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Sample records for all-hazards emergency management

  1. 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)...

  2. 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…

  3. Preparedness and Emergency Response Research Centers: Using a Public Health Systems Approach to Improve All-Hazards Preparedness and Response

    PubMed Central

    Leinhos, Mary; 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. PMID:25355970

  4. 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).

  5. 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.

  6. Managing emergency department overcrowding.

    PubMed

    Olshaker, Jonathan S

    2009-11-01

    Emergency department (ED) crowding and ambulance diversion has been an increasingly significant national problem for more than a decade. More than 90% of hospital ED directors reported overcrowding as a problem resulting in patients in hallways, full occupancy of ED beds, and long waits, occurring several times a week. Overcrowding has many other potential detrimental effects including diversion of ambulances, frustration for patients and ED personnel, lesser patient satisfaction, and most importantly, greater risk for poor outcomes. This article gives a basic blueprint for successfully making hospital-wide changes using principles of operational management. It briefly covers the causes, significance, and dangers of overcrowding, and then focuses primarily on specific solutions. PMID:19932394

  7. [Crisis management in emergency medicine].

    PubMed

    Mizobata, Yasumitsu

    2016-02-01

    There is no "complete safety" in the medical treatment. Unavoidable events or human errors may frighten the patients' safety. Because of its characteristics, emergency medicine is one of the medical fields where treating the patients under the vast safety is difficult. It is inevitable to understand the background of human errors in the emergency medicine under the "SHEL" model. The implementation of the safety measures, such as minimum encounter, minimum probability, multiple detections, and minimum damage is helpful to prevent unfortunate outcomes. Since the emergency medicine treats the severely injured or critical ill patients, its daily works are the picture of the crisis management, and the most suitable environment to train the crisis management competence. The person in charge of crisis management of the institution should put the emergency department to practical use of medical staffs' crisis management training. PMID:26915239

  8. Value-Based Emergency Management.

    PubMed

    Corrigan, Zachary; Winslow, Walter; Miramonti, Charlie; Stephens, Tim

    2016-02-01

    This article touches on the complex and decentralized network that is the US health care system and how important it is to include emergency management in this network. By aligning the overarching incentives of opposing health care organizations, emergency management can become resilient to up-and-coming changes in reimbursement, staffing, and network ownership. Coalitions must grasp the opportunity created by changes in value-based purchasing and impending Centers for Medicare and Medicaid Services emergency management rules to engage payers, physicians, and executives. Hope and faith in doing good is no longer enough for preparedness and health care coalitions; understanding how physicians are employed and health care is delivered and paid for is now necessary. Incentivizing preparedness through value-based compensation systems will become the new standard for emergency management. PMID:26878308

  9. Management of hypertension emergencies.

    PubMed

    Elliott, William J

    2003-12-01

    Although they have become less common, hypertensive emergencies occur with an incidence of approximately 1 to 2/100,000 people per year. Our knowledge about this problem, its pathophysiology, risk factors, and appropriate treatment options has expanded during the past decade. A hypertensive emergency can be declared when an elevated blood pressure is associated with acute target-organ damage. Rapid evaluation and treatment (typically with an intravenously administered agent) should be instituted, usually in an intensive care unit setting, and the patient should be observed carefully during acute blood-pressure lowering. When properly treated, the prognosis for these patients is not nearly as dismal as it was more than 60 years ago, and the initial level of function of target organs (brain, heart, kidneys) is more indicative of an emergency than the actual level of blood pressure. Therapeutic options include the time-tested sodium nitroprusside (which has toxic metabolic products and is contraindicated in pregnancy, tobacco amblyopia, and Leber's optic atrophy); fenoldopam mesylate; and nicardipine. When properly treated, "malignant hypertension" need be considered malignant no longer. PMID:14594569

  10. 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. PMID:24828913

  11. 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…

  12. Hypertensive emergencies: diagnosis and management.

    PubMed

    Phillips, Robert A; Greenblatt, Jonathan; Krakoff, Lawrence R

    2002-01-01

    The treatment of hypertension is preventive medicine. This principle applies in the emergency room as well as the clinic. However, there are crucial contrasts between these two care settings related to specific goals of management for real emergencies and nonemergency conditions. In the emergency room, rapid triage is necessary to separate those who can safely be sent home for future clinic assessment from those who require immediate interventions including short stays in 24-hour observation units or hospitalization for more serious problems. This review focuses on decisions related to hypertension management in the emergency room and over brief periods of observation and treatment. Strategy is supported by evidence-based considerations whenever possible. Where outcome studies are not available, we rely on the rationale derived from relevant clinical research. PMID:12138413

  13. Emergency management: An annotated bibliography

    SciTech Connect

    Not Available

    1988-03-01

    Training Resources and Data Exchange (TRADE) is an organization designed to increase communication and exchange of ideas, information, and resources among US Department of Energy contractors and DOE personnel. Oak Ridge Associated Universities, located in Oak Ridge, Tennessee, manages TRADE for the DOE. The Emergency Preparedness Special Interest Group (EP SIG) is a group formed within TRADE for emergency preparedness coordinators and trainers to share information about emergency preparedness training and other EP resources. This bibliography was prepared for the EP SIG as a resource for EP training and planning activities.

  14. Interdisciplinary approach to all-hazards preparedness: are you ready? How do we know?

    PubMed

    Levy, Leonard A; Rokusek, Cecilia F; Bragg, Sally M; Howell, James T

    2009-03-01

    The Center for Bioterrorism and All-Hazards Preparedness (CBAP) at Nova Southeastern University College of Osteopathic Medicine is part of the National Education Strategy Team supported by the Assistant Secretary for Preparedness and Response. It developed and implemented an extensive interdisciplinary community-focused, all-hazards preparedness program as a template for use nationally. CBAP provides discipline-customized education and training experiences in emergency and disaster preparedness using multiple formats. In addition to addressing competencies that all responders must have, the CBAP National Education Strategy Team has special emphasis areas in personal planning, vulnerable and hard-to-reach populations, the employment of "cells" in the community, evidence-based evaluation including a unique casualty objective-structured clinical examination, use of student and faculty and Medical Reserve Corps volunteers, all-hazards preparedness aimed at school children, and programs addressing campus violence. CBAP emphasizes that all-hazards preparedness is an academic discipline that necessitates those trained have periodic updates to maintain their currency. PMID:19202400

  15. [In-hospital emergency management].

    PubMed

    Jantzen, Tanja; Fischer, Matthias; Müller, Michael P; Seewald, Stephan; Wnent, Jan; Gräsner, Jan-Thorsten

    2013-06-01

    5-10% of in-hospital patients are affected by adverse events, 10% of these requiring CPR. Standardized in-hospital emergency management may improve results, including reduction of mortality, hospital stay and cost. Early warning scores and clinical care outreach teams may help to identify patients at risk and should be combined with standard operation procedure and consented alarm criteria. These teams of doctors and nurses should be called for all in hospital emergencies, providing high-end care and initiate ICU measures at bedside. In combination with standard means of documentation assessment and evaluation--including entry in specific registers--the quality of in-hospital emergency management and patient safety could be improved. PMID:23828085

  16. 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. PMID:25350357

  17. Pediatric Ingestions: Emergency Department Management.

    PubMed

    Tarango Md, Stacy M; Liu Md, Deborah R

    2016-04-01

    Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs. Evidence regarding the evaluation and management of common pediatric ingestions is comprised largely of case reports and retrospective studies. This issue provides a review of these studies as well as consensus guidelines addressing the initial resuscitation, diagnosis, and treatment of common pediatric ingestions. Also discussed are current recommendations for decontamination, administration of antidotes for specific toxins, and management of ingested foreign bodies. PMID:27104813

  18. Integrated Safety, Environmental and Emergency Management System (ISEEMS)

    SciTech Connect

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-05-01

    The Risk Management and NEPA (National Environmental Policy Act) Department of Sandia National Laboratories/New Mexico (SNL/NM) recognized the need for hazard and environmental data analysis and management to support the line managers` need to know, understand, manage and document the hazards in their facilities and activities. The Integrated Safety, Environmental, and Emergency Management System (ISEEMS) was developed in response to this need. SNL needed a process that would quickly and easily determine if a facility or project activity contained only standard industrial hazards and therefore require minimal safety documentation, or if non-standard industrial hazards existed which would require more extensive analysis and documentation. Many facilities and project activities at SNL would benefit from the quick screening process used in ISEEMS. In addition, a process was needed that would expedite the NEPA process. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables SNL line organizations to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. All hazard-related information contained within ISEEMS is location based and can be displayed using on-line maps and building floor plans. This visual representation provides for quick assimilation and analysis.

  19. 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.

  20. 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

  1. 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. PMID:26451942

  2. Epilepsy emergencies: diagnosis and management.

    PubMed

    Foreman, Brandon; Hirsch, Lawrence J

    2012-02-01

    Seizures and status epilepticus are epilepsy emergencies with high morbidity and mortality. Early treatment is crucial, and the identification of an underlying etiology informs both continued treatment and prognosis. Many patients have underdiagnosed nonconvulsive seizures or nonconvulsive status epilepticus, particularly the comatose or critically ill. Timely EEG can be useful for diagnosis, management, optimizing treatment response, and determining prognosis in these patients. Refractory conditions can be quite complicated with limited evidence-based guidance, but treatment should not be restricted by nihilism even in the most prolonged cases, especially if there is not widespread irreversible brain injury. PMID:22284053

  3. Earth sciences and emergency management

    USGS Publications Warehouse

    Andrews, R.

    1990-01-01

    As understanding of California's earthquake risk had increased over the past decade, there has been a concurrent expansion of interactions between emergency management professionals and earth scientists. The effort have resulted not from a formal plan-though the U.S National Earthquake Hazards Reduction Program has provided much of the support for scientific advances since 1977-but from interactions focused on specific projects. three examples stand out, perhaps suggesting how mutually beneficial exchanges can simultaneously enhance science and public safety. 

  4. 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

  5. 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.

  6. The management of overseas emergencies.

    PubMed

    Thomas, Michael John Glyn

    2007-03-01

    Grave shortages of blood occur in over 80% of the countries in the world. These result from cultural taboos against donation, inadequate funding of the local transfusion service, high incidence of transfusion transmissible diseases, and rarity of a particular blood group, such as Rhesus negative in Asia, or any combination of these factors. Someone visiting such a country, requiring a transfusion, may, by receiving local blood, deprive the local community of a scarce resource. To resolve this problem the Blood Care Foundation has developed a fast reliable service to provide blood to travellers in emergency from countries where supplies are more abundant. Standard operating procedures (SOPs) to cover all aspects of sourcing blood and transfusion equipment, quality control and the requesting and transporting of blood to the patient within the shortest possible time have been produced. Five sourcing blood banks (BBs), 3 satellite BBs and over 200 transfusion support points have been established. Alarm centre medical and administrative staff and anaesthetists, who act as blood couriers have been trained. The methods of requesting blood in an emergency have been integrated with major medical assistance companies. By co-operating with a major refrigeration manufacturer, a transport box has been designed and tested, which can maintain a temperature of 2-8 degrees C for over 120h. In addition a rabies service has recently been introduced where supplies of rabies immunoglobulin and/or vaccine are taken by trained couriers to the person who has been bitten. As well as preserving the local blood supply, local health services are helped in 2 ways. Blood, transfusion fluids and equipment, when they have 20% of their shelf life remaining, are donated to local hospitals. Secondly, when the Quality Assurance Manager visits locations, he helps train the local transfusion staff, thereby helping them to improve their own service. PMID:17298918

  7. 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…

  8. Managing rural emergency department overcrowding.

    PubMed

    Van Vonderen, Mary L

    2008-01-01

    Emergency department visits reached more than 115 million in 2005, a 30% increase over the past decade. Although much has been written regarding these numbers, little attention has been focused on the impact of overcrowding and volume increases on rural emergency departments. Rural emergency departments face challenges unlike their urban counterparts that make implementation of current overcrowding strategies difficult or impossible. This article addresses these challenges and suggests strategies specific to the needs of rural emergency departments. PMID:18820558

  9. Emergency Management Guidelines for Telepsychiatry

    PubMed Central

    Hilty, Donald M.; Yellowlees, Peter

    2007-01-01

    Objective Telepsychiatry, in the form of live-interactive videoconferencing, is an emerging application for emergency psychiatric assessment and treatment, can improve the quality and quantity of mental health services, particularly for rural, remote and isolated populations. Despite the potential of emergency telepsychiatry, the literature has been fairly limited in this area. Method Drawing on the combined clinical and administrative experiences of its authors this article reviews the common administrative, legal/ethical and clinical issues that arise in emergency telepsychiatry. Results An initial set of guidelines for emergency telepsychiatry is presented to generate further discussion to assist those who are considering establishing general telepsychiatry and/or emergency telepsychiatry services. Conclusion The practices and techniques of emergency telepsychiatry are relatively new and require further examination, modification and refinement so that they may be fully utilized within comprehensive mental health service systems. PMID:17484936

  10. Managing hospital emergency power testing programs.

    PubMed

    Stymiest, D L

    1997-04-01

    All hospitals must have an emergency power testing program that includes generator load testing and emergency power supply system maintenance. This document examines a management program that uses lessons learned from an emergency power testing program to improve the hospital's facilities and training. PMID:10166993

  11. Educating Emergency Managers About Weather -Related Hazards

    NASA Astrophysics Data System (ADS)

    Spangler, T. C.; Johnson, V.

    2006-12-01

    The most common crises that emergency managers face are those related to hazardous weather - snowstorms, floods, hurricanes, heat waves, tornadoes, etc. However, man-made disasters, such as accidental releases of hazardous substances or terrorist acts, also often have a weather component. For example, after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, emergency managers were concerned that thunderstorms in the area might cause the building to collapse, putting rescuers in further danger. Training emergency managers to recognize the importance of weather in disaster planning and response has been a small but important focus of the COMET Program's educational development effort. Topics addressed in COMET training modules that are pertinent to emergency management include fire weather, hurricanes, flood events, and air contaminant dispersion. Additionally, the module entitled Anticipating Hazardous Weather and Community Risk provides an overview of basic meteorological processes, describes a broad range of weather phenomenon, and then addresses what forecast products are available to emergency managers to assess a threat to their community. In many of the modules, learners are presented with scenarios that give them the opportunity to practice decision-making in hazardous weather situations. We will demonstrate some of those scenarios and discuss how training can be used to model good emergency management skills. We will discuss ways to communicate with the emergency management community and provide examples of how distance learning can be used to educate and train emergency managers.

  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. PMID:25193454

  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. Going ... going ... gone? Federal Emergency Management Agency.

    PubMed

    Gresham, R

    1994-01-01

    Bashing the Federal Emergency Management Agency (FEMA) has become routine among EMS providers. The time has come for the agency's day of reckoning. Here's a look at the Congressional bills designed to build a better FEMA. PMID:10131244

  15. 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. PMID:27108920

  16. Comprehensive management of hypertensive emergencies and urgencies.

    PubMed

    Mansoor, George A; Frishman, William H

    2002-01-01

    Despite advances in chronic hypertension management, hypertensive emergencies and urgencies remain as serious complications. Much of this relates to poor compliance with effective antihypertensive management. Hypertensive emergencies and urgencies can also be seen as the initial manifestations of hypertension in pregnancy and in the perioperative period. Multiple classes of intravenous antihypertensive drugs are available to treat hypertensive emergencies, and specific agents may have an advantage in a given clinical situation. Orally active agents are used to treat hypertensive urgencies, and include clonidine, angiotensin-converting enzyme inhibitors, and labetalol. Most patients respond to drug therapy, but problems may arise related to a rapid normalization of blood pressure. PMID:12441013

  17. Aggressive Management of Surgical Emergencies

    PubMed Central

    Bengmark, Stig

    2006-01-01

    Increasing evidence suggests that two factors significantly influence outcome in a surgical emergency – premorbid health and the degree of inflammation during the first 24 h following trauma. Repeat observations suggest that the depth of post-trauma immunoparalysis reflects the height of early inflammatory response. Administration to surgical emergencies, as was routine in the past, of larger amounts of fluid and electrolytes, fat, sugar and nutrients seems counterproductive as it increases immune dysfunction, impairs resistance to disease and, in fact, increases morbidity. Instead, strong efforts should be made to limit the obvious superinflammation, which occurs during the first 24 h after trauma and, thereby, reduce the subsequent immuno-paralysis. paralysis. Several approaches show efficacy in limiting early superinflammation such as strict control of blood glucose, avoida nce of stored blood when possible, supply of antioxidants, live lactic acid bacteria and plant fibres. This review focuses mainly on use of live lactic acid bacteria and plant fibres, often called synbiotics. Encouraging experience is reported from clinical trials in liver transplantation, severe pancreatitis and extensive trauma. Immediate control of inflammation by enteral nutrition and supply of antioxidants, lactic acid bacteria and fibres is facilitated by feeding tubes, introduced as early as possible on arrival at the hospital. PMID:17132308

  18. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  19. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  20. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  1. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  2. 44 CFR 351.20 - The Federal Emergency Management Agency.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... emergency plans and preparedness in accordance with FEMA procedures in 44 CFR part 350. (h) Develop... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false The Federal Emergency Management Agency. 351.20 Section 351.20 Emergency Management and Assistance FEDERAL EMERGENCY...

  3. Management of cardiac emergencies in small animals.

    PubMed

    DeFrancesco, Teresa C

    2013-07-01

    Cardiac emergencies are life-threatening conditions that must be diagnosed quickly to avoid delays in therapy. A timely and accurate diagnosis leads to early relief of symptoms and improved survival. This article provides both a comprehensive review and updated management recommendations for common cardiac emergencies in dogs and cats. Specifically, the article confers updates for the efficient clinical recognition of decompensated cardiac patients, including focused echocardiography, cardiac biomarkers, and electrocardiogram interpretation. This article also reviews the latest recommendations for the treatment of heart failure (including the use of pimobendan) and the management of arrhythmias, pericardial effusion, and aortic thromboembolism. PMID:23747262

  4. Strategies for managing a busy emergency department.

    PubMed

    Campbell, Samuel G; Sinclair, Douglas E

    2004-07-01

    In a time of increased patient loads and emergency department (ED) exit block, the need for strategies to manage patient flow in the ED has become increasingly important. In March 2002 we contacted all 1282 members of the Canadian Association of Emergency Physicians and asked them to delineate strategies for enhancing ED patient flow and ED productivity without increasing stress levels, reducing care standards or compromising patient safety. Thirty physicians responded. Their suggested flow management strategies, which ranged from clinical decision-making to communication to choreography of time, space and personnel, are summarized here. PMID:17382005

  5. 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.

  6. Risk management of international trade: emergency preparedness.

    PubMed

    Torres, A; David, M J; Bowman, Q P

    2002-12-01

    Emergency preparedness and management are among the most important and critical issues facing animal health in the world today. The goals of a country for an animal health emergency management (AHEM) system should include the following: --being prepared to detect and manage an outbreak of a foreign animal disease --preventing the introduction of foreign and emerging animal pathogens --having an appropriate response system for control and eradication of the disease --having a system for recovery from animal health emergencies, including natural disasters. An AHEM system can no longer be limited to a single organisation within a country. In the event of a serious threat to the animal agriculture of a country, broader and more comprehensive participation is required. If not properly planned for, animal health emergencies can rapidly become national disasters. Therefore, it is essential that the central government of a country work towards these goals through partnerships with other Federal and State/Provincial/District organisations, academic institutions and national animal industries. PMID:12523689

  7. 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

  8. 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.

  9. Special Population Planner for Emergency Management

    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.

  10. Emergency management in the early phase.

    PubMed

    Crick, M; McKenna, T; Buglova, E; Winkler, G; Martincic, R

    2004-01-01

    An overview of response management in the early phase of an emergency at a nuclear installation is provided from a systems approach. This starts with the recognition of response goals, and using detailed analyses of threats, past experience, international law and principles, a response strategy is developed. The process is illustrated for the case of severe accidents at pressurized water reactors (PWRs) and identifies the need for and nature of: emergency classification based on plant conditions, notification, radiological monitoring and assessment strategies, operational criteria for implementing protective action decisions and management of public information. From the strategy detailed, functional and infrastructure requirements can be defined. The paper also presents some reflections on the key differences between response to emergencies arising from accidents and those arising from deliberate acts; on the preparedness and response capabilities of States, highlighting areas where generic improvements are needed and how best to achieve that. PMID:15238649

  11. Current diagnosis and management of hypertensive emergency.

    PubMed

    Haas, Andrew R; Marik, Paul E

    2006-01-01

    The appropriate and timely evaluation and treatment of patients with severely elevated blood pressure is essential to avoid serious adverse outcomes. Most importantly, the distinction between a hypertensive emergency (crisis) and urgency needs to be made. A sudden elevation in systolic (SBP) and/or diastolic blood pressure (DBP) that is associated with acute end organ damage (cardiovascular, cerebrovascular, or renal) is defined as a hypertensive crisis or emergency. In contrast, acute elevation in SBP and/or DBP not associated with evidence of end organ damage is defined as hypertensive urgency. In patients with a hypertensive emergency, blood pressure control should be attained as expeditiously as possible with parenteral medications to prevent ongoing and potentially permanent end organ damage. In contrast, with hypertensive urgency, blood pressure control can be achieved with the use of oral medications within 24-48 hours. This paper reviews the management of hypertensive emergencies. PMID:17150051

  12. 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.

  13. ARAC: A support capability for emergency managers

    SciTech Connect

    Pace, J.C.; Sullivan, T.J.; Baskett, R.L.

    1995-08-01

    This paper is intended to introduce to the non-radiological emergency management community the 20-year operational history of the Atmospheric Release Advisory Capability (ARAC), its concept of operations, and its applicability for use in support of emergency management decision makers. ARAC is a centralized federal facility for assessing atmospheric releases of hazardous materials in real time, using a robust suite of three-dimensional atmospheric transport and diffusion models, extensive geophysical and source-description databases, automated meteorological data acquisition systems, and experienced staff members. Although originally conceived to respond to nuclear accidents, the ARAC system has proven to be extremely adaptable, and has been used successfully during a wide variety of nonradiological hazardous chemical situations. ARAC represents a proven, validated, operational support capability for atmospheric hazardous releases.

  14. [Emergency room management of contaminated patients].

    PubMed

    Strohm, P C; Hammer, T O; Kopp, K; Knobloch, V; Alawadi, K; Bannasch, H; Köstler, W; Zipfel, E; Südkamp, N P

    2008-06-01

    Accidents with the risk of exposure to hazardous nuclear, biological, or chemical materials are rare. Most emergency rooms are not familiar with the management of contaminated patients after this kind of incident. There are also ambiguous cases concerning the contamination status of the patient. The medical attendance should be performed carefully and under special security arrangements until a hazard for third persons can be excluded. The security arrangements should protect both (medical) personnel and third persons. Early medical treatment combined with decontamination should be the aim. Based on the case of a contaminated patient who was brought to our emergency department after an explosion of a fog grenade with red phosphorus, we discuss our management concept and the current literature. PMID:18066517

  15. Building public confidence in emergency management.

    PubMed

    Pearce, Tony

    2016-01-01

    Over the years the State of Victoria has suffered many disasters, some of them resulting in extensive community, economic and environmental loss. A number of significant events, including the 2009 Victorian bushfires, major flood events in 2010-11 and their subsequent inquiries have resulted in the biggest overhaul of Victoria's emergency management arrangements since 1983. One significant element of the new arrangements is the inclusion of an entity whose role it is to assure the emergency management arrangements at the system level--the first time such a role has existed. This paper will describe the reform programme currently underway in Victoria, as well as the governance and structural arrangements that have been put in place, before detailing the assurance processes that are being implemented. PMID:26897618

  16. 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.

  17. Current Management of Surgical Oncologic Emergencies

    PubMed Central

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    Objectives For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. Method A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. Results In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. Conclusion In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy. PMID:25933135

  18. Integrated Safety, Environmental, & Emergency Management Systems (ISEEMS)

    SciTech Connect

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-05-01

    Sandia`s Risk Management and NEPA Department recognized the need for hazard and environmental data analysis and management to support the line managers` need to know, understand, manage and document the hazards inherent in their facilities and activities. ISEEMS (Integrated Safety, Environmental, & Emergency Management System) was developed in response to this need. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables Sandia to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. The Preliminary Hazard Screening module of ISEEMS determines the facility or project activity hazard classification and facility designation. ISEEMS` geo-referenced icon allows immediate, visual integration of hazard information across geographic boundaries resulting in significant information compression. At Sandia, ISEEMS runs on the Sandia Internal Restricted Network, in an MS-Windows environment on standard PC hardware. The possibility of transporting ISEEMS to a ``WEB-like`` environment is being explored.

  19. Awareness of emergency management of dental trauma

    PubMed Central

    Namdev, Ritu; Jindal, Ayushi; Bhargava, Smriti; Bakshi, Lokesh; Verma, Reena; Beniwal, Disha

    2014-01-01

    Aim: Traumatic dental injuries frequently occur in society and may occur at home. The ultimate prognosis of an avulsed tooth occurring in a child may depend on the parents’ knowledge of appropriate emergency measures. This study is aimed at evaluating the awareness level of a sample of Indian (Rohtak, Haryana) parents in the management of dental trauma. Materials and Methods: A total of 1500 parents were surveyed using a self-administered structured questionnaire. The questionnaire was divided into three parts. The tabulated data were statistically analyzed using the Chi-square test. Result: This study indicated a low level of knowledge regarding tooth avulsion and replantation procedures to be followed in emergency. The residing area and age of parent did not affect the knowledge and awareness of parents. Moreover, well-educated parents also had very little or no information about dental trauma first-aid. The lack of significance in correct answers between those with and without such experience indicated that past experience did not seem to have increase the knowledge of the correct emergency procedures. Very little or no information about tooth avulsion and replantation had been given to most of them. Conclusion: Dental injury prevention and management should be recognized as a major public health issue and adequate resources to be allocated for research in this area. Educational programs to improve the knowledge and awareness among the parents have to be implemented. PMID:25395768

  20. Emerging Contaminant Issues, Including Management Of Emerging Contaminants In Wastewater

    EPA Science Inventory

    Emerging contaminants are receiving increasing media and scientific attention. These chemicals are sometimes referred to as compounds of emerging concern or trace organic compounds, and include several groups of chemicals including endocrine disrupting compounds (EDCs), and pha...

  1. 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.

  2. Emergency management of acute abdomen in children.

    PubMed

    Balachandran, Binesh; Singhi, Sunit; Lal, Sadhna

    2013-03-01

    Acute abdomen can be defined as a medical emergency in which there is sudden and severe pain in abdomen with accompanying signs and symptoms that focus on an abdominal involvement. It accounts for about 8 % of all children attending the emergency department. The goal of emergency management is to identify and treat any life-threatening medical or surgical disease condition and relief from pain. In mild cases often the cause is gastritis or gastroenteritis, colic, constipation, pharyngo-tonsilitis, viral syndromes or acute febrile illnesses. The common surgical causes are malrotation and Volvulus (in early infancy), intussusception, acute appendicitis, and typhoid and ischemic enteritis with perforation. Lower lobe pneumonia, diabetic ketoacidosis and acute porphyria should be considered in patients with moderate-severe pain with little localizing findings in abdomen. The approach to management in ED should include, in order of priority, a rapid cardiopulmonary assessment to ensure hemodynamic stability, focused history and examination, surgical consult and radiologic examination to exclude life threatening surgical conditions, pain relief and specific diagnosis. In a sick patient the initial steps include rapid IV access and normal saline 20 ml/kg (in the presence of shock/hypovolemia), adequate analgesia, nothing per oral/IV fluids, Ryle's tube aspiration and surgical consultation. An ultrasound abdomen is the first investigation in almost all cases with moderate and severe pain with localizing abdominal findings. In patients with significant abdominal trauma or features of pancreatitis, a Contrast enhanced computerized tomography (CECT) abdomen will be a better initial modality. Continuous monitoring and repeated physical examinations should be done in all cases. Specific management varies according to the specific etiology. PMID:23456644

  3. Multiattribute risk analysis in nuclear emergency management.

    PubMed

    Hämäläinen, R P; Lindstedt, M R; Sinkko, K

    2000-08-01

    Radiation protection authorities have seen a potential for applying multiattribute risk analysis in nuclear emergency management and planning to deal with conflicting objectives, different parties involved, and uncertainties. This type of approach is expected to help in the following areas: to ensure that all relevant attributes are considered in decision making; to enhance communication between the concerned parties, including the public; and to provide a method for explicitly including risk analysis in the process. A multiattribute utility theory analysis was used to select a strategy for protecting the population after a simulated nuclear accident. The value-focused approach and the use of a neutral facilitator were identified as being useful. PMID:11051070

  4. The configuration management program for the Emergency Management Support System

    SciTech Connect

    Probasco, K M; Stephan, E G

    1991-08-01

    Emergency response software is used increasingly by the US Department of Energy's (DOE's) Emergency Management Project (EMP) personnel at Hanford Site. This software must be reliable, of high quality, and capable of performing critical functions to support assessment of actual or potential consequences of any hazardous accidents onsite or events having potential offsite impacts. To better control the software and ensure its suitability for use as a tool to protect employees, the public, and environment, a method for specifying and certifying its capabilities and documenting its development and implementation was needed. A team of EMP staff, composed of personnel from Pacific Northwest Laboratory (PNL) and Boeing Computer Services- Richland (BCSR) under the direction of PNL EMP, responded to this need by developing a software configuration management program (CMP). This report documents the development of the CMP, including the strategies upon which the CMP is based, and describes the program as it has been implemented for EMS System software. The program relies on the integration of its three primary elements: the configuration management staff, tools, and process. Configuration management staff run the program, using specially designed configuration management forms to guide, document, and track the life cycle of the software. The configuration management process itself is reflected in the instructive forms and summarized in flowcharts representing each phase of the process -- from requirements specification through implementation and maintenance. 7 refs., 9 figs., 1 tab.

  5. Emerging haemostatic agents and patient blood management.

    PubMed

    Tanaka, Kenichi A; Kor, Daryl J

    2013-03-01

    The transfusion of allogeneic blood products has been considered as a life-saving procedure for patients suffering from major traumatic injury and those who are undergoing major surgery. The safety of blood products has improved in terms of infectious complications over the last three decades due to advanced donor screening procedures and tests. Nevertheless, non-infectious complications including a blood-type mismatch, volume overload and immunologic and non-immunologic reactions to blood products can adversely affect clinical outcomes. It is thus important to implement a patient-specific strategy in diagnosing bleeding cause(s) and optimising haemostatic therapy. This strategy is an integral part of patient blood management applicable to many perioperative patients. Recent advances in the haemostatic management and transfusion include better understanding of the pathomechanisms of coagulopathy, availability of point-of-care coagulation monitoring and introductions of pathogen-inactivated plasma and factor concentrates as well as recombinant coagulation factors. Understanding the indications and limitations of conventional haemostatic therapy, and potential indications and complications relating to emerging haemostatic agents, is important for perioperative physicians. In this article, we discuss current issues related to allogeneic plasma products and emerging biological haemostatic agents and techniques. Further, we review the mechanisms of action and available preclinical or clinical data for each therapeutic agent. PMID:23590923

  6. Supporting Community Emergency Management Planning Through a Geocollaboration Software Architecture

    NASA Astrophysics Data System (ADS)

    Schafer, Wendy A.; Ganoe, Craig H.; Carroll, John M.

    Emergency management is more than just events occurring within an emergency situation. It encompasses a variety of persistent activities such as planning, training, assessment, and organizational change. We are studying emergency management planning practices in which geographic communities (towns and regions) prepare to respond efficiently to significant emergency events. Community emergency management planning is an extensive collaboration involving numerous stakeholders throughout the community and both reflecting and challenging the community’s structure and resources. Geocollaboration is one aspect of the effort. Emergency managers, public works directors, first responders, and local transportation managers need to exchange information relating to possible emergency event locations and their surrounding areas. They need to examine geospatial maps together and collaboratively develop emergency plans and procedures. Issues such as emergency vehicle traffic routes and staging areas for command posts, arriving media, and personal first responders’ vehicles must be agreed upon prior to an emergency event to ensure an efficient and effective response. This work presents a software architecture that facilitates the development of geocollaboration solutions. The architecture extends prior geocollaboration research and reuses existing geospatial information models. Emergency management planning is one application domain for the architecture. Geocollaboration tools can be developed that support community-wide emergency management planning and preparedness. This chapter describes how the software architecture can be used for the geospatial, emergency management planning activities of one community.

  7. 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

  8. Emergency management of ureteral stones: Recent advances

    PubMed Central

    Osorio, Luis; Lima, Estêvão; Autorino, Riccardo; Marcelo, Filinto

    2008-01-01

    Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators’ experience, patients’ preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed. PMID:19468497

  9. Emergency Management of Hypertension in Children

    PubMed Central

    Singh, Dinesh; Akingbola, Olugbenga; Yosypiv, Ihor; El-Dahr, Samir

    2012-01-01

    Systemic arterial hypertension in children has traditionally been thought to be secondary in origin. Increased incidence of risk factors like obesity, sedentary life-styles, and faulty dietary habits has led to increased prevalence of the primary arterial hypertension (PAH), particularly in adolescent age children. PAH has become a global epidemic worldwide imposing huge economic constraint on health care. Sudden acute increase in systolic and diastolic blood pressure can lead to hypertensive crisis. While it generally pertains to secondary hypertension, occurrence of hypertensive crisis in PAH is however rare in children. Hypertensive crisis has been further subclassified depending on presence or absence of end-organ damage into hypertensive emergency or urgency. Both hypertensive emergencies and urgencies are known to cause significant morbidity and mortality. Increasing awareness among the physicians, targeted at investigation of the pathophysiology of hypertension and its complications, better screening methods, generation, and implementation of novel treatment modalities will impact overall outcomes. In this paper, we discuss the etiology, pathogenesis, and management of hypertensive crisis in children. An extensive database search using keywords was done to obtain the information. PMID:22577545

  10. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager`s point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  11. Management of acute diarrhea in emergency room.

    PubMed

    Dekate, Parag; Jayashree, M; Singhi, Sunit C

    2013-03-01

    Acute diarrhea is the second leading cause of under-five mortality in India. It is defined as the passage of frequent watery stools (>3/24 h). Recent change in consistency of stools is more important than frequency. Acute diarrhea is caused by variety of viral, bacterial and parasitic agents. The common ones are: Rotavirus, E. coli, Shigella, Cholera, and Salmonella. Campylobacter jejuni, Giardia and E. histolytica are also not uncommon. The most important concern in management of acute diarrhea in Emergency room (ER) is fluid and electrolyte imbalances and treatment of underlying infection, wherever applicable. It includes, initial stabilization (identification and treatment of shock), assessment of hydration and rehydration therapy, recognition and treatment of electrolyte imbalance, and use of appropriate antimicrobials wherever indicated. For assessment of hydration clinical signs are generally reliable; however, in severely malnourished children sunken eyes and skin turgor are unreliable. Oral Rehydration Therapy is the cornerstone of management of dehydration. Intravenous fluids are not routinely recommended except in cases of persistent vomiting and/or shock. Majority of cases can be managed in ER and at home. Hospitalization is indicated in infants <3 mo, children with severe dehydration, severe malnutrition, toxic look, persistent vomiting and suspected surgical abdomen. Supplementations with zinc and probiotics have been shown to reduce severity and duration of diarrhea; however evidence does not support the use of antisecretary, antimotility and binding agents. Education of parents about hand hygiene, safe weaning and safe drinking water etc., can help in reducing incidence of this important health problem in the country. PMID:23192407

  12. Code orange: Towards transformational leadership of emergency management systems.

    PubMed

    Caro, Denis H J

    2015-09-01

    The 21(st) century calls upon health leaders to recognize and respond to emerging threats and systemic emergency management challenges through transformative processes inherent in the LEADS in a caring environment framework. Using a grounded theory approach, this qualitative study explores key informant perspectives of leaders in emergency management across Canada on pressing needs for relevant systemic transformation. The emerging model points to eight specific attributes of transformational leadership central to emergency management and suggests that contextualization of health leadership is of particular import. PMID:26135294

  13. Emergency management training program: Guide to good practice

    SciTech Connect

    Not Available

    1991-07-01

    The Emergency Management Training Program Guide to Good Practice is a project of the Training Resources and Data Exchange (TRADE) Emergency Management Issues Special Interest Group (EMI SIG). EMI SIG members expressed interest in a resource to assist in development of a comprehensive emergency management training program. This publication provides guidelines, methods, and materials for EMI SIG members to use, assisting in complete and effective emergency management programs. The purposes of the Emergency Management Training Program Guide to Good Practice are: Provide guidance in the development and management of Emergency Management (EM) training programs; Assist EM trainers to incorporate components of the DOE Emergency Management System philosophy of planning, preparedness, readiness assurance, and response into EM training programs; Help EM training managers meet EM training requirements and conditions established by current regulations and policies; Supplement other TRADE EMI SIG documents and complement individual facility training documents. This program is designed for emergency management personnel who are responsible for providing or overseeing EM training but who do not necessarily possess expertise in developing training. It provides good practices from the manager's point of view on how to produce, administer, and document facility EM training programs in the spirit of the DOE EM system philosophy. Basic guidance is also included for personnel who design, develop, deliver, and/or evaluate EM training programs or parts. This guidance includes key points of EM training programs and identifies other documents that contain useful and/or more detailed training information.

  14. 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.

  15. Responding to the deaf in disasters: establishing the need for systematic training for state-level emergency management agencies and community organizations

    PubMed Central

    2013-01-01

    Background Deaf and hard-of-hearing (Deaf/HH) individuals have been underserved before and during emergencies. This paper will assess Deaf/HH related emergency preparedness training needs for state emergency management agencies and deaf-serving community-based organizations (CBOs). Methods Four approaches were used: 1) a literature review; 2) results from 50 key informant (KI) interviews from state and territorial-level emergency management and public health agencies; 3) results from 14 KI interviews with deaf-serving CBOs in the San Francisco Bay Area; and 4) a pilot program evaluation of an emergency responder training serving the Deaf/HH in one urban community. Results Results from literature review and state and territorial level KIs indicate that there is a substantive gap in emergency preparedness training on serving Deaf/HH provided by state agencies. In addition, local KI interviews with 14 deaf-serving CBOs found gaps in training within deaf-serving CBOs. These gaps have implications for preparing for and responding to all-hazards emergencies including weather-related or earthquake-related natural disasters, terrorist attacks, and nuclear-chemical disasters. Conclusion Emergency preparedness trainings specific to responding to or promoting preparedness of the Deaf/HH is rare, even for state agency personnel, and frequently lack standardization, evaluation, or institutionalization in emergency management infrastructure. This has significant policy and research implications. Similarly, CBOs are not adequately trained to serve the needs of their constituents. PMID:23497178

  16. 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.

  17. 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. PMID:20378490

  18. Managing Pediatric Pain in the Emergency Department.

    PubMed

    Bailey, Benoit; Trottier, Evelyne D

    2016-08-01

    Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs. PMID:27260499

  19. [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. PMID:23385622

  20. 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…

  1. Comprehensive emergency management: Evacuating threatened populations. Topical report

    SciTech Connect

    Perry, R.W.

    1983-01-01

    The structure of emergency management is outlined and emergency management tasks including mitigation and preparedness activities, are addressed. Four actors in the emergency management system are described: local governments, state governments, Federal government, and private organizations. Man-made and natural disasters are compared and human response to three emergency situations is described: (1) the nuclear reaction incident at Three Mile Island, (2) the May 18, 1980 eruption of Mt. St. Helens volcano, and (3) a riverine flood. Citizen response comparisons among these disaster events is focused on: (1) the source and credibility of evacuation warnings; and (2) citizen evacuation decisions. Information is supplied on the way citizens make decisions in emergencies, social-psychological responses to emergencies, the context of evacuation planning in hazard management, and strategies for enhancing citizen compliance with evacuation warnings.

  2. 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. PMID:26642170

  3. 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…

  4. Diagnosis and management of environmental thoracic emergencies.

    PubMed

    Tourigny, Paul D; Hall, Chris

    2012-05-01

    Physiologic sequelae from increasing ambient pressure in underwater activities, decreasing ambient pressure while at altitude, or the consequences of drowning present a unique set of challenges to emergency physicians. In addition, several environmental toxins cause significant respiratory morbidity, whether they be pulmonary irritants, simple asphyxiants, or systemic toxins. It is important for emergency physicians to understand the pathophysiology of these illnesses as well as to apply this knowledge to the clinical arena either in the prehospital setting or in the emergency department. Current treatment paradigms and controversies within these regimens are discussed. PMID:22487116

  5. 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…

  6. Conflicts between managed care organizations and emergency departments in California.

    PubMed Central

    Johnson, L A; Derlet, R W

    1996-01-01

    To control costs, managed care organizations have begun to restrict the use of hospital emergency departments by their enrollees. They are doing this by educating enrollees, providing better access to 24-hour urgent care, denying preauthorizations for care for some patients who do present to emergency departments, and retrospectively denying payment for certain patients who use emergency services. Changing traditional use of emergency departments has resulted in conflicts between managed care organizations and these departments. Because federal law mandates access to emergency care for all persons, disagreements occur over the precise definition of an emergency medical condition. In addition, conflicts occur over the scope and payment for the medical screening examination required by federal law of persons presenting to an emergency department. Finally, issues arise related to the safety of patients who present to emergency departments and request care but are denied care because the managed care organization does not authorize the visit. Recent legislation in California has attempted to reconcile differences between managed care practices and federal and state laws; however, areas of continued conflict need to be resolved to prevent possible adverse consequences for patients actually needing emergency care. PMID:8775727

  7. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 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...

  8. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 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...

  9. Prehospital emergency trauma care and management.

    PubMed

    Kerby, Jeffrey D; Cusick, Marianne V

    2012-08-01

    Prehospital care of the trauma patient is continuing to evolve; however, the principles of airway maintenance, hemorrhage control, and appropriate resuscitative maneuvers remain central to the role of the emergency medical care provider. Recent changes in the regulations for research in emergency settings will allow randomized trials to proceed to test new devices, drugs, and resuscitative strategies in the prehospital environment. The creation of prehospital research networks will provide the appropriate infrastructure to greatly facilitate the development of new protocols and the execution of large-scale randomized trials with the potential to change current prehospital practice. PMID:22850149

  10. Chemical Biological Emergency Management Information System

    2004-06-15

    CB-EMIS is designed to provide information and analysis to transit system operators and emergency responders in the event of a chemical attack on a subway system. The software inforporates detector data, video images, train data, meteorological data, and above- and below-ground plume dispersion models, hight of the liquid level.

  11. 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. PMID:24857588

  12. 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. PMID:25350356

  13. 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. PMID:25062826

  14. 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…

  15. 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…

  16. 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…

  17. 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.

  18. 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…

  19. 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

  20. Emergency department management of nerve agent exposure.

    PubMed

    Pfaff, B L

    1998-01-01

    Nerve agents are toxic chemicals developed for use by the military, but used by terrorists against civilian populations. As threats of terrorism increase, it is possible that health care providers will be confronted with multiple victims of nerve agent exposure. Nerve agents are highly toxic forms of organophosphate poisons that potentially could cause harm to anyone who comes in contact. Emergency personnel need to be familiar with the agents, know how to prepare for encountering and treating victims, and know how to protect all people involved from further poisoning. PMID:9855972

  1. Operation Windshield and the simplification of emergency management.

    PubMed

    Andrews, Michael

    2016-01-01

    Large, complex, multi-stakeholder exercises are the culmination of years of gradual progression through a comprehensive training and exercise programme. Exercises intended to validate training, refine procedures and test processes initially tested in isolation are combined to ensure seamless response and coordination during actual crises. The challenges of integrating timely and accurate situational awareness from an array of sources, including response agencies, municipal departments, partner agencies and the public, on an ever-growing range of media platforms, increase information management complexity in emergencies. Considering that many municipal emergency operations centre roles are filled by staff whose day jobs have little to do with crisis management, there is a need to simplify emergency management and make it more intuitive. North Shore Emergency Management has accepted the challenge of making emergency management less onerous to occasional practitioners through a series of initiatives aimed to build competence and confidence by making processes easier to use as well as by introducing technical tools that can simplify processes and enhance efficiencies. These efforts culminated in the full-scale earthquake exercise, Operation Windshield, which preceded the 2015 Emergency Preparedness and Business Continuity Conference in Vancouver, British Columbia. PMID:26897621

  2. 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…

  3. 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. PMID:25779898

  4. Acute pain management curriculum for emergency medicine residency programs.

    PubMed

    Motov, Sergey M; Marshall, John P

    2011-10-01

    Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs possess inadequate knowledge and lack formal training in acute pain management. The purpose of this article is to create a formal educational curriculum that would assist emergency medicine (EM) residents in proper assessment and treatment of acute pain, as well as in providing a solid theoretical and practical knowledge base for managing acute pain in the ED. The authors propose a series of lectures, case-oriented study groups, practical small group sessions, and class-specific didactics with the goal of enhancing the theoretical and practical knowledge of acute pain management in the ED. PMID:21692900

  5. Case studies of emergency management of screwworm.

    PubMed

    Reichard, R

    1999-04-01

    Screwworm myiasis, caused by infestation of even minor wounds by the obligative parasitic larval stages of the New World screwworm (NWS) (Cochliomyia hominivorax) or Old World screwworm (OWS) (Chrysomya bezziana) flies, is a major cause of livestock morbidity and mortality in tropical and sub-tropical regions of the world. The two parasites occur in different hemispheres but are remarkably homologous. Animal health emergencies result from the invasion of new territories by the parasites or, in the case of NWS, reinfestation of areas from which the parasite had been eradicated after great effort and expense. The author reviews the biology of the parasites and the effects of screwworm, in addition to prevention of infestation upon the introduction of animals. Examples of three programmes or events are described. The first is the eradication of previously exotic NWS from an epizootic in Libya before the parasite spread to become enzootic in the Mediterranean Basin and eventually other areas of the Eastern Hemisphere. The second example reviews the serious consequences of the extension of the range of OWS into Iraq where conditions at the time were favourable for propagation and unfavourable for control. The third example describes the NWS programme strategy in North and Central America which, for forty years, has been to progressively achieve eradication and then protection of areas from north to south on that continent, employing the sterile insect technique (SIT). Outbreaks in areas where screwworm has already been eradicated divert costly programme resources and slow progress southwards, and are considered emergencies. Some problems encountered and the solutions found during the height of the eradication programme in Mexico are described. Although to date eradication of screwworms has only been accomplished with the application of SIT, this technique alone will not eradicate the pest. The author describes other elements which are required to control or eradicate

  6. Industrial ecology: an emerging management science.

    PubMed Central

    Piasecki, B

    1992-01-01

    Pollution is a complex equation, compounded by population, rate of consumption, and toxic emissions per unit of resource consumed. This article defines industrial ecology as a management science that focuses a corporation's expertise on the third variable. Thus, industrial ecology is involved with changing the efficiency of machines, not just changing the law or a firm's compliance strategy. This article also explores how this emphasis allows a profoundly different orientation than the end-of-the-pipe regulatory approach of the last 20 yr. PMID:11607271

  7. The role of strategic planning in emergency management

    SciTech Connect

    Douglas, N.B.; Harrison, G.T.

    1995-12-31

    Rapid technology development, competition for resources, and an increasing awareness of the global community are but a few of the many forces and trends affecting today`s Emergency Management Organizations. Implementing a continuous Strategic Planning process helps an Emergency Management Organization to formulate responses to issues such as those stated above. By continuously monitoring the forces and trends in its environment, the organization is able to succinctly identify its strategic issues and subsequently frame an appropriate infrastructure of goals, objectives, and strategies. Strategic Planning also holds significant potential for the emergency management community at large. The wide range of expertise and the inherent dependencies between Emergency Management Organizations at all levels of government -- including the local, national, and international arenas -- makes the emergency management community an ideal candidate to capitalize on the benefits resulting from joint strategic planning. The identification of common issues, priorities, and requirements provides the foundation for increased resource and information sharing, as well as the formulation of strategic partnerships between organizations to battle common threats.

  8. [Health alert management and emerging risk].

    PubMed

    Pillonel, J

    2010-12-01

    Following health crisis that have occurred in the nineties (contaminated blood, mad cow, asbestos, etc.) and more recently those generated by the heat wave in 2003 or by emerging infectious pathogens (SARS, West Nile, Chikungunya, H5N1, H1N1…), a real health vigilance system has been progressively developed in France. After a brief historical overview of the health alert system, this article will give the guiding principles of its current organization in France and will present two examples of recent health alerts (Chikungunya in the Reunion Island in 2005-2006 and hepatitis A outbreak in the Côtes-d'Armor in August 2007), that have needed the implementation of preventive measures regarding the blood donor selection. These two examples have shown that the position of the alert in the French health vigilance system needs to be very close to the event. In that case, health alert is a very useful tool for decision making especially when measures have to be taken to prevent transfusion-transmitted pathogens. PMID:21051258

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

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

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

  10. 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. PMID:25799698

  11. Emerging electromembrane technologies in hazardous management

    SciTech Connect

    Grebenyuk, V.D.; Grebenyuk, O.V.

    1995-12-31

    A new generalized index of ecological estimation of different technological process is suggested. It is the number of salt equivalents which contaminate environment when a production unit is making. The quantity of salt equivalent have been calculated not only as necessary amount for the technological process by itself, but as amount of energy and different materials for an entire technology. The estimation of different methods of water treatment is shown. The electrodialysis is the most ecological method of water desalination in comparison with others. This conclusion was spreaded on other electromembrane technologies in hazardous management. Such as: (1) Brackish water desalination, (2) Acid rain prevention, (3) Recuperation of pure heavy metals from rinse galvanic water.

  12. 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

    2016-03-01

    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

  13. Emergency mental health management in bioterrorism events.

    PubMed

    Benedek, David M; Holloway, Harry C; Becker, Steven M

    2002-05-01

    The United States has not suffered significant psychosocial or medical consequences from the use of biological weapons within its territories. This has contributed to a "natural" state of denial at the community level. This denial could amplify the sense of crisis, anxiety, fear, chaos, and disorder that would accompany such a bioterrorist event. A key part of primary prevention involves counteracting this possibility before an incident occurs. Doing so will require realistic information regarding the bioterrorism threat followed by the development of a planned response and regular practice of that response. Unlike in natural disasters or other situations resulting in mass casualties, emergency department physicians or nurses and primary care physicians (working in concert with epidemiologic agencies), rather than police, firemen, or ambulance personnel, will be most likely to first identify the unfolding disaster associated with a biological attack. Like community leaders, this group of medical responders must be aware of its own susceptibility to mental health sequelae and performance decrement as the increasing demands of disaster response outpace the availability of necessary resources. A bioterrorist attack will necessitate treatment of casualties who experience neuropsychiatric symptoms and syndromes. Although symptoms may result from exposure to infection with specific biological agents, similar symptoms may result from the mere perception of exposure or arousal precipitated by fear of infection, disease, suffering, and death. Conservative use of psychotropic medications may reduce symptoms in exposed and uninfected individuals, as may cognitive-behavioral interventions. Clear, consistent, accessible, reliable, and redundant information (received from trusted sources) will diminish public uncertainty about the cause of symptoms that might otherwise prompt persons to seek unnecessary treatment. Training and preparation for contingencies experienced in an

  14. 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.

  15. Active management of food allergy: an emerging concept.

    PubMed

    Anagnostou, Katherine; Stiefel, Gary; Brough, Helen; du Toit, George; Lack, Gideon; Fox, Adam T

    2015-04-01

    IgE-mediated food allergies are common and currently there is no cure. Traditionally, management has relied upon patient education, food avoidance and the provision of an emergency medication plan. Despite this, food allergy can significantly impact on quality of life. Therefore, in recent years, evolving research has explored alternative management strategies. A more active approach to management is being adopted, which includes early introduction of potentially allergenic foods, anticipatory testing, active monitoring, desensitisation to food allergens and active risk management. This review will discuss these areas in turn. PMID:25378378

  16. Precision Information Environments Envisioning the future of emergency management

    SciTech Connect

    2010-04-01

    Researchers at Pacific Northwest National Laboratory are developing future work environments for the emergency management community called Precision Information Environments (or PIEs). PIEs will provide tailored access to information and decision support capabilities in a system that supports the multiple user roles, contexts, and phases of emergency management, planning, and response. This video gives you a look at one vision for the future. To view an annotated version that describes each of the technology concepts you'll see as well as the end user needs that motivated them and the research challenges that must be addressed to make them a reality visit http://precisioninformation.org.

  17. 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.

  18. 44 CFR Appendix A to Part 62 - Federal Emergency Management Agency, Federal Insurance Administration, Financial Assistance...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... under the WYO (Write Your Own) Program. 44 CFR part 62, appendix B. These data shall be validated/edited... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Federal Emergency Management... 62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF...

  19. 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

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

    PubMed

    Mathieson, Sarah; Whalen, Desmond; Dubrowski, Adam

    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

  1. 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…

  2. 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…

  3. 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 ...

  4. 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…

  5. Testicular torsion and the acute scrotum: current emergency management.

    PubMed

    Ta, Anthony; D'Arcy, Frank T; Hoag, Nathan; D'Arcy, John P; Lawrentschuk, Nathan

    2016-06-01

    The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective. It outlines the types and mechanisms of testicular torsion, and examines the current and possible future roles of labwork and radiological imaging in diagnosis. Emergency departments should be wary of younger males presenting with the acute scrotum. PMID:26267075

  6. 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. PMID:20956193

  7. Emergency strategies and trends in the management of liver trauma.

    PubMed

    Jiang, Hongchi; Wang, Jizhou

    2012-09-01

    The liver is the most frequently injured organ during abdominal trauma. The management of hepatic trauma has undergone a paradigm shift over the past several decades, with mandatory operation giving way to nonoperative treatment. Better understanding of the mechanisms and grade of liver injury aids in the initial assessment and establishment of a management strategy. Hemodynamically unstable patients should undergo focused abdominal sonography for trauma, whereas stable patients may undergo computed tomography, the standard examination protocol. The grade of liver injury alone does not accurately predict the need for operation, and nonoperative management is rapidly becoming popular for high-grade injuries. Hemodynamic instability with positive focused abdominal sonography for trauma and peritonitis is an indicator of the need for emergent operative intervention. The damage control concept is appropriate for the treatment of major liver injuries and is associated with significant survival advantages compared with traditional prolonged surgical techniques. Although surgical intervention for hepatic trauma is not as common now as it was in the past, current trauma surgeons should be familiar with the emergency surgical skills necessary to manage complex hepatic injuries, such as packing, Pringle maneuver, selective vessel ligation, resectional debridement, and parenchymal sutures. The present review presents emergency strategies and trends in the management of liver trauma. PMID:22673827

  8. 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. PMID:27575640

  9. 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.

  10. Ocular Injuries: New Strategies In Emergency Department Management.

    PubMed

    Messman, Anne M

    2015-11-01

    Ocular injuries are common in the emergency department, and they are the most frequent cause of noncongenital monocular blindness in children and adults. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of patients with all types of ocular trauma, including pain management, the use of antibiotics, cycloplegics, steroids, antifibrinolytics, and patching. Bedside ocular ultrasound has profoundly expanded diagnostic capability, particularly for the multiply injured patient, and routine management and disposition of patients with corneal abrasions has evolved significantly as well. Diagnosis and management of patients with retrobulbar hemorrhage is discussed in detail, with resources for performing vision-saving lateral canthotomy. Systematic evaluation and management of ocular trauma patients will ensure these patients have the best chance for a favorable final visual outcome. PMID:26466300

  11. 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.

  12. 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.

  13. 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.

  14. 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. PMID:26750811

  15. Acute carbon monoxide poisoning: Emergency management and hyperbaric oxygen therapy

    SciTech Connect

    Severance, H.W.; Kolb, J.C.; Carlton, F.B.; Jorden, R.C.

    1989-10-01

    An ice storm in February 1989 resulted in numerous incidences of carbon monoxide poisoning in central Mississippi secondary to exposure to open fires in unventilated living spaces. Sixteen cases were treated during this period at the University of Mississippi Medical Center and 6 received Hyperbaric Oxygen therapy. These 6 cases and the mechanisms of CO poisoning are discussed and recommendations for emergency management are reviewed.10 references.

  16. Management of hypertensive emergencies: implications for the critical care nurse.

    PubMed

    Schulenburg, Margaret

    2007-01-01

    Hypertensive emergencies are characterized by acute blood pressure elevations and potential for end organ damage. The critical care nurse must understand the pathophysiology to appreciate the therapeutic management and complications associated with the devastating clinical event. Stroke, renal damage and failure, retinopathy, aortic dissection, and encephalopathy are among the sequelae of severe hypertensive episodes. Intravenous medications are the treatment of choice to lower the blood pressure without risking hypoperfusion of the brain and other vital organs. PMID:17356350

  17. 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.

  18. Visualizing diurnal population change in urban areas for emergency management.

    PubMed

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

    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. PMID:21491706

  19. 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.

  20. Risk management: application of early warning systems to emergency plans

    NASA Astrophysics Data System (ADS)

    Garcia, C.; Sterlacchini, S.; Pasuto, A.; de Amicis, M.

    2009-04-01

    Warning System and emergency plans are two fundamental elements of risk management and governance, but unfortunately, most of the times, they are developed independently one from the other, as sequential steps not necessary linked. The main goal of this research is to develop a methodology for applying Early Warning Systems - Community Based to the emergency plan using the results of social surveys and quantitative risk assessment, taking into account the administrative structure and the planning system of the study area, as well as the legislative obligations of each entity involved in the risk governance and emergency management. Using a integrative scientific and social approach to natural hazards the research aim to contribute to fill the gap between scientists, policy makers, stakeholders and community. Initially applied in Comunità Montana Valtellina di Tirano, Italy, the methodology involves the application of two comprehensive surveys. The first is addressed to stakeholders (including policy makers, emergency managers, emergency volunteers, consultants and scientists) in order to determine their needs, points of view, concerns and constraints. The second survey is addressed specifically to local community to assess risk perception, awareness, needs, capacity and level of trust towards stakeholders, besides asking for their willingness to participate in future risk communication activities. The Early Warning System developed includes all the stages of the early warning process (hazard evaluation and forecasting; warning and dissemination and public response) and would be based on a multidisciplinary partnership that takes into account the different actors involved in the risk management in order to accomplish a more reliable and credible result, including an emergency plan specifically designed for each study area. After evaluating the results of the surveys, information and education campaigns will be developed with the objective of reducing vulnerability

  1. Implementation of state assistance program for training and education in emergency management--Federal Emergency Management Agency. Final rule.

    PubMed

    1981-01-01

    This rule sets forth a description of the FEMA training and education assistance program to the States. The program functions through State Cooperative Agreements and is designed to further comprehensive emergency management training including emergency preparedness planning, hazard mitigation, and disaster response and recovery. In response to State and local expressed needs, FEMA was formed to coordinate and manage all disaster planning and response in one Agency. The combined training responsibilities of predecessor agencies are now being administered by the Training and Education Office of FEMA using the State Cooperative Agreements and Regional Support Contracts as the vehicle to meet individual State training needs. This rule defines the objectives and elements of the program, the funding approach, and the State application/proposal. PMID:10249532

  2. 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

  3. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    PubMed Central

    Damiani, Gianluca Raffaello; Merola, Viviana; Barnaba, Mario; Landi, Stefano; Cormio, Gennaro; Pellegrino, Antonio

    2014-01-01

    A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management. PMID:25254049

  4. Management of atrial fibrillation in the emergency department.

    PubMed

    Crozier, I; Melton, I; Pearson, S

    2003-04-01

    Abstract Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is a frequent cause for presentation to the emergency department. With an understanding of the pathophysiology and types of AF, efficient and effective management strategies for AF can be formulated. Patients with paroxysmal AF will often revert spontaneously and can initially be managed on an outpatient basis, unless an antiarrhythmic is commenced. In patients with AF and severe underlying heart disease, the management is primarily directed at the underlying heart disease, supplemented with rate-controlling measures, and prevention of thromboembolic complications. In patients with persistent AF good rate control, early cardioversion and initiation of an antiarrhythmic are likely to reduce the risk of recurrence. PMID:12680985

  5. Federal Emergency Management Information system (FEMIS) data management guide. Version 1.2

    SciTech Connect

    Burnett, R.A.; Downing, T.R.; Gaustad, K.L.; Johnson, S.M.; Loveall, R.M.; Winters, C.

    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 and Biological Defense Command. The FEMIS Data Management 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 data files and database that support the administrative, user-environment, database management, and operational capabilities of FEMIS. This document provides a description of the relational and spatial information present in FEMIS. It describes how the data was assembled, how it is loaded, and how it is managed while the system is in operation.

  6. 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. PMID:16622359

  7. Strengthening the Federal Emergency Management Agency's disaster response capabilities.

    PubMed

    Cannon, Glenn M

    2008-04-01

    The Federal Emergency Management Agency's (FEMA) Disaster Operations Directorate provides the core federal response capability to save lives and to protect property in US communities that have been overwhelmed by the impact of a major disaster or emergency. The directorate executes its mission through three main programme areas: operational direction, command and control; operational teams; and operational planning. Based on lessons learned from years of disaster response experience, FEMA is now taking a more proactive and collaborative approach with its partners. This paper discusses how FEMA is placing a greater emphasis on response operations and strengthening capabilities across the full range of operational and support missions by comprehensively revamping its disaster operations model; enhancing its headquarters and regional operations centres; enhancing its headquarters and regional operational planning capabilities; and addressing catastrophic disaster planning and related critical preparedness issues. PMID:21339114

  8. 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…

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

    PubMed

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

    2015-02-01

    After a radiation emergency that involves the dispersal of radioactive material, patients can become externally and internally contaminated with 1 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 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 diethylenetriamine pentaacetic acid (DTPA) and zinc DTPA. PMID:25455668

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

    DOE PAGESBeta

    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.

  11. Lessons learned in public health emergency management: personal reflections.

    PubMed

    Kizer, K W

    2000-01-01

    Multiple environmental, ecological, and socio-political forces are converging to increase the occurrence of both natural and technological disasters. Ten forces are of most concern in this regard. These are: 1) global warming, with its consequent weather extremes and climate changes; 2) continued rapid human population growth and concomitant increased urbanization; 3) decreased bio-diversity and consequent ecological fragility; 4) deforestation and loss of natural habitat for animal species, with resultant greater overlap of human and animal habitats, human exposure to animal pathogens, and other ecological perturbations; 5) increased technological development throughout the world (especially in developing countries with their typically immature safety programs); 6) globalization and increased population mobility; 7) sub-national religious and ethnic conflicts, and their potential for conflict escalation and large scale displacement of populations; 8) the collapse of several major countries and consequent unraveling of national identity and social order; 9) the rise of terrorism; and 10) dramatic advances in the science and technology of computing, communications, biotechnology, and genomics. This paper describes 10 lessons learned relative to the public health aspects of emergency management, especially as they pertain to disasters. 1) Planning pays; 2) A bad situation can be made worse by inappropriate responses; 3) Most life saving interventions will occur before the disaster happens and immediately afterwards by local action; 4) Public health emergency management is not a democratic process; 5) Psychological impacts are usually greater than anticipated; 6) Communications and information management are vital, but often are the weak link in the response chain; 7) Collaboration and partnerships are essential; 8) Unsolicited volunteers and aid are inevitable and must be planned for and managed; 9) Never assume anything, and always expect the unexpected; and 10

  12. Emergent properties of proteostasis in managing cystic fibrosis.

    PubMed

    Balch, William E; Roth, Daniela M; Hutt, Darren M

    2011-02-01

    Cystic fibrosis (CF) is a consequence of defective recognition of the multimembrane spanning protein cystic fibrosis conductance transmembrane regulator (CFTR) by the protein homeostasis or proteostasis network (PN) (Hutt and Balch (2010). Like many variant proteins triggering misfolding diseases, mutant CFTR has a complex folding and membrane trafficking itinerary that is managed by the PN to maintain proteome balance and this balance is disrupted in human disease. The biological pathways dictating the folding and function of CFTR in health and disease are being studied by numerous investigators, providing a unique opportunity to begin to understand and therapeutically address the role of the PN in disease onset, and its progression during aging. We discuss the general concept that therapeutic management of the emergent properties of the PN to control the energetics of CFTR folding biology may provide significant clinical benefit. PMID:21421917

  13. Targeted temperature management in emergency medicine: current perspectives

    PubMed Central

    Hunter, Benton R; Ellender, Timothy J

    2015-01-01

    Landmark trials in 2002 showed that therapeutic hypothermia (TH) after out-of-hospital cardiac arrest due to ventricular tachycardia or ventricular fibrillation resulted in improved likelihood of good neurologic recovery compared to standard care without TH. Since that time, TH has been frequently instituted in a wide range of cardiac arrest patients regardless of initial heart rhythm. Recent evidence has evaluated how, when, and to what degree TH should be instituted in cardiac arrest victims. We outline early evidence, as well as recent trials, regarding the use of TH or targeted temperature management in these patients. We also provide evidence-based suggestions for the institution of targeted temperature management/TH in a variety of emergency medicine settings. PMID:27147892

  14. 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

  15. 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.

  16. Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management.

    PubMed

    Hong, Victor

    2016-01-01

    Patients with borderline personality disorder (BPD) are high utilizers of psychiatric emergency services and present unique challenges in that setting. Frequently advised to visit an emergency department (ED) if safety is in question, their experiences once there often do not have beneficial effects. Issues specific to patients with BPD in the ED include volatile interactions with staff, repeat visits, concerns about safety (and liability), and disposition. Emergency department staff attitudes toward these patients are frequently negative when compared to patients with other diagnoses, and can detrimentally affect outcomes and perpetuate stigma regarding BPD. These attitudes are often due to lack of education and training about how to understand, approach, and treat the patient with BPD. The limited literature regarding the treatment of BPD in the ED offers few guidelines. This article presents an approach based on Good Psychiatric Management that can reduce negative reactions by ED staff and make ED visits more effective and less harmful. Relevant principles include psychoeducation, the reinforcement of the connection between symptoms and interpersonal stressors, and employment of an active, authentic therapeutic stance. Training ED staff in these principles could lead to attitudinal changes, reduced stigma, and potentially improved outcomes. PMID:27603743

  17. 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. PMID:27615348

  18. Sustainable risk management of emerging contaminants in municipal wastewaters.

    PubMed

    Martin, O V; Voulvoulis, N

    2009-10-13

    The presence of emerging contaminants in municipal wastewaters, particularly endocrine-disrupting compounds such as oestrogenic substances, has been the focus of much public concern and scientific attention in recent years. Due to the scientific uncertainty still surrounding their effects, the Precautionary Principle could be invoked for the interim management of potential risks. Therefore, precautionary prevention risk-management measures could be employed to reduce human exposure to the compounds of concern. Steroid oestrogens are generally recognized as the most significant oestrogenically active substances in domestic sewage effluent. As a result, the UK Environment Agency has championed a 'Demonstration Programme' to investigate the potential for removal of steroid oestrogens and alkylphenol ethoxylates during sewage treatment. Ecological and human health risks are interdependent, and ecological injuries may result in increased human exposures to contaminants or other stressors. In this context of limiting exposure to potential contaminants, examining the relative contribution of various compounds and pathways should be taken into account when identifying effective risk-management measures. In addition, the explicit use of ecological objectives within the scope of the implementation of the EU Water Framework Directive poses new challenges and necessitates the development of ecosystem-based decision tools. This paper addresses some of these issues and proposes a species sensitivity distribution approach to support the decision-making process related to the need and implications of sewage treatment work upgrade as risk-management measures to the presence of oestrogenic compounds in sewage effluent. PMID:19736227

  19. [Paediatric emergencies; example of the management of winter epidemics].

    PubMed

    Mercier, Jean-Christophe; Bellettre, Xavier; Lejay, Émilie; Desmarest, Marie; Titomanlio, Luigi

    2015-01-01

    Every year, epidemics of viral bronchiolitis and gastroenteritis occur with a significant increase in the number of visits (by a factor 1.8) and hospitalisations that can over-exceed bed capacity leading to transfer sick children to other hospitals. This kind of hospital 'crisis' is not limited to paediatrics, big cities or western nations. It is a worldwide worrying problem. Because our hospital sits in the Northern districts of Paris where a large community of m.ncants lives in poverty, our number of visits is high (mean 250 per day), and winter epidemics further jeopardise the difficult equilibrium achieved between quality management and waiting times. Thus, we have taken various initiatives in terms of organisation of the paediatric emergency department and other wards, including a "fast track" clinic, the opening of beds dedicated to winter epidemics, the institution of a "bed manager" in order to more easily find a bed, and a larger use of home hospitalisations. Furthermore, we created a specific committee which may decide on various indicators of tension whether it is necessary to cancel programmed hospitalisations or surgery.in order to resolve the emergency crisis. This kind of organisation can serve as a model for other hospitals facing winter epidemics crises. PMID:25842428

  20. Emergency planning and management in health care: priority research topics

    PubMed Central

    Boyd, Alan; Chambers, Naomi; French, Simon; Shaw, Duncan; King, Russell; Whitehead, Alison

    2014-01-01

    Many major incidents have significant impacts on people's health, placing additional demands on health-care organisations. The main aim of this paper is to suggest a prioritised agenda for organisational and management research on emergency planning and management relevant to U.K. health care, based on a scoping study. A secondary aim is to enhance knowledge and understanding of health-care emergency planning among the wider research community, by highlighting key issues and perspectives on the subject and presenting a conceptual model. The study findings have much in common with those of previous U.S.-focused scoping reviews, and with a recent U.K.-based review, confirming the relative paucity of U.K.-based research. No individual research topic scored highly on all of the key measures identified, with communities and organisations appearing to differ about which topics are the most important. Four broad research priorities are suggested: the affected public; inter- and intra-organisational collaboration; preparing responders and their organisations; and prioritisation and decision making. PMID:25013721

  1. 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.

  2. [Management of adult abdominal pain in the Emergency Room].

    PubMed

    Chiche, L; Roupie, E; Delassus, P

    2006-01-01

    Abdominal pain is a commonplace reason for surgical consultation in the emergency department and is the the most common symptom which the digestive surgeon on-call must evaluate. He must understand the pathophysiologic basis of visceral pain and referred pain in order to appreciate its diverse manifestations. Abdominal pain can stem from many causes intestinal and non-intestinal, medical and surgical. Evaluation and management in the emergency department must be rapid and pragmatic; clinical history and physical examination should define the gravity of the case, direct the first diagnostic procedures and complementary examinations, and guide the therapeutic direction. Ultrasonography is a quick and effective diagnostic procedure in the diagnosis of biliary, urologic, and gynecologic pathologies; it can be useful for other digestive problems as well. The new generation spiral CT scanner gives excellent definition of digestive and vascular pathologies. The initial evaluation and management of the acute abdomen may determine the prognosis of the patient; it should lead to prompt symptomatic relief and to a well-directed treatment appropriate to the diagnosis. PMID:16609646

  3. Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol

    PubMed Central

    Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

    2013-01-01

    Introduction Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. Methods and analysis To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. Ethics and dissemination This protocol has been approved by the CSSS Alphonse–Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific

  4. Biodefense countermeasures: the impact of Title IV of the US Pandemic and All-Hazards Preparedness Act

    PubMed Central

    Gronvall, GK

    2008-01-01

    The 2006 US Pandemic and All-Hazards Preparedness Act gave the Department of Health and Human Services (HHS) new authority to fund the development and procurement of medical countermeasures against chemical, biological, radiological, and nuclear (CBRN) threats. The legislation builds on the authority the HHS gained in 2004 under Project BioShield, which established a fund to procure medical countermeasures. This article reviews the new HHS authorities and the improvements on BioShield, and it describes some of the challenges HHS will face in exercising the new authorities to fund the development and procurement of medical countermeasures against CBRN threats. PMID:22460212

  5. 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.

  6. 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. PMID:26642169

  7. Management of Fever in Postpneumococcal Vaccine Era: Comparison of Management Practices by Pediatric Emergency Medicine and General Emergency Medicine Physicians

    PubMed Central

    Goldman, David L.; Avner, Jeffrey R.

    2014-01-01

    Background. The primary objective of this study was to compare management practices of general emergency physicians (GEMPs) and pediatric emergency medicine physicians (PEMPs) for well-appearing young febrile children. Methods. We retrospectively reviewed the charts of well-appearing febrile children aged 3–36 months who presented to a large urban children's hospital (PED), staffed by PEMPs, or a large urban general emergency department (GED), staffed by GEMPs. Demographics, immunization status, laboratory tests ordered, antibiotic usage, and final diagnoses were collected. Results. 224 cases from the PED and 237 cases from the GED were reviewed. Children seen by PEMPs had significantly less CXRs (23 (10.3%) versus 51 (21.5%), P = 0.001) and more rapid viral testing done (102 (45%) versus 40 (17%), P < 0.0001). A diagnosis of a viral infection was more common in the PED, while a diagnosis of bacterial infection (including otitis media) was more common in the GED. More GED patients were prescribed antibiotics (41% versus 27%, P = 0.002), while more PED patients were treated with oseltamivir (6.7% versus 0.4%, P < 0.001). Conclusions. Our findings identify important differences in the care of the young, well-appearing febrile child by PEMPs and GEMPs and highlight the need for standardization of care. PMID:24982807

  8. Improving acute medical management: Junior Doctor Emergency Prescription Cards

    PubMed Central

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa

    2016-01-01

    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC “usability”. To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found “easy to use” (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post

  9. 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.

  10. 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.

  11. Federal Emergency Management Information System (FEMIS). Data Management Guide, FEMIS: Phase 1, Version 1.1u

    SciTech Connect

    Burnett, R.A.; Johnson, D.M.; Johnson, S.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 and Biological Defense Command. The FEMIS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain the data resources in the system.

  12. 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

  13. Urinary Tract Infections: Current and Emerging Management Strategies

    PubMed Central

    Barber, Amelia E.; Norton, J. Paul; Spivak, Adam M.; Mulvey, Matthew A.

    2013-01-01

    Acute cystitis is one of the most commonly encountered bacterial infections and is responsible for substantial morbidity and high medical costs in the United States and across the globe. Though generally considered to be self-limiting and easily treated with antibiotics, urinary tract infections (UTIs) are often incompletely resolved by antibiotic therapy and frequently recur. This is in part due to the ability of uropathogenic bacteria to invade, replicate, and persist within host epithelial cells. The biological complexity of these infections combined with a dramatic rise in antibiotic-resistant pathogens highlight the need for alternative therapies. In this review we examine current management strategies for UTIs, as well as emerging treatments, including novel compounds that block bacterial interactions with the urothelium and vaccines focused on preventing both acute and recurrent infections. PMID:23645845

  14. A bed management strategy for overcrowding in the emergency department.

    PubMed

    Barrett, Lynn; Ford, Suzanne; Ward-Smith, Peggy

    2012-01-01

    In 2006, the Institute of Medicine cited growing visit volumes, hospital closures, financial pressures, and operational inefficiencies as the principal reasons for emergency department (ED) overcrowding and called for regulatory measures to resolve the problem. A Midwest medical center with 59,000 annual ED visits instituted a bed management strategy to decrease the need to board, or hold, admitted hospital patients in the ED awaiting transfer to an inpatient care unit. This strategy was successful in improving the hold time from an average of 216 minutes to 103 minutes, or by 52%. This allowed the staff at the hospital to care for an additional 2,936 patients. During this same time, the overall hospital mortality decreased by 0.07% and patient satisfaction scores improved 1%. The greatest outcome from this intervention was realized in the potential revenue increase of over $2 million. PMID:22558725

  15. 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. PMID:27416582

  16. Emergency presentation and management of acute severe asthma in children

    PubMed Central

    Øymar, Knut; Halvorsen, Thomas

    2009-01-01

    Acute severe asthma is one of the most common medical emergency situations in childhood, and physicians caring for acutely ill children are regularly faced with this condition. In this article we present a summary of the pathophysiology as well as guidelines for the treatment of acute severe asthma in children. The cornerstones of the management of acute asthma in children are rapid administration of oxygen, inhalations with bronchodilators and systemic corticosteroids. Inhaled bronchodilators may include selective b2-agonists, adrenaline and anticholinergics. Additional treatment in selected cases may involve intravenous administration of theophylline, b2-agonists and magnesium sulphate. Both non-invasive and invasive ventilation may be options when medical treatment fails to prevent respiratory failure. It is important that relevant treatment algorithms exist, applicable to all levels of the treatment chain and reflecting local considerations and circumstances. PMID:19732437

  17. 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.

  18. Therapeutic Management of Familial Hypercholesterolemia: Current and Emerging Drug Therapies.

    PubMed

    Patel, Roshni S; Scopelliti, Emily M; Savelloni, Julie

    2015-12-01

    Familial hypercholesterolemia (FH) is a genetic disorder characterized by significantly elevated low-density lipoprotein cholesterol (LDL-C) concentrations that result from mutations of the LDL receptor, apolipoprotein B (apo B-100), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Early and aggressive treatment can prevent premature atherosclerotic cardiovascular disease in these high-risk patients. Given that the cardiovascular consequences of FH are similar to typical hypercholesterolemia, traditional therapies are utilized to decrease LDL-C levels. Patients with FH should receive statins as first-line treatment; high-potency statins at high doses are often required. Despite the use of statins, additional treatments are often necessary to achieve appropriate LDL-C lowering in this patient population. Novel drug therapies that target the pathophysiologic defects of the condition are continuously emerging. Contemporary therapies including mipomersen (Kynamro, Genzyme), an oligonucleotide inhibitor of apo B-100 synthesis; lomitapide (Juxtapid, Aegerion), a microsomal triglyceride transfer protein inhibitor; and alirocumab (Praluent, Sanofi-Aventis/Regeneron) and evolocumab (Repatha, Amgen), PCSK9 inhibitors, are currently approved by the U.S. Food and Drug Administration for use in FH. This review highlights traditional as well as emerging contemporary therapies with supporting clinical data to evaluate current recommendations and discuss the future direction of FH management. PMID:26684558

  19. Channelopathies - emerging trends in the management of inherited arrhythmias.

    PubMed

    Chockalingam, Priya; Mizusawa, Yuka; Wilde, Arthur Am

    2015-01-01

    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

  20. 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.

  1. [General principles of wound management in emergency departments].

    PubMed

    Zacher, M T; Högele, A M; Hanschen, M; von Matthey, F; Beer, A-K; Gebhardt, F; Biberthaler, P; Kanz, K-G

    2016-04-01

    Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The next step is débridement of contaminated and devitalized tissue. There are several wound closure techniques available, including adhesive tapes, staples, tissue adhesives and numerous forms of sutures. Management of specific wounds requires particular strategies. A bleeding control problem frequently occurs with scalp lacerations. Superficial scalp lacerations can be closed by alternative wound closure methods, for example by twisting and fixing hair and the use of tissue adhesives, i.e. hair apposition technique (HAT). For strongly bleeding lacerations of the scalp, the epicranial aponeurosis should be incorporated into the hemostasis. Aftercare varies depending on both the characteristics of the wound and those of the patient and includes adequate analgesia as well as minimizing the risk of infection. Sufficient wound aftercare starts with the treating physician informing the patient about the course of events, potential complications and providing relevant instructions. PMID:27059794

  2. 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

  3. 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...

  4. 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…

  5. 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

  6. Automatic search of geospatial features for disaster and emergency management

    NASA Astrophysics Data System (ADS)

    Zhang, Chuanrong; Zhao, Tian; Li, Weidong

    2010-12-01

    Although the fast development of OGC (Open Geospatial Consortium) WFS (Web Feature Service) technologies has undoubtedly improved the sharing and synchronization of feature-level geospatial information across diverse resources, literature shows that there are still apparent limitations in the current implementation of OGC WFSs. Currently, the implementation of OGC WFSs only emphasizes syntactic data interoperability via standard interfaces and cannot resolve semantic heterogeneity problems in geospatial data sharing. To help emergency responders and disaster managers find new ways of efficiently searching for needed geospatial information at the feature level, this paper aims to propose a framework for automatic search of geospatial features using Geospatial Semantic Web technologies and natural language interfaces. We focus on two major tasks: (1) intelligent geospatial feature retrieval using Geospatial Semantic Web technologies; (2) a natural language interface to a geospatial knowledge base and web feature services over the Semantic Web. Based on the proposed framework we implemented a prototype. Results show that it is practical to directly discover desirable geospatial features from multiple semantically heterogeneous sources using Geospatial Semantic Web technologies and natural language interfaces.

  7. 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

    2016-01-01

    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). PMID:27389463

  8. 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.…

  9. 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)…

  10. 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…

  11. Hepatocellular carcinoma: natural history, current management, and emerging tools

    PubMed Central

    Tinkle, Christopher L; Haas-Kogan, Daphne

    2012-01-01

    Hepatocellular carcinoma (HCC) is the most common primary liver tumor and represents the third-leading cause of cancer-related death in the world. The incidence of HCC continues to increase worldwide, with a unique geographic, age, and sex distribution. The most important risk factor associated with HCC is liver cirrhosis, with the majority of cases caused by chronic infection with hepatitis B (HBV) and C (HCV) viruses and alcohol abuse, although nonalcoholic fatty liver disease is emerging as an increasingly important cause. Primary prevention in the form of HBV vaccination has led to a significant decrease in HBV-related HCC, and initiation of antiviral therapy appears to reduce the incidence of HCC in patients with chronic HBV or HCV infection. Additionally, the use of ultrasonography enables the early detection of small liver tumors and forms the backbone of recommended surveillance programs for patients at high risk for the development of HCC. Cross-sectional imaging studies, including computed tomography and magnetic resonance imaging, represent further noninvasive techniques that are increasingly employed to diagnose HCC in patients with cirrhosis. The mainstay of potentially curative therapy includes surgery – either resection or liver transplantation. However, most patients are ineligible for surgery, because of either advanced disease or underlying liver dysfunction, and are managed with locoregional and/or systemic therapies. Randomized controlled trials have demonstrated a survival benefit with both local therapies, either ablation or embolization, and systemic therapy in the form of the multikinase inhibitor sorafenib. Despite this, median survival remains poor and recurrence rates significant. Further advances in our understanding of the molecular pathogenesis of HCC hold promise in improving the diagnosis and treatment of this highly lethal cancer. PMID:22904613

  12. Emergency management communication on university Web sites: A 7-year study.

    PubMed

    Brown, Kelly L; Holguin, Gina; Scott, Tara Halbrook

    2016-01-01

    In the last several years, disasters-both manmade and natural-have taken their toll on college campuses. Extant research shows that college campuses have greatly increased their emergency management efforts. One area in which colleges and universities have made strides is emergency management communication. There has been some research examining emergency management communication across campuses, but there is still much to learn. This research fills a gap in this area by investigating the use of university Web sites to disseminate emergency management information to the university stakeholders. Data were gathered in 2007 and 2014 from the Web sites of public, 4-year universities in Indiana. The results show that universities are using the Internet to communicate emergency management information to their stakeholders. Among the most common categories of information available on the Web sites are links to other agencies, university response information, and threat levels. Implications for future research are discussed. PMID:27575641

  13. 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. PMID:25754216

  14. Emergency management in health: key issues and challenges in the UK

    PubMed Central

    2012-01-01

    Background Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. Methods The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. Results We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Conclusions Four thematic categories for future research emerged: (i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained. (ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required. (iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus

  15. 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

  16. Quality function deployment in emergency planning and management

    SciTech Connect

    Schaub, D.; Tufekci, S.

    1995-12-31

    Quality Function Deployment (QFD) is an engineering tool for organizing and ranking information into matrix form in order to understand the attributes or actions that are needed to achieve a common goal, and to align cross-functional teams strategically to quickly and efficiently meet that common goal. Although this tool has been used primarily in the manufacturing world for product or process planning, it can easily and effectively be applied at various levels within the emergency planning/response environment as an aid to prioritize critical resources. Applications will be discussed at the personal or user level, local emergency response level, state and federal levels. By utilizing QFD, these entities will be better able to address emergency situations. QFD can also be a cornerstone to continuously improve readiness to handle the crucial time just prior to, and just after, the emergency occurs.

  17. Emergency department evaluation and management of foot and ankle pain.

    PubMed

    Wedmore, Ian; Young, Scott; Franklin, Jill

    2015-05-01

    Foot and ankle injuries are a frequent cause for a visit to the Emergency Department. A thorough evaluation and treatment of these injuries needs to be an area of in-depth familiarity for the Emergency Medicine physician. The key to proper evaluation is first a history and physical examination that focuses on determining what, if any, imaging is required. Subsequently, a focused history, physical examination, and imaging will then determine if an injury is stable or unstable, requiring operative intervention. PMID:25892727

  18. 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. PMID:17008263

  19. 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. PMID:25991506

  20. Oxygenation via a Biventricular Assist Device for Emergency Airway Management.

    PubMed

    Howitt, Samuel Henry; Stirling, Sarah; Krysiak, Piotr; Pate, Bryce; Maybauer, Marc Oliver

    2016-05-01

    A 56-year-old man receiving mechanical circulatory support via a biventricular assist device suffered an airway emergency secondary to bleeding into the airway. An improvised solution to gain control of the airway in the short term was devised, and an oxygenator was inserted into the circuit, providing an alternative means of gas exchange while definitive control of the airway was achieved. This case changed practice in our institution, where we now make contingency plans for emergency oxygenator insertion into the circuits of all patients with a biventricular assist device who show any sign of airway hemorrhage. PMID:27136082

  1. Management Education in Emerging Economies: The Impossible Dream?

    ERIC Educational Resources Information Center

    Napier, N. K.; Harvey, Michael; Usui, Kengo

    2008-01-01

    Providing management education in countries where poverty is rampant seems a contradiction in terms. Yet it may help the country to develop stronger competitiveness and economic development. The article proposes a tentative framework to show how management education might be implemented in the world's poorest countries. The proposed framework…

  2. 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 public,…

  3. 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…

  4. 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

  5. Incident and Emergency Medical Services Management from a Regional Perspective

    PubMed Central

    Sisiopiku, Virginia P.; Cavusoglu, Ozge

    2012-01-01

    Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS) to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA) area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA) platform. Moreover, first responders’ travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA) over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts. PMID:22851940

  6. 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.

  7. 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…

  8. Assessment and management of bullied children in the emergency department.

    PubMed

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

    2013-03-01

    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

  9. 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…

  10. Incident and emergency medical services management from a regional perspective.

    PubMed

    Sisiopiku, Virginia P; Cavusoglu, Ozge

    2012-07-01

    Traffic crashes and other emergencies have impacts on traffic operations in transportation networks, often resulting in non-recurring congestion. Congestion, in turn, may impede the ability of Emergency Medical Services (EMS) to provide timely response to those in need of medical attention. The work in this paper investigated the impact of incidents of varying severity and duration on transportation network performance in the Birmingham (AL, USA) area. The intensity and extent of the impact over space and time were assessed on the basis of average speeds. The analysis of incident scenarios was performed using the Visual Interactive System for Transport Algorithms (VISTA) platform. Moreover, first responders' travel times to the scene of the incident were collected to identify best units for responding, in an effort to improve current dispatching practices. Finally, a secondary incident on the EMS to the hospital was considered to further demonstrate the superiority of Dynamic Traffic Assignment (DTA) over traditional static assignment methods in capturing dynamically changing traffic conditions. The study findings are expected to benefit local transportation planners, traffic engineers, emergency responders, and policy makers by allowing them to assess various response strategies to major incidents and emergencies and select the ones that minimize their potential impacts. PMID:22851940

  11. 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…

  12. Information Technology Utilization in Emergency Management at Exxon Research and Engineering Company.

    ERIC Educational Resources Information Center

    Soled, E. H.; And Others

    1987-01-01

    This description of the role of the Information Services Division of Exxon Research and Engineering Division in emergency management covers the information technology developed and used for internally generated and published information, and how this information is used to prevent emergencies and deal with them should they actually occur. (EM)

  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. Automated external defibrillator use for in-hospital emergency management.

    PubMed

    Huschak, G; Dünnebier, A; Kaisers, U X; Huschens, B; Bercker, S

    2016-05-01

    The in-hospital spread of automated external defibrillators (AEDs) is aimed to allow for a shock-delivery within three minutes. However, it has to be questioned if the implementation of AED alone really contributes to a 'heart-safe hospital'. We performed a cohort study of 1008 in-hospital emergency calls in a university tertiary care hospital, analysing cardiopulmonary resuscitation (CPR) cases with and without AED use. In total, 484 patients (48%) had cardiac arrest and received CPR. Response time of the emergency team was 4.3 ± 4.0 minutes. Only 8% percent of the CPR cases had a shockable rhythm. In three of 43 placements a shock was delivered by the AED. There were no differences in survival between patients with CPR only and CPR with AED use. Our data do not support the use of an AED for in-hospital CPR if a professional response team is rapidly available. PMID:27246934

  15. Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome.

    PubMed

    Klein Nulent, Casper G A; de Graaff, Henri J D; Ketelaars, Rein; Sewnaik, Aniel; Maissan, Iscander M

    2016-08-15

    A 44-year-old man presented to our emergency department with a pharyngeal hemorrhage, 6 weeks after a total laryngectomy and extensive neck dissection. Immediate surgical intervention was necessary to stop massive arterial hemorrhage from the pharynx. The head and neck surgeon successfully ligated the common carotid artery during this procedure. We describe the anesthetic strategy and the thromboelastometry (ROTEM®)-guided massive transfusion protocol. PMID:27310900

  16. Severe acute malnutrition during emergencies: burden management, and gaps.

    PubMed

    Bahwere, Paluku

    2014-06-01

    Natural and man-made disasters, including floods, droughts, earthquakes, and armed conflicts, create nutrition crises. Unfortunately, the frequency and severity of such disasters have been increasing since the beginning of the 20th century, and their contribution to the burden of acute malnutrition is increasing every year. However, their contribution to the burden of acute malnutrition is underrecognized due to the ways in which global statistics are built and causes of death are reported. Fortunately, the success of the current protocol for treatment of severe acute malnutrition (SAM) and the integrated approach to treatment has created a momentum allowing expanded coverage of treatment of SAM, especially in humanitarian emergency contexts. For this progress to be maintained and accelerated, changes in nutrition information systems at the national and global levels are needed, and the persisting barriers to the expansion and integration of treatment of SAM into routine health systems need to be removed. Emergency funding approaches and objectives have to include sustaining and amplifying the achievements of the short-term palliative interventions. Nutrition programs implemented in emergency contexts have the capacity to contribute to answering priority research questions, and this capacity should be more optimally utilized. PMID:25069293

  17. 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

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

    PubMed

    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. Effect of insecticide management history on emergence phenology and neonicotinoid resistance in Leptinotarsa decemlineata (Coleoptera: Chrysomelidae).

    PubMed

    Huseth, A S; Groves, R L

    2013-12-01

    Emergence phenology and fitness attributes of several Colorado potato beetle, Leptinotarsa decemlineata (Say), populations were measured under field and greenhouse conditions. Anecdotal observations by producers and pest managers in many locations of the upper Midwest increasingly suggested that select populations of Colorado potato beetle were emerging over a longer period in the spring and were less sensitive to systemic neonicotinoids in cultivated potato. These changes in emergence phenology may be related to changes in systemic insecticide concentration over time. Specifically, a prolonged period of adult emergence in the spring increases the potential of low-dose chronic exposure to systemic neonicotinoid insecticides in potato. In 2010 and 2011, our objectives were twofold: 1) establish a common garden experiment to compare the emergence phenology of Colorado potato beetle populations uniquely managed with variable insecticide inputs, and 2) measure postdormancy fitness of emerged adult beetles from among these selected populations. Cumulative adult emergence was modeled with logistic regression. Results from this study found no clear evidence for direct relationships between phenology and management history or resistance. Differences in reproductive capacity, sex ratio, and body size were apparent in some instances. However, these results did not uniformly correspond to one specific form of potato pest management tested here. In this study, long-term reliance on systemic insecticides for Colorado potato beetle control did not serve as a strong predictor for variable life history for selected populations in Wisconsin. PMID:24498751

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

    PubMed

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

    2016-07-01

    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. PMID:27388086

  1. The German approach to emergency/disaster management.

    PubMed

    Domres, B; Schauwecker, H H; Rohrmann, K; Roller, G; Maier, G W; Manger, A

    2000-01-01

    Disaster control and disaster relief in Germany are public tasks. But the government has shifted the responsibility of the administration of these tasks to the 16 states, the so called "Lander", because the EFG is a federal republic. The same is valid for the civil defense and the civil protection in the case of military or international risks. The 16 states are also responsible for the legislation of rescue service, fire fighting service and disaster control (natural and technical disasters). Counties and district-free cities are responsible for the organisation of these services. The German system is based on the principle of subsidiary between official and private institutions. A lot of official and private relief organisations are responsible for the execution of disaster relief tasks. In Germany the following organisations exist: Official (GO): Technisches Hilfswerk (THW/Federal Technical Support Service), Feuerwehren (Fire Brigades/professionals and volunteers) Academie of Emergency Planning and Civil Defense Private (NGO): Arbeiter-Samariter-Bund Deutschland (ASB/Workers' Samaritan Association Germany), Deutsche Gesellschaft zur Rettung Schiffbruchiger (DGzRS, German Lifesaving Association), Deutsches Rotes Kreuz (DRK/German Red Cross), Johanniter-Unfall-Hilfe (JUH/St. John's Ambulance), Malteser Hilfsdienst (MEID/Maltese-Relief-Organisation). ASB, DRK, JUH and MHD are specialised in the field of rescue, medical and welfare services and medical disaster relief. 80% of the German rescue service and 95% of the German disaster medical relief are realised by these NGO's. NGO's and GO's employ more than 1.2 million volunteers and appr. 100,000 professionals. Rescue service is carried out by professionals, disaster relief by volunteers. The German constitution allows to call the federal army in case of disaster, to support the disaster relief organisations (for example: flood Oder River 1997, train-crash "ICE" 1998). In all counties and district free cities

  2. 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).

  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. Decision making as community adaptation: a case study of emergency managers in Oklahoma.

    PubMed

    Donner, William R

    2008-06-01

    This paper explores how emergency managers make judgments regarding long-term policy and offers a sociological account of organisational decision making within an ecological context. Discussions with emergency managers focusing on the relative merits of rainfall estimation and tornado detection served as data with which to address these issues. Among the 39 interviewees, a consensus emerged favouring tornado detection over rainfall estimation. From these findings, the paper attempts to understand why emergency managers prefer tornado detection to rainfall estimation and to develop theoretical generalisations explaining trends in these preferences. When developing long-term policy, analysis of transcripts revealed emergency managers to be most concerned with the relative uncertainty of hazards, the capabilities of technology in hazard mitigation, and how the public perceives environmental threats. Given the environmental, technological, and social concerns reflected in this reasoning, there appears to be a strong ecological context driving the need for tornado detection among emergency managers. Implications and concerns are presented in the final section. PMID:18380856

  5. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  6. 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.…

  7. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  8. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  9. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  10. 47 CFR 95.143 - Managing a GMRS system in an emergency.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Managing a GMRS system in an emergency. 95.143 Section 95.143 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES General Mobile Radio Service (GMRS) § 95.143 Managing a GMRS system in...

  11. SOME EMERGING ISSUES IN WATERSHED MANAGEMENT LANDSCAPE PATTERNS SUSTAINABILITY WITH CUMULATIVE ENVIRONMENTAL CHANGE

    EPA Science Inventory

    Emerging issues in watershed management include the need to assess the effects of management activities on the time scale of several cutting rotations (>100 yrs) and on spatial sacles that consider factors impinging from beyond watershed boundaries. ong-range analysis reveals str...

  12. 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

    ... 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 Review... of Management and Budget, via fax at 202-395-5167 or via the Internet at...

  13. 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…

  14. 76 FR 38183 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... Under Emergency Review by the Office of Management and Budget (OMB) Title: Evaluation of Adolescent... Training 533 1 .7 373 Princeton Center for Leadership Training (PCLT)/ 533 1 .6 320 TeenPEP Total 2468 1601... Officer for ACF, Office of Management and Budget, Paperwork Reduction Project, 725 17th Street...

  15. Emergency Management of Seizures in the School Setting

    ERIC Educational Resources Information Center

    O'Dell, Christine; O'Hara, Kathryn; Kiel, Sarah; McCullough, Kathleen

    2007-01-01

    Effective seizure management in the school setting is a critical issue for students with seizures, as well as their parents, classmates, and school personnel. The unpredictable nature of seizures and the potential outcomes of experiencing a seizure in school are sources of anxiety for students with seizures. The ability to respond appropriately to…

  16. 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.

  17. From Plutocracy to Pluralism: Managing the Emerging Technostructure.

    ERIC Educational Resources Information Center

    Heterick, Robert C., Jr.; Sanders, William H.

    1993-01-01

    Advocates the formulation of an information systems strategy for higher education in light of trends affecting the information age, including globalization, networking, restructuring, pluralism, and automation. Management strategies of leadership, responsibility, organization, and funding are discussed; and implications for instruction, outreach,…

  18. The Emergence of Management Education in Central Europe.

    ERIC Educational Resources Information Center

    Waddock, Sandra

    1997-01-01

    Management education in East Central Europe exists in a context of rapid evolution, the need to establish credibility, and contradictory demand. Programs must deal with the transition to a market economy, social versus profit orientation, lack of qualified faculty, and the need for textbooks and case material. (SK)

  19. The allergic emergency--management of severe allergic reactions.

    PubMed

    Werner-Busse, Alexandra; Zuberbier, Torsten; Worm, Margitta

    2014-05-01

    Anaphylaxis is characterized by the sudden onset of acute allergic symptoms involving two or more organ systems. An acute allergic emergency is a challenge for physicians due to its life-threatening potential. The incidence of anaphylactic reactions has increased in recent years. Most frequent elicitors of mast cell and primarily histamine dependent anaphylactic reactions are food, insect venom or drugs. Allergic -reactions are graded into four groups according to the classification by Ring and Messmer; grade I is defined by the onset of cutaneous symptoms only whereas grade IV is characterized by cardiovascular shock as well as cardiac and/or respiratory arrest. The treatment of allergic reactions should be guided by the severity of the reaction. Initially an intramuscular epinephrine injection into the lateral thigh should be given if cutaneous, mucosal and cardiovascular/respiratory symptoms occur. Additionally, the patient should receive intravenous antihistamines and corticosteroids. For self-treatment in the case of an allergic emergency, oral antihistamines and corticosteroids should be prescribed to the patient. PMID:24673732

  20. 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.

  1. [Comparison of management of ambulatory emergency patients in the family practice and the hospital emergency center].

    PubMed

    Bovet Fritschi, Caroline; Ballmer, Peter E

    2014-06-18

    The increase in health care cost is broadly discussed in the public, either in the hospital or ambulatory setting. With the present study we compared the invoice amount generated by a first doctor's advice in the general practitioner to the one in the emergency room. In addition, we compared the diagnostic procedures used in the general practice to the one in the hospital, and whether the choice of diagnostic procedures would substantially influence the invoice amount. The invoice amount in the hospital setting was on average CHF 197.-, i. e. 134%, higher compared to the general practice. The difference in the invoice amount was largely explained by more diagnostic procedures in the hospital. Moreover, part of the higher invoice amount was generated by the extensive physical examination by doctors in the hospital. PMID:24938157

  2. 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.

  3. 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

  4. Delirium: An Emerging Frontier in Management of Critically Ill Children

    PubMed Central

    Smith, Heidi A.B.; Fuchs, D. Catherine; Pandharipande, Pratik P.; Barr, Frederick E.; Ely, E. Wesley

    2009-01-01

    OBJECTIVES Introduce pediatric delirium and provide understanding of acute brain dysfunction with its classification and clinical presentations. Understand how delirium is diagnosed and discuss current modes of delirium diagnosis in the critically ill adult population and translation to pediatrics. Understand the prevalence and prognostic significance of delirium in the adult and pediatric critically ill population. Discuss the pathophysiology of delirium as currently understood. Provide general management guidelines for delirium. PMID:19576533

  5. 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

  6. Emerging Advances in the Management of Cardiac Amyloidosis.

    PubMed

    Vranian, Michael N; Sperry, Brett W; Valent, Jason; Hanna, Mazen

    2015-11-01

    Amyloidosis is a disease in which proteins misfold, aggregate into fibrils, and deposit extracellularly disrupting organ architecture and function. There are two main types which affect the heart: light chain (AL) amyloidosis and transthyretin cardiac amyloidosis (ATTR). There is a misconception that cardiac amyloidosis has no effective treatment options. However, over the past decade, there has been extensive research and drug development. Outcomes are improving in AL amyloidosis with evolving chemotherapeutic regimens and novel monoclonal antibodies. In ATTR, therapies that decrease protein production, prevent dissociation, and promote clearance have the potential to slow or even halt a disease which is uniformly fatal. Selected patients may be candidates for heart and/or stem cell transplant and should be promptly referred to an experienced amyloid program. Herein, we discuss the emerging advances for the treatment of cardiac amyloidosis. PMID:26374453

  7. 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. PMID:17299923

  8. 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.

  9. 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.

  10. 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

  11. Emerging concepts in the management of acute retinal necrosis.

    PubMed

    Wong, Robert William; Jumper, J Michael; McDonald, H Richard; Johnson, Robert N; Fu, Arthur; Lujan, Brandon J; Cunningham, Emmett T

    2013-05-01

    Acute retinal necrosis (ARN), also known as Kirisawa-type uveitis, is an uncommon condition caused by infection of the retina by one of the herpes family of viruses, most typically varicella zoster virus or herpes simplex virus and less commonly cytomegalovirus. Clinical diagnosis can be challenging and is often aided by PCR-based analysis of ocular fluids. Treatment typically involves extended use of one or more antiviral agents. Long term retinal detachment risk is high. We review the literature on ARN and present an approach to the diagnosis and management of this serious condition. PMID:23235944

  12. The Vortex: a universal 'high-acuity implementation tool' for emergency airway management.

    PubMed

    Chrimes, N

    2016-09-01

    Factors influencing performance during emergency airway management can be broadly divided into issues with preparation and those with implementation. Effective design of resources that provide guidance on management requires consideration of the context in which they are to be used. Many of the major airway guidelines do not specify whether they are intended to be used during preparation or implementation and may not take the context for use into account in their design. This can produce tools which may be not only ineffective but actively disruptive to team function in an emergency. The Vortex is a novel, simple, and predominantly visually based cognitive aid, which has been specifically designed to be used in real time during airway emergencies to support team function and target recognized failings in airway crisis management. Unlike the major algorithms, which are context specific, the Vortex is flexible enough for the same tool to be applied to any circumstance in which airway management takes place, independent of context, patient type, or the intended airway device. This makes the same tool suitable for use by emergency physicians, intensivists, paramedical staff, and anaesthetists. The Vortex contains many of the recognized features of an ideal cognitive tool and may be effective in reducing implementation errors in emergency airway management. Experimental evidence is required to establish this. PMID:27440673

  13. 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. PMID:27529058

  14. School management and contingency theory: an emerging perspective.

    PubMed

    Hanson, E M

    1979-01-01

    In an article written for educational administrators, Hanson explains the assumptions, framework, and application of contingency theory. The author sees contingency theory as a way for organizations to adapt to uncertainty by developing a strategic plan with alternative scenarios. He urges school administrators to join businessmen and public managers in using a technique described as "the most powerful current sweeping over the organizational field." The theory assumes that: (1) a maze of goals govern the development of events; (2) different management approaches may be appropriate within the same organization; and (3) different leadership styles suit different situations. Contingency planning helps the organization to respond to uncertainty in the external environment by identifying possible events that may occur and by preparing alternative stratgies to deal with them. Hanson describes the purpose of this process as providing "a more effective match between an organization and its environment." He explains that contingency theory analyzes the internal adjustments of the organization (e.g., decision making process, structure, technology, instructional techniques) as it seeks to meet the shifting demands of its external or internal environments. According to the author, the intent of contingency theory is to establish an optimal "match" between environmental demands (and support) and the response capabilities of the organization including its structure, planning process, and leadership style. PMID:10247889

  15. 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. PMID:26808323

  16. 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

  17. 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. PMID:10190219

  18. Management of keloids and hypertrophic scars: current and emerging options

    PubMed Central

    Gauglitz, Gerd G

    2013-01-01

    In the context of growing aesthetic awareness, a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. However, excessive scarring following surgery or trauma remains difficult to improve despite a plethora of advocated treatment strategies as frequently observed in daily clinical routine. It is thus still preferable to prevent scarring by minimizing risk factors as much as possible. Hence, it remains crucial for the physician to be aware of basic knowledge of healing mechanisms and skin anatomy, as well as an appreciation of suture material and wound closure techniques to minimize the risk of postoperative scarring. Next to existing, well known prophylactic and therapeutic strategies for the improvement of excessive scarring, this article discusses emerging techniques such as intralesional cryotherapy, intralesional 5-fluorouracil, interferon, and bleomycin. Some of them have been successfully tested in well-designed trials and already have extended or may extend the current spectrum of excessive scar treatment in the near future. Innovative options such as imiquimod 5% cream, photodynamic therapy, or botulinum toxin A may also be of certain importance; however, the data currently available is too contradictory for definite recommendations. PMID:23637546

  19. A theoretical framework for negotiating the path of emergency management multi-agency coordination.

    PubMed

    Curnin, Steven; Owen, Christine; Paton, Douglas; Brooks, Benjamin

    2015-03-01

    Multi-agency coordination represents a significant challenge in emergency management. The need for liaison officers working in strategic level emergency operations centres to play organizational boundary spanning roles within multi-agency coordination arrangements that are enacted in complex and dynamic emergency response scenarios creates significant research and practical challenges. The aim of the paper is to address a gap in the literature regarding the concept of multi-agency coordination from a human-environment interaction perspective. We present a theoretical framework for facilitating multi-agency coordination in emergency management that is grounded in human factors and ergonomics using the methodology of core-task analysis. As a result we believe the framework will enable liaison officers to cope more efficiently within the work domain. In addition, we provide suggestions for extending the theory of core-task analysis to an alternate high reliability environment. PMID:25480001

  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. 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. PMID:18498369

  2. 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.

  3. Fluid assessment and management in the emergency department.

    PubMed

    Di Somma, Salvatore; Gori, Chiara Serena; Grandi, Tommaso; Risicato, Marcello Giuseppe; Salvatori, Emiliano

    2010-01-01

    Evaluation of hydration state or water homeostasis is an important component in the assessment and treatment of critically ill patients in the emergency department (ED). The main purpose of ED physicians is to immediately distinguish between normal hydrated, dehydrated and hyperhydrated states. Fluid depletion may result from renal losses and extrarenal losses (from the GI tract, respiratory system, skin, fever, sepsis, third space accumulations). Total body fluid increase can result from heart failure, kidney disease, liver disease, malignant lymphoedema or thyroid disease. In patients with fluid overload due to acute heart failure, diuretics should be given when there is evidence of systemic volume overload, in a dose up-titrated according to renal function, systolic blood pressure, and history of chronic diuretic use. The bioelectrical impedance vector analysis (BIVA) is a noninvasive technique to estimate body mass and water composition by bioelectrical impedance measurements, resistance and reactance. In patients with hyperhydration state due to heart failure, some authors showed that reactance is strongly related to BNP values and the NYHA functional classes. Other authors found a correlation between impedance and central venous pressure in critically ill patients. We have been analyzing the hydration state at admission to the ED, 24, 72 h after admission and at discharge, and found a significant and indirectly proportional correlation between BIVA hydration and the Caval index at the time of presentation to the ED and 24 and 72 h after hospital admission. Moreover, at admission we found an inverse relationship between BIVA hydration and reduced urine output that became directly proportional at 72 h. This confirms the good response to diuretic therapy with the shift of fluids from interstitial spaces. PMID:20428007

  4. An asthma management system in a pediatric emergency department

    PubMed Central

    Dexheimer, Judith W.; Abramo, Thomas J.; Arnold, Donald H.; Johnson, Kevin B.; Shyr, Yu; Ye, Fei; Fan, Kang-Hsien; Patel, Neal; Aronsky, Dominik

    2013-01-01

    Introduction Pediatric asthma exacerbations account for >1.8 million emergency department (ED) visits annually. Asthma guidelines are intended to guide time-dependent treatment decisions that improve clinical outcomes; however, guideline adherence is inadequate. We examined whether an automatic disease detection system increases clinicians' use of paper-based guidelines and decreases time to a disposition decision. Methods We evaluated a computerized asthma detection system that triggered NHLBI-adopted, evidence-based practice to improve care in an urban, tertiary care pediatric ED in a 3-month (7/09–9/09) prospective, randomized controlled trial. A probabilistic system screened all ED patients for acute asthma. For intervention patients, the system generated the asthma protocol at triage for intervention patients to guide early treatment initiation, while clinicians followed standard processes for control patients. The primary outcome measures included time to patient disposition. Results The system identified 1100 patients with asthma exacerbations, of which 704 had a final asthma diagnosis determined by a physician-established reference standard. The positive predictive value for the probabilistic system was 65%. The median time to disposition decision did not differ among the intervention (289 min; IQR = (184, 375)) and control group (288 min; IQR = (185, 375)) (p= 0.21). The hospital admission rate was unchanged between intervention (37%) and control groups (35%) (p= 0.545). ED length of stay did not differ among the intervention (331 min; IQR =(226, 581)) and control group (331 min; IQR = (222, 516)) (p = 0.568). Conclusion Despite a high level of support from the ED leadership and staff, a focused education effort, and implementation of an automated disease detection, the use of the paper-based asthma protocol remained low and time to patient disposition did not change. PMID:23218449

  5. 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

  6. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  7. A modeling and experiment framework for the emergency management in AHC transmission.

    PubMed

    Chen, Bin; Ge, Yuanzheng; Zhang, Laobing; Zhang, Yongzheng; Zhong, Ziming; Liu, Xiaocheng

    2014-01-01

    Emergency management is crucial to finding effective ways to minimize or even eliminate the damage of emergent events, but there still exists no quantified method to study the events by computation. Statistical algorithms, such as susceptible-infected-recovered (SIR) models on epidemic transmission, ignore many details, thus always influencing the spread of emergent events. In this paper, we first propose an agent-based modeling and experiment framework to model the real world with the emergent events. The model of the real world is called artificial society, which is composed of agent model, agent activity model, and environment model, and it employs finite state automata (FSA) as its modeling paradigm. An artificial campus, on which a series of experiments are done to analyze the key factors of the acute hemorrhagic conjunctivitis (AHC) transmission, is then constructed to illustrate how our method works on the emergency management. Intervention measures and optional configurations (such as the isolation period) of them for the emergency management are also given through the evaluations in these experiments. PMID:24693330

  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. 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.

  10. 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…

  11. Identification and Management of Deep Brain Stimulation Intra- and Postoperative Urgencies and Emergencies

    PubMed Central

    Morishita, Takashi; Foote, Kelly D.; Burdick, Adam P.; Katayama, Yoichi; Yamamoto, Takamitsu; Frucht, Steven J.; Okun, Michael S.

    2009-01-01

    Deep brain stimulation (DBS) has been increasingly utilized for the therapeutic treatment of movement disorders, and with the advent of this therapy more postoperative urgencies and emergencies have emerged. In this paper, we will review, identify, and suggest management strategies for both intra- and postoperative urgencies and emergencies. We have separated the scenarios into 1- surgery/procedure related, 2- hardware related, 3- stimulation induced difficulties, and 4- others. We have included ten illustrative (and actual) case vignettes to augment the discussion of each issue. PMID:19896407

  12. Emergency management and mass fatalities: who owns the dead?

    PubMed

    Crabtree, Jim

    2009-11-01

    Mass fatality incidents are always unexpected and put a sudden stress on local response agencies to cooperate and share resources to accomplish tasks that are outside their normal activities. Lines of legal authority are often conflicting when two or more agencies are statutorily in charge. Within the USA, the local coroner system is almost universally delegated as responsible for all involved tasks including body recovery, yet the coroner is almost always the smallest responding agency, with the smallest labour pool from which to draw and the least experience of formal Incident Command System (ICS) procedures at large incidents. This paper explores the many tasks required following a mass fatality incident and the necessity for pre-event written agreements to be negotiated between local, state and federal agencies to ensure that material and personnel can be readily shared and reimbursed without bureaucratic misunderstanding in order to accomplish known objectives. Also explored are potential National Incident Management System conflicts in applying unified command to situations where legal authority and level of commitment are not synonymous. PMID:20378492

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

    PubMed

    Asgharpour, Amon; Kumar, Divya; Sanyal, Arun

    2015-10-01

    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

  14. Emergent airway management in a case of fibrodysplasia ossificans progressiva

    PubMed Central

    Parekh, Uma R.; Read, Selina; Desai, Vimal; Budde, Arne O.

    2014-01-01

    Fibrodysplasia ossificans progressiva (FOP), or Stone man syndrome, is rare and one of the most disabling genetic conditions of the connective tissue due to progressive extraskeletal ossification. It usually presents in the first decade of life as painful inflammatory swellings, either spontaneously or in response to trauma, which later ossify and lead to severe disability. Progressive spinal deformity including thoracolumbar kyphoscoliosis leads to thoracic insufficiency syndrome, increasing the risk for pneumonia and right sided heart failure. We present the airway management in a 22-year-old male, diagnosed with FOP with severe disability, who required urgent airway intervention as a result of respiratory failure from pnuemonia. Tracheostomy triggers ossification and consequent airway obstruction at the tracheostomy site and laryngoscopy triggers temporomandibular joint ankylosis. Therefore, awake fiber-optic endotracheal intubation is recommended in these patients. Use of an airway endoscopy mask enabled us to simultaneously maintain non-invasive ventilation and intubate the patient in a situation where tracheostomy needed to be avoided. PMID:25425787

  15. 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

  16. Current management strategies and emerging treatments for functional dyspepsia.

    PubMed

    Camilleri, Michael; Stanghellini, Vincenzo

    2013-03-01

    Functional dyspepsia refers to painful and nonpainful symptoms that are perceived to arise in the upper digestive tract but are not secondary to organic, systemic or metabolic diseases. The symptoms of this syndrome often overlap with those of GERD and IBS, making its management far from simple. If Helicobacter pylori infection is diagnosed in patients with functional dyspepsia, it should be treated. In patients with mild or intermittent symptoms, reassurance and lifestyle advice might be sufficient; in patients not responding to these measures, or in those with more severe symptoms, drug therapy should be considered. Both PPIs and prokinetics can be used in initial empirical pharmacotherapy based on symptom patterns--a PPI is more likely to be effective in the presence of retrosternal or epigastric burning or epigastric pain, whereas a prokinetic is more effective in dyspepsia with early satiation or postprandial fullness. Although combinations of PPIs and prokinetics might have additive symptomatic effects, single-drug therapy is initially preferable. Antidepressants or referral to a psychiatrist or psychotherapist can be considered in nonresponders and in those whose symptoms have a marked effect on daily functioning. Despite extensive research, functional dyspepsia treatment often remains unsatisfactory. Better characterization of dyspeptic subgroups and understanding of underlying mechanisms will enable treatment advances to be made in the future. PMID:23381190

  17. Emergency managers as community change agents: an expanded vision of the profession.

    PubMed

    Drabek, Thomas E

    2014-01-01

    Reflecting the historical evolution of attack preparedness, technological failures, and so-called natural disaster events, the profession of emergency management confronts new challenges today. In part, these reflect important cultural differences among stakeholder groups, especially local emergency managers. homeland security personnel, and those focused on public health threats and business continuity. An expanded and more strategic vision of the profession is required wherein fundamental assumption sets are placed into broader contexts. Contrary to the drift experienced in the US during the past decade, a major paradigm shift is required reflecting new orientations and program priorities. PMID:24757750

  18. 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

  19. Case management for frequent users of the emergency department: study protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background We devised a randomised controlled trial to evaluate the effectiveness and efficiency of an intervention based on case management care for frequent emergency department users. The aim of the intervention is to reduce such patients’ emergency department use, to improve their quality of life, and to reduce costs consequent on frequent use. The intervention consists of a combination of comprehensive case management care and standard emergency care. It uses a clinical case management model that is patient-identified, patient-directed, and developed to provide high intensity services. It provides a continuum of hospital- and community-based patient services, which include clinical assessment, outreach referral, and coordination and communication with other service providers. Methods/Design We aim to recruit, during the first year of the study, 250 patients who visit the emergency department of the University Hospital of Lausanne, Switzerland. Eligible patients will have visited the emergency department 5 or more times during the previous 12 months. Randomisation of the participants to the intervention or control groups will be computer generated and concealed. The statistician and each patient will be blinded to the patient’s allocation. Participants in the intervention group (N = 125), additionally to standard emergency care, will receive case management from a team, 1 (ambulatory care) to 3 (hospitalization) times during their stay and after 1, 3, and 5 months, at their residence, in the hospital or in the ambulatory care setting. In between the consultations provided, the patients will have the opportunity to contact, at any moment, the case management team. Participants in the control group (N = 125) will receive standard emergency care only. Data will be collected at baseline and 2, 5.5, 9, and 12 months later, including: number of emergency department visits, quality of life (EuroQOL and WHOQOL), health services use, and relevant costs

  20. Emergency management of the paediatric patient with generalized convulsive status epilepticus

    PubMed Central

    Friedman, JN

    2011-01-01

    The present guideline paper addresses the emergency management of generalized convulsive status epilepticus (CSE) in children and infants older than one month of age. It replaces the previous statement from 1996, and includes a new treatment algorithm and table of recommended medications, reflecting new evidence and the evolution of clinical practice over the past 15 years. The document focuses on the acute pharmacological management of CSE, but some issues regarding supportive care, diagnostic approach and treatment of refractory CSE are discussed. PMID:22294869

  1. 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…

  2. Designing a HAZMAT (hazardous materials) incident management system for facilities with widely varying emergency organization structures

    SciTech Connect

    Carter, R.J.; Easterly, C.E.

    1988-01-01

    Oak Ridge National Laboratory is currently conducting a research program for the United States Air Force, the purpose of which is to assist them in their emergency planning for HAZMAT spills. This paper describes the first two tasks in the program. These tasks are oriented towards: determining the extent of the hazardous materials (HAZMAT) problem and establishing plans directed toward HAZMAT incident management.

  3. 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…

  4. 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 ...

  5. 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

    ... under the WYO (Write Your Own) Program. 44 CFR part 62, appendix B. These data shall be validated/edited... 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...

  6. Sensitivities to source-term parameters of emergency planning zone boundaries for waste management facilities

    SciTech Connect

    Mueller, C.J.

    1995-07-01

    This paper reviews the key parameters comprising airborne radiological and chemical release source terms, discusses the ranges over which values of these parameters occur for plausible but severe waste management facility accidents, and relates the concomitant sensitivities of emergency planning zone boundaries predicted on calculated distances to early severe health effects.

  7. 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…

  8. 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…

  9. 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

    ... Federal Emergency Management Agency U.S. Fire Administration--001 9/11 Heroes Stamp Act of 2001 System of.... Fire Administration (USFA) is giving notice that it proposes to retire DHS/FEMA/USFA--001 9/11 Heroes Stamp Act of 2001 System of Records (70 FR 43218, July 26, 2005). ] This system was...

  10. 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…

  11. 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.

  12. 78 FR 62638 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget (OMB) Title: Low Income Home Energy Assistance Program (LIHEAP) Grantee Needs...

  13. 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. PMID:25987916

  14. 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

  15. Massachusetts Emergency Departments’ Resources and Physicians’ Knowledge of Management of Traumatic Dental Injuries

    PubMed Central

    Needleman, Howard L.; Stucenski, Keri; Forbes, Peter; Chen, Qiaoli (Lily); Stack, Anne M.

    2012-01-01

    Background Hospital emergency departments (ED) are confronted with triaging and managing dental emergencies of both traumatic and non-traumatic origin. However, the literature suggests that there exists inadequate knowledge of the management of traumatic dental injuries (TDI) among medical professionals who must be knowledgeable and have the appropriate resources needed to triage or treat patients presenting with TDI. Aim The aims of this study were to; 1) evaluate the resources of Massachusetts emergency departments (MED) for TDI, 2) determine the knowledge of management of TDI among MED physicians, and 3) investigate potential factors that affect their knowledge. Material and Methods Surveys were mailed to MED directors and their physicians. The director survey contained questions regarding institutional information for each emergency department (ED). The physician survey contained questions about physician characteristics and tested their knowledge of managing dental trauma. Results A total of 72 surveys (16 MED directors and 56 physicians) were returned and included in the analysis. Only 50% of the MED had on-site dental coverage, 43.8% had 24-hour off-site dental coverage and none had a formal written dental trauma protocol. MED physician’s knowledge of the appropriate management of luxations and avulsions was generally good, but poor for dental fractures. The MED physician’s knowledge for the emergent nature of the various injuries was generally good with that of avulsions being the best. Physicians were more likely to have a better knowledge of managing dental trauma if they were specialists in pediatric emergency medicine (p=0.001) or their hospitals had an academic affiliation (p=0.05). Conclusions Based on the findings from this study educational campaigns must be undertaken to improve both the resources available to the ED, as well as to improve the knowledge of physicians regarding emergency management of TDI. In addition, efforts should be made by

  16. Preparing for veterinary emergencies: disaster management and the Incident Command System.

    PubMed

    Madigan, J; Dacre, I

    2009-08-01

    An important question that all veterinary schools should consider is whether veterinary students should be trained to deal with local or regional states of emergency or disasters, such as hurricanes, tornadoes, wildfires, hail and ice storms, wind storms, fires, earthquakes, tsunamis, floods and epidemics. When a large-scale emergency or disaster does strike, the consequences can be dire for the domestic and wild animals of the region and for the humans within the vicinity of seriously and painfully injured animals. The authors argue that emergency preparedness is essential for the veterinary profession to meet its obligations to both animals and humans. The four basic components of disaster management are: mitigation, preparedness, response/emergency relief and recovery. PMID:20128473

  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. PMID:26312660

  19. 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. PMID:26663307

  20. Current concepts in management of pain in children in the emergency department.

    PubMed

    Krauss, Baruch S; Calligaris, Lorenzo; Green, Steven M; Barbi, Egidio

    2016-01-01

    Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects. PMID:26095580

  1. [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

  2. The Influential Factor Analysis of Classification Partition Management Mode on the Emergency Triage

    PubMed Central

    NA, Zhang; HUAIXIN, Cui

    2016-01-01

    Background: The aim of the study was to discuss on the influential factors of the mode of classification of partition management in the emergency triage. Method: Retrospectively analyzing the effects of emergency triage of 156 cases who adopted the classification partition management mode during Oct 2014 to Oct 2015 in Xuzhou Central Hospital (Xuzhou, Jiangsu Province, China). They were divided into triage success group of 108 cases and triage failure group of 48 cases. Comparing the single factor analysis and multi-factor analysis, and selecting possible influential factors. Result: According to the single factor analysis, for the patients who came to the doctor in the daytime and working days, the higher education degree and compliance they had, the faster the back-show time of emergency inspect and check came back, the more comprehensive the body examination and disease history taking were done, the simpler the disease condition was, the higher triage success rate they received. Compared to the emergency observation time between two groups, the difference was not statistically significant. According to the multi-factor analysis, the emergency check and examination back-show time, the comprehensive degree of body examination and disease history taking and the complexity degree of disease could be the independent risk factors for triage success. Conclusion: Simplify the examination procedure, improve the efficiency of back-show and acquire detail disease information are important methods for the improvement of triage success. PMID:27516994

  3. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky. The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: an emergency management plan, with emphasis on the catastrophic earthquake; an Emergency Operations Center Duty Roster Manual; an Integrated Automated Emergency Management Information System (IAEMIS); and a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6, Volume III -- Chapter 7, and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume I, provides an introduction, summary and recommendations, and the emergency operations center direction and control.

  4. 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. PMID:26021392

  5. 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.

  6. 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. PMID:27478494

  7. Advanced Concepts and Controversies in Emergency Department Pain Management.

    PubMed

    Motov, Sergey M; Nelson, Lewis S

    2016-06-01

    Pain is the most common complaint for which patients come to the emergency department (ED). Emergency physicians are responsible for pain relief in a timely, efficient, and safe manner in the ED. The improvement in our understanding of the neurobiology of pain has balanced the utilization of nonopioid and opioid analgesia, and simultaneously has led to more rational and safer opioid prescribing practices. This article reviews advances in pain management in the ED for patients with acute and chronic pain as well as describes several newer strategies and controversies. PMID:27208710

  8. Knowledge of Emergency Management of Traumatized Teeth among Schoolteachers in Mashhad, Iran.

    PubMed

    Mehrabkhani, Maryam; Ajami, Behjatolmolok; Parisay, Iman; Bolboli, Ali; Akbarian, Golsa

    2015-01-01

    Background and aims. Dental trauma is an important oral health problem in children that requires immediate and appropriate management for long term success. The aim of this study was to evaluate the knowledge of elementary school teachers about emergency management of traumatic dental injuries in children. Materials and methods. A total of 163 teachers from 21 elementary schools from Mashhad, Iran participated in this study. Data were collected using a two-part questionnaire comprised of questions regarding demographic data and participants' knowledge about dental trauma. Results. The level of the teachers' knowledge was moderate (53.3%). Of the 163 participants, 104 (63.8%) were females and 59 (36.2%) were males. Among several predictors that were surveyed in this study, only the age of respondents signifi-cantly impacted the teachers' knowledge (P = 0.004). Conclusion. The results of this study showed the moderate level of knowledge of teachers regarding emergency manage-ment of traumatized teeth. Adding dental trauma management courses in the teacher training curriculum and requiring teachers to be updated in regards to this issue can improve their knowledge and thus led to better management of traumatic dental injuries in children. PMID:26236440

  9. 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.

  10. Knowledge of Emergency Management of Traumatized Teeth among Schoolteachers in Mashhad, Iran

    PubMed Central

    Mehrabkhani, Maryam; Ajami, Behjatolmolok; Parisay, Iman; Bolboli, Ali; Akbarian, Golsa

    2015-01-01

    Background and aims. Dental trauma is an important oral health problem in children that requires immediate and appropriate management for long term success. The aim of this study was to evaluate the knowledge of elementary school teachers about emergency management of traumatic dental injuries in children. Materials and methods. A total of 163 teachers from 21 elementary schools from Mashhad, Iran participated in this study. Data were collected using a two-part questionnaire comprised of questions regarding demographic data and participants' knowledge about dental trauma. Results. The level of the teachers' knowledge was moderate (53.3%). Of the 163 participants, 104 (63.8%) were females and 59 (36.2%) were males. Among several predictors that were surveyed in this study, only the age of respondents signifi-cantly impacted the teachers' knowledge (P = 0.004). Conclusion. The results of this study showed the moderate level of knowledge of teachers regarding emergency manage-ment of traumatized teeth. Adding dental trauma management courses in the teacher training curriculum and requiring teachers to be updated in regards to this issue can improve their knowledge and thus led to better management of traumatic dental injuries in children. PMID:26236440

  11. 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. PMID:26529995

  12. 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

  13. 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. PMID:15056343

  14. 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

  15. Anaesthetic management of parturient with acute atrial fibrillation for emergency caesarean section.

    PubMed

    Gupta, Madhu; Subramanian, Shalini; Adlakha, Preeti

    2013-01-01

    A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed. PMID:23781350

  16. Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

    PubMed Central

    Gupta, Madhu; Subramanian, Shalini; Adlakha, Preeti

    2013-01-01

    A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed. PMID:23781350

  17. The Management of Gas-Filled Eyes in the Emergency Department

    PubMed Central

    Lim, Lik Thai; Ah-kee, Elliott Y.; House, Beve P.; Walker, Jonathan D.

    2014-01-01

    Background. Intraocular gas bubbles are commonly used in retinal surgery. There are specific management guidelines that need to be followed to ensure surgical success, and there are also unique ophthalmic and systemic complications that can occur in such patients. Objective. To educate emergency department personnel about important issues in the management of patients who have a gas-filled eye following retinal surgery. Case Report. A patient with a gas-filled eye developed several complications including pain, severe vision loss, high-grade atrioventricular (AV) block, and pneumocephalus. Conclusion. Awareness of potential problems that may arise in patients with gas-filled eyes who present to the emergency department may help minimize morbidity for such patients. PMID:25525528

  18. [Anesthetic management of a pediatric patient with hypohidrotic ectodermal dysplasia undergoing emergency surgery].

    PubMed

    Ahiskalioglu, Elif Oral; Ahiskalioglu, Ali; Firinci, Binali; Dostbil, Aysenur; Aksoy, Mehmet

    2015-01-01

    Ectodermal dysplasias are rare conditions with a triad of hypotrichosis, anodontia and anhidrosis. In literature review there have been only a few reports of anesthetic management of patients with ectodermal dysplasias. Hyperthermia is a very serious risk which may occur due to the defect of sweat glands. The present case involves a 10-year-old child with ectodermal dysplasia who presented with an acute abdomen and was considered for an emergency surgery. Our aim was to demonstrate the successful management of this case using a combination of general and epidural anesthesia. It is important for anesthesiologist to have information about this syndrome in case of emergency operations, since it can prevent serious complications and even save lives. PMID:26655713

  19. Anesthetic management of a pediatric patient with hypohidrotic ectodermal dysplasia undergoing emergency surgery.

    PubMed

    Ahiskalioglu, Elif Oral; Ahiskalioglu, Ali; Firinci, Binali; Dostbil, Aysenur; Aksoy, Mehmet

    2015-01-01

    Ectodermal dysplasias are rare conditions with a triad of hypotrichosis, anodontia and anhidrosis. In literature review there have been only a few reports of anesthetic management of patients with ectodermal dysplasias. Hyperthermia is a very serious risk which may occur due to the defect of sweat glands. The present case involves a 10-year-old child with ectodermal dysplasia who presented with an acute abdomen and was considered for an emergency surgery. Our aim was to demonstrate the successful management of this case using a combination of general and epidural anesthesia. It is important for anesthesiologist to have information about this syndrome in case of emergency operations, since it can prevent serious complications and even save lives. PMID:26614152

  20. Continuity of operations planning in college athletic programs: The case for incorporating Federal Emergency Management Guidelines.

    PubMed

    Hall, Stacey A; Allen, Brandon L; Phillips, Dennis

    2016-01-01

    College athletic departments have a responsibility to provide a safe environment for student-athletes; however, most colleges do not have a crisis management plan that includes procedures for displaced student-athletes or alternate facilities to perform athletic events. Continuity of operations planning ensures athletic programs are equipped to maintain essential functions during, or shortly after, a disruption of operations due to possible hazards. Previous studies have identified a lack of emergency preparedness and continuity planning in college athletic departments. The purpose of this article is to illustrate in detail one approach to disaster planning for college athletic departments, namely the Federal Emergency Management Agency (FEMA) continuity of operations framework. By adhering to FEMA guidelines and promoting a best practices model, athletic programs can effectively plan to address potential hazards, as well as protect the organization's brand, image, and financial sustainability after a crisis event. PMID:26963231

  1. Evolution of an experiential learning partnership in emergency management higher education.

    PubMed

    Knox, Claire Connolly; Harris, Alan S

    2016-01-01

    Experiential learning allows students to step outside the classroom and into a community setting to integrate theory with practice, while allowing the community partner to reach goals or address needs within their organization. Emergency Management and Homeland Security scholars recognize the importance, and support the increased implementation, of this pedagogical method in the higher education curriculum. Yet challenges to successful implementation exist including limited resources and time. This longitudinal study extends the literature by detailing the evolution of a partnership between a university and office of emergency management in which a functional exercise is strategically integrated into an undergraduate course. The manuscript concludes with a discussion of lessons learned from throughout the multiyear process. PMID:27438962

  2. 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

  3. 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. PMID:25708551

  4. Race/ethnicity and asthma management among adults presenting to the emergency department.

    PubMed

    Venkat, Arvind; Hasegawa, Kohei; Basior, Jeanne M; Crandall, Cameron; Healy, Megan; Inboriboon, P Charles; Sullivan, Ashley F; Camargo, Carlos A

    2015-08-01

    We investigated whether racial/ethnic disparities exist in asthma management among 1785 adults requiring emergency department (ED) treatment. In this multicentre study, non-Hispanic blacks with increased chronic asthma severity were only as likely (P > 0.05) as non-Hispanic whites or Hispanics to utilize controller medications or see asthma specialists before ED presentation and to be prescribed recommended inhaled corticosteroids at ED discharge. Improved ED education on evidence-based chronic disease management is needed to address continuing race/ethnicity-based asthma disparities. PMID:26081521

  5. What's in a wait? Contrasting management science and economic perspectives on waiting for emergency care.

    PubMed

    Morton, Alec; Bevan, Gwyn

    2008-02-01

    The current paper reviews and contrasts a management science view of waiting for healthcare, which centres on queues as devices for buffering demand, with an economic view, which stresses the role of the incentive structure, in the context of English Accident and Emergency Departments. We demonstrate that the management science view provides insight into waiting time performance within a single facility but is limited in its ability to shed light on variations in performance across facilities. We argue, with reference to supporting data, that such variations may be explainable by a proper understanding of the incentive structure in A&E Departments. PMID:17825940

  6. New Jersey's EMS response to Superstorm Sandy: a case study of the emergency management assistance compact.

    PubMed

    Clancy, Terry; Christensen, Kenneth; Cortacans, Henry P

    2014-06-01

    In the United States, understanding the Emergency Management Assistance Compact (EMAC) is critical to responding to a natural disaster or manmade event. Recently, the State of New Jersey responded to Superstorm Sandy and implemented the EMAC system by requesting ambulances to aid in the Emergency Medical Services response. New Jersey's response to Superstorm Sandy was unprecedented in that this storm affected the entire state and EMS community. New Jersey's EMS community and infrastructure were impacted greatly, despite years of planning and preparation for such an event. Once received, out-of-state EMS resources were integrated into New Jersey's emergency management and EMS systems. In this report, each phase of the EMAC in New Jersey is explored, from how the response was coordinated to how it ultimately was executed. The state coordinated its response on multiple levels and, as such, tested the practical applicability of the EMAC process and employed best practices and solutions to issues that arose. These best practices and solutions may prove invaluable for any state or territory that may activate the EMAC system for emergency medical service resources. PMID:24844291

  7. Improving the quality of cancer pain management in an academic medical center emergency department.

    PubMed

    Won, Young Hwa; Choi, Yun Jung; Ahn, Shin; Lee, Jae-Lyun; Park, Jeong Yun; Kim, Sulhwa; Kim, Tae Won; Kim, Yeon Hee

    2014-12-01

    The impact and outcomes of the implementation of a pain management guideline and pain assessment standard operating procedure (SOP) in a cancer-specific emergency department are evaluated in this article. After implementation of the SOP, the number of pain assessments conducted per patient during hospitalization increased, as did the percentage of patients who underwent a pain assessment at admission, within one hour after analgesic medication was administered, and at regular intervals. PMID:25427696

  8. 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

  9. Preventative safety management supported by an emergency response system for sour gas production in North Germany

    SciTech Connect

    Grossmann, U.M.; Schoenbach, H.C.

    1996-12-31

    In general, the onshore production of oil and gas in North place in densely populated areas. Approximately 800 MMSCFD of gas are produced from sour gas reservoirs, with H{sub 2}S-concentrations of up to 20 Vol.-% being involved. Despite a high technical safety standard and different organizational measures in the production of sour gas, emergency cases cannot be absolutely ruled out. H{sub 2}S concentrations of more than 700 ppm will cause immediate death. In Germany the production of hydrocarbons is regulated by the Federal Mining Law. According to these regulations an extensive gas protection plan and gas alarm plan have to be set up for sour gas operations. This includes establishing an emergency response organization and a gas alarm management guide. Beyond the legal requirements Mobil Erdgas-Erdoel GmbH (MEEG) has implemented an emergency response management system in compliance with Mobil Oil`s worldwide safety philosophy to minimize the risk for the population, the employees and the environment. The installation of two electronic data systems enables the crisis management team to respond faster, more safely and in a less complicated manner to accidental sour gas releases. The introduction of the Emergency Information and Response System (EMIS) makes possible the display and manipulation of maps in different scales and geographically oriented data. The expansion of the process master computer by installing an H{sub 2}S-Gas alarm system has achieved the online measurements of H{sub 2}S concentrations, wind direction and wind velocity at sour gas production facilities. The system, which is operated at the gas dispatcher center, gives the crisis response team the opportunity to predict the location of sour gas release and the area being impacted. Consequently rescue parties will be directed to the location in a safe manner and, if necessary, measures will be managed for evacuating the residents living in the danger zones around sour gas facilities.

  10. 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.

  11. Managing for biodiversity: Emerging ideas for the electric utility industry-summary statement

    SciTech Connect

    Mattice, J.; Fraser, M.; Ragone, S.

    1996-11-01

    The conference entitled {open_quotes}Managing for Biodiversity: Emerging ideas for the Electric Utility Industry{close_quotes} 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. Topics covered in this article are the following: sustainable development: challenge for utilities; Stewardship issues; where do we go from here-EPRI perspective. 34 refs.

  12. Airway registry: a performance improvement surveillance project of emergency department airway management.

    PubMed

    Phelan, Michael P; Glauser, Jonathan; Yuen, Ho-Wang A; Sturges-Smith, Elizabeth; Schrump, Stefanie E

    2010-01-01

    The aim of this study was to determine if use of a standardized airway data collection sheet can survey airway management practices in an emergency department. Success rates and trends from the authors' facility have been benchmarked against the National Emergency Airway Registry (NEAR). This study included all patients requiring invasive airway management during a 21-month period (July 1, 2005, through March 31, 2007). An audit form was developed and implemented to collect data on intubations. During the study period, 224 patients required invasive airway control. Of all airways managed by emergency medicine residents, the intubation success rate was 99% (200/203; 95% confidence interval [CI] = 96%-100%), with 3% of those (6/203; 95% CI = 1%-6%) requiring more than 3 attempts; 3 patients (1%; 95% CI = 0%-4%) could not be intubated and required a surgical airway. Use of an airway registry based on the NEAR registry as a benchmark of rates and types of successful intubation allows comparison of airway practices. PMID:20505111

  13. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP -- Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: an emergency management plan, with emphasis on the catastrophic earthquake; an Emergency Operations Center Duty Roster Manual; an Integrated Automated Emergency Management Information System (IAEMIS); and a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6, Volume III -- Chapter 7, and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume II, discusses methodology, engineering and environmental analyses, and operational procedures.

  14. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc. initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP -- Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: (1) an emergency management plan with emphasis on the catas trophic earthquake; (2) an Emergency Operations Center Duty Roster Manual; (3) an Integrated Automated Emergency Management Information System (IAEMIS); and (4) a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I -- Chapters 1--3; Volume II -- Chapters 4--6; Volume III -- Chapter 7; and Volume IV -- 23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is this document numbered as Volume III.

  15. Martin Marietta Paducah Gaseous Diffusion Plant comprehensive earthquake emergency management program

    SciTech Connect

    Not Available

    1990-02-28

    Recognizing the value of a proactive, integrated approach to earthquake preparedness planning, Martin Marietta Energy Systems, Inc, initiated a contract in June 1989 with Murray State University, Murray, Kentucky, to develop a comprehensive earthquake management program for their Gaseous Diffusion Plant in Paducah, Kentucky (PGDP--Subcontract No. 19P-JV649V). The overall purpose of the program is to mitigate the loss of life and property in the event of a major destructive earthquake. The program includes four distinct (yet integrated) components: (1) an emergency management plan, with emphasis on the catas trophic earthquake, (2) an Emergency Operations Center Duty Roster Manual, (3) an Integrated Automated Emergency Management Information System (IAEMIS), and (4) a series of five training program modules. The PLAN itself is comprised of four separate volumes: Volume I--Chapters 1--3; Volume II--Chapters 4--6, Volume III--Chapter 7, and Volume IV--23 Appendices. The EOC Manual (which includes 15 mutual aid agreements) is designated as Chapter 7 in the PLAN and is a stand alone'' document numbered as Volume III. This document, Volume IV contains the appendices to this report.

  16. 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. PMID:20116780

  17. 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).

  18. A Survey on Hong Kong Secondary School Students' Knowledge of Emergency Management of Dental Trauma

    PubMed Central

    Young, Cecilia; Wong, Kin Yau; Cheung, Lim K.

    2014-01-01

    Objectives To investigate Hong Kong secondary school students' knowledge of emergency management of dental trauma. Method A questionnaire survey on randomly selected secondary school students using cluster sampling. Results Only 36.6% (209/571) of the respondents were able to correctly identify the appropriate place for treatment of dental injury. 55.2% of the respondents knew the suitable time for treatment. Only 24.7% of the respondents possessed the knowledge of how to correctly manage fractured teeth. Only 23.6% of them knew how to manage displaced teeth. 62.5% of them correctly answered that knocked-out deciduous teeth should not be replanted to the original position, but few of them (23.6%) knew that permanent teeth should be replanted. Moreover, 37.1% of the respondents correctly identified at least one of the appropriate media for storing a knocked-out tooth. First-aid training and acquisition of dental injury information from other sources were significant factors that positive responses from these questions would lead to higher scores. Conclusion Hong Kong secondary school students' knowledge of emergency management of dental trauma is considered insufficient. An educational campaign in secondary schools dedicated to students is recommended. Prior first-aid training and acquisition of dental injury information from other sources positively relate to the level of knowledge. Dental trauma emergency management is recommended to be added to first-aid publications and be taught to students and health professionals.Trial Registration: Hong Kong Clinical Trial Centre HKCTR-1344 PMID:24400088

  19. 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. PMID:22576135

  20. 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

  1. Are we ready and how do we know? The urgent need for performance metrics in hospital emergency management.

    PubMed

    Lazar, Eliot J; Cagliuso, Nicholas V; Gebbie, Kristine M

    2009-03-01

    An extraordinary number of health care quality and patient safety indicators have been developed for hospitals and other health care institutions; however, few meaningful indicators exist for comprehensive assessment of hospital emergency management. Although health care institutions have invested considerable resources in emergency management preparedness, the need for universally accepted, evidence-based performance metrics to measure these efforts remains largely unfulfilled. We suggest that this can be remediated through the application of traditional health care quality paradigms, coupled with novel analytic approaches to develop meaningful performance data in hospital emergency management. PMID:19002013

  2. 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

  3. Emergency department evaluation and management of blunt chest and lung trauma (Trauma CME).

    PubMed

    Morley, Eric J; Johnson, Scott; Leibner, Evan; Shahid, Jawad

    2016-06-01

    The majority of blunt chest injuries are minor contusions or abrasions; however, life-threatening injuries, including tension pneumothorax, hemothorax, and aortic rupture can occur and must be recognized early. This review focuses on the diagnosis, management, and disposition of patients with blunt injuries to the ribs and lung. Utilization of decision rules for chest x-ray and computed tomography are discussed, along with the emerging role of bedside lung ultrasonography. Management controversies presented include the limitations of needle thoracostomy us¬ing standard needle, chest tube placement, and chest tube size. Finally, a discussion is provided related to airway and ventilation management to assist in the timing and type of interventions needed to maintain oxygenation. PMID:27177417

  4. 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

  5. [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. PMID:27188111

  6. Evolving need for alternative triage management in public health emergencies: a Hurricane Katrina case study.

    PubMed

    Klein, Kelly R; Pepe, Paul E; Burkle, Frederick M; Nagel, Nanci E; Swienton, Raymond E

    2008-09-01

    In many countries, traditional medical planning for disasters developed largely in response to battlefield and multiple casualty incidents, generally involving corporal injuries. The mass evacuation of a metropolitan population in the aftermath of Hurricane Katrina evolved into life-and-death triage scenarios involving thousands of patients with nontraumatic illnesses and special medical needs. Although unprecedented in the United States, triage management needs for this disaster were similar to other large-scale public health emergencies, both natural and human-generated, that occurred globally in the past half-century. The need for alternative triage-management processes similar to the methodologies of other global mass public health emergencies is illustrated through the experience of disaster medical assistance teams in the first 3 days following Katrina's landfall. The immediate establishment of disaster-specific, consensus-based, public health emergency-related triage protocols-developed with ethical and legal expertise and a renewed focus on multidimensional, multifactorial matrix decision-making processes-is strongly recommended. PMID:18769266

  7. Web-based multimedia courseware for emergency cardiac patient management simulations.

    PubMed

    Ambrosiadou, V; Compton, T; Panchal, T; Polovina, S

    2000-01-01

    This is a multidisciplinary inter-departmental/faculty project between the departments of computer science, electronic, communications and electrical engineering and nursing and paramedic sciences. The objective is to develop a web based multimedia front end to existing simulations of cardiac emergency scenaria. It will be used firstly in the teaching of nurses. The University of Hertfordshire is the only University in Britain using simulations of cardiac emergency scenaria for nurse and paramedic science education and therefore this project will add the multimedia dimension in distributed courses over the web and will assess the improvement in the educational process. The use of network and multimedia technologies, provide interactive learning, immediate feedback to students' responses, individually tailored instructions, objective testing and entertaining delivery. The end product of this project will serve as interactive material to enhance experiential learning for nursing students using the simulations of cardiac emergency scenaria. The emergency treatment simulations have been developed using VisSim and may be compiled as C code. The objective of the project is to provide a web based user friendly multimedia interface in order to demonstrate the way in which patients may be managed in critical situations by applying advanced technological equipment and drug administration. Then the user will be able to better appreciate the concepts involved by running the VisSim simulations. The evaluation group for the proposed software will be the Department of Nursing and Paramedic Sciences About 200 nurses use simulations every year for training purposes as part of their course requirements. PMID:11187619

  8. [Simulation in obstetrics and gynecology - a new method to improve the management of acute obstetric emergencies].

    PubMed

    Blum, Ronja; Gairing Bürglin, Anja; Gisin, Stefan

    2008-11-01

    In medical specialties, such as anaesthesia, the use of simulation has increased over the past 15 years. Medical simulation attempts to reproduce important clinical situations to practise team training or individual skills in a risk free environment. For a long time simulators have only been used by the airline industry and the military. Simulation as a training tool for practicing critical situations in obstetrics is not very common yet. Experience and routine are crucial to evaluate a medical emergency correctly and to take the appropriate measures. Nowadays the obstetrician requires a combination of manual and communication skills, fast emergency management and decision-making skills. Therefore simulation may help to attain these skills. This may not only satisfy the high expectations and demands of the patients towards doctors and midwives but would also help to keep calm in difficult situations and avoid mistakes. The goal is a risk free delivery for mother and child. Therefore we developed a simulation- based curricular unit for hands-on training of four different obstetric emergency scenarios. In this paper we describe our results about the feedback of doctors and midwives on their personal experiences due to this simulation-based curricular unit. The results indicate that simulation seems to be an accepted method for team training in emergency situations in obstetrics. Whether patient security increases after the regularly use of drill training needs to be investigated in further studies. PMID:18979433

  9. Cervical Spinal Injury In Pediatric Blunt Trauma Patients: Management In The Emergency Department.

    PubMed

    Dixon, Andrew

    2016-03-01

    Spinal injuries from blunt trauma are uncommon in pediatric patients, representing only about 1.5% of all blunt trauma patients. However, the potentially fatal consequences of spinal injuries make them of great concern to emergency clinicians. Clinical goals in the emergency department are to identify all injuries using selective imaging and to minimize further harm from spinal cord injury. Achieving these goals requires an understanding of the age-related physiologic differences that affect patterns of injury and radiologic interpretation in children, as well as an appreciation of high-risk clinical clues and mechanisms. This issue reviews current approaches to prehospital immobilization, identification of low-risk patients who may be clinically cleared from immobilization, a rational approach to the use of radiologic imaging, and the existing evidence for medical management of spinal cord injuries. PMID:26894868

  10. 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

    2016-01-01

    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. PMID:27580322

  11. A framework for assessing and managing risks posed by emerging diseases.

    PubMed

    Walshe, Terry; Burgman, Mark

    2010-02-01

    Frameworks for analyzing the risks of emerging diseases and invasive species often have relied on unstructured estimates of likelihoods and consequences. We suggest a flexible alternative that offers more transparent analysis without need for additional data. Its strength lies in explicit and complementary treatment of technical and social judgments. We describe a system in which cognitive maps, Bayes nets, and multicriteria analysis can be used in tandem to structure a problem, identify exposure pathways, combine data and expert judgement to estimate the likelihoods, and assess consequences of alternative decisions. These tools may be employed in participatory settings or as part of standard regulatory practice. We illustrate this approach with an assessment of the management of an emerging disease that poses a hazard to Australia. PMID:19878485

  12. [Anesthetic Management of a 105-year-old Man Undergoing Emergency Abdominal Surgery].

    PubMed

    Komasawa, Nobuyasu; Nishihara, Isao; Minami, Toshiaki

    2016-02-01

    As Japan's population ages, the number of cases of emergency abdominal surgery at advanced ages is increasing. A 105-year-old man weighing 37 kg combined with aortic stenosis and regurgitation was scheduled for emergency surgery for incarcerated inguinofemoral hernia. General anesthesia was induced with short-acting analgesics and sedatives. The patient was extubated uneventfully in the operating room and discharged without any major complications. Anesthetic management of elderly patients requires appropriate preoperative evaluation of complicating diseases, degree of consciousness, and nutritional condition. For those aged 100 years and older in particular, their quality of life should be considered. Close and cooperative communication between surgeons and anesthesiologists are also an important aspect in treating these charged without any major complications. PMID:27017779

  13. Endocrine emergencies in critically ill patients: Challenges in diagnosis and management

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Jindal, Ravi

    2012-01-01

    Endocrine emergencies pose unique challenges for the attending intensivist while managing critically ill patients. Besides taking care of primary disease state, one has to divert an equal attention to the possible associated endocrinopathies also. One of the common reasons for inability to timely diagnose an endocrinal failure in critically ill patients being the dominance of other severe systemic diseases and their clinical presentation. The timely diagnosis and administration of therapeutic interventions for these endocrine disorders can improve the outcome in critically ill patients. The timely diagnosis and administration of timely therapeutics in common endocrine disorders like severe thyroid disease, acute adrenal insufficiency and diabetic ketoacidosis significantly influence the outcome and prognosis. Careful evaluation of clinical history and a high degree of suspicion are the corner stone to diagnose such problems. Aggressive management of the patient is equally important as the complications are devastating and can prove highly fatal. The present article is an attempt to review some of the common endocrine emergencies in intensive care unit and the challenges associated with their diagnosis and management. PMID:23087855

  14. Waiting management at the emergency department – a grounded theory study

    PubMed Central

    2013-01-01

    Background An emergency department (ED) should offer timely care for acutely ill or injured persons that require the attention of specialized nurses and physicians. This study was aimed at exploring what is actually going on at an ED. Methods Qualitative data was collected 2009 to 2011 at one Swedish ED (ED1) with 53.000 yearly visits serving a population of 251.000. Constant comparative analysis according to classic grounded theory was applied to both focus group interviews with ED1 staff, participant observation data, and literature data. Quantitative data from ED1 and two other Swedish EDs were later analyzed and compared with the qualitative data. Results The main driver of the ED staff in this study was to reduce non-acceptable waiting. Signs of non-acceptable waiting are physical densification, contact seeking, and the emergence of critical situations. The staff reacts with frustration, shame, and eventually resignation when they cannot reduce non-acceptable waiting. Waiting management resolves the problems and is done either by reducing actual waiting time by increasing throughput of patient flow through structure pushing and shuffling around patients, or by changing the experience of waiting by calming patients and feinting maneuvers to cover up. Conclusion To manage non-acceptable waiting is a driving force behind much of the staff behavior at an ED. Waiting management is done either by increasing throughput of patient flow or by changing the waiting experience. PMID:23496853

  15. 41 CFR 102-75.760 - Who must the Office of Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA) notify that surplus real property is available for correctional facility, law enforcement, or emergency management response purposes... enforcement, or emergency management response purposes? OJP or FEMA must send notices of availability to...

  16. 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. PMID:25193457

  17. 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. PMID:25918108

  18. 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…

  19. 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. PMID:24487264

  20. Emergent management of postpartum hemorrhage for the general and acute care surgeon

    PubMed Central

    2009-01-01

    Background Postpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education. Methods The purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion. Results A stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm. Conclusion The manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage. PMID:19939251

  1. Geophysical approach for emergency management of landslide: the experience of Basilicata Civil Protection (southern Italy)

    NASA Astrophysics Data System (ADS)

    Colangelo, G.; Lapenna, V.; Perrone, A.; Loperte, A.

    2009-04-01

    The Basilicata region (Southern Italy), being dissected by numerous and often significant rivers and characterized by the outcrop of terrains with bad mechanical properties, is one of the more exposed regions of the southern Apennine chain to hydrogeologic hazard and shows a complete panorama of mass movements. During the last years, after strong precipitations, this region has been affected by the reactivation of many quiescent landslides that involved buildings and infrastructures constructed on the slopes. The risk for people and assets needed the intervention of the end users involved in the risk management and, in particular, the inspection of Regional Department of Infrastructure and Civil Protection (RDICP). In many involved areas and for many families evacuation decrees have been issued in order to allow the damage valuation. An important contribution has been provided by the geophysical data and, in particular, by the 2D electrical resistivity tomographies (ERTs) that have been carried out in the areas some days after the event by IMAA-CNR. In this work we present the results regarding the application of unconventional geoelectrical techniques used for the emergency management of landslide in Basilicata Region (southern Italy). The information obtained by the application of indirect surveys appeared to be particularly useful for the end users involved in the risks management. In particular, taking into account the cycle of landslides emergency, the obtained data could give a valid contribution during the post-event phase which mainly regards the damage valuation. Indeed, only a corrected assessment of the damage and a precise geometric reconstruction of the landslide body, can direct the intervention actions of the end users. The results represent a valid cognitive support to choose the most appropriate technical solution for strengthening of the slopes and an example of best practice for the cooperation between the research activity (IMAA-CNR) and field

  2. 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

  3. 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

  4. 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.

  5. 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. PMID:25870370

  6. Current and Emerging Therapies for the Management of Functional Gastrointestinal Disorders

    PubMed Central

    Craig, Orla F.; Quigley, Eamonn M. M.

    2011-01-01

    The functional gastrointestinal disorders are common disorders that are associated with significant quality-of-life impairment and considerable economic burden on the healthcare system. They are frequently associated with a comorbid psychiatric condition; this, together with a striking lack of effective pharmacological therapies, means they represent a considerable therapeutic challenge to the treating physician. In this overview, we examine the evidence to support the use of agents currently used in the management of the more common functional gastrointestinal disorders and review emerging therapies. PMID:23251744

  7. 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.

  8. 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.

  9. A Risk Radar driven by Internet of intelligences serving for emergency management in community.

    PubMed

    Huang, Chongfu; Wu, Tong; Renn, Ortwin

    2016-07-01

    Today, most of the commercial risk radars only have the function to show risks, as same as a set of risk matrixes. In this paper, we develop the Internet of intelligences (IOI) to drive a risk radar monitoring dynamic risks for emergency management in community. An IOI scans risks in a community by 4 stages: collecting information and experience about risks; evaluating risk incidents; verifying; and showing risks. Employing the information diffusion method, we optimized to deal with the effective information for calculating risk value. Also, a specific case demonstrates the reliability and practicability of risk radar. PMID:27005588

  10. 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.

  11. 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…

  12. 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

  13. 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. PMID:26118664

  14. 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. PMID:26062310

  15. 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

  16. 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.

  17. 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.

  18. Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

    PubMed Central

    2014-01-01

    Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development

  19. 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

  20. Evaluation of knowledge and attitude of school teachers about emergency management of traumatic dental injury

    PubMed Central

    Singh, Mala; Ingle, Navin Anand; Kaur, Navpreet; Yadav, Pramod

    2015-01-01

    Introduction: Traumatic dental injuries (TDIs) are widespread in the population and are a serious dental public health problem among children. Dental trauma may cause both functional and esthetic problems, with possible impacts on the patient's quality of life. Aim: To investigate teacher's knowledge and attitudes of Mathura city about emergency management of TDIs in children. Materials and Methods: A total of 352 teachers from total 23 schools of Mathura city were included in the study. Data were collected through a survey, which included a self-administered questionnaire. The questionnaire consisted of three major parts containing multiple-choice questions. Results: Among the teachers 51.1% were males and 48.9% were females. Majority of the respondents, that is, 33.5% were between 31 and 40 years of age. Most respondents (34%) had more than 10 years of teaching experience. Majority of the teachers (39.2%) had educational qualification other than B.Ed. and M.Ed. degrees. Physical education teachers comprised the largest group of school teachers. Regarding knowledge and attitude, the teachers with 10–20 years of teaching experience, physical education teachers, and the teachers other than B.Ed. and M.Ed. qualifications had given more correct answers to the questions when compared with other groups. Conclusion: For the teachers having a low level of knowledge, there is a need for greater awareness to improve teachers’ knowledge and attitudes related to the emergency management of TDIs in children by organizing educative and motivational programs. PMID:25992335

  1. 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.

  2. [Perioperative Management of Emergency Gastrointestinal Surgery in a Patient with Left Ventricular Non-compaction].

    PubMed

    Kurazumi, Takuya; Suzuki, Takeshi; Ideno, Satoshi; Sakuma, Takahiro; Nagafuchi, Mari; Sato, Tomoyuki; Oshida, Junya

    2015-02-01

    Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy characterized by heart failure, arrhythmia, and embolic events. A 65-year-old man, previously diagnosed as LVNC, was admitted to the emergency department with severe abdominal pain. He was diagnosed as appendicitis and treated conservatively with antibiotics. The echocardiogram examination showed left ventricular ejection fraction of less than 25%, and his B-type natriuretic peptide assay was > 5,000 pg x ml(-1) on admission. Ten days after admission, he underwent emergency surgery for suspected perforation of vermiform appendix. Transesophageal echocardiography (TEE) was used for real-time evaluation of cardiac function and restrictive fluid management during surgery. He was transferred to intensive care unit (ICU) for postoperative care, and extubated 16 hours after surgery. On the third postoperative day, he was discharged from ICU without any complications. We consider that perioperative hemodynamic management with TEE may be useful for gastrointestinal tract surgeries in patients with severe cardiac disease, such as LVNC. PMID:26121812

  3. Ventilator Strategies and Rescue Therapies for Management of Acute Respiratory Failure in the Emergency Department.

    PubMed

    Mosier, Jarrod M; Hypes, Cameron; Joshi, Raj; Whitmore, Sage; Parthasarathy, Sairam; Cairns, Charles B

    2015-11-01

    Acute respiratory failure is commonly encountered in the emergency department (ED), and early treatment can have effects on long-term outcome. Noninvasive ventilation is commonly used for patients with respiratory failure and has been demonstrated to improve outcomes in acute exacerbations of chronic obstructive lung disease and congestive heart failure, but should be used carefully, if at all, in the management of asthma, pneumonia, and acute respiratory distress syndrome. Lung-protective tidal volumes should be used for all patients receiving mechanical ventilation, and FiO2 should be reduced after intubation to achieve a goal of less than 60%. For refractory hypoxemia, new rescue therapies have emerged to help improve the oxygenation, and in some cases mortality, and should be considered in ED patients when necessary, as deferring until ICU admission may be deleterious. This review article summarizes the pathophysiology of acute respiratory failure, management options, and rescue therapies including airway pressure release ventilation, continuous neuromuscular blockade, inhaled nitric oxide, and extracorporeal membrane oxygenation. PMID:26014437

  4. 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

  5. [Perioperative Management of Emergency Operation for a Patient with Carcinoid Syndrome].

    PubMed

    Oishi, Yuri; Kawanoue, Naoya; Minami, Eriko; Ishikawa, Tomoki; Shin, Yoshiaki; Mieda, Hideyuki; Ishii, Mizue; Iwasaki, Etsu; Fukushima, Tomihiro; Tokioka, Hiroaki

    2015-12-01

    We report a case of carcinoid syndrome requiring an emergency operation for an upper gastrointestinal perforation. A 46-year-old man had undergone left lower lobectomy for a lung carcinoid tumor seven years previously, and liver metastasis was found five years previously. He developed cutaneous flushing and watery diarrhea, and was diagnosed with carcinoid syndrome one year previously. Although he was treated with octreotid, his symptoms became worse and he was admitted to our hospital. During the hospital stay, he underwent an emergency operation for an upper gastrointestinal perforation. Before the operation, hemodynamics were unstable. Anesthesia was induced with sevoflurane and propofol, and maintained with sevoflurane and remifentanil. Only vasopressin was used for the treatment of hypotension. Landiolol was used for perioperative tachyarrythmia. During anesthesia, there was no severe hypotension or hypertension. After the operation, he was managed with intubation in the ICU. Octreotid was administered again for the carcinoid syndrome. Vasopressin was necessary for the treatment of hypotension in the ICU. After improvement of hemodynamics, extubation was performed on the 3rd ICU day and he was discharged from the ICU on the 4th ICU day. In conclusion, we were able to perform good perioperative management of carcinoid syndrome accompanied by hemodynamic instability. PMID:26790329

  6. Established and emerging ancillary techniques in management of microbial keratitis: a review.

    PubMed

    Robaei, Dana; Carnt, Nicole; Watson, Stephanie

    2016-09-01

    Microbial keratitis is a sight-threatening condition and an ocular emergency, because of the potential for rapid progression. Intensive topical antimicrobials are the mainstay and the gold standard of treatment for microbial keratitis. However, despite appropriate diagnosis and therapy, treatment failure is still common, and can result in significant morbidity due to corneal perforation and/or scarring. For this reason, clinicians continue to seek novel treatment techniques in order to expand the armamentarium of tools available to manage microbial keratitis, and in doing so improve clinical outcomes. In this review, we examine the evidence for some established, as well as a few emerging ancillary techniques used to manage microbial keratitis. These include topical corticosteroids, corneal collagen cross-linking, intrastromal antimicrobials, amniotic membrane transplantation and miscellaneous other techniques. Of these, collagen cross-linking shows some promise for selected cases of infectious keratitis, although more research in the area is required before it is accepted as mainstream treatment for this potentially blinding condition. PMID:26888977

  7. 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

  8. 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).

  9. Variation in patient management based on ECG interpretation by emergency medicine and internal medicine residents.

    PubMed

    Trzeciak, Stephen; Erickson, Timothy; Bunney, E Bradshaw; Sloan, Edward P

    2002-05-01

    This study was performed to determine the impact of electrocardiogram (ECG) interpretation on urgent patient care decisions by internal medicine (IM) and emergency medicine (EM) resident physicians. Six clinical scenarios and ECGs were given to 31 IM residents and 31 EM residents at a university medical center. Based on the ECG interpretation, the residents were asked to select the best patient management from a list of choices. IM and EM residents were equally likely to choose the correct management for complete heart block (90% IM v 97% EM, P = NS), and pulseless ventricular tachycardia (VT) (94% IM v 97% EM, P = NS). IM residents were less likely to choose the correct management for acute posterior wall myocardial infarction (MI) (26% IM v 74% EM, P <.0001) and unstable supraventricular tachycardia (SVT) (87% IM v 100% EM, P <.05). Residents in both programs were equally likely to misinterpret left ventricular hypertrophy (LVH) (23% IM and 16% EM, P = NS) and benign early repolarization (BER) (48% IM and 52% EM, P = NS) as acute myocardial ischemia when presented with a clinical history not suggestive of cardiac ischemia. IM and EM residents were equally likely to choose the correct management for complete heart block and pulseless VT. Compared with EM residents, IM residents were less likely to choose the correct management of posterior wall MI and unstable SVT. Both IM and EM residents were prone to misinterpreting LVH and BER as acute myocardial ischemia. Resident education in both specialties should focus on ECG interpretation skills to improve patient management decisions. PMID:11992338

  10. Managing bleeding and emergency reversal of newer oral anticoagulants: a review for primary care providers.

    PubMed

    Peacock, W Frank

    2014-10-01

    The therapeutic landscape for anticoagulation management is undergoing a shift from the use of traditional anticlotting agents such as heparins and warfarin as the only options to the growing adoption of newer target-specific oral anticoagulants (TSOACs) with novel mechanisms of action. Dabigatran, the first TSOAC approved for use in the United States, is a direct competitive inhibitor of thrombin. It has predictable kinetics, with an elimination half-life of 12 to 17 hours in healthy volunteers. Apixaban and rivaroxaban are selective inhibitors of factor Xa, and also display first-order kinetics. In younger healthy individuals, apixaban has an apparent half-life of approximately 12 hours, whereas rivaroxaban has an elimination half-life of 5 to 9 hours. Understanding the pharmacologic properties of these newer drugs can lead to better insights regarding their respective safety and efficacy profiles and their application in clinical practice. Laboratory assessments have been developed to measure the anticoagulant efficacy of these newer agents. However, the results of these tests can be highly variable, and are therefore not always useful for monitoring the anticoagulation effects of these agents. In addition, several strategies have been documented for the potential reversal of the anticoagulant effects of these drugs, from the temporary discontinuation of an agent before elective surgery to suggested emergency procedures in the case of major bleeding events. New, specific reversal agents for dabigatran, apixaban, and rivaroxaban are currently being developed, and dabigatran has received fast-track designation from the US Food and Drug Administration. Until comprehensive clinical guidelines are developed, institutions involved in emergency care should establish their own procedures for the management of patients undergoing anticoagulation who require emergency treatment. These protocols should include appropriate laboratory testing to assess anticoagulant activity

  11. 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. PMID:12508505

  12. 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…

  13. Network Organizational Development in the Public Sector: A Case Study of the Federal Emergency Management Administration (FEMA).

    ERIC Educational Resources Information Center

    Ward, Robert; Wamsley, Gary; Schroder, Aaron; Robins, David B.

    2000-01-01

    Does information technology "pull" the organizational management toward change in terms of authority and control, or is information technology "pushed" through the organization, by management, to maintain its existing system of authority and control? These conflicting positions are explored through a case study of the Federal Emergency Management…

  14. 7 CFR Exhibit J to Subpart G of... - Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's...

  15. 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... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's...

  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, 2012 CFR

    2012-01-01

    ... Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's...

  17. 7 CFR Exhibit J to Subpart G of... - Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's...

  18. 7 CFR Exhibit J to Subpart G of... - Locations and Telephone Numbers of Federal Emergency Management Administration's Regional Offices

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Management Administration's Regional Offices J Exhibit J to Subpart G of Part 1940 Agriculture Regulations of... REGULATIONS (CONTINUED) GENERAL Environmental Program Pt. 1940, Subpt. G, Exh. J Exhibit J to Subpart G of Part 1940—Locations and Telephone Numbers of Federal Emergency Management Administration's...

  19. 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. PMID:27146659

  20. 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…

  1. Floods and climate: emerging perspectives for flood risk assessment and management

    NASA Astrophysics Data System (ADS)

    Merz, B.; Aerts, J.; Arnbjerg-Nielsen, K.; Baldi, M.; Becker, A.; Bichet, A.; Blöschl, G.; Bouwer, L. M.; Brauer, A.; Cioffi, F.; Delgado, J. M.; Gocht, M.; Guzzetti, F.; Harrigan, S.; Hirschboeck, K.; Kilsby, C.; Kron, W.; Kwon, H.-H.; Lall, U.; Merz, R.; Nissen, K.; Salvatti, P.; Swierczynski, T.; Ulbrich, U.; Viglione, A.; Ward, P. J.; Weiler, M.; Wilhelm, B.; Nied, M.

    2014-02-01

    Flood estimation and flood management have traditionally been the domain of hydrologists, water resources engineers and statisticians, and disciplinary approaches have abound. Dominant views have been shaped; one example is the catchment perspective: floods are formed and influenced by the interaction of local, catchment-specific characteristics, such as meteorology, topography and geology. These traditional views have been beneficial, but they have a narrow framing. In this paper we contrast traditional views with broader perspectives that are emerging from an improved understanding of the climatic context of floods. We conclude: (1) extending the traditional system boundaries (local catchment, recent decades, hydrological/hydraulic processes) opens up exciting possibilities for better understanding and improved tools for flood risk assessment and management. (2) Statistical approaches in flood estimation need to be complemented by the search for the causal mechanisms and dominant processes in the atmosphere, catchment and river system that leave their fingerprints on flood characteristic. (3) Natural climate variability leads to time-varying flood characteristics, and this variation may be partially quantifiable and predictable, with the perspective of a dynamic, climate informed flood risk management. (4) Efforts are needed to fully account for factors that contribute to changes in all three risk components (hazard, exposure, vulnerability), and to better understand the interactions between society and floods. (5) Given the global scale and societal importance, we call for the organization of an international multidisciplinary collaboration and data sharing initiative to understand further the links between climate and flooding and to advance flood research.

  2. Floods and climate: emerging perspectives for flood risk assessment and management

    NASA Astrophysics Data System (ADS)

    Merz, B.; Aerts, J.; Arnbjerg-Nielsen, K.; Baldi, M.; Becker, A.; Bichet, A.; Blöschl, G.; Bouwer, L. M.; Brauer, A.; Cioffi, F.; Delgado, J. M.; Gocht, M.; Guzzetti, F.; Harrigan, S.; Hirschboeck, K.; Kilsby, C.; Kron, W.; Kwon, H.-H.; Lall, U.; Merz, R.; Nissen, K.; Salvatti, P.; Swierczynski, T.; Ulbrich, U.; Viglione, A.; Ward, P. J.; Weiler, M.; Wilhelm, B.; Nied, M.

    2014-07-01

    Flood estimation and flood management have traditionally been the domain of hydrologists, water resources engineers and statisticians, and disciplinary approaches abound. Dominant views have been shaped; one example is the catchment perspective: floods are formed and influenced by the interaction of local, catchment-specific characteristics, such as meteorology, topography and geology. These traditional views have been beneficial, but they have a narrow framing. In this paper we contrast traditional views with broader perspectives that are emerging from an improved understanding of the climatic context of floods. We come to the following conclusions: (1) extending the traditional system boundaries (local catchment, recent decades, hydrological/hydraulic processes) opens up exciting possibilities for better understanding and improved tools for flood risk assessment and management. (2) Statistical approaches in flood estimation need to be complemented by the search for the causal mechanisms and dominant processes in the atmosphere, catchment and river system that leave their fingerprints on flood characteristics. (3) Natural climate variability leads to time-varying flood characteristics, and this variation may be partially quantifiable and predictable, with the perspective of dynamic, climate-informed flood risk management. (4) Efforts are needed to fully account for factors that contribute to changes in all three risk components (hazard, exposure, vulnerability) and to better understand the interactions between society and floods. (5) Given the global scale and societal importance, we call for the organization of an international multidisciplinary collaboration and data-sharing initiative to further understand the links between climate and flooding and to advance flood research.

  3. 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.

  4. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands.

    PubMed

    Dijkstra, B M; Berben, S A A; van Dongen, R T M; Schoonhoven, L

    2014-01-01

    Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking the specific circumstances of pain management of trauma patients in the chain of emergency care into account. The aim of this systematic review was to identify effective and safe initial pharmacological pain interventions, available in the Netherlands, for trauma patients with acute pain in the chain of emergency care. Up to December 2011, a systematic search strategy was performed with MeSH terms and free text words, using the bibliographic databases CINAHL, PubMed and Embase. Methodological quality of the articles was assessed using standardized evaluation forms. Of a total of 2328 studies, 25 relevant studies were identified. Paracetamol (both orally and intravenously) and intravenous opioids (morphine and fentanyl) proved to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) showed mixed results and are not recommended for use in pre-hospital ambulance or (helicopter) emergency medical services [(H)EMS]. These results could be used for the development of recommendations on evidence-based pharmacological pain management and an algorithm to support the provision of adequate (pre-hospital) pain management. Future studies should address analgesic effectiveness and safety of various drugs in (pre-hospital) emergency care. Furthermore, potential innovative routes of administration (e.g., intranasal opioids in adults) need further exploration. PMID:23737462

  5. Recurarization in a successfully managed case of posterior reversible encephalopathy syndrome (PRES) for emergency caesarean section.

    PubMed

    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

  6. Inhaled Foreign Bodies In Pediatric Patients: Proven Management Techniques In The Emergency Department.

    PubMed

    Maraynes, Megan; Agoritsas, Konstantinos

    2015-10-01

    Foreign body inhalation affects thousands of children every year, and it remains a significant cause of morbidity and mortality in children. Inhaled organic or inorganic foreign bodies can become lodged in the posterior nasopharynx, larynx, trachea, or bronchi. Presentation of foreign body inhalation can range from nonspecific respiratory symptoms to respiratory failure associated with a choking episode. In this issue, an in-depth review of the etiology, pathophysiology, diagnosis, and treatment of inhaled foreign bodies is presented. Risk factors for foreign body inhalation and clinical clues to diagnosis, as well as emergent management of inhaled foreign bodies are reviewed. A systematic approach, as described in this issue, will aid in timely and accurate diagnosis and treatment of inhaled foreign bodies, thereby limiting future complications and morbidity. PMID:26510331

  7. Emerging trends in epidemiology and management of infections caused by carbapenem-resistant Enterobacteriaceae.

    PubMed

    Martirosov, Dmitriy M; Lodise, Thomas P

    2016-06-01

    The recent emergence and spread of infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are concerning because carbapenems have represented a last line of defense against resistant strains of gram-negative pathogens. Existing therapies against CRE include tigecycline, the recently approved drug ceftazidime-avibactam, and older drugs not widely used in recent years, such as colistin, fosfomycin, and aminoglycosides. Best practices for use of the available drugs are not well defined. New therapeutic options with activity against CRE offer the opportunity to enhance our current approach to managing patients with infections due to CRE. The purpose of this report is to review the evolving epidemiology and treatment of infections due to CRE. As part of the treatment overview, this manuscript will discuss supportive data for antibiotics currently being used in the treatment of infections due to CRE, as well as those recently approved and in late-stage development. PMID:27033631

  8. 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

  9. 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. PMID:27249877

  10. Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department.

    PubMed

    Judge, Pavan; Meckler Mshs, Garth

    2016-05-01

    Congenital heart disease is the most common form of all congenital malformations and, despite advances in prenatal and newborn screening, it may present undiagnosed to the emergency department. Signs and symptoms of congenital heart disease are variable and often nonspecific, making recognition and treatment challenging. Patient presentations can range from life-threatening shock or cyanosis in a neonate to respiratory distress or failure to thrive in infants. Advances in surgical techniques have improved short- and long-term survival of infants and children with congenital heart disease, but these children are at risk for a variety of complications related to the underlying or surgical anatomy and physiology. This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease. PMID:27096879

  11. 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.

  12. 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. PMID:25296518

  13. Emergency Department Evaluation and Management of Children With Simple Febrile Seizures.

    PubMed

    Carapetian, Stephanie; Hageman, Joseph; Lyons, Evelyn; Leonard, Daniel; Janies, Kathryn; Kelley, Kent; Fuchs, Susan

    2015-09-01

    Workup of simple febrile seizures (SFS) has changed as the American Academy of Pediatrics made revisions to practice guidelines. In 2011, revisions were made regarding need for lumbar puncture (LP) as part of the SFS workup. This study surveyed more than 100 emergency departments regarding workup of children with SFS and performed a medical record review of workup that was performed. The survey shows that laboratory workup is done routinely and LP is done infrequently. The majority documents a complete exam. The medical record review demonstrates documentation of the examination, frequent laboratory and infrequent LP evaluation. Consistent with the American Academy of Pediatrics' revisions, survey and record reviews demonstrate that LP testing is infrequent. Contrary to the guideline, laboratory studies are routinely performed. This study suggests there is an opportunity to improve management of SFS by directing efforts toward finding the source of the fever and away from laboratory workup. PMID:25667312

  14. 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. PMID:10190200

  15. Anthropogenic Signatures in Nutrient Loads Exported from Managed Catchments: Emergence of Effective Biogeochemical Stationarity

    NASA Astrophysics Data System (ADS)

    Basu, N. B.; Destouni, G.; Jawitz, J. W.; Thompson, S. E.; Rinaldo, A.; Sivapalan, M.; Rao, P. C.

    2010-12-01

    Examining the impacts of large-scale human modifications of watersheds (e.g., land-use intensification for food production; hydrologic modification though extensive tile-drainage, etc.) on the hydrologic and biogeochemical responses, and ecological impacts at various scales has been the focus of monitoring and modeling studies over the past two decades. Complex interactions between hydrology and biogeochemistry and the need to predict responses across scales has led to the development of detailed process based models that are computation intensive and calibration dependent. Despite the perceived complexity, our overall hypothesis is that human modifications and intensive management of these watersheds have led to more predictable responses, typical of an engineered, less-complex system rather than natural, complex systems. Thus, simpler and more efficient approaches can be used in these systems for predicting hydrologic and biogeochemical responses. It has been argued that human interferences and climate change may have contributed to the demise of hydrologic stationarity. However, our synthesis of observational data shows 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), and for geogenic constituents exported from a catchment are linearly correlated to discharge (QT), leading to temporal invariance of the flow-weighted concentration, Cf = (LT/QT). Emergence of this consistent pattern across diverse catchments is attributed to the anthropogenic legacy of accumulated nutrient sources generating memory, similar to ubiquitously present sources for geogenic constituents. These responses are characteristic of transport-limited systems. In contrast, in the absence of legacy sources in less-managed

  16. 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. PMID:23331181

  17. Leptospirosis in American Samoa 2010: epidemiology, environmental drivers, and the management of emergence.

    PubMed

    Lau, Colleen L; Dobson, Annette J; Smythe, Lee D; Fearnley, Emily J; Skelly, Chris; Clements, Archie C A; Craig, Scott B; Fuimaono, Saipale D; Weinstein, Philip

    2012-02-01

    Leptospirosis has recently been reported as an emerging disease worldwide, and a seroprevalence study was undertaken in American Samoa to better understand the drivers of transmission. Antibodies indicative of previous exposure to leptospirosis were found in 15.5% of 807 participants, predominantly against three serovars that were not previously known to occur in American Samoa. Questionnaires and geographic information systems data were used to assess behavioral factors and environmental determinants of disease transmission, and logistic regression was used to identify factors associated with infection. Many statistically significant factors were consistent with previous studies, but we also showed a significant association with living at lower altitudes (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.03-2.28), and having higher numbers of piggeries around the home (OR = 2.63, 95% CI: 1.52-4.40). Our findings support a multifaceted approach to combating the emergence of leptospirosis, including modification of individual behavior, but importantly also managing the evolving environmental drivers of risk. PMID:22302868

  18. Leptospirosis in American Samoa 2010: Epidemiology, Environmental Drivers, and the Management of Emergence

    PubMed Central

    Lau, Colleen L.; Dobson, Annette J.; Smythe, Lee D.; Fearnley, Emily J.; Skelly, Chris; Clements, Archie C. A.; Craig, Scott B.; Fuimaono, Saipale D.; Weinstein, Philip

    2012-01-01

    Leptospirosis has recently been reported as an emerging disease worldwide, and a seroprevalence study was undertaken in American Samoa to better understand the drivers of transmission. Antibodies indicative of previous exposure to leptospirosis were found in 15.5% of 807 participants, predominantly against three serovars that were not previously known to occur in American Samoa. Questionnaires and geographic information systems data were used to assess behavioral factors and environmental determinants of disease transmission, and logistic regression was used to identify factors associated with infection. Many statistically significant factors were consistent with previous studies, but we also showed a significant association with living at lower altitudes (odds ratio [OR] = 1.53, 95% confidence interval [CI]: 1.03–2.28), and having higher numbers of piggeries around the home (OR = 2.63, 95% CI: 1.52–4.40). Our findings support a multifaceted approach to combating the emergence of leptospirosis, including modification of individual behavior, but importantly also managing the evolving environmental drivers of risk. PMID:22302868

  19. Increasing the Reliability of Decision-Support Systems for Nuclear Emergency Management

    NASA Astrophysics Data System (ADS)

    Ionescu, Tudor B.

    2013-04-01

    Decision support systems for nuclear emergency management (DSNE) are currently used worldwide to assist decision makers in taking emergency response countermeasures in case of accidental releases of radioactive materials from nuclear facilities. The present work has been motivated by the fact that, up until now, DSNE systems have not been regarded as safety critical software systems. The core of any DSNE system is represented by the different simulation codes linked together to form the dispersion simulation workflow. These codes require input emission and meteorological data to produce forecasts of the atmospheric dispersion of radioactive pollutants and other substances. However, the reliability of the system not only depends on the trustworthiness of the measured (or generated) input data but also on the reliability of the simulation codes used. The main goal of this work is to improve the reliability of DSNE systems by adapting current state of the art methods from the domain of software reliability engineering to the case of atmospheric dispersion simulation codes. The current approach is based on the "design by diversity principle" for improving the reliability of simulation codes and the trustworthiness of simulation results. The effectiveness of the approach has been tested using the results of two test versions of the RODOS DSNE system used in several European countries.

  20. Difficult airway management with bonfils fiberscope in case of emergency: acute abdomen with ileus.

    PubMed

    Maldini, Branka; Novotny, Zdenko; Letica-Brnadić, Renata; Brkljacić, Ana; Bartolek, Dubravka

    2012-09-01

    This clinical report describes an emergency case of a 49-year-old man, ASA E III status, with clinical symptoms of acute abdomen and ileus, who was scheduled for urgent surgery. Predictors of difficult intubation (Mallampati test Class III, short thyro-mental (< 6 cm) and sterno-mental distance (<10 cm) with limited mouth opening (inter-incisor gap < 3 cm) were associated with significant comorbidity (rheumatoid arthritis, heart disease, obesity (body mass index 32.6 kg m-2), cervical spine mobility and generalized vascular disease). A specialist experienced in airway management decided on one attempt of Bonfils fiberoptic intubation as primary intervention and urgent tracheotomy, if needed, as secondary intervention. Immediately after assuming supine position on the operating table, the patient lost consciousness and cardiac arrest developed. Successful intubation with oxygenation was followed by cardiopulmonary resuscitation. Upon stabilization of the patient's vital functions, urgent surgery was performed. In the emergency case presented, we succeeded quickly to secure the airway with Bonfils fiberoptic intubation, which allowed for appropriate oxygenation and starting resuscitation. The high risk of the possible aspiration was avoided by timely provision of airway in the experienced anesthetist's hands. PMID:23330419

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Emerging issues with diagnosis and management of fungal infections in solid organ transplant recipients.

    PubMed

    Farmakiotis, D; Kontoyiannis, D P

    2015-05-01

    Invasive fungal infections (IFIs) are being increasingly recognized in solid organ transplant (SOT) recipients, and delayed diagnosis can lead to graft loss and death. Therefore, there is a low threshold for prophylaxis and early initiation of empiric antifungal treatment, in this patient population. Meanwhile, the increasing consumption of antifungals is associated with high cost, medication toxicities and the emergence of resistance in Candida species, all of which call for rational use of antifungal agents. The implementation of fungal biomarkers, molecular diagnostic methods and direct detection of volatile fungal metabolites in breath samples could lead to faster diagnosis, early appropriate treatment and improved clinical outcomes, but also aid in the de-escalation of antifungal treatment. Those novel diagnostic modalities need to be validated specifically in SOT recipients. Infectious diseases consultation can contribute to optimization of care through prompt initiation and appropriate modification of antifungal treatment, management of medication toxicities and drug-drug interactions, as well as source control. In this review, we conceptually summarize recent advances in the diagnosis and management of IFI in SOT recipients, and highlight the importance of early diagnostic tools and good stewardship of antifungal drugs. PMID:25655091

  7. Weight management in type 2 diabetes: current and emerging approaches to treatment.

    PubMed

    Van Gaal, Luc; Scheen, André

    2015-06-01

    Diabetes is a growing global health concern, as is obesity. Diabetes and obesity are intrinsically linked: obesity increases the risk of diabetes and also contributes to disease progression and cardiovascular disease. Although the benefits of weight loss in the prevention of diabetes and as a critical component of managing the condition are well established, weight reduction remains challenging for individuals with type 2 diabetes due to a host of metabolic and psychological factors. For many patients, lifestyle intervention is not enough to achieve weight loss, and alternative options, such as pharmacotherapy, need to be considered. However, many traditional glucose-lowering medications may lead to weight gain. This article focuses on the potential of currently available pharmacological strategies and on emerging approaches in development to support the glycemic and weight-loss goals of individuals with type 2 diabetes. Two pharmacotherapy types are considered: those developed primarily for blood glucose control that have a favorable effect on body weight and those developed primarily to induce weight loss that have a favorable effect on blood glucose control. Finally, the potential of combination therapies for the management of obese patients with type 2 diabetes is discussed. PMID:25998297

  8. Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

    PubMed Central

    Clarke, Samuel; Horeczko, Timothy; Carlisle, Matthew; Barton, Joseph D.; Ng, Vivienne; Al-Somali, Sameerah; Bair, Aaron E.

    2014-01-01

    Background Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM) skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS). We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Methods Forty-five emergency medicine residents were tracked with annual simulation assessments between 2006 and 2011. We used mixed-methods repeated-measures regression analyses to evaluate elements of the Ottawa GRS by level of training to predict performance growth throughout a 3-year residency. Results Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. Conclusions In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance. PMID:25499769

  9. 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. PMID:27277897

  10. 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

  11. Quality indicators for the assessment and management of pain in the emergency department: A systematic review

    PubMed Central

    Stang, Antonia S; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

    2014-01-01

    BACKGROUND: Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. OBJECTIVE: To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. METHODS: Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. RESULTS: The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. CONCLUSION: Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas. PMID:25337856

  12. Current and emerging strategies in the management of venous thromboembolism: benefit–risk assessment of dabigatran

    PubMed Central

    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. PMID:26064057

  13. Emergency department management of acute exacerbations of chronic obstructive pulmonary disease and factors associated with hospitalization

    PubMed Central

    Khialani, Bharat; Sivakumaran, Pathmanathan; Keijzers, Gerben; Sriram, Krishna Bajee

    2014-01-01

    Background: Currently there is a paucity of information about biomarkers that can predict hospitalization for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients presenting to the emergency department (ED). There is limited data on the consistency of ED management of AECOPD with local COPD guidelines. The aim of this study was to identify biomarkers associated with hospitalization in AECOPD patients and to determine if the ED management was concordant with local COPD guidelines. Materials and Methods: We performed a retrospective audit of consecutive AECOPD patients presenting to the Gold Coast Hospital ED over a 6-month period. Results: During the study period, 122 AECOPD patients (51% male, mean age (SE) 71 (±11) years) presented to the ED. Ninety-eight (80%) patients were hospitalized. Univariate analysis identified certain factors associated with hospitalization: Older age, former smokers, home oxygen therapy, weekday presentation, SpO2 < 92%, and raised inflammatory markers (white cell count (WCC) and C-reactive protein (CRP)). After adjustment for multiple variable, increased age was significantly associated with hospitalization (odds ratio (OR) 1.09; 95% confidence interval (CI): 1.00-1.18; P = 0.05). Radiology assessment and pharmacological management was in accordance with COPD guidelines. However, spirometry was performed in 17% of patients and 28% of patients with hypercapneic respiratory failure received noninvasive ventilation (NIV). Conclusion: We identified several factors on univariate analysis that were associated with hospitalization. Further research is required to determine the utility of these biomarkers in clinical practice. Also, while overall adherence to local COPD guidelines was good, there is scope for improvement in performing spirometry and provision of NIV to eligible patients. PMID:25097600

  14. Linking ShakeMap and Emergency Managers in the Utah Region

    NASA Astrophysics Data System (ADS)

    Pankow, K.; Bausch, D.; Carey, B.

    2007-12-01

    In 2001, the University of Utah Seismograph Stations (UUSS) locally customized and began producing automatic ShakeMaps in Utah's Wasatch Front urban corridor as part of a new real-time earthquake information system developed under the Advanced National Seismic System. In 2005, motivated by requests from Utah's Division of Homeland Security and FEMA, ShakeMap capabilities were expanded to cover the entire Utah region. Now in 2007, ShakeMap capabilities throughout the region will again be enhanced by increased station coverage. The increased station coverage comes both from permanent stations funded by a state initiative and from the temporary deployment of EarthScope USArray stations. The state initiative will add ~22 strong-motion instruments and ~10 broadband instruments to the UUSS network. The majority of these stations will be located in southwestern Utah--one of the fastest growing regions in the U.S. EarthScope will evenly distribute 70 broadband stations in the region during 2007 that will be removed after 18 to 24 months. In addition to the enhanced station coverage for producing ShakeMaps in the Utah region, the transfer of information to the emergency response community is also being enhanced. First, tools are being developed that will link ShakeMap data with HAZUS loss-estimation software in near-real-time for rapid impact assessment. Second, ShakeMap scenarios are being used in conjunction with HAZUS loss-estimation software to produce customized maps for planning and preparedness exercises and also for developing templates that can be used following a significant regional earthquake. With the improvements to ShakeMap and the improved dialogue with the emergency managers, a suite of maps and information products were developed based on scenario earthquakes for training and exercise purposes. These products will be available in a timely fashion following a significant earthquake in the Utah region.

  15. 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

  16. 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.

  17. 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

    2014-01-01

    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

  18. 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

  19. Management of In-Flight Medical Emergencies: Are Senior Medical Students Prepared to Respond to this Community Need?

    PubMed Central

    Katzer, Robert J.; Duong, David; Weber, Matthew; Memmer, Amy; Buchanan, Ian

    2014-01-01

    Introduction In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medical emergencies. Methods A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. Results 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. Conclusion This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flight medical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medical education. PMID:25493155

  20. Problems and Issues in Using Emerging Computer Technologies To Manage and Evaluate Instructional Programs 1, 2, 3.

    ERIC Educational Resources Information Center

    Atwood, Nancy K.

    School districts have begun examining the feasibility of, and in some cases are developing and implementing automated systems for, managing and evaluating instructional programs. This paper describes and analyzes the issues and problems that emerged over the course of three projects--a large suburban school in the West, a consortium of five small…

  1. 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…

  2. 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

  3. [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. PMID:26983190

  4. Emergency Obstetric Care in a Rural Hospital: On-call Specialists Can Manage C-sections

    PubMed Central

    Ashtekar, Shyam V; Kulkarni, Madhav B; Ashtekar, Ratna S; Sadavarte, Vaishali S

    2012-01-01

    Background: Institutional birth and Emergency Obstetric Care (EmOC) are important strategies of the National Rural Health Mission (NRHM). While the Community Health Center (CHC) is expected to serve EmOC needs in NRHM, the CHCs are hamstrung due to chronic shortage of specialist doctors. Alternative strategies are therefore needed for ensuring EmOC. Objectives: This study aims to estimate the EmOC needs in a private rural hospital from case records and find some useful predictors for caesarian section (C-section) and to assess C-section needs in the context of on-call specialist support. Materials and Methods: We analyzed a two-decade series of 2587 obstetric cases in a private rural hospital for normal deliveries and EmOC including C-section. Results: About 80% of the obstetric cases were normal deliveries. Of the remaining 20% cases that required EmOC, nearly one-third required C-section. In the series, two maternal deaths occurred due to hemorrhage. About 13% case records showed past abortion, which adds to EmOC workload. Primipararous mothers with higher age had a greater incidence (23%) of C-section. The C-section rate shows a steady rise from 3% to above 10% in the series. Conclusions: This rural hospital required C-section in 6.4% cases. This C-section workload was managed with the help of on-call specialists. The local hospital team could manage 93.6% of the cases and abortions with only two maternal deaths. This strategy of an on-call specialist team can be an option for CHCs till resident specialists are adequately available. PMID:23112445

  5. Predictors of Patient Satisfaction With Pain Management in the Emergency Department.

    PubMed

    Fallon, Echo; Fung, Sierra; Rubal-Peace, Georgina; Patanwala, Asad E

    2016-01-01

    To identify predictors of patient satisfaction with pain control measured after emergency department (ED) discharge. This was a prospective, cross-sectional study conducted in an academic, urban ED in the United States. Adult patients with a pain-related complaint were interviewed via telephone within 72 hr of discharge from the ED. A standardized questionnaire was used to obtain demographic and clinical information. The primary outcome of interest was patient satisfaction with pain management in the ED measured using the following question: "How often was your pain well controlled in the ED?" (0-10 scale; 0 = never, 10 = always). Linear regression analyses were used to identify predictors of pain satisfaction. The study included 75 patients. The mean age of patients was 43 ± 18 years, and the majority of patients were female (n = 47; 63%). There were 24 patients (32%) who had chronic pain conditions, 23 (31%) with depression, and 2 patients who admitted to using heroin. In the multivariate regression analysis, patient perception of enough pain medication provision (coefficient = 2.81; 95% CI [1.35, 4.26]; p < 0.001), staff helpfulness (coefficient = 0.35; 95% CI [0.10, 0.59]; p = 0.006), report of generalized pain (coefficient = -1.62; 95% CI [-2.87, -0.36]; p = 0.013), and lowest pain score achieved in the ED (coefficient = -0.30; 95% CI [-0.53, -0.04]; p = 0.021) was significantly associated with patient satisfaction (model R = 0.57). Patient perception of enough pain medication provision, staff helpfulness, lowest pain scores achieved, and patient report of generalized pain were associated with satisfaction with pain management in the ED. PMID:27139133

  6. Prospective observational study of emergency airway management in the critical care environment of a tertiary hospital in Melbourne.

    PubMed

    Dyett, J F; Moser, M S; Tobin, A E

    2015-09-01

    The objective of this study is to describe the population of patients receiving emergency airway management outside operating theatres at our institution, a tertiary referral centre in Melbourne. A registry of all patients receiving emergency airway management in the emergency department, ICU and on the wards as part of Medical Emergency Response teams' care, was prospectively collected. There were 128 adults and one paediatric patient requiring emergency airway management recruited to the study. Data for analysis included patient demographics, pre-oxygenation and apnoeic oxygenation, staff, drugs, details of laryngoscopic attempts, adjuncts, airway manoeuvres, complications sustained and method of confirmation of endotracheal tube placement. Over a 12-month period, there were 139 intubations of 129 patients, requiring a total of 169 attempts. Respiratory failure was the most common indication for intubation. Intubation was successful on the first episode of laryngoscopy in 116 (83.5%) patients. Complications occurred in 48 patients. In the cohort of patients without respiratory failure, nasal cannulae apnoeic oxygenation significantly reduced the incidence of hypoxaemia (0 out of 31 [0.0%] versus 10 out of 60 [16.7%], P=0.016; absolute risk reduction 16.7%; number needed to treat: 6). Waveform capnography was used to confirm endotracheal tube placement in 133 patients and there were four episodes of oesophageal intubation, all of which were recognised immediately. In the critical care environment of our institution, emergency airway management is achieved with a first-attempt success rate that is comparable to overseas data. Nasal cannulae apnoeic oxygenation appears to significantly reduce the risk of hypoxaemia in patients without respiratory failure and the use of waveform capnography eliminates episodes of unrecognised oesophageal intubation. PMID:26310407

  7. Predicting late-season emergence for improved giant ragweed (Ambrosia trifida) management in Ohio

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Variable late-season seedling emergence makes it difficult to know the optimum time to implement giant ragweed control and avoid crop yield loss in Ohio. Current giant ragweed seedling emergence models do not account for late-season emergence patterns characteristic of the eastern U.S. Corn Belt. Ou...

  8. 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. PMID:27062002

  9. 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. PMID:26543787

  10. A multi-scale urban atmospheric dispersion model for emergency management

    NASA Astrophysics Data System (ADS)

    Miao, Yucong; Liu, Shuhua; Zheng, Hui; Zheng, Yijia; Chen, Bicheng; Wang, Shu

    2014-11-01

    To assist emergency management planning and prevention in case of hazardous chemical release into the atmosphere, especially in densely built-up regions with large populations, a multi-scale urban atmospheric dispersion model was established. Three numerical dispersion experiments, at horizontal resolutions of 10 m, 50 m and 3000 m, were performed to estimate the adverse effects of toxic chemical release in densely built-up areas. The multi-scale atmospheric dispersion model is composed of the Weather Forecasting and Research (WRF) model, the Open Source Field Operation and Manipulation software package, and a Lagrangian dispersion model. Quantification of the adverse health effects of these chemical release events are given by referring to the U.S. Environmental Protection Agency's Acute Exposure Guideline Levels. The wind fields of the urban-scale case, with 3 km horizontal resolution, were simulated by the Beijing Rapid Update Cycle system, which were utilized by the WRF model. The sub-domain-scale cases took advantage of the computational fluid dynamics method to explicitly consider the effects of buildings. It was found that the multi-scale atmospheric dispersion model is capable of simulating the flow pattern and concentration distribution on different scales, ranging from several meters to kilometers, and can therefore be used to improve the planning of prevention and response programs.

  11. 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.

  12. 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.

  13. 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. PMID:25783163

  14. 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.

  15. 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.

  16. 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.

  17. Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

    PubMed

    Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

    2014-01-01

    The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM). PMID:25000022

  18. Clinical policy: Critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy.

    PubMed

    Hahn, Sigrid A; Lavonas, Eric J; Mace, Sharon E; Napoli, Anthony M; Fesmire, Francis M

    2012-09-01

    This clinical policy from the American College of Emergency Physicians is the revision of the 2003 Clinical Policy: Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy.(1) A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions: (1) Should the emergency physician obtain a pelvic ultrasound in a clinically stable pregnant patient who presents to the emergency department (ED) with abdominal pain and/or vaginal bleeding and a beta human chorionic gonadotropin (β-hCG) level below a discriminatory threshold? (2) In patients who have an indeterminate transvaginal ultrasound, what is the diagnostic utility of β-hCG for predicting possible ectopic pregnancy? (3) In patients receiving methotrexate for confirmed or suspected ectopic pregnancy, what are the implications for ED management? Evidence was graded and recommendations were developed based on the strength of the available data in the medical literature. A literature search was also performed for a critical question from the 2003 clinical policy.(1) Is the administration of anti-D immunoglobulin indicated among Rh-negative women during the first trimester of pregnancy with threatened abortion, complete abortion, ectopic pregnancy, or minor abdominal trauma? Because no new, high-quality articles were found, the management recommendations from the previous policy are discussed in the introduction. PMID:22921048

  19. 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, 2013 CFR

    2013-01-01

    ... 7 Agriculture 14 2013-01-01 2013-01-01 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...

  20. 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, 2014 CFR

    2014-01-01

    ... 7 Agriculture 14 2014-01-01 2014-01-01 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...

  1. 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, 2012 CFR

    2012-01-01

    ... 7 Agriculture 14 2012-01-01 2012-01-01 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...

  2. 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

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Memorandum of Understanding Between the Federal 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...

  3. Last call: ethanol metabolism and the implications for emergency department clinicians managing patients with extreme ethanol intoxication.

    PubMed

    Johnson, Jeremy M

    2009-01-01

    The legal consumption of alcohol at a drinking age of 21 years and the accepting, ubiquitous nature of our society has caused alcohol consumption to become highly prevalent in our society. To this avail, emergency departments will continue to see a greater number of intoxicated patients, and it is imperative that clinicians remain up to date about treatment strategies and general management of the acutely intoxicated individual. This article expounds on many of the subtle presentations that may be featured by the intoxicated patient and discusses the current treatment modalities and pitfalls utilized by today's emergency clinician. PMID:20118874

  4. [How to manage disasters: learning from recent experiences in the Emergency Department of a University Teaching Hospital, Italy].

    PubMed

    Gioffrè-Florio, Maria Antonietta; Murabito, Letizia Maria; Crupi, Giovanni; Famà, Fausto

    2015-01-01

    The medical approach to disasters has been always a problematic issue for emergency departments. The authors of this paper reflect on possible efficient solutions for managing a massive influx of casualties in an Emergency Department, by analysing the responses to previous local catastrophic events, such as the collision of 'Segesta Jet', the great fire of Patti, the floods of Giampilieri/Scaletta and Saponara. The authors' point to a need for providing more extensive training of medical students in clinical aspects of disaster medicine. PMID:26847274

  5. 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

  6. 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

  7. Expanding Hematoma's Life-Threatening Neck and Face Emergency Management of Ballistic Injuries.

    PubMed

    Shuker, Sabri T

    2016-07-01

    This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy. PMID:27315316

  8. Observing the work of an urban safety-net psychiatric emergency room: managing the unmanageable

    PubMed Central

    Lincoln, Alisa K.; White, Andrew; Aldsworth, Casandra; Johnson, Peggy; Strunin, Lee

    2010-01-01

    Staff in the psychiatric emergency room (PER) have demanding jobs requiring a complex balance between the needs and safety of the individual and the community, systemic resources, and job responsibilities while providing timely, effective care. Little research exists concerning day-to-day work activities of PER staff, their interaction, and their perceptions of their work. This study explored the work of PER staff and the organisational context of the PER work setting. Observations of staff were conducted in the public spaces of a public urban PER using two observational techniques. The first was designed to measure the types of work activities staff engaged in and the time spent in these work activities (work task data). The second technique was the gathering of observational data by a peripheral-member-researcher (participant observation data). Analyses were conducted of both the work task and participant observation data. Results indicate that most PER staff time is spent in administrative and phone tasks, while less than a third is spent on direct clinical work. Four important issues for PER work were identified: a workload that is unmanageable, managing the unmanageable, bogus referrals and dumping and insurance problems. The PER remains the front-line of the medical and social service systems. Work done in these settings is of critical importance; however little attention is paid to the content and nature of the work. Our study demonstrates that staff of the PER face challenges on many levels as they struggle with the task of working with people presenting in psychiatric and social crisis. PMID:20149148

  9. 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

  10. 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.

  11. Low-back pain at the emergency department: still not being managed?

    PubMed Central

    Rizzardo, Alessandro; Miceli, Luca; Bednarova, Rym; Guadagnin, Giovanni Maria; Sbrojavacca, Rodolfo; Della Rocca, Giorgio

    2016-01-01

    Background Low-back pain (LBP) affects about 40% of people at some point in their lives. In the presence of “red flags”, further tests must be done to rule out underlying problems; however, biomedical imaging is currently overused. LBP involves large in-hospital and out-of-hospital economic costs, and it is also the most common musculoskeletal disorder seen in emergency departments (EDs). Patients and methods This retrospective observational study enrolled 1,298 patients admitted to the ED, including all International Classification of Diseases 10 diagnosis codes for sciatica, lumbosciatica, and lumbago. We collected patients’ demographic data, medical history, lab workup and imaging performed at the ED, drugs administered at the ED, ED length of stay (LOS), numeric rating scale pain score, admission to ward, and ward LOS data. Thereafter, we performed a cost analysis. Results Mean numeric rating scale scores were higher than 7/10. Home medication consisted of no drug consumption in up to 90% of patients. Oxycodone–naloxone was the strong opioid most frequently prescribed for the home. Once at the ED, nonsteroidal anti-inflammatory drugs and opiates were administered to up to 72% and 42% of patients, respectively. Imaging was performed in up to 56% of patients. Mean ED LOS was 4 hours, 14 minutes. A total of 43 patients were admitted to a ward. The expense for each non-ward-admitted patient was approximately €200 in the ED, while the mean expense for ward-admitted patients was €9,500, with a mean LOS of 15 days. Conclusion There is not yet a defined therapeutic care process for the patient with LBP with clear criteria for an ED visit. It is to this end that we need a clinical pathway for the prehospital management of LBP syndrome and consequently for an in-hospital time-saving therapeutic approach to the patient. PMID:26929631

  12. Public confidence in local management officials: organizational credibility and emergency behavior

    SciTech Connect

    Sorensen, J.H.

    1984-01-01

    Confidence issues create potential risks for the public in any emergency situation. They do so because credibility and associated perceptions of legitimacy and competency of organizations are determinants of human behavior in disasters. Credibility, however, is only one of numerous factors that shape response of people or organizations to a threatening event. The purposes of this paper are to review what is known about the way in which credibility and related constructs influence emergency response, discuss how this knowledge applies to radiological emergency planning, and suggest how credibility-induced risk can be minimized in emergency planning and response.

  13. 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.…

  14. 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…

  15. Management of upper gastrointestinal bleeding from portal hypertension: Elective or emergency operation?

    PubMed Central

    Liu, Sen

    2014-01-01

    Objective: To evaluate the clinical outcome of emergency and elective operation of splenectomy with periesophagogastric devascularization in treating upper gastrointestinal hemorrhage resulted from portal hypertension. Methods: We retrospectively reviewed 219 patients of upper gastrointestinal hemorrhage resulted from portal hypertension treated using emergency or elective operation between Jul 2002 and Aug 2010. The clinical data were collected and analyzed. Results: In the group of elective operation, four patients with grade B and three with grade C died, and in the group of emergency operation, two patients with Grade B and four with Grade C died. The Grade C patients treated using emergency operation presented with a higher mortality than those treated using elective operation, but no significant difference was found (p>0.05). In the two groups, no patients with Grade A died. 17 cases (11.1%) suffered from complications in the group of elective operation and 11 cases (16.7 %) in emergency operation (p>0.05). The complication rate in patients with Grade C is significantly higher than that in patients with Grade A or B in each group (p<0.05). The hospital stay and cost in group of elective operation are significantly higher than those in group of emergency operation (p<0.05). Conclusion: The patients with Grade A or B treated using emergency operation have similar clinical outcomes as those treated using elective operation, but emergency operation may result in higher rate of death and complication in patients with Grade C. PMID:24948982

  16. 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.

  17. The depressed patient and suicidal patient in the emergency department: evidence-based management and treatment strategies.

    PubMed

    Chang, Bernard; Gitlin, David; Patel, Ronak

    2011-09-01

    There are approximately 12 million emergency department (ED) visits related to mental health/substance abuse annually. Approximately 650,000 patients are evaluated annually for suicide attempts. Evidence to guide the management and treatment of depression and suicidal ideation in the ED is limited. A large variation exists in the quality of care provided due to the lack of standardized guidelines aiding emergency clinicians. Depression ften manifests as unexplained somatic complaints, adding to the challenge of making this diagnosis in the ED. Recognition of depression by emergency clinicians has proved poor. Suicide is associated with multiple risk factors, of which a prior history of suicide attempts is the single strongest predictor. A systematic approach is required in the ED to identify patients with or at risk of having depression, and screening tools may offer utility to identify high-risk patients. PMID:22164363

  18. Lessons learned: medical and health care management for emergency workers at the TEPCO Fukushima Daiichi APP accident.

    PubMed

    Koerner, John; Yasui, Shojiro

    2014-01-01

    During the emergency work at the Fukushima Daiichi Atomic Power Plant (APP), the Tokyo Electric Power Company (TEPCO) and the Japanese government experienced various problems in medical and health care management issues, including special medical examinations, on-site triage and initial treatment, patient transportation, lodging and food, and long-term health care for emergency workers. To resolve these problems, the Ministry of Health, Labor and Welfare (MHLW) issued a series of compulsory directives and provided administrative guidance to TEPCO. Based on the experiences and lessons learned, the MHLW recognized that the proper management and implementation of medical and health care management in response to a similar accident would require sufficient measures and systematic preparation, including the following: 1. In case of large-scale nuclear accidents, the government needs to assist in dispatching medical staff to the affected plants. 2. Nuclear facility operators, medical facilities and fire departments should make an agreement to clarify the division of the roles played prior to the accident and should conduct emergency drills periodically with the full attendance of related personnel to identify and resolve the problems. 3. Operators need to develop a support base at a safe distance from the plant and to prepare to develop makeshift lodgings in case of emergency. 4. Operators need to come to an agreement to share food stocks among closely located nuclear plants and prepare cooking equipment that can be used in case of blackout to provide warm foods and drinks to as many workers as possible. 5. It is necessary to conduct long-term follow-up for emergency workers, including health care system, medical examinations and mental health consultations. PMID:24467339

  19. [Management of agitated, violent or psychotic patients in the emergency department: an overdue protocol for an increasing problem].

    PubMed

    Jiménez Busselo, M T; Aragó Domingo, J; Nuño Ballesteros, A; Loño Capote, J; Ochando Perales, G

    2005-12-01

    Patients with extreme agitation, delirium, violent behavior or acute psychosis are frequently evaluated in the emergency departments of general hospitals. However, the traditional infrequency of this type of situation in pediatric emergency services can lead to a certain lack of foresight and efficiency in the initial management of these patients. Because of the current known increase of psychosocial disorders in pediatric emergencies, new pharmacological treatments for juvenile psychotic processes, and particularly the lack of compliance with these treatments, as well as the earlier consumption of ever more varied illicit drugs among young people, the frequency and diversity of this kind of disorder is on the increase. The treatment of agitation, aggression and violence begins with successful management of the acute episode, followed by strategies designed to reduce the intensity and frequency of subsequent episodes. The key to safety is early intervention to prevent progression from agitation to aggression and violence. Consequently, urgent measures designed to inhibit agitation should be adopted without delay by the staff initially dealing with the patient, usually in the emergency unit. Patients with psychomotor agitation disorder (PMAD) may require emergency physical and/or chemical restraints for their own safety and that of the healthcare provider in order to prevent harmful clinical sequelae and to expedite medical evaluation to determine the cause. However, the risks of restraint measures must be weighed against the benefits in each case. This review aims to present the emergency measures to be taken in children with PMAD. The distinct etiological situations and criteria for the choice of drugs for chemical restraint in each situation, as well as the complications associated with certain drugs, are discussed. It is advisable, therefore, that health professionals become familiar with the distinct pharmacological options. PMID:16324619

  20. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial

    PubMed Central

    Anderson, Jacqueline; Dolk, Anders; Torgerson, Jarl; Nyberg, Svante; Skau, Tommy; Forsberg, Birger C.; Werr, Joachim; Öhlen, Gunnar

    2016-01-01

    Background A small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of healthcare consumption including unplanned hospitalizations and overall healthcare costs. In response, several case and disease management programs aimed at reducing healthcare consumption in this group have been tested; however, results vary widely. Objectives To investigate whether a telephone-based, nurse-led case management intervention can reduce healthcare consumption for frequent Emergency Department visitors in a large-scale setup. Methods A total of 12 181 frequent Emergency Department users in three counties in Sweden were randomized using Zelen’s design or a traditional randomized design to receive either a nurse-led case management intervention or no intervention, and were followed for healthcare consumption for up to 2 years. Results The traditional design showed an overall 12% (95% confidence interval 4–19%) decreased rate of hospitalization, which was mostly driven by effects in the last year. Similar results were achieved in the Zelen studies, with a significant reduction in hospitalization in the last year, but mixed results in the early development of the project. Conclusion Our study provides evidence that a carefully designed telephone-based intervention with accurate and systematic patient selection and appropriate staff training in a centralized setup can lead to significant decreases in healthcare consumption and costs. Further, our results also show that the effects are sensitive to the delivery model chosen. PMID:25969342

  1. 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.

  2. The connection between long-term and short-term risk management strategies: examples from land-use planning and emergency management in four European case studies

    NASA Astrophysics Data System (ADS)

    Prenger-Berninghoff, K.; Cortes, V. J.; Sprague, T.; Aye, Z. C.; Greiving, S.; Głowacki, W.; Sterlacchini, S.

    2014-04-01

    The need for continuous adaptation to complex and unforeseen events requires enhancing the links between planning and preparedness phases to reduce future risks in the most efficient way. In this context, the legal-administrative and cultural context has to be taken into account. This is why four case study areas of the CHANGES1 project (Nehoiu Valley in Romania, Ubaye Valley in France, Val Canale in Italy, and Wieprzówka catchment in Poland) serve as examples to highlight currently implemented risk management strategies for land-use planning and emergency preparedness. The strategies described in this paper were identified by means of exploratory and informal interviews in each study site. Results reveal that a dearth or, in very few cases, a weak link exists between spatial planners and emergency managers. Management strategies could benefit from formally intensifying coordination and cooperation between emergency services and spatial planning authorities. Moreover, limited financial funds urge for a more efficient use of resources and better coordination towards long-term activities. The research indicates potential benefits to establishing or, in some cases, strengthening this link and provides suggestions for further development in the form of information and decision support systems as a key connection point. Aside from the existent information systems for emergency management, it was found that a common platform, which integrates involvement of these and other relevant actors could enhance this connection and address expressed stakeholder needs. 1 Marie Curie ITN CHANGES - Changing Hydro-meteorological Risks as Analyzed by a New Generation of European Scientists.

  3. A Clinical Audit of the Management of Acute Asthmatic Attacks in Adults and Children Presenting to an Emergency Department

    PubMed Central

    Dasgupta, S; Williams, EW; Walters, C; Eldemire-Shearer, D; Williams-Johnson, J

    2014-01-01

    Objective: To compare the guidelines in the University Hospital of the West Indies (UHWI) acute asthma management protocol with actual practice in the Accident and Emergency Department. Methods: A prospective docket audit was done of all consecutive medical records of patients, presenting with a diagnosed acute asthmatic attack between June 1 and September 30, 2010, to the emergency department of the UHWI. A convenient sample was used. The audit tool used was created from the UHWI protocol for the emergency management of asthma in adults and children, as well as the British Adult Asthma Audit Tool. The audit tool assessed three main sections: initial assessment, initial management, and discharge considerations. Data were coded and entered in Microsoft Excel 2007 and statistical analyses conducted using Stata version 10. Management patterns were compared to the actual protocol and then discussed. Results: A total of 15 864 patients were seen during the study period. Of these, a total of 293 patients were seen for a presentation of acute asthma. More females (57.3%) than males were seen, with the mean age of 33.53 years. Only 31% of patients were given a severity assessment of mild, moderate, or severe. Peak expiratory flow rate (PEFR) was attempted and recorded in 62%, but only 18.1% of patients had both pre and post PEFR done. Only 4.4% of patients were administered nebulizations within the suggested time frame. Positively, 94.2% of patients were given a prescription for inhaled corticosteroids and bronchodilators to continue post-discharge. Conclusion: Acute asthma management still remains an area of medical practice that continues to have long-standing difficulties. Failure to assess and document the severity of asthma attacks along with the under-utilization of PEFR was noted. PMID:25314279

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. The Emergence of Human Resource Management as a Profession in the Public Schools.

    ERIC Educational Resources Information Center

    Aks, Robert G.

    Within the private sector, the human resource management perspective has replaced the traditional personnel management approach. A similar evolution within the educational community is necessary for implementation of successful school reforms. Presented in this paper are an overview of the transition from personnel management to human resource…

  9. 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…

  10. Emergency product generation for disaster management using RISAT and DMSAR quick look SAR processors

    NASA Astrophysics Data System (ADS)

    Desai, Nilesh; Sharma, Ritesh; Kumar, Saravana; Misra, Tapan; Gujraty, Virendra; Rana, SurinderSingh

    2006-12-01

    Since last few years, ISRO has embarked upon the development of two complex Synthetic Aperture Radar (SAR) missions, viz. Spaceborne Radar Imaging Satellite (RISAT) and Airborne SAR for Disaster Mangement (DMSAR), as a capacity building measure under country's Disaster Management Support (DMS) Program, for estimating the extent of damage over large areas (~75 Km) and also assess the effectiveness of the relief measures undertaken during natural disasters such as cyclones, epidemics, earthquakes, floods and landslides, forest fires, crop diseases etc. Synthetic Aperture Radar (SAR) has an unique role to play in mapping and monitoring of large areas affected by natural disasters especially floods, owing to its unique capability to see through clouds as well as all-weather imaging capability. The generation of SAR images with quick turn around time is very essential to meet the above DMS objectives. Thus the development of SAR Processors, for these two SAR systems poses considerable challenges and design efforts. Considering the growing user demand and inevitable necessity for a full-fledged high throughput processor, to process SAR data and generate image in real or near-real time, the design and development of a generic SAR Processor has been taken up and evolved, which will meet the SAR processing requirements for both Airborne and Spaceborne SAR systems. This hardware SAR processor is being built, to the extent possible, using only Commercial-Off-The-Shelf (COTS) DSP and other hardware plug-in modules on a Compact PCI (cPCI) platform. Thus, the major thrust has been on working out Multi-processor Digital Signal Processor (DSP) architecture and algorithm development and optimization rather than hardware design and fabrication. For DMSAR, this generic SAR Processor operates as a Quick Look SAR Processor (QLP) on-board the aircraft to produce real time full swath DMSAR images and as a ground based Near-Real Time high precision full swath Processor (NRTP). It will

  11. 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.

  12. 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

  13. Thoracic emergencies.

    PubMed

    Worrell, Stephanie G; Demeester, Steven R

    2014-02-01

    This article discusses thoracic emergencies, including the anatomy, pathophysiology, clinical presentation, examination, diagnosis, technique, management, and treatment of acute upper airway obstruction, massive hemoptysis, spontaneous pneumothorax, and pulmonary empyema. PMID:24267505

  14. 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.

  15. The national incident management system: a multi-agency approach to emergency response in the United States of America.

    PubMed

    Annelli, J F

    2006-04-01

    This paper outlines the development of a universal incident management system across all of government in the United States of America called the National Incident Management System. The system has been incorporated into the National Response Plan and the procedures of United States Department of Agriculture (USDA) agencies, using the United States Forest Service's National Interagency Incident Management System as a model. This model has enhanced USDA's effectiveness in a wide range of emergencies that might affect American agriculture, including natural disasters (e.g. earthquakes, floods, hurricanes, pest and disease outbreaks, and wilderness and other types of fires), nuclear and conventional events, or the accidental or deliberate introduction of a biological, chemical or radiological agent threatening the United States food supply, critical infrastructure or economy. PMID:16796051

  16. 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.

  17. Emergency management: e-learning as an immediate response to veterinary training needs.

    PubMed

    Alessandrini, Barbara; D'Albenzio, Silvia; Turrini, Monica; Valerii, Lejla; Moretti, Michela; Pediconi, Ombretta; Callegari, Maria Luisa; Lelli, Rossella

    2012-01-01

    Veterinary training plays a crucial role in increasing effectiveness of veterinary response to epidemic and non-epidemic emergencies. Being able to assess learning needs and to deliver training is acknowledged as a strategic priority in veterinary public health activities. The validation of an e-learning system that is able to respond to the urgent needs of veterinary professionals to ensure the despatch of rapid teaching methods on emerging and re-emerging animal diseases and zoonoses was the core of a research project developed in the Mediterranean Basin between 2005 and 2009. The project validated a new transferable, sustainable and repeatable learning model, the main components of which are described. The model is applied to an emergency situation that occurred in Italy in 2008, when West Nile disease outbreaks were reported in northern Italy. Approximately 450 official veterinarians were trained, using an e-learning system that showed adaptability and effectiveness in transferring knowledge, skills and competence to face the situation. The case was used to validate the effectiveness of the model and proved that it can be applied in any emergency situation, i.e. every time that rapid dissemination of knowledge and skills is required. PMID:22718337

  18. 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

  19. 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

  20. Knowledge management: evaluating the organizational requirements and culture for an emerging technology.

    PubMed Central

    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. PMID:12463893