treatment of SD based on the current literature. Results To achieve successful management, early diagnosis is mandatory in cases of deviation from the normal postoperative course. If diagnostic procedures fail to deliver a correlate for the clinical situation of the patient, re-laparotomy or re-laparoscopy still remain among the most important diagnostic and/or therapeutic principles in visceral surgery when a patient's clinical status deteriorates. Conclusion The ability to recognize and successfully manage complications is a crucial part of the surgical treatment of diverticular disease and should be mastered by any surgeon qualified in this field. PMID:26989382

  18. Reverse quality management: developing evidence-based best practices in health emergency management.

    PubMed

    Lynch, Tim; Cox, Paul

    2006-01-01

    The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.

  19. Medical Emergency Team syndromes and an approach to their management

    PubMed Central

    Jones, Daryl; Duke, Graeme; Green, John; Briedis, Juris; Bellomo, Rinaldo; Casamento, Andrew; Kattula, Andrea; Way, Margaret

    2006-01-01

    Introduction Most literature on the medical emergency team (MET) relates to its effects on patient outcome. Less information exists on the most common causes of MET calls or on possible approaches to their management. Methods We reviewed the calling criteria and clinical causes of 400 MET calls in a teaching hospital. We propose a set of minimum standards for managing a MET review and developed an approach for managing common problems encountered during MET calls. Results The underlying reasons for initiating MET calls were hypoxia (41%), hypotension (28%), altered conscious state (23%), tachycardia (19%), increased respiratory rate (14%) and oliguria (8%). Infection, pulmonary oedema, and arrhythmias featured as prominent causes of all triggers for MET calls. The proposed minimum requirements for managing a MET review included determining the cause of the deterioration, documenting the events surrounding the MET, establishing a medical plan and ongoing medical follow-up, and discussing the case with the intensivist if certain criteria were fulfilled. A systematic approach to managing episodes of MET review was developed based on the acronym 'A to G': ask and assess; begin basic investigations and resuscitation, call for help if needed, discuss, decide, and document, explain aetiology and management, follow-up, and graciously thank staff. This approach was then adapted to provide a management plan for episodes of tachycardia, hypotension, hypoxia and dyspnoea, reduced urinary output, and altered conscious state. Conclusion A suggested approach permits audit and standardization of the management of MET calls and provides an educational framework for the management of acutely unwell ward patients. Further evaluation and validation of the approach are required. PMID:16507153

  20. IEMIS (Integrated Emergency Management Information System) Floodplain Mapping Based on a Lidar Derived Data Set.

    DTIC Science & Technology

    1988-02-05

    0-A193 971 IEMIS (INTEGRATED EMERGENCY MANAGEMENT INFORMATION SYSTEM ) FLOODPLRIN MAP.. (U) ARMY ENGINEER WATERWAYS EXPERIMENT STATION VICKSBURG HS J...illustrate the application of the automated mapping capabilities of the Integrated Emergency Management Information System (IEMIS) to FISs. Unclassified...mapping capabilities of the Integrated Emergency Management Information System (IEMIS) to FISs. II. BACKGROUND The concept of mounting laser ranging

  1. Emergency Management Students' Perceptions of the Use of WebEOC[R] to Support Authentic Learning

    ERIC Educational Resources Information Center

    Johnson, Thomas

    2012-01-01

    This study investigates the use of software technology that is used by emergency management professionals to create an authentic learning environment in emergency and disaster management courses in the classroom. Participants were 235 upper-level students enrolled in residential and online emergency and disaster management courses at a mid-sized…

  2. Emerging paradigms on glucose management in the intensive care unit.

    PubMed

    Evans, A S; Hosseinian, L; Mechanick, J I

    2014-12-01

    Hyperglycemia is common in critical illness and leads to increased morbidity and mortality. Controversy exists whether tight glycemic control via intensive insulin therapy can safely and effectively improve outcomes. In this review article, we will sort through the pertinent evidence base to identify salient, yet emergent, paradigms to guide management. To this end, we will discuss underlying biologic mechanisms relevant to hyperglycemia and insulinization in critical illness, summarize results of major randomized controlled clinical trials for glycemic control in the intensive care unit (ICU), and fill in the gaps with necessary information. We will conclude with specific messages, not only reflecting our own clinical experiences, but amenable to implementation in different ICU settings.

  3. Emergency department management of patients internally contaminated with radioactive material

    SciTech Connect

    Kazzi, Ziad; Buzzell, Jennifer; Bertelli, Luiz; Christensen, Doran

    2014-11-15

    After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with one or more radionuclides. Internal contamination can lead to the delivery of harmful ionizing radiation doses to various organs and tissues or the whole body. The clinical consequences can range from acute radiation syndrome (ARS) to the long term development of cancer. Estimating the amount of radioactive material absorbed into the body can guide the management of patients. Treatment includes, in addition to supportive care and long term monitoring, certain medical countermeasures like Prussian blue, Calcium DTPA and Zinc DTPA.

  4. Emergent Management of Intracardiac Thrombosis during Liver Transplantation

    PubMed Central

    Protin, Caroline

    2016-01-01

    Intraoperative thromboembolism is a well-documented complication associated with orthotopic liver transplantation (OLT) but its identification and intraoperative treatment are still an emerging topic in anesthesia. Intracardiac thrombus during OLT is associated with a high mortality rate. There are only a few reports describing the successful management of thromboembolism during OLT. We describe a case where routine intraoperative transesophageal echocardiography during a live donor liver transplantation enabled early detection of an intracardiac thrombus with subsequent successful heparin treatment. Our case suggests that if an intracardiac thrombus is identified early (before hemodynamic instability occurs), the use of IV heparin may be a safe therapeutic option. PMID:28070442

  5. Advances in diagnosis and management of hypokalemic and hyperkalemic emergencies.

    PubMed

    Pepin, Jeffrey; Shields, Christopher

    2012-02-01

    With up to 56% of individuals taking diuretics likely to develop hypokalemia, and comorbid disease and many other types of medications having the potential to induce hyperkalemia, potassium abnormalities are some of the most commonly seen electrolyte abnormalities in the emergency department (ED). Unless recognized and treated appropriately, they can also be some of the most deadly. Symptoms accompanying potassium abnormalities are often vague, involving multiple organ systems. This evidence-based review discusses the etiology, differential diagnosis, and diagnostic studies for detecting hypokalemia and hyperkalemia, including managing laboratory errors that lead to factitious potassium findings. Recognition and treatment of life-threatening dysrhythmias in hypokalemia and hyperkalemia are key to managing these potassium abnormalities. Electrocardiogram (ECG) findings, treatment algorithms, and controversies on treating potassium abnormalities in the ED are discussed, with recommendations on criteria for disposition.

  6. Identification and Management of Information Problems by Emergency Department Staff

    PubMed Central

    Murphy, Alison R.; Reddy, Madhu C.

    2014-01-01

    Patient-care teams frequently encounter information problems during their daily activities. These information problems include wrong, outdated, conflicting, incomplete, or missing information. Information problems can negatively impact the patient-care workflow, lead to misunderstandings about patient information, and potentially lead to medical errors. Existing research focuses on understanding the cause of these information problems and the impact that they can have on the hospital’s workflow. However, there is limited research on how patient-care teams currently identify and manage information problems that they encounter during their work. Through qualitative observations and interviews in an emergency department (ED), we identified the types of information problems encountered by ED staff, and examined how they identified and managed the information problems. We also discuss the impact that these information problems can have on the patient-care teams, including the cascading effects of information problems on workflow and the ambiguous accountability for fixing information problems within collaborative teams. PMID:25954457

  7. Federal Emergency Management Information System (FEMIS) Data Management Guide for FEMIS Version 1.4.6

    SciTech Connect

    Angel, L.K.; Bower, J.C.; Burnett, R.A.; Downing, T.R.; Fangman, P.M.; Hoza, M.; Johnson, D.M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Schulze, S.A.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  8. Nutrient loads exported from managed catchments reveal emergent biogeochemical stationarity

    NASA Astrophysics Data System (ADS)

    Basu, Nandita B.; Destouni, Georgia; Jawitz, James W.; Thompson, Sally E.; Loukinova, Natalia V.; Darracq, Amélie; Zanardo, Stefano; Yaeger, Mary; Sivapalan, Murugesu; Rinaldo, Andrea; Rao, P. Suresh C.

    2010-12-01

    Complexity of heterogeneous catchments poses challenges in predicting biogeochemical responses to human alterations and stochastic hydro-climatic drivers. Human interferences and climate change may have contributed to the demise of hydrologic stationarity, but our synthesis of a large body of observational data suggests that anthropogenic impacts have also resulted in the emergence of effective biogeochemical stationarity in managed catchments. Long-term monitoring data from the Mississippi-Atchafalaya River Basin (MARB) and the Baltic Sea Drainage Basin (BSDB) reveal that inter-annual variations in loads (LT) for total-N (TN) and total-P (TP), exported from a catchment are dominantly controlled by discharge (QT) leading inevitably to temporal invariance of the annual, flow-weighted concentration, $\\overline{Cf = (LT/QT). Emergence of this consistent pattern across diverse managed catchments is attributed to the anthropogenic legacy of accumulated nutrient sources generating memory, similar to ubiquitously present sources for geogenic constituents that also exhibit a linear LT-QT relationship. These responses are characteristic of transport-limited systems. In contrast, in the absence of legacy sources in less-managed catchments, $\\overline{Cf values were highly variable and supply limited. We offer a theoretical explanation for the observed patterns at the event scale, and extend it to consider the stochastic nature of rainfall/flow patterns at annual scales. Our analysis suggests that: (1) expected inter-annual variations in LT can be robustly predicted given discharge variations arising from hydro-climatic or anthropogenic forcing, and (2) water-quality problems in receiving inland and coastal waters would persist until the accumulated storages of nutrients have been substantially depleted. The finding has notable implications on catchment management to mitigate adverse water-quality impacts, and on acceleration of global biogeochemical cycles.

  9. Recognition and management of seizures in children in emergency departments.

    PubMed

    Caplan, Edward; Dey, Indranil; Scammell, Andrea; Burnage, Katy; Paul, Siba Prosad

    2016-09-01

    Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management. Seizures in children can be an extremely distressing experience for parents, who should be supported and kept informed by experienced ED nurses. Nurses also play a vital role in educating parents on correct administration of anticonvulsants and safety advice. This article discusses the aetiology, clinical presentation, diagnosis and management of children with seizures, with particular emphasis on epilepsy. It includes two reflective case studies to highlight the challenges faced by healthcare professionals managing children who present with convulsions.

  10. Insertion Success of the Laryngeal Tube in Emergency Airway Management.

    PubMed

    Bernhard, Michael; Gries, André; Ramshorn-Zimmer, Alexandra; Wenzel, Volker; Hossfeld, Bjoern

    2016-01-01

    Background. Emergency airway management (AM) is a priority when resuscitating critically ill or severely injured patients. The goal of this study was to determine the success rates of LT insertion during AM. Methods. Studies that included LT first-pass insertion (FPI) and overall-pass insertion (OPI) success by emergency medical services and in-hospital providers performing AM for emergency situations as well as for scheduled surgery published until July 2014 were searched systematically in Medline. Results. Data of 36 studies (n = 1,897) reported a LT FPI success by physicians of 82.5% with an OPI success of 93.6% (p < 0.001). A cumulative analysis of all 53 studies (n = 3,600) led to FPI and OPI success of 80.1% and 92.6% (p < 0.001), respectively. The results of 26 studies (n = 2,159) comparing the LT with the laryngeal mask airway (LMA) demonstrated a FPI success of 77.0 versus 78.7% (p = 0.36) and an OPI success of 92.2 versus 97.7% (p < 0.001). Conclusion. LT insertion failed in the first attempt in one out of five patients, with an overall failure rate in one out of 14 patients. When compared with the LT, the LMA had a cumulative 5.5% better OPI success rate.

  11. Insertion Success of the Laryngeal Tube in Emergency Airway Management

    PubMed Central

    Gries, André; Ramshorn-Zimmer, Alexandra; Wenzel, Volker

    2016-01-01

    Background. Emergency airway management (AM) is a priority when resuscitating critically ill or severely injured patients. The goal of this study was to determine the success rates of LT insertion during AM. Methods. Studies that included LT first-pass insertion (FPI) and overall-pass insertion (OPI) success by emergency medical services and in-hospital providers performing AM for emergency situations as well as for scheduled surgery published until July 2014 were searched systematically in Medline. Results. Data of 36 studies (n = 1,897) reported a LT FPI success by physicians of 82.5% with an OPI success of 93.6% (p < 0.001). A cumulative analysis of all 53 studies (n = 3,600) led to FPI and OPI success of 80.1% and 92.6% (p < 0.001), respectively. The results of 26 studies (n = 2,159) comparing the LT with the laryngeal mask airway (LMA) demonstrated a FPI success of 77.0 versus 78.7% (p = 0.36) and an OPI success of 92.2 versus 97.7% (p < 0.001). Conclusion. LT insertion failed in the first attempt in one out of five patients, with an overall failure rate in one out of 14 patients. When compared with the LT, the LMA had a cumulative 5.5% better OPI success rate. PMID:27642595

  12. D Geo-Information Requirements for Disaster and Emergency Management

    NASA Astrophysics Data System (ADS)

    Demir Ozbek, E.; Zlatanova, S.; Ates Aydar, S.; Yomralioglu, T.

    2016-06-01

    A conceptual approach is proposed to define 3D geo-information requirement for different types of disasters. This approach includes components such as Disaster Type-Sector-Actor-Process-Activity-Task-Data. According to disaster types processes, activities, tasks, sectors, and responsible and operational actors are derived. Based on the tasks, the needed level of detail for 3D geo-information model is determined. The levels of detail are compliant with the 3D international standard CityGML. After a brief introduction on the disaster phases and geo-information requirement for actors to perform the tasks, the paper discusses the current situation of disaster and emergency management in Turkey and elaborates on components of conceptual approach. This paper discusses the 3D geo-information requirements for the tasks to be used in the framework of 3D geo-information model for Disaster and Emergency Management System in Turkey. The framework is demonstrated for an industrial fire case in Turkey.

  13. Federal Emergency Management Information System (FEMIS) Data Management Guide Version 1.3

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Hoza, M.; Johnson, S.M.; Loveall, R.M.; Millard, W.D.; Winters, C.; Wood, B.M.

    1996-12-01

    FEMIS is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical and Biological Defense Command. FEMIS is designed to help civilian emergency management personnel to plan for and support their responses to a chemical-releasing event at a military chemical stockpile. This guide provides the background as well as the operations and procedures needed to generate and maintain the data resources in the system. Database administrators, system administrators, and general users can use this guide to manage the datafiles and database. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, loaded, and managed while the system is in operation.

  14. An academic approach to climate change emergency preparedness.

    PubMed

    Trask, Jeffrey A

    To achieve effective emergency management and business continuity, all hazards should be considered during the planning and preparedness process. In recent years, several new hazards have attracted the attention of Emergency Management and Business Continuity practitioners. Climate change presents a unique challenge. Practitioners must rely on historical data combined with scientific projections to guide their planning and preparedness efforts. This article examines how an academic institution's emergency management programme can plan successfully for this hazard by focusing on best practices in the area of building cross-departmental and cross-jurisdictional relationships. Examples of scientific data related to the hazard of climate change will be presented along with the latest guidance from the Federal Emergency Management Agency encouraging the planning for future hazards. The article presents a functional exercise in which this hazard was prominently featured, and presents testimony from subject matter experts. Recommendations for emergency management and business continuity programmes are so provided.

  15. Electric power emergency management mechanism considering the access of new energy and renewable energy

    NASA Astrophysics Data System (ADS)

    Zhang, Baoqun; Ma, Longfei; Gong, Cheng; Jiao, Ran; Shi, Rui; Chi, Zhongjun; Ding, Yifeng

    2017-01-01

    Scholars at home and abroad have had a thorough research about the theory system and the frame of emergency management on the background of traditional grid, but for the improvement of the emergency mechanism when new energy and renewable energy access the grid, more work should be done. This paper will summarize the predecessors' work on emergency management, discuss the impact of emergency management while new energy and renewable energy access the grid and some suggestions are given.

  16. Federal Emergency Management Information System (FEMIS) data management guide, version 1.4.5

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.

    1998-06-26

    The Federal Emergency Management Information System (FEMIS) information resources are described in this FEMIS Data Management Guide. To comprehend what types of data are present, where the data is located, and how it is managed during the life span of the system, a basic understanding of the FEMIS architecture is necessary. The system is being developed by Pacific Northwest National Laboratory (PNNL) and is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). The capability to connect to remote CSEPP sites and share information will be present in a future release. Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide efficient EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links. FEMIS is a client/server system where much of the application software is located in the client PC. This client software integrates the FEMIS application, government furnished dispersion and evacuation models, and Commercial-Off-The-Shelf (COTS) software tools such as the ArcView geographic information system (GIS) and Microsoft Project (electron planning). A UNIX server provides data management services, ARC/INFO GIS capabilities, evacuation (Evac) modeling, electron main (E-mail), and meteorological (Met) input processing. A PC communication utility is available to interface with external subsystems. At this time, the weather collection system (Handar Met System) is the only external subsystem.

  17. Crisis resource management, simulation training and the medical emergency team.

    PubMed

    Gillon, Stuart; Radford, Sam; Chalwin, Richard; Devita, Michael; Endacott, Ruth; Jones, Daryl

    2012-09-01

    Recently there has been increased focus on improved detection and management of deteriorating patients in Australian hospitals. Since the introduction of the medical emergency team (MET) model there has been an increased role for intensive care unit staff in responding to deterioration of patients in hospital wards. Review and management of MET patients differs from the traditional model of ward patient review, as ICU staff may not know the patient. Furthermore, assessment and intervention is often time-critical and must occur simultaneously. Finally, about 10% of MET patients require intensive care-level interventions to be commenced on the ward, and this requires participation of non-ICU-trained ward staff. • To date, the interventions performed by MET staff and approaches to training responders have been relatively under investigated, particularly in the Australian and New Zealand context. In this article we briefly review the principles of the MET and contend that activation of the MET by ward staff represents a response to a medical crisis. We then outline why MET intervention differs from traditional ward-based doctor-patient encounters, and emphasise the importance of non-technical skills during the MET response. Finally, we suggest ways in which the skills required for crisis resource management within the MET can be taught to ICU staff, and the potential benefits, barriers and difficulties associated with the delivery of such training in New Zealand and Australia.

  18. New emerging therapies in the management of chronic lymphocytic leukemia

    PubMed Central

    Li, Xiao-Lin; Zhang, Ci-Xian

    2016-01-01

    Chronic lymphocytic leukemia (CLL) is considered incurable despite advances in management strategies. New drugs targeting cell pathways are currently being developed for the efficient management of CLL. Various strategies involving different targets have been developed, or are currently in the developing stage. A search was conducted in the electronic database PubMed, for pre-clinical as well as clinically controlled trials reporting various strategies against CLL currently under investigation. Novel strategies included use of antibodies, small cell inhibitors, such as spleen tyrosine kinase, LYN, cyclin-dependent kinase, and histone deacetylase inhibitors. The present review examined these new and emerging strategies for the efficient management of CLL. The review involves a discussion of novel strategies being examined worldwide against CLL, including anti-CD20, anti-CD37, anti-CD23, anti-CD40, SYK/LYN inhibitors, BTK inhibitors, p13k inhibitors and recent developments such as the use of cyclin-dependent kinase inhibitors/histone deacetylase inhibitors. PMID:27899962

  19. Emergency Preparedness in the 10-Mile Emergency Planning Zone Surrounding Nuclear Power Plants

    PubMed Central

    Adalja, Amesh A.; Sell, Tara Kirk; Ravi, Sanjana J.; Minton, Katie; Morhard, Ryan

    2015-01-01

    Objectives Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and public health practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site public health preparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Methods Using a qualitative, interview-based method, we consulted 120 county emergency managers, state health preparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Results Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. Conclusions This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants. PMID:26692825

  20. Research on Group Decision-Making Mechanism of Internet Emergency Management

    NASA Astrophysics Data System (ADS)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  1. Integrated Emergency Management: The Roles of Federal, State, and Local Government with Implications for Homeland Security

    DTIC Science & Technology

    2007-11-02

    1 INTEGRATED EMERGENCY MANAGEMENT DEFINITION AND FRAMEWORK…………..2 THE ROLE OF THE FEDERAL GOVERNMENT………………………………………………….5...providing resources to combat domestic disasters from whatever source. INTEGRATED EMERGENCY MANAGEMENT DEFINITION AND FRAMEWORK The functions of emergency

  2. Knowledge and Confidence of a Convenience Sample of Australasian Emergency Doctors in Managing Dental Emergencies: Results of a Survey

    PubMed Central

    Samaei, Hossein; Weiland, Tracey Joy; Dilley, Stuart; Jelinek, George Alexander

    2015-01-01

    Background. We aimed to determine Australasian Specialist Emergency Physicians' and Emergency Physicians in Training (Trainees') level of knowledge of common dental emergencies. We also explored confidence in managing dental emergencies; predictors of confidence and knowledge; and preferences for further dental education. Methods. A questionnaire was distributed electronically (September 2011) and directly (November 2011) to Fellows and Trainees of the Australasian College for Emergency Medicine. It explored demographics, confidence, knowledge of dental emergencies, and educational preferences. Results. Response rate was 13.6% (464/3405) and college members were proportionally represented by region. Fewer than half (186/446; 42%) had received dental training. Sixty-two percent (244/391, 95% CI 57.5–67.1) passed (>50%) a knowledge test. More than 60% incorrectly answered questions on dental fracture, periodontal abscess, tooth eruption dates, and ulcerative gingivitis. Forty percent (166/416) incorrectly answered a question about Ludwig's Angina. Eighty-three percent (360/433) were confident in the pharmacological management of toothache but only 26% (112/434) confident in recognizing periodontal disease. Knowledge was correlated with confidence (r = 0.488). Interactive workshops were preferred by most (386/415, 93%). Conclusions. The knowledge and confidence of Australasian Emergency Physicians and Trainees in managing dental emergencies are varied, yet correlated. Interactive training sessions in dental emergencies are warranted. PMID:25821600

  3. Transient Global Amnesia: Emergency Department Evaluation And Management.

    PubMed

    Faust, Jeremy Samuel; Nemes, Andreea

    2016-08-01

    Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department.

  4. Enhanced risk management by an emerging multi-agent architecture

    NASA Astrophysics Data System (ADS)

    Lin, Sin-Jin; Hsu, Ming-Fu

    2014-07-01

    Classification in imbalanced datasets has attracted much attention from researchers in the field of machine learning. Most existing techniques tend not to perform well on minority class instances when the dataset is highly skewed because they focus on minimising the forecasting error without considering the relative distribution of each class. This investigation proposes an emerging multi-agent architecture, grounded on cooperative learning, to solve the class-imbalanced classification problem. Additionally, this study deals further with the obscure nature of the multi-agent architecture and expresses comprehensive rules for auditors. The results from this study indicate that the presented model performs satisfactorily in risk management and is able to tackle a highly class-imbalanced dataset comparatively well. Furthermore, the knowledge visualised process, supported by real examples, can assist both internal and external auditors who must allocate limited detecting resources; they can take the rules as roadmaps to modify the auditing programme.

  5. Management of acute traumatic stress in nuclear and radiological emergencies.

    PubMed

    Vazquez, Marina; Jordan, Osvaldo; Kuper, Enrique; Hernandez, Daniel; Galmarini, Martin; Ferraro, Augusto

    2010-06-01

    In order to effectively respond to and minimize the psychological impact following disasters, such as radio-nuclear ones, it is essential to understand the mechanisms involved in such conditions and how to prevent and treat the psychological impacts, including those related to acute traumatic stress and its consequences across life span. Radio-nuclear emergencies may cause psychological traumatic stress, with its potentially significant consequences in mental health, with both short and long-term effects, which extend beyond the individuals directly affected. Ionizing radiation cannot be perceived by human senses and most people are unaware of the magnitude of its effects, which could result in feelings of helplessness and vulnerability. Those situations with a high degree of uncertainty, regarding potential future health effects, are more psychologically traumatic than others. The present century has witnessed a steady increase in the number of publications concerning the mental health impact of traumatic events, showing the need of increasing the study of traumatic stress and its impact on mental health. A prompt, planned and effective response to manage disaster-induced acute traumatic stress may prevent the evolutionary reactions of traumatic stress into disorders or even chronic stress diseases that can appear after a nuclear or radiological emergency.

  6. A Quantitative Study of Critical Thinking Skills amongst Local Emergency Managers

    ERIC Educational Resources Information Center

    Peerbolte, Stacy L.

    2010-01-01

    Emergency managers must be able to think critically to identify and anticipate situations, solve problems, and make judgments and decisions to effectively and efficiently assume and manage risks. An assessment of the extent to which local emergency managers are able to think critically has not yet been conducted. Based in systems theory and the…

  7. 76 FR 19107 - Privacy Act of 1974; Department of Homeland Security Federal Emergency Management Agency-011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... Management Agency--011 Training and Exercise Program Records System of Records AGENCY: Privacy Office, DHS... titled, ``Department of Homeland Security Federal Emergency Management Agency--011 Training and Exercise.../Federal Emergency Management Agency to collect and maintain records on its training and exercise...

  8. 76 FR 78227 - Notice of Request for Extension of Approval of an Information Collection; Emergency Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-16

    ... Collection; Emergency Management Response System AGENCY: Animal and Plant Health Inspection Service, USDA... Emergency Management Response System. DATES: We will consider all comments that we receive on or before... Management Response System, contact Dr. Steven Finch, Senior Staff Veterinarian, Preparedness and...

  9. Emergent aquatics: stand establishment, management, and species screening

    SciTech Connect

    Pratt, D.C.; Andrews, N.J.; Dubbe, D.R.; Garver, E.G.; Penko, M.; Read, P.E.; Zimmerman, E.S.

    1982-11-01

    Several emergent aquatic species have been identified as potential biomass crops, including Typha spp. (cattail), Scirpus spp. (rush), Sparganium spp. (bur reed), and Phragmites (reed). This report discusses first year results from studies of stand establishment and management, Typha nutrient requirements, wetland species yield comparisons, and Typha micropropagation. In a comparison of the relative effectiveness of seed, seedlings, and rhizomes for stand establishment, rhizomes appeared to be more consistent and productive under a wire variety of conditions. Both rhizomes and seedling established plots grew successfully on excavated peatland sites. First season results from a multiyear fertilizer rate experiment indicate that fertilizer treatment resulted in significantly increased tissue nutrient concentrations which should carry over into subsequent growing seasons. Shoot density and belowground dry weight were also significantly increased by phosphorus + potassium and potassium applications, respectively. First season yields of selected wetland species from managed paddies generally were comparable to yields reported from natural stands. Several particularly productive clones of Typha spp. have been identified. A method of establishing Typha in tissue culture is described.

  10. Channelopathies - Emerging Trends in The Management of Inherited Arrhythmias

    PubMed Central

    Chockalingam, Priya; Mizusawa, Yuka; Wilde, Arthur A.M.

    2016-01-01

    In spite of their relative rarity, inheritable arrhythmias have come to the forefront as a group of potentially fatal but preventable cause of sudden cardiac death in children and (young) adults. Comprehensive management of inherited arrhythmias includes diagnosing and treating the proband and identifying and protecting affected family members. This has been made possible by the vast advances in the field of molecular biology enabling better understanding of the genetic underpinnings of some of these disease groups, namely congenital long QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome. The ensuing knowledge of the genotype-phenotype correlations enables us to risk-stratify, prognosticate and treat based on the genetic test results. The various diagnostic modalities currently available to us, including clinical tools and genetic technologies, have to be applied judiciously in order to promptly identify those affected and to spare the emotional burden of a potentially lethal disease in the unaffected individuals. The therapeutic armamentarium of inherited arrhythmias includes pharmacological agents, device therapies and surgical interventions. A treatment strategy keeping in mind the risk profile of the patients, the local availability of drugs and the expertise of the treating personnel is proving effective. While opportunities for research are numerous in this expanding field of medicine, there is also tremendous scope for incorporating the emerging trends in managing patients and families with inherited arrhythmias in the Indian subcontinent. PMID:25852242

  11. Energy Emergency Management Information System (EEMIS): functional requirements

    SciTech Connect

    Not Available

    1980-10-17

    This report deals with the functional requirements of the Energy Emergency Management Information System (EEMIS) as it is defined for State level use (EEMIS-S). This report provides a technical description of the EEMIS-S requirements. These guidelines state that in order to create the widest practicable competition the system's requirements, with few exceptions, must be expressed in functional terms without reference to specific hardware or software products, and that wherever exceptions are made a statement of justification must be provided. In addition, these guidelines set forth a recommended maximum threshold limit of annual contract value for schedule contract procurements. Section 2.0 presents a general overview of the EEMIS structure in terms of requirements for vendor support. The functional requirements for each component are developed by section as: Teleprocessing Monitor Requirements, Section 3.0; EEMIS File Requirements, Section 4.0; Data Base Management Requirements, Section 5.0; Application Program Requirements, Section 6.0; and Utility Program Requirements, Section 7.0. The final Section, 8.0, justifies the use of the GSA Teleprocessing Service Program - Multiple Award Schedule Contracts (TSP-MASC) procurement process. The intent of this section is to substantiate, in this instance, the desirability of obtaining time-sharing vendor services to support EEMIS under a schedule contract, even if certain TSP-MASC threshold limits might be exceeded.

  12. Management of macroscopic haematuria in the emergency department.

    PubMed

    Hicks, Derek; Li, Chi-Ying

    2007-06-01

    Macroscopic haematuria is a commonly seen condition in the emergency department (ED), which has a variety of causes. However, most importantly, macroscopic haematuria has a high diagnostic yield for urological malignancy. 30% of patients presenting with painless haematuria are found to have a malignancy. The majority of these patients can be managed in the outpatient setting. This review of current literature suggests a management pathway that can be used in the ED. A literature search was done using Medline, PubMed and Google. In men aged >60 years, the positive predictive value of macroscopic haematuria for urological malignancy is 22.1%, and in women of the same age it is 8.3%. In terms of the need for follow-up investigation, a single episode of haematuria is equally important as recurrent episodes. Baseline investigation in the ED includes full blood count, urea and electrolyte levels, midstream urine dipstick, beta human chorionic gonadotrophin, and formal microscopy, culture and sensitivities. Treatment of macroscopic haematuria aims at RESP--Resuscitation, Ensuring, Safe and Prompt. Indications for admission include clot retention, cardiovascular instability, uncontrolled pain, sepsis, acute renal failure, coagulopathy, severe comorbidity, heavy haematuria or social restrictions. Discharged patients should drink plenty of clear fluids and return for further medical attention if the following occur: clot retention, worsening haematuria despite adequate fluid intake, uncontrolled pain or fever, or inability to cope at home. Follow-up by a urological team should be promptly arranged, ideally within the 2-week cancer referral target.

  13. Information technology and emergency management: preparedness and planning in US states.

    PubMed

    Reddick, Christopher

    2011-01-01

    The purpose of this paper is to examine the impact of information technology (IT) on emergency preparedness and planning by analysing a survey of US state government departments of emergency management. The research results show that there has been a significant impact of IT on emergency planning. IT has proven to be effective for all phases of emergency management, but especially for the response phase. There are numerous technologies used in emergency management, ranging from the internet, Geographic Information Systems and wireless technologies to more advanced hazard analysis models. All were generally viewed as being effective. Lack of financial resources and support from elected officials is a perennial problem in public administration, and was found to be prevalent in this study of IT and emergency management. There was evidence that state governments rating high on a performance index were more likely to use IT for emergency management.

  14. Municipal Emergency Management System: a strategy towards information and managing resources

    NASA Astrophysics Data System (ADS)

    Pacheco, J.

    2009-04-01

    The Azores archipelago is located in the North Atlantic Ocean, on a complex geological setting where the North American, Eurasian and African plates meet. Throughout its history the geological and meteorological hazards have been the most significant and had cause thousands of deaths and extensive damages. To prepare and mitigate the impact of catastrophic events there are emergency plans to guide the authorities and to instruct the population. However, a key point on the effectiveness of any emergency plan is the efficiency on getting the relevant information from the existing plans and conveying quality information to the operational teams and to the population. To address this issue the Municipal Emergency Management System was designed as a modular software with a core database and two different applications; one back-office to input and manage data and one front-end to query the database. The database is installed in a server and the system runs over an Intranet or the Internet, allowing its management and query to be done anywhere. The information on the system comprises two sets of data: (a) static data, regarding guidelines from the official Municipal Emergency Plan and a broad characterization of the county that does not need to be updated frequently (geography, geomorphology, climatology and the main hazards to consider) and (b) dynamic information, concerning data that requires regular updating such as available resources, administrative officials, pertinent private organisations etc.. All dynamic data in the core database is organised in three layers: (1) administrative organisations with geographical expression (such as province or district), (2) entities with capability to provide aid on provisions, accommodations, health, infrastructures, construction, transportation and security (public services, non-governmental organisations, enterprises or individual persons) and (3) operative information (applicable laws, tasks of each operative structure of the

  15. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... establishment of State and local emergency instrumentation systems for radiation detection and measurement. (l...., potassium iodide) to reduce the radiation dose to specific organs as a result of radiological emergencies....

  16. Emerging challenges in managing hepatitis B in HIV patients.

    PubMed

    Soriano, Vincent; Labarga, Pablo; de Mendoza, Carmen; Peña, José M; Fernández-Montero, José V; Benítez, Laura; Esposito, Isabella; Barreiro, Pablo

    2015-09-01

    Roughly 10 % of HIV-positive individuals worldwide have concomitant chronic hepatitis B virus (HBV) infection, with large differences between geographical regions and/or risk groups. Hepatitis B is a preventable infection with vaccines. However, it cannot be eradicated once acquired, resembling HIV and in contrast with HCV. In developed countries, hepatitis B exhibits particular features in the HIV population. First, HBV infection is less frequently misdiagnosed than in the general population. Second, nucleos(t)ide analogs active against HBV are widely used as part of antiretroviral combinations and are taken by most HIV patients. Lastly, as the HIV population ages given the success of antiretroviral therapy, non-AIDS co-morbidities are becoming a major cause of disease, for which specific drugs are required, increasing the risk of interactions and hepatotoxicity. Furthermore, concern on HBV reactivation is rising as immunosuppressive drug therapies are increasingly been used for cancers and other non-malignant conditions. In this scenario, new challenges are emerging in the management of hepatitis B in HIV-positive individuals. Among them, major interest is focused on failures to suppress HBV replication, HBV breakthroughs and reactivations, the meaning of isolated anti-HBc, screening for liver cancer, and the complexity arising when hepatitis viruses C and/or D are additionally present. This review will focus on these challenges and the major advances in HBV coinfection in HIV.

  17. Addressing challenges for future strategic-level emergency management: reframing, networking, and capacity-building.

    PubMed

    Bosomworth, Karyn; Owen, Christine; Curnin, Steven

    2017-04-01

    The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers.

  18. Supporting the Federal Emergency Management Agency Rescuers: a variation of critical incident stress management.

    PubMed

    Garcia, Evangeline; Horton, Denise A

    2003-02-01

    The purpose of this article was to document the efforts of two military installations in facilitating Critical Incident Stress Management teams for Federal Emergency Management Agency Rescue and Recovery Units following the attacks on the World Trade Center on September 11, 2001. McGuire Air Force Base accepted the mission to support the rotating task forces with emotional support, and Fort Dix offered temporary lodging while the teams were in-bound and out-bound to the "Ground Zero" site. A team, comprised of staff from both installations due to the configuration of professional and support staffs, does the Critical Incident Stress Management work. Both installations are within commuting distance of New York City and could provide adequate safety, security, and logistics to the teams. The classic crisis management models were not called into play, as that service was not asked for; however, it was clear to the McGuire Air Force Base/Fort Dix Critical Incident Stress Management team members that the rescue and recovery teams needed their physical presence. Many rescue organizations have their own "debriefing teams," yet it is believed that "outside teams" may be helpful as interim measures to demonstrate the universality of the process of coping with traumatic stress and grief management. It is hoped that this article honors the workers who came together to help in a very difficult time for our country. This article documents the interim measures that were taken for a group of people moving through crisis.

  19. Incident Management Systems and Building Emergency Management Capacity during the 2014-2016 Ebola Epidemic - Liberia, Sierra Leone, and Guinea.

    PubMed

    Brooks, Jennifer C; Pinto, Meredith; Gill, Adrienne; Hills, Katherine E; Murthy, Shivani; Podgornik, Michelle N; Hernandez, Luis F; Rose, Dale A; Angulo, Frederick J; Rzeszotarski, Peter

    2016-07-08

    Establishing a functional incident management system (IMS) is important in the management of public health emergencies. In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC established the Emergency Management Development Team (EMDT) to coordinate technical assistance for developing emergency management capacity in Guinea, Liberia, and Sierra Leone. EMDT staff, deployed staff, and partners supported each country to develop response goals and objectives, identify gaps in response capabilities, and determine strategies for coordinating response activities. To monitor key programmatic milestones and assess changes in emergency management and response capacities over time, EMDT implemented three data collection methods in country: coordination calls, weekly written situation reports, and an emergency management dashboard tool. On the basis of the information collected, EMDT observed improvements in emergency management capacity over time in all three countries. The collaborations in each country yielded IMS structures that streamlined response and laid the foundation for long-term emergency management programs.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

  20. Emergency Management Standards for NCAA Division I-A Football Stadia

    ERIC Educational Resources Information Center

    Hoogstra, Joshua R.

    2012-01-01

    In the best of times, emergency managers of athletic event venues struggle with the responsibilities of venue security. The possibility of terrorist threats exacerbates the situation, especially when security threats can involve a critical mass of spectators at an event. Emergency managers at the National Collegiate Athletic Association (NCAA)…

  1. Like a Hurricane: A Citation Analysis of Emergency Management Scholarly Literature

    ERIC Educational Resources Information Center

    Noe, Jennifer; Furay, Julia

    2013-01-01

    This bibliometric study used citation analysis to uncover citing characteristics in the burgeoning academic field of emergency management. Of the 281 degree programs listed by the Federal Emergency Management Agency nationwide, those at community colleges accounted for 17% of the total. Using the interdisciplinary database of Academic Search…

  2. Effective Behavior Management in Preschool Classrooms and Children's Task Orientation: Enhancing Emergent Literacy and Language Development

    ERIC Educational Resources Information Center

    Dobbs-Oates, Jennifer; Kaderavek, Joan N.; Guo, Ying; Justice, Laura M.

    2011-01-01

    This study investigated the relations among preschool teachers' behavior management, children's task orientation, and children's emergent literacy and language development, as well as the extent to which task orientation moderated the relation between teachers' behavior management and children's emergent literacy and language development.…

  3. Nursing management of aggression in a Singapore emergency department: A qualitative study.

    PubMed

    Tan, Mei Fen; Lopez, Violeta; Cleary, Michelle

    2015-09-01

    In Singapore, anecdotal evidence suggests that nurses are concerned about managing aggressive incidents in the emergency department. In this study, registered nurses' perceptions of managing aggressive patients in an emergency department were explored. Ten registered nurses from the emergency department of an acute public hospital in Singapore were interviewed. Four overarching themes emerged from the thematic analysis: (i) impact of aggressive patients on nurses; (ii) nursing assessment of aggressive behaviors; (iii) nursing management of aggressive behaviors; and (iv) organizational support and responsiveness. Further research is required to better support nurses to deliver optimal care for aggressive patients and achieve positive and effective outcomes.

  4. Project management plan, Hazardous Materials Management and Emergency Response Training Center

    SciTech Connect

    Borgeson, M.E.

    1994-12-12

    For the next 30 years, the main activities at the Hanford Site will involve the handling and cleanup of toxic substances. Thousands of workers involved in these new activities will need systematic training appropriate to their tasks and associated risks. This project is an important part of the Hanford Site mission and will enable the US Department of Energy (DOE) to meet high standards for safety. The Hazardous Materials Management and Emergency Response Training Center (HAMMER) project will construct a centralized regional training center dedicated to training hazardous materials workers and emergency responders in classrooms and with hands-on, realistic training aids representing actual field conditions. The HAMMER Training Center will provide a cost-effective, high-quality way to meet the Hanford Site training needs. The training center creates a partnership among DOE; government contractors; labor; local, state, and tribal governments; and selected institutions of higher education.

  5. Towards a better management of complex emergencies through crisis management meta-modelling.

    PubMed

    Lauras, Matthieu; Truptil, Sébastien; Bénaben, Frédérick

    2015-10-01

    Managing complex emergency situations is a challenging task, mainly due to the heterogeneity of the partners involved and the critical nature of such events. Whatever approach is adopted to support this objective, one unavoidable issue is knowledge management. In the context of our research project, gathering, formalising and exploiting all the knowledge and information about a given crisis situation is a critical requirement. This paper presents some research results concerning this specific topic: from a theoretical point of view, the generic dimensions of crisis characterisation are defined, while from a technical point of view, we describe a software solution able to collect that knowledge (based on meta-models and ontologies). This is used to confront the characteristics of the situation (context) with characteristics of the resources (relief system) in order to design a suitable response. Finally, an illustrative example concerning a crash between a tanker truck and a train is described.

  6. Emergency ventilation of the tracheostomy patient, part II: a story of tracheotomy history and emergency airway management--advocating education for emergency resuscitation.

    PubMed

    Sharp, Deidra Lynn

    2005-01-01

    Over a period of 5000 years, dramatic changes have occurred in airway management, tracheotomy procedure terminology, indications, techniques, instruments, settings where procedures are performed, tube design and patient outcomes. Specialized knowledge and skills necessary to safely care for tracheostomy patients and to provide effective respiratory resuscitation are reviewed. The purpose of this paper is to document the history of the tracheotomy as a backdrop for understanding patient management. Recommendations for staff education regarding emergency ventilation of the tracheostomy patient are presented.

  7. Policy-based approach to emergency bio-data management for mobile healthcare.

    PubMed

    Chun, Seung-Man; Park, Jong-Tae

    2014-01-01

    In m-healthcare service, accurate detection and notification of emergency situation are critical to chronic patients' life. Since they are usually performed by a limited number of medical staff, it is difficult to simultaneously support many patients in real-time. This article presents an architecture to support the emergency bio-data management for m-healthcare service using personalized emergency policy. The salient feature of the proposed architecture is that the decision on emergency is made using personalized emergency policy. Specifically, the structure of the detailed system components has also been designed. The emergency condition of the individual bio-data collected from wireless body area network is detected automatically using personalized emergency policy. The message flow diagram based on the personalized emergency policy is described. This enables quick emergency rescue service provided to the patient both accurately and immediately. The prototype of proposed system has been built to demonstrate the design concept.

  8. Managing alcohol related aggression in the emergency department (Part I).

    PubMed

    Ferns, Terry; Cork, Alison

    2008-01-01

    Internationally, violence in the emergency department (ED) is of a constant concern to emergency practitioners. Frequently, both original research papers and anecdotal reports emphasise the phenomenon of alcohol related aggression in the ED. In this first paper, we highlight the literatures discussion of alcohol related violence in the emergency department and the potential psychological effects of alcohol intoxication. In the second we offer personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

  9. Organizational Leaders and Managers: Historical and Emerging Perspectives.

    ERIC Educational Resources Information Center

    Howard, Ann; Bray, Douglas W.

    This paper examines 100 years of study of managers and leaders. The paper is divided into five distinct eras, with a color scheme providing a metaphor for each period. The five periods and their dates are: (1) Management Foundations, 1886-1916, when the first call was issued for a systematic study of management; (2) Rollercoaster Economy,…

  10. Collection and Dissemination of Volcanic Hazard Information for Emergency Managers

    NASA Astrophysics Data System (ADS)

    Mouginis-Mark, P. J.; Horton, K. A.; Garbeil, H.

    2010-12-01

    At the companion AGU special session in 2000, we predicted a significant future increase in the use of volcanic hazard information by emergency managers, such as the Pacific Disaster Center (PDC). Improvements in digital elevation models for volcanoes, the understanding of plume eruption dynamics, lava flow emplacement, and dome growth would all contribute to more accurate estimations of the likely damage and area affected. Automated "event detection algorithms" based on remote monitoring sensors, and on more frequent high resolution satellite coverage, were expected to provide quantitative data that would be distributed to the disaster management community via user-interactive web pages tailored to their geographic region of interest and the on-going style of volcanism. This year's activity at Iceland's Eyjafjallajokull volcano highlighted the need for a wide diversity of remote sensing capabilities around the world. It became clear that airline officials and trans-Atlantic flyers required detailed regional information that was often unavailable from the suite of orbital sensors. Contrast this with the wealth of orbital data, from more than a dozen different spacecraft, that was collected daily over the Gulf Oil Spill in mid-2010, and used for near real-time deployment of ships and coastal crews dealing with the event. So what has limited the use of remote sensing data for volcano hazard assessment? There have been some remote sensing successes. The on-going eruption of Halema'uma'u has prompted the development of an array of FLYSPEC SO2 measurement instruments that will be deployed downwind of the vent in order to provide better monitoring and prediction of hazardous conditions for the USGS Hawaiian Volcano Observatory and the Hawaii Volcanoes National Park. This array will provide high resolution, real-time measurement of SO2 flux from the vent during the daylight hours. However, this is a ground-based capability, rather than orbital. One of the inhibitors to

  11. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS RADIOLOGICAL EMERGENCY PLANNING AND PREPAREDNESS.... (b) Issue guidance in cooperation with other Federal agencies concerning their responsibilities for...) Foster cooperation of industry, technical societies, Federal agencies and other constituencies in...

  12. Managing alcohol related aggression in the emergency department (Part II).

    PubMed

    Cork, Alison; Ferns, Terry

    2008-04-01

    Violence in the emergency department (ED) is a global problem. In our first paper, we highlighted the potential psychological effects of alcohol intoxication, the literatures discussion of alcohol related violence in the emergency department and the importance of developing positive nurse/service user relationships. In this second paper, we discuss personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

  13. Hypertensive emergencies in children: identification and management of dangerously high blood pressure.

    PubMed

    Constantine, E; Merritt, C

    2009-04-01

    The prevalence of hypertension in the pediatric population is rising, coincident with the rise in childhood obesity worldwide. While most hypertensive children do not require emergent care, hypertensive urgencies and emergencies may be encountered in the outpatient clinic, the emergency department or the inpatient ward. To avoid the life-threatening complications associated with both hypertension and its treatment, the treating physician should be familiar with the presentation and management of pediatric hypertension. This review will serve to examine some of the important aspects of pediatric hypertensive urgencies and emergencies, including common causes, important features of diagnosis and options for medical management.

  14. Supporting command and control training functions in the emergency management domain using cognitive systems engineering.

    PubMed

    Ntuen, Celestine A; Balogun, Obafemi; Boyle, Edward; Turner, Amy

    The design and implementation of MERMAIDS, a computer-based training system in the domain of emergency command and control, is described. The research investigates the use of cognitive systems engineering and information management tools for modelling and representing training knowledge of emergency system operators. We propose a decision-centric human-computer interface as a new method of supporting computer-based modelling in the domain of emergency systems. Several interacting themes in information management relevant to emergency response planning are discussed.

  15. Enhancing the Relevance of Incident Management Systems in Public Health Emergency Preparedness: A Novel Conceptual Framework.

    PubMed

    Bochenek, Richard; Grant, Moira; Schwartz, Brian

    2015-08-01

    We outline a conceptual framework developed to meet the needs of public health professionals in the province of Ontario for incident management system-related education and training. By using visual models, this framework applies a public health lens to emergency management, introducing concepts relevant to public health and thereby shifting the focus of emergency preparedness from a strict "doctrine" to a more dynamic and flexible approach grounded in the traditional principles of incident management systems. These models provide a foundation for further exploration of the theoretical foundations for public health emergency preparedness in practice.

  16. Emergency Management Span of Control: Optimizing Organizational Structures to Better Prepare Vermont for the Next Major or Catastrophic Disaster

    DTIC Science & Technology

    2008-12-01

    B. Presnell. Modeling an Emergency Operations Center with Agents. Paper presented at the 2005 Winter Simulation Conference, Walt Disney World ...management in Vermont, to enable effective emergency management during the next man-made or natural disaster. 15. NUMBER OF PAGES 159 14. SUBJECT TERMS...regional construct for emergency management in Vermont, to enable effective emergency management during the next man-made or natural disaster. vi THIS

  17. School Management and Contingency Theory: An Emerging Perspective.

    ERIC Educational Resources Information Center

    Hanson, E. Mark

    An understanding of the "situational" characteristics of the organizational forces that influence the relationships between environmental, management, and performance variables is now coming to be seen as a key to understanding the management process itself. This paper is a synthesis of the contingency theory literature drawn from the…

  18. Assessment of the Temperament, Motivation, and Capability of a School System District for Emergency Management/Crisis Performance

    ERIC Educational Resources Information Center

    Hoff, Larry A.

    2009-01-01

    This study was a cross-sectional study of leadership and staff of a public school system in Georgia concerning their temperament type, emergency management motivation and emergency management knowledge in relation to Emergency Management/Crisis performance (ERCM). The study consisted of an inclusive questionnaire that contains questions on four…

  19. General medicine and surgery for dental practitioners: part 3. Management of specific medical emergencies in dental practice.

    PubMed

    Greenwood, M; Meechan, J G

    2014-07-11

    In this paper, the actions needed to manage specific medical emergencies are discussed. Each emergency requires a correct diagnosis to be made for effective and safe management. Contemporary management in dental practice avoids the intravenous route when drugs are required to treat the emergency.

  20. 75 FR 1037 - Office of Safe and Drug-Free Schools; Overview Information; Readiness and Emergency Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ...; Readiness and Emergency Management for Schools; Notice Inviting Applications for New Awards for Fiscal Year... Emergency Management for Schools (REMS) grant program provides funds to local educational agencies (LEAs) to... must include a plan to create, strengthen, or improve emergency management plans, at the LEA and...

  1. The Office of Land and Emergency Management is Seeking Feedback on Reducing Regulatory Burden

    EPA Pesticide Factsheets

    This page contains information about the comments the Office of Land and Emergency Management is collecting and the public meeting they are holding in response to Executive Order 13777 Regulatory Reform Review

  2. Defining disaster resilience: comparisons from key stakeholders involved in emergency management in Victoria, Australia.

    PubMed

    Goode, Natassia; Salmon, Paul M; Spencer, Caroline; McArdle, Dudley; Archer, Frank

    2017-01-01

    Three years after the introduction of the National Strategy for Disaster Resilience there remains no unanimously adopted definition of disaster resilience within Australia's emergency management sector. The aim of this study is to determine what the concept means to key stakeholders in the emergency management sector in the Australian State of Victoria, and how these conceptualisations overlap and diverge. Via an online survey, 113 people were asked how they define disaster resilience in their work in the emergency management sector. A data mining software tool, Leximancer, was employed to uncover the relationships between the definitions provided. The findings show that stakeholders see resilience as an 'ability' that encompasses emergency management activities and personal responsibility. However, the findings also highlight some possible points of conflict between stakeholders. In addition, the paper outlines and discusses a number of potential consequences for the implementation and the success of the resilience-based approach in Australia.

  3. The Multi-Dimensional Nature of Emergency Communications Management

    ERIC Educational Resources Information Center

    Staman, E. Michael; Katsouros, Mark; Hach, Richard

    2009-01-01

    Within an incredibly short period--perhaps less than twenty-four months--the need for emergency preparedness has risen to a higher level of urgency than at any other time in the history of academe. Large or small, public or private, higher education institutions are seriously considering the dual problems of notification and communications…

  4. Managing Bipolar Youths in a Psychiatric Inpatient Emergency Service

    ERIC Educational Resources Information Center

    Masi, Gabriele; Mucci, Maria; Pias, Paola; Muratori, Filippo

    2011-01-01

    Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 plus or minus 3.1 years) received a diagnosis of BD, according to historical information, prolonged…

  5. Action Guide for Emergency Management at Institutions of Higher Education

    ERIC Educational Resources Information Center

    US Department of Education, 2009

    2009-01-01

    Because of recent violent crimes, natural disasters, and other emergencies or crises, colleges and universities are convening committees and task forces to reexamine or conduct a comprehensive review of policies, procedures, and systems related to campus safety and security. As with many critical areas on the agendas of administrators, campus…

  6. Assessment and Management of Bullied Children in the Emergency Department

    PubMed Central

    Waseem, Muhammad; Ryan, Mary; Foster, Carla Boutin; Peterson, Janey

    2015-01-01

    Bullying is an important public health issue in the United States. Up to 30% of children report exposure to such victimization. Not only does it hurt bully victim, but it also negatively impacts the bully, other children, parents, school staff, and health care providers. Because bullying often presents with accompanying serious emotional and behavioral symptoms, there has been an increase in psychiatric referrals to emergency departments. Emergency physicians may be the first responders in the health care system for bullying episodes. Victims of bullying may present with nonspecific symptoms and be reluctant to disclose being victimized, contributing to the underdiagnosis and underreporting of bully victimization. Emergency physicians therefore need to have heightened awareness of physical and psychosocial symptoms related to bullying. They should rapidly screen for bullying, assess for injuries and acute psychiatric issues that require immediate attention, and provide appropriate referrals such as psychiatry and social services. This review defines bullying, examines its presentations and epidemiology, and provides recommendations for the assessment and evaluation of victims of bullying in the emergency department. PMID:23462401

  7. Guidelines for the management of anaphylaxis in the emergency department.

    PubMed Central

    Gavalas, M; Sadana, A; Metcalf, S

    1998-01-01

    An algorithm for the emergency treatment of anaphylaxis is presented. The need for early hands-on involvement of senior personnel is stressed. Continuous assessment, monitoring of response to treatment, and a low threshold for hospital admission for observation and further treatment if necessary are required. PMID:9570048

  8. Emergency Management in Public Administration Education. Volume 2, Number 1

    DTIC Science & Technology

    1985-01-01

    of the 1976 Earthquake in the Soca River Basin," in Social and Economic Aspects of Earthquakes: Proceedings of the Third International Conference...Uses, Institute of Behavioral Science, Boulder, Colorado: Univ-ersity of Colorado, 1976 . Baltz, Duane, "Applying Interlocal Agreements to Emergency...Research Findings, Issues, Implications for Organizational Policy," Boulder, Colorado: Institute of Behavioral Science, University of Colorado, 1976

  9. Cloud-Based Data Sharing Connects Emergency Managers

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Under an SBIR contract with Stennis Space Center, Baltimore-based StormCenter Communications Inc. developed an improved interoperable platform for sharing geospatial data over the Internet in real time-information that is critical for decision makers in emergency situations.

  10. Early identification and management of patients with severe sepsis and septic shock in the emergency department.

    PubMed

    Keegan, Joshua; Wira, Charles R

    2014-11-01

    Severe sepsis and septic shock have great relevance to Emergency Medicine physicians because of their high prevalence, morbidity, and mortality. Treatment is time-sensitive, depends on early identification risk stratification, and has the potential to significantly improve patient outcomes. In this article, we review the pathophysiology of, and evidence basis for, the emergency department management of severe sepsis and septic shock.

  11. Pharmaceutical prescribing for children. Part 6. The management of medical emergencies in children in dental practice.

    PubMed

    Palmer, Nikolaus O A; Fleming, Pádraig; Randall, Christine

    2007-01-01

    This paper is the seventh in the series on prescribing medicines for child dental patients. Here, the authors aim to describe the medical emergencies that may occur in children presenting for dental treatment and to provide guidelines on their management, with particular reference to the use of emergency drugs.

  12. Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin

    PubMed Central

    Ahanhanzo, Yolaine Glèlè; Kpozehouen, Alphonse; Sopoh, Ghislain; Sossa-Jérôme, Charles; Ouedraogo, Laurent; Wilmet-Dramaix, Michèle

    2016-01-01

    Introduction The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. Methods The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. Results The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Conclusion Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility. PMID:27800116

  13. Emerging technological and cultural shifts advancing drylands research and management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Sustainable provisioning of ecosystem services in dryland landscapes is complicated by extreme conditions that constrain biological responses to perturbation, vast spatial and temporal complexity, and uncertainty regarding the resilience of these ecosystems to management practices and climate change...

  14. Materials management and logistics in the emergency department.

    PubMed

    Williams, Mike

    2004-02-01

    The modern ED must create a clinical environment that has a predictable and sustainable production process equal to the needs of the patients. This means careful analysis of supply and equipment needs but also of costs and revenue challenges. Prediction models and contemporary supply chain management tools go a long way in assisting the manager to meet this need and in maintaining a clinically competent and financially stable ED.

  15. The Role of Science and Technology in Emergency Management.

    DTIC Science & Technology

    1982-01-01

    AD-A12 998 THE RDLE 0F SCIENCE AND TECHNOLOGY IN EMERGENCY I/ MANAGEMEN (U) NATIONAL RESEARCH CDUNCI WASHINDTON DC UN S D R W MDRSE ET AL 1982 EMW-C...victims. Also, operations may be mounted to counter secondary threats, such as urban fires in earthquakes, contaminated water supplies or other...Keely, and E. C. Lusk. Current Status and Future Considerations for a Transportation System for Spent Fuel and Radioactive Wastes . Barnwell, South

  16. Recent California Water Transfers: Emerging Options in Water Management

    DTIC Science & Technology

    1992-12-01

    SWP water supply contractors or to meet other SWP and State obligations. In other words , transferred water received lowest conveyance and storage...and operation. For agricultural water districts, the existence of water banks and spot markets during drought has implications for the wording of water ...AD-A273 276 / j US Army Corps II l IIIIIIIIII of Engineers Hydrologic Engineering Center Recent California Water Transfers: Emerging Options in Water

  17. Disaster management and the critical thinking skills of local emergency managers: correlations with age, gender, education, and years in occupation.

    PubMed

    Peerbolte, Stacy L; Collins, Matthew Lloyd

    2013-01-01

    Emergency managers must be able to think critically in order to identify and anticipate situations, solve problems, make judgements and decisions effectively and efficiently, and assume and manage risk. Heretofore, a critical thinking skills assessment of local emergency managers had yet to be conducted that tested for correlations among age, gender, education, and years in occupation. An exploratory descriptive research design, using the Watson-Glaser Critical Thinking Appraisal-Short Form (WGCTA-S), was employed to determine the extent to which a sample of 54 local emergency managers demonstrated the critical thinking skills associated with the ability to assume and manage risk as compared to the critical thinking scores of a group of 4,790 peer-level managers drawn from an archival WGCTA-S database. This exploratory design suggests that the local emergency managers, surveyed in this study, had lower WGCTA-S critical thinking scores than their equivalents in the archival database with the exception of those in the high education and high experience group.

  18. Adult Status Epilepticus: A Review of the Prehospital and Emergency Department Management

    PubMed Central

    Billington, Michael; Kandalaft, Osama R.; Aisiku, Imoigele P.

    2016-01-01

    Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents. PMID:27563928

  19. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management

    PubMed Central

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    training of emergency issues, increasing the teamwork, facing a variety of patients, practicing the role of general practitioners, role-playing on a real patient's bedside, having a multilateral approach to the patient, reducing the wasting time on minor wards, balancing the work and rest schedules of the interns, and better learning and satisfaction of the interns. Over 60% of the participants believed the program has the following benefits: More attention on the training plan, improving the learning of patient management, being more responsive for the training of interns, increasing operational approach to emergency patients, being more aware of the performed actions, and increasing the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managing during the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure. PMID:24520557

  20. Emerging geomorphic approaches to guide river management practices

    NASA Astrophysics Data System (ADS)

    Brierley, Gary; Hooke, Janet

    2015-12-01

    Humans have been modifying river systems across much of the world for many thousands of years. Initially, piecemeal impacts inadvertently affected particular parts of landscapes. Subsequently, many rivers have been subjected to multiple layers of human disturbance, and changes have become widespread and systematic. Increasingly, human impacts reflect deliberative actions as part of river management programmes. These activities entail significant choices in determining the desirable (or acceptable) state and behavioural regime of a river. Typically, contemporary decision-making reflects negotiations among multiple stakeholders, seeking to provide balanced approaches to the management of socio-economic, cultural, and environmental values (e.g. Jähnig et al., 2011).

  1. Elective and emergent operative management of ulcerative colitis.

    PubMed

    Metcalf, Amanda M

    2007-06-01

    Surgical therapy of ulcerative colitis is effective, safe, and provides an improved quality of life in those whose disease cannot be managed medically. In the elective setting, widespread acceptance of restorative proctocolectomy has made surgical therapy an attractive option in the overall management of ulcerative colitis. Enthusiasm for this procedure should be tempered by the acknowledgment of the significant incidence of pouchitis in the long term, however. Proctocolectomy with ileostomy remains a good surgical option for patients who are unsuitable for restorative procedures. The standard therapy for fulminant colitis or toxic megacolon remains subtotal colectomy with ileostomy. Patients undergoing subtotal colectomy are candidates for conversion to restorative procedures.

  2. Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

    PubMed

    Popat, H; Thomas, K; Farnell, D J J

    2016-07-08

    Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.

  3. Using Geo-Data Corporately on the Response Phase of Emergency Management

    NASA Astrophysics Data System (ADS)

    Demir Ozbek, E.; Ates, S.; Aydinoglu, A. C.

    2015-08-01

    Response phase of emergency management is the most complex phase in the entire cycle because it requires cooperation between various actors relating to emergency sectors. A variety of geo-data is needed at the emergency response such as; existing data provided by different institutions and dynamic data collected by different sectors at the time of the disaster. Disaster event is managed according to elaborately defined activity-actor-task-geodata cycle. In this concept, every activity of emergency response is determined with Standard Operation Procedure that enables users to understand their tasks and required data in any activity. In this study, a general conceptual approach for disaster and emergency management system is developed based on the regulations to serve applications in Istanbul Governorship Provincial Disaster and Emergency Directorate. The approach is implemented to industrial facility explosion example. In preparation phase, optimum ambulance locations are determined according to general response time of the ambulance to all injury cases in addition to areas that have industrial fire risk. Management of the industrial fire case is organized according to defined actors, activities, and working cycle that describe required geo-data. A response scenario was prepared and performed for an industrial facility explosion event to exercise effective working cycle of actors. This scenario provides using geo-data corporately between different actors while required data for each task is defined to manage the industrial facility explosion event. Following developing web technologies, this scenario based approach can be effective to use geo-data on the web corporately.

  4. Assistive Technology and Older Adults in Disasters: Implications for Emergency Management.

    PubMed

    McSweeney-Feld, Mary Helen

    2017-02-01

    This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).

  5. How To Manage the Emerging Generational Divide in the Contemporary Knowledge-Rich Workplace.

    ERIC Educational Resources Information Center

    Novicevic, Milorad M.; Buckley, M. Ronald

    2001-01-01

    Addresses the manager's dilemmas and options in resolving emerging latent intergenerational conflict in the contemporary knowledge-rich workplace. Topics include a theoretical framework for generational divide management; the polarization in task requirements; social and environmental factors; differences in employee needs and expectations; and…

  6. Quality management case studies in health service emergencies: SARS and wildland-urban interface fires.

    PubMed

    Lynch, Tim; Dauphinee, Wayne

    2005-01-01

    The province of British Columbia, Canada, experienced 2 major health emergency situations during 2003: severe acute respiratory syndrome (SARS) in early 2003 and wildland-urban interface fires during the summer of 2003. The interface fires occurred within the boundaries of the Interior Health Authority, 1 of 5 health authorities responsible for the delivery of health services in their respective areas of the province. The British Columbia Center for Disease Control (BCCDC) managed the SARS crisis in the province. Both organizations subsequently conducted quality management reviews of their handling of these emergency situations. This article reports on the quality management review of health services delivery during the interface fires and explores the role of physicians during regional emergencies. A similar report was published in the Spring 2004 edition of Quality Management in Health Care on the way SARS was managed at the BCCDC. This article also compares managing a foreseeable emergency situation, such as a wildland-urban interface fire, with managing the unknown, which describes the situation during the initial stages of SARS. The realities confronting the unknown, and the need to manage the situation such that learning and discovery environments are allowed to come into being and evolve rapidly, are discussed.

  7. Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department

    ERIC Educational Resources Information Center

    Choo, Esther K.; Spiro, David M.; Lowe, Robert A.; Newgard, Craig D.; Hall, Michael Kennedy; McConnell, Kenneth John

    2010-01-01

    Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs.…

  8. Managing for Biodiversity: Emerging Ideas for the Electric Utility Industry-Summary Statement

    PubMed

    MATTICE; FRASER; RAGONE; DAUGHERTY; WISNIEWSKI

    1996-11-01

    / The conference entitled "Managing for Biodiversity: Emerging Ideas for the Electric Utility Industry" was held in Williamsburg, Virginia, USA, during 19-20 March 1996. This paper provides an overview of the key points, conclusions, and recommendations from both the presentations/papers and the discussions throughout the conference.KEY WORDS: Biodiversity; Partnerships; Utilities; Ecosystem management; Conservation; Electrification

  9. Compliance with and attitudes towards the management of medical emergencies in general dental practice.

    PubMed

    Johnson, T M; Kurt-Gabel, C

    2014-02-01

    Patient safety and risk management are increasing priorities in dental practice today. Ensuring that members of the dental team are prepared and equipped to adequately manage the common medical emergencies that might occur is an expectation of the public and increasingly demanded by the inspecting and regulatory bodies in healthcare.

  10. Assessment and emergency management of suicidality in personality disorders.

    PubMed

    Zaheer, Juveria; Links, Paul S; Liu, Eleanor

    2008-09-01

    This article examines the association between suicidal behavior and personality disorders. It updates the review of epidemiological evidence for the association between suicidal behavior and suicide in individuals who have a personality disorder diagnosis, particularly in borderline personality disorder (BPD). The second part of the article presents new empirical evidence that characterizes suicidal behavior in patients who have BPD, specifically examining patient characteristics that differentiate patients who have BPD with a history of high versus low lethality suicide attempts. Finally, the article discusses the approach to a patient who has BPD and presents to the emergency department because of an increased risk of suicide.

  11. A Guide for Emergency Evacuation Management and Operations

    DTIC Science & Technology

    1981-02-01

    to be stockpiled will be determined in part by the amount of water available in each shelter as a result of being trapped in the plumbing system, water...lbs. Sugars, Syrups , Honey and Other Sweets 1/2 lb. 20-6 EXHIBIT 20.2 NATIONAL EMERGENCY WXIMUM FOOD ALLOWANCE SUBSTITUTES FOR FOODS I1 EXHIBIT 20.1...differences encountered in host area operations. No guidance can replace the professional judgement and local knowledge in determining how best to react to

  12. Emerging Network Storage Management Standards for Intelligent Data Storage Subsystems

    NASA Technical Reports Server (NTRS)

    Podio, Fernando; Vollrath, William; Williams, Joel; Kobler, Ben; Crouse, Don

    1998-01-01

    This paper discusses the need for intelligent storage devices and subsystems that can provide data integrity metadata, the content of the existing data integrity standard for optical disks and techniques and metadata to verify stored data on optical tapes developed by the Association for Information and Image Management (AIIM) Optical Tape Committee.

  13. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.2

    SciTech Connect

    Burford, M.J.; Burnett, R.A.; Curtis, L.M.

    1996-05-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS system package. System administrators, database administrators, and general users can use this guide to install, configure, and maintain the FEMIS client software package. This document provides a description of the FEMIS environment; distribution media; data, communications, and electronic mail servers; user workstations; and system management.

  14. Managing emergencies and abnormal situations in air traffic control (part I): taskwork strategies.

    PubMed

    Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry

    2010-07-01

    A lot of research in Air Traffic Control (ATC) has focused on human errors in decision making whilst little attention has been paid to the cognitive strategies employed by controllers in managing abnormal situations. This study looks into cognitive strategies in taskwork that enable controllers to become resilient decision-makers. Two field studies were carried out where novice and experienced controllers were observed in simulator training in emergency and unusual scenarios. A prototype model of taskwork strategies in air traffic management was developed and its construct validity was tested in the context of the field studies. A companion study (part II), follows that investigates aspects of teamwork in the same field and contributes to the development of a generic model of Taskwork & Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). The final section addresses the difficulties experienced by novice controllers and explains taskwork strategies employed by experts to manage uncertainty and balance workload in simulator emergencies.

  15. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.3

    SciTech Connect

    Burford, M.J.; Burnett, R.A.; Downing, T.R.

    1996-12-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the (Pacific Northwest National Laboratory) (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. 91 This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login, privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment.

  16. Collaboration between civilian and military healthcare professionals: a better way for planning, preparing, and responding to all hazard domestic events.

    PubMed

    Marklund, LeRoy A; Graham, Adrienne M; Morton, Patricia G; Hurst, Charles G; Motola, Ivette; Robinson, Donald W; Kelley, Vivian A; Elenberg, Kimberly J; Russler, Michael F; Boehm, Daniel E; Higgins, Dawn M; McAndrew, Patrick E; Williamson, Hope M; Atwood, Rodney D; Huebner, Kermit D; Brotons, Angel A; Miller, Geoffrey T; Rimpel, Laukton Y; Harris, Larry L; Santiago, Manuel; Cantrell, LeRoy

    2010-01-01

    Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.

  17. The re-emergence of clinical service line management.

    PubMed

    Litch, Bonnie K

    2007-01-01

    As healthcare leaders are positioning their organizations for a more competitive environment characterized by expanding consumer choice models, they are renewing their attention on organizing along clinical service lines. Bringing together clinical services in ways meaningful to patients can improve quality b better integrating care, while at the same time strengthening an organization's market position and creating new opportunities for increased physician collaboration--from collaborative planning to management to economic participation.

  18. Management of Pneumothorax in Emergency Medicine Departments: Multicenter Trial

    PubMed Central

    Ince, Abdulkadir; Ozucelik, Dogac Niyazi; Avci, Akkan; Nizam, Ozgur; Dogan, Halil; Topal, Mehmet Ali

    2013-01-01

    Background: Pneumothorax is common and life-threatening clinical condition which may require emergency treatment in Emergency Medicine Departments. Objectives: We aimed to reveal the epidemiological analysis of the patients admitted to the Emergency Department with pneumothorax. Material and Methods: This case-control and multi-center study was conducted in the patients treated with the diagnosis of pneumothorax between 01.01.2010-31.12.2010. Patient data were collected from hospital automation system. According to the etiology of the pneumothorax, study groups were arranged like spontaneous pneumothorax and traumatic pneumothorax. Results: 82.2% (n = 106) of patients were male and 17.8% (n = 23) of patients were female and mean age were 31.3 ± 20,2 (Minimum: 1, Maximum: 87). 68.2% (n = 88) of patients were spontaneous pneumothorax (61.36%, n=79 were primary spontaneous pneumothorax) and 31.8% (n = 41) of patients were traumatic pneumothorax (21.95% were iatrogenic pneumothorax). Main complaint is shortness of breath (52.3%, n=67) and 38% (n=49) of patients were smokers. Posteroanterior (PA) Chest X-Ray has been enough for 64.3% (n = 83) of the patients' diagnosis. Tube thoracostomy is applied to 84.5% (n = 109) of patients and surgery is applied to 9.3% (n = 12) of patients and 6.2% (n = 8) of patients were discharged with conservative treatment. Spontaneous pneumothorax showed statistically significant high recurrence compared with traumatic pneumothorax (P = 0.007). 4.65% of (n = 6) patients died. The average age of those who died (9.3 ± 19.9), statistically were significantly lower the mean age of living patients (32.4 ± 19.7) (t test, P = 0,006). 83.33% of the patients who died were neonatals and in the 0-1 years age group, and five of these patients were secondary spontaneous pneumothorax, and one of these patients were iatrogenic pneumothorax due to mechanical ventilation. Conclusions: Pneumothorax in adults can be treated by tube thoracostomy or

  19. Current and emerging treatments for the management of osteogenesis imperfecta

    PubMed Central

    Monti, Elena; Mottes, Monica; Fraschini, Paolo; Brunelli, PierCarlo; Forlino, Antonella; Venturi, Giacomo; Doro, Francesco; Perlini, Silvia; Cavarzere, Paolo; Antoniazzi, Franco

    2010-01-01

    Osteogenesis imperfecta (OI) is the most common bone genetic disorder and it is characterized by bone brittleness and various degrees of growth disorder. Clinical severity varies widely; nowadays eight types are distinguished and two new forms have been recently described although not yet classified. The approach to such a variable and heterogeneous disease should be global and therefore multidisciplinary. For simplicity, the objectives of treatment can be reduced to three typical situations: the lethal perinatal form (type II), in which the problem is survival at birth; the severe and moderate forms (types III–IX), in which the objective is ‘autonomy’; and the mild form (type I), in which the aim is to reach ‘normal life’. Three types of treatment are available: non-surgical management (physical therapy, rehabilitation, bracing and splinting), surgical management (intramedullary rod positioning, spinal and basilar impression surgery) and medical-pharmacological management (drugs to increase the strength of bone and decrease the number of fractures as bisphosphonates or growth hormone, depending on the type of OI). Suggestions and guidelines for a therapeutic approach are indicated and updated with the most recent findings in OI diagnosis and treatment. PMID:20856683

  20. Transforming Water Management: an Emerging Promise of Integrated Earth Observations

    NASA Astrophysics Data System (ADS)

    Lawford, R. G.

    2011-12-01

    Throughout its history, civilization has relied on technology to facilitate many of its advances. New innovations and technologies have often provided strategic advantages that have led to transformations in institutions, economies and ultimately societies. Observational and information technologies are leading to significant developments in the water sector. After a brief introduction tracing the role of observational technologies in the areas of hydrology and water cycle science, this talk explores the existing and potential contributions of remote sensing data in water resource management around the world. In particular, it outlines the steps being undertaken by the Group on Earth Observations (GEO) and its Water Task to facilitate capacity building efforts in water management using Earth Observations in Asia, Africa and Latin and Caribbean America. Success stories on the benefits of using Earth Observations and applying GEO principles are provided. While GEO and its capacity building efforts are contributing to the transformation of water management through interoperability, data sharing, and capacity building, the full potential of these contributions has not been fully realized because impediments and challenges still remain.

  1. IT management and governance systems and their emergence in healthcare.

    PubMed

    Mohrmann, Gregg; Kropf, Roger

    2007-01-01

    Today's healthcare IT departments are challenged with understanding the total service demand imposed by their user communities and how much of their limited resources are available to meet that demand. This challenge is being addressed through the use of new IT management and governance (IT-MG) systems. This software supports IT governance and project and portfolio management. IT-MG is a relatively new term to healthcare; it entails reviewing and managing demand for IT services from inception to completion through the application of IT resources. These systems help save time through automated reporting and quicker delivery of services; they save money by more effectively addressing resource needs on time and on budget. The systems also reduce the number of administrative tasks through process automation; increase customer satisfaction by communicating services and deliverables more quickly and accurately; and help executives make better and more informed decisions about priorities and expectations through reporting that was previously nonexistent. This article will explore IT-MG systems and present a case study of a hospital that rapidly implemented this type of system.

  2. [Emergency care of vertigo patients: suggestions for efficient management].

    PubMed

    Kogashiwa, Yasunao; Takei, Yasuhiko; Matsuda, Takeaki; Karaho, Takehiro; Morita, Masahiro; Kohno, Naoyuki

    2009-10-01

    Some diseases in which persons show vertigo or dizziness may be life-threatening, regardless of symptom severity, and require careful attention. These include diseases of the inner ear, central nervous system, and cardiovascular manifestation. In May 2006, a group in charge of primary emergency consultation began work enabling physicians to treat vertigo patients more efficiently and safely, as detailed in this report. Of the 173 persons with vertigo hospitalized from January 2004 to March 2008, six had cerebrovascular manifestations clarified only after hospitalization, underscoring the importance of careful examination, especially of those 75 years of age older, having continuous headache, having severe trunk ataxia despite apparently mild eye nystagmus, or reporting a history of high blood pressure, diabetes mellitus, hyperlipidemia, or ischemic heart disease.

  3. Emergency management of bleeding esophageal varices: Drugs, bands or sleep?

    PubMed Central

    Yan, Brian M; Lee, Samuel S

    2006-01-01

    Variceal bleeding is a severe complication of cirrhosis leading to significant morbidity and mortality. Treatment of acute variceal bleeding has improved dramatically since the era of the mechanical balloon tamponade. These advances include endoscopic band ligation or sclerotherapy, and vasoactive pharmacological options such as somatostatin, octreotide, vasopressin and terlipressin. Evidence from a multitude of clinical trials and meta-analyses comparing endoscopic and pharmacological treatments suggests near equivalence in efficacy for initial hemostasis, mortality and rate of rebleeding. This raises the question of whether on-call gastroenterologists should be performing emergency endoscopic treatment in the middle of the night or start pharmacological treatment and delay endoscopy until optimal patient and working conditions the next morning. The present review analyzes the available comparative data between endoscopic and pharmacological treatment options. Although the literature cannot yet definitively answer the question posed, the authors suggest that delaying endoscopic treatment until the next morning may be the most reasonable practical approach. PMID:16550260

  4. Management of oral and genital herpes in the emergency department.

    PubMed

    Mell, Howard K

    2008-05-01

    The epidemiology of oral and genital herpes has dramatically changed over the past decade. Herpes simplex virus-1, traditionally associated with oral herpes, is now implicated in an increasing percentage of genital herpes cases. The possibility of "autoinoculation" (or self-infection) of anatomic sites other than that of the primary infection has been recognized. New methods of suppression therapy are being examined. These changes have led to a revision in the recommendations by the Centers for Disease Control and Prevention (CDC). This review discusses herpes infections of the oral and genital mucosa and the suggested approach to the infected patient who presents in the emergency department. Specific attention is given to the CDC's 2006 guidelines for the treatment of sexually transmitted diseases.

  5. Sepsis in cirrhosis: emerging concepts in pathogenesis, diagnosis and management.

    PubMed

    Philips, Cyriac Abby; Sarin, Shiv Kumar

    2016-11-01

    Infections and sepsis are more common in cirrhotic than in the general population and constitute the commonest cause of sudden worsening and death. The diagnosis of systemic inflammatory syndrome and sepsis are challenging in cirrhotics due to an underlying a state of hyperdynamic circulation. Further, poor nutritional and bone marrow reserves lead to modest host immune response, the so called immunoparalysis state and the outcome of antibiotic therapy is suboptimal. In this review, a comprehensive description of current and emerging concepts in the pathogenesis and diagnosis of sepsis with importance to current and novel biomarkers for diagnosis of sepsis in cirrhosis is presented. Furthermore, novel treatment options and preventive strategies are discussed to improve the overall survival.

  6. On a Monitoring Network of Territory Elements for Emergency Management

    NASA Astrophysics Data System (ADS)

    Teramo, A.; Marino, A.; Termini, D.; Teramo, M.; Saccà, C.; Romeo, M.; de Domenico, D.; Lupò, D.

    2010-12-01

    The proposed methodological approach, based on the implementation of innovative monitoring networks of territories falling within high seismicity areas, aims at the arrangement of tools for a reduction of urban and territorial seismic vulnerability through procedures of territorial diagnostics with early warning thresholds. In this preliminary phase of the study, several problems have been analysed and solved related to wireless sensor typology to be used and data to be acquired for the realization of a expert system for a real time check of escape route conditions in case of a catastrophe, and the structural reliability of buildings, also strategic type, for preliminary damage evaluations. Specific analysis tools of acquired data by monitoring networks have been arranged for an analysis in relation to main territorial risk factors of a given area, arranging GIS maps in real time for the reduction of territorial system criticalities also during the emergencies.

  7. Pharmacotherapy for uveitis: current management and emerging therapy

    PubMed Central

    Barry, Robert J; Nguyen, Quan Dong; Lee, Richard W; Murray, Philip I; Denniston, Alastair K

    2014-01-01

    Uveitis, a group of conditions characterized by intraocular inflammation, is a major cause of sight loss in the working population. Most uveitis seen in Western countries is noninfectious and appears to be autoimmune or autoinflammatory in nature, requiring treatment with immunosuppressive and/or anti-inflammatory drugs. In this educational review, we outline the ideal characteristics of drugs for uveitis and review the data to support the use of current and emerging therapies in this context. It is crucial that we continue to develop new therapies for use in uveitis that aim to suppress disease activity, prevent accumulation of damage, and preserve visual function for patients with the minimum possible side effects. PMID:25284976

  8. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.4

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Downing, T.R.

    1997-11-21

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login privileges, and usage. The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via telecommunications links.

  9. Federal Emergency Management Information System (FEMIS) system administration guide, version 1.4.5

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Carter, R.J.

    1998-06-26

    The Federal Emergency Management Information Systems (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the US Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication, data distribution, and notification functionality necessary to operate FEMIS in a networked, client/server environment. The UNIX server provides an Oracle relational database management system (RDBMS) services, ARC/INFO GIS (optional) capabilities, and basic file management services. PNNL developed utilities that reside on the server include the Notification Service, the Command Service that executes the evacuation model, and AutoRecovery. To operate FEMIS, the Application Software must have access to a site specific FEMIS emergency management database. Data that pertains to an individual EOC`s jurisdiction is stored on the EOC`s local server. Information that needs to be accessible to all EOCs is automatically distributed by the FEMIS

  10. Current and emerging treatment options in the management of lupus

    PubMed Central

    Jordan, Natasha; D’Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected. PMID:27529058

  11. Current and emerging treatment options in the management of lupus.

    PubMed

    Jordan, Natasha; D'Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected.

  12. Complications of bariatric surgery: Presentation and emergency management.

    PubMed

    Kassir, Radwan; Debs, Tarek; Blanc, Pierre; Gugenheim, Jean; Ben Amor, Imed; Boutet, Claire; Tiffet, Olivier

    2016-03-01

    The epidemic in obesity has led to an increase in number of so called bariatric procedures. Doctors are less comfortable managing an obese patient after bariatric surgery. Peri-operative mortality is less than 1%. The specific feature in the obese patient is that the classical signs of peritoneal irritation are never present as there is no abdominal wall and therefore no guarding or rigidity. Simple post-operative tachycardia in obese patients should be taken seriously as it is a WARNING SIGNAL. The most common complication after surgery is peritonitis due to anastomotic fistula formation. This occurs typically as an early complication within the first 10 days post-operatively and has an incidence of 1-6% after gastric bypass and 3-7% after sleeve gastrectomy. Post-operative malnutrition is extremely rare after restrictive surgery (ring, sleeve gastrectomy) although may occur after malabsorbative surgery (bypass, biliary pancreatic shunt) and is due to the restriction and change in absorption. Prophylactic cholecystectomy is not routinely carried out during the same procedure as the bypass. Superior mesenteric vein thrombosis after bariatric surgery is a diagnosis which should be considered in the presence of any postoperative abdominal pain. Initially a first etiological assessment is performed (measurement of antithrombin III and of protein C and protein S, testing for activated protein C resistance). If the least doubt is present, a medical or surgical consultation should be requested with a specialist practitioner in the management of obese patients as death rates increase with delayed diagnosis.

  13. Emerging strategies in the management of essential tremor

    PubMed Central

    Hedera, Peter

    2016-01-01

    Currently available therapies for essential tremor (ET) provide sufficient control only for less than a half of patients and many unmet needs exist. This is in part due to the empiric nature of existing treatment options and persisting uncertainties about the pathogenesis of ET. The emerging concept of ET as a possible neurodegenerative disorder, better understanding of associated biochemical changes, including alterations in the γ-aminobutyric acid (GABA)-ergic system and gap junctions, and the identification of the role of the leucine-rich repeat and immunoglobulin-like domain-containing 1 (LINGO-1) gene in ET pathogenesis suggest new avenues for more targeted therapies. Here we review the most promising new approaches to treating ET, including allosteric modulation of GABA receptors and modifications of the LINGO-1 pathway. Medically refractory tremor can be successfully treated by high-frequency deep brain stimulation (DBS) of the ventral intermediate nucleus, but surgical therapies are also fraught with limitations due to adverse effects of stimulation and the loss of therapeutic response. The selection of additional thalamic and extrathalamic targets for electrode placements and the development of a closed-loop DBS system enabling automatic adjustment of stimulation parameters in response to changes in electrophysiologic brain activity are also reviewed. Tremor cancellation methods using exoskeleton and external hand-held devices are also briefly discussed. PMID:28382111

  14. Emerging intravesical therapies for management of nonmuscle invasive bladder cancer

    PubMed Central

    Tomaszewski, Jeffrey J; Smaldone, Marc C

    2010-01-01

    Transitional cell carcinoma (TCC) is the second most common urologic malignancy, and 70% of patients present with superficial or nonmuscle invasive bladder cancer (NMIBC). Intravesical bacillus Calmette-Guerin (BCG) is the most effective agent for preventing disease recurrence, and the only therapy able to inhibit disease progression. However, recurrence rates as high as 30% and significant local and systemic toxicity have led to increased interest in alternative intravesical therapies. In patients refractory or intolerant to BCG, BCG-interferon α2b, gemcitabine, and anthracyclines (doxorubicin, epirubicin, valrubicin) have demonstrated durable clinical responses. Phase I trials investigating alternative cytotoxic agents, such as apaziquone, taxanes (docetaxel, paclitaxel), and suramin are reporting promising data. Novel immunomodulating agents have demonstrated promise as efficacious alternatives in patients refractory to BCG. Optimization of existing chemotherapeutic regimens using hyperthermia, photodynamic therapy, magnetically-targeted carriers, and liposomes remains an area of active investigation. Despite enthusiasm for new intravesical agents, radical cystectomy remains the treatment of choice for patients with NMIBC who have failed intravesical therapy and selected patients with naïve T1 tumors and aggressive features. This report provides a comprehensive review of contemporary intravesical therapy for NMIBC and refractory NMIBC, with an emphasis on emerging agents and novel treatment modalities. PMID:24198616

  15. Emergency management of disasters involving livestock in developing countries.

    PubMed

    Heath, S E; Kenyon, S J; Zepeda Sein, C A

    1999-04-01

    Different disasters have similar consequence on the health and welfare of livestock. Numerous geophysical disasters can exacerbate epizootics, resulting in the deaths of many animals and the reduction of production efficiency. These disasters also present a considerable threat of spoilage of processed foods, endangering public health. Furthermore, large-scale disasters involving animals can modify the long-term stability of national economies, the environment and social structures. The authors discuss the vulnerability of the livestock industry to natural disasters and the impact of floods, droughts and transboundary diseases and pests on national economies. Examples are given on how some losses can be avoided, evaluated and compensated. The role of the veterinarian is presented in relation to work conducted by other relief organisations in cases of emergency. In developing countries, mitigation programmes should focus on strengthening global animal health services. Preparedness needs to be community based, with education provided in a timely manner. Effective recovery from disasters should be based on mitigation programmes, including international trade and mutual aid agreements between neighbouring countries to supply appropriate goods and environmentally and culturally appropriate breeds of livestock. Disaster relief for the care of livestock should be recognised as a form of humanitarian assistance, given the benefits to be derived for public health and the socio-economic implications of successful intervention.

  16. Responding to emergencies: How organization and management make a difference

    SciTech Connect

    Metlay, D.S.; Haber, S.B.; Luckas, W.J.

    1989-01-01

    There is an observable and definable process that occurs during the course of responding to an abnormal event at a nuclear power plant. Each of the elements that comprise that process involves collective action and consequently is influenced by the character and effectiveness of organizational and managerial arrangements. Factors which affect each element include overt ones like the allocation of authority and responsibility and the skill of personnel, as well as covert factors like the methods used to resolve uncertainty. The purpose of this research project is to examine the process of response that occurs to an abnormal event at a nuclear power plant and where possible to identify the organizational and management factors that influence that process.

  17. Established and Emerging Approaches for the Management of Dyslipidaemia

    PubMed Central

    Norata, Giuseppe Danilo

    2012-01-01

    The key role of dyslipidaemia in determining cardiovascular disease (CVD) has been proved beyond reasonable doubt, and therefore several dietary and pharmacological approaches have been developed. The discovery of statins has provided a very effective approach in reducing cardiovascular risk as documented by the results obtained in clinical trials and in clinical practice. The current efficacy of statins or other drugs, however, comes short of providing the benefit that could derive from a further reduction of LDL cholesterol (LDL-C) in high-risk and very high risk patients. Furthermore, experimental data clearly suggest that other lipoprotein classes beyond LDL play important roles in determining cardiovascular risk. For these reasons a number of new potential drugs are under development in this area. Aim of this review is to discuss the available and the future pharmacological strategies for the management of dyslipidemia. PMID:24278703

  18. VTOL aircraft in emergency planning and management: a model for a helipad network.

    PubMed

    Caprì, Salvatore; Ignaccolo, Matteo; Inturri, Giuseppe

    2009-03-01

    The scientific literature regarding HEMS (Helicopter Emergency Medical Service) planning lacks a method for defining optimal sites for helipads that takes into account risk distribution and hospital location. Such a method could minimise overall rescue time in emergency situations. In this paper a method that supports the decisions taken by disaster planners and managers is developed, focusing on the quantification of necessary air resources for the management of some probable calamities. Given a region characterised by a natural and non-natural disaster risk map, along with a comprehensive transport system (also characterised by a risk map), a set of emergency destinations (hospitals), a set of heliports/helipads dislocated on the territory and a number of available HEMS rotorcraft, the aim of the paper is to assess the adequacy of the VTOL/FATO (Vertical Take-Off and Landing/Final Take-Off and Landing Area) system in order to deal with a set of possible emergencies.

  19. Project plan, Hazardous Materials Management and Emergency Response Training Center: Project 95L-EWT-100

    SciTech Connect

    Borgeson, M.E.

    1994-11-09

    The Hazardous Materials Management and Emergency Response (HAMMER) Training Center will provide for classroom lectures and hands-on practical training in realistic situations for workers and emergency responders who are tasked with handling and cleanup of toxic substances. The primary objective of the HAMMER project is to provide hands-on training and classroom facilities for hazardous material workers and emergency responders. This project will also contribute towards complying with the planning and training provisions of recent legislation. In March 1989 Title 29 Code of Federal Regulations Occupational Safety and Health Administration 1910 Rules and National Fire Protection Association Standard 472 defined professional requirements for responders to hazardous materials incidents. Two general types of training are addressed for hazardous materials: training for hazardous waste site workers and managers, and training for emergency response organizations.

  20. Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

    SciTech Connect

    Kelly, K.E.

    1994-11-09

    For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel.

  1. Adapting global influenza management strategies to address emerging viruses.

    PubMed

    Noah, Diana L; Noah, James W

    2013-07-15

    Death by respiratory complications from influenza infections continues to be a major global health concern. Antiviral drugs are widely available for therapy and prophylaxis, but viral mutations have resulted in resistance that threatens to reduce the long-term utility of approved antivirals. Vaccination is the best method for controlling influenza, but vaccine strategies are blunted by virus antigenic drift and shift. Genetic shift in particular has led to four pandemics in the last century, which have prompted the development of efficient global surveillance and vaccination programs. Although the influenza pandemic of 2009 emphasized the need for the rapid standardization of global surveillance methods and the preparation and dissemination of global assay standards for improved reporting and diagnostic tools, outbreaks of novel influenza strains continue to occur, and current efforts must be enhanced by aggressive public education programs to promote increased vaccination rates in the global population. Recently, a novel H7N9 avian influenza virus with potential to become a pandemic strain emerged in China and was transmitted from animals to humans with a demonstrated >20% mortality rate. Sporadic outbreaks of highly lethal avian virus strains have already increased public awareness and altered annual vaccine production strategies to prevent the natural adaption of this virus to human-to-human transmission. Additional strategies for combating influenza include advancement of new antivirals for unexploited viral or host cellular targets; novel adjuvants and alternate vaccine delivery systems; and development of universal protein, DNA, or multivalent vaccines designed to increase immune responsiveness and enhance public health response times.

  2. Outcomes-Balanced Framework for Emergency Management: A Predictive Model for Preparedness

    DTIC Science & Technology

    2013-09-01

    the Center for Homeland Defense and Security (Naval Postgraduate School ), points out that “emergency management has customarily been a gathering of...efforts on elementary school students to create the preparedness responsibility, called Student 52 Tools for Emergency Planning (STEP). The STEP...awareness with family members. In 2012–13 school year, Wisconsin will have over 10,000 students in more than 270 classrooms enrolled across the state

  3. Managing emergencies and abnormal situations in air traffic control (part II): teamwork strategies.

    PubMed

    Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry

    2010-07-01

    Team performance has been studied in many safety-critical organizations including aviation, nuclear power plant, offshore oil platforms and health organizations. This study looks into teamwork strategies that air traffic controllers employ to manage emergencies and abnormal situations. Two field studies were carried out in the form of observations of simulator training in emergency and unusual scenarios of novices and experienced controllers. Teamwork strategies covered aspects of team orientation and coordination, information exchange, change management and error handling. Several performance metrics were used to rate the efficiency of teamwork and test the construct validity of a prototype model of teamwork. This is a companion study to an earlier investigation of taskwork strategies in the same field (part I) and contributes to the development of a generic model for Taskwork and Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). Suggestions are made on how to use T(2)EAM to develop training programs, assess team performance and improve mishap investigations.

  4. Hunger strikers: historical perspectives from the emergency management of refugee camp asylum seekers.

    PubMed

    Burkle, Frederick M; Chan, Jimmy T S; Yeung, Richard D S

    2013-12-01

    The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

  5. Field, discipline, and profession: Understanding three major labels of emergency management.

    PubMed

    Urby, Heriberto; McEntire, David A

    2015-01-01

    The "field," "discipline," and "profession"--three major labels of emergency management--have often been interchanged as if any of these define the others. In this work, the authors examine these major labels to provide meaning, explanation, and application to each one based on the emergency management literature currently available. The authors accomplish this by the following: 1) defining and describing the established field's progression through the years; 2) examining how close we are to a discipline in today's emergency management arena; 3) discussing the advancement to becoming a profession; and 4) providing recommendations for the future. Clarifying these three major labels, the development of the field into a formidable and mature discipline as well as a distinguished and noble profession may be hastened.

  6. Nonpharmacological Interventions for Pain Management in Paramedicine and the Emergency Setting: A Review of the Literature

    PubMed Central

    Pak, Sok Cheon; Micalos, Peter S.; Maria, Sonja J.; Lord, Bill

    2015-01-01

    Paramedicine and the emergency medical services have been moving in the direction of advancing pharmaceutical intervention for the management of pain in both acute and chronic situations. This coincides with other areas of advanced life support and patient management strategies that have been well researched and continue to benefit from the increasing evidence. Even though paramedic practice is firmly focused on pharmacological interventions to alleviate pain, there is emerging evidence proposing a range of nonpharmacological options that can have an important role in pain management. This review highlights literature that suggests that paramedicine and emergency medical services should be considering the application of complementary and alternative therapies which can enhance current practice and reduce the use of pharmacological interventions. PMID:25918548

  7. Federal Emergency Management Information System (FEMIS) System Administration Guide for FEMIS Version 1.4.6

    SciTech Connect

    Arp, J.A.; Bower, J.C.; Burnett, R.A.; Carter, R.J.; Downing, T.R.; Fangman, P.M.; Gerhardstein, L.H.; Homer, B.J.; Johnson, D.M.; Johnson, R.L.; Johnson, S.M.; Loveall, R.M.; Martin, T.J.; Millard, W.D.; Schulze, S.A.; Stoops, L.R.; Tzemos, S.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  8. Federal Emergency Management Information System (FEMIS), Installation Guide for FEMIS 1.4.6

    SciTech Connect

    Arp, J.A.; Burnett, R.A.; Carter, R.J.; Downing, T.R.; Dunkle, J.R.; Fangman, P.M.; Gackle, P.P.; Homer, B.J.; Johnson, D.M.; Johnson, R.L.; Johnson, S.M.; Loveall, R.M.; Stephan, A.J.; Millard, W.D.; Wood, B.M.

    1999-06-29

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and response tool that was developed by the Pacific Northwest National Laboratory (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide provides information necessary for the system administrator to maintain the FEMIS system. The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are corrected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). Thus, FEMIS is an integrated software product that resides on client/server computer architecture. The main body of FEMIS software, referred to as the FEMIS Application Software, resides on the PC client(s) and is directly accessible to emergency management personnel. The remainder of the FEMIS software, referred to as the FEMIS Support Software, resides on the UNIX server. The Support Software provides the communication data distribution and notification functionality necessary to operate FEMIS in a networked, client/server environment.

  9. Bile acids: emerging role in management of liver diseases

    PubMed Central

    Asgharpour, Amon; Kumar, Divya

    2016-01-01

    Bile acids are well known for their effects on cholesterol homeostasis and lipid digestion. Since the discovery of bile acid receptors, of which there are farnesoid X receptor (FXR), a nuclear receptor, and the plasma membrane G-protein receptor, as well as Takeda G-protein coupled receptor clone 5, further roles have been elucidated for bile acids including glucose and lipid metabolism as well as inflammation. Additionally, treatment with bile acid receptor agonists has shown a decrease in the amount of atherosclerosis plaque formation and decreased portal vascular resistance and portal hypotension in animal models. Furthermore, rodent models have demonstrated antifibrotic activity using bile acid receptor agonists. Early human data using a FXR agonist, obeticholic acid, have shown promising results with improvement of histological activity and even a reduction of fibrosis. Human studies are ongoing and will provide further information on bile acid receptor agonist therapies. Thus, bile acids and their derivatives have the potential for management of liver diseases and potentially other disease states including diabetes and the metabolic syndrome. PMID:26320013

  10. Bone turnover markers: Emerging tool in the management of osteoporosis

    PubMed Central

    Shetty, Sahana; Kapoor, Nitin; Bondu, Joseph Dian; Thomas, Nihal; Paul, Thomas Vizhalil

    2016-01-01

    Bone is a dynamic tissue which undergoes constant remodeling throughout the life span. Bone turnover is balanced with coupling of bone formation and resorption at various rates leading to continuous remodeling of bone. A study of bone turnover markers (BTMs) provides an insight of the dynamics of bone turnover in many metabolic bone disorders. An increase in bone turnover seen with aging and pathological states such as osteoporosis leads to deterioration of bone microarchitecture and thus contributes to an increase in the risk of fracture independent of low bone mineral density (BMD). These microarchitectural alterations affecting the bone quality can be assessed by BTMs and thus may serve as a complementary tool to BMD in the assessment of fracture risk. A systematic search of literature regarding BTMs was carried out using the PubMed database for the purpose of this review. Various reliable, rapid, and cost-effective automated assays of BTMs with good sensitivity are available for the management of osteoporosis. However, BTMs are subjected to various preanalytical and analytical variations necessitating strict sample collection and assays methods along with utilizing ethnicity-based reference standards for different populations. Estimation of fracture risk and monitoring the adherence and response to therapy, which is a challenge in a chronic, asymptomatic disease such as osteoporosis, are the most important applications of measuring BTMs. This review describes the physiology of bone remodeling, various conventional and novel BTMs, and BTM assays and their role in the assessment of fracture risk and monitoring response to treatment with antiresorptive or anabolic agents. PMID:27867890

  11. A stratified response system for the emergency management of the severely injured.

    PubMed Central

    Lloyd, D. A.; Patterson, M.; Robson, J.; Phillips, B.

    2001-01-01

    A decade ago, there were justifiable criticisms of the delivery of emergency care for injured patients in accident and emergency departments in the UK. To address this, a trauma management system was developed in 1991 at Alder Hey Hospital, Liverpool. This includes a trauma team, communication system, management guidelines and quality assurance. On admission to the accident and emergency department, injured patients are triaged to one of three levels of injury severity, and a multidisciplinary team lead by a paediatric surgeon or senior accident and emergency department physician is activated. The level of injury severity determines the composition of the trauma team. A care pathway based on ATLS/APLS principles has been developed. The response process as well patient management are documented and reviewed at a monthly audit meeting. Currently, more than 80% of eligible patients are managed using the trauma system, with an over-triage rate of about 25%. Regular modifications to the trauma system since its inception in 1991 have resulted in an efficient and effective management structure. Stratification of the trauma response has minimised unnecessary use of the multidisciplinary trauma team and ensures that mobilisation and use of hospital staff and resources are tailored to the needs of the injured patient. Although developed in a specialist children's hospital, the system could be adapted for any acute hospital. PMID:11212442

  12. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    PubMed Central

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  13. Emergency!

    ERIC Educational Resources Information Center

    Geissler, Rebecca

    2006-01-01

    For generations, schools have routinely held fire drills. However, ensuring a safe learning environment is more complicated than staging an occasional drill. Schools and universities should have an integrated school safety plan, and it must address how to manage site hazards in science labs, kitchens and other building areas. It is essential for…

  14. Can Merging the Roles of Public Health Preparedness and Emergency Management Increase the Efficiency and Effectiveness of Emergency Planning and Response?

    PubMed Central

    Vielot, Nadja A.; Horney, Jennifer A.

    2014-01-01

    Some jurisdictions have reduced workforce and reallocated responsibilities for public health preparedness and emergency management to more efficiently use resources and improve planning and response. Key informant interviews were conducted in six counties in North Carolina (USA) to discuss perceptions of the challenges and opportunities provided by the new shared positions. Respondents feel that planning and response have improved, but that requirements related to activities or equipment that are eligible for funding (particularly on the public health side) can present an impediment to consolidating public health preparedness and emergency management roles. As the financial resources available for public health preparedness and emergency management continue to be reduced, the merging of the roles and responsibilities of public health preparedness and emergency management may present jurisdictions with an effective alternative to reducing staff, and potentially, readiness. PMID:24619123

  15. [Emergency medicine at the limit: shock-, analgesic therapy and airway management in difficult terrain].

    PubMed

    Rauch, Simon; Schenk, Kai; Rainer, Bernhard; Strapazzon, Giacomo; Paal, Peter; Brugger, Hermann

    2016-01-01

    Rescue operations in mountain and remote areas pose special challenges for the rescue team and often differ substantially from rescue missions in the urban environment. Given the growing sports and leisure activities in mountains, incidence of alpine emergencies is expected to rise further. The following article describes the treatment of haemorrhagic shock, analgesic therapy and airway management in mountain rescue.

  16. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Agency, Federal Insurance Administration, Financial Assistance/Subsidy Arrangement A Appendix A to Part... OF CLAIMS Pt. 62, App. A Appendix A to Part 62—Federal Emergency Management Agency, Federal Insurance... insurance using the Standard Flood Insurance Policy. Accounting Data: Pursuant to Section 1310 of the Act,...

  17. Search Is an Emergency: A Field Coordinator's Guide for Managing the Search Function.

    ERIC Educational Resources Information Center

    Lavalla, Rick; And Others

    The pocket-sized guide book is intended for law enforcement and land management agencies responsible for land-based search and rescue missions and is also useful for outdoor leaders. The information in the book is based on two premises, that a search is an emergency situation and that a search is a classic mystery. The guidebook contains…

  18. Diagnosis and management of new and re-emerging diseases of highbush blueberries in Michigan

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Blueberries are an important commodity in Michigan and disease management is crucial for production of high-quality fruit. Over the past 6 years, a number of new and re-emerging diseases have been diagnosed in the state. In 2009, Blueberry scorch virus (BlScV) and Blueberry shock virus (BlShV) were ...

  19. Anaesthetic management of a case of dilated cardiomyopathy for emergency appendectomy.

    PubMed

    Raj, Ravi; Kumar, Mritunjay; Batra, Meenu

    2014-01-01

    The anesthetic management of a patient with dilated cardiomyopathy (DCM) undergoing non-cardiac surgery poses a challenge for anesthesiologist either due to pre-existing or a risk of precipitating congestive heart failure. We report a successful use of combined spinal epidural for emergency appendicectomy in a patient of DCM. Different anesthetic concerns and agents, some recent advances are also discussed.

  20. 75 FR 31447 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... HUMAN SERVICES Administration for Children and Families Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget Title: State Personal Responsibility... Application to include program narrative........ 59 1 40 2360 Performance Progress Reports 59 2 10 1180 Year...

  1. It's Not Business as Usual: New and Emerging Career in Marketing, Finance, and Management

    ERIC Educational Resources Information Center

    Miller, April J.

    2010-01-01

    There have been many changes in the field of business as a result of technological advancements, government regulations, and shifts in focus. These new career opportunities have arisen as a result: social media marketers, financial examiners, and project managers. In this article, the author discusses these new and emerging career opportunities in…

  2. Managing for biodiversity: Emerging ideas for the electric utility industry—summary statement

    NASA Astrophysics Data System (ADS)

    Mattice, Jack; Fraser, Myra; Ragone, Stephen; Daugherty, David; Wisniewski, Joe

    1996-11-01

    The conference entitled “Managing for Biodiversity: Emerging Ideas for the Electric Utility Industry” was held in Williamsburg, Virginia, USA, during 19 20 March 1996. This paper provides an overview of the key points, conclusions, and recommendations from both the presentations/papers and the discussions throughout the conference.

  3. Bibliography for nuclear criticality accident experience, alarm systems, and emergency management

    SciTech Connect

    Putman, V.L.

    1995-09-01

    The characteristics, detection, and emergency management of nuclear criticality accidents outside reactors has been an important component of criticality safety for as long as the need for this specialized safety discipline has been recognized. The general interest and importance of such topics receives special emphasis because of the potentially lethal, albeit highly localized, effects of criticality accidents and because of heightened public and regulatory concerns for any undesirable event in nuclear and radiological fields. This bibliography lists references which are potentially applicable to or interesting for criticality alarm, detection, and warning systems; criticality accident emergency management; and their associated programs. The lists are annotated to assist bibliography users in identifying applicable: industry and regulatory guidance and requirements, with historical development information and comments; criticality accident characteristics, consequences, experiences, and responses; hazard-, risk-, or safety-analysis criteria; CAS design and qualification criteria; CAS calibration, maintenance, repair, and testing criteria; experiences of CAS designers and maintainers; criticality accident emergency management (planning, preparedness, response, and recovery) requirements and guidance; criticality accident emergency management experience, plans, and techniques; methods and tools for analysis; and additional bibliographies.

  4. 76 FR 30940 - Information Collection Being Submitted to the Office of Management and Budget for Emergency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-27

    ... technology, and (e) ways to further reduce the information collection burden on small business concerns with... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION Information Collection Being Submitted to the Office of Management and Budget for Emergency...

  5. Managing the Transition to College: Family Functioning, Emotion Coping, and Adjustment in Emerging Adulthood

    ERIC Educational Resources Information Center

    Johnson, Vanessa Kahen; Gans, Susan E.; Kerr, Sandra; LaValle, William

    2010-01-01

    Using a self-reported assessment of 320 first-time college students, we tested the hypothesis that one's ability to manage emotion moderates the relationship between family environment and college adjustment. Results add to growing evidence that the way one views one's whole family environment during the emerging adulthood years is linked to one's…

  6. A Whole Community Approach to Emergency Management for the United States Virgin Islands

    ERIC Educational Resources Information Center

    Williams, Mutryce A.

    2016-01-01

    Public-private partnerships in emergency management are widely encouraged in the academic literature, yet the government of the United States Virgin Islands (USVI) tends to view collaboration from the private sector as an impediment to good policy. This occurs in spite of the island nation's geography that makes it susceptible to natural and human…

  7. A dental undergraduate course for the management of medical emergencies in dental practice.

    PubMed

    Balmer, M C

    2008-11-01

    There is a specific requirement for undergraduate dental students to be trained in the management of medical emergencies that may arise in dental practice. This paper describes a practical skills course that has been developed specifically to fulfil this requirement. The rationale, course structure, methodology of delivery and assessment methods are discussed in detail.

  8. 75 FR 11191 - Privacy Act of 1974; Retirement of Department of Homeland Security Federal Emergency Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... Stamp be distributed. The records in the system are considered permanent Federal Government records, as... Emergency Management Agency System of Records AGENCY: Privacy Office, DHS. ACTION: Notice of retirement of a Privacy Act system of records notice. SUMMARY: In accordance with the Privacy Act of 1974 the...

  9. Assessing Roles of People, Technology and Structure in Emergency Management Systems: A Public Sector Perspective

    ERIC Educational Resources Information Center

    Kim, Minkyun; Sharman, Raj; Cook-Cottone, Catherine P.; Rao, H. Raghav; Upadhyaya, Shambhu J.

    2012-01-01

    Emergency management systems are a critical factor in successful mitigation of natural and man-made disasters, facilitating responder decision making in complex situations. Based on socio-technical systems, have which four components (people, technology, structure and task), this study develops a research framework of factors affecting effective…

  10. The Con Edison Emergency Child Care Plan for Management Employees: Summary Plan Description.

    ERIC Educational Resources Information Center

    Consolidated Edison Co., Brooklyn, NY.

    This summary plan description offers guidelines for participation in a pilot program that provides short-term emergency care for children of Con Edison managers who are under 13 years old. The plan offers professional, in-home child care that can be used when usual arrangements have collapsed. The summary plan description addresses the following…

  11. Seeking Accountability through State-Appointed Emergency District Management. Working Paper #28

    ERIC Educational Resources Information Center

    Arsen, David; Mason, Mary L.

    2012-01-01

    Michigan's Local Government and School District Accountability Act of 2011 empowers the governor to appoint emergency managers (EMs) in financially-troubled school districts. EMs assume all powers of the superintendent and school board. They can reshape academic programs, nullify labor contracts, and open and close schools. This paper analyzes the…

  12. 77 FR 75159 - Information Collection Being Submitted to the Office of Management and Budget for Emergency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... used, digitized, geographic information system (GIS) format. Accurate and accessible maps are essential... COMMISSION Information Collection Being Submitted to the Office of Management and Budget for Emergency Review... public and other Federal agencies to take this opportunity to comment on the following...

  13. [Emergency room management of multiple trauma : ATLS® and S3 guidelines].

    PubMed

    Bouillon, B; Probst, C; Maegele, M; Wafaisade, A; Helm, P; Mutschler, M; Brockamp, T; Shafizadeh, S; Paffrath, T

    2013-09-01

    Trauma management in the emergency room is an important part of the treatment chain of the severely injured. Important decisions with respect to diagnostics and treatment must be made under time pressure. Successful trauma management in the emergency room requires a hospital tailored treatment protocol. This written protocol needs consent from all participating disciplines and must be known by all members of the resuscitation team. The ATLS® and the recently published clinical practice guidelines on multiple trauma can be of help in order to establish or update such protocols. In order to continuously evaluate and improve performance in the emergency room local quality circles are needed that truly follow that aim. Important factors are reliability of agreement between the different disciplines and continuous communication of results to the team members. In order to be successful such quality circles need people that care.

  14. Psychiatric and medical management of marijuana intoxication in the emergency department.

    PubMed

    Bui, Quan M; Simpson, Scott; Nordstrom, Kimberly

    2015-05-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient's psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care.

  15. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    PubMed Central

    Bui, Quan M.; Simpson, Scott; Nordstrom, Kimberly

    2015-01-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. PMID:25987916

  16. 7 CFR Exhibit J to Subpart G of... - Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's Regional... floodplain information, ask for the Natural and Technological Hazards Division....

  17. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations

    PubMed Central

    Dotson, G. Scott; Hudson, Naomi L.; Maier, Andrew

    2016-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

  18. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    PubMed

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.

  19. Management of a patient with diabetic ketoacidosis in the emergency department.

    PubMed

    Lavoie, Megan Elizabeth

    2015-05-01

    Diabetic ketoacidosis is a common problem among known and newly diagnosed diabetic children and adolescents for which they will often seek care in the emergency department (ED). Technological advances are leading to changes in outpatient management of diabetes. The ED physician needs to be aware of the new technologies in the care of diabetic children and comfortable managing patients using continuous subcutaneous insulin infusions. This article reviews the ED management of diabetic ketoacidosis and its associated complications, as well as the specific recommendations in caring for patients using the continuous subcutaneous insulin infusion, serum ketone monitoring, and continuous glucose monitoring.

  20. [Pre-hospital management of adults with life-threatening emergencies].

    PubMed

    Wattel, Francis; Dubois, François

    2012-01-01

    In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas

  1. Management of disasters and complex emergencies in Africa: The challenges and constraints.

    PubMed

    Aliyu, Alhaji

    2015-01-01

    Natural and man-made catastrophes have caused significant destruction and loss of lives throughout human history. Disasters accompany a wide variety of events with multiple causes and consequences often leading to a cascade of related events. African continent has not been spared of these events. A new phenomenon in the continent is terrorism that is fuelled by globalization of arms trade and has contributed significantly to escalation of conflicts in sub-Saharan Africa (SSA) resulting in complex emergencies and destruction of socioeconomic structures. The aim of this paper is to review relevant papers on management of disasters and complex emergencies in Africa and the challenges and constraints against the background of a weakened health system. Systematic search of published literature was conducted between 1990 and 2013. Grey literature (technical reports, government documents), published peer review journals, abstracts, relevant books and internet articles were reviewed. The review revealed that the frequency of both natural and man-made disasters in Africa is escalating. Complex emergencies are also on the increase since the Rwandan crisis in 1994. The impact of these events has overstretched and overwhelmed the health care system that is least prepared to handle and cope with the surge capacity and also render normal services. In conclusion, there is an urgent need for national emergency agencies/departments across Africa to develop a robust emergency preparedness and response plan. Every hospital most have a disaster management committee with flexible disaster management plan to respond to these catastrophes. There is a need for curriculum review in tertiary institutions across SSA to introduce and or expand training in disaster management.

  2. Federal Emergency Management Information Systems (FEMIS), System Administration Guide FEMIS: Phase 1, Version 1.1u

    SciTech Connect

    Cerna, P.A.; Conner, W.M.; Curtis, L.M.

    1995-06-01

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package.

  3. Integrating emerging earth science technologies into disaster risk management: an enterprise architecture approach

    NASA Astrophysics Data System (ADS)

    Evans, J. D.; Hao, W.; Chettri, S. R.

    2014-12-01

    Disaster risk management has grown to rely on earth observations, multi-source data analysis, numerical modeling, and interagency information sharing. The practice and outcomes of disaster risk management will likely undergo further change as several emerging earth science technologies come of age: mobile devices; location-based services; ubiquitous sensors; drones; small satellites; satellite direct readout; Big Data analytics; cloud computing; Web services for predictive modeling, semantic reconciliation, and collaboration; and many others. Integrating these new technologies well requires developing and adapting them to meet current needs; but also rethinking current practice to draw on new capabilities to reach additional objectives. This requires a holistic view of the disaster risk management enterprise and of the analytical or operational capabilities afforded by these technologies. One helpful tool for this assessment, the GEOSS Architecture for the Use of Remote Sensing Products in Disaster Management and Risk Assessment (Evans & Moe, 2013), considers all phases of the disaster risk management lifecycle for a comprehensive set of natural hazard types, and outlines common clusters of activities and their use of information and computation resources. We are using these architectural views, together with insights from current practice, to highlight effective, interrelated roles for emerging earth science technologies in disaster risk management. These roles may be helpful in creating roadmaps for research and development investment at national and international levels.

  4. Life-threatening endocrine emergencies during pregnancy - management and therapeutic features.

    PubMed

    Harbeck, Birgit; Rahvar, Amir-Hossein; Danneberg, Sven; Schütt, Morten; Sayk, Friedhelm

    2017-03-31

    Endocrine emergencies during pregnancy may be life-threatening events for both mother and fetus. Besides pregnancy-associated endocrine disorders, several pre-existing endocrinopathies such as type-1 diabetes and Grave's disease or adrenal failure may acutely deteriorate during pregnancy. Since "classical" signs are often modified by pregnancy, early diagnosis and management may be hampered. In addition, laboratory tests show altered physiologic ranges and pharmacologic options are limited while therapeutic goals are mostly tighter than in the non-pregnant patient. Though subclinical endocrinopathies are more frequent and worth consideration due to their related adverse sequelae, this article focuses on endocrine emergencies complicating pregnancy.

  5. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting.

    PubMed

    Sartelli, Massimo; Catena, Fausto; Ansaloni, Luca; Coccolini, Federico; Griffiths, Ewen A; Abu-Zidan, Fikri M; Di Saverio, Salomone; Ulrych, Jan; Kluger, Yoram; Ben-Ishay, Ofir; Moore, Frederick A; Ivatury, Rao R; Coimbra, Raul; Peitzman, Andrew B; Leppaniemi, Ari; Fraga, Gustavo P; Maier, Ronald V; Chiara, Osvaldo; Kashuk, Jeffry; Sakakushev, Boris; Weber, Dieter G; Latifi, Rifat; Biffl, Walter; Bala, Miklosh; Karamarkovic, Aleksandar; Inaba, Kenji; Ordonez, Carlos A; Hecker, Andreas; Augustin, Goran; Demetrashvili, Zaza; Melo, Renato Bessa; Marwah, Sanjay; Zachariah, Sanoop K; Shelat, Vishal G; McFarlane, Michael; Rems, Miran; Gomes, Carlos Augusto; Faro, Mario Paulo; Júnior, Gerson Alves Pereira; Negoi, Ionut; Cui, Yunfeng; Sato, Norio; Vereczkei, Andras; Bellanova, Giovanni; Birindelli, Arianna; Di Carlo, Isidoro; Kok, Kenneth Y; Gachabayov, Mahir; Gkiokas, Georgios; Bouliaris, Konstantinos; Çolak, Elif; Isik, Arda; Rios-Cruz, Daniel; Soto, Rodolfo; Moore, Ernest E

    2016-01-01

    Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

  6. From Civil Protection Plan to Disaster Management. PETer evolution from GIS tool to multi-area Emergency Management System

    NASA Astrophysics Data System (ADS)

    Frigerio, Simone; Sterlacchini, Simone; Malet, Jean-Philippe; Glade, Thomas

    2010-05-01

    PETer (Protection and Emergency of the Territory) has been developed since 2006 as a tool to manage all the information available to perform a wide range of Civil Protection activities. Based on MapObjects spatial support, it was relied on capacity to manage data from different sources and at different scale, offering practical GIS-tools for a technical and practical use during crisis state. At the first stages of the development, after different assessment, critical on-field analysis and a direct proof on test area, the approach came into sight like a valid database management for the entire dataset, but quite static, not full-blown for every emergency necessity, too complicate and not enough user-friendly, considering people in charge during emergency management, the quick change of state with many parameters involved and also uncertainty, hesitation, confusion or general panic among decision makers. As a second step of research, a more down-to-earth methodology targeted to cope with the aftermath of critical events is presented here. It takes advantage of Geographical Information Systems (GIS), Decision Support Systems (DSS), and Information and Communication Technology (ICT) to prepare, apply and coordinate Civil Protection plans. The main aim was to set up and manage contingency plans in advance; that is, to identify and prepare people in charge to take action to define the activities to be performed, to be aware of available resources and to optimize the communication system among the people involved, in order to efficiently face a prospective crisis phase. A disaster preparedness plan should anticipate the demands for a disaster relief operation and indicate the most effective way of joining those requirements. Through scientific and technical co-operation between public and private research groups, a new platform was planned and set up, in order to test the aims of the project. The application was based on a cooperative organizational structure by which

  7. Implementation of NAP4 emergency airway management recommendations in a quaternary-level pediatric hospital.

    PubMed

    Long, Elliot; Cincotta, Domenic; Grindlay, Joanne; Pellicano, Anastasia; Clifford, Michael; Sabato, Stefan

    2017-02-28

    Emergency airway management, particularly outside of the operating room, is associated with a high incidence of life-threatening adverse events. Based on the recommendations of the 4th National Audit Project, we aimed to develop hospital-wide systems changes to improve the safety of emergency airway management. We describe a framework for governance in the form of a hospital airway special interest group. We describe the development and implementation of the following systems changes: 1. A local intubation algorithm modified from the Difficult Airway Society's plan A-B-C-D approach, including clear pathways for airway escalation, and emphasizing the concepts of resuscitation prior to intubation, planning for failure, and avoidance of fixation error. 2. Simplified and standardized airway equipment located in identical airway carts in all critical care areas. 3. A preintubation checklist and equipment template to standardize preparation for airway management. 4. Availability of continuous waveform endtidal capnography in all critical care areas for confirmation of correct endotracheal tube placement. 5. Multidisciplinary team training to address the technical and nontechnical aspects of nonoperating room intubation. In addition, we describe methodology for ongoing monitoring of performance through a quality assurance framework. In conclusion, changes in the process of emergency airway management at a hospital level are feasible through collaboration. Their impact on patient-based outcomes requires further study.

  8. Improving Capacity Management in the Emergency Department: A Review of the Literature, 2000-2012.

    PubMed

    McCaughey, Deirdre; Erwin, Cathleen O; DelliFraine, Jami L

    2015-01-01

    Capacity management (CM) is a critical component of maintaining and improving healthcare quality and patient safety. One particular area for concern has been the emergency department and the growing issues of patient overcrowding, boarding, and ambulance diversion, which can result in poor patient care and less efficient operations. This study provides a review of the current and most relevant academic literature on capacity management directly related to hospital emergency departments, identifies strengths and weaknesses of the approaches discussed in the literature, and provides practical recommendations for health services administrators implementing CM in their organizations. An extensive literature search was conducted using several search engines and scholarly databases. Articles were identified based on a combination of keywords and then were reviewed and selected for inclusion in the study in adherence to specified criteria. The CM literature includes a great divergence of themes, topics, and definitions. Twenty-two articles were selected for their relevance to emergency department CM with a focus on operations management concepts. A categorization scheme was used, resulting in four thematic groups of articles: problems, solutions, outcomes, and metrics. Healthcare managers wishing to implement solutions to CM problems have a wide variety of operations literature to draw on that can address scheduling and patient throughput, but there are also a number of studies that consider electronic and technological solutions to CM problems. All of these solutions have the potential to positively influence the quality of patient care, including satisfaction.

  9. A scenario-based modeling approach for emergency evacuation management and risk analysis under multiple uncertainties.

    PubMed

    Lv, Y; Huang, G H; Guo, L; Li, Y P; Dai, C; Wang, X W; Sun, W

    2013-02-15

    Nuclear emergency evacuation is important to prevent radioactive harms by hazardous materials and to limit the accidents' consequences; however, uncertainties are involved in the components and processes of such a management system. In the study, an interval-parameter joint-probabilistic integer programming (IJIP) method is developed for emergency evacuation management under uncertainties. Optimization techniques of interval-parameter programming (IPP) and joint-probabilistic constrained (JPC) programming are incorporated into an integer linear programming framework, so that the approach can deal with uncertainties expressed as joint probability and interval values. The IJIP method can schedule the optimal routes to guarantee the maximum population evacuated away from the effected zone during a finite time. Furthermore, it can also facilitate post optimization analysis to enhance robustness in controlling system violation risk imposed on the joint-probabilistic constraints. The developed method has been applied to a case study of nuclear emergency management; meanwhile, a number of scenarios under different system conditions have been analyzed. It is indicated that the solutions are useful for evacuation management practices. The result of the IJIP method can not only help to raise the capability of disaster responses in a systematic manner, but also provide an insight into complex relationships among evacuation planning, resources utilizations, policy requirements and system risks.

  10. Management of an emergency: to be prepared for the unwanted event.

    PubMed

    Lipp, M; Kubota, Y; Malamed, S F; Matsuura, H; Sykes, P

    1992-01-01

    Every dental office needs an adequate emergency treatment structure. While theoretical and practical pregraduate education in emergency medicine is included (in differing degrees) in the curricula of dental schools throughout the world, postgraduate training is generally undertaken on a voluntary basis. Repeated training in emergency techniques is encouraged for the dentist and dental office staff, as the trained and coordinated action of the whole team in the dental office is necessary when an emergency occurs. Whenever possible, a recognized risk factor should be eliminated or its possible influence minimized prior to dental treatment. Patients requiring immediate dental therapy will need appropriate monitoring, adequate application of systemically acting drugs, or even treatment under standby conditions. Diagnostic equipment as well as equipment for monitoring the respiratory and cardiovascular systems should be available. Several monitors (blood pressure, ECG, and pulsoximetry) have been introduced to dentistry and have their indications in special patient groups. Clear therapeutic concepts are the endpoint of proper emergency management. The restoration of an undisturbed vital function has to be achieved, followed by detailed therapy. Dentists should refresh their knowledge of emergency treatment techniques and prepare themselves with therapeutic guidelines.

  11. Applying the emergency risk management process to tackle the crisis of antibiotic resistance

    PubMed Central

    Dominey-Howes, Dale; Bajorek, Beata; Michael, Carolyn A.; Betteridge, Brittany; Iredell, Jonathan; Labbate, Maurizio

    2015-01-01

    We advocate that antibiotic resistance be reframed as a disaster risk management problem. Antibiotic-resistant infections represent a risk to life as significant as other commonly occurring natural disasters (e.g., earthquakes). Despite efforts by global health authorities, antibiotic resistance continues to escalate. Therefore, new approaches and expertise are needed to manage the issue. In this perspective we: (1) make a call for the emergency management community to recognize the antibiotic resistance risk and join in addressing this problem; (2) suggest using the risk management process to help tackle antibiotic resistance; (3) show why this approach has value and why it is different to existing approaches; and (4) identify public perception of antibiotic resistance as an important issue that warrants exploration. PMID:26388864

  12. Managing professionals: The emerging leadership role of Victorian Maternal and Child Health coordinators.

    PubMed

    Reiger, Kerreen; Keleher, Helen

    2004-04-01

    Drawing on research into cultural and organizational change in the Victorian Maternal and Child Health Service during the 1990s, this paper examines implications for the nursing leadership provided by service coordinators. The project included a quantitative survey of nurses and semistructured interviews with managers and coordinators. Under a strongly neo-liberal state government in Victoria, Australia, services were fundamentally restructured through tendering processes. A competitive, productivist culture was introduced that challenged the professional ethos of nurses and a primary health orientation to the care of mothers and infants. This paper focuses on the pressures that the entrepreneurial environment presented to maternal and child health nurses' identity and collegial relations and to the coordination role. It argues that coordinators emerged as a significant nursing management group at the interface of administrative change and the management of professional practice. Although many nurses skillfully negotiated tensions with peers and management, their leadership role needs further clarification and support.

  13. [Workforce management in Emergency Care Units: government strategies and profile of healthcare professionals].

    PubMed

    Machado, Cristiani Vieira; de Lima, Luciana Dias; O'Dwyer, Gisele; de Andrade, Carla Lourenço Tavares; Baptista, Tatiana Wargas de Faria; Pitthan, Rachel Guimarães Vieira; Ibañez, Nelson

    2016-02-01

    In the late 2000s, the expansion of Emergency Care Units (UPAs) in Brazil's policy for provision of urgent healthcare included hiring a large contingent of health professionals. This article analyzes government strategies for workforce management and the profile of these professionals in the UPAs in the State of Rio de Janeiro, which has the largest number of such units in the country. The methods included document analysis, interviews with managers, and visits to the UPAs and interviews with coordinators, physicians, and nurses. The results showed that the workforce management strategies varied over time and according to administrative sphere (state versus municipal). The so-called Social Organizations became the main hirers of health professionals in the UPAs, since they allowed management flexibility. However, there were problems with selection and stability, with a predominance of young professionals with limited experience and high physician turnover. Instability associated with outsourced hiring reinforced the view of work at the UPA as a temporary job.

  14. Managing Epilepsy Well: Emerging e-Tools for epilepsy self-management.

    PubMed

    Shegog, Ross; Bamps, Yvan A; Patel, Archna; Kakacek, Jody; Escoffery, Cam; Johnson, Erica K; Ilozumba, Ukwuoma O

    2013-10-01

    The Managing Epilepsy Well (MEW) Network was established in 2007 by the Centers for Disease Control and Prevention Epilepsy Program to expand epilepsy self-management research. The network has employed collaborative research strategies to develop, test, and disseminate evidence-based, community-based, and e-Health interventions (e-Tools) for epilepsy self-management for people with epilepsy, caregivers, and health-care providers. Since its inception, MEW Network collaborators have conducted formative studies (n=7) investigating the potential of e-Health to support epilepsy self-management and intervention studies evaluating e-Tools (n=5). The MEW e-Tools (the MEW website, WebEase, UPLIFT, MINDSET, and PEARLS online training) and affiliated e-Tools (Texting 4 Control) are designed to complement self-management practices in each phase of the epilepsy care continuum. These tools exemplify a concerted research agenda, shared methodological principles and models for epilepsy self-management, and a communal knowledge base for implementing e-Health to improve quality of life for people with epilepsy.

  15. Implementation of a novel emergency surgical unit significantly improves the management of gallstone pancreatitis

    PubMed Central

    Kulendran, M; Liasis, L; Qurashi, K; Sen, M; Gould, S

    2015-01-01

    Introduction Emergency surgery is changing rapidly with a greater workload, early subspecialisation and centralisation of emergency care. We describe the impact of a novel emergency surgical unit (ESU) on the definitive management of patients with gallstone pancreatitis (GSP). Methods A comparative audit was undertaken for all admissions with GSP before and after the introduction of the ESU over a six-month period. The impact on compliance with British Society of Gastroenterology (BSG) guidelines was assessed. Results Thirty-five patients were treated for GSP between December 2013 and May 2014, after the introduction of the ESU. This was twice the nationally reported average for a UK trust over a six-month period. All patients received definitive management for their GSP and 100% of all suitable patients received treatment during the index admission or within two weeks of discharge. This was a significantly greater proportion than that prior to the introduction of the ESU (57%, p=0.0001) as well as the recently reported national average (34%). The mean length of total inpatient stay was reduced significantly after the ESU was introduced from 13.7 ± 4.7 days to 7.8 ± 2.1 days (p=0.03). The mean length of postoperative stay also fell significantly from 6.7 ± 2.6 days to 1.8 ± 0.8 days (p=0.001). Conclusions A dedicated ESU following national recommendations for emergency surgery care by way of using dedicated emergency surgeons and a streamlined protocol for common presentations has been shown by audit of current practice to significantly improve the management of patients presenting to a busy district general hospital with GSP. PMID:26263941

  16. Emergency Response and Long Term Planning: Two sides of the Coin for Managing Water Resources

    NASA Astrophysics Data System (ADS)

    Metchis, K.; Beller-Simms, N.

    2014-12-01

    As projected by the US National Climate Assessment and the IPCC, extreme climate and weather events are occurring more frequently and with more intensity across the nation. Communities - and the water resource managers that serve them - are facing difficult choices to increase emergency preparedness, recover from costly impacts, and increase long term resilience. The presentation is based on a recent set of case studies about what happened in six communities that experienced one or more extreme events, focusing on water resource management. Two of the case studies will be presented, revealing that building climate resilience is not just about long term planning - it is also about taking the steps to be prepared for - and to be able to recover from - emergency events. The results of this study have implications for educating local officials on ways to think about resilience to balance both long-term and short-term preparedness.

  17. Effective Coordination and Management of Emerging Infectious Diseases in Wildlife Populations.

    PubMed

    Hyatt, Alex; Aguirre, A Alonso; Jeggo, Martyn; Woods, Rupert

    2015-09-01

    A transdisciplinary, One Health approach is proposed for the coordination of wildlife health diagnostics, research, and policy development. In some countries, considerable effort has been made to establish specific activities including surveillance and integration of wildlife health within diagnostic and research laboratories. We suggest that some of these activities can be improved and many countries still require national structures to deal with wildlife disease investigation and management. We also suggest that scientists in this field should actively engage with national and international organizations and conferences to influence the development of policy, diagnostics, research, and management of emerging wildlife diseases.

  18. Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

    PubMed Central

    Navuluri, Rakesh; Patel, Jay; Kang, Lisa

    2012-01-01

    Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

  19. Management of emerging multidrug-resistant tuberculosis in a low-prevalence setting.

    PubMed

    Catho, G; Couraud, S; Grard, S; Bouaziz, A; Sénéchal, A; Valour, F; Perpoint, T; Braun, E; Biron, F; Ferry, T; Chidiac, C; Freymond, N; Perrot, E; Souquet, P-J; Maury, J-M; Tronc, F; Veziris, N; Lina, G; Dumitrescu, O; Ader, F

    2015-05-01

    Multidrug-resistant (MDR) tuberculosis (TB) is an emerging concern in communities with a low TB prevalence and a high standard of public health. Twenty-three consecutive adult MDR TB patients who were treated at our institution between 2007 and 2013 were reviewed for demographic characteristics and anti-TB treatment management, which included surgical procedures and long-term patient follow-up. This report of our experience emphasizes the need for an individualized approach as MDR TB brings mycobacterial disease management to a higher level of expertise, and for a balance to be found between international current guidelines and patient-tailored treatment strategies.

  20. Emergency Difficult Airway Management in a Patient with Severe Epidermolysis Bullosa

    PubMed Central

    Özkan, Ahmet Selim; Kayhan, Gülay Erdoğan; Akbaş, Sedat; Kaçmaz, Osman; Durmuş, Mahmut

    2016-01-01

    Epidermolysis bullosa (EB) is a rare disease characterised by vesiculobullous lesions with minimal trauma to the skin and mucous membranes. Bleeding, scar tissue, contractures, oedema and lesions that can spread throughout the body can cause a difficult airway and vascular access in patients with EB. Therefore, anaesthetic management in patients with EB is a major problem even for experienced anaesthesiologists. Herein, we report a case of difficult airway management in a patient diagnosed with severe EB who presented for emergency tracheostomy because of respiratory failure under general anaesthesia. PMID:27909609

  1. Potential Applications of Cable Television (CATV) to the FEMA (Federal Emergency Management Agency) Communications Mission.

    DTIC Science & Technology

    1983-07-01

    8217D-RI31 326 POTENTIAL APPLICATIONS OF CABLE TELEVISION (CATY) TO i2 THE FEMA (FEDERAL EM.. (U) CONTROL ENERGY CORP BOSTON MR D D GILLIGAN ET AL. JUL...9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK AREA & WORK UNIT NUMBERS Control Energy Corporation 470 Atlantic...Avenue Boston, MA 02210 ______________ 11. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Federal Emergency Management Agency July, 1983 OAM

  2. Emergent Management of Postpartum Hemorrhage for the General and Acute Care Surgeon

    DTIC Science & Technology

    2009-01-01

    who would try medical measures on their own, or call another obstetrical practitioner. Resuscitation Once significant postpartum hemorrhage has been...Research Clinical Obstetrics and Gynaecology 2002, 16(1):81-98. 12. Roberts WE: Emergent Obstetric Management of Postpar- tum Hemorrhage . Obstetrics and...Spring, MD, USA and 4Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, DC, USA Email: Allison B Weisbrod

  3. Oil terrorism-militancy link: Mediating role of moral disengagement in emergency and crisis management.

    PubMed

    Mafimisebi, Oluwasoye Patrick; Thorne, Sara

    2015-01-01

    The controversial issues of terrorism and militancy have generated contemporary interests and different interpretations have emerged on how to combat and manage these dangerous events. This study widens understanding of moral disengagement mechanism application in the perpetuation of inhumanities within the context of oil terrorist and militant behaviors. The research findings and model are explicit on how people form moral evaluations of agents who are forced to make morally relevant decisions over times in context of crisis situations. Quite crucially, understanding the context of terrorism and militancy provides policymakers, emergency and crisis managers better analysis and response to such events. The research fundamental purpose was to investigate the mediating role of moral disengagement on delinquency of oil terrorism and militancy; and considered implications for emergency and crisis management practices. The study found that situational-induced crises such as oil terrorism and militancy were sufficient to account for an individual's misdeeds and unethical or inhumane decisions made under frustration and agitation may be perceived as less indicative of one's fundamental character. Findings suggest that more repugnant delinquencies could have been committed in the name of justice than in the name of injustice, avenues for future research. In context, the result of the moral disengagement scale shows that morality of delinquency (oil terrorism and militancy) is accomplished by cognitively redefining the morality of such acts. The main finding is that people in resistance movements are rational actors making rational choices. The authors argue that theorists, policymakers, and practitioners must give meaningful attention to understanding the multidimensional nature of emergency, crisis and disaster management for better strength of synthesis between theory and practice. The research is concluded by thorough examination of the implication and limitations for

  4. Traumatic Inferior Gluteal Artery Pseudoaneurysm and Arteriovenous Fistula Managed with Emergency Transcatheter Embolization

    SciTech Connect

    Keeling, A. N.; Naughton, P. A.; Leahy, A. L.; Lee, M. J.

    2008-07-15

    We present a case of blunt trauma to the buttock resulting in an inferior gluteal artery pseudoaneurysm and arteriovenous fistula. The characteristic diagnostic features on CT angiography and digital subtraction angiography (DSA), along with the emergency percutaneous management of this traumatic vascular injury, are described. A review of the literature demonstrates inferior gluteal artery pseudoaneurysm is a rare condition, while successful treatment with glue embolization is previously unreported.

  5. Confronting Emergent Nuclear-Armed Regional Adversaries: Prospects for Neutralization, Strategies for Escalation Management

    DTIC Science & Technology

    2015-01-01

    C O R P O R A T I O N Research Report Confronting Emergent Nuclear-Armed Regional Adversaries Prospects for Neutralization, Strategies for...Armed Regional Adversaries: Prospects for Neutralization, Strategies for Escalation Management 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...states with small nuclear arsenals. It examines prospects for neutralizing their nuclear capabilities via combinations of offensive and defensive

  6. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    PubMed Central

    Patel, Nirali H; Romero, Sarah K; Kaelber, David C

    2012-01-01

    Hypertension (HTN) in the pediatric population is estimated to have a world-wide prevalence of 2%–5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1) safely lower blood pressure, and (2) treat/minimize acute end organ damage, while (3) identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8-hour period. PMID:27147865

  7. Geographic Information System Technology Leveraged for Crisis Planning, Emergency, Response, and Disaster Management

    NASA Astrophysics Data System (ADS)

    Ross, A.; Little, M. M.

    2013-12-01

    NASA's Atmospheric Science Data Center (ASDC) is piloting the use of Geographic Information System (GIS) technology that can be leveraged for crisis planning, emergency response, and disaster management/awareness. Many different organizations currently use GIS tools and geospatial data during a disaster event. ASDC datasets have not been fully utilized by this community in the past due to incompatible data formats that ASDC holdings are archived in. Through the successful implementation of this pilot effort and continued collaboration with the larger Homeland Defense and Department of Defense emergency management community through the Homeland Infrastructure Foundation-Level Data Working Group (HIFLD WG), our data will be easily accessible to those using GIS and increase the ability to plan, respond, manage, and provide awareness during disasters. The HIFLD WG Partnership has expanded to include more than 5,900 mission partners representing the 14 executive departments, 98 agencies, 50 states (and 3 territories), and more than 700 private sector organizations to directly enhance the federal, state, and local government's ability to support domestic infrastructure data gathering, sharing and protection, visualization, and spatial knowledge management.The HIFLD WG Executive Membership is lead by representatives from the Department of Defense (DoD) Office of the Assistant Secretary of Defense for Homeland Defense and Americas' Security Affairs - OASD (HD&ASA); the Department of Homeland Security (DHS), National Protection and Programs Directorate's Office of Infrastructure Protection (NPPD IP); the National Geospatial-Intelligence Agency (NGA) Integrated Working Group - Readiness, Response and Recovery (IWG-R3); the Department of Interior (DOI) United States Geological Survey (USGS) National Geospatial Program (NGP), and DHS Federal Emergency Management Agency (FEMA).

  8. Present-day prehospital airway management in the former Eastern German state of Thuringia: equipment and education of emergency physicians.

    PubMed

    Hüter, Lars; Schreiber, Torsten; Reichel, Jens; Schwarzkopf, Konrad

    2009-04-01

    We describe the condition of education and equipment regarding prehospital airway management in the German federal state of Thuringia, representing a part of former Eastern Germany. In 2006 a postal survey of the 39 emergency medical stations (EMS) in Thuringia was carried out. The response rate was 100%. In 72% of the EMS, a device for extraglottic airway management and in all EMS a device for cricothyrotomy was available. A device to monitor end-tidal CO2 was available in 41%. Difficulties in airway management in the past two years were reported from 74% of the EMS. Ongoing training and education in airway management is provided in 82% of the emergency districts. This survey reveals wide variations in the equipment for airway management available to prehospital emergency physicians in Thuringia. Given the reported difficulties in airway management, availability of a more standardized set of airway management devices in Thuringia may be helpful.

  9. Emergency and crisis management: critical incident stress management for first responders and business organisations.

    PubMed

    Guenthner, Daniel H

    2012-01-01

    A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

  10. Impact of standardized patients on the training of medical students to manage emergencies

    PubMed Central

    Herbstreit, Frank; Merse, Stefanie; Schnell, Rainer; Noack, Marcel; Dirkmann, Daniel; Besuch, Anna; Peters, Jürgen

    2017-01-01

    Abstract Background: Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach. Methods: Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings (“acute chest pain,” “stroke,” and “acute dyspnea/asthma”) or traditional small group seminars. Before and after the respective training pathways, the students’ knowledge base (multiple-choice examination) and practical performance (objective structured clinical examination using 3 different emergency scenarios) were assessed. Results: Teaching using standardized patients resulted in a significant albeit small improvement in objective structured clinical examination scores (61.2 ± 3 for the standardized patient trained group vs 60.3 ± 3.5 for the traditional seminar group; P = 0.017, maximum achievable score: 66), but no difference in the written examination scores (27.4 ± 2.4 vs 27.0 ± 4.4; P = 0.341; maximum achievable score: 30). Conclusion: Teaching management of emergencies using standardized patients can improve medical students’ performance in clinical tests, and a change from traditional seminars in favor of practice sessions with standardized patients does not compromise the learning of medical facts. PMID:28151877

  11. Pain management policies and practices in pediatric emergency care: a nationwide survey of Italian hospitals

    PubMed Central

    2013-01-01

    Background Pain experienced by children in emergency departments (EDs) is often poorly assessed and treated. Although local protocols and strategies are important to ensure appropriate staff behaviours, few studies have focussed on pain management policies at hospital or department level. This study aimed at describing the policies and reported practices of pain assessment and treatment in a national sample of Italian pediatric EDs, and identifying the assocoated structural and organisational factors. Methods A structured questionnaire was mailed to all the 14 Italian pediatric and maternal and child hospitals and to 5 general hospitals with separate pediatric emergency room. There were no refusals. Information collected included the frequency and mode of pain assessment, presence of written pain management protocols, use of local anaesthetic (EMLA cream) before venipuncture, and role of parents. General data on the hospital and ED were also recorded. Multiple Correspondence Analysis was used to explore the multivariable associations between the characteristics of hospitals and EDs and their pain management policies and practices. Results Routine pain assessment both at triage and in the emergency room was carried out only by 26% of surveyed EDs. About one third did not use algometric scales, and almost half (47.4%) did not have local protocols for pain treatment. Only 3 routinely reassessed pain after treatment, and only 2 used EMLA. All EDs allowed parents’ presence and most (17, 89.9%) allowed them to stay when painful procedures were carried out. Eleven hospitals (57.9%) allowed parents to hold their child during blood sampling. Pediatric and maternal and child hospitals, those located in the North of Italy, equipped with medico-surgical-traumatological ED and short stay observation, and providing full assessment triage over 24 hours were more likely to report appropriate policies for pain management both at triage and in ER. A nurses to admissions ratio

  12. Managing Delirium In The Emergency Department: Tools For Targeting Underlying Etiology.

    PubMed

    Wong, Nelson; Abraham, Gallane

    2015-10-01

    Delirium represents the complex junction between vulnerable patients, medical conditions, and environmental factors. Given the varied presentations of this disorder and the emergency department clinical environment, recognition and treatment may be challenging. Delirium can be diagnosed using validated standardized screening tools such as the Confusion Assessment Method. Management of delirium is directed towards rapidly treating the underlying medical condition while preventing and managing the behavioral symptoms with nonpharmacological (first-line) and pharmacological (second-line) interventions. In the severely agitated patient, pharmacological treatment tailored to the patient's age and comorbidities may be required as the initial treatment to facilitate evaluation and management of the underlying medical condition. Effective risk stratification and triage tools can positively impact patient and staff safety, as well as patient outcomes.

  13. Headache in Pregnancy: An Approach to Emergency Department Evaluation and Management

    PubMed Central

    Schoen, Jessica C.; Campbell, Ronna L.; Sadosty, Annie T.

    2015-01-01

    Headache is a common presenting complaint in the emergency department. The differential diagnosis is broad and includes benign primary causes as well as ominous secondary causes. The diagnosis and management of headache in the pregnant patient presents several challenges. There are important unique considerations regarding the differential diagnosis, imaging options, and medical management. Physiologic changes induced by pregnancy increase the risk of cerebral venous thrombosis, dissection, and pituitary apoplexy. Preeclampsia, a serious condition unique to pregnancy, must also be considered. A high index of suspicion for carbon monoxide toxicity should be maintained. Primary headaches should be a diagnosis of exclusion. When advanced imaging is indicated, magnetic resonance imaging (MRI) should be used, if available, to reduce radiation exposure. Contrast agents should be avoided unless absolutely necessary. Medical therapy should be selected with careful consideration of adverse fetal effects. Herein, we present a review of the literature and discuss an approach to the evaluation and management of headache in pregnancy PMID:25834672

  14. Severe Traumatic Brain Injury In Children: An Evidence-Based Review Of Emergency Department Management.

    PubMed

    Morrissey, Kirsten; Fairbrother, Hilary

    2016-10-01

    More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes. This issue discusses methods to maintain adequate oxygenation, maximize management of intracranial hypertension, and optimize blood pressure in the emergency department to improve neurologic outcomes following pediatric severe traumatic brain injury.

  15. Sociotechnical design of an electronic tool for managing transient ischemic attack in the emergency department.

    PubMed

    Lau, Francis; Partridge, Colin; Penn, Andrew; Stanley, Dana; Votova, Kristine; Bibok, Maximilian; Harris, Devin; Lu, Linghong

    2015-01-01

    This paper describes the adoption of a prototype electronic decision support tool for managing transient ischemic attack (TIA) in the Emergency Department (ED) of a health region in Canada. A clinician-driven sociotechnical design approach is used to develop, test and implement the prototype with the aim to improve TIA management in the ED. In this study, we worked closely with ED staff to: identify issues and needs in TIA management; build/test/refine prototype versions of the electronic TIA decision support tool; and explore strategies to implement the tool for routine use in the ED. A blood protein biomarker test under development will also be incorporated as part of this tool in a subsequent phase. Thus far the prototype has demonstrated the potential to improve triage, risk stratification, and disposition decisions based on historical TIA and mimic cases. A prospective multi-site clinical utility study is planned for spring of 2016.

  16. Development and Implementation of Real-Time Information Delivery Systems for Emergency Management

    NASA Technical Reports Server (NTRS)

    Wegener, Steve; Sullivan, Don; Ambrosia, Vince; Brass, James; Dann, R. Scott

    2000-01-01

    The disaster management community has an on-going need for real-time data and information, especially during catastrophic events. Currently, twin engine or jet aircraft with limited altitude and duration capabilities collect much of the data. Flight safety is also an issue. Clearly, much of the needed data could be delivered via over-the-horizon transfer through a uninhabited aerial vehicles (UAV) platform to mission managers at various locations on the ground. In fact, because of the ability to stay aloft for long periods of time, and to fly above dangerous situations, UAV's are ideally suited for disaster missions. There are numerous situations that can be considered disastrous for the human population. Some, such as fire or flood, can continue over a period of days. Disaster management officials rely on data from the site to respond in an optimum way with warnings, evacuations, rescue, relief, and to the extent possible, damage control. Although different types of disasters call for different types of response, most situations can be improved by having visual images and other remotely sensed data available. "Disaster Management" is actually made up of a number of activities, including: - Disaster Prevention and Mitigation - Emergency Response Planning - Disaster Management (real-time deployment of resources, during an event) - Disaster / Risk Modeling All of these activities could benefit from real-time information, but a major focus for UAV-based technology is in real-time deployment of resources (i.e., emergency response teams), based on changing conditions at the location of the event. With all these potential benefits, it is desirable to demonstrate to user agencies the ability to perform disaster management missions as described. The following demonstration project is the first in a program designed to prove the feasibility of supporting disaster missions with UAV technology and suitable communications packages on-board. A several-year program is envisioned

  17. General Dental Practitioners’ Knowledge about the Emergency Management of Dental Trauma

    PubMed Central

    Akhlaghi, Najmeh; Nourbakhsh, Nosrat; Khademi, Abbasali; Karimi, Leila

    2014-01-01

    Introduction: The aim of this descriptive cross-sectional study was to assess the general dental practitioners (GDPs)’s knowledge regarding the emergency management of traumatic dental injuries (TDI) in Isfahan, Iran. Methods and Materials: In this study a two-part questionnaire consisting of 14 questions was distributed among 241 GDPs. Part 1 included seven questions focusing on personal and professional information and part 2 asked questions about seven given cases of dental traumas. One score was dedicated to each correct answer; the total score of 0 to 4 was considered as poor knowledge, while scores 5-8, 9-11 and 12-14 were assigned as moderate, good and excellent knowledge, respectively. The data were analyzed using the Student’s t-test and one-way ANOVA. Spearman’s and Pearson’s correlation coefficient were used to determine the associations between the emergency treatment knowledge and dentists’ professional information. Results: With regards to the level of GDP’s knowledge, the mean score was 7.61±2.68 suggesting a moderate score; a total of 177 (73.2%) of the dentists showed a moderate level of knowledge. A significant association was found between the frequency of dental trauma cases that were encountered and treated by GDPs in their daily practice (P=0.004, r=0.2). Conclusion: The overall knowledge of GDPs about the emergency management of TDI in the selected community was moderate. PMID:25386204

  18. [Difficult Ventilation Requiring Emergency Endotracheal Intubation during Awake Craniotomy Managed by Laryngeal Mask Airway].

    PubMed

    Matsuda, Asako; Mizota, Toshiyuki; Tanaka, Tomoharu; Segawa, Hajime; Fukuda, Kazuhiko

    2016-04-01

    We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased. We immediately started manual ventilation, but the airway resistance was extremely high and we could not adequately ventilate the patient. We administered muscle relaxant for suspected laryngospasm, but ventilatory status did not improve; so we decided to conduct emergency endotracheal intubation. We tried to intubate using Airwayscope or LMA-Fastrach, but they were not effective in our case. Finally trachea was intubated using transnasal fiberoptic bronchoscopy. We discuss airway management during awake craniotomy, focusing on emergency endotracheal intubation during surgery.

  19. A rule-based approach for the correlation of alarms to support Disaster and Emergency Management

    NASA Astrophysics Data System (ADS)

    Gloria, M.; Minei, G.; Lersi, V.; Pasquariello, D.; Monti, C.; Saitto, A.

    2009-04-01

    Key words: Simple Event Correlator, Agent Platform, Ontology, Semantic Web, Distributed Systems, Emergency Management The importance of recognition of emergency's typology to control the critical situation for security of citizens has been always recognized. It follows this aspect is very important for proper management of a hazardous event. In this work we present a solution for the recognition of emergency's typology adopted by an Italian research project, called CI6 (Centro Integrato per Servizi di Emergenza Innovativi). In our approach, CI6 receives alarms by citizen or people involved in the work (for example: police, operator of 112, and so on). CI6 represents any alarm by a set of information, including a text that describes it and obtained when the user points out the danger, and a pair of coordinates for its location. The system realizes an analysis of text and automatically infers information on the type of emergencies by means a set of parsing rules and rules of inference applied by a independent module: a correlator of events based on their log and called Simple Event Correlator (SEC). SEC, integrated in CI6's platform, is an open source and platform independent event correlation tool. SEC accepts input both files and text derived from standard input, making it flexible because it can be matched to any application that is able to write its output to a file stream. The SEC configuration is stored in text files as rules, each rule specifying an event matching condition, an action list, and optionally a Boolean expression whose truth value decides whether the rule can be applied at a given moment. SEC can produce output events by executing user-specified shell scripts or programs, by writing messages to files, and by various other means. SEC has been successfully applied in various domains like network management, system monitoring, data security, intrusion detection, log file monitoring and analysis, etc; it has been used or integrated with many

  20. Comparison of lispro insulin and regular insulin in the management of hyperglycaemic emergencies.

    PubMed

    Adesina, O F; Kolawole, B A; Ikem, R T; Adebayo, O J; Soyoye, D O

    2011-03-01

    This study compared the efficacy and safety of Lispro insulin and regular insulin in the management of hyperglycemic emergencies (HE). Fifty patients who presented in HE to the Emergency unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife participated in the study. Hyperglycaemic emergency was diagnosed when plasma glucose level was >17 mmol/L (300 mg/dl) in the presence of polyuria and polydipsia that warrants emergency hospital admission. Subjects in the Lispro insulin group had a statum dose of 0.3 IU/kg, while those in the regular insulin group had a statum dose of 20 IU equally split between the intravenous and intramuscular routes. Further insulin therapy was by the intramuscular route. Data was analysed using the Statistical package for social sciences (SPSS) version 11. Hyperglycaemia resolved within the first 8 hours in 60 and 40% percent of subjects in the lispro and regular insulin treated groups respectively. The time taken for resolution of hyperglycaemia was similar in both treatment groups, 6.6 +/- 0.8 hours for the lispro insulin group and 7.4 +/- 0.8 hours for the regular insulin group p = 0.51. The number of episodes of hypoglycaemia and hypokalemia in the two treatment groups did not differ statistically (p = 1.0 and 0.38 respectively). Eight (16%) subjects died. Lispro insulin is a safe and efficacious alternative to regular insulin in the treatment of HE.

  1. Functional design criteria for the Hazardous Materials Management and Emergency Response (HAMMER) Training Center. Revision 1

    SciTech Connect

    Sato, P.K.

    1995-03-10

    Within the United States, there are few hands-on training centers capable of providing integrated technical training within a practical application environment. Currently, there are no training facilities that offer both radioactive and chemical hazardous response training. There are no hands-on training centers that provide training for both hazardous material operations and emergency response that also operate as a partnership between organized labor, state agencies, tribes, and local emergency responders within the US Department of Energy (DOE) complex. Available facilities appear grossly inadequate for training the thousands of people at Hanford, and throughout the Pacific Northwest, who are required to qualify under nationally-mandated requirements. It is estimated that 4,000 workers at the Hanford Site alone need hands-on training. Throughout the Pacific Northwest, the potential target audience would be over 30,000 public sector emergency response personnel, as well as another 10,000 clean-up workers represented by organized labor. The HAMMER Training Center will be an interagency-sponsored training center. It will be designed, built, and operated to ensure that clean-up workers, fire fighters, and public sector management and emergency response personnel are trained to handle accidental spills of hazardous materials. Training will cover wastes at clean-up sites, and in jurisdictions along the transportation corridors, to effectively protect human life, property, and the environment.

  2. Surveillance, detection and response: managing emerging diseases at national and international levels.

    PubMed

    Jebara, K Ben

    2004-08-01

    Globalisation is leading to a rise in the emergence of diseases and the author describes the new challenges that this brings for individual countries and the international community. The paper describes the existing international early warning systems and response mechanisms, discusses the role of international organisations in managing diseases that have the potential for cross-border spread, and underlines the importance of disease surveillance, detection and response at national level. While international collaboration exists in dealing with disease emergency situations, there is a need to develop regional and international contingency plans that can be launched as soon as an emergency situation arises. This will only be possible if there is the political will to tackle problems wherever they occur. The Global Early Warning System, which is a system currently being developed jointly by the Food and Agriculture Organization of the United Nations, the World Organisation for Animal Health and the World Health Organization, could provide an effective framework in which to achieve a higher level of international emergency preparedness.

  3. Is emergency management an integrated element of business continuity management? A case study with security professionals in Western Australia.

    PubMed

    Frohde, Kenny; Brooks, David J

    2014-01-01

    Emergency management (EM) and business continuity management (BCM) frameworks incorporate various strategic and operational measures. Defined within a number of national and international standards and guidelines, such concepts may be integrated within one another to provide increased resilience to disruptive events. Nevertheless, there is a degree of dispute regarding concept integration among security and EM professionals and bodies of knowledge. In line with cognitive psychology exemplar-based concepts, such disputes may be associated with a lack of precision in communality in the approach to EM and BCM. This paper presents a two-stage study, where stage 1 critiqued national and international literature and stage 2 applied semi-structured interviews with security managers in Western Australia. Findings indicate the existence of contradictory views on EM and its integration within BCM. As such, this study concludes that EM is considered a vital component of BCM by the majority of security managers. However, there is broader dispute regarding its degree of integration. Understanding the underpinnings of such disputes will aid in raising the standards and application of professionalism within security, EM and BCM domains, supporting clarification and definition of professional boundaries.

  4. Helicopter emergency medical services in major incident management: A national Norwegian cross-sectional survey

    PubMed Central

    Johnsen, Anne Siri; Sollid, Stephen J. M.; Vigerust, Trond; Jystad, Morten; Rehn, Marius

    2017-01-01

    Objective Helicopter Emergency Medical Services (HEMS) aim to bring a highly specialised crew to the scene of major incidents for triage, treatment and transport. We aim to describe experiences made by HEMS in Norway in the management of major incidents. Design Doctors, rescue paramedics and pilots working in Norwegian HEMS and Search and Rescue Helicopters (SAR) January 1st 2015 were invited to a cross-sectional study on experiences, preparedness and training in major incident management. Results We identified a total of 329 Norwegian crewmembers of which 229 (70%) responded; doctors 101/150, (67%), rescue paramedics 64/78 (82%), pilots 64/101, (63%). HEMS and SAR crewmembers had experience from a median of 2 (interquartile range 0–6) major incidents. Road traffic incidents were the most frequent mechanism and blunt trauma the dominating injury. HEMS mainly contributed with triage, treatment and transport. Communication with other emergency services prior to arrival was described as bad, but good to excellent when cooperating on scene. The respondents called for more interdisciplinary exercises. Conclusion HEMS and SAR crewmembers have limited exposure to major incident management. Interdisciplinary training on frequent scenarios with focus on cooperation and communication is called for. PMID:28192440

  5. Diagnosis and management of urinary tract infections in the emergency department.

    PubMed

    Best, Jessica; Kitlowski, Andrew David; Ou, Derek; Bedolla, John

    2014-07-01

    Urinary tract infections are a heterogeneous group of disorders, involving infection of all or part of the urinary tract, and are defined by bacteria in the urine with clinical symptoms that may be acute or chronic. Approximately 1 million urinary tract infections are treated every year in United States emergency departments. The female-to-male ratio is 6:1. Urinary tract infections are categorized as upper versus lower tract involvement and as uncomplicated versus complicated. The emergency clinician must carefully categorize the infection and take into account patient host factors to optimally treat and disposition patients. A working knowledge of local or at least national susceptibility patterns of the most likely pathogens is essential. A variety of special populations exist that require special management, including pregnant females, patients with anatomic abnormalities, and instrumented patients.

  6. Public Health Emergency Operations Center - A critical component of mass gatherings management infrastructure.

    PubMed

    Elachola, Habidah; Al-Tawfiq, Jaffar A; Turkestani, Abdulhafiz; Memish, Ziad A

    2016-08-31

    Mass gatherings (MG) are characterized by the influx of large numbers of people with the need to have infrastructural changes to support these gatherings. Thus, Public Health Emergency Operations Center (PHEOC) is critical management infrastructure for both the delivery of public health functions and for mounting adequate response during emergencies. The recognition of the importance of PHEOC at the leadership and political level is foundational for the success of any public health intervention during MG. The ability of the PHEOC to effectively function depends on appropriate design and infrastructure, staffing and command structure, and plans and procedures developed prior to the event. Multi-ministerial or jurisdictional coordination will be required and PHEOC should be positioned with such authorities. This paper outlines the essential concepts, elements, design, and operational aspects of PHEOC during MG.

  7. Emergency department management of syncope: need for standardization and improved risk stratification.

    PubMed

    Thiruganasambandamoorthy, Venkatesh; Taljaard, Monica; Stiell, Ian G; Sivilotti, Marco L A; Murray, Heather; Vaidyanathan, Aparna; Rowe, Brian H; Calder, Lisa A; Lang, Eddy; McRae, Andrew; Sheldon, Robert; Wells, George A

    2015-08-01

    Variations in emergency department (ED) syncope management have not been well studied. The goals of this study were to assess variations in management, and emergency physicians' risk perception and disposition decision making. We conducted a prospective study of adults with syncope in six EDs in four cities over 32 months. We collected patient characteristics, ED management, disposition, physicians' prediction probabilities at index presentation and followed patients for 30 days for serious outcomes: death, myocardial infarction (MI), arrhythmia, structural heart disease, pulmonary embolism, significant hemorrhage, or procedural interventions. We used descriptive statistics, ROC curves, and regression analyses. We enrolled 3662 patients: mean age 54.3 years, and 12.9 % were hospitalized. Follow-up data were available for 3365 patients (91.9 %) and 345 patients (10.3 %) suffered serious outcomes: 120 (3.6 %) after ED disposition including 48 patients outside the hospital. After accounting for differences in patient case mix, the rates of ED investigations and disposition were significantly different (p < 0.0001) across the four study cities; as were the rates of 30-day serious outcomes (p < 0.0001) and serious outcomes after ED disposition (p = 0.0227). There was poor agreement between physician risk perception and both observed event rates and referral patterns (p < 0.0001). Only 76.7 % (95 % CI 68.1-83.6) of patients with serious outcomes were appropriately referred. There are large and unexplained differences in ED syncope management. Moreover, there is poor agreement between physician risk perception, disposition decision making, and serious outcomes after ED disposition. A valid risk-stratification tool might help standardize ED management and improve disposition decision making.

  8. An innovative fever management education program for parents, caregivers, and emergency nurses.

    PubMed

    Alqudah, Muhammad; Johnson, Maree; Cowin, Leanne; George, Ajesh

    2014-01-01

    Parents frequently present to the emergency department (ED) concerned about their child's fever. Fever management education programs have been found to improve parents' knowledge of managing fever, although no education program was identified that specifically considered parents with lower functional health literacy. This article describes the development of an easily understood children's fever management education program for parents with varying levels of health literacy. A review of existing literature and guidelines was conducted. Pictorial images and written material constrained to fifth-grade level of readability were used. Academics and ED experts confirmed the content of this evidence-based program. The education program, a combination of Digital Video Disc (DVD) and a brochure in relation to child fever management, is currently being trailed at an ED in Sydney and is appropriate for EDs or primary care settings. Tailoring education programs with plain and simple language is potentially beneficial to all parents (or caregivers) presenting to the ED with children experiencing fever. This program will provide nurses with a simple and clear fever management brochure or DVD to give to parents or caregivers with varying levels of health literacy. We envisage that this program will be continuously televised within local EDs and available for parents or caregivers to view online.

  9. A Standardized Method of Preventing and Managing Emergencies within the Context of Evidence-Based Therapy Implementation

    ERIC Educational Resources Information Center

    Urgelles, Jessica; Donohue, Brad; Wilks, Chelsey; Van Hasselt, Vincent B.; Azrin, Nathan H.

    2012-01-01

    Families served within child welfare settings evidence a wide range of emergencies or unexpected crises or circumstances that may lead to danger and make it difficult for them to focus on treatment planning. Mental health treatment providers are often unprepared to effectively manage emergencies during implementation of evidence-based prescribed…

  10. On Becoming Batman: An Ethnographic Examination of Hero Imagery in Early-Career Residential Life Emergency Management

    ERIC Educational Resources Information Center

    Molina, Danielle K.

    2016-01-01

    Emergency response is an essential function of all residential life staff, but particularly for resident assistants serving on the front line. This organizational ethnography examined the role that professional identity played for early-career residential life practitioners engaged in emergency management. The data elucidated heroism as a…

  11. 76 FR 53918 - Privacy Act of 1974; Department of Homeland Security/Federal Emergency Management Agency-001...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-30

    ... SECURITY Office of the Secretary Privacy Act of 1974; Department of Homeland Security/Federal Emergency Management Agency--001 National Emergency Family Registry and Locator System of Records AGENCY: Privacy Office, DHS. ACTION: Notice of Privacy Act system of records. SUMMARY: In accordance with the Privacy...

  12. A Prevalence and Management Study of Acute Pain in Children Attending Emergency Departments by Ambulance.

    PubMed

    Murphy, Adrian; McCoy, Siobhan; O'Reilly, Kay; Fogarty, Eoin; Dietz, Jason; Crispino, Gloria; Wakai, Abel; O'Sullivan, Ronan

    2016-01-01

    Pain is the most common symptom in the emergency setting and remains one of the most challenging problems for emergency care providers, particularly in the pediatric population. The primary objective of this study was to determine the prevalence of acute pain in children attending emergency departments (EDs) in Ireland by ambulance. In addition, this study sought to describe the prehospital and initial ED management of pain in this population, with specific reference to etiology of pain, frequency of pain assessment, pain severity, and pharmacological analgesic interventions. A prospective cross-sectional study was undertaken over a 12-month period of all pediatric patients transported by emergency ambulance to four tertiary referral hospitals in Ireland. All children (<16 years) who had pain as a symptom (regardless of cause) at any stage during the prehospital phase of care were included in this study. Over the study period, 6,371 children attended the four EDs by emergency ambulance, of which 2,635 (41.4%, 95% confidence interval 40.2-42.3%) had pain as a documented symptom on the ambulance patient care report (PCR) form. Overall 32% (n = 856) of children who complained of pain were subject to a formal pain assessment during the prehospital phase of care. Younger age, short transfer time to the ED, and emergency calls between midnight and 6 am were independently associated with decreased likelihood of having a documented assessment of pain intensity during the prehospital phase of care. Of the 2,635 children who had documented pain on the ambulance PCR, 26% (n = 689) received some form of analgesic agent prior to ED arrival. Upon ED arrival 54% (n = 1,422) of children had a documented pain assessment and some form of analgesic agent was administered to 50% (n = 1,324). Approximately 41% of children who attend EDs in Ireland by ambulance have pain documented as their primary symptom. This study suggests that the management of acute pain in children transferred by

  13. CERCLA reporting requirements, DOE occurrence reporting, and the DOE Emergency Management System. CERCLA Information Brief

    SciTech Connect

    Dailey, R.

    1993-10-01

    The Emergency Management System (EMS) provides a structure for reporting and processing operations information related to DOE owned/operated facilities. Hazardous Substance (HS) releases are subject to reporting requirements under the EMS as well as under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). CERCLA requires reporting of HS releases into the environment in amounts greater than or equal to Reportable Quantities (RQs). This Information Brief elaborates on earlier CERCLA reporting and response process information Briefs by providing a general explanation of these CERCLA or EMS requirements, procedures, and events as they pertain to releases of HS`s at DOE facilities.

  14. Emergency management of heat exchanger leak on cardiopulmonary bypass with hypothermia.

    PubMed

    Gukop, P; Tiezzi, A; Mattam, K; Sarsam, M

    2015-11-01

    Heat exchanger leak on cardiopulmonary bypass is very rare, but serious. The exact incidence is not known. It is an emergency associated with the potential risk of blood contamination, air embolism and haemolysis, difficulty with re-warming, acidosis, subsequent septic shock, multi-organ failure and death. We present a prompt, highly co-ordinated algorithm for the successful management of this important rare complication. There is need for further research to look for safety devices that detect leaks and techniques to reduce bacterial load. It is essential that teams practice oxygenator change-out routines and have a well-established change-out protocol.

  15. Phytophthora ramorum: integrative research and management of an emerging pathogen in California and Oregon forests.

    PubMed

    Rizzo, David M; Garbelotto, Matteo; Hansen, Everett M

    2005-01-01

    Phytophthora ramorum, causal agent of sudden oak death, is an emerging plant pathogen first observed in North America associated with mortality of tanoak (Lithocarpus densiflorus) and coast live oak (Quercus agrifolia) in coastal forests of California during the mid-1990s. The pathogen is now known to occur in North America and Europe and have a host range of over 40 plant genera. Sudden oak death has become an example of unintended linkages between the horticultural industry and potential impacts on forest ecosystems. This paper examines the biology and ecology of P. ramorum in California and Oregon forests as well discussing research on the pathogen in a broader management context.

  16. Decision support system for emergency management of oil spill accidents in the Mediterranean Sea

    NASA Astrophysics Data System (ADS)

    Liubartseva, Svitlana; Coppini, Giovanni; Pinardi, Nadia; De Dominicis, Michela; Lecci, Rita; Turrisi, Giuseppe; Cretì, Sergio; Martinelli, Sara; Agostini, Paola; Marra, Palmalisa; Palermo, Francesco

    2016-08-01

    This paper presents an innovative web-based decision support system to facilitate emergency management in the case of oil spill accidents, called WITOIL (Where Is The Oil). The system can be applied to create a forecast of oil spill events, evaluate uncertainty of the predictions, and calculate hazards based on historical meteo-oceanographic datasets. To compute the oil transport and transformation, WITOIL uses the MEDSLIK-II oil spill model forced by operational meteo-oceanographic services. Results of the modeling are visualized through Google Maps. A special application for Android is designed to provide mobile access for competent authorities, technical and scientific institutions, and citizens.

  17. Evaluation and management of traumatic knee injuries in the emergency department.

    PubMed

    Knutson, Tristan; Bothwell, Jason; Durbin, Ricky

    2015-05-01

    Posttraumatic knee pain is a common presentation in the emergency department (ED). The use of clinical decision rules can rule out reliably fractures of the knee and reduce the unnecessary cost and radiation exposure associated with plain radiographs. If ligamentous or meniscal injury to the knee is suspected, the ED physician should arrange for expedited follow- up with the patient's primary care physician or an orthopedic specialist for consideration of an MRI and further management. Patients presenting after high-energy mechanisms are at risk for occult fracture and vascular injuries. ED providers must consider these injuries in the proper clinical setting.

  18. The emerging role of lidar remote sensing in coastal research and resource management

    USGS Publications Warehouse

    Brock, John C.; Purkis, Samuel J.

    2009-01-01

    Knowledge of coastal elevation is an essential requirement for resource management and scientific research. Recognizing the vast potential of lidar remote sensing in coastal studies, this Special Issue includes a collection of articles intended to represent the state-of-the-art for lidar investigations of nearshore submerged and emergent ecosystems, coastal morphodynamics, and hazards due to sea-level rise and severe storms. Some current applications for lidar remote sensing described in this Special Issue include bluegreen wavelength lidar used for submarine coastal benthic environments such as coral reef ecosystems, airborne lidar used for shoreline mapping and coastal change detection, and temporal waveform-resolving lidar used for vegetation mapping.

  19. Radiation Effects on Emerging Technologies: Implications of Space Weather Risk Management

    NASA Technical Reports Server (NTRS)

    LaBel, Kenneth A.; Barth, Janet L.

    2000-01-01

    As NASA and its space partners endeavor to develop a network of satellites capable of supporting humankind's needs for advanced space weather prediction and understanding, one of the key challenges is to design a space system to operate in the natural space radiation environment In this paper, we present a description of the natural space radiation environment, the effects of interest to electronic or photonic systems, and a sample of emerging technologies and their specific issues. We conclude with a discussion of operations in the space radiation hazard and considerations for risk management.

  20. The role of the emergency department in the management of acute heart failure: An international perspective on education and research.

    PubMed

    Pang, Peter S; Collins, Sean P; Miró, Òscar; Bueno, Hector; Diercks, Deborah B; Di Somma, Salvatore; Gray, Alasdair; Harjola, Veli-Pekka; Hollander, Judd E; Lambrinou, Ekaterini; Levy, Phillip D; Papa, AnnMarie; Möckel, Martin

    2015-08-11

    Emergency departments are a major entry point for the initial management of acute heart failure (AHF) patients throughout the world. The initial diagnosis, management and disposition - the decision to admit or discharge - of AHF patients in the emergency department has significant downstream implications. Misdiagnosis, under or overtreatment, or inappropriate admission may place patients at increased risk for adverse events, and add costs to the healthcare system. Despite the critical importance of initial management, data are sparse regarding the impact of early AHF treatment delivered in the emergency department compared to inpatient or chronic heart failure management. Unfortunately, outcomes remain poor, with nearly a third of patients dying or re-hospitalised within 3 months post-discharge. In the absence of robust research evidence, consensus is an important source of guidance for AHF care. Thus, we convened an international group of practising emergency physicians, cardiologists and advanced practice nurses with the following goals to improve outcomes for AHF patients who present to the emergency department or other acute care setting through: (a) a better understanding of the pathophysiology, presentation and management of the initial phase of AHF care; (b) improving initial management by addressing knowledge gaps between best practices and current practice through education and research; and (c) to establish a framework for future emergency department-based international education and research.

  1. Helpful Hints for School Emergency Management: The National Incident Management System (NIMS) and Schools. Frequently Asked Questions and FY 2006 NIMS Compliance Activities for Schools

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    "Helpful Hints" offers a quick overview of school emergency preparedness topics that are frequently the subject of inquiries. The National Incident Management System (NIMS) is a comprehensive system that improves tribal and local emergency response operations through the use of the Incident Command System (ICS) and the application of standardized…

  2. Emerging therapeutic approaches for the management of diabetes mellitus and macrovascular complications.

    PubMed

    Golden, Sherita Hill

    2011-08-02

    Type 2 diabetes mellitus (DM) affects an estimated 25.8 million people in the United States and is the 7th leading cause of death. While effective therapy can prevent or delay the complications that are associated with diabetes, according to the Center for Disease Control, 35% of Americans with DM are undiagnosed, and another 79 million Americans have blood glucose levels that greatly increase their risk of developing DM in the next several years. One of the Healthy People 2020 goals is to reduce the disease and economic burden of DM and improve the quality of life for all persons who have, or are at risk for, DM. Achieving this goal requires a concentrated focus on improving the management of diabetes and in targeting prevention of macrovascular complications. This article reviews established and emerging therapeutic approaches for managing DM and prevention of macrovascular complications.

  3. Decreasing avoidable hospital admissions with the implementation of an emergency department case management program.

    PubMed

    Sharieff, Ghazala Q; Cantonis, Matt; Tressler, Michelle; Whitehead, Mary; Russe, Jamie; Lovell, Eric

    2014-01-01

    With the passage of the Affordable Care Act, increased emphasis has been placed on optimizing quality and reducing expenditures. The use of an emergency department case manager (EDCM) is reemerging as an important initiative in the quest to provide high-quality care and decrease unnecessary hospital admissions. A pilot study of the use of EDCMs was conducted in one of the authors' EDs during a 6-month trial period. By using evidence-based criteria, the EDCM helped in real time to verify admission criteria, assisted with inpatient versus outpatient designation, found community alternatives to hospital admission, and initiated discharge planning for patients who required admission and were at high risk for readmission. EDCMs also worked with pharmacists to assist with medication management for patients who required assistance with obtaining prescriptions. Because of the pilot study's success, the authors' health care system will be implementing EDCMs throughout the organization.

  4. [Management of the pediatric dental patient with seizure disorder: prevention and treatment of emergencies].

    PubMed

    Shapira, Y; Sapir, S; Amir, E

    2003-09-01

    Seizures are not infrequent in childhood and may occur during dental treatment. Generalized seizures and particularly the Tonic-clonic (grand-mal) are the most hazardous and may induce self-injury, aspiration, and medical emergency as status epilepticus. The differential diagnosis of isolated seizure attack should consider hyperventilation, hyperglycemia, local anesthetic toxicity, and anoxia. The pediatric dentist should be aware of predisposing factors that may induce seizure attack in their patients. Proper precautionary measures could prevent the attack from occurring or at least reduce its consequences. The diagnosis as to the cause of the seizure, as well as providing proper management, could prevent further complications. This article presents the medical and dental history relevant for prevention of seizure attack in the dental chair, antiepileptic drugs with possible interactions with the dental treatment and management of such attack, should they occurs.

  5. Practice Management and Health Policy Education in Radiology: An Emerging Imperative.

    PubMed

    DeQuesada, Ivan M; Chokshi, Falgun H; Mullins, Mark E; Duszak, Richard

    2015-10-01

    As society places increased responsibility on practicing physicians for addressing accelerating health care costs and delivery system inefficiencies, traditional education and training programs have left most physicians ill equipped to assume this responsibility. A variety of new initiatives are underway that dramatically change how radiology training programs address these issues. We review the emerging need for better physician education in health policy and practice management, detail the history and requirements of the ACGME and the ABR Healthcare Economics Milestone Project, and outline mechanisms by which radiology residency programs can comply with these requirements. We describe our own new comprehensive pilot curriculum, Practice Management, Health Policy, and Professionalism for Radiology Residents (P(3)R(2)), which may serve as a potential model for other training programs seeking to develop targeted curricula in these newly required areas.

  6. The use of emergency manuals in perioperative crisis management: a cautious approach.

    PubMed

    Szabo, Ashley; August, David A; Klainer, Suzanne; Miller, Andrew D; Kaye, Alan D; Raemer, Daniel B; Urman, Richard D

    2015-01-01

    When an unexpected perioperative crisis arises, simulation studies have suggested that the use of an emergency manual (EM) may offset the large cognitive load involved in crisis management, facilitating the efficient performance of key steps in treatment. However, little is known about how well EMs will translate into actual practice and what is required to use them optimally. While EMs are a promising tool in the management of perioperative critical events, more research is needed to define best practices and their limitations. In the interim, cautious use of these cognitive aids is recommended, especially when the diagnosis is not straightforward, falls "in between" sections of the EM, or falls outside of the EM itself. Further research should focus on the efficacy of EMs as measured by the percentage of critical steps correctly performed by their users in scenarios that do not closely mirror one of the listed EM scenarios from the beginning or as the situation evolves.

  7. Dynamic Information Management and Exchange for Command and Control Applications: A Framework in Support of Emergency Management for Specified and Unspecified Emergencies

    DTIC Science & Technology

    2014-03-01

    Suppose that during the night the ECG wave of a patient p shows an interference dissociation (i.e., a rare case of arrhythmia , which might have not...record of p. In this case, we might have that: (1) arrhythmia emergency and related policy have been specified, thus the emergency is detected and d2...is allowed to access the medical record of p due to an existing emergency policy; (2) arrhythmia emergency and related policy are unspecified, thus the

  8. Managing Agitation Associated with Schizophrenia and Bipolar Disorder in the Emergency Setting

    PubMed Central

    Zeller, Scott L.; Citrome, Leslie

    2016-01-01

    Introduction Patient agitation represents a significant challenge in the emergency department (ED), a setting in which medical staff are working under pressure dealing with a diverse range of medical emergencies. The potential for escalation into aggressive behavior, putting patients, staff, and others at risk, makes it imperative to address agitated behavior rapidly and efficiently. Time constraints and limited access to specialist psychiatric support have in the past led to the strategy of “restrain and sedate,” which was believed to represent the optimal approach; however, it is increasingly recognized that more patient-centered approaches result in improved outcomes. The objective of this review is to raise awareness of best practices for the management of agitation in the ED and to consider the role of new pharmacologic interventions in this setting. Discussion The Best practices in Evaluation and Treatment of Agitation (BETA) guidelines address the complete management of agitation, including triage, diagnosis, interpersonal calming skills, and medicine choices. Since their publication in 2012, there have been further developments in pharmacologic approaches for dealing with agitation, including both new agents and new modes of delivery, which increase the options available for both patients and physicians. Newer modes of delivery that could be useful in rapidly managing agitation include inhaled, buccal/sublingual and intranasal formulations. To date, the only formulation administered via a non-intramuscular route with a specific indication for agitation associated with bipolar or schizophrenia is inhaled loxapine. Non-invasive formulations, although requiring cooperation from patients, have the potential to improve overall patient experience, thereby improving future cooperation between patients and healthcare providers. Conclusion Management of agitation in the ED should encompass a patient-centered approach, incorporating non-pharmacologic approaches

  9. Patient safety in emergency airway management and rapid sequence intubation: metaphorical lessons from skydiving.

    PubMed

    Levitan, Richard M

    2003-07-01

    Concern about patient safety and failed rapid sequence intubation has led to an increased awareness of potentially difficult laryngoscopy situations and algorithms promoting techniques in awake patients. Given the low overall incidence of failed laryngoscopy, however, prediction of difficult laryngoscopy has poor positive predictive value and uncertain clinical utility, especially in emergency settings. Non-rapid sequence intubation approaches have comparatively lower chances of intubation success, require more time, and are associated with more complications. As a specialty, emergency medicine has adopted rapid sequence intubation as the mainstay of emergency airway treatment for many appropriate reasons; the problem that must be addressed is how patient safety can be ensured while what is an inherently dangerous procedure is performed. A novel way to conceptualize patient risk and safety issues in rapid sequence intubation is to examine how inherent risk is managed in skydiving. Metaphorical lessons from skydiving that are applicable to rapid sequence intubation include (1) a redundancy of safety; (2) a methodic approach to primary chute deployment; (3) use of backup chutes that are fast, simple, and easy to deploy; (4) attention to monitoring; and (5) equipment vigilance. This article reviews how each of these lessons apply metaphorically to rapid sequence intubation, wherein the primary chute is laryngoscopy, the backup chute is rescue ventilation, and monitoring involves pulse oximetry.

  10. Dynamic equilibrium strategy for drought emergency temporary water transfer and allocation management

    NASA Astrophysics Data System (ADS)

    Xu, Jiuping; Ma, Ning; Lv, Chengwei

    2016-08-01

    Efficient water transfer and allocation are critical for disaster mitigation in drought emergencies. This is especially important when the different interests of the multiple decision makers and the fluctuating water resource supply and demand simultaneously cause space and time conflicts. To achieve more effective and efficient water transfers and allocations, this paper proposes a novel optimization method with an integrated bi-level structure and a dynamic strategy, in which the bi-level structure works to deal with space dimension conflicts in drought emergencies, and the dynamic strategy is used to deal with time dimension conflicts. Combining these two optimization methods, however, makes calculation complex, so an integrated interactive fuzzy program and a PSO-POA are combined to develop a hybrid-heuristic algorithm. The successful application of the proposed model in a real world case region demonstrates its practicality and efficiency. Dynamic cooperation between multiple reservoirs under the coordination of a global regulator reflects the model's efficiency and effectiveness in drought emergency water transfer and allocation, especially in a fluctuating environment. On this basis, some corresponding management recommendations are proposed to improve practical operations.

  11. Federal Emergency Management Information System (FEMIS) Bill of Materials (BOM) for FEMIS Version 1.3

    SciTech Connect

    Burford, M.J.; Gerhardstein, L.H.; Johnson, R.L.; Loveall, R.M.; Martin, T.J.; Millard, W.D.; Stoops, L.R.; Winters, C.; Wood, B.M.

    1997-02-07

    This document describes the Bill of Materials (BOM) for the Federal Emergency Management Information System (FEMIS) for version 1.3. FEMIS runs on a client/server platform consisting of a UNIX system, employed as a data server, and personal computers (PCs) using the Windows NT operating system. Servers and PCs require the operating system, utility software, communications and other internal cards that are also listed in the following sections. FEMIS will support the use of Commercial Off-The-Shelf (COTS) software applications and tools. Several configurations are possible at a Chemical Stockpile Emergency Preparedness Program (CSEPP) site. In this description, a site is understood to be compromised of several installations, including the depot, surrounding Immediate Response Zone (IRZ) and Protective Action Zone (PAZ) counties, and one or more state Emergency Operations Centers (EOCs). In general, the main differences between possible configurations are the number of users at an installation, the location of the UNIX data server(s), and wide area network (WAN) link between installations. The number of PC workstations will vary between installations.

  12. Emergence of collective action and environmental networking in relation to radioactive waste management

    SciTech Connect

    Williams, R.G.; Payne, B.A.

    1985-01-01

    This paper explores the relationship between the national environmental movement and nuclear technology in relation to a local emergent group. The historical development of nuclear technology in this conutry has followed a path leading to continued fear and mistrust of waste management by a portion of the population. At the forefront of opposition to nuclear technology are people and groups endorsing environmental values. Because of the antinuclear attitudes of environmentalists and the value orientation of appropriate technologists in the national environmental movement, it seems appropriate for local groups to call on these national groups for assistance regarding nuclear-related issues. A case study is used to illustrate how a local action group, once integrated into a national environmental network, can become an effective, legitimate participant in social change. The formation, emergence, mobilization, and networking of a local group opposed to a specific federal radioactive waste management plan is described based on organizational literature. However, inherent contradictions in defining the local versus national benefits plus inherent problems within the environmental movement could be acting to limit the effectiveness of such networks. 49 refs.

  13. Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training

    PubMed Central

    Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

    2015-01-01

    Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice. PMID:26788056

  14. Evaluating the Potential Usefulness of new Hurricane Indices for Emergency Management and Other Decision Makers

    NASA Astrophysics Data System (ADS)

    Jordan, M. R.; Clayson, C. A.

    2006-12-01

    Over the past 35 years, the Saffir-Simpson scale has used wind speed as a means for categorizing damage and surge risks associated with hurricanes. Time has shown, however, that hurricanes with the same wind speed do not necessarily cause equal damage values and storm-surge heights. Therefore, it is prudent to now consider a different method for categorizing storms so that emergency management officials in a coastal location can have a better idea as to the potential hazards posed by a particular hurricane. Recognizing this need, three new indices were developed by Lakshmi Kantha in 2005 for evaluating hurricane intensity, hurricane damage potential, and hurricane surge potential. This paper applies these indices to a twenty-year database (1986-2005) of Atlantic, U.S.-landfalling hurricanes and compares the relative indices to known damage estimates and surge heights. Some general conclusions will be made regarding the possible usefulness of these indices for emergency management officials in areas prone to landfalling tropical cyclones.

  15. Pain Management of Pediatric Musculoskeletal Injury in the Emergency Department: A Systematic Review

    PubMed Central

    Trottier, Evelyne D.; Gouin, Serge

    2016-01-01

    Background. Pain management for children with musculoskeletal injuries is suboptimal and, in the absence of clear evidence-based guidelines, varies significantly. Objective. To systematically review the most effective pain management for children presenting to the emergency department with musculoskeletal injuries. Methods. Electronic databases were searched systematically for randomized controlled trials of pharmacological and nonpharmacological interventions for children aged 0–18 years, with musculoskeletal injury, in the emergency department. The primary outcome was the risk ratio for successful reduction in pain scores. Results. Of 34 studies reviewed, 8 met inclusion criteria and provided data on 1169 children from 3 to 18 years old. Analgesics used greatly varied, making comparisons difficult. Only two studies compared the same analgesics with similar routes of administration. Two serious adverse events occurred without fatalities. All studies showed similar pain reduction between groups except one study that favoured ibuprofen when compared to acetaminophen. Conclusions. Due to heterogeneity of medications and routes of administration in the articles reviewed, an optimal analgesic cannot be recommended for all pain categories. Larger trials are required for further evaluation of analgesics, especially trials combining a nonopioid with an opioid agent or with a nonpharmacological intervention. PMID:27445614

  16. Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training.

    PubMed

    Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

    2015-01-01

    Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

  17. Integrated water resources management for emergency situations: A case study of Macau.

    PubMed

    Huang, JianYong; Lou, Inchio; Li, YingXia

    2016-12-01

    Integrated urban water management (IUWM) is a useful tool that can be used to alleviate water resource shortages in developing regions like Macau, where 98% of the raw water comes from mainland China. In Macau, scarce water resources deteriorate rapidly in emergency situations, such as accidental chemical spills upstream of the supply reservoir or salty tides. During these times, only the water from the two freshwater reservoirs in Macau can be used. In this study, we developed urban water management optimization models that integrated the raw water supply from the two reservoirs with various proposed governmental policies (wastewater reuse, rainwater collection, and water saving). We then determined how various water resource strategies would influence the urban water supply in Macau in emergency situations. Our results showed that, without imported raw water, the water supply from only the two Macau reservoirs would last for 7.95days. However, when all the government policies were included in the model, the supply could be extended to 13.79days. Out of the three non-conventional water resources, wastewater reuse is the most beneficial for increasing the Macau water supply, and rainwater collection also has great potential.

  18. Experience feedback committee in emergency medicine: a tool for security management

    PubMed Central

    Lecoanet, André; Sellier, Elodie; Carpentier, Françoise; Maignan, Maxime; Seigneurin, Arnaud; François, Patrice

    2014-01-01

    Objective Emergency departments are high-risk structures. The objective was to analyse the functioning of an experience feedback committee (EFC), a security management tool for the analysis of incidents in a medical department. Methods We conducted a descriptive study based on the analysis of the written documents produced by the EFC between November 2009 and May 2012. We performed a double analysis of all incident reports, meeting minutes and analysis reports. Results During the study period, there were 22 meetings attended by 15 professionals. 471 reported incidents were transmitted to the EFC. Most of them (95%) had no consequence for the patients. Only one reported incident led to the patient's death. 12 incidents were analysed thoroughly and the committee decided to set up 14 corrective actions, including eight guideline writing actions, two staff trainings, two resource materials provisions and two organisational changes. Conclusions The staff took part actively in the EFC. Following the analysis of incidents, the EFC was able to set up actions at the departmental level. Thus, an EFC seems to be an appropriate security management tool for an emergency department. PMID:23964063

  19. Federal Emergency Management Information System (FEMIS) Bill of Materials (BOM) for FEMIS Version 1.4.6

    SciTech Connect

    Homer, B.J., Johnson, D.M.; Wood, B.M.; Stoops, L.R.; Fangman, P.M.; Johnson, R.L.; Loveall, R.M.; Millard, W.D.; Johnson, S.M.; Downing, T.R.

    1999-03-12

    This document describes the hardware and software required for the Federal Emergency Management Information System version 1.4.6 (FEMIS{copyright} v1.4.6). FEMIS is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCS via a Wide Area Network (WAN).

  20. Public health emergencies and the public health/managed care challenge.

    PubMed

    Rosenbaum, Sara; Skivington, Skip; Praeger, Sandra

    2002-01-01

    The relationship between insurance and public health is an enduring topic in public health policy and practice. Insurers share certain attributes with public health. But public health agencies operate in relation to the entire community that they are empowered by public law to serve and without regard to the insurance status of community residents; on the other hand, insurers (whether managed care or otherwise) are risk-bearing entities whose obligations are contractually defined and limited to enrolled members and sponsors. Public insurers such as Medicare and Medicaid operate under similar constraints. The fundamental characteristics that distinguish managed care-style insurance and public health become particularly evident during periods of public health emergency, when a public health agency's basic obligations to act with speed and flexibility may come face to face with the constraints on available financing that are inherent in the structure of insurance. Because more than 70% of all personal health care in the United States is financed through insurance, public health agencies effectively depend on insurers to finance necessary care and provide essential patient-level data to the public health system. Critical issues of state and federal policy arise in the context of the public health/insurance relations during public health emergencies. These issues focus on coverage and the power to make coverage decisions, as well as the power to define service networks and classify certain data as exempt from public reporting. The extent to which a formal regulatory approach may become necessary is significantly affected by the extent to which private entities themselves respond to the problem with active efforts to redesign their services and operations to include capabilities and accountability in the realm of public health emergency response.

  1. A Longitudinal Study of Impression Management Strategies and Leadership Emergence: The Moderating Roles of Gender and Virtualness

    ERIC Educational Resources Information Center

    Lim, Yong-Kwan

    2011-01-01

    This study used a longitudinal study spanning a twelve-week time period and involving 165 undergraduate students to examine the combined impact of gender and impression management strategies on leader emergence by members relying on low versus high virtualness. The subjects were formed into 44 self-managed work groups and charged with completing…

  2. Simulation training for emergency teams to manage acute ischemic stroke by telemedicine

    PubMed Central

    Richard, Sébastien; Mione, Gioia; Varoqui, Claude; Vezain, Arnaud; Brunner, Arielle; Bracard, Serge; Debouverie, Marc; Braun, Marc

    2016-01-01

    Abstract Telemedicine contributes to initiating early intravenous recombinant tissue plasminogen activator (rt-PA) treatment for patients with acute cerebral infarction in areas without a stroke unit. However, the experience and skills of the emergency teams in the spokes to prepare patients and administer rt-PA treatment are ill-defined. Improving these skills could vastly improve management of acute stroke by telemedicine. We developed a medical simulation training model for emergency teams to perform intravenous rt-PA treatment in a telestroke system. From February 2013 to May 2015, 225 learners from 6 emergency teams included in the telestroke system “Virtuall”—in Lorrain (northeastern France)—received a standardized medical simulation training module to perform rt-PA treatment. All learners were assessed with the same pretraining and posttraining test consisting of 52 items. The percentage of right answers was determined for every learner before and after training. Median percentages of right answers were significantly higher in the posttraining test overall (82 ± 10 vs. 59 ± 13% pretraining; P < 0.001), but also in all professional subgroups: physicians (88 ± 8 vs. 67 ± 12%; P < 0.001), paramedical staff (80 ± 9 vs. 54 ± 12%; P < 0.001), nurses (80 ± 8 vs. 54 ± 12%; P < 0.001), and auxiliary nurses (76 ± 17 vs. 37 ± 15%; P = 0.002). We describe for the first time a training model for emergency teams in a telestroke system. We demonstrate significant gain in knowledge for all groups of healthcare professionals. This simulation model could be applied in any medical simulation center and form the basis of a standardized training program of spokes in a telestroke system. PMID:27311003

  3. Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future.

    PubMed

    Rossignol, Patrick; Legrand, Matthieu; Kosiborod, Mikhail; Hollenberg, Steven M; Peacock, W Frank; Emmett, Michael; Epstein, Murray; Kovesdy, Csaba P; Yilmaz, Mehmet Birhan; Stough, Wendy Gattis; Gayat, Etienne; Pitt, Bertram; Zannad, Faiez; Mebazaa, Alexandre

    2016-11-01

    Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia. The INI-CRCT developed a treatment algorithm reflecting expert opinion of best practices in the context of current evidence, identified gaps in knowledge, and set priorities for future research. We searched PubMed (to August 4, 2015) for consensus guidelines, reviews, randomized clinical trials, and observational studies, limited to English language but not by publication date. Treatment approaches are based on small studies, anecdotal experience, and traditional practice patterns. The safety and real-world effectiveness of standard therapies remain unproven. Prospective research is needed and should include studies to better characterize the population, define the serum potassium thresholds where life-threatening arrhythmias are imminent, assess the potassium and electrocardiogram response to standard interventions. Randomized, controlled trials are needed to test the safety and efficacy of new potassium binders for the emergency treatment of severe hyperkalemia in hemodynamically stable patients. Existing emergency treatments for severe hyperkalemia are not supported by a compelling body of evidence, and they are used inconsistently across institutions, with potentially significant associated side effects. Further research is needed to fill knowledge gaps, and definitive clinical trials are needed to better define optimal management strategies, and ultimately to improve outcomes in these patients.

  4. Emergency bronchoscopy for foreign-body aspiration in a child with type I mucopolysaccharidosis: a challenging airway management experience.

    PubMed

    Kendigelen, Pinar; Tunali, Yusuf; Tutuncu, Ayse; Ashyralyyeva, Gulruh; Emre, Senol; Kaya, Guner

    2016-08-01

    The mucopolysaccharidosis (MPS) is a rare lysosomal storage disease. Glycosaminoglycans (GAG) accumulate in musculoskeletal system, connective tissues. Enlarged tongue, short immobile neck, and limited mobility of the cervical spine and temporomandibular joints render the airway management potentially risky. MPS children have high anesthetic risks, especially in airway management of emergency situations. The foreign-body aspiration requiring intervention with rigid bronchoscopy is an urgent and risky clinical situation. We present our experience with a challenging airway management with a three-year-old child with MPS who needed emergency bronchoscopy due to peanut aspiration.

  5. Emergency health and risk management in sub-saharan Africa: a lesson from the embassy bombings in Tanzania and Kenya.

    PubMed

    Clack, Zoanne A; Keim, Mark E; Macintyre, Anthony G; Yeskey, Kevin

    2002-01-01

    In 1998, terrorists simultaneously bombed United States Embassies in Dar es Salaam, Tanzania and Nairobi, Kenya. The local response to these bombings was unorganized and ad hoc, indicating the need for basic disaster preparedness and improvement of emergency management capabilities in both countries. In this context, risk and risk management are defined and are related to the health hazards affecting Tanzanians and Kenyans. In addition, the growing number of injuries in Tanzania is addressed and the relationship between risk management and injury is explored. Also, an emergency medicine-based strategy for injury control and prevention is proposed. Implications of implementing such a protocol in developing nations also are discussed.

  6. Airmanship on the Ground: How the Aviation Industry Can Fundamentally Change the Way First Responders Manage Complex Emergencies

    DTIC Science & Technology

    2015-03-01

    tasks, tactics, and strategy that are required to manage a house fire. She knows, for example, that two firefighters must complete the task of removing...and identifying threat management strategies must be defined. Procedures must make clear the criteria for requesting extra fuel and the process for...GROUND: HOW THE AVIATION INDUSTRY CAN FUNDAMENTALLY CHANGE THE WAY FIRST RESPONDERS MANAGE COMPLEX EMERGENCIES by Ryan Fields-Spack March

  7. Emerging themes in the ecology and management of North American forests

    USGS Publications Warehouse

    Sharik, Terry L.; Adair, William; Baker, Fred A.; Battaglia, Michael; Comfort, Emily J.; D'Amato, Anthony W.; Delong, Craig; DeRose, R. Justin; Ducey, Mark J.; Harmon, Mark; Levy, Louise; Logan, Jesse A.; O'Brien, Joseph; Palik, Brian J.; Roberts, Scott D.; Rogers, Paul C.; Shinneman, Douglas J.; Spies, Thomas; Taylor, Sarah L.; Woodall, Christopher; Youngblood, Andrew

    2010-01-01

    The 7th North American Forest Ecology Workshop, consisting of 149 presentations in 16 oral sessions and a poster session, reflected a broad range of topical areas currently under investigation in forest ecology and management. There was an overarching emphasis on the role of disturbance, both natural and anthropogenic, in the dynamics of forest ecosystems, and the recognition that legacies from past disturbances strongly influence future trajectories. Climate was invoked as a major driver of ecosystem change. An emphasis was placed on application of research findings for predicting system responses to changing forest management initiatives. Several “needs” emerged from the discussions regarding approaches to the study of forest ecosystems, including (1) consideration of variable spatial and temporal scales, (2) long-term monitoring, (3) development of universal databases more encompassing of time and space to facilitate meta-analyses, (4) combining field studies and modeling approaches, (5) standardizing methods of measurement and assessment, (6) guarding against oversimplification or overgeneralization from limited site-specific results, (7) greater emphasis on plant-animal interactions, and (8) better alignment of needs and communication of results between researchers and managers.

  8. Current and emerging strategies in the management of venous thromboembolism: benefit-risk assessment of dabigatran.

    PubMed

    Fanola, Christina L

    2015-01-01

    Venous thromboembolism (VTE) is a disease state that carries significant morbidity and mortality, and is a known cause of preventable death in hospitalized and orthopedic surgical patients. There are many identifiable risk factors for VTE, yet up to half of VTE incident cases have no identifiable risk factor and carry a high likelihood of recurrence, which may warrant extended therapy. For many years, parenteral unfractionated heparin, low-molecular weight heparin, fondaparinux, and oral vitamin K antagonists (VKAs) have been the standard of care in VTE management. However, limitations in current drug therapy options have led to suboptimal treatment, so there has been a need for rapid-onset, fixed-dosing novel oral anticoagulants in both VTE treatment and prophylaxis. Oral VKAs have historically been challenging to use in clinical practice, with their narrow therapeutic range, unpredictable dose responsiveness, and many drug-drug and drug-food interactions. As such, there has also been a need for novel anticoagulant therapies with fewer limitations, which has recently been met. Dabigatran etexilate is a fixed-dose oral direct thrombin inhibitor available for use in acute and extended treatment of VTE, as well as prophylaxis in high-risk orthopedic surgical patients. In this review, the risks and overall benefits of dabigatran in VTE management are addressed, with special emphasis on clinical trial data and their application to general clinical practice and special patient populations. Current and emerging therapies in the management of VTE and monitoring of dabigatran anticoagulant-effect reversal are also discussed.

  9. Ayurvedic management of life-threatening skin emergency erythroderma: A case study

    PubMed Central

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2015-01-01

    Erythroderma or generalized exfoliative dermatitis is a skin disorder that requires attention equivalent to medical emergencies. It is more prevalent in male population. It accounts for 35 cases/100,000 cases in dermatologic outpatient departments. In erythroderma even with proper management there are certain metabolic burdens and complications which make it more critical. The primary aim, in this case, was to treat the patient with Ayurvedic management. A 18-year-old patient, suffering from erythroderma, was treated on the line of Kapala Kushtha and Audumbera Kushtha. The patient had primarily suffered from psoriasis for 8 years. Erythroderma was developed due to abrupt self-medication with an unknown amount of intramuscular methylprednisolone several times in last month. Rasamanikya-125 mg, Arogyavardhini Vati-1 g, Kaishora Guggulu-1 g, Khadirarista-20 ml, and Panchatikta Ghrita-20 ml, all drugs twice a day with 3-4 times local application of Jatyadi Taila were administered. A decoction of Jwarhara Kashaya was also administered in the dose of 40 ml twice a day. The patient had relief from the acute phase after 20 days of treatment and complete remission after 3 months of treatment. This case study demonstrates that Ayurvedic management may be useful in erythroderma like acute and life-threatening condition. PMID:26730142

  10. Ayurvedic management of life-threatening skin emergency erythroderma: A case study.

    PubMed

    Singh, Sarvesh Kumar; Rajoria, Kshipra

    2015-01-01

    Erythroderma or generalized exfoliative dermatitis is a skin disorder that requires attention equivalent to medical emergencies. It is more prevalent in male population. It accounts for 35 cases/100,000 cases in dermatologic outpatient departments. In erythroderma even with proper management there are certain metabolic burdens and complications which make it more critical. The primary aim, in this case, was to treat the patient with Ayurvedic management. A 18-year-old patient, suffering from erythroderma, was treated on the line of Kapala Kushtha and Audumbera Kushtha. The patient had primarily suffered from psoriasis for 8 years. Erythroderma was developed due to abrupt self-medication with an unknown amount of intramuscular methylprednisolone several times in last month. Rasamanikya-125 mg, Arogyavardhini Vati-1 g, Kaishora Guggulu-1 g, Khadirarista-20 ml, and Panchatikta Ghrita-20 ml, all drugs twice a day with 3-4 times local application of Jatyadi Taila were administered. A decoction of Jwarhara Kashaya was also administered in the dose of 40 ml twice a day. The patient had relief from the acute phase after 20 days of treatment and complete remission after 3 months of treatment. This case study demonstrates that Ayurvedic management may be useful in erythroderma like acute and life-threatening condition.

  11. Novel Treatments for Metastatic Cutaneous Melanoma and the Management of Emergent Toxicities

    PubMed Central

    Lemech, Charlotte; Arkenau, Hendrik-Tobias

    2012-01-01

    The last 12 months have seen the beginning of a new era in the treatment options available for patients with metastatic cutaneous melanoma, a disease previously characterised by its poor prognosis and limited treatment options. Two mechanistically diverse agents have now demonstrated an overall survival benefit in different patient subgroups and further clinical trials are ongoing with emerging single agents and novel combinations. The first agent to demonstrate an overall survival benefit was the CTLA-4 antibody, ipilimumab, illustrating the importance of the immune system and immunomodulation in melanoma tumorigenesis. The second group of agents to show a survival benefit were the selective BRAF inhibitors, vemurafenib and GSK2118436, in patients who are BRAF V600 mutation positive. In addition, in the same BRAF mutant patient population, MEK inhibitors also show promising results and are currently under investigation in later stage trials. Although ipilimumab, BRAF and MEK inhibitors are just passing through the clinical trials arena, their use will rapidly become more widespread. Along with their significant clinical benefits, there are also unique adverse events related to these agents. Although the majority are mild and can be managed with supportive treatment, some toxicities require special management strategies. We outline up-to-date clinical development and management guidelines for ipilimumab, as well as the BRAF and MEK inhibitors. PMID:22253555

  12. Incorporating Chemical Hazards into an Emergency Management Plan. Lessons Learned from School Crises and Emergencies. Volume 2, Issue 4

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    "Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on a chemical spill that went unreported for approximately seven years, setting off a series of responses from the school district's Environmental Health and Safety Department (EHS) and the state…

  13. Medical management of endometriosis: emerging evidence linking inflammation to disease pathophysiology.

    PubMed

    Bruner-Tran, K L; Herington, J L; Duleba, A J; Taylor, H S; Osteen, K G

    2013-04-01

    Progesterone action normally mediates the balance between anti-inflammatory and proinflammatory processes throughout the female reproductive tract. However, in women with endometriosis, endometrial progesterone resistance, characterized by alterations in progesterone responsive gene and protein expression, is now considered a central element in disease pathophysiology. Recent studies additionally suggest that the peritoneal microenvironment of endometriosis patients exhibits altered physiological characteristics that may further promote inflammation-driven disease development and progression. Within this review, we summarize our current understanding of the pathogenesis of endometriosis with an emphasis on the role that inflammation plays in generating not only the progesterone-resistant eutopic endometrium but also a peritoneal microenvironment that may contribute significantly to disease establishment. Viewing endometriosis from the emerging perspective that a progesterone resistant endometrium and an immunologically compromised peritoneal microenvironment are biologically linked risk factors for disease development provides a novel mechanistic framework to identify new therapeutic targets for appropriate medical management.

  14. [Chikungunya, an emerging viral disease. Proposal of an algorithm for its clinical management].

    PubMed

    Palacios-Martínez, D; Díaz-Alonso, R A; Arce-Segura, L J; Díaz-Vera, E

    2015-01-01

    Chikungunya fever (CHIK) is an emerging viral disease. It is caused by the Chikungunya virus, an alphavirus from the Togaviridae family. It is transmitted to humans by the bite of infected mosquitoes, mainly Aedes aegypti and Aedes albopictus. They are also involved in the transmission of dengue, malaria, etc. CHIK is now endemic in any region of Africa and Southeast-Asia. Cases of CHIK have been reported in America, the Caribbean, and Europe (France, Italy and Spain). There are reservoirs of these mosquitoes in some regions of Spain (Catalonia, Alicante, Murcia and Balearic islands). CHIK is characterized by a sudden high and debilitating fever, and severe or disabling symmetrical arthralgia. It tends to improve in days or weeks. There are severe and chronic forms of CHIK. There is no specific treatment or prophylaxis for CHIK. An algorithm is proposed for the clinical management of CHIK based in the latest guidelines.

  15. Recurarization in a successfully managed case of posterior reversible encephalopathy syndrome (PRES) for emergency caesarean section

    PubMed Central

    Parikh, Suchita; Tavri, Snehlata; Mohite, Shubha

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome of headache, visual changes, altered mental status and seizures with radiologic findings of posterior cerebral white matter edema. It is seen in hypertensive encephalopathy, renal failure, and autoimmune disorders or in patients on immunosuppressants. We report a case of 24-year-old primigravida who presented at term with sudden onset hypertension, neurological deficits, and an episode of the visual blackout. Magnetic resonance imaging showed features suggestive of PRES. She was posted for emergency lower segment cesarean section. General anesthesia was administered and blood pressure managed with antihypertensives. Postoperatively, she developed acute respiratory depression after prophylactic administration of injection magnesium sulfate. This case highlights that good clinical acumen along with early neuroimaging helps in prompt diagnosis, treatment and prevention of long-term neurological sequelae in PRES and the anesthetic implications of administering magnesium sulfate in the immediate post neuromuscular block reversal phase. PMID:27212776

  16. Assessment and Management of Work-Related Stress in Hospital Emergency Departments in Italy.

    PubMed

    d'Ettorre, Gabriele; Greco, Maria Rita

    2016-01-01

    Recent changes in the organization of the healthcare system, triggered by the current economic crisis in Italy, require interventions aimed at minimizing the impact of work-related stress (WRS) on healthcare workers' health status and well-being. Emergency department (ED) personnel appear to be particularly vulnerable to WRS as a consequence of specific occupational risk factors. The aim of this retrospective observational study was to analyze the level of WRS after improvement interventions implemented by the management staff of the ED and focused on work context factors. The assessment of WRS showed that nurses and physicians of the ED are exposed to a medium level of risk; the improvement interventions aimed at reducing WRS were focused on: (1) function and organizational culture; (2) role within the occupational organization; and (3) relationships at work policy. These interventions were found to be significantly effective in reducing the risk of WRS.

  17. Motor complications in Parkinson's disease: a comprehensive review of emergent management strategies.

    PubMed

    Marques de Sousa, Susana; Massano, João

    2013-11-01

    Motor complications (dyskinesias and motor fluctuations) are a common and disabling problem of dopaminergic therapy in Parkinson's disease, which are often difficult to treat with the current therapeutic strategies. It has been proposed that continuous dopaminergic delivery could reduce the emergence of motor complications, which has been tried with levodopa intestinal infusion or subcutaneous apomorphine infusion. In selected refractory cases, surgical approaches such as deep brain stimulation should be considered. Ongoing clinical and preclinical research tried to lead the field into the discovery of other therapeutic targets and strategies that might prevent or reduce motor complications. These include drugs targeting non-dopaminergic systems (e.g. glutamatergic, serotonergic, noradrenergic, adenosinergic and cholinergic systems), gene therapy for delivering neurotrophic factors or critical enzymes for dopamine synthesis, and cell therapy. These studies found variable results, some of them promising, with the possibility of new therapeutic armamentarium in the management of Parkinson's disease in the near future.

  18. Management of animal health emergencies: general principles and legal and international obligations.

    PubMed

    Marabelli, R; Ferri, G; Bellini, S

    1999-04-01

    The Eighth Round of the General Agreement on Tariffs and Trade led to the creation of the World Trade Organization and to the adoption of the Sanitary and Phytosanitary (SPS) Agreement, thus considerably changing the rules of international trade in animals and animal products. Animal health measures may result in trade restrictions, but governments accept that these restrictions may sometimes be necessary and appropriate to ensure food safety and animal health protection. The SPS Agreement acknowledges the rights of governments to adopt measure to protect human, animal and plant health. To ensure effective animal health protection, without unjustifiable discrimination, the operational procedures of Veterinary Services must be standardised, especially those concerning disease notification, epidemiological information, certification for international trade and management of animal health emergencies. Veterinary Services must be further supported by a proper legislative framework and adequate financial resources.

  19. The emerging role of lidar remote sensing in coastal research and resource management

    USGS Publications Warehouse

    Brock, J.C.; Purkis, S.J.

    2009-01-01

    Knowledge of coastal elevation is an essential requirement for resource management and scientific research. Recognizing the vast potential of lidar remote sensing in coastal studies, this Special Issue includes a collection of articles intended to represent the state-of-the-art for lidar investigations of nearshore submerged and emergent ecosystems, coastal morphodynamics, and hazards due to sea-level rise and severe storms. Some current applications for lidar remote sensing described in this Special Issue include bluegreen wavelength lidar used for submarine coastal benthic environments such as coral reef ecosystems, airborne lidar used for shoreline mapping and coastal change detection, and temporal waveform-resolving lidar used for vegetation mapping. ?? 2009 Coastal Education and Research Foundation.

  20. [Perioperative management of direct oral anticoagulant in emergency surgery and bleeding. Haemostasis monitoring and treatment].

    PubMed

    Hidalgo, F; Gómez-Luque, A; Ferrandis, R; Llau, J V; de Andrés, J; Gomar, C; Sierra, P; Castillo, J; Torres, L M

    2015-10-01

    There is an almost unanimous consensus on the management of the direct new oral anticoagulants, dabigatran, rivaroxaban, and apixaban in elective surgery. However, this general consensus does not exist in relation with the direct new oral anticoagulants use in emergency surgery, especially in the bleeding patient. For this reason, a literature review was performed using the MEDLINE-PubMed. An analysis was made of the journal articles, reviews, systematic reviews, and practices guidelines published between 2000 and 2014 using the terms "monitoring" and "reversal". From this review, it was shown that the routine tests of blood coagulation, such as the prothrombin time and activated partial thromboplastin time, have a limited efficacy in the perioperative control of blood coagulation in these patients. There is currently no antidote to reverse the effects of these drugs, although the possibility of using concentrated prothrombin complex and recombinant activated factor vii has been suggested for the urgent reversal of the anticoagulant effect.

  1. An evidence-based approach to the management of hematuria in children in the emergency department.

    PubMed

    Pade, Kathryn H; Liu, Deborah R

    2014-09-01

    Hematuria is defined as an abnormal number of red blood cells in urine. Even a tiny amount of blood (1 mL in 1000 mL of urine) is sufficient to make urine appear pink or red. In the pediatric population, the majority of etiologies are benign and often asymptomatic. However, hematuria may also be a sign of renal pathology, local infection, or systemic disease. Hematuria can be differentiated into 2 categories: macroscopic hematuria (visible to the naked eye) and microscopic hematuria (> 5 red blood cells/high-powered field on urinalysis). This review will outline the current literature regarding evaluation and management of pediatric patients who present to the emergency department with hematuria. Obtaining a thorough history and the appropriate diagnostic tests will be discussed in depth.

  2. Conventional and emerging treatments in the management of acute primary angle closure

    PubMed Central

    Boey, Pui Yi; Singhal, Shweta; Perera, Shamira A; Aung, Tin

    2012-01-01

    The management of acute primary angle closure is directed at lowering the intraocular pressure and relieving pupil block. Conventional treatment involves the use of medical treatment and laser peripheral iridotomy, respectively, as a means for achieving these aims. Newer therapeutic strategies have been described that are potentially useful adjuncts or alternatives to conventional treatment. Emerging strategies that lower intraocular pressure include anterior chamber paracentesis, as well as laser procedures such as iridoplasty and pupilloplasty. A possible alternative to relieving pupil block is lens extraction, and may be combined with adjunctive measures such as goniosynechiolysis and viscogoniosynechiolysis. Trabeculectomy has a limited role in the acute setting. This review paper reviews the current evidence regarding conventional and newer treatment modalities for acute primary angle closure. PMID:22536030

  3. Decision support for water quality management of contaminants of emerging concern.

    PubMed

    Fischer, Astrid; Ter Laak, Thomas; Bronders, Jan; Desmet, Nele; Christoffels, Ekkehard; van Wezel, Annemarie; van der Hoek, Jan Peter

    2017-05-15

    Water authorities and drinking water companies are challenged with the question if, where and how to abate contaminants of emerging concern in the urban water cycle. The most effective strategy under given conditions is often unclear to these stakeholders as it requires insight into several aspects of the contaminants such as sources, properties, and mitigation options. Furthermore the various parties in the urban water cycle are not always aware of each other's requirements and priorities. Processes to set priorities and come to agreements are lacking, hampering the articulation and implementation of possible solutions. To support decision makers with this task, a decision support system was developed to serve as a point of departure for getting the relevant stakeholders together and finding common ground. The decision support system was iteratively developed in stages. Stakeholders were interviewed and a decision support system prototype developed. Subsequently, this prototype was evaluated by the stakeholders and adjusted accordingly. The iterative process lead to a final system focused on the management of contaminants of emerging concern within the urban water cycle, from wastewater, surface water and groundwater to drinking water, that suggests mitigation methods beyond technical solutions. Possible wastewater and drinking water treatment techniques in combination with decentralised and non-technical methods were taken into account in an integrated way. The system contains background information on contaminants of emerging concern such as physical/chemical characteristics, toxicity and legislative frameworks, water cycle entrance pathways and a database with associated possible mitigation methods. Monitoring data can be uploaded to assess environmental and human health risks in a specific water system. The developed system was received with great interest by potential users, and implemented in an international water cycle network.

  4. Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit

    PubMed Central

    Alavi-Moghaddam, Mostafa; Anvari, Ali; Soltani Delgosha, Reaza; Kariman, Hamid

    2017-01-01

    Introduction: Although significant development in the field of medicine is achieved, sepsis is still a major issue threatening humans’ lives. This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines. Method: This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations. The mean knowledge score and the compliance rate of studied measures regarding standard protocols were calculated using SPSS version 21. Results: 30 emergency medicine residents were audited (63.3% male). The mean knowledge score of studied residents regarding standard guidelines were 5.07 ± 1.78 (IQR = 2) in pre education and 8.17 ± 1.31 (IQR = 85) in post education phase (p < 0.001). There was excellent compliance with standard in 4 (22%) studied measures, good in 2 (11%), fair in 1 (6%), weak in 2 (11%), and poor in 9 (50%). 64% of poor compliance measures correlated to therapeutic factors. After training, score of 5 measures including checking vital signs in < 20 minute, central vein pressure measurement in < 1 hour, blood culture request, administration of vasopressor agents, and high flow O2 therapy were improved clinically, but not statistically. Conclusion: The protocol adherence in management of severe sepsis and septic shock for urine output measurement, central venous pressure monitoring, administration of inotrope agents, blood transfusion, intravenous antibiotic and hydration therapy, and high flow O2 delivery were disappointingly low. It seems training workshops and implementation of Clinical audit can improve residents’ adherence to current standard guidelines regarding severe sepsis and septic shock. PMID:28286823

  5. Collaboration in crisis and emergency management: Identifying the gaps in the case of storm 'Alexa'.

    PubMed

    Sawalha, Ihab Hanna Salman

    2014-01-01

    Failing to collaborate in crisis and emergency situations will increase the vulnerability of organisations and societies towards potential disasters. This paper highlights the significance of effective collaboration at different levels in times of crises. The case of snow storm 'Alexa', which hit Jordan in December 2013, was considered for the purpose of this research. The impact of Alexa raised many questions regarding the country's preparedness and the capacity of its infrastructure to maintain critical business functions across various industry sectors. First, should people individually take all the responsibility to manage crises and emergencies in order to protect themselves and their belongings? Secondly, should organisations join efforts with other organisations within the same or different sectors? Thirdly, should governments seek external collaboration for the ultimate goal of securing their economies? These issues are significant as they underline the element of collaboration. This paper contributes to the understanding of the role of collaboration in times of intense difficulty and loss of control. The proposition made by this research is that an effective collaborative process is positively associated with perceptions of improved disaster risk reduction practices.

  6. Update On Emerging Antivirals For The Management Of Herpes Simplex Virus Infections: A Patenting Perspective

    PubMed Central

    Vadlapudi, Aswani D.; Vadlapatla, Ramya K.; Mitra, Ashim K.

    2015-01-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly in immunocompromised patients. Moreover, some drugs are associated with dose-limiting toxicities which limit their further utility. Therefore, there is a need to develop new antiherpetic compounds with different mechanisms of action which will be safe and effective against emerging drug resistant viral isolates. Significant advances have been made towards the design and development of novel antiviral therapeutics during the last decade. As evident by their excellent antiviral activities, pharmaceutical companies are moving forward with several new compounds into various phases of clinical trials. This review provides an overview of structure and life cycle of HSV, progress in the development of new therapies, update on the advances in emerging therapeutics under clinical development and related recent patents for the treatment of Herpes simplex virus infections. PMID:23331181

  7. Update on emerging antivirals for the management of herpes simplex virus infections: a patenting perspective.

    PubMed

    Vadlapudi, Aswani D; Vadlapatla, Ramya K; Mitra, Ashim K

    2013-04-01

    Herpes simplex virus (HSV) infections can be treated efficiently by the application of antiviral drugs. The herpes family of viruses is responsible for causing a wide variety of diseases in humans. The standard therapy for the management of such infections includes acyclovir (ACV) and penciclovir (PCV) with their respective prodrugs valaciclovir and famciclovir. Though effective, long term prophylaxis with the current drugs leads to development of drug-resistant viral isolates, particularly in immunocompromised patients. Moreover, some drugs are associated with dose-limiting toxicities which limit their further utility. Therefore, there is a need to develop new antiherpetic compounds with different mechanisms of action which will be safe and effective against emerging drug resistant viral isolates. Significant advances have been made towards the design and development of novel antiviral therapeutics during the last decade. As evident by their excellent antiviral activities, pharmaceutical companies are moving forward with several new compounds into various phases of clinical trials. This review provides an overview of structure and life cycle of HSV, progress in the development of new therapies, update on the advances in emerging therapeutics under clinical development and related recent patents for the treatment of Herpes simplex virus infections.

  8. Scenario-based design: A method for connecting information system design with public health operations and emergency management

    PubMed Central

    Reeder, Blaine; Turner, Anne M

    2011-01-01

    Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. Methods: Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. Results: Interview analysis identified twenty-five information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create twenty-five scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. Conclusion: The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design. PMID:21807120

  9. The management of adult psychiatric emergencies in low-income and middle-income countries: a systematic review.

    PubMed

    Nadkarni, Abhijit; Hanlon, Charlotte; Bhatia, Urvita; Fuhr, Daniela; Ragoni, Celina; de Azevedo Perocco, Sérgio Luiz; Fortes, Sandra; Shidhaye, Rahul; Kinyanda, Eugene; Rangaswamy, Thara; Patel, Vikram

    2015-06-01

    The aim of this Review is to identify effective interventions and treatment guidelines to manage common types of psychiatric emergencies in non-specialist settings in low-income and middle-income countries. Mental health specialist services in low-income and middle-income countries are scarce. We did a systematic review of interventions for psychiatric emergencies and a literature search for low-income and middle-income-specific treatment guidelines for psychiatric emergencies. A dearth of high-quality guidelines and contextualised primary evidence for management of psychiatric emergencies in low-income and middle-income countries exists. Filling these gaps in present guidelines needs to be an urgent research priority in view of the adverse health and social consequences of such presentations and the present drive to scale up mental health care.

  10. On constant alert: lessons to be learned from Israel's emergency response to mass-casualty terrorism incidents.

    PubMed

    Adini, Bruria; Peleg, Kobi

    2013-12-01

    In its short modern history, Israel has had to contend with numerous mass-casualty incidents caused by terrorism. As a result, it has developed practical national preparedness policies for responding to such events. Israel's Supreme Health Authority, a committee of the Ministry of Health, coordinates emergency management nationwide. All emergency personnel, health care providers, and medical facilities operate under national policies designed to ensure a swift and coordinated response to any incident, based on an "all hazards" approach that emphasizes core elements commonly encountered in mass-casualty incidents. Israel's emergency management system includes contingency planning, command and control, centrally coordinated response, cooperation, and capacity building. Although every nation is unique, many of the lessons that Israel has learned may be broadly applicable to preparation for mass-casualty incidents in the United States and other countries.

  11. Lessons learned from the snow emergency management of winter season 2008-2009 in Piemonte

    NASA Astrophysics Data System (ADS)

    Bovo, Dr.; Pelosini, Dr.; Cordola, Dr.

    2009-09-01

    The winter season 2008-2009 has been characterized by heavy snowfalls over the whole Piemonte, in the Western Alps region. The snowfalls have been exceptional because of their earliness, persistence and intensity. The impact on the regional environment and territory has been relevant, also from the economical point of view, as well as the effort of the people involved in the forecasting, prevention and fighting actions. The environmental induced effects have been shown until late spring. The main critical situations have been arisen from the snowfalls earliness in season, the several snow precipitation events over the plains, the big amount of snow accumulation on the ground, as well as the anomaly with respect to the last 30 years climatic trend of snow conditions in Piemonte. The damage costs to the public property caused by the snowfalls have been estimated by the Regione Piemonte to be 470 million euros, giving evidence of the real emergency dimension of the event, never occurred during the last 20 years. The technical support from the Regional Agency for Environmental Protection of Regione Piemonte (Arpa Piemonte) to the emergency management allowed to analyse and highlight the direct and induced effects of the heavy snowfalls, outlining risk scenarios characterized by different space and time scales. The risk scenarios deployment provided a prompt recommendation list, both for the emergency management and for the natural phenomena evolution surveillance planning to assure the people and property safety. The risk scenarios related to the snow emergency are different according to the geographical and anthropic territory aspects. In the mountains, several natural avalanche releases, characterized frequently by a large size, may affect villages, but they may also interrupt the main and secondary roads both down in the valleys and small villages road access, requiring a long time for the complete and safe snow removal and road re-opening. The avalanches often

  12. Knowledge, Awareness and Attitude towards Emergency Management of Dental Trauma among the Parents of Kolkata-An Institutional Study

    PubMed Central

    Jain, Parul; Angrish, Paras; Saha, Subrata; Patra, Tamal Kanti; Saha, Nilanjana; Mitra, Malay

    2016-01-01

    Introduction Traumatic dental injuries are one of the commonly encountered dental emergencies. Missing anterior tooth in children due to any injury can be a source of considerable physical and psychological discomfort for the child. The prognosis of some dental injuries depends to a great extent on parents’ knowledge of correct and prompt emergency measures. Aim The purpose of this cross-sectional study was to assess the knowledge, attitude and awareness level of parents regarding the emergency management of dental trauma and to find out the relation of the responses to social variables. Materials and Methods A total of 2000 parents were surveyed over a period of three months using a pretested close ended questionnaire prepared in English, Hindi as well as in the regional language which was divided into three parts: Part 1 contained questions on personal information, Part 2 on an imaginary case of trauma to assess their knowledge regarding trauma management and Part 3 related to their attitude towards dental trauma management education. The data was statistically analysed using descriptive and chi-square statistics. Results The overall knowledge of parents regarding emergency management of trauma was not satisfactory. Although most of the people were in favour of taking professional consultation for emergency management of trauma but most of them were unaware of the steps that need to be taken on their part so as to minimize complications and improve prognosis. Conclusion Educational campaigns are the need of the day to increase the knowledge of parents regarding emergency management of dental trauma. PMID:27630963

  13. Development of an Assessment for Entrustable Professional Activity (EPA) 10: Emergent Patient Management

    PubMed Central

    Thompson, Laura R.; Leung, Cynthia G.; Green, Brad; Lipps, Jonathan; Schaffernocker, Troy; Ledford, Cynthia; Davis, John; Way, David P.; Kman, Nicholas E.

    2017-01-01

    Introduction Medical schools in the United States are encouraged to prepare and certify the entrustment of medical students to perform 13 core entrustable professional activities (EPAs) prior to graduation. Entrustment is defined as the informed belief that the learner is qualified to autonomously perform specific patient-care activities. Core EPA-10 is the entrustment of a graduate to care for the emergent patient. The purpose of this project was to design a realistic performance assessment method for evaluating fourth-year medical students on EPA-10. Methods First, we wrote five emergent patient case-scenarios that a medical trainee would likely confront in an acute care setting. Furthermore, we developed high-fidelity simulations to realistically portray these patient case scenarios. Finally, we designed a performance assessment instrument to evaluate the medical student’s performance on executing critical actions related to EPA-10 competencies. Critical actions included the following: triage skills, mustering the medical team, identifying causes of patient decompensation, and initiating care. Up to four students were involved with each case scenario; however, only the team leader was evaluated using the assessment instruments developed for each case. Results A total of 114 students participated in the EPA-10 assessment during their final year of medical school. Most students demonstrated competence in recognizing unstable vital signs (97%), engaging the team (93%), and making appropriate dispositions (92%). Almost 87% of the students were rated as having reached entrustment to manage the care of an emergent patient (99 of 114). Inter-rater reliability varied by case scenario, ranging from moderate to near-perfect agreement. Three of five case-scenario assessment instruments contained items that were internally consistent at measuring student performance. Additionally, the individual item scores for these case scenarios were highly correlated with the global

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

    PubMed Central

    2009-01-01

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

  15. Real Time Integration of Field Data Into a GIS Platform for the Management of Hydrological Emergencies

    NASA Astrophysics Data System (ADS)

    Mangiameli, M.; Mussumeci, G.

    2013-01-01

    A wide series of events requires immediate availability of information and field data to be provided to decision-makers. An example is the necessity of quickly transferring the information acquired from monitoring and alerting sensors or the data of the reconnaissance of damage after a disastrous event to an Emergency Operations Center. To this purpose, we developed an integrated GIS and WebGIS system to dynamically create and populate via Web a database with spatial features. In particular, this work concerns the gathering and transmission of spatial data and related information to the desktop GIS so that they can be displayed and analyzed in real time to characterize the operational scenario and to decide the rescue interventions. As basic software, we used only free and open source: QuantumGIS and Grass as Desktop GIS, Map Server with PMapper application for the Web-Gis functionality and PostGreSQL/PostGIS as Data Base Management System (DBMS). The approach has been designed, developed and successfully tested in the management of GIS-based navigation of an autonomous robot, both to map its trajectories and to assign optimal paths. This paper presents the application of our system to a simulated hydrological event that could interest the province of Catania, in Sicily. In particular, assuming that more teams draw up an inventory of the damage, we highlight the benefits of real-time transmission of the information collected from the field to headquarters.

  16. Application of knowledge management and the intelligence continuum for medical emergencies and disaster scenarios.

    PubMed

    Wickramasinghe, Nilmini; Bali, Rajeev K; Naguib, Raouf N G

    2006-01-01

    The world has recently witnessed several large scale natural disasters. These include the Asian tsunami which devastated many of the countries around the rim of the Indian Ocean in December 2004, extensive flooding in many parts of Europe in August 2005, hurricane katrina (September 2005), the outbreak of severe acute respiratory syndrome (SARS) in many regions of Asia and Canada in 2003 and the Pakistan earthquake (towards the end of 2005). Such emergency and disaster situations (E&DS) serve to underscore the utter chaos that ensues in the aftermath of such events, the many casualties and lives lost not to mention the devastation and destruction that is left behind. One recurring theme that is apparent in all these situations is that, irrespective of the warnings of imminent threats, countries have not been prepared and ready to exhibit effective and efficient crisis management. This paper examines the application of the tools, techniques and processes of the knowledge economy to develop a prescriptive model that will support superior decision making in E&DS, thereby enabling effective and efficient crisis management.

  17. CAMEO-Valdez: A user's perspective. [Computer-Aided Management of Emergency Operations

    SciTech Connect

    Haas, T.J.

    1990-01-11

    On the morning of March 24, 1989, the tanker EXXON VALDEZ ran aground on Bligh Reef in Alaska's Prince William Sound. The vessel was carrying over 53 million gallons of North Slope crude oil of which almost 11 million gallons were spilled in the water. The immediately impacted area included most of the western part of the Sound, but eventually, the area expanded to include parts of Seward, Homer, and Kodiak. This event constituted the worst oil spill in the history of this country, and was identified as a 'spill of national significance.' A major response to clean up the oil by EXXON, which was closely monitored by Federal and State agencies and various interest groups, was necessary. Early in the response it was obvious to the Federal On-Scene Coordinator (FOSC) that a computer-aided management system was necessary to monitor the progress of the spill clean-up operations. This paper will describe CAMEO (Computer-Aided Management of Emergency Operations) - Valdez, developed for the FOSC by the National Oceanographic and Atmospheric Administration acting in its role as the Scientific Support Coordinator (SSC). A discussion of how CAMEO was used and an evaluation of its effectiveness will also be presented.

  18. The management of ureteric stones in the Accident and Emergency department.

    PubMed

    Dawson, Kirsty; Dawson, Lindsay

    2014-01-01

    Ureteric stones is a common cause for attendance to the A&E department. Active or conservative management is delivered dependent on the relevant history, clinical condition, and investigation results. The majority of patients can be treated conservatively and do not require admission. However, some cases of ureteric stones present as a urological emergency if, for example, there is an infected obstructed system. An initial audit over a two month period of A&E admissions with radiologically proven ureteric stones demonstrated there was no easily accessible, specific criteria used to guide which patients were admitted and which patients were discharged from A&E. Therefore, an admission criteria and discharge proforma was developed and implemented in the A&E department to ensure patients were appropriately discharged if they could be managed conservatively and appropriately admitted if they potentially required further observation and intervention. A repeat audit using the same methods and criteria was carried out and demonstrated fewer unnecessary admissions and fewer inappropriate discharges.

  19. Inhaled short-acting bronchodilators for managing emergency childhood asthma: an overview of reviews.

    PubMed

    Pollock, M; Sinha, I P; Hartling, L; Rowe, B H; Schreiber, S; Fernandes, R M

    2017-02-01

    International guidelines provide conflicting recommendations on how to use bronchodilators to manage childhood acute wheezing conditions in the emergency department (ED), and there is variation within and among countries in how these conditions are managed. This may be reflective of uncertainty about the evidence. This overview of systematic reviews (SRs) aimed to synthesize, appraise, and present all SR evidence on the efficacy and safety of inhaled short-acting bronchodilators to treat asthma and wheeze exacerbations in children 0-18 years presenting to the ED. Searching, review selection, data extraction and analysis, and quality assessments were conducted using methods recommended by The Cochrane Collaboration. Thirteen SRs containing 56 relevant trials and 5526 patients were included. Results demonstrate the efficacy of short-acting beta-agonist (SABA) delivered by metered-dose inhaler as first-line therapy for younger and older children (hospital admission decreased by 44% in younger children, and ED length of stay decreased by 33 min in older children). Short-acting anticholinergic (SAAC) should be added to SABA for older children in severe cases (hospital admission decreased by 27% and 74% when compared to SABA and SAAC alone, respectively). Continuous nebulization, addition of magnesium sulfate to SABA, and levosalbutamol compared to salbutamol cannot be recommended in routine practice.

  20. Emergency Department Placement and Management of Indwelling Urinary Catheters in Older Adults: Knowledge, Attitudes, and Practice

    PubMed Central

    Viswanathan, Kartik; Rosen, Tony; Mulcare, Mary R.; Clark, Sunday; Hayes, Jaime; Lachs, Mark S.; Flomenbaum, Neal

    2015-01-01

    BACKGROUND Indwelling Urinary Catheters (IUCs) are placed frequently in older adults in the emergency department (ED). While often a critical intervention, IUCs carry significant risks, particularly for geriatric patients, including infection, delirium, and falls. In addition, once placed, IUCs are rarely removed in the ED and may remain for an extended period after transfer of care, leading to poor outcomes. The purpose of this research was to examine the current knowledge, attitudes, and practice of ED nurses and other providers regarding IUC placement and management in older adults. METHODS We surveyed ED providers including nurses, attending physicians, Emergency Medicine (EM) residents, nurse practitioners (NPs), and physician assistants (PAs) at a large, urban, academic medical center. We developed comprehensive written questionnaires designed using items from previously validated instruments and questions created specifically for this study. In addition, we assessed providers' management of 25 unique clinical scenarios, each representing an established appropriate or inappropriate indication for IUC placement. RESULTS 127 ED providers participated: 43 nurses, 21 attending physicians, 47 residents, and 17 NP/PAs. 91% of nurses and 88% of other providers reported comfort with appropriate indications for IUC placement. Despite this, in the clinical vignettes nurses correctly identified the appropriate approach for IUC placement in only 40% of cases and other providers in only 37%. Reported practices were most divergent from accepted standards in delirium, with 3% of nurses and 1% of other providers appropriately avoiding IUC placement. Practice varied widely between individual providers, with the nurse participants reporting appropriate practice in 16%–64% of clinical scenarios and other providers in 8%–68%. Few nurses or other providers reported reassessing their patients for IUC removal at transfer to the hospital upstairs (28% of nurses and 7% of other

  1. A New Role for Emergency Management: Fostering Trust to Enhance Collaboration in Complex Adaptive Emergency Response Systems

    DTIC Science & Technology

    2009-12-01

    analysis derived from an interview process, which involved senior management of seven public safety agencies, in order to draw conclusions on the role of...in the furtherance of collaborative agency partnerships. The methodology for this study involved data collection and thematic analysis derived from...TRUST MATRIX...........................................................................................65 V. ANALYSIS

  2. An institutional approach to the management of the 'Can't Intubate, Can't Oxygenate' emergency in children.

    PubMed

    Sabato, Stefano C; Long, Elliot

    2016-08-01

    The 'Can't Intubate Can't Oxygenate' emergency is rare in children. Nevertheless, airway clinicians involved in pediatric airway management must be able to rescue the airway percutaneously through the front of the neck should this situation be encountered. Little evidence exists in children to guide rescue techniques, and extrapolation of adult evidence may be problematic due to anatomical differences. This document reviews the currently available evidence, and presents a practical approach to standardizing equipment, techniques, and training for managing the 'Can't Intubate Can't Oxygenate' emergency in children.

  3. A Cloud Robotics Based Service for Managing RPAS in Emergency, Rescue and Hazardous Scenarios

    NASA Astrophysics Data System (ADS)

    Silvagni, Mario; Chiaberge, Marcello; Sanguedolce, Claudio; Dara, Gianluca

    2016-04-01

    Cloud robotics and cloud services are revolutionizing not only the ICT world but also the robotics industry, giving robots more computing capabilities, storage and connection bandwidth while opening new scenarios that blend the physical to the digital world. In this vision, new IT architectures are required to manage robots, retrieve data from them and create services to interact with users. Among all the robots this work is mainly focused on flying robots, better known as drones, UAV (Unmanned Aerial Vehicle) or RPAS (Remotely Piloted Aircraft Systems). The cloud robotics approach shifts the concept of having a single local "intelligence" for every single UAV, as a unique device that carries out onboard all the computation and storage processes, to a more powerful "centralized brain" located in the cloud. This breakthrough opens new scenarios where UAVs are agents, relying on remote servers for most of their computational load and data storage, creating a network of devices where they can share knowledge and information. Many applications, using UAVs, are growing as interesting and suitable devices for environment monitoring. Many services can be build fetching data from UAVs, such as telemetry, video streaming, pictures or sensors data; once. These services, part of the IT architecture, can be accessed via web by other devices or shared with other UAVs. As test cases of the proposed architecture, two examples are reported. In the first one a search and rescue or emergency management, where UAVs are required for monitoring intervention, is shown. In case of emergency or aggression, the user requests the emergency service from the IT architecture, providing GPS coordinates and an identification number. The IT architecture uses a UAV (choosing among the available one according to distance, service status, etc.) to reach him/her for monitoring and support operations. In the meantime, an officer will use the service to see the current position of the UAV, its

  4. Problems and barriers of pain management in the emergency department: Are we ever going to get better?

    PubMed Central

    Motov, Sergey M; Khan, Abu NGA

    2009-01-01

    Pain is the most common reason people visit emergency rooms. Pain does not discriminate on the basis of gender, race or age. The state of pain management in the emergency department (ED) is disturbing. ED physicians often do not provide adequate analgesia to their patients, do not meet patients’ expectations in treating their pain, and struggle to change their practice regarding analgesia. A review of multiple publications has identified the following causes of poor management of painful conditions in the ED: failure to acknowledge pain, failure to assess initial pain, failure to have pain management guidelines in ED, failure to document pain and to assess treatment adequacy, and failure to meet patient’s expectations. The barriers that preclude emergency physicians from proper pain management include ethnic and racial bias, gender bias, age bias, inadequate knowledge and formal training in acute pain management, opiophobia, the ED, and the ED culture. ED physicians must realize that pain is a true emergency and treat it as such. PMID:21197290

  5. A standardized method of preventing and managing emergencies within the context of evidence-based therapy implementation.

    PubMed

    Urgelles, Jessica; Donohue, Brad; Wilks, Chelsey; Van Hasselt, Vincent B; Azrin, Nathan H

    2012-07-01

    Families served within child welfare settings evidence a wide range of emergencies or unexpected crises or circumstances that may lead to danger and make it difficult for them to focus on treatment planning. Mental health treatment providers are often unprepared to effectively manage emergencies during implementation of evidence-based prescribed therapy sessions. In this study, the authors empirically developed a standardized intervention to assist mental health providers in emergency prevention and management (EPM) with their clients. EPM includes assessment of emergent conditions and a self-control procedure that may be utilized by consumers to prevent or resolve emergencies. EPM responses of 26 mothers referred by Child Protective Services for 6 months of evidence-supported treatment were examined. Relevant to clinical utility, the results indicated that providers implemented EPM in a little more than half (56.9%) of their treatment sessions, and all emergencies assessed in EPM were endorsed by at least 8% of the sample throughout their treatment. EPM was implemented with fidelity according to service providers, and corroborated by blind raters. Participants were found to be compliant and satisfied with EPM. The average number of emergencies endorsed over the course of EPM administrations was negatively correlated with the frequency of EPM administrations, suggesting that EPM may have helped reduce emergencies. Pretreatment factors (e.g., household income, child abuse potential, family functioning, parental stress, child behavior problems, number of days child removed from home) and hard drug use (but not marijuana or alcohol) during treatment were associated with the number of emergencies reported by participants.

  6. Network-aware scalable video monitoring system for emergency situations with operator-managed fidelity control

    NASA Astrophysics Data System (ADS)

    Al Hadhrami, Tawfik; Nightingale, James M.; Wang, Qi; Grecos, Christos

    2014-05-01

    In emergency situations, the ability to remotely monitor unfolding events using high-quality video feeds will significantly improve the incident commander's understanding of the situation and thereby aids effective decision making. This paper presents a novel, adaptive video monitoring system for emergency situations where the normal communications network infrastructure has been severely impaired or is no longer operational. The proposed scheme, operating over a rapidly deployable wireless mesh network, supports real-time video feeds between first responders, forward operating bases and primary command and control centers. Video feeds captured on portable devices carried by first responders and by static visual sensors are encoded in H.264/SVC, the scalable extension to H.264/AVC, allowing efficient, standard-based temporal, spatial, and quality scalability of the video. A three-tier video delivery system is proposed, which balances the need to avoid overuse of mesh nodes with the operational requirements of the emergency management team. In the first tier, the video feeds are delivered at a low spatial and temporal resolution employing only the base layer of the H.264/SVC video stream. Routing in this mode is designed to employ all nodes across the entire mesh network. In the second tier, whenever operational considerations require that commanders or operators focus on a particular video feed, a `fidelity control' mechanism at the monitoring station sends control messages to the routing and scheduling agents in the mesh network, which increase the quality of the received picture using SNR scalability while conserving bandwidth by maintaining a low frame rate. In this mode, routing decisions are based on reliable packet delivery with the most reliable routes being used to deliver the base and lower enhancement layers; as fidelity is increased and more scalable layers are transmitted they will be assigned to routes in descending order of reliability. The third tier

  7. Emergency end of life operations for CNES remote sensing satellites—Management and operational process

    NASA Astrophysics Data System (ADS)

    Bertrand, Régis; Alby, Fernand; Costes, Thierry; Dejoie, Joël; Delmas, Dominique-Roland; Delobette, Damien; Gibek, Isabelle; Gleyzes, Alain; Masson, Françoise; Meyer, Jean-Renaud; Moreau, Agathe; Perret, Lionel; Riclet, François; Ruiz, Hélène; Schiavon, Françoise; Spizzi, Pierre; Viallefont, Pierre; Villaret, Colette

    2012-10-01

    continue its mission using the redundancy, b/. the EOL operations must be planned within a mid-term period, or c/. the EOL operations must be implemented as soon as possible by the operational teams. The paper describes this management and operational process illustrated with study cases of failures on SPOT and PLEIADES satellites corresponding to various emergency situations.

  8. Web-of-Objects (WoO)-Based Context Aware Emergency Fire Management Systems for the Internet of Things

    PubMed Central

    Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

    2014-01-01

    Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository. PMID:24531299

  9. Web-of-Objects (WoO)-based context aware emergency fire management systems for the Internet of Things.

    PubMed

    Shamszaman, Zia Ush; Ara, Safina Showkat; Chong, Ilyoung; Jeong, Youn Kwae

    2014-02-13

    Recent advancements in the Internet of Things (IoT) and the Web of Things (WoT) accompany a smart life where real world objects, including sensing devices, are interconnected with each other. The Web representation of smart objects empowers innovative applications and services for various domains. To accelerate this approach, Web of Objects (WoO) focuses on the implementation aspects of bringing the assorted real world objects to the Web applications. In this paper; we propose an emergency fire management system in the WoO infrastructure. Consequently, we integrate the formation and management of Virtual Objects (ViO) which are derived from real world physical objects and are virtually connected with each other into the semantic ontology model. The charm of using the semantic ontology is that it allows information reusability, extensibility and interoperability, which enable ViOs to uphold orchestration, federation, collaboration and harmonization. Our system is context aware, as it receives contextual environmental information from distributed sensors and detects emergency situations. To handle a fire emergency, we present a decision support tool for the emergency fire management team. The previous fire incident log is the basis of the decision support system. A log repository collects all the emergency fire incident logs from ViOs and stores them in a repository.

  10. Federal Emergency Management Information System (FEMIS) Bill of Materials (BOM) for FEMIS Version 1.4.7

    SciTech Connect

    Arp, Jonathan A. ); Downing, Timothy R. ); Gackle, Philip P. ); Homer, Brian J. ); Johnson, Daniel M. ); Johnson, Ranata L. ); Johnson, Sharon M. ); Loveall, Robert M. ); Millard, W David ); Stoops, Lamar R. ); Tzemos, Spyridon ); Wood, Blanche M. )

    1999-12-01

    This document describes the hardware and software required for the Federal Emergency Management Information System version 1.4.7 (FEMIS v1.4.7) released by Pacific Northwest National Laboratory (PNNL). Information included in this document about hardware and software requirements is subject to change.

  11. 76 FR 47584 - Information Collection Being Submitted to the Office of Management and Budget (OMB) for Emergency...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... COMMISSION Information Collection Being Submitted to the Office of Management and Budget (OMB) for Emergency... respondents, including the use of automated collection techniques or other forms of information technology; and ways to further reduce the information collection burden on small business concerns with...

  12. Planning and Conducting a Functional Exercise. Helpful Hints for School Emergency Management. Volume 2, Issue 4, 2007

    ERIC Educational Resources Information Center

    US Department of Education, 2007

    2007-01-01

    A key component of comprehensive school and school district emergency management plans is an exercise program that includes the five types of exercises: (1) orientation seminars; (2) drills; (3) tabletop exercises; and (4) functional exercises. Functional exercises are excellent tools for testing the extent to which an existing emergency…

  13. [Non elective cesarean section: use of a color code to optimize management of obstetric emergencies].

    PubMed

    Rudigoz, René-Charles; Huissoud, Cyril; Delecour, Lisa; Thevenet, Simone; Dupont, Corinne

    2014-06-01

    The medical team of the Croix Rousse teaching hospital maternity unit has developed, over the last ten years, a set of procedures designed to respond to various emergency situations necessitating Caesarean section. Using the Lucas classification, we have defined as precisely as possible the degree of urgency of Caesarian sections. We have established specific protocols for the implementation of urgent and very urgent Caesarean section and have chosen a simple means to convey the degree of urgency to all team members, namely a color code system (red, orange and green). We have set time goals from decision to delivery: 15 minutes for the red code and 30 minutes for the orange code. The results seem very positive: The frequency of urgent and very urgent Caesareans has fallen over time, from 6.1 % to 1.6% in 2013. The average time from decision to delivery is 11 minutes for code red Caesareans and 21 minutes for code orange Caesareans. These time goals are now achieved in 95% of cases. Organizational and anesthetic difficulties are the main causes of delays. The indications for red and orange code Caesarians are appropriate more than two times out of three. Perinatal outcomes are generally favorable, code red Caesarians being life-saving in 15% of cases. No increase in maternal complications has been observed. In sum: Each obstetric department should have its own protocols for handling urgent and very urgent Caesarean sections. Continuous monitoring of their implementation, relevance and results should be conducted Management of extreme urgency must be integrated into the management of patients with identified risks (scarred uterus and twin pregnancies for example), and also in structures without medical facilities (birthing centers). Obstetric teams must keep in mind that implementation of these protocols in no way dispenses with close monitoring of labour.

  14. Emergency Department Management of Suspected Calf-Vein Deep Venous Thrombosis: A Diagnostic Algorithm

    PubMed Central

    Kitchen, Levi; Lawrence, Matthew; Speicher, Matthew; Frumkin, Kenneth

    2016-01-01

    Introduction Unilateral leg swelling with suspicion of deep venous thrombosis (DVT) is a common emergency department (ED) presentation. Proximal DVT (thrombus in the popliteal or femoral veins) can usually be diagnosed and treated at the initial ED encounter. When proximal DVT has been ruled out, isolated calf-vein deep venous thrombosis (IC-DVT) often remains a consideration. The current standard for the diagnosis of IC-DVT is whole-leg vascular duplex ultrasonography (WLUS), a test that is unavailable in many hospitals outside normal business hours. When WLUS is not available from the ED, recommendations for managing suspected IC-DVT vary. The objectives of the study is to use current evidence and recommendations to (1) propose a diagnostic algorithm for IC-DVT when definitive testing (WLUS) is unavailable; and (2) summarize the controversy surrounding IC-DVT treatment. Discussion The Figure combines D-dimer testing with serial CUS or a single deferred FLUS for the diagnosis of IC-DVT. Such an algorithm has the potential to safely direct the management of suspected IC-DVT when definitive testing is unavailable. Whether or not to treat diagnosed IC-DVT remains widely debated and awaiting further evidence. Conclusion When IC-DVT is not ruled out in the ED, the suggested algorithm, although not prospectively validated by a controlled study, offers an approach to diagnosis that is consistent with current data and recommendations. When IC-DVT is diagnosed, current references suggest that a decision between anticoagulation and continued follow-up outpatient testing can be based on shared decision-making. The risks of proximal progression and life-threatening embolization should be balanced against the generally more benign natural history of such thrombi, and an individual patient’s risk factors for both thrombus propagation and complications of anticoagulation. PMID:27429688

  15. Guidelines for the emergency management of asthma in adults. CAEP/CTS Asthma Advisory Committee. Canadian Association of Emergency Physicians and the Canadian Thoracic Society.

    PubMed Central

    Beveridge, R C; Grunfeld, A F; Hodder, R V; Verbeek, P R

    1996-01-01

    OBJECTIVE: To develop a set of comprehensive, standardized evidence-based guidelines for the assessment and treatment of acute asthma in adults in the emergency setting. OPTIONS: The use of medications was evaluated by class, dose, route, onset of action and optimal mode of delivery. The use of objective measurements and clinical features to assess response to therapy were evaluated in relation to the decision to admit or discharge the patient or arrange for follow-up care. OUTCOMES: Control of symptoms and disease reflected in hospital admission rates, frequency of treatment failures following discharge, resolution of symptoms and improvement of spirometric test results. EVIDENCE: Previous guidelines, articles retrieved through a search of MEDLINE, emergency medical abstracts and information from members of the expert panel were reviewed by members of the Canadian Association of Emergency Physicians (CAEP) and the Canadian Thoracic Society. Where evidence was not available, consensus was reached by the expert panel. The resulting guidelines were reviewed by members of the parent organizations. VALUES: The evidence-based methods and values of the Canadian Task Force on the Periodic Health Examination were used. BENEFITS, HARMS AND COSTS: As many as 80% of the approximate 400 deaths from asthma each year in Canada are felt to be preventable. The use of guidelines, aggressive emergency management and consistent use of available options at discharge are expected to decrease the rates of unnecessary hospital admissions and return visits to emergency departments because of treatment failures. Substantial decreases in costs are expected from the use of less expensive drugs, or drug delivery systems, fewer hospital admissions and earlier return to full activity after discharge. RECOMMENDATIONS: Beta2-agonists are the first-line therapy for the management of acute asthma in the emergency department (grade A recommendation). Bronchodilators should be administered by the

  16. Identify-Isolate-Inform: A Tool for Initial Detection and Management of Measles Patients in the Emergency Department

    PubMed Central

    Koenig, Kristi L.; Alassaf, Wajdan; Burns, Michael J.

    2015-01-01

    Measles (rubeola) is a highly contagious airborne disease that was declared eliminated in the U.S. in the year 2000. Only sporadic U.S. cases and minor outbreaks occurred until the larger outbreak beginning in 2014 that has become a public health emergency. The “Identify-Isolate-Inform” tool will assist emergency physicians to be better prepared to detect and manage measles patients presenting to the emergency department. Measles typically presents with a prodrome of high fever, and cough/coryza/conjunctivitis, sometimes accompanied by the pathognomonic Koplik spots. Two to four days later, an erythematous maculopapular rash begins on the face and spreads down the body. Suspect patients must be immediately isolated with airborne precautions while awaiting laboratory confirmation of disease. Emergency physicians must rapidly inform the local public health department and hospital infection control personnel of suspected measles cases. PMID:25834659

  17. Identify-isolate-inform: a tool for initial detection and management of measles patients in the emergency department.

    PubMed

    Koenig, Kristi L; Alassaf, Wajdan; Burns, Michael J

    2015-03-01

    Measles (rubeola) is a highly contagious airborne disease that was declared eliminated in the U.S. in the year 2000. Only sporadic U.S. cases and minor outbreaks occurred until the larger outbreak beginning in 2014 that has become a public health emergency. The "Identify-Isolate-Inform" tool will assist emergency physicians to be better prepared to detect and manage measles patients presenting to the emergency department. Measles typically presents with a prodrome of high fever, and cough/coryza/conjunctivitis, sometimes accompanied by the pathognomonic Koplik spots. Two to four days later, an erythematous maculopapular rash begins on the face and spreads down the body. Suspect patients must be immediately isolated with airborne precautions while awaiting laboratory confirmation of disease. Emergency physicians must rapidly inform the local public health department and hospital infection control personnel of suspected measles cases.

  18. Development of a model-based flood emergency management system in Yujiang River Basin, South China

    NASA Astrophysics Data System (ADS)

    Zeng, Yong; Cai, Yanpeng; Jia, Peng; Mao, Jiansu

    2014-06-01

    Flooding is the most frequent disaster in China. It affects people's lives and properties, causing considerable economic loss. Flood forecast and operation of reservoirs are important in flood emergency management. Although great progress has been achieved in flood forecast and reservoir operation through using computer, network technology, and geographic information system technology in China, the prediction accuracy of models are not satisfactory due to the unavailability of real-time monitoring data. Also, real-time flood control scenario analysis is not effective in many regions and can seldom provide online decision support function. In this research, a decision support system for real-time flood forecasting in Yujiang River Basin, South China (DSS-YRB) is introduced in this paper. This system is based on hydrological and hydraulic mathematical models. The conceptual framework and detailed components of the proposed DSS-YRB is illustrated, which employs real-time rainfall data conversion, model-driven hydrologic forecasting, model calibration, data assimilation methods, and reservoir operational scenario analysis. Multi-tiered architecture offers great flexibility, portability, reusability, and reliability. The applied case study results show the development and application of a decision support system for real-time flood forecasting and operation is beneficial for flood control.

  19. Modeling of Natural Coastal Hazards in Puerto Rico in Support of Emergency Management and Coastal Planning

    NASA Astrophysics Data System (ADS)

    Mercado, A., Jr.

    2015-12-01

    The island of Puerto Rico is not only located in the so-called Caribbean hurricane alley, but is also located in a tsunami prone region. And both phenomena have affected the island. For the past few years we have undergone the task of upgrading the available coastal flood maps due to storm surges and tsunamis. This has been done taking advantage of new Lidar-derived, high resolution, topography and bathymetry and state-of-the-art models (MOST for tsunamis and ADCIRC/SWAN for storm surges). The tsunami inundation maps have been converted to evacuation maps. In tsunamis we are also working in preparing hazard maps due to tsunami currents inside ports, bays, and marinas. The storm surge maps include two scenarios of sea level rise: 0.5 and 1.0 m above Mean High Water. All maps have been adopted by the Puerto Rico State Emergency Management Agency, and are publicly available through the Internet. It is the purpose of this presentation to summarize how it has been done, the spin-off applications they have generated, and how we plan to improve coastal flooding predictions.

  20. Managing produced water from coal seam gas projects: implications for an emerging industry in Australia.

    PubMed

    Davies, Peter J; Gore, Damian B; Khan, Stuart J

    2015-07-01

    This paper reviews the environmental problems, impacts and risks associated with the generation and disposal of produced water by the emerging coal seam gas (CSG) industry and how it may be relevant to Australia and similar physical settings. With only limited independent research on the potential environmental impacts of produced water, is it necessary for industry and government policy makers and regulators to draw upon the experiences of related endeavours such as mining and groundwater extraction accepting that the conclusions may not always be directly transferrable. CSG is widely touted in Australia as having the potential to provide significant economic and energy security benefits, yet the environmental and health policies and the planning and regulatory setting are yet to mature and are continuing to evolve amidst ongoing social and environmental concerns and political indecision. In this review, produced water has been defined as water that is brought to the land surface during the process of recovering methane gas from coal seams and includes water sourced from CSG wells as well as flowback water associated with drilling, hydraulic fracturing and gas extraction. A brief overview of produced water generation, its characteristics and environmental issues is provided. A review of past lessons and identification of potential risks, including disposal options, is included to assist in planning and management of this industry.

  1. Assessing the impact of a radiology information management system in the emergency department

    NASA Astrophysics Data System (ADS)

    Redfern, Regina O.; Langlotz, Curtis P.; Lowe, Robert A.; Horii, Steven C.; Abbuhl, Stephanie B.; Kundel, Harold L.

    1998-07-01

    To evaluate a conventional radiology image management system, by investigating information accuracy, and information delivery. To discuss the customization of a picture archival and communication system (PACS), integrated radiology information system (RIS) and hospital information system (HIS) to a high volume emergency department (ED). Materials and Methods: Two data collection periods were completed. After the first data collection period, a change in work rules was implemented to improve the quality of data in the image headers. Data from the RIS, the ED information system, and the HIS as well as observed time motion data were collected for patients admitted to the ED. Data accuracy, patient waiting times, and radiology exam information delivery were compared. Results: The percentage of examinations scheduled in the RIS by the technologists increased from 0% (0 of 213) during the first period to 14% (44 of 317) during the second (p less than 0.001). The percentage of images missing identification numbers decreased from 36% (98 of 272) during the first data collection period to 10% (56 of 562) during the second period (p less than 0.001). Conclusions: Radiologic services in a high-volume ED, requiring rapid service, present important challenges to a PACS system. Strategies can be implemented to improve accuracy and completeness of the data in PACS image headers in such an environment.

  2. Management of motor complications in Parkinson disease: current and emerging therapies.

    PubMed

    Espay, Alberto J

    2010-11-01

    Motor fluctuations and dyskinesias are common motor complications that manifest within the first few years from the initiation of therapy in patients with Parkinson disease. These complications negatively affect the quality of life and represent an important source of disability. A growing number of therapeutic options including treatments aimed at prolonging the efficacy of levodopa (eg, selective monoamine oxidase-B inhibitors and catechol-O-methyltransferase inhibitors), administration of longer-acting dopamine agonists (eg, rotigotine, sustained-release ropinirole), and continuous administration of intraduodenal levodopa exist or will soon become available. Patients who maintain a good response to levodopa but continue to experience disabling motor complications despite the best medical management may benefit from a regimen of subcutaneous apomorphine, ideally delivered by a subcutaneous pump, or deep-brain stimulation of the subthalamic nucleus or internal portion of the pallidum. Emerging therapies for motor complications are expected to further enhance continuous (physiologic) delivery of dopaminergic drugs and extend the reach of therapies beyond the dopaminergic system to influence not only the motor but also the vast range of nonmotor complications of this multisystemic disease.

  3. Acute migraine in the Emergency Department: extending European principles of management.

    PubMed

    Martelletti, Paolo; Farinelli, Ivano; Steiner, Timothy J

    2008-10-01

    The World Health Organization (WHO) placed migraine 19th among all causes of disability (12th in women) measured in years of healthy life lost to disability (YLD). The importance of headache disorders, particularly of the primary forms, is established by their distribution worldwide, their duration (the majority being life-long conditions) and their imposition of both disability and life-style restrictions among large numbers of people. For these reasons, headache disorders should represent a public-health priority. In the Emergency Department (ED), as elsewhere, migraine is often under-diagnosed-and under-treated when it is diagnosed. The result is likely to be failure of treatment. Particular attention to diagnosis is needed in ED patients with acute headache, since there is a higher probability of secondary headache due to underlying pathologies. According to European principles of management, acute migraine treatment generally is stepwise. Of the two main steps, the first relies on symptomatic medication, preferably NSAIDs with or without antiemetics. The second step uses specific therapies, usually triptans. Modifications to routine practice are appropriate in the ED. Parenteral administration of symptomatic therapies is a preferred first choice, whilst immediate resort to triptans may be appropriate, and achieve better outcomes, in patients with severe headache and diagnostic confirmation of migraine.

  4. Emerging contaminants in the environment: Risk-based analysis for better management.

    PubMed

    Naidu, Ravi; Arias Espana, Victor Andres; Liu, Yanju; Jit, Joytishna

    2016-07-01

    Emerging contaminants (ECs) are chemicals of a synthetic origin or deriving from a natural source that has recently been discovered and for which environmental or public health risks are yet to be established. This is due to limited available information on their interaction and toxicological impacts on receptors. Several types of ECs exist such as antibiotics, pesticides, pharmaceuticals, personal care products, effluents, certain naturally occurring contaminants and more recently nanomaterials. ECs may derive from a known source, for example released directly to the aquatic environment from direct discharges such as those from wastewater treatment plants. Although in most instances the direct source cannot be identified, ECs have been detected in virtually every country's natural environment and as a consequence they represent a global problem. There is very limited information on the fate and transport of ECs in the environment and their toxicological impact. This lack of information can be attributed to limited financial resources and the lack of analytical techniques for detecting their effects on ecosystems and human health on their own or as mixture. We do not know how ECs interact with each other or various contaminants. This paper presents an overview of existing knowledge on ECs, their fate and transport and a risk-based analysis for ECs management and complementary strategies.

  5. European Gravity Service for Improved Emergency Management - Project Overview and First Results

    NASA Astrophysics Data System (ADS)

    Jaeggi, A.; Jean, Y.; Weigelt, M. L. B.; Flechtner, F.; Gruber, C.; Guntner, A.; Gouweleeuw, B.; Mayer-Gürr, T.; Kvas, A.; Martinis, S.; Zwenzer, H.; Bruinsma, S.; Lemoine, J. M.; Flury, J.; Bourgogne, S.

    2015-12-01

    The project European Gravity Service for Improved Emergency Management (EGSIEM) of the Horizon 2020 Framework Programme for Research and Innovation of the European Commission has started in January 2015. EGSIEM shall demonstrate that observations of the redistribution of water and ice mass derived from the current GRACE mission, the future GRACE-FO mission, and additional data provide critical and complementary information to more traditional Earth Observation products and open the door for innovative approaches to flood and drought monitoring and forecasting. We give an overview of the project and present first results from the three key objectives that EGSIEM shall address: 1) to establish a scientific combination service to deliver the best gravity products for applications in Earth and environmental science research based on the unified knowledge of the European GRACE community, 2) to establish a near real-time and regional service to reduce the latency and increase the temporal resolution of the mass redistribution products, and 3) to establish a hydrological and early warning service to develop gravity-based indicators for extreme hydrological events and to demonstrate their value for flood and drought forecasting and monitoring services. All of these services shall be tailored to the various needs of the respective communities. Significant efforts shall also be devoted to transform the service products into user-friendly and easy-to-interpret data sets and the development of visualization tools.

  6. European Gravity Service for Improved Emergency Management - Status and project highlights

    NASA Astrophysics Data System (ADS)

    Mayer-Guerr, Torsten; Adrian, Jäggi; Meyer, Ulrich; Jean, Yoomin; Susnik, Andreja; Weigelt, Matthias; van Dam, Tonie; Flechtner, Frank; Gruber, Christian; Güntner, Andreas; Gouweleeuw, Ben; Kvas, Andreas; Klinger, Beate; Flury, Jakob; Bruinsma, Sean; Lemoine, Jean-Michel; Zwenzner, Hendrik; Bourgogne, Stephane; Bandikova, Tamara

    2016-04-01

    The European Gravity Service for Improved Emergency Management (EGSIEM) is a project of the Horizon 2020 Framework Programme for Research and Innovation of the European Commission. EGSIEM shall demonstrate that observations of the redistribution of water and ice mass derived from the current GRACE mission, the future GRACE-FO mission, and additional data provide critical and complementary information to more traditional Earth Observation products and open the door for innovative approaches to flood and drought monitoring and forecasting. In the frame of EGSIEM three key services should established: 1) a scientific combination service to deliver the best gravity products for applications in Earth and environmental science research based on the unified knowledge of the European GRACE community, 2) a near real-time and regional service to reduce the latency and increase the temporal resolution of the mass redistribution products, and 3) a hydrological and early warning service to develop gravity-based indicators for extreme hydrological events and to demonstrate their value for flood and drought forecasting and monitoring services. All of these services shall be tailored to the various needs of the respective communities. Significant efforts shall also be devoted to transform the service products into user-friendly and easy-to-interpret data sets and the development of visualization tools. In this talk the status of the ongoing project is presented and selected results are discussed.

  7. The general use of outdoor warning sirens: a preliminary survey of emergency managers.

    PubMed

    Brotzge, Jerald A; Donner, William R

    2015-01-01

    With more direct, personal warning systems becoming popular, the continued maintenance of older warning systems, such as outdoor warning sirens, may be jeopardized as emergency managers (EMs) seek to optimize their limited budgets. However, the extent to which sirens are embedded into the American landscape and culture argues against their removal. To better quantify the distribution and use of outdoor warning sirens, an international survey of EMs was conducted to learn more about where siren systems are deployed and how they are operated. Approximately 593 respondents started the 31 question survey with 383 completing it. Questions were asked regarding siren network size, alternative warning systems, siren use and capabilities, and testing. For those without sirens, a series of questions were asked for why sirens were not used. In general, a lack of perceived threat, high costs, and large geographic area kept some jurisdictions from installing sirens. Of those that operate siren networks, half of networks are small (≤10 sirens), while a small percentage of jurisdictions (6.3 percent) operate very large networks (>100). A large majority of respondents expected to maintain or expand their networks within the next 5 years. Three-quarters of respondents use additional warning systems. Nearly half of respondents use sirens for nonweather applications, and nearly two-thirds have the capability to use multiple sound alerts. Overall, sirens remain a popular tool for warning on a variety of local hazards though how the sirens are operated and tested vary widely by jurisdiction.

  8. Emergency management training in Korea: combining and balancing supply- and demand-centered paradigms.

    PubMed

    Ha, Kyoo-Man; Park, Sosoon; Yoon, Yi; Nam, Ki-Hun; Oh, Hyeon-Mun

    2015-01-01

    This article aims to encourage NEMA (or newly named as MPSS) to combine its supply-centered paradigm with a newly proposed "demand-centered paradigm" in the Korean field of emergency management training (EMT). Based on qualitative content analysis, this paper defined the current field of EMT to be a supply-centered paradigm via three components: locations, courses, and participants. This paradigm focuses on EMT provision as supplied and dictated by the national government. On the other hand, a demand-centered model is about looking into stakeholders' actual needs for EMT. In this regard, alternatives with reference to the demand-centered paradigm via the same three components were discussed and considered. The key tenet is that having revealed that NEMA has unequivocally focused on the results side or effectiveness of EMT via a supply-centered paradigm, Korea should address and consider the same three components, this time by fusing and incorporating a fair process of EMT by enlisting active roles from the local community, academic scholars, and civilian training attendees in a demand-centered paradigm.

  9. The Psychogeriatric Patient in the Emergency Room: Focus on Management and Disposition

    PubMed Central

    Patel, Priyanka; Grossberg, George T.

    2014-01-01

    Background. The growing geriatric population in the United States (US) has prompted better understanding of treatment of the elderly in the hospital and emergency room (ER) settings. This study examines factors influencing the disposition of psychogeriatric patients after their initial presentation in the ER. Methods. Data was collected on patients 65 years of age or older arriving at the ER of a large urban hospital in the USA (January 2009–December 2010). Results. Of the total subjects (n = 95) included in the study, majority were females (66.3%) with an average age of 75.5 years. The chief complaint for psychogeriatric patients coming to the ER was delirium (61.6%). Caucasians were significantly more likely than African-American patients to get a psychiatric consult (33% versus 9%). Patients with delirium were less likely than patients with other psychiatric complaints to get a psychiatric consult in the ER (1.2% versus 47.2%) and less likely to be referred to a psychiatric inpatient unit compared to patients with other psychiatric complaints (2.4% versus 16.7%). Conclusion. Even though delirium is the most common reason for ER visits among psychogeriatric patients, very few delirium patients got a psychiatric consultation in the ER. A well-equipped geriatric psychiatry unit can manage delirium and associated causes. PMID:24734206

  10. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Understanding Between the Federal Emergency Management Agency and the Farmers Home Administration or...

  11. 7 CFR Exhibit A to Subpart B of... - Memorandum of Understanding Between the Federal Emergency Management Agency and the Farmers Home...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... Emergency Management Agency and the Farmers Home Administration or Its Successor Agency under Public Law 103... any FmHA or its successor agency under Public Law 103-354 County Office....

  12. Shift, Interrupted: Strategies for Managing Difficult Patients Including Those with Personality Disorders and Somatic Symptoms in the Emergency Department.

    PubMed

    Moukaddam, Nidal; AufderHeide, Erin; Flores, Araceli; Tucci, Veronica

    2015-11-01

    Difficult patients are often those who present with a mix of physical and psychiatric symptoms, and seem refractory to usual treatments or reassurance. such patients can include those with personality disorders, those with somatization symptoms; they can come across as entitled, drug-seeking, manipulative, or simply draining to the provider. Such patients are often frequent visitors to Emergency Departments. Other reasons for difficult encounters could be rooted in provider bias or countertransference, rather than sole patient factors. Emergency providers need to have high awareness of these possibilities, and be prepared to manage such situations, otherwise workup can be sub-standard and dangerous medical mistakes can be made.

  13. The Emerging Role of Lenalidomide in the Management of Lymphoid Malignancies

    PubMed Central

    Hernandez-Ilizaliturri, Francisco J.; Batoo, Sameer A.

    2011-01-01

    of lenalidomide in combination with rituximab in previously untreated indolent lymphoma are promising and warrant further study. In addition, the evaluation of lenalidomide in the maintenance setting or in combination with other target-specific agents (i.e. proteasome inhibitors) in aggressive lymphomas is being addressed in ongoing clinical trials. In summary, lenalidomide is emerging as a biologically active and novel agent in the treatment of B-cell neoplasms. Future translational and clinical studies will further define the role of lenalidomide in the management of de novo or relapsed/refractory CLL or B-cell lymphomas and identify the subset of patients most likely to gain clinical benefit. PMID:23556075

  14. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    NASA Astrophysics Data System (ADS)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; p<.05); SMS had a moderate significant positive relationship to Night Vision Goggles (NVG) (r=.38; p<.05); and SMS had a slight significant positive relationship with Terrain Avoidance Warning System (TAWS) (r=.234; p<.05). Multiple regression analysis suggested that when combined with NVG, TAWS, and SMS, HEMS years of experience explained 81.4% of the variance in accident rate scores (p<.05), and HEMS years of experience was found to be a significant predictor of accident rates (p<.05). Additional quantitative regression analysis was recommended to replicate the results of this study and to consider the influence of these variables for continued reduction of HEMS accidents, and to induce execution of SMS and aviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A

  15. Pain management via Ultrasound-guided Nerve Block in Emergency Department; a Case Series Study

    PubMed Central

    Nejati, Amir; Teymourian, Houman; Behrooz, Leili; mohseni, Gholamreza

    2017-01-01

    Introduction: Pain is the most common complaint of patients referring to emergency department (ED). Considering the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of ultrasound-guided nerve blocks in this setting. Methods: 46 patients who came to the ED with injured extremities were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their site of injury (1.5 mg Bupivacaine per kg of patient’s weight). Patients were asked about their level of pain before and after receiving the nerve block based on numerical rating scale. The difference between pre and post block pain severity was measured. Both patients and physicians were asked about their satisfaction with the nerve block in 5 tiered Likert scale. Results: 46 patients with the mean age of 37.5 ± 12.5 years (8-82 years) received ultrasound-guided nerve block (84.8% male). 6 Sciatic, 25 axillary, and 15 femoral nerve blocks were performed. Mean pain severity on NRS score at the time of admission was 8.1 ± 1.4, which reduced to 2.04 ± 2.06 after block. 25 (54.3%) patients were highly satisfied (Likert scale 5), 15 (32.6%) were satisfied (Likert scale 4), 3 (6.5%) were neutral and had no opinion (Likert scale 3), 1 (2.1%) was not satisfied (Likert scale 2), and 2 (4.3%) were highly unsatisfied (Likert scale 1). There was no significant difference among the satisfaction scores within the three block locations (p = 0.8). There was no significant difference in physicians’ level of satisfaction between the three block locations either (p = 0.9). 1 (2.1%) case of agitation and tachycardia and 1 (2.1%) case of vomiting were observed after the procedure. Conclusion: Ultrasound-guided nerve block of extremities is a safe and effective method that can be used for pain management in the ED. It results in high levels of satisfaction among both patients and physicians.

  16. Crisis crowdsourcing framework: designing strategic configurations of crowdsourcing for the emergency management domain

    USGS Publications Warehouse

    Liu, Sophia B.

    2014-01-01

    Crowdsourcing is not a new practice but it is a concept that has gained significant attention during recent disasters. Drawing from previous work in the crisis informatics, disaster sociology, and computer-supported cooperative work (CSCW) literature, the paper first explains recent conceptualizations of crowdsourcing and how crowdsourcing is a way of leveraging disaster convergence. The CSCW concept of “articulation work” is introduced as an interpretive frame for extracting the salient dimensions of “crisis crowdsourcing.” Then, a series of vignettes are presented to illustrate the evolution of crisis crowdsourcing that spontaneously emerged after the 2010 Haiti earthquake and evolved to more established forms of public engagement during crises. The best practices extracted from the vignettes clarified the efforts to formalize crisis crowdsourcing through the development of innovative interfaces designed to support the articulation work needed to facilitate spontaneous volunteer efforts. Extracting these best practices led to the development of a conceptual framework that unpacks the key dimensions of crisis crowdsourcing. The Crisis Crowdsourcing Framework is a systematic, problem-driven approach to determining the why, who, what, when, where, and how aspects of a crowdsourcing system. The framework also draws attention to the social, technological, organizational, and policy (STOP) interfaces that need to be designed to manage the articulation work involved with reducing the complexity of coordinating across these key dimensions. An example of how to apply the framework to design a crowdsourcing system is offered with with a discussion on the implications for applying this framework as well as the limitations of this framework. Innovation is occurring at the social, technological, organizational, and policy interfaces enabling crowdsourcing to be operationalized and integrated into official products and services.

  17. A flexible simulation platform to quantify and manage emergency department crowding

    PubMed Central

    2014-01-01

    Background Hospital-based Emergency Departments are struggling to provide timely care to a steadily increasing number of unscheduled ED visits. Dwindling compensation and rising ED closures dictate that meeting this challenge demands greater operational efficiency. Methods Using techniques from operations research theory, as well as a novel event-driven algorithm for processing priority queues, we developed a flexible simulation platform for hospital-based EDs. We tuned the parameters of the system to mimic U.S. nationally average and average academic hospital-based ED performance metrics and are able to assess a variety of patient flow outcomes including patient door-to-event times, propensity to leave without being seen, ED occupancy level, and dynamic staffing and resource use. Results The causes of ED crowding are variable and require site-specific solutions. For example, in a nationally average ED environment, provider availability is a surprising, but persistent bottleneck in patient flow. As a result, resources expended in reducing boarding times may not have the expected impact on patient throughput. On the other hand, reallocating resources into alternate care pathways can dramatically expedite care for lower acuity patients without delaying care for higher acuity patients. In an average academic ED environment, bed availability is the primary bottleneck in patient flow. Consequently, adjustments to provider scheduling have a limited effect on the timeliness of care delivery, while shorter boarding times significantly reduce crowding. An online version of the simulation platform is available at http://spark.rstudio.com/klopiano/EDsimulation/. Conclusion In building this robust simulation framework, we have created a novel decision-support tool that ED and hospital managers can use to quantify the impact of proposed changes to patient flow prior to implementation. PMID:24912662

  18. Human survival in volcanic eruptions: Thermal injuries in pyroclastic surges, their causes, prognosis and emergency management.

    PubMed

    Baxter, Peter J; Jenkins, Susanna; Seswandhana, Rosadi; Komorowski, Jean-Christophe; Dunn, Ken; Purser, David; Voight, Barry; Shelley, Ian

    2017-02-21

    This study of burns patients from two eruptions of Merapi volcano, Java, in 1994 and 2010, is the first detailed analysis to be reported of thermal injuries in a large series of hospitalised victims of pyroclastic surges, one of the most devastating phenomena in explosive eruptions. Emergency planners in volcanic crises in populated areas have to integrate the health sector into disaster management and be aware of the nature of the surge impacts and the types of burns victims to be expected in a worst scenario, potentially in numbers and in severity that would overwhelm normal treatment facilities. In our series, 106 patients from the two eruptions were treated in the same major hospital in Yogyakarta and a third of these survived. Seventy-eight per cent were admitted with over 40% TBSA (total body surface area) burns and around 80% of patients were suspected of having at least some degree of inhalation injury as well. Thirty five patients suffered over 80% TBSA burns and only one of these survived. Crucially, 45% of patients were in the 40-79% TBSA range, with most suspected of suffering from inhalation injury, for whom survival was most dependent on the hospital treatment they received. After reviewing the evidence from recent major eruptions and outlining the thermal hazards of surges, we relate the type and severity of the injuries of these patients to the temperatures and dynamics of the pyroclastic surges, as derived from the environmental impacts and associated eruption processes evaluated in our field surveys and interviews conducted by our multi-disciplinary team. Effective warnings, adequate evacuation measures, and political will are all essential in volcanic crises in populated areas to prevent future catastrophes on this scale.

  19. Current and emerging pharmacologic therapies for the management of postmenopausal osteoporosis.

    PubMed

    Lewiecki, E Michael

    2009-10-01

    Postmenopausal osteoporosis is an asymptomatic skeletal disease that is often underdiagnosed and undertreated. Osteoporotic fractures are associated with substantial morbidity and mortality and impaired quality of life-socially, emotionally, and financially. Considering the growing burden of osteoporotic fractures worldwide, there remains an ongoing need for progress in the diagnosis of osteoporosis, identification of individuals at high fracture risk, and treatment to prevent fractures. Adequate intake of calcium and vitamin D is recommended as baseline therapy for osteoporosis prevention and treatment. Available pharmacological agents for the management of postmenopausal osteoporosis may not be appropriate for all women. Oral bisphosphonates are generally considered first-line therapy for patients with osteoporosis, but their use may be limited by gastrointestinal side effects. Other agents include hormone therapy, the selective estrogen receptor modulator (SERM) raloxifene, salmon calcitonin, teriparatide (human recombinant parathyroid hormone), and strontium ranelate (in some countries). Factors that may contribute to poor compliance and persistence with current osteoporosis therapies include drug intolerance, complexity of dosing regimens, and poor understanding of the relative benefit and risk with treatment. Emerging therapies for postmenopausal osteoporosis include novel SERMs (bazedoxifene, lasofoxifene, ospemifene, arzoxifene) and denosumab. Because SERMs can display mixed functional estrogen receptor agonist or antagonist activity depending on the target tissue, they may confer beneficial effects on bone with limited stimulation of other tissues (e.g., breast, endometrium). Clinical investigation of these promising new agents is ongoing to evaluate efficacy and safety, with the goal of developing effective strategies to maximize long-term tolerance, compliance, and persistence with therapy.

  20. State of the art development of a real time system for earthquake emergency management in Romania

    NASA Astrophysics Data System (ADS)

    Ionescu, Constantin; Marmureanu, Alexandru; Manea, Liviu

    2013-04-01

    Earthquake represents a major natural disaster. The main problem after the occurrence of a strong earthquake is to minimize the total number of fatalities. As a consequence, a rapid early warning system was developed in Romania that provides a 25-32 seconds warning time to Bucharest facilities for Vrancea earthquakes. The Rapid Earthquake Warning System (REWS) was developed for Southern part of Romania and for Northern part of Bulgaria. A Rapid Earthquake Warning System provides few to tens of seconds of advanced warning time of impending ground motions, allowing mitigation actions to be taken in the short term, immediately after the strong motion occurs. The information is the key point in the disaster management, and the communication system is one of the most important component. After a strong earthquake is detected in the epicenter area, REWS (Romanian Earthquake Early Warning System) will generate an alarm notification, AlertMap, computation of the parameters of earthquakes, ShakeMap and loss estimation. All these are generated by the Romanian and Bulgarian data centers, in parallel. Warning message containing the necessary parameters are sent to local emergency centers via a software module for notifications. The above mentioned module provides notifications for all the existing subscribers related to the seismic events detected by the acquisition and evaluation modules. In the first step, the user notification message center module uses the computed real-time parameters of the detected events and a set of customizable rules to generate messages that contains the parameters of the events. Then the messages are sent by using specific channels of communication, in order to be received by the user. The system produces different types of notifications: visual, audible, SMS, email and web page content customized for the user. All notifications are issued based on predefined conditions such as recipient's needs and are based on user's criteria. All notifications

  1. A Survey over the Dentists’ and Endodntists’ Approaches towards the Management of Endodontic Emergencies in Mashhad, Iran

    PubMed Central

    Bidar, Maryam; Gharechahi, Maryam; Soleimani, Tayebeh; Eslami, Neda

    2015-01-01

    Introduction: Pain or swelling caused by various stages of inflammation/infection of the pulp/periradicular area is among endodontic emergencies. Determining the most effective method of emergency treatment is a challenging issue in endodontics. The goal of this study was to determine and compare the level of knowledge in general dentists and endodontists about endodontic emergency treatment plan in Mashhad, Iran in 2012-2013. Methods and Materials: In this cross-sectional descriptive study, 152 questionnaires were distributed among 120 general dentists and 32 endodontists of Mashhad. The questionnaire contained two separate parts. The first part included demographic information and in the second part different treatment protocols were suggested for 12 various conditions of pulp/periapical emergencies, and the participants were asked to choose the correct option(s). To determine the relationship between qualitative variables, the chi-square analysis was used. The level of significance was set at 0.05. Results: There were significant differences between treatment plans presented by general dentists and endodontists about endodontic emergencies, especially in cases of necrotic pulp and subsequent swelling. Conclusion: Level of knowledge of dentists about the indications of incision and drainage, intra-canal medicament, root filing beyond the apical foramen and antibiotic prescription was not enough. These findings highlight the importance of refreshing courses for general dentists to improve their competency in the management of endodontic emergencies. PMID:26523142

  2. To require the Administrator of the Federal Emergency Management Agency to submit a report regarding certain plans regarding assistance to applicants and grantees during the response to an emergency or disaster.

    THOMAS, 113th Congress

    Rep. Hartzler, Vicky [R-MO-4

    2017-02-16

    02/17/2017 Referred to the Subcommittee on Economic Development, Public Buildings and Emergency Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. To require the Administrator of the Federal Emergency Management Agency to submit a report regarding certain plans regarding assistance to applicants and grantees during the response to an emergency or disaster.

    THOMAS, 113th Congress

    Rep. Hartzler, Vicky [R-MO-4

    2017-02-16

    02/28/2017 Subcommittee on Economic Development, Public Buildings and Emergency Management Discharged. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  4. Martin Marietta Energy Systems, Inc. comprehensive earthquake management plan: Emergency Operations Center training manual

    SciTech Connect

    Not Available

    1990-02-28

    The objective of this training is to: describe the responsibilities, resources, and goals of the Emergency Operations Center and be able to evaluate and interpret this information to best direct and allocate emergency, plant, and other resources to protect life and the Paducah Gaseous Diffusion Plant.

  5. Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Instructor's Lesson Plans.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this instructor's guide provides a standardized approach for providing training in emergency medical care for first responders to traffic accidents. The objective of the course is to provide training in all aspects of emergency medical…

  6. Crash Injury Management: Emergency Medical Services for Traffic Law Enforcement Officers. Student Study Guide.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    To assist in the continuing efforts to improve the safety of the motorist on the nation's highways and roads, this student guide provides a standardized approach for first responders to traffic accidents to learn emergency medical care. Training is provided in all aspects of emergency medical care required at the scene of a traffic accident.…

  7. Perceived Case Management Needs and Service Preferences of Frequent Emergency Department Users: Lessons Learned in a Large Urban Centre

    PubMed Central

    Kahan, Deborah; Poremski, Daniel; Wise-Harris, Deborah; Pauly, Daniel; Leszcz, Molyn; Wasylenki, Donald; Stergiopoulos, Vicky

    2016-01-01

    Objectives This study aimed to explore the service needs and preferences of frequent emergency department users with mental health and addictions concerns who participated in a brief intensive case management intervention. Methods We conducted semi-structured individual interviews with 20 frequent emergency department users with mental health and addictions challenges, 13 service providers involved in the delivery of a brief case management intervention, and a focus group with intervention case managers. Thematic analysis was used to explore perceived service user profiles, service needs and preferences of care. Results Service users experienced complex health and social needs and social isolation, while exhibiting resilience and the desire to contribute. They described multiple instances of stigmatization in interactions with healthcare professionals. Components of the brief intensive case management intervention perceived to be helpful included system navigation, advocacy, intermediation, and practical needs assistance. Frequent service users valued relational responsiveness, a non-judgmental stance, and a recovery orientation in case managers. Conclusion Interventions for frequent service users in mental health may be enhanced by focusing on the engagement of formal and informal social supports, practical needs assistance, system navigation, advocacy and intermediation, and attention to the recovery goals of service users. PMID:28002491

  8. Many emergency department visits could be managed at urgent care centers and retail clinics.

    PubMed

    Weinick, Robin M; Burns, Rachel M; Mehrotra, Ateev

    2010-09-01

    Americans seek a large amount of nonemergency care in emergency departments, where they often encounter long waits to be seen. Urgent care centers and retail clinics have emerged as alternatives to the emergency department for nonemergency care. We estimate that 13.7-27.1 percent of all emergency department visits could take place at one of these alternative sites, with a potential cost savings of approximately $4.4 billion annually. The primary conditions that could be treated at these sites include minor acute illnesses, strains, and fractures. There is some evidence that patients can safely direct themselves to these alternative sites. However, more research is needed to ensure that care of equivalent quality is provided at urgent care centers and retail clinics compared to emergency departments.

  9. 4,871 Emergency Airway Encounters by Air Medical Providers: A Report of the Air Transport Emergency Airway Management (NEAR VI: “A-TEAM”) Project

    PubMed Central

    Brown, Calvin A.; Cox, Kelly; Hurwitz, Shelley; Walls, Ron M.

    2014-01-01

    Introduction Pre-hospital airway management is a key component of resuscitation although the benefit of pre-hospital intubation has been widely debated. We report a large series of pre-hospital emergency airway encounters performed by air-transport providers in a large, multi-state system. Methods We retrospectively reviewed electronic intubation flight records from an 89 rotorcraft air medical system from January 01, 2007, through December 31, 2009. We report patient characteristics, intubation methods, success rates, and rescue techniques with descriptive statistics. We report proportions with 95% confidence intervals and binary comparisons using chi square test with p-values <0.05 considered significant. Results 4,871 patients had active airway management, including 2,186 (44.9%) medical and 2,685 (55.1%) trauma cases. There were 4,390 (90.1%) adult and 256 (5.3%) pediatric (age ≤ 14) intubations; 225 (4.6%) did not have an age recorded. 4,703 (96.6%) had at least one intubation attempt. Intubation was successful on first attempt in 3,710 (78.9%) and was ultimately successful in 4,313 (91.7%). Intubation success was higher for medical than trauma patients (93.4% versus 90.3%, p=0.0001 JT test). 168 encounters were managed primarily with an extraglottic device (EGD). Cricothyrotomy was performed 35 times (0.7%) and was successful in 33. Patients were successfully oxygenated and ventilated with an endotracheal tube, EGD, or surgical airway in 4809 (98.7%) encounters. There were no reported deaths from a failed airway. Conclusion Airway management, predominantly using rapid sequence intubation protocols, is successful within this high-volume, multi-state air-transport system. PMID:24672610

  10. Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

    PubMed Central

    Blake, Denise; Lyons, Antonia

    2016-01-01

    Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely “health and wellbeing”, “developing an emergency management plan”, and “stock, dose verification, and scripts” which led to an overarching concept of “service continuity in OST preparedness planning”. Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive. PMID:27834915

  11. The impact of geographic information systems on emergency management decision making at the U.S. Department of Homeland Security

    NASA Astrophysics Data System (ADS)

    King, Steven Gray

    Geographic information systems (GIS) reveal relationships and patterns from large quantities of diverse data in the form of maps and reports. The United States spends billions of dollars to use GIS to improve decisions made during responses to natural disasters and terrorist attacks, but precisely how GIS improves or impairs decision making is not known. This research examined how GIS affect decision making during natural disasters, and how GIS can be more effectively used to improve decision making for emergency management. Using a qualitative case study methodology, this research examined decision making at the U.S. Department of Homeland Security (DHS) during a large full-scale disaster exercise. This study indicates that GIS provided decision makers at DHS with an outstanding context for information that would otherwise be challenging to understand, especially through the integration of multiple data sources and dynamic three-dimensional interactive maps. Decision making was hampered by outdated information, a reliance on predictive models based on hypothetical data rather than actual event data, and a lack of understanding of the capabilities of GIS beyond cartography. Geospatial analysts, emergency managers, and other decision makers who use GIS should take specific steps to improve decision making based on GIS for disaster response and emergency management.

  12. Which skills boost service provider confidence when managing people presenting with psychiatric emergencies?

    PubMed

    Poremski, Daniel; Lim, Xin Ya; Kunjithapatham, Ganesh; Koh, Doris; Alexander, Mark; Cheng, Lee

    2016-12-01

    The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints.

  13. Test and calibration of rainfall thresholds for use in a regional civil defense emergency management system

    NASA Astrophysics Data System (ADS)

    Ponziani, F.; Pandolfo, C.; Stelluti, M.; Berni, N.; Brocca, L.

    2009-04-01

    With regard to the evaluation of hydrogeological risk in Italy, the Italian Civil Defence Emergency Management System has a national hydrometeorological alert office (called Chief Functional Center) and a network of 21 Regional Centers (Decentrate Functional Centers, CFD) whose main purpose is the monitoring and evaluation of critical hydraulic and hydrogeological events, mainly caused by heavy rainfall. The national alert procedure, in use at the CFD in Umbria , is based on a 3-level scale, and the main instrument for the choice of landslide hazard level is the rainfall thresholds, as heavy rainfall is the most important factor in the triggering of landslides. The current thresholds have been established by a wide rainfall dataset for a large area of Central Italy; up to now they have been seen to work well with regard to the hydraulic risk, but in order to cope with the hydrogeological risk we need more investigation. Therefore a statistical and comparative study between the rainfall thresholds and the landslide datasets occurring in past rainfall events was performed, in order to measure their performance in terms of false and missed alarms; the main goal of this goal was to try to tune the thresholds to the complex and varying geomorphologic conditions in Umbria. In fact subsequent compressive and extensional tectonic phases produced in this area chains, lakes, intermontane valleys and river grabens, with complex lithostratigraphy. Moreover, due to its importance in the triggering of landslides, a method to evaluate moisture content in soil was implemented. About 20 temporal windows (5-10days wide), apparent (in terms of events recorded with several landslides) in the historical landslide datasets available from 1991 to 2001 were analyzed, plus a severe hydrometeorological event which occurred in December 2008. IDW spatial estimate of cumulative rainfall, moisture content, and local rainfall threshold for every landslide site, using the data from the regional

  14. Keeping PEDIATRICS in pediatric disaster management: Before, during, and in the aftermath of complex emergencies.

    PubMed

    Kelly, Frances

    2010-12-01

    From 1900 there have been more than 9800 natural disasters affecting more than 67 million children worldwide. Because of unique physical, developmental, and psychosocial characteristics of children, caring for them during complex emergencies is different to caring for adults. However, planning for these unique physical, developmental, and psychosocial needs has not been well addressed when planning for complex emergencies. Therefore, the purpose of this article is to review those characteristics of children that place them at higher disaster risk, and discuss the preparations necessary to meet their needs before, during, and in the aftermath of complex emergencies.

  15. Sensitivity of emergent sociohydrologic dynamics to internal system properties and external sociopolitical factors: Implications for water management

    NASA Astrophysics Data System (ADS)

    Elshafei, Y.; Tonts, M.; Sivapalan, M.; Hipsey, M. R.

    2016-06-01

    It is increasingly acknowledged that effective management of water resources requires a holistic understanding of the coevolving dynamics inherent in the coupled human-hydrology system. One of the fundamental information gaps concerns the sensitivity of coupled system feedbacks to various endogenous system properties and exogenous societal contexts. This paper takes a previously calibrated sociohydrology model and applies an idealized implementation, in order to: (i) explore the sensitivity of emergent dynamics resulting from bidirectional feedbacks to assumptions regarding (a) internal system properties that control the internal dynamics of the coupled system and (b) the external sociopolitical context; and (ii) interpret the results within the context of water resource management decision making. The analysis investigates feedback behavior in three ways, (a) via a global sensitivity analysis on key parameters and assessment of relevant model outputs, (b) through a comparative analysis based on hypothetical placement of the catchment along various points on the international sociopolitical gradient, and (c) by assessing the effects of various direct management intervention scenarios. Results indicate the presence of optimum windows that might offer the greatest positive impact per unit of management effort. Results further advocate management tools that encourage an adaptive learning, community-based approach with respect to water management, which are found to enhance centralized policy measures. This paper demonstrates that it is possible to use a place-based sociohydrology model to make abstractions as to the dynamics of bidirectional feedback behavior, and provide insights as to the efficacy of water management tools under different circumstances.

  16. Quality Management in Higher Education: Towards a Better Understanding of an Emerging Field

    ERIC Educational Resources Information Center

    Pratasavitskaya, Halina; Stensaker, Bjorn

    2010-01-01

    The article analyses how quality management is understood in higher education research. By reviewing a number of academic contributions addressing quality management issues in "Quality in Higher Education" from 1995-2008, the article identifies central concepts associated with quality management, discusses whether there are commonalities to be…

  17. The Emerging Role of the Work-Family Manager. Report Number 987.

    ERIC Educational Resources Information Center

    Johnson, Arlene A.; Rose, Karol L.

    The definition and structure of the relatively new job of work-family manager and the qualifications and career opportunities of individuals holding the job were explored in a study. Information was gathered from focus group discussions of 32 work-family managers, 68 completed responses to a 1991 survey of a sample of 116 work-family managers, a…

  18. Asthma Self-Management: A Study in an Emergency Room of a Chest Hospital in Delhi, India

    PubMed Central

    Kotwani, Anita; Shendge, Sushil

    2012-01-01

    Objectives: Poorly controlled asthma imposes a considerable burden and is a serious public health problem in the developing world. A key challenge for healthcare professionals is to help patients to engage in self-management behaviours with optimal adherence to appropriate treatment. The aim of the present study was to investigate the pattern of self-management in asthmatic patients enrolled as out-patients in a tertiary care referral public chest hospital, in Delhi, India. Methods: The study population was adult asthma patients (n=200) visiting the emergency room (December 2008-December 2009) of a chest hospital for asthma exacerbation. The data was collected through a questionnaire regarding the self-management of asthma. Results: Enrolled patients (64.0% female) were registered as asthma out-patients in the study hospital for a mean of 5.4±4.4 years. Patients visiting the emergency room (ER) and having an unscheduled visit to doctor at least twice in the previous 12 months were 86.5% and 91.0%. Patients were classified according to the disease severity as having intermittent (17.0%) or persistent (83.0%) asthma. Not all patients had metered dose inhalers at home. Only 2.0% of patients were prescribed peak flow meters and were keeping a diary of their readings. With one exception, patients did not have written action plans for treatment provided by doctor or health facility. No statistical difference was found in the pattern of self-management of patients having persistent or intermittent asthma. Conclusions: Findings revealed poor self-management of asthma and poor communication from doctors regarding self-management to the patients. Suitable actions and interventions are needed by health professionals to implement patient self-management asthma programme for optimum asthma control. PMID:23532570

  19. Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.

    PubMed

    Vandenberg, Ann E; Stevens, Melissa; Echt, Katharina V; Hastings, S Nicole; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Belbis, Stephanie; Vaughan, Camille P

    2016-04-01

    The Enhancing Quality of Prescribing Practices for Older Veterans Discharged From the Emergency Department (EQUiPPED) program aimed to reduce potentially inappropriate medication prescribing to older adults at 5 VAMCs.

  20. Martin Marietta Energy Systems, Inc. comprehensive earthquake management plan: Plant Emergency Squad training manual

    SciTech Connect

    Not Available

    1990-01-01

    The training objectives are to: Describe the responsibilities of the Plant Emergency Squad during the damage assessment/abatement process and relate its importance to the protection and recovery of plant personnel following an earthquake.

  1. Martin Marietta Energy Systems, Inc. comprehensive earthquake management plan: Local Emergency Squads training manual

    SciTech Connect

    Not Available

    1990-01-01

    The training objectives are: Describe the Local Emergency Squad's goals and responsibilities during the damage assessment process and relate its importance to the protection and recovery of plant personnel following an earthquake.

  2. Ready for the Future: Assessing the Collaborative Capacity of State Emergency Management Agencies

    DTIC Science & Technology

    2013-03-01

    Domestic Violence, Drugs, Gangs, Sexual Assault], Public Safety & Victim Services; Regional Response, Recovery Colorado: Division of Emergency...Functional Needs Preparedness Planning, Business & Industry Preparedness Planning, Citizen Corps, CERT & Teen CERT, Disaster Public Assistance, Disaster

  3. Heavy precipitation and the responses within emergency management - a new approach for emergency planning and disaster prevention by utilizing fire brigade operation data

    NASA Astrophysics Data System (ADS)

    Kutschker, Thomas; Glade, Thomas

    2015-04-01

    An increase of intense rainfall events in the center regions of Europe is one of the assumed effects of climate change. Climate scenarios indicate also large seasonal and regional differences concerning the magnitude. Structural damages and financial loss resulting from heavy precipitation depend on natural parameters such as topography and vegetation cover of the specific area, but also on socio-economic parameters such as urbanized and industrialized areas, population density and the presence of critical infrastructure. In particular mudflows and floods cause damages such as flooded basements and streets, undercutting of roads or spilled sewage drains. The emergency management has to consider these effects appropriately. Commonly, this is the responsibilities is taken by the fire brigades and civil protection units. Within their daily routines, numerous data is collected, but commonly not utilized for scientific purposes. In particular fire brigade operation data can be used accordingly to describe the intensity of the aftermath when heavy precipitation strikes a certain area. One application is described in this study based on a example in Offenbach, Germany. The civil protection in Germany is based on a federal system with a bottom-up command-structure and responsibility to the local community. Therefore it is not easy to collect the overall incident data for a widespread affected area. To examine particular local effects of heavy precipitation events it is necessary to match the meteorological data provided by the German Meteorological Service (DWD) with the incident data of all effected fire brigades, which sometimes is impeded by the usual resolution of meteorological data. In this study, a method of comprehensive evaluation of meteorological data and the operation data from local fire brigades has been developed for the Rhine-Main-Area. This area is one of the largest metropolitan regions in Germany with a very high density in population as well as

  4. A Strategy of Dialogue for Communicating Hazard and Risk Information Between the Science and Emergency Management Sectors

    NASA Astrophysics Data System (ADS)

    Eisner, R. K.

    2015-12-01

    This presentation will describe a collaborative dialogue process between earth scientists and emergency management officials that focused on translation of science into policy, building long term trust based relationships between sectors and unified presentation of hazards, risks and consequence management to public officials and the general public. The author will describe the structure and process of the California Earthquake Prediction Evaluation Council (CEPEC) in assessing the credibility of long and short term earthquake predictions, assessment of risk, and the formulation of public communication strategies and preparatory actions by government agencies. For nearly 4 decades, earth scientists, politically appointed state officials and emergency managers have engaged in ongoing discussions of the policy implications of research on potential seismic risk. Some discussions were scheduled and occurred over months, and others were ad hoc and occurred in the minutes between potential precursory incidents and possible large events. The effectiveness of this process was dependent on building respect for ones counterparts expertise, bias and responsibilities, clear communication of data, uncertainty and knowledge of the physical models assumed, history and probabilities; and the physical and political consequences of possible events; and the costs and economic and social disruption of alternative preparedness actions. But, the dialogue included political and social scientists, representatives of the print and broadcast media, political and management officials from federal, state and local governments. The presentation will provide an assessment of the effectiveness of the collaborative dialogue process and lessons on sustaining a long term partnership among the participating federal, state and local officials.

  5. Rescue and Emergency Management of a Man-Made Disaster: Lesson Learnt from a Collapse Factory Building, Bangladesh

    PubMed Central

    Biswas, Animesh; Mashreky, Saidur Rahman; Humaira, Tasnuva; Dalal, Koustuv

    2015-01-01

    A tragic disaster occurred on April 24, 2013, in Bangladesh, when a nine storied building in a suburban area collapsed and killed 1115 people and injured many more. The study describes the process of rescue operation and emergency management services provided in the event. Data were collected using qualitative methods including in-depth interviews and a focus group discussion with the involved medical students, doctors, volunteers, and local people. Immediately after the disaster, rescue teams came to the place from Bangladesh Armed Forces, Bangladesh Navy, Bangladesh Air Force, and Dhaka Metropolitan and local Police and doctors, medical students, and nurses from nearby medical college hospitals and private hospitals and students from colleges and universities including local civil people. Doctors and medical students provided 24-hour services at the disaster place and in hospitals. Minor injured patients were treated at health camps and major injured patients were immediately carried to nearby hospital. Despite the limitations of a low resource setting, Bangladesh faced a tremendous challenge to manage the man-made disaster and experienced enormous support from different sectors of society to manage the disaster carefully and saved thousands of lives. This effort could help to develop a standard emergency management system applicable to Bangladesh and other counties with similar settings. PMID:25954767

  6. Rescue and emergency management of a man-made disaster: lesson learnt from a collapse factory building, Bangladesh.

    PubMed

    Biswas, Animesh; Rahman, Aminur; Mashreky, Saidur Rahman; Humaira, Tasnuva; Dalal, Koustuv

    2015-01-01

    A tragic disaster occurred on April 24, 2013, in Bangladesh, when a nine storied building in a suburban area collapsed and killed 1115 people and injured many more. The study describes the process of rescue operation and emergency management services provided in the event. Data were collected using qualitative methods including in-depth interviews and a focus group discussion with the involved medical students, doctors, volunteers, and local people. Immediately after the disaster, rescue teams came to the place from Bangladesh Armed Forces, Bangladesh Navy, Bangladesh Air Force, and Dhaka Metropolitan and local Police and doctors, medical students, and nurses from nearby medical college hospitals and private hospitals and students from colleges and universities including local civil people. Doctors and medical students provided 24-hour services at the disaster place and in hospitals. Minor injured patients were treated at health camps and major injured patients were immediately carried to nearby hospital. Despite the limitations of a low resource setting, Bangladesh faced a tremendous challenge to manage the man-made disaster and experienced enormous support from different sectors of society to manage the disaster carefully and saved thousands of lives. This effort could help to develop a standard emergency management system applicable to Bangladesh and other counties with similar settings.

  7. Federal Emergency Management Information System (FEMIS) Bill of Materials (BOM) for FEMIS version 1.4.5

    SciTech Connect

    Fangman, P.M.; Gerhardstein, L.H.; Homer, B.J.

    1998-06-05

    This document describes the hardware and software required for the Federal Emergency Management Information System version 1.4.5 (FEMIS v1.4.5). The FEMIS system is designed for a single Chemical Stockpile Emergency Preparedness Program (CSEPP) site that has multiple Emergency Operations Centers (EOCs). Each EOC has personal computers (PCs) that emergency planners and operations personnel use to do their jobs. These PCs are connected via a local area network (LAN) to servers that provide EOC-wide services. Each EOC is interconnected to other EOCs via a Wide Area Network (WAN). A UNIX server provides a platform to support the Oracle relational database management system (RDBMS) distributed by Pacific Northwest National Laboratory (PNNL), ARC/INFO geographic information system (GIS) capabilities (optional), basic file management services, the evacuation model (ESIM), the data exchange interface (DEI), and the notification service. FEMIS is a client/server system where much of the application software is located in the client PC. This client software includes the FEMIS application, government furnished dispersion and evacuation models, and Commercial-Off-The-Shelf (COTS) software applications, including the ArcView GIS and Microsoft Project (electronic planning). Several configurations are possible at a CSEPP site. In this document, a site is understood to include several installations of FEMIS, including the Depot, surrounding Immediate Response Zone (IRZ) and Protective Action Zone (PAZ) counties, and one or more state EOCs. In general, the main differences between possible configurations are the numbers of PC workstations at an installation, the location of the UNIX server(s), and the WAN links between installations.

  8. Modeling and managing urban water demand through smart meters: Benefits and challenges from current research and emerging trends

    NASA Astrophysics Data System (ADS)

    Cominola, A.; Giuliani, M.; Castelletti, A.; Piga, D.; Rizzoli, A. E.

    2015-12-01

    Urban population growth, climate and land use change are expected to boost residential water demand in urban contexts in the next decades. In such a context, developing suitable demand-side management strategies is essential to meet future water demands, pursue water savings, and reduce the costs for water utilities. Yet, the effectiveness of water demand management strategies (WDMS) relies on our understanding of water consumers' behavior, their consumption habits, and the water use drivers. While low spatial and temporal resolution water consumption data, as traditionally gathered for billing purposes, hardly support this understanding, the advent of high-resolution, smart metering technologies allowed for quasi real-time monitoring water consumption at the single household level. This, in turn, is advancing our ability in characterizing consumers' behavior, modeling, and designing user-oriented residential water demand management strategies. Several water smart metering programs have been rolled-out in the last two decades worldwide, addressing one or more of the following water demand management phases: (i) data gathering, (ii) water end-uses characterization, (iii) user modeling, (iv) design and implementation of personalized WDMS. Moreover, the number of research studies in this domain is quickly increasing and big economic investments are currently being devoted worldwide to smart metering programs. With this work, we contribute the first comprehensive review of more than 100 experiences in the field of residential water demand modeling and management, and we propose a general framework for their classification. We revise consolidated practices, identify emerging trends and highlight the challenges and opportunities for future developments given by the use of smart meters advancing residential water demand management. Our analysis of the status quo of smart urban water demand management research and market constitutes a structured collection of information

  9. Modelling the benefits of flood emergency management measures in reducing damages: a case study on Sondrio, Italy

    NASA Astrophysics Data System (ADS)

    Molinari, D.; Ballio, F.; Menoni, S.

    2013-08-01

    The European "Floods Directive" 2007/60/EU has produced an important shift from a traditional approach to flood risk management centred only on hazard analysis and forecast to a newer one which encompasses other aspects relevant to decision-making and which reflect recent research advances in both hydraulic engineering and social studies on disaster risk. This paper accordingly proposes a way of modelling the benefits of flood emergency management interventions calculating the possible damages by taking into account exposure, vulnerability, and expected damage reduction. The results of this model can be used to inform decisions and choices for the implementation of flood emergency management measures. A central role is played by expected damages, which are the direct and indirect consequence of the occurrence of floods in exposed and vulnerable urban systems. How damages should be defined and measured is a key question that this paper tries to address. The Floods Directive suggests that mitigation measures taken to reduce flood impact need to be evaluated also by means of a cost-benefit analysis. The paper presents a methodology for assessing the effectiveness of early warning for flash floods, considering its potential impact in reducing direct physical damage, and it assesses the general benefit in regard to other types of damages and losses compared with the emergency management costs. The methodology is applied to the case study area of the city of Sondrio in the northern Alpine region of Italy. A critical discussion follows the application. Its purpose is to highlight the strengths and weaknesses of available models for quantifying direct physical damage and of the general model proposed, given the current state of the art in damage and loss assessment.

  10. Knowledge management: evaluating the organizational requirements and culture for an emerging technology.

    PubMed

    Parton, Chris; Wang, Samuel J; Middleton, Blackford

    2002-01-01

    The purpose of this paper is to explore the application of knowledge management concepts to an information systems (IS) knowledge base, as opposed to a clinical one. The field of Medical Informatics is committed to helping others manage medical information and knowledge through the application of information technology. At Partners HealthCare, a wide variety of clinical information management systems have been built and implemented in complex environments, creating an extensive applied informatics knowledge base. How should healthcare IS departments manage this intellectual capital? That's the question that Partners HealthCare is asking its senior and middle IS managers. This paper reports on an internal survey addressing Knowledge Management (KM) requirements, the potential application of this technology in our organization, and discusses where we are today and where to go from here.

  11. Satellite and Aerial Remote Sensing in Support of Disaster Response Operations Conducted by the Texas Division of Emergency Management

    NASA Astrophysics Data System (ADS)

    Wells, G. L.; Tapley, B. D.; Bettadpur, S. V.; Howard, T.; Porter, B.; Smith, S.; Teng, L.; Tapley, C.

    2014-12-01

    The effective use of remote sensing products as guidance to emergency managers and first responders during field operations requires close coordination and communication with state-level decision makers, incident commanders and the leaders of individual strike teams. Information must be tailored to meet the needs of different emergency support functions and must contain current (ideally near real-time) data delivered in standard formats in time to influence decisions made under rapidly changing conditions. Since 2003, a representative of the University of Texas Center for Space Research (CSR) has served as a member of the Governor's Emergency Management Council and has directed the flow of information from remote sensing observations and high performance computing modeling and simulations to the Texas Division of Emergency Management in the State Operations Center. The CSR team has supported response and recovery missions resulting from hurricanes, tornadoes, flash floods, wildfires, oil spills and other natural and man-made disasters in Texas and surrounding states. Through web mapping services, state emergency managers and field teams have received threat model forecasts, real-time vehicle tracking displays and imagery to support search-and-clear operations before hurricane landfall, search-and-rescue missions following floods, tactical wildfire suppression, pollution monitoring and hazardous materials detection. Data servers provide near real-time satellite imagery collected by CSR's direct broadcast receiving system and post data products delivered during activations of the United Nations International Charter on Space and Major Disasters. In the aftermath of large-scale events, CSR is charged with tasking state aviation resources, including the Air National Guard and Texas Civil Air Patrol, to acquire geolocated aerial photography of the affected region for wide area damage assessment. A data archive for each disaster is available online for years following

  12. Surgical Management of Liver Hydatid Cyst Related Non-traumatic Emergencies: Single Center Experience

    PubMed Central

    DINC, Tolga; KAYILIOGLU, Selami Ilgaz; AKTURK, Okan Murat; COSKUN, Faruk

    2016-01-01

    Background: Vast majority of complaints and physical examination findings of hydatid disease are common in emergency room patients. Different emergency presentations of hydatid cyst disease and their treatment are evaluated. We studied preoperative laboratory findings of these patients to identify any parameters to predict hydatid cyst-biliary system communication. Methods: We reviewed the files of patients who underwent emergency surgery due to liver hydatid cysts and related conditions between March 2010 and March 2014 in Ankara Numune Research and Training Hospital, Turkey, retrospectively. Patients were grouped, regarding to the presence of biliary system involvement. Results: Twelve patients (9 males, 3 females) were included. We identified two groups. Biliary system involved group (n=9) had significantly higher pre-operative gamma glutamine transferase and alkaline phosphatase levels (P=0.036). No significant difference was noted regarding other pre-operative laboratory findings. Mortality rate was 17%. Conclusion: Medical literature lacks sufficient information about hydatid disease related non-traumatic emergency surgeries. Preoperative elevated gamma glutamyl transferase and alkaline phosphatase levels may be questioned as a warning about cyst-biliary communication in hydatid cyst patients with abdominal pain in the emergency room. Future studies with larger sample sizes are needed. In addition, prolongation of the time before diagnosis in these patients may result in life threatening complications. PMID:28127370

  13. Emergencies in Orthodontics. Part 2: Management of Removable Appliances, Functional Appliances and other Adjuncts to Orthodontic Treatment.

    PubMed

    Dowsing, Paul; Murray, Alison; Sandler, Jonathan

    2015-04-01

    In the second of two papers, management of orthodontic emergencies involving appliances other than Fixed appliances will be detailed. Problems relating to removable appliances, as well as other orthodontic adjuncts, will be discussed. Unfortunately, orthodontic appliance breakage does occur, despite the clinicians giving clear and concise instructions to the patients and their parents at fitting. If general dental practitioners have a practical knowledge of how to diagnose problems and to provide appropriate advice or timely 'emergency' treatment, this will significantly reduce the inconvenience for all parties concerned. It should also ensure that treatment progresses in the most efficient and comfortable manner for their patients. In specific situations the early, accurate identification of the problem and instigation of its appropriate management can avoid more serious consequences. Clinical Relevance: Appropriate handling of an orthodontic 'emergency' by the dentist can, on many occasions, provide immediate relief to the patient. This will, in turn, allow treatment to continue in the right direction, thus allowing more efficient and effective use of valuable resources.

  14. An integrated web system to support veterinary activities in Italy for the management of information in epidemic emergencies.

    PubMed

    Iannetti, S; Savini, L; Palma, D; Calistri, P; Natale, F; Di Lorenzo, A; Cerella, A; Giovannini, A

    2014-03-01

    The management of public health emergencies is improved by quick, exhaustive and standardized flow of data on disease outbreaks, by using specific tools for data collection, registration and analysis. In this context, the National Information System for the Notification of Outbreaks of Animal Diseases (SIMAN) has been developed in Italy to collect and share data on the notifications of outbreaks of animal diseases. SIMAN is connected through web services to the national database of animals and holdings (BDN) and has been integrated with tools for the management of epidemic emergencies. The website has been updated with a section dedicated to the contingency planning in case of epidemic emergency. EpiTrace is one such useful tool also integrated in the BDN and based on the Social Network Analysis (SNA) and on network epidemiological models. This tool gives the possibility of assessing the risk associated to holdings and animals on the basis of their trade, in order to support the veterinary services in tracing back and forward the animals in case of outbreaks of infectious diseases.

  15. Corneal Emergencies.

    PubMed

    Belknap, Ellen B

    2015-09-01

    Corneal emergencies can be due to a number of different causes and may be vision threatening if left untreated. In an attempt to stabilize the cornea, it is of benefit to place an Elizabethan collar on the patient to prevent further corneal damage. This article discusses the diagnosis, prognosis, and management of corneal emergencies in dogs and cats.

  16. Hypertensive Emergency in Aortic Dissection and Thoracic Aortic Aneurysm—A Review of Management

    PubMed Central

    Gupta, Prateek K.; Gupta, Himani; Khoynezhad, Ali

    2009-01-01

    Over the last few decades, treatment for aortic dissection and thoracic aortic aneurysms has evolved significantly with improvement in outcomes. Treatment paradigms include medical, endovascular and surgical options. As aortic dissection presents as a hypertensive emergency, diligent control of BP is of utmost importance in order to reduce the progression of dissection with possible aortic branch malperfusion. Treatment should begin on arrival to the emergency department and continues in the intensive care unit, endovascular suite or the operating room. Novel antihypertensive medications with improved pharmacological profile and improved surgical techniques, have improved the prognosis of patients with aortic aneurysm and/or aortic dissection. Nevertheless, morbidity and mortality remain high and hypertensive emergency poses a significant challenge in aortic dissection and thoracic aortic aneurysms. PMID:27713224

  17. Web-based emergency response exercise management systems and methods thereof

    DOEpatents

    Goforth, John W.; Mercer, Michael B.; Heath, Zach; Yang, Lynn I.

    2014-09-09

    According to one embodiment, a method for simulating portions of an emergency response exercise includes generating situational awareness outputs associated with a simulated emergency and sending the situational awareness outputs to a plurality of output devices. Also, the method includes outputting to a user device a plurality of decisions associated with the situational awareness outputs at a decision point, receiving a selection of one of the decisions from the user device, generating new situational awareness outputs based on the selected decision, and repeating the sending, outputting and receiving steps based on the new situational awareness outputs. Other methods, systems, and computer program products are included according to other embodiments of the invention.

  18. Learning Management: Emerging Directions for Learning To Learn in the Workplace. Information Series No. 320.

    ERIC Educational Resources Information Center

    Cheren, Mark E., Ed.; And Others

    This collection, which should be of particular interest to adult education teachers, trainers, and researchers, suggests new models for attaining learning management skills to facilitate on-the-job learning. In the introduction, Mark E. Cheren discusses the need for new models and terms and examines the concepts of learning management and…

  19. Mixed Methods in Emerging Academic Subdisciplines: The Case of Sport Management

    ERIC Educational Resources Information Center

    van der Roest, Jan-Willem; Spaaij, Ramón; van Bottenburg, Maarten

    2015-01-01

    This article examines the prevalence and characteristics of mixed methods research in the relatively new subdiscipline of sport management. A mixed methods study is undertaken to evaluate the epistemological/philosophical, methodological, and technical levels of mixed methods design in sport management research. The results indicate that mixed…

  20. LMS Transitioning to "Moodle": A Surprising Case of Successful, Emergent Change Management

    ERIC Educational Resources Information Center

    Lawler, Alan

    2011-01-01

    During 2009-10 the University of Ballarat implemented the open-source learning management system (LMS) "Moodle" alongside its existing legacy LMS, "Blackboard". While previous IT implementations have been troublesome at the university, notably the student information and finance management systems in 2008-09, the…