Medical and radiological aspects of emergency preparedness and response at SevRAO facilities.

PubMed

Savkin, M N; Sneve, M K; Grachev, M I; Frolov, G P; Shinkarev, S M; Jaworska, A

2008-12-01

Regulatory cooperation between the Norwegian Radiation Protection Authority and the Federal Medical Biological Agency (FMBA) of the Russian Federation has the overall goal of promoting improvements in radiation protection in Northwest Russia. One of the projects in this programme has the objectives to review and improve the existing medical emergency preparedness capabilities at the sites for temporary storage of spent nuclear fuel and radioactive waste. These are operated by SevRAO at Andreeva Bay and in Gremikha village on the Kola Peninsula. The work is also intended to provide a better basis for regulation of emergency response and medical emergency preparedness at similar facilities elsewhere in Russia. The purpose of this paper is to present the main results of that project, implemented by the Burnasyan Federal Medical Biophysical Centre. The first task was an analysis of the regulatory requirements and the current state of preparedness for medical emergency response at the SevRAO facilities. Although Russian regulatory documents are mostly consistent with international recommendations, some distinctions lead to numerical differences in operational intervention criteria under otherwise similar conditions. Radiological threats relating to possible accidents, and related gaps in the regulation of SevRAO facilities, were also identified. As part of the project, a special exercise on emergency medical response on-site at Andreeva Bay was prepared and carried out, and recommendations were proposed after the exercise. Following fruitful dialogue among regulators, designers and operators, special regulatory guidance has been issued by FMBA to account for the specific and unusual features of the SevRAO facilities. Detailed sections relate to the prevention of accidents, and emergency preparedness and response, supplementing the basic Russian regulatory requirements. Overall it is concluded that (a) the provision of medical and sanitary components of emergency response at SevRAO facilities is a priority task within the general system of emergency preparedness; (b) there is an effective and improving interaction between SevRAO and the local medical institutions of FMBA and other territorial medical units; (c) the infrastructure of emergency response at SevRAO facilities has been created and operates within the framework of Russian legal and normative requirements. Further proposals have been made aimed at increasing the effectiveness of the available system of emergency preparedness and response, and to promote interagency cooperation.

Guidance for Facilities on Risk Management Programs (RMP)

EPA Pesticide Factsheets

Includes supplemental guidance specific to ammonia refrigeration, wastewater treatment, propane storage, warehouses, chemical distributors, offsite consequence analysis, retail agriculture, applicability of program levels, prevention, emergency response.

The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

PubMed Central

Ziraba, Abdhalah K; Mills, Samuel; Madise, Nyovani; Saliku, Teresa; Fotso, Jean-Christophe

2009-01-01

Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1) delay in making the decision to seek care; 2) delay in reaching an appropriate obstetric facility; and 3) delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums) while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden of morbidity and mortality was a challenge due to poor and incomplete medical records. Conclusion The quality of emergency obstetric care services in Nairobi slums is poor and needs improvement. Specific areas that require attention include supervision, regulation of maternity facilities; and ensuring that basic equipment, supplies, and trained personnel are available in order to handle obstetric complications in both public and private facilities. PMID:19284626

77 FR 40647 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-10

... operation of the shared unit's diesel generator (emergency power) and to assure long term operation of the... actuation system limiting safety system settings, and emergency diesel generator surveillance start voltage... specification for the Vogtle Electric Generating Plant, Units 1 and 2, associated with the ``Steam Generator (SG...

Clinical and perceived quality of care for maternal, neonatal and antenatal care in Kenya and Namibia: the service provision assessment.

PubMed

Diamond-Smith, Nadia; Sudhinaraset, May; Montagu, Dominic

2016-08-11

The majority of women in sub-Saharan Africa now deliver in a facility, however, little is known about the quality of services for maternal and newborn basic and emergency care, nor how this is associated with patient's perception of their experiences. Using data from the Service Provision Assessment (SPA) survey from Kenya 2010 and Namibia 2009, we explore whether facilities have the necessary signal functions for providing emergency and basic maternal (EmOC) and newborn care (EmNC), and antenatal care (ANC) using descriptives and multivariate regression. We explore differences by type of facility (hospital, center or other) and by private and public facilities. Finally, we see if patient satisfaction (taken from exit surveys at antenatal care) is associated with the quality of services (specific services provided). We find that most facilities do not have all of the signal functions, with 46 and 27 % in Kenya and 18 and 5 % in Namibia of facilities have high/basic scores in routine and emergency obstetric care, respectively. We found that hospitals preform better than centers in general and few differences emerged between public and private facilities. Patient perceptions were not consistently associated with services provided; however, patients had fewer complaints in private compared to public facilities in Kenya (-0.46 fewer complaints in private) and smaller facilities compared to larger in Namibia (-0.26 fewer complaints in smaller facilities). Service quality itself (measured in scores), however, was only significantly better in Kenya for EmOC and EmNC. This analysis sheds light on the inadequate levels of care for saving maternal and newborn lives in most facilities in two countries of Africa. It also highlights the disconnect between patients' perceptions and clinical quality of services. More effort is needed to ensure that high quality supply of services is present to meet growing demand as an increasing number of women deliver in facilities.

Simulation Technology Laboratory Building 970 hazards assessment document

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

Wood, C.L.; Starr, M.D.

1994-11-01

The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Simulation Technology Laboratory, Building 970. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distances at which a postulated facility event will producemore » consequences exceeding the ERPG-2 and Early Severe Health Effects thresholds are 78 and 46 meters, respectively. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 100 meters.« less

Tier II Forms and Instructions

EPA Pesticide Factsheets

Facilities must comply with the new requirements on the Tier II emergency and hazardous chemical inventory form starting reporting year 2013, which is due by March 1, 2014. Some states may have specific requirements for reporting and submission.

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.

OIL AND GAS FACILITY EMERGENCY AWARENESS PARTNERSHIP

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

Tod Bryant

2002-08-31

Energy Education Partnership, Inc. (EEPI) is a 501(c) (3) subsidiary of the Interstate Oil and Gas Compact Commission (IOGCC). The organization was formed four years ago for charitable, educational, and scientific purposes. EEPI adheres to the same mission of IOGCC, and that is to promote conservation and efficient recovery of domestic oil and natural gas resources while protecting health, safety and the environment. The membership of EEPI/IOCGG is composed of the governors of the 30 oil and gas producing states, seven associate member states, and five international affiliates. The governors appoint official representatives and committee members to participate in themore » programs. The membership of EEPI/IOGCC is dedicated to the conservation and prudent utilization of oil and natural gas resources through education and training. Engineers, geologist, environmental scientists and researchers who perform the majority of fossil energy research in the United States all work with EEPI/IOGCC on projects. The ''Oil and Gas Facility Emergency Awareness Program'' consists of three main parts, with two optional projects for the states involved in the pilot program. The three main parts of the program consist of the following: (1) Create a generic publication using the Ohio Oil and Gas Energy Education Program's publication, ''Responding to Oilfield Emergencies'', which is not state-specific. (2) Prepare a training program for emergency response teams, state and federal regulators, oil and gas facility owners and operators, and local citizens. The program will be developed as a PowerPoint presentation and will assist the students in becoming more aware of emergency situations at an oil or gas facility. The students learn who is the designated ''first responder'' in charge, how all people can work together in preventing and controlling problems at an oil or gas facility, and what to do during an emergency. Familiarity with equipment and hazardous substances are introduced as part of the program. (3) Once the publication and the training program are developed, a video that will be used as an introduction to the actual training class, as a refresher for the class, or in a ''train-the-trainer'' program will be produced. In addition to the above-noted three steps, optional projects were considered by the pilot program states. Two optional projects were considered by the states: (1) Working with the local, regional or state firefighters, a training facility would be created using oil and gas equipment. This part of the project will require cooperation between firefighters and industry, and will assist especially the emergency responders in learning more about oil and gas equipment. (2) Also under consideration was a related web site that would include the location of all oil and gas wells and accessible only by password. The overall ''Oil and Gas Facility Emergency Awareness Program'' has many benefits, some of which are: The process will provide opportunity for key industry leaders to develop relationships with local emergency management agencies. Industry personnel will be able to better understand emergency planning, and emergency personnel will better understand industry operations. Health, safety and environment will be better protected because of training. Better risk management will improve the operating climate for independent oil and gas producers. The ''Oil and Gas Facility Emergency Awareness Program'' benefits the emergency response teams, oil and gas facility owners and operators, state and federal regulators, the environment, and most especially the citizens. All groups must work together for the health, safety and protection of the community and the environment.« less

Substantiation To Accompany Claims of Trade Secrecy Under EPCRA

EPA Pesticide Factsheets

This form is required under the Emergency Planning and Community Right-to-Know Act. Facility must be able to describe safeguarding measures, disclosure history, and why the specific chemical identity is a secret of interest to competitors.

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities1

PubMed Central

Carter, Eileen J.; Cohen, Bevin; Murray, Meghan T.; Saiman, Lisa; Larson, Elaine L.

2015-01-01

Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities. PMID:25773517

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

PubMed

Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

2017-06-01

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

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...

Standard operating procedures, water immersion facility, revision B

NASA Technical Reports Server (NTRS)

1979-01-01

General guideline procedures to identify those factors that are common to all spacecraft design laboratory support group emergency procedures and to establish the basic rescue plan are presented. This eliminates needless repetition of the fundamentals from the other, more specific procedures.

Special Considerations for Mass Violence Events in Senior Living Facilities: A Case Report on the Pinelake Health and Rehab Center Shooting.

PubMed

Martin, Cody; Powell, David

2017-02-01

The 2009 Pinelake Health and Rehab Center shooting in Carthage, North Carolina, presents a unique case study for examining the specific considerations for mass violence events in senior living facilities. A variety of factors, including reduced sensory perception, reduced mobility, and cognitive decline, may increase the vulnerability of the populations of senior living facilities during mass violence events. Management of response aspects such as evacuation, relocation, and reunification also require special consideration in the context of mass violence at senior living facilities. Better awareness of these vulnerabilities and response considerations can assist facility administrators and emergency managers when preparing for potential mass violence events at senior living facilities. (Disaster Med Public Health Preparedness. 2017;11:150-152).

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...

Improving Student Safety.

ERIC Educational Resources Information Center

Dorn, Michael; Trump, Kenneth S.; Nichols, R. Leslie

2001-01-01

Presents the latest information on how schools can keep their students safe. Safety oriented actions discussed cover incident reporting and tracking, tactical site surveys, school safety and emergency operations planning, staff development efforts, and facility design. Explains the need to review and test specific prevention concepts and emergency…

Decontamination Workshop for Emergency Responding Personnel How Clean is Clean Enough 12-14 September 2007

DTIC Science & Technology

2008-09-01

refers to a Medical Treatment Facility (MTF), can we assume that disrobing is sufficient? Is it possible to develop specific site clearance criteria ...o First responders , medical personnel, and the HAZMAT team o Incident Commanders o Public information officials o Hospitals and hospital networks ...clean personnel (both victims and first responders ) need to be when they are released from the incident site (or treatment facility for those that make

Cross-sectional Survey of Long-Term Care Facilities in the Rockaway Peninsula: Preparedness and Response During Hurricane Sandy.

PubMed

Jiang, Lynn; Tedeschi, Christopher; Subaiya, Saleena

2018-04-01

Few studies have described the challenges experienced by long-term care facilities (LTCFs) following Hurricane Sandy. This study examined LTCF preparedness and experiences during and after the storm. A cross-sectional survey was conducted 2 years after Hurricane Sandy to assess LTCF demographics, preparation, and post-storm resources. Surveys were conducted at LTCFs located on the Rockaway Peninsula of New York City. All LTCFs located in a heavily affected area were approached. Of 29 facilities, 1 had closed, 5 did not respond, 9 declined to participate, and 14 participated, yielding a response rate of 50% for open facilities. Twenty-one percent of the facilities had preparations specifically for hurricanes. More than 70% of the facilities had lost electricity, heat, and telephone service, and one-half had evacuated. Twenty-one percent of the facilities reported not receiving any assistance and over one-half reported that relief resources did not meet their needs. Many LTCFs lacked plans specific to such a large-scale event. Since nearly all of the LTCFs in the region were affected, preexisting transportation and housing plans may have been inadequate. Future preparation could include hazard-specific planning and reliance on resources from a wider geographic area. Access to electricity emerged as a top priority. (Disaster Med Public Health Preparedness. 2018;12:194-200).

[In-hospital management of victims of chemical weapons of mass destruction].

PubMed

Barelli, Alessandro; Gargano, Flavio; Proietti, Rodolfo

2005-01-01

Emergency situations caused by chemical weapons of mass destruction add a new dimension of risk to those handling and treating casualties. The fundamental difference between a hazardous materials incident and conventional emergencies is the potential for risk from contamination to health care professionals, patients, equipment and facilities of the Emergency Department. Accurate and specific guidance is needed to describe the procedures to be followed by emergency medical personnel to safely care for a patient, as well as to protect equipment and people. This review is designed to familiarize readers with the concepts, terminology and key operational considerations that affect the in-hospital management of incidents by chemical weapons.

Emergency and urgent care capacity in a resource-limited setting: an assessment of health facilities in western Kenya

PubMed Central

Burke, Thomas F; Hines, Rosemary; Ahn, Roy; Walters, Michelle; Young, David; Anderson, Rachel Eleanor; Tom, Sabrina M; Clark, Rachel; Obita, Walter; Nelson, Brett D

2014-01-01

Objective Injuries, trauma and non-communicable diseases are responsible for a rising proportion of death and disability in low-income and middle-income countries. Delivering effective emergency and urgent healthcare for these and other conditions in resource-limited settings is challenging. In this study, we sought to examine and characterise emergency and urgent care capacity in a resource-limited setting. Methods We conducted an assessment within all 30 primary and secondary hospitals and within a stratified random sampling of 30 dispensaries and health centres in western Kenya. The key informants were the most senior facility healthcare provider and manager available. Emergency physician researchers utilised a semistructured assessment tool, and data were analysed using descriptive statistics and thematic coding. Results No lower level facilities and 30% of higher level facilities reported having a defined, organised approach to trauma. 43% of higher level facilities had access to an anaesthetist. The majority of lower level facilities had suture and wound care supplies and gloves but typically lacked other basic trauma supplies. For cardiac care, 50% of higher level facilities had morphine, but a minority had functioning ECG, sublingual nitroglycerine or a defibrillator. Only 20% of lower level facilities had glucometers, and only 33% of higher level facilities could care for diabetic emergencies. No facilities had sepsis clinical guidelines. Conclusions Large gaps in essential emergency care capabilities were identified at all facility levels in western Kenya. There are great opportunities for a universally deployed basic emergency care package, an advanced emergency care package and facility designation scheme, and a reliable prehospital care transportation and communications system in resource-limited settings. PMID:25260371

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study

PubMed Central

Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-01-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes. PMID:28207061

Health facility challenges to the provision of Option B+ in western Kenya: a qualitative study.

PubMed

Helova, Anna; Akama, Eliud; Bukusi, Elizabeth A; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Spangler, Sydney A; Turan, Janet M; Wanga, Iris; Abuogi, Lisa L

2017-03-01

Current WHO guidelines recommend lifelong antiretroviral therapy (ART) for all HIV-positive individuals, including pregnant and breastfeeding women (Option B+) in settings with generalized HIV epidemics. While Option B+ is scaled-up in Kenya, insufficient adherence and retention to care could undermine the expected positive impact of Option B+. To explore challenges to the provision of Option B+ at the health facility level, we conducted forty individual gender-matched in-depth interviews with HIV-positive pregnant/postpartum women and their male partners, and four focus groups with thirty health care providers at four health facilities in western Kenya between September-November 2014. Transcripts were coded with the Dedoose software using a coding framework based on the literature, topics from interview guides, and emerging themes from transcripts. Excerpts from broad codes were then fine-coded using an inductive approach. Three major themes emerged: 1) Option B+ specific challenges (same-day initiation into treatment, health care providers unconvinced of the benefits of Option B+, insufficient training); 2) facility resource constraints (staff and drug shortages, long queues, space limitations); and 3) lack of client-friendly services (scolding of patients, inconvenient operating hours, lack of integration of services, administrative requirements). This study highlights important challenges at the health facility level related to Option B+ rollout in western Kenya. Addressing these specific challenges may increase linkage, retention and adherence to life-long ART treatment for pregnant HIV-positive women in Kenya, contribute towards elimination of mother-to-child HIV transmission, and improve maternal and child outcomes.

Antimicrobial stewardship in long term care facilities: what is effective?

PubMed

Nicolle, Lindsay E

2014-02-12

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.

Trissolcus japonicus (Ashmead) emerges in North America

USDA-ARS?s Scientific Manuscript database

Trissolcus japonicus (Ashmead) is an Asian egg parasitoid of the brown marmorated stink bug, Halyomorpha halys (Stål). It has been under study in U.S. quarantine facilities since 2007 to evaluate its efficacy as a candidate classical biological control agent and its host specificity with regard to t...

Implementing a Reentry Framework at a Correctional Facility: Challenges to the Culture

ERIC Educational Resources Information Center

Rudes, Danielle S.; Lerch, Jennifer; Taxman, Faye S.

2011-01-01

Implementation research is emerging in the field of corrections, but few studies have examined the complexities associated with implementing change among frontline workers embedded in specific organizational cultures. Using a mixed methods approach, the authors examine the challenges faced by correctional workers in a work release correctional…

Age-related variation in primary care-type presentations to emergency departments.

PubMed

Freed, Gary; Gafforini, Sarah; Carson, Norman

2015-08-01

A significant amount of attention has been paid to the increase in emergency department (ED) presentations in Australia. Questions have arisen regarding whether all of those presenting to the ED are actually in need of true emergency services. Under-standing the characteristics of those patients who may be cared for in non-emergency settings is important for future health system strategies. The aim of this study was to identify age-related variation in primary care type emergency department (ED) presentations over time. A secondary analysis of data from the Victorian emergency minimum dataset (VEMD) between 2002-13 was conducted. The main outcomes were patterns of primary care type ED presentations for different ages groups over time, age-specific patterns of specific primary care type exclusion criteria and primary care type ED presentations by residents from aged care facilities. The proportion of triage category 4 or 5 ED presentations that met the criteria for a primary care type visit was greatest in the 0-4-year age group and tended to decrease as the age of the patient increased. Triage category 4 or 5 presentation by ambulance was uncommon in the younger age groups, surpassed 10% in the 50-54-year age group, and was >70% for those aged >90 years. The greater proportion of residential aged care facility patients who arrived by ambulance resulted in a much smaller proportion of primary care type visits. There are marked differences by age in the proportion of triage category 4 or 5 ED presentations that met the criteria for primary care type visits. These results indicate it was primarily younger patients who presented to the ED with non-urgent conditions. Most might be able to safely receive care in a primary care setting.

33 CFR 127.1205 - Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1205 Emergency shutdown. (a) Each... elements that melt at less than 105 °C (221 °F) and activate the emergency shutdown, or have a sensor that...

33 CFR 127.1205 - Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Hazardous Gas Equipment § 127.1205 Emergency shutdown. (a) Each... elements that melt at less than 105 °C (221 °F) and activate the emergency shutdown, or have a sensor that...

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

20 CFR 638.530 - Emergency use of personnel, equipment and facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... facilities. 638.530 Section 638.530 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.530 Emergency use of personnel, equipment and facilities. The Job Corps Director may provide emergency...

Measuring facility capability to provide routine and emergency childbirth care to mothers and newborns: An appeal to adjust for delivery caseload of facilities

PubMed Central

Allen, Stephanie M.; Opondo, Charles; Campbell, Oona M. R.

2017-01-01

Background Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. Methods We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care. A facility was considered capable of providing a function if necessary tracer items were present and, for emergency functions, if the function had been performed in the previous three months. We weighted facility capability by delivery caseload, and compared results with those generated using traditional “survey weights”. Results Of the 403 facilities providing childbirth care, the proportion meeting criteria for capability were: 13% for general infrastructure, 6% for basic emergency obstetric care, 3% for basic emergency newborn care, 13% and 11% for routine maternal and newborn care, respectively. When the new caseload weights accounting for delivery volume were applied, capability improved and the proportions of deliveries occurring in a facility meeting capability criteria were: 51% for general infrastructure, 46% for basic emergency obstetric care, 12% for basic emergency newborn care, 36% and 18% for routine maternal and newborn care, respectively. This is because most of the caseload was in hospitals, which generally had better capability. Despite these findings, fewer than 2% of deliveries occurred in a facility capable of providing all functions. Conclusion Reporting on the percentage of facilities capable of providing certain functions misrepresents the capacity to provide care at the national level. Delivery caseload weights allow adjustment for patient volume, and shift the denominator of measurement from facilities to individual deliveries, leading to a better representation of the context in which facility births take place. These methods could lead to more standardized national datasets, enhancing their ability to inform policy at a national and international level. PMID:29049412

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...

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...

33 CFR 154.1035 - Specific requirements for facilities that could reasonably be expected to cause significant and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... spill management team member within the organizational structure described in paragraph (b)(3)(iii) of... discharge, potential discharge, or emergency involving the following equipment and scenarios: (A) Failure of manifold, mechanical loading arm, other transfer equipment, or hoses, as appropriate; (B) Tank overfill; (C...

29 CFR 1926.23 - First aid and medical attention.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false First aid and medical attention. 1926.23 Section 1926.23... Provisions § 1926.23 First aid and medical attention. First aid services and provisions for medical care... prescribing specific requirements for first aid, medical attention, and emergency facilities are contained in...

Perceptions of the importance of physical setting in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-01-01

Research indicates that architectural design can provide therapeutic effects. Six setting characteristics are considered of primary importance in health-care facilities: comforts and conveniences, safety, attractiveness, size, privacy, and arrangement/location. This study presents the perceptions regarding these and other setting features held by female clients and staff from a substance abuse treatment facility. Results support the importance of these six setting characteristics in influencing clients' treatment goals. Four other setting variables emerged as important to women's recovery: participation in a residential, drug-free, gender-specific program that provides on-site child care. Attention to these variables may provide facilities with an advantage in today's competitive market for clients.

A statewide model program to improve emergency department readiness for pediatric care.

PubMed

Cichon, Mark E; Fuchs, Susan; Lyons, Evelyn; Leonard, Daniel

2009-08-01

Pediatric emergency patients have unique needs, requiring specialized personnel, training, equipment, supplies, and medications. Deficiencies in these areas have resulted in historically poorer outcomes for pediatric patients versus adults. Since 1985, federally funded Emergency Medical Services for Children (EMSC) programs in each state have been working to improve the quality of pediatric emergency care. The Health Resources and Services Administration now requires that all EMSC grantees report on specific performance measures. This includes implementation of a standardized system recognizing hospitals that are able to stabilize or manage pediatric medical emergencies and trauma cases. We describe the steps involved in implementing Illinois' 3-level facility recognition process to illustrate a model that other states might use to provide appropriate pediatric care and comply with new Health Resources and Services Administration performance measures.

Cleanups in My Community

EPA Pesticide Factsheets

Cleanups in My Community (CIMC) is a public web application that enables integrated access through maps, lists and search filtering to site-specific information EPA has across all cleanup programs. CIMC taps into data publicly available from EPA's EnviroFacts (RCRA Corrective Action facilities, Brownfields properties and grant areas, Superfund NPL sites, other facility data) and web services (water monitoring stations, impaired waters, emergency responses, tribal boundaries, congressional districts, etc.) and connects to other applications (e.g., Superfund's CPAD) to provide easy seamless access to site-specific cleanup information with explanatory text and within the context of related data. Data can be filtered by cleanup program, geography, environmental indicators, controls, and cleanup stage. CIMC also provides some web services that integrate these data for others to use in their applications.

32 CFR 644.486 - Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or similar contracts. 644.486 Section 644.486 National... Disposal of buildings and improvements constructed under emergency plant facilities (EPF) or similar...

Landlord project multi-year program plan, fiscal year 1999, WBS 1.5

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

Dallas, M.D.

The MYWP technical baseline describes the work to be accomplished by the Project and the technical standards which govern that work. The mission of Landlord Project is to provide more maintenance replacement of general infrastructure facilities and systems to facilitate the Hanford Site cleanup mission. Also, once an infrastructure facility or system is no longer needed the Landlord Project transitions the facility to final closure/removal through excess, salvage or demolition. Landlord Project activities will be performed in an environmentally sound, safe, economical, prudent, and reliable manner. The Landlord Project consists of the following facilities systems: steam, water, liquid sanitary waste,more » electrical distribution, telecommunication, sanitary landfill, emergency services, general purpose offices, general purpose shops, general purpose warehouses, environmental supports facilities, roads, railroad, and the site land. The objectives for general infrastructure support are reflected in two specific areas, (1) Core Infrastructure Maintenance, and (2) Infrastructure Risk Mitigation.« less

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

26 CFR 1.168A-6 - Depreciation of portion of emergency facility not subject to amortization.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Depreciation of portion of emergency facility... for Individuals and Corporations § 1.168A-6 Depreciation of portion of emergency facility not subject... in lieu of any deduction for depreciation which would otherwise be allowable under section 167 is...

Pediatric issues in disaster management, Part 1: the emergency medical system and surge capacity.

PubMed

Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

2010-01-01

Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. The authors discuss key components of disaster planning and management for pediatric patients, including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs (SHCNs), mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three-part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate setup and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: children with SHCNs and mental health issues.

44 CFR 352.6 - FEMA determination on the commitment of Federal facilities and resources.

Code of Federal Regulations, 2011 CFR

2011-10-01

... commitment of Federal facilities and resources. 352.6 Section 352.6 Emergency Management and Assistance... PLANTS: EMERGENCY PREPAREDNESS PLANNING Certifications and Determinations § 352.6 FEMA determination on the commitment of Federal facilities and resources. (a) A licensee request for Federal facilities and...

44 CFR 206.252 - Insurance requirements for facilities damaged by flood.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities damaged by flood. 206.252 Section 206.252 Emergency Management and Assistance FEDERAL EMERGENCY... Assistance Insurance Requirements § 206.252 Insurance requirements for facilities damaged by flood. (a) Where... insurance policy. (b) The reduction stated above shall not apply to a PNP facility which could not be...

Why Are Women Dying When They Reach Hospital on Time? A Systematic Review of the ‘Third Delay’

PubMed Central

Knight, Hannah E.; Self, Alice; Kennedy, Stephen H.

2013-01-01

Background The ‘three delays model’ attempts to explain delays in women accessing emergency obstetric care as the result of: 1) decision-making, 2) accessing services and 3) receipt of appropriate care once a health facility is reached. The third delay, although under-researched, is likely to be a source of considerable inequity in access to emergency obstetric care in developing countries. The aim of this systematic review was to identify and categorise specific facility-level barriers to the provision of evidence-based maternal health care in developing countries. Methods and Findings Five electronic databases were systematically searched using a 4-way strategy that combined search terms related to: 1) maternal health care; 2) maternity units; 3) barriers, and 4) developing countries. Forty-three original research articles were eligible to be included in the review. Thirty-two barriers to the receipt of timely and appropriate obstetric care at the facility level were identified and categorised into six emerging themes (Drugs and equipment; Policy and guidelines; Human resources; Facility infrastructure; Patient-related and Referral-related). Two investigators independently recorded the frequency with which barriers relating to the third delay were reported in the literature. The most commonly cited barriers were inadequate training/skills mix (86%); drug procurement/logistics problems (65%); staff shortages (60%); lack of equipment (51%) and low staff motivation (44%). Conclusions This review highlights how a focus on patient-side delays in the decision to seek care can conceal the fact that many health facilities in the developing world are still chronically under-resourced and unable to cope effectively with serious obstetric complications. We stress the importance of addressing supply-side barriers alongside demand-side factors if further reductions in maternal mortality are to be achieved. PMID:23704943

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

Determinants of non-urgent Emergency Department attendance among females in Qatar.

PubMed

Read, Jen'nan Ghazal; Varughese, Shinu; Cameron, Peter A

2014-01-01

The use of emergency department (ED) services for non-urgent conditions is well-studied in many Western countries but much less so in the Middle East and Gulf region. While the consequences are universal-a drain on ED resources and poor patient outcomes-the causes and solutions are likely to be region and country specific. Unique social and economic circumstances also create gender-specific motivations for patient attendance. Alleviating demand on ED services requires understanding these circumstances, as past studies have shown. We undertook this study to understand why female patients with low-acuity conditions choose the emergency department in Qatar over other healthcare options. Prospective study at Hamad General Hospital's (HGH) emergency department female "see-and-treat" unit that treats low-acuity cases. One hundred female patients were purposively recruited to participate in the study. Three trained physicians conducted semi-structured interviews with patients over a three-month period after they had been treated and given informed consent. The study found that motivations for ED attendance were systematically influenced by employment status as an expatriate worker. Forty percent of the sample had been directed to the ED by their employers, and the vast majority (89%) of this group cited employer preference as the primary reason for choosing the ED. The interviews revealed that a major obstacle to workers using alternative facilities was the lack of a government-issued health card, which is available to all citizens and residents at a nominal rate. Reducing the number of low-acuity cases in the emergency department at HGH will require interventions aimed at encouraging patients with non-urgent conditions to use alternative healthcare facilities. Potential interventions include policy changes that require employers to either provide workers with a health card or compel employees to acquire one for themselves.

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2011 CFR

2011-01-01

... could communicate with a safety system. In this case, appropriate isolation devices would be required at..., feedwater flow, and reactor power; (2) Safety injection: Reactor core isolation cooling flow, high-pressure... data points identified in the ERDS Data Point Library 9 (site specific data base residing on the ERDS...

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2010 CFR

2010-01-01

... could communicate with a safety system. In this case, appropriate isolation devices would be required at..., feedwater flow, and reactor power; (2) Safety injection: Reactor core isolation cooling flow, high-pressure... data points identified in the ERDS Data Point Library 9 (site specific data base residing on the ERDS...

18 CFR 292.307 - System emergencies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false System emergencies. 292... § 292.307 System emergencies. (a) Qualifying facility obligation to provide power during system... during a system emergency only to the extent: (1) Provided by agreement between such qualifying facility...

18 CFR 292.307 - System emergencies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false System emergencies. 292... § 292.307 System emergencies. (a) Qualifying facility obligation to provide power during system... during a system emergency only to the extent: (1) Provided by agreement between such qualifying facility...

44 CFR 331.5 - Production facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Production facilities. 331.5 Section 331.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... and essential economic and strategic factors. ...

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... radioactive waste in a licensed storage facility; (3) Obtaining access to a disposal facility by voluntary... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission...

Emergency, anaesthetic and essential surgical capacity in the Gambia

PubMed Central

Shivute, Nestor; Bickler, Stephen; Cole-Ceesay, Ramou; Jargo, Bakary; Abdullah, Fizan; Cherian, Meena

2011-01-01

Abstract Objective To assess the resources for essential and emergency surgical care in the Gambia. Methods The World Health Organization’s Tool for Situation Analysis to Assess Emergency and Essential Surgical Care was distributed to health-care managers in facilities throughout the country. The survey was completed by 65 health facilities – one tertiary referral hospital, 7 district/general hospitals, 46 health centres and 11 private health facilities – and included 110 questions divided into four sections: (i) infrastructure, type of facility, population served and material resources; (ii) human resources; (iii) management of emergency and other surgical interventions; (iv) emergency equipment and supplies for resuscitation. Questionnaire data were complemented by interviews with health facility staff, Ministry of Health officials and representatives of nongovernmental organizations. Findings Important deficits were identified in infrastructure, human resources, availability of essential supplies and ability to perform trauma, obstetric and general surgical procedures. Of the 18 facilities expected to perform surgical procedures, 50.0% had interruptions in water supply and 55.6% in electricity. Only 38.9% of facilities had a surgeon and only 16.7% had a physician anaesthetist. All facilities had limited ability to perform basic trauma and general surgical procedures. Of public facilities, 54.5% could not perform laparotomy and 58.3% could not repair a hernia. Only 25.0% of them could manage an open fracture and 41.7% could perform an emergency procedure for an obstructed airway. Conclusion The present survey of health-care facilities in the Gambia suggests that major gaps exist in the physical and human resources needed to carry out basic life-saving surgical interventions. PMID:21836755

STS-60 Cosmonauts in Weightless Environment Training Facility (WETF) training

NASA Image and Video Library

1993-01-07

S93-26022 (Feb 1993) --- Russian cosmonaut Sergei Krikalev maneuvers a small life raft during bailout training at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Shuttle crew members frequently utilize the 25-ft. deep pool to learn proper procedures to follow in the event of emergency egress from their Space Shuttle via the escape pole system. Krikalev is one of two cosmonauts in training for the STS-60 mission. One of the two will serve as primary payload specialist with the other filling an alternate's role. This pool and the facility in which it is housed are titled the WET-F because they are also used by astronauts rehearsing both mission-specific and contingency extravehicular activities (EVA).

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

33 CFR 146.125 - Emergency drills.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Emergency drills. 146.125 Section... CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.125 Emergency drills. (a) Emergency drills shall be conducted at least once each month by the person in charge of the manned facility. The drill...

76 FR 21299 - Emergency Planning and Notification; Emergency Planning and List of Extremely Hazardous...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-15

...EPA is proposing to revise the manner by which the regulated community would apply the threshold planning quantities (TPQs) for those extremely hazardous substances (EHSs) that are non-reactive solid chemicals in solution form. Specifically, facilities with a solid EHS in solution would be subject to the Emergency Planning requirements if the amount of the solid chemical on-site, when multiplied by 0.2, equaled or exceeded the lower published TPQ, based on data that shows less potential for the solid chemical in solution to remain airborne in the event of an accidental release. Previously, EPA assumed that 100% of the chemical could become airborne in the event of an accidental release.

Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

PubMed

Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

2015-11-25

The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase service access across the catchment in remote rural contexts and requires accompanying measures for demand enhancement, transportation access, and targeting of the more disadvantaged clientele.

Emergency service: a strategy for hospital-sponsored ambulatory care satellites.

PubMed

Gregory, D; Klegon, D; Steinhauer, B

1984-01-01

This analysis of the overall market position of free-standing emergency care was based on a telephone survey of 300 randomly chosen households in a southeastern metropolitan area. Results show that consumer preferences for cost and convenience create a strong market for free-standing emergency facilities. Emergicare centers are in an ideal situation to capture the market for acute and minor emergency care. To be worthwhile, the emergency room in a more comprehensive ambulatory care facility should serve as a feeder of new patients and be profitable in its own right. However, free-standing emergency facilities must not only attract patients through convenience and price, but they must also maintain patients through assuring quality care and satisfaction.

33 CFR 127.205 - Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.205 Emergency shutdown. Each transfer... automatically when the fixed sensors under § 127.201(b) measure LNG concentrations exceeding 40% of the lower...

33 CFR 127.205 - Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) WATERFRONT FACILITIES WATERFRONT FACILITIES HANDLING LIQUEFIED NATURAL GAS AND LIQUEFIED HAZARDOUS GAS Waterfront Facilities Handling Liquefied Natural Gas Equipment § 127.205 Emergency shutdown. Each transfer... automatically when the fixed sensors under § 127.201(b) measure LNG concentrations exceeding 40% of the lower...

Review of emergency obstetric care interventions in health facilities in the Upper East Region of Ghana: a questionnaire survey.

PubMed

Kyei-Onanjiri, Minerva; Carolan-Olah, Mary; Awoonor-Williams, John Koku; McCann, Terence V

2018-03-15

Maternal morbidity and mortality is most prevalent in resource-poor settings such as sub-Saharan Africa and southern Asia. In sub-Saharan Africa, Ghana is one of the countries still facing particular challenges in reducing its maternal morbidity and mortality. Access to emergency obstetric care (EmOC) interventions has been identified as a means of improving maternal health outcomes. Assessing the range of interventions provided in health facilities is, therefore, important in determining capacity to treat obstetric emergencies. The aim of this study was to examine the availability of emergency obstetric care interventions in the Upper East Region of Ghana. A cross-sectional survey of 120 health facilities was undertaken. Status of emergency obstetric care was assessed through an interviewer administered questionnaire to directors/in-charge officers of maternity care units in selected facilities. Data were analysed using descriptive statistics. Eighty per cent of health facilities did not meet the criteria for provision of emergency obstetric care. Comparatively, private health facilities generally provided EmOC interventions less frequently than public health facilities. Other challenges identified include inadequate skill mix of maternity health personnel, poor referral processes, a lack of reliable communication systems and poor emergency transport systems. Multiple factors combine to limit women's access to a range of essential maternal health services. The availability of EmOC interventions was found to be low across the region; however, EmOC facilities could be increased by nearly one-third through modest investments in some existing facilities. Also, the key challenges identified in this study can be improved by enhancing pre-existing health system structures such as Community-based Health Planning and Services (CHPS), training more midwifery personnel, strengthening in-service training and implementation of referral audits as part of health service monitoring. Gaps in availability of EmOC interventions, skilled personnel and referral processes must be tackled in order to improve obstetric outcomes.

Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities.

PubMed

Calvello, Emilie J B; Tenner, Andrea G; Broccoli, Morgan C; Skog, Alexander P; Muck, Andrew E; Tupesis, Janis P; Brysiewicz, Petra; Teklu, Sisay; Wallis, Lee; Reynolds, Teri

2016-08-01

A major barrier to successful integration of acute care into health systems is the lack of consensus on the essential components of emergency care within resource-limited environments. The 2013 African Federation of Emergency Medicine Consensus Conference was convened to address the growing need for practical solutions to further implementation of emergency care in sub-Saharan Africa. Over 40 participants from 15 countries participated in the working group that focused on emergency care delivery at health facilities. Using the well-established approach developed in the WHO's Monitoring Emergency Obstetric Care, the workgroup identified the essential services delivered-signal functions-associated with each emergency care sentinel condition. Levels of emergency care were assigned based on the expected capacity of the facility to perform signal functions, and the necessary human, equipment and infrastructure resources identified. These consensus-based recommendations provide the foundation for objective facility capacity assessment in developing emergency health systems that can bolster strategic planning as well as facilitate monitoring and evaluation of service delivery. 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/

Biosafety and biosecurity measures: management of biosafety level 3 facilities.

PubMed

Zaki, Adel N

2010-11-01

With the increasing biological threat from emerging infectious diseases and bioterrorism, it has become essential for governments around the globe to increase awareness and preparedness for identifying and containing those agents. This article introduces the basic concepts of laboratory management, laboratory biosafety and laboratory biosecurity. Assessment criteria for laboratories' biorisk should include both biosafety and biosecurity measures. The assessment requires setting specific goals and selecting management approaches. In order to implement technologies at the laboratory working level, a management team should be created whose role is to implement biorisk policies, rules and regulations appropriate for that facility. Rules and regulations required by government authorities are presented, with special emphasis on methods for air control, and liquid and solid waste management. Management and biorisk measures and appropriate physical facilities must keep pace, ensuring efficient facilities that protect workers, the environment, the product (research, diagnostic and/or vaccine) and the biological pathogen. Published by Elsevier B.V.

44 CFR 321.5 - Retention of industrial facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Retention of industrial facilities. 321.5 Section 321.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS MAINTENANCE OF THE MOBILIZATION BASE (DEPARTMENT OF DEFENSE...

40 CFR 267.55 - What is the role of the emergency coordinator?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false What is the role of the emergency... STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.55 What is the role of the emergency... familiar with all aspects of the facility's contingency plan, all operations and activities at the facility...

78 FR 65690 - Trees and Plantings Associated With Eligible Facilities, RP9524.5

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

...] Trees and Plantings Associated With Eligible Facilities, RP9524.5 AGENCY: Federal Emergency Management... policy Trees and Plantings Associated with Eligible Facilities. The Federal Emergency Management Agency... trees, shrubs, and other plantings, including limited eligibility for replacement of grass and sod...

44 CFR 321.5 - Retention of industrial facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities. 321.5 Section 321.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY..., DEPARTMENT OF ENERGY, MARITIME ADMINISTRATION) § 321.5 Retention of industrial facilities. (a) Industrial... components in a mobilization period. (b) Each idle plant in the reserves shall be reviewed annually by the...

The association between the availability of ambulatory care and non-emergency treatment in emergency medicine departments: a comprehensive and nationwide validation.

PubMed

Chan, Chien-Lung; Lin, Wender; Yang, Nan-Ping; Huang, Hsin-Tsung

2013-05-01

To quantify dynamic availability of ambulatory care, and to examine possible associations with non-emergency treatments in emergency departments (EDs). Longitudinal data from the Taiwan National health Insurance Research Database were used to evaluate 749,584 emergency-medicine cases occurring between 2005 and 2010 according to a modified New York University algorithm. Multivariable-cumulative-logistic-regression analysis with generalized estimating-equation methods was used to determine associations between availability of ambulatory care and the urgency of patients' medical needs during ED visits. More than half (53.04%) of the ED visits that were evaluated in our study were classified as non-emergencies, and over half of these occurred despite a high availability of ambulatory care facilities (median > 96%). Compared with patients in areas with a low availability of ambulatory care, patients in areas of medium to high availability showed approximately 0.8 times lower odds ratios for associations with non-emergency ED visits. Non-emergency ED visits may be reduced by increasing the availability of ambulatory care facilities in areas with deficits in the availability of such facilities. However, increasing the availability of ambulatory care by raising the number of available ambulatory care physicians or the number of ambulatory care facilities may not reduce non-emergency ED visits in areas with medium to high availability of ambulatory care facilities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

STS-60 Cosmonauts in Weightless Environment Training Facility (WETF) training

NASA Image and Video Library

1993-01-07

S93-26021 (Feb 1993) --- Russian cosmonaut Sergei Krikalev maneuvers a small life raft during bailout training at the Johnson Space Center's (JSC) Weightless Environment Training Facility (WET-F). Two SCUBA-equipped divers assisted Krikalev in the STS-60 training exercise. Shuttle crew members frequently utilize the 25-ft. deep pool to learn proper procedures to follow in the event of emergency egress from their Space Shuttle via the escape pole system. Krikalev is one of two cosmonauts in training for the STS-60 mission. One of the two will serve as primary payload specialist with the other filling an alternate's role. This pool and the facility in which it is housed are titled the WET-F, because they are also used by astronauts rehearsing both mission-specific and contingency extravehicular activities (EVA).

Cardiovascular emergency preparedness in recreation facilities at major US universities: college fitness center emergency readiness.

PubMed

Herbert, William G; Herbert, David L; McInnis, Kyle J; Ribisl, Paul M; Franklin, Barry A; Callahan, Mandy; Hood, Aaron W

2007-01-01

Recent American Heart Association/American College of Sports Medicine (AHA/ACSM) guidelines advocate preparticipation screening, planning, and rehearsal for emergencies and automated external defibrillators in all health/fitness facilities. The authors evaluated adherence to these recommendations at 158 recreational service departments in major US universities (51% response rate for 313 institutions queried). Many made their facilities available to unaffiliated residents, with 39% offering programs for those with special medical conditions. Only 18% performed universal preparticipation screening. Twenty-seven percent reported having 1 or more exercise-related instances of cardiac arrest or sudden cardiac death within the past 5 years. Seventy-three percent had an automated external defibrillator, but only 6% reported using it in an emergency. Almost all had written emergency plans, but only 50% posted their plans, and only 27% performed the recommended quarterly emergency drills. The authors' findings suggest low awareness of and adherence to the AHA/ACSM recommendations for identifying individuals at risk for exercise-related cardiovascular complications and for handling such emergencies in university-based fitness facilities. (

44 CFR 352.24 - Provision of technical assistance and Federal facilities and resources.

Code of Federal Regulations, 2011 CFR

2011-10-01

... assistance and Federal facilities and resources. 352.24 Section 352.24 Emergency Management and Assistance... PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal Participation § 352.24 Provision of technical assistance and Federal facilities and resources. (a) Under a determination under subpart A (44 CFR 352.5(f) and...

44 CFR 206.252 - Insurance requirements for facilities damaged by flood.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities damaged by flood. 206.252 Section 206.252 Emergency Management and Assistance FEDERAL EMERGENCY... Assistance Insurance Requirements § 206.252 Insurance requirements for facilities damaged by flood. (a) Where an insurable building damaged by flooding is located in a special flood hazard area identified for...

75 FR 63209 - Indiana Michigan Power Company; Notice of Consideration of Issuance of Amendment to Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... emergency operating procedures (EOP), and site survey monitoring that support modification of emergency plan... Power Company; Notice of Consideration of Issuance of Amendment to Facility Operating License, Proposed... Regulatory Commission (the Commission) is considering issuance of an amendment to Facility Operating License...

Use of the Homeland-Defense Operational Planning System (HOPS) for Emergency Management

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

Durling, Jr., R L; Price, D E

2005-12-16

The Homeland-Defense Operational Planning System (HOPS), is a new operational planning tool leveraging Lawrence Livermore National Laboratory's expertise in weapons systems and in sparse information analysis to support the defense of the U.S. homeland. HOPS provides planners with a basis to make decisions to protect against acts of terrorism, focusing on the defense of facilities critical to U.S. infrastructure. Criticality of facilities, structures, and systems is evaluated on a composite matrix of specific projected casualty, economic, and sociopolitical impact bins. Based on these criteria, significant unidentified vulnerabilities are identified and secured. To provide insight into potential successes by malevolent actors,more » HOPS analysts strive to base their efforts mainly on unclassified open-source data. However, more cooperation is needed between HOPS analysts and facility representatives to provide an advantage to those whose task is to defend these facilities. Evaluated facilities include: refineries, major ports, nuclear power plants and other nuclear licensees, dams, government installations, convention centers, sports stadiums, tourist venues, and public and freight transportation systems. A generalized summary of analyses of U.S. infrastructure facilities will be presented.« less

A cross-sectional survey of essential surgical capacity in Somalia

PubMed Central

Elkheir, Natalie; Sharma, Akshay; Cherian, Meena; Saleh, Omar Abdelrahman; Everard, Marthe; Popal, Ghulam Rabani; Ibrahim, Abdi Awad

2014-01-01

Objective To assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems. Design Cross-sectional survey. Setting Health facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS). Participants 14 health facilities. Measures The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment. Results The 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities. Conclusions According to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the allocation of resources and provision of emergency and essential surgical services. PMID:24812189

A cross-sectional survey of essential surgical capacity in Somalia.

PubMed

Elkheir, Natalie; Sharma, Akshay; Cherian, Meena; Saleh, Omar Abdelrahman; Everard, Marthe; Popal, Ghulam Rabani; Ibrahim, Abdi Awad

2014-05-07

To assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems. Cross-sectional survey. Health facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS). 14 health facilities. The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment. The 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities. According to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the allocation of resources and provision of emergency and essential surgical services.

10 CFR 205.379 - Application for approval of the installation of permanent facilities for emergency use only.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Emergency Interconnection of Electric Facilities and the Transfer of Electricity to Alleviate An Emergency Shortage of Electric Power § 205.379 Application for approval of the installation of...

75 FR 33821 - Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-15

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0024] Recovery Policy RP9524.10; Direct Disaster-Related Damage to Eligible Facilities AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice of availability; request for comments. SUMMARY: The Federal Emergency...

Environmental Assessment for the NASA First Response Facility

NASA Technical Reports Server (NTRS)

Kennedy, Carolyn

2003-01-01

NASA intends to construct a First Response Facility for integrated emergency response and health management. This facility will consolidate the Stennis Space Center fire department, medical clinic, security operations, emergency operations and the energy management and control center. The alternative considered is the "No Action Alternative". The proposed action will correct existing operational weaknesses and enhance capabilities to respond to medical emergencies and mitigate any other possible threats. Environmental impacts include are emissions, wetlands disturbance, solid waste generation, and storm water control.

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the disposal facility or facilities which had been receiving the waste stream of concern before the... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...

Hurricane risk mitigation - Emergency Operations Center

NASA Image and Video Library

2008-07-29

Construction work on a new Emergency Operations Center at Stennis Space Center is nearing completion. Construction is expected to be complete by February 2009, with actual occupancy of the building planned for later that year. The new building will house fire, medical and security teams and will provide a top-grade facility to support storm emergency responder teams and emergency management operations for the south Mississippi facility.

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness

PubMed Central

Dettinger, Julia; Calkins, Kimberly; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys

2018-01-01

Background Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. Objective-method We compare emergency readiness using the signal functions model and a novel clinical cascade. The cascades model readiness as the proportion of facilities with resources to identify the emergency (stage 1), treat it (stage 2) and monitor-modify therapy (stage 3). Data were collected from 44 Kenyan clinics as part of an implementation trial. Findings Although most facilities (77.0%) stock maternal signal function tracer drugs, far fewer have resources to practically identify and treat emergencies. In hypertensive emergencies for example, 38.6% of facilities have resources to identify the emergency (Stage 1 readiness, including sphygmomanometer, stethoscope, urine collection device, protein test). 6.8% have the resources to treat the emergency (Stage 2, consumables (IV Kit, fluids), durable goods (IV pole) and drugs (magnesium sulfate and hydralazine). No facilities could monitor or modify therapy (Stage 3). Across five maternal emergencies, the signal functions overestimate readiness by 54.5%. A consistent, step-wise pattern of readiness loss across signal functions and care stage emerged and was profoundly consistent at 33.0%. Significance Comparing estimates from the maternal signal functions and cascades illustrates four themes. First, signal functions overestimate practical readiness by 55%. Second, the cascade’s intuitive indicators can support cross-sector health system or program planners to more precisely measure and improve emergency care. Third, adding few variables to existing readiness inventories permits step-wise modeling of readiness loss and can inform more precise interventions. Fourth, the novel aggregate readiness loss indicator provides an innovative and intuitive approach for modeling health system emergency readiness. Additional testing in diverse contexts is warranted. PMID:29474397

EPA RE-Powering Mapper: Alternative Energy Potential at Cleanup Sites

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management??s (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 10

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 4

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Large Scale

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 2

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 6

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 8

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 7

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 5

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 3

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Solar on Landfills

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 9

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Utility Scale

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Screening Shapefile

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Center for Program Analysis (CPA) initiated the RE-Powering America??s Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

EPA RE-Powering Mapper Region 1

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Office of Land and Emergency Management (OLEM) Office of Communications, Partnerships and Analysis (OCPA) initiated the RE-Powering America's Land Initiative to demonstrate the enormous potential that contaminated lands, landfills, and mine sites provide for developing renewable energy in the United States. EPA developed national level site screening criteria in partnership with the U.S. Department of Energy (DOE) National Renewable Energy Laboratory (NREL) for wind, solar, biomass, and geothermal facilities. While the screening criteria demonstrate the potential to reuse contaminated land for renewable energy facilities, the criteria and data are neither designed to identify the best sites for developing renewable energy nor all-inclusive. Therefore, more detailed, site-specific analysis is necessary to identify or prioritize the best sites for developing renewable energy facilities based on the technical and economic potential. Please note that these sites were only pre-screened for renewable energy potential. The sites were not evaluated for land use constraints or current on the ground conditions. Additional research and site-specific analysis are needed to verify viability for renewable energy potential at a given site.

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2013 CFR

2013-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2014 CFR

2014-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

10 CFR Appendix E to Part 50 - Emergency Planning and Preparedness for Production and Utilization Facilities

Code of Federal Regulations, 2012 CFR

2012-01-01

... organization shall be described. The communication steps to be taken to alert or activate emergency personnel... operations facility must include the following: (1) Space for members of an NRC site team and Federal, State, and local responders; (2) Additional space for conducting briefings with emergency response personnel...

40 CFR 355.10 - Must my facility comply with the emergency planning requirements of this subpart?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 28 2011-07-01 2011-07-01 false Must my facility comply with the emergency planning requirements of this subpart? 355.10 Section 355.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS...

38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

Code of Federal Regulations, 2010 CFR

2010-07-01

... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment...

40 CFR 370.41 - What is Tier I inventory information?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., and phone number. (g) Emergency contact. The name, title, and phone number(s) of at least one local... chemical accident at your facility. You must provide an emergency phone number where such emergency... the box marked N/A, not applicable. (g) The phone number of your facility (optional). (h) The North...

Determinants of non-urgent Emergency Department attendance among females in Qatar

PubMed Central

Read, Jen'nan Ghazal; Varughese, Shinu; Cameron, Peter A.

2014-01-01

Background: The use of emergency department (ED) services for non-urgent conditions is well-studied in many Western countries but much less so in the Middle East and Gulf region. While the consequences are universal—a drain on ED resources and poor patient outcomes—the causes and solutions are likely to be region and country specific. Unique social and economic circumstances also create gender-specific motivations for patient attendance. Alleviating demand on ED services requires understanding these circumstances, as past studies have shown. We undertook this study to understand why female patients with low-acuity conditions choose the emergency department in Qatar over other healthcare options. Setting and design: Prospective study at Hamad General Hospital's (HGH) emergency department female “see-and-treat” unit that treats low-acuity cases. One hundred female patients were purposively recruited to participate in the study. Three trained physicians conducted semi-structured interviews with patients over a three-month period after they had been treated and given informed consent. Results: The study found that motivations for ED attendance were systematically influenced by employment status as an expatriate worker. Forty percent of the sample had been directed to the ED by their employers, and the vast majority (89%) of this group cited employer preference as the primary reason for choosing the ED. The interviews revealed that a major obstacle to workers using alternative facilities was the lack of a government-issued health card, which is available to all citizens and residents at a nominal rate. Conclusion: Reducing the number of low-acuity cases in the emergency department at HGH will require interventions aimed at encouraging patients with non-urgent conditions to use alternative healthcare facilities. Potential interventions include policy changes that require employers to either provide workers with a health card or compel employees to acquire one for themselves. PMID:25745599

KENNEDY SPACE CENTER, FLA. - Emergency crew members transport an “injured” astronaut during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members transport an “injured” astronaut during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Hospital all-risk emergency preparedness in Ghana.

PubMed

Norman, I D; Aikins, M; Binka, F N; Nyarko, K M

2012-03-01

This paper assessed the emergency preparedness programs of health facilities for all-risks but focused on Road Traffic Accidents, (RTA) resulting in surge demand. It adopted W. H. O checklist covering hospital preparedness, equipment, manpower and surge capacity planning as best practices for the mitigation of public health emergencies. This is a cross-sectional study of purposively selected health facilities. The method used consisted of site visit, questionnaire survey, literature and internet review. The W. H. O. standard for emergency preparedness of health facilities was used to evaluate and assess the nation's hospitals surge capacity programs. The study was conducted between March-June, 2010. A total of 22 district and regional health facilities including teaching hospitals participated in the study. All 10 regions of the country were covered. These were: (1) many of the nation's hospitals were not prepared for large RTA's resulting in surge demands, and did not possess general emergency preparedness programs. (2) The hospitals' respective abilities to handle large scale RTA's were compromised by the lack of competent medical and allied health personnel and adequate supplies. The inadequacies of the hospital system in responding to emergencies raise serious public health concerns. The biggest challenge facing the hospitals in their emergency intervention is the lack of pre-emergency and emergency preparedness plans as well as the coordination of the hospitals response mechanisms. The paper ended with recommendations on how the nation's hospitals and their supervisory agencies could improve emergency preparedness.

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

Hazardous Materials Verification and Limited Characterization Report on Sodium and Caustic Residuals in Materials and Fuel Complex Facilities MFC-799/799A

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

Gary Mecham

2010-08-01

This report is a companion to the Facilities Condition and Hazard Assessment for Materials and Fuel Complex Sodium Processing Facilities MFC-799/799A and Nuclear Calibration Laboratory MFC-770C (referred to as the Facilities Condition and Hazards Assessment). This report specifically responds to the requirement of Section 9.2, Item 6, of the Facilities Condition and Hazards Assessment to provide an updated assessment and verification of the residual hazardous materials remaining in the Sodium Processing Facilities processing system. The hazardous materials of concern are sodium and sodium hydroxide (caustic). The information supplied in this report supports the end-point objectives identified in the Transition Planmore » for Multiple Facilities at the Materials and Fuels Complex, Advanced Test Reactor, Central Facilities Area, and Power Burst Facility, as well as the deactivation and decommissioning critical decision milestone 1, as specified in U.S. Department of Energy Guide 413.3-8, “Environmental Management Cleanup Projects.” Using a tailored approach and based on information obtained through a combination of process knowledge, emergency management hazardous assessment documentation, and visual inspection, this report provides sufficient detail regarding the quantity of hazardous materials for the purposes of facility transfer; it also provides that further characterization/verification of these materials is unnecessary.« less

An emergency medical planning guide for commercial spaceflight events.

PubMed

Law, Jennifer; Vanderploeg, James

2012-09-01

Commercial spaceflight events transporting paying passengers into space will begin to take place at various spaceports around the country within the next few years. Many spaceports are located in remote areas that are far from major hospitals and trauma centers. Spaceport medical directors should develop emergency medical plans (EMPs) to prepare for potential medical contingencies that may occur during commercial spaceflight events. The aim of this article is to guide spaceport medical directors in emergency medical planning for commercial spaceflight events. This guide is based on our experience and a recently developed EMP for Spaceport America which incorporated a literature review of mass gathering medicine, existing planning guides for mass gathering events, and EMPs for analogous aerospace events. We propose a multipronged approach to emergency medical planning, consisting of event planning, medical reconnaissance, medical personnel, protocols, physical facility and hardware, and documentation. Medical directors should use this guide to develop an emergency medical plan tailored to the resources and constraints specific to their events.

Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels

PubMed Central

Razzak, Junaid A; Baqir, Syed M; Khan, Uzma Rahim; Heller, David; Bhatti, Junaid; Hyder, Adnan A

2015-01-01

Background The importance of emergency medical care for the successful functioning of health systems has been increasingly recognised. This study aimed to evaluate emergency and trauma care facilities in four districts of the province of Sindh, Pakistan. Method We conducted a cross-sectional health facility survey in four districts of the province of Sindh in Pakistan using a modified version of WHO’s Guidelines for essential trauma care. 93 public health facilities (81 primary care facilities, nine secondary care hospitals, three tertiary hospitals) and 12 large private hospitals were surveyed. Interviews of healthcare providers and visual inspections of essential equipment and supplies as per guidelines were performed. A total of 141 physicians providing various levels of care were tested for their knowledge of basic emergency care using a validated instrument. Results Only 4 (44%) public secondary, 3 (25%) private secondary hospitals and all three tertiary care hospitals had designated emergency rooms. The majority of primary care health facilities had less than 60% of all essential equipments overall. Most of the secondary level public hospitals (78%) had less than 60% of essential equipments, and none had 80% or more. A fourth of private secondary care facilities and all tertiary care hospitals (n=3; 100%) had 80% or more essential equipments. The average percentage score on the physician knowledge test was 30%. None of the physicians scored above 60% correct responses. Conclusions The study findings demonstrated a gap in both essential equipment and provider knowledge necessary for effective emergency and trauma care. PMID:24157684

44 CFR 312.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.1... civil defense personnel, materials, and facilities, supported in whole or in part through contributions...

44 CFR 312.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.1... civil defense personnel, materials, and facilities, supported in whole or in part through contributions...

44 CFR 312.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.1... civil defense personnel, materials, and facilities, supported in whole or in part through contributions...

44 CFR 312.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.1... civil defense personnel, materials, and facilities, supported in whole or in part through contributions...

44 CFR 312.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.1... civil defense personnel, materials, and facilities, supported in whole or in part through contributions...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FOR FACILITIES LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan”section is the core of the response plan. Put information in easy-to-use...

KENNEDY SPACE CENTER, FLA. - Emergency crew members assess medical needs on “injured” astronauts removed from the orbiter crew compartment mock-up during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members assess medical needs on “injured” astronauts removed from the orbiter crew compartment mock-up during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia.

PubMed

Girma, Meseret; Yaya, Yaliso; Gebrehanna, Ewenat; Berhane, Yemane; Lindtjørn, Bernt

2013-11-04

Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (<2% of expected births compared to an overall average of 6.6%). Moreover, some remotely located institutions had very high maternal deaths (>4% of deliveries, much higher than the average 1.9%). Based on a population of 1.7 million people, there should be 14 basic and four comprehensive emergency obstetric care (EmOC) facilities in the Zone. Our study found that only three basic and two comprehensive EmOC service qualifying facilities serve this large population which is below the UN's minimum recommendation. The utilization of the existing facilities for delivery was also low, which is clearly inadequate to reduce maternal deaths to the MDG target.

VIEW OF BUILDING 122 WHICH HOUSES THE ONSITE MEDICAL FACILITIES ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF BUILDING 122 WHICH HOUSES THE ON-SITE MEDICAL FACILITIES OF THE ROCKY FLATS PLANT AND THE OCCUPATIONAL HEALTH AND INTERNAL DOSIMETRY ORGANIZATIONS. EMERGENCY MEDICAL SERVICES, DIAGNOSIS, DECONTAMINATION, FIRST AID, X-RAY, MINOR SURGICAL TREATMENT, AND AMBULATORY ACTIVITIES ARE CARRIED OUT IN THIS BUILDING. (1/98) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

Nursing home evacuation plans.

PubMed

Castle, Nicholas G

2008-07-01

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

Report: EPA Lacks Internal Controls to Prevent Misuse of Emergency Drinking Water Facilities

EPA Pesticide Factsheets

Report #11-P-0001, October 12, 2010. EPA cannot accurately assess the risk of public water systems delivering contaminated drinking water from emergency facilities because of limitations in Safe Drinking Water Information System (SDWIS) data management.

Emergency care in 59 low- and middle-income countries: a systematic review

PubMed Central

Abujaber, Samer; Makar, Maggie; Stoll, Samantha; Kayden, Stephanie R; Wallis, Lee A; Reynolds, Teri A

2015-01-01

Abstract Objective To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. PMID:26478615

A large-scale computer facility for computational aerodynamics

NASA Technical Reports Server (NTRS)

Bailey, F. R.; Ballhaus, W. F., Jr.

1985-01-01

As a result of advances related to the combination of computer system technology and numerical modeling, computational aerodynamics has emerged as an essential element in aerospace vehicle design methodology. NASA has, therefore, initiated the Numerical Aerodynamic Simulation (NAS) Program with the objective to provide a basis for further advances in the modeling of aerodynamic flowfields. The Program is concerned with the development of a leading-edge, large-scale computer facility. This facility is to be made available to Government agencies, industry, and universities as a necessary element in ensuring continuing leadership in computational aerodynamics and related disciplines. Attention is given to the requirements for computational aerodynamics, the principal specific goals of the NAS Program, the high-speed processor subsystem, the workstation subsystem, the support processing subsystem, the graphics subsystem, the mass storage subsystem, the long-haul communication subsystem, the high-speed data-network subsystem, and software.

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.

KSC-06pd0517

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, an emergency rescue worker tends to an "injured astronaut" inside a rescue vehicle. Volunteers and emergency rescue workers are participating in a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Troy Cryder

KSC-06pd0516

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel gently place an "injured astronaut" onto a stretcher. Volunteers and emergency rescue workers are participating in a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Troy Cryder

Site Selection and Resource Allocation of Oil Spill Emergency Base for Offshore Oil Facilities

NASA Astrophysics Data System (ADS)

Li, Yunbin; Liu, Jingxian; Wei, Lei; Wu, Weihuang

2018-02-01

Based on the analysis of the historical data about oil spill accidents in the Bohai Sea, this paper discretizes oil spilled source into a limited number of spill points. According to the probability of oil spill risk, the demand for salvage forces at each oil spill point is evaluated. Aiming at the specific location of the rescue base around the Bohai Sea, a cost-benefit analysis is conducted to determine the total cost of disasters for each rescue base. Based on the relationship between the oil spill point and the rescue site, a multi-objective optimization location model for the oil spill rescue base in the Bohai Sea region is established. And the genetic algorithm is used to solve the optimization problem, and determine the emergency rescue base optimization program and emergency resources allocation ratio.

Mediating Systems of Care: Emergency Calls to Long-Term Care Facilities at Life's End.

PubMed

Waldrop, Deborah P; McGinley, Jacqueline M; Clemency, Brian

2018-04-09

Nursing home (NH) residents account for over 2.2 million emergency department visits yearly; the majority are cared for and transported by prehospital providers (emergency medical technicians and paramedics). The purpose of this study was to investigate prehospital providers' perceptions of emergency calls at life's end. This article focuses on perceptions of end-of-life calls in long-term care (LTC). This pilot study employed a descriptive cross-sectional design. Concepts from the symbolic interaction theory guided the exploration of perceptions and interpretations of emergency calls in LTC facilities. A purposeful sample of prehospital providers was developed from one agency in a small northeastern U.S. city. Semistructured interviews were conducted with 43 prehospital providers to explore their perceptions of factors that trigger emergency end-of-life calls in LTC facilities. Qualitative data analysis involved iterative coding in an inductive process that included open, systematic, focused, and axial coding. Interview themes illustrated the contributing factors as follows: care crises; dying-related turmoil; staffing ratios; and organizational protocols. Distress was crosscutting and present in all four themes. The findings illuminate how prehospital providers become mediators between NHs and emergency departments by managing tension, conflict, and challenges in patient care between these systems and suggest the importance of further exploration of interactions between LTC staff, prehospital providers, and emergency departments. Enhanced communication between LTC facilities and prehospital providers is important to address potentially inappropriate calls and transport requests and to identify means for collaboration in the care of sick frail residents.

KENNEDY SPACE CENTER, FLA. - Emergency crew members lower a volunteer “astronaut” from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members lower a volunteer “astronaut” from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KENNEDY SPACE CENTER, FLA. - A helicopter approaches an orbiter crew compartment mock-up as part of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - A helicopter approaches an orbiter crew compartment mock-up as part of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

[Resources and capacity of emergency trauma care services in Peru].

PubMed

Rosales-Mayor, Edmundo; Miranda, J Jaime; Lema, Claudia; López, Luis; Paca-Palao, Ada; Luna, Diego; Huicho, Luis

2011-09-01

The objectives of this study were to evaluate the resources and capacity of emergency trauma care services in three Peruvian cities using the WHO report Guidelines for Essential Trauma Care. This was a cross-sectional study in eight public and private healthcare facilities in Lima, Ayacucho, and Pucallpa. Semi-structured questionnaires were applied to the heads of emergency departments with managerial responsibility for resources and capabilities. Considering the profiles and volume of care in each emergency service, most respondents in all three cities classified their currently available resources as inadequate. Comparison of the health facilities showed a shortage in public services and in the provinces (Ayacucho and Pucallpa). There was a widespread perception that both human and physical resources were insufficient, especially in public healthcare facilities and in the provinces.

41 CFR 102-74.240 - What are Federal agencies' occupant emergency responsibilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.240 What are... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are Federal...

Uncertainty in Predicted Neighborhood-Scale Green Stormwater Infrastructure Performance Informed by field monitoring of Hydrologic Abstractions

NASA Astrophysics Data System (ADS)

Smalls-Mantey, L.; Jeffers, S.; Montalto, F. A.

2013-12-01

Human alterations to the environment provide infrastructure for housing and transportation but have drastically changed local hydrology. Excess stormwater runoff from impervious surfaces generates erosion, overburdens sewer infrastructure, and can pollute receiving bodies. Increased attention to green stormwater management controls is based on the premise that some of these issues can be mitigated by capturing or slowing the flow of stormwater. However, our ability to predict actual green infrastructure facility performance using physical or statistical methods needs additional validation, and efforts to incorporate green infrastructure controls into hydrologic models are still in their infancy stages. We use more than three years of field monitoring data to derive facility specific probability density functions characterizing the hydrologic abstractions provided by a stormwater treatment wetland, streetside bioretention facility, and a green roof. The monitoring results are normalized by impervious area treated, and incorporated into a neighborhood-scale agent model allowing probabilistic comparisons of the stormwater capture outcomes associated with alternative urban greening scenarios. Specifically, we compare the uncertainty introduced into the model by facility performance (as represented by the variability in the abstraction), to that introduced by both precipitation variability, and spatial patterns of emergence of different types of green infrastructure. The modeling results are used to update a discussion about the potential effectiveness of urban green infrastructure implementation plans.

AED use in businesses, public facilities and homes by minimally trained first responders.

PubMed

Jorgenson, Dawn B; Skarr, Teresa; Russell, James K; Snyder, David E; Uhrbrock, Karen

2003-11-01

Automated external defibrillators (AEDs) have become increasingly available outside of the Emergency Medical Systems (EMS) community to treat sudden cardiac arrest (SCA). We sought to study the use of AEDs in the home, businesses and other public settings by minimally trained first responders. The frequency of AED use, type of training offered to first responders, and outcomes of AED use were investigated. In addition, minimally trained responders were asked if they had encountered any safety problems associated with the AED. We conducted a telephone survey of businesses and public facilities (2683) and homes (145) owning at least one AED for at least 12 months. Use was defined as an AED taken to a medical emergency thought to be a SCA, regardless of whether the AED was applied to the patient or identified a shockable rhythm. Of owners that participated in the survey, 13% (209/1581) of businesses and 5% (4/73) of homes had responded with the AED to a suspected cardiac arrest. Ninety-five percent of the businesses/public facilities offered training that specifically covered AED use. The rate of use for the AEDs was highest in residential buildings, public places, malls and recreational facilities with an overall usage rate of 11.6% per year. In-depth interviews were conducted with lay responders who had used the AED in a suspected cardiac arrest. In the four cases where the AED was used solely by a lay responder, all four patients survived to hospital admission and two were known to be discharged from the hospital. There were no reports of injury or harm. This survey demonstrates that AEDs purchased by businesses and homes were frequently taken to suspected cardiac arrests. Lay responders were able to successfully use the AEDs in emergency situations. Further, there were no reports of harm or injury to the operators, bystanders or patients from lay responder use of the AEDs.

44 CFR 331.5 - Production facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Production facilities. 331.5... AND FACILITIES IN LABOR SURPLUS AREAS § 331.5 Production facilities. All Federal departments and... production facilities, including expansion, to the extent that such selection is consistent with existing law...

KSC-06pd0515

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency personnel lower an "injured astronaut" on a stretcher down the stairs of the orbiter mockup. Volunteers and emergency rescue workers are participating in a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Jim Grossmann

Hypothermia in a Rural Setting: An Emergency Medicine Simulation Scenario

PubMed Central

Jong, Robert; Heroux, Aron; Dubrowski, Adam

2017-01-01

Patients presenting with hypothermia in a rural emergency department can be quite challenging to manage without significant mortality and morbidity. Standard medical school curricula do not fully prepare trainees for the unique aspects of practice in northern rural and remote communities. Training opportunities on site may provide a solution to this lack of experience. However, these communities often have limited simulation-based resources and expertise for conducting and developing simulation scenarios. In this technical report, we outline a hypothermia simulation that utilizes only basic resources and is, thus, practical for rural and remote facilities. The aim of this report is to better equip trainees, clinicians, and emergency department staff who may encounter such a scenario in their practice. While the simulation is specifically designed for medical students, resident doctors, and emergency department staff, it could also be applicable in other low-resource settings, such as military bases, search and rescue stations, and arctic travel and tourism infirmaries. PMID:29511605

41 CFR 102-74.230 - Who is responsible for establishing an occupant emergency program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.230 Who is... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who is responsible for...

41 CFR 102-74.245 - Who makes the decision to activate the Occupant Emergency Organization?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency Program § 102-74.245... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who makes the decision...

44 CFR 351.21 - The Nuclear Regulatory Commission.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true The Nuclear Regulatory... Assignments § 351.21 The Nuclear Regulatory Commission. (a) Assess NRC nuclear facility (e.g., commercial... protect the health and safety of the public. (b) Verify that nuclear facility licensee emergency plans can...

44 CFR 351.21 - The Nuclear Regulatory Commission.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false The Nuclear Regulatory... Assignments § 351.21 The Nuclear Regulatory Commission. (a) Assess NRC nuclear facility (e.g., commercial... protect the health and safety of the public. (b) Verify that nuclear facility licensee emergency plans can...

44 CFR 351.21 - The Nuclear Regulatory Commission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false The Nuclear Regulatory... Assignments § 351.21 The Nuclear Regulatory Commission. (a) Assess NRC nuclear facility (e.g., commercial... protect the health and safety of the public. (b) Verify that nuclear facility licensee emergency plans can...

44 CFR 351.21 - The Nuclear Regulatory Commission.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false The Nuclear Regulatory... Assignments § 351.21 The Nuclear Regulatory Commission. (a) Assess NRC nuclear facility (e.g., commercial... protect the health and safety of the public. (b) Verify that nuclear facility licensee emergency plans can...

75 FR 44005 - Notice of Submission of Proposed Information Collection to OMB Emergency Comment Request, Capital...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... develop facilities to provide early childhood education, adult education, and/or job training programs for... Proposed Information Collection to OMB Emergency Comment Request, Capital Fund Education and Training... following information: Title of Proposal: Capital Fund Education and Training Community Facilities (CFCF...

KSC-06pd0499

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency personnel tend to "injured astronauts" during a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0493

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel tend to an "injured astronaut." Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0498

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency personnel tend to "injured astronauts" during a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0487

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel get equipment ready for a simulated emergency rescue of a shuttle crew after landing. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0511

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency personnel tend to "injured astronauts" during a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/George Shelton

Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh

PubMed Central

Wichaidit, Wit; Alam, Mahbub-Ul; Halder, Amal K.; Unicomb, Leanne; Hamer, Davidson H.; Ram, Pavani K.

2016-01-01

Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC. PMID:27273640

Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

PubMed Central

Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

2014-01-01

Background As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. Objective This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. Design This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. Results 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility. Conclusions The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities. PMID:25511879

Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam.

PubMed

Van Minh, Hoang; Tuan Anh, Tran; Rocklöv, Joacim; Bao Giang, Kim; Trang, Le Quynh; Sahlen, Klas-Göran; Nilsson, Maria; Weinehall, Lars

2014-01-01

As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area. This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues. This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken. 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility. The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

Emerging technology: A key enabler for modernizing pharmaceutical manufacturing and advancing product quality.

PubMed

O'Connor, Thomas F; Yu, Lawrence X; Lee, Sau L

2016-07-25

Issues in product quality have produced recalls and caused drug shortages in United States (U.S.) in the past few years. These quality issues were often due to outdated manufacturing technologies and equipment as well as lack of an effective quality management system. To ensure consistent supply of safe, effective and high-quality drug products available to the patients, the U.S. Food and Drug Administration (FDA) supports modernizing pharmaceutical manufacturing for improvements in product quality. Specifically, five new initiatives are proposed here to achieve this goal. They include: (i) advancing regulatory science for pharmaceutical manufacturing; (ii) establishing a public-private institute for pharmaceutical manufacturing innovation; (iii) creating incentives for investment in the technological upgrade of manufacturing processes and facilities; (iv) leveraging external expertise for regulatory quality assessment of emerging technologies; and (v) promoting the international harmonization of approaches for expediting the global adoption of emerging technologies. Published by Elsevier B.V.

Consequence assessment for Airborne Releases of SO{sub 2} from the Y-12 Pilot Dechlorination Facility

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

Pendergrass, W.R.

The Atmospheric Turbulence and Diffusion Division was requested by the Department of Energy`s Oak Ridge Operations Office to conduct a consequence assessment for potential atmospheric releases of SO{sub 2} from the Y-12 Pilot Dechlorination Facility. The focus of the assessment was to identify ``worst`` case meteorology which posed the highest concentration exposure potential for both on-site as well as off-site populations. A series of plausible SO{sub 2} release scenarios were provided by Y-12 for the consequence assessment. Each scenario was evaluated for predictions of downwind concentration, estimates of a five-minute time weighted average, and estimate of the dimension of themore » puff. The highest hazard potential was associated with Scenario 1, in which a total of eight SO{sub 2} cylinders are released internally to the Pilot Facility and exhausted through the emergency venting system. A companion effort was also conducted to evaluate the potential for impact of releases of SO{sub 2} from the Pilot Facility on the population of Oak Ridge. While specific transport trajectory data is not available for the Pilot Facility, extrapolations based on the Oak Ridge Site Survey and climatological records from the Y-12 meteorological program does not indicate the potential for impact on the city of Oak Ridge. Steering by the local topographical features severely limits the potential impact ares. Due to the lack of specific observational data, both tracer and meteorological, only inferences can be made concerning impact zones. It is recommended tat the Department of Energy Oak Ridge Operations examine the potential for off-site impact and develop the background data to prepare impact zones for releases of hazardous materials from the Y-12 facility.« less

KENNEDY SPACE CENTER, FLA. - Emergency crew members on the ground take hold of a volunteer “astronaut” lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members on the ground take hold of a volunteer “astronaut” lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KENNEDY SPACE CENTER, FLA. - Emergency crew members help a volunteer “astronaut” onto the ground after being lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Emergency crew members help a volunteer “astronaut” onto the ground after being lowered from the top of the orbiter crew compartment mock-up that is the scene of a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Pilot statewide study of pediatric emergency department alignment with national guidelines.

PubMed

Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard

2013-07-01

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.

Running to Safety: Analysis of Disaster Susceptibility of Neighborhoods and Proximity of Safety Facilities in Silay City, Philippines

NASA Astrophysics Data System (ADS)

Patiño, C. L.; Saripada, N. A.; Olavides, R. D.; Sinogaya, J.

2016-06-01

Going on foot is the most viable option when emergency responders fail to show up in disaster zones at the quickest and most reasonable time. In the Philippines, the efficacy of disaster management offices is hampered by factors such as, but not limited to, lack of equipment and personnel, distance, and/or poor road networks and traffic systems. In several instances, emergency response times exceed acceptable norms. This study explores the hazard susceptibility, particularly to fire, flood, and landslides, of neighborhoods vis-à-vis their proximity to safety facilities in Silay City, Philippines. Imbang River exposes communities in the city to flooding while the mountainous terrain makes the city landslide prone. Building extraction was done to get the possible human settlements in the city. The building structures were extracted through image processing using a ruleset-based approach in the process of segmentation and classification of LiDAR derivatives and ortho-photos. Neighborhoods were then identified whether they have low to high susceptibility to disaster risks in terms of floods and landslides based on the hazards maps obtained from the Philippines' Mines and Geosciences Bureau (MGB). Service area analyses were performed to determine the safety facilities available to different neighborhoods at varying running times. Locations which are inaccessible or are difficult to run to because of distance and corresponding hazards were determined. Recommendations are given in the form of infrastructure installation, relocation of facilities, safety equipment and vehicle procurement, and policy changes for specific areas in Silay City.

The quality of free antenatal and delivery services in Northern Sierra Leone.

PubMed

Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou

2017-07-12

The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of consumables, non-functional basic emergency obstetric care facilities, and geographic inequities in access to CEOC facilities. These findings suggest that the health sector needs to urgently investigate continuing inequities adversely influencing the uptake of these services, and explore more sustainable funding mechanisms. Without this, the country is unlikely to achieve its goal of reducing maternal deaths.

44 CFR 19.410 - Comparable facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Comparable facilities. 19.410... Activities Prohibited § 19.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

44 CFR 19.410 - Comparable facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Comparable facilities. 19.410... Activities Prohibited § 19.410 Comparable facilities. A recipient may provide separate toilet, locker room, and shower facilities on the basis of sex, but such facilities provided for students of one sex shall...

KSC-06pd0489

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, an "astronaut" exits the orbiter mockup. Emergency rescue personnel are behind. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0501

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - During a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel carry an "injured astronaut" to a waiting helicopter. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0496

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel place an "injured astronaut" into a rescue vehicle. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0491

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel place an "injured astronaut" onto a stretcher. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0500

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - During a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel carry an "injured astronaut" to a waiting helicopter. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0490

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel aid an "astronaut" who just left the orbiter mockup. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

KSC-06pd0513

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, emergency personnel tends to an "injured astronaut" inside a rescue vehicle during a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Jim Grossmann

41 CFR 102-74.260 - What action must the Designated Official initiate when there is advance notice of an emergency?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Occupant Emergency... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What action must the...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

18 CFR 2.60 - Facilities and activities during an emergency-accounting treatment of defense-related expenditures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Facilities and activities during an emergency-accounting treatment of defense-related expenditures. 2.60 Section 2.60 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL...

Inter-facility transfer of surgical emergencies in a developing country: effects on management and surgical outcomes.

PubMed

Khan, Salma; Zafar, Hasnain; Zafar, Syed Nabeel; Haroon, Naveed

2014-02-01

Outcomes of surgical emergencies are associated with promptness of the appropriate surgical intervention. However, delayed presentation of surgical patients is common in most developing countries. Delays commonly occur due to transfer of patients between facilities. The aim of the present study was to assess the effect of delays in treatment caused by inter-facility transfers of patients presenting with surgical emergencies as measured by objective and subjective parameters. We prospectively collected data on all patients presenting with an acute surgical emergency at Aga Khan University Hospital (AKUH). Information regarding demographics, social class, reason and number of transfers, and distance traveled were collected. Patients were categorized into two groups, those transferred to AKUH from another facility (transferred) and direct arrivals (non-transfers). Differences between presenting physiological parameters, vital statistics, and management were tested between the two groups by the chi square and t tests. Ninety-nine patients were included, 49 (49.5 %) patients having been transferred from another facility. The most common reason for transfer was "lack of satisfactory surgical care." There were significant differences in presenting pulse, oxygen saturation, respiratory rate, fluid for resuscitation, glasgow coma scale, and revised trauma score (all p values <0.001) between transferred and non-transferred patients. In 56 patients there was a further delay in admission, and the most common reason was bed availability, followed by financial constraints. Three patients were shifted out of the hospital due to lack of ventilator, and 14 patients left against medical advice due to financial limitations. One patient died. Inter-facility transfer of patients with surgical emergencies is common. These patients arrive with deranged physiology which requires complex and prolonged hospital care. Patients who cannot afford treatment are most vulnerable to transfers and delays.

Alternative measures of spatial distribution and availability of health facilities for the delivery of emergency obstetric services in island communities.

PubMed

Oyerinde, Koyejo; Baravilala, Wame

2014-12-01

International guidelines and recommendations for availability and spatial distribution of emergency obstetric care services do not adequately address the challenges of providing emergency health services in island communities. The isolation and small population sizes that are typical of islands and remote populations limit the applicability of international guidelines in such communities. Universal access to emergency obstetric care services, when pregnant women encounter complications, is one of the three key strategies for reducing maternal and newborn mortality; the other two being family planning and skilled care during labor. The performance of selected lifesaving clinical interventions (signal functions) over a 3-month period is commonly used to assess and assign performance categories to health facilities but island communities might not have a large enough population to generate demand for all the signal functions over a 3-month period. Similarly, availability and spatial distribution recommendations are typically based on the size of catchment populations, but the populations of island communities tend to be sparsely distributed. With illustrations from six South Pacific Island states, we argue that the recommendation for availability of health facilities, that there should be at least five emergency obstetric care facilities (including at least one comprehensive facility) for every 500,000 population, and the recommendation for equitable distribution of health facilities, that all subnational areas meet the availability recommendation, can be substituted with a focus on access to blood transfusion and obstetric surgical care within 2 hours for all pregnant residents of islands. Island communities could replace the performance of signal functions over a 3-month period with a demonstrated capacity to perform signal functions if the need arises.

Federal guide for a radiological response: Supporting the Nuclear Regulatory Commission during the initial hours of a serious accident

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

Hogan, R.T.

1993-11-01

This document is a planning guide for those Federal agencies that work with the Nuclear Regulatory commission (NRC) during the initial hours of response to a serious radiological emergency in which the NRC is the Lead Federal Agency (LFA). These Federal agencies are: DOE, EPA, USDA, HHS, NOAA, and FEMA. This guide is intended to help these agencies prepare for a prompt response. Instructions are provided on receiving the initial notification, the type of person to send to the scene, the facility at which people are needed, how to get them to that facility, and what they should do whenmore » they arrive. Federal agencies not specifically mentioned in this guide may also be asked to support the NRC.« less

Trends in Facility Management Technology: The Emergence of the Internet, GIS, and Facility Assessment Decision Support.

ERIC Educational Resources Information Center

Teicholz, Eric

1997-01-01

Reports research on trends in computer-aided facilities management using the Internet and geographic information system (GIS) technology for space utilization research. Proposes that facility assessment software holds promise for supporting facility management decision making, and outlines four areas for its use: inventory; evaluation; reporting;…

Hospital Ownership of a Postacute Care Facility Influences Discharge Destinations After Emergent Surgery.

PubMed

Abdelsattar, Zaid M; Gonzalez, Andrew A; Hendren, Samantha; Regenbogen, Scott E; Wong, Sandra L

2016-08-01

The aim of the study was to identify hospital characteristics associated with variation in patient disposition after emergent surgery. Colon resections in elderly patients are often done in emergent settings. Although these operations are known to be riskier, there are limited data regarding postoperative discharge destination. We evaluated Medicare beneficiaries who underwent emergent colectomy between 2008 and 2010. Using hierarchical logistic regression, we estimated patient and hospital-level risk-adjusted rates of nonhome discharges. Hospitals were stratified into quintiles based on their nonhome discharge rates. Generalized linear models were used to identify hospital structural characteristics associated with nonhome discharges (comparing discharge to skilled nursing facilities vs home with/without home health services). Of the 122,604 patients surviving to discharge after emergent colectomy at 3012 hospitals, 46.7% were discharged to a nonhome destination. There was a wide variation in risk and reliability-adjusted nonhome discharge rates across hospitals (15% to 80%). Patients at hospitals in the highest quintile of nonhome discharge rates were more likely to have longer hospitalizations (15.1 vs 13.2; P < 0.001) and more complications (43.2% vs 34%; P < 0.001). On multivariable analysis, only hospital ownership of a skilled nursing facility (P < 0.001), teaching status (P = 0.025), and low nurse-to-patient ratios (P = 0.002) were associated with nonhome discharges. Nearly half of Medicare beneficiaries are discharged to a nonhome destination after emergent colectomy. Hospital ownership of a skilled nursing facility and low nurse-to-patient ratios are highly associated with nonhome discharges. This may signify the underlying financial incentives to preferentially utilize postacute care facilities under the traditional fee-for-service payment model.

KSC-06pd0494

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - In a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, emergency rescue personnel tend to an "injured astronaut" on a stretcher at the bottom of the steps to the orbiter mockup. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

10 CFR 62.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Emergency access means access to an operating non-Federal or regional low-level radioactive waste disposal... regional low-level radioactive waste disposal facility or facilities for a period not to exceed 180 days... waste. Non-Federal disposal facility means a low-level radioactive waste disposal facility that is...

44 CFR 312.6 - Materials and facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Materials and facilities. 312... OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.6 Materials and facilities. FEMA also contributes to the development and...

Measuring Coverage in MNCH: Validating Women’s Self-Report of Emergency Cesarean Sections in Ghana and the Dominican Republic

PubMed Central

Tunçalp, Özge; Stanton, Cynthia; Castro, Arachu; Adanu, Richard; Heymann, Marilyn; Adu-Bonsaffoh, Kwame; Lattof, Samantha R.; Blanc, Ann; Langer, Ana

2013-01-01

Background Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR). Methods and Findings This study compares hospital-based data, considered the reference standard, against women’s self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. Conclusions Questions used in this study to identify emergency cesarean section are promising but insufficient to promote for inclusion in international survey questionnaires. Additional studies which confirm the accuracy of key facility-based indicators in advance of data collection and which use a longer recall period are warranted. PMID:23667428

Use of personal protective equipment for respiratory protection.

PubMed

Sargent, Edward V; Gallo, Frank

2003-01-01

Management of hazards in biomedical research facilities requires the application of the traditional industrial hygiene responsibilities of anticipation, recognition, evaluation, and control to characterize the work environment, evaluate tasks and equipment, identify hazards, define exposure groups, and recommend controls. Generally, the diversity and unique characteristics of hazards faced by laboratory and animal facility employees and the short-term and low-level nature of the exposures factor into the selection of proper exposure control measures in the laboratory. The proper selection of control measures is based on a hierarchy of elimination and minimization by engineering controls, followed last by personal protective equipment when exposures cannot be eliminated. Once it is decided that personal protective equipment is needed, specific regulations and guidelines define safety standards for research facilities, including the elements of a sound respiratory protection program. These elements include respirator selection (including appropriate protection factors), medical evaluation, fit testing, training, inspection, maintenance and care, quality, quantity and flow of breathing air, and routine and emergency use procedures.

From Inpatient to Clinic to Home to Hospice and Back: Using the "Pop Up" Pediatric Palliative Model of Care.

PubMed

Mherekumombe, Martha F

2018-04-26

Children and young people with life-limiting illnesses who need palliative care often have complex diverse medical conditions that may involve multiple hospital presentations, medical admissions, care, or transfer to other medical care facilities. In order to provide patients with holistic care in any location, palliative care clinicians need to carefully consider the ways to maintain continuity of care which enhances the child's quality of life. An emerging model of care known as "Pop Up" describes the approaches to supporting children and young people in any facility. A Pop Up is a specific intervention over and above the care that is provided to a child, young person and their family aimed at improving the confidence of local care providers to deliver ongoing care. This paper looks at some of the factors related to care transfer for pediatric palliative patients from one care facility to another, home and the impact of this on the family and medical care.

From Inpatient to Clinic to Home to Hospice and Back: Using the “Pop Up” Pediatric Palliative Model of Care

PubMed Central

Mherekumombe, Martha F.

2018-01-01

Children and young people with life-limiting illnesses who need palliative care often have complex diverse medical conditions that may involve multiple hospital presentations, medical admissions, care, or transfer to other medical care facilities. In order to provide patients with holistic care in any location, palliative care clinicians need to carefully consider the ways to maintain continuity of care which enhances the child’s quality of life. An emerging model of care known as “Pop Up” describes the approaches to supporting children and young people in any facility. A Pop Up is a specific intervention over and above the care that is provided to a child, young person and their family aimed at improving the confidence of local care providers to deliver ongoing care. This paper looks at some of the factors related to care transfer for pediatric palliative patients from one care facility to another, home and the impact of this on the family and medical care. PMID:29701661

10 CFR 62.13 - Contents of a request for emergency access: Alternatives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... following: (1) Storage of low-level radioactive waste at the site of generation; (2) Storage of low-level... disposal at a Federal low-level radioactive waste disposal facility in the case of a Federal or defense...

A scoping review and research synthesis on financing and regulating oral care in long-term care facilities.

PubMed

MacEntee, Michael I; Kazanjian, Arminee; Kozak, Jean-Francois; Hornby, Kathy; Thorne, Sally; Kettratad-Pruksapong, Matana

2012-06-01

Oral health care for frail elders is grossly inadequate almost everywhere, and our knowledge of regulating and financing oral care in this context is unclear. This scoping study examined and summarised the published literature available and the gaps in knowledge about regulating and financing oral care in long-term care (LTC) facilities. We limited the electronic search to reports on regulating and financing oral care, including reports, commentaries, reviews and policy statements on financing and regulating oral health-related services. The broad electronic search identified 1168 citations, which produced 42 references, including 26 pieces of grey literature for a total of 68 papers. Specific information was found on public and private funding of care and on difficulties regulating care because of professional segregation, difficulties assessing need for care, uncertainty on appropriateness of treatments and issues around scope of professional practice. A wide range of information along with 19 implications and 18 specific gaps in knowledge emerged relevant to financing and regulating oral healthcare services in LTC facilities. Effort has been given to enhancing oral care for frail elders, but there is little agreement on how the care should be regulated or financed within the LTC sector. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF BUILDING 122 EXAMINATION FACILITIES THAT SUPPORT ROUTINE EMPLOYEE AND SUBCONTRACTOR PHYSICAL EXAMINATIONS. (10/85) - Rocky Flats Plant, Emergency Medical Services Facility, Southwest corner of Central & Third Avenues, Golden, Jefferson County, CO

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

40 CFR 266.204 - Standards applicable to emergency responses.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HAZARDOUS WASTE MANAGEMENT FACILITIES Military Munitions § 266.204 Standards applicable to emergency responses. Explosives and munitions emergencies involving military munitions or explosives are subject to 40...

7 CFR 1794.21 - Categorically excluded proposals without an ER.

Code of Federal Regulations, 2010 CFR

2010-01-01

... an emergency situation to return to service damaged facilities of an applicant's system. (b) Electric... electric generating or fuel processing facilities and related support structures where there is negligible... boundaries of an existing electric generating facility site. A description of the facilities to be...

A comprehensive review on nano-molybdenum disulfide/DNA interfaces as emerging biosensing platforms.

PubMed

Kukkar, Manil; Mohanta, Girish C; Tuteja, Satish K; Kumar, Parveen; Bhadwal, Akhshay Singh; Samaddar, Pallabi; Kim, Ki-Hyun; Deep, Akash

2018-06-01

The development of nucleic acid-based portable platforms for the real-time analysis of diseases has attracted considerable scientific and commercial interest. Recently, 2D layered molybdenum sulfide (2D MoS 2 from here on) nanosheets have shown great potential for the development of next-generation platforms for efficient signal transduction. Through combination with DNA as a biorecognition medium, MoS 2 nanostructures have opened new opportunities to design and construct highly sensitive, specific, and commercially viable sensing devices. The use of specific short ssDNA sequences like aptamers has been proven to bind well with the unique transduction properties of 2D MoS 2 nanosheets to realize aptasensing devices. Such sensors can be operated on the principles of fluorescence, electro-cheumuluminescence, and electrochemistry with many advantageous features (e.g., robust biointerfacing through various conjugation chemistries, facile sensor assembly, high stability with regard to temperature/pH, and high affinity to target). This review encompasses the state of the art information on various design tactics and working principles of MoS 2 /DNA sensor technology which is emerging as one of the most sought-after and valuable fields with the advent of nucleic acid inspired devices. To help achieve a new milestone in biosensing applications, great potential of this emerging technique is described further with regard to sensitivity, specificity, operational convenience, and versatility. Copyright © 2018 Elsevier B.V. All rights reserved.

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...

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.

KENNEDY SPACE CENTER, FLA. - An “injured” rescue worker is lifted into an M-113 armored personnel carrier provided for transportation during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - An “injured” rescue worker is lifted into an M-113 armored personnel carrier provided for transportation during a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

How to HAMMER home hazardous materials training

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

Ollero, J.

1994-10-01

This article describes HAMMER - the Hazardous Materials Management and Emergency Response Training - program being developed at the Hanford Reservation. The program uses true-to-life props and facilities to simulate emergencies and hazardous conditions. Topics covered include the set-up of the facility and training; the demand for such training; the involvement of the Army Corps of Engineers; the props to be constructed; the educational involvement of Tulane and Xavier Univerisities of Louisiana; temporary facility for the program; partnership with Indian Nations and Stakeholders; and budget plans and constriction. 9 figs.

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

PubMed

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-08-01

Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response

PubMed Central

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-01-01

ABSTRACT Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595

KSC-04PD-0231

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members transport an injured astronaut during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

42 CFR 483.55 - Dental services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...

42 CFR 483.55 - Dental services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...

42 CFR 483.55 - Dental services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...

42 CFR 483.55 - Dental services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...

42 CFR 483.55 - Dental services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Dental services. 483.55 Section 483.55 Public... Care Facilities § 483.55 Dental services. The facility must assist residents in obtaining routine and 24-hour emergency dental care. (a) Skilled nursing facilities. A facility (1) Must provide or obtain...

Development, validation and testing of a nursing home to emergency room transfer checklist.

PubMed

Tsai, Hsiu-Hsin; Tsai, Yun-Fang

2018-01-01

To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer. Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking. Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist. Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay. Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%. The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process. Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults between facilities such as nursing homes and hospitals. © 2017 John Wiley & Sons Ltd.

2004 Toxic Chemical Release Inventory Report for the Emergency Planning and Community Right-to-Know Act of 1986, Title III, Section 313

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

M. Stockton

2006-01-15

Section 313 of Emergency Planning and Community Right-to-Know Act (EPCRA) specifically requires facilities to submit a Toxic Chemical Release Inventory Report (Form R) to the U.S. Environmental Protection Agency (EPA) and state agencies if the owners and operators manufacture, process, or otherwise use any of the listed toxic chemicals above listed threshold quantities. EPA compiles this data in the Toxic Release Inventory database. Form R reports for each chemical over threshold quantities must be submitted on or before July 1 each year and must cover activities that occurred at the facility during the previous year. For reporting year 2004, Losmore » Alamos National Laboratory (LANL or the Laboratory) submitted Form R reports for lead compounds, nitric acid, and nitrate compounds as required under the EPCRA Section 313. No other EPCRA Section 313 chemicals were used in 2004 above the reportable thresholds. This document provides a description of the evaluation of EPCRA Section 313 chemical use and threshold determinations for LANL for calendar year 2004, as well as background information about data included on the Form R reports.« less

Emergency department access targets and the older patient: a retrospective cohort study of emergency department presentations by people living in residential aged care facilities.

PubMed

Street, Maryann; Marriott, Jonathon R; Livingston, Patricia M

2012-11-01

There is limited research on the effect of emergency access targets on health outcomes for older patients from Residential Aged Care Facilities. The aims were to: (1) identify length of stay for Residential Aged Care patients relative to access targets; and (2) examine hospital admission rates, readmission rates, inpatient costs and mortality. Retrospective cohort study of all emergency presentations for Residential Aged Care patients in 2009 at one Australian metropolitan health service. The 4637 emergency presentations by 3184 Residential Aged Care patients in 2009 represented 3.4% of all emergency presentations. Mean length of stay was 7.9 hours (SD=4.5 hours); 84% of Residential Aged Care patients remained in the Emergency Department longer than four hours. Admitted patients were 3.6 times more likely to spend more than eight hours in the Emergency Department compared with those not admitted (p<0.001). Patients in the urgent triage category were 9.5 times more likely to spend more than eight hours in the Emergency Department compared to patients triaged as non-urgent (p<0.001). Inpatient costs were associated with length of admission and median cost per day was $AUD 1175. Few Residential Aged Care patients were discharged within the four hours access target. This has implications for health care outcomes and costs associated with providing emergency care for patients living in Residential Aged Care Facilities. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

Satisfaction with emergency obstetric and new born care services among clients using public health facilities in Jimma Zone, Oromia Regional State, Ethiopia; a cross sectional study.

PubMed

Kumsa, Alemayehu; Tura, Gurmessa; Nigusse, Aderajew; Kebede, Getahun

2016-04-25

The 2005 report of United Nations Millennium Project of Transforming Health Systems for women and children concluded that universal access to Emergency Obstetric and New born Care could reduce maternal deaths by 74%. Even though some studies investigated quality of Emergency Obstetric and New born Care in different parts of the world, there is scarcity of data regarding this issue in Ethiopia, particularly in Jimma zone. Therefore, the aim of this study was to assess satisfaction with Emergency Obstetric and new born Care services among clients using public health facilities in Jimma zone, Southwest Ethiopia. A facility-based cross sectional study was conducted in Jimma Zone from April 01-30, 2014. The data were collected by interviewing 403 clients, who gave birth in the past 12 months prior to data collection in 34 randomly selected public health facilities. The collected data were entered by using Epi-info version 3.5.4 and analysed using SPSS version 20.0. Linear regression analysis was done to ascertain the association between covariates and the outcome variable, and finally the results were presented using frequency distribution tables, graphs and texts. The overall mean client satisfaction with Emergency Obstetric and New born Care services in this study was 79.4%; 95% CI (75%, 83%). The result of linear regression analysis revealed that a unit decrease in satisfaction to availability of drugs and equipment, decreased overall clients' satisfaction by 0.23 unit 95% CI (0.15, 0.31). The level of clients' satisfaction with Emergency Obstetric and New born Care services was low in the study area. Factors such as availability of essential equipment and drugs, health workers' communication, health care provided, and attitude of health workers had positive association with client satisfaction with Emergency Obstetric and New born Care services. This in turn could affect utilization of Emergency Obstetric and New born Care services and play a role in contribution to maternal and new born mortality. Therefore, the efforts of health facilities leaders and health care providers towards improvement of quality of care could contribute more for better maternal satisfaction.

Bypassing health facilities for childbirth in the context of the JSY cash transfer program to promote institutional birth: A cross-sectional study from Madhya Pradesh, India

PubMed Central

Sabde, Yogesh; Chaturvedi, Sarika; Randive, Bharat; Sidney, Kristi; Salazar, Mariano; De Costa, Ayesha; Diwan, Vishal

2018-01-01

Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program. Our results provide information to support the optimal utilization of facilities at different levels of the healthcare system for childbirth. Data was collected from 96 facilities (74 public) and 720 rural mothers who delivered at these facilities were interviewed. Multilevel logistic regression was used to analyze the data. Facility obstetric care functionality was assessed by the number of emergency obstetric care (EmOC) signal functions performed in the last three months. Thirty eighth percent of the mothers bypassed the nearest public facility for their current delivery. Primiparity, higher education, arriving by hired transport and a longer distance from home to the nearest facility increased the odds of bypassing a public facility for childbirth. The variance partition coefficient showed that 37% of the variation in bypassing the nearest public facility can be attributed to difference between facilities. The number of basic emergency obstetric care signal functions (AOR = 0.59, 95% CI 0.37–0.93), and the availability of free transportation at the nearest facility (AOR = 0.11, 95% CI 0.03–0.31) were protective factors against bypassing. The variation between facilities (MOR = 3.85) was more important than an individual’s characteristics to explain bypassing in MP. This multilevel study indicates that in this setting, a focus on increasing the level of emergency obstetric care functionality in public obstetric care facilities will allow more optimal utilization of facilities for childbirth under the JSY program thereby leading to better outcomes for mothers. PMID:29385135

Bypassing health facilities for childbirth in the context of the JSY cash transfer program to promote institutional birth: A cross-sectional study from Madhya Pradesh, India.

PubMed

Sabde, Yogesh; Chaturvedi, Sarika; Randive, Bharat; Sidney, Kristi; Salazar, Mariano; De Costa, Ayesha; Diwan, Vishal

2018-01-01

Bypassing health facilities for childbirth can be costly both for women and health systems. There have been some reports on this from Sub-Saharan African and from Nepal but none from India. India has implemented the Janani Suraksha Yojana (JSY), a large national conditional cash transfer program which has successfully increased the number of institutional births in India. This paper aims to study the extent of bypassing the nearest health facility offering intrapartum care in three districts of Madhya Pradesh, India, and to identify individual and facility determinants of bypassing in the context of the JSY program. Our results provide information to support the optimal utilization of facilities at different levels of the healthcare system for childbirth. Data was collected from 96 facilities (74 public) and 720 rural mothers who delivered at these facilities were interviewed. Multilevel logistic regression was used to analyze the data. Facility obstetric care functionality was assessed by the number of emergency obstetric care (EmOC) signal functions performed in the last three months. Thirty eighth percent of the mothers bypassed the nearest public facility for their current delivery. Primiparity, higher education, arriving by hired transport and a longer distance from home to the nearest facility increased the odds of bypassing a public facility for childbirth. The variance partition coefficient showed that 37% of the variation in bypassing the nearest public facility can be attributed to difference between facilities. The number of basic emergency obstetric care signal functions (AOR = 0.59, 95% CI 0.37-0.93), and the availability of free transportation at the nearest facility (AOR = 0.11, 95% CI 0.03-0.31) were protective factors against bypassing. The variation between facilities (MOR = 3.85) was more important than an individual's characteristics to explain bypassing in MP. This multilevel study indicates that in this setting, a focus on increasing the level of emergency obstetric care functionality in public obstetric care facilities will allow more optimal utilization of facilities for childbirth under the JSY program thereby leading to better outcomes for mothers.

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh.

PubMed

Roy, Lumbini; Biswas, Taposh Kumar; Chowdhury, Mahbub Elahi

2017-01-01

Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh.

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...

Case study of medical evacuation before and after the Fukushima Daiichi nuclear power plant accident in the great east Japan earthquake.

PubMed

Okumura, Tetsu; Tokuno, Shinichi

2015-01-01

In Japan, participants in the disaster-specific medical transportation system have received ongoing training since 2002, incorporating lessons learned from the Great Hanshin Earthquake. The Great East Japan Earthquake occurred on March 11, 2011, and the very first disaster-specific medical transport was performed. This article reviews in detail the central government's control and coordination of the disaster medical transportation process following the Great East Japan Earthquake and the Fukushima Daiichi Nuclear Power Plant Accident. In total, 124 patients were air transported under the coordination of the C5 team in the emergency response headquarter of the Japanese Government. C5 includes experts from the Cabinet Office, Cabinet Secretariat, Fire Defense Agency, Ministry of Health, Labour and Welfare, and Ministry of Defense. In the 20-30 km evacuation zone around the Fukushima Daiichi nuclear power plant, 509 bedridden patients were successfully evacuated without any fatalities during transportation. Many lessons have been learned in disaster-specific medical transportation. The national government, local government, police, and fire agencies have made significant progress in their mutual communication and collaboration. Fortunately, hospital evacuation from the 20-30 km area was successfully performed with the aid of local emergency physicians and Disaster Medical Assistance Teams (DMATs) who have vast experience in patient transport in the course of day-to-day activities. The emergency procedures that are required during crises are an extension of basic daily procedures that are performed by emergency medical staff and first responders, such as fire fighters, emergency medical technicians, or police officers. Medical facilities including nursing homes should have a plan for long-distance (over 100 km) evacuation, and the plan should be routinely reevaluated with full-scale exercises. In addition, hospital evacuation in disaster settings should be supervised by emergency physicians and be handled by disaster specialists who are accustomed to patient transportation on a daily basis.

A fail safe laser activated switch used as an emergency control link at the Langley Vortex Research Facility

NASA Technical Reports Server (NTRS)

Kassel, P. C., Jr.

1978-01-01

A fail safe light activated switch was used as an emergency control link at the Langley Vortex Research Facility. In this facility aircraft models were towed through a still air test chamber by a gasoline powered vehicle which was launched from one end of a 427-meter track and attained velocities to 31 m/sec in the test chamber. A 5 mW HeNe laser with a mechanical copper provided a connecting link with the moving tow vehicle on which a silicon photodiode receiver with a specially designed amplifier provided a fail safe switching action. This system provided an emergency means of stopping the vehicle by turning off the laser to interrupt the power to the vehicle ignition and brake release systems.

Implementing a bioterrorism response plan in your pharmacy.

PubMed

Teeter, David; Terriff, Colleen

2002-01-01

Pharmacies and other types of health care facilities need emergency response plans. Pharmacists need to stay current on biologic and other agents that can be used as agents of mass destruction and their clinical management. Local plans should incorporate federal resources that can be used in emergencies, but the time required for these resources to be organized, delivered, and distributed needs to be considered. Pharmacists are urged to assist with inventories of available health care facilities, supplies, and medications. Planning needs to be coordinated with local emergency preparedness officials.

Emergency preparedness and planning

NASA Technical Reports Server (NTRS)

Bouvier, Kenneth

1993-01-01

Monsanto's emergency response plan in dealing with hazardous materials at their facilities is presented. Topics discussed include the following: CPR training; emergency medial training; incident reports; contractor injuries; hazardous materials transport; evacuation; and other industrial safety concerns.

Inland area contingency plan and maps for Pennsylvania (on CD-ROM). Data file

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

NONE

1996-12-01

EPA Region III has assembled on this CD a multitude of environmental data, in both visual and textual formats. While targeted for Facility Response Planning under the Oil Pollution Act of 1990, this information will prove helpful to anyone in the environmental arena. Specifically, the CD will aid contingency planning and emergency response personnel. Combining innovative GIS technology with EPA`s state-specific data allows you to display maps, find and identify map features, look at tabular information about map features, and print out maps. The CD was designed to be easy to use and incorporates example maps as well as helpmore » sections describing the use of the environmental data on the CD, and introduces you to the IACP Viewer and its capabilities. These help features will make it easy for you to conduct analysis, produce maps, and browse the IACP Plan. The IACP data are included in two formats: shapefiles, which can be viewed with the IACP Viewer or ESRI`s ArcView software (Version 2.1 or higher), and ARC/INFO export files, which can be imported into ARC/INFO or converted to other GIS data formats. Point Data Sources: Sensitive Areas, Surface Drinking Water Intakes, Groundwater Intakes, Groundwater Supply Facilities, NPL (National Priority List) Sites, FRP (Facility Response Plan) Facilities, NPDES (National Pollutant Discharge Elimination System) Facilities, Hospitals, RCRA (Resource Conservation and Recovery Act) Sites, TRI (Toxic Release Inventory) Sites, CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act) Sites Line Data Sources: TIGER Roads, TIGER Railroads, TIGER Hydrography, Pipelines Polygon Data Sources: State Boundaries, County Boundaries, Watershed Boundaries (8-digit HUC), TIGER Hydrography, Public Lands, Populated Places, IACP Boundaries, Coast Guard Boundaries, Forest Types, US Congressional Districts, One-half Mile Buffer of Surface Drinking Water Intakes.« less

Inland area contingency plan and maps for Virginia (on CD-ROM). Data file

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

NONE

1996-12-01

EPA Region III has assembled on this CD a multitude of environmental data, in both visual and textual formats. While targeted for Facility Response Planning under the Oil Pollution Act of 1990, this information will prove helpful to anyone in the environmental arena. Specifically, the CD will aid contingency planning and emergency response personnel. Combining innovative GIS technology with EPA`s state-specific data allows you to display maps, find and identify map features, look at tabular information about map features, and print out maps. The CD was designed to be easy to use and incorporates example maps as well as helpmore » sections describing the use of the environmental data on the CD, and introduces you to the IACP Viewer and its capabilities. These help features will make it easy for you to conduct analysis, produce maps, and browse the IACP Plan. The IACP data are included in two formats: shapefiles, which can be viewed with the IACP Viewer or ESRI`s ArcView software (Version 2.1 or higher), and ARC/INFO export files, which can be imported into ARC/INFO or converted to other GIS data formats. Point Data Sources: Sensitive Areas, Surface Drinking Water Intakes, Groundwater Intakes, Groundwater Supply Facilities, NPL (National Priority List) Sites, FRP (Facility Response Plan) Facilities, NPDES (National Pollutant Discharge Elimination System) Facilities, Hospitals, RCRA (Resource Conservation and Recovery Act) Sites, TRI (Toxic Release Inventory) Sites, CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act) Sites Line Data Sources: TIGER Roads, TIGER Railroads, TIGER Hydrography, Pipelines Polygon Data Sources: State Boundaries, County Boundaries, Watershed Boundaries (8-digit HUC), TIGER Hydrography, Public Lands, Populated Places, IACP Boundaries, Coast Guard Boundaries, Forest Types, US Congressional Districts, One-half Mile Buffer of Surface Drinking Water Intakes.« less

44 CFR 206.62 - Available assistance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Available assistance. 206.62 Section 206.62 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF..., facilities, and managerial, technical and advisory services) in support of State and local emergency...

The relationship between physical activity facility proximity and leisure-time physical activity in persons with spinal cord injury.

PubMed

Arbour, Kelly P; Martin Ginis, Kathleen A

2009-07-01

Within the general able-bodied population, proximity of one's home to physical activity facilities is modestly associated with physical activity behavior. Currently, no research has examined whether facility proximity is related to physical activity among persons living with disabilities. To examine (1) the level of agreement between perceived and actual proximity to accessible physical activity facilities and (2) the relationship between facility proximity (perceived and actual) and leisure-time physical activity (LTPA) among persons with spinal cord injury (SCI). It was hypothesized that (1) perceived and actual proximity measures would exhibit low agreement and (2) a small, positive relationship would emerge between proximity (perceived and actual) and LTPA. Data from 50 Ontario residents living with SCI (70% male; 52% tetraplegia) were collected for proximity and LTPA. Perceived facility proximity was determined by a self-report "YES" versus "NO" presence measure, while actual facility proximity was assessed using Geographical Information Systems. An SCI-specific instrument, the PARA-SCI, was used to measure LTPA. Low agreement levels were found between perceived and actual proximity. LTPA status (active versus inactive) was shown to moderate the relationship, with higher agreement levels found for participants who reported engaging in mild or heavy LTPA versus their inactive counterparts, but only for the 30-minute wheeling boundary. Contrary to hypothesis, people living within a 30-minute wheel from an accessible facility were less likely to engage in heavy LTPA than were people who did not have an accessible facility located within a 30-minute wheel. No significant associations were found between LTPA and perceived proximity. Living in close proximity to a facility that provides accessible programming and equipment does not necessarily translate into greater physical activity behavior.

Access to emergency care services: a transversal ecological study about Brazilian emergency health care network.

PubMed

Rocha, T A H; da Silva, N C; Amaral, P V; Barbosa, A C Q; Rocha, J V M; Alvares, V; de Almeida, D G; Thumé, E; Thomaz, E B A F; de Sousa Queiroz, R C; de Souza, M R; Lein, A; Toomey, N; Staton, C A; Vissoci, J R N; Facchini, L A

2017-12-01

Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distribution, 12% of the population was more than 120 km away from a health facility with a neonatal ICU. The maternities situation is different from other specialties, where 81% of the total Brazilian population was within 1 h or less from such health facilities. Our results highlighted a polarization in distribution of Brazilian health care facilities. There is a concentration of hospitals in urban areas more developed and access gaps in rural areas and the Amazon region. Our results demonstrate that the distribution of emergency services in Brazil is not facilitating access to the population due to geographical barriers associated with great distances. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

44 CFR 206.253 - Insurance requirements for facilities damaged by disasters other than flood.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities damaged by disasters other than flood. 206.253 Section 206.253 Emergency Management and Assistance... ASSISTANCE Public Assistance Insurance Requirements § 206.253 Insurance requirements for facilities damaged... facility and its contents which were damaged by a disaster other than flood, the Grantee shall notify the...

The Various Applications of 3D Printing in Cardiovascular Diseases.

PubMed

El Sabbagh, Abdallah; Eleid, Mackram F; Al-Hijji, Mohammed; Anavekar, Nandan S; Holmes, David R; Nkomo, Vuyisile T; Oderich, Gustavo S; Cassivi, Stephen D; Said, Sameh M; Rihal, Charanjit S; Matsumoto, Jane M; Foley, Thomas A

2018-05-10

To highlight the various applications of 3D printing in cardiovascular disease and discuss its limitations and future direction. Use of handheld 3D printed models of cardiovascular structures has emerged as a facile modality in procedural and surgical planning as well as education and communication. Three-dimensional (3D) printing is a novel imaging modality which involves creating patient-specific models of cardiovascular structures. As percutaneous and surgical therapies evolve, spatial recognition of complex cardiovascular anatomic relationships by cardiologists and cardiovascular surgeons is imperative. Handheld 3D printed models of cardiovascular structures provide a facile and intuitive road map for procedural and surgical planning, complementing conventional imaging modalities. Moreover, 3D printed models are efficacious educational and communication tools. This review highlights the various applications of 3D printing in cardiovascular diseases and discusses its limitations and future directions.

[Organization of medical equipment and stock supply of military medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry in emergency situations].

PubMed

Korniushko, I G; Iakovlev, S V; Krasavin, K D; Lemeshkin, R N

2011-10-01

The article outlined the modern concept of medical equipment and stock supply of medical facilities and groups of Disaster Medicine Service of the Russian Defense Ministry involved into the remedial of the medical actions of emergency situations. The structure of the units of medical supplies in these conditions is presented.

40 CFR 370.41 - What is Tier I inventory information?

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and phone number. (g) Emergency contact. The name, title, and phone number(s) of at least one local... chemical accident at your facility. You must provide an emergency phone number where such emergency...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

38 CFR 17.1003 - Emergency transportation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Emergency transportation... Facilities § 17.1003 Emergency transportation. Notwithstanding the provisions of § 17.1002, payment or... the emergency transportation; (c) The veteran has no coverage under a health-plan contract for...

Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team.

PubMed

Kakou-Guikahue, Maurice; N'Guetta, Roland; Anzouan-Kacou, Jean-Baptiste; Kramoh, Euloge; N'Dori, Raymond; Ba, Serigne Abdou; Diao, Maboury; Sarr, Moustapha; Kane, Abdoul; Kane, Adama; Damorou, Findide; Balde, Dadhi; Diarra, Mamadou Bocary; Djiddou, Mohamed; Kimbally-Kaki, Gisèle; Zabsonre, Patrice; Toure, Ibrahim Ali; Houénassi, Martin; Gamra, Habib; Chajai, Bachir; Gerardin, Benoit; Pillière, Rémy; Aubry, Pierre; Iliou, Marie-Christine; Isnard, Richard; Leprince, Pascal; Cottin, Yves; Bertrand, Edmond; Juillière, Yves; Monsuez, Jean-Jacques

2016-01-01

Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge. To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations. The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities. The outcome of patients with ACS is affected by clearly identified factors, including: delay to reaching first medical contact, achieving effective hospital transportation, increased time from symptom onset to reperfusion therapy, limited primary emergency facilities (especially in rural areas) and emergency medical service (EMS) prehospital management, and hence limited numbers of patients eligible for myocardial reperfusion (thrombolytic therapy and/or percutaneous coronary intervention [PCI]). With only five catheterization laboratories in the 10 participating countries, PCI rates are very low. However, in recent years, catheterization laboratories have been built in referral cardiology departments in large African towns (Abidjan and Dakar). Improvements in patient care and outcomes should target limited but selected objectives: increasing awareness and recognition of ACS symptoms; education of rural-based healthcare professionals; and developing and managing a network between first-line healthcare facilities in rural areas or small cities, emergency rooms in larger towns, the EMS, hospital-based cardiology departments and catheterization laboratories. Faced with the increasing prevalence of ACS in sub-Saharan Africa, healthcare policies should be developed to overcome the multiple shortcomings blunting optimal management. European and/or North American management guidelines should be adapted to African specificities. Our consensus statement aims to optimize patient management on the basis of realistic considerations, given the healthcare facilities, organizations and few cardiology teams that are available. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

[Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire].

PubMed

Tseng, Wei-Wen; Shih, Chung-Liang; Chien, Shen-Wen

2013-04-01

Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

ShakeCast: Automating and improving the use of shakemap for post-earthquake deeision-making and response

USGS Publications Warehouse

Wald, D.; Lin, K.-W.; Porter, K.; Turner, Loren

2008-01-01

When a potentially damaging earthquake occurs, utility and other lifeline managers, emergency responders, and other critical users have an urgent need for information about the impact on their particular facilities so they can make appropriate decisions and take quick actions to ensure safety and restore system functionality. ShakeMap, a tool used to portray the extent of potentially damaging shaking following an earthquake, on its own can be useful for emergency response, loss estimation, and public information. However, to take full advantage of the potential of ShakeMap, we introduce ShakeCast. ShakeCast facilitates the complicated assessment of potential damage to a user's widely distributed facilities by comparing the complex shaking distribution with the potentially highly variable damageability of their inventory to provide a simple, hierarchical list and maps of structures or facilities most likely impacted. ShakeCast is a freely available, post-earthquake situational awareness application that automatically retrieves earthquake shaking data from ShakeMap, compares intensity measures against users' facilities, sends notifications of potential damage to responsible parties, and generates facility damage maps and other Web-based products for both public and private emergency managers and responders. ?? 2008, Earthquake Engineering Research Institute.

KSC-04PD-0227

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members rescue an astronaut from inside the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0233

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members rescue an injured astronaut from the orbiter crew compartment mock-up during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0237

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members assess medical needs on injured astronauts removed from the orbiter crew compartment mock-up during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0239

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members transport an injured astronaut during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0234

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members help an injured astronaut after removing him from the orbiter crew compartment mock-up during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0236

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members help an injured astronaut who was removed from the orbiter crew compartment mock- up during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0223

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crews leave the scene after a helicopter removed rescued astronauts from the scene. They are taking part in a Mode VII emergency landing simulation at Kennedy Space Center, in order to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts simulating various injuries inside an orbiter crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0235

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members help an injured astronaut from the orbiter crew compartment mock-up during a Mode VII emergency landing simulation at Kennedy Space Center. Another is on the ground. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0232

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members rescue an injured astronaut from the orbiter crew compartment mock-up during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Service readiness, health facility management practices, and delivery care utilization in five states of Nigeria: a cross-sectional analysis.

PubMed

Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun

2016-10-06

Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery after controlling for socio-demographic factors. Improving uptake of delivery care would require greater attention to rural-urban inequities and health facility management practices, and to increasing the number of health facilities with fundamental elements for delivery of basic emergency obstetric and neonatal care.

Non-physician communities in Japan: are they still disadvantaged?

PubMed

Kashima, S; Inoue, K; Matsumoto, M; Takeuchi, K

2014-01-01

Non-physician community' (NPC) is a policy term that indicates a medically underserved area in Japan. Designated NPCs are politically targeted as the foci of medical resource allocation. NPC is defined as a specified district where 50 or more persons dwell within a geographic diameter of 4 km and medical care is not easily accessible. The definition of NPC was first introduced in 1960 and has been unchanged for more than half a century despite radical social changes in rural Japan. This study examines whether designated NPCs are still more disadvantaged in terms of geographical access to healthcare in comparison to other communities. Hiroshima prefecture, which has the largest number of NPCs in terms of tertiary healthcare areas of Japan, was used as the study area. Targeted communities were all the NPCs in the prefecture, and, as controls, two community groups were selected: non-NPC adjacent to NPC, and municipal center. We measured driving time from NPCs and control communities to the nearest healthcare facilities, which were classified into the following two types: primary or secondary care facilities (n=2636) and tertiary care facilities (equal to tertiary emergency care centers; n=6). We further calculated the driving time to the nearest facilities for secondary emergency care (n=246) extracted from the 2636 primary or secondary care facilities. The median driving times to the nearest primary or secondary healthcare facility for NPC, non-NPC, and municipal center were 11 minutes, 11 minutes, and 1 minute, respectively; the times to a tertiary healthcare facility (equal to an accident and emergency care center) were 80 minutes, 84 minutes, and 68 minutes, respectively; and the times to a secondary emergency care facility were 24 minutes, 18 minutes, and 15 minutes, respectively. Although a municipal center was significantly more advantageous in driving time compared to a primary or secondary care facility, the disadvantage of a NPC in access was no more obvious than an adjacent non-NPC for any type of healthcare facility. NPCs had a disadvantage in access time to primary, secondary and tertiary medical care compared with a municipal center. NPCs, however, did not have a greater access disadvantage in comparison to adjacent rural communities for any type of medical facility. As such, future resource allocation policies in Japan need to redefine medically underserved communities.

33 CFR 146.140 - Emergency Evacuation Plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be contacted; (5) List the facility's communications equipment, its available frequencies, and the communications schedules with shore installations, standby vessels, rescue aircraft, and other OCS facilities... its personnel would be placed in jeopardy and a mass evacuation of the facility's personnel would be...

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

PubMed

De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

2015-12-01

The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring patients requiring a higher level of care was present in most (80%) clinics and one of the hospitals. However, no facility had a written protocol for transferring patients to other facilities. One hospital reported intermittent access to an ambulance for transfers. Deficits in the supply of emergency equipment and limited protocols for inter-facility transfers exist in North East Department of Haiti. These essential areas represent appropriate targets for interventions aimed at improving access to emergency care within the North East region of Haiti.

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

33 CFR 146.110 - Emergency signals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Emergency signals. 146.110...) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS Manned OCS Facilities § 146.110 Emergency signals. (a) The owner, the owner's agent, or the person in charge shall establish emergency signals to be used for...

Design and fabrication of an elliptical micro-lens array with grating for laser safety

NASA Astrophysics Data System (ADS)

Li, L. H.; Wu, B. Q.; Chan, C. Y.; Lee, W. B.; Dong, L. H.

2015-10-01

With the enormous expansion of laser usage in medicine, industry and research, all facilities must formulate and adhere to specific safety methods that appropriately address user protection. The protective ellipticalal microstructure with grating is a novel technology which can provide the principal means of ensuring against ocular injury, and must be worn at all times during laser operation. On the basis of Fresnel's law and the diffractive law, Solidworks and Lighttools software are applied to design the elliptical micro-lens array and correspondent grating. The height of the microstructure is 100um and its period is 3mm. The period of grating is 5um. It is shown that the amount of emergent light of a specific wavelength (1064nm) can reflect more than 40° from the incident light through simulation, while the incident light is perpendicular to the microstructure. The fabrication adopts the ultra-precision single point diamond method and injection molding method. However, it is found in the test that the surface roughness has a serious effect on the angle between the emergent and incident light. As a result, the element can reflect the vertical incidence beam into a tilted emergent beam with a certain angular degree , as well as protecting users from laser damage injures.

Essential medicines for emergency care in Africa.

PubMed

Broccoli, Morgan C; Pigoga, Jennifer L; Nyirenda, Mulinda; Wallis, Lee; Calvello Hynes, Emilie J

2018-04-07

Essential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury. We undertook a multistep consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final inperson consensus process. The final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML, but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (eg, district hospitals) and an additional 78 for advanced facilities (eg, tertiary centres). The 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation and will be a useful tool for practical expansion of emergency care delivery in Africa. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Organization of workplace first aid in health care facilities].

PubMed

Ciavarella, M; Sacco, A; Bosco, Maria Giuseppina; Chinni, V; De Santis, A; Pagnanelli, A

2007-01-01

Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. To discuss the topic in the light of the guidelines contained in the literature. We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

PubMed

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

76 FR 63353 - Proposed Information Collection (Payment and Reimbursement for Emergency Services for Non Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... (Payment and Reimbursement for Emergency Services for Non Service-Connected Conditions in Non-VA Facilities... to determine a claimant's eligibility for reimbursement or payment for emergency medical treatment at... information technology. Title: Payment and Reimbursement for Emergency Services for Non Service-Connected...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2010 CFR

2010-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

Code of Federal Regulations, 2011 CFR

2011-10-01

... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

24 CFR 576.53 - Use as an emergency shelter.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY HOMELESS ASSISTANCE ACT Program Requirements § 576.53 Use as an emergency shelter. (a)(1) Restrictions and definition... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Use as an emergency shelter. 576.53...

Long-stay in short-stay inpatient facilities: risk factors and barriers to discharge

PubMed Central

Gigantesco, Antonella; de Girolamo, Giovanni; Santone, Giovanni; Miglio, Rossella; Picardi, Angelo

2009-01-01

Background The aim of the present study was to assess the characteristics of long-stay inpatients in public and private Italian acute inpatient facilities, to identify risk factors and correlates of the long duration of hospital stay in these patients, and to identify possible barriers to alternative placements. Methods All patients in 130 Italian public and private psychiatric inpatient units who had been hospitalized for more than 3 months during a specific index period were assessed with standardized assessment instruments and compared to patients discharged during the same index period, but staying in hospital for less than 3 months (short-stay inpatients). Assessed domains included demographic, clinical, and treatment characteristics, as well as process of care. Logistic regression analysis was used to identify specific variables predicting inpatient long-stay status. Reasons for delaying patient discharge, as reported by treatment teams, were also analyzed. Results No overall differences between long-stay and short-stay patients emerged in terms of symptom severity or diagnostic status. Admission to a private inpatient facility and display of violent behavior during hospital stay were the most powerful predictors of long-stay. Lack of housing and a shortage of community support were the reasons most commonly cited by treatment teams as barriers to discharge. Conclusion Extra-clinical factors are important determinants of prolonged hospitalization in acute inpatient settings. PMID:19698136

Faster response time : effective use of resources : integrating transportation systems and emergency management systems

DOT National Transportation Integrated Search

1999-01-01

This brochure discusses how coordinating the efforts of emergency dispatchers with transportation management agencies can improve efficiency and response times. It is noted that when emergency services agencies share facilities and traffic monitoring...

Emergency obstetric and newborn care signal functions in public and private facilities in Bangladesh

PubMed Central

2017-01-01

Background Signal functions for emergency obstetric and newborn care (EmONC) are the major interventions for averting maternal and neonatal mortalities. Readiness of the facilities is essential to provide all the basic and comprehensive signal functions for EmONC to ensure emergency services from the designated facilities. The study assessed population coverage and availability of EmONC services in public and private facilities in Bangladesh. Methods An assessment was conducted in all the public and private facilities providing obstetric care in to in-patients 24 districts. Data were collected on the performance of signal functions for EmONC from the study facilities in the last three months prior to the date of assessment. Trained data-collectors interviewed the facility managers and key service providers, along with review of records, using contextualized tools. Population coverage of signal functions was assessed by estimating the number of facilities providing the signal functions for EmONC compared to the United Nations requirements. Availability was assessed in terms of the proportion of facilities providing the services by type of facilities and by district. Results Caesarean section (CS) delivery and blood transfusion (BT) services (the two major components of comprehensive EmONC) were respectively available in 6.4 (0.9 public and 5.5 private) and 5.6 (1.3 public and 4.3 private) facilities per 500,000 population. The signal functions for basic EmONC, except two (parental anticonvulsants and assisted vaginal delivery), were available in a minimum of 5 facilities (public and private sectors combined) per 500,000 population. A major inter-district variation in the availability of signal functions was observed in each public- and private-sector facility. Among the various types of facilities, only the public medical college hospitals had all the signal functions. The situation was poor in other public facilities at the district and sub-district levels as well as in private facilities. Conclusions In the public sector, CS delivery and BT services were available in the minimum required number of facilities. However, to ensure basic EmONC services, participation of the private sector is necessary. Public-private partnership should be promoted for nationwide coverage of signal functions for EmONC in Bangladesh. PMID:29091965

40 CFR 265.16 - Personnel training.

Code of Federal Regulations, 2010 CFR

2010-07-01

... successfully complete a program of classroom instruction or on-the-job training that teaches them to perform... facility employees that receive emergency response training pursuant to Occupational Safety and Health... documents and records at the facility: (1) The job title for each position at the facility related to...

10 CFR 205.378 - Disconnection of temporary facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Disconnection of temporary facilities. 205.378 Section 205.378 Energy DEPARTMENT OF ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System... Electric Facilities and the Transfer of Electricity to Alleviate An Emergency Shortage of Electric Power...

KSC-04PD-0226

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members prepare to rescue another astronaut from inside the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0224

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members return to the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts simulating various injuries inside the mock-up compartment. Rescuers have had to remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0229

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members on the ground take hold of a volunteer astronaut lowered from the top of the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0225

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members prepare to rescue another astronaut from inside the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0230

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members help a volunteer astronaut onto the ground after being lowered from the top of the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0228

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. Emergency crew members lower a volunteer astronaut from the top of the orbiter crew compartment mock-up that is the scene of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

The NASA integrated test facility and its impact on flight research

NASA Technical Reports Server (NTRS)

Mackall, D. A.; Pickett, M. D.; Schilling, L. J.; Wagner, C. A.

1988-01-01

The Integrated Test Facility (ITF), being built at NASA Ames-Dryden Flight Research Facility, will provide new test capabilities for emerging research aircraft. An overview of the ITF and the challenges being addressed by this unique facility are outlined. The current ITF capabilities, being developed with the X-29 Forward Swept Wing Program, are discussed along with future ITF activities.

Fire safety of ground-based space facilities on the spaceport ;Vostochny;

NASA Astrophysics Data System (ADS)

Artamonov, Vladimir S.; Gordienko, Denis M.; Melikhov, Anatoly S.

2017-06-01

The facilities of the spaceport ;Vostochny; and the innovative technologies for fire safety to be implemented are considered. The planned approaches and prospects for fire safety ensuring at the facilities of the spaceport ;Vostochny; are presented herein, based on the study of emergency situations having resulted in fire accidents and explosion cases at the facilities supporting space vehicles operation.

KENNEDY SPACE CENTER, FLA. - In the Launch Control Center, officials monitor the “Mode VII” emergency landing simulation being conducted at Kennedy Space Center and managed and directed from the LCC. From left are Dr. Luis Moreno and Dr. David Reed, with Bionetics Life Sciences, and Dr. Philip Scarpa, with the KSC Safety, Occupational Health and Environment Division. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - In the Launch Control Center, officials monitor the “Mode VII” emergency landing simulation being conducted at Kennedy Space Center and managed and directed from the LCC. From left are Dr. Luis Moreno and Dr. David Reed, with Bionetics Life Sciences, and Dr. Philip Scarpa, with the KSC Safety, Occupational Health and Environment Division. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer “astronauts” who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Optimal location of emergency stations in underground mine networks using a multiobjective mathematical model.

PubMed

Lotfian, Reza; Najafi, Mehdi

2018-02-26

Background Every year, many mining accidents occur in underground mines all over the world resulting in the death and maiming of many miners and heavy financial losses to mining companies. Underground mining accounts for an increasing share of these events due to their special circumstances and the risks of working therein. Thus, the optimal location of emergency stations within the network of an underground mine in order to provide medical first aid and transport injured people at the right time, plays an essential role in reducing deaths and disabilities caused by accidents Objective The main objective of this study is to determine the location of emergency stations (ES) within the network of an underground coal mine in order to minimize the outreach time for the injured. Methods A three-objective mathematical model is presented for placement of ES facility location selection and allocation of facilities to the injured in various stopes. Results Taking into account the radius of influence for each ES, the proposed model is capable to reduce the maximum time for provision of emergency services in the event of accident for each stope. In addition, the coverage or lack of coverage of each stope by any of the emergency facility is determined by means of Floyd-Warshall algorithm and graph. To solve the problem, a global criterion method using GAMS software is used to evaluate the accuracy and efficiency of the model. Conclusions 7 locations were selected from among 46 candidates for the establishment of emergency facilities in Tabas underground coal mine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

KENNEDY SPACE CENTER, FLA. - Volunteers from the KSC Fire-Rescue team dressed in launch and entry suits settle into seats in an orbiter crew compartment mock-up under the guidance of George Brittingham, USA suit technician on the Closeout Crew. Brittingham is helping Catherine Di Biase, a nurse with Bionetics Life Sciences. They are all taking part in a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - Volunteers from the KSC Fire-Rescue team dressed in launch and entry suits settle into seats in an orbiter crew compartment mock-up under the guidance of George Brittingham, USA suit technician on the Closeout Crew. Brittingham is helping Catherine Di Biase, a nurse with Bionetics Life Sciences. They are all taking part in a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews will respond to the volunteer “astronauts” simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Laser Propulsion - Quo Vadis

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

Bohn, Willy L.

First, an introductory overview of the different types of laser propulsion techniques will be given and illustrated by some historical examples. Second, laser devices available for basic experiments will be reviewed ranging from low power lasers sources to inertial confinement laser facilities. Subsequently, a status of work will show the impasse in which the laser propulsion community is currently engaged. Revisiting the basic relations leads to new avenues in ablative and direct laser propulsion for ground based and space based applications. Hereby, special attention will be devoted to the impact of emerging ultra-short pulse lasers on the coupling coefficient andmore » specific impulse. In particular, laser sources and laser propulsion techniques will be tested in microgravity environment. A novel approach to debris removal will be discussed with respect to the Satellite Laser Ranging (SRL) facilities. Finally, some non technical issues will be raised aimed at the future prospects of laser propulsion in the international community.« less

Continent or incontinent? That is the question.

PubMed

Taunton, Roma Lee; Swagerty, Daniel L; Lasseter, Joyce A; Lee, Robert H

2005-09-01

A qualitative, emergent, case study design guided the description of care provided to nursing home residents with urinary incontinence in three Midwestern nursing facilities. Participants included 17 residents and 16 family members or friends of the respective residents. Staff and managers involved in the planning and delivery of care to the participating residents also were included. The three facilities represented variation in size, location, ownership, and Medicare certification. Data were collected via observation, resident record audit, and semi-structured interview. Definitions of incontinence varied among staff. A collectively held expectation that residents would be toileted every 2 hours was not met. Maintaining skin integrity was the primary motivation for keeping residents clean and dry. Medical directors viewed incontinence as a nursing problem. Staff described situations in which incontinence was improved for specific residents, but there was little evidence of formal programs to maintain continence or improve incontinence.

40 CFR 372.22 - Covered facilities for toxic chemical release reporting.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 29 2013-07-01 2013-07-01 false Covered facilities for toxic chemical... (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS TOXIC CHEMICAL RELEASE REPORTING: COMMUNITY RIGHT-TO-KNOW Reporting Requirements § 372.22 Covered facilities for toxic chemical...

[Survey of analytical works for drugs at emergency and critical care centers with high-performance instruments provided by the Ministry of Health and Welfare (at present: Ministry of Health, Labour, and Welfare) in fiscal 1998--continuation of survey with 2008 survey results as point of reference].

PubMed

Saito, Takeshi; Tominaga, Aya; Nozawa, Mayu; Unei, Hiroko; Hatano, Yayoi; Fujita, Yuji; Iseki, Ken; Hori, Yasushi

2013-09-01

In a 2008 survey of the 73 emergency and critical care centers around the nation that were equipped with the drug and chemical analytical instrument provided by the Ministry of Welfare (currently the Ministry of Health, Labour, and Welfare) in 1998, 36 of those facilities were using the analytical instruments. Of these 36 facilities, a follow-up survey of the 17 facilities that recorded 50 or analyses per year. Responses were gained from 16 of the facilities and we learned that of those, 14 facilities (87.5%) were conducting analyses using the instrument. There was a positive mutual correlation between the annual number of cases of the 14 facilities conducting analyses with the instrument and the number of work hours. Depending on the instrument in use, average analytical instrument parts and maintenance expenses were roughly three million yen and consumables required a maximum three million yen for analysis of 51-200 cases per year. From this, we calculate that such expenses can be covered under the allowed budget for advanced emergency and critical care centers of 5,000 NHI points (1 point = 10 yen). We found there were few facilities using the instrument for all 15 of the toxic substances recommended for testing by the Japanese Society for Clinical Toxicology. There tended to be no use of the analytical instrument for compounds with no toxicology cases. However, flexible responses were noted at each facility in relation to frequently analyzed compounds. It is thought that a reevaluation of compounds subject to analysis is required.

The Role of a National Biocontainment Laboratory in Emergencies.

PubMed

Le Duc, James W; Ksiazek, Thomas G

2015-01-01

Over a decade ago, the National Institutes of Health awarded partial support for the construction and operation of 2 National Biocontainment Laboratories, with the condition that they would be available to assist in the event of public health emergencies-although how a biocontainment facility located on an academic campus might contribute was not defined. Here we offer examples of how one of these laboratories has contributed to a coordinated response to 2 recent international public health emergencies. Essential assets for success include highly trained and experienced staff, access to reference pathogens and reagents, cutting-edge knowledge of the field, appropriate biocontainment facilities, robust biosafety and biosecurity programs, and availability of modern instrumentation. The ability to marry the strengths of academia in basic and applied research with access to appropriate biocontainment facilities while drawing on a highly skilled cadre of experienced experts has proven extremely valuable in the response to recent national emergencies and will continue to do so in the future. Areas where additional planning and preparation are needed have also been identified through these experiences.

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2014 CFR

2014-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2012 CFR

2012-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2013 CFR

2013-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

40 CFR 267.57 - What must the emergency coordinator do after an emergency?

Code of Federal Regulations, 2011 CFR

2011-07-01

... OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.57 What must the..., or any other material that results from a release, fire, or explosion at the facility. (b) The... completed. (2) All emergency equipment listed in the contingency plan is cleaned and fit for its intended...

State Laws on Emergency Holds for Mental Health Stabilization.

PubMed

Hedman, Leslie C; Petrila, John; Fisher, William H; Swanson, Jeffrey W; Dingman, Deirdre A; Burris, Scott

2016-05-01

Psychiatric emergency hold laws permit involuntary admission to a health care facility of a person with an acute mental illness under certain circumstances. This study documented critical variation in state laws, identified important questions for evaluation research, and created a data set of laws to facilitate the public health law research of emergency hold laws' impact on mental health outcomes. The research team built a 50-state, open-source data set of laws currently governing emergency holds. A protocol and codebook were developed so that the study may be replicated and extended longitudinally, allowing future research to accurately capture changes to current laws. Although every state and the District of Columbia have emergency hold laws, state law varies on the duration of emergency holds, who can initiate an emergency hold, the extent of judicial oversight, and the rights of patients during the hold. The core criterion justifying an involuntary hold is mental illness that results in danger to self or others, but many states have added further specifications. Only 22 states require some form of judicial review of the emergency hold process, and only nine require a judge to certify the commitment before a person is hospitalized. Five states do not guarantee assessment by a qualified mental health professional during the emergency hold. The article highlights variability in state law for emergency holds of persons with acute mental illness. How this variability affects the individual, the treatment system, and law enforcement behavior is unknown. Research is needed to guide policy making and implementation on these issues.

EPCRA Tier II Emergency and Hazardous Chemical Inventory Form

EPA Pesticide Factsheets

Required for Emergency and Hazardous Chemical Inventory reporting. Must provide facility identification, chemical description, indication of physical and health hazards, inventory information, and storage details.

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

NASA Astrophysics Data System (ADS)

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

2015-08-01

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

Patterns and determinants of pathways to reach comprehensive emergency obstetric and neonatal care (CEmONC) in South Sudan: qualitative diagrammatic pathway analysis.

PubMed

Elmusharaf, Khalifa; Byrne, Elaine; AbuAgla, Ayat; AbdelRahim, Amal; Manandhar, Mary; Sondorp, Egbert; O'Donovan, Diarmuid

2017-08-29

Maternity referral systems have been under-documented, under-researched, and under-theorised. Responsive emergency referral systems and appropriate transportation are cornerstones in the continuum of care and central to the complex health system. The pathways that women follow to reach Emergency Obstetric and Neonatal Care (EmONC) once a decision has been made to seek care have received relatively little attention. The aim of this research was to identify patterns and determinants of the pathways pregnant women follow from the onset of labour or complications until they reach an appropriate health facility. This study was conducted in Renk County in South Sudan between 2010 and 2012. Data was collected using Critical Incident Technique (CIT) and stakeholder interviews. CIT systematically identified pathways to healthcare during labour, and factors associated with an event of maternal mortality or near miss through a series of in-depth interviews with witnesses or those involved. Face-to-face stakeholder interviews were conducted with 28 purposively identified key informants. Diagrammatic pathway and thematic analysis were conducted using NVIVO 10 software. Once the decision is made to seek emergency obstetric care, the pregnant woman may face a series of complex steps before she reaches an appropriate health facility. Four pathway patterns to CEmONC were identified of which three were associated with high rates of maternal death: late referral, zigzagging referral, and multiple referrals. Women who bypassed nonfunctional Basic EmONC facilities and went directly to CEmONC facilities (the fourth pathway pattern) were most likely to survive. Overall, the competencies of the providers and the functionality of the first point of service determine the pathway to further care. Our findings indicate that outcomes are better where there is no facility available than when the woman accesses a non-functioning facility, and the absence of a healthcare provider is better than the presence of a non-competent provider. Visiting non-functioning or partially functioning healthcare facilities on the way to competent providers places the woman at greater risk of dying. Non-functioning facilities and non-competent providers are likely to contribute to the deaths of women.

Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.

PubMed

Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E W; Stekelenburg, Jelle

2015-02-03

Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents findings from a national emergency obstetric and neonatal care needs assessment related to PAC, with the aim of providing insight into the current situation and recommendations for improvement of PAC services. A national Emergency Obstetric and Neonatal Care Needs Assessment was conducted from December 2009 through February 2010 at 78 of the 127 facilities designated to provide emergency obstetric and neonatal care services in Afghanistan. Research tools were adapted from the Averting Maternal Death and Disability Program Needs Assessment Toolkit and national midwifery education assessment tools. Descriptive statistics were used to summarize facility characteristics, and linear regression models were used to assess the factors associated with providers' PAC knowledge and skills. The average number of women receiving PAC in the past year in each facility was 244, with no significant difference across facility types. All facilities had at least one staff member who provided PAC services. Overall, 70% of providers reported having been trained in PAC and 68% felt confident in their ability to perform these services. On average, providers were able to identify 66% of the most common complications of unsafe or incomplete abortion and 57% of the steps to take in examining and managing women with these complications. Providers correctly demonstrated an average of 31% of the tasks required for PAC during a simulated procedure. Training was significantly associated with PAC knowledge and skills in multivariate regression models, but other provider and facility characteristics were not. While designated emergency obstetric facilities in Afghanistan generally have most supplies and equipment for PAC, the capacity of healthcare providers to deliver PAC is limited. Therefore, we strongly recommend training all skilled birth attendants in PAC services. In addition, a PAC training package should be integrated into pre-service medical education.

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration

PubMed Central

Miech, Edward J.; Sico, Jason J.; Phipps, Michael S.; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B.; Moran, Eileen; Bravata, Dawn M.

2017-01-01

Objective: To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). Methods: We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Results: Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. Conclusions: The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. PMID:29117959

Visitor restriction policies and practices in children's hospitals in North America: results of an Emerging Infections Network Survey.

PubMed

Pong, Alice L; Beekmann, Susan E; Faltamo, Mekleet M; Polgreen, Philip M; Shane, Andi L

2018-06-21

To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities. An electronic survey to characterize VRPP in pediatric healthcare facilities. The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed. A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%). Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.

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.

KSC-04PD-0222

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. In a Mode VII emergency landing simulation at Kennedy Space Center, a helicopter crew helps rescued astronauts. The purpose of Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts simulating various injuries inside an orbiter crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0220

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. A helicopter approaches an orbiter crew compartment mock-up as part of a Mode VII emergency landing simulation at Kennedy Space Center. The purpose is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews will respond to the volunteer astronauts simulating various injuries. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

The influence of travel time on emergency obstetric care seeking behavior in the urban poor of Bangladesh: a GIS study.

PubMed

Panciera, Rocco; Khan, Akib; Rizvi, Syed Jafar Raza; Ahmed, Shakil; Ahmed, Tanvir; Islam, Rubana; Adams, Alayne M

2016-08-22

Availability of Emergency Obstetric Care (EmOC) is crucial to avert maternal death due to life-threatening complications potentially arising during delivery. Research on the determinants of utilization of EmOC has neglected urban settings, where traffic congestion can pose a significant barrier to the access of EmOC facilities, particularly for the urban poor due to costly and limited transportation options. This study investigates the impact of travel time to EmOC facilities on the utilization of facility-based delivery services among mothers living in urban poor settlements in Sylhet, Bangladesh. A cross-sectional EmOC health-seeking behavior survey from 39 poor urban clusters was geo-spatially linked to a comprehensive geo-referenced dataset of EmOC facility locations. Geo-spatial techniques and logistic regression were then applied to quantify the impact of travel time on place of delivery (EmOC facility or home), while controlling for confounding socio-cultural and economic factors. Increasing travel time to the nearest EmOC facility is found to act as a strong deterrent to seeking care for the urban poor in Sylhet. Logistic regression results indicate that a 5-min increase in travel time to the nearest EmOC facility is associated with a 30 % decrease (0.655 odds ratio, 95 % CI: 0.529-0.811) in the likelihood of delivery at an EmOC facility rather than at home. Moreover, the impact of travel time varies substantially between public, NGO and private facilities. A 5-min increase in travel time from a private EmOC facility is associated with a 32.9 % decrease in the likelihood of delivering at a private facility, while for public and Non-Government Organizations (NGO) EmOC facilities, the impact is lower (28.2 and 28.6 % decrease respectively). Other strong determinants of delivery at an EmOC facility are the use of antenatal care and mother's formal education, while Muslim mothers are found to be more likely to deliver at home. Geospatial evidence points to the need to strengthen referral and emergency transport systems in order to reduce urban travel time, and establish or relocate EmOC facilities closer to where the poor reside. However, female education and antenatal care coverage remain the most important determinants of facility delivery.

33 CFR 146.140 - Emergency Evacuation Plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... placing the facility in operation. The OCMI reviews the EEP to determine whether all items listed in..., and environmental conditions, such as approaching hurricanes or ice floes, in which the facility or...

33 CFR 146.140 - Emergency Evacuation Plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... placing the facility in operation. The OCMI reviews the EEP to determine whether all items listed in..., and environmental conditions, such as approaching hurricanes or ice floes, in which the facility or...

33 CFR 146.140 - Emergency Evacuation Plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... placing the facility in operation. The OCMI reviews the EEP to determine whether all items listed in..., and environmental conditions, such as approaching hurricanes or ice floes, in which the facility or...

33 CFR 146.140 - Emergency Evacuation Plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... placing the facility in operation. The OCMI reviews the EEP to determine whether all items listed in..., and environmental conditions, such as approaching hurricanes or ice floes, in which the facility or...

Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department.

PubMed

Goldstein, K P; Kviz, F J; Daum, R S

1993-11-10

Because some have advocated the use of emergency departments to administer delayed childhood immunizations, we evaluated the accuracy of immunization histories obtained in this setting by comparison with medical records of inner-city health care facilities. Questionnaires were orally administered to adults accompanying children to the emergency department. Individual medical records were reviewed. Pediatric emergency department at Wyler Children's Hospital, University of Chicago and 68 inner-city primary care clinics. Children aged 3 to 65 months registering for medical care. Of the sample, 98% were African American; 75% were Medicaid recipients. Adults' knowledge of immunization histories, immunization cards, and medical records compared with American Academy of Pediatrics/Immunization Practices Advisory Committee recommendations. Of the accompanying adults, 64% stated that their child's general immunization status was "up-to-date"; 65% of these had clinic records confirming that status. Only 8% of specific regimens stated by these adults accurately matched those found in clinic records. Moreover, 45% of adults accompanying children at least 16 months and older provided inaccurate information regarding previous receipt of measles immunization. Information provided by accompanying adults (from recall or from immunization cards) is inadequate to determine accurately which preschoolers in the pediatric emergency department are delayed in immunizations.

Where to go? Strategic modelling of access to emergency shelters in Mozambique.

PubMed

Gall, Melanie

2004-03-01

This paper, through spatial-analysis techniques, examines the accessibility of emergency shelters for vulnerable populations, and outlines the benefits of an extended and permanently established shelter network in central Mozambique. The raster-based modelling approach considers data on land cover, locations of accommodation centres in 2000, settlements and infrastructure. The shelter analysis is a two-step process determining access for vulnerable communities first, followed by a suitability analysis for additional emergency shelter sites. The results indicate the need for both retrofitting existing infrastructure (schools, health posts) to function as shelters during an emergency, and constructing new facilities - at best multi-purpose facilities that can serve as social infrastructure and shelter. Besides assessing the current situation in terms of availability and accessibility of emergency shelters, this paper provides an example of evaluating the effectiveness of humanitarian assistance without conventional mechanisms like food tonnage and number of beneficiaries.

KSC-06pd0486

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - Equipment is in place at NASA Kennedy Space Center's Shuttle Landing Facility for a simulated emergency rescue of a shuttle crew after landing. At center is the orbiter mockup. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

Disaster Response and Preparedness Application: Emergency Environmental Response Tool (EERT)

NASA Technical Reports Server (NTRS)

Smoot, James; Carr, Hugh; Jester, Keith

2003-01-01

In 2000, the National Aeronautics and Space Administration (NASA) Environmental Office at the John C. Stennis Space Center (SSC) developed an Environmental Geographic Information Systems (EGIS) database. NASA had previously developed a GIS database at SSC to assist in the NASA Environmental Office's management of the Center. This GIS became the basis for the NASA-wide EGIS project, which was proposed after the applicability of the SSC database was demonstrated. Since its completion, the SSC EGIS has aided the Environmental Office with noise pollution modeling, land cover assessment, wetlands delineation, environmental hazards mapping, and critical habitat delineation for protected species. At SSC, facility management and safety officers are responsible for ensuring the physical security of the facilities, staff, and equipment as well as for responding to environmental emergencies, such as accidental releases of hazardous materials. All phases of emergency management (planning, mitigation, preparedness, and response) depend on data reliability and system interoperability from a variety of sources to determine the size and scope of the emergency operation. Because geospatial data are now available for all NASA facilities, it was suggested that this data could be incorporated into a computerized management information program to assist facility managers. The idea was that the information system could improve both the effectiveness and the efficiency of managing and controlling actions associated with disaster, homeland security, and other activities. It was decided to use SSC as a pilot site to demonstrate the efficacy of having a baseline, computerized management information system that ultimately was referred to as the Emergency Environmental Response Tool (EERT).

An assessment of Chemical, Biological, Radiologic, Nuclear, and Explosive preparedness among emergency department healthcare providers in an inner city emergency department.

PubMed

Kotora, Joseph G

2015-01-01

Emergency healthcare providers are required to care for victims of Chemical, Biological, Radiologic, Nuclear, and Explosive (CBRNE) agents. However, US emergency departments are often ill prepared to manage CBRNE casualties. Most providers lack adequate knowledge or experience in the areas of patient decontamination, hospital-specific disaster protocols, interagency familiarization, and available supply of necessary medical equipment and medications. This study evaluated the CBRNE preparedness of physicians, nurses, and midlevel providers in an urban tertiary care emergency department. This retrospective observational survey study used a previously constructed questionnaire instrument. A total of 205 e-mail invitations were sent to 191 eligible providers through an online survey distribution tool (Survey Monkey®). Respondents were enrolled from February 1, 2014 to March 15, 2014. Simple frequencies of correct answers were used to determine the level of preparedness of each group. Cronbach's coefficient α was used to validate the precision of the study instrument. Finally, validity coefficients and analysis of variance ANOVA were used to determine the strength of correlation between demographic variables, as well as the variation between individual responses. Fifty-nine providers responded to the questionnaire (31.14 percent response rate). The overall frequency of correct answers was 66.26 percent, indicating a relatively poor level of CBRNE preparedness. The study instrument lacked precision and reliability (coefficient α 0.4050). Significant correlations were found between the frequency of correct answers and the respondents' gender, practice experience, and previous experience with a CBRNE incident. Significant variance exists between how providers believe casualties should be decontaminated, which drugs should be administered, and the interpretation of facility-specific protocols. Emergency care providers are inadequately prepared to manage CBRNE incidents. Furthermore, a valid and precise instrument capable of measuring preparedness needs to be developed. Standardized educational curriculums that consider healthcare providers' genders, occupations, and experience levels may assist in closing the knowledge gaps between providers and reinforce emergency departments' CBRNE preparedness.

IoT based mobile health hub

NASA Astrophysics Data System (ADS)

Thomas, Diljo; Vineeth, V. L.; Siddharth, P. G.; Shanmugasundaram, M.

2017-11-01

Technological innovations have a great influence on bio medical field. Even in this advanced era people are struggling due to lack of medical attention or delay in arranging adequate health care. Most of the hospitals have emergency vehicle facility and they are successful in providing emergency response to the needy patient. But the delay in arranging medical attention in hospital is still a big issue. One solution to the above problem is to provide a channel of communication between the emergency vehicle and hospital such that the patient information along with the vitals can be made available to the hospital prior to the arrival of emergency vehicle. This paper proposes such a system where the patient information and vitals are measured and uploaded to a cloud facility. This information helps the doctor to arrange quick medical response.

44 CFR 352.6 - FEMA determination on the commitment of Federal facilities and resources.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Certifications and Determinations § 352.6 FEMA determination on... radiological emergency preparedness plan. (d) The FEMA Deputy Administrator for the National Preparedness...

44 CFR 312.4 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true General. 312.4 Section 312.4 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.4...

School Emergency Planning Guide.

ERIC Educational Resources Information Center

Benedetto, Harry J.

This guide was prepared to assist Pennsylvania schools and communities in the development of comprehensive emergency plans. Procedures for identifying and responding to potential community and school emergency situations are presented. A plan for developing and organizing mass care centers utilizing school and community facilities and resources is…

49 CFR 192.167 - Compressor stations: Emergency shutdown.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Components § 192.167 Compressor stations: Emergency shutdown. (a) Except for unattended field compressor... fires, and electrical facilities in the vicinity of gas headers and in the compressor building, except that: (i) Electrical circuits that supply emergency lighting required to assist station personnel in...

49 CFR 192.167 - Compressor stations: Emergency shutdown.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Components § 192.167 Compressor stations: Emergency shutdown. (a) Except for unattended field compressor... fires, and electrical facilities in the vicinity of gas headers and in the compressor building, except that: (i) Electrical circuits that supply emergency lighting required to assist station personnel in...

Recommendations for Emergency Management Planning for School Facilities.

ERIC Educational Resources Information Center

Texas Education Agency, Austin.

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

Trends in CT scan rates in children and pregnant women: teaching, private, public and nonprofit facilities.

PubMed

Hoshiko, Sumi; Smith, Daniel; Fan, Cathyn; Jones, Carrie R; McNeel, Sandra V; Cohen, Ronald A

2014-05-01

Radiation exposure from medical sources now equals or exceeds that from natural background sources, largely attributable to a 20-fold increase in CT use since 1980. Increasing exposure to children and fetuses is of most concern due to their heightened susceptibility. More recently, CT use may be leveling or decreasing, but it is unclear whether this change is widespread or varies by type of institution. We sought to characterize trends in CT utilization in California hospitals and emergency departments among children and pregnant women, looking at different types of facilities, such as teaching, private, public and nonprofit institutions. We examined frequency of CT examinations by year from 229 facilities reporting CT usage in routinely collected California statewide data for 2005-2012. We modeled trends overall and by facility type. CT scans for pediatric and pregnant patient visits in the emergency department increased initially, then started to decline after 2008. Among hospital admissions, rates declined or leveled after 2005. In the emergency department, CT rates varied between types of facilities, with teaching hospitals reducing use sooner and more sharply than other types of facilities. CT utilization in California among children and pregnant women has begun to level or decline. Still, population exposure remains at historically high levels, warranting consideration of potential public health implications. Further examination of reasons for trends among hospital types, particularly how teaching hospitals have reduced rates of CT utilization, may help identify strategies for CT reduction without compromising patient care.

Applying social science and public health methods to community-based pandemic planning.

PubMed

Danforth, Elizabeth J; Doying, Annette; Merceron, Georges; Kennedy, Laura

2010-11-01

Pandemic influenza is a unique threat to communities, affecting schools, businesses, health facilities and individuals in ways not seen in other emergency events. This paper aims to outline a local government project which utilised public health and social science research methods to facilitate the creation of an emergency response plan for pandemic influenza coincidental to the early stages of the 2009 H1N1 ('swine flu') outbreak. A multi-disciplinary team coordinated the creation of a pandemic influenza emergency response plan which utilised emergency planning structure and concepts and encompassed a diverse array of county entities including schools, businesses, community organisations, government agencies and healthcare facilities. Lessons learned from this project focus on the need for (1) maintaining relationships forged during the planning process, (2) targeted public health messaging, (3) continual evolution of emergency plans, (4) mutual understanding of emergency management concepts by business and community leaders, and (5) regional coordination with entities outside county boundaries.

Identification and assessment of site treatment plan implementation opportunities for emerging technologies

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

Bernard, E.A.

1995-12-31

The Department of Energy (DOE), in response to the 1992 Federal Facility Compliance Act, has prepared Site Treatment Plans (STP) for the approximately 2,000 waste streams identified within its mixed waste inventory Concurrently, emerging mixed waste treatment technologies are in final development. This paper defines a three-phase process to identify and assess implementation opportunities for these emerging technologies within the STP. It highlights the first phase, functional matching of expected treatment capabilities with proposed treatment requirements. Matches are based on treatment type, regulated contaminant and waste matrix type, for both capabilities and requirements. Results identify specific waste streams and volumesmore » that could be treated by each emerging technology. A study for Plasma Hearth Process, Delphi DETOX{sup sm}, Supercritical Water Oxidation and Vitrification shows that about 200,000 ml of DOE`s mixed waste inventory can potentially be treated by one or more of these emerging technologies. Actual implementations are small fractions of the treatable inventory. Differences between potential and actual implementations must be minimized to accrue optimum benefit from implementation of emerging or alternative treatment technologies. Functional matching is the first phase in identifying and quantifying benefits, addressing technology system and treatment issues, and providing, in part, the basis for STP implementation decisions. DOE, through EM`s Office of Technology Development, has funded this work.« less

megaTALs: a rare-cleaving nuclease architecture for therapeutic genome engineering.

PubMed

Boissel, Sandrine; Jarjour, Jordan; Astrakhan, Alexander; Adey, Andrew; Gouble, Agnès; Duchateau, Philippe; Shendure, Jay; Stoddard, Barry L; Certo, Michael T; Baker, David; Scharenberg, Andrew M

2014-02-01

Rare-cleaving endonucleases have emerged as important tools for making targeted genome modifications. While multiple platforms are now available to generate reagents for research applications, each existing platform has significant limitations in one or more of three key properties necessary for therapeutic application: efficiency of cleavage at the desired target site, specificity of cleavage (i.e. rate of cleavage at 'off-target' sites), and efficient/facile means for delivery to desired target cells. Here, we describe the development of a single-chain rare-cleaving nuclease architecture, which we designate 'megaTAL', in which the DNA binding region of a transcription activator-like (TAL) effector is used to 'address' a site-specific meganuclease adjacent to a single desired genomic target site. This architecture allows the generation of extremely active and hyper-specific compact nucleases that are compatible with all current viral and nonviral cell delivery methods.

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

PubMed

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

2016-01-01

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

Interface Control Document for the Traffic Lights and Emergency Communications System at Gretna and Governor Nicholls Traffic Light Facilities

DOT National Transportation Integrated Search

1997-11-06

Gretna and Governor Nicholls Light facilities are two manned shore side : facilities mounted in critical areas on the banks of the Mississippi River in : the port of New Orleans, Louisiana. Coast Guard plans call for the lights to : be remotely contr...

Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study.

PubMed

Varghese, Beena; Krishnamurthy, Jayanna; Correia, Blaze; Panigrahi, Ruchika; Washington, Maryann; Ponnuswamy, Vinotha; Mony, Prem

2016-12-23

The majority of the maternal and perinatal deaths are preventable through improved emergency obstetric and newborn care at facilities. However, the quality of such care in India has significant gaps in terms of provider skills and in their preparedness to handle emergencies. We tested the feasibility, acceptability, and effectiveness of a "skills and drills" intervention, implemented between July 2013 and September 2014, to improve emergency obstetric and newborn care in the state of Karnataka, India. Emergency drills through role play, conducted every 2 months, combined with supportive supervision and a 2-day skills refresher session were delivered across 4 sub-district, secondary-level government facilities by an external team of obstetric and pediatric specialists and nurses. We evaluated the intervention through a quasi-experimental design with 4 intervention and 4 comparison facilities, using delivery case sheet reviews, pre- and post-knowledge tests among providers, objective structured clinical examinations (OSCEs), and qualitative in-depth interviews. Primary outcomes consisted of improved diagnosis and management of selected maternal and newborn complications (postpartum hemorrhage, pregnancy-induced hypertension, and birth asphyxia). Secondary outcomes included knowledge and skill levels of providers and acceptability and feasibility of the intervention. Knowledge scores among providers improved significantly in the intervention facilities; in obstetrics, average scores between the pre- and post-test increased from 49% to 57% (P=.006) and in newborn care, scores increased from 48% to 56% (P=.03). Knowledge scores in the comparison facilities were similar but did not improve significantly over time. Skill levels were significantly higher among providers in intervention facilities than comparison facilities (mean objective structured clinical examination scores for obstetric skills: 55% vs. 46%, respectively; for newborn skills: 58% vs. 48%, respectively; P<.001 for both obstetric and newborn), along with their confidence in managing complications. However, this did not result in significant differences in correct diagnosis and management of complications between intervention and comparison facilities. Shortage of trained nurses and doctors along with unavailability of a consistent supply chain was cited by most providers as major health systems barriers affecting provision of care. Improvements in knowledge, skills, and confidence levels of providers as a result of the skills and drills intervention was not sufficient to translate into improved diagnosis and management of maternal and newborn complications. System-level changes including adequate in-service training may also be necessary to improve maternal and newborn outcomes. © Varghese et al.

How the University of Texas system responded to the need for interim storage of low-level radioactive waste materials.

PubMed

Emery, Robert J

2012-11-01

Faced with the prospect of being unable to permanently dispose of low-level radioactive wastes (LLRW) generated from teaching, research, and patient care activities, component institutions of the University of Texas System worked collaboratively to create a dedicated interim storage facility to be used until a permanent disposal facility became available. Located in a remote section of West Texas, the University of Texas System Interim Storage Facility (UTSISF) was licensed and put into operation in 1993, and since then has provided safe and secure interim storage for up to 350 drums of dry solid LLRW at any given time. Interim storage capability provided needed relief to component institutions, whose on-site waste facilities could have possibly become overburdened. Experiences gained from the licensing and operation of the site are described, and as a new permanent LLRW disposal facility emerges in Texas, a potential new role for the storage facility as a surge capacity storage site in times of natural disasters and emergencies is also discussed.

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

Code of Federal Regulations, 2014 CFR

2014-01-01

... Response Purposes § 102-75.760 Who must the Office of Justice Programs (OJP) and the Federal Emergency... Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA) notify that surplus real property is available for correctional facility, law enforcement, or emergency management response purposes...

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... Response Purposes § 102-75.760 Who must the Office of Justice Programs (OJP) and the Federal Emergency... Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA) notify that surplus real property is available for correctional facility, law enforcement, or emergency management response purposes...

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

Code of Federal Regulations, 2012 CFR

2012-01-01

... Response Purposes § 102-75.760 Who must the Office of Justice Programs (OJP) and the Federal Emergency... Justice Programs (OJP) and the Federal Emergency Management Agency (FEMA) notify that surplus real property is available for correctional facility, law enforcement, or emergency management response purposes...

EPCRA Section 304

EPA Pesticide Factsheets

Overview of emergency release notification requirements under Emergency Planning and Community Right-to-Know Act. If an accidental chemical release exceeds the applicable minimal reportable quantity, the facility must notify SERCs and the NRC.

77 FR 23161 - Onsite Emergency Response Capabilities

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... entire facility. The emergency diesel generators started at all six units, providing alternating current... known as station blackout (SBO). One diesel generator remained functional on Unit 6. Despite the actions...

Comparing Utilization and Costs of Care in Freestanding Emergency Departments, Hospital Emergency Departments, and Urgent Care Centers.

PubMed

Ho, Vivian; Metcalfe, Leanne; Dark, Cedric; Vu, Lan; Weber, Ellerie; Shelton, George; Underwood, Howard R

2017-12-01

We compare utilization, price per visit, and the types of care delivered across freestanding emergency departments (EDs), hospital-based EDs, and urgent care centers in Texas. We analyzed insurance claims processed by Blue Cross Blue Shield of Texas from 2012 to 2015 for patient visits to freestanding EDs, hospital-based EDs, or urgent care centers in 16 Texas metropolitan statistical areas containing 84.1% of the state's population. We calculated the aggregate number of visits, average price per visit, proportion of price attributable to facility and physician services, and proportion of price billed to Blue Cross Blue Shield of Texas versus out of pocket, by facility type. Prices for the top 20 diagnoses and procedures by facility type are compared. Texans use hospital-based EDs and urgent care centers much more than freestanding EDs, but freestanding ED utilization increased 236% between 2012 and 2015. The average price per visit was lower for freestanding EDs versus hospital-based EDs in 2012 ($1,431 versus $1,842), but prices in 2015 were comparable ($2,199 versus $2,259). Prices for urgent care centers were only $164 and $168 in 2012 and 2015. Out-of-pocket liability for consumers for all these facilities increased slightly from 2012 to 2015. There was 75% overlap in the 20 most common diagnoses at freestanding EDs versus urgent care centers and 60% overlap for hospital-based EDs and urgent care centers. However, prices for patients with the same diagnosis were on average almost 10 times higher at freestanding and hospital-based EDs relative to urgent care centers. Utilization of freestanding EDs is rapidly expanding in Texas. Higher prices at freestanding and hospital-based EDs relative to urgent care centers, despite substantial overlap in services delivered, imply potential inefficient use of emergency facilities. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Emergency Planning for Municipal Wastewater Treatment Facilities.

ERIC Educational Resources Information Center

Lemon, R. A.; And Others

This manual for the development of emergency operating plans for municipal wastewater treatment systems was compiled using information provided by over two hundred municipal treatment systems. It covers emergencies caused by natural disasters, civil disorders and strikes, faulty maintenance, negligent operation, and accidents. The effects of such…

42 CFR 483.362 - Monitoring of the resident in and immediately after restraint.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CARE FACILITIES Condition of Participation for the Use of Restraint or Seclusion in Psychiatric... use of emergency safety interventions must be physically present, continually assessing and monitoring... duration of the emergency safety intervention. (b) If the emergency safety situation continues beyond the...

42 CFR 483.362 - Monitoring of the resident in and immediately after restraint.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CARE FACILITIES Condition of Participation for the Use of Restraint or Seclusion in Psychiatric... use of emergency safety interventions must be physically present, continually assessing and monitoring... duration of the emergency safety intervention. (b) If the emergency safety situation continues beyond the...

40 CFR 264.55 - Emergency coordinator.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Contingency Plan and Emergency Procedures § 264.55 Emergency coordinator. At all times, there must be at least...'s contingency plan, all operations and activities at the facility, the location and characteristics... addition, this person must have the authority to commit the resources needed to carry out the contingency...

Emerging Contaminants and Federal Facility Contaminants of Concern

EPA Pesticide Factsheets

This page links to fact sheets summarizing contaminants of concern and emerging contaminants that present unique issues and challenges to the environmental community in general and to FFRRO in particular.

Faster response time, effective use of resources : integrating transportation systems and emergency management systems.

DOT National Transportation Integrated Search

1999-01-01

When emergency services agencies share : facilities and traffic monitoring resources : with transportation management agencies, : the efficiency and speed of incident : response are measurably improved.

KENNEDY SPACE CENTER, FLA. - A rescue team carries an “injured” astronaut toward the helicopter for transportation to a local hospital. They are all taking part in a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

NASA Image and Video Library

2004-02-18

KENNEDY SPACE CENTER, FLA. - A rescue team carries an “injured” astronaut toward the helicopter for transportation to a local hospital. They are all taking part in a “Mode VII” emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-06pd0519

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - At NASA Kennedy Space Center's Shuttle Landing Facility, volunteer Charlie Plain poses as an injured astronaut during a simulated emergency landing of a shuttle crew. Plain is a Public Affairs Web writer. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Troy Cryder

To Stay or to Leave: Factors Influencing Victims' Decisions to Stay or Leave a Domestic Violence Emergency Shelter.

PubMed

Fisher, Elisa M; Stylianou, Amanda M

2016-04-28

Domestic violence (DV) emergency shelters play a vital role in supporting victims who seek to leave abusive partners and gain independence. Research indicates that numerous positive outcomes for victims and their children are associated with utilization of DV shelter programs. Yet, research also suggests that DV shelter programs may be unable to comprehensively meet the needs of all victims, and many choose to leave shelters soon after their arrival. To better understand the ways in which DV shelter programs support victims but also fail to meet their needs, this article explores the factors that influence victims' decisions to stay or leave a DV emergency shelter program through qualitative interviews with 33 DV shelter residents. Study participants indicate that three types of factors influence their decision to stay or leave the shelter program: (a) contextual factors, (b) partner or family relationship factors, and (c) shelter-specific factors. Shelter-specific factors cited as important contributors to satisfaction or dissatisfaction with shelter living include policies, staff and services, displacement from one's home community, and facilities. Findings provide information from the perspective of victims on the factors that influence one's decision to stay or leave a DV program and can be used to support service providers and advocates in building programs that are both supportive of victims' needs and conductive to longer shelter stays. © The Author(s) 2016.

Chemical Emergency Preparedness and Prevention Advisory: Ammonia

EPA Pesticide Factsheets

This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can minimize risks from this extremely hazardous substance, especially when present in excess of its 500 pounds threshold planning quantity.

Chemical Emergency Preparedness and Prevention on Tribal Lands

EPA Pesticide Factsheets

This fact sheet familiarizes tribal leaders with EPCRA and Chemical Accident Prevention Program requirements. Tribal Emergency Response Commissions (TERCs) can appoint LEPCs, develop contingency plans, and review facilities' Risk Management Plans.

Emerging Contaminants – Dinitrotoluene (DNT)

EPA Pesticide Factsheets

This fact sheet, developed by the U.S. Environmental Protection Agency’s Federal Facilities Restoration and Reuse Office (FFRRO), provides a brief summary of the emerging contaminant Dinitrotoluene (DNT) including physical and chemical properties.

The Arab American Experience with Diabetes: Perceptions, Myths and Implications for Culturally-Specific Interventions

PubMed Central

Bertran, Elizabeth A; Pinelli, Nicole R; Sills, Stephen J; Jaber, Linda A

2016-01-01

Aims Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans’ knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. Methods Sixty-nine self-identified Arab or Arab Americans ≥ 30 years of age and without diabetes participated in 8 focus groups. Results Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma. The main barrier to healthcare was lack of health insurance and/or cost of care. Intervention preferences included gender-specific exercise, group-delivered education featuring religious ideology, inclusion of the family, and utilization of community facilities. Conclusion Lifestyle interventions for Arab Americans need to address cultural preferences, diabetes myths, and folk remedies. Interventions should incorporate Arabic cultural content and gender-specific group education and exercise. Utilization of family support and religious centers will enable culturally-acceptable and cost-effective interventions. PMID:27460886

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

PubMed

Baxter, Megan

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

75 FR 68614 - Agency Information Collection Activities: Submission for OMB Review; Comment Request, OMB No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-08

... preparedness. The NETC site has facilities and housing available for those participating in emergency... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2010-0043...: Federal Emergency Management Agency, DHS. ACTION: Notice; 30-day notice and request for comments; revision...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

40 CFR 265.56 - Emergency procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES Contingency Plan and Emergency Procedures § 265.56 Emergency procedures. (a) Whenever there is an... with designated response roles if their help is needed. (b) Whenever there is a release, fire, or... possible hazards to human health or the environment that may result from the release, fire, or explosion...

The Effectiveness of an Emergent Literacy Intervention for Teenage Parents

ERIC Educational Resources Information Center

Scott, Amy; van Bysterveldt, Anne; McNeill, Brigid

2016-01-01

This study determined the effectiveness of an experimental emergent literacy intervention, targeting teenage mothers attending an educational facility. Using a pretest/posttest research design, 27 participants completed a 7­-week intervention based in the classroom, targeting a range of emergent literacy skills that they could utilize when reading…

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 3 2012-10-01 2012-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

45 CFR 671.17 - Cases of emergency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Cases of emergency. 671.17 Section 671.17 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION WASTE REGULATION... emergency relating to the safety of human life or of ships, aircraft or other equipment and facilities of...

40 CFR 264.227 - Emergency repairs; contingency plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Emergency repairs; contingency plans... FACILITIES Surface Impoundments § 264.227 Emergency repairs; contingency plans. (a) A surface impoundment... days after detecting the problem. (c) As part of the contingency plan required in subpart D of this...

KSC-04PD-0221

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. A helicopter is landing near rescue team members taking part in a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts simulating various injuries inside an orbiter crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

44 CFR 206.253 - Insurance requirements for facilities damaged by disasters other than flood.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities damaged by disasters other than flood. 206.253 Section 206.253 Emergency Management and Assistance... by disasters other than flood. (a) Prior to approval of a Federal grant for the restoration of a facility and its contents which were damaged by a disaster other than flood, the Grantee shall notify the...

Systems Check: Community Colleges Turn to Facilities Assessments to Plan Capital Projects and Avoid Expensive Emergency Repairs

ERIC Educational Resources Information Center

Joch, Alan

2014-01-01

With an emphasis on planning and cutting costs to make better use of resources, facilities managers at community colleges across the nation have undertaken facilities audits usually with the help of outside engineers. Such assessments analyze the history and structural integrity of buildings and core components on campus, including heating…

47 CFR 73.3516 - Specification of facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Specification of facilities. 73.3516 Section 73... BROADCAST SERVICES Rules Applicable to All Broadcast Stations § 73.3516 Specification of facilities. (a) An application for facilities in the AM, FM, TV or Class A TV broadcast services, or low power TV service shall...

Inland area contingency plan and maps for Delaware, Maryland, West Virginia, District of Columbia (on CD-ROM). Data file

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

NONE

1996-12-01

EPA Region III has assembled on this CD a multitude of environmental data, in both visual and textual formats. While targeted for Facility Response Planning under the Oil Pollution Act of 1990, this information will prove helpful to anyone in the environmental arena. Specifically, the CD will aid contingency planning and emergency response personnel. Combining innovative GIS technology with EPA`s state-specific data allows you to display maps, find and identify map features, look at tabular information about map features, and print out maps. The CD was designed to be easy to use and incorporates example maps as well as helpmore » sections describing the use of the environmental data on the CD, and introduces you to the IACP Viewer and its capabilities. These help features will make it easy for you to conduct analysis, produce maps, and browse the IACP Plan. The IACP data are included in two formats: shapefiles, which can be viewed with the IACP Viewer or ESRI`s ArcView software (Version 2.1 or higher), and ARC/INFO export files, which can be imported into ARC/INFO or converted to other GIS data formats. Point Data Sources: Sensitive Areas, Surface Drinking Water Intakes, Groundwater Intakes, Groundwater Supply Facilities, NPL (National Priority List) Sites, FRP (Facility Response Plan) Facilities, NPDES (National Pollutant Discharge Elimination System) Facilities, Hospitals, RCRA (Resource Conservation and Recovery Act) Sites, TRI (Toxic Release Inventory) Sites, CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act) Sites Line Data Sources: TIGER Roads, TIGER Railroads, TIGER Hydrography, Pipelines Polygon Data Sources: State Boundaries, County Boundaries, Watershed Boundaries (8-digit HUC), TIGER Hydrography, Public Lands, Populated Places, IACP Boundaries, Coast Guard Boundaries, Forest Types, US Congressional Districts, One-half Mile Buffer of Surface Drinking Water Intakes.« less

7 CFR 3570.67 - Project selection priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... emergencies, such as the loss of a community facility due to an accident or natural disaster or the loss of... funds, emergency conditions caused by economic problems, natural disasters, or leveraging of funds...

7 CFR 3570.67 - Project selection priorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... emergencies, such as the loss of a community facility due to an accident or natural disaster or the loss of... funds, emergency conditions caused by economic problems, natural disasters, or leveraging of funds...

7 CFR 3570.67 - Project selection priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... emergencies, such as the loss of a community facility due to an accident or natural disaster or the loss of... funds, emergency conditions caused by economic problems, natural disasters, or leveraging of funds...

Tier2 Submit Software

EPA Pesticide Factsheets

Download this tool for Windows or Mac, which helps facilities prepare a Tier II electronic chemical inventory report. The data can also be exported into the CAMEOfm (Computer-Aided Management of Emergency Operations) emergency planning software.

Personnel Safety on Electrified Railroads

DOT National Transportation Integrated Search

1980-06-01

Potential electrical hazards to fire, police, and rescue personnel responding to emergencies on electrified railways are examined. Data on descriptions of electrical facilities, types of accidents and danger to emergency personnel, and reviews of ope...

Alimentary tract surgery in the nonagenarian: elective vs. emergent operations.

PubMed

Blansfield, Joseph A; Clark, Susan C; Hofmann, Mary T; Morris, Jon B

2004-01-01

The objective of this study was to compare elective with emergent surgery in patients over the age of 90 years. We retrospectively reviewed the records of patients over 90 years of age who underwent alimentary tract surgery between 1994 and 2002 at a community teaching hospital. Of 100 patients (mean age 92 years; range 90 to 98 years), 82 were women and 18 were men. Seventy-three percent were admitted from private homes or assisted-living facilities, and 27% came from a skilled-nursing facility (SNF). Major comorbid conditions existed in 93%. Procedures included right hemicolectomy (22%), adhesiolysis and/or small bowel resection (19%), cholecystectomy (14%), left-sided or sigmoid colectomy (11%), and perineal proctectomy (8%). Overall morbidity and mortality were 36% and 15%, respectively. Postoperative complications included respiratory failure and pneumonia (11%), arrhythmias (9%), delirium (7%), congestive heart failure and myocardial infarction (6%), and urinary complications (4%). Twenty-eight percent of the operations were elective, and 72% were emergent. Morbidity and mortality were higher in the emergent group (41% and 19%, respectively) than in the elective group (26% and 4%, respectively; P=0.04), especially for patients with an emergent surgical problem who came from a nursing home (22%). Average length of stay was 12 +/- 10 days (range 2 to 69 days) with little difference between elective and emergent cases. Sixty-four percent of patients were discharged to skilled-nursing facilities. Alimentary tract surgery can be performed safely in nonagenarians, and they should not be denied surgical care solely because of age.

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.

Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh.

PubMed

Alam, Badrul; Mridha, Malay K; Biswas, Taposh K; Roy, Lumbini; Rahman, Maksudur; Chowdhury, Mahbub E

2015-10-01

To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi-structured questionnaire completed through interviews of managers and service providers, and record review. In total, 8.6 (2.1 public and 6.5 private) facilities per 500000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%-48.4%) and use of parenteral anticonvulsants to treat pre-eclampsia/eclampsia (range 48.6%-80.8%) were low. The main reason for non-availability of EmOC services was a lack of specialist/trained providers. Bangladesh needs to increase the availability of EmOC services through innovative public-private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed. Copyright © 2015. Published by Elsevier Ireland Ltd.

Department of Energy Operational Readiness Review for the Waste Isolation Pilot Plant

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

None, None

The U.S. Department of Energy (DOE) has completed an Operational Readiness Review (ORR) for the restart of Contact Handled (CH) waste emplacement at the Waste Isolation Pilot Plant (WIPP) located near Carlsbad, New Mexico. The ORR team assessed the readiness of Nuclear Waste Partnership, LLC (NWP) to manage and perform receipt through CH waste emplacement, and associated waste handling and management activities, including the ability of the National TRU Program (NTP) to evaluate the waste currently stored at the WIPP site against the revised and enhanced Waste Acceptance Criteria (WAC). Field work for this review began on November 14, 2015more » and was completed on November 30, 2016. The DOE ORR was conducted in accordance with the Department of Energy Operational Readiness Review Implementation Plan for the Waste Isolation Pilot Plant, dated November 8, 2016, and DOE Order 425.1D, Verification of Readiness to Start Up or Restart Nuclear Facilities. The review activities included personnel interviews, record reviews, direct observation of operations and maintenance demonstrations, and observation of multiple operational and emergency drills/exercises. The DOE ORR also evaluated the adequacy of the contractor’s ORR (CORR) and the readiness of the DOE Carlsbad field Office (CBFO) to oversee the startup and execution of CH waste emplacement activities at the WIPP facility. The WIPP facility is categorized as a Hazard Category 2 DOE Nonreactor Nuclear Facility for all surface and Underground (UG) operations per DOE-STD-1027-92, Hazard Categorization and Accident Analysis Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports. In addition, the WIPP experienced two events in February, 2014 that resulted in Accident Investigations being performed in accordance with the requirements of DOE Order 225.1B, Accident Investigations. Based upon the results of the accident investigations and hazard categorization of the facility, the team placed significant emphasis on the following areas: fire protection, emergency preparedness, radiological protection, nuclear safety, and operations. The identification of specific focus areas was not intended to diminish the importance of other areas of the review, but to ensure that these areas received a particularly thorough and in-depth evaluation due to their significance with respect to the safe operation of the facility.« less

Chemical Emergency Preparedness and Prevention Advisory: Hydrogen Fluoride

EPA Pesticide Factsheets

This advisory recommends ways Local Emergency Planning Committees (LEPCs) and chemical facilities can reduce risks posed by the presence of hydrogen fluoride (HF), a strong inorganic acid used to manufacture CFCs, in their communities.

Surviving the storms: Emergency preparedness in Texas nursing facilities and assisted living facilities.

PubMed

Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley

2008-08-01

This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparednesstraining, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.

Temperature measurement using infrared imaging systems during turbine engine altitude testing

NASA Technical Reports Server (NTRS)

Burns, Maureen E.

1994-01-01

This report details the use of infrared imaging for temperature measurement and thermal pattern determination during simulated altitude engine testing in the NASA Lewis Propulsion Systems Laboratory. Three identical argon-cooled imaging systems were installed in the facility exhaust collector behind sapphire windows to look at engine internal surfaces. The report describes the components of each system, presents the specifics of the complicated installation, and explains the operation of the systems during engine testing. During the program, several problems emerged, such as argon contamination system, component overheating, cracked sapphire windows, and other unexplained effects. This report includes a summary of the difficulties as well as the solutions developed. The systems performed well, considering they were in an unusually harsh exhaust environment. Both video and digital data were recorded, and the information provided valuable material for the engineers and designers to quickly make any necessary design changes to the engine hardware cooling system. The knowledge and experience gained during this program greatly simplified the installation and use of the systems during later test programs in the facility. The infrared imaging systems have significantly enhanced the measurement capabilities of the facility, and have become an outstanding and versatile testing resource in the Propulsion Systems Laboratory.

NASA Johnson Space Center Usability Testing and Analysis facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Holden, Kritina L.

2005-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility performs research for NASA's HumanSystems Integration Program, under the HumanSystems Research and Technology Division. Specifically, the UTAF provides human factors support for space vehicles, including the International Space Station, the Space Shuttle, and the forthcoming Crew Exploration Vehicle. In addition, there are ongoing collaborative research efforts with external corporations and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes and requirements. This presentation will provide an overview of ongoing activities, and will address how the UTAF projects will evolve to meet new space initiatives.

Utilization of a state run public private emergency transportation service exclusively for childbirth: the Janani (maternal) Express program in Madhya Pradesh, India.

PubMed

Sidney, Kristi; Ryan, Kayleigh; Diwan, Vishal; De Costa, Ayesha

2014-01-01

In 2009 the state government of Madhya Pradesh, India launched an emergency obstetric transportation service, Janani Express Yojana (JEY), to support the cash transfer program that promotes institutional delivery. JEY, a large scale public private partnership, lowers geographical access barriers to facility based care. The state contracts and pays private agencies to provide emergency transportation at no cost to the user. The objective was to study (a) the utilization of JEY among women delivering in health facilities, (b) factors associated with usage, (c) the timeliness of the service. A cross sectional facility based study was conducted in facilities that carried out > ten deliveries a month. Researchers who spent five days in each facility administered a questionnaire to all women who gave birth there to elicit socio-demographic characteristics and transport related details. 35% of women utilised JEY to reach a facility, however utilization varied between study districts. Uptake was highest among women from rural areas (44%), scheduled tribes (55%), and poorly educated women (40%). Living in rural areas and belonging to scheduled tribes were significant predictors for JEY usage. Almost 1/3 of JEY users (n = 104) experienced a transport related delay. The JEY service model complements the cash transfer program by providing transport to a facility to give birth. A study of the distribution of utilization in population subgroups suggests the intervention was successful in reaching the most vulnerable population, promoting equity in access. While 1/3 of women utilized the service and it saved them money; 30% experienced significant transport related delays in reaching a facility, which is comparable to women using public transportation. Further research is needed to understand why utilization is low, to explore if there is a need for service expansion at the community level and to improve the overall time efficiency of JEY.

MIDG-Emerging grid technologies for multi-site preclinical molecular imaging research communities.

PubMed

Lee, Jasper; Documet, Jorge; Liu, Brent; Park, Ryan; Tank, Archana; Huang, H K

2011-03-01

Molecular imaging is the visualization and identification of specific molecules in anatomy for insight into metabolic pathways, tissue consistency, and tracing of solute transport mechanisms. This paper presents the Molecular Imaging Data Grid (MIDG) which utilizes emerging grid technologies in preclinical molecular imaging to facilitate data sharing and discovery between preclinical molecular imaging facilities and their collaborating investigator institutions to expedite translational sciences research. Grid-enabled archiving, management, and distribution of animal-model imaging datasets help preclinical investigators to monitor, access and share their imaging data remotely, and promote preclinical imaging facilities to share published imaging datasets as resources for new investigators. The system architecture of the Molecular Imaging Data Grid is described in a four layer diagram. A data model for preclinical molecular imaging datasets is also presented based on imaging modalities currently used in a molecular imaging center. The MIDG system components and connectivity are presented. And finally, the workflow steps for grid-based archiving, management, and retrieval of preclincial molecular imaging data are described. Initial performance tests of the Molecular Imaging Data Grid system have been conducted at the USC IPILab using dedicated VMware servers. System connectivity, evaluated datasets, and preliminary results are presented. The results show the system's feasibility, limitations, direction of future research. Translational and interdisciplinary research in medicine is increasingly interested in cellular and molecular biology activity at the preclinical levels, utilizing molecular imaging methods on animal models. The task of integrated archiving, management, and distribution of these preclinical molecular imaging datasets at preclinical molecular imaging facilities is challenging due to disparate imaging systems and multiple off-site investigators. A Molecular Imaging Data Grid design, implementation, and initial evaluation is presented to demonstrate the secure and novel data grid solution for sharing preclinical molecular imaging data across the wide-area-network (WAN).

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration.

PubMed

Damush, Teresa M; Miech, Edward J; Sico, Jason J; Phipps, Michael S; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B; Moran, Eileen; Bravata, Dawn M

2017-12-12

To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

2002 Toxic Chemical Release Inventory Report for the Emergency Planning and Community Right-to-Know Act of 1986, Title III, Section 313

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

M. Stockton

2003-11-01

For reporting year 2002, Los Alamos National Laboratory (LANL or the Laboratory) submitted Form R reports for lead compounds and mercury as required under the Emergency Planning and Community Right-to-Know Act (EPCRA), Section 313. No other EPCRA Section 313 chemicals were used in 2002 above the reportable thresholds. This document was prepared to provide a description of the evaluation of EPCRA Section 313 chemical usage and threshold determinations for LANL for calendar year 2002 as well as provide background information about the data included on the Form R reports. Section 313 of EPCRA specifically requires facilities to submit a Toxicmore » Chemical Release Inventory report (Form R) to the U.S. Environmental Protection Agency (EPA) and state agencies if the owners and operators manufacture, process, or otherwise use any of the listed toxic chemicals above listed threshold quantities. EPA compiles this data in the Toxic Release Inventory database. Form R reports for each chemical over threshold quantities must be submitted on or before July 1 each year and must cover activities that occurred at the facility during the previous year. In 1999 EPA promulgated a final rule on Persistent Bioaccumulative Toxics (PBTs). This rule added several chemicals to the EPCRA Section 313 list of toxic chemicals and established lower reporting thresholds for these and other PBT chemicals that were already reportable under EPCRA Section 313. These lower thresholds became applicable in reporting year 2000. In 2001, EPA expanded the PBT rule to include a lower reporting threshold for lead and lead compounds. Facilities that manufacture, process, or otherwise use more than 100 lb of lead or lead compounds must submit a Form R.« less

Impact of the 2004-2005 Influenza Vaccine Shortage on Immunization Practices in Long-Term Care Facilities

PubMed Central

Mody, Lona; Langa, Kenneth M.; Malani, Preeti N.

2012-01-01

Objective To assess the response of long-term care facilities (LTCFs) to the 2004-2005 influenza vaccine shortage and the impact on resident and healthcare worker (HCW) immunization rates. Methods A 12-item questionnaire was sent to 824 randomly selected LTCFs in December 2004. The following 2 open-ended questions were also asked: “How did you cope with the vaccine shortage?” and “Who helped you get your supply?” Immunization rates reported by LTCF administrators for 2003-2003 and 2003-2004 were compared with those for 2004-2005. Immunization rates were defined as the proportion of all eligible residents and HCWs who received influenza vaccine. Results Responses were received from 380 LTCFs (46.3%), which had a total of 38,447 beds. Resident mean influenza immunization rates (±SD) decreased from 85% ± 15.3% in 2002-2003 and 85.1% ± 15.3% in 2003-2004 to 81.9% ± 19.4% in the 2004-2005 influenza season (P = .025). The immunization rates among HCWs also decreased from 51% in 2002-2003 and 2003-2004 to 38.4% in 2004-2005 (P < .001). In response to one of the open-ended questions, 96 facilities (25.3%) reported that they obtained vaccine from 2 or more sources. Eight percent commented on specific intensified infection control efforts, and only 2.3% commented on emergency preparedness. Conclusions The influenza vaccine shortage in 2004-2005 impacted immunization practices of LTCFs across the United States, leading to decreases in both resident and HCW vaccination rates. The significant decrease in vaccination rates in LTCFs is of concern and has broad implications for policy makers working on emergency preparedness for a possible pandemic of influenza. PMID:16622817

2006 Toxic Chemical Release Inventory Report for the Emergency Planning and Community Right-to-Know Act of 1986, Title III, Section 313

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

Ecology and Air Quality Group

2007-12-12

For reporting year 2006, Los Alamos National Laboratory (LANL or the Laboratory) submitted Form R reports for lead as required under the Emergency Planning and Community Right-to-Know Act (EPCRA) Section 313. No other EPCRA Section 313 chemicals were used in 2006 above the reportable thresholds. This document was prepared to provide a description of the evaluation of EPCRA Section 313 chemical use and threshold determinations for LANL for calendar year 2006, as well as to provide background information about data included on the Form R reports. Section 313 of EPCRA specifically requires facilities to submit a Toxic Chemical Release Inventorymore » Report (Form R) to the U.S. Environmental Protection Agency (EPA) and state agencies if the owners and operators manufacture, process, or otherwise use any of the listed toxic chemicals above listed threshold quantities. EPA compiles this data in the Toxic Release Inventory database. Form R reports for each chemical over threshold quantities must be submitted on or before July 1 each year and must cover activities that occurred at the facility during the previous year. In 1999, EPA promulgated a final rule on persistent bioaccumulative toxics (PBTs). This rule added several chemicals to the EPCRA Section 313 list of toxic chemicals and established lower reporting thresholds for these and other PBT chemicals that were already reportable. These lower thresholds became applicable in reporting year 2000. In 2001, EPA expanded the PBT rule to include a lower reporting threshold for lead and lead compounds. Facilities that manufacture, process, or otherwise use more than 100 lb of lead or lead compounds must submit a Form R.« less

Distribution and predictors of emergency department charges: the case of a tertiary hospital in Lebanon.

PubMed

Saleh, Shadi; Mourad, Yara; Dimassi, Hani; Hitti, Eveline

2016-03-18

As health care costs continue to increase worldwide, health care systems, and more specifically hospitals are facing continuous pressure to operate more efficiently. One service within the hospital sector whose cost structure has been modestly investigated is the Emergency Department (ED). The study aims to report on the distribution of ED resource use, as expressed in charges, and to determine predictors of/contributors to total ED charges at a major tertiary hospital in Lebanon. The study used data extracted from the ED discharge database for visits between July 31, 2012 and July 31, 2014. Patient visit bills were reported under six major categories: solutions, pharmacy, laboratory, physicians, facility, and radiology. Characteristics of ED visits were summarized according to patient gender, age, acuity score, and disposition. Univariate and multivariate analyses were conducted with total charges as the dependent variable. Findings revealed that the professional fee (40.9 %) followed by facility fee (26.1 %) accounted for the majority of the ED charges. While greater than 80 % of visit charges went to physician and facility fee for low acuity cases, these contributed to only 52 and 54 % of the high acuity presentations where ancillary services and solutions' contribution to the total charges increased. The total charges for males were $14 higher than females; age was a predictor of higher charges with total charges of patients greater than 60 years of age being around $113 higher than ages 0-18 after controlling for all other variables. Understanding the components and determinants of ED charges is essential to developing cost-containment interventions. Institutional modeling of charging patterns can be used to offer price estimates to ED patients who request this information and ultimately help create market competition to drive down costs.

Lack of CT scanner in a rural emergency department increases inter-facility transfers: a pilot study.

PubMed

Bergeron, Catherine; Fleet, Richard; Tounkara, Fatoumata Korika; Lavallée-Bourget, Isabelle; Turgeon-Pelchat, Catherine

2017-12-28

Rural emergency departments (EDs) are an important gateway to care for the 20% of Canadians who reside in rural areas. Less than 15% of Canadian rural EDs have access to a computed tomography (CT) scanner. We hypothesized that a significant proportion of inter-facility transfers from rural hospitals without CT scanners are for CT imaging. Our objective was to assess inter-facility transfers for CT imaging in a rural ED without a CT scanner. We selected a rural ED that offers 24/7 medical care with admission beds but no CT scanner. Descriptive statistics were collected from 2010 to 2015 on total ED visits and inter-facility transfers. Data was accessible through hospital and government databases. Between 2010 and 2014, there were respectively 13,531, 13,524, 13,827, 12,883, and 12,942 ED visits, with an average of 444 inter-facility transfers. An average of 33% (148/444) of inter-facility transfers were to a rural referral centre with a CT scan, with 84% being for CT scan. Inter-facility transfers incur costs and potential delays in patient diagnosis and management, yet current databases could not capture transfer times. Acquiring a CT scan may represent a reasonable opportunity for the selected rural hospital considering the number of required transfers.

10 CFR 62.12 - Contents of a request for emergency access: General information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... EMERGENCY ACCESS TO NON-FEDERAL AND REGIONAL LOW-LEVEL WASTE DISPOSAL FACILITIES Request for a Commission... the person(s) or company(ies) generating the low-level radioactive waste for which the determination...) Certification that the radioactive waste for which emergency access is requested is low-level radioactive waste...

75 FR 48370 - Biweekly Notice Applications and Amendments to Facility Operating Licenses Involving No...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-10

... revise the minimum Emergency Diesel Generator (EDG) output voltage acceptance criterion in Surveillance... ensures the timely transfer of plant safety system loads to the Emergency Diesel Generators in the event a... from the emergency diesel generators in a timely manner. This change is needed to bring Fermi 2 into...

40 CFR 370.41 - What is Tier I inventory information?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., and phone number. (g) Emergency contact. The name, title, and phone number(s) of at least one local... chemical accident at your facility. You must provide an emergency phone number where such emergency... accompanied by your full name, official title, signature, date signed, and total number of pages in the...

40 CFR 370.41 - What is Tier I inventory information?

Code of Federal Regulations, 2012 CFR

2012-07-01

..., and phone number. (g) Emergency contact. The name, title, and phone number(s) of at least one local... chemical accident at your facility. You must provide an emergency phone number where such emergency... accompanied by your full name, official title, signature, date signed, and total number of pages in the...

Supporting NASA Facilities Through GIS

NASA Technical Reports Server (NTRS)

Ingham, Mary E.

2000-01-01

The NASA GIS Team supports NASA facilities and partners in the analysis of spatial data. Geographic Information System (G[S) is an integration of computer hardware, software, and personnel linking topographic, demographic, utility, facility, image, and other geo-referenced data. The system provides a graphic interface to relational databases and supports decision making processes such as planning, design, maintenance and repair, and emergency response.

Use of a geographic information system to assess accessibility to health facilities providing emergency obstetric and newborn care in Bangladesh.

PubMed

Chowdhury, Mahbub E; Biswas, Taposh K; Rahman, Monjur; Pasha, Kamal; Hossain, Mollah A

2017-08-01

To use a geographic information system (GIS) to determine accessibility to health facilities for emergency obstetric and newborn care (EmONC) and compare coverage with that stipulated by UN guidelines (5 EmONC facilities per 500 000 individuals, ≥1 comprehensive). A cross-sectional study was undertaken of all public facilities providing EmONC in 24 districts of Bangladesh from March to October 2012. Accessibility to each facility was assessed by applying GIS to estimate the proportion of catchment population (comprehensive 500 000; basic 100 000) able to reach the nearest facility within 2 hours and 1 hour of travel time, respectively, by existing road networks. The minimum number of public facilities providing comprehensive and basic EmONC services (1 and 5 per 500 000 individuals, respectively) was reached in 16 and 3 districts, respectively. However, after applying GIS, in no district did 100% of the catchment population have access to these services. A minimum of 75% and 50% of the population had accessibility to comprehensive services in 11 and 5 districts, respectively. For basic services, accessibility was much lower. Assessing only the number of EmONC facilities does not ensure universal coverage; accessibility should be assessed when planning health systems. © 2017 International Federation of Gynecology and Obstetrics.

Spatial distribution of emergency obstetric and newborn care services in Ghana: Using the evidence to plan interventions.

PubMed

Bosomprah, Samuel; Tatem, Andrew J; Dotse-Gborgbortsi, Winfred; Aboagye, Patrick; Matthews, Zoe

2016-01-01

To provide clear policy directions for gaps in the provision of signal function services and sub-regions requiring priority attention using data from the 2010 Ghana Emergency Obstetric and Newborn Care (EmONC) survey. Using 2010 survey data, the fraction of facilities with only one or two signal functions missing was calculated for each facility type and EmONC designation. Thematic maps were used to provide insight into inequities in service provision. Of 1159 maternity facilities, 89 provided all the necessary basic or comprehensive EmONC signal functions 3months prior to the 2010 survey. Only 21% of facility-based births were in fully functioning EmONC facilities, but an additional 30% occurred in facilities missing one or two basic signal functions-most often assisted vaginal delivery and removal of retained products. Tackling these missing signal functions would extend births taking place in fully functioning facilities to over 50%. Subnational analyses based on estimated total pregnancies in each district revealed a pattern of inequity in service provision across the country. Upgrading facilities missing only one or two signal functions will allow Ghana to meet international standards for availability of EmONC services. Reducing maternal deaths will require high national priority given to addressing inequities in the distribution of EmONC services. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

ShakeCast Manual

USGS Publications Warehouse

Lin, Kuo-Wan; Wald, David J.

2008-01-01

ShakeCast is a freely available, post-earthquake situational awareness application that automatically retrieves earthquake shaking data from ShakeMap, compares intensity measures against users? facilities, and generates potential damage assessment notifications, facility damage maps, and other Web-based products for emergency managers and responders.

32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

Code of Federal Regulations, 2012 CFR

2012-07-01

... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

Code of Federal Regulations, 2011 CFR

2011-07-01

... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

Code of Federal Regulations, 2010 CFR

2010-07-01

... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

32 CFR 728.74 - Applicants for appointment in the regular Navy or Marine Corps and reserve components, including...

Code of Federal Regulations, 2013 CFR

2013-07-01

... NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other... and Marine Corps facilities or MEPS may be furnished emergency medical and dental care, including...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

26 CFR 1.7704-2 - Transition provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... residential section, which includes suites of rooms, dining facilities, lounges, and gamerooms; (B) An assisted-living section, which provides laundry and housekeeping services, health monitoring, and emergency care; and (C) A nursing section, which provides private and semiprivate rooms, dining facilities...

26 CFR 1.7704-2 - Transition provisions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... residential section, which includes suites of rooms, dining facilities, lounges, and gamerooms; (B) An assisted-living section, which provides laundry and housekeeping services, health monitoring, and emergency care; and (C) A nursing section, which provides private and semiprivate rooms, dining facilities...

77 FR 61826 - Pipeline Safety: Communication During Emergency Situations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... liquefied natural gas pipeline facilities that operators should immediately and directly notify the Public.... Background Federal regulations for gas, liquefied natural gas (LNG), and hazardous liquid pipeline facilities...

44 CFR 312.3 - Policy.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.3... civil defense preparedness. (2) Encouraging the development of comprehensive disaster preparedness and...

44 CFR 312.3 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.3... civil defense preparedness. (2) Encouraging the development of comprehensive disaster preparedness and...

44 CFR 312.3 - Policy.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.3... civil defense preparedness. (2) Encouraging the development of comprehensive disaster preparedness and...

44 CFR 312.3 - Policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.3... civil defense preparedness. (2) Encouraging the development of comprehensive disaster preparedness and...

44 CFR 312.3 - Policy.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.3... civil defense preparedness. (2) Encouraging the development of comprehensive disaster preparedness and...

78 FR 19746 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... proposed change would not change the current limiting EDG [emergency diesel generator] failure but would... evaluated? Response: No. The proposed change would not change the current EDG [emergency diesel generator...

KSC-06pd0509

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - Inside the orbiter mockup at NASA Kennedy Space Center's Shuttle Landing Facility, volunteer "astronaut" Charlie Plain, with InDyne Inc., gets settled in a seat with the help of United Space Alliance Insertion Tech Mike Thompson before a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/George Shelton

KSC-06pd0508

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - Inside the orbiter mockup at NASA Kennedy Space Center's Shuttle Landing Facility, volunteer "astronaut" Jeremy Garcia, with United Space Alliance (USA), is helped with his launch and entry suit by USA Insertion Tech George Brittingham before a simulated emergency landing of a shuttle crew. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/George Shelton

KSC-06pd0502

NASA Image and Video Library

2006-03-15

KENNEDY SPACE CENTER, FLA. - During a simulated emergency landing of a shuttle crew at NASA Kennedy Space Center's Shuttle Landing Facility, medevac personnel tend to an "injured astronaut" in the helicopter. The astronaut will be taken to an area hospital participating in the simulation. Known as a Mode VI exercise, the operation uses volunteer workers from the Center to pose as astronauts. The purpose of the simulation is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. Photo credit: NASA/Kim Shiflett

Usage of emergency medical services by children with special health care needs.

PubMed

Suruda, A; Vernon, D D; Diller, E; Dean, J M

2000-01-01

To describe the usage of emergency medical services (EMS) by children with special health care needs (CSHCN). All EMS runs and related hospital records for children aged 0-17 years in Utah in 1991-92 were linked. The CSHCN status was determined from ICD-9 diagnoses using three available definitions. The amounts of EMS usage were compared between CSHCN and other children. A pediatric intensive care practitioner determined CSHCN status by chart review for 915 children transported by EMS to a pediatric tertiary care hospital, and his classification was compared with the CSHCN status assigned by the three ICD-9-based definitions. The three definitions assigned CSHCN status for 2% to 24% of children using EMS. When compared with other children, CSHCN were more likely to be admitted to the hospital, more likely to use EMS for transfer between health care facilities, and more likely to receive prehospital procedures such as intravenous therapy. In the group of children whose charts were reviewed individually, one ICD-9-based definition most closely agreed to determination of CSHCN status by a pediatric intensive care practitioner. Children with special health care needs who use EMS are more likely to receive advanced life support service, to receive prehospital procedures, and to be transferred from one health care facility to another. There is need for a specific and measurable definition of CSHCN that can be applied to existing health data.

KSC-04PD-0238

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. An injured rescue worker is lifted into an M-113 armored personnel carrier provided for transportation during a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2- 1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0242

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. A helicopter rescue team prepares another injured astronaut for transportation to a local hospital. They are all taking part in a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

KSC-04PD-0241

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. A helicopter rescue team prepares another injured astronaut for transportation to a local hospital. They are all taking part in a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Stennis all-hazards network adopted throughout NASA

NASA Image and Video Library

2009-10-13

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

Extravasation injuries: a review.

PubMed

Goutos, I; Cogswell, L K; Giele, H

2014-10-01

Extravasation injuries are common emergencies in clinical practice. If they are not recognized and treated promptly, they can lead to deleterious functional and cosmetic outcomes. There is a vast range of agents involved in these injuries and marked paucity of evidence to support their specific management. Following an extensive literature review, we outline management principles for clinicians involved in the care of patients with extravasation injuries. Key parameters in deciding appropriate management plans include the volume/toxicity of the agent, the necrosis interval of the injury, patient-related factors, as well as the facilities and expertise available in the setting of individual cases of extravasation. © The Author(s) 2014.

Care of an undocumented immigrant

PubMed Central

Beresford, H. Richard

2014-01-01

Summary This commentary addresses the care of an undocumented immigrant with neuromyelitis optica in the context of a state law designed to deny state-funded medical services to individuals whose presence in the United States is unlawful. It considers specific circumstances in which the law would permit or require medical care for undocumented persons in state medical facilities, including a duty to “stabilize” an “emergency medical condition” and the provision of care necessary to “protect life or safety.” It also addresses dilemmas clinicians may experience when faced with an apparent tension between their professional ethical obligations and legal rules aimed at enforcing immigration policies. PMID:29443225

LAFD: TA-55 General Facility Familiarization Tour, Course #55261

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

Rutherford, Victor Stephen; Miller, Joshua; Mason, Robert Clifford

Los Alamos National Laboratory (LANL) will conduct familiarization tours for personnel of the Los Alamos County Fire Department (LAFD) at the TA-55 General Facility. These familiarization tours are official LANL business; the purpose of these tours is to orient LAFD firefighters to the facility so that they can respond efficiently and quickly to a variety of emergency situations. This orientation includes, among other topics, ingress and egress of the area and buildings, layout and organization of the facility, evacuation procedures and assembly points, and areas of concern within the various buildings at the facility. LAFD firefighters have the skills andmore » abilities to perform firefighting operations and other emergency response tasks that cannot be provided by LANL personnel who have the required clearance level. This handout provides details of the information, along with maps and diagrams, to be presented during the familiarization tours. The handout will be distributed to the trainees at the time of the tour. A corresponding checklist will also be used as guidance during the familiarization tours to ensure that all required information is presented to LAFD personnel.« less

Trajectory of cause of death among brought dead neonates in tertiary care public facilities of Pakistan: A multicenter study.

PubMed

Mustufa, Muhammad Ayaz; Sheikh, Munir Ahmed; Taseer, Ijaz-Ul-Haque; Raza, Syed Jamal; Arshad, Muhammad Sohail; Akhter, Tasleem; Arain, Ghazala Mohyuddin; Habibullah, Sultana; Safdar, Sohail; Firdous, Rukhsana; Adnan, Muhammad

2017-02-01

Considering the fact that Pakistan is amongst the countries with very high neonatal mortality rates, we conducted a research study to determine the possible causes and characteristics of neonates presenting dead to the emergency department of tertiary public health care facilities of Pakistan using verbal autopsies. A descriptive case series study was conducted in emergency department/pediatrics ward/neonatal ward/nursery unit of ten tertiary care public health facilities, situated in seven major cities of Pakistan from November, 2011 to June, 2013. Precoded verbal autopsy proforma was used to collect information regarding cause of death, family narratives and other associated risks accountable for pathway to mortality. We identified 431 neonates presenting dead to the emergency department (238 males and 193 females). Sepsis (26.7%), birth asphyxia (18.8%) and persistent pulmonary arrest (17.2%) were main primary causes of brought death. Around 72% brought dead neonates were referred from doctors/health care facilities and more than 28% caregivers mentioned that they were not informed about the diagnosis/ailment of their deceased newborn. Findings of our study suggest that infectious disease remains the main primary cause of neonatal mortality. Underweight in newborns (64%) was estimated as a leading associated risk. Delays in referrals to respective health care facility enlightened the concern of sub-standard prerequisites of neonatal care that could be one of the major contributing risk factor of high mortality rates.

Quarterly report on Defense Nuclear Facilities Safety Board Recommendation 90-7 for the period ending December 31, 1992

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

Cash, R.J.; Dukelow, G.T.; Forbes, C.J.

1993-03-01

This is the seventh quarterly report on the progress of activities addressing safety issues associated with Hanford Site high-level radioactive waste tanks that contain ferrocyanide compounds. In the presence of oxidizing materials, such as nitrates or nitrites, ferrocyanide can be made to explode in the laboratory by heating it to high temperatures [above 285{degrees}C (545{degrees}F)]. In the mid 1950s approximately 140 metric tons of ferrocyanide were added to 24 underground high-level radioactive waste tanks. An implementation plan (Cash 1991) responding to the Defense Nuclear Facilities Safety Board Recommendation 90-7 (FR 1990) was issued in March 1991 describing the activities thatmore » were planned and underway to address each of the six parts of Recommendation 90-7. A revision to the original plan was transmitted to US Department of Energy by Westinghouse Hanford Company in December 1992. Milestones completed this quarter are described in this report. Contents of this report include: Introduction; Defense Nuclear Facilities Safety Board Implementation Plan Task Activities (Defense Nuclear Facilities Safety Board Recommendation for enhanced temperature measurement, Recommendation for continuous temperature monitoring, Recommendation for cover gas monitoring, Recommendation for ferrocyanide waste characterization, Recommendation for chemical reaction studies, and Recommendation for emergency response planning); Schedules; and References. All actions recommended by the Defense Nuclear Facilities Safety Board for emergency planning by Hanford Site emergency preparedness organizations have been completed.« less

Gaps in monitoring systems for Implanon NXT services in South Africa: An assessment of 12 facilities in two districts

PubMed

Pillay, D; Morroni, C; Pleaner, M; Adeogba, O; Chersich, M; Naidoo, N; Mullick, S; Rees, H

2017-10-01

Background. Implanon NXT, a long-acting subdermal contraceptive implant, was introduced in South Africa (SA) in early 2014 as part of an expanded contraceptive method mix. After initial high levels of uptake, reports emerged of frequent early removals and declines in use. Monitoring of progress and challenges in implant service delivery could identify aspects of the programme that require strengthening. Objectives. To assess data management and record keeping within implant services at primary care facilities. Methods. We developed a checklist to assess the tools used for monitoring implant services and data reporting to district offices. The checklist was piloted in seven facilities. An additional six high-volume and six low-volume implant insertion clinics in the City of Johannesburg (CoJ), Gauteng Province, and the Dr Kenneth Kaunda District, North West Province, were selected for assessment. Results. All 12 facilities completed a Daily Head Count Register, which tallied the number of clients attending the clinic, but not information about implant use. A more detailed Tick Register recorded services that clinic attendees received, with nine documenting number of implant insertions and six implant removals. A more specific tool, an Insertion Checklist, collected data on insertion procedures and client characteristics, but was only used in CoJ (five of six facilities). Other registers, which were developed de novo by staff at individual facilities, captured more detailed information about insertions and removals, including reasons. Five of six low-volume insertion facilities used these registers, but only three of six high-volume facilities. No facilities used the form specifically developed by the National Department of Health for implant pharmacovigilance. Nine of 12 clinics reported data on numbers of insertions to the district office, six reported removals and none provided data on reasons for removals. Conclusion. For data to inform effective decision-making and quality improvement in implant services in SA, standardised reporting guidelines and data collection tools are needed, reinforced by staff training and quality assessment of data collection. Staff often took the initiative to fill gaps in reporting systems. Current systems are unable to accurately monitor uptake or discontinuation, or identify aspects of services requiring strengthening. Lack of pharmacovigilance data is especially concerning. Deficiencies noted in these monitoring systems may be common to family planning services more broadly, which warrants investigation. Creative Commons Attribution - NonCommercial Works License (CC BY-NC 4.0)

Emergency medical service attitudes toward geriatric prehospital care and continuing medical education in geriatrics.

PubMed

Peterson, Lars-Kristofer N; Fairbanks, Rollin J; Hettinger, Aaron Z; Shah, Manish N

2009-03-01

To understand the opinions of emergency medical service (EMS) providers regarding their ability to care for older adults, the domains of geriatric medicine in which they need more training, and the modality through which continuing education could be best delivered. Qualitative study using key informant interviews. Prehospital EMS system in Rochester, New York. EMS providers, EMS instructors and administrators, emergency physicians, and geriatricians. Semistructured interviews were conducted using an interview guide that addressed knowledge and skill deficiencies, recommendations for improvement of geriatrics continuing education, and delivery methods of education. Participant responses were generally congruous despite the diverse backgrounds, and redundancy was achieved rapidly. All participants perceived a deficit in EMS education on the care of older adults, particularly related to communications with patients and skilled nursing facility staff. All desired more geriatric continuing education for EMS providers, especially in communications and psychosocial issues. Education was desired in various modalities. Further geriatric continuing education for EMS providers is needed. Some specific topics relate to medical issues, but a large proportion involve communications and psychosocial issues. Education should be delivered in a variety of modalities to meet the needs of the EMS community. Emerging on-line video technologies may bridge the gap between learners preferring classroom-based modailities and those preferring self-study modules.

A telemedicine health care delivery system

NASA Technical Reports Server (NTRS)

Sanders, Jay H.

1991-01-01

The Interactive Telemedicine Systems (ITS) system was specifically developed to address the ever widening gap between our medical care expertise and our medical care delivery system. The frustrating reality is that as our knowledge of how to diagnose and treat medical conditions has continued to advance, the system to deliver that care has remained in an embryonic stage. This has resulted in millions of people being denied their most basic health care needs. Telemedicine utilizes an interactive video system integrated with biomedical telemetry that allows a physician at a base station specialty medical complex or teaching hospital to examine and treat a patient at multiple satellite locations, such as rural hospitals, ambulatory health centers, correctional institutions, facilities caring for the elderly, community hospital emergency departments, or international health facilities. Based on the interactive nature of the system design, the consulting physician at the base station can do a complete history and physical examination, as if the patient at the satellite site was sitting in the physician's office. This system is described.

Survival of the hospital emergency department: strategic alternatives for the future.

PubMed

Widra, L S; Fottler, M D

1988-01-01

Diverse and pervasive environmental forces are reshaping hospital emergency services as hospitals strive to respond to consumer preferences related to cost and convenience. Complacency can no longer serve as a standard operating procedure for hospital emergency departments competing against lower-priced, consumer-oriented, free-standing facilities. Strategic alternatives, a five-step strategy for survival and growth, and a projection of future models of hospital emergency services are examined.

Current variability of clinical practice management of pediatric diabetic ketoacidosis in Illinois pediatric emergency departments.

PubMed

Barrios, Ellen K; Hageman, Joseph; Lyons, Evelyn; Janies, Kathryn; Leonard, Daniel; Duck, Stephen; Fuchs, Susan

2012-12-01

This study aimed to investigate the management of pediatric patients with diabetic ketoacidosis (DKA) presenting to emergency departments (EDs) participating in the Illinois Emergency Medical Services for Children (EMSC) Facility Recognition program. In 2010, Illinois EMSC conducted a survey (including case scenarios) and medical record review regarding management of pediatric patients with DKA. Data were submitted by 116 EDs. Survey response rate was 94%. Only 34% of EDs had a documented DKA guideline/policy; 37% reported that they did not have hospital adult or pediatric endocrinology services. Case scenarios identified a high percentage of respondents given an intravenous (IV) isotonic sodium chloride solution of 10 to 20 mL/kg during the first hour. However 17% to 21% would use an alternative choice such as administering initial IV solution of 0.45 sodium chloride, initiating an insulin drip before fluids, or waiting for more laboratory results before giving fluids or insulin. A total of 532 medical record reviews were submitted. In 87% of records, patients received an initial IV isotonic sodium chloride solution within the first hour. In 74%, patients received IV insulin infusion/drip (0.1 U/kg/h) after the initial fluid bolus. Of the patients, 51% were transferred to another facility; 22% were admitted to an intensive care unit. Best ED practice management of pediatric DKA includes establishing a specific guideline/protocol and ensuring access to a pediatric endocrinologist. Both were identified as improvement areas in this project. Illinois EMSC has developed an educational module and provided direct feedback to all participating EDs, to improve their management of pediatric patients with DKA.

7 CFR 15b.38 - Health care facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... facilities. (a) Communications. A recipient that provides notice concerning benefits or services or written... ensure that qualified handicapped persons, including those with impaired sensory or speaking skills, are... effective communication with persons with impaired hearing for the purpose of providing emergency health...

Astronauts and cosmonauts during emergency bailout training session

NASA Technical Reports Server (NTRS)

1994-01-01

Using small life rafts, several cosmonauts and astronauts participating in joint Russia - United States space missions take part in an emergency bailout training session in the JSC Weightless Environment Training Facility (WETF) 25-feet-deep pool. In the

ERCMExpress. Volume 3, Issue 5

ERIC Educational Resources Information Center

Taylor, Matt

2007-01-01

The Emergency Response and Crisis Management (ECRM) Technical Assistance Center's newsletter "ERCMExpress" provides comprehensive information on key issues in school emergency management. Many nontraditional schools across the United States, such as storefront schools, rural schools, and alternative education facilities, face challenges…

General RMP Guidance - Chapter 8: Emergency Response Program

EPA Pesticide Factsheets

If you have a Program 2 or 3 process at your facility, 40 CFR Part 68 (risk management program) requires an emergency response program in place if employees respond to some releases involving regulated toxic or flammable substances.

10 CFR 205.377 - Reports.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ENERGY OIL ADMINISTRATIVE PROCEDURES AND SANCTIONS Electric Power System Permits and Reports; Applications; Administrative Procedures and Sanctions Emergency Interconnection of Electric Facilities and the Transfer of Electricity to Alleviate An Emergency Shortage of Electric Power § 205.377 Reports. In addition...

77 FR 74030 - Pacific Gas and Electric Company, Humboldt Bay Power Plant, Unit 3; Schedular Exemption From...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-12

...) Emergency Response Organization Augmentation at Alternate Facility--capability for staging emergency... significant effect on the quality of the human environment (77 FR 71198; November 29, 2012). This exemption is...

49 CFR 193.2509 - Emergency procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Emergency procedures. 193.2509 Section 193.2509 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY LIQUEFIED NATURAL GAS FACILITIES...

75 FR 67807 - Pipeline Safety: Emergency Preparedness Communications

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... is issuing an Advisory Bulletin to remind operators of gas and hazardous liquid pipeline facilities... Gas Pipeline Systems. Subject: Emergency Preparedness Communications. Advisory: To further enhance the...

Tornado Recovery Ongoing at NASA’s Michoud Assembly Facility, New Orleans LA

NASA Image and Video Library

2017-02-07

Teams at NASA’s Michoud Assembly Facility in New Orleans are continuing with recovery efforts following a tornado strike at the facility Tuesday, Feb. 7. Michoud remains closed to all but security and emergency operations crews. For more than half a century, Michoud has been the space agency’s premiere site for manufacturing and assembly of large-scale space structures and systems.

A new era of emergency care: planning and design consideration.

PubMed

Zilm, Frank

2007-01-01

Emergency care is one of the most complex, rapidly growing areas of ambulatory care. Providers need to consider new issues related to management of low-acuity patients, capacity for surge events, and the need to integrate patient focused care into the emergency department environment. This article explores these issues and discusses basic organizational topologies for facilities.

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2014 CFR

2014-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2012 CFR

2012-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

40 CFR 267.56 - What are the required emergency procedures for the emergency coordinator?

Code of Federal Regulations, 2011 CFR

2011-07-01

... FACILITIES OPERATING UNDER A STANDARDIZED PERMIT Contingency Plan and Emergency Procedures § 267.56 What are... designated response roles if their help is needed. (b) Whenever there is a release, fire, or explosion, the... environment that may result from the release, fire, or explosion. This assessment must consider both direct...

Method and computer program product for maintenance and modernization backlogging

DOEpatents

Mattimore, Bernard G; Reynolds, Paul E; Farrell, Jill M

2013-02-19

According to one embodiment, a computer program product for determining future facility conditions includes a computer readable medium having computer readable program code stored therein. The computer readable program code includes computer readable program code for calculating a time period specific maintenance cost, for calculating a time period specific modernization factor, and for calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. In another embodiment, a computer-implemented method for calculating future facility conditions includes calculating a time period specific maintenance cost, calculating a time period specific modernization factor, and calculating a time period specific backlog factor. Future facility conditions equal the time period specific maintenance cost plus the time period specific modernization factor plus the time period specific backlog factor. Other embodiments are also presented.

Measurement of the potential geographic accessibility from call to definitive care for patient with acute stroke.

PubMed

Freyssenge, J; Renard, F; Schott, A M; Derex, L; Nighoghossian, N; Tazarourte, K; El Khoury, C

2018-01-12

The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car. The method proposed analyses the potential geographic accessibility of stroke care infrastructure in different scenarios. The study allows better considering of the issues inherent to an area: difficult weather conditions, traffic congestion and failure to respect the distance limits of emergency transport. Depending on the scenario, access times vary considerably within the same commune. For example, between the first and the second scenario for cities in the north of Rhône county, there is a 10 min difference to the nearest Primary Stroke Center (PSC). For the first scenario, 90% of the population is 20 min away of the PSC and 96% for the second scenario. Likewise, depending on the modal vector (fire brigade or emergency medical service), overall accessibility from the emergency call to admission to a Comprehensive Stroke Center (CSC) can vary by as much as 15 min. The setting up of the various scenarios and modal comparison based on the calculation of overall accessibility makes this a new method for calculating potential access to care facilities. It is important to take into account the specific pathological features and the availability of care facilities for modelling. This method is innovative and recommendable for measuring accessibility in the field of health care. This study makes possible to highlight the patients' extension of care delays. Thus, this can impact the improvement of patient care and rethink the healthcare organization. Stroke is addressed here but it is applicable to other pathologies.

Does identity shape leadership and management practice? Experiences of PHC facility managers in Cape Town, South Africa

PubMed Central

Daire, Judith; Gilson, Lucy

2014-01-01

In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager’s job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better support for leadership development could include talent-spotting and nurturing, induction and peer-mentoring for newly appointed facility managers, ongoing peer-support once in post and continuous reflective practice. PMID:25274644

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

40 CFR 372.20 - Process for modifying covered chemicals and facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... chemicals and facilities. 372.20 Section 372.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS TOXIC CHEMICAL RELEASE REPORTING: COMMUNITY RIGHT-TO-KNOW Reporting Requirements § 372.20 Process for modifying covered chemicals...

42 CFR 405.2102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... facilities under emergency circumstances. ESRD Network organization. The administrative governing body to the network and liaison to the Federal government. ESRD service. The type of care or services furnished to an... and/or utilization of such services is made. Network, ESRD. All Medicare-approved ESRD facilities in a...

42 CFR 405.2102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... facilities under emergency circumstances. ESRD Network organization. The administrative governing body to the network and liaison to the Federal government. ESRD service. The type of care or services furnished to an... and/or utilization of such services is made. Network, ESRD. All Medicare-approved ESRD facilities in a...

42 CFR 405.2102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... facilities under emergency circumstances. ESRD Network organization. The administrative governing body to the network and liaison to the Federal government. ESRD service. The type of care or services furnished to an... and/or utilization of such services is made. Network, ESRD. All Medicare-approved ESRD facilities in a...

38 CFR 17.1006 - Decisionmakers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1006 Decisionmakers. The Chief of the Health Administration Service or an equivalent official at the VA medical.... 1725, except that the Fee Service Review Physician or equivalent officer at the VA medical facility of...

38 CFR 17.1006 - Decisionmakers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1006 Decisionmakers. The Chief of the Health Administration Service or an equivalent official at the VA medical.... 1725, except that the Fee Service Review Physician or equivalent officer at the VA medical facility of...

Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

PubMed

Dorsten, Aimee-Marie; Sifford, K Susan; Bharucha, Ashok; Mecca, Laurel Person; Wactlar, Howard

2009-03-01

ASSISTIVE TECHNOLOGIES ARE RELATIVELY novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

PubMed

Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

2016-01-01

To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

Cystic Echinococcosis in Spain: Current Situation and Relevance for Other Endemic Areas in Europe

PubMed Central

Rojo-Vazquez, Francisco A.; Pardo-Lledias, Javier; Francos-Von Hunefeld, Marcelo; Cordero-Sanchez, Miguel; Alamo-Sanz, Rufino; Hernandez-Gonzalez, Ana; Brunetti, Enrico; Siles-Lucas, Mar

2011-01-01

Cystic echinococcosis (CE) remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians. PMID:21283615

44 CFR 312.4 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.4... based on approval of the activities and projects described in the Annual Program Paper, and/or...

44 CFR 312.4 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.4... based on approval of the activities and projects described in the Annual Program Paper, and/or...

44 CFR 312.4 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.4... based on approval of the activities and projects described in the Annual Program Paper, and/or...

44 CFR 312.4 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.4... based on approval of the activities and projects described in the Annual Program Paper, and/or...

Gaps in the Substance Use Disorder Treatment Referral Process: Provider Perceptions.

PubMed

Blevins, Claire E; Rawat, Nishi; Stein, Michael D

2018-05-07

The demand for substance use disorder treatment is increasing, fueled by the opioid epidemic and the Affordable Care Act mandate to treat substance use disorders. The increased demand for treatment, however, is not being met by a corresponding increase in access to or availability of treatment. This report focuses specifically on the treatment referral process, which we have identified as 1 of the key barriers to timely and effective treatment. Difficulties in referral to substance use disorder treatment are examined through the lens of providers who make referrals (ie, referral source) and individuals who work in substance use disorder facilities (ie, referral recipient). Administrative officials, emergency department physicians, addiction physicians, government officials, providers, insurance officials, and mental health advocates (n = 59) were interviewed on the referral process protocol, challenges for providers and others making referrals, and issues with substance use treatment facility intake procedures. Several main themes were identified as barriers in the process: difficulties in determining patient eligibility, lack of transparency regarding treatment capacity, referral source knowledge/understanding of options, and issues with communication between referral source and recipient. We then proposed several solutions to address specific barriers. Current gaps in the referral process cause delays to care. Improving systems would involve addressing these themes and expanding the use of appropriate treatments for the many patients in need.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed

Randive, Bharat; Chaturvedi, Sarika; Mistry, Nerges

2012-12-31

Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of contracting in for EmOC. Local circumstances dictate balance between introduction or expansion of contracts with private sector and strengthening public provisions and that neither of these disregard the need to strengthen public systems. Sustainability of contracting in arrangements, their effect on increasing coverage of EmOC services in rural areas and overlapping provisions for contracting in EmOC specialists are issues for future consideration.

Contracting in specialists for emergency obstetric care- does it work in rural India?

PubMed Central

2012-01-01

Background Contracting in private sector is promoted in developing countries facing human resources shortages as a challenge to reduce maternal mortality. This study explored provision, practice, performance, barriers to execution and views about contracting in specialists for emergency obstetric care (EmOC) in rural India. Methods Facility survey was conducted in all secondary and tertiary public health facilities (44) in three heterogeneous districts in Maharashtra state of India. Interviews (42) were conducted with programme managers and district and block level officials and with public and private EmOC specialists. Locations of private obstetricians in the study districts were identified and mapped. Results Two schemes, namely Janani Suraksha Yojana and Indian Public Health standards (IPHS) provided for contracting in EmOC specialists. The IPHS provision was chosen for use mainly due to greater sum for contracting in (US $ 30/service episode vs.300 US$/month). The positions of EmOC specialists were vacant in 83% of all facilities that hence had a potential for contracting in EmOC specialists. Private specialists were contracted in at 20% such facilities. The contracting in of specialists did not greatly increase EmOC service outputs at facilities, except in facilities with determined leadership. Contracting in specialists was useful for non emergency conditions, but not for obstetric emergencies. The contracts were more of a relational nature with poor monitoring structures. Inadequate infrastructure, longer distance to private specialists, insufficient financial provision for contracting in, and poor management capacities were barriers to effective implementation of contracting in. Dependency on the private sector was a concern among public partners while the private partners viewed contracting in as an opportunity to gain experience and credibility. Conclusions Density and geographic distribution of private specialists are important influencing factors in determining feasibility and use of contracting in for EmOC. Local circumstances dictate balance between introduction or expansion of contracts with private sector and strengthening public provisions and that neither of these disregard the need to strengthen public systems. Sustainability of contracting in arrangements, their effect on increasing coverage of EmOC services in rural areas and overlapping provisions for contracting in EmOC specialists are issues for future consideration. PMID:23276148

KSC-04PD-0243

NASA Technical Reports Server (NTRS)

2004-01-01

KENNEDY SPACE CENTER, FLA. A helicopter rescue team carries another injured astronaut to a helicopter for transportation to a local hospital. They are all taking part in a Mode VII emergency landing simulation at Kennedy Space Center. The purpose of the Mode VII is to exercise emergency preparedness personnel, equipment and facilities in rescuing astronauts from a downed orbiter and providing immediate medical attention. This simulation presents an orbiter that has crashed short of the Shuttle Landing Facility in a wooded area 2-1/2 miles south of Runway 33. Emergency crews are responding to the volunteer astronauts who are simulating various injuries inside the crew compartment mock-up. Rescuers must remove the crew, provide triage and transport to hospitals those who need further treatment. Local hospitals are participating in the exercise.

Timeliness and access to healthcare services via telemedicine for adolescents in state correctional facilities.

PubMed

Fox, Karen C; Somes, Grant W; Waters, Teresa M

2007-08-01

The aim of this study was to examine the effectiveness of a telemedicine program in improving timeliness of and access to healthcare services in adolescent correctional facilities. This study is a pre/post quasi-experimental design comparing time to treatment and healthcare use in the year preceding and the 2 years after the implementation of a telemedicine program in four facilities housing adolescents from 12 to 19. Timeliness of care is measured by time from referral to date of service (for behavioral healthcare only). Access to care is measured by use of outpatient care, emergency department (ED) visits, and inpatient visits. Two of the four state correctional facilities had a significant decrease (24%) in time from referral to treatment after the implementation of the telemedicine intervention. The facilities not showing significant improvements in timeliness experienced difficulty implementing the telemedicine program. The telemedicine program was also associated with significant improvements in access to care. Outpatient visits increased by 40% in the 2 years after implementation of telemedicine. For each 1% increase in telemedicine usage, outpatient visits increased by 1%, whereas emergency room visits decreased by 7%. Telemedicine can have a positive impact on timeliness of and access to care for youth in correctional facilities.

Hardware-in-the-loop environment facility to address pilot-vehicle-interface issues of a fighter aircraft

NASA Astrophysics Data System (ADS)

Pandurangareddy, Meenige

2002-07-01

The evolution of Pilot-Vehicle-Interface (PVI) of a fighter aircraft is a complex task. The PVI design involves both static and dynamic issues. Static issues involve the study of reach of controls and switches, ejection path clearance, readability of indicators and display symbols, etc. Dynamic issues involve the study of the effect of aircraft motion on display symbols, pilot emergency handling, situation awareness, weapon aiming, etc. This paper describes a method of addressing the above issues by building a facility with cockpit, which is ergonomically similar to the fighter cockpit. The cockpit is also fitted with actual displays, controls and switches. The cockpit is interfaced with various simulation models of aircraft and outside-window-image generators. The architecture of the facility is designed to represent the latencies of the aircraft and facilitates replacement of simulation models with actual units. A parameter injection facility could be used to induce faults in a comprehensive manner. Pilots could use the facility right from familiarising themselves with procedures to start the engine, take-off, navigate, aim the weapons, handling of emergencies and landing. This approach is being followed and further being enhanced on Cockpit-Environment-Facility (CEF) at Aeronautical Development Agency (ADA), Bangalore, India.

Before the Emergency: A Framework for Evaluating Emergency Preparedness Alternatives at Higher Education Institutions

DTIC Science & Technology

2010-09-01

Operations and Procedures • Logistics and Facilities • Training • Exercises, Evaluation and Corrective Actions • Crisis Communications ...Assessment Team BCA Benefit-cost analysis CEO Chief Executive Officer CERT Community Emergency Response Team CFR Code of Federal Regulations...CHDS Center for Homeland Defense and Security CPG 101 Comprehensive Preparedness Guidelines 101 CPP Community Preparedness and Participation CPW

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2013 CFR

2013-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2014 CFR

2014-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

30 CFR 254.23 - What information must I include in the “Emergency response action plan” section?

Code of Federal Regulations, 2012 CFR

2012-07-01

... LOCATED SEAWARD OF THE COAST LINE Oil-Spill Response Plans for Outer Continental Shelf Facilities § 254.23 What information must I include in the “Emergency response action plan” section? The “Emergency response action plan” section is the core of the response plan. Put information in easy-to-use formats such...

Energy Systems Sensor Laboratory | Energy Systems Integration Facility |

Science.gov Websites

NREL Sensor Laboratory Energy Systems Sensor Laboratory The Energy Systems Integration Facility's Energy Systems Sensor Laboratory is designed to support research, development, testing, and evaluation of advanced hydrogen sensor technologies to support the needs of the emerging hydrogen

40 CFR 264.32 - Required equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... supply water hose streams, or foam producing equipment, or automatic sprinklers, or water spray systems... communications or alarm system capable of providing immediate emergency instruction (voice or signal) to facility...-held two-way radio, capable of summoning emergency assistance from local police departments, fire...

40 CFR 264.32 - Required equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... supply water hose streams, or foam producing equipment, or automatic sprinklers, or water spray systems... communications or alarm system capable of providing immediate emergency instruction (voice or signal) to facility...-held two-way radio, capable of summoning emergency assistance from local police departments, fire...