What is a health emergency? The difference in definition and understanding between patients and health professionals.

PubMed

Morgans, Amee; Burgess, Stephen J

2011-08-01

Investigations into 'inappropriate' use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient's right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as 'inappropriate'. To define a 'health emergency' and compare patient and health professionals perspectives. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. No significant relationship was found between the two ratings of urgency (P=0.51). CONCLUSIONS; Differing definitions of a 'health emergency' may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation.

78 FR 31769 - Accessible Emergency Information; Apparatus Requirements for Emergency Information and Video...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... Accessible Emergency Information; Apparatus Requirements for Emergency Information and Video Description...] Accessible Emergency Information; Apparatus Requirements for Emergency Information and Video Description... manufacturers of devices that display video programming to ensure that certain apparatus are able to make...

The role of the emergency physician in emergency medical services for children.

PubMed

Gausche-Hill, Marianne; Johnson, Ramon W; Warden, Craig R; Brennan, John A

2003-08-01

Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

PubMed

Malamed, Stanley F

2015-12-01

Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

The use of emergency contraception in Australasian emergency departments.

PubMed

Millar, J R; Leach, D S; Maclean, A V; Kovacs, G T

2001-09-01

To review the prescribing of emergency contraception by emergency departments in Australasia and compare it with other providers. A postal questionnaire was sent to the director of each of the 79 Australasian College for Emergency Medicine accredited emergency departments in Australasia inquiring about the availability and prescribing habits for emergency contraception within each department. Of the 79 emergency departments, 69 (87.3%) responded to the questionnaire and were aware of the 'emergency contraception regimen'. The majority of departments prescribed appropriately (56%) and only one department did not arrange adequate follow up. Anti-emetics are always used by 45 departments (78.9%). Discussion of future contraceptive needs at the time of presentation was only undertaken by 25 departments (43.9%). Written clinical guidelines for emergency contraception were present in 28 departments (40.6%). Emergency departments are accessed by patients requesting contraception following unprotected intercourse or contraceptive failure. The prescribing of emergency contraception in Australasian emergency departments is comparable with other providers but substantial improvements could be made. Suggestions to assist this improvement include written clinical guidelines and patient information and purpose-made medication packs.

Behavioral emergencies in India: a population based epidemiological study.

PubMed

Saddichha, Sahoo; Vibha, Pandey; Saxena, Mukul Kumar; Methuku, Mithilesh

2010-05-01

Behavioral emergencies constitute an important but neglected part of emergencies seen worldwide in both emergency departments and by emergency services. Yet research on behavioral emergencies in India has been scarce. The study aimed to evaluate the occurrence of acute behavioral problems as an emergency attended by our emergency management service-108 services. During the period of August 1st 2007-July 31st 2008, all behavioral emergencies presenting to our emergency services in the states of Gujarat and Andhra Pradesh, which together account for more than 15% of India's population, were reviewed for data completeness and validity. Key word analysis of recorded case details was carried out to determine cause of emergency. Survival to hospital and 48-h outcome was also evaluated to study risk factors for mortality. A total of 40,541 cases of behavioral emergencies were recorded, in which the male:female ratio was 1.3:1. Most victims were in the 20 and 30 years (42%), from a poor socio-economic background (93%), rural area (74.3%), and backward caste (42.6%). Suicidal attempts, whether in the form of poisoning (60.5%) or otherwise (30.7%) was the most common emergency, followed by acute psychiatric causes (4%) and alcohol intoxication (3%). Victims, who met a fatal outcome, were more likely to be male (p = 0.02), having a better socio-economic condition (p < 0.001) and older (p < 0.001). Suicidal attempts, which form the largest chunk of behavioral emergencies, need to be tackled on a war-footing, given the sensitivity it deserves. Acute psychiatric emergencies, which form about 9% of all emergencies, require the emerging role of emergency psychiatric services.

Child Development and Emergent Literacy.

ERIC Educational Resources Information Center

Whitehurst, Grover J.; Lonigan, Christopher J.

1998-01-01

Offers a typology of emergent literacy skills, reviews research relating emergent literacy to reading, and reviews evidence linking emergent literacy environments and development of emergent literacy skills. Proposes that emergent literacy consists of inside-out skills and outside-in skills that are influential at different times during reading…

The Student Volunteer Army: a 'repeat emergent' emergency response organisation.

PubMed

Carlton, Sally; Mills, Colleen E

2017-10-01

This paper seeks to contribute to understanding of the factors associated with an effective emergent emergency response organisation and to provide new insights into this understudied area. It examines, through an analysis of a range of textual resources, the emergence and re-emergence of the Student Volunteer Army (SVA) during the devastating earthquakes in Canterbury, New Zealand, in 2010-11. This evaluation is conducted in relation to the four key features of an effective emergency response organisation: adaptability; direction; leadership; and communication. In addition, the paper aims to further understanding of 'emergency entrepreneurship' and thus of the values and strategies that underpin social entrepreneur organisations in times of normalcy. The paper concludes that the unique position of the SVA as a 'repeat emergent' emergency response organisation enabled it to innovate continually and to improve repeatedly its systems, relationships, and image, such that it exhibited features common to emergent and established emergency response organisations. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Medical Emergencies in Goa

PubMed Central

Saddichha, Sahoo; Saxena, Mukul Kumar

2010-01-01

Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Federal role in the emergency response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING...

44 CFR 351.20 - The Federal Emergency Management Agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 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 MANAGEMENT... Interagency Assignments § 351.20 The Federal Emergency Management Agency. (a) Establish policy and provide...

46 CFR 112.25-10 - Transfer of emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-10 Transfer of emergency loads. (a) When...

46 CFR 112.25-10 - Transfer of emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-10 Transfer of emergency loads. (a) When...

46 CFR 112.25-10 - Transfer of emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-10 Transfer of emergency loads. (a) When...

46 CFR 112.25-10 - Transfer of emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-10 Transfer of emergency loads. (a) When...

46 CFR 112.25-10 - Transfer of emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-10 Transfer of emergency loads. (a) When...

Emergent Literacy of Deaf Children

ERIC Educational Resources Information Center

Williams, Cheri

2004-01-01

This article reviews the literature on emergent literacy in young deaf children, focusing on the nature and course of both emergent reading and emergent writing. Beginning with definitions and background information concerning emergent literacy as a field of study, it examines instructional approaches that support emergent literacy learning. The…

44 CFR 206.225 - Emergency work.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Emergency work. 206.225... Emergency work. (a) General. (1) Emergency protective measures to save lives, to protect public health and safety, and to protect improved property are eligible. (2) In determining whether emergency work is...

Does the emergency surgery score accurately predict outcomes in emergent laparotomies?

PubMed

Peponis, Thomas; Bohnen, Jordan D; Sangji, Naveen F; Nandan, Anirudh R; Han, Kelsey; Lee, Jarone; Yeh, D Dante; de Moya, Marc A; Velmahos, George C; Chang, David C; Kaafarani, Haytham M A

2017-08-01

The emergency surgery score is a mortality-risk calculator for emergency general operation patients. We sought to examine whether the emergency surgery score predicts 30-day morbidity and mortality in a high-risk group of patients undergoing emergent laparotomy. Using the 2011-2012 American College of Surgeons National Surgical Quality Improvement Program database, we identified all patients who underwent emergent laparotomy using (1) the American College of Surgeons National Surgical Quality Improvement Program definition of "emergent," and (2) all Current Procedural Terminology codes denoting a laparotomy, excluding aortic aneurysm rupture. Multivariable logistic regression analyses were performed to measure the correlation (c-statistic) between the emergency surgery score and (1) 30-day mortality, and (2) 30-day morbidity after emergent laparotomy. As sensitivity analyses, the correlation between the emergency surgery score and 30-day mortality was also evaluated in prespecified subgroups based on Current Procedural Terminology codes. A total of 26,410 emergent laparotomy patients were included. Thirty-day mortality and morbidity were 10.2% and 43.8%, respectively. The emergency surgery score correlated well with mortality (c-statistic = 0.84); scores of 1, 11, and 22 correlated with mortalities of 0.4%, 39%, and 100%, respectively. Similarly, the emergency surgery score correlated well with morbidity (c-statistic = 0.74); scores of 0, 7, and 11 correlated with complication rates of 13%, 58%, and 79%, respectively. The morbidity rates plateaued for scores higher than 11. Sensitivity analyses demonstrated that the emergency surgery score effectively predicts mortality in patients undergoing emergent (1) splenic, (2) gastroduodenal, (3) intestinal, (4) hepatobiliary, or (5) incarcerated ventral hernia operation. The emergency surgery score accurately predicts outcomes in all types of emergent laparotomy patients and may prove valuable as a bedside decision-making tool for patient and family counseling, as well as for adequate risk-adjustment in emergent laparotomy quality benchmarking efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

46 CFR 112.20-15 - Transfer of emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-15 Transfer of emergency loads. (a) When the potential of the final emergency power source reaches 85 to 95...

46 CFR 112.20-15 - Transfer of emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-15 Transfer of emergency loads. (a) When the potential of the final emergency power source reaches 85 to 95...

46 CFR 112.20-15 - Transfer of emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-15 Transfer of emergency loads. (a) When the potential of the final emergency power source reaches 85 to 95...

46 CFR 112.20-15 - Transfer of emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-15 Transfer of emergency loads. (a) When the potential of the final emergency power source reaches 85 to 95...

46 CFR 112.20-15 - Transfer of emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source § 112.20-15 Transfer of emergency loads. (a) When the potential of the final emergency power source reaches 85 to 95...

46 CFR 109.503 - Emergency signals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency signals. 109.503 Section 109.503 Shipping... Emergency Signals § 109.503 Emergency signals. (a) Emergency stations signals are established as follows: (1) The signal to man emergency stations is a rapid succession of short soundings of both the general...

46 CFR 109.503 - Emergency signals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Emergency signals. 109.503 Section 109.503 Shipping... Emergency Signals § 109.503 Emergency signals. (a) Emergency stations signals are established as follows: (1) The signal to man emergency stations is a rapid succession of short soundings of both the general...

46 CFR 112.15-1 - Temporary emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND POWER SYSTEMS Emergency Loads § 112.15-1 Temporary emergency loads. On vessels required by § 112.05-5(a) to have a temporary emergency power source, the following emergency lighting and power loads must be arranged so that they can be energized from the temporary emergency power source: (a...

46 CFR 112.15-1 - Temporary emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND POWER SYSTEMS Emergency Loads § 112.15-1 Temporary emergency loads. On vessels required by § 112.05-5(a) to have a temporary emergency power source, the following emergency lighting and power loads must be arranged so that they can be energized from the temporary emergency power source: (a...

46 CFR 112.15-1 - Temporary emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND POWER SYSTEMS Emergency Loads § 112.15-1 Temporary emergency loads. On vessels required by § 112.05-5(a) to have a temporary emergency power source, the following emergency lighting and power loads must be arranged so that they can be energized from the temporary emergency power source: (a...

76 FR 44926 - Renewal of Declaration Regarding Emergency Use of Doxycycline Hyclate Tablets Accompanied by...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-27

... Emergency Use of Doxycycline Hyclate Tablets Accompanied by Emergency Use Information and Amendment To... hyclate tablets accompanied by emergency use information subject to the terms of any authorization issued... authorization of the emergency use of doxycycline hyclate tablets accompanied by emergency use information...

29 CFR 1910.38 - Emergency action plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Exit Routes and Emergency Planning § 1910.38 Emergency action plans. (a) Application. An employer must have an emergency action plan whenever an OSHA standard in this...) Written and oral emergency action plans. An emergency action plan must be in writing, kept in the...

29 CFR 1910.38 - Emergency action plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Exit Routes and Emergency Planning § 1910.38 Emergency action plans. (a) Application. An employer must have an emergency action plan whenever an OSHA standard in this...) Written and oral emergency action plans. An emergency action plan must be in writing, kept in the...

Focus issue articles on emerging and re-emerging plant diseases

USDA-ARS?s Scientific Manuscript database

This review sums up the key findings of seventeen articles on emerging and re-emerging plant diseases that are designated for the July focus issue in Phytopathology. The emerging and re-emerging diseases discussed include those caused by three viral, six fungal, five oomycete, and four bacterial pa...

46 CFR 109.503 - Emergency signals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Emergency signals. 109.503 Section 109.503 Shipping... Emergency Signals § 109.503 Emergency signals. (a) Emergency stations signals are established as follows: (1) The signal to man emergency stations is a rapid succession of short soundings of both the general...

46 CFR 109.503 - Emergency signals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency signals. 109.503 Section 109.503 Shipping... Emergency Signals § 109.503 Emergency signals. (a) Emergency stations signals are established as follows: (1) The signal to man emergency stations is a rapid succession of short soundings of both the general...

46 CFR 109.503 - Emergency signals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency signals. 109.503 Section 109.503 Shipping... Emergency Signals § 109.503 Emergency signals. (a) Emergency stations signals are established as follows: (1) The signal to man emergency stations is a rapid succession of short soundings of both the general...

Mountain pine beetle emergence from lodgepole pine at different elevations near Fraser, CO

Treesearch

J Tishmack; S.A. Mata; J.M. Schmid

2005-01-01

Mountain pine beetle emergence was studied at 8760 ft, 9200 ft, and 9900 ft near Fraser, CO. Beetles began emerging at 8760 ft between July 9 and July 14 while no beetles emerged at 9200 ft and only one beetle emerged at 9900 ft during the same period. Beetle emergence continued at relatively low but fluctuating rates for the next two to three weeks. Peak emergence...

Vehicle coordinated transportation dispatching model base on multiple crisis locations

NASA Astrophysics Data System (ADS)

Tian, Ran; Li, Shanwei; Yang, Guoying

2018-05-01

Many disastrous events are often caused after unconventional emergencies occur, and the requirements of disasters are often different. It is difficult for a single emergency resource center to satisfy such requirements at the same time. Therefore, how to coordinate the emergency resources stored by multiple emergency resource centers to various disaster sites requires the coordinated transportation of emergency vehicles. In this paper, according to the problem of emergency logistics coordination scheduling, based on the related constraints of emergency logistics transportation, an emergency resource scheduling model based on multiple disasters is established.

1996-1997 TEMA/DOE oversite annual report

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

NONE

1998-01-01

The Tennessee Emergency Management Agency (TEMA) has entered into a five-year agreement with the Department of Energy (DOE) to provide emergency response activities associated with the Oak Ridge Reservation (ORR). The Agreement in Principle (AIP) delineates the duties and responsibilities of the parties. The agreement tasked TEMA with the following responsibilities: develop offsite emergency plans; conduct emergency management training; develop offsite emergency organizations; develop emergency communications; develop emergency facilities; conduct exercises and drills; provide detection and protection equipment; and develop an emergency staff. This document reports on progress on these tasks during the past year.

1996--1997 TEMA/DOE oversight annual report

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

NONE

1998-06-01

The Tennessee Emergency Management Agency (TEMA) has entered into a five-year agreement with the Department of Energy (DOE) to provide emergency response activities associated with the Oak Ridge Reservation (ORR). The Agreement in Principle (AIP) delineates the duties and responsibilities of the parties. The agreement tasked TEMA with the following responsibilities: develop offsite emergency plans; conduct emergency management training; develop offsite emergency organizations; develop emergency communications; develop emergency facilities; conduct exercises and drills; provide detection and protection equipment; and develop an emergency staff. This report describes progress on the 14 deliverables connected with this contract.

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Assessment of a group of nigerian dental students' education on medical emergencies.

PubMed

Ehigiator, O; Ehizele, Ao; Ugbodaga, Pi

2014-03-01

The training of dental students in the management of medical emergencies is of utmost importance as they may encounter some of these emergencies at some point in their career. The aim of this study was to evaluate the medical emergency education in a Nigerian Dental School. This descriptive cross-sectional study was carried out among 124 final year dental students of the University of Benin, Benin City. Data was collected using a self-administered questionnaire. The questionnaire elicited information on demography, knowledge of inclusion of a medical emergency in the dental curriculum, knowledge of guidelines on medical emergency formulated by any dental authority, opinion on the comprehensiveness of the present training on medical emergency, type of medical emergency training received, previous encounter with a medical emergency, previous participation in emergency drills and knowledge of the content of an emergency kit. Descriptive statistics was carried out on the collected data. Only 58.1% (72/124) respondents were aware of the inclusion of a medical emergency in the dental curriculum and fewer, 17.7% (22/124), were aware of guidelines on medical emergency formulated by any dental authority. Fifty-two out of all the respondents (41.9%) claimed not to have received any form of training on medical emergency. Only 22.6% (28/123) had previously participated in an emergency drills and just 34.7% (43/124) had ever seen an emergency kit. It can be concluded from this study that the level of training and level of knowledge on medical emergencies of the studied dental students is below desirable standard. It is therefore necessary to put proper strategies in place to strengthen their identified areas of weakness.

Addressing barriers to emergency anaphylaxis care: from emergency medical services to emergency department to outpatient follow-up.

PubMed

Fineman, Stanley M; Bowman, Steven H; Campbell, Ronna L; Dowling, Paul; O'Rourke, Dianne; Russell, W Scott; Sublett, J Wesley; Wallace, Dana

2015-10-01

Anaphylaxis is a systemic life-threatening allergic reaction that presents unique challenges for emergency care practitioners. Allergists and emergency physicians have a history of collaborating to promote an evidence-based, multidisciplinary approach to improve the emergency management and follow-up of patients with or at risk of anaphylaxis. To review recent scientific literature about anaphylaxis, discuss barriers to care, and recommend strategies to support improvement in emergency anaphylaxis care. An expert panel of allergists and emergency physicians was convened by the American College of Allergy, Asthma and Immunology in November 2014 to discuss current knowledge about anaphylaxis, identify opportunities for emergency practitioners and allergists to partner to address barriers to care, and recommend strategies to improve medical management of anaphylaxis along the continuum of care: from emergency medical systems and emergency department practitioners for acute management through appropriate outpatient follow-up with allergists to confirm diagnosis, identify triggers, and plan long-term care. The panel identified key barriers to anaphylaxis care, including difficulties in making an accurate diagnosis, low rates of epinephrine administration during acute management, and inadequate follow-up. Strategies to overcome these barriers were discussed and recommendations made for future allergist/emergency physician collaborations, and key messages to be communicated to emergency practitioners were proposed. The panel recommended that allergists and emergency physicians continue to work in partnership, that allergists be proactive in outreach to emergency care practitioners, and that easy-to-access educational programs and materials be developed for use by emergency medical systems and emergency department practitioners in the training environment and in practice. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

A two-stage optimization model for emergency material reserve layout planning under uncertainty in response to environmental accidents.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Liu, Rentao; Wang, Peng

2016-06-05

In the emergency management relevant to pollution accidents, efficiency emergency rescues can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, a two-stage optimization framework is developed for emergency material reserve layout planning under uncertainty to identify material warehouse locations and emergency material reserve schemes in pre-accident phase coping with potential environmental accidents. This framework is based on an integration of Hierarchical clustering analysis - improved center of gravity (HCA-ICG) model and material warehouse location - emergency material allocation (MWL-EMA) model. First, decision alternatives are generated using HCA-ICG to identify newly-built emergency material warehouses for risk sources which cannot be satisfied by existing ones with a time-effective manner. Second, emergency material reserve planning is obtained using MWL-EMA to make emergency materials be prepared in advance with a cost-effective manner. The optimization framework is then applied to emergency management system planning in Jiangsu province, China. The results demonstrate that the developed framework not only could facilitate material warehouse selection but also effectively provide emergency material for emergency operations in a quick response. Copyright © 2016. Published by Elsevier B.V.

Eye Emergencies

MedlinePlus

... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

Childhood Emergencies

MedlinePlus

... In A Medical Emergency Childhood Emergencies Careers in Emergency Medicine Seconds Save Lives Be Prepared Safe Citizen Day ... case report was reported online in Annals of Emergency Medicine. More Than 200,000 Kids Treated in ERs ...

The impact of an emergency fee increase on the composition of patients visiting emergency departments.

PubMed

Jung, Hyemin; Do, Young Kyung; Kim, Yoon; Ro, Junsoo

2014-11-01

This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

Emergency Medical Services - Multiple Languages

MedlinePlus

... Section Health and Well-Being 11 - Emergency Room - English PDF Health and Well-Being 11 - Emergency Room - ... Section Health and Well-Being 11 - Emergency Room - English PDF Health and Well-Being 11 - Emergency Room - ...

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Emergencies in motoneuron disease.

PubMed

Finsterer, Josef; Stöllberger, Claudia

2017-08-01

Genetic and acquired motor-neuron-disorders (MNDs) may undergo acute deterioration resulting in various emergency situations. This literature review aims at summarising and discussing current knowledge about emergencies in MNDs. Emergencies that have been reported in MND patients include: respiratory, bulbar, cardiac, septic, epileptic, psychiatric, pain-related, and traumatic emergencies. Emergencies due to respiratory insufficiency have the strongest impact on morbidity and mortality in MNDs. To optimise the management of emergencies in MNDs, it is recommended to discuss these topics with the patient prior to their occurrence. After informed consent, patients may indicate their decision by signing an advance directive as to how such emergencies should be managed in case they arise. Generally, treatment of emergencies in MNDs is not at variance from treatment of similar emergencies due to other causes, but some peculiarities need to be pointed out. It is concluded that patients with MNDs may experience various emergencies during the disease course. Management of these conditions should be discussed with the patient prior to their appearance. Management of these emergencies follows general guidelines, which widely vary between countries, and depend on the availability of a patient's advance directive.

Disparities in access to emergency general surgery care in the United States.

PubMed

Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

2018-02-01

As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

[Online survey of the organizational structures of emergency neurology in Germany].

PubMed

Topka, H; Pfefferkorn, T; Andres, F; Kastrup, A; Klein, M; Niesen, W; Poppert, H

2017-06-01

In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.

A Scoping Review: Communication Between Emergency Physicians and Patients in the Emergency Department.

PubMed

Roh, HyeRin; Park, Kyung Hye

2016-05-01

Understanding the basic qualities of communication between emergency physicians and patients could improve communication in the emergency department. The objectives of this scoping review are to map the literature about the gaps in communication between emergency physicians and patients in the emergency department and make recommendations for further research. A scoping review of literature published since 1980 and written in English was undertaken using the following databases: Pubmed, Scopus, and SocINDEX. The articles were searched for using two-keyword combinations of the following keywords joined by "AND": "communication," "patient," "emergency physician," "emergency department/emergency room/accident," and "emergency room." Seventeen articles were included in the final review. Five research issues were covered by the 17 papers: patient-centered communication, information sharing, bad news delivery, shared decision making, and physicians' perspectives on communication. Emergency physicians have several communication characteristics: doctor-driven decision making, focusing on efficient information gathering, immature communication techniques, and obstacles to overcoming miscommunication. Patients also have several communication characteristics: active participation in medical encounters, expectation of physician as a reliable guide, understanding physicians' difficulties, and factors that contribute to understanding. Several conclusions about emergency department communication between patients and emergency physicians were drawn. Additional research is required to consider diverse patient needs in the emergency department. Furthermore, training programs for emergency physicians to improve the quality of communication should be developed and implemented in line with our research findings. Copyright © 2016 Elsevier Inc. All rights reserved.

The economic role of the Emergency Department in the health care continuum: applying Michael Porter's five forces model to Emergency Medicine.

PubMed

Pines, Jesse M

2006-05-01

Emergency Medicine plays a vital role in the health care continuum in the United States. Michael Porters' five forces model of industry analysis provides an insight into the economics of emergency care by showing how the forces of supplier power, buyer power, threat of substitution, barriers to entry, and internal rivalry affect Emergency Medicine. Illustrating these relationships provides a view into the complexities of the emergency care industry and offers opportunities for Emergency Departments, groups of physicians, and the individual emergency physician to maximize the relationship with other market players.

Optimizing Patient-centered Communication and Multidisciplinary Care Coordination in Emergency Diagnostic Imaging: A Research Agenda.

PubMed

Sabbatini, Amber K; Merck, Lisa H; Froemming, Adam T; Vaughan, William; Brown, Michael D; Hess, Erik P; Applegate, Kimberly E; Comfere, Nneka I

2015-12-01

Patient-centered emergency diagnostic imaging relies on efficient communication and multispecialty care coordination to ensure optimal imaging utilization. The construct of the emergency diagnostic imaging care coordination cycle with three main phases (pretest, test, and posttest) provides a useful framework to evaluate care coordination in patient-centered emergency diagnostic imaging. This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication and multidisciplinary care coordination that ensure patient-centered emergency diagnostic imaging. Prioritized research questions provided the framework to define a research agenda for multidisciplinary care coordination in emergency diagnostic imaging. © 2015 by the Society for Academic Emergency Medicine.

Factors influencing the decision to use nurse practitioners in the emergency department.

PubMed

McGee, Laurie A; Kaplan, Louise

2007-10-01

Emergency department overcrowding is a serious problem nationwide. Of an estimated 14 million visits to hospital emergency departments, only 12.9% are considered emergent. Many emergency departments, however, employ only physicians despite the fact that nurse practitioners have a proven record of providing high quality, cost-effective care in the emergency department. The purpose of the study was to determine factors that influence the decision to use nurse practitioners in the emergency department. Interviews were conducted with ED managers in hospitals that both employ and do not employ nurse practitioners in the emergency department. In this study, the primary reason that nurse practitioners were not employed by emergency departments was that physician groups with whom the hospitals contract refuse to use nurse practitioners. Emergency department managers of facilities with nurse practitioners reported high levels of satisfaction with the nurse practitioners performance. The 2 ED managers without nurse practitioners in their facility were highly supportive of having nurse practitioners in the emergency department and have advocated for hiring nurse practitioners. Education needs to occur with emergency departments regarding the value of the nurse practitioner's role to the facility. Research is needed to investigate why emergency department physician groups resist hiring nurse practitioners. Increased staffing with nurse practitioners in the emergency department can serve to reduce overcrowding, reduce waiting times, and increase patient satisfaction.

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article.

PubMed

Hu, Jiaxiang; Chen, Chao; Kuai, Tingting

2018-02-01

With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China.

3 CFR - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels... Emergency Relating to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

46 CFR 112.15-10 - Loads on systems without a temporary emergency power source.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Loads § 112.15-10 Loads on systems without a temporary emergency power source. If there is no temporary emergency power source, the loads... 46 Shipping 4 2013-10-01 2013-10-01 false Loads on systems without a temporary emergency power...

46 CFR 112.15-10 - Loads on systems without a temporary emergency power source.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Loads § 112.15-10 Loads on systems without a temporary emergency power source. If there is no temporary emergency power source, the loads... 46 Shipping 4 2014-10-01 2014-10-01 false Loads on systems without a temporary emergency power...

46 CFR 112.15-10 - Loads on systems without a temporary emergency power source.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Loads § 112.15-10 Loads on systems without a temporary emergency power source. If there is no temporary emergency power source, the loads... 46 Shipping 4 2012-10-01 2012-10-01 false Loads on systems without a temporary emergency power...

46 CFR 112.15-10 - Loads on systems without a temporary emergency power source.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Loads § 112.15-10 Loads on systems without a temporary emergency power source. If there is no temporary emergency power source, the loads... 46 Shipping 4 2011-10-01 2011-10-01 false Loads on systems without a temporary emergency power...

46 CFR 112.15-10 - Loads on systems without a temporary emergency power source.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Loads § 112.15-10 Loads on systems without a temporary emergency power source. If there is no temporary emergency power source, the loads... 46 Shipping 4 2010-10-01 2010-10-01 false Loads on systems without a temporary emergency power...

[Emerging noninfectious diseases].

PubMed

Consiglio, Ezequiel

2008-11-01

In recent years, emerging diseases were defined as being infectious, acquiring high incidence, often suddenly, or being a threat or an unexpected phenomenon. This study discusses the hallmarks of emerging diseases, describing the existence of noninfectious emerging diseases, and elaborating on the advantages of defining noninfectious diseases as emerging ones. From the discussion of various mental health disorders, nutritional deficiencies, external injuries and violence outcomes, work injuries and occupational health, and diseases due to environmental factors, the conclusion is drawn that a wide variety of noninfectious diseases can be defined as emergent. Noninfectious emerging diseases need to be identified in order to improve their control and management. A new definition of "emergent disease" is proposed, one that emphasizes the pathways of emergence and conceptual traits, rather than descriptive features.

[Development and application of emergency medical information management system].

PubMed

Wang, Fang; Zhu, Baofeng; Chen, Jianrong; Wang, Jian; Gu, Chaoli; Liu, Buyun

2011-03-01

To meet the needs of clinical practice of rescuing critical illness and develop the information management system of the emergency medicine. Microsoft Visual FoxPro, which is one of Microsoft's visual programming tool, is used to develop computer-aided system included the information management system of the emergency medicine. The system mainly consists of the module of statistic analysis, the module of quality control of emergency rescue, the module of flow path of emergency rescue, the module of nursing care in emergency rescue, and the module of rescue training. It can realize the system management of emergency medicine and,process and analyze the emergency statistical data. This system is practical. It can optimize emergency clinical pathway, and meet the needs of clinical rescue.

[Current situation of pediatric emergency in tertiary and teaching hospitals in 15 provinces, municipalities and autonomous regions in China Mainland].

PubMed

2014-12-01

Pre-hospital care, emergency department and critical care medicine are the key components of emergency medical service system. Two investigations about the pediatric critical care medicine in China mainland showed great progress. In recent years, most hospitals in China mainland have established emergency department, hardware configuration and staff status were gradually standardized. But most of the emergency departments mainly provide service to adult patients and pediatric emergency medicine lags behind. The purpose of this investigation was to understand the current situation and main problems of pediatric emergency in China mainland. A questionnaire developed by the Subspecialty Group of Pediatrics, Chinese Society of Emergency Medicine and the Subspecialty Group of Emergency Medicine, Chinese Society of Pediatrics was e-mailed to the members of the above-mentioned two subspecialty groups. The contents of the questionnaire included 46 items which were divided into 5 categories: the general situation of the hospital, the pediatric emergency setting and composition, key equipments and techniques, staff status, training program and running data from 2011 to 2012. Sixty-three questionnaires were delivered and 27 (42.9%) hospitals responded which located in 15 different provinces, municipalities and autonomous regions. Among the 27 hospitals, 10 (37.0%) had no pediatric resuscitation room; 25 (92.6%) had no equipments for cardiac output monitor and gastric lavage; 13 (48.1%) had no bedside fibrolaryngoscope or fiberbronchoscope; 5 (18.5%) had no blood gas analyzer; 4 (14.8%) without respirator, defibrillator, bedside radiography or ultrasonic equipment; 2 (7.4%) had no neonatal incubator; 9 (33.3%) could not do intraossous infusion. The average ratio of professional emergency pediatricians to all physicians was 43.5%. Twenty hospitals incompletely filled in the pediatric emergency running data. The main problems existing in pediatric emergency include: imperfect pediatric emergency settings; short of key equipment; key rescue techniques are not popularized, acute shortage of emergency pediatricians and inadequate monitoring and management of pediatric emergency. The major ways to solve the predicament in pediatric emergency should include: the policy and financial support from national and local government; training pediatricians, especially urgent training of emergency pediatricians; improving pediatric emergency development and management.

Burden of emergency conditions and emergency care utilization: New estimates from 40 countries

PubMed Central

Chang, Cindy Y.; Abujaber, Samer; Reynolds, Teri A.; Camargo, Carlos A.; Obermeyer, Ziad

2016-01-01

Objective To estimate the global and national burden of emergency conditions, and compare them to emergency care utilization rates. Methods We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care utilization rates were obtained from a systematic literature review on emergency care facilities in low- and middle-income countries (LMICs), supplemented by national health system reports. Findings All 15 leading causes of death and DALYs globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency utilization. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47,728 per 100,000 population (IQR 45,253-50,085) in low-income, 25,186 (IQR 21,982-40,480) in middle-income, and 15,691 (IQR 14,649-16,382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency utilization rates were the lowest in low-income countries, with median 8 visits per 1,000 population (IQR 6-10), 78 (IQR 25-197) in middle-income, and 264 (IQR 177-341) in high-income countries. Conclusion Despite higher burden of emergency conditions, emergency utilization rates are substantially lower in LMICs, likely due to limited access to emergency care. PMID:27334758

Retrospective evaluation of urological admissions to emergency service of a training and research hospital.

PubMed

Topaktaş, Ramazan; Altın, Selçuk; Aydın, Cemil; Akkoç, Ali; Yılmaz, Yakup

2014-12-01

Many patients consult emergency services with urological complaints. The aim of this study was to investigate the epidemiology, clinical presentation and treatments of urological emergency cases in a training and research hospital. We retrospectively evaluated urological emergency patients referred to the emergency unit between July 2012 and July 2013 according to age, gender, affected organ, radiological imaging techniques and treatment. Among 141.844 emergency cases, 3.113 (2.19%) were urological emergencies and 53.2% of the patients were male (mean age: 49.1), and 46.8% of them were female (median age: 42.8). The most frequent illness was genitourinary infection constituting 41.2% of the cases followed by renal colic (36.9%). Among the urological emergencies 483 (15.5%) patients were hospitalized and 152 surgical operations were performed. The mostly performed procedure was the placement of a suprapubic catheter in 34 patients constituting (22.3%) of the cases. Totally eight patients were referred to another experienced health center due to different reasons. Most of the urological emergency patients do not require emergency surgical interventions however, timely identification and management of urological emergencies with in-depth clinical evaluation are important to prevent late complications. Therefore the doctors working in emergency services must be heedful of urological emergencies.

An intelligent IoT emergency vehicle warning system using RFID and Wi-Fi technologies for emergency medical services.

PubMed

Lai, Yeong-Lin; Chou, Yung-Hua; Chang, Li-Chih

2018-01-01

Collisions between emergency vehicles for emergency medical services (EMS) and public road users have been a serious problem, impacting on the safety of road users, emergency medical technicians (EMTs), and the patients on board. The aim of this study is to develop a novel intelligent emergency vehicle warning system for EMS applications. The intelligent emergency vehicle warning system is developed by Internet of Things (IoT), radio-frequency identification (RFID), and Wi-Fi technologies. The system consists of three major parts: a system trigger tag, an RFID system in an emergency vehicle, and an RFID system at an intersection. The RFID system either in an emergency vehicle or at an intersection contains a controller, an ultrahigh-frequency (UHF) RFID reader module, a Wi-Fi module, and a 2.4-GHz antenna. In addition, a UHF ID antenna is especially designed for the RFID system in an emergency vehicle. The IoT system provides real-time visual warning at an intersection and siren warning from an emergency vehicle in order to effectively inform road users about an emergency vehicle approaching. The developed intelligent IoT emergency vehicle warning system demonstrates the capabilities of real-time visual and siren warnings for EMS safety.

How to Better Prepare Your Community for a Chemical Emergency: A Guide for State, Tribal and Local Agencies

EPA Pesticide Factsheets

This guide provides an overview of EPCRA requirements for State Emergency Response Commissions, Tribal Emergency Response Commissions, Local Emergency Planning Committees, and Tribal Emergency Planning Committees.

[Cooperation between emergency and forensic medicine - retrospective evaluation of pre-hospital emergency measures].

PubMed

Buschmann, Claas T; Kleber, Christian; Tsokos, Michael; Püschel, Klaus; Hess, Thorsten; Kerner, Thoralf; Stuhr, Markus

2015-06-01

Emergency medical research is subject to special conditions. Emergency patients e.g. are generally considered to be non-capable of giving consent. This results in sparse emergency medical data when compared to clinical observation studies under controlled conditions. After emergency medical treatment, deceased patients are not rarely subject to forensic investigation. The cooperation between emergency and forensic medicine has not only emergency medical training potential in individual cases, but also scientific innovation potential especially with respect to the retrospective evaluation of pre-hospital emergency measures. Such partnerships (like in Berlin at the Charité - Universitätsmedizin Berlin between the Institute of Legal Medicine and the Center for Musculoskeletal Surgery or in Hamburg between the Institute for Legal Medicine at the University Hospital and the Municipal Fire Brigade with the Emergency Medical Service) are yet exceptional in Germany. © Georg Thieme Verlag Stuttgart · New York.

Emergency contraception.

PubMed

Conard, Lee Ann E; Gold, Melanie A

2005-10-01

Emergency contraception is increasing in use and has become a universal standard of care in the United States. This article reviews available forms of emergency contraception, their indications, contraindications, adverse effects and efficacy at preventing pregnancy. This article describes the mechanism of action of different forms of emergency contraception and provides recommendations on when to start or restart an ongoing method of contraceptive after emergency contraception use. Literature on the impact of the advance provision of emergency contraception on contracepting behaviors is reviewed, and behavior change counseling related to emergency contraception is described.

Emergent literacy of deaf children.

PubMed

Williams, Cheri

2004-01-01

This article reviews the literature on emergent literacy in young deaf children, focusing on the nature and course of both emergent reading and emergent writing. Beginning with definitions and background information concerning emergent literacy as a field of study, it examines instructional approaches that support emergent literacy learning. The review of the literature is organized into four major sections that reflect the body of work to date. The article concludes with an eye toward the future of emergent literacy in pedagogy, theory, and research.

Pediatric office emergencies.

PubMed

Fuchs, Susan

2013-10-01

Pediatricians regularly see emergencies in the office, or children that require transfer to an emergency department, or hospitalization. An office self-assessment is the first step in determining how to prepare for an emergency. The use of mock codes and skill drills make office personnel feel less anxious about medical emergencies. Emergency information forms provide valuable, quick information about complex patients for emergency medical services and other physicians caring for patients. Furthermore, disaster planning should be part of an office preparedness plan. Copyright © 2013 Elsevier Inc. All rights reserved.

The Impact of Hospital Closures and Hospital and Population Characteristics on Increasing Emergency Department Volume: A Geographic Analysis.

PubMed

Lee, David C; Carr, Brendan G; Smith, Tony E; Tran, Van C; Polsky, Daniel; Branas, Charles C

2015-12-01

Emergency visits are rising nationally, whereas the number of emergency departments is shrinking. However, volume has not increased uniformly at all emergency departments. It is unclear what factors account for this variability in emergency volume growth rates. The objective of this study was to test the association of hospital and population characteristics and the effect of hospital closures with increases in emergency department volume. The study team analyzed emergency department volume at New York State hospitals from 2004 to 2010 using data from cost reports and administrative databases. Multivariate regression was used to evaluate characteristics associated with emergency volume growth. Spatial analytics and distances between hospitals were used in calculating the predicted impact of hospital closures on emergency department use. Among the 192 New York hospitals open from 2004 to 2010, the mean annual increase in emergency department visits was 2.7%, but the range was wide (-5.5% to 11.3%). Emergency volume increased nearly twice as fast at tertiary referral centers (4.8%) and nonurban hospitals (3.7% versus urban at 2.1%) after adjusting for other characteristics. The effect of hospital closures also strongly predicted variation in growth. Emergency volume is increasing faster at specific hospitals: tertiary referral centers, nonurban hospitals, and those near hospital closures. This study provides an understanding of how emergency volume varies among hospitals and predicts the effect of hospital closures in a statewide region. Understanding the impact of these factors on emergency department use is essential to ensure that these populations have access to critical emergency services.

Using social network analysis to understand Missouri's system of public health emergency planners.

PubMed

Harris, Jenine K; Clements, Bruce

2007-01-01

Effective response to large-scale public health threats requires well-coordinated efforts among individuals and agencies. While guidance is available to help states put emergency planning programs into place, little has been done to evaluate the human infrastructure that facilitates successful implementation of these programs. This study examined the human infrastructure of the Missouri public health emergency planning system in 2006. The Center for Emergency Response and Terrorism (CERT) at the Missouri Department of Health and Senior Services has responsibility for planning, guiding, and funding statewide emergency response activities. Thirty-two public health emergency planners working primarily in county health departments contract with CERT to support statewide preparedness. We surveyed the planners to determine whom they communicate with, work with, seek expertise from, and exchange guidance with regarding emergency preparedness in Missouri. Most planners communicated regularly with planners in their region but seldom with planners outside their region. Planners also reported working with an average of 12 local entities (e.g., emergency management, hospitals/ clinics). Planners identified the following leaders in Missouri's public health emergency preparedness system: local public health emergency planners, state epidemiologists, the state vaccine and grant coordinator, regional public health emergency planners, State Emergency Management Agency area coordinators, the state Strategic National Stockpile coordinator, and Federal Bureau of Investigation Weapons of Mass Destruction coordinators. Generally, planners listed few federal-level or private-sector individuals in their emergency preparedness networks. While Missouri public health emergency planners maintain large and varied emergency preparedness networks, there are opportunities for strengthening existing ties and seeking additional connections.

Emergencies and Emergency Permits for Ocean Dumping

EPA Pesticide Factsheets

Emergency permits under the MPRSA are issued if disposed material poses a threat to human health. Information is provided on emergency permit examples and disposal sites. Emergencies to safeguard life at sea does not require an ocean dumping permit.

78 FR 13207 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-26

...--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the... Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

76 FR 11071 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

...--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the... Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... north of Cuba. On February 26, 2004, by Proclamation 7757, the national emergency was extended and its...

Best Practices in Wireless Emergency Alerts

DTIC Science & Technology

2014-02-01

California Emergency Management Agency (Cal EMA)  Cassidian Communications  Cecil County Emergency Management Services, Maryland  City of...Jefferson County Emergency Communication Authority (JCECA), Colorado  Johnson County Emergency Management Agency, Kansas  Larimer Emergency Telephone...origination community and the challenges its members faced. Due to the infancy of the WEA service, many interviewees were not yet using WEA during the

Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

PubMed

Pedigo, Ryan Anthony; Zaurova, Milana

2017-06-22

Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

Emergency responders' critical infrared (ERCI)

NASA Astrophysics Data System (ADS)

Konsin, Larry S.

2004-08-01

Emergency Responders (Fire, Police, Medical, and Emergency Management) face a high risk of injury or death. Even before September 11, 2001, public and private organizations have been driven to better protect Emergency Responders through education, training and improved technology. Recent research on Emergency Responder safety, health risks, and personal protective requirements, shows infrared (IR) imaging as a critical need. Today"s Emergency Responders are increasingly challenged to do more, facing demands requiring technological assistance and/or solutions. Since the introduction of Fire Service IR imaging in the mid 1990s, applications have increased. Emergency response IR is no longer just seeing through smoke to find victims or the seat of a fire. Many more mission critical needs now exist across the broad spectrum of emergency response. At the same time, Emergency Responder injuries and deaths are increasing. The Office of Domestic Preparedness (ODP) has also recognized IR imaging as critical in protecting our communities -- and in preventing many of the injuries and deaths of Emergency Responders. Currently, only 25% of all fire departments (or less than 7% of individual firefighters) have IR imaging. Availability to Police, EMS and Emergency Management is even lower. Without ERCI, Emergency Responders and our communities are at risk.

Non-Communicable Diseases in Emergencies: A Call to Action

PubMed Central

Demaio, Alessandro; Jamieson, Jennifer; Horn, Rebecca; de Courten, Maximilian; Tellier, Siri

2013-01-01

Recent years have demonstrated the devastating health consequences of complex emergencies and natural disasters and thereby highlighted the importance of comprehensive and collaborative approaches to humanitarian responses and risk reduction. Simultaneously, noncommunicable diseases are now recognised as a real and growing threat to population health and development; a threat that is magnified by and during emergencies. Noncommunicable diseases, however, continue to receive little attention from humanitarian organisations in the acute phase of disaster and emergency response. This paper calls on all sectors to recognise and address the specific health challenges posed by noncommunicable diseases in emergencies and disaster situations. This publication aims to highlight the need for: • Increased research on morbidity and mortality patterns due to noncommunicable diseases during and following emergencies; • Raised awareness through greater advocacy for the issue and challenges of noncommunicable diseases during and following emergencies; • Incorporation of noncommunicable diseases into existing emergency-related policies, standards, and resources; • Development of technical guidelines on the clinical management of noncommunicable diseases in emergencies; • Greater integration and coordination in health service provision during and following emergencies; • Integrating noncommunicable diseases into practical and academic training of emergency workers and emergency-response coordinators. PMID:24056956

Red flag findings in children with headaches: Prevalence and association with emergency department neuroimaging.

PubMed

Tsze, Daniel S; Ochs, Julie B; Gonzalez, Ariana E; Dayan, Peter S

2018-01-01

Background Clinicians appear to obtain emergent neuroimaging for children with headaches based on the presence of red flag findings. However, little data exists regarding the prevalence of these findings in emergency department populations, and whether the identification of red flag findings is associated with potentially unnecessary emergency department neuroimaging. Objectives We aimed to determine the prevalence of red flag findings and their association with neuroimaging in otherwise healthy children presenting with headaches to the emergency department. Our secondary aim was to determine the prevalence of emergent intracranial abnormalities in this population. Methods A prospective cohort study of otherwise healthy children 2-17 years of age presenting to an urban pediatric emergency department with non-traumatic headaches was undertaken. Emergency department physicians completed a standardized form to document headache descriptors and characteristics, associated symptoms, and physical and neurological exam findings. Children who did not receive emergency department neuroimaging received 4-month telephone follow-up. Outcomes included emergency department neuroimaging and the presence of emergent intracranial abnormalities. Results We enrolled 224 patients; 197 (87.9%) had at least one red flag finding on history. Several red flag findings were reported by more than a third of children, including: Headache waking from sleep (34.8%); headache present with or soon after waking (39.7%); or headaches increasing in frequency, duration and severity (40%, 33.1%, and 46.3%). Thirty-three percent of children received emergency department neuroimaging. The prevalence of emergent intracranial abnormalities was 1% (95% CI 0.1, 3.6). Abnormal neurological exam, extreme pain intensity of presenting headache, vomiting, and positional symptoms were independently associated with emergency department neuroimaging. Conclusions Red flag findings are common in children presenting with headaches to the emergency department. The presence of red flag findings is associated with emergency department neuroimaging, although the risk of emergent intracranial abnormalities is low. Many children with headaches may be receiving unnecessary neuroimaging due to the high prevalence of non-specific red flag findings.

Evidence-based support for the all-hazards approach to emergency preparedness

PubMed Central

2012-01-01

Background During the last decade there has been a need to respond and recover from various types of emergencies including mass casualty events (MCEs), mass toxicological/chemical events (MTEs), and biological events (pandemics and bio-terror agents). Effective emergency preparedness is more likely to be achieved if an all-hazards response plan is adopted. Objectives To investigate if there is a relationship among hospitals' preparedness for various emergency scenarios, and whether components of one emergency scenario correlate with preparedness for other emergency scenarios. Methods Emergency preparedness levels of all acute-care hospitals for MCEs, MTEs, and biological events were evaluated, utilizing a structured evaluation tool based on measurable parameters. Evaluations were made by professional experts in two phases: evaluation of standard operating procedures (SOPs) followed by a site visit. Relationships among total preparedness and different components' scores for various types of emergencies were analyzed. Results Significant relationships were found among preparedness for different emergencies. Standard Operating Procedures (SOPs) for biological events correlated with preparedness for all investigated emergency scenarios. Strong correlations were found between training and drills with preparedness for all investigated emergency scenarios. Conclusions Fundamental critical building blocks such as SOPs, training, and drill programs improve preparedness for different emergencies including MCEs, MTEs, and biological events, more than other building blocks, such as equipment or knowledge of personnel. SOPs are especially important in unfamiliar emergency scenarios. The findings support the adoption of an all-hazards approach to emergency preparedness. PMID:23098065

Improvement of Emergency Management Mechanism of Public Health Crisis in Rural China: A Review Article

PubMed Central

HU, Jiaxiang; CHEN, Chao; KUAI, Tingting

2018-01-01

Background: With the rapid development of social economy in China, various public health emergencies frequently occur. Such emergencies cause a serious threat to human health and public safety, especially in rural China. Owing to flaws in emergency management mechanism and policy, the government is not capable to effectively deal with public health emergencies. Therefore, this study aimed to discuss the path to improve the emergency management mechanism for public health emergency in rural China. Methods: This study was conducted in 2017 to detect the emergency management mechanism of public health crisis (EMMPHC) in Rural China. Data were collected using the following keywords: Rural China, public health emergency, emergency management mechanism, organization mechanism, operation mechanism in the databases of PubMed, Scopus, Web of Science, and CNKI. Results: EMMPHC in rural China can be enhanced from the following three aspects. First, a permanent institution for rural emergency management with public health management function is established. Second, the entire process of emergency management mechanism, including the stages of pre-disaster, disaster, and post-disaster, is improved. Finally, investment in rural public health is increased, and an adequate reserve system for emergency resources is formed. Conclusion: The new path of EMMPHC in rural China can effectively help the local government accomplish the dispatch capability in public health emergency, and it has important research significance for the protection of public health and social stability of residents in rural China. PMID:29445625

Emergence flux declines disproportionately to larval density along a stream metals gradient

USGS Publications Warehouse

Schmidt, Travis S.; Kraus, Johanna M.; Walters, David M.; Wanty, Richard B.

2013-01-01

Effects of contaminants on adult aquatic insect emergence are less well understood than effects on insect larvae. We compared responses of larval density and adult emergence along a metal contamination gradient. Nonlinear threshold responses were generally observed for larvae and emergers. Larval densities decreased significantly at low metal concentrations but precipitously at concentrations of metal mixtures above aquatic life criteria (Cumulative Criterion Accumulation Ratio (CCAR) ≥ 1). In contrast, adult emergence declined precipitously at low metal concentrations (CCAR ≤ 1), followed by a modest decline above this threshold. Adult emergence was a more sensitive indicator of the effect of low metals concentrations on aquatic insect communities compared to larvae, presumably because emergence is limited by a combination of larval survival and other factors limiting successful emergence. Thus effects of exposure to larvae are not manifest until later in life (during metamorphosis and emergence). This loss in emergence reduces prey subsidies to riparian communities at concentrations considered safe for aquatic life. Our results also challenge the widely held assumption that adult emergence is a constant proportion of larval densities in all streams.

Emergency material allocation and scheduling for the application to chemical contingency spills under multiple scenarios.

PubMed

Liu, Jie; Guo, Liang; Jiang, Jiping; Jiang, Dexun; Wang, Peng

2017-01-01

In the emergency management relevant to chemical contingency spills, efficiency emergency rescue can be deeply influenced by a reasonable assignment of the available emergency materials to the related risk sources. In this study, an emergency material scheduling model (EMSM) with time-effective and cost-effective objectives is developed to coordinate both allocation and scheduling of the emergency materials. Meanwhile, an improved genetic algorithm (IGA) which includes a revision operation for EMSM is proposed to identify the emergency material scheduling schemes. Then, scenario analysis is used to evaluate optimal emergency rescue scheme under different emergency pollution conditions associated with different threat degrees based on analytic hierarchy process (AHP) method. The whole framework is then applied to a computational experiment based on south-to-north water transfer project in China. The results demonstrate that the developed method not only could guarantee the implementation of the emergency rescue to satisfy the requirements of chemical contingency spills but also help decision makers identify appropriate emergency material scheduling schemes in a balance between time-effective and cost-effective objectives.

Historical development and current status of emergency nursing in Turkey.

PubMed

Selimen, Deniz; Gürkan, Aysel

2009-09-01

As the demand for high quality Accident and Emergency Departments and nursing staff increases throughout Turkey, the need for more specialized emergency nurse training has also increased. Although there have been a number of positive developments regarding emergency nursing standards, the general quality of emergency nurse training needs to be improved and job definitions amended to better reflect the specialist duties of emergency nurses.

A 21-year study of seasonal and interspecific variation of hatchling emergence in a nearctic freshwater turtle community: to overwinter or not to overwinter?

USGS Publications Warehouse

Lovich, Jeffrey E.; Ernst, Carl H.; Ernst, Evelyn M.; Riley, Julia L.

2014-01-01

Hatchling emergence patterns were studied in a community of six species of freshwater turtles in Lancaster County, Pennsylvania, U.S.A. including: Chelydra serpentina, Chrysemys picta, Clemmys guttata, Glyptemys insculpta, G. muhlenbergii, and Sternotherus odoratus. Data were collected every year from 1965 to 1985 on estimated date of emergence, carapace length, April – May precipitation, August – September precipitation, annual precipitation, and low temperature and occurrence of precipitation during the 24-hrs prior to the time of each hatchling detection (n = 806). Chelydra serpentina, Ch. picta, and Cl. guttata hatchlings have a facultative delayed emergence strategy. The other species (G. insculpta, G. muhlenbergii, and S. odoratus) appear to be obligate early emergers, with the exception of one hatchling G. muhlenbergii that delayed emergence. Early emergence occurred in some species every year except 1973, the year following intense flooding and nest destruction associated with a major hurricane. However, the majority of hatchlings delayed emergence until the year following oviposition. Mean estimated calendar day of emergence varied annually in C. serpentina and Ch. picta. The same variable also varied among species for comparisons of both early and delayed emergence. Chelydra serpentina hatchlings emerged earlier than all other species whether they used an early or delayed strategy. Carapace length of Ch. picta hatchlings varied significantly among years and C. serpentina hatchlings that delayed emergence were significantly larger in carapace length than those that emerged early. Seasonal and previous 24-hr precipitation had varying effects on the number of emerging hatchlings, but August – September precipitation in one year had a strong correlation with the number of hatchlings that delayed emergence until the following spring. The number of hatchlings detected peaked at a previous 24-hour air temperature of about 12°C for both early and late emergence. Small species like G. muhlenbergii and S. odoratus may emerge early to limit potential hatchling competition in diverse communities of freshwater turtles with primarily delayed emergence.

Research on Crowdsourcing Emergency Information Extraction of Based on Events' Frame

NASA Astrophysics Data System (ADS)

Yang, Bo; Wang, Jizhou; Ma, Weijun; Mao, Xi

2018-01-01

At present, the common information extraction method cannot extract the structured emergency event information accurately; the general information retrieval tool cannot completely identify the emergency geographic information; these ways also do not have an accurate assessment of these results of distilling. So, this paper proposes an emergency information collection technology based on event framework. This technique is to solve the problem of emergency information picking. It mainly includes emergency information extraction model (EIEM), complete address recognition method (CARM) and the accuracy evaluation model of emergency information (AEMEI). EIEM can be structured to extract emergency information and complements the lack of network data acquisition in emergency mapping. CARM uses a hierarchical model and the shortest path algorithm and allows the toponomy pieces to be joined as a full address. AEMEI analyzes the results of the emergency event and summarizes the advantages and disadvantages of the event framework. Experiments show that event frame technology can solve the problem of emergency information drawing and provides reference cases for other applications. When the emergency disaster is about to occur, the relevant departments query emergency's data that has occurred in the past. They can make arrangements ahead of schedule which defense and reducing disaster. The technology decreases the number of casualties and property damage in the country and world. This is of great significance to the state and society.

Mental Health and Drivers of Need in Emergent and Non-Emergent Emergency Department (ED) Use: Do Living Location and Non-Emergent Care Sources Matter?

PubMed

McManus, Moira C; Cramer, Robert J; Boshier, Maureen; Akpinar-Elci, Muge; Van Lunen, Bonnie

2018-01-13

Emergency department (ED) utilization has increased due to factors such as admissions for mental health conditions, including suicide and self-harm. We investigate direct and moderating influences on non-emergent ED utilization through the Behavioral Model of Health Services Use. Through logistic regression, we examined correlates of ED use via 2014 New York State Department of Health Statewide Planning and Research Cooperative System outpatient data. Consistent with the primary hypothesis, mental health admissions were associated with emergent use across models, with only a slight decrease in effect size in rural living locations. Concerning moderating effects, Spanish/Hispanic origin was associated with increased likelihood for emergent ED use in the rural living location model, and non-emergent ED use for the no non-emergent source model. 'Other' ethnic origin increased the likelihood of emergent ED use for rural living location and no non-emergent source models. The findings reveal 'need', including mental health admissions, as the largest driver for ED use. This may be due to mental healthcare access, or patients with mental health emergencies being transported via first responders to the ED, as in the case of suicide, self-harm, manic episodes or psychotic episodes. Further educating ED staff on this patient population through gatekeeper training may ensure patients receive the best treatment and aid in driving access to mental healthcare delivery changes.

A state-wide survey of medical emergency management in dental practices: incidence of emergencies and training experience.

PubMed

Müller, M P; Hänsel, M; Stehr, S N; Weber, S; Koch, T

2008-05-01

Only a few data exist about the occurrence of emergencies in dental practice and the training experience of dental practice teams in life support. This study evaluates the incidence of emergencies in dental practices, the attitude of dentists towards emergency management and their training experience. Anonymous questionnaires were sent to all 2998 dentists listed in the Saxony State Dental Council Register in January 2005. 620 questionnaires were returned. 77% of the responders expressed an interest in emergency management and 84% stated that they owned an emergency bag. In the 12-month study period, 57% of the dentists reported up to 3 emergencies and 36% of the dentists reported up to 10 emergencies. Vasovagal syncope was the most frequent emergency (1238 cases). As two cardiac arrests occurred, it is estimated that one sudden cardiac arrest occurs per 638,960 patients in dental practice. 42 severe life-threatening events were reported in all 1,277,920 treated patients. 567 dentists (92%) took part in emergency training following graduation (23% participated once and 68% more than once). Medical emergencies are not rare in dental practice, although most of them are not life-threatening. Improvement of competence in emergency management should include repeated participation in life support courses, standardisation of courses and offering courses designed to meet the needs of dentists.

49 CFR 239.201 - Emergency preparedness plan; filing and approval.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Emergency preparedness plan; filing and approval...) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PASSENGER TRAIN EMERGENCY PREPAREDNESS Review, Approval, and Retention of Emergency Preparedness Plans § 239.201 Emergency preparedness plan...

49 CFR 110.40 - Activities eligible for funding.

Code of Federal Regulations, 2010 CFR

2010-10-01

... emergency response drills and exercises associated with emergency preparedness plans. (6) Provision of... associated with training, a course of study, and tests and evaluation of emergency preparedness plans. (4..., and implementation of emergency plans required under the Emergency Planning and Community Right-to...

44 CFR 15.8 - Gambling.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Gambling. 15.8 Section 15.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING...

44 CFR 15.8 - Gambling.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Gambling. 15.8 Section 15.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING...

44 CFR 15.8 - Gambling.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Gambling. 15.8 Section 15.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING...

44 CFR 15.8 - Gambling.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Gambling. 15.8 Section 15.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING...

44 CFR 15.8 - Gambling.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Gambling. 15.8 Section 15.8 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING...

44 CFR 351.2 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Scope. 351.2 Section 351.2 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS RADIOLOGICAL EMERGENCY PLANNING AND PREPAREDNESS General § 351.2 Scope. The emergency planning and...

44 CFR 351.2 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Scope. 351.2 Section 351.2 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS RADIOLOGICAL EMERGENCY PLANNING AND PREPAREDNESS General § 351.2 Scope. The emergency planning and...

44 CFR 351.2 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Scope. 351.2 Section 351.2 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS RADIOLOGICAL EMERGENCY PLANNING AND PREPAREDNESS General § 351.2 Scope. The emergency planning and...

44 CFR 351.2 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Scope. 351.2 Section 351.2 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS RADIOLOGICAL EMERGENCY PLANNING AND PREPAREDNESS General § 351.2 Scope. The emergency planning and...

Defining an emerging disease.

PubMed

Moutou, F; Pastoret, P-P

2015-04-01

Defining an emerging disease is not straightforward, as there are several different types of disease emergence. For example, there can be a 'real' emergence of a brand new disease, such as the emergence of bovine spongiform encephalopathy in the 1980s, or a geographic emergence in an area not previously affected, such as the emergence of bluetongue in northern Europe in 2006. In addition, disease can emerge in species formerly not considered affected, e.g. the emergence of bovine tuberculosis in wildlife species since 2000 in France. There can also be an unexpected increase of disease incidence in a known area and a known species, or there may simply be an increase in our knowledge or awareness of a particular disease. What all these emerging diseases have in common is that human activity frequently has a role to play in their emergence. For example, bovine spongiform encephalopathy very probably emerged as a result of changes in the manufacturing of meat-and-bone meal, bluetongue was able to spread to cooler climes as a result of uncontrolled trade in animals, and a relaxation of screening and surveillance for bovine tuberculosis enabled the disease to re-emerge in areas that had been able to drastically reduce the number of cases. Globalisation and population growth will continue to affect the epidemiology of diseases in years to come and ecosystems will continue to evolve. Furthermore, new technologies such as metagenomics and high-throughput sequencing are identifying new microorganisms all the time. Change is the one constant, and diseases will continue to emerge, and we must consider the causes and different types of emergence as we deal with these diseases in the future.

Attrition from emergency medicine clinical practice in the United States.

PubMed

Ginde, Adit A; Sullivan, Ashley F; Camargo, Carlos A

2010-08-01

We estimate the annual attrition from emergency medicine clinical practice. We performed a cross-sectional analysis of the American Medical Association's 2008 Physician Masterfile, which includes data on all physicians who have ever obtained a medical license in at least 1 US state. We restricted the analysis to physicians who completed emergency medicine residency training or who obtained emergency medicine board certification. We defined attrition as not being active in emergency medicine clinical practice. Attrition was reported as cumulative and annualized rates, with stratification by years since training graduation. Death rates were estimated from life tables for the US population. Of the 30,864 emergency medicine-trained or emergency medicine board-certified physicians, 26,826 (87%) remain active in emergency medicine clinical practice. Overall, type of attrition was 45% to non-emergency medicine clinical practice, 22% retired, 14% administration, and 10% research/teaching. Immediate attrition (<2 years since training graduation) was 6.5%. The cumulative attrition rates from 2 to 15 years postgraduation were stable (5% to 9%) and thereafter were progressively higher, with 18% having left emergency medicine clinical practice at 20 years postgraduation and 25% at 30 years postgraduation. Annualized attrition rates were highest for the first 5 years postgraduation and after 40 years postgraduation; between 5 and 40 years, the rates remained low (<1%). The overall annual attrition rate from emergency medicine clinical practice, including estimated death rate, was approximately 1.7%. Despite the high stress and demands of emergency medicine, overall attrition remains low and compares favorably with that of other medical specialties. These data have positive implications for the emergency physician workforce and are important for accurate estimation of and planning for emergency physician workforce needs. 2009 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Canadian Eskimo permanent tooth emergence timing.

PubMed

Mayhall, J T; Belier, P L; Mayhall, M F

1978-08-01

To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

Sustainability and the local emergency manager.

PubMed

Jensen, Jessica; Chauvet, Regine Laurence

2014-01-01

The objective of this study was to explore how local county emergency managers conceptualize sustainability and apply the concept within their jobs. Qualitative, semistructured telephone and face-to-face interviews were used to collect data from a purposive and convenience sample of local county emergency managers. Interviews were conducted with Florida and North Dakota emergency managers. Twenty-five local county emergency managers participated in this study. The study demonstrated that there is a lack of definitional clarity in emergency manager conceptualizations of sustainability. Nevertheless, emergency managers apply the concept to their jobs in important ways. Emergency management has the opportunity to further define its role vis-à-vis sustainability and how it does so will have implications for the communities it serves, the professionals who will be tasked with it, and the educators who will support the development of future generations of emergency management professionals.

Emergency medicine in modern Europe.

PubMed

Fleischmann, Thomas; Fulde, Gordian

2007-08-01

Emergency medicine in the highly advanced world is traditionally performed in two different ways. The first is the well-known Anglo-American system with skilled EDs, and a pre-hospital emergency medical service utilizing paramedics. The second is the so-called Franco-German system, with a highly developed pre-hospital emergency physician service, but only a basic organization of hospital-based emergency medicine. This gap is now closing fast because of the rapid advancement of hospital-based emergency medicine in Europe. Four criteria might be used to measure this: the recognition as a specialty, the specialist training programme, the professional organization of emergency physicians and the presence of academic centres in Europe. Eleven of the 27 European countries recognize hospital-based emergency medicine as a specialty already. These include Belgium, Czech Republic, Estonia, Hungary, Ireland, Italy, Malta, Poland, Romania, Slovenia and the United Kingdom. Other nations are striving to do so, for example Sweden, France, Germany and Greece. There is no doubt that emergency medicine is gaining momentum and other countries will follow. Training for the specialty of emergency medicine is advanced already. Several curricula presently exist in the respective European countries. A task force, governed by the European Society for Emergency Medicine has been working hard to create a model curriculum for all of Europe, which is expected to be published in 2007. This comprises a 5-year specialty training, with three of them spent in an ED. The curriculum follows a symptom-oriented approach to emergency medicine, and includes a skilled description of the key competencies of the future trained emergency physicians. Given the century-long history of the pre-hospital emergency physician service in some European countries, a number of professional bodies exist representing pre-hospital emergency doctors. Within the last few years, ED physicians followed suit forming organizations of their own. In some countries, the next step of amalgamation has occurred, with the merger of EMS and ED emergency physician organizations, although no country has abolished the pre-hospital emergency physician service. The last milestone, the development of academic emergency centres, has only just started. This process will take some time. The present paper describes the present and future of emergency medicine in some European countries using these criteria.

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.25 Limitation on...

49 CFR 239.203 - Retention of emergency preparedness plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Retention of emergency preparedness plan. 239.203... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PASSENGER TRAIN EMERGENCY PREPAREDNESS Review, Approval, and Retention of Emergency Preparedness Plans § 239.203 Retention of emergency preparedness plan. Each passenger...

44 CFR 206.35 - Requests for emergency declarations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Requests for emergency declarations. 206.35 Section 206.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

44 CFR 206.35 - Requests for emergency declarations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Requests for emergency declarations. 206.35 Section 206.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

44 CFR 206.35 - Requests for emergency declarations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Requests for emergency declarations. 206.35 Section 206.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

44 CFR 206.35 - Requests for emergency declarations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Requests for emergency declarations. 206.35 Section 206.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

44 CFR 206.35 - Requests for emergency declarations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Requests for emergency declarations. 206.35 Section 206.35 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206...

77 FR 70970 - Accessible Emergency Information, and Apparatus Requirements for Emergency Information and Video...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

... Emergency Information, and Apparatus Requirements for Emergency Information and Video Description... blind and visually disabled and that television apparatus are able to make available video description... of the Apparatus Emergency Information and Video Description Requirements. Form No.: Not applicable...

Optimized maritime emergency resource allocation under dynamic demand.

PubMed

Zhang, Wenfen; Yan, Xinping; Yang, Jiaqi

2017-01-01

Emergency resource is important for people evacuation and property rescue when accident occurs. The relief efforts could be promoted by a reasonable emergency resource allocation schedule in advance. As the marine environment is complicated and changeful, the place, type, severity of maritime accident is uncertain and stochastic, bringing about dynamic demand of emergency resource. Considering dynamic demand, how to make a reasonable emergency resource allocation schedule is challenging. The key problem is to determine the optimal stock of emergency resource for supplier centers to improve relief efforts. This paper studies the dynamic demand, and which is defined as a set. Then a maritime emergency resource allocation model with uncertain data is presented. Afterwards, a robust approach is developed and used to make sure that the resource allocation schedule performs well with dynamic demand. Finally, a case study shows that the proposed methodology is feasible in maritime emergency resource allocation. The findings could help emergency manager to schedule the emergency resource allocation more flexibly in terms of dynamic demand.

Optimized maritime emergency resource allocation under dynamic demand

PubMed Central

Yan, Xinping; Yang, Jiaqi

2017-01-01

Emergency resource is important for people evacuation and property rescue when accident occurs. The relief efforts could be promoted by a reasonable emergency resource allocation schedule in advance. As the marine environment is complicated and changeful, the place, type, severity of maritime accident is uncertain and stochastic, bringing about dynamic demand of emergency resource. Considering dynamic demand, how to make a reasonable emergency resource allocation schedule is challenging. The key problem is to determine the optimal stock of emergency resource for supplier centers to improve relief efforts. This paper studies the dynamic demand, and which is defined as a set. Then a maritime emergency resource allocation model with uncertain data is presented. Afterwards, a robust approach is developed and used to make sure that the resource allocation schedule performs well with dynamic demand. Finally, a case study shows that the proposed methodology is feasible in maritime emergency resource allocation. The findings could help emergency manager to schedule the emergency resource allocation more flexibly in terms of dynamic demand. PMID:29240792

NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies.

PubMed

D'Onofrio, Gail; Jauch, Edward; Jagoda, Andrew; Allen, Michael H; Anglin, Deirdre; Barsan, William G; Berger, Rachel P; Bobrow, Bentley J; Boudreaux, Edwin D; Bushnell, Cheryl; Chan, Yu-Feng; Currier, Glenn; Eggly, Susan; Ichord, Rebecca; Larkin, Gregory L; Laskowitz, Daniel; Neumar, Robert W; Newman-Toker, David E; Quinn, James; Shear, Katherine; Todd, Knox H; Zatzick, Douglas

2010-11-01

The Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (2003) identified a need to enhance the research base for emergency care. As a result, a National Institutes of Health (NIH) Task Force on Research in Emergency Medicine was formed to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. We identify key research questions essential to advancing the science of emergency care and discuss the barriers and strategies to advance research by exploring the collaboration between NIH and the emergency care community. Experts from emergency medicine, neurology, psychiatry, and public health assembled to review critical areas in need of investigation, current gaps in knowledge, barriers, and opportunities. Neurologic emergencies included cerebral resuscitation, pain, stroke, syncope, traumatic brain injury, and pregnancy. Mental health topics included suicide, agitation and delirium, substances, posttraumatic stress, violence, and bereavement. Presentations and group discussion firmly established the need for translational research to bring basic science concepts into the clinical arena. A coordinated continuum of the health care system that ensures rapid identification and stabilization and extends through discharge is necessary to maximize overall patient outcomes. There is a paucity of well-designed, focused research on diagnostic testing, clinical decisionmaking, and treatments in the emergency setting. Barriers include the limited number of experienced researchers in emergency medicine, limited dedicated research funding, and difficulties of conducting research in chaotic emergency environments stressed by crowding and limited resources. Several themes emerged during the course of the roundtable discussion, including the need for development of (1) a research infrastructure for the rapid identification, consent, and tracking of research subjects that incorporates innovative informatics technologies, essential for future research; (2) diagnostic strategies and tools necessary to understand key populations and the process of medical decisionmaking, including the investigation of the pathobiology of symptoms and symptom-oriented therapies; (3) collaborative research networks to provide unique opportunities to form partnerships, leverage patient cohorts and clinical and financial resources, and share data; (4) formal research training programs integral for creating new knowledge and advancing the science and practice of emergency medicine; and (5) recognition that emergency care is part of an integrated system from emergency medical services dispatch to discharge. The NIH Roundtable "Opportunities to Advance Research on Neurological and Psychiatric Emergencies" created a framework to guide future emergency medicine-based research initiatives. Emergency departments provide the portal of access to the health care system for most patients with acute neurologic and psychiatric illness. Emergency physicians and colleagues are primed to investigate neurologic and psychiatric emergencies that will directly improve the delivery of care and patient outcomes. Copyright © 2010. Published by Mosby, Inc.

Update on emergency contraception.

PubMed

Fok, Wing Kay; Blumenthal, Paul D

2016-12-01

Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

HMOs and the barriers to access for the pediatric population requiring emergency medical services.

PubMed

Uva, J L

1996-06-01

The main objectives of this study are to analyze the Massachusetts Health Maintenance Organizations (HMOs) in order to determine their standard definition of an emergency, the HMOs instructions for seeking emergency care, and distribution of such instructions for the pediatric population. A 15-question survey concerning pediatric emergency care policies and procedures was asked of each of the 20 HMOs contacted. Quarterly statements of each of the 20 HMOs were obtained from the Division of Insurance as well as the HMO's written materials distributed to the enrollees as member handbooks. Ninety percent of the HMOs had a definition of emergency care for the adult population, whereas 0% had a definition of emergency care specifically for the pediatric population. One hundred percent of the HMOs had instructions for emergency care, but 0% had specific provisions for pediatric emergency care. All 20 HMOs inform their enrollees about emergency policies through a member handbook. The results of this study reveal the lack of a standard definition of an emergency for HMOs. The current definitions of "urgent," "emergency," and "life-threatening emergency" care do not reflect the pediatric population, rather, these definitions are based on the adult population. The lack of specific pediatric guidelines could compromise the health of the children in HMOs.

Ethical issues in the response to Ebola virus disease in United States emergency departments: a position paper of the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine.

PubMed

Venkat, Arvind; Asher, Shellie L; Wolf, Lisa; Geiderman, Joel M; Marco, Catherine A; McGreevy, Jolion; Derse, Arthur R; Otten, Edward J; Jesus, John E; Kreitzer, Natalie P; Escalante, Monica; Levine, Adam C

2015-05-01

The 2014 outbreak of Ebola virus disease (EVD) in West Africa has presented a significant public health crisis to the international health community and challenged U.S. emergency departments (EDs) to prepare for patients with a disease of exceeding rarity in developed nations. With the presentation of patients with Ebola to U.S. acute care facilities, ethical questions have been raised in both the press and medical literature as to how U.S. EDs, emergency physicians (EPs), emergency nurses, and other stakeholders in the health care system should approach the current epidemic and its potential for spread in the domestic environment. To address these concerns, the American College of Emergency Physicians, the Emergency Nurses Association, and the Society for Academic Emergency Medicine developed this joint position paper to provide guidance to U.S. EPs, emergency nurses, and other stakeholders in the health care system on how to approach the ethical dilemmas posed by the outbreak of EVD. This paper will address areas of immediate and potential ethical concern to U.S. EDs in how they approach preparation for and management of potential patients with EVD. © 2015 by the Society for Academic Emergency Medicine.

Developing an active emergency medical service system based on WiMAX technology.

PubMed

Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang

2012-10-01

The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

Emergency department crowding in Singapore: Insights from a systems thinking approach.

PubMed

Schoenenberger, Lukas K; Bayer, Steffen; Ansah, John P; Matchar, David B; Mohanavalli, Rajagopal L; Lam, Sean Sw; Ong, Marcus Eh

2016-01-01

Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care. The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied. The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created. Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study

PubMed Central

Ro, Young Sun; Shin, Sang Do; Jeong, Joongsik; Kim, Min Jung; Jung, Young Hee; Kamgno, Joseph; Alain, Etoundi Mballa Georges; Hollong, Bonaventure

2017-01-01

Objectives To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers. Design A cross-sectional study using a community-based survey. Setting Yaoundé, Cameroon. Participants All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling. Primary outcome measures Unmet needs for emergency care. Results Among the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care. Conclusions Residents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon. PMID:28167749

Abstract to publication ratio for papers presented at scientific meetings: how does emergency medicine compare?

PubMed

Walby, A; Kelly, A M; Georgakas, C

2001-12-01

The aims of the present study were to determine the publication rate of abstracts presented by Australasian emergency physicians at major emergency medicine meetings and to identify the site of publication of papers. All free paper abstracts presented (oral and poster) by Australasian emergency physicians and trainees at five Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings between 1995 and 1998 were identified retrospectively from conference programmes. In order to determine whether or not the abstract had been published, the PubMed database (http://www4.ncbi.nlm.nih.gov/PubMed/) was searched using the presenter's name and key words from the abstract. In addition, a hand search of the non-abstracted journal Emergency Medicine was conducted. Of the 207 free paper abstracts identified, 73 (35%) had been published as full articles. Papers were published in a variety of journals; however, Emergency Medicine accounted for almost half the published papers. The mean time between presentation and publication was 12.6 months (median 11 months). The abstract to publication rate for papers presented by Australasian emergency physicians and trainees at Australasian College for Emergency Medicine/Australasian Society for Emergency Medicine and International Conference on Emergency Medicine meetings is 35%, which is lower than that reported by some other established specialities, but comparable to rates reported for US-based national and international emergency medicine meetings. Future research should look at barriers to the publication of findings and ways to assist the publication process.

Overwintering temperature and body condition shift emergence dates of spring-emerging solitary bees.

PubMed

Schenk, Mariela; Mitesser, Oliver; Hovestadt, Thomas; Holzschuh, Andrea

2018-01-01

Solitary bees in seasonal environments must align their life-cycles with favorable environmental conditions and resources; the timing of their emergence is highly fitness relevant. In several bee species, overwintering temperature influences both emergence date and body weight at emergence. High variability in emergence dates among specimens overwintering at the same temperatures suggests that the timing of emergence also depends on individual body conditions. However, possible causes for this variability, such as individual differences in body size or weight, have been rarely studied. In a climate chamber experiment using two spring-emerging mason bees ( Osmia cornuta and O. bicornis ), we investigated the relationship between temperature, emergence date, body weight, and body size, the last of which is not affected by overwintering temperature. Our study showed that body weight declined during hibernation more strongly in warm than in cold overwintering temperatures. Although bees emerged earlier in warm than in cold overwintering temperatures, at the time of emergence, bees in warm overwintering temperatures had lower body weights than bees in cold overwintering temperatures (exception of male O. cornuta ). Among specimens that experienced the same overwintering temperatures, small and light bees emerged later than their larger and heavier conspecifics. Using a simple mechanistic model we demonstrated that spring-emerging solitary bees use a strategic approach and emerge at a date that is most promising for their individual fitness expectations. Our results suggest that warmer overwintering temperatures reduce bee fitness by causing a decrease in body weight at emergence. We showed furthermore that in order to adjust their emergence dates, bees use not only temperature but also their individual body condition as triggers. This may explain differing responses to climate warming within and among bee populations and may have consequences for bee-plant interactions as well as for the persistence of bee populations under climate change.

Burden of emergency conditions and emergency care usage: new estimates from 40 countries.

PubMed

Chang, Cindy Y; Abujaber, Samer; Reynolds, Teri A; Camargo, Carlos A; Obermeyer, Ziad

2016-11-01

To estimate the global and national burden of emergency conditions, and compare them to emergency care usage rates. We coded all 291 Global Burden of Disease 2010 conditions into three categories to estimate emergency burden: conditions that, if not addressed within hours to days of onset, commonly lead to serious disability or death; conditions with common acute decompensations that lead to serious disability or death; and non-emergencies. Emergency care usage rates were obtained from a systematic literature review on emergency care facilities in low-income and middle-income countries (LMICs), supplemented by national health system reports. All 15 leading causes of death and disability-adjusted life years (DALYs) globally were conditions with potential emergent manifestations. We identified 41 facility-based reports in 23 countries, 12 of which were in LMICs; data for 17 additional countries were obtained from national or regional reports on emergency usage. Burden of emergency conditions was the highest in low-income countries, with median DALYs of 47 728 per 100 000 population (IQR 45 253-50 085) in low-income, 25 186 (IQR 21 982-40 480) in middle-income and 15 691 (IQR 14 649-16 382) in high-income countries. Patterns were similar using deaths to measure burden and excluding acute decompensations from the definition of emergency conditions. Conversely, emergency usage rates were the lowest in low-income countries, with median 8 visits per 1000 population (IQR 6-10), 78 (IQR 25-197) in middle-income and 264 (IQR 177-341) in high-income countries. Despite higher burden of emergency conditions, emergency usage rates are substantially lower in LMICs, likely due to limited access to emergency care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

PubMed

Lee, Andrew C K; Phillips, Wendy; Challen, Kirsty; Goodacre, Steve

2012-10-19

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. 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. 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. 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 specific planning, and reactive versus proactive approaches to emergencies.(iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed.

Evaluating the Emergency Notification Systems of the NASA White Sands Test

NASA Technical Reports Server (NTRS)

Chavez, Alfred Paul

2004-01-01

The problem was that the NASA Fire and Emergency Services did not know if the current emergency notification systems on the NASA White Sands Test Facility were appropriate for alerting the employees of an emergency. The purpose of this Applied Research Project was to determine if the current emergency notification systems of the White Sands Test Facility are appropriate for alerting the employees of an emergency. This was a descriptive research project. The research questions were: 1) What are similar facilities using to alert the employees of an emergency?; 2) Are the current emergency notification systems suitable for the community hazards on the NASA White Sands Test Facility?; 3) What is the NASA Fire and Emergency Services currently using to measure the effectiveness of the emergency notification systems?; and 4) What are the current training methods used to train personnel to the emergency notification systems at the NASA White Sands Test Facility? The procedures involved were to research other established facilities, research published material from credible sources, survey the facility to determine the facility perception of the emergency notification systems, and evaluate the operating elements of the established emergency notification systems for the facility. The results were that the current systems are suitable for the type of hazards the facility may endure. The emergency notification systems are tested frequently to ensure effectiveness in the event of an emergency. Personnel are trained and participate in a yearly drill to make certain personnel are educated on the established systems. The recommendations based on the results were to operationally improve the existing systems by developing and implementing one system that can overall notify the facility of a hazard. Existing procedures and training should also be improved to ensure that all personnel are educated on what to do when the emergency notification systems are activated.

Emergency Medicine Resources within the Clinical Translational Science Institutes: A Cross-Sectional Study

PubMed Central

Meurer, William J.; Quinn, James; Lindsell, Christopher; Schneider, Sandra; Newgard, Craig D.

2016-01-01

Background The Clinical and Translational Science Award (CTSA) program aims to strengthen and support translational research by accelerating the process of translating laboratory discoveries into treatments for patients, training a new generation of clinical and translational researchers, and engaging communities in clinical research efforts. Yet, little is known about how emergency care researchers have interacted with and utilized the resources of academic institutions with CTSAs. Objective The purpose of this survey was to describe how emergency care researchers use local CTSA resources, to ascertain what proportion of CTSA consortium members have active emergency care research programs, and to solicit participation in a national CTSA-associated emergency care translational research network. Methods Survey of all emergency departments affiliated with a CTSA. Results Of the 65 CTSA consortium members, three had no emergency care research program and we obtained responses from 46 of the remaining 62 (74% response rate). The interactions with and resources used by emergency care researchers varied widely. Methodology and biostatistics support was most frequently accessed (77%), followed closely by education and training programs (60%). Several emergency care research programs (76%) had submitted for funding through CTSAs, with 71% receiving awards. Most CTSA consortium members had an active emergency care research infrastructure: 21 (46%) had 24/7 availability to recruit and screen for research, 21 (46%) had less than 24/7 research recruitment. A number of emergency care research programs participated in NIH research networks with the Neurological Emergencies Treatment Trials network most highly represented with 23 (59%) sites. Most emergency care research programs (96%) were interested in participating in a CTSA-based emergency care translational research network. Conclusions Despite little initial involvement in development of the CTSA program, there has been moderate interaction between CTSAs and emergency care. There is considerable interest in participating in a CTSA consortium based emergency care translational research network. PMID:26826059

Preliminary assessment of appropriateness of emergency care service use: actions taken and consultations obtained before emergency care presentation.

PubMed

Tzeng, Huey-Ming

2011-01-01

Inappropriate use of emergency care services can increase hospital readmissions and related costs. This pilot, cross-sectional survey project determined whether home health care patients who receive emergency care services during a Medicare-approved home care episode sought consultation from health care professionals before they made the emergency care visit. The two research questions were: (a) What actions were taken by the patient before making an emergency care visit?; (b) If prior consultation was obtained, what were the suggestions? Preliminary data were obtained from a Michigan-based, Medicare-certified, not-for-profit home health agency affiliated with a university health system. A two-page questionnaire recorded up to three emergency care visits. Volunteer participants were Medicare patients who had no cognitive deficits and were able to communicate with home health care providers (HHCPs) by themselves. Thirty-five emergency care visits were reported; 31 (88.6%) Medicare patients participated and 4 (11.4%) of them had two emergency care visits. Before the patients made an emergency care visit, they most often called their primary care physicians (PCPs; N = 20, 57.1%), followed by the HHCPs (N = 10, 28.6%). All 20 patients who contacted their PCPs and 7 patients who contacted their HHCPs were advised to seek emergency care services. In 20 emergency care visits the patient was admitted for an acute hospital stay; the other 15 patients went home. Most patients contacted their PCPs or HHCPs before they went to an emergency department or urgent care facility. These results implied that PCPs and HHCPs seemed to perceive that the need for emergency care should be determined at an emergency room or urgent care facility. This study was unable to differentiate the need for emergency care services or the appropriateness of the advice given by PCPs or HHCPs when the home care patients were under the care of a medical team.

Preparedness of government owned dental clinics for the management of medical emergencies: a survey of government dental clinics in Lagos.

PubMed

Gbotolorun, O M; Babatunde, L B; Osisanya, O; Omokhuale, E

2012-01-01

An emergency is a medical condition demanding immediate treatments. The aim of the study was to determine the knowledge and ability of dental surgeons in the management of medical emergencies and the availability of emergency drugs and equipment in government dental clinics and hospitals in Lagos State. The study was a descriptive cross-sectional study of knowledge and ability of Dental Surgeons in the management of medical emergencies, prevalence of medical emergencies in dental practice and availability of emergency drugs and equipment in dental practice in government dental clinics and hospitals in Lagos State. The study covered 22 government dental clinics and hospitals in Lagos State. Data obtained was entered into a computerand analyzed using Statistical Package for Social Science (SPSS) Version-16 data analysis software. Chi Square and cross-tabulations were used for the analysis. A 95% Confidence Level was used and a p-value of less than or equal to 0.05 was considered statistically significant. Of a population of 255 Dental Surgeons on the nominal rolls of all the health institutions, 224 (87%)responded.Of the total respondents, 204 (91.1%) stated they had no emergency kit in their dental clinics (p < 0.05) while 158 respondents (70.5%) stated they had no emergency drugs in their dental practice to manage medical emergencies (p < 0.05). The commonest emergencies reported was syncope 104 respondents (33.8%). 161 respondents (71.9%) claimed they are able to manage medical emergencies encountered in their dental practice if kits and drugs are available. The findings of the study show that government dental clinics/hospital in Lagos seem not to be adequately prepared to manage medical emergency. Although 71.9% of the dentist claimed they could mange such emergencies should they arise 91.1% and 70% of the respondent claimed they and no emergency kits and drugs to manage such emergencies in their hospital respectively should they arise.

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management... COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.25 Limitation on committing Federal facilities and resources for emergency preparedness. (a) The commitment of Federal...

Emergency Preparedness & Recovery News Releases - PHE

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and reload this page. Skip over global navigation links U.S. Department of Health and Human Services Health Emergency - Leading a Nation Prepared Search Search PHE Home > Emergency Emergency Preparedness necesitan medicamentos HHS Acting Secretary Declares Public Health Emergency to Address National Opioid

46 CFR 112.20-3 - Normal source for emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

....20-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source...'s service generating plant. (b) The power from the ship's service generating plant for the emergency...

46 CFR 112.25-3 - Normal source for emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

....25-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-3 Normal source for...

46 CFR 112.30-3 - Normal source for emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

....30-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-3 Normal source for emergency loads. (a) The normal source...

46 CFR 112.30-5 - Transfer of emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-5 Transfer of emergency loads. If there is a reduction of potential of the...

46 CFR 112.20-3 - Normal source for emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

....20-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source...'s service generating plant. (b) The power from the ship's service generating plant for the emergency...

46 CFR 112.25-3 - Normal source for emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

....25-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-3 Normal source for...

46 CFR 112.20-3 - Normal source for emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

....20-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source...'s service generating plant. (b) The power from the ship's service generating plant for the emergency...

46 CFR 112.30-3 - Normal source for emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

....30-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-3 Normal source for emergency loads. (a) The normal source...

46 CFR 112.30-3 - Normal source for emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

....30-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-3 Normal source for emergency loads. (a) The normal source...

46 CFR 112.30-5 - Transfer of emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-5 Transfer of emergency loads. If there is a reduction of potential of the...

46 CFR 112.20-3 - Normal source for emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

....20-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source...'s service generating plant. (b) The power from the ship's service generating plant for the emergency...

46 CFR 112.30-5 - Transfer of emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-5 Transfer of emergency loads. If there is a reduction of potential of the...

46 CFR 112.20-3 - Normal source for emergency loads.

Code of Federal Regulations, 2013 CFR

2013-10-01

....20-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency Power Source...'s service generating plant. (b) The power from the ship's service generating plant for the emergency...

46 CFR 112.30-5 - Transfer of emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-5 Transfer of emergency loads. If there is a reduction of potential of the...

46 CFR 112.30-3 - Normal source for emergency loads.

Code of Federal Regulations, 2014 CFR

2014-10-01

....30-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-3 Normal source for emergency loads. (a) The normal source...

46 CFR 112.25-3 - Normal source for emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

....25-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-3 Normal source for...

46 CFR 112.30-3 - Normal source for emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

....30-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-3 Normal source for emergency loads. (a) The normal source...

46 CFR 112.25-3 - Normal source for emergency loads.

Code of Federal Regulations, 2011 CFR

2011-10-01

....25-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-3 Normal source for...

46 CFR 112.30-5 - Transfer of emergency loads.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-5 Transfer of emergency loads. If there is a reduction of potential of the...

46 CFR 112.25-3 - Normal source for emergency loads.

Code of Federal Regulations, 2012 CFR

2012-10-01

....25-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatic Starting Diesel Engine or Gas Turbine Driven Emergency Power Source as the Sole Emergency Power Source § 112.25-3 Normal source for...

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Criteria for emergency publication. 17.3..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

44 CFR 351.20 - The Federal Emergency Management Agency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... plans. (f) Assess, with the assistance of other Federal agencies, the adequacy of State and local... emergency plans and preparedness. (i) Develop and manage a radiological emergency response training program... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true The Federal Emergency...

44 CFR 351.20 - The Federal Emergency Management Agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... plans. (f) Assess, with the assistance of other Federal agencies, the adequacy of State and local... emergency plans and preparedness. (i) Develop and manage a radiological emergency response training program... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false The Federal Emergency...

77 FR 73509 - Emerging World Pharma, Inc.; Order of Suspension of Trading

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Emerging World Pharma, Inc.; Order of... lack of current and accurate information concerning the securities of Emerging World Pharma, Inc. (``Emerging World''). Emerging World is a Florida corporation purportedly based in Manassas, Virginia and...

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

1 CFR 17.3 - Criteria for emergency publication.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Criteria for emergency publication. 17.3 Section..., AND PROCESSING OF DOCUMENTS FILING FOR PUBLIC INSPECTION AND PUBLICATION SCHEDULES Emergency Schedule § 17.3 Criteria for emergency publication. The emergency schedule is designed to provide the fastest...

75 FR 18484 - Emerging Technology and Research Advisory Committee; Notice of Open Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... Emerging Technologies Analysis. 2. ETRAC Panel on Emerging Technologies. 3. History of the Laser. 4... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Open Meeting The Emerging Technology and Research Advisory Committee (ETRAC) [[Page...

46 CFR 196.37-25 - Emergency lights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Emergency lights. 196.37-25 Section 196.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-25 Emergency lights. (a) All emergency lights...

46 CFR 196.37-25 - Emergency lights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 7 2014-10-01 2014-10-01 false Emergency lights. 196.37-25 Section 196.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-25 Emergency lights. (a) All emergency lights...

46 CFR 196.37-25 - Emergency lights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 7 2011-10-01 2011-10-01 false Emergency lights. 196.37-25 Section 196.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-25 Emergency lights. (a) All emergency lights...

46 CFR 196.37-25 - Emergency lights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 7 2013-10-01 2013-10-01 false Emergency lights. 196.37-25 Section 196.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-25 Emergency lights. (a) All emergency lights...

46 CFR 196.37-25 - Emergency lights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 7 2012-10-01 2012-10-01 false Emergency lights. 196.37-25 Section 196.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS OPERATIONS Markings for Fire and Emergency Equipment, etc. § 196.37-25 Emergency lights. (a) All emergency lights...

Emergency Victim Care. A Textbook for Emergency Medical Personnel.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

This textbook for emergency medical personnel should be useful to fire departments, private ambulance companies, industrial emergency and rescue units, police departments, and nurses. The 30 illustrated chapters cover topics such as: (1) Emergency Medical Service Vehicles, (2) Safe Driving Practices, (3) Anatomy and Physiology, (4) Closed Chest…

75 FR 43996 - Agency Information Collection Activities: Proposed Collection; Comment Request, OMB No. 1660-0029...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... space and/or housing for emergency preparedness training conducted at the Federal Emergency Management... Federal Emergency Management Agency (FEMA) may conduct training for the purpose of emergency preparedness... emergency preparedness. The NETC site has facilities and housing available for those participating in...

78 FR 65676 - Agency Information Collection Activities: Proposed Collection; Comment Request; Approval and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... and/or housing for emergency preparedness training conducted at the Federal Emergency Management... the purpose of emergency preparedness. In response, FEMA established the National Emergency Training... those participating in emergency preparedness training and a request for use of these areas must be made...

15 CFR 700.4 - Priorities and allocations in a national emergency.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., including domestic emergency preparedness requirements, of approved programs. (b) The special rules... national emergency. 700.4 Section 700.4 Commerce and Foreign Trade Regulations Relating to Commerce and... allocations in a national emergency. (a) In the event of a national emergency, special rules may be...

Getting "Ready" for an Emergency: Emergency Preparedness Series--Part 3

ERIC Educational Resources Information Center

Apel, Laura

2009-01-01

This article presents part 3 of a series of articles giving timely information about potential emergency situations and offering suggestions and new technology that exceptional families can use to prepare for emergencies--everything from localized to large scale emergencies, everything from natural disasters to terrorist attacks. In 2003 the…

36 CFR 4.3 - Authorized emergency vehicles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Authorized emergency vehicles... INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.3 Authorized emergency vehicles. (a) The operator of an authorized emergency vehicle, when responding to an emergency or when pursuing or apprehending an actual or suspected...

36 CFR 4.3 - Authorized emergency vehicles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Authorized emergency vehicles... INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.3 Authorized emergency vehicles. (a) The operator of an authorized emergency vehicle, when responding to an emergency or when pursuing or apprehending an actual or suspected...

36 CFR 4.3 - Authorized emergency vehicles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Authorized emergency vehicles... INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.3 Authorized emergency vehicles. (a) The operator of an authorized emergency vehicle, when responding to an emergency or when pursuing or apprehending an actual or suspected...

36 CFR 4.3 - Authorized emergency vehicles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Authorized emergency vehicles... INTERIOR VEHICLES AND TRAFFIC SAFETY § 4.3 Authorized emergency vehicles. (a) The operator of an authorized emergency vehicle, when responding to an emergency or when pursuing or apprehending an actual or suspected...

46 CFR 112.43-15 - Emergency lighting feeders.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Emergency lighting feeders. 112.43-15 Section 112.43-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Lighting Systems § 112.43-15 Emergency lighting feeders. For a vessel with...

46 CFR 112.43-15 - Emergency lighting feeders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lighting feeders. 112.43-15 Section 112.43-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Lighting Systems § 112.43-15 Emergency lighting feeders. For a vessel with...

46 CFR 112.01-20 - Final emergency power source.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Final emergency power source. 112.01-20 Section 112.01-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-20 Final emergency...

46 CFR 112.01-20 - Final emergency power source.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Final emergency power source. 112.01-20 Section 112.01-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-20 Final emergency...

46 CFR 112.43-15 - Emergency lighting feeders.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency lighting feeders. 112.43-15 Section 112.43-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Lighting Systems § 112.43-15 Emergency lighting feeders. For a vessel with...

46 CFR 112.43-15 - Emergency lighting feeders.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency lighting feeders. 112.43-15 Section 112.43-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Lighting Systems § 112.43-15 Emergency lighting feeders. For a vessel with...

46 CFR 112.01-20 - Final emergency power source.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Final emergency power source. 112.01-20 Section 112.01-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-20 Final emergency...

46 CFR 112.01-20 - Final emergency power source.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Final emergency power source. 112.01-20 Section 112.01-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-20 Final emergency...

46 CFR 112.43-15 - Emergency lighting feeders.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Emergency lighting feeders. 112.43-15 Section 112.43-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Lighting Systems § 112.43-15 Emergency lighting feeders. For a vessel with...

Assessing School Emergency Care Preparedness.

ERIC Educational Resources Information Center

Hale, Charles; Varnes, Jill

A study assessed the emergency health care preparedness of a north central Florida public school district in light of seven criteria: (1) school policies regarding delivery of emergency health care; (2) identification of school personnel responsible for rendering emergency care; (3) training levels of emergency health care providers (first aid and…

44 CFR 206.37 - Processing requests for declarations of a major disaster or emergency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Processing requests for declarations of a major disaster or emergency. 206.37 Section 206.37 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER...

44 CFR 206.37 - Processing requests for declarations of a major disaster or emergency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Processing requests for declarations of a major disaster or emergency. 206.37 Section 206.37 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER...

44 CFR 206.37 - Processing requests for declarations of a major disaster or emergency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Processing requests for declarations of a major disaster or emergency. 206.37 Section 206.37 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER...

44 CFR 206.37 - Processing requests for declarations of a major disaster or emergency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Processing requests for declarations of a major disaster or emergency. 206.37 Section 206.37 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER...

18 CFR 376.209 - Procedures during periods of emergency requiring activation of the Continuity of Operations Plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... periods of emergency requiring activation of the Continuity of Operations Plan. 376.209 Section 376.209... GENERAL RULES ORGANIZATION, MISSION, AND FUNCTIONS; OPERATIONS DURING EMERGENCY CONDITIONS Commission Operation During Emergency Conditions § 376.209 Procedures during periods of emergency requiring activation...

47 CFR 11.13 - Emergency Action Notification (EAN) and Emergency Action Termination (EAT).

Code of Federal Regulations, 2010 CFR

2010-10-01

... Emergency Action Termination (EAT). 11.13 Section 11.13 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... Action Termination (EAT). (a) The Emergency Action Notification (EAN) is the notice to all EAS... Emergency Action Termination (EAT) is the notice to all EAS Participants and to the general public that the...

46 CFR 112.01-20 - Final emergency power source.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Final emergency power source. 112.01-20 Section 112.01-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Definitions of Emergency Lighting and Power Systems § 112.01-20 Final emergency...

29 CFR 1910.38 - Emergency action plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... action plan must include at a minimum: (1) Procedures for reporting a fire or other emergency; (2... 29 Labor 5 2013-07-01 2013-07-01 false Emergency action plans. 1910.38 Section 1910.38 Labor... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Exit Routes and Emergency Planning § 1910.38 Emergency action plans...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2011 CFR

2011-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

44 CFR 352.27 - Federal role in the emergency response.

Code of Federal Regulations, 2012 CFR

2012-10-01

... response. 352.27 Section 352.27 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Federal Participation § 352.27 Federal role in the emergency response. In addition to the Federal component of the licensee offsite emergency response plan described in subpart B (§ 352.26), and after...

75 FR 49507 - Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.4, Emergency Medical Care and Medical Evacuations AGENCY: Federal Emergency... Management Agency (FEMA) is accepting comments on RP9525.4, Emergency Medical Care and Medical Evacuations... emergency medical care and medical evacuation expenses that are eligible for reimbursement under the...

44 CFR 206.37 - Processing requests for declarations of a major disaster or emergency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Processing requests for declarations of a major disaster or emergency. 206.37 Section 206.37 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER...

36 CFR 28.14 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Emergency action. 28.14... Emergency action. If allowable by local law and if immediate action is essential to avoid or eliminate an... for undertaking the emergency action no longer exist, the agency or person shall cease an emergency...

29 CFR 1917.30 - Emergency action plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emergency action and for reaction time for safe escape of employees from the workplace or the immediate work... 29 Labor 7 2010-07-01 2010-07-01 false Emergency action plans. 1917.30 Section 1917.30 Labor... (CONTINUED) MARINE TERMINALS Marine Terminal Operations § 1917.30 Emergency action plans. (a) Emergency...

28 CFR 65.82 - Procedure for requesting a Presidential determination of an immigration emergency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... determination of an immigration emergency. 65.82 Section 65.82 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Immigration Emergency Fund § 65.82 Procedure for requesting a Presidential determination of an immigration emergency. (a) The President may make a...

47 CFR 80.864 - Emergency electric lights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Emergency electric lights. 80.864 Section 80... W § 80.864 Emergency electric lights. (a) Emergency electric light(s) must be installed to...) The emergency electric light(s) must be energized from the reserve power supply, if a reserve power...

46 CFR 78.47-33 - Emergency lights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Emergency lights. 78.47-33 Section 78.47-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-33 Emergency lights. (a) All emergency lights shall be marked...

46 CFR 97.37-25 - Emergency lights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency lights. 97.37-25 Section 97.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-25 Emergency lights. (a) All emergency lights shall...

46 CFR 97.37-25 - Emergency lights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Emergency lights. 97.37-25 Section 97.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-25 Emergency lights. (a) All emergency lights shall...

47 CFR 80.864 - Emergency electric lights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Emergency electric lights. 80.864 Section 80... W § 80.864 Emergency electric lights. (a) Emergency electric light(s) must be installed to...) The emergency electric light(s) must be energized from the reserve power supply, if a reserve power...

46 CFR 97.37-25 - Emergency lights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Emergency lights. 97.37-25 Section 97.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-25 Emergency lights. (a) All emergency lights shall...

46 CFR 78.47-33 - Emergency lights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 3 2012-10-01 2012-10-01 false Emergency lights. 78.47-33 Section 78.47-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-33 Emergency lights. (a) All emergency lights shall be marked...

46 CFR 97.37-25 - Emergency lights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Emergency lights. 97.37-25 Section 97.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-25 Emergency lights. (a) All emergency lights shall...

46 CFR 78.47-33 - Emergency lights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 3 2013-10-01 2013-10-01 false Emergency lights. 78.47-33 Section 78.47-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-33 Emergency lights. (a) All emergency lights shall be marked...

47 CFR 80.864 - Emergency electric lights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Emergency electric lights. 80.864 Section 80... W § 80.864 Emergency electric lights. (a) Emergency electric light(s) must be installed to...) The emergency electric light(s) must be energized from the reserve power supply, if a reserve power...

46 CFR 78.47-33 - Emergency lights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 3 2014-10-01 2014-10-01 false Emergency lights. 78.47-33 Section 78.47-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-33 Emergency lights. (a) All emergency lights shall be marked...

47 CFR 80.864 - Emergency electric lights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Emergency electric lights. 80.864 Section 80... W § 80.864 Emergency electric lights. (a) Emergency electric light(s) must be installed to...) The emergency electric light(s) must be energized from the reserve power supply, if a reserve power...

47 CFR 80.864 - Emergency electric lights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Emergency electric lights. 80.864 Section 80... W § 80.864 Emergency electric lights. (a) Emergency electric light(s) must be installed to...) The emergency electric light(s) must be energized from the reserve power supply, if a reserve power...

46 CFR 97.37-25 - Emergency lights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Emergency lights. 97.37-25 Section 97.37-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 97.37-25 Emergency lights. (a) All emergency lights shall...

46 CFR 78.47-33 - Emergency lights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 3 2011-10-01 2011-10-01 false Emergency lights. 78.47-33 Section 78.47-33 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS OPERATIONS Markings for Fire and Emergency Equipment, Etc. § 78.47-33 Emergency lights. (a) All emergency lights shall be marked...

Dedicated pediatric behavioral health unit: serving the unique and individual needs of children in behavioral health crisis.

PubMed

Grover, Purva; Lee, Timothy

2013-02-01

Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. The emergency services for behavioral health unit at Akron Children's Hospital is an innovative model for delivering care to pediatric patients with mental health emergencies. A multidisciplinary team using the expertise of emergency services, psychiatry, social work, parent advisory counsel, security services, and engineering/architecture developed the emergency services for behavioral health unit blueprint, process, and staffing model.

The FIFA medical emergency bag and FIFA 11 steps to prevent sudden cardiac death: setting a global standard and promoting consistent football field emergency care.

PubMed

Dvorak, Jiri; Kramer, Efraim B; Schmied, Christian M; Drezner, Jonathan A; Zideman, David; Patricios, Jon; Correia, Luis; Pedrinelli, André; Mandelbaum, Bert

2013-12-01

Life-threatening medical emergencies are an infrequent but regular occurrence on the football field. Proper prevention strategies, emergency medical planning and timely access to emergency equipment are required to prevent catastrophic outcomes. In a continuing commitment to player safety during football, this paper presents the FIFA Medical Emergency Bag and FIFA 11 Steps to prevent sudden cardiac death. These recommendations are intended to create a global standard for emergency preparedness and the medical response to serious or catastrophic on-field injuries in football.

Selective versus comprehensive emergency management in Korea.

PubMed

Ha, Kyoo-Man; Oh, Hyeon-Mun

2014-01-01

In spite of Korean governments' efforts, many emergency management practitioners wonder whether what is actually being practiced is selective or comprehensive management. Using a qualitative content analysis and experiences in practice, the article analyzes the barriers to selective emergency management and the paths to comprehensive emergency management via the same three management elements: stakeholders, phases of the emergency management lifecycle, and hazards and impacts. Four analytical levels are considered: central government level, industry level, community level, and household level. Korea, despite its self-praise, has to transform its selective emergency management into comprehensive emergency management in time.

Health promoting attitudes and behaviors of emergency physicians: exploring gender differences.

PubMed

Rondeau, Kent V; Francescutti, Louis H; Cummings, Garnet E

2006-01-01

The purpose of this paper is to report on gender differences in emergency physicians with respect to their attitudes, knowledge, and practices concerning health promotion and disease prevention. A mail survey of 325 male and 97 female Canadian emergency physicians. Results suggest female emergency physicians report having greater knowledge of health promotion topics, spend more time with each of their patients in the emergency setting, and engage in more health promotion counseling in the emergency setting than do their male counterparts. The paper argues that in the future, educating and socializing emergency physicians, both male and female, in the practice of health promotion will enhance the potential of the emergency department to be a more effective resource for their community.

Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication.

PubMed

Paek, Hye-Jin; Hilyard, Karen; Freimuth, Vicki; Barge, J Kevin; Mindlin, Michele

2010-06-01

Recent natural and human-caused disasters have awakened public health officials to the importance of emergency preparedness. Guided by health behavior and media effects theories, the analysis of a statewide survey in Georgia reveals that self-efficacy, subjective norm, and emergency news exposure are positively associated with the respondents' possession of emergency items and their stages of emergency preparedness. Practical implications suggest less focus on demographics as the sole predictor of emergency preparedness and more comprehensive measures of preparedness, including both a person's cognitive stage of preparedness and checklists of emergency items on hand. We highlight the utility of theory-based approaches for understanding and predicting public emergency preparedness as a way to enable more effective health and risk communication.

Employee Perceptions of Their Organization's Level of Emergency Preparedness Following a Brief Workplace Emergency Planning Educational Presentation.

PubMed

Renschler, Lauren A; Terrigino, Elizabeth A; Azim, Sabiya; Snider, Elsa; Rhodes, Darson L; Cox, Carol C

2016-06-01

A brief emergency planning educational presentation was taught during work hours to a convenience sample of employees of various workplaces in Northern Missouri, USA. Participants were familiarized with details about how an emergency plan is prepared by management and implemented by management-employee crisis management teams - focusing on both employee and management roles. They then applied the presentation information to assess their own organization's emergency preparedness level. Participants possessed significantly (p < 0.05) higher perceptions of their organization's level of emergency preparedness than non-participants. It is recommended that an assessment of organizational preparedness level supplement emergency planning educational presentations in order to immediately apply the material covered and encourage employees to become more involved in their organization's emergency planning and response. Educational strategies that involve management-employee collaboration in activities tailored to each workplace's operations and risk level for emergencies should be implemented.

Study on Mine Emergency Mechanism based on TARP and ICS

NASA Astrophysics Data System (ADS)

Xi, Jian; Wu, Zongzhi

2018-01-01

By analyzing the experiences and practices of mine emergency in China and abroad, especially the United States and Australia, normative principle, risk management principle and adaptability principle of constructing mine emergency mechanism based on Trigger Action Response Plans (TARP) and Incident Command System (ICS) are summarized. Classification method, framework, flow and subject of TARP and ICS which are suitable for the actual situation of domestic mine emergency are proposed. The system dynamics model of TARP and ICS is established. The parameters such as evacuation ratio, response rate, per capita emergency capability and entry rate of rescuers are set up. By simulating the operation process of TARP and ICS, the impact of these parameters on the emergency process are analyzed, which could provide a reference and basis for building emergency capacity, formulating emergency plans and setting up action plans in the emergency process.

American College of Emergency Physicians Ethics Manual.

PubMed

1991-10-01

Ethical concerns are a major part of the clinical practice of emergency medicine. The emergency physician must make hard choices, not only with regard to the scientific/technical aspects but also with regard to the moral aspects of caring for emergency patients. By the nature of the specialty, emergency physicians face ethical dilemmas often requiring prompt decisions with limited information. This manual identifies important moral principles and values in emergency medicine. The underlying assumption is that a knowledge of moral principles and ethical values helps the emergency physician make responsible moral choices. Neither the scientific nor the moral aspects of clinical decision making can be reduced to simple formulas. Nevertheless, decisions must be made. Emergency physicians should, therefore, be cognizant of the ethical principles that are important for emergency medicine, understand the process of ethical reasoning, and be capable of making rational moral decisions based on a stable framework of values.

[Emergency Doctor Training for Psychiatric Emergencies: Evaluation of an Interactive Training Program].

PubMed

Flüchter, Peter; Müller, Vincent; Bischof, Felix; Pajonk, Frank-Gerald Bernhard

2017-03-01

Aim Emergency physicians are often confronted with psychiatric emergencies, but are not well trained for it and often feel unable to cope sufficiently with them. The aim of this investigation was to examine whether multisensoric training may improve learning effects in the training of emergency physicians with regard to psychiatric emergencies. Method Participation in a multi-modal, multi-media training program with video case histories and subsequent evaluation by questionnaire. Results 66 emergency physicians assessed their learning effects. 75 % or 73 % rated it as "rather high" or "very high". In particular, in comparison with classical training/self-study 89 % assessed the effects in learning as "rather high" or "very high" . Conclusion This training receives a high level of acceptance. Using videos, learning content may be provided more practice-related. Thus, emergency physicians are able to develop a greater understanding of psychiatric emergencies. © Georg Thieme Verlag KG Stuttgart · New York.

Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland.

PubMed

Sugrue, M; Maier, R; Moore, E E; Boermeester, M; Catena, F; Coccolini, F; Leppaniemi, A; Peitzman, A; Velmahos, G; Ansaloni, L; Abu-Zidan, F; Balfe, P; Bendinelli, C; Biffl, W; Bowyer, M; DeMoya, M; De Waele, J; Di Saverio, S; Drake, A; Fraga, G P; Hallal, A; Henry, C; Hodgetts, T; Hsee, L; Huddart, S; Kirkpatrick, A W; Kluger, Y; Lawler, L; Malangoni, M A; Malbrain, M; MacMahon, P; Mealy, K; O'Kane, M; Loughlin, P; Paduraru, M; Pearce, L; Pereira, B M; Priyantha, A; Sartelli, M; Soreide, K; Steele, C; Thomas, S; Vincent, J L; Woods, L

2017-01-01

Opportunities to improve emergency surgery outcomes exist through guided better practice and reduced variability. Few attempts have been made to define optimal care in emergency surgery, and few clinically derived key performance indicators (KPIs) have been published. A summit was therefore convened to look at resources for optimal care of emergency surgery. The aim of the Donegal Summit was to set a platform in place to develop guidelines and KPIs in emergency surgery. The project had multidisciplinary global involvement in producing consensus statements regarding emergency surgery care in key areas, and to assess feasibility of producing KPIs that could be used to monitor process and outcome of care in the future. Forty-four key opinion leaders in emergency surgery, across 7 disciplines from 17 countries, composed evidence-based position papers on 14 key areas of emergency surgery and 112 KPIs in 20 acute conditions or emergency systems. The summit was successful in achieving position papers and KPIs in emergency surgery. While position papers were limited by non-graded evidence and non-validated KPIs, the process set a foundation for the future advancement of emergency surgery.

Nonemergent emergency department visits under the National Health Insurance in Taiwan.

PubMed

Tsai, Jeffrey Che-Hung; Chen, Wen-Yi; Liang, Yia-Wun

2011-05-01

To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Report on the emergency response to the event on May 14, 1997, at the plutonuim reclamation facility, Hanford Site, Richland,Washington

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

Shoop, D.S.

1997-08-20

On the evening of May 14,1997, a chemical explosion Occurred at the Plutonium Reclamation Facility (PRF) in the 200 West Area(200-W) of the Hanford Site. The event warranted the declaration of an Alert emergency, activation of the Hanford Emergency Response Organization (BRO), and notification of offsite agencies. As a result of the emergency declaration, a subsequent evaluation was conducted to assess: 9 the performance of the emergency response organization o the occupational health response related to emergency activities o event notifications to offsite and environmental agencies. Additionally, the evaluation was designed to: 9 document the chronology of emergency and occupationalmore » health responses and environmental notifications connected with the explosion at the facility 0 assess the adequacy of the Hanford Site emergency preparedness activities; response readiness; and emergency management actions, occupational health, and environmental actions 0 provide an analysis of the causes of the deficiencies and weaknesses in the preparedness and response system that have been identified in the evaluation of the response a assign organizational responsibility to correct deficiencies and weaknesses a improve future performance 0 adjust elements of emergency implementing procedures and emergency preparedness activities.« less

Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China

PubMed Central

Duan, Weili; He, Bin

2015-01-01

In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP) was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency. PMID:26184260

Emergency Response System for Pollution Accidents in Chemical Industrial Parks, China.

PubMed

Duan, Weili; He, Bin

2015-07-10

In addition to property damage and loss of lives, environment pollution, such as water pollution and air pollution caused by accidents in chemical industrial parks (CIPs) is a significant issue in China. An emergency response system (ERS) was therefore planned to properly and proactively cope with safety incidents including fire and explosions occurring in the CIPs in this study. Using a scenario analysis, the stages of emergency response were divided into three levels, after introducing the domino effect, and fundamental requirements of ERS design were confirmed. The framework of ERS was composed mainly of a monitoring system, an emergency command center, an action system, and a supporting system. On this basis, six main emergency rescue steps containing alarm receipt, emergency evaluation, launched corresponding emergency plans, emergency rescue actions, emergency recovery, and result evaluation and feedback were determined. Finally, an example from the XiaoHu Chemical Industrial Park (XHCIP) was presented to check on the integrality, reliability, and maneuverability of the ERS, and the result of the first emergency drill with this ERS indicated that the developed ERS can reduce delays, improve usage efficiency of resources, and raise emergency rescue efficiency.

Assessing Mental Models of Emergencies Through Two Knowledge Elicitation Tasks.

PubMed

Whitmer, Daphne E; Sims, Valerie K; Torres, Michael E

2017-05-01

The goals of this study were to assess the risk identification aspect of mental models using standard elicitation methods and how university campus alerts were related to these mental models. People fail to follow protective action recommendations in emergency warnings. Past research has yet to examine cognitive processes that influence emergency decision-making. Study 1 examined 2 years of emergency alerts distributed by a large southeastern university. In Study 2, participants listed emergencies in a thought-listing task. Study 3 measured participants' time to decide if a situation was an emergency. The university distributed the most alerts about an armed person, theft, and fire. In Study 2, participants most frequently listed fire, car accident, heart attack, and theft. In Study 3, participants quickly decided a bomb, murder, fire, tornado, and rape were emergencies. They most slowly decided that a suspicious package and identify theft were emergencies. Recent interaction with warnings was only somewhat related to participants' mental models of emergencies. Risk identification precedes decision-making and applying protective actions. Examining these characteristics of people's mental representations of emergencies is fundamental to further understand why some emergency warnings go ignored. Someone must believe a situation is serious to categorize it as an emergency before taking the protective action recommendations in an emergency warning. Present-day research must continue to examine the problem of people ignoring warning communication, as there are important cognitive factors that have not yet been explored until the present research.

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England

PubMed Central

Renzi, C; Lyratzopoulos, G; Card, T; Chu, T P C; Macleod, U; Rachet, B

2016-01-01

Background: More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes. Methods: Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period. Results: Emergency diagnosis occurred in 35% and 15% of the 1029 colon and 577 rectal cancers. ‘Background' primary-care consultations (2–5 years before diagnosis) were similar for either group. In the year before diagnosis, >95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% vs 71% (P<0.001); rectal cancer: 49% vs 61% (P=0.043)). ‘Alarm' symptoms were recorded less frequently in emergency presenters (e.g., rectal bleeding: 9 vs 24% (P=0.002)). However, about 1/5 of emergency presenters (18 and 23% for colon and rectal cancers) had ‘alarm' symptoms the year before diagnosis. Conclusions: Emergency presenters have similar ‘background' consultation history as non-emergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them. PMID:27537389

Young women's accounts of factors influencing their use and non-use of emergency contraception: in-depth interview study

PubMed Central

Free, Caroline; Lee, Raymond M; Ogden, Jane

2002-01-01

Objectives To explore young women's accounts of their use and non-use of emergency contraception. Design Qualitative study using in-depth interviews. Participants 30 women aged 16-25; participants from socially deprived inner city areas were specifically included. Setting Community, service, and educational settings in England. Results Young women's accounts of their non-use of emergency contraception principally concerned evaluations of the risk conferred by different contraceptive behaviours, their evaluations of themselves in needing emergency contraception, and personal difficulties in asking for emergency contraception. Conclusions The attitudes and concerns of young women, especially those from disadvantaged backgrounds, may make them less able or willing than others to take advantage of recent increases in access to emergency contraception. Interventions that aim to increase the use of emergency contraception need to address the factors that influence young women's non-use of emergency contraception. What is already known on this topicLimited knowledge of, or poor access to, emergency contraception, and concerns about side effects and moral issues may reduce the use of emergency contraception in women at riskYoung people can be embarrassed about using contraception servicesInterventions to increase knowledge of and access to emergency contraception have had limited success among teenagersWhat this study addsPerceptions of low vulnerability to pregnancy, negative self evaluations about the need for such contraception, and concerns about what others think deter young women from using emergency contraceptionThese women find it difficult to ask for emergency contraceptionThe attitudes and concerns of young women, especially those from deprived inner city areas, may render them least willing and able to obtain emergency contraception PMID:12480855

The profile of women who seek emergency contraception from the family planning service.

PubMed

Lo, Sue S T; Ho, P C

2012-08-01

OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were satisfactory.

Community preparedness for emergency: a cross-sectional survey of residents in Heilongjiang of China

PubMed Central

Xu, Weilan; Hao, Yanhua; Wu, Qunhong; Ning, Ning; You, Jia; Liu, Chaojie; Jiao, Mingli; Gao, Lijun; Kang, Zheng; Liang, Libo; Sun, Hong; Cui, Yu; Li, Ye; Han, Xiaonan; Fang, Xin; Zhao, Xiyan; Hu, Man; Ding, Ding; Gao, Hao; Lu, Jun

2015-01-01

Objective This article aims to identify factors that shape the knowledge, attitudes and behaviours of community residents in China's Heilongjiang province towards emergency preparedness. Findings of such a study may provide evidence to support the development of effective public risk communication strategies and education campaigns. Design A cross-sectional household questionnaire survey was conducted in Heilongjiang province in 2014. A stratified cluster sampling strategy was employed to select study participants. The questionnaires were administered using face-to-face interviews. 2800 questionnaires were completed, among which 2686 (95.9%) were considered valid for data analyses. A multivariate logistic regression model was adopted to identify the extent to which the independent variables were associated with emergency preparedness. Results Fewer than 5% respondents were well prepared for emergency. Over half (52%) of poorly prepared respondents did not know what to do in emergency; women (OR=1.691), higher household income (OR ranging from 1.666 to 2.117), previous experience with emergency (OR=1.552), higher levels of knowledge about emergency (OR=2.192), risk awareness (OR=1.531), self-efficacy (OR=1.796), as well as positive attitudes towards emergency preparedness (OR=2.265) were significant predictors for emergency preparedness. Neither educational attainment nor exposure to awareness-raising entered into the logic regression model as a significant predictor for emergency preparedness. Conclusions The level of emergency preparedness in Heilongjiang residents is very low, which is linked with poor knowledge and attitudes of the residents towards emergency preparedness. Future emergency awareness campaigns should be more focused and tailored to the needs of intended audience, taking into consideration of their usual source of information and knowledge in relation to emergency. PMID:26553829

Significant acceleration of emergency response using smartphone geolocation data and a worldwide emergency call support system.

PubMed

Weinlich, Michael; Kurz, Peter; Blau, Melissa B; Walcher, Felix; Piatek, Stefan

2018-01-01

When patients are disorientated or experience language barriers, it is impossible to activate the emergency response system. In these cases, the delay for receiving appropriate help can extend to several hours. A worldwide emergency call support system (ECSS), including geolocation of modern smartphones (GPS, WLAN and LBS), was established referring to E911 and eCall systems. The system was tested for relevance in quickly forwarding abroad emergency calls to emergency medical services (EMS). To verify that geolocation data from smartphones are exact enough to be used for emergency cases, the accuracy of GPS (global positioning system), Wi-Fi (wireless LAN network) and LBS (location based system) was tested in eleven different countries and compared to actual location. The main objective was analyzed by simulation of emergencies in different countries. The time delay in receiving help in unsuccessful emergency call cases by using the worldwide emergency call support system (ECSS) was measured. GPS is the gold standard to locate patients with an average accuracy of 2.0 ± 3.3 m. Wi-Fi can be used within buildings with an accuracy of 7.0 ± 24.1 m. Using ECSS, the emergency call leads to a successful activation of EMS in 22.8 ± 10.8 min (Median 21 min). The use of a simple app with one button to touch did never cause any delay. The worldwide emergency call support system (ECSS) significantly improves the emergency response in cases of disorientated patients or language barriers. Under circumstances without ECSS, help can be delayed by 2 or more hours and might have relevant lifesaving effects. This is the first time that Wi-Fi geolocation could prove to be a useful improvement in emergencies to enhance GPS, especially within or close to buildings.

Insect emergence in relation to floods in wet meadows and swamps in the River Dalälven floodplain.

PubMed

Vinnersten, T Z Persson; Östman, Ö; Schäfer, M L; Lundström, J O

2014-08-01

Annual variation in flood frequency and hydroperiod during the vegetation season has ecological impacts on the floodplain biota. Although many insect groups may have a lower emergence during a flood event, it is poorly known how annual emergence of insects in temporary wetlands is related to the variation in hydrology. Between May and September, we studied the weekly emergence of 18 insect taxa over six consecutive years, 2002-2007, in six temporary flooded wetlands (four wet meadows and two forest swamps) in the River Dalälven floodplains, Central Sweden. We used emergence traps to collect emerging insects from terrestrial and aquatic parts of wet meadows and swamp forests. In all wetlands, the insect fauna was numerically dominated by the orders Diptera, Hymenoptera, Coleoptera and Homoptera. On a weekly basis, 9 out of the 18 insect taxa had lower emergence in weeks with flood than in weeks with no flood, whereas no taxon had a higher emergence in weeks with flood. Over the seasons, we related insect emergence to seasonal flood frequency and length of hydroperiod. The emergence of most studied taxa decreased with increasing hydroperiod, which suggests that emergence after floods do not compensate for the reduced emergence during floods. Only Culicidae and the aquatic Chironomidae sub-families Tanypodinae and Chironominae showed an increase in emergence with increasing hydroperiod, whereas Staphylinidae peaked at intermediate hydroperiod. We conclude that a hydroperiod covering up to 40% of the vegetation season has a significant negative effect on the emergence of most taxa and that only a few taxa occurring in the temporary wetlands are actually favoured by a flood regime with recurrent and unpredictable floods.

Evaluation of demands, usage and unmet needs for emergency care in Yaoundé, Cameroon: a cross-sectional study.

PubMed

Ro, Young Sun; Shin, Sang Do; Jeong, Joongsik; Kim, Min Jung; Jung, Young Hee; Kamgno, Joseph; Alain, Etoundi Mballa Georges; Hollong, Bonaventure

2017-02-06

To assess the burden of emergent illnesses and emergency care system usage by Yaoundé residents and to evaluate unmet needs for emergency care and associated barriers. A cross-sectional study using a community-based survey. Yaoundé, Cameroon. All residents living in Yaoundé were selected as the target population to investigate the needs and usage of emergency care in Yaoundé. 14 households in every health area (47 in total) were selected using 2-stage sampling. Unmet needs for emergency care. Among the 3201 participants from 619 households who completed the survey, 1113 (34.8%) with median age of 22 experienced 1 or more emergency conditions in the previous year. Respondents who experienced emergency conditions used emergency units (7.0%), outpatient clinics (46.5%) or hospitalisation (13.0%), and in overall, 68.8% of them reported unmet needs for emergency care. The primary reasons for not seeking healthcare were economic issues (37.2%) and use of complementary medicine (22.2%). Young age (adjusted OR (95% CI) 1.80 (1.23 to 2.62)), rental housing (1.50 (1.11 to 2.03)) and moderate household income (0.60 (0.36 to 0.99)) were associated with unmet needs for emergency care. Residents of Yaoundé had a high demand for emergency care, and high unmet needs were observed due to low emergency care usage. Development of a cost-effective, universal emergency care system is urgently needed in Cameroon. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A protocol for a pragmatic randomized controlled trial evaluating outcomes of emergency nurse practitioner service.

PubMed

Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard

2014-09-01

To evaluate emergency nurse practitioner service effectiveness on outcomes related to quality of care and service responsiveness. Increasing service pressures in the emergency setting have resulted in the adoption of service innovation models; the most common and rapidly expanding of these is the emergency nurse practitioner. The delivery of high quality patient care in the emergency department is one of the most important service indicators to be measured in health services today. The rapid uptake of emergency nurse practitioner service in Australia has outpaced the capacity to evaluate this model in outcomes related to safety and quality of patient care. Pragmatic randomized controlled trial at one site with 260 participants. This protocol describes a definitive prospective randomized controlled trial, which will examine the impact of emergency nurse practitioner service on key patient care and service indicators. The study control will be standard emergency department care. The intervention will be emergency nurse practitioner service. The primary outcome measure is pain score reduction and time to analgesia. Secondary outcome measures are waiting time, number of patients who did not wait, length of stay in the emergency department and representations within 48 hours. Scant research enquiry evaluating emergency nurse practitioner service on patient effectiveness and service responsiveness exists currently. This study is a unique trial that will test the effectiveness of the emergency nurse practitioner service on patients who present to the emergency department with pain. The research will provide an opportunity to further evaluate emergency nurse practitioner models of care and build research capacity into the workforce. Trial registration details: Australian and New Zealand Clinical Trials Registry dated 18th August 2013, ACTRN12613000933752. © 2014 John Wiley & Sons Ltd.

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 conferences. PMID:23633423

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

PubMed

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

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. 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. 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 conferences.

Natural selection constrains personality and brain gene expression differences in Atlantic salmon (Salmo salar).

PubMed

Thörnqvist, Per-Ove; Höglund, Erik; Winberg, Svante

2015-04-01

In stream-spawning salmonid fishes there is a considerable variation in the timing of when fry leave the spawning nests and establish a feeding territory. The timing of emergence from spawning nests appears to be related to behavioural and physiological traits, e.g. early emerging fish are bolder and more aggressive. In the present study, emerging Atlantic salmon (Salmo salar L.) alevins were sorted into three fractions: early, intermediate and late emerging. At the parr stage, behaviour, stress responses, hindbrain monoaminergic activity and forebrain gene expression were explored in fish from the early and late emerging fractions (first and last 25%). The results show that when subjected to confinement stress, fish from the late emerging fraction respond with a larger activation of the brain serotonergic system than fish from the early fraction. Similarly, in late emerging fish, stress resulted in elevated expression of mRNA coding for serotonin 1A receptors (5-HT1A), GABA-A receptor-associated protein and ependymin, effects not observed in fish from the early emerging fraction. Moreover, fish from the early emerging fraction displayed bolder behaviour than their late emerging littermates. Taken together, these results suggest that time of emergence, boldness and aggression are linked to each other, forming a behavioural syndrome in juvenile salmon. Differences in brain gene expression between early and late emerging salmon add further support to a relationship between stress coping style and timing of emergence. However, early and late emerging salmon do not appear to differ in hypothalamus-pituitary-interrenal (HPI) axis reactivity, another characteristic of divergent stress coping styles. © 2015. Published by The Company of Biologists Ltd.

Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity

PubMed Central

Shah, Gulzar H.; Newell, Bobbie; Whitworth, Ruth E.

2016-01-01

Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. Conclusion: LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection. PMID:27694648

High-Fidelity Simulation: Preparing Dental Hygiene Students for Managing Medical Emergencies.

PubMed

Bilich, Lisa A; Jackson, Sarah C; Bray, Brenda S; Willson, Megan N

2015-09-01

Medical emergencies can occur at any time in the dental office, so being prepared to properly manage the situation can be the difference between life and death. The entire dental team must be properly trained regarding all aspects of emergency management in the dental clinic. The aim of this study was to evaluate a new educational approach using a high-fidelity simulator to prepare dental hygiene students for medical emergencies. This study utilized high-fidelity simulation (HFS) to evaluate the abilities of junior dental hygiene students at Eastern Washington University to handle a medical emergency in the dental hygiene clinic. Students were given a medical emergency scenario requiring them to assess the emergency and implement life-saving protocols in a simulated "real-life" situation using a high-fidelity manikin. Retrospective data were collected for four years from the classes of 2010 through 2013 (N=114). The results indicated that learning with simulation was effective in helping the students identify the medical emergency in a timely manner, implement emergency procedures correctly, locate and correctly utilize contents of the emergency kit, administer appropriate intervention/treatment for a specific patient, and provide the patient with appropriate follow-up instructions. For dental hygiene programs seeking to enhance their curricula in the area of medical emergencies, this study suggests that HFS is an effective tool to prepare students to appropriately handle medical emergencies. Faculty calibration is essential to standardize simulation.

Emergency Nurses' Perceptions of Providing End-of-Life Care in a Hong Kong Emergency Department: A Qualitative Study.

PubMed

Tse, Johnson Wai Keung; Hung, Maria Shuk Yu; Pang, Samantha Mei Che

2016-05-01

Provision of end-of-life (EOL) care in the emergency department has improved globally in recent years and has a different scope of interventions than traditional emergency medicine. In 2010, a regional hospital established the first ED EOL service in Hong Kong. The aim of this study was to understand emergency nurses' perceptions regarding the provision of EOL care in the emergency department. A qualitative approach was used with purposive sampling of 16 nurses who had experience in providing EOL care. Semi-structured, face-to-face interviews were conducted from May to October, 2014. All the interviews were transcribed verbatim for content analysis. Four themes were identified: (1) doing good for the dying patients, (2) facilitating family engagement and involvement, (3) enhancing personal growth and professionalism, and (4) expressing ambiguity toward resource deployment. Provision of EOL care in the emergency department can enhance patients' last moment of life, facilitate the grief and bereavement process of families, and enhance the professional development of staff in emergency department. It is substantiated that EOL service in the emergency department enriches EOL care in the health care system. Findings from this study integrated the perspectives on ED EOL services from emergency nurses. The integration of EOL service in other emergency departments locally and worldwide is encouraged. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

[Management of ophthalmologic emergencies in general emergency departments: A retrospective multicenter study].

PubMed

Jeannin, A; Mouriaux, F; Mortemousque, B

2016-09-01

The growing shortage of working ophthalmologists makes it more difficult for the patient to access ophthalmological care, especially in an emergent context. These patients are thus taken to general emergency departments for ophthalmologic problems. To observe the epidemiological characteristics of ophthalmic patients in general emergency centers and question the emergency physicians on their practice of ophthalmology. A retrospective epidemiological study was conducted in the emergency departments of Rennes, Lorient and Saint-Brieuc over a period of three months. The demographic characteristics, diagnoses, examinations and procedures performed, opinions obtained from ophthalmologists and patient outcomes were studied. A qualitative study by online questionnaire was sent to the emergency physicians. Seven hundred and eighty-one patients were included, mainly men (68%) under 35 years (45%). The most frequent diagnosis was extra-ocular foreign body (32%). An ophthalmologist opinion was requested in 79% within 24hours. The online questionnaire was sent to 74 emergency physicians: 92% of them were willing to participate in additional training, 90% had sufficient means to practice ophthalmology in the emergency room. Emergency physicians could handle the most frequent ophthalmological emergencies, extra-ocular foreign bodies and minor trauma, with adapted material resources, autonomy for these conditions, and willingness for ophthalmologic training. Protocols could be proposed in order to optimize the care of these patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Color on emergency mapping

NASA Astrophysics Data System (ADS)

Jiang, Lili; Qi, Qingwen; Zhang, An

2007-06-01

There are so many emergency issues in our daily life. Such as typhoons, tsunamis, earthquake, fires, floods, epidemics, etc. These emergencies made people lose their lives and their belongings. Every day, every hour, even every minute people probably face the emergency, so how to handle it and how to decrease its hurt are the matters people care most. If we can map it exactly before or after the emergencies; it will be helpful to the emergency researchers and people who live in the emergency place. So , through the emergency map, before emergency is occurring we can predict the situation, such as when and where the emergency will be happen; where people can refuge, etc. After disaster, we can also easily assess the lost, discuss the cause and make the lost less. The primary effect of mapping is offering information to the people who care about the emergency and the researcher who want to study it. Mapping allows the viewers to get a spatial sense of hazard. It can also provide the clues to study the relationship of the phenomenon in emergency. Color, as the basic element of the map, it can simplify and clarify the phenomenon. Color can also affects the general perceptibility of the map, and elicits subjective reactions to the map. It is to say, structure, readability, and the reader's psychological reactions can be affected by the use of color.

14 CFR 27.805 - Flight crew emergency exits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Flight crew emergency exits. 27.805 Section... § 27.805 Flight crew emergency exits. (a) For rotorcraft with passenger emergency exits that are not convenient to the flight crew, there must be flight crew emergency exits, on both sides of the rotorcraft or...

14 CFR 29.805 - Flight crew emergency exits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Flight crew emergency exits. 29.805 Section... Accommodations § 29.805 Flight crew emergency exits. (a) For rotorcraft with passenger emergency exits that are not convenient to the flight crew, there must be flight crew emergency exits, on both sides of the...

14 CFR 29.805 - Flight crew emergency exits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Flight crew emergency exits. 29.805 Section... Accommodations § 29.805 Flight crew emergency exits. (a) For rotorcraft with passenger emergency exits that are not convenient to the flight crew, there must be flight crew emergency exits, on both sides of the...

14 CFR 27.805 - Flight crew emergency exits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Flight crew emergency exits. 27.805 Section... § 27.805 Flight crew emergency exits. (a) For rotorcraft with passenger emergency exits that are not convenient to the flight crew, there must be flight crew emergency exits, on both sides of the rotorcraft or...

"Emergency!" or How to Learn to Live with Neoliberal Globalization

ERIC Educational Resources Information Center

Robbins, Christopher G.

2008-01-01

The author explores the cultural politics of neoliberal globalization, its deformations of critical facets of public culture as it has returned home, and he explores the politics of emergency. Rather than seeing the politics of emergency as something indicative of an emerging "emergency regime" attendant to the terror war, he argues that the…

National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module X. Medical Emergencies.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This instructor's lesson plan guide on medical emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Ten units of study are presented: (1) diabetic emergencies; (2) anaphylactic reactions; (3) exposure to environmental extremes; (4) alcoholism and drug abuse; (5) poisoning and…

77 FR 67739 - Continuation of the National Emergency With Respect to Iran

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency Economic Powers Act...

78 FR 68321 - Continuation of the National Emergency With Respect to Iran

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-13

...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran and, pursuant to the International Emergency Economic Powers Act...

76 FR 70033 - Continuation of the National Emergency With Respect to Iran

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-09

...--Continuation of the National Emergency With Respect to Iran #0; #0; #0; Presidential Documents #0; #0; #0;#0... Emergency With Respect to Iran On November 14, 1979, by Executive Order 12170, the President declared a national emergency with respect to Iran, pursuant to the International Emergency Economic Powers Act (50 U...

46 CFR 112.20-10 - Diesel or gas turbine driven emergency power source.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Diesel or gas turbine driven emergency power source. 112.20-10 Section 112.20-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency...

46 CFR 112.20-10 - Diesel or gas turbine driven emergency power source.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Diesel or gas turbine driven emergency power source. 112.20-10 Section 112.20-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency...

46 CFR 112.20-10 - Diesel or gas turbine driven emergency power source.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Diesel or gas turbine driven emergency power source. 112.20-10 Section 112.20-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having a Temporary and a Final Emergency...

75 FR 49508 - Recovery Policy, RP9525.7, Labor Costs-Emergency Work

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

...] Recovery Policy, RP9525.7, Labor Costs--Emergency Work AGENCY: Federal Emergency Management Agency, DHS... (FEMA) is accepting comments on RP9525.7, Labor Costs--Emergency Work. This is an existing policy that... who perform emergency work (Categories A and B). DATES: Comments must be received by September 13...

Boundaries as Mechanisms for Learning in Emergency Exercises with Students from Emergency Service Organisations

ERIC Educational Resources Information Center

Andersson, Annika

2016-01-01

To prepare emergency response organisations for collaborative work in unpredictable and dynamic situations, various types of exercises are widely used. Still, our knowledge of collaboration exercises with emergency response students is limited. This study aimed to contribute to this field by exploring boundaries that emerged between collaborating…

48 CFR 52.219-20 - Notice of Emerging Small Business Set-Aside.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Clauses 52.219-20 Notice of Emerging Small Business Set-Aside. As prescribed in 19.1008(b), insert the following provision: Notice of Emerging Small Business Set-Aside (JAN 1991) Offers or quotations under this acquisition are solicited from emerging small business concerns only. Offers that are not from an emerging...

29 CFR 1926.35 - Employee emergency action plans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 8 2012-07-01 2012-07-01 false Employee emergency action plans. 1926.35 Section 1926.35... Provisions § 1926.35 Employee emergency action plans. (a) Scope and application. This section applies to all emergency action plans required by a particular OSHA standard. The emergency action plan shall be in writing...

29 CFR 1926.35 - Employee emergency action plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false Employee emergency action plans. 1926.35 Section 1926.35... Provisions § 1926.35 Employee emergency action plans. (a) Scope and application. This section applies to all emergency action plans required by a particular OSHA standard. The emergency action plan shall be in writing...

29 CFR 1926.35 - Employee emergency action plans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 8 2013-07-01 2013-07-01 false Employee emergency action plans. 1926.35 Section 1926.35... Provisions § 1926.35 Employee emergency action plans. (a) Scope and application. This section applies to all emergency action plans required by a particular OSHA standard. The emergency action plan shall be in writing...

29 CFR 1926.35 - Employee emergency action plans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 8 2014-07-01 2014-07-01 false Employee emergency action plans. 1926.35 Section 1926.35... Provisions § 1926.35 Employee emergency action plans. (a) Scope and application. This section applies to all emergency action plans required by a particular OSHA standard. The emergency action plan shall be in writing...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

44 CFR 352.26 - Arrangements for Federal response in the licensee offsite emergency response plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Federal response in the licensee offsite emergency response plan. Federal agencies may be called upon to assist the licensee in developing a licensee offsite emergency response plan in areas such as: (a... response in the licensee offsite emergency response plan. 352.26 Section 352.26 Emergency Management and...

33 CFR 149.660 - What are the requirements for emergency power?

Code of Federal Regulations, 2013 CFR

2013-07-01

...; and (2) Contain only machinery and equipment for the supply of emergency power (i.e., no oil or... emergency power? 149.660 Section 149.660 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Equipment Emergency Power § 149.660 What are the requirements for emergency power? (a) Each pumping platform...

33 CFR 149.660 - What are the requirements for emergency power?

Code of Federal Regulations, 2012 CFR

2012-07-01

...; and (2) Contain only machinery and equipment for the supply of emergency power (in other words, no oil... emergency power? 149.660 Section 149.660 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Equipment Emergency Power § 149.660 What are the requirements for emergency power? (a) Each pumping platform...

33 CFR 149.660 - What are the requirements for emergency power?

Code of Federal Regulations, 2014 CFR

2014-07-01

...; and (2) Contain only machinery and equipment for the supply of emergency power (i.e., no oil or... emergency power? 149.660 Section 149.660 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... Equipment Emergency Power § 149.660 What are the requirements for emergency power? (a) Each pumping platform...

Review of implementation strategies to change healthcare provider behaviour in the emergency department.

PubMed

de Wit, Kerstin; Curran, Janet; Thoma, Brent; Dowling, Shawn; Lang, Eddy; Kuljic, Nebojsa; Perry, Jeffrey J; Morrison, Laurie

2018-05-01

Advances in emergency medicine research can be slow to make their way into clinical care, and implementing a new evidence-based intervention can be challenging in the emergency department. The Canadian Association of Emergency Physicians (CAEP) Knowledge Translation Symposium working group set out to produce recommendations for best practice in the implementation of a new science in Canadian emergency departments. A systematic review of implementation strategies to change health care provider behaviour in the emergency department was conducted simultaneously with a national survey of emergency physician experience. We summarized our findings into a list of draft recommendations that were presented at the national CAEP Conference 2017 and further refined based on feedback through social media strategies. We produced 10 recommendations for implementing new evidence-based interventions in the emergency department, which cover identifying a practice gap, evaluating the evidence, planning the intervention strategy, monitoring, providing feedback during implementation, and desired qualities of future implementation research. We present recommendations to guide future emergency department implementation initiatives. There is a need for robust and well-designed implementation research to guide future emergency department implementation initiatives.

Emerging and re-emerging infections.

PubMed

Lim, V K

1999-06-01

An emerging infection is defined as an infection which has newly appeared in a population while a re-emerging infection is one which has existed in the past but its incidence is rapidly increasing. The reasons for the emergence and re-emergence of infections are not well understood but appear to be associated with factors that involve the pathogen, the host and the environment. These factors are often inter-related and act together in a complex manner to bring about changes in patterns of infection. Pathogens are extremely resourceful and possess mechanisms to adapt to new hosts and environments as well as to acquire new virulence traits. Host factors include herd immunity, social behaviour and demographics. Environmental factors like the climate, deforestation and new technologies have an impact on the emergence of infections. The challenge is to contain an infection when it emerges but more importantly to prevent its emergence in the first place. As the emergence of an infection is complex and multifactorial, a multidisciplinary approach is required. Health based strategies alone are insufficient. Social, economic and environmental measures and the political will to implement appropriate policies are equally important.

STORC safety initiative: a multicentre survey on preparedness & confidence in obstetric emergencies.

PubMed

Guise, Jeanne-Marie; Segel, Sally Y; Larison, Kristine; M Jump, Sarah; Constable, Marion; Li, Hong; Osterweil, Patricia; Dieter Zimmer

2010-12-01

Patient safety is a national and international priority. The purpose of this study was to understand clinicians' perceptions of teamwork during obstetric emergencies in clinical practice, to examine factors associated with confidence in responding to obstetric emergencies and to evaluate perceptions about the value of team training to improve preparedness. An anonymous survey was administered to all clinical staff members who respond to obstetric emergencies in seven Oregon hospitals from June 2006 to August 2006. 614 clinical staff (74.5%) responded. While over 90% felt confident that the appropriate clinical staff would respond to emergencies, more than half reported that other clinical staff members were confused about their role during emergencies. Over 84% were confident that emergency drills or simulation-based team training would improve performance. Clinical staff who respond to obstetric emergencies in their practice reported feeling confident that the qualified personnel would respond to an emergency; however, they were less confident that the responders would perform well as a team. They reported that simulation and team training may improve their preparedness and confidence in responding to emergencies.

Emergency Contraception Website

MedlinePlus

Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This website is ...

Idaho National Laboratory Emergency Readiness Assurance Plan — Fiscal Year 2016

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

None, None

Battelle Energy Alliance, LLC, the prime contractor for Idaho National Laboratory (INL), provides this Emergency Readiness Assurance Plan (ERAP) for Fiscal Year 2016 in accordance with DOE O 151.1C, “Comprehensive Emergency Management System.” The ERAP documents the readiness of the INL Emergency Management Program using emergency response planning and preparedness activities as the basis. It describes emergency response planning and preparedness activities, and where applicable, summarizes and/or provides supporting information in tabular form for easy access to data. The ERAP also provides budget, personnel, and planning forecasts for Fiscal Year 2017. Specifically, the ERAP assures the Department of Energy Idahomore » Operations Office that stated emergency capabilities at INL are sufficient to implement PLN 114, “INL Emergency Plan/RCRA Contingency Plan.”« less

Development and evaluation of educational materials for pre-hospital and emergency department personnel on the care of patients with autism spectrum disorder.

PubMed

McGonigle, John J; Migyanka, Joann M; Glor-Scheib, Susan J; Cramer, Ryan; Fratangeli, Jeffrey J; Hegde, Gajanan G; Shang, Jennifer; Venkat, Arvind

2014-05-01

With the rising prevalence of patients with autism spectrum disorder (ASD), there has been an increase in the acute presentation of these individuals to the general health care system. Emergency medical services and emergency department personnel commonly address the health care needs of patients with ASD at times of crisis. Unfortunately, there is little education provided to front-line emergency medical technicians, paramedics and emergency nurses on the characteristics of ASD and how these characteristics can create challenges for individuals with ASD and their health care providers in the pre-hospital and emergency department settings. This paper describes the development of educational materials on ASD and the results of training of emergency medical services and emergency department personnel.

Idaho National Laboratory Emergency Readiness Assurance Plan — Fiscal Year 2014

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

Bush, Shane

Battelle Energy Alliance, LLC, the prime contractor for Idaho National Laboratory (INL), provides this Emergency Readiness Assurance Plan (ERAP) for Fiscal Year 2014 in accordance with DOE O 151.1C, “Comprehensive Emergency Management System.” The ERAP documents the readiness of the INL Emergency Management Program using emergency response planning and preparedness activities as the basis. It describes emergency response planning and preparedness activities, and where applicable, summarizes and/or provides supporting information in tabular form for easy access to data. The ERAP also provides budget, personnel, and planning forecasts for Fiscal Year 2015. Specifically, the ERAP assures the Department of Energy Idahomore » Operations Office that stated emergency capabilities at INL are sufficient to implement PLN-114, “INL Emergency Plan/RCRA Contingency Plan.”« less

A Review of Current and Emerging Approaches to Pain Management in the Emergency Department.

PubMed

Todd, Knox H

2017-12-01

Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches. For some of these therapies, sparse evidence exists to support their efficacy for emergency department use. The purpose of this paper is to review historical trends and emerging approaches to emergency department analgesia, with a particular focus on the USA and Canada. We conducted a qualitative review of past and current descriptive studies of emergency department pain practice, as well as clinical trials of emerging pain treatment modalities. The review considers the increasing use of non-opioid and multimodal analgesic therapies, including migraine therapies, regional anesthesia, subdissociative-dose ketamine, nitrous oxide, intravenous lidocaine and gabapentinoids, as well as broad programmatic initiatives promoting the use of non-opioid analgesics and nonpharmacologic interventions. While migraine therapies, regional anesthesia, nitrous oxide and subdissociative-dose ketamine are supported by a relatively robust evidence base, data supporting the emergency department use of intravenous lidocaine, gabapentinoids and various non-pharmacologic analgesic interventions remain sparse. Additional research on the relative safety and efficacy of non-opioid approaches to emergency department analgesia is needed. Despite a limited research base, it is likely that non-opioid analgesic modalities will be employed with increasing frequency. A new generation of emergency physicians is seeking additional training in pain medicine and increasing dialogue between emergency medicine and pain medicine researchers, educators and clinicians could contribute to better management of emergency department pain.

The effects of host size and temperature on the emergence of Echinoparyphium recurvatum cercariae from Lymnaea peregra under natural light conditions.

PubMed

Morley, N J; Adam, M E; Lewis, J W

2010-09-01

The production of cercariae from their snail host is a fundamental component of transmission success in trematodes. The emergence of Echinoparyphium recurvatum (Trematoda: Echinostomatidae) cercariae from Lymnaea peregra was studied under natural sunlight conditions, using naturally infected snails of different sizes (10-17 mm) within a temperature range of 10-29 degrees C. There was a single photoperiodic circadian cycle of emergence with one peak, which correlated with the maximum diffuse sunlight irradiation. At 21 degrees C the daily number of emerging cercariae increased with increasing host snail size, but variations in cercarial emergence did occur between both individual snails and different days. There was only limited evidence of cyclic emergence patterns over a 3-week period, probably due to extensive snail mortality, particularly those in the larger size classes. Very few cercariae emerged in all snail size classes at the lowest temperature studied (10 degrees C), but at increasingly higher temperatures elevated numbers of cercariae emerged, reaching an optimum between 17 and 25 degrees C. Above this range emergence was reduced. At all temperatures more cercariae emerged from larger snails. Analysis of emergence using the Q10 value, a measure of physiological processes over temperature ranges, showed that between 10 and 21 degrees C (approximately 15 degrees C) Q10 values exceeded 100 for all snail size classes, indicating a substantially greater emergence than would be expected for normal physiological rates. From 14 to 25 degrees C (approximately 20 degrees C) cercarial emergence in most snail size classes showed little change in Q10, although in the smallest size class emergence was still substantially greater than the typical Q10 increase expected over this temperature range. At the highest range of 21-29 degrees C (approximately 25 degrees C), Q10 was much reduced. The importance of these results for cercarial emergence under global climate change is discussed.

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.

Emergency Nurses Association

MedlinePlus

... medications to treat a medical emergency. Study: Workplace bullying is underestimated driver of nurse and patient outcomes ... Emergency Nurses Association theory helps identify and correct bullying behavior. Join the Emergency Nurses Week Celebration Led ...

Emergency Medical Services

MedlinePlus

... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

Disabilities - Multiple Languages

MedlinePlus

... for Emergencies Now: Information for People with Disabilities - English PDF Prepare for Emergencies Now: Information for People ... for Emergencies Now: Information for People with Disabilities - English PDF Prepare for Emergencies Now: Information for People ...

Initiating an online asthma management program in urban emergency departments: the recruitment experience.

PubMed

Joseph, Christine L M; Lu, Mei; Stokes-Bruzzelli, Stephanie; Johnson, Dayna A; Duffy, Elizabeth; Demers, Michele; Zhang, Talan; Ownby, Dennis R; Zoratti, Edward; Mahajan, Prashant

2016-01-01

The emergency department could represent a means of identifying patients with asthma who could benefit from asthma interventions. To assess the initiation of a Web-based tailored asthma intervention in the emergency department of 2 urban tertiary care hospitals. In addition to awareness strategies for emergency department staff (eg, attending nursing huddles, division meetings, etc), recruitment experiences are described for 2 strategies: (1) recruitment during an emergency department visit for acute asthma and (2) recruitment from patient listings (mail or telephone). Patient enrollment was defined as baseline completion, randomization, and completion of the first of 4 online sessions. Of 499 eligible patients 13 to 19 years old visiting the emergency department for asthma during the study period, 313 (63%) were contacted in the emergency department (n = 65) or by mail or telephone (n = 350). Of these, 121 (38.6%) were randomized. Mean age of the study sample was 15.4 years and 88.4% were African American. Refusal rates for emergency department recruitment and mail or telephone were 18.5% (12 of 65) and 16.6% (58 of 350), respectively. On average, emergency department enrollment took 44 to 67 minutes, including downtime. When surveyed, emergency department providers were more positive about awareness activities and emergency department recruitment than were research staff. Emergency department recruitment was feasible but labor intensive. Refusal rates were similar for the 2 strategies. Targeting patients with acute asthma in the emergency department is one way of connecting with youth at risk of future acute events. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Committee Opinion No 707: Access to Emergency Contraception.

PubMed

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

PubMed

2017-07-01

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

ACOG Committee Opinion No. 487: Preparing for clinical emergencies in obstetrics and gynecology.

PubMed

2011-04-01

Patient care emergencies may periodically occur at any time in any setting, particularly the inpatient setting. To respond to these emergencies, it is important that obstetrician-gynecologists prepare themselves by assessing potential emergencies that might occur, creating plans that include establishing early warning systems, designating specialized first responders, conducting emergency drills, and debriefing staff after actual events to identify strengths and opportunities for improvement. Having such systems in place may reduce or prevent the severity of medical emergencies.

Towards integrated crisis support of regional emergency networks.

PubMed

Caro, D H

1999-01-01

Emergency and crisis management pose multidimensional information systems challenges for communities across North America. In the quest to reduce mortality and morbidity risks and to increase the level of crisis preparedness, regional emergency management networks have evolved. Integrated Crisis Support Systems (ICSS) are enabling information technologies that assist emergency managers by enhancing the ability to strategically manage and control these regional emergency networks efficiently and effectively. This article underscores the ICCS development, control and leadership issues and their promising implications for regional emergency management networks.

Emergency nurses' perceptions of emergency department preparedness for an ebola outbreak: A qualitative descriptive study.

PubMed

Pincha Baduge, Mihirika Sds; Moss, Cheryle; Morphet, Julia

2017-05-01

Ebola Virus Disease is highly contagious and has high mortality. In 2014, when the outbreak in West Africa was declared a public health emergency, emergency departments in Australia commenced preparation and vigilance for people presenting with ebola like symptoms, to limit spread of the disease. To examine Australian emergency nurses' perceptions regarding their own and their emergency departments' preparedness to manage an ebola outbreak. A qualitative descriptive design was used to collect and analyse data in one metropolitan emergency department in Victoria, Australia. Four focus groups were conducted with 13 emergency nurses. Data were thematically analysed. Major themes emerged from the data: organisational, personal and future preparedness. Participants' believed that both the organisation and themselves had achieved desirable and appropriate preparedness for ebola in their emergency setting. Participants trusted their organisation to prepare and protect them for ebola. Appropriate policies, procedures, and equipment infrastructure were reportedly in place. Nurses' decisions to care for a patient with ebola were informed by professional commitment, and personal responsibilities. Participants were concerned about transmitting ebola to their families, and suggested that more regular training in personal protective equipment would increase confidence and skill in self-protection. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Knowledge and confidence of a convenience sample of australasian emergency doctors in managing dental emergencies: results of a survey.

PubMed

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

2015-01-01

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

Emergency medical systems in low- and middle-income countries: recommendations for action.

PubMed Central

Kobusingye, Olive C.; Hyder, Adnan A.; Bishai, David; Hicks, Eduardo Romero; Mock, Charles; Joshipura, Manjul

2005-01-01

Emergency medical care is not a luxury for rich countries or rich individuals in poor countries. This paper makes the point that emergency care can make an important contribution to reducing avoidable death and disability in low- and middle-income countries. But emergency care needs to be planned well and supported at all levels--at the national, provincial and community levels--and take into account the entire spectrum of care, from the occurrence of an acute medical event in the community to the provision of appropriate care at the hospital. The mix of personnel, materials, and health-system infrastructure can be tailored to optimize the provision of emergency care in settings with different levels of resource availability. The misconception that emergency care cannot be cost effective in low-income settings is demonstrably inaccurate. Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes. With better planning, the ongoing costs of emergency care can result in better outcomes and better cost-effectiveness. Every country and community can and should provide emergency care regardless of their place in the ratings of developmental indices. We make the case for universal access to emergency care and lay out a research agenda to fill the gaps in knowledge in emergency care. PMID:16184282

Emergency medicine in the United Arab Emirates

PubMed Central

2014-01-01

It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as consultants overseeing care. Prehospital care and emergency medical services (EMS) operate under the auspices of the police department. Standardized protocols have been established for paramedic certification, triage, and destination decisions. The majority of ambulances offer basic life support (BLS/Type 2) with a growing minority offering advanced life support (ALS/Type 3). Medicine residency programs were established 5 years ago and form the foundation for training emergency medicine specialists for UAE. This article describes the full spectrum of emergency medicine in the UAE: prehospital care, EMS, hospital-based emergency care, training in emergency medicine, and disaster preparedness. We hope that our experience, our understanding of the challenges faced by the specialty, and the anticipated future directions will be of importance to others advancing emergency medicine in their region and across the globe. PMID:24401695

A comparison of single-dose dexmedetomidine or propofol on the incidence of emergence delirium in children undergoing general anaesthesia for magnetic resonance imaging.

PubMed

Bong, C L; Lim, E; Allen, J C; Choo, W L H; Siow, Y N; Teo, P B Y; Tan, J S K

2015-04-01

Emergence delirium is a significant problem in children regaining consciousness following general anaesthesia. We compared the emergence characteristics of 120 patients randomly assigned to receive a single intravenous dose of dexmedetomidine 0.3 μg.kg(-1) , propofol 1 mg.kg(-1) , or 10 ml saline 0.9% before emerging from general anaesthesia following a magnetic resonance imaging scan. Emergence delirium was diagnosed as a score of 10 or more on the Paediatric Anaesthesia Emergence Delirium scale. The incidence of emergence delirium was 42.5% in the dexmedetomidine group, 33.3% in the propofol group and 41.5% in the saline group (p = 0.671). Three patients in the dexmedetomidine group, none in the propofol group and two in the saline group required pharmacological intervention for emergence delirium (p = 0.202). Administration of neither dexmedetomidine nor propofol significantly reduced the incidence, or severity, of emergence delirium. The only significant predictor for emergence delirium was the time taken to awaken from general anaesthesia, with every minute increase in wake-up time reducing the odds of emergence delirium by 7%. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

Lung Emergencies

MedlinePlus

... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...

Emergency preparedness in a sample of persons with disabilities.

PubMed

Gershon, Robyn R M; Kraus, Lewis E; Raveis, Victoria H; Sherman, Martin F; Kailes, June I

2013-01-01

The objective of this study was to characterize emergency preparedness in this vulnerable population, and to ascertain the role of the personal assistant (PA) and the potential impact of prior emergency experience on preparedness efforts. Cross-sectional Internet-based survey conducted in 2011. Convenience sample. Two-hundred fifty-three community residents with cognitive and /or physical disabilities, all receiving personal assistance services. Emergency preparedness, operationalized as responses to a seven-item scale. The mean score for the emergency preparedness scale was 2.32 (SD = 2.74), range 0-7. Even though 62.8 percent (n = 159) of the participants had previously experienced one or more large-scale emergencies, only 47.4 percent (n = 120) of the entire sample and 55.3 percent (n = 88) of those with actual emergency experience reported preparing an emergency plan. Sixty-three percent (n = 76) of those reporting a plan had involved their PA in its development. Participants who reported such involvement were significantly more likely to have higher scores on the emergency preparedness scale (p < 0.001). Participants who had experienced a prior emergency were also more likely to score higher on the emergency preparedness scale (p < 0.001). In general, participants reported limited attention to other basic preparedness recommendations: only 28 percent (n = 70) had prepared a "go-bag" with necessary supplies, 29 percent (n = 74) had developed a strategy for communicating with their PA during emergencies, and 32 percent (n = 81) had stockpiled emergency supplies. Of particular importance, only 26 percent (n = 66) had made alternative back-up plans for personal assistance. Involving the PA in the planning process and experiencing an emergency were both significantly associated with higher emergency preparedness scores in this sample of people living with disabilities. However, critical deficiencies in preparedness were noted, such as lack of back-up plans for replacing their PA. Despite a concerted national effort to improve preparedness in the population of people living with disabilities, important preparedness gaps remain. These findings highlight the need for additional study on emergency preparedness barriers in people living with disabilities so that effective strategies to reduce vulnerabilities can be identified.

Handbook, Living Life's Emergencies: A Guide for Home Preparedness.

ERIC Educational Resources Information Center

Lavalla, Patrick

Although not intended as a complete manual, the guide gives families a better chance of surviving and recovering from a major emergency by helping them learn what emergencies and disasters could occur in the area, how to prepare for them, what action to take in emergencies, and how to develop emergency skills. The guide explains what supplies to…

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:…

Emergency medicine: beyond the basics.

PubMed

Malamed, S F

1997-07-01

Medical emergencies can arise in the dental office. Preparedness for these emergencies is predicated on an ability to rapidly recognize a problem and to effectively institute prompt and proper management. In all emergency situations, management is based on implementation of basic life support, as needed. The author describes the appropriate management of two common emergency situations: allergy and chest pain.

3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

3 CFR - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels... Emergency Relating to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and... north of Cuba. In July 1996 and on subsequent occasions, the Cuban government stated its intent to...

3 CFR - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Code of Federal Regulations, 2013 CFR

2013-01-01

... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation... aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation 7757, the national...

75 FR 8791 - Continuation of the National Emergency Relating to Cuba and of the Emergency Authority Relating...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

... to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of... February 23, 2010 Continuation of the National Emergency Relating to Cuba and of the Emergency Authority....-registered civilian aircraft in international airspace north of Cuba. On February 26, 2004, by Proclamation...

Communication between nurses and physicians: strategies to surviving in the emergency department trenches.

PubMed

Abourbih, Daniel; Armstrong, Sherry; Nixon, Kirsty; Ackery, Alun D

2015-02-01

The emergency department (ED) is a challenging and stressful work environment where communication lapses can lead to negative health outcomes. This article offers strategies to Emergency Medicine residents, nurses and staff physicians on how to improve communication to optimize patient care. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Emergency Nursing Review Questions: July 2017.

PubMed

Shaw, Tracy

2017-07-01

The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

10 CFR 50.103 - Suspension and operation in war or national emergency.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Suspension and operation in war or national emergency. 50..., Emergency Operations by the Commission § 50.103 Suspension and operation in war or national emergency. (a) Whenever Congress declares that a state of war or national emergency exists, the Commission, if it finds it...

Emergency care of raptors.

PubMed

Graham, Jennifer E; Heatley, J Jill

2007-05-01

Raptors may present with a variety of conditions, such as trauma, debilitation, and disease, that necessitate emergency care. Emergency treatment should prioritize stabilization of the patient. Diagnostic testing should be delayed until feasible based on patient status. This article reviews emergency medicine in raptors, including appropriate handling and restraint, hospitalization, triage and patient assessment, sample collection, supportive care, and common emergency presentations.

46 CFR 35.10-5 - Muster lists, emergency signals, and manning-T/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Muster lists, emergency signals, and manning-T/ALL. 35... Fire and Emergency Requirements § 35.10-5 Muster lists, emergency signals, and manning—T/ALL. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W...

46 CFR 35.10-5 - Muster lists, emergency signals, and manning-T/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 1 2013-10-01 2013-10-01 false Muster lists, emergency signals, and manning-T/ALL. 35... Fire and Emergency Requirements § 35.10-5 Muster lists, emergency signals, and manning—T/ALL. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W...

46 CFR 35.10-5 - Muster lists, emergency signals, and manning-T/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Muster lists, emergency signals, and manning-T/ALL. 35... Fire and Emergency Requirements § 35.10-5 Muster lists, emergency signals, and manning—T/ALL. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W...

46 CFR 35.10-5 - Muster lists, emergency signals, and manning-T/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 1 2012-10-01 2012-10-01 false Muster lists, emergency signals, and manning-T/ALL. 35... Fire and Emergency Requirements § 35.10-5 Muster lists, emergency signals, and manning—T/ALL. The requirements for muster lists, emergency signals, and manning must be in accordance with subchapter W...

46 CFR 199.80 - Muster list and emergency instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the general emergency alarm system and public address system; (2) The emergency signals; (3) The... in an emergency; (4) The location of lifejackets, including child-size lifejackets; and (5) The...

Designing a data-driven decision support tool for nurse scheduling in the emergency department: a case study of a southern New Jersey emergency department.

PubMed

Otegbeye, Mojisola; Scriber, Roslyn; Ducoin, Donna; Glasofer, Amy

2015-01-01

A health system serving Burlington and Camden Counties, New Jersey, sought to improve labor productivity for its emergency departments, with emphasis on optimizing nursing staff schedules. Using historical emergency department visit data and operating constraints, a decision support tool was designed to recommend the number of emergency nurses needed in each hour for each day of the week. The pilot emergency department nurse managers used the decision support tool's recommendations to redeploy nurse hours from weekends into a float pool to support periods of demand spikes on weekdays. Productivity improved significantly, with no unfavorable impact on patient throughput, and patient and staff satisfaction. Today's emergency department manager can leverage the increasing ease of access to the emergency department information system's data repository to successfully design a simple but effective tool to support the alignment of its nursing schedule with demand patterns. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

An emergency dental service for students: 4-year findings.

PubMed

Sinclair, J; Wilson, N H

1997-06-01

To describe the arrangements for the provision of emergency dental services for students at the University of Manchester and to report data collected during the first four and a half years of the student emergency dental services (SEDS) unit based at the University Dental Hospital of Manchester. Data pertaining to every student attending SEDS since its inception were collected by means of questionnaire including provision to record diagnoses, treatment needs and the emergency care provided. The incidence of dental emergencies within the student population served by SEDS has been found to be 39 emergencies per 1000 students per annum, with the service being most heavily used by overseas students. Caries, pulpal pathology and failed restorations account for 46 per cent of the presenting emergencies, with pericoronitis (19 per cent) and other emergencies of periodontal origin (14 per cent) being common place. It is concluded that a student emergency dental service may be found to be an important element of student medical and related welfare services.

Cohort study of oncologic emergencies in patients with head and neck cancer.

PubMed

Reyes-Gibby, Cielito C; Melkonian, Stephanie C; Hanna, Ehab Y; Yeung, Sai-Ching J; Lu, Charles; Chambers, Mark S; Banala, Srinivas R; Gunn, Gary B; Shete, Sanjay S

2017-06-01

Treatments for head and neck squamous cell carcinoma (HNSCC) are associated with toxicities that lead to emergency department presentation. We utilized data from an ongoing prospective cohort of newly diagnosed, previously untreated patients (N = 298) with HNSCC to evaluate the association between clinical and epidemiologic factors and risk for and frequency of emergency department presentation. Time to event was calculated from the date of treatment initiation to emergency department presentation, date of death, or current date. Frequency of emergency department presentation was the sum of emergency department visits during the follow-up time. History of hypertension, normal/underweight body mass index (BMI), and probable depression predicted increased risk for emergency department presentation. BMI and severe pain were associated with higher frequency of emergency department presentations. Clinical and epidemiologic factors can help predict patients with HNSCC who will present to the emergency department. Such knowledge may improve treatment-related patient outcomes and quality of life. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1195-1204, 2017. © 2017 Wiley Periodicals, Inc.

Summary of NIH Medical-Surgical Emergency Research Roundtable held on April 30 to May 1, 2009.

PubMed

Kaji, Amy H; Lewis, Roger J; Beavers-May, Tony; Berg, Robert; Bulger, Eileen; Cairns, Charles; Callaway, Clifton; Camargo, Carlos A; Carcillo, Joseph; DeBiasi, Roberta; Diaz, Tania; Ducharme, Francine; Glickman, Seth; Heilpern, Katherine; Hickey, Robert; Hoek, Terry Vanden; Hollander, Judd; Janson, Susan; Jurkovich, Gregory; Kellermann, Arthur; Kingsmore, Stephen; Kline, Jeffrey; Kuppermann, Nathan; Lowe, Robert; McLario, David; Nathanson, Larry; Nichol, Graham; Peitzman, Andrew; Richardson, Lynne; Sanders, Arthur; Shah, Manish; Shapiro, Nathan; Silverman, Robert; Than, Martin; Wilber, Scott; Yealy, Donald M

2010-11-01

In 2003, the Institute of Medicine Committee on the Future of Emergency Care in the United States Health System convened and identified a crisis in emergency care in the United States, including a need to enhance the research base for emergency care. As a result, the National Institutes of Health (NIH) formed an NIH Task Force on Research in Emergency Medicine to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. The objectives of these discussions were to identify key research questions essential to advancing the scientific underpinnings of emergency care and to discuss the barriers and best means to advance research by exploring the role of research networks and collaboration between the NIH and the emergency care community. The Medical-Surgical Research Roundtable was convened on April 30 to May 1, 2009. Before the roundtable, the emergency care domains to be discussed were selected and experts in each of the fields were invited to participate in the roundtable. Domain experts were asked to identify research priorities and challenges and separate them into mechanistic, translational, and clinical categories. After the conference, the lists were circulated among the participants and revised to reach a consensus. Emergency care research is characterized by focus on the timing, sequence, and time sensitivity of disease processes and treatment effects. Rapidly identifying the phenotype and genotype of patients manifesting a specific disease process and the mechanistic reasons for heterogeneity in outcome are important challenges in emergency care research. Other research priorities include the need to elucidate the timing, sequence, and duration of causal molecular and cellular events involved in time-critical illnesses and injuries, and the development of treatments capable of halting or reversing them; the need for novel animal models; and the need to understand why there are regional differences in outcome for the same disease processes. Important barriers to emergency care research include a limited number of trained investigators and experienced mentors, limited research infrastructure and support, and regulatory hurdles. The science of emergency care may be advanced by facilitating the following: (1) training emergency care investigators with research training programs; (2) developing emergency care clinical research networks; (3) integrating emergency care research into Clinical and Translational Science Awards; (4) developing emergency care-specific initiatives within the existing structure of NIH institutes and centers; (5) involving emergency specialists in grant review and research advisory processes; (6) supporting learn-phase or small, clinical trials; and (7) performing research to address ethical and regulatory issues. Enhancing the research base supporting the care of medical and surgical emergencies will require progress in specific mechanistic, translational, and clinical domains; effective collaboration of academic investigators across traditional clinical and scientific boundaries; federal support of research in high-priority areas; and overcoming limitations in available infrastructure, research training, and access to patient populations. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Increased ICU resource needs for an academic emergency general surgery service*.

PubMed

Lissauer, Matthew E; Galvagno, Samuel M; Rock, Peter; Narayan, Mayur; Shah, Paulesh; Spencer, Heather; Hong, Caron; Diaz, Jose J

2014-04-01

ICU needs of nontrauma emergency general surgery patients are poorly described. This study was designed to compare ICU utilization of emergency general surgery patients admitted to an acute care emergency surgery service with other general surgery patients. Our hypothesis is that tertiary care emergency general surgery patients utilize more ICU resources than other general surgical patients. Retrospective database review. Academic, tertiary care, nontrauma surgical ICU. All patients admitted to the surgical ICU over age 18 between March 2004 and June 2012. None. Six thousand ninety-eight patients were evaluated: 1,053 acute care emergency surgery, 1,964 general surgery, 1,491 transplant surgery, 995 facial surgery/otolaryngology, and 595 neurosurgery. Acute care emergency surgery patients had statistically significantly longer ICU lengths of stay than other groups: acute care emergency surgery (13.5 ± 17.4 d) versus general surgery (8.7 ± 12.9), transplant (7.8 ± 11.6), oral-maxillofacial surgery (5.5 ± 4.2), and neurosurgery (4.47 ± 9.8) (all p< 0.01). Ventilator usage, defined by percentage of total ICU days patients required mechanical ventilation, was significantly higher for acute care emergency surgery patients: acute care emergency surgery 73.4% versus general surgery 64.9%, transplant 63.3%, oral-maxillofacial surgery 58.4%, and neurosurgery 53.1% (all p < 0.01). Continuous renal replacement therapy usage, defined as percent of patients requiring this service, was significantly higher in acute care emergency surgery patients: acute care emergency surgery 10.8% versus general surgery 4.3%, transplant 6.6%, oral-maxillofacial surgery 0%, and neurosurgery 0.5% (all p < 0.01). Acute care emergency surgery patients were more likely interhospital transfers for tertiary care services than general surgery or transplant (24.5% vs 15.5% and 8.3% respectively, p < 0.001 for each) and more likely required emergent surgery (13.7% vs 6.7% and 3.5%, all p < 0.001). Chronic comorbidities were similar between acute care emergency surgery and general surgery, whereas transplant had fewer. Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs will allow for better deployment of hospital resources.

[Prevalence and severity of hypertensive emergencies and outbreaks in the hospital emergency department of CHU Timone at Marseille: Follow-up in three months of hospitalized patients].

PubMed

Guiga, H; Sarlon-Bartoli, G; Silhol, F; Radix, W; Michelet, P; Vaïsse, B

2016-06-01

Evaluation of the prevalence and severity of hypertensive emergencies and crisis in an Emergency Service of Timone hospital in Marseille and follow-up of 3 months of hospitalized emergencies. This study was conducted in the Emergency Department between April 1 and June 30, 2015. All patients with BP>180 and/or 110mmHg was recorded and classified in true emergencies (presence of visceral pain) and hypertensive isolated crisis. A phone follow-up patients was organized. During this period, 170 patients were identified: 95 (56%) hypertensive crisis and 75 (44%) hypertensive emergencies: 25 OAP (33%), 18 ischemic stroke (24%), 15 hemorrhagic stroke (20%), 9 angina (12%) and 8 different. The clinical characteristics of hypertensive emergencies are preferentially dyspnea (27%) motor deficit (36%), and chest pain (16%). The BP of hypertensive emergencies at their admission (3 measurements, oscillometric automatic device) is close to the hypertensive crisis (198.17±19.3 to 96.4±21.2mmHg versus 191±31.6 to 96.12±21). The BP controlled after 15minutes of rest is lower for crisis compared to real emergencies (152±47 to 79±28 vs. 174±31 to 86±26). Age emergency is larger (77±14 vs. 67±17), the number of slightly larger drug (1.79 versus 1.67±1±1). Telephone follow-up was performed after an average period of three months. Ninety-nine patients were contacted by telephone: 46 patients who were admitted for hypertensive emergency patients and 53 for a push. Eighteen deaths have been recorded, including 15 among hypertensive emergencies (9 in hemorrhagic stroke, 5 for ischemic stroke, and 1 for OAP) with 5-hospital deaths within 48hours after admission and 10 within 3 months in patients hospitalized with hypertensive emergency or 33%. Seventy-seven patients out of 99 had been reviewed by their attending physicians. A questionnaire was sent by mail to patients who have not answered the phone contacts, and responses are pending. Hypertensive emergencies hospitalized in Timone Hospital represent 44% of patients hospitalized for emergency HTA. Their gravity is 1/3 since most patients die within three months warranting closer management of these fragile patients by creating a specialized consulting postemergency. Copyright © 2016. Published by Elsevier SAS.

Warning Signs of Childhood Emergencies

MedlinePlus

... Health & Safety Tips » Warning Signs of Childhood Emergencies Warning Signs of Childhood Emergencies Because their bodies are ... if your child exhibits any of the following warning signs of a medical emergency: Any significant change ...

Emergency Management of Myasthenia Gravis

MedlinePlus

... to weakened throat muscles and accumulated secretions. EMERGENCY MANAGEMENT OF MG The MGFA mission is to facilitate ... fax mgfa@myasthenia.org • www.myasthenia.org EMERGENCY MANAGEMENT OF MG Emergency Management Important information for the ...

Emergency medical dispatch : national standard curriculum ready

DOT National Transportation Integrated Search

1996-05-01

This Traffic Tech describes the recently updated "Emergency Medical Dispatch: National Standard Curriculum," which was developed in 1972. Emergency service providers use these uniform standards to develop or select an emergency medical dispatch progr...

Research requirements for emergency power to permit hover-one-engine-inoperative helicopter operation

NASA Technical Reports Server (NTRS)

Yost, J. H.

1976-01-01

The research and technology demonstration requirements to achieve emergency-power capability for a civil helicopter are documented. The goal for emergency power is the ability to hover with one engine inoperative, transition to minimum-power forward flight, and continue to a safe landing where emergency power may or may not be required. The best method to obtain emergency power is to augment the basic engine power by increasing the engine's speed and turbine-inlet temperature, combined with water-alcohol injection at the engine inlet. Other methods, including turbine boost power and flywheel energy, offer potential for obtaining emergency power for minimum time durations. Costs and schedules are estimated for a research and development program to bring emergency power through a hardware-demonstration test. Interaction of engine emergency-power capability with other helicopter systems is examined.

Emerging infections: a perpetual challenge

PubMed Central

Morens, David M; Folkers, Gregory K; Fauci, Anthony S

2008-01-01

Emerging and re-emerging infectious diseases, and their determinants, have recently attracted substantial scientific and popular attention. HIV/AIDS, severe acute respiratory syndrome, H5N1 avian influenza, and many other emerging diseases have either proved fatal or caused international alarm. Common and interactive co-determinants of disease emergence, including population growth, travel, and environmental disruption, have been increasingly documented and studied. Are emerging infections a new phenomenon related to modern life, or do more basic determinants, transcending time, place, and human progress, govern disease generation? By examining a number of historically notable epidemics, we suggest that emerging diseases, similar in their novelty, impact, and elicitation of control responses, have occurred throughout recorded history. Fundamental determinants, typically acting in concert, seem to underlie their emergence, and infections such as these are likely to continue to remain challenges to human survival. PMID:18992407

The relation between open-field and emergence tests in a hyperactive mouse model.

PubMed

Lalonde, R; Strazielle, C

2009-12-01

The relation between open-field and emergence tests was examined in mice with idiopathic hypertension. Spontaneous hypertensive mice (SHM) crossed more segments and reared more often in the open-field than normotensive controls at both age levels. In contrast, grooming episodes decreased only in the older SHM cohort. While young SHM emerged more quickly from a toy object only partially, complete emergence was faster only in the older SHM cohort. In the entire series, open-field segments were inversely correlated with 2- and 4-paw emergence latencies. There was also an inverse correlation between rears and 2-paw emergence but a positive correlation between grooming episodes and both types of emergence. In view of its association with open-field activity, the emergence test may have value in screening potential ADHD therapies.

High Altitude Platforms for Disaster Recovery: Capabilities, Strategies, and Techniques for Providing Emergency Telecommunications

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

Juan D. Deaton

2008-05-01

Natural disasters and terrorist acts have significant potential to disrupt emergency communication systems. These emergency communication networks include first-responder, cellular, landline, and emergency answering services such as 911, 112, or 999. Without these essential emergency communications capabilities, search, rescue, and recovery operations during a catastrophic event will be severely debilitated. High altitude platforms could be fitted with telecommunications equipment and used to support these critical communications missions once the catastrophic event occurs. With the ability to be continuously on station, HAPs provide excellent options for providing emergency coverage over high-risk areas before catastrophic incidents occur. HAPs could also provide enhancedmore » 911 capabilities using either GPS or reference stations. This paper proposes potential emergency communications architecture and presents a method for estimating emergency communications systems traffic patterns for a catastrophic event.« less

Emergency department overcrowding: the impact of resource scarcity on physician job satisfaction.

PubMed

Rondeau, Kent V; Francescutti, Louis H

2005-01-01

Emergency departments in most developed countries have been experiencing significant overcrowding under a regime of severe resource constraints. Physicians in emergency departments increasingly find themselves toiling in workplaces that are characterized by diminished availability of, limited access to, and decreased stability of critical resources. Severe resource constraints have the potential to greatly weaken the overall job satisfaction of emergency physicians. This article examines the impact of hospital resource constraints on the job satisfaction of a large sample of emergency physicians in Canada. After controlling for workflow and patient characteristics and for various institutional and physician characteristics, institutional resource constraints are found to be major contributors to emergency physician job dissatisfaction. Resource factors that have the greatest impact on job satisfaction include availability of emergency room physicians, access to hospital technology and emergency beds, and stability of financial (investment) resources.

The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives.

PubMed

Martel, John; Oteng, Rockefeller; Mould-Millman, Nee-Kofi; Bell, Sue Anne; Zakariah, Ahmed; Oduro, George; Kowalenko, Terry; Donkor, Peter

2014-10-01

Ghana's first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. We describe the history and status of novel postgraduate emergency physician, nurse, and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist-level emergency physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national Emergency Medical Service. This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled health care workers in Ghana and may serve as a model for similar developing nations. Copyright © 2014 Elsevier Inc. All rights reserved.

Emergency Contraception: Do Your Patients Have a Plan B?

PubMed

Bullock, Holly; Salcedo, Jennifer

2015-12-01

Emergency contraception is used after unprotected sex, inadequately protected sex, or sexual assault to reduce the risk of pregnancy. Of emergency contraceptive methods available in the United States, the copper intrauterine device has the highest efficacy, followed by ulipristal acetate, levonorgestrel-containing emergency contraceptive pills, and the Yuzpe method. However, access to the most effective methods is limited. Although advanced prescription of emergency contraceptive pills and counseling on emergency contraception to all reproductive-aged women is recommended, women should be advised to contact their health care providers after taking emergency contraceptive pills to discuss possible copper intrauterine device placement and other follow-up. Copyright © 2015 Elsevier Inc. All rights reserved.

Los Alamos National Laboratory emergency management plan. Revision 1

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

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,more » transportation accidents, electrical accidents, and natural disasters.« less

Civil Defense, U. S. A.: A Programmed Orientation to Civil Defense. Unit 4. Warning, Emergency Operations, and Support Programs.

ERIC Educational Resources Information Center

Defense Civil Preparedness Agency (DOD), Battle Creek, MI.

The need for, and a description of, emergency functions required to save lives and protect property in nuclear or natural disasters are presented. Topics discussed include: (1) The Civil Defense Warning System, (2) Introduction to the Emergency Operations Program, (3) Five subprograms of the Emergency Operations Program, (4) Emergency Operations…

A New Model For Understanding Incident Management

DTIC Science & Technology

2016-12-01

organization of emergency management practitioners with over 9,000 worldwide members. IAEM is “dedicated to promoting the ‘ Principles of Emergency... management . Additionally, IAEM promotes the “ principles of emergency management ” as established through Emergency Management Institute (EMI...of what emergency managers are or what they do specifically; principles for the profession and prescribed requirements for being certified as an

46 CFR 35.10-15 - Emergency lighting and power systems-T/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Emergency lighting and power systems-T/ALL. 35.10-15... Emergency Requirements § 35.10-15 Emergency lighting and power systems—T/ALL. (a) Where fitted, it shall be the duty of the master to see that the emergency lighting and power systems are tested and inspected...

46 CFR 35.10-15 - Emergency lighting and power systems-T/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 1 2011-10-01 2011-10-01 false Emergency lighting and power systems-T/ALL. 35.10-15... Emergency Requirements § 35.10-15 Emergency lighting and power systems—T/ALL. (a) Where fitted, it shall be the duty of the master to see that the emergency lighting and power systems are tested and inspected...

Engineering risk assessment for emergency disposal projects of sudden water pollution incidents.

PubMed

Shi, Bin; Jiang, Jiping; Liu, Rentao; Khan, Afed Ullah; Wang, Peng

2017-06-01

Without an engineering risk assessment for emergency disposal in response to sudden water pollution incidents, responders are prone to be challenged during emergency decision making. To address this gap, the concept and framework of emergency disposal engineering risks are reported in this paper. The proposed risk index system covers three stages consistent with the progress of an emergency disposal project. Fuzzy fault tree analysis (FFTA), a logical and diagrammatic method, was developed to evaluate the potential failure during the process of emergency disposal. The probability of basic events and their combination, which caused the failure of an emergency disposal project, were calculated based on the case of an emergency disposal project of an aniline pollution incident in the Zhuozhang River, Changzhi, China, in 2014. The critical events that can cause the occurrence of a top event (TE) were identified according to their contribution. Finally, advices on how to take measures using limited resources to prevent the failure of a TE are given according to the quantified results of risk magnitude. The proposed approach could be a potential useful safeguard for the implementation of an emergency disposal project during the process of emergency response.

A Conceptual Framework to Measure Systems’ Performance during Emergency Preparedness Exercises

PubMed Central

Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

2014-01-01

Large-scale public health emergencies require a sophisticated, coordinated response involving multiple entities to protect health and minimize suffering. However, the rarity of such emergencies presents a barrier to gathering observational data about the effectiveness of the public health response before such events occur. For this reason, public health practitioners increasingly have relied on simulated emergencies, known as “exercises” as proxies to test their emergency capabilities. However, the formal evaluation of performance in these exercises, historically has been inconsistent, and there is little research to describe how data acquired from simulated emergencies actually support conclusions about the quality of the public health emergency response system. Over the past six years, we have designed and evaluated more than seventy public health emergency exercises, collaborating with public health agencies, hospitals and others to test a wide variety of systems and their capabilities. Using the data and experience that we gathered, we have developed a conceptual framework that describes the essential elements necessary to consider when applying performance measurement science to public health emergency exercises. We suggest that this framework may assist practitioners and researchers who wish to better measure performance in exercises and to improve public health emergency preparedness. PMID:25233015

Energetics of emergence in the cicadas, Cyclochila australasiae and Abricta curvicosta (Homoptera: Cicadidae).

PubMed

Harvey, Prudence M; Thompson, Michael B

2006-09-01

The final moult in cicadas marks a major transition in lifestyle and is a behaviour that makes the cicada vulnerable to predation. Consequently, emergence times are short and, we predict, therefore the rate of energy consumption would be high. Hence, we measured the energetic cost of emergence in Cyclochila australasiae (green grocer) and Abricta curvicosta (floury baker) cicadas during the final moult from nymph to adult cicada. Maximum energy expended whilst emerging was compared between the sexes and species. Even though C. australasiae take longer to emerge than A. curvicosta, the mass-specific cost of emergence is not different between the two species (C. australasiae: 11.34+/-2.55 J g(-1); A. curvicosta: 12.91+/-1.90 J g(-1)). The mass-specific metabolic rates of fully emerged adults of both species are approximately twice those of the nymphs and the maximum metabolic rate during emergence is about 1.5 times higher than the resting metabolic rate of emerged adults. Emergence times, as indicated by rates of oxygen consumption, are longer than expected and probably reflect limitations in the oxygen capacity of the cicadas during moulting.

Closing emergency operating rooms improves efficiency.

PubMed

Wullink, Gerhard; Van Houdenhoven, Mark; Hans, Erwin W; van Oostrum, Jeroen M; van der Lans, Marieke; Kazemier, Geert

2007-12-01

Long waiting times for emergency operations increase a patient's risk of postoperative complications and morbidity. Reserving Operating Room (OR) capacity is a common technique to maximize the responsiveness of an OR in case of arrival of an emergency patient. This study determines the best way to reserve OR time for emergency surgery. In this study two approaches of reserving capacity were compared: (1) concentrating all reserved OR capacity in dedicated emergency ORs, and (2) evenly reserving capacity in all elective ORs. By using a discrete event simulation model the real situation was modelled. Main outcome measures were: (1) waiting time, (2) staff overtime, and (3) OR utilisation were evaluated for the two approaches. Results indicated that the policy of reserving capacity for emergency surgery in all elective ORs led to an improvement in waiting times for emergency surgery from 74 (+/-4.4) minutes to 8 (+/-0.5) min. Working in overtime was reduced by 20%, and overall OR utilisation can increase by around 3%. Emergency patients are operated upon more efficiently on elective Operating Rooms instead of a dedicated Emergency OR. The results of this study led to closing of the Emergency OR in the Erasmus MC (Rotterdam, The Netherlands).

Emerging contaminants: Presentations at the 2009 Toxicology and Risk Assessment Conference

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

Murnyak, George, E-mail: George.murnyak@us.army.mil; Vandenberg, John, E-mail: Vandenberg.John@epamail.epa.gov; Yaroschak, Paul J., E-mail: Paul.Yaroschak@osd.mil

2011-07-15

A session entitled 'Emerging Contaminants' was held in April 2009 in Cincinnati, OH at the 2009 Toxicology and Risk Assessment Conference. The purpose of the session was to share information on both programmatic and technical aspects associated with emerging contaminants. Emerging contaminants are chemicals or materials that are characterized by a perceived or real threat to human health or environment, a lack of published health standards or an evolving standard. A contaminant may also be 'emerging' because of the discovery of a new source, a new pathway to humans, or a new detection method or technology. The session included fivemore » speakers representing the Department of Defense (DoD), the Environmental Protection Agency (EPA), and each of the military services. The DoD created the Emerging Contaminant Directorate to proactively address environmental, health, and safety concerns associated with emerging contaminants. This session described the scan-watch-action list process, impact assessment methodology, and integrated risk management concept that DoD has implemented to manage emerging contaminants. EPA presented emerging trends in health risk assessment. Researchers made technical presentations on the status of some emerging contaminates in the assessment process (i.e. manganese, RDX, and naphthalene).« less

The "prudent layperson" definition of an emergency medical condition.

PubMed

Li, James; Galvin, Hannah K; Johnson, Sandra C

2002-01-01

The study objectives, based on federal and state legislative language, were to objectively define symptoms and signs commonly agreed on by "prudent laypersons" as "emergency medical conditions." After comprehensive tabulation of symptom classifications from the International Classification of Diseases (ICD-9), we performed a survey of nonmedical laypersons. Data analysis included descriptive statistics, proportional calculations, and 95% confidence intervals. A minority of symptoms and signs (25/87, 29%) were considered emergency medical conditions by more than half of nonmedical survey respondents who were self-defined as prudent laypersons. The leading conditions deemed emergencies were loss of consciousness, seizure, no recognition of one side of the body, paralysis, shock, gangrene, coughing blood, trouble breathing, chest pain, and choking. Pain, except for renal colic or chest pain, was not considered an emergency. No symptoms or signs specifically related to gynecologic disorders were considered emergencies. Most symptoms and signs tabulated in the diagnostic coding manual, ICD-9, are not considered emergency medical conditions by self-designated prudent laypersons. These include many conditions that are commonly investigated and treated in the emergency department setting. Use of the prudent layperson standard for reimbursable emergency health services may not reflect the actual scope of symptoms necessitating emergency care.

Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia.

PubMed

Tesfaye, Tatek; Tilahun, Tizta; Girma, Eshetu

2012-03-12

In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH). Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011 Data was collected using structured questionnaire and analyzed using SPSS version 17.0. In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives. The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

PubMed Central

Alzahrani, Fuad; Kyratsis, Yiannis

2017-01-01

Objectives To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. Design Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014. Setting All 4 public hospitals in Mecca, Saudi Arabia. Participants 106 registered nurses in hospital emergency departments. Main outcome measure Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness. Results Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management. Conclusions Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness. PMID:28400457

Integrated hospital emergency care improves efficiency.

PubMed

Boyle, A A; Robinson, S M; Whitwell, D; Myers, S; Bennett, T J H; Hall, N; Haydock, S; Fritz, Z; Atkinson, P

2008-02-01

There is uncertainty about the most efficient model of emergency care. An attempt has been made to improve the process of emergency care in one hospital by developing an integrated model. The medical admissions unit was relocated into the existing emergency department and came under the 4-hour target. Medical case records were redesigned to provide a common assessment document for all patients presenting as an emergency. Medical, surgical and paediatric short-stay wards were opened next to the emergency department. A clinical decision unit replaced the more traditional observation unit. The process of patient assessment was streamlined so that a patient requiring admission was fully clerked by the first attending doctor to a level suitable for registrar or consultant review. Patients were allocated directly to specialty on arrival. The effectiveness of this approach was measured with routine data over the same 3-month periods in 2005 and 2006. There was a 16.3% decrease in emergency medical admissions and a 3.9% decrease in emergency surgical admissions. The median length of stay for emergency medical patients was reduced from 7 to 5 days. The efficiency of the elective surgical services was also improved. Performance against the 4-hour target declined but was still acceptable. The number of bed days for admitted surgical and medical cases rose slightly. There was an increase in the number of medical outliers on surgical wards, a reduction in the number of incident forms and formal complaints and a reduction in income for the hospital. Integrated emergency care has the ability to use spare capacity within emergency care. It offers significant advantages beyond the emergency department. However, improved efficiency in processing emergency patients placed the hospital at a financial disadvantage.

[Substance related disorder in emergency services: Which attitudes?

PubMed

Rica, M; Principe, A; Le Reste, J-Y; Guillou Landreat, M

2017-02-01

Substance related disorders are more prevalent in emergency services than in the general population, about 20% of individuals in emergency care test positive for alcohol. Emergency services are strategic places to identify alcohol misuse. Attitudes to individuals presenting substance related disorders are important in developing therapeutic relationships and applying interventions. This study explores the attitudes of an emergency staff to these individuals across a range of roles, and evolution in face of an addictology care improvement. Data were gathered from an emergency service sample from the emergency department of a general hospital in Morlaix (France). We used a short questionnaire, adapted from previous similar French studies. Twenty-five persons answered the first questionnaire and 18 the second. A self-administrated attitudes questionnaire showed its interest in our study and helped us to identify attitudes and to initiate a reflection on behaviours in emergency care. Moreover, it helped to change attitudes towards individuals presenting substance related disorders. The daily setting of an addictive disorders specialized unit in emergency changed the point of view on addictive disorders of both physicians and nurses. We showed differences in addictive related disorders prevalence perception among patients attending emergency care between the two evaluations. But we also showed that physicians and nurses stressed that it was more difficult to ask patients in emergency care on the second evaluation, after and despite a daily addictive disorders specialized setting. We showed several limits in emergency staff care relationship with patients with substance related disorders. They identified difficulties to talk about addictive disorders, especially in younger and older patients. Regarding literature, we discuss our study limits and different ways of improving addictology care in emergency services. Copyright © 2015 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

The attitudes and awareness of emergency department (ED) physicians towards the management of common dentofacial emergencies.

PubMed

Trivedy, Chetan; Kodate, Naonori; Ross, Alastair; Al-Rawi, Harrith; Jaiganesh, Thiagarajan; Harris, Tim; Anderson, Janet E

2012-04-01

Dentofacial emergencies are a common presentation to the emergency department (ED) but there is little recent data on physicians' knowledge, confidence and attitudes in handling these cases. A questionnaire was administered to 103 ED physicians. The sample was primarily drawn from London hospitals as well a smaller contribution from around the UK and included physicians with a range of experience and at different grades. The majority of the 102 participants (76.5%) did not receive any formal training in managing dentofacial emergencies. The percentage of participants who were happy to manage common dentofacial emergencies is as follows: dental trauma (20.4%); major facial trauma (39.8%); interpreting facial X-rays (68.0%); and facial suturing (85.4%). When questioned 12.1% of the participants felt that ED physicians should be responsible for managing dental emergencies compared to 22.4% who felt that ED physicians should manage maxillofacial emergencies. Only 3.9% of the participants would opt to be treated by an ED doctor in the event of them presenting to the ED with a dental injury. The remaining 72.5% would prefer to be seen by a maxillofacial surgeon, 23.5% by a dentist and none of the participants opted to be seen by the emergency nurse practitioner. ED physicians do not feel confident in managing some dentofacial emergencies. This may be attributed to a lack of training in this area as well as exposure to these types of emergencies. There is a need for greater awareness, validated guidelines and training resources for ED physicians to treat dentofacial emergencies as well more research in this field of emergency medicine. © 2011 John Wiley & Sons A/S.

Emergency Wound Care After a Natural Disaster

MedlinePlus

... Protect Your Pets Emergency Wound Care After a Natural Disaster Language: English (US) Español (Spanish) Recommend on ... Go Fact Sheet Emergency Wound Care After a Natural Disaster [NOTE: Health professionals should see Emergency Wound ...

Handbook of emergency management for state-level transportation agencies.

DOT National Transportation Integrated Search

2010-03-01

The Department of Homeland Security has mandated specific systems and techniques for the management of emergencies in the United States, including the Incident Command System, the National Incident Management System, Emergency Operations Plans, Emerg...

Medical emergencies in the dermatology office: incidence and options for crisis preparedness.

PubMed

Hazen, Paul G; Daoud, Shaza; Hazen, Brent P; Engstrom, Conley W; Turgeon, Karen L; Reep, Michael D; Tanphaichitr, Arthapol; Styron, Brandie T

2014-05-01

Medical emergencies may occur in any setting, including dermatology offices. We examined the incidence of medical emergencies in a survey of 34 dermatologists northeast Ohio. Fifty-five events occurred over 565 combined years of clinical practice, an incidence of 1 episode every 10.3 years. We also review options for better preparedness for medical emergencies in dermatology practices, ranging from an emergency action plan for emergency personnel, basic life support (BLS) certification, advanced cardiac life support (ACLS) certification, and on-site automatic electronic defibrillators (AEDs).

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. © 2015 The Canadian College of Health Leaders.

Best practices in managing child and adolescent behavioral health emergencies [digest].

PubMed

Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M; Wormley, Molly

2018-01-22

Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

[Simulation as possible training for palliative emergencies: prospective initial data analysis of participants from two simulation training sessions].

PubMed

Wiese, C H R; Bosse, G; Schröder, T; Lassen, C L; Bundscherer, A C; Graf, B M; Zausig, Y A

2015-01-01

Palliative emergencies describe an acute situation in patients with a life-limiting illness. At present defined curricula for prehospital emergency physician training for palliative emergencies are limited. Simulation-based training (SBT) for such palliative emergency situations is an exception both nationally and internationally. This article presents the preparation of recommendations in the training and development of palliative care emergency situations. A selected literature search was performed using PubMed, EMBASE, Medline and the Cochrane database (1990-2013). Reference lists of included articles were checked by two reviewers. Data of the included articles were extracted, evaluated und summarized. In the second phase the participants of two simulated scenarios of palliative emergencies were asked to complete an anonymous 15-item questionnaire. The results of the literature search and the questionnaire-based investigation were compared and recommendations were formulated based on the results. Altogether 30 eligible national and international articles were included. Overall, training curricula in palliative emergencies are currently being developed nationally and internationally but are not yet widely integrated into emergency medical training and education. In the second part of the investigation, 25 participants (9 male, 16 female, 20 physicians and 5 nurses) were included in 4 multiprofessional emergency medical simulation training sessions. The most important interests of the participants were the problems for training and further education concerning palliative emergencies described in the national and international literature. The literature review and the expectations of the participants underlined that the development and characteristics of palliative emergencies will become increasingly more important in outpatient emergency medicine. All participants considered palliative care to be very important concerning the competency for end-of-life decisions in palliative patients. For this reason, special curricula and simulation for dealing with palliative care patients and special treatment decisions in emergency situations seem to be necessary.

Emergency thoracotomies: Two center study.

PubMed

Sersar, Sameh Ibrahim; Alanwar, Mohammed Adel

2013-01-01

Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support. Emergency thoracotomy has an important role in emergency big volume hospitals and can save a lot of lives. Outcome can be improved by increasing the learning curve and the integrated cooperation of the emergency and surgical teams.

Community preparedness for emergency: a cross-sectional survey of residents in Heilongjiang of China.

PubMed

Xu, Weilan; Hao, Yanhua; Wu, Qunhong; Ning, Ning; You, Jia; Liu, Chaojie; Jiao, Mingli; Gao, Lijun; Kang, Zheng; Liang, Libo; Sun, Hong; Cui, Yu; Li, Ye; Han, Xiaonan; Fang, Xin; Zhao, Xiyan; Hu, Man; Ding, Ding; Gao, Hao; Lu, Jun

2015-11-09

This article aims to identify factors that shape the knowledge, attitudes and behaviours of community residents in China's Heilongjiang province towards emergency preparedness. Findings of such a study may provide evidence to support the development of effective public risk communication strategies and education campaigns. A cross-sectional household questionnaire survey was conducted in Heilongjiang province in 2014. A stratified cluster sampling strategy was employed to select study participants. The questionnaires were administered using face-to-face interviews. 2800 questionnaires were completed, among which 2686 (95.9%) were considered valid for data analyses. A multivariate logistic regression model was adopted to identify the extent to which the independent variables were associated with emergency preparedness. Fewer than 5% respondents were well prepared for emergency. Over half (52%) of poorly prepared respondents did not know what to do in emergency; women (OR=1.691), higher household income (OR ranging from 1.666 to 2.117), previous experience with emergency (OR=1.552), higher levels of knowledge about emergency (OR=2.192), risk awareness (OR=1.531), self-efficacy (OR=1.796), as well as positive attitudes towards emergency preparedness (OR=2.265) were significant predictors for emergency preparedness. Neither educational attainment nor exposure to awareness-raising entered into the logic regression model as a significant predictor for emergency preparedness. The level of emergency preparedness in Heilongjiang residents is very low, which is linked with poor knowledge and attitudes of the residents towards emergency preparedness. Future emergency awareness campaigns should be more focused and tailored to the needs of intended audience, taking into consideration of their usual source of information and knowledge in relation to emergency. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Self-reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: a national survey.

PubMed

Al-Shaqsi, Sultan; Gauld, Robin; McBride, David; Al-Kashmiri, Ammar; Al-Harthy, Abdullah

2015-02-01

Disasters occur more frequently. Acute care providers are the first to respond to mass emergencies from the healthcare sector. The preparedness of acute care providers in New Zealand to respond to mass emergencies has not been previously studied. To assess the self-reported training and experience of New Zealand acute care providers to respond to mass emergencies and the factors associated with strong preparedness. A cross-sectional national survey of 1500 acute care providers in New Zealand carried out between 2009 and 2010. The survey assessed experience, training and self-reported preparedness. It also determined the factors associated with strong perceived preparedness. The response rate to this survey was 60.7%. Nurses had a higher response rate than doctors or paramedics. Only 29.2% of acute care providers reported responding to a previous mass emergency event. There were 53.5% of acute care providers who reported having formal training in how to deal with mass emergencies, whereas 58.1% of participants reported that they were aware of their role during a healthcare mass emergency response. The factors associated with self-reported strong preparedness to deal with mass emergencies included: being a paramedic, previous training, participation in a drill, willingness to report to work during an infection or man-made emergency, ability to triage and general awareness of the role during a mass emergency. Almost half of New Zealand acute healthcare providers have no training in dealing with mass emergency events. Training and general awareness of the role during a mass emergency response were the main factors associated with strong self-reported preparedness of acute care providers. The apparent efficacy of training allied to lack of availability means that it should be a national priority. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Pediatric emergencies on a US-based commercial airline.

PubMed

Moore, Brian R; Ping, Jennifer M; Claypool, David W

2005-11-01

The purpose of this investigation was to determine the incidence and character of pediatric emergencies on a US-based commercial airline and to evaluate current in-flight medical kits. In-flight consultations to a major US airline by a member of our staff are recorded in an institutional database. In this observational retrospective review, the database was queried for consultations for all passengers up to 18 years old between January 1, 1995, and December 31, 2002. Consultations were reviewed for type of emergency, use of the medical kit, and unscheduled landings. Two hundred twenty-two pediatric consultations were identified, representing 1 pediatric call per 20,775 flights. The mean age of patients was 6.8 years. Fifty-three emergencies were preflight calls, and 169 were in-flight pediatric consultations. The most common in-flight consultations concerned infectious disease (45 calls, 27%), neurological (25 calls, 15%), and respiratory tract (22 calls, 13%) emergencies. The emergency medical kit was used for 60 emergencies. Nineteen consultations (11%) resulted in flight diversions (1/240,000 flights), most commonly because of in-flight neurological (9) and respiratory tract (5) emergencies. International flights had a higher incidence than domestic flights of consultations and diversions for pediatric emergencies. The most common in-flight pediatric emergencies involved infectious diseases and neurological and respiratory tract problems. Emergency medical kits should be expanded to include pediatric medications.

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

PubMed Central

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

2015-01-01

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

The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) and Substance Use Among College Students.

PubMed

Allem, Jon-Patrick; Sussman, Steve; Unger, Jennifer B

2017-12-01

Transition-to-adulthood themes, or thoughts and feelings about emerging adulthood, have been measured by the Inventory of the Dimensions of Emerging Adulthood (IDEA) and found to be associated with substance use among emerging adults. It has been suggested, however, that the IDEA is lengthy and may not include the most unique and theoretically relevant constructs of emerging adulthood. The Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) was developed as an alternative instrument, but research has yet to determine the relationship between the IDEA-R and substance use among emerging adults (ages 18-25 years). College students completed surveys indicating their identification with transition-to-adulthood themes and substance use. Logistic regression models examined the associations between transition-to-adulthood themes and marijuana use and binge drinking, respectively. Participants who felt emerging adulthood was a time of identity exploration were less likely to report marijuana use, while feelings of experimentation/possibility were positively associated with marijuana use and binge drinking. The IDEA-R may be useful for identifying correlates of substance use among emerging adults. Future research should evaluate the IDEA-R among representative samples of emerging adults to confirm the findings of this study. Health professionals working in substance use prevention may consider targeting the themes of identity exploration and experimentation/possibility in programs intended for emerging adults.

Universality of emergent states in diverse physical systems

NASA Astrophysics Data System (ADS)

Guidry, Mike

2017-12-01

Our physics textbooks are dominated by examples of simple weakly-interacting microscopic states, but most of the real world around us is most effectively described in terms of emergent states that have no clear connection to simple textbook states. Emergent states are strongly-correlated and dominated by properties that emerge as a consequence of interactions and are not part of the description of the corresponding weakly-interacting system. This paper proposes a connection of weakly-interacting textbook states and realistic emergent states through fermion dynamical symmetries having fully-microscopic generators of the emergent states. These imply unique truncation of the Hilbert space for the weakly-interacting system to a collective subspace where the emergent states live. Universality arises because the possible symmetries under commutation of generators, which transcend the microscopic structure of the generators, are highly restricted in character and determine the basic structure of the emergent state, with the microscopic structure of the generators influencing emergent state only parametrically. In support of this idea we show explicit evidence that high-temperature superconductors, collective states in heavy atomic nuclei, and graphene quantum Hall states in strong magnetic fields exhibit a near-universal emergent behavior in their microscopically-computed total energy surfaces, even though these systems share essentially nothing in common at the microscopic level and their emergent states are characterized by fundamentally different order parameters.

Clinician awareness of tetanus-diphtheria vaccination in trauma patients: a questionnaire study

PubMed Central

2012-01-01

Background Most trauma patients visit the hospital via the emergency department. They are at high risk for tetanus infection because many trauma patients are wounded. Tetanus immunity in the Korean population has been revealed to be decreased in age groups over 20 years old. It is important for emergency physicians to vaccinate patients with the tetanus booster in wound management. Methods Questionnaires were sent to the directors of the emergency departments of resident training hospitals certified by the Korean Society of Emergency Medicine. Results Two thirds of the emergency department directors surveyed reported applying tetanus prophylaxis guidelines to more than 80% of wounded patients. However, about 45% of clinicians in the emergency departments considered giving less than half of the wounded patient tetanus booster vaccinations, and there were no distinct differences in tetanus booster vaccination rates among different age groups. Most emergency physicians are familiar with tetanus prophylaxis guidelines for wound management. However, more than half of the emergency department directors reported that the major reason for not considering tetanus-diphtheria vaccination was due to assumptions that patients already had tetanus immunity. Conclusion Attitude changes should be encouraged among emergency physicians regarding tetanus prophylaxis. As emergency physicians are frequently confronted with patients that are at a high risk for tetanus infection in emergency situations, they need to be more informed regarding tetanus immunity epidemiology and encouraged to administer tetanus booster vaccines. PMID:22587533

44 CFR 352.28 - Reimbursement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement. 352.28 Section 352.28 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal...

40 CFR 300.200 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Preparedness § 300.200 General. This subpart summarizes emergency preparedness activities relating... local emergency preparedness activities under SARA Title III, also known as the “Emergency Planning and... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND...

44 CFR 334.2 - Policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... government to meet essential defense and civilian needs during any national security emergency. Accordingly, each Federal department and agency shall prepare its national security emergency preparedness plans and...

When to use the emergency room - child

MedlinePlus

Emergency room - child; Emergency department - child; Urgent care - child; ER - when to use ... How quickly does your child need care? If your child could die or be permanently disabled, it is an emergency. Call 911 to have the ...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

44 CFR 352.25 - Limitation on committing Federal facilities and resources for emergency preparedness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... licensee offsite emergency response plan only to the extent necessary to compensate for the... response plan. ... Federal facilities and resources for emergency preparedness. 352.25 Section 352.25 Emergency Management...

Applying the lessons of maternal mortality reduction to global emergency health

PubMed Central

Skog, Alexander P; Tenner, Andrea G; Wallis, Lee A

2015-01-01

Abstract Over the last few decades, maternal health has been a major focus of the international community and this has resulted in a substantial decrease in maternal mortality globally. Although, compared with maternal illness, medical and surgical emergencies account for far more morbidity and mortality, there has been less focus on global efforts to improve comprehensive emergency systems. The thoughtful and specific application of the concepts used in the effort to decrease maternal mortality could lead to major improvements in global emergency health services. The so-called three-delay model that was developed for maternal mortality can be adapted to emergency service delivery. Adaptation of evaluation frameworks to include emergency sentinel conditions could allow effective monitoring of emergency facilities and further policy development. Future global emergency health efforts may benefit from incorporating strategies for the planning and evaluation of high-impact interventions. PMID:26240463

Emergent Constraints for Cloud Feedbacks and Climate Sensitivity

DOE PAGES

Klein, Stephen A.; Hall, Alex

2015-10-26

Emergent constraints are physically explainable empirical relationships between characteristics of the current climate and long-term climate prediction that emerge in collections of climate model simulations. With the prospect of constraining long-term climate prediction, scientists have recently uncovered several emergent constraints related to long-term cloud feedbacks. We review these proposed emergent constraints, many of which involve the behavior of low-level clouds, and discuss criteria to assess their credibility. With further research, some of the cases we review may eventually become confirmed emergent constraints, provided they are accompanied by credible physical explanations. Because confirmed emergent constraints identify a source of model errormore » that projects onto climate predictions, they deserve extra attention from those developing climate models and climate observations. While a systematic bias cannot be ruled out, it is noteworthy that the promising emergent constraints suggest larger cloud feedback and hence climate sensitivity.« less

Rebuilding Emergency Care After Hurricane Sandy.

PubMed

Lee, David C; Smith, Silas W; McStay, Christopher M; Portelli, Ian; Goldfrank, Lewis R; Husk, Gregg; Shah, Nirav R

2014-04-09

A freestanding, 911-receiving emergency department was implemented at Bellevue Hospital Center during the recovery efforts after Hurricane Sandy to compensate for the increased volume experienced at nearby hospitals. Because inpatient services at several hospitals remained closed for months, emergency volume increased significantly. Thus, in collaboration with the New York State Department of Health and other partners, the Health and Hospitals Corporation and Bellevue Hospital Center opened a freestanding emergency department without on-site inpatient care. The successful operation of this facility hinged on key partnerships with emergency medical services and nearby hospitals. Also essential was the establishment of an emergency critical care ward and a system to monitor emergency department utilization at affected hospitals. The results of this experience, we believe, can provide a model for future efforts to rebuild emergency care capacity after a natural disaster such as Hurricane Sandy. (Disaster Med Public Health Preparedness. 2014;0:1-4).

Errors in imaging patients in the emergency setting

PubMed Central

Reginelli, Alfonso; Lo Re, Giuseppe; Midiri, Federico; Muzj, Carlo; Romano, Luigia; Brunese, Luca

2016-01-01

Emergency and trauma care produces a “perfect storm” for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements to reduce errors in the emergency setting are knowledge, experience and the correct application of imaging protocols. This article aims to highlight the definition and classification of errors in radiology, the causes of errors in emergency radiology and the spectrum of diagnostic errors in radiography, ultrasonography and CT in the emergency setting. PMID:26838955

The Emergency Care of Patients With Cancer: Setting the Research Agenda.

PubMed

Brown, Jeremy; Grudzen, Corita; Kyriacou, Demetrios N; Obermeyer, Ziad; Quest, Tammie; Rivera, Donna; Stone, Susan; Wright, Jason; Shelburne, Nonniekaye

2016-12-01

To identify research priorities and appropriate resources and to establish the infrastructure required to address the emergency care of patients with cancer, the National Institutes of Health's National Cancer Institute and the Office of Emergency Care Research sponsored a one-day workshop, "Cancer and Emergency Medicine: Setting the Research Agenda," in March 2015 in Bethesda, MD. Participants included leading researchers and clinicians in the fields of oncology, emergency medicine, and palliative care, and representatives from the National Institutes of Health. Attendees were charged with identifying research opportunities and priorities to advance the understanding of the emergency care of cancer patients. Recommendations were made in 4 areas: the collection of epidemiologic data, care of the patient with febrile neutropenia, acute events such as dyspnea, and palliative care in the emergency department setting. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Designing a Clinical Dashboard to Fill Information Gaps in the Emergency Department

PubMed Central

Swartz, Jordan L.; Cimino, James J.; Fred, Matthew R.; Green, Robert A.; Vawdrey, David K.

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties. PMID:25954420

Errors in imaging patients in the emergency setting.

PubMed

Pinto, Antonio; Reginelli, Alfonso; Pinto, Fabio; Lo Re, Giuseppe; Midiri, Federico; Muzj, Carlo; Romano, Luigia; Brunese, Luca

2016-01-01

Emergency and trauma care produces a "perfect storm" for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements to reduce errors in the emergency setting are knowledge, experience and the correct application of imaging protocols. This article aims to highlight the definition and classification of errors in radiology, the causes of errors in emergency radiology and the spectrum of diagnostic errors in radiography, ultrasonography and CT in the emergency setting.

Designing a clinical dashboard to fill information gaps in the emergency department.

PubMed

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

[Advance directives in prehospital emergency treatment : prospective questionnaire-based analysis].

PubMed

Brokmann, J C; Grützmann, T; Pidun, A K; Groß, D; Rossaint, R; Beckers, S K; May, A T

2014-01-01

The handling of advance directives (AD) in prehospital emergency treatment in Germany is characterized by instability. In the project "Advance directives in preclinical emergency medical aid" ("Patientenverfügungen in der präklinischen Notfallmedizin") the frequency and quality of ADs in emergency situations was investigated. The aim of this study was to fill the gaps in research and to collate data on how consideration of the self-determination of patients in emergency situations can be optimized. Over a period of 12 months from December 2007 to December 2008 a questionnaire was included in the emergency documentation of the medical emergency service in Aachen. Emergency patients were asked by emergency physicians to provide an AD and the quantitative as well as qualitative features of these ADs were examined. Furthermore, the study recorded what kinds of problems occurred with ADs in emergency situations and what measures were needed to correct this deficiency. The reactions of patients were documented on a numeral rating scale with a score of 1 reflecting a negative and 10 reflecting a positive reaction. In the 12-month period emergency doctors recorded 1,321 missions and after application of the exclusion criteria (e.g. missing signature, incomplete documentation and late delivery) 1,047 documented questionnaires were available for the analysis. A total of 127 out of 1,047 emergency patients provided an AD, 44 had a durable power of attorney and 27 had appointed a legal representative for healthcare. Of the emergency patients 20 had a legal attendant and 43 out of the 127 ADs could be presented to the emergency team during the emergency mission. The emergency team often encountered difficulties regarding the handling of the ADs due to the time factor and unclear wording. The latter included the following problems: misleading formulation (19.1 %), difficulty with the complexity (14.9 %) and contradicting information (4 %). Only 29 (61.7 %) of the durable powers of attorney were signed and legally binding. From the view of the emergency physicians the following information was lacking but would be helpful in emergency situations: emergency plan, hierarchy of those given power of attorney, knowledge of risks regarding ADs and medication requirements. The results show that for an AD to apply in an emergency situation certain standards are necessary that assure the practicability, especially if a patient does not wish to be resuscitated. Most difficulties with ADs occurred with imprecise formulation, text length and inconsistency of statements. The following instructions were usually missing: hierarchy of those given power of attorney and specification on medication, information about the scope of the ADs, statement about resuscitation, extent and limitations of the desired treatment, especially with patients certified as terminally ill and instructions on who should decide about medical treatment in a conflict situation. A so-called emergency instruction which gives on a single page the patient's statement on resuscitation would have been very helpful in individual cases. The results suggest that patients may need more information and education about AD to guarantee patients rights and self-determination.

46 CFR 35.10-5 - Muster lists, emergency signals, and manning-T/ALL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Muster lists, emergency signals, and manning-T/ALL. 35.10-5 Section 35.10-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Fire and Emergency Requirements § 35.10-5 Muster lists, emergency signals, and manning—T/ALL. The requirements for muster lists, emergency signals, and...

Emergency contraception: Focus on the facts.

PubMed

Najera, Deanna Bridge

2016-01-01

Significant progress on contraception, and in particular emergency contraception, has been made in the past decade. Emergency contraception was first introduced as a stand-alone prescription in 1998, and the interaction of politics and medicine meant a tumultuous course to the drug becoming available over the counter. This article reviews how emergency contraception works, the effectiveness of different methods, pros and cons, and the history of emergency contraception.

Obstetrical emergencies.

PubMed

Biddle, D; Macintire, D K

2000-05-01

This article discusses different techniques that can be used in the diagnosis and treatment of obstetrical emergencies. Female reproductive emergencies commonly encountered by small animal practitioners include pyometra, dystocia, cesarean section, mastitis, eclampsia, uterine torsion, and uterine prolapse. A thorough knowledge of normal and abnormal reproductive behavior will aid the emergency veterinarian in successfully managing such cases. Timely diagnosis and treatment of these emergencies will often give a good outcome.

American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2017-2018).

PubMed

Nelson, Lewis S; Keim, Samuel M; Baren, Jill M; Beeson, Michael S; Carius, Michael L; Chudnofsky, Carl R; Gausche-Hill, Marianne; Goyal, Deepi G; Kowalenko, Terry; Marco, Catherine A; Muelleman, Robert L; Johnston, Mary M; Joldersma, Kevin B

2018-05-01

The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine-sponsored residency and fellowship programs, as well as the residents and fellows training in those programs. We present the 2018 annual report on the status of US emergency medicine training programs. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Pediatric Abdominal Pain: An Emergency Medicine Perspective.

PubMed

Smith, Jeremiah; Fox, Sean M

2016-05-01

Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. Copyright © 2016 Elsevier Inc. All rights reserved.

General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management.

PubMed

Greenwood, M; Meechan, J G

2014-06-13

Dental practitioners need knowledge of the diagnosis and management of medical emergencies. This paper deals with the general aspects of emergency treatment including basic management principles which are applicable to all emergencies. The next paper in this series, part 3, deals with more specific aspects of medical emergency management.

[Activity report on a rapid post-emergency consultation for the management of dermatological emergencies [corrected

PubMed

Ingen-Housz-Oro, S; Mirkamali, A; Valeyrie-Allanore, L; Chosidow, O; Wolkenstein, P

2010-01-01

Dermatological emergencies generally consist of infection and inflammation, including cutaneous drug reactions. Most patients are either not seen again or else are followed by their GP, but it may be a long time before they see a dermatologist once more, even if monitoring is necessary. We created a rapid post-emergency consultation reserved for these patients alone requiring short-term reevaluation, and we report the results of the new consultation herein. One consultation per week is exclusively for patients seen in dermatological emergency units requiring rapid reassessment (i.e. within two weeks) for follow-up or in cases of uncertainty in the diagnosis. Between June 2008 and June 2009, 40 consultations were carried out, with 370 patients being enrolled and 214 attending the consultation (40% absenteeism), i.e. 3% of emergency unit patients. The mean time from the emergency consultation was 9.2 days and the reasons for consultation were: 34% infectious dermatoses, 36% inflammatory dermatoses, 7.5% cutaneous drug reactions and 19% miscellaneous diagnosis, with 4.2% uncertainty about diagnosis. The outcome after the emergency consultation was favourable in 76% of cases (complete healing or improvement). A follow-up consultation was proposed in 41.5% of cases, with 77.5% of patients attending. While the creation of this consultation did not significantly reduce the number of patients returning to the emergency service, it was welcomed by all dermatologists in charge of such dermatological emergency services. This rapid post-emergency consultation forms a small part of the activities of the dermatological emergency unit but is positive in the view of the dermatologists in charge of emergency consultations since it means patients can be given appointments soon after initial treatment, thus avoiding the need to return to the emergency unit. The diseases seen at this unit are similar to those seen in the emergency unit. While absenteeism is considerable, this type of consultation results in the organisation of further ongoing care for 40% of patients, most of whom comply with treatment. Copyright 2010 Elsevier Masson SAS. All rights reserved.

Emergency contraception.

PubMed

2012-12-01

Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives.

Redefining disease emergence to improve prioritization and macro-ecological analyses.

PubMed

Rosenthal, Samantha R; Ostfeld, Richard S; McGarvey, Stephen T; Lurie, Mark N; Smith, Katherine F

2015-12-01

Microbial infections are as old as the hosts they sicken, but interest in the emergence of pathogens and the diseases they cause has been accelerating rapidly. The term 'emerging infectious disease' was coined in the mid-1900s to describe changes in disease dynamics in the modern era. Both the term and the phenomena it is meant to characterize have evolved and diversified over time, leading to inconsistencies and confusion. Here, we review the evolution of the term 'emerging infectious disease' (EID) in the literature as applied to human hosts. We examine the pathways (e.g., speciation or strain differentiation in the causative agent vs. rapid geographic expansion of an existing pathogen) by which diseases emerge. We propose a new framework for disease and pathogen emergence to improve prioritization. And we illustrate how the operational definition of an EID affects conclusions concerning the pathways by which diseases emerge and the ecological and socioeconomic drivers that elicit emergence. As EIDs appear to be increasing globally, and resources for science level off or decline, the research community is pushed to prioritize its focus on the most threatening diseases, riskiest potential pathogens, and the places they occur. The working definition of emerging infectious diseases and pathogens plays a crucial role in prioritization, but we argue that the current definitions may be impeding these efforts. We propose a new framework for classifying pathogens and diseases as "emerging" that distinguishes EIDs from emerging pathogens and novel potential pathogens. We suggest prioritization of: 1) EIDs for adaptation and mitigation, 2) emerging pathogens for preventive measures, and 3) novel potential pathogens for intensive surveillance.

Interdisciplinary approaches to understanding disease emergence: the past, present, and future drivers of Nipah virus emergence.

PubMed

Daszak, Peter; Zambrana-Torrelio, Carlos; Bogich, Tiffany L; Fernandez, Miguel; Epstein, Jonathan H; Murray, Kris A; Hamilton, Healy

2013-02-26

Emerging infectious diseases (EIDs) pose a significant threat to human health, economic stability, and biodiversity. Despite this, the mechanisms underlying disease emergence are still not fully understood, and control measures rely heavily on mitigating the impact of EIDs after they have emerged. Here, we highlight the emergence of a zoonotic Henipavirus, Nipah virus, to demonstrate the interdisciplinary and macroecological approaches necessary to understand EID emergence. Previous work suggests that Nipah virus emerged due to the interaction of the wildlife reservoir (Pteropus spp. fruit bats) with intensively managed livestock. The emergence of this and other henipaviruses involves interactions among a suite of anthropogenic environmental changes, socioeconomic factors, and changes in demography that overlay and interact with the distribution of these pathogens in their wildlife reservoirs. Here, we demonstrate how ecological niche modeling may be used to investigate the potential role of a changing climate on the future risk for Henipavirus emergence. We show that the distribution of Henipavirus reservoirs, and therefore henipaviruses, will likely change under climate change scenarios, a fundamental precondition for disease emergence in humans. We assess the variation among climate models to estimate where Henipavirus host distribution is most likely to expand, contract, or remain stable, presenting new risks for human health. We conclude that there is substantial potential to use this modeling framework to explore the distribution of wildlife hosts under a changing climate. These approaches may directly inform current and future management and surveillance strategies aiming to improve pathogen detection and, ultimately, reduce emergence risk.

Parental Physical Force and Alcohol Use in Emerging Adults: Mediation by Psychological Problems.

PubMed

Pollard, Mary Ward; McKinney, Cliff

2016-07-01

Research has indicated that negative parenting practices, such as physical punishment, are associated with negative outcomes in children. These negative outcomes can present during childhood and during emerging adulthood. One negative consequence can be excessive alcohol use, a problematic outcome with its own myriad consequences. The goal of the current study was to examine the effects of parental physical force on emerging adult functioning, specifically alcohol and psychological problems. A sample of 488 young adults completed questionnaires on current perceptions related to alcohol-related problems, physical and psychological aggression by their parents experienced during the previous year, and current emotional and behavioral functioning. Results showed full mediation between paternal physical force and emerging adult alcohol problems by emerging adult psychological problems. Emerging adult psychological problems partially mediated the effect of maternal physical force on emerging adult alcohol problem. Gender did not moderate these effects. The results support existing literature suggesting that the use of parental physical force may lead to a chain reaction of problems, even during emerging adulthood. These results also reveal that emerging adults report currently receiving physical force from their parents, which brings to light a concerning lack of literature on the use of parental physical force on emerging adult children. These results advocate for positive parenting practives and efforts to teach them, even for emerging adult children. The results may also clinically suggest that paying attention to parental force in emerging adult clients could yield a better understanding of their current functioning, especially including excessive alcohol use.

An intensive assessment of alcohol use and emergency department utilization in homeless alcohol-dependent adults.

PubMed

Holtyn, August F; Jarvis, Brantley P; Subramaniam, Shrinidhi; Wong, Conrad J; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

2017-09-01

Excessive alcohol use among the homeless may contribute to their high rates of emergency department use. Survey-based studies have provided some information on the relation between alcohol and emergency department use among the homeless. This study used an intensive schedule of random breath collections and self-report assessments to examine the relation between emergency department utilization and alcohol use in homeless alcohol-dependent adults. Data were from homeless alcohol-dependent adults (N=116) who were participating in a therapeutic workplace that provided job-skills training every weekday for 26 weeks. Breath-sample collections and assessments of self-reported alcohol use were scheduled each week, an average of twice per week per participant, at random times between 9:00 A.M. and 5:00 P.M. Participants received $35 for each breath sample collected. Self-reports of emergency department use were assessed throughout the study. Thirty-four percent of participants reported attending an emergency department and reported an average of 2.2 emergency department visits (range 1-10 visits). Alcohol intoxication was the most common reason for emergency department use. Participants who used the emergency department had significantly more alcohol-positive breath samples and more self-reported heavy alcohol use than participants who did not use the emergency department. This study provided a rare intensive assessment of alcohol and emergency department use in homeless alcohol-dependent adults over an extended period. Emergency department use was high and was significantly related to indices of alcohol use. Copyright © 2017 Elsevier B.V. All rights reserved.

Evolution of European Union legislation on emergency research.

PubMed

Mentzelopoulos, Spyros D; Mantzanas, Michail; van Belle, Gerald; Nichol, Graham

2015-06-01

Emergency research is necessary to prevent exposure of patients to unvalidated clinical practice (nonmaleficence), and to improve the dismal prognosis of disorders requiring emergent treatment such as cardiac arrest (beneficence). Regulations that govern clinical research should conform to bioethical principles of respect for nonmaleficence, beneficence, autonomy, and justice. Our objectives are to review the evolution of European Union (EU) legislation on emergency research, and to identify potentially remaining problems. EU legislative sources on clinical research and medical literature describing the impact of EU Regulations on emergency research. Article 5 of EU Directive 2001/20/EC required consent before enrolment in a research study to ensure the autonomy of potentially incapacitated research subjects. However, obtaining such consent is often impossible in emergency situations. Directive 2001/20/EC was criticized for potentially preventing emergency research. Several EU Member States addressed this problem by permitting deferred consent. International ethical guidelines supporting deferred consent were also cited by Good Clinical Practice Directive 2005/28/EC. However, Directive 2001/20/EC was not revised to achieve harmonization of EU emergency research, thus resulting in ongoing "ambiguity" as regards to emergency research legitimacy. This will be definitively addressed by applying EU Regulation No. 536/2014 and repealing Directive 2001/20/EC. The new EU Regulation permits using deferred consent under clearly specified conditions, and may foster emergency research that evaluates interventions posing minimal risk relative to standard practice. Legislation related to emergency research in Europe has evolved to increase concordance with bioethical principles so as to increase evidence-based improvements in emergency care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Frequency of in-office emergencies in primary care

PubMed Central

Liddy, Clare; Dreise, Heather; Gaboury, Isabelle

2009-01-01

ABSTRACT OBJECTIVE To quantify the frequency and types of in-office emergencies seen by FPs. DESIGN A retrospective descriptive analysis of the frequency and types of in-office emergencies seen by FPs was done using the City of Ottawa Emergency Medical Services database. SETTING Community medical offices in the Ottawa, Ont, region during a 3-year period (2004 to 2006). PARTICIPANTS All patients for whom an ambulance was called to a medical office or clinic during the study period. MAIN OUTCOME MEASURES Number of emergency calls from FPs’ offices, primary complaints, seasonal variation, distance to the nearest emergency facility, and patients’ demographic characteristics. RESULTS A total of 3033 code 04 (life-threatening) emergency calls were received from FPs’ offices during the study period. Demographic analysis of the calls showed that 91.3% of calls were regarding adult patients with an average age of 51.5 years. There was an overall statistically significant difference in the sex of the patients presenting (P < .001), but it was attributable to calls about genitourinary emergencies, which were almost all for women. The most common type of emergency reported was cardiovascular complaints. Of the 992 cardiovascular emergencies, 74.3% were complaints of ischemic chest pain. CONCLUSION There is a great burden on the health care system from emergency calls, with continued unpreparedness from FPs. Clearly, FPs must take seriously the risk of being unprepared for in-office emergencies. Dissemination strategies must be developed so that the guidelines that have been developed can be effectively implemented in FP offices across the country. PMID:19826161

Recommended minimal emergency equipment and resources for schools: national consensus group report.

PubMed

Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

2003-06-01

Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency Medical Services for Children (EMSC), the National Association of School Nurses (NASN) was charged with the task of convening a consensus group to formulate a recommended list of minimal essential emergency equipment and resources that should be present in all schools. This article provides an overview of the issues surrounding minimal emergency equipment needs for schools, presents recommended minimal emergency equipment and resources, and recommendations for further actions.

78 FR 72122 - Draft Emergency Preparedness Frequently Asked Questions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-02

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0262] Draft Emergency Preparedness Frequently Asked... of guidance documents related to the development and maintenance of emergency preparedness program... the interpretation or applicability of emergency preparedness guidance issued or endorsed by the NRC...

44 CFR 352.4 - Licensee certification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Licensee certification. 352.4 Section 352.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING...

44 CFR 327.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... equipment for the emergency preparedness programs of the U.S. Government. ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Purpose. 327.1 Section 327.1 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY...

77 FR 64562 - Draft Emergency Preparedness Frequently Asked Questions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0248] Draft Emergency Preparedness Frequently Asked... Nuclear Regulatory Commission. Mark Thaggard, Deputy Director for Emergency Preparedness, Division of... comment. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) is making available for comment Emergency...

44 CFR 352.29 - Appeal process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Appeal process. 352.29 Section 352.29 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal...

44 CFR 350.4 - Exclusions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY PREPAREDNESS REVIEW AND APPROVAL OF STATE AND LOCAL RADIOLOGICAL EMERGENCY PLANS AND PREPAREDNESS... licensee emergency preparedness except as these assessments and determinations affect the emergency... planning and preparedness with respect to emergencies at commercial nuclear power facilities and does not...

77 FR 25504 - Draft Emergency Preparedness Frequently Asked Questions

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-30

... NUCLEAR REGULATORY COMMISSION [NRC-2012-0098] Draft Emergency Preparedness Frequently Asked... comment Emergency Preparedness (EP) frequently asked questions (EPFAQs). These EPFAQs will be used to... Emergency Preparedness Frequently Asked Questions is available electronically under ADAMS Accession Number...

RMP Guidance for Chemical Distributors - Chapter 8: Emergency Response Program

EPA Pesticide Factsheets

Depending on the level of processes at your facility, part 68 may require an emergency response program: an emergency response plan, emergency response equipment procedures, employee training, and procedures to ensure the program is up-to-date.

46 CFR 112.30-1 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-1 General. This subpart contains requirements applicable to emergency power installations having...

46 CFR 112.30-1 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-1 General. This subpart contains requirements applicable to emergency power installations having...

46 CFR 112.30-1 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-1 General. This subpart contains requirements applicable to emergency power installations having...

46 CFR 112.30-1 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-1 General. This subpart contains requirements applicable to emergency power installations having...

46 CFR 112.30-1 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING EMERGENCY LIGHTING AND POWER SYSTEMS Emergency Systems Having an Automatically Connected Storage Battery as the Sole Emergency Power Source § 112.30-1 General. This subpart contains requirements applicable to emergency power installations having...

Emergency preparedness for those who care for infants in developed country contexts

PubMed Central

2011-01-01

Emergency management organisations recognise the vulnerability of infants in emergencies, even in developed countries. However, thus far, those who care for infants have not been provided with detailed information on what emergency preparedness entails. Emergency management authorities should provide those who care for infants with accurate and detailed information on the supplies necessary to care for them in an emergency, distinguishing between the needs of breastfed infants and the needs of formula fed infants. Those who care for formula fed infants should be provided with detailed information on the supplies necessary for an emergency preparedness kit and with information on how to prepare formula feeds in an emergency. An emergency preparedness kit for exclusively breastfed infants should include 100 nappies and 200 nappy wipes. The contents of an emergency preparedness for formula fed infants will vary depending upon whether ready-to-use liquid infant formula or powdered infant formula is used. If ready-to-use liquid infant formula is used, an emergency kit should include: 56 serves of ready-to-use liquid infant formula, 84 L water, storage container, metal knife, small bowl, 56 feeding bottles and teats/cups, 56 zip-lock plastic bags, 220 paper towels, detergent, 120 antiseptic wipes, 100 nappies and 200 nappy wipes. If powdered infant formula is used, an emergency preparedness kit should include: two 900 g tins powdered infant formula, 170 L drinking water, storage container, large cooking pot with lid, kettle, gas stove, box of matches/lighter, 14 kg liquid petroleum gas, measuring container, metal knife, metal tongs, feeding cup, 300 large sheets paper towel, detergent, 100 nappies and 200 nappy wipes. Great care with regards hygiene should be taken in the preparation of formula feeds. Child protection organisations should ensure that foster carers responsible for infants have the resources necessary to formula feed in the event of an emergency. Exclusive and continued breastfeeding should be promoted as an emergency preparedness activity by emergency management organisations as well as health authorities. The greater the proportion of infants exclusively breastfed when an emergency occurs, the more resilient the community, and the easier it will be to provide effective aid to the caregivers of formula fed infants. PMID:22059481

Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses.

PubMed

Lin, Blossom Yen-Ju; Wan, Thomas T H; Hsu, Chung-Ping Cliff; Hung, Feng-Ru; Juan, Chi-Wen; Lin, Cheng-Chieh

2012-05-01

Given the limited studies on emergency care management, this study aimed to explore the relationships of emergency department (ED) culture values to certain dimensions of ED physicians' and nurses' work satisfaction and intent to leave. Four hundred and forty-two emergency medical professionals completed the employee satisfaction questionnaire across 119 hospital-based EDs, which had culture value evaluations filed, were used as unit of analysis in this study. Adjusting the personal and employment backgrounds, and the surrounded EDs' unit characteristics and environmental factors, multiple regression analyses revealed that clan and market cultures were related to emergency physicians' work satisfaction and intent to leave. On the other hand, adhocracy, market and hierarchical cultures were related to emergency nurses' work satisfaction. There do exist different patterns among various culture types on various work satisfaction dimensions and intent to leave of emergency physicians and nurses. The findings could offer hospital and ED leaders insights for changes or for building a better atmosphere to enhance the work life of emergency physicians and nurses.

Strengthening Emergency Care Systems to Mitigate Public Health Challenges Arising from Influxes of Individuals with Different Socio-Cultural Backgrounds to a Level One Emergency Center in South East Europe.

PubMed

Twomey, Michèle; Šijački, Ana; Krummrey, Gert; Welzel, Tyson; Exadaktylos, Aristomenis K; Ercegovac, Marko

2018-03-12

Emergency center visits are mostly unscheduled, undifferentiated, and unpredictable. A standardized triage process is an opportunity to obtain real-time data that paints a picture of the variation in acuity found in emergency centers. This is particularly pertinent as the influx of people seeking asylum or in transit mostly present with emergency care needs or first seek help at an emergency center. Triage not only reduces the risk of missing or losing a patient that may be deteriorating in the waiting room but also enables a time-critical response in the emergency care service provision. As part of a joint emergency care system strengthening and patient safety initiative, the Serbian Ministry of Health in collaboration with the Centre of Excellence in Emergency Medicine (CEEM) introduced a standardized triage process at the Clinical Centre of Serbia (CCS). This paper describes four crucial stages that were considered for the integration of a standardized triage process into acute care pathways.

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues.

PubMed

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-06

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks' statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.

Emergence of viral hemorrhagic fevers: is recent outbreak of Crimean Congo Hemorrhagic Fever in India an indication?

PubMed

Lahariya, C; Goel, M K; Kumar, A; Puri, M; Sodhi, A

2012-01-01

The emerging and re-emerging diseases are posing a great health risk for the last few years. One such category of diseases is viral haemorrhagic fevers (VHFs), which have emerged in the new territories, worldwide. Crimean Congo Hemorrhagic Fever (CCHF) cases, for the first time in India, were reported from Gujarat, in January 2011. The emergence of diseases not reported earlier, pose great economic and social challenge, burden health system, and create panic reaction. Nonetheless, with recent experience in control of epidemic diseases, and advances in basic scientific knowledge; the public health community is better prepared for these unexpected events. This review provides information to physicians on CCHF for managing outbreak, and identifies public health measures to prevent emergence and re-emergence of VHFs (including CCHF) in future. The authors suggest that though, there are a few challenging and unanswered questions, the public health preparedness still remains the key to control emerging and re-emerging diseases. The countries where virus activities have been reported need to be prepared accordingly.

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues

PubMed Central

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-01

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. PMID:29316614

Emergency Contraception in Emergency Departments in Oregon, 2003

PubMed Central

Rosenberg, Kenneth D.; DeMunter, Jodi K.; Liu, Jihong

2005-01-01

Objectives. We sought to learn about access to emergency contraception (EC) in Oregon emergency departments, both for women who are rape patients and for women who have had consensual unprotected sexual intercourse (“nonrape patients”). Methods. We interviewed emergency department staff in 54 of Oregon’s 57 licensed emergency departments in February–March 2003 (response rate = 94.7%). Results. Only 61.1% of Oregon emergency departments routinely offered EC to rape patients. Catholic hospitals were as likely as non-Catholic hospitals to routinely offer EC to rape patients. The hospitals most likely to routinely offer EC to rape patients had a written protocol for the care of rape patients that included offering EC (P = .02) and access to staff with specialized sexual assault training (P=.002). For nonrape patients, 46.3% of emergency departments discouraged the prescribing of EC. Catholic hospitals were significantly less likely than non-Catholic hospitals to provide access to EC for nonrape patients (P=.05). Conclusions. Oregon emergency departments do not routinely offer EC to women who have been raped or to women who have had consensual unprotected sexual intercourse. PMID:15985646

Emergent literacy profiles of preschool-age children with specific language impairment.

PubMed

Cabell, Sonia Q; Lomax, Richard G; Justice, Laura M; Breit-Smith, Allison; Skibbe, Lori E; McGinty, Anita S

2010-12-01

The primary aim of the present study was to explore the heterogeneity of emergent literacy skills among preschool-age children with specific language impairment (SLI) through examination of profiles of performance. Fifty-nine children with SLI were assessed on a battery of emergent literacy skills (i.e., alphabet knowledge, print concepts, emergent writing, rhyme awareness) and oral language skills (i.e., receptive/expressive vocabulary and grammar). Cluster analysis techniques identified three emergent literacy profiles: (1) Highest Emergent Literacy, Strength in Alphabet Knowledge; (2) Average Emergent Literacy, Strength in Print Concepts; and (3) Lowest Emergent Literacy across Skills. After taking into account the contribution of child age, receptive and expressive language skills made a small contribution to the prediction of profile membership. The present findings, which may be characterized as exploratory given the relatively modest sample size, suggest that preschool-age children with SLI display substantial individual differences with regard to their emergent literacy skills and that these differences cannot be fully determined by children's age or oral language performance. Replication of the present findings with a larger sample of children is needed.

[Treatment of emergencies in the hospital--problems and management].

PubMed

Sablotzki, A; Schubert, S; Kuhn, C; Radke, J; Czeslick, E

2003-01-01

Due to the growing number of high-risk patients, the increasing proportion of geriatric patients and the expansion of surgical and invasive-diagnostic procedures, medical stuff in hospitals are confronted with a rising number of emergency situations. Nearly 50% are of cardio-circulatory origin and occur during surgical interventions or immediately afterwards. Another cause of life-threatening complications are side-effects of orally or intravenously administered agents, especially after treatment with antibiotics, anaesthetics, analgetics and sedatives. Due to a lack of emergency training and management in most hospitals, the survival rate after cardiopulmonary resuscitation in general wards lies between just two and 35%. Thus it seems necessary to perform special training in CPR procedures and emergency management at regular intervals for the entire medical stuff. In addition, a special infrastructure for giving sufficient treatment in emergencies has to be established (emergency team, emergency telephone number, intra-hospital emergency car). The second part of this review presents current diagnostic and therapeutic strategies for the most common emergency situations, e.g. anaphylaxis, myocardial infarction, pulmonary embolism, gastrointestinal bleeding, and heparin-induced thrombocytopenia (HIT).

Treatment of palliative care emergencies by prehospital emergency physicians in Germany: an interview based investigation.

PubMed

Wiese, C H R; Bartels, U E; Ruppert, D; Marung, H; Luiz, T; Graf, B M; Hanekop, G G

2009-06-01

Palliative care medical emergencies as a consequence of advanced cancer account for approximately 3% of all prehospital emergency cases. Therefore, prehospital emergency physicians (EP) are confronted with 'end of life decisions'. No educational content exists concerning palliative medicine in emergency medicine curricula. Over the course of 6 months, we interviewed 150 EPs about their experiences in 'end of life decisions' using a specific questionnaire. The total response rate was 69% (n = 104). Most of the interviewed EPs (89%, n = 93) had been confronted with palliative care medical emergencies and expressed uncertainties in dealing with these difficult situations, especially in the area of psychosocial care of the patients (50%). The emergency treatment of palliative care patients can become a particular challenge for any EP. A large percentage of interviewed EPs felt uncertain about aspects of social care and in the assessment of decisions at the end of life. Further information and training are necessary to amenable EPs to provide adequate patient-oriented care to palliative care patients and their relatives in emergency situations.

Educating First Responders to Provide Emergency Services to Individuals with Disabilities

PubMed Central

Wolf-Fordham, Susan B.; Twyman, Janet S.; Hamad, Charles D.

2015-01-01

Objective Individuals with disabilities experience more negative outcomes due to natural and manmade disasters and emergencies than do people without disabilities. This vulnerability appears due in part to knowledge gaps among public health and safety emergency planning and response personnel (responders). The research assessed the effectiveness of an online program to increase emergency responder knowledge about emergency planning and response for individuals with disabilities. Method Researchers developed an online course designed to teach public health, emergency planning/management and other first response personnel about appropriate, efficient and equitable emergency planning, response, interaction and communication with children and adults with disabilities before, during and after disasters or emergencies. Course features include an ongoing storyline, exercises embedded in the form of “real life” scenarios, and game-like features such as points and timed segments. Results Evaluation measures indicated significant pre- to post-test gains in learner knowledge and simulated applied skills. Conclusion An online program using scenarios and simulations is an effective means to make disability-related training available to a wide variety of emergency responders across geographically disparate areas. PMID:25859692

PAs and NPs in an emergency room-linked acute care clinic.

PubMed

Currey, C J

1984-12-01

The use of hospital emergency rooms for nonurgent care during evenings hours often strains medical resources and may affect the quality of emergency care. One facility's effective use of an after-hours acute care clinic staffed by PAs and NPs to divert nonurgent problems away from its emergency room is outlined. PAs and NPs work during peak demand hours (evenings and weekends) under the supervision of an emergency room physician, and receive supplementary support from other emergency room personnel. Incoming patients are referred to the emergency room or acute care clinic, depending on the nature of their problems. Acute care clinic patients are then treated by the PA or NP and either released or referred to an emergency room physician, if their conditions warrant additional treatment. As a result, use of the acute care clinic has greatly reduced the amount of non-urgent medical treatment in the emergency room and has provided other advantages to both patients and staff as well. These advantages and the encouraging statistics following six months of the clinic's operation are discussed.

Emergency vehicle traffic signal preemption system

NASA Technical Reports Server (NTRS)

Foster, Conrad F. (Inventor); Bachelder, Aaron D. (Inventor)

2005-01-01

An emergency vehicle traffic light preemption system for preemption of traffic lights at an intersection to allow safe passage of emergency vehicles. The system includes a real-time status monitor of an intersection which is relayed to a communications controller for transmission to emergency vehicles as well as to a central dispatch office. The system also provides for audio warnings at an intersection to protect pedestrians who may not be in a position to see visual warnings or for various reasons cannot hear the approach of emergency vehicles. A transponder mounted on an emergency vehicle provides autonomous control so the vehicle operator can attend to getting to an emergency and not be concerned with the operation of the system. Activation of a Code 3 situation provides communications with each intersection being approached by an emergency vehicle and indicates whether the intersection is preempted or if there is any conflict with other approaching emergency vehicles. On-board diagnostics handle various information including heading, speed, and acceleration sent to a communications controller which is transmitted to an intersection and which also simultaneously receives information regarding the status of an intersection.

APIC State-of-the-Art Report: the role of the infection preventionist in emergency management.

PubMed

Rebmann, Terri

2009-05-01

This report summarizes the scope and role of infection preventionists in emergency management for all types of disasters. Preventing the transmission of infectious agents during a disaster is an essential component of emergency management. Previous disasters have illustrated the need for better infection prevention and the involvement of an infection prevention professional in planning for and responding to such events. An evidence-based approach was used, consisting of a literature review and review by members of the Association for Professionals in Infection Control and Epidemiology, Inc, Emergency Preparedness Committee. Nine domains were identified that describe the role of the infection preventionist in emergency management: knowledge of disasters and emergency management, assessing readiness and emergency management plans, infection prevention coverage, participation in disaster response and recovery, health care policy development, surveillance, patient management, physical plant issues, and infection preventionist as educator. Details for each domain are provided. Infection preventionists need to become more involved in emergency management at the personal, facility, and community level. This report outlines the infection preventionist's responsibilities related to emergency management.

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

PubMed

Bosomworth, Karyn; Owen, Christine; Curnin, Steven

2017-04-01

The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

PubMed Central

2013-01-01

Background A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks. Methods This was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index – the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used. Results Information on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B–D patients was 14.3 (95% CI: 11.5-18.0). Conclusion The majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B–D patients. Thus, the newly implemented Danish criteria-based dispatch system seems to triage patients with high risk of admission and death to the highest level of emergency. Further studies are needed to determine the degree of over- and undertriage and prognostic factors. PMID:23835246

44 CFR 352.7 - Review and evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Review and evaluation. 352.7 Section 352.7 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING...

44 CFR 352.3 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Purpose and scope. 352.3 Section 352.3 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING...

44 CFR 60.26 - Local coordination.

Code of Federal Regulations, 2010 CFR

2010-10-01

...., mudflow) and flood-related erosion area management, forecasting, emergency preparedness, and damage... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Local coordination. 60.26 Section 60.26 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF...

44 CFR 150.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Civil defense officer (or member of a recognized civil defense or emergency preparedness organization... Emergency Preparedness Director/Coordinator in accordance with a Federal, State or local emergency plan and... officer (or member of a recognized civil defense or emergency preparedness organization), or a law...

78 FR 33862 - Draft Emergency Preparedness Frequently Asked Questions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-05

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0113] Draft Emergency Preparedness Frequently Asked... Commission. William Gott, Acting Deputy Director for Emergency Preparedness, Division of Preparedness and... comment. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) is making available for comment Emergency...

44 CFR 327.4 - Disputes.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Disputes. 327.4 Section 327.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... Defense in accordance with this order, the Administrator, Federal Emergency Management Agency, shall...

44 CFR 327.4 - Disputes.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Disputes. 327.4 Section 327.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... Defense in accordance with this order, the Administrator, Federal Emergency Management Agency, shall...

44 CFR 327.4 - Disputes.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Disputes. 327.4 Section 327.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... Defense in accordance with this order, the Administrator, Federal Emergency Management Agency, shall...

44 CFR 327.4 - Disputes.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Disputes. 327.4 Section 327.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... Defense in accordance with this order, the Administrator, Federal Emergency Management Agency, shall...

44 CFR 206.225 - Emergency work.

Code of Federal Regulations, 2010 CFR

2010-10-01

... needs have been met. (d) Emergency public transportation. Emergency public transportation to meet emergency needs and to provide transportation to public places and such other places as necessary for the... HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Public Assistance Eligibility § 206.225...

Speeding response -- saving lives : automatic vehicle location capabilities for emergency vehicles

DOT National Transportation Integrated Search

1999-01-01

This brochure focuses on the application of automatic vehicle location systems to emergency services. It discusses how AVL works with emergency vehicles. how it accommodates a wide range of emergency situations, and the benefits of its use.

46 CFR 133.80 - Emergency instructions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Emergency instructions. 133.80 Section 133.80 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OFFSHORE SUPPLY VESSELS LIFESAVING SYSTEMS... emergency. (b) Emergency instructions. Illustrations and instructions in English and any other appropriate...

76 FR 41273 - National Emergency Communications Plan (NECP) Tribal Report

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... DEPARTMENT OF HOMELAND SECURITY [Docket No. DHS-2011-0025] National Emergency Communications Plan... Communications (CS&C), Office of Emergency Communications (OEC), will submit the following information collection... concerning New Information Collection Request, National Emergency Communications Plan Tribal Report. DHS...

14 CFR 133.31 - Emergency operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Emergency operations. 133.31 Section 133.31... OPERATIONS Operating Rules and Related Requirements § 133.31 Emergency operations. (a) In an emergency... Amdt. 133-11, 54 FR 39294, Sept. 25, 1989] ...

44 CFR 15.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY TRAINING.... Weather means the Mt. Weather Emergency Operations Center, Bluemont, Virginia. Mt. Weather Executive Director means the Executive Director of the Mt. Weather Emergency Operations Center. NETC means the...

44 CFR 15.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY.... Weather means the Mt. Weather Emergency Operations Center, Bluemont, Virginia. Mt. Weather Executive Director means the Executive Director of the Mt. Weather Emergency Operations Center. NETC means the...

44 CFR 15.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY.... Weather means the Mt. Weather Emergency Operations Center, Bluemont, Virginia. Mt. Weather Executive Director means the Executive Director of the Mt. Weather Emergency Operations Center. NETC means the...

44 CFR 15.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY.... Weather means the Mt. Weather Emergency Operations Center, Bluemont, Virginia. Mt. Weather Executive Director means the Executive Director of the Mt. Weather Emergency Operations Center. NETC means the...

44 CFR 15.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY GENERAL CONDUCT AT THE MT. WEATHER EMERGENCY ASSISTANCE CENTER AND AT THE NATIONAL EMERGENCY.... Weather means the Mt. Weather Emergency Operations Center, Bluemont, Virginia. Mt. Weather Executive Director means the Executive Director of the Mt. Weather Emergency Operations Center. NETC means the...

78 FR 40098 - Emerging Technology and Research Advisory Committee;

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting The Emerging Technology and Research Advisory Committee (ETRAC... Assistant Secretary for Export Administration on emerging technology and research activities, including...

44 CFR 352.1 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... preparedness such as: Provision of support for the preparation off site radiological emergency response plans....1 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... the Administrator, FEMA or designee. (c) EPZ means Emergency Planning Zone. (d) FEMA means the Federal...

Curriculum for Undergraduate Education in Emergency Medicine.

ERIC Educational Resources Information Center

Brown, Charles G.; And Others

1984-01-01

As emergency medicine became a specialty, it was realized that traditional training of physicians in urgent, emergent, and acute care problems was deficient. Surveys and studies demonstrate that the emergency medicine curricula in American medical schools remains at a minimum. (MLW)

A Comprehensive Approach to Emergency Planning

ERIC Educational Resources Information Center

Worsley, Tracy L.; Beckering, Don

2007-01-01

It is essential that the traditional emergency management structure be used as a framework for higher education emergency planning. The four phases of emergency management should be reflected in the architecture of all planning efforts. These include "preparedness," "response," "mitigation," and "recovery."…

75 FR 53563 - National Preparedness Month, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-01

... America A Proclamation During National Preparedness Month, we stress the importance of strengthening the... families, our communities, and our country. The Federal Emergency Management Agency's (FEMA) Ready Campaign... on emergency preparedness, including how to prepare a family emergency plan, create an emergency...

40 CFR 265.55 - Emergency coordinator.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.55 Emergency coordinator. At all times, there must... aspects of the facility's contingency plan, all operations and activities at the facility, the location... out the contingency plan. [Comment: The emergency coordinator's responsibilities are more fully...

FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER PHYSICAL SYSTEMS

DTIC Science & Technology

2018-02-23

FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER- PHYSICAL SYSTEMS UNIVERSITY OF TEXAS AT ARLINGTON FEBRUARY 2018 FINAL...COVERED (From - To) APR 2015 – APR 2017 4. TITLE AND SUBTITLE FORMAL MODELING, MONITORING, AND CONTROL OF EMERGENCE IN DISTRIBUTED CYBER- PHYSICAL ...dated 16 Jan 09 13. SUPPLEMENTARY NOTES 14. ABSTRACT This project studied emergent behavior in distributed cyber- physical systems (DCPS). Emergent

Emergency Plan for the Locks and Dams at St. Anthony Falls Minneapolis, Minnesota

DTIC Science & Technology

1987-03-01

Identification Subplan APPENDIX B Emergency Operations and Repair Subplan APPENDIX C Emergency Notification Subplan APPENDIX D Inundation Map Package...Emergency Operations and Repair Subplan 3) Appendix C , Emergency Notification Subplan 4) Appendix D , Inundation Maps and Hydraulic Data b. AP...which were selected for planning include: a. Structural Damage b. Sabotage c . Extreme Storm d . Excess Seepage e. Failure Due to Scouring A brief dis

77 FR 5983 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

...--Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc]te d'Ivoire... February 3, 2012 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with...

77 FR 11377 - Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... Vol. 77 Friday, No. 37 February 24, 2012 Part VI The President Notice of February 23, 2012--Continuation of the National Emergency With Respect to Cuba and of the Emergency Authority Relating to the Regulation of the Anchorage and Movement of Vessels Notice of February 23, 2012--Continuation of the National Emergency With Respect to Libya #0; #0; #0;...

Death of a child in the emergency department.

PubMed

O'Malley, Patricia J; Barata, Isabel A; Snow, Sally K

2014-07-01

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association have collaborated to identify practices and principles to guide the care of children, families, and staff in the challenging and uncommon event of the death of a child in the emergency department in this policy statement and in an accompanying technical report. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Southern states radiological emergency response laws and regulations

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

Not Available

1989-07-01

The purpose of this report is to provide a summary of the emergency response laws and regulations in place in the various states within the southern region for use by legislators, emergency response planners, the general public and all persons concerned about the existing legal framework for emergency response. SSEB expects to periodically update the report as necessary. Radiation protection regulations without emergency response provisions are not included in the summary.

Avoiding emergency department visits for COPD, pneumonia, and heart failure: when should patients go to the emergency department?

PubMed

Fritz, Deborah; McKenzie, Patricia

2014-01-01

Patients with pneumonia, chronic obstructive pulmonary disease (COPD), and heart failure make frequent visits to the emergency department. Heart failure alone is the reason for more than 1 million emergency department visits annually in the United States. This article describes strategies home care clinicians can use to prevent unnecessary emergency department visits for patients with pneumonia, COPD and heart failure.

Idaho National Laboratory Emergency Readiness Assurance Plan - Fiscal Year 2015

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

Farmer, Carl J.

Department of Energy Order 151.1C, Comprehensive Emergency Management System requires that each Department of Energy field element documents readiness assurance activities, addressing emergency response planning and preparedness. Battelle Energy Alliance, LLC, as prime contractor at the Idaho National Laboratory (INL), has compiled this Emergency Readiness Assurance Plan to provide this assurance to the Department of Energy Idaho Operations Office. Stated emergency capabilities at the INL are sufficient to implement emergency plans. Summary tables augment descriptive paragraphs to provide easy access to data. Additionally, the plan furnishes budgeting, personnel, and planning forecasts for the next 5 years.

Urologic Emergencies.

PubMed

Manjunath, Adarsh S; Hofer, Matthias D

2018-03-01

Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney. Copyright © 2017 Elsevier Inc. All rights reserved.

The clinical manifestations, diagnosis, and treatment of adrenal emergencies.

PubMed

Tucci, Veronica; Sokari, Telematé

2014-05-01

Emergency medicine physicians should be able to identify and treat patients whose clinical presentations, including key historical, physical examination, and laboratory findings are consistent with diagnoses of primary, secondary, and tertiary adrenal insufficiency, adrenal crisis, and pheochromocytoma. Failure to make a timely diagnosis leads to increased morbidity and mortality. As great mimickers, adrenal emergencies often present with a constellation of nonspecific signs and symptoms that can lead even the most diligent emergency physician astray. The emergency physician must include adrenal emergencies in the differential diagnosis when encountering such clinical pictures. Copyright © 2014 Elsevier Inc. All rights reserved.

Reptile Critical Care and Common Emergencies.

PubMed

Music, Meera Kumar; Strunk, Anneliese

2016-05-01

Reptile emergencies are an important part of exotic animal critical care, both true emergencies and those perceived as emergencies by owners. The most common presentations for reptile emergencies are addressed here, with information on differential diagnoses, helpful diagnostics, and approach to treatment. In many cases, reptile emergencies are actually acute presentations originating from a chronic problem, and the treatment plan must include both clinical treatment and addressing husbandry and dietary deficiencies at home. Accurate owner expectations must be set in order to have owner compliance to long-term treatment plans. Copyright © 2016 Elsevier Inc. All rights reserved.

Emergent pediatric thoracotomy following traumatic arrest.

PubMed

Easter, Joshua S; Vinton, Deborah T; Haukoos, Jason S

2012-12-01

Emergent thoracotomy is a potentially life-saving procedure following traumatic cardiac arrest. The procedure has been studied extensively in adults, but its role in pediatric traumatic cardiac arrest remains unclear. We aimed to determine the prevalence of survival following emergent resuscitative thoracotomy in children. This was a retrospective cohort study that included consecutive patients<18 years old who underwent emergent thoracotomy following traumatic cardiac arrest over a 15-year period. Factors previously associated with survival following thoracotomy in adults were measured. During the study period, 29 patients underwent emergent thoracotomy. Of these, 3 (10%, 95% confidence interval [CI]: 2-27%) survived to hospital discharge. All survivors sustained penetrating trauma to the heart and had signs of life on arrival of emergency medical services. Of the 13 patients who sustained blunt trauma, 0 (0%, 95% CI: 0-25%) survived, despite 69% (9/13) demonstrating signs of life on arrival of emergency medical services and 38% (5/13) having temporary return of spontaneous circulation. Emergent thoracotomy is a potentially life-saving procedure for children following traumatic cardiac arrest. It appears most successful in children suffering penetrating trauma to the heart with signs of life on arrival of emergency medical services. Larger studies are needed to determine the factors associated with this survival benefit for emergent thoracotomy in children. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A Methodology for Training International Space Station Crews to Respond to On-Orbit Emergencies

NASA Technical Reports Server (NTRS)

Balmain, Clinton; Fleming, Mark

2009-01-01

Most spaceflight crewmembers agree that emergency training is among the most important training they receive. If an emergency event occurs on-orbit crewmembers want to be able to rely on a thorough and proficient knowledge of emergency operations and procedures. The inherent complexity of ISS and the international nature of the onboard operations have resulted in emergency procedures that are complex by any measure; as a result, a very robust apparatus has been developed to give crewmembers initial training on emergency procedures and ensure proficiency up to (and even after) launch. One of the most important aspects of complex onboard operations in general, and emergency operations specifically, is learning how to coordinate roles and responsibilities with fellow crewmembers. A primary goal of NASA s emergency training program is to allow the crewmembers who will actually be together on-orbit to practice executing the emergency responses together before they fly. As with any operation that includes the use of software and hardware, the fidelity of the simulation environment is a critical element to successful training. The NASA training division has spent considerable time and effort to develop a simulator that addresses the most important aspects of emergency response, working within very difficult space and budgetary constraints.

The impact of humanitarian emergencies on the prevalence of violence against children: an evidence-based ecological framework.

PubMed

Rubenstein, Beth L; Stark, Lindsay

2017-03-01

Little is known about the patterns and mechanisms by which humanitarian emergencies may exacerbate violence against children. In this article, we propose using the ecological framework to examine the impact of humanitarian emergencies on interpersonal violence against children. We consider the literature that supports this framework and suggest future directions for research to fill identified gaps in the framework. The relationship between humanitarian emergencies and violence against children depends on risk factors at multiple levels, including a breakdown of child protection systems, displacement, threats to livelihoods, changing gender roles, changing household composition, overcrowded living conditions, early marriage, exposure to conflict or other emergency events, and alcohol abuse. The empirical evidence supporting the proposed emergency/violence framework is limited by cross-sectional study designs and a propensity to predominantly examine individual-level determinants of violence, especially exposure to conflict or emergency events. Thus, there is a pressing need to contextualize the relationship between conflict or emergency events and violence against children within the wider ecological and household dynamics that occur during humanitarian emergencies. Ultimately, this will require longitudinal observations of children, families and communities from before the emergency through recovery and improvements to ongoing global surveillance systems. More complete data will enable the humanitarian community to design effective, appropriate and well-targeted interventions.

Nonrandom patterns of roost emergence in big brown bats, Eptesicus fuscus

USGS Publications Warehouse

Gillam, E.H.; O'Shea, T.J.; Brigham, R.M.

2011-01-01

In most colonial species of bats individuals emerge en masse from day roosts each evening to begin foraging. Although some aspects of emergence behavior are understood, one previously unexplored area is the specific order in which individuals emerge. The goal of our research was to determine if big brown bats, Eptesicus fuscus, fitted with passive integrated transponder tags emerge from roosts in buildings each evening in a nonrandom order. We assessed relative and absolute order of emergence to determine if order is concordant across nights and whether individuals consistently emerge in close association with specific roost mates. We found significant concordance in rank order among nights at all roosts. At 5 roosts concordance decreased as time between dates increased. Association rates between individuals were low, and temporal analyses revealed that associations rapidly degraded over time, indicating that bats do not emerge each evening consistently with the same group of roost mates. We discuss how social structure, information transfer, and/or individual energetic needs could be responsible for the observed nonrandom patterns of emergence. Our results suggest that emergence order represents behavioral information that traditionally has been overlooked and that might be useful for characterizing aspects of the ecology and social behavior of bats and other species with cryptic behavior. ?? 2011 American Society of Mammalogists.

A critical assessment of outcomes in emergency versus nonemergency general surgery using the American College of Surgeons National Surgical Quality Improvement Program database.

PubMed

Becher, Robert D; Hoth, J Jason; Miller, Preston R; Mowery, Nathan T; Chang, Michael C; Meredith, J Wayne

2011-07-01

Emergent operations are thought to carry higher morbidity and mortality than nonemergent cases. However, there is a lack of specific outcomes data for emergent general surgery procedures. The objective of our study was to assess and quantify postoperative morbidity and mortality for emergency versus nonemergency general surgery operations. All general surgery inpatients were identified in the American College of Surgeons National Surgical Quality Improvement Program 2008 database. Preoperative, intraoperative, and postoperative clinical metrics and occurrences were assessed. A total of 25,770 emergent and 98,867 nonemergent cases were identified. Postoperative morbidity was significantly worse in the emergent group, including ventilation more than 48 hours, bleeding requiring transfusion, deep vein thrombosis, renal failure, and need for reoperation. Overall, emergent cases had significantly more postoperative complications (22.8% vs 14.2%) and higher mortality rates (6.5% vs 1.4%). General surgery patients who undergo emergent operations have significantly poorer outcomes when compared with nonemergent patients; our analysis has quantified these differences. Emergent patients seem to manifest unique clinical, pathophysiologic, and inflammatory responses to their surgical disease. This data suggests that there is a need for improvement in both methods and systems of care for the emergent population.

Exploring the key predictors of retention in emergency nurses.

PubMed

Sawatzky, Jo-Ann V; Enns, Carol L

2012-07-01

To explore the factors that predict the retention of nurses working in emergency departments. The escalating shortage of nurses is one of the most critical issues facing specialty areas, such as the emergency department. Therefore, it is important to identify the key influencing and intermediary factors that affect emergency department nurses' intention to leave. As part of a larger study, a cross-sectional survey was completed by 261 registered nurses working in the 12 designated emergency departments within rural, urban community and tertiary hospitals in Manitoba, Canada. Twenty-six per cent of the respondents will probably/definitely leave their current emergency department jobs within the next year. Engagement was the key predictor of intention to leave (P < 0.001). Engagement was also associated with job satisfaction, compassion satisfaction, compassion fatigue, and burnout (P < 0.05). In an ordinal least-squares model (R(2) = 0.44), nursing management, professional practice, collaboration with physicians, staffing resources and shift work emerged as significant influencing factors for engagement. Engagement plays a central role in emergency department nurses intention to leave. Addressing the factors that influence engagement may reduce emergency department nurses' intention to leave. This study highlights the value of research-based evidence as the foundation for developing innovative strategies for the retention of emergency department nurses. © 2012 Blackwell Publishing Ltd.

Major emerging and re-emerging zoonoses in China: a matter of global health and socioeconomic development for 1.3 billion.

PubMed

Liu, Quan; Cao, Lili; Zhu, Xing-Quan

2014-08-01

Emerging and re-emerging zoonoses are a significant public health concern and cause considerable socioeconomic problems globally. The emergence of severe acute respiratory syndrome (SARS), highly pathogenic avian influenza (HPAI) H5N1, avian influenza H7N9, and severe fever with thrombocytopenia syndrome (SFTS), and the re-emergence of rabies, brucellosis, and other zoonoses have had a significant effect on the national economy and public health in China, and have affected other countries. Contributing factors that continue to affect emerging and re-emerging zoonoses in China include social and environmental factors and microbial evolution, such as population growth, urbanization, deforestation, livestock production, food safety, climate change, and pathogen mutation. The Chinese government has devised new strategies and has taken measures to deal with the challenges of these diseases, including the issuing of laws and regulations, establishment of disease reporting systems, implementation of special projects for major infectious diseases, interdisciplinary and international cooperation, exotic disease surveillance, and health education. These strategies and measures can serve as models for the surveillance and response to continuing threats from emerging and re-emerging zoonoses in other countries. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Parent cortisol and family relatedness predict anxious behavior in emerging adults.

PubMed

Johnson, Vanessa Kahen; Gans, Susan E

2016-10-01

Emerging-adult cortisol response during family interaction predicts change in emerging-adult anxious behavior during the transition to college (Gans & Johnson, in press). In the present study, we take an additional step toward integrating family systems research and physiology by including assessment of parent physiology. We collect salivary cortisol from parents and emerging adults during triadic family interaction. Emerging adults (N = 101) between the ages of 17 and 19 years were assessed at 3 time points across their first college year: the summer before college and the Fall and Spring semesters. Two parents accompanied the emerging-adult child to the summer assessment; all family members provided 4 saliva samples each at 20-min intervals. Later assessments of emerging adults included measures of internalizing behaviors. Parents' cortisol secretion patterns during family interaction predict their emerging-adult children's cortisol secretion pattern, parent perceptions of the family environment, and emerging-adult children's internalizing behavior during the college transition. Different patterns of results emerged for mothers' and fathers' cortisol response to family interaction and for families with sons or with daughters. The approach taken by this study provides a first step toward understanding how interrelationships among elements of physiology and family functioning contribute to adjustment during major life transitions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Exploring the views of emergency department staff on the use of videoconferencing for mental health emergencies in southwestern Ontario.

PubMed

Pangka, Kyle R; Chandrasena, Ranjith; Wijeratne, Nishardi; Mann, Miriam

2015-01-01

Patients presenting to a rural emergency department (ED) with mental health symptoms have difficulty accessing services of mental health professionals [1,2]. Videoconferencing (VC) has been found to improve patient access to health services that require specialist care in rural EDs [3,4,5]. Although previous studies highlight the benefit of using VC for patients presenting with mental health emergencies, no study has investigated the current views and use of VC for mental health emergencies in EDs in Southwestern Ontario [3,5,6]. To explore the views of ED staff regarding the use of VC in mental health emergencies, structured telephone interviews were conducted with representatives from EDs in the Erie St. Clair and Southwest Local Health Integration Networks (LHIN). Participants noted that using VC for mental health emergencies may improve patient experience and benefit crisis response teams. VC was perceived by some participants as a means to expedite the direct assessment of a patient presenting with a mental health emergency by a mental health specialist. However several participants stated that using VC for mental health emergencies strains ED resources. Lack of use and difficulty accessing a psychiatrist were identified as potential barriers to implementing the use of VC for mental health emergencies.

Shared Governance and Work Engagement in Emergency Nurses.

PubMed

Siller, Jennifer; Dolansky, Mary A; Clavelle, Joanne T; Fitzpatrick, Joyce J

2016-07-01

Lack of work engagement in emergency nurses has been linked to increased job turnover, burnout, and lack of job satisfaction. Shared governance is a vehicle that can be used by emergency nursing leaders to increase work engagement among emergency nurses. Research is lacking about the relationship between perceptions of shared governance and work engagement in emergency nurses. In this study we examined the relationship between ED nurses' perceptions of shared governance and work engagement. A descriptive correlation design was used with a convenience sample of 43 emergency nurses recruited through the ENA Web site. Participants completed a demographic questionnaire, the Index of Professional Nursing Governance Tool, and the Utrecht Work Engagement Scale. The mean total work engagement score indicated average engagement (M = 4.4, standard deviation = 1.2). A significant positive relationship was found between shared governance and work engagement, indicating that as perceptions of shared governance increase, work engagement increases (r (41) = 0.62, P < .001). The study provides beginning evidence on the relationship of shared governance and work engagement in emergency nurses. Understanding the relationship between perceptions of shared governance and work engagement in emergency nurses may assist emergency nursing leaders in developing and testing interventions to enhance it. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

Emergency Physician Utilization of Alcohol/Substance Screening, Brief Advice and Discharge: A 10-Year Comparison.

PubMed

Broderick, Kerryann B; Kaplan, Bonnie; Martini, Dyllon; Caruso, Emily

2015-10-01

In 2007, of the 130 million emergency department (ED) visits, ∼ 38 million were due to injury, and of those, 1.9 million involved alcohol. The emergency department is a pivotal place to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) due to the high number of patients presenting with alcohol/substance abuse risk factors or related injuries. This study compares two surveys, approximately 11 years apart, of emergency physicians nationwide which assesses the use of validated screening tools, the availability of community resources for alcohol/substance abuse treatment, and the prevailing attitudes of emergency physicians regarding Screening and Brief Intervention for alcohol/substance abuse. We performed cross-sectional anonymous surveys of 1500 emergency physicians drawn from American College of Emergency Physicians members. The survey results were compared for time interval change. The two surveys had comparable response rates. The median percentage of patients screened for alcohol/substance abuse in 1999 was 15%, vs. 20% in 2010. In 2010, 26% of emergency physicians had a formal screening tool, and the majority used Cut-down, Annoyed, Guilty, Eye-opener (85%). In 2010, a statistically significant increase in the number of emergency physicians said they would "always" or "almost always" use discharge instructions that were specific for alcohol/substance abuse, if available, vs. 1999. Few emergency physicians screen for alcohol/substance abuse despite evidence that screening and brief intervention is effective. Emergency physicians are receptive to the use of discharge material. Copyright © 2015 Elsevier Inc. All rights reserved.

Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care

PubMed Central

Ibrahim, N.A.; Oludara, M.A.; Ajani, A.; Mustafa, I.; Balogun, R.; Idowu, O.; Osuoji, R.; Omodele, F.O.; Aderounmu, A.O.A.; Solagberu, B.A.

2015-01-01

Introduction Significant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes. Methods A one year prospective cohort study of all non-trauma emergencies in adults seen at the surgical emergency room of LASUTH from 1st October, 2011 to 30th September, 2012 was conducted. Data was analyzed using SPSS version 15.0. Results Of a total of 7536 patients seen, there were 7122 adults. Those with non-trauma conditions were 2065 representing 29% of adult emergencies. Age ranged between 15 and 97 years and male to female ratio was 1.7:1. Acute abdomen (30%), urological problems (18%) and malignancies (10%) were the most common. Among 985 patients requiring admission only 464 (47%) were admitted while the remaining 53% were referred to other centers. Emergency surgical intervention was carried out in 222 patients representing 48% of admitted patients. There were 12 (24%) non-trauma deaths in the emergency room. They were due to acute abdomen and malignancies in half of the cases. Conclusion Facilities for patients needing emergency care were inadequate with more than half of those requiring admission referred. Attention should be paid to the provision of emergency surgical services to the teeming number of patients seen on yearly basis in the Teaching Hospital. PMID:26566434

Positive Coping: A Unique Characteristic to Pre-Hospital Emergency Personnel.

PubMed

Ebadi, Abbas; Froutan, Razieh

2017-01-01

It is important to gain a thorough understanding of positive coping methods adopted by medical emergency personnel to manage stressful situations associated with accidents and emergencies. Thus, the purpose of this study was to gain a better understanding of positive coping strategies used by emergency medical service providers. This study was conducted using a qualitative content analysis method. The study participants included 28 pre-hospital emergency personnel selected from emergency medical service providers in bases located in different regions of the city of Mashhad, Iran, from April to November 2016. The purposive sampling method also was used in this study, which was continued until data saturation was reached. To collect the data, semistructured open interviews, observations, and field notes were used. Four categories and 10 subcategories were extracted from the data on the experiences of pre-hospital emergency personnel related to positive coping strategies. The four categories included work engagement, smart capability, positive feedback, and crisis pioneering. All the obtained categories had their own subcategories, which were determined based on their distinctly integrated properties. The results of this study show that positive coping consists of several concepts used by medical emergency personnel, management of stressful situations, and ultimately quality of pre-hospital clinical services. Given the fact that efficient methods such as positive coping can prevent debilitating stress in an individual, pre-hospital emergency authorities should seek to build and strengthen "positive coping" characteristics in pre-hospital medical emergency personnel to deal with accidents, emergencies, and injuries through adopting regular and dynamic policies.

Barriers to the operation of mental health legislation in Australian emergency departments: a qualitative analysis.

PubMed

Jelinek, George; Mackinlay, Claire; Weiland, Tracey; Hill, Nicole; Gerdtz, Marie

2011-06-01

This study aimed to describe the perceived barriers faced by emergency clinicians in utilising mental health legislation in Australian hospital emergency departments. A semi-structured interview methodology was used to assess what barriers emergency department doctors and nurses perceive in the operation of mental health legislation. Key findings from the interview data were drawn in accordance with the most commonly represented themes. A total of 36 interviews were conducted with 20 members of the Australasian College for Emergency Medicine and 16 members of the College for Emergency Nursing Australasia representing the various Australian jurisdictions. Most concerning to clinicians were the effects of access block and overcrowding on the appropriate use of mental health legislation, and the substandard medical care that mental health patients received as a result of long periods in the emergency department. Many respondents were concerned about the lack of applicability of mental health legislation to the emergency department environment, variation in legislation between States and Territories causing problems for clinicians working interstate, and a lack of knowledge and training in mental health legislation. Many felt that clarification of legislative issues around duty of care and intoxicated or violent patients was required. The authors conclude that access block has detrimental effects on emergency mental health care as it does in other areas of emergency medicine. Consideration should be given to uniform national mental health legislation to better serve the needs of people with mental health emergencies.

Therapeutic hypothermia following out-of-hospital cardiac arrest; does it start in the emergency department?

PubMed

Galloway, R; Sherren, P B

2010-12-01

The use of therapeutic hypothermia after cardiac arrest is a well-practised treatment modality in the intensive care unit (ICU). However, recent evidence points to advantages in starting the cooling process as soon as possible after the return of spontaneous circulation (ROSC). There are no data on implementation of this treatment in the emergency department. A telephone survey was conducted of the 233 emergency departments in the UK. The most senior available clinician was asked if, in cases where they have a patient with a ROSC after an out-of-hospital cardiac arrest, would therapeutic hypothermia be started in the emergency department. Of the 233 hospitals called, 230 responded, of which 35% would start cooling in the emergency department. Of this 35%, over half (56%) said the decision to start cooling was made by the emergency physician before consultation with the ICU. Also, of the 35% who would begin cooling in the emergency department, 55% would cool only for ventricular fibrillation/ventricular tachycardia, 66% would monitor temperature centrally, and 14% would use specialised cooling equipment. There is often a delay in getting patients to ICU from the emergency department, and thus the decision not to start cooling in the emergency department may impact significantly on patient outcome. The dissemination of these data may persuade emergency physicians that starting treatment in the emergency department is an appropriate and justifiable decision that is becoming a more accepted practice throughout the UK.

Public health emergencies and responses: what are they, how long do they last, and how many staff does your agency need?

PubMed

Posid, Joseph M; Bruce, Sherrie M; Guarnizo, Julie T; O'Connor, Ralph C; Papagiotas, Stephen S; Taylor, Melissa L

2013-12-01

Responding to outbreaks is one of the most routine yet most important functions of a public health agency. However, some outbreaks are bigger, more visible, or more complex than others, prompting discussion about when an "outbreak" becomes a "public health emergency." When a public health emergency is identified, resources (eg, funding, staff, space) may need to be redirected from core public health programs to contribute to the public health emergency response. The need to sustain critical public health functions while preparing for public health emergency responses raises a series of operational and resource management questions, including when a public health emergency begins and ends, why additional resources are needed, how long an organization should expect staff to be redirected, and how many staff (or what proportion of the agency's staff ) an organization should anticipate will be needed to conduct a public health emergency response. This article addresses these questions from a national perspective by reviewing events for which the Centers for Disease Control and Prevention redirected staff from core public health functions to respond to a series of public health emergencies. We defined "public health emergency" in both operational and public health terms and found that on average each emergency response lasted approximately 4 months and used approximately 9.5% of our workforce. We also provide reasons why public health agencies should consider the impact of redirecting resources when preparing for public health emergencies.

Differences in emergency colorectal surgery in Medicaid and uninsured patients by hospital safety net status.

PubMed

Bradley, Cathy J; Dahman, Bassam; Sabik, Lindsay M

2015-02-01

We examined whether safety net hospitals reduce the likelihood of emergency colorectal cancer (CRC) surgery in uninsured and Medicaid-insured patients. If these patients have better access to care through safety net providers, they should be less likely to undergo emergency resection relative to similar patients at non- safety net hospitals. Using population-based data, we estimated the relationship between safety net hospitals, patient insurance status, and emergency CRC surgery. We extracted inpatient admission data from the Virginia Health Information discharge database and matched them to the Virginia Cancer Registry for patients aged 21 to 64 years who underwent a CRC resection between January 1, 1999, and December 31, 2005 (n = 5488). We differentiated between medically defined emergencies and those that originated in the emergency department (ED). For each definition of emergency surgery, we estimated the linear probability models of the effects of being treated at a safety net hospital on the probability of having an emergency resection. Safety net hospitals reduce emergency surgeries among uninsured and Medicaid CRC patients. When defining an emergency resection as those that involved an ED visit, these patients were 15 to 20 percentage points less likely to have an emergency resection when treated in a safety net hospital. Our results suggest that these hospitals provide a benefit, most likely through the access they afford to timely and appropriate care, to uninsured and Medicaid-insured patients relative to hospitals without a safety net mission.

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...