Science.gov

Sample records for mass casualty event

  1. [Mass casualty events].

    PubMed

    Guła, Przemysław; Hładki, Waldemar; Brongel, Leszek

    2006-01-01

    Authors present problems concerning mass--casualty accidents, specificity of action rescue-system on different levels of co-operation, kind of segregation of victims and efficiency of the medical rescue system in Poland. Attention has been paid to the continuous instructions and education of life-saving services, preferably by simulation of events without earlier information of the interested. It is necessary to establish and abide official dependence by the rules of co-operation of components of life-saving system. A separate problem is the implementation of rescue--activities in special situations: nuclear, biological and chemical contamination, and with very important safety measures for people taking part in rescue action.

  2. Preparing hospitals for toxicological mass casualties events.

    PubMed

    Tur-Kaspa, I; Lev, E I; Hendler, I; Siebner, R; Shapira, Y; Shemer, J

    1999-05-01

    For most hospital staffs, treatment of chemical casualties presents an obscure and even frightening situation. We report our unique experience from hospital drills in order to improve hospital preparedness for patient management under mass casualty conditions involving hazardous chemicals. Twenty-one major hospitals in Israel. A unique hospital deployment plan for the management of chemical casualties was developed, and hospitals were required to have a full chemical practice drill every 3 to 5 yrs. These drills were designed as realistically as possible, and all included the use of personal protective equipment, decontamination, and treatment of simulated patients. Twenty-five percent of these patients, simulating children and adults, required intensive care and ventilation support. Hospitals were inspected and reviewed on the quality of treatment given and the overall continuity of care as well as on their administrative performance. Between 1986 to 1994, 30 full chemical practice drills were conducted in 21 major hospitals. Each drill included treatment of 100 to 400 simulated patients. The lessons from the hospital drills are described and were incorporated in the proposed revised hospital deployment plan. All hospitals significantly improved their ability to respond appropriately to these incidents. The level of preparedness for a chemical mass casualty scenario should be established according to the existing threat and the available resources. The proposed plan can serve as a basis for hospital planning and staff training worldwide, thus facilitating optimal care in the event of an incident involving toxic chemicals. A cost-effective scale for hospital preparation levels according to the existing threat is suggested.

  3. Airway management during a mass casualty event.

    PubMed

    Talmor, Daniel

    2008-02-01

    Mass casualty respiratory failure will lead to many challenges, not the least of which is safe and secure management of the victims' airways. These patients will be sicker than those typically managed in the operating room and will require more emergency management of their airways. Mass casualty incidents involving biological or chemical agents will pose the additional risk of exposure to pathogen. During the severe acute respiratory syndrome epidemic in Toronto, airway manipulation was clearly identified as the procedure most associated with risk to health care workers. Planning for scenarios such as these will require consideration of personal protection for health care workers to minimize these risks. Understanding the risks involved and the airway techniques required for each possible scenario will be key to planning and preparation.

  4. Prehospital preparedness for pediatric mass-casualty events.

    PubMed

    Shirm, Steve; Liggin, Rebecca; Dick, Rhonda; Graham, James

    2007-10-01

    Recent events have reiterated the need for well-coordinated planning for mass-casualty events, including those that involve children. The objective of this study was to document the preparedness of prehospital emergency medical services agencies in the United States for the care of children who are involved in mass-casualty events. A national list of all licensed prehospital emergency medical services agencies was prepared through contact with each state's emergency medical services office. A survey was mailed to 3748 emergency medical services agencies that were selected randomly from the national list in November 2004; a second survey was mailed to nonresponders in March 2005. Descriptive statistics were used to describe study variables. Most (72.9%) agencies reported having a written plan for response to a mass-casualty event, but only 248 (13.3%) reported having pediatric-specific mass-casualty event plans. Most (69%) services reported that they did not have a specific plan for response to a mass-casualty event at a school. Most (62.1%) agencies reported that their mass-casualty event plan does not include provisions for people with special health care needs. Only 19.2% of the services reported using a pediatric-specific triage protocol for mass-casualty events, and 12.3% reported having a pediatrician involved in their medical control. Although most (69.3%) agencies reported participation in a local or regional disaster drill in the past year, fewer than half of those that participated in drills (49.0%) included pediatric victims. Although children are among the most vulnerable in the event of disaster, there are substantial deficiencies in the preparedness plans of prehospital emergency medical services agencies in the United States for the care of children in a mass-casualty event.

  5. Evacuation Priorities in Mass Casualty Terror-Related Events

    PubMed Central

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

    2004-01-01

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

  6. Emergency department staff preparedness for mass casualty events involving children.

    PubMed

    Rassin, Michal; Avraham, Miri; Nasi-Bashari, Anat; Idelman, Sigalit; Peretz, Yaniv; Morag, Shani; Silner, Dina; Weiss, Gali

    2007-01-01

    In recent years, the World Health Organization in general, and Israel in particular, have dealt with mass casualty events (MCEs) resulting from terrorism. Children are the casualties in many of these events-a reality that forces hospitals to prepare to deal with such a scenario. A literature review designed to identify unique recommendations regarding pediatric MCEs highlights both a lack of existing training programs and uncertainty on the part of health care staff when dealing with these events. The purpose of the study was to examine the preparedness level of emergency department staff to deal with MCEs involving pediatric casualties. The study included 104 physicians and nurses working in, or responding to, the emergency department at a hospital in Israel. The study included a 41-item questionnaire examining perception, approaches, and staff knowledge regarding dealing with pediatric MCEs versus those involving adults. The reliability of all sections of the questionnaire ranged between Chronbach's alpha coefficient 0.6 alpha-0.94. The preparedness levels for MCEs involving children were found to be low. Study participants ranked the likelihood of a pediatric MCE lower than one involving adults, while ranking significantly higher (P = .000) their ability to cope mentally and the knowledge and skills required when treating adults involved in MCEs. While nurses ranked higher than physicians regarding their knowledge and skills in dealing with pediatric MCE casualties, the level of knowledge for MCEs involving children was low in all subjects. Staff agreement for the parent of an MCE victim to be present during treatment was medium-low. On the basis of these findings, additional research involving a larger number of individuals and hospitals is indicated to determine if these results are consistent throughout the region.

  7. Mass-casualty events at schools: a national preparedness survey.

    PubMed

    Graham, James; Shirm, Steve; Liggin, Rebecca; Aitken, Mary E; Dick, Rhonda

    2006-01-01

    Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the chi2 test was used to compare urban versus rural preparedness. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.

  8. Assessment of hospital pharmacy preparedness for mass casualty events.

    PubMed

    Awad, Nadia I; Cocchio, Craig

    2015-04-01

    To assess the preparedness of hospital pharmacies in New Jersey to provide pharmaceutical services in mass casualty scenarios. An electronic cross-sectional survey was developed to assess the general knowledge of available resources and attitudes toward the preparedness of the pharmacy department. Out of 60 invitations to participate, 18 surveys (30%) were completed. Respondents practiced at community hospitals (12, 66.6%) with no trauma center designation (11, 67.4%) that served more than 500 licensed beds (five, 29.4%). Six respondents (35.3%) indicated that 75,000 to 100,000 patients visited their emergency departments annually. Seventeen sites (94.4%) reported the existence of an institutional disaster preparedness protocol; 10 (55.5%) indicated that there is a specific plan for the pharmacy department. Most respondents (10, 55.5%) were unsure whether their hospitals had an adequate supply of analgesics, rapid sequence intubation agents, vasopressors, antiemetics, respiratory medications, ophthalmics, oral antimicrobials, and chemical-weapon-specific antidotes. Five (27.7%) agreed that the pharmacy disaster plan included processes to ensure care for patients already hospitalized, and four (22.2%) agreed that the quantity of medication was adequate to treat patients and hospital employees if necessary. Medication stock and quantities were determined based on national or international guidelines at three (16.6%) institutions surveyed. This survey demonstrates a lack of general consensus regarding hospital pharmacy preparedness for mass casualty scenarios despite individualized institutional protocols for disaster preparedness. Standardized recommendations from government and/or professional pharmacy organizations should be developed to guide the preparation of hospital pharmacy departments for mass casualty scenarios.

  9. Assessment of Hospital Pharmacy Preparedness for Mass Casualty Events

    PubMed Central

    Awad, Nadia I.; Cocchio, Craig

    2015-01-01

    Objectives: To assess the preparedness of hospital pharmacies in New Jersey to provide pharmaceutical services in mass casualty scenarios. Methods: An electronic cross-sectional survey was developed to assess the general knowledge of available resources and attitudes toward the preparedness of the pharmacy department. Results: Out of 60 invitations to participate, 18 surveys (30%) were completed. Respondents practiced at community hospitals (12, 66.6%) with no trauma center designation (11, 67.4%) that served more than 500 licensed beds (five, 29.4%). Six respondents (35.3%) indicated that 75,000 to 100,000 patients visited their emergency departments annually. Seventeen sites (94.4%) reported the existence of an institutional disaster preparedness protocol; 10 (55.5%) indicated that there is a specific plan for the pharmacy department. Most respondents (10, 55.5%) were unsure whether their hospitals had an adequate supply of analgesics, rapid sequence intubation agents, vasopressors, antiemetics, respiratory medications, ophthalmics, oral antimicrobials, and chemical-weapon-specific antidotes. Five (27.7%) agreed that the pharmacy disaster plan included processes to ensure care for patients already hospitalized, and four (22.2%) agreed that the quantity of medication was adequate to treat patients and hospital employees if necessary. Medication stock and quantities were determined based on national or international guidelines at three (16.6%) institutions surveyed. Conclusion: This survey demonstrates a lack of general consensus regarding hospital pharmacy preparedness for mass casualty scenarios despite individualized institutional protocols for disaster preparedness. Standardized recommendations from government and/or professional pharmacy organizations should be developed to guide the preparation of hospital pharmacy departments for mass casualty scenarios. PMID:25859121

  10. Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents

    PubMed Central

    Ramesh, Aruna C.; Kumar, S.

    2010-01-01

    In a mass casualty situation due to chemical, biological, radiological, or nuclear (CBRN) event, triage is absolutely required for categorizing the casualties in accordance with medical care priorities. Dealing with a CBRN event always starts at the local level. Even before the detection and analysis of agents can be undertaken, zoning, triage, decontamination, and treatment should be initiated promptly. While applying the triage system, the available medical resources and maximal utilization of medical assets should be taken into consideration by experienced triage officers who are most familiar with the natural course of the injury presented and have detailed information on medical assets. There are several triage systems that can be applied to CBRN casualties. With no one standardized system globally or nationally available, it is important for deploying a triage and decontamination system which is easy to follow and flexible to the available medical resources, casualty number, and severity of injury. PMID:21829319

  11. Research issues in preparedness for mass casualty events, disaster, war, and terrorism.

    PubMed

    Hinton Walker, Patricia; Garmon Bibb, Sandra C; Elberson, Karen L

    2005-09-01

    This article provides a perspective on the types of research questions that might be explored and strategies used in relation to disaster,terrorism, and mass casualty events. Research is addressed in the context of three areas of focus: issues related to the health care provider; issues affecting the patient, individual, family, and community; and issues related to the health care system.

  12. The Hartford Consensus to improve survivability in mass casualty events: Process to policy.

    PubMed

    Jacobs, Lenworth; Burns, Karyl J

    2014-01-01

    The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events was formed to make recommendations to improve survival from intentional mass casualty incidents. This article describes the development of the Hartford Consensus and the process used to disseminate and implement its findings. Members of the Committee included individuals from select public safety organizations. The first meeting of the Committee was held on April 2, 2013, and a second meeting was held on July 11, 2013. Attendance at the second meeting was enlarged and included representatives from the Federal Emergency Management Agency and the National Security Staff of the Office of the President. The results of these meetings became known as the Hartford Consensus. The ideas generated at the meetings produced two documents, one from each meeting. These are referred to as Hartford Consensus I and II. Hartford Consensus I is a concept document and Hartford Consensus II is a call to action that no one should die from uncontrolled bleeding. The recommendations are being incorporated into training programs and have been endorsed by many organizations whose members are involved in the response to mass casualty incidents. The Joint Committee to Create a National Policy to Enhance Survivability from Mass Casualty Shooting Events was successful in stimulating policy to bring about change. Training and resources including tourniquets and hemostatic dressing are being directed to help ameliorate the unfortunate reality of intentional mass injury.

  13. Effect of Hospital Staff Surge Capacity on Preparedness for a Conventional Mass Casualty Event

    PubMed Central

    Welzel, Tyson B.; Koenig, Kristi L.; Bey, Tareg; Visser, Errol

    2010-01-01

    Objectives: To assess current medical staffing levels within the Hospital Referral System in the City of Cape Town Metropolitan Municipality, South Africa, and analyze the surge capacity needs to prepare for the potential of a conventional mass casualty incident during a planned mass gathering. Methods: Query of all available medical databases of both state employees and private medical personnel within the greater Cape Town area to determine current staffing levels and distribution of personnel across public and private domains. Analysis of the adequacy of available staff to manage a mass casualty incident. Results: There are 594 advanced pre-hospital personnel in Cape Town (17/100,000 population) and 142 basic pre-hospital personnel (4.6/100,000). The total number of hospital and clinic-based medical practitioners is 3097 (88.6/100,000), consisting of 1914 general physicians; 54.7/100,000 and 1183 specialist physicians; 33.8/100,000. Vacancy rates for all medical practitioners range from 23.5% to 25.5%. This includes: nursing post vacancies (26%), basic emergency care practitioners (39.3%), advanced emergency care personnel (66.8%), pharmacy assistants (42.6%), and pharmacists (33.1%). Conclusion: There are sufficient numbers and types of personnel to provide the expected ordinary healthcare needs at mass gathering sites in Cape Town; however, qualified staff are likely insufficient to manage a concurrent mass casualty event. Considering that adequate correctly skilled and trained staff form the backbone of disaster surge capacity, it appears that Cape Town is currently under resourced to manage a mass casualty event. With the increasing size and frequency of mass gathering events worldwide, adequate disaster surge capacity is an issue of global relevance. PMID:20823971

  14. An Analysis of Mass Casualty Incidents in the Setting of Mass Gatherings and Special Events.

    PubMed

    Turris, Sheila A; Lund, Adam; Bowles, Ronald R

    2014-04-16

    Mass gatherings (MGs) and special events typically involve large numbers of people in unfamiliar settings, potentially creating unpredictable situations. To assess the information available to guide emergency services and onsite medical teams in planning and preparing for potential mass casualty incidents (MCIs), we analyzed the literature for the past 30 years. A search of the literature for MCIs at MGs from 1982 to 2012 was conducted and analyzed. Of the 290 MCIs included in this study, the most frequently reported mechanism of injury involved the movement of people under crowded conditions (162; 55.9%), followed by special hazards (eg, airplane crashes, pyrotechnic displays, car crashes, boat collisions: 57; 19.6%), structural failures (eg, building code violations, balcony collapses: 38; 13.1%), deliberate events (26; 9%), and toxic exposures (7; 2.4%). Incidents occurred in Asia (71; 24%), Europe (69; 24%), Africa (48; 17%), North America (48; 27%), South America (27; 9%), the Middle East (25; 9%), and Australasia (2; 1%). A minimum of 12 877 deaths and 27 184 injuries resulted. Based on our findings, we recommend that a centralized database be created. With this database, researchers can further develop evidence to guide prevention efforts and mitigate the effects of MCIs during MGs. (Disaster Med Public Health Preparedness. 2014;0:1-7).

  15. Critical issues in preparing for a mass casualty event: highlights from a new community planning guide.

    PubMed

    2007-09-01

    To assist community planners in allocating scarce resources in a mass casualty event, the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) and the Office of the Assistant Secretary for Preparedness and Response collaborated with leading experts on a series of issue papers on preparedness and response. These papers were presented at an expert meeting in Washington, DC, in June 2006. The papers, revised based on meeting discussions, have been published by AHRQ as Mass Medical Care with Scarce Resources: A Community Planning Guide.

  16. Willingness to respond: of emergency department personnel and their predicted participation in mass casualty terrorist events.

    PubMed

    Masterson, Lori; Steffen, Christel; Brin, Michael; Kordick, Mary Frances; Christos, Steve

    2009-01-01

    In May 2003, the TOPOFF 2 national disaster drill demonstrated inadequate preparedness for mass casualty terrorist events and failed to address the willingness of Emergency Department (ED) personnel to assist with these events. The objective of this study was to examine ED personnel willingness to respond to various multiple casualty events. A prospective voluntary survey of ED personnel from multiple hospitals was randomly administered in the form of vignette-based questionnaires. The survey of 204 participants at eight hospitals in the Chicago area revealed that staff members were more willing to work additional hours for victims of an airplane crash (98.0%), than for a radioactive bomb (85.3%), or a biologic agent (54.0%). For the biologic agent only, men were significantly more likely to respond than women. Hospital management should anticipate significant reductions in workforce during biologic and radioactive disaster events. Employees' willingness to respond was not augmented by any incentives offered by hospitals, although enhanced financial remuneration and disability coverage showed the most potential to increase response.

  17. Surgeon preparedness for mass casualty events: Adapting essential military surgical lessons for the home front.

    PubMed

    Remick, Kyle N; Shackelford, Stacy; Oh, John S; Seery, Jason M; Grabo, Daniel; Chovanes, John; Gross, Kirby R; Nessen, Shawn C; Tai, Nigel Rm; Rickard, Rory F; Elster, Eric; Schwab, C W

    2016-01-01

    Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front. Military Damage Control Surgery (mDCS) combines the established concept of clinical DCS (cDCS) with key combat situational awareness factors that enable surgeons to optimally care for multiple, complex patients, from multiple simultaneous events, with limited resources. These additional considerations involve the surgeon's role of care within the deployed trauma system and the battlefield effects. The proposed new concept of mass casualty DCS (mcDCS) similarly combines cDCS decisions with key factors of situational awareness for civilian surgeons faced with complex MCEs to optimize outcomes. The additional considerations for a civilian MCE include the surgeon's role of care within the regional trauma system and the incident effects. Adapting institutionalized lessons from combat surgery to civilian surgical colleagues will enhance national preparedness for complex MCEs on the home front.

  18. Systematic review of strategies to manage and allocate scarce resources during mass casualty events.

    PubMed

    Timbie, Justin W; Ringel, Jeanne S; Fox, D Steven; Pillemer, Francesca; Waxman, Daniel A; Moore, Melinda; Hansen, Cynthia K; Knebel, Ann R; Ricciardi, Richard; Kellermann, Arthur L

    2013-06-01

    Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs. Our literature search included MEDLINE, Scopus, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Global Health, Web of Science, and the Cochrane Database of Systematic Reviews, from 1990 through late 2011. We also searched the gray literature, using the New York Academy of Medicine's Grey Literature Report and key Web sites. We included both English- and foreign-language articles. We included studies that evaluated strategies used in actual mass casualty events or tested through drills, exercises, or computer simulations. We excluded studies that lacked a comparison group or did not report quantitative outcomes. Data extraction, quality assessment, and strength of evidence ratings were conducted by a single researcher and reviewed by a second; discrepancies were reconciled by the 2 reviewers. Because of heterogeneity in outcome measures, we qualitatively synthesized findings within categories of strategies. From 5,716 potentially relevant citations, 74 studies met inclusion criteria. Strategies included reducing demand for health care services (18 studies), optimizing use of existing resources (50), augmenting existing resources (5), implementing crisis standards of care (5), and multiple categories (4). The evidence was sufficient to form conclusions on 2 strategies, although the strength of evidence was rated as low. First, as a strategy to reduce demand for health care services, points of dispensing can be used to efficiently distribute biological countermeasures after a bioterrorism attack or influenza pandemic, and their organization influences speed of

  19. Patient distribution in a mass casualty event of an airplane crash.

    PubMed

    Postma, Ingri L E; Weel, Hanneke; Heetveld, Martin J; van der Zande, Ineke; Bijlsma, Taco S; Bloemers, Frank W; Goslings, J Carel

    2013-11-01

    Difficulties have been reported in the patient distribution during Mass Casualty Incidents. In this study we analysed the regional patient distribution protocol (PDP) and the actual patient distribution after the 2009 Turkish Airlines crash near Amsterdam. Analysis of the patient distribution of 126 surviving casualties of the crash by collecting data on medical treatment capacity, number of patients received per hospital, triage classification, Injury Severity Score (ISS), secondary transfers, distance from the crash site, and the critical mortality rate. The PDP holds ambiguous definitions of medical treatment capacity and was not followed. There were 14 receiving hospitals (distance from crash: 5.8-53.5 km); four hospitals received 133-213% of their treatment capacity, and 5 hospitals received 1 patient. Three hospitals within 20 km of the crash did not receive any casualties. Level I trauma centres received 89% of the 'critical' casualties and 92% of the casualties with ISS ≥ 16. Only 3 casualties were secondarily transferred, and no casualties died in, or on the way to hospital (critical mortality rate=0%). Patient distribution worked out well after the crash as secondary transfers were low and critical mortality rate was zero. However, the regional PDP was not followed in this MCI and casualties were unevenly distributed among hospitals. The PDP is indistinctive, and should be updated in cooperation between Emergency Services, surrounding hospitals, and Schiphol International Airport as a high risk area. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Regional Variation in Causes of Injuries among Terrorism Victims for Mass Casualty Events

    PubMed Central

    Regens, James L.; Schultheiss, Amy; Mould, Nick

    2015-01-01

    The efficient allocation of medical resources to prepare for and respond to mass casualty events (MCEs) attributable to intentional acts of terrorism is a major challenge confronting disaster planners and emergency personnel. This research article examines variation in regional patterns in the causes of injures associated with 77,258 successful terrorist attacks that occurred between 1970 and 2013 involving the use of explosives, firearms, and/or incendiaries. The objective of this research is to estimate regional variation in the use of different conventional weapons in successful terrorist attacks in each world region on variation in injury cause distributions. Indeed, we find that the distributions of the number of injuries attributable to specific weapons types (i.e., by cause) vary greatly among the 13 world regions identified within the Global Terrorism Database. PMID:26347857

  1. MASCAL: RFID Tracking of Patients, Staff and Equipment to Enhance Hospital Response to Mass Casualty Events

    PubMed Central

    Fry, Emory A.; Lenert, Leslie A.

    2005-01-01

    Most medical facilities practice managing the large numbers of seriously injured patients expected during catastrophic events. As the demands on the healthcare team increase, however, the challenges faced by managers escalate, workflow bottlenecks develop and system capacity decreases. This paper describes MASCAL, an integrated software–hardware system designed to enhance management of resources at a hospital during a mass casualty situation. MASCAL uses active 802.11b asset tags to track patients, equipment and staff during the response to a disaster. The system integrates tag position information with data from personnel databases, medical information systems, registration applications and the US Navy’s TACMEDCS triage application in a custom visual disaster management environment. MASCAL includes interfaces for a hospital command center, local area managers (emergency room, operating suites, radiology, etc.) and registration personnel. MASCAL is an operational system undergoing functional evaluation at the Naval Medical Center, San Diego, CA. PMID:16779042

  2. A burn mass casualty event due to boiler room explosion on a cruise ship: preparedness and outcomes.

    PubMed

    Tekin, Akin; Namias, Nicholas; O'Keeffe, Terence; Pizano, Louis; Lynn, Mauricio; Prater-Varas, Robin; Quintana, Olga Delia; Borges, Leda; Ishii, Mary; Lee, Seong; Lopez, Peter; Lessner-Eisenberg, Sharon; Alvarez, Angel; Ellison, Tom; Sapnas, Katherine; Lefton, Jennifer; Ward, Charles Gillon

    2005-03-01

    The purpose of this study was to review our experience with a mass casualty incident resulting from a boiler room steam explosion aboard a cruise ship. Experience with major, moderate, and minor burns, steam inhalation, mass casualty response systems, and psychological sequelae will be discussed. Fifteen cruise ship employees were brought to the burn center after a boiler room explosion on a cruise ship. Eleven were triaged to the trauma resuscitation area and four to the surgical emergency room. Seven patients were intubated for respiratory distress or airway protection. Six patients had >80 per cent burns with steam inhalation, and all of these died. One of the 6 patients had 99 per cent burns with steam inhalation and died after withdrawal of support within the first several hours. All patients with major burns required escharotomy on arrival to trauma resuscitation. One patient died in the operating room, despite decompression by laparotomy for abdominal compartment syndrome and pericardiotomy via thoracotomy for cardiac tamponade. Four patients required crystalloid, 20,000 mls/m2-27,000 ml/m2 body surface area (BSA) in the first 48 hours to maintain blood pressure and urine output. Three of these four patients subsequently developed abdominal compartment syndrome and died in the first few days. The fourth patient of this group died after 26 days due to sepsis. Five patients had 13-20 per cent bums and four patients had less than 10 per cent burns. Two of the patients with 20 per cent burns developed edema of the vocal cords with mild hoarseness. They improved and recovered without intubation. The facility was prepared for the mass casualty event; having just completed a mass casualty drill several days earlier. Twenty-six beds were made available in 50 minutes for anticipated casualties. Fifteen physicians reported immediately to the trauma resuscitation area to assist in initial stabilization. The event occurred at shift change; thus, adequate support

  3. Mass casualty events: blood transfusion emergency preparedness across the continuum of care.

    PubMed

    Doughty, Heidi; Glasgow, Simon; Kristoffersen, Einar

    2016-04-01

    Transfusion support is a key enabler to the response to mass casualty events (MCEs). Transfusion demand and capability planning should be an integrated part of the medical planning process for emergency system preparedness. Historical reviews have recently supported demand planning for MCEs and mass gatherings; however, computer modeling offers greater insights for resource management. The challenge remains balancing demand and supply especially the demand for universal components such as group O red blood cells. The current prehospital and hospital capability has benefited from investment in the management of massive hemorrhage. The management of massive hemorrhage should address both hemorrhage control and hemostatic support. Labile blood components cannot be stockpiled and a large surge in demand is a challenge for transfusion providers. The use of blood components may need to be triaged and demand managed. Two contrasting models of transfusion planning for MCEs are described. Both illustrate an integrated approach to preparedness where blood transfusion services work closely with health care providers and the donor community. Preparedness includes appropriate stock management and resupply from other centers. However, the introduction of alternative transfusion products, transfusion triage, and the greater use of an emergency donor panel to provide whole blood may permit greater resilience. © 2016 AABB.

  4. Gaming to Predict Human Responses to Mass Casualty Events: An Approach for Quick Look Tools for Pandemic Influenza

    SciTech Connect

    Brigantic, Robert T.; Muller, George; Taylor, Aimee E.; Papatyi, Anthony F.

    2009-10-09

    There is a need to better understand and describe social intelligence in the realm of handling mass casualty events such as pandemic influenza, earthquakes, and other natural or manmade disasters. A comprehension of social intelligence is needed in order to accurately feed and drive models and simulations that attempt to describe and quantify human responses to such mass casualty events, which can allow decision makers to identify potential mitigation strategies that might be used to minimize the impacts of these events by reducing numbers of deaths, injuries, and other societal (e.g., economic) consequences. We propose to develop a better understanding of social intelligence and socially driven human responses through the use of games and game-like interfaces with a direct application focused on infectious diseases.

  5. [National preparedness for biological mass casualty event: between the devil and the deep blue sea].

    PubMed

    Eldad, Arieh

    2002-05-01

    Species of plants and animals, as well as nations of human beings were extinguished throughout the prehistory and history of this planet. One of the possible explanations for this phenomenon is a large scale epidemic of viral, bacterial or fungal infections. One well-documented example was the smallpox epidemic among native Indians of South America following the European invasion. Deliberate dissemination of disease was used as a weapon during the Middle Ages when corpses of plague casualties were thrown over the walls and into the besieged towns. The Book of Kings II, of the Bible, in chapter 19 recalls the story of 185,000 soldiers of Sennacherib that died in one night, near the walls of Jerusalem. The possibility of causing mass casualty by dissemination of infectious disease has driven countries and terrorist organizations to produce and store large quantities of bacteria or viruses. The death of thousands in the USA on September 11, 2001, demonstrated that terror has no moral prohibitions, only technical limitations. Terror organizations will not hesitate to use weapons for mass destruction to kill many, and if only few will die, it will still serve the purpose of these evil organizations: to strew panic, to destroy normal life and to increase fear and instability. Any government that faces decisions about how to be better prepared against biological warfare is pushed between the devil and the deep blue sea. On the one hand: the better we will be prepared, equipped with antibiotics and vaccines--the more lives of casualties we will be able to save. Better public education will help to reduce the damage, but, on the other hand--in order to cause more people to make the effort to equip themselves or to refresh their protective kit--we will have to increase their level of concern. In order to improve the medical education of all members of the medical teams we will have to start a broad and intense campaign, thereby taking the risk of increasing stress in the

  6. Multidisciplinary team response to a mass burn casualty event: outcomes and implications.

    PubMed

    Cleland, Heather J; Proud, David; Spinks, Anneliese; Wasiak, Jason

    2011-06-06

    To describe the characteristics of patients with burn injury admitted to a major trauma hospital in Melbourne following the Black Saturday bushfires of 7 February 2009, and to provide a detailed analysis of the hospital's response to the crisis. A retrospective chart review of ambulance and hospital records of patients admitted to the Victorian Adult Burns Service (VABS) at The Alfred Hospital (The Alfred) following the bushfires. Patient characteristics and outcomes: age, sex, total and full thickness body surface area burnt, type and site of burn, hospital and intensive care unit length of stay (LOS) and receipt of standard burn care practices. Estimated glomerular filtration rate, theatre time and LOS data for the bushfire cohort compared with corresponding data for historical cohorts from VABS and from a similar institution in New Zealand. Nineteen patients were admitted to VABS over the first 48 hours after the bushfires. Of these, nine patients were subsequently admitted to The Alfred's intensive care unit. Most patients (74%) were men with a mean age of 52.7 years (SD, 12.4 years). Seventeen patients (89%) underwent at least one surgical procedure, which resulted in 4355 minutes of theatre time for the bushfire cohort in the first week. Hospital LOS was similar for the bushfire and New Zealand cohorts. Compared with the VABS historical cohort, there was a higher incidence of abnormal renal function among the bushfire cohort patients. Although relatively few patients with severe burns were admitted to VABS, significant increases in resource allocation were required to manage them in terms of additional theatre time, consumables and staffing. The experience of VABS may aid planning for future mass burns casualty events.

  7. Recommendations for action: a community meeting in preparation for a mass-casualty opioid overdose event in Southeastern Ontario.

    PubMed

    Moore, Kieran Michael; Papadomanolakis-Pakis, Nicholas; Hansen-Taugher, Adrienne; Guan, Tianxiu H; Schwartz, Brian; Stewart, Paula; Leece, Pamela; Bochenek, Richard

    2017-01-01

    Given the steady rise of overdose morbidity and mortality in North America, and increasing frequency of sudden clusters of non-fatal and fatal overdoses in other jurisdictions, regional preparedness plans to respond effectively to clusters of overdoses may reduce the impact of such events on the population. On the 27th of February 2017 in Kingston, Ontario, KFL&A Public Health, in collaboration with public health partners, hosted a full-day workshop involving table-top exercises and discussions for service partners on how to prepare for, respond to, and manage a mass-casualty event secondary to opioid overdose in Southeastern Ontario. The workshop assisted in identifying the various challenges faced by service partners, provided an understanding of the roles and responsibilities of partner agencies, and helped to determine next steps in preparation to address a mass opioid overdose situation at the local level. This report suggests key roles and responsibilities of partners involved in responding to a mass-casualty event secondary to opioid overdose, recommendations to address the feedback and challenges raised throughout the workshop, and a protocol to help determine when to activate an Incident Management System (IMS).

  8. A state survey of emergency department preparedness for the care of children in a mass casualty event.

    PubMed

    Thompson, Tonya; Lyle, Kristen; Mullins, S Hope; Dick, Rhonda; Graham, James

    2009-01-01

    The Institute of Medicine has issued two reports over the past 10 years raising concerns about the care of children in the emergency medical care system of the United States. Given that children are involved in most mass casualty events and there are deficiencies in the day-to-day emergency care of children, this project was undertaken to document the preparedness of hospitals in AR for the care of children in mass casualty or disaster situations. Mailed survey to all emergency department medical directors in AR. Nonresponders received a second mailed survey and an attempt at survey via phone. Medical directors of the emergency departments of the 80 acute care hospitals in AR. Seventy-two of 80 directors responded (90 percent response rate). Only 13 percent of hospitals reported they have pediatric mass casualty protocols and in only 28 percent of hospitals the disaster plan includes pediatric-specific issues such as parental reunification. Most hospitals hold mass casualty training events (94 percent), at least annually, but only 64 percent report including pediatric patients in their disaster drills. Most hospitals include local fire (90 percent), police (82 percent), and emergency medical services (77 percent) in their drills, but only 23 percent report involving local schools in the disaster planning process. Eighty-three percent of hospitals responding reported their staff is trained in decontamination procedures. Thirty-five percent reported having warm water showers available for infant/children decontamination. Ninety-four percent of hospitals have a plan for calling in extra staff in a disaster situation, which most commonly involves a phone tree (43 percent). Ninety-three percent reported the availability of Ham Radios, walkie-talkie, or Arkansas Wireless Information Network (AWIN) units for communication in case of land line loss, but only 16 percent reported satellite phone or Tandberg units. Twelve percent reported reliance on cell phones in this

  9. Human Casualties in Impact Events

    NASA Astrophysics Data System (ADS)

    Gritzner, C.

    1997-10-01

    It is widespread error to believe that people were never killed by meteorites. It was concluded that there no human casualties due to meteorite falls because there were no reports about such incidents, but there are reports of these rare events. The statement of no one ever being killed by a meteorite may intend that the danger even of asteroid and comet impacts onto the Earth is only fiction, but the danger is real. It is a low-probability-high-consequence event for large impactors (more than 1 km). Even from meteorites, however, people were reported struck to death. This article gives a survey over reports of human casualties from 616 A.D. well to our century.

  10. Interlaboratory comparison of the dicentric chromosome assay for radiation biodosimetry in mass casualty events.

    PubMed

    Wilkins, Ruth C; Romm, Horst; Kao, Tzu-Cheg; Awa, Akio A; Yoshida, Mitsuaki A; Livingston, Gordon K; Jenkins, Mark S; Oestreicher, Ursula; Pellmar, Terry C; Prasanna, Pataje G S

    2008-05-01

    This interlaboratory comparison validates the dicentric chromosome assay for assessing radiation dose in mass casualty accidents and identifies the advantages and limitations of an international biodosimetry network. The assay's validity and accuracy were determined among five laboratories following the International Organization for Standardization guidelines. Blood samples irradiated at the Armed Forces Radiobiology Research Institute were shipped to all laboratories, which constructed individual radiation calibration curves and assessed the dose to dose-blinded samples. Each laboratory constructed a dose-effect calibration curve for the yield of dicentrics for (60)Co gamma rays in the 0 to 5-Gy range, using the maximum likelihood linear-quadratic model, Y = c + alphaD + betaD(2). For all laboratories, the estimated coefficients of the fitted curves were within the 99.7% confidence intervals (CIs), but the observed dicentric yields differed. When each laboratory assessed radiation doses to four dose-blinded blood samples by comparing the observed dicentric yield with the laboratory's own calibration curve, the estimates were accurate in all laboratories at all doses. For all laboratories, actual doses were within the 99.75% CI for the assessed dose. Across the dose range, the error in the estimated doses, compared to the physical doses, ranged from 15% underestimation to 15% overestimation.

  11. Engaging Active Bystanders in Mass Casualty Events and Other Life-Threatening Emergencies: A Pilot Training Course Demonstration.

    PubMed

    Smith, Tracey O; Baker, Susan D; Roberts, Kathryn; Payne, Skip A

    2016-04-01

    Emerging research indicates the critical role members of the public can play in saving lives and reducing morbidity at the scene in the immediate aftermath of a disaster. It is anticipated that with training, more members of the public will be ready and able to assist should they be present at mass casualty events or other circumstances in which there are serious injuries or potential loss of life. This article describes a training course developed by multiple federal and nonfederal partners aimed at preparing the public to become "active bystanders" followed by a pilot demonstration project conducted by Medical Reserve Corps Units. The outcomes of the project indicated that the training was comprehensive and appropriate for members of the public with little or no first aid knowledge. National availability of the "Becoming an Active Bystander" training course is currently being planned.

  12. Rural mass casualty preparedness and response: the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events.

    PubMed

    Viswanathan, Kristin P; Bass, Robert; Wijetunge, Gamunu; Altevogt, Bruce M

    2012-10-01

    The Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events hosted a workshop at the request of the Federal Interagency Committee on Emergency Medical Services (FICEMS) that brought together a range of stakeholders to broadly identify and confront gaps in rural infrastructure that challenge mass casualty incident (MCI) response and potential mechanisms to fill them. This report summarizes the presentations and discussions around 6 major issues specific to rural MCI preparedness and response: (1) improving rural response to MCI through improving daily capacity and capability, (2) leveraging current and emerging technology to overcome infrastructure deficits, (3) sustaining and strengthening relationships, (4) developing and sharing best practices across jurisdictions and sectors, (5) establishing metrics research and development, and (6) fostering the need for federal leadership to expand and integrate EMS into a broader rural response framework.

  13. The Internet's role in a biodosimetric response to a radiation mass casualty event.

    PubMed

    Sugarman, S L; Livingston, G K; Stricklin, D L; Abbott, M G; Wilkins, R C; Romm, H; Oestreicher, U; Yoshida, M A; Miura, T; Moquet, J E; Di Giorgio, M; Ferrarotto, C; Gross, G A; Christiansen, M E; Hart, C L; Christensen, D M

    2014-05-01

    Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet.

  14. Game-based mass casualty burn training.

    PubMed

    Kurenov, Sergei N; Cance, William W; Noel, Ben; Mozingo, David W

    2009-01-01

    An interactive, video game-based training module, Burn Center, was developed to simulate the real-life emergency events of a mass casualty disaster scenario, involving in 40 victims.The game contains two components - triage and resuscitation. The goal of the triage game is to correctly stabilize, sort, tag and transport burn victims during a mass casualty event at a busy theme park. After complete the triage component, the player will then take on the role of a burn care provider, balancing the clinical needs of multiple burn patients through a 36-hour resuscitation period, using familiar computer-simulated hospital devices. Once complete, players of Burn Center will come away with applicable skills and knowledge of burn care, for both field triage and initial resuscitation of the burn patients.

  15. SIMEDIS: a Discrete-Event Simulation Model for Testing Responses to Mass Casualty Incidents.

    PubMed

    Debacker, Michel; Van Utterbeeck, Filip; Ullrich, Christophe; Dhondt, Erwin; Hubloue, Ives

    2016-12-01

    It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS). Computer modelling and simulation enable to study and test operational assumptions in a virtual but controlled experimental environment. The SIMEDIS (Simulation for the assessment and optimization of medical disaster management) simulation model consists of 3 interacting components: the victim creation model, the victim monitoring model where the health state of each victim is monitored and adapted to the evolving clinical conditions of the victims, and the medical response model, where the victims interact with the environment and the resources at the disposal of the healthcare responders. Since the main aim of the DMR is to minimize as much as possible the mortality and morbidity of the survivors, we designed a victim-centred model in which the casualties pass through the different components and processes of a DMRS. The specificity of the SIMEDIS simulation model is the fact that the victim entities evolve in parallel through both the victim monitoring model and the medical response model. The interaction between both models is ensured through a time or medical intervention trigger. At each service point, a triage is performed together with a decision on the disposition of the victims regarding treatment and/or evacuation based on a priority code assigned to the victim and on the availability of resources at the service point. The aim of the case

  16. Weapons of Mass Destruction Events With Contaminated Casualties: Effective Planning for Health Care Facilities

    DTIC Science & Technology

    2000-01-12

    for Metropolitan MedicalStrikeTeams,43whichwerecom- posed of specially trained local person- nelwereorganized tohelpcommunities respond to events...munityresponseentities, includingemer- gencymanagement, lawenforcement ,fire, andmedicalpersonnel.Thecurrentpro- gramforhospitalpersonnelhaslackedde- tailed...yet been reached on this controversial point. This issue should be addressed through compre- hensive planning that includes local en- vironmental and

  17. Mass casualty following unprecedented tornadic events in the Southeast: natural disaster outcomes at a Level I trauma center.

    PubMed

    Hartmann, Elizabeth H; Creel, Nathan; Lepard, Jacob; Maxwell, Robert A

    2012-07-01

    On April 27, 2011, an EF4 (enhanced Fujita scale) tornado struck a 48-mile path across northwest Georgia and southeast Tennessee. Traumatic injuries sustained during this tornado and others in one of the largest tornado outbreaks in history presented to the regional Level I trauma center, Erlanger Health System, in Chattanooga, TN. Patients were triaged per mass casualty protocols through an incident command center and triage officer. Medical staffing was increased to anticipate a large patient load. Records of patients admitted as a result of tornado-related injury were retrospectively reviewed and characterized by the injury patterns, demographics, procedures performed, length of stay, and complications. One hundred four adult patients were treated in the emergency department; of these, 28 (27%) patients required admission to the trauma service. Of those admitted, 16 (57%) were male with an age range of 21 to 87 years old and an average length of stay of 10.9 ± 11.8 days. Eleven (39%) patients required intensive care unit admissions. The most common injuries seen were those of soft tissue, bony fractures, and the chest. Interventions included tube thoracostomies, exploratory laparotomies, orthopedic fixations, soft tissue reconstructions, and craniotomy. All 28 patients admitted survived to discharge. Nineteen (68%) patients were discharged home, six (21%) went to a rehabilitation hospital, and three (11%) were transferred to skilled nursing facilities. Emergency preparedness and organization are key elements in effectively treating victims of natural disasters. Those victims who survive the initial tornadic event and present to a Level I trauma center have low mortality. Like in our experience, triage protocols need to be implemented to quickly and effectively manage mass injuries.

  18. State-of-the-Art Advances in Radiation Biodosimetry for Mass Casualty Events Involving Radiation Exposure.

    PubMed

    Sproull, Mary; Camphausen, Kevin

    2016-11-01

    With the possibility of large-scale terrorist attacks around the world, the need for modeling and development of new medical countermeasures for potential future chemical, biological, radiological and nuclear (CBRN) has been well established. Project Bioshield, initiated in 2004, provided a framework to develop and expedite research in the field of CBRN exposures. To respond to large-scale population exposures from a nuclear event or radiation dispersal device (RDD), new methods for determining received dose using biological modeling became necessary. The field of biodosimetry has advanced significantly beyond this original initiative, with expansion into the fields of genomics, proteomics, metabolomics and transcriptomics. Studies are ongoing to evaluate the use of lymphocyte kinetics for dose assessment, as well as the development of field-deployable EPR technology. In addition, expansion of traditional cytogenetic assessment methods through the use of automated platforms and the development of laboratory surge capacity networks have helped to advance our biodefense preparedness. In this review of the latest advances in the field of biodosimetry we evaluate our progress and identify areas that still need to be addressed to achieve true field-deployment readiness.

  19. Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event.

    PubMed

    Toltzis, Philip; Soto-Campos, Gerardo; Shelton, Christian R; Kuhn, Evelyn M; Hahn, Ryan; Kanter, Robert K; Wetzel, Randall C

    2015-09-01

    ICU resources may be overwhelmed by a mass casualty event, triggering a conversion to Crisis Standards of Care in which critical care support is diverted away from patients least likely to benefit, with the goal of improving population survival. We aimed to devise a Crisis Standards of Care triage allocation scheme specifically for children. A triage scheme is proposed in which patients would be divided into those requiring mechanical ventilation at PICU presentation and those not, and then each group would be evaluated for probability of death and for predicted duration of resource consumption, specifically, duration of PICU length of stay and mechanical ventilation. Children will be excluded from PICU admission if their mortality or resource utilization is predicted to exceed predetermined levels ("high risk"), or if they have a low likelihood of requiring ICU support ("low risk"). Children entered into the Virtual PICU Performance Systems database were employed to develop prediction equations to assign children to the exclusion categories using logistic and linear regression. Machine Learning provided an alternative strategy to develop a triage scheme independent from this process. One hundred ten American PICUs : One hundred fifty thousand records from the Virtual PICU database. None. The prediction equations for probability of death had an area under the receiver operating characteristic curve more than 0.87. The prediction equation for belonging to the low-risk category had lower discrimination. R for the prediction equations for PICU length of stay and days of mechanical ventilation ranged from 0.10 to 0.18. Machine learning recommended initially dividing children into those mechanically ventilated versus those not and had strong predictive power for mortality, thus independently verifying the triage sequence and broadly verifying the algorithm. An evidence-based predictive tool for children is presented to guide resource allocation during Crisis Standards

  20. Public health preparedness for mass-casualty events: a 2002 state-by-state assessment.

    PubMed

    Mann, N Clay; MacKenzie, Ellen; Anderson, Cheryl

    2004-01-01

    The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies. During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism. Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation (48%), and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22-48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan. These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and

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

    PubMed

    Hopmeier, Michael; Abrahams, Jonathan; Carr, Zhanat

    2010-06-01

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

  2. Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS): development and application of computer modeling to selected National Planning Scenarios for high-consequence events.

    PubMed

    Scheulen, James J; Thanner, Meridith H; Hsu, Edbert B; Latimer, Christian K; Brown, Jeffrey; Kelen, Gabor D

    2009-02-01

    Few tools exist that are sufficiently robust to allow manipulation of key input variables to produce casualty estimates resulting from high-consequence events reflecting local or specific regions of concern. This article describes the design and utility of a computerized modeling simulation tool, Electronic Mass Casualty Assessment and Planning Scenarios (EMCAPS), developed to have broad application across emergency management and public health fields as part of a catastrophic events preparedness planning process. As a scalable, flexible tool, EMCAPS is intended to support emergency preparedness planning efforts at multiple levels ranging from local health systems to regional and state public health departments to Metropolitan Medical Response System jurisdictions. Designed around the subset of the National Planning Scenarios with health effects, advanced by the US Department of Homeland Security, the tool's platform is supported by the detailed descriptions and readily retrievable evidence-based assumptions of each scenario. The EMCAPS program allows the user to manipulate key scenario-based input variables that would best reflect the region or locale of interest. Inputs include population density, vulnerabilities, event size, and potency, as applicable. Using these inputs, EMCAPS generates the anticipated population-based health surge influence of the hazard scenario. Casualty estimates are stratified by injury severity/types where appropriate. Outputs are graph and table tabulations of surge estimates. The data can then be used to assess and tailor response capabilities for specific jurisdictions, organizations, and health care systems. EMCAPS may be downloaded without cost from http://www.hopkins-cepar.org/EMCAPS/EMCAPS.html as shareware.

  3. Decontamination of mass casualties--re-evaluating existing dogma.

    PubMed

    Levitin, Howard W; Siegelson, Henry J; Dickinson, Stanley; Halpern, Pinchas; Haraguchi, Yoshikura; Nocera, Anthony; Turineck, David

    2003-01-01

    The events of 11 September 2001 became the catalyst for many to shift their disaster preparedness efforts towards mass-casualty incidents. Emergency responders, healthcare workers, emergency managers, and public health officials worldwide are being tasked to improve their readiness by acquiring equipment, providing training and implementing policy, especially in the area of mass-casualty decontamination. Accomplishing each of these tasks requires good information, which is lacking. Management of the incident scene and the approach to victim care varies throughout the world and is based more on dogma than scientific data. In order to plan effectively for and to manage a chemical, mass-casualty event, we must critically assess the criteria upon which we base our response. This paper reviews current standards surrounding the response to a release of hazardous materials that results in massive numbers of exposed human survivors. In addition, a significant effort is made to prepare an international perspective on this response. Preparations for the 24-hour threat of exposure of a community to hazardous material are a community responsibility for first-responders and the hospital. Preparations for a mass-casualty event related to a terrorist attack are a governmental responsibility. Reshaping response protocols and decontamination needs on the differences between vapor and liquid chemical threats can enable local responders to effectively manage a chemical attack resulting in mass casualties. Ensuring that hospitals have adequate resources and training to mount an effective decontamination response in a rapid manner is essential.

  4. Mass casualty management of a large-scale bioterrorist event: an epidemiological approach that shapes triage decisions.

    PubMed

    Burkle, Frederick M

    2002-05-01

    The threat of a BT event has catalyzed serious reflection on the troublesome issues that come with event management and triage. Such reflection has had the effect of multiplying the efforts to find solutions to what could become a catastrophic public health disaster. Management options are becoming more robust, as are reliable detection devices and rapid access to stockpiled antibiotics and vaccines. There is much to be done, however, especially in the organizing, warehousing, and granting/exercising authority for resource allocations. The introduction of these new options should encourage one to believe that, in time, evolving standards of care will make it possible to rethink the currently unthinkable consequences. Unfortunately the cost of such preparedness is high and out of reach of most governments. Most of the developing world has neither the will nor the means to plan for BT events and remains overwhelmed with basic public health concerns (i.e., water, food, sanitation, shelter) that must take priority. Therefore, developed countries will be expected to respond using international exogenous resources to mitigate the effects of such a disaster. As a result, the state capacity of the effected government will be severely compromised. If triage and management of casualties is further compromised, terrorists will have met their goals. One could argue that health sciences will continue for decades to play catch up with the advanced technology driving potential bioagent weaponry. If one lesson was learned from the review of the former Soviet Union's biological weapons program, it is that the unthinkable remains an option to terrorists who have comparable expertise. It is crucial to develop realistic strategies for a BT event. Triage planning (the process of establishing criteria for health care prioritization) permits society to see cases in the context of diverse moral perspectives, limited resources, and compelling health care demands. This includes a competent

  5. Personal Protective Equipment Guide for Military Medical Treatment Facility Personnel Handling Casualties From Weapons of Mass Destruction and Terrorism Events

    DTIC Science & Technology

    2003-08-01

    Press, Washington, 1999. 134. Tactics, Techniques , and Procedures for Biological Defense, Army Field Manual 3-11.86. Note: currently being...appropriate Army Field Manuals and other references for these situations, such as Medical Management of Chemical Casualties Handbook (USAMRICD...August 2003 indicates that most cases occurred after direct contact with blood, secretions , or tissues of infected patients or nonhuman

  6. Planning for a Mass Casualty Incident in Arkansas Schools

    ERIC Educational Resources Information Center

    Patterson, Harry; Liggin, Rebecca; Shirm, Steve; Nation, Brian; Dick, Rhonda

    2005-01-01

    School preparedness includes the possibility of a natural disaster, but recent events also confirm a need for preparedness and prevention efforts for intentional mass casualty incidents (MCIs). This survey examined the preparedness for the prevention and response for MCIs at public schools in Arkansas. This survey demonstrated that most school…

  7. Shifting the Paradigm of Trauma Medicine to Positively Influence Critical Mortality Rates Following a Mass Casualty Event

    DTIC Science & Technology

    2009-06-01

    ground zero, while another 300 sought care at the next hospital which was within one mile ( Pesola , Dujar, & Wilson, 2002, pp. 220-2). On March 11, 2004...another 300 sought care at the next hospital over which was within one mile ( Pesola , 2002, p. 220). It is prudent that the lessons of military...logistics, injuries, sustained and clinical management of casualties treated at the closets hospitals. Critical Care, 9, 104-111. Pesola , G.R

  8. Multiple casualty terror events: the anesthesiologist's perspective.

    PubMed

    Shamir, Micha Y; Weiss, Yoram G; Willner, Dafna; Mintz, Yoav; Bloom, Allan I; Weiss, Yuval; Sprung, Charles L; Weissman, Charles

    2004-06-01

    In a 28-mo period 14 multiple-casualty terror events occurred in Jerusalem, challenging the Department of Anesthesiology and Critical Care Medicine of the city's sole Level 1 trauma center. We performed a retrospective review of the response of the department to evaluate staff activities, resource use (emergency department, operating rooms, and intensive care unit [ICU]), and patient flow. A total of 1062 people were injured in the 14 multi-casualty terror incidents. The emergency department treated 355 victims; 108 of them were hospitalized, and 58 underwent surgery during the first 8 h. Only two surgeries were performed during the first hour, and the average time to the first surgery was 124 min. Fifty-one patients were admitted to the ICU an average of 5.5 h after the terror event. After a terrorist act, multiple, simultaneous efforts were required of the anesthesiology department, including taking part in the initial resuscitation in the emergency department, anesthetizing victims for surgery and angiographies, and caring for them in the recovery room and ICU. Therefore, anesthesiology departments are greatly impacted by such events and must plan for them to maximize the use of available personnel and to have the appropriate equipment and supplies available. Anesthesiologists provide essential care to patients injured in terror events, from the initial resuscitation through therapeutic/diagnostic procedures and surgeries. Operational issues faced by a department of anesthesiology during the initial 8 h after terrorist actions were examined. Multiple, and often parallel, efforts were required of the department.

  9. Modelling mass casualty decontamination systems informed by field exercise data.

    PubMed

    Egan, Joseph R; Amlôt, Richard

    2012-10-16

    In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS). The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing) of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit.

  10. Modelling Mass Casualty Decontamination Systems Informed by Field Exercise Data

    PubMed Central

    Egan, Joseph R.; Amlôt, Richard

    2012-01-01

    In the event of a large-scale chemical release in the UK decontamination of ambulant casualties would be undertaken by the Fire and Rescue Service (FRS). The aim of this study was to track the movement of volunteer casualties at two mass decontamination field exercises using passive Radio Frequency Identification tags and detection mats that were placed at pre-defined locations. The exercise data were then used to inform a computer model of the FRS component of the mass decontamination process. Having removed all clothing and having showered, the re-dressing (termed re-robing) of casualties was found to be a bottleneck in the mass decontamination process during both exercises. Computer simulations showed that increasing the capacity of each lane of the re-robe section to accommodate 10 rather than five casualties would be optimal in general, but that a capacity of 15 might be required to accommodate vulnerable individuals. If the duration of the shower was decreased from three minutes to one minute then a per lane re-robe capacity of 20 might be necessary to maximise the throughput of casualties. In conclusion, one practical enhancement to the FRS response may be to provide at least one additional re-robe section per mass decontamination unit. PMID:23202768

  11. Managing mass casualties and decontamination.

    PubMed

    Chilcott, Robert P

    2014-11-01

    Careful planning and regular exercising of capabilities is the key to implementing an effective response following the release of hazardous materials, although ad hoc changes may be inevitable. Critical actions which require immediate implementation at an incident are evacuation, followed by disrobing (removal of clothes) and decontamination. The latter can be achieved through bespoke response facilities or various interim methods which may utilise water or readily available (dry, absorbent) materials. Following transfer to a safe holding area, each casualty's personal details should be recorded to facilitate a health surveillance programme, should it become apparent that the original contaminant has chronic health effects.

  12. Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

    SciTech Connect

    Greenwalt, R. J.; Hibbard, W. J.

    2016-05-04

    Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

  13. Mass Casualty Chemical Incident Operational Framework, Assessment and Best Practices

    SciTech Connect

    Greenwalt, R.; Hibbard, W.

    2016-08-09

    Emergency response agencies in most US communities are organized, sized, and equipped to manage those emergencies normally expected. Hospitals in particular do not typically have significant excess capacity to handle massive numbers of casualties, as hospital space is an expensive luxury if not needed. Unfortunately this means that in the event of a mass casualty chemical incident the emergency response system will be overwhelmed. This document provides a self-assessment means for emergency managers to examine their response system and identify shortfalls. It also includes lessons from a detailed analysis of five communities: Baltimore, Boise, Houston, Nassau County, and New Orleans. These lessons provide a list of potential critical decisions to allow for pre-planning and a library of best practices that may be helpful in reducing casualties in the event of an incident.

  14. [Simplified schema of action of the ambulance rescue services during mass casualty].

    PubMed

    Guła, Przemysław; Hładki, Waldemar; Górski, Krzysztof; Popławska, Małgorzata

    2008-01-01

    Authors represented problems relating mass - casualty accidents and manner of segregation of victims. Lifesaving activities in mass - casualty usually leads to increased emotional stress. It is the result of event specificity, and also of external threats in the zone of activity. Authors presented schema prepared for needs of Cracow's - Ambulance Rescue Services, being the adaptation of universally accepted in western countries algorithm (SAD CHALETS).

  15. Emergency radiology and mass casualty incidents-report of a mass casualty incident at a level 1 trauma center.

    PubMed

    Bolster, Ferdia; Linnau, Ken; Mitchell, Steve; Roberge, Eric; Nguyen, Quynh; Robinson, Jeffrey; Lehnert, Bruce; Gross, Joel

    2017-02-01

    The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage. Nineteen patients were transferred to our level 1 trauma center. Eighteen casualties arrived within 72 min. Sixteen arrived within 1 h of the first patient arrival, and 1 casualty was transferred 3 h later having initially been assessed at another hospital. Eighteen casualties (94.7 %) underwent diagnostic imaging in the emergency department. Of these 18 casualties, 15 had a trauma series (portable chest x-ray and x-ray of pelvis). Whole-body trauma computed tomography scans (WBCT) were performed on 15 casualties (78.9 %), 12 were immediate and performed during the initial active phase of the MCI, and 3 WBCTs were delayed. The initial 12 WBCTs were completed in 101 min. The mean number of radiographic studies performed per patient was 3 (range 1-8), and the total number of injuries detected was 88. The surge in imaging requirements during an MCI can be significant and exceed normal operating capacity. This report of our radiology experience during a recent MCI and subsequent after-action review serves to provide an example of how radiology capacity and workflow functioned during an MCI, in order to provide emergency radiologists and response planners with practical recommendations for implementation in the event of a future MCI.

  16. 2014 Fort Hood, Texas, mass casualty incident: reviews and perspectives.

    PubMed

    Strommen, Joshua J; Waterman, Scott M; Mitchell, Christopher A; Grogan, Brian F

    2015-09-01

    On April 2, 2014, in Fort Hood, Texas, an active shooter incident occurred where four active duty soldiers were tragically killed. Active shooter incidents are becoming alarmingly more frequent over the last decade in the USA. The authors provide a detailed account of the events that occurred within the hospital and an evaluation of the triage decisions made on that day. A detailed review of mass casualty preparedness and the general approach to triage processes are also described.

  17. Mass casualty incidents - time to engage.

    PubMed

    Ben-Ishay, Offir; Mitaritonno, Michele; Catena, Fausto; Sartelli, Massimo; Ansaloni, Luca; Kluger, Yoram

    2016-01-01

    Mass casualty incident continues to overwhelm medical systems worldwide. Preparedness for an MCI is a crucial requisite for the injured better outcome. The World Society of Emergency Surgery initiated a survey in regard to its senior member's personal and institutional preparedness for MCI. The results here in presented indicate that WSES should engage in a formatted and structured preparedness course for medical institutions and individuals."By all appearances it seems to be just another normal Saturday morning in the emergency department (ED). Patients occupy thirty out of the sixty beds; some awaits discharge, some awaits admission to the hospital. All of a sudden the squeaky voice of the red phone is tearing the air, the hard metal voice on the line is reporting of an explosion in the nearby train station, estimated number of casualties is 80. You ask for their estimated time of arrival, when you hear the first sirens of ambulances parking out of the ED; no answer was needed.

  18. Decision-support information system to manage mass casualty incidents at a level 1 trauma center.

    PubMed

    Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon

    2013-12-01

    Mass casualty incidents are probably the greatest challenge to a hospital. When such an event occurs, hospitals are required to instantly switch from their routine activity to conditions of great uncertainty and confront needs that exceed resources. We describe an information system that was uniquely designed for managing mass casualty events. The web-based system is activated when a mass casualty event is declared; it displays relevant operating procedures, checklists, and a log book. The system automatically or semiautomatically initiates phone calls and public address announcements. It collects real-time data from computerized clinical and administrative systems in the hospital, and presents them to the managing team in a clear graphic display. It also generates periodic reports and summaries of available or scarce resources that are sent to predefined recipients. When the system was tested in a nationwide exercise, it proved to be an invaluable tool for informed decision making in demanding and overwhelming situations such as mass casualty events.

  19. Primary Triage in a Mass-casualty Event Possesses a Risk of Increasing Informational Confusion: A Simulation Study Using Shannon's Entropy.

    PubMed

    Ajimi, Yasuhiko; Sasaki, Masaru; Uchida, Yasuyuki; Kaneko, Ichiro; Nakahara, Shinya; Sakamoto, Tetsuya

    2016-10-01

    Introduction Primary triage in a mass-casualty event setting using low-visibility tags may lead to informational confusion and difficulty in judging triage attribution of patients. In this simulation study, informational confusion during primary triage was investigated using a method described in a prior study that applied Shannon's Information Theory to triage. Hypothesis Primary triage using a low-visibility tag leads to a risk of informational confusion in prioritizing care, owing to the intermingling of pre- and post-triage patients. It is possible that Shannon's entropy evaluates the degree of informational confusion quantitatively and improves primary triage. The Simple Triage and Rapid Treatment (START) triage method was employed. In Setting 1, entropy of a triage area with 32 patients was calculated for the following situations: Case 1 - all 32 patients in the triage area at commencement of triage; Case 2 - 16 randomly imported patients to join 16 post-triage patients; Case 3 - eight patients imported randomly and another eight grouped separately; Case 4 - 16 patients grouped separately; Case 5 - random placement of all 32 post-triage patients; Case 6 - isolation of eight patients of minor priority level; Case 7 - division of all patients into two groups of 16; and Case 8 - separation of all patients into four categories of eight each. In Setting 2, entropies in the triage area with 32 patients were calculated continuously with each increase of four post-triage patients in Systems A and B (System A - triage conducted in random manner; and System B - triage arranged into four categories). In Setting 1, entropies in Cases 1-8 were 2.00, 3.00, 2.69, 2.00, 2.00, 1.19, 1.00, and 0.00 bits/symbol, respectively. Entropy increased with random triage. In Setting 2, entropies of System A maintained values the same as, or higher than, those before initiation of triage: 2.00 bits/symbol throughout the triage. The graphic waveform showed a concave shape and took 3

  20. Diagnostic and Treatment Innovations for Mass Casualties

    DTIC Science & Technology

    2016-08-01

    10 –4 coulomb per kilogram ( C kg –1 ) rad [absorbed dose] 1 × 10 –2 joule per kilogram (J kg –1 ) [gray (Gy)] rem [equivalent and effective...6201 Fort Belvoir, VA 22060-6201 T E C H N IC A L R E P O R T DTRA-TR-16-91 Diagnostic and Treatment Innovations for Mass Casualties...3 pascal (Pa) Temperature degree Fahrenheit ( o F) [T( o F) − 32]/1.8 degree Celsius ( o C ) degree Fahrenheit ( o F) [T( o F) + 459.67]/1.8

  1. The state of US trauma systems: public perceptions versus reality--implications for US response to terrorism and mass casualty events.

    PubMed

    Champion, Howard R; Mabee, Marcia S; Meredith, J Wayne

    2006-12-01

    not been made a national priority. Trauma systems must be adequately developed and supported to fulfill the public's expectation to receive the best possible care if seriously injured, and to ensure readiness for mass casualty and terrorist incidents.

  2. Predicting Resource Needs for Multiple and Mass Casualty Events in Combat: Lessons Learned From Combat Support Hospital Experience in Operation Iraqi Freedom

    DTIC Science & Technology

    2009-04-01

    explosions and gunshot wound ) firefights. The primary mechanism of injury for the majority of casualties (73%) was explosion, with the remaining 27% of...casualties injured by gunshot wound . The mean ISS for casualties who were in- jured in explosive incidents (improvised explosives, rocket, or mortar...slightly lower base deficit (5 vs. 3.5, p 0.05), and lower ISS (8.1 vs. 9.8, p 0.05) in patients who suffered gunshot wound mechanism compared

  3. Management of Mass Casualties Using Doctor Helicopters and Doctor Cars.

    PubMed

    Ohsaka, Hiromichi; Ishikawa, Kouhei; Omori, Kazuhiko; Jitsuiki, Kei; Yoshizawa, Toshihiko; Yanagawa, Youichi

    At approximately 10 o'clock in September 2015, a minibus carrying 18 people accidentally slid backwards because of a malfunctioning brake system while climbing a steep incline on Togasayama Mountain, colliding with a van (Toyota HiAce wagon) carrying 11 people that was situated behind the minibus. Togasayama Mountain is located 1 hour by car and 10 minutes by helicopter from our hospital. The minibus slid off a roadside cliff at a height of 0.5 m and rolled over after colliding with the van. There were 7 victims with yellow tags and 22 with green tags. Two Doctor Helicopters and 1 Doctor Car cooperated with the fire departments by providing medical treatments, selection of medical facilities, and dispersion transportation. In this mass casualty event, there were no mortalities, and all of the victims recovered without sequelae. The coordinated and combined use of Doctor Helicopters and Doctor Cars in addition to the activities of the fire department in response to a mass casualty event resulted in appropriate triage, medical treatments, selection of medical facilities, and dispersion transportation. Copyright © 2017 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  4. Amputations in natural disasters and mass casualties: staged approach.

    PubMed

    Wolfson, Nikolaj

    2012-10-01

    Amputation is a commonly performed procedure during natural disasters and mass casualties related to industrial accidents and military conflicts where large civilian populations are subjected to severe musculoskeletal trauma. Crush injuries and crush syndrome, an often-overwhelming number of casualties, delayed presentations, regional cultural and other factors, all can mandate a surgical approach to amputation that is different than that typically used under non-disaster conditions. The following article will review the subject of amputation during natural disasters and mass casualties with emphasis on a staged approach to minimise post-surgical complications, especially infection.

  5. Development of sulfanegen for mass cyanide casualties.

    PubMed

    Patterson, Steven E; Moeller, Bryant; Nagasawa, Herbert T; Vince, Robert; Crankshaw, Daune L; Briggs, Jacquie; Stutelberg, Michael W; Vinnakota, Chakravarthy V; Logue, Brian A

    2016-06-01

    Cyanide is a metabolic poison that inhibits the utilization of oxygen to form ATP. The consequences of acute cyanide exposure are severe; exposure results in loss of consciousness, cardiac and respiratory failure, hypoxic brain injury, and dose-dependent death within minutes to hours. In a mass-casualty scenario, such as an industrial accident or terrorist attack, currently available cyanide antidotes would leave many victims untreated in the short time available for successful administration of a medical countermeasure. This restricted therapeutic window reflects the rate-limiting step of intravenous administration, which requires both time and trained medical personnel. Therefore, there is a need for rapidly acting antidotes that can be quickly administered to large numbers of people. To meet this need, our laboratory is developing sulfanegen, a potential antidote for cyanide poisoning with a novel mechanism based on 3-mercaptopyruvate sulfurtransferase (3-MST) for the detoxification of cyanide. Additionally, sulfanegen can be rapidly administered by intramuscular injection and has shown efficacy in many species of animal models. This article summarizes the journey from concept to clinical leads for this promising cyanide antidote.

  6. Will emergency health care providers respond to mass casualty incidents?

    PubMed

    Syrett, James I; Benitez, John G; Livingston, William H; Davis, Eric A

    2007-01-01

    Emergency response plans often call on health care providers to respond to the workplace outside of their normal working pattern. Providers will report to work during a mass casualty emergency regardless of family duties, type of incident, or availability of treatment. Survey of emergency personnel needed to respond to a mass casualty incident. Two scenarios were presented: one involving the release of a non-transmissible biological agent with proven treatment and the other the release of a transmissible biological agent with no treatment. At critical time points, participants were asked whether they would report to work. Additional questions considered the effect of commonly used treatment dissemination methods. A total of 186 surveys were issued and returned. (45 physicians, 29 nurses, 86 EMS personnel, and 20 support staff); 6 were incomplete and excluded. Initial commitment rates were 78%. The highest commitment rate identified was 84% and the lowest was 18%. Any treatment dissemination method excluding providers' family members led to decreases in commitment rate, as did agents identified to be transmissible. As an event develops, fewer health care providers will report to work and at no time will all providers report when asked. This conclusion may be generalizable to several types of incidents ranging from pandemic influenza to bioterrorism. Identification of the causative agent is a major decision point for providers to return to or stay away from work. Offering on-site treatment of providers' family increases commitment to work. These factors should be considered in emergency planning.

  7. Will emergency health care providers respond to mass casualty incidents?

    PubMed

    Syrett, James I; Benitez, John G; Livingston, William H; Davis, Eric A

    2007-01-01

    Emergency response plans often call on health care providers to respond to the workplace outside of their normal working pattern. Providers will report to work during a mass casualty emergency regardless of family duties, type of incident, or availability of treatment. Survey of emergency personnel needed to respond to a mass casualty incident. Two scenarios were presented: one involving the release of a nontransmissible biological agent with proven treatment and the other the release of a transmissible biological agent with no treatment. At critical time points, participants were asked whether they would report to work. Additional questions considered the effect of commonly used treatment dissemination methods. A total of 186 surveys were issued and returned. (45 physicians, 29 nurses, 86 EMS personnel, and 20 support staff); 6 were incomplete and excluded. Initial commitment rates were 78%. The highest commitment rate identified was 84% and the lowest was 18%. Any treatment dissemination method excluding providers' family members led to decreases in commitment rate, as did agents identified to be transmissible. As an event develops, fewer health care providers will report to work and at no time will all providers report when asked. This conclusion may be generalizable to several types of incidents ranging from pandemic influenza to bioterrorism. Identification of the causative agent is a major decision point for providers to return to or stay away from work. Offering on-site treatment of providers' family increases commitment to work. These factors should be considered in emergency planning.

  8. Medical response of a physician and two nurses to the mass-casualty event resulting in the Phi Phi Islands from the tsunami.

    PubMed

    Ammartyothin, Surasak; Ashkenasi, Issac; Schwartz, Dagan; Leiba, Adi; Nakash, Guy; Pelts, Rami; Goldberg, Avishay; Bar-Dayan, Yaron

    2006-01-01

    The Phi Phi Islands are isolated islands located about one hour by ship from the mainland in Krabi province of Thailand. There is a small medical facility where the director is the one physician that provides care to residents and tourists. This small medical facility faced an enormous mass casualty incident due to the 2004 Tsunami. The hospital was damaged by the Tsunami wave and was not functional, one crew member died and another was injured. Medical care and evacuation posed a unique problem in the Phi Phi Islands due to remoteness, limited medical resources, lack of effective communication with the main land and the large number of victims. An alternative medical facility was located in a nearby hotel. The crew included the medical director, two nurses, two additional staff members, 10 local volunteers, and hotel staff members. The medical crew had to treat 600-700 casualties in 24 hours. Most of the victims were mildly injured, but approximately 100 (15%) of the victims could not walk due to their injuries. The medical director, made a conscious decision to initially treat only circulation ("C") problems, by controlling external hemorrhages. This decision was driven by the lack of equipment and personnel to deal with airway ("A") and breathing ("B") problems. In the post-disaster debriefing, the Phi Phi Island hospital physician noted five major lessons concerning disaster management in such extreme situation in a small facility located in a remote area: (1) effective resistant communication facilities must be ensured; (2) clear, simple "evacuation plans" should be made in advance; (3) plans should be made to ensure automatic reinforcement of remote areas with evacuation vehicles, medical equipment and medical personnel; (4) efficient cooperation with medical volunteers must be planned and drilled; and (5) every team member of such a hospital must participate in an educational program and periodic drills should be done to improve the disaster and emergency

  9. Blood bank protocols for large-scale civilian casualty events: experience from terrorist bombing in Israel.

    PubMed

    Dann, E J; Bonstein, L; Arbov, L; Kornberg, A; Rahimi-Levene, N

    2007-04-01

    Terrorist attacks in crowded places cause multiple casualties that are evacuated by quick succession to nearby hospitals. The study goals were to analyse the issues of patient misidentification and excessive blood request and to develop recommendations for the management of such episodes. A retrospective analysis of nine explosion attacks was performed. In nine consecutive events, 450 casualties were reported by the National Ambulance Service, 82 of whom (18%) died on the explosion site and 368 were admitted to nearby trauma centres. Red blood cell units were typed and cross-matched for 70 patients. Seventy-three per cent of the blood supplied over the first 24 h was administered during the first 2 h. The cross-matched/transfused ratio was 2.52 +/- 1.42, reflecting the overestimation of blood requirement in mass casualty episodes. In the mass casualty setup, blood bank personnel should be alert to a potential mistransfusion or a blood collection error. Unidentified patients are subjected to errors due to only one-digit difference in their temporary identification number. Application of the system using an additional sequential four-digit number printed in bold and large size font for patients at admission reduced the possibility of misidentification. Modern technologies, including error-reduction design wristbands, barcode-based system or radiofrequency identification tags may also increase reliability of patient identification in the mass casualty setup.

  10. Surgical response to multiple casualty incidents following single explosive events.

    PubMed

    Propper, Brandon W; Rasmussen, Todd E; Davidson, Scott B; Vandenberg, Sheri L; Clouse, W Darrin; Burkhardt, Gabe E; Gifford, Shaun M; Johannigman, Jay A

    2009-08-01

    Modern publications on response to single explosive events are from non-US hospitals, predate current resuscitation guidelines and lack detail on surgical and intensive care unit (ICU) requirements. The objective of this study is to provide a contemporary account of surge response to multiple casualty incidences following explosive events managed at a US trauma hospital in Iraq. Observational study and retrospective chart review of 72-hour transfusion, operating room, and ICU resource utilization from 3 multiple casualty incidences managed at the US Air Force Theater Hospital, Balad AB, Iraq between February and April 2008. Fifty patients were treated with a mean injury severity score of 19. Forty-eight percent (n = 24) of casualties required blood transfusion with 4 patients receiving 43% (N = 74 units) of the packed red blood cells (pRBC). An average of 3.5 and 3.8 units of pRBC and plasma, respectively, was transfused per casualty (pRBC:plasma ratio of 1:1.1). Seventy-six percent (n = 38) of patients required immediate operation upon initial presentation. A total of 191 procedures were performed in parallel during 75 operations (3.8 procedures per casualty). Fifty percent (n = 25) of patients required ICU admission with nearly the same number (n = 24) requiring mechanical ventilator support beyond that required for operation. All cause, in-hospital mortality was 8% (n = 4). Results from this study provide a contemporary assessment of transfusion, surgical, and intensive care resource requirements after a single explosive event. Data from this experience may translate into useful guidelines for emergency planners worldwide.

  11. Improving hospital mass casualty preparedness through ongoing readiness evaluation.

    PubMed

    Adini, Bruria; Laor, Daniel; Hornik-Lurie, Tzipora; Schwartz, Dagan; Aharonson-Daniel, Limor

    2012-01-01

    The objective of this study was to investigate the effect of ongoing use of an evaluation tool on hospitals' emergency preparedness for mass casualty events (MCEs). Two cycles of evaluation of emergency preparedness were conducted based on measurable parameters. A significant increase was found in mean total scores between the 2 cycles (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training, and equipment, but the change was significant only in the training category. Relative increase was highest for hospitals that did not experience real MCEs. This study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated, measurable benchmarks. Ongoing assessment of emergency preparedness motivates hospitals to improve capabilities and results in a more effective emergency response mechanism. Use of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the areas evaluated.

  12. Meteorite falls in China and some related human casualty events

    NASA Technical Reports Server (NTRS)

    Yau, Kevin; Weissman, Paul; Yeomans, Donald

    1994-01-01

    Statistics of witnessed and recovered meteorite falls found in Chinese historical texts for the period from 700 B.C. to A.D. 1920 are presented. Several notable features can be seen in the binned distribution as a function of time. An apparent decrease in the number of meteorite reports in the 18th century is observed. An excess of observed meteorite falls in the period from 1840 to 1880 seems to correspond to a similar excess in European data. A chi sq probability test suggest that the association between the two data sets are real. Records of human casualities and structural damage resulting from meteorite falls are also given. A calculation based on the number of casualty events in the Chinese meteorite records suggests that the probability of a meteroite striking a human is far greater than previous estimates. However, it is difficult to verify the accuracy of the reported casualty events.

  13. Model uniform core criteria for mass casualty triage.

    PubMed

    2011-06-01

    There is a need for model uniform core criteria for mass casualty triage because disasters frequently cross jurisdictional lines and involve responders from multiple agencies who may be using different triage tools. These criteria (Tables 1-4) reflect the available science, but it is acknowledged that there are significant research gaps. When no science was available, decisions were formed by expert consensus derived from the available triage systems. The intent is to ensure that providers at a mass-casualty incident use triage methodologies that incorporate these core principles in an effort to promote interoperability and standardization. At a minimum, each triage system must incorporate the criteria that are listed below. Mass casualty triage systems in use can be modified using these criteria to ensure interoperability. The criteria include general considerations, global sorting, lifesaving interventions, and assignment of triage categories. The criteria apply only to providers who are organizing multiple victims in a discrete geographic location or locations, regardless of the size of the incident. They are classified by whether they were derived through available direct scientific evidence, indirect scientific evidence, expert consensus, and/or are used in multiple existing triage systems. These criteria address only primary triage and do not consider secondary triage. For the purposes of this document the term triage refers to mass-casualty triage and provider refers to any person who assigns primary triage categories to victims of a mass-casualty incident.

  14. Management of Mass Casualty Burn Disasters

    DTIC Science & Technology

    2005-05-01

    jet fuel, to complex and hard-to-deploy weapons such as biologic and chemical agents’ (3). The purpose of this article is to review recent experience ...1994 Pope Air Force Base (AFB) aircraft crash from an anaesthesiology perspective (14). Those authors noted critical shortages of laryngoscopes...responses of nearby hospitals have been described (18–20). In addition, Yurt and colleagues reviewed their experi - ence with casualties from that disaster who

  15. Mass Casualty Incident Primary Triage Methods in China

    PubMed Central

    Chen, Jin-Hong; Yang, Jun; Yang, Yu; Zheng, Jing-Chen

    2015-01-01

    Objective: To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China. Data Sources: Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/), and China Earthquake Information (http://www.csi.ac.cn/). Study Selection: We included studies associated with mass casualty events related to China, the PT applied in China, guidelines and standards, and application and development of the carding PT method in China. Results: From 3976 potentially relevant articles, 22 met the inclusion criteria, 20 Chinese, and 2 English. These articles included 13 case reports, 3 retrospective analyses of MCI, two methods introductions, three national or sectoral criteria, and one simulated field testing and validation. There were a total of 19 kinds of MCI PT methods that have been reported in China from 1950 to 2014. In addition, there were 15 kinds of PT methods reported in the literature from the instance of the application. Conclusions: The national and sectoral current triage criteria are developed mainly for earthquake relief. Classification is not clear. Vague criteria (especially between moderate and severe injuries) operability are not practical. There are no triage methods and research for children and special populations. There is no data and evidence supported triage method. We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real, practical, and efficient PT method. PMID:26415807

  16. Hepatitis B outbreak following a mass-casualty incident, Australia.

    PubMed

    Italiano, Claire M; Speers, David J; Chidlow, Glenys R; Dowse, Gary K; Robertson, Andrew G; Flexman, James P

    2011-08-01

    On 16 April 2009, a boat carrying 47 Afghan asylum seekers and 2 Indonesian crew exploded in Australian waters, resulting in mass casualties. Of these casualties, 23 persons who suffered significant burns were transferred to Royal Perth Hospital, Perth, Western Australia. One patient was subsequently shown to be a hepatitis B virus (HBV) carrier at the time of the explosion. Over the following months, 3 other patients received a diagnosis of acute hepatitis B, and an additional 4 patients showed serological evidence of recent HBV infection, including 1 patient who was transferred to another Australian city. Molecular typing determined that the strains from the HBV carrier and the acute and recent case patients formed a closely related cluster, and the investigation suggested that transmission occurred at or around the time of the boat explosion. This is the first report of confirmed transmission of HBV following a disaster, and it reinforces the importance of postexposure prophylaxis for HBV in mass casualty situations.

  17. Criteria and models for the distribution of casualties in trauma-related mass casualty incidents: a systematic literature review protocol.

    PubMed

    Khajehaminian, Mohammad Reza; Ardalan, Ali; Hosseini Boroujeni, Sayed Mohsen; Nejati, Amir; Keshtkar, Abbasali; Foroushani, Abbas Rahimi; Ebadati E, Omid Mahdi

    2017-07-12

    One of the most critical practices in mass casualty incident management is vacating the victims from scene of the incident and transporting them to proper healthcare facilities. Decision on distribution of casualties needs to be taken on pre-developed policies and structured decision support mechanisms. While many studies tried to present models for the distribution of casualties, no systematic review has yet been conducted to evaluate the existing models on casualty distribution following mass casualty incidents. A systematic review is therefore needed to examine the existing models of patient distribution and to provide a summary of the models. This systematic review protocol is aimed to examine the existing models and extracting rules and principles of mass casualty distribution. This study will comprehensively investigate existing papers with search phrases and terms including "mass casualty incident", distribution, evacuation, and Mesh terms directly corresponding to search phrases. No limitations on the type of studies, date of publication, or language of the relevant documents will be imposed. PubMed, Web of Science, Scopus, and Google Scholar will be searched to access the relevant documents. Included papers will be critically appraised by two independent reviewers. The data including incidents type, scene characteristics, patient features, pre-hospital resources, and hospital resources will be categorized. Subgroup analysis will be conducted when possible. To the best of our knowledge, no study has yet addressed the effects and interaction of contributing factors on the decision-making processes for casualty's distribution. This is the first study that comprehensively assesses and critically appraises the current models of casualty distribution. This study will provide evidences about models and criteria for casualty distribution following mass casualty incidents. PROSPERO Registration Number: CRD42016049115.

  18. [Triage--and the management of mass casualty incidents].

    PubMed

    Peters, Sigurd

    2010-01-01

    Triage ("sorting") will only be necessary in the setting of mass casualties and lack of sufficient paramedical and medical specialists as well as equipment. Triage means that the victims will be divided into four categories denoting urgency of treatment and chance of survival. The most experienced medical doctor or officer is responsible for the triage. Copyright (c) 2010. Published by Elsevier GmbH.

  19. Mass casualty tracking with air traffic control methodologies.

    PubMed

    Hoskins, Jason D; Graham, Ross F; Robinson, Duane R; Lutz, Clifford C; Folio, Les R

    2009-06-01

    An intrahospital casualty throughput system modeled after air traffic control (ATC) tracking procedures was tested in mass casualty exercises. ATC uses a simple tactile process involving informational progress strips representing each aircraft, which are held in bays representing each stage of flight to prioritize and manage aircraft. These strips can be reordered within the bays to indicate a change in priority of aircraft sequence. In this study, a similar system was designed for patient tracking. We compared the ATC model and traditional casualty tracking methods of paper and clipboard in 18 four-hour casualty scenarios, each with 5 to 30 mock casualties. The experimental and control groups were alternated to maximize exposure and minimize training effects. Results were analyzed with Mann-Whitney statistical analysis with p value < 0.05 (two-sided). The ATC method had significantly (p = 0.017) fewer errors in critical patient data (eg, name, social security number, diagnosis). Specifically, the ATC method better tracked the mechanism of injury, working diagnosis, and disposition of patients. The ATC method also performed considerably better with patient accountability during mass casualty scenarios. Data strips were comparable with the control method in terms of ease of use. In addition, participants preferred the ATC method to the control (p = 0.003) and preferred using the ATC method (p = 0.003) to traditional methods in the future. The ATC model more effectively tracked patient data with fewer errors when compared with the clipboard method. Application of these principles can enhance trauma management and can have application in civilian and military trauma centers and emergency rooms.

  20. Mass Casualty Incident Response and Aeromedical Evacuation in Antarctica

    PubMed Central

    Mills, Christopher N.; Mills, Gregory H.

    2011-01-01

    Antarctica is one of the most remote regions on Earth. Mass casualty incident (MCI) responses in Antarctica are prone to complications from multiple environmental and operational challenges. This review of the current status of MCI risks and response strategies for Antarctica focuses on aeromedical evacuation, a critical component of many possible MCI scenarios. Extreme cold and weather, a lack of medical resources and a multitude of disparate international bases all exert unique demands on MCI response planning. Increasing cruise ship traffic is also escalating the risk of MCI occurrence. To be successful, MCI response must be well coordinated and undertaken by trained rescuers, especially in the setting of Antarctica. Helicopter rescue or aeromedical evacuation of victims to off-continent facilities may be necessary. Currently, military forces have the greatest capacity for mass air evacuation. Specific risks that are likely to occur include structure collapses, vehicle incapacitations, vehicle crashes and fires. All of these events pose concomitant risks of hypothermia among both victims and rescuers. Antarctica’s unique environment requires flexible yet robust MCI response planning among the many entities in operation on the continent. PMID:21691470

  1. Mass casualty triage after an airplane crash near Amsterdam.

    PubMed

    Postma, Ingri L E; Weel, Hanneke; Heetveld, Martin J; van der Zande, Ineke; Bijlsma, Taco S; Bloemers, Frank W; Goslings, J Carel

    2013-08-01

    Triage is an important aspect of the management of mass casualty incidents. This study describes the triage after the Turkish Airlines Crash near Amsterdam in 2009. The results of the triage and the injuries of P3 casualties were evaluated. In addition, the role of the trauma mechanism and its effect on spinal immobilisation during transport was analysed. Retrospective analysis of investigational reports, ambulance forms, and medical charts of survivors of the crash. Outcomes were triage classification, type of injury, AIS, ISS, emergency interventions and the spinal immobilisation during transport. A minimal documentation of prehospital triage was found, and no exact numbers could be recollected. During inhospital triage 28% was triaged as P1, 10% had an ISS ≥ 16 and 3% met the modified Baxt criteria for emergency intervention. 40% was triaged P3, 72% had an ISS ≤ 8 and 63% was discharged from the Emergency Department after evaluation. In hospital over-triage was up to 89%. Critical mortality rate was 0%. Nine per cent of P3 casualties and 17% of 'walking' casualties had serious injuries. Twenty-two per cent of all casualties was transported with spinal immobilisation. Of the casualties diagnosed with spinal injury 22% was not transported with spinal immobilisation. After the Turkish Airlines Crash documentation of prehospital triage was minimal. According to the Baxt criteria the overtriage was high. Injuries sustained by plane crash survivors that seem minimally harmed must not be underestimated. Considering the high energy trauma mechanism, too little consideration was given to spinal immobilisation during transport. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Mechanical ventilation in mass casualty scenarios. Augmenting staff: project XTREME.

    PubMed

    Hanley, Michael E; Bogdan, Gregory M

    2008-02-01

    Disaster preparedness typically includes plans that address the need for surge capacity to manage mass-casualty events. A major concern of disaster preparedness in respiratory therapy focuses on responding to a sudden increase in the volume of patients who require mechanical ventilation. Plans for such disasters must include contingencies to address surge capacity in ventilator inventories and the respiratory therapy staff who will manage the ventilators. Tactics to address these situations include efforts to lower demand by transferring patients to other institutions as well as efforts to augment staffing levels. Staff can be augmented by mobilization of deployable teams of volunteers from outside the region and through exploitation of local resources. The latter includes strategies to recruit local respiratory therapists who are currently in either non-clinical or non-hospital-based positions and policies that optimize existing respiratory therapy resources within an institution by canceling elective surgeries, altering shift structure, and postponing vacations. An alternative approach would employ non-respiratory-therapy staff to assist in the management of patients with respiratory failure. Project XTREME (Cross-Training Respiratory Extenders for Medical Emergencies) is a cross-training program developed to facilitate training of non-respiratory-therapy health professionals to assist in the management of patients who require mechanical ventilation. It includes an interactive digital video disc as well as a competency validation laboratory and is designed to be performed at the time of an emergency. Pilot testing of the program suggests it is effective.

  3. Are surgical residents prepared for mass casualty incidents?

    PubMed

    Galante, Joseph M; Jacoby, Robert C; Anderson, John T

    2006-05-01

    We hypothesized that resident education is inadequate with respect to management of mass casualty incidents that may involve chemical, biological, and nuclear exposures. Chief level residents in surgery (n = 10), emergency medicine (n = 10), and anesthesia (n = 8) were asked to complete a survey questionnaire. Responses were tabulated and statistically analyzed with Mann-Whitney Rank Sum, Student's t test, and Kruskal-Wallis one-way analysis of variance. All of the residents were similar with respect to age, sex, and intended setting of clinical practice. Only a single resident reported military experience. Two residents (7.1%) had administered medical care while wearing a protective suit. Compared with emergency medicine residents, surgical residents reported significantly less formal teaching in mass casual incidents (P = 0.02), trauma triage (P = 0.01), and nuclear, biological, chemical agents (P = 0.002). When surgical residents were compared with anesthesia residents, there was significantly less training for surgical residents in nuclear, chemical, and biological agents (P = 0.02). Multiple/mass casualty incident experience did not differ between residents. However, the most common incident involved only three to five patients with blunt trauma. Emergency medicine residents were significantly more comfortable in treating patients with exposure to anthrax (P = 0.01), sarin (P = 0.04), and nuclear exposure (P = 0.01). Surgical residents have significantly less formal training in mass casualties, triage, and chemical, biological, and nuclear exposures than residents in other specialties. Therefore, surgical residents are less comfortable treating these types of patients. Because surgeons often are expected to take leadership roles in mass casualty incidents, surgical education should be modified to match or exceed that of other specialties.

  4. Management of blast ear injuries in mass casualty environments.

    PubMed

    Okpala, Nnaemeka

    2011-11-01

    To establish a management pathway for blast ear injuries in mass casualty environments and to review the management of ear injuries caused by blast. Relevant literature search on blast injury was performed through MEDLINE. Comprehensive review of management of blast injuries of the ear was undertaken. There was an overview of the pathophysiology of blast and detailed discussion of management of injuries of the external, middle, and inner ear. With any ear symptoms or injury, the patient should be referred to the otolaryngologist for further management. The management of blast injury should ensure detection at an early stage, potentially life-threatening cases in mass casualty situations and ensuring that subtle injuries affecting the ear are not missed.

  5. Scalable patients tracking framework for mass casualty incidents.

    PubMed

    Yu, Xunyi; Ganz, Aura

    2011-01-01

    We introduce a system that tracks patients in a Mass Casualty Incident (MCI) using active RFID triage tags and mobile anchor points (DM-tracks) carried by the paramedics. The system does not involve any fixed deployment of the localization devices while maintaining a low cost triage tag. The localization accuracy is comparable to GPS systems without incurring the cost of providing a GPS based device to every patient in the disaster scene.

  6. Disasters and mass casualties: I. General principles of response and management.

    PubMed

    Born, Christopher T; Briggs, Susan M; Ciraulo, David L; Frykberg, Eric R; Hammond, Jeffrey S; Hirshberg, Asher; Lhowe, David W; O'Neill, Patricia A

    2007-07-01

    Disaster planning and response to a mass casualty incident pose unique demands on the medical community. Because they would be required to confront many casualties with bodily injury and surgical problems, surgeons in particular must become better educated in disaster management. Compared with routine practice, triage principles in disasters require an entirely different approach to evaluation and care and often run counter to training and ethical values. An effective response to disaster and mass casualty events should focus on an "all hazards" approach, defined as the ability to adapt and apply fundamental disaster management principles universally to any mass casualty incident, whether caused by people or nature. Organizational tools such as the Incident Command System and the Hospital Incident Command System help to effect a rapid and coordinated response to specific situations. The United States federal government, through the National Response Plan, has the responsibility to respond quickly and efficiently to catastrophic incidents and to ensure critical life-saving assistance. International medical surgical response teams are capable of providing medical, surgical, and intensive care services in austere environments anywhere in the world.

  7. Disaster preparedness: Experience from a smoke inhalation mass casualty incident.

    PubMed

    Goh, Siang-Hiong; Tiah, Ling; Lim, Hoon-Chin; Ng, Elaine Kim-Choon

    2006-12-01

    We describe a modified triage system used in managing a smoke inhalation mass casualty incident that we recently encountered at our community hospital. The patients were triaged as priority 1, 2 or 3 on the basis of their symptoms, signs and circumstances at scene. In addition, the use of fibre-optic examinations of the upper airway, chest radiography and carboxyhaemoglobin levels with arterial blood gas analyses were used to aid in disposal plans. Of the 22 patients evacuated, 15 were triaged as priority 2 and the remaining seven as priority 3. None of the patients was identified as priority 1. All the priority 2 patients underwent further investigations. Those with mild upper airway oedema (four patients) or raised carboxyhaemoglobin levels (two patients) were admitted. Only one patient had both. Another patient who was a known asthmatic developed bronchospasm and was admitted as well. All six were admitted to the general ward with subsequent good recovery and were discharged within 3 days. The remaining nine priority 2 and seven priority 3 patients were discharged from the emergency department. These modified triage criteria, with selective use of fibre-optic examinations, chest radiography and arterial blood gas analyses with carboxyhaemoglobin levels, are useful in smoke inhalation mass casualty incidents without dermal burns. Systemic injury and poisoning by toxic fumes often coexist with airway burns and should not be overlooked. Lastly, disaster planning and frequent drills at both local and national levels will optimize the response to future mass casualty incidents.

  8. Bioterrorism and mass casualty preparedness in hospitals: United States, 2003.

    PubMed

    Niska, Richard W; Burt, Catharine W

    2005-09-27

    This study examined the content of hospital terrorism preparedness emergency response plans; whether those plans had been updated since September 11, 2001; collaboration of hospitals with outside organizations; clinician training in the management of biological, chemical, explosive, and nuclear exposures; drills on the response plans; and equipment and bed capacity. The National Hospital Ambulatory Medical Care Survey (NHAMCS) is an annual survey of a probability sample of approximately 500 non-Federal general and short-stay hospitals in the United States. A Bioterrorism and Mass Casualty Supplement was included in the 2003 survey and provided the data for this analysis. Almost all hospitals have plans for responding to natural disasters (97.3 percent). Most have plans for responding to chemical (85.5 percent), biological (84.8 percent), nuclear or radiological (77.2 percent), and explosive incidents (76.9 percent). About three-quarters of hospitals were integrated into community-wide disaster plans (76.4 percent), and 75.9 percent specifically reported a cooperative planning process with other local health care facilities. Despite these plans, only 46.1 percent reported written memoranda of understanding with these facilities to accept inpatients during a declared disaster. Hospitals varied widely in their plans for re-arranging schedules and space in the event of a disaster. Training for hospital incident command and smallpox, anthrax, chemical, and radiological exposures was ahead of training for other infectious diseases. The percentage of hospitals training their staff in any exposure varied from 92.1 percent for nurses to 49.2 percent for medical residents. Drills for natural disasters occurred more often than those for chemical, biological, explosive, nuclear, and epidemic incidents. More hospitals staged drills for biological attacks than for severe epidemics. Despite explosions being the most common form of terrorism, drills for these were staged by only

  9. Disaster planning: the basics of creating a burn mass casualty disaster plan for a burn center.

    PubMed

    Kearns, Randy D; Conlon, Kathe M; Valenta, Andrea L; Lord, Graydon C; Cairns, Charles B; Holmes, James H; Johnson, Daryhl D; Matherly, Annette F; Sawyer, Dalton; Skarote, Mary Beth; Siler, Sean M; Helminiak, Radm Clare; Cairns, Bruce A

    2014-01-01

    In 2005, the American Burn Association published burn disaster guidelines. This work recognized that local and state assets are the most important resources in the initial 24- to 48-hour management of a burn disaster. Historical experiences suggest there is ample opportunity to improve local and state preparedness for a major burn disaster. This review will focus on the basics of developing a burn surge disaster plan for a mass casualty event. In the event of a disaster, burn centers must recognize their place in the context of local and state disaster plan activation. Planning for a burn center takes on three forms; institutional/intrafacility, interfacility/intrastate, and interstate/regional. Priorities for a burn disaster plan include: coordination, communication, triage, plan activation (trigger point), surge, and regional capacity. Capacity and capability of the plan should be modeled and exercised to determine limitations and identify breaking points. When there is more than one burn center in a given state or jurisdiction, close coordination and communication between the burn centers are essential for a successful response. Burn surge mass casualty planning at the facility and specialty planning levels, including a state burn surge disaster plan, must have interface points with governmental plans. Local, state, and federal governmental agencies have key roles and responsibilities in a burn mass casualty disaster. This work will include a framework and critical concepts any burn disaster planning effort should consider when developing future plans.

  10. Assessing and Improving Hospital Mass-Casualty Preparedness: A No-Notice Exercise.

    PubMed

    Waxman, Daniel A; Chan, Edward W; Pillemer, Francesca; Smith, Timothy Wj; Abir, Mahshid; Nelson, Christopher

    2017-08-07

    In recent years, mass-casualty incidents (MCIs) have become more frequent and deadly, while emergency department (ED) crowding has grown steadily worse and widespread. The ability of hospitals to implement an effective mass-casualty surge plan, immediately and expertly, has therefore never been more important. Yet, mass-casualty exercises tend to be highly choreographed, pre-scheduled events that provide limited insight into hospitals' true capacity to respond to a no-notice event under real-world conditions. To address this gap, the US Department of Health and Human Services (Washington, DC USA), Office of the Assistant Secretary for Preparedness and Response (ASPR), sponsored development of a set of tools meant to allow any hospital to run a real-time, no-notice exercise, focusing on the first hour and 15 minutes of a hospital's response to a sudden MCI, with the goals of minimizing burden, maximizing realism, and providing meaningful, outcome-oriented metrics to facilitate self-assessment. The resulting exercise, which was iteratively developed, piloted at nine hospitals nationwide, and completed in 2015, is now freely available for anyone to use or adapt. This report demonstrates the feasibility of implementing a no-notice exercise in the hospital setting and describes insights gained during the development process that might be helpful to future exercise developers. It also introduces the use of ED "immediate bed availability (IBA)" as an objective, dynamic measure of an ED's physical capacity for new arrivals. Waxman DA , Chan EW , Pillemer F , Smith TWJ , Abir M , Nelson C . Assessing and improving hospital mass-casualty preparedness: a no-notice exercise. Prehosp Disaster Med. 2017;32(6):1-5.

  11. Implementing RFID technology in a novel triage system during a simulated mass casualty situation.

    PubMed

    Jokela, Jorma; Simons, Tomi; Kuronen, Pentti; Tammela, Juha; Jalasvirta, Pertti; Nurmi, Jouni; Harkke, Ville; Castrén, Maaret

    2008-01-01

    The purpose of this study is to determine the applicability of Radio Frequency Identification (RFID) technology and commercial cellular networks to provide an online triage system for handling mass casualty situations. This was tested by a using a pilot system for a simulated mass casualty situation during a military field exercise. The system proved to be usable. Compared to the currently used system, it also dramatically improves the general view of mass casualty situations and enhances medical emergency readiness in a military medical setting. The system can also be adapted without any difficulties by the civilian sector for the management of mass casualty disasters.

  12. Resource planning for ambulance services in mass casualty incidents: a DES-based policy model.

    PubMed

    Rauner, Marion S; Schaffhauser-Linzatti, Michaela M; Niessner, Helmut

    2012-09-01

    Due to an increasing number of mass casualty incidents, which are generally complex and unique in nature, we suggest that decision makers consider operations research-based policy models to help prepare emergency staff for improved planning and scheduling at the emergency site. We thus develop a discrete-event simulation policy model, which is currently being applied by disaster-responsive ambulance services in Austria. By evaluating realistic scenarios, our policy model is shown to enhance the scheduling and outcomes at operative and online levels. The proposed scenarios range from small, simple, and urban to rather large, complex, remote mass casualty emergencies. Furthermore, the organization of an advanced medical post can be improved on a strategic level to increase rescue quality, including enhanced survival of injured victims. In particular, we consider a realistic mass casualty incident at a brewery relative to other exemplary disasters. Based on a variety of such situations, we derive general policy implications at both the macro (e.g., strategic rescue policy) and micro (e.g., operative and online scheduling strategies at the emergency site) levels.

  13. Comparative analysis of showering protocols for mass-casualty decontamination.

    PubMed

    Amlot, Richard; Larner, Joanne; Matar, Hazem; Jones, David R; Carter, Holly; Turner, Elizabeth A; Price, Shirley C; Chilcott, Robert P

    2010-01-01

    A well-established provision for mass-casualty decontamination that incorporates the use of mobile showering units has been developed in the UK. The effectiveness of such decontamination procedures will be critical in minimizing or preventing the contamination of emergency responders and hospital infrastructure. The purpose of this study was to evaluate three empirical strategies designed to optimize existing decontamination procedures: (1) instructions in the form of a pictorial aid prior to decontamination; (2) provision of a washcloth within the showering facility; and (3) an extended showering period. The study was a three-factor, between-participants (or "independent") design with 90 volunteers. The three factors each had two levels: use of washcloths (washcloth/no washcloth), washing instructions (instructions/no instructions), and shower cycle duration (three minutes/six minutes). The effectiveness of these strategies was quantified by whole-body fluorescence imaging following application of a red fluorophore to multiple, discrete areas of the skin. All five showering procedures were relatively effective in removing the fluorophore "contaminant", but the use of a cloth (in the absence of instructions) led to a significant ( appox. 20%) improvement in the effectiveness of decontamination over the standard protocol (p <0.05). Current mass-casualty decontamination effectiveness, especially in children, can be optimized by the provision of a washcloth. This simple but effective approach indicates the value of performing controlled volunteer trials for optimizing existing decontamination procedures.

  14. Estimating shaking-induced casualties and building damage for global earthquake events: a proposed modelling approach

    USGS Publications Warehouse

    So, Emily; Spence, Robin

    2013-01-01

    Recent earthquakes such as the Haiti earthquake of 12 January 2010 and the Qinghai earthquake on 14 April 2010 have highlighted the importance of rapid estimation of casualties after the event for humanitarian response. Both of these events resulted in surprisingly high death tolls, casualties and survivors made homeless. In the Mw = 7.0 Haiti earthquake, over 200,000 people perished with more than 300,000 reported injuries and 2 million made homeless. The Mw = 6.9 earthquake in Qinghai resulted in over 2,000 deaths with a further 11,000 people with serious or moderate injuries and 100,000 people have been left homeless in this mountainous region of China. In such events relief efforts can be significantly benefitted by the availability of rapid estimation and mapping of expected casualties. This paper contributes to ongoing global efforts to estimate probable earthquake casualties very rapidly after an earthquake has taken place. The analysis uses the assembled empirical damage and casualty data in the Cambridge Earthquake Impacts Database (CEQID) and explores data by event and across events to test the relationships of building and fatality distributions to the main explanatory variables of building type, building damage level and earthquake intensity. The prototype global casualty estimation model described here uses a semi-empirical approach that estimates damage rates for different classes of buildings present in the local building stock, and then relates fatality rates to the damage rates of each class of buildings. This approach accounts for the effect of the very different types of buildings (by climatic zone, urban or rural location, culture, income level etc), on casualties. The resulting casualty parameters were tested against the overall casualty data from several historical earthquakes in CEQID; a reasonable fit was found.

  15. On constant alert: lessons to be learned from Israel's emergency response to mass-casualty terrorism incidents.

    PubMed

    Adini, Bruria; Peleg, Kobi

    2013-12-01

    In its short modern history, Israel has had to contend with numerous mass-casualty incidents caused by terrorism. As a result, it has developed practical national preparedness policies for responding to such events. Israel's Supreme Health Authority, a committee of the Ministry of Health, coordinates emergency management nationwide. All emergency personnel, health care providers, and medical facilities operate under national policies designed to ensure a swift and coordinated response to any incident, based on an "all hazards" approach that emphasizes core elements commonly encountered in mass-casualty incidents. Israel's emergency management system includes contingency planning, command and control, centrally coordinated response, cooperation, and capacity building. Although every nation is unique, many of the lessons that Israel has learned may be broadly applicable to preparation for mass-casualty incidents in the United States and other countries.

  16. How will military/civilian coordination work for reception of mass casualties from overseas?

    PubMed

    Mackenzie, Colin; Donohue, John; Wasylina, Philip; Cullum, Woodrow; Hu, Peter; Lam, David M

    2009-01-01

    In Maryland, there have been no military/civilian training exercises of the Medical Mutual Aid Agreement for >20 years. The aims of this paper are to describe the National Disaster Medical System (NDMS), to coordinate military and civilian medical mutual aid in response to arrival of overseas mass casualties, and to evaluate the mass-casualty reception and bed "surge" capacity of Maryland NDMS Hospitals. Three tabletop exercises and a functional exercise were performed using a simulated, overseas, military mass-casualty event. The first tabletop exercise was with military and civilian NMDS partners. The second tested the revised NDMS activation plan. The third exercised the Authorities of State Emergency Medical System and Walter Reed Army Medical Center Directors of Emergency Medicine over Maryland NDMS hospitals, and their Medical Mutual Aid Agreement. The functional exercise used Homeland Security Exercise Evaluation Program tools to evaluate reception, triage, staging, and transportation of 160 notional patients (including 20 live, moulaged "patients") and one canine. The first tabletop exercise identified deficiencies in operational protocols for military/civilian mass-casualty reception, triage, treatment, and problems with sharing a Unified Command. The second found improvements in the revised NDMS activation plan. The third informed expectations for NDMS hospitals. In the functional exercise, all notional patients were received, triaged, dispatched, and accounted in military and five civilian hospitals within two hours. The canine revealed deficiencies in companion/military animal reception, holding, treatment, and evacuation. Three working groups were suggested: (1) to ensure 100% compliance with triage tags, patient accountability, and return of equipment used in mass casualty events and exercises; (2) to investigate making information technology and imaging networks available for Emergency Operation Centers and Incident Command; and (3) to establish NDMS

  17. Education and training of medical students for mass casualties situations.

    PubMed

    Adler, J

    1979-06-01

    During the academic years I 9 75 and I 9 76 an interdisciplinary course in mass casualty management was given to sixth year medical students at the Hebrew University-Hadassah Medical School in Jerusalem. The course included introductory lectures in definition of types of disasters, objectives in disaster intervention, description of local and national rescue organizations. Special importance was paid to mage of casualties and to a centralized system of evacuation from the disaster site. Further, hospital planning and deployment, stressing the role of the Emergency Room physician. The specific approach to multiple injuries including neurosurgical, orthopedic, abdominal, chest and soft tissue wounds was discussed in a panel meeting. Stress intervention and a comprehensive lecture on public health problems concluded this part of the course. The last half-day was devoted to a practical exercise, simulating a town severely damaged by an earthquake. Although the course was an elective one, it was extremely well attended by the students, and its implementation was enthusiastically performed by both teachers and students.

  18. Can a pediatric trauma center improve the response to a mass casualty incident?

    PubMed

    Barthel, Erik R; Pierce, James R; Goodhue, Catherine J; Burke, Rita V; Ford, Henri R; Upperman, Jeffrey S

    2012-10-01

    Recent events including the 2001 terrorist attacks on New York; Hurricane Katrina; the 2010 Haitian and Chilean earthquakes; and the 2011 earthquake, tsunami, and nuclear disaster in Japan have reminded disaster planners and responders of the tremendous scale of mass casualty disasters and their resulting human devastation. Although adult disaster medicine is a well-developed field with roots in wartime medicine, we are increasingly recognizing that children may comprise up to 50% of disaster victims, and response mechanisms are often designed without adequate preparation for the number of pediatric victims that can result. In this short educational review, we explore the differences between the pediatric and adult disaster and trauma populations, the requirements for designation of a site as a pediatric trauma center (PTC), and the magnitude of the problem of pediatric disaster patients as described in the literature, specifically as it pertains to the availability and use of designated PTCs as opposed to trauma centers in general. We also review our own experience in planning and simulating pediatric mass casualty events and suggest strategies for preparedness when there is no PTC available. We aim to demonstrate from this brief survey that the availability of a designated PTC in the setting of a mass casualty disaster event is likely to significantly improve the outcome for the pediatric demographic of the affected population. We conclude that the relative scarcity of disaster data specific to children limits epidemiologic study of the pediatric disaster population and offer suggestions for strategies for future study of our hypothesis. Systematic review, level III.

  19. Ultrasonographic applications after mass casualty incident caused by Wenchuan earthquake.

    PubMed

    Dan, Deng; Mingsong, Liao; Jie, Tao; Xiaobo, Wu; Zhong, Chen; Yan, Liang; Xiaojin, Lai; Ming, Chang

    2010-06-01

    Ultrasonography has been widely applied in clinical settings, and its role in the assessment of trauma has been approved. However, there are very few reports about its role in the management of mass casualties. In our hospital, we retrospectively analyzed the application, the methods, and the role of ultrasonography in rescuing the Wenchuan earthquake victims. On a total of 3,307 wounded patients, 1,207 were examined by ultrasonography, and on a part of them, a follow-up was also performed. A total number of 1,386 ultrasound examinations were performed. Among them, 115 patients received ultrasound-guided interventional diagnosis and treatments. Ultrasound screening detected 23 cases of hemoperitoneum, 45 cases of pleural effusion (blood), 1 case of traumatic intimal tear of femoral artery, 3 cases of deep veins phlebothrombosis of lower limbs, 12 cases of deep-part hematoma of soft tissues. In five cases of negative results by ultrasonography, visceral injury was confirmed later by surgery or computed tomography or contrast-enhanced ultrasonography. All the ultrasound-guided interventional treatments were performed successfully, without any serious complication. The detection rate of trauma-related diseases was 6.96% (84 of 1,207) without false positive; however, the false negative rate was 5.6% (5 of 89). The bedside ultrasound became the preferred examination for the majority of injuries in middle and later stage after earthquake (72 hours to 6 weeks), accounting for 73.9% (458 of 620) of examinations. Ultrasonography-based FAST method was the primary examination tool of trauma in the early stage after earthquake. In our hospital, ultrasonography was widely used in the triage of earthquake victims, bedside examination of severe cases, and interventional treatments. The advantages of ultrasonography such as convenience, noninvasiveness, high accuracy, and repeatability have been sufficiently demonstrated in this mass casualty, where ultrasonography played a great

  20. Orthopaedic triage during natural disasters and mass casualties: do scoring systems matter?

    PubMed

    Wolfson, Nikolaj

    2013-08-01

    Mass casualty events, either natural disasters or man-made, are associated with extremities injuries. The treating surgeon often faces a challenging decision: can the affected extremity be saved or amputated? The following article will present the author's view on the subject of triage and the use of scoring systems in the decision-making process whether to salvage or amputate an affected extremity. The author will analyse the existing scoring systems and emphasise significance of the regional factors: geographical, cultural and level of health care, as factors playing roles in this process.

  1. Mass Casualty Incident Management Preparedness: A Survey of the American College of Surgeons Committee on Trauma.

    PubMed

    Lewis, Aaron M; Sordo, Salvador; Weireter, Leonard J; Price, Michelle A; Cancio, Leopoldo; Jonas, Rachelle B; Dent, Daniel L; Muir, Mark T; Aydelotte, Jayson D

    2016-12-01

    Mass casualty incidents (MCIs) are events resulting in more injured patients than hospital systems can handle with standard protocols. Several studies have assessed hospital preparedness during MCIs. However, physicians and trauma surgeons need to be familiar with their hospital's MCI Plan. The purpose of this survey was to assess hospitals' and trauma surgeon's preparedness for MCIs. Online surveys were e-mailed to members of the American College of Surgeons committee on Trauma Ad Hoc Committee on Disaster and Mass Casualty Management before the March 2012 meeting. Eighty surveys were analyzed (of 258). About 76 per cent were American College of Surgeons Level I trauma centers, 18 per cent were Level II trauma centers. Fifty-seven per cent of Level I and 21 per cent of Level II trauma centers had experienced an MCI. A total of 98 per cent of respondents thought it was likely their hospital would see a future MCI. Severe weather storm was the most likely event (95%), followed by public transportation incident (86%), then explosion (85%). About 83 per cent of hospitals had mechanisms to request additional physician/surgeons, and 80 per cent reported plans for operative triage. The majority of trauma surgeons felt prepared for an MCI and believed an event was likely to occur in the future. The survey was limited by the highly select group of respondents and future surveys will be necessary.

  2. [Mass casualty incidents : preparedness of German soccer arenas].

    PubMed

    Luiz, T; Preisegger, T; Madler, C

    2013-04-01

    Each weekend soccer arenas attract hundreds of thousands of spectators with the German Bundesliga being one of the most attractive sport series worldwide. In 2006 when the FIFA soccer World Cup™ took place in Germany, the precautions in the participating arenas against mass casualty incidents (MCI) reached a level formerly unknown in Germany. However, it is unknown how soccer arenas are prepared to deal with such incidents in everyday life. In 2011 all German major soccer league clubs were questioned about medical precautions in case of MCIs occurring in the stadium. The questionnaire included the following items: stadium capacity, the number of paramedic personnel, emergency physicians and ambulance vehicles, the command and communication structures, the availability of MCI plans, recent MCI drills and the frequency of MCI. Out of 39, 15 (38.4 %) participated, 50 % from the first league and 20.8 % from the second league. The mean stadium capacity was 41,800 spectators (minimum 10,600, maximum 80,700). Depending on the number of spectators and the individual risk score of the match the following resources were available within the stadiums (average, minimum, maximum,): emergency medical technicians 61-67 (15, 120), emergency physicians 2.3-2.5 (1, 5) and transport capacity 5.3-5.8 patients (1, 15). In 14 arenas (93.3 %) the medical personnel were trained in mass casualty care and had prepared MCI operation schedules. All stadiums had mission control centers equipped with a variety of wired and wireless communication tools, although only eight (52.3 %) arenas used a joint command structure and five (33.3 %) arenas reported MCIs (defined as a scenario involving more than 10 patients) within the past 10 years. In 40 % of the participants the last MCI-related exercise was conducted more than 36 months ago. Most of the participating arenas were adequately staffed to manage the first phase of MCIs but in contrast command structures and transport capacities often

  3. Disasters and mass casualties: II. explosive, biologic, chemical, and nuclear agents.

    PubMed

    Born, Christopher T; Briggs, Susan M; Ciraulo, David L; Frykberg, Eric R; Hammond, Jeffrey S; Hirshberg, Asher; Lhowe, David W; O'Neill, Patricia A; Mead, Joann

    2007-08-01

    Terrorists' use of explosive, biologic, chemical, and nuclear agents constitutes the potential for catastrophic events. Understanding the unique aspects of these agents can help in preparing for such disasters with the intent of mitigating injury and loss of life. Explosive agents continue to be the most common weapons of terrorists and the most prevalent cause of injuries and fatalities. Knowledge of blast pathomechanics and patterns of injury allows for improved diagnostic and treatment strategies. A practical understanding of potential biologic, chemical, and nuclear agents, their attendant clinical symptoms, and recommended management strategies is an important prerequisite for optimal preparation and response to these less frequently used agents of mass casualty. Orthopaedic surgeons should be aware of the principles of management of catastrophic events. Stress is less an issue when one is adequately prepared. Decontamination is essential both to manage victims and prevent further spread of toxic agents to first responders and medical personnel. It is important to assess the risk of potential threats, thereby allowing disaster planning and preparation to be proportional and aligned with the actual casualty event.

  4. Identifying Meningitis During an Anthrax Mass Casualty Incident: Systematic Review of Systemic Anthrax Since 1880

    PubMed Central

    Katharios-Lanwermeyer, Stefan; Holty, Jon-Erik; Person, Marissa; Sejvar, James; Haberling, Dana; Tubbs, Heather; Meaney-Delman, Dana; Pillai, Satish K.; Hupert, Nathaniel; Bower, William A.; Hendricks, Katherine

    2016-01-01

    BACKGROUND Bacillus anthracis, the causative agent of anthrax, is a potential bioterrorism agent. Anthrax meningitis may be a manifestation of B. anthracis infection, has high mortality, and requires more aggressive treatment than anthrax without meningitis. Rapid identification and treatment of anthrax meningitis are essential for successful management of an anthrax mass casualty incident. METHODS Three hundred six published reports from 1880 through 2013 met pre-defined inclusion criteria. We calculated descriptive statistics for abstracted cases and conducted multivariable regression on separate derivation and validation cohorts to identify clinical diagnostic and prognostic factors for anthrax meningitis. RESULTS One hundred thirty-two of 363 (36%) cases with systemic anthrax met anthrax meningitis criteria. Severe headache, altered mental status, meningeal signs, and other neurological signs at presentation independently predicted meningitis in the derivation cohort and are proposed as a four-item screening tool for use during mass casualty incidents. Presence of any one factor on admission had a sensitivity for finding anthrax meningitis of 89% (83%) in the adult (pediatric) validation cohorts. Anthrax meningitis was unlikely in the absence of any of these signs or symptoms ([LR−]=0.12 [0.19] for adult [pediatric] cohorts), while presence of two or more factors made meningitis very likely ([LR+]=26.5 [29.2]). Survival of anthrax meningitis was predicted by treatment with a bactericidal agent (P=0.005) and use of multiple antimicrobials (P=0.012). CONCLUSIONS We developed an evidence-based triage tool for screening patients for meningitis during an anthrax mass casualty incident; its use could improve both patient outcomes and resource allocation in such an event. PMID:27025833

  5. Assessing hospital preparedness using an instrument based on the Mass Casualty Disaster Plan Checklist: results of a statewide survey.

    PubMed

    Higgins, Wayne; Wainright, Charles; Lu, Ning; Carrico, Ruth

    2004-10-01

    Hospitals would play a critical role in a weapon of mass destruction (WMD) event. The purpose of this study is to assess preparedness for mass casualty events in short-term and long-term hospitals in Kentucky. All short-term and long-term hospitals in Kentucky were surveyed using an instrument based on the Mass Casualty Disaster Plan Checklist and a brief supplemental bioterrorism preparedness questionnaire based on a checklist developed for the Agency for Healthcare Research and Quality. Responses were received from 116 of the 118 (98%) hospitals surveyed. Hospitals reported surge capacity equal to 27% of licensed beds, and virtually all respondents were engaged in planning for weapons of mass destruction events. However, advanced planning and preparation were less common. Large regional differences were observed, especially in the area of pharmaceutical planning. Preparedness planning in general and pharmaceutical management planning in particular were more advanced in counties participating in the Metropolitan Medical Response System Program (MMRS). Hospital mass casualty preparedness efforts were in an early stage of development at the time of this survey, and some critical capabilities, such as isolation, decontamination, and syndromic surveillance were clearly underdeveloped. Preparedness planning was more advanced among hospitals located in MMRS counties.

  6. Pre-hospital management of mass casualty civilian shootings: a systematic literature review.

    PubMed

    Turner, Conor D A; Lockey, David J; Rehn, Marius

    2016-11-08

    Mass casualty civilian shootings present an uncommon but recurring challenge to emergency services around the world and produce unique management demands. On the background of a rising threat of transnational terrorism worldwide, emergency response strategies are of critical importance. This study aims to systematically identify, describe and appraise the quality of indexed and non-indexed literature on the pre-hospital management of modern civilian mass shootings to guide future practice. Systematic literature searches of PubMed, Cochrane Database of Systematic Reviews and Scopus were conducted in conjunction with simple searches of non-indexed databases; Web of Science, OpenDOAR and Evidence Search. The searches were last carried out on 20 April 2016 and only identified those papers published after the 1 January 1980. Included documents had to contain descriptions, discussions or experiences of the pre-hospital management of civilian mass shootings. From the 494 identified manuscripts, 73 were selected on abstract and title and after full text reading 47 were selected for inclusion in analysis. The search yielded reports of 17 mass shooting events, the majority from the USA with additions from France, Norway, the UK and Kenya. Between 1994 and 2015 the shooting of 1649 people with 578 deaths at 17 separate events are described. Quality appraisal demonstrated considerable heterogeneity in reporting and revealed limited data on mass shootings globally. Key themes were identified to improve future practice: tactical emergency medical support may harmonise inner cordon interventions, a need for inter-service education on effective haemorrhage control, the value of senior triage operators and the need for regular mass casualty incident simulation.

  7. Telemedical support of prehospital emergency care in mass casualty incidents.

    PubMed

    Plischke, M; Wolf, K H; Lison, T; Pretschner, D P

    1999-09-09

    In the German emergency medical service system (EMSS) medical treatment can be improved in most of mass casualty incidents (MCI). Currently, the incident commander who is responsible for classification of the victims (depending on their urgency and condition, the so called triage) and ordered transportation uses paper-based documentation. Triage tags are used to identify and classify patients and gather treatment information. This can cause problems in medical treatment and in transportation of injured victims. Object-oriented modelling, simulation, and visualisation of processes can show deficits in treatment and data processing and thereby help to optimise medical workflow and logistics. If documentation by paramedics and emergency physicians is done electronically, all patient records could be send to a telemedical centre for central data administration. A telemedical supported triage tag helps identifying victims and managing detailed identification protocols. The paper-based documentation in emergency would become obsolete, if hospitals can query all protocols, diagnoses, and findings from the telemedical centre. Safety and security aspects can be guaranteed. The complete medical treatment workflow can be supported by telemedicine. Therefore, in case of MCI, telemedicine can optimise medical treatment and exonerate the paramedics from unnecessary documentation.

  8. Drones at the service for training on mass casualty incident

    PubMed Central

    Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo

    2017-01-01

    Abstract Mass casualty incidents (MCI) are characterized by a large number of victims with respect to the resources available. In this study, we aimed to analyze the changes produced in the self-perception of students who were able to visualize aerial views of a simulation of a MCI. A simulation study, mixed method, was performed to compare the results from an ad hoc questionnaire. The 35 students from the Emergency Nursing Master from the UCAM completed a questionnaire before and after watching an MCI video with 40 victims in which they had participated. The main variable measured was the change in self-perception (CSP). The CSP occurred in 80% (28/35) of the students (P = .001). Students improved their individual (P = .001) and group (P = .006) scores. They also described that their personal performance had better results than the group performance (P = .047). The main conclusion of this study is that drones could lead to CSP and appraisal of the MCI simulation participants. PMID:28658106

  9. Development of Mass-casualty Life Support-CBRNE (MCLS-CBRNE) in Japan.

    PubMed

    Anan, Hideaki; Otomo, Yasuhiro; Kondo, Hisayoshi; Homma, Masato; Koido, Yuichi; Morino, Kazuma; Oshiro, Kenichi; Harikae, Kiyokazu; Akasaka, Osamu

    2016-10-01

    This report outlines the need for the development of an advanced course in mass-casualty life support (MCLS) and introduces the course content. The current problems with education on disasters involving chemical agents, biological agents, radiation/nuclear attacks, or explosives (CBRNE) in Japan are presented. This newly developed "MCLS-CBRNE" program was created by a Ministry of Health, Labour, and Welfare (Tokyo, Japan) research group based on these circumstances. Modifications were then made after a trial course. Training opportunities for relevant organizations to learn how to act at a CBRNE disaster site currently are lacking. The developed course covers initial responses at a disaster site. This one-day training course comprises lectures, three tabletop simulations, and practical exercises in pre-decontamination triage and post-decontamination triage. With regard to field exercises conducted to date, related organizations have experienced difficulties in understanding each other and adapting their approaches. Tabletop simulations provide an opportunity for participants to learn how organizations working on-site, including fire, police, and medical personnel, act with differing goals and guiding principles. This course appears useful as a means for relevant organizations to understand the importance of developing common guidelines. The MCLS-CBRNE training is proposed to support CBRNE disaster control measures during future events. Anan H , Otomo Y , Kondo H , Homma M , Koido Y , Morino K , Oshiro K , Harikae K , Akasaka O . Development of mass-casualty life support-CBRNE (MCLS-CBRNE) in Japan. Prehosp Disaster Med. 2016;31(5):547-550.

  10. Management of conventional mass casualty incidents: ten commandments for hospital planning.

    PubMed

    Lynn, Mauricio; Gurr, Daniel; Memon, Abdul; Kaliff, Jennifer

    2006-01-01

    The successful management of mass casualty incidents (MCIs) requires standardization of planning, training, and deployment of response. Recent events in the United States, most importantly the Hurricane season in 2005, demonstrated a lack of a unified response plan at local, regional, state, and federal levels. A standard Israeli protocol for hospital preparedness for conventional MCIs, produced by the Office of Emergency Preparedness of the Israeli Ministry of Health, has been reviewed, modified, adapted, and tested in both drills and actual events at a large university medical center in the United States. Lessons learned from this process are herein presented as the10 most important steps (ie, Commandments) to follow when preparing hospitals to be able to respond to conventional MCIs. The standard Israeli emergency protocols have proved to be universally adaptable, flexible, and designed to be adapted by any healthcare institution, regardless of its size and location.

  11. Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

    PubMed

    Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

    2012-04-01

    The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

  12. Policies for managing emergency medical services in mass casualty incidents.

    PubMed

    Adini, B; Bodas, M; Nilsson, H; Peleg, K

    2017-09-01

    Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of >80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents' origin country. 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

    PubMed

    Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

    2014-10-01

    On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

  14. Precision of in-hospital triage in mass-casualty incidents after terror attacks.

    PubMed

    Ashkenazi, Itamar; Kessel, Boris; Khashan, Tawfik; Haspel, Jacob; Oren, Meir; Olsha, Oded; Alfici, Ricardo

    2006-01-01

    Proper management of mass-casualty incidents (MCIs) relies on triage as a critical component of the disaster plan. [corrected] The objective of this study was to assess the precision of triage in mass-casualty incidents. The precision of decisions made by two experienced triage officers was examined in two large MCIs. These decisions were compared to the real severity of injury as defined by the Israeli Defence Forces (IDF) classification of severity of injuries and the Injury Severity Score (ISS). Two experienced trauma physicians triaged a total of 94 casualties into 77 mild, seven moderate, and 10 severe casualties. Based on the IDF criteria, there were 74 mild, five moderate, and 15 severe casualties. Based on ISS scoring, there were 78 mild (ISS <9), five moderate (9 < or = ISS < 16), and 11 severe (ISS <16) casualties. Of 15 severely injured victims defined by the IDF classification of injury severity, the triage officers identified only seven (47%). Primary triage, even when carried out by experienced trauma physicians, can be unreliable in a MCI.

  15. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    PubMed

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.

  16. Perceived preparedness for a mass casualty disaster in the United States: a survey.

    PubMed

    Glick, J; Birnbaum, M L

    1998-01-01

    A mass casualty disaster (MCD) never has occurred in the United States, but such an event remains a fearful possibility. The purpose of this study was to establish baseline information concerning the perceptions relative to the capabilities of the United States to respond to a MCD of persons most likely to involved in the responses to such an event when it does occur. A survey was constructed in 1995 to query the perceptions of persons in authority in federal, state, and local agencies who would participate in the medical responses to a MCD. Participants were asked to select the most likely scenario, a hurricane or earthquake, that could generate 30,000 casualties within their respective region. The survey requested respondent's perceptions as to the timing of the federal responses and the quality and sufficiency of these responses. The survey also sought information about the availability of plans to meet such a catastrophe in the region, and the frequency with which such plans have been exercised. Responses were grouped by phase of the responses and whether the respondents were employed by federal, state, or local agencies. Descriptive statistics were used to summarize the data. When appropriate, a one-tailed t-test was used to compare the responses of the groups. A p-value = 0.05 was considered statistically significant. A total of 104 surveys were distributed of which 88 were completed and returned (85%). Both the federal and state respondents had considerable experienced in this area. Overall, the federal respondents were more optimistic about the availability, utility, and timely arrival of federal resources to assist regions in meeting the medical needs. In each of the three phases of MCD responses evaluated (medical response, patient evacuation, and definitive care), there was concern that there were insufficient resources to meet the requirements. States and local respondents perceived that initially, they will be on their own for field rescue, life

  17. Wireless Vital Sign Sensor Network Simulations for Mass Casualty Response

    DTIC Science & Technology

    2013-11-27

    Casualty, Network Simulation 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT: Unclassified 18. NUMBER OF PAGES 19 19a. NAME OF... security takes priority over medical treatment of the wounded, so it assumed that only two responders are available to provide medical care during...in ZigBee products. Since ZigBee software stacks are widely available and since a standard exists for ZigBee use in healthcare, it is a very

  18. Prophylaxis for blood-borne diseases during the London 7/7 mass casualty terrorist bombing: a review and the role of bioethics.

    PubMed

    Edwards, Dafydd S; Barnett-Vanes, A; Narayan, N; Patel, H D L

    2016-10-01

    The suicide bombings in London on 7 July 2005 resulted in a mass casualty situation. Over 50% of casualties were treated at the Royal London Hospital where clinicians witnessed large numbers of severely injured patients. In some casualties human biological foreign material was found embedded in the soft tissue originating from the suicide bombers or other casualties. This had the potential of placing individuals at risk of transmission of blood-borne diseases. Advances in the fields of medicine and biology have led to increased survivorship in the context of trauma and mass casualty incidents. This has resulted in the emergence of ethical scenarios surrounding patient management. A systematic review of the literature of the 7/7 bombings, and suicide bombings reported globally, where biological implantation is noted, was performed to examine the medicolegal issues arising during such attack. Twelve casualties with human tissue implanted were recorded in the 7/7 bombings. While all patients at risk were given prophylaxis based on recommendations by the Health Protection Agency, several ethical considerations surfaced as a result. In this paper, we compare the sequence of events and the management process of the victims of the 7/7 bombings and the evidence-based research regarding blood-borne infection transmission. Furthermore, it explores the ethical dilemmas, experienced by the senior author on 7/7, surrounding prophylaxis for blood-borne diseases and protocols to avoid confusion over best practice in future bombing incidents.

  19. Preparing South Carolina Emergency Departments for Mass Casualties with an Emphasis on the Planning Process

    DTIC Science & Technology

    2013-03-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited PREPARING SOUTH...CAROLINA EMERGENCY DEPARTMENTS FOR MASS CASUALTIES WITH AN EMPHASIS ON THE PLANNING PROCESS by Colleen Mary Donovan March 2013 Thesis ...March 2013 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE PREPARING SOUTH CAROLINA EMERGENCY DEPARTMENTS FOR MASS

  20. Terrorism, trauma, and mass casualty triage: how might we solve the latest mind-body problem?

    PubMed

    Engel, Charles C; Locke, Steven; Reissman, Dori B; DeMartino, Robert; Kutz, Ilan; McDonald, Michael; Barsky, Arthur J

    2007-06-01

    The global war on terrorism has led to increased concern about the ability of the U.S. healthcare system to respond to casualties from a chemical, biological, or radiological agent attack. Relatively little attention, however, has focused on the potential, in the immediate aftermath of such an attack, for large numbers of casualties presenting to triage points with acute health anxiety and idiopathic physical symptoms. This sort of "mass idiopathic illness" is not a certain outcome of chemical, biological, or radiological attack. However, in the event that this phenomenon occurs, it could result in surges in demand for medical evaluations that may disrupt triage systems and endanger lives. Conversely, if continuous primary care is not available for such patients after initial triage, many may suffer with unrecognized physical and emotional injuries and illness. This report is the result of an expert planning initiative seeking to facilitate triage protocols that will address the possibility of mass idiopathic illness and bolster healthcare system surge capacity. The report reviews key triage assumptions and gaps in knowledge and offers a four-stage triage model for further discussion and research. Optimal triage approaches offer flexibility and should be based on empirical studies, critical incident modeling, lessons from simulation exercises, and case studies. In addition to staging, the proposed triage and longitudinal care model relies on early recognition of symptoms, development of a registry, and use of non-physician care management to facilitate later longitudinal followup and collaboration between primary care and psychiatry for the significant minority of patients who develop persistent idiopathic symptoms associated with reduced functional status.

  1. Panel 2.5: mass-casualty management and hospital care.

    PubMed

    Borra, Agostino; Perez, Luis Jorge; Min, Tin; Puavilai, Wilai; Seo, Norimasa; Tipsunthonsak, Nakhon

    2005-01-01

    This is a summary of the presentations and discussion of Panel 2.5, Mass-Casualty Management and Hospital Care of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to mass-casualty management and hospital care as pertain to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) recommendations; and (3) conclusions. Subsections of the conclusion section include: (1) lessons learned; (2) what was done well?; and (3) what could have been done better?.

  2. Mass-casualty, terrorist bombings: implications for emergency department and hospital emergency response (Part II).

    PubMed

    Halpern, Pinchas; Tsai, Ming-Che; Arnold, Jeffrey L; Stok, Edita; Ersoy, Gurkan

    2003-01-01

    This article reviews the implications of mass-casualty, terrorist bombings for emergency department (ED) and hospital emergency responses. Several practical issues are considered, including the performance of a preliminary needs assessment, the mobilization of human and material resources, the use of personal protective equipment, the organization and performance of triage, the management of explosion-specific injuries, the organization of patient flow through the ED, and the efficient determination of patient disposition. As long as terrorists use explosions to achieve their goals, mass-casualty, terrorist bombings remain a required focus for hospital emergency planning and preparedness.

  3. Does self-reporting facilitate history taking in food poisoning mass-casualty incidents?

    PubMed

    Hsu, Ya-I; Huang, Ying C

    2014-08-01

    questions were scored "good" in comprehensibility. Self-reporting of symptoms can shorten the time of history taking during a food poisoning mass-casualty event without sacrificing the completeness of information.

  4. Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident.

    PubMed

    Wachira, Benjamin W; Abdalla, Ramadhani O; Wallis, Lee A

    2014-10-01

    At approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital. This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.

  5. Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing.

    PubMed

    El Sayed, Mazen; Chami, Ali F; Hitti, Eveline

    2017-09-20

    Mass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital's existing disaster preparedness plan. Casualties' arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital's resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2017; page 1 of 7).

  6. Clinical review: The role of the intensive care physician in mass casualty incidents: planning, organisation, and leadership

    PubMed Central

    Shirley, Peter J; Mandersloot, Gerlinde

    2008-01-01

    There is a long-standing, broad assumption that hospitals will ably receive and efficiently provide comprehensive care to victims following a mass casualty event. Unfortunately, the majority of medical major incident plans are insufficiently focused on strategies and procedures that extend beyond the pre-hospital and early-hospital phases of care. Recent events underscore two important lessons: (a) the role of intensive care specialists extends well beyond the intensive care unit during such events, and (b) non-intensive care hospital personnel must have the ability to provide basic critical care. The bombing of the London transport network, while highlighting some good practices in our major incident planning, also exposed weaknesses already described by others. Whilst this paper uses the events of the 7 July 2005 as its point of reference, the lessons learned and the changes incorporated in our planning have generic applications to mass casualty events. In the UK, the Department of Health convened an expert symposium in June 2007 to identify lessons learned from 7 July 2005 and disseminate them for the benefit of the wider medical community. The experiences of clinicians from critical care units in London made a large contribution to this process and are discussed in this paper. PMID:18492221

  7. Mass Casualty Decontamination in the United States: An Online Survey of Current Practice

    PubMed Central

    Power, Sarah; Symons, Charles; Carter, Holly; Jones, Emma; Larner, Joanne; Matar, Hazem; Chilcott, Robert P.

    2016-01-01

    Mass casualty decontamination is a public health intervention that would be employed by emergency responders following a chemical, biological, or radiological incident. The decontamination of large numbers of casualties is currently most often performed with water to remove contaminants from the skin surface. An online survey was conducted to explore US fire departments' decontamination practices and their preparedness for responding to incidents involving mass casualty decontamination. Survey respondents were asked to provide details of various aspects of their decontamination procedures, including expected response times to reach casualties, disrobing procedures, approaches to decontamination, characteristics of the decontamination showering process, provision for special populations, and any actions taken following decontamination. The aim of the survey was to identify any differences in the way in which decontamination guidance is implemented across US states. Results revealed that, in line with current guidance, many US fire departments routinely use the “ladder-pipe system” for conducting rapid, gross decontamination of casualties. The survey revealed significant variability in ladder-pipe construction, such as the position and number of fire hoses used. There was also variability in decontamination characteristics, such as water temperature and water pressure, detergent use, and shower duration. The results presented here provide important insights into the ways in which implementation of decontamination guidance can vary between US states. These inconsistencies are thought to reflect established perceived best practices and local adaptation of response plans to address practical and logistical constraints. These outcomes highlight the need for evidence-based national guidelines for conducting mass casualty decontamination. PMID:27442794

  8. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study.

    PubMed

    Boonthep, Nuttapong; Intharachat, Suthee; Iemsomboon, Tassanee

    2012-01-03

    Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS) regarding Thai military personnel injured in the mass casualty incident (MCI) April 10, 2010. A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR) of ISS comparing injured body region categories. In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%). These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%). A total of 18 patients (11.7%) had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS). However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04), abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P < 0.01), head & neck injury (adjusted OR = 13.8; 95% CI, 2.4-80.4; P < 0.01) and chest injury (adjusted OR = 9.9; 95% CI, 2.1-47.3; P < 0.01). Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future.

  9. Factors influencing injury severity score regarding Thai military personnel injured in mass casualty incident April 10, 2010: lessons learned from armed conflict casualties: a retrospective study

    PubMed Central

    2012-01-01

    Background Political conflicts in Bangkok, Thailand have caused mass casualties, especially the latest event April 10, 2010, in which many military personnel were injured. Most of them were transferred to Phramongkutklao Hospital, the largest military hospital in Thailand. The current study aimed to assess factors influencing Injury Severity Score (ISS) regarding Thai military personnel injured in the mass casualty incident (MCI) April 10, 2010. Methods A total of 728 injured soldiers transferred to Phramongkutklao Hospital were reviewed. Descriptive statistics was used to display characteristics of the injuries, relationship between mechanism of injury and injured body regions. Multiple logistic regressions were used to calculate the adjusted odds ratio (adjusted OR) of ISS comparing injured body region categories. Results In all, 153 subjects defined as major data category were enrolled in this study. Blast injury was the most common mechanism of injury (90.2%). These victims displayed 276 injured body regions. The most common injured body region was the extremities (48.5%). A total of 18 patients (11.7%) had an ISS revealing more than 16 points. Three victims who died were expected to die due to high Trauma and Injury Severity Score (TRISS). However, one with high TRISS survived. Factors influencing ISS were age (p = 0.04), abdomen injury (adjusted OR = 29.9; 95% CI, 5.8-153.5; P < 0.01), head & neck injury (adjusted OR = 13.8; 95% CI, 2.4-80.4; P < 0.01) and chest injury (adjusted OR = 9.9; 95% CI, 2.1-47.3; P < 0.01). Conclusions Blast injury was the most common mechanism of injury among Thai military personnel injured in the MCI April 10, 2010. Age and injured body region such as head & neck, chest and abdomen significantly influenced ISS. These factors should be investigated for effective medical treatment and preparing protective equipment to prevent such injuries in the future. PMID:22214518

  10. Information Sharing for Medical Triage Tasking During Mass Casualty/Humanitarian Operations

    DTIC Science & Technology

    2009-12-01

    Mobile file sharing, Humanitarian response, Mass Casualty, WiFi network cloud 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18... WiFi Cloud ........................60 2. Setup of the Portal ..........................60 3. Command Post Setup ...........................61 4...56 Figure 11. Cisco Aironet Wireless Access Point.............59 Figure 12. Pelican Case w/Customizing Padding..............60 Figure 13. WiFi

  11. Cyanide Antidotes for Mass Casualties: Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery

    DTIC Science & Technology

    2013-10-01

    held high- throughput ultrasonic monodisperse aerosol inhalers for detoxification of massive CN poisoning. IV. CONCLUSIONS Significant effect of...Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery PRINCIPAL INVESTIGATOR: Gerry R...Antidotes for Mass Casualties: Comparison of Intramuscular Injector by Autoinjector, Intraosseous Injection, and Inhalational Delivery 5a. CONTRACT

  12. [Triage protocols for mass casualty incidents : An overview 30 years after START].

    PubMed

    Streckbein, S; Kohlmann, T; Luxen, J; Birkholz, T; Prückner, S

    2016-08-01

    Since the publication of the first mass casualty triage protocol approximately 30 years ago, numerous adaptions and alternatives have been introduced and are currently in use throughout the world. This variety may represent a challenge for the cooperation between emergency medical providers and the interoperability of emergency medical services often required during mass casualty incidents. To enhance cooperation and interoperability a standardization of triage protocols is required. This survey was carried out in order to identify and characterize published triage protocols on national and international levels. Furthermore, evidence for validation of the identified triage algorithms was discussed and recommendations for standardization of triage protocols are given. In a systematic literature search 59 relevant articles were identified and evaluated with respect to the given objectives. A total of 12 triage concepts were identified and characterized which are categorized according to the basic principle. The endpoints of the studies, the chosen observation units and the mode of data collection were discussed with respect to their impact on validation. Furthermore, the impact of the degree and dynamics of system capacity overload, which are pathognomonic for mass casualty incidents, were discussed. There is not sufficient evidence to declare one of the triage protocols superior in all aspects to the others and no triage protocol has been implemented on a comprehensive level in Germany. In order to initialize a national or regional convergence process towards an interoperability of emergency medical services, the model uniform core criteria for mass casualty triage approach has been identified as being appropriate.

  13. Using a joint triage model for multi-hospital response to a mass casualty incident in New York city.

    PubMed

    Arquilla, Bonnie; Paladino, Lorenzo; Reich, Charlotte; Brandler, Ethan; Lucchesi, Michael; Shetty, Sanjay

    2009-05-01

    This paper defines a specific plan which allows two separate institutions, with different capabilities, to function as a single receiving entity in the event of a mass casualty incident. The street between the two institutions will be closed to traffic and a two-phase process initiated. Arriving ambulances will first be quickly screened to expedite the most critical patients followed by formal triage and directing patients to one of the two facilities. Preparation for this plan requires prior coordination between local authorities and the administrations of both institutions. This plan can serve as a general model for disaster preparedness when two or more institutions with different capabilities are located in close proximity.

  14. Portable ultrasonography in mass casualty incidents: The CAVEAT examination

    PubMed Central

    Stawicki, Stanislaw Peter; Howard, James M; Pryor, John P; Bahner, David P; Whitmill, Melissa L; Dean, Anthony J

    2010-01-01

    Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments, including pre-hospital triage, emergency department, and critical care settings. The increasing availability of light-weight, robust, user-friendly, and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident (MCI). Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid, focused protocols using hand-carried emergency ultrasonography could be developed. Following a detailed review of the current use of portable ultrasonography in military and civilian MCI settings, we propose a protocol for sonographic evaluation of the chest, abdomen, vena cava, and extremities for acute triage. The protocol is two-tiered, based on the urgency and technical difficulty of the sonographic examination. In addition to utilization of well-established bedside abdominal and thoracic sonography applications, this protocol incorporates extremity assessment for long-bone fractures. Studies of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings. PMID:22474622

  15. Mass-casualty victim "surge" management. Preparing for bombings and blast-related injuries with possibility of hazardous materials exposure.

    PubMed

    Severance, Harry W

    2002-01-01

    Bombings and other blast-related events place severe demands on pre-hospital and in-hospital systems. The resulting surge of victims can overwhelm the resources of any facility not prepared for such an event. The September 11 terrorist attacks underscore the urgency of our need for preparedness. The challenges become even more daunting when there is possible hazmat exposure as well; this means that adequate and rapid disposition of victims is even more critical in order to avoid contamination of hospitals systems or whole communities. Federal agencies have been designated and federal mandates have been issued to address mass casualty events, but federal or even regional systems cannot respond in time to address the massive and immediate needs generated by an explosion. Local communities must take the lead in developing incident command systems for initial management of such events. Hospital and pre-hospital providers play a key role in such planning. Ultimate management and disposition of large numbers of casualties, especially if contaminated, cannot follow standard patient management protocols; new protocols are needed. To avoid a total, overwhelming break down of in-hospital resources, hospitals need to assume a lead role in addressing such issues in their local communities.

  16. Primary triage of mass burn casualties with associated severe traumatic injuries.

    PubMed

    Atiyeh, B; Gunn, S William A; Dibo, S

    2013-03-31

    A key aim in any mass disaster event is to avoid diverting resources by overwhelming specialized tertiary centers with minor casualties. The most crucial aspect of an effective disaster response is pre-hospital triage at the scene. Unfortunately, many triage systems have serious shortcomings in their methodologies and no existing triage system has enough scientific evidence to justify its universal adoption. Moreover, it is observed that the optimal approach to planning is by no means clear-cut and that each new incident involving burns appears to produce its own unique problems not all of which were predictable. In most major burns disasters, victims mostly have combined trauma burn injuries and form a heterogeneous group with a broad range of devastating injuries. Are these victims primarily burn patients or trauma patients? Should they be taken care of in a burn center or in a trauma center or only in a combined burns-trauma center? Who makes the decision? The present review is aimed at answering some of these questions.

  17. Expedited electronic entry: a new way to manage mass-casualty radiology order workflow.

    PubMed

    Bookman, Kelly; Zane, Richard

    2013-08-01

    One of the important tenets of emergency preparedness is that planning for disaster response should resemble standard operating procedure whenever possible. Electronic order entry has become part of the standard operating procedures of most institutions but many of these systems are either too cumbersome for use during a surge or can even be rendered non-functional during a sudden patient surge such as a mass-casualty incident (MCI). Presented here is an experience with delayed radiology order entry during a recent MCI and the after action programming of the system based on this real experience. In response to the after action analysis of the MCI, a task force was assigned to solve the MCI radiology order entry problem and a solution to streamline disaster image ordering was devised. A "browse page" was created that lists every x-ray and every CT scan that might be needed in such an event with all required information defaulted to "Disaster." This created a way to order multiple images for any one patient, with 40% time saving over standard electronic order entry. This disaster radiology order entry solution is an example of the surge preparedness needed to promote patient safety and efficient care delivery as the widespread deployment of electronic health records and order entry continues across the United States.

  18. An after-action review tool for EDs: learning from mass casualty incidents.

    PubMed

    Tami, Greenberg; Bruria, Adini; Fabiana, Eden; Tami, Chen; Tali, Ankri; Limor, Aharonson-Daniel

    2013-05-01

    Conducting a thorough after-action review (AAR) process is an important component in improving preparedness for mass casualty incidents (MCIs). The study aimed to develop a structured AAR tool for use by medical teams in emergency departments after an MCI and to identify the best possible procedure for its conduct. On the basis of knowledge acquired from an extensive literature review, a structured tool for conducting an AAR in the emergency department was developed. A modified Delphi process was conducted to achieve content validity of the tool, involving 48 medical professionals from all 6 level I trauma centers in Israel. The AAR tool was tested during a simulated MCI drill. All experts support the conduct of an AAR in the ED after an MCI to build and maintain capacity for an adequate emergency response. More than 80% agreement was achieved regarding 14 components that were implemented in the proposed AAR tool. Ninety-four percent perceived that AARs should be conducted within 24 hours from the event using both written reports and face-to-face discussions. Both physicians and nurses should participate. The incident manager should lead the AAR, limiting the time allocated for each speaker and for the AAR in whole. Conducting a structured AAR in all emergency departments after an MCI facilitates both learning lessons regarding the function of the medical staff and ventilation of feelings, thus mitigating anxieties and expediting a speedy return to normalcy. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Primary triage of mass burn casualties with associated severe traumatic injuries

    PubMed Central

    Atiyeh, B.; Gunn, S. William A.; Dibo, S.

    2013-01-01

    Summary A key aim in any mass disaster event is to avoid diverting resources by overwhelming specialized tertiary centers with minor casualties. The most crucial aspect of an effective disaster response is pre-hospital triage at the scene. Unfortunately, many triage systems have serious shortcomings in their methodologies and no existing triage system has enough scientific evidence to justify its universal adoption. Moreover, it is observed that the optimal approach to planning is by no means clear-cut and that each new incident involving burns appears to produce its own unique problems not all of which were predictable. In most major burns disasters, victims mostly have combined trauma burn injuries and form a heterogeneous group with a broad range of devastating injuries. Are these victims primarily burn patients or trauma patients? Should they be taken care of in a burn center or in a trauma center or only in a combined burns-trauma center? Who makes the decision? The present review is aimed at answering some of these questions. PMID:23966900

  20. Family support and victim identification in mass casualty terrorist attacks: an integrative approach.

    PubMed

    Gagin, Roni; Cohen, Miri; Peled-Avram, Maya

    2005-01-01

    Terrorist bombing attacks in Israel between 2000 and 2004 caused mass casualties. After each attack in the north of Israel, Rambam Medical Center, the largest hospital in the region, absorbs the majority of injured, especially the more severely injured and unidentified victims. Immediately with the media reports of a terrorist attack, tens of relatives come to the hospital, looking for missing family members. This paper describes an assistance unit for families of unidentified victims. It is staffed by the hospital's social work department, and its tasks are to identify the unidentified victims, help relatives find and be united with them, and assist other relatives in the identification of bodies of deceased family members. The process involves gathering information from relatives and cross-checking it with data and pictures from the hospitals' emergency and operating rooms; and providing crisis intervention and psychological first aid to victims' relatives. The family assistance unit works with several other professional units in the hospital and in the community, and always adjusts its operations to the features of each event. Clearer guidelines for dynamic training of social workers and research-based interventions to prevent compassion fatigue among the workers must be further developed.

  1. Use of a computer-mediated Delphi process to validate a mass casualty conceptual model.

    PubMed

    Culley, Joan M

    2011-05-01

    Since the original work on the Delphi technique, multiple versions have been developed and used in research and industry; however, very little empirical research has been conducted that evaluates the efficacy of using online computer, Internet, and e-mail applications to facilitate a Delphi method that can be used to validate theoretical models. The purpose of this research was to develop computer, Internet, and e-mail applications to facilitate a modified Delphi technique through which experts provide validation for a proposed conceptual model that describes the information needs for a mass-casualty continuum of care. Extant literature and existing theoretical models provided the basis for model development. Two rounds of the Delphi process were needed to satisfy the criteria for consensus and/or stability related to the constructs, relationships, and indicators in the model. The majority of experts rated the online processes favorably (mean of 6.1 on a seven-point scale). Using online Internet and computer applications to facilitate a modified Delphi process offers much promise for future research involving model building or validation. The online Delphi process provided an effective methodology for identifying and describing the complex series of events and contextual factors that influence the way we respond to disasters.

  2. Mobile DIORAMA-II: infrastructure less information collection system for mass casualty incidents.

    PubMed

    Ganz, Aura; Schafer, James M; Yang, Zhuorui; Yi, Jun; Lord, Graydon; Ciottone, Gregory

    2014-01-01

    In this paper we introduce DIORAMA-II system that provides real time information collection in mass casualty incidents. Using a mobile platform that includes active RFID tags and readers as well as Smartphones, the system can determine the location of victims and responders. The system provides user friendly multi dimensional user interfaces as well as collaboration tools between the responders and the incident commander. We conducted two simulated mass casualty incidents with 50 victims each and professional responders. DIORAMA-II significantly reduces the evacuation time by up to 43% when compared to paper based triage systems. All responders that participated in all trials were very satisfied. They felt in control of the incident and mentioned that the system significantly reduced their stress level during the incident. They all mentioned that they would use the system in an actual incident.

  3. Adolescent epidemic hysteria presenting as a mass casualty, toxic exposure incident

    SciTech Connect

    Selden, B.S.

    1989-08-01

    Discussed is a case of explosive epidemic hysteria presenting as a mass casualty, toxic inhalation incident. Fifteen adolescent female students were triaged from a school of 700 persons exposed to sewer gas and arrived simultaneously at the emergency department complaining of a variety of nonspecific symptoms without physical findings. These symptoms quickly remitted with reassurance and dispersion of the group. Factors important in the recognition and treatment of epidemic hysteria are presented.

  4. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study.

    PubMed

    Duncan, Edward A S; Colver, Keith; Dougall, Nadine; Swingler, Kevin; Stephenson, John; Abhyankar, Purva

    2014-02-22

    Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item's importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. This study is the first to produce an expert consensus on the items and quantities of clinical equipment

  5. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: a national Delphi study

    PubMed Central

    2014-01-01

    Background Major short-notice or sudden impact incidents, which result in a large number of casualties, are rare events. However health services must be prepared to respond to such events appropriately. In the United Kingdom (UK), a mass casualties incident is when the normal response of several National Health Service organizations to a major incident, has to be supported with extraordinary measures. Having the right type and quantity of clinical equipment is essential, but planning for such emergencies is challenging. To date, the equipment stored for such events has been selected on the basis of local clinical judgment and has evolved without an explicit evidence-base. This has resulted in considerable variations in the types and quantities of clinical equipment being stored in different locations. This study aimed to develop an expert consensus opinion of the essential items and minimum quantities of clinical equipment that is required to treat 100 people at the scene of a big bang mass casualties event. Methods A three round modified Delphi study was conducted with 32 experts using a specifically developed web-based platform. Individuals were invited to participate if they had personal clinical experience of providing a pre-hospital emergency medical response to a mass casualties incident, or had responsibility in health emergency planning for mass casualties incidents and were in a position of authority within the sphere of emergency health planning. Each item’s importance was measured on a 5-point Likert scale. The quantity of items required was measured numerically. Data were analyzed using nonparametric statistics. Results Experts achieved consensus on a total of 134 items (54%) on completion of the study. Experts did not reach consensus on 114 (46%) items. Median quantities and interquartile ranges of the items, and their recommended quantities were identified and are presented. Conclusions This study is the first to produce an expert consensus on the

  6. Single event mass spectrometry

    DOEpatents

    Conzemius, Robert J.

    1990-01-16

    A means and method for single event time of flight mass spectrometry for analysis of specimen materials. The method of the invention includes pulsing an ion source imposing at least one pulsed ion onto the specimen to produce a corresponding emission of at least one electrically charged particle. The emitted particle is then dissociated into a charged ion component and an uncharged neutral component. The ion and neutral components are then detected. The time of flight of the components are recorded and can be used to analyze the predecessor of the components, and therefore the specimen material. When more than one ion particle is emitted from the specimen per single ion impact, the single event time of flight mass spectrometer described here furnis This invention was made with Government support under Contract No. W-7405-ENG82 awarded by the Department of Energy. The Government has certain rights in the invention.

  7. Research approaches to mass casualty incidents response: development from routine perspectives to complexity science.

    PubMed

    Shen, Weifeng; Jiang, Libing; Zhang, Mao; Ma, Yuefeng; Jiang, Guanyu; He, Xiaojun

    2014-01-01

    To review the research methods of mass casualty incident (MCI) systematically and introduce the concept and characteristics of complexity science and artificial system, computational experiments and parallel execution (ACP) method. We searched PubMed, Web of Knowledge, China Wanfang and China Biology Medicine (CBM) databases for relevant studies. Searches were performed without year or language restrictions and used the combinations of the following key words: "mass casualty incident", "MCI", "research method", "complexity science", "ACP", "approach", "science", "model", "system" and "response". Articles were searched using the above keywords and only those involving the research methods of mass casualty incident (MCI) were enrolled. Research methods of MCI have increased markedly over the past few decades. For now, dominating research methods of MCI are theory-based approach, empirical approach, evidence-based science, mathematical modeling and computer simulation, simulation experiment, experimental methods, scenario approach and complexity science. This article provides an overview of the development of research methodology for MCI. The progresses of routine research approaches and complexity science are briefly presented in this paper. Furthermore, the authors conclude that the reductionism underlying the exact science is not suitable for MCI complex systems. And the only feasible alternative is complexity science. Finally, this summary is followed by a review that ACP method combining artificial systems, computational experiments and parallel execution provides a new idea to address researches for complex MCI.

  8. Scientific framework for research on disaster and mass casualty incident in Korea: building consensus using Delphi method.

    PubMed

    Kim, Chu Hyun; Park, Ju Ok; Park, Chang Bae; Kim, Seong Chun; Kim, Soo Jin; Hong, Ki Jeong

    2014-01-01

    We aimed to determine the scientific framework for research on disaster and mass casualty incident (MCI) in Korea, especially Korean terminology, feasible definition, and epidemiologic indices. The two staged policy Delphi method was performed by instructors of National Disaster Life Support (NDLS®) with the constructed questionnaire containing items based on the literature review. The first-stage survey was conducted by 11 experts through two rounds of survey for making issue and option. The second-stage survey was conducted by 35 experts for making a generalized group based consensus. Experts were selected among instructors of National Disaster Life Support Course. Through two staged Delphi survey experts made consensus: 1) the Korean terminology "jaenan" with "disaster" and "dajung-sonsang-sago" with "MCI"; 2) the feasible definition of "disaster" as the events that have an effect on one or more municipal local government area (city-county-district) or results in ≥ 10 of death or ≥ 50 injured victims; 3) the feasible definition of MCI as the events that result in ≥ 6 casualties including death; 4) essential 31 epidemiologic indices. Experts could determine the scientific framework in Korea for research on disaster medicine, considering the distinct characteristics of Korea and current research trends.

  9. Mass-casualty, terrorist bombings: epidemiological outcomes, resource utilization, and time course of emergency needs (Part I).

    PubMed

    Arnold, Jeffrey L; Tsai, Ming-Che; Halpern, Pinchas; Smithline, Howard; Stok, Edita; Ersoy, Gurkan

    2003-01-01

    This article characterizes the epidemiological outcomes, resource utilization, and time course of emergency needs in mass-casualty, terrorist bombings producing 30 or more casualties. Eligible bombings were identified using a MEDLINE search of articles published between 1996 and October 2002 and a manual search of published references. Mortality, injury frequency, injury severity, emergency department (ED) utilization, hospital admission, and time interval data were abstracted and relevant rates were determined for each bombing. Median values for the rates and the inter-quartile ranges (IQR) were determined for bombing subgroups associated with: (1) vehicle delivery; (2) terrorist suicide; (3) confined-space setting; (4) open-air setting; (5) structural collapse sequela; and (6) structural fire sequela. Inclusion criteria were met by 44 mass-casualty, terrorist bombings reported in 61 articles. Median values for the immediate mortality rates and IQRs were: vehicle-delivery, 4% (1-25%); terrorist-suicide, 19% (7-44%); confined-space 4% (1-11%); open-air, 1% (0-5%); structural-collapse, 18% (5-26%); structural fire 17% (1-17%); and overall, 3% (1-14%). A biphasic pattern of mortality and unique patterns of injury frequency were noted in all subgroups. Median values for the hospital admission rates and IQRs were: vehicle-delivery, 19% (14-50%); terrorist-suicide, 58% (38-77%); confined-space, 52% (36-71%); open-air, 13% (11-27%); structural-collapse, 41% (23-74%); structural-fire, 34% (25-44%); and overall, 34% (14-53%). The shortest reported time interval from detonation to the arrival of the first patient at an ED was five minutes. The shortest reported time interval from detonation to the arrival of the last patient at an ED was 15 minutes. The longest reported time interval from detonation to extrication of a live victim from a structural collapse was 36 hours. Epidemiological outcomes and resource utilization in mass-casualty, terrorist bombings vary with the

  10. Physical medicine and rehabilitation in the military: the Bosnian mass casualty experience.

    PubMed

    Marin, R

    2001-04-01

    On February 5, 1994, a 120-mm mortar shell crashed into the main Market Square of Sarajevo, Bosnia. The explosion killed 66 and injured 206. The United States evacuated 71 of the injured to Landstuhl Regional Medical Center, where the Physical Medicine and Rehabilitation Service evaluated 28 victims. This mass casualty evacuation underscores the role of Army physiatrists in humanitarian assistance and wartime casualty management. The author collected data regarding demographic factors, injury types, complications, and functional limitations. Seventeen of the 28 patients evaluated were injured during the market bombing, with the rest being injured before the bombing. Of 132 diagnoses in these 28 patients, 31 were fractures, 14 were amputations, 8 were peripheral neuropathies, 3 were spinal cord injuries, and 1 was a traumatic brain injury. Contractures and decubitus ulcers, both complications of immobility, accounted for 18 of the diagnoses. Ambulatory impairments were present in all of the patients, and 4 patients had major impairments in activities of daily living.

  11. Cost Analysis of 48 Burn Patients in a Mass Casualty Explosion Treated at Chang Gung Memorial Hospital.

    PubMed

    Mathews, Alexandra L; Cheng, Ming-Huei; Muller, John-Michael; Lin, Miffy Chia-Yu; Chang, Kate W C; Chung, Kevin C

    2017-01-01

    Little is known about the costs of treating burn patients after a mass casualty event. A devastating Color Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This study was performed to investigate the economic effects of treating burn patients at a single medical center after an explosion disaster. A detailed retrospective analysis on 48 patient expense records at Chang Gung Memorial Hospital after the Color Dust explosion was performed. Data were collected during the acute treatment period between June 27, 2015 and September 30, 2015. The distribution of cost drivers for the entire patient cohort (n=48), patients with a percent total body surface area burn (%TBSA)≥50 (n=20), and those with %TBSA <50 (n=28) were analyzed. The total cost of 48 burn patients over the acute 3-month time period was $2,440,688, with a mean cost per patient of $50,848 ±36,438. Inpatient ward fees (30%), therapeutic treatment fees (22%), and medication fees (11%) were found to be the three highest cost drivers. The 20 patients with a %TBSA ≥50 consumed $1,559,300 (63.8%) of the total expenses, at an average cost of $77,965±34,226 per patient. The 28 patients with a %TBSA <50 consumed $881,387 (36.1%) of care expenses, at an average cost of $31,478±23,518 per patient. In response to this mass casualty event, inpatient ward fees represented the largest expense. Hospitals can reduce this fee by ensuring wound dressing and skin substitute materials are regionally stocked and accessible. Medication fees may be higher than expected when treating a mass burn cohort. In preparation for a future event, hospitals should anticipate patients with a %TBSA≥50 will contribute the majority of inpatient expenses. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Mass casualty response in the 2008 Mumbai terrorist attacks.

    PubMed

    Roy, Nobhojit; Kapil, Vikas; Subbarao, Italo; Ashkenazi, Isaac

    2011-12-01

    The November 26-29, 2008, terrorist attacks on Mumbai were unique in its international media attention, multiple strategies of attack, and the disproportionate national fear they triggered. Everyone was a target: random members of the general population, iconic targets, and foreigners alike were under attack by the terrorists. A retrospective, descriptive study of the distribution of terror victims to various city hospitals, critical radius, surge capacity, and the nature of specialized medical interventions was gathered through police, legal reports, and interviews with key informants. Among the 172 killed and 304 injured people, about four-fifths were men (average age, 33 years) and 12% were foreign nationals. The case-fatality ratio for this event was 2.75:1, and the mortality rate among those who were critically injured was 12%. A total of 38.5% of patients arriving at the hospitals required major surgical intervention. Emergency surgical operations were mainly orthopedic (external fixation for compound fractures) and general surgical interventions (abdominal explorations for penetrating bullet/shrapnel injuries). The use of heavy-duty automatic weapons, explosives, hostages, and arson in these terrorist attacks alerts us to new challenges to medical counterterrorism response. The need for building central medical control for a coordinated response and for strengthening public hospital capacity are lessons learned for future attacks. These particular terrorist attacks had global consequences, in terms of increased security checks and alerts for and fears of further similar "Mumbai-style" attacks. The resilience of the citizens of Mumbai is a critical measure of the long-term effects of terror attacks.

  13. Disaster metrics: quantitative benchmarking of hospital surge capacity in trauma-related multiple casualty events.

    PubMed

    Bayram, Jamil D; Zuabi, Shawki; Subbarao, Italo

    2011-06-01

    Hospital surge capacity in multiple casualty events (MCE) is the core of hospital medical response, and an integral part of the total medical capacity of the community affected. To date, however, there has been no consensus regarding the definition or quantification of hospital surge capacity. The first objective of this study was to quantitatively benchmark the various components of hospital surge capacity pertaining to the care of critically and moderately injured patients in trauma-related MCE. The second objective was to illustrate the applications of those quantitative parameters in local, regional, national, and international disaster planning; in the distribution of patients to various hospitals by prehospital medical services; and in the decision-making process for ambulance diversion. A 2-step approach was adopted in the methodology of this study. First, an extensive literature search was performed, followed by mathematical modeling. Quantitative studies on hospital surge capacity for trauma injuries were used as the framework for our model. The North Atlantic Treaty Organization triage categories (T1-T4) were used in the modeling process for simplicity purposes. Hospital Acute Care Surge Capacity (HACSC) was defined as the maximum number of critical (T1) and moderate (T2) casualties a hospital can adequately care for per hour, after recruiting all possible additional medical assets. HACSC was modeled to be equal to the number of emergency department beds (#EDB), divided by the emergency department time (EDT); HACSC = #EDB/EDT. In trauma-related MCE, the EDT was quantitatively benchmarked to be 2.5 (hours). Because most of the critical and moderate casualties arrive at hospitals within a 6-hour period requiring admission (by definition), the hospital bed surge capacity must match the HACSC at 6 hours to ensure coordinated care, and it was mathematically benchmarked to be 18% of the staffed hospital bed capacity. Defining and quantitatively benchmarking the

  14. Mass casualties in Tahrir Square at the climax of the Egyptian uprising: evidence of an emerging pattern of regime's organized escalating violence during 10 hours on the night of January 28, 2011.

    PubMed

    Sarhan, Mohamed D; Dahaba, Ashraf A; Marco, Michael; Salah, Ayman

    2012-12-01

    Documentation of the management of mass casualties in Tahrir Square. We documented the sequences of our medical response to mass casualties in Tahrir Square between January 28, 2011, and February 4, 2011, at "Kasr El-Ainy" Cairo University Hospital, the largest hospital in the Middle East and the tertiary referral center for all hospitals in Egypt that happened to be the closest to Tahrir Square. At the peak of Tahrir Square demonstrations, injured protesters received first aid in a makeshift clinic inside Tahrir Square, manned by volunteer doctors and nurses, before they were evacuated to the Cairo University Hospital Surgical Casualty Department. General surgeons, orthopedic surgeons, anesthesiologists, and critical care nurses from multidisciplinary teams hastily triaged and treated the incoming casualties. Thousands of casualties were seen at the peak of the uprising. This article provides a detailed review of mass casualties seen between January 28, 2011, and February 4, 2011. Of 3012 casualties, 453 were triaged as "immediate care" patients. On arrival, 339 of 453 patients (74.8%) needed surgical intervention within 6 hours of arrival whereas 74 of 453 patients (16.3%) were managed conservatively. Forty of 453 (8.8%) of patients did not survive their injuries. Most of the inpatients (302/453, 66.6%) were admitted within 10 hours on January 28, 2011, during which evidence of a pattern of regime's organized escalating violence emerged. We describe the pattern of injuries and our management of Tahrir Square mass casualties. We believe that forming multidisciplinary teams of surgeons, anesthesiologists, and nurses was the key to our effective management of such a huge event.

  15. Clinical Framework and Medical Countermeasure Use During an Anthrax Mass-Casualty Incident.

    PubMed

    Bower, William A; Hendricks, Katherine; Pillai, Satish; Guarnizo, Julie; Meaney-Delman, Dana

    2015-12-04

    In 2014, CDC published updated guidelines for the prevention and treatment of anthrax (Hendricks KA, Wright ME, Shadomy SV, et al. Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults. Emerg Infect Dis 2014;20[2]. Available at http://wwwnc.cdc.gov/eid/article/20/2/13-0687_article.htm). These guidelines provided recommended best practices for the diagnosis and treatment of persons with naturally occurring or bioterrorism-related anthrax in conventional medical settings. An aerosolized release of Bacillus anthracis spores over densely populated areas could become a mass-casualty incident. To prepare for this possibility, the U.S. government has stockpiled equipment and therapeutics (known as medical countermeasures [MCMs]) for anthrax prevention and treatment. However, previously developed, publicly available clinical recommendations have not addressed the use of MCMs or clinical management during an anthrax mass-casualty incident, when the number of patients is likely to exceed the ability of the health care infrastructure to provide conventional standards of care and supplies of MCMs might be inadequate to meet the demand required. To address this gap, in 2013, CDC conducted a series of systematic reviews of the scientific literature on anthrax to identify evidence that could help clinicians and public health authorities set guidelines for intravenous antimicrobial and antitoxin use, diagnosis of anthrax meningitis, and management of common anthrax-specific complications in the setting of a mass-casualty incident. Evidence from these reviews was presented to professionals with expertise in anthrax, critical care, and disaster medicine during a series of workgroup meetings that were held from August 2013 through March 2014. In March 2014, a meeting was held at which 102 subject matter experts discussed the evidence and adapted the existing best practices guidance to a clinical use framework for the

  16. A web-based model to support patient-to-hospital allocation in mass casualty incidents.

    PubMed

    Amram, Ofer; Schuurman, Nadine; Hedley, Nick; Hameed, S Morad

    2012-05-01

    In a mass casualty situation, evacuation of severely injured patients to the appropriate health care facility is of critical importance. The prehospital stage of a mass casualty incident (MCI) is typically chaotic, characterized by dynamic changes and severe time constraints. As a result, those involved in the prehospital evacuation process must be able to make crucial decisions in real time. This article presents a model intended to assist in the management of MCIs. The Mass Casualty Patient Allocation Model has been designed to facilitate effective evacuation by providing key information about nearby hospitals, including driving times and real-time bed capacity. These data will enable paramedics to make informed decisions in support of timely and appropriate patient allocation during MCIs. The model also enables simulation exercises for disaster preparedness and first response training. Road network and hospital location data were used to precalculate road travel times from all locations in Metro Vancouver to all Level I to III trauma hospitals. Hospital capacity data were obtained from hospitals and were updated by tracking patient evacuation from the MCI locations. In combination, these data were used to construct a sophisticated web-based simulation model for use by emergency response personnel. The model provides information critical to the decision-making process within a matter of seconds. This includes driving times to the nearest hospitals, the trauma service level of each hospital, the location of hospitals in relation to the incident, and up-to-date hospital capacity. The dynamic and evolving nature of MCIs requires that decisions regarding prehospital management be made under extreme time pressure. This model provides tools for these decisions to be made in an informed fashion with continuously updated hospital capacity information. In addition, it permits complex MCI simulation for response and preparedness training.

  17. Radiological work-up after mass casualty incidents: are ATLS guidelines applicable?

    PubMed

    Postma, Ingri L E; Beenen, L F M; Bijlsma, T S; Berger, F H; Heetveld, M J; Bloemers, F W; Goslings, J C

    2014-03-01

    In mass casualty incidents (MCI) a large number of patients need to be evaluated and treated fast. Well-designed radiological guidelines can save lives. The purpose of this study was to evaluate the Advanced Trauma Life Support (ATLS) radiological guidelines in the MCI of an aeroplane crash. Medical data of all 126 survivors of an aeroplane crash were analysed. Data included type and body region of the radiological studies performed on the survivors, Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) codes and trauma care level of the hospitals. Ninety patients (72 %) underwent one or more imaging studies: in total 297 radiographs, 148 CTs and 18 ultrasounds were performed. Only 18 % received diagnostic imaging of all four body regions as recommended by ATLS. Compliance with ATLS was highest (73.3 %) in severely injured victims (ISS ≥16); this group underwent two thirds of the (near) total body CTs, all performed in level I trauma centres. Overall compliance with ATLS radiological guidelines was low, although high in severely injured patients. Level I trauma centres frequently used (near) total body CT. Deviation from ATLS guidelines in radiological work-up in less severely injured patients can be safe and did not result in delayed diagnosis of serious injury. • Radiological imaging protocols can assist the management of mass casualty incidents needs. • Advanced Trauma Life Support (ATLS) radiological guidelines have been developed. • But radiological guidelines have not frequently been applied in aeroplane crashes. • Aircraft accidents are of high energy so ATLS guidelines should be applied. • Following mass casualty incidents total body CT seems appropriate within ATLS protocols.

  18. BET 2: Is prehospital focused abdominal ultrasound useful during triage at mass casualty incidents?

    PubMed

    2013-07-01

    A short-cut review was carried out to determined whether the addition of prehospital focused abdominal ultrasound to triage protocols might reduce time to necessary surgery and reduce overall mortality. Thirty-five papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of those best papers are shown in table 2. It is concluded that although the feasibility of prehospital ultrasound in mass casualty incidents has been demonstrated, there is, as yet, no clear evidence of benefit as part of a triage protocol.

  19. Autonomous mobile platform for enhanced situational awareness in Mass Casualty Incidents.

    PubMed

    Yang, Dongyi; Schafer, James; Wang, Sili; Ganz, Aura

    2014-01-01

    To enhance the efficiency of the search and rescue process of a Mass Casualty Incident, we introduce a low cost autonomous mobile platform. The mobile platform motion is controlled by an Android Smartphone mounted on a robot. The pictures and video captured by the Smartphone camera can significantly enhance the situational awareness of the incident commander leading to a more efficient search and rescue process. Moreover, the active RFID readers mounted on the mobile platform can improve the localization accuracy of victims in the disaster site in areas where the paramedics are not present, reducing the triage and evacuation time.

  20. Teaching mass casualty triage skills using immersive three-dimensional virtual reality.

    PubMed

    Vincent, Dale S; Sherstyuk, Andrei; Burgess, Lawrence; Connolly, Kathleen K

    2008-11-01

    Virtual reality (VR) environments offer potential advantages over traditional paper methods, manikin simulation, and live drills for mass casualty training and assessment. The authors measured the acquisition of triage skills by novice learners after exposing them to three sequential scenarios (A, B, and C) of five simulated patients each in a fully immersed three-dimensional VR environment. The hypothesis was that learners would improve in speed, accuracy, and self-efficacy. Twenty-four medical students were taught principles of mass casualty triage using three short podcasts, followed by an immersive VR exercise in which learners donned a head-mounted display (HMD) and three motion tracking sensors, one for their head and one for each hand. They used a gesture-based command system to interact with multiple VR casualties. For triage score, one point was awarded for each correctly identified main problem, required intervention, and triage category. For intervention score, one point was awarded for each correct VR intervention. Scores were analyzed using one-way analysis of variance (ANOVA) for each student. Before and after surveys were used to measure self-efficacy and reaction to the training. Four students were excluded from analysis due to participation in a recent triage research program. Results from 20 students were analyzed. Triage scores and intervention scores improved significantly during Scenario B (p < 0.001). Time to complete each scenario decreased significantly from A (8:10 minutes) to B (5:14 minutes; p < 0.001) and from B to C (3:58 minutes; p < 0.001). Self-efficacy improved significantly in the areas of prioritizing treatment, prioritizing resources, identifying high-risk patients, and beliefs about learning to be an effective first responder. Novice learners demonstrated improved triage and intervention scores, speed, and self-efficacy during an iterative, fully immersed VR triage experience.

  1. Data quality for situational awareness during mass-casualty events.

    PubMed

    Demchak, Barry; Griswold, William G; Lenert, Leslie A

    2007-10-11

    Incident Command systems often achieve situational awareness through manual paper-tracking systems. Such systems often produce high latencies and in-complete data, resulting in inefficient and ineffective resource deployment. WIISARD (Wireless Internet Information System for Medical Response in Disasters) collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to incident commanders. Yet, the introduction of IT into a disaster setting is not problem-free. Notably, system component failures can delay the delivery of data. The type and extent of a failure can have varying effects on the usefulness of information displays. We describe a small, coherent set of customizble information overlays to address this problem, and we discuss reactions to these displays by medical commanders.

  2. Situational awareness during mass-casualty events: command and control.

    PubMed

    Demchak, Barry; Chan, Theodore C; Griswold, William G; Lenert, Leslie A

    2006-01-01

    In existing Incident Command systems, situational awareness is achieved manually through paper tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. The WIISARD system collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to Incident Commanders. The WIISARD Command Center solves the problem of data over-load and uncertainty through the careful use of limited screen area and novel visualization techniques.

  3. Data Quality for Situational Awareness during Mass-Casualty Events

    PubMed Central

    Demchak, Barry; Griswold, William G.; Lenert, Leslie A.

    2007-01-01

    Incident Command systems often achieve situational awareness through manual paper-tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. WIISARD (Wireless Internet Information System for Medical Response in Disasters) collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to incident commanders. Yet, the introduction of IT into a disaster setting is not problem-free. Notably, system component failures can delay the delivery of data. The type and extent of a failure can have varying effects on the usefulness of information displays. We describe a small, coherent set of customizble information overlays to address this problem, and we discuss reactions to these displays by medical commanders. PMID:18693821

  4. Situational Awareness During Mass-Casualty Events: Command and Control

    PubMed Central

    Demchak, Barry; Chan, Theordore C.; Griswold, William G.; Lenert, Leslie

    2006-01-01

    In existing Incident Command systems1, situational awareness is achieved manually through paper tracking systems. Such systems often produce high latencies and incomplete data, resulting in inefficient and ineffective resource deployment. The WIISARD2 system collects much more data than a paper-based system, dramatically reducing latency while increasing the kinds and quality of information available to Incident Commanders. The WIISARD Command Center solves the problem of data overload and uncertainty through the careful use of limited screen area and novel visualization techniques. PMID:17238524

  5. The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents.

    PubMed

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Garijo Gonzalo, Gracia; Martinez Monzon, Carlos; Pelaez Corres, Nieves; Rodriguez Soler, Alberto; Turegano Fuentes, Fernando

    2016-04-29

    This text describes the process of development of the new Spanish Prehospital Advanced Triage Method (META) and explain its main features and contribution to prehospital triage systems in mass casualty incidents. The triage META is based in the Advanced Trauma Life Support (ATLS) protocols, patient's anatomical injuries and mechanism of injury. It is a triage method with four stages including early identification of patients with severe trauma that would benefit from a rapid evacuation to a surgical facility and introduces a new patient flow by-passing the advanced medical post to improve evacuation. The stages of triage META are: I) Stabilization triage that classifies patients according to severity to set priorities for initial emergency treatment; II) Identifying patients requiring urgent surgical treatment, this is done at the same time than stage I and creates a new flow of patients with high priority for evacuation; III) Implementation of Advanced Trauma Life Support protocols to patients previously classified according to stablished priority; and IV) Evacuation triage, stablishing evacuation priorities in case of lacks of appropriate transport resources. The triage META is to be applied only by prehospital providers with advanced knowledge and training in advanced trauma life support care and has been designed to be implemented as prehospital procedure in mass casualty incidents (MCI).

  6. Continuous arteriovenous hemofiltration with dialysis (CAVH-D): an alternative to hemodialysis in the mass casualty situation.

    PubMed

    Omert, L; Reynolds, H N; Wiles, C E

    1991-01-01

    Renal failure is a common sequela of mass casualty, particularly when crush injury is involved. Traditional management of renal failure with hemodialysis equipment may be difficult or inaccessible due to lack of electricity and water supply or damage to existing equipment. Furthermore, a sudden new population of renal failure patients may overwhelm an existing dialysis program. The rapid mobilization of traditional hemodialysis equipment may be delayed due to limited supply, manufacturing delays, or inventory shortages. For these reasons, we propose the use of continuous arteriovenous hemofiltration with dialysis (CAVH-D) as an alternative renal support modality for the mass casualty situation.

  7. Impact of a predefined hospital mass casualty response plan in a limited resource setting with no pre-hospital care system.

    PubMed

    Shah, Adil Aijaz; Rehman, Abdul; Sayyed, Raza Hasnain; Haider, Adil Hussain; Bawa, Amber; Zafar, Syed Nabeel; Zia-Ur-Rehman; Ali, Kamran; Zafar, Hasnain

    2015-01-01

    Pre-hospital triage is an intricate part of any mass casualty response system. However, in settings where no such system exists, it is not known if hospital-based disaster response efforts are beneficial. This study describes in-hospital disaster response management and patient outcomes following a mass casualty event (MCE) involving 200 victims in a lower-middle income country in South Asia. We performed a single-center, retrospective review of bombing victims presenting to a trauma center in the spring of 2013, after a high energy car bomb leveled a residential building. Descriptive analysis was utilized to present demographic variables and physical injuries. A disaster plan was devised based on the canons of North-American trauma care; some adaptations to the local environment were incorporated. Relevant medical and surgical specialties were mobilized to the ED awaiting a massive influx of patients. ED waiting room served as the triage area. Operating rooms, ICU and blood bank were alerted. Seventy patients presented to the ED. Most victims (88%) were brought directly without prehospital triage or resuscitation. Four were pronounced dead on arrival. The mean age of victims was 27 (±14) years with a male preponderance (78%). Penetrating shrapnel injury was the most common mechanism of injury (71%). Most had a systolic blood pressure (SBP) >90 with a mean of 120.3 (±14.8). Mean pulse was 90.2 (±21.6) and most patients had full GCS. Extremities were the most common body region involved (64%) with orthopedics service being consulted most frequently. Surgery was performed on 36 patients, including 4 damage control surgeries. All patients survived. This overwhelming single mass-casualty incident was met with a swift multidisciplinary response. In countries with no prehospital triage system, implementing a pre-existing disaster plan with pre-defined interdisciplinary responsibilities can streamline in-hospital management of casualties. Copyright © 2014 Elsevier Ltd

  8. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis

    PubMed Central

    Carter, Holly; Amlôt, Richard

    2016-01-01

    Introduction: Mass casualty decontamination is an intervention employed by first responders at the scene of an incident involving noxious contaminants.  Many countries have sought to address the challenge of decontaminating large numbers of affected casualties through the provision of rapidly deployable temporary showering structures, with accompanying decontamination protocols.  In this paper we review decontamination guidance for emergency responders and associated research evidence, in order to establish to what extent psychosocial aspects of casualty management have been considered within these documents. The review focuses on five psychosocial aspects of incident management: likely public behaviour; responder management style; communication strategy; privacy/ modesty concerns; and vulnerable groups. Methods: Two structured literature reviews were carried out; one to identify decontamination guidance documents for first responders, and another to identify evidence which is relevant to the understanding of the psychosocial aspects of mass decontamination.  The guidance documents and relevant research were reviewed to identify whether the guidance documents contain information relating to psychosocial issues and where it exists, that the guidance is consistent with the existing evidence-base. Results: Psychosocial aspects of incident management receive limited attention in current decontamination guidance.  In addition, our review has identified a number of gaps and inconsistencies between guidance and research evidence.  For each of the five areas we identify: what is currently presented in guidance documents, to what extent this is consistent with the existing research evidence and where it diverges.  We present a series of evidence-based recommendations for updating decontamination guidance to address the psychosocial aspects of mass decontamination. Conclusions: Effective communication and respect for casualties’ needs are critical in ensuring

  9. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project.

    PubMed

    Baker, David J; Murray, Virginia S G; Carli, Pierre A

    2013-01-01

    The European Union (EU) Mass Casualties and Health (MASH) project that ran between 2008 and 2010 was designed to study the management of mass casualties from chemical and radiological releases and associated health implications. One area of study for this project concerned arrangements within EU Member States for the management of mass casualties following a chemical release. This was undertaken via a confidential online questionnaire that was sent to selected points of contact throughout the EU. Responses were obtained from 18 states from respondents holding senior positions in chemical planning and incident response. Information gathered shows a lack of uniformity within the EU about the organization of responses to chemical releases and the provision of medical care. This article presents the overall findings of the study demonstrating differences between countries on planning and organization, decontamination, prehospital emergency medical responses, clinical diagnoses, and therapy and aftercare. Although there may be an understandable reluctance from national respondents to share information on security and other grounds, the findings, nevertheless, revealed substantial differences between current planning and operational responses within the EU states for the management of mass chemical casualties. The existing international networks for response to radiation incidents are not yet matched by equivalent networks for chemical responses yet sufficient information was available from the study to identify potential deficiencies, identify common casualty management pathways, and to make recommendations for future operations within the EU. Improvements in awareness and training and the application of modern information and communications will help to remedy this situation. Specialized advanced life support and other medical care for chemical casualties appear lacking in some countries. A program of specialized training and action are required to apply the findings

  10. Socio-demographic Characteristics and Leading Causes of Death Among the Casualties of Meteorological Events Compared With All-cause Deaths in Korea, 2000-2011

    PubMed Central

    Lee, Kyung Eun; Myung, Hyung-Nam; Na, Wonwoong

    2013-01-01

    Objectives This study investigated the socio-demographic characteristics and medical causes of death among meteorological disaster casualties and compared them with deaths from all causes. Methods Based on the death data provided by the National Statistical Office from 2000 to 2011, the authors analyzed the gender, age, and region of 709 casualties whose external causes were recorded as natural events (X330-X389). Exact matching was applied to compare between deaths from meteorological disasters and all deaths. Results The total number of deaths for last 12 years was 2 728 505. After exact matching, 642 casualties of meteorological disasters were matched to 6815 all-cause deaths, which were defined as general deaths. The mean age of the meteorological disaster casualties was 51.56, which was lower than that of the general deaths by 17.02 (p<0.001). As for the gender ratio, 62.34% of the meteorological event casualties were male. While 54.09% of the matched all-cause deaths occurred at a medical institution, only 7.6% of casualties from meteorological events did. As for occupation, the rate of those working in agriculture, forestry, and fishery jobs was twice as high in the casualties from meteorological disasters as that in the general deaths (p<0.001). Meteorological disaster-related injuries like drowning were more prevalent in the casualties of meteorological events (57.48%). The rate of amputation and crushing injury in deaths from meteorological disasters was three times as high as in the general deaths. Conclusions The new information gained on the particular characteristics contributing to casualties from meteorological events will be useful for developing prevention policies. PMID:24137528

  11. Oral and Enteral Resuscitation of Burn Shock The Historical Record and Implications for Mass Casualty Care

    PubMed Central

    Kramer, George C.; Michell, Michael W.; Oliveira, Hermes; Brown, Tim La H.; Herndon, David; Baker, R. David; Muller, Michael

    2010-01-01

    In the aftermath of a mass disaster, standard care methods for treatment of burn injury will often not be available for all victims. A method of fluid resuscitation for burns that has largely been forgotten by contemporary burn experts is enteral resuscitation. We identified 12 studies with over 700 patients treated with enteral resuscitation, defined as drinking or gastric infusion of salt solutions, from the literature. These studies suggest that enteral resuscitation can be an effective treatment for burn shock under conditions in which the standard IV therapy is unavailable or delayed, such as in mass disasters and combat casualties. Enteral resuscitation of burn shock was effective in patients with moderate (10–40% TBSA) and in some patients with more severe injuries. The data suggests that some hypovolemic burn and trauma patients can be treated exclusively with enteral resuscitation, and others might benefit from enteral resuscitation as an initial alternative and a supplement to IV therapy. A complication of enteral resuscitation was vomiting, which occurred less in children and much less when therapy was initiated within the first postburn hour. Enteral resuscitation is contra-indicated when the patient is in “peripheral circulatory collapse”. The optimal enteral solution and regimen has not yet been defined, nor has its efficacy been tested against modern IV resuscitation. The oldest studies used glucose-free solutions of buffered isotonic and hypotonic saline. Studies that are more recent show benefit of adding glucose to electrolyte solutions similar to those used in the treatment of cholera. If IV therapy for mass casualty care is delayed due to logistical constraints, enteral resuscitation should be considered. PMID:20827301

  12. Cyanide antidotes for mass casualties: water-soluble salts of the dithiane (sulfanegen) from 3-mercaptopyruvate for intramuscular administration.

    PubMed

    Patterson, Steven E; Monteil, Alexandre R; Cohen, Jonathan F; Crankshaw, Daune L; Vince, Robert; Nagasawa, Herbert T

    2013-02-14

    Current cyanide antidotes are administered by IV infusion, which is suboptimal for mass casualties. Therefore, in a cyanide disaster, intramuscular (IM) injectable antidotes would be more appropriate. We report the discovery of the highly water-soluble sulfanegen triethanolamine as a promising lead for development as an IM injectable cyanide antidote.

  13. Cyanide Antidotes for Mass Casualties: Water-Soluble Salts of the Dithiane (Sulfanegen) from 3-Mercaptopyruvate for Intramuscular Administration

    PubMed Central

    Patterson, Steven E.; Monteil, Alexandre R.; Cohen, Jonathan F.; Crankshaw, Daune L.; Vince, Robert; Nagasawa, Herbert T.

    2013-01-01

    Current cyanide antidotes are administered by IV infusion which is suboptimal for mass casualties. Therefore, in a cyanide disaster intramuscular (IM) injectable antidotes would be more appropriate. We report the discovery of the highly water-soluble sulfanegen triethanolamine as a promising lead for development as an IM injectable cyanide antidote. PMID:23301495

  14. Mass casualty incident surveillance and monitoring using identity aware video analytics.

    PubMed

    Yu, Xunyi; Ganz, Aura

    2010-01-01

    In this paper, we propose an identity aware video analytic system that can assist securing the perimeter of a mass casualty incident scene and generate identity annotated video records for forensics and training purposes. Establishing a secure incident scene perimeter and enforcing access control to different zones is a demanding task for current video surveillance systems which lack the ability to provide the identity of the target and its security clearance. Our system which combines active RFID sensors with video analytic tools recovers the identity of the target enabling the activation of suitable alert policies. The system also enables annotation of incident scene video with identity metadata, facilitating the incident response process reconstruction for forensics analysis and emergency response training.

  15. An Interprofessional Approach to Continuing Education With Mass Casualty Simulation: Planning and Execution.

    PubMed

    Saber, Deborah A; Strout, Kelley; Caruso, Lisa Swanson; Ingwell-Spolan, Charlene; Koplovsky, Aiden

    2017-10-01

    Many natural and man-made disasters require the assistance from teams of health care professionals. Knowing that continuing education about disaster simulation training is essential to nursing students, nurses, and emergency first responders (e.g., emergency medical technicians, firefighters, police officers), a university in the northeastern United States planned and implemented an interprofessional mass casualty incident (MCI) disaster simulation using the Project Management Body of Knowledge (PMBOK) management framework. The school of nursing and University Volunteer Ambulance Corps (UVAC) worked together to simulate a bus crash with disaster victim actors to provide continued education for community first responders and train nursing students on the MCI process. This article explains the simulation activity, planning process, and achieved outcomes. J Contin Educ Nurs. 2017;48(10):447-453. Copyright 2017, SLACK Incorporated.

  16. Mass casualty modelling: a spatial tool to support triage decision making.

    PubMed

    Amram, Ofer; Schuurman, Nadine; Hameed, Syed M

    2011-06-10

    During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS) was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc.), and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Upon running the model, driving time from the MCI location to the surrounding hospitals is quickly displayed alongside information regarding hospital capacity and capability, thereby assisting the user in the decision-making process. The use of SDSS in the prioritization of MCI evacuation decision making is potentially valuable in cases of mass casualty. The key to this model is the utilization of pre-calculated driving times from each hospital in the region to each point on the road network. The incorporation of real-time traffic and hospital capacity data would further improve this model.

  17. Mass-casualty Response to the Kiss Nightclub in Santa Maria, Brazil.

    PubMed

    Dal Ponte, Silvana T; Dornelles, Carlos F D; Arquilla, Bonnie; Bloem, Christina; Roblin, Patricia

    2015-02-01

    On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.

  18. Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001.

    PubMed

    Ozoilo, Kenneth N; Pam, Ishaya C; Yiltok, Simon J; Ramyil, Alice V; Nwadiaro, Hyacinth C

    2013-10-28

    Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response.

  19. Effectiveness of hospital staff mass-casualty incident training methods: a systematic literature review.

    PubMed

    Hsu, Edbert B; Jenckes, Mollie W; Catlett, Christina L; Robinson, Karen A; Feuerstein, Carolyn; Cosgrove, Sara E; Green, Gary B; Bass, Eric B

    2004-01-01

    Recently, mass-casualty incident (MCI) preparedness and training has received increasing attention at the hospital level. To review the existing evidence on the effectiveness of disaster drills, technology-based interventions and tabletop exercises in training hospital staff to respond to an MCI. A systematic, evidence-based process was conducted incorporating expert panel input and a literature review with the key terms: "mass casualty", "disaster", "disaster planning", and "drill". Paired investigators reviewed citation abstracts to identify articles that included evaluation of disaster training for hospital staff. Data were abstracted from the studies (e.g., MCI type, training intervention, staff targeted, objectives, evaluation methods, and results). Study quality was reviewed using standardized criteria. Of 243 potentially relevant citations, 21 met the defined criteria. Studies varied in terms of targeted staff, learning objectives, outcomes, and evaluation methods. Most were characterized by significant limitations in design and evaluation methods. Seventeen addressed the effectiveness of disaster drills in training hospital staff in responding to an MCI, four addressed technology-based interventions, and none addressed tabletop exercises. The existing evidence suggests that hospital disaster drills are effective in allowing hospital employees to become familiar with disaster procedures, identify problems in different components of response (e.g., incident command, communications, triage, patient flow, materials and resources, and security) and provide the opportunity to apply lessons learned to disaster response. The strength of evidence on other training methods is insufficient to draw valid recommendations. Current evidence on the effectiveness of MCI training for hospital staff is limited. A number of studies suggest that disaster drills can be effective in training hospital staff. However, more attention should be directed to evaluating the

  20. Mass casualty modelling: a spatial tool to support triage decision making

    PubMed Central

    2011-01-01

    Background During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS) was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. Methods This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc.), and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Results Upon running the model, driving time from the MCI location to the surrounding hospitals is quickly displayed alongside information regarding hospital capacity and capability, thereby assisting the user in the decision-making process. Conclusions The use of SDSS in the prioritization of MCI evacuation decision making is potentially valuable in cases of mass casualty. The key to this model is the utilization of pre-calculated driving times from each hospital in the region to each point on the road network. The incorporation of real-time traffic and hospital capacity data would further improve this model. PMID:21663636

  1. BASIC REVIEW OF ENDOTRACHEAL INTUBATION FOR PROVIDERS AT A MASS CASUALTY.

    PubMed

    Boedeker, Ben; Murray, W Bosseau

    2008-01-01

    During a mass casualty scenario (whether manmade or natural disaster), healthcare providers could likely be overwhelmed by patients, many of whom would need airway support. In such a situation, medical personnel from a wide variety of backgrounds may be called upon to provide airway management. Such personnel could include emergency medical technicians, nurses, physician's assistants and physicians from all specialties. In our current practice, a similar mix of medical providers are being tasked with increased airway management to support conscious sedation delivery. Increasing demand for airway management skills requires more airway training for medical personnel who may be involved in disaster medicine or other 'out of operating room' care. To support the growing airway training needs for medical providers, especially in the advent of a mass casualty situation, a virtual training platform was created in collaboration with the Telemedicine and Advanced Technology Research Center, Medical Material and Research Command, US Army, the United States Army Chemical Care Casualty Division, Aberdeen Proving Grounds, MD and a consortium of universities. This project was funded by an unrestricted educational grant from Karl Storz Endoscopy America, Inc and from a grant from the Telemedicine and Advanced Technology Research Center, Medical Material Research Command, US Army. Its goal is to gradually develop a comprehensive virtual training textbook to support personnel involved in medical disaster management and other out of operating room patient care requiring appropriate airway skills. This web-based manuscript is intended to represent the initial training module in support of the collaborative airway management training project. A mannequin-based intubation training module followed by intubation experience in the operating room are meant to complete the full instructional package. The initial training module was designed with an emphasis on graphics. The web-based format

  2. Mass Casualty Incidents in the Underground Mining Industry: Applying the Haddon Matrix on an Integrative Literature Review.

    PubMed

    Engström, Karl Gunnar; Angrén, John; Björnstig, Ulf; Saveman, Britt-Inger

    2017-06-08

    Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review. A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing. Most of the reports were descriptive regarding injury-creating technical and environmental factors. The influence of rock characteristics was an important pre-event environmental factor. The organic nature of coal adds risks not shared in hard-rock mines. A sequence of mechanisms is commonly described, often initiated by a human factor in interaction with technology and step-wise escalation to involve environmental circumstances. Socioeconomic factors introduce heterogeneity. In the Haddon matrix, emergency medical services are mainly a post-event environmental issue, which were not well described in the available literature. The US Quecreek Coal Mine incident of 2002 stands out as a well-planned rescue mission. Evaluation of the preparedness to handle underground mining incidents deserves further scientific attention. Preparedness must include the medical aspects of rescue operations. (Disaster Med Public Health Preparedness. 2017;page 1 of 9).

  3. Mass casualty incidents: are NHS staff prepared? An audit of one NHS foundation trust.

    PubMed

    Milkhu, C S; Howell, D C J; Glynne, P A; Raptis, D; Booth, H L; Langmead, L; Datta, V K

    2008-09-01

    Lack of knowledge of an NHS trust's major incident policies by clinical staff may result in poorly coordinated responses during a mass casualty incident (MCI). To audit knowledge of the major incident policy by clinical staff working in a central London major acute NHS trust designated to receive casualties on a 24-h basis during a MCI. A 12-question proforma was distributed to 307 nursing and medical staff in the hospital, designed to assess their knowledge of the major incident policy. Completed proformas were collected over a 2-month period between December 2006 and February 2007. A reply rate of 34% was obtained, with a reasonable representation from all disciplines ranging from nurses to consultants. Despite only 41% having read the policy in full, 70% knew the correct immediate action to take if informed of major incident activation. 76% knew the correct stand-down procedure. 56% knew the correct reporting point but less than 25% knew that an action card system was utilised. Nurses had significantly (p<0.01) more awareness of the policy than doctors. In view of the heightened terrorist threat in London, knowledge of major incident policy is essential. The high percentage of positive responses relating to immediate and stand-down actions reflects the rolling trust-wide MCI education programme and the organisational memory of the trust following several previous MCI in the capital. There is still scope for an improvement in awareness, however, particularly concerning knowledge of action cards, which are now displayed routinely throughout clinical areas and will be incorporated into induction packs.

  4. Evaluation of a CT triage protocol for mass casualty incidents: results from two large-scale exercises.

    PubMed

    Körner, Markus; Krötz, Michael M; Wirth, Stefan; Huber-Wagner, Stefan; Kanz, Karl-Georg; Boehm, Holger F; Reiser, Maximilian; Linsenmaier, Ulrich

    2009-08-01

    The purpose of this study was to evaluate the feasibility, stability, and reproducibility of a dedicated CT protocol for the triage of patients in two separate large-scale exercises that simulated a mass casualty incident (MCI). In both exercises, a bomb explosion at the local soccer stadium that had caused about 100 casualties was simulated. Seven casualties who were rated "critical" by on-site field triage were admitted to the emergency department and underwent whole-body CT. The CT workflow was simulated with phantoms. The history of the casualties was matched to existing CT examinations that were used for evaluation of image reading under MCI conditions. The times needed for transfer and preparation of patients, examination, image reconstruction, total time in the CT examination room, image transfer to PACS, and image reading were recorded, and mean capacities were calculated and compared using the Mann-Whitney U test. We found no significant time differences in transfer and preparation of patients, duration of CT data acquisition, image reconstruction, total time in the CT room, and reading of the images. The calculated capacities per hour were 9.4 vs. 9.8 for examinations completed, and 8.2 vs. 7.2 for reports completed. In conclusion, CT triage is feasible and produced constant results with this dedicated and fast protocol.

  5. An argument for equipping civilian hospitals with a multiple respirator system for a chemical warfare mass casualty situation.

    PubMed

    Heller, O; Aldar, Y; Vosk, M; Shemer, J

    1991-01-01

    During the Persian Gulf war, the entire Israeli population was under the threat of chemical missiles. One of the main effects of chemical agents (e.g., organophosphorus) is respiratory distress, which requires treatment with mechanical ventilation and oxygen enrichment. In the event of a chemical missile attack, the civilian hospitals may enter a state of insufficiency for treating such victims due to the limited amount of equipment, staff and oxygen/air sources. A possible technological solution is a multiple respirator system (MRS) with a multiple oxygen enrichment system designed for use in the battlefield. The advantages of these technologies in the civilian hospital setting during a chemical mass casualty situation are: (a) rapid deployment, (b) high transportability, (c) capability of operation in any location, (d) modularity, and (e) less medical staff for operation. Two types of MRS are described and issues concerning their selection are discussed. The authorities responsible for national health policy may wish to adopt and incorporate these technologies into their hospital and emergency services preparedness system.

  6. Mass Casualties and Health Care Following the Release of Toxic Chemicals or Radioactive Material—Contribution of Modern Biotechnology

    PubMed Central

    Göransson Nyberg, Ann; Stricklin, Daniela; Sellström, Åke

    2011-01-01

    Catastrophic chemical or radiological events can cause thousands of casualties. Such disasters require triage procedures to identify the development of health consequences requiring medical intervention. Our objective is to analyze recent advancements in biotechnology for triage in mass emergency situations. In addition to identifying persons “at risk” of developing health problems, these technologies can aid in securing the unaffected or “worried well”. We also highlight the need for public/private partnerships to engage in some of the underpinning sciences, such as patho-physiological mechanisms of chemical and radiological hazards, and for the necessary investment in the development of rapid assessment tools through identification of biochemical, molecular, and genetic biomarkers to predict health effects. For chemical agents, biomarkers of neurotoxicity, lung damage, and clinical and epidemiological databases are needed to assess acute and chronic effects of exposures. For radiological exposures, development of rapid, sensitive biomarkers using advanced biotechnologies are needed to sort exposed persons at risk of life-threatening effects from persons with long-term risk or no risk. The final implementation of rapid and portable diagnostics tools suitable for emergency care providers to guide triage and medical countermeasures use will need public support, since commercial incentives are lacking. PMID:22408587

  7. Diagnostic precision of triage algorithms for mass casualty incidents. English version.

    PubMed

    Heller, A R; Salvador, N; Frank, M; Schiffner, J; Kipke, R; Kleber, C

    2017-08-10

    Regarding survival and quality of life recent mass casualty incidents again emphasize the importance of early identification of the correct degree of injury/illness to enable prioritization of treatment amongst patients and their transportation to an appropriate hospital. The present study investigated existing triage algorithms in terms of sensitivity (SE) and specificity (SP) as well as its process duration in a relevant emergency patient cohort. In this study 500 consecutive air rescue missions were evaluated by means of standardized patient records. Classification of patients was accomplished by 19 emergency physicians. Every case was independently classified by at least 3 physicians without considering any triage algorithm. Existing triage algorithms Primary Ranking for Initial Orientation in Emergency Medical Services (PRIOR), modified Simple Triage and Rapid Treatment (mSTaRT), Field Triage Score (FTS), Amberg-Schwandorf Algorithm for Triage (ASAV), Simple Triage and Rapid Treatment (STaRT), Care Flight, and Triage Sieve were additionally carried out computer based on each case, to enable calculation of quality criteria. The analyzed cohort had an age of (mean ± SD) 59 ± 25 years, a NACA score of 3.5 ± 1.1 and consisted of 57% men. On arrival 8 patients were deceased. Consequently, 492 patients were included in the analysis. The distribution of triage categories T1/T2/T3 were 10%/47%/43%, respectively. The highest diagnostic quality was achieved with START, mSTaRT, and ASAV yielding a SE of 78% and a SP ranging from 80-83%. The subgroup of surgical patients reached a SE of 95% and a SP between 85-91%. The newly established algorithm PRIOR exerted a SE of 90% but merely a SP of 54% in the overall cohort thereby consuming the longest time for overall decision. Triage procedures with acceptable diagnostic quality exist to identify the most severely injured. Due to its high rate of false positive results (over-triage) the recently developed

  8. A single, improvised "Kassam" rocket explosion can cause a mass casualty incident: a potential threat for future international terrorism?

    PubMed

    Schwartz, D; Ostfeld, I; Bar-Dayan, Y

    2009-04-01

    Over 2000 improvised rockets (called "Kassam" rockets) have been targeted at the south of Israel from the Gaza strip since 2001. Most of them have injured relatively few people. The first known case of a multicasualty incident (MCI) caused by the landing of a single, improvised rocket is described. The event is described according to the disastrous incidents systematic analysis through components, interactions and results methodology (DISAST-CIR). The rocket hit a military training tent camp in the south of Israel at 01:18 hours. At that time, all soldiers were in bed and were not using any protective gear. A total of 76 soldiers was injured (three severe, eight moderate and 65 mild). The most prevalent types of injuries were upper extremity (33%) and lower extremity (30%) trauma, tinnitus (30%) and acute stress reactions (32%). A total of 67 casualties was evacuated to the nearest level two hospital, Barzilai, in a two-phase distribution characterised by different patterns of injury severity and type. All urgent casualties arrived at hospitals within 1 h 24 minutes, whereas most stress casualties arrived in the later phase. Seven casualties were secondarily transported to level one trauma centres. 42 of the casualties were hospitalised and 17 needed urgent surgery. None has died. A single low-tech mortar with poor accuracy and small warhead (estimated weight of 10 kg only) can cause a large-scale MCI. As international terrorist organisations can easily gain access to improvised rockets, the latter may become a threat in many countries. Emergency systems should thus be prepared for that adverse possibility.

  9. MiRTE: Mixed Reality Triage and Evacuation game for Mass Casualty information systems design, testing and training.

    PubMed

    Yu, Xunyi; Ganz, Aura

    2011-01-01

    In this paper we introduce a Mixed Reality Triage and Evacuation game, MiRTE, that is used in the development, testing and training of Mass Casualty Incident (MCI) information systems for first responders. Using the Source game engine from Valve software, MiRTE creates immersive virtual environments to simulate various incident scenarios, and enables interactions between multiple players/first responders. What distinguishes it from a pure computer simulation game is that it can interface with external mass casualty incident management systems, such as DIORAMA. The game will enable system developers to specify technical requirements of underlying technology, and test different alternatives of design. After the information system hardware and software are completed, the game can simulate various algorithms such as localization technologies, and interface with an actual user interface on PCs and Smartphones. We implemented and tested the game with the DIORAMA system.

  10. Virtual reality and live simulation: a comparison between two simulation tools for assessing mass casualty triage skills.

    PubMed

    Luigi Ingrassia, Pier; Ragazzoni, Luca; Carenzo, Luca; Colombo, Davide; Ripoll Gallardo, Alba; Della Corte, Francesco

    2015-04-01

    This study tested the hypothesis that virtual reality simulation is equivalent to live simulation for testing naive medical students' abilities to perform mass casualty triage using the Simple Triage and Rapid Treatment (START) algorithm in a simulated disaster scenario and to detect the improvement in these skills after a teaching session. Fifty-six students in their last year of medical school were randomized into two groups (A and B). The same scenario, a car accident, was developed identically on the two simulation methodologies: virtual reality and live simulation. On day 1, group A was exposed to the live scenario and group B was exposed to the virtual reality scenario, aiming to triage 10 victims. On day 2, all students attended a 2-h lecture on mass casualty triage, specifically the START triage method. On day 3, groups A and B were crossed over. The groups' abilities to perform mass casualty triage in terms of triage accuracy, intervention correctness, and speed in the scenarios were assessed. Triage and lifesaving treatment scores were assessed equally by virtual reality and live simulation on day 1 and on day 3. Both simulation methodologies detected an improvement in triage accuracy and treatment correctness from day 1 to day 3 (P<0.001). The time to complete each scenario and its decrease from day 1 to day 3 were detected equally in the two groups (P<0.05). Virtual reality simulation proved to be a valuable tool, equivalent to live simulation, to test medical students' abilities to perform mass casualty triage and to detect improvement in such skills.

  11. [Emergency preparedness based on coherent integration of crisis response resources: workshop on mass casualty management in Bethlehem in June 1999].

    PubMed

    Amblard, J; Fleury, M; Ruolt, N

    2002-01-01

    In June 1999, the Humanitarian Action Division of the Foreign Affairs Department organized a training course on the mass casualty management within the framework of religious festivities related to the Bethlehem 2000 project. This initiative was undertaken at the request of the Palestinian Authority and the General Consulate of France in Jerusalem. Palestinian and French specialists in the field worked together in three workshops devoted to rescue, search and first aid; medical outposts and triage; and emergency and surgical care in referring hospitals.

  12. Training healthcare personnel for mass-casualty incidents in a virtual emergency department: VED II.

    PubMed

    Heinrichs, Wm Leroy; Youngblood, Patricia; Harter, Phillip; Kusumoto, Laura; Dev, Parvati

    2010-01-01

    Training emergency personnel on the clinical management of a mass-casualty incident (MCI) with prior chemical, biological, radioactive, nuclear, or explosives (CBRNE) -exposed patients is a component of hospital preparedness procedures. The objective of this research was to determine whether a Virtual Emergency Department (VED), designed after the Stanford University Medical Center's Emergency Department (ED) and populated with 10 virtual patient victims who suffered from a dirty bomb blast (radiological) and 10 who suffered from exposure to a nerve toxin (chemical), is an effective clinical environment for training ED physicians and nurses for such MCIs. Ten physicians with an average of four years of post-training experience, and 12 nurses with an average of 9.5 years of post-graduate experience at Stanford University Medical Center and San Mateo County Medical Center participated in this IRB-approved study. All individuals were provided electronic information about the clinical features of patients exposed to a nerve toxin or radioactive blast before the study date and an orientation to the "game" interface, including an opportunity to practice using it immediately prior to the study. An exit questionnaire was conducted using a Likert Scale test instrument. Among these 22 trainees, two-thirds of whom had prior Code Triage (multiple casualty incident) training, and one-half had prior CBRNE training, about two-thirds felt immersed in the virtual world much or all of the time. Prior to the training, only four trainees (18%) were confident about managing CBRNE MCIs. After the training, 19 (86%) felt either "confident" or "very confident", with 13 (59%) attributing this change to practicing in the virtual ED. Twenty-one (95%) of the trainees reported that the scenarios were useful for improving healthcare team skills training, the primary objective for creating them. Eighteen trainees (82%) believed that the cases also were instructive in learning about clinical

  13. Preparedness of German Paramedics and Emergency Physicians for a Mass Casualty Incident: A National Survey.

    PubMed

    Fischer, Philipp; Kabir, Karoush; Weber, Oliver; Wirtz, Dieter C; Bail, Hermann; Ruchholtz, Steffen; Stein, Mickey; Burger, Christof

    2008-10-01

    Paramedics and physicians are important components of our emergency medical system. To date, no survey has been carried out assessing physicians and paramedics regarding their preparedness for a mass casualty incident (MCI) resulting from a terrorist attack in Germany. The aim of this study was to assess the current state of preparedness of emergency physicians and paramedics for an MCI. Using an online questionnaire, we interviewed 1,707 emergency physicians and paramedics in Germany. The replies were analyzed statistically with the one-way analysis of variance (ANOVA) test and the Tukey-Kramer multiple comparisons test. In all, 95% of the emergency physicians and paramedics knew their area of responsibility in the case of an MCI. However, 45% of them were unaware of injury patterns and treatment strategies in patients following nuclear, chemical or biological contamination. Of the interviewed emergency physicians and paramedics, 97% asked for further specific training for MCI/terrorism attacks. Emergency physicians and paramedics are still insufficiently prepared for nuclear, chemical, and biological as well as conventional terrorism attacks. The emergency training of emergency physicians and paramedics must be modified to accommodate the increased risk of catastrophes and terrorist attacks.

  14. Assessment of Biodosimetry Methods for a Mass-Casualty Radiological Incident: Medical Response and Management Considerations

    PubMed Central

    Sullivan, Julie M.; Prasanna, Pataje G. S.; Grace, Marcy B.; Wathen, Lynne; Wallace, Rodney L.; Koerner, John F.; Coleman, C. Norman

    2013-01-01

    Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual’s radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual’s dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a stand-alone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, we reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point. PMID:24162058

  15. Assessment of biodosimetry methods for a mass-casualty radiological incident: medical response and management considerations.

    PubMed

    Sullivan, Julie M; Prasanna, Pataje G S; Grace, Marcy B; Wathen, Lynne K; Wallace, Rodney L; Koerner, John F; Coleman, C Norman

    2013-12-01

    Following a mass-casualty nuclear disaster, effective medical triage has the potential to save tens of thousands of lives. In order to best use the available scarce resources, there is an urgent need for biodosimetry tools to determine an individual's radiation dose. Initial triage for radiation exposure will include location during the incident, symptoms, and physical examination. Stepwise triage will include point of care assessment of less than or greater than 2 Gy, followed by secondary assessment, possibly with high throughput screening, to further define an individual's dose. Given the multisystem nature of radiation injury, it is unlikely that any single biodosimetry assay can be used as a standalone tool to meet the surge in capacity with the timeliness and accuracy needed. As part of the national preparedness and planning for a nuclear or radiological incident, the authors reviewed the primary literature to determine the capabilities and limitations of a number of biodosimetry assays currently available or under development for use in the initial and secondary triage of patients. Understanding the requirements from a response standpoint and the capability and logistics for the various assays will help inform future biodosimetry technology development and acquisition. Factors considered include: type of sample required, dose detection limit, time interval when the assay is feasible biologically, time for sample preparation and analysis, ease of use, logistical requirements, potential throughput, point-of-care capability, and the ability to support patient diagnosis and treatment within a therapeutically relevant time point.

  16. Adequacy of US Hospital Security Preparedness for Mass Casualty Incidents: Critical Lessons From the Israeli Experience.

    PubMed

    Golabek-Goldman, Michele

    2016-01-01

    Due to Israel's threat environment, Israeli hospitals have developed effective and innovative security preparations for responding to all-hazards incidents. Although Israeli hospital preparedness has been the subject of international praise and attention, there has been a dearth of research focused specifically on applying Israeli hospital security measures to the US hospital setting to augment emergency planning. This study examined practical and cost-effective lessons from the Israeli experience for improving US hospital security preparedness for a wide range of mass casualty incidents, both natural and man-made. Sixty semi-structured interviews were conducted with officials throughout Israel's and America's health, defense, and emergency response communities. Hospital preparedness was examined and disaster drills were evaluated in both countries, with San Francisco hospitals analyzed as a case study. Qualitative analysis was conducted and recommendations were made on the basis of an all-hazards approach to emergency preparedness. US hospitals examined in this study had not undertaken crucial preparations for managing the security consequences of a large-scale disaster. Recommendations from Israel included installing permanent emergency signage, improving security perimeter protocols and training, increasing defense against primary and secondary attacks, enhancing coordination with law enforcement, the National Guard, and other outside security agencies, and conducting more frequent and realistic lockdown exercises. A number of US hospitals have overlooked the important role of security in emergency preparedness. This study analyzed practical and cost-effective security recommendations from Israel to remedy this dangerous deficiency in some US hospitals' disaster planning.

  17. Drones at the service for training on mass casualty incident: A simulation study.

    PubMed

    Fernandez-Pacheco, Antonio Nieto; Rodriguez, Laura Juguera; Price, Mariana Ferrandini; Perez, Ana Belen Garcia; Alonso, Nuria Perez; Rios, Manuel Pardo

    2017-06-01

    Mass casualty incidents (MCI) are characterized by a large number of victims with respect to the resources available. In this study, we aimed to analyze the changes produced in the self-perception of students who were able to visualize aerial views of a simulation of a MCI. A simulation study, mixed method, was performed to compare the results from an ad hoc questionnaire. The 35 students from the Emergency Nursing Master from the UCAM completed a questionnaire before and after watching an MCI video with 40 victims in which they had participated. The main variable measured was the change in self-perception (CSP). The CSP occurred in 80% (28/35) of the students (P = .001). Students improved their individual (P = .001) and group (P = .006) scores. They also described that their personal performance had better results than the group performance (P = .047). The main conclusion of this study is that drones could lead to CSP and appraisal of the MCI simulation participants.

  18. Improving emergency medical dispatching with emphasis on mass-casualty incidents.

    PubMed

    Kleinoscheg, Gabriel; Burgsteiner, Harald; Bernroider, Martin; Kiechle, Günter; Obermayer, Maria

    2014-01-01

    Dispatching ambulances is a demanding and stressful task for dispatchers. This is especially true in case of mass-casualty incidents. Therefore, the aim of this work was to investigate if and to what extent the dispatch operation of the Red Cross Salzburg can be optimized on such occasions with a computerized system. The basic problem of a dynamic multi-vehicle Dial-a-Ride Problem with time windows was enhanced according to the requirements of the Red Cross Salzburg. The general objective was to minimize the total mileage covered by ambulances and the waiting time of patients. Furthermore, in case of emergencies suitable adaptions to a plan should be carried out automatically. Consequently, the problem is solved by using the Adaptive Large Neighborhood Search. Evaluation results indicate that the system outperforms a human dispatcher by between 2.5% and 36% within 1 minute of runtime concerning total costs. Moreover, the system's response time in case that a plan has to be updated is less than 1 minute on average.

  19. Identifying Factors That May Influence Decision-Making Related to the Distribution of Patients During a Mass Casualty Incident.

    PubMed

    Hall, Trevor Nt; McDonald, Andrew; Peleg, Kobi

    2017-09-18

    We aimed to identify and seek agreement on factors that may influence decision-making related to the distribution of patients during a mass casualty incident. A qualitative thematic analysis of a literature review identified 56 unique factors related to the distribution of patients in a mass casualty incident. A modified Delphi study was conducted and used purposive sampling to identify peer reviewers that had either (1) a peer-reviewed publication within the area of disaster management or (2) disaster management experience. In round one, peer reviewers ranked the 56 factors and identified an additional 8 factors that resulted in 64 factors being ranked during the two-round Delphi study. The criteria for agreement were defined as a median score greater than or equal to 7 (on a 9-point Likert scale) and a percentage distribution of 75% or greater of ratings being in the highest tertile. Fifty-four disaster management peer reviewers, with hospital and prehospital practice settings most represented, assessed a total of 64 factors, of which 29 factors (45%) met the criteria for agreement. Agreement from this formative study suggests that certain factors are influential to decision-making related to the distribution of patients during a mass casualty incident. (Disaster Med Public Health Preparedness. 2017; page 1 of 8).

  20. Short Text Messages (SMS) as an Additional Tool for Notifying Medical Staff in Case of a Hospital Mass Casualty Incident.

    PubMed

    Timler, Dariusz; Bogusiak, Katarzyna; Kasielska-Trojan, Anna; Neskoromna-Jędrzejczak, Aneta; Gałązkowski, Robert; Szarpak, Łukasz

    2016-02-01

    The aim of the study was to verify the effectiveness of short text messages (short message service, or SMS) as an additional notification tool in case of fire or a mass casualty incident in a hospital. A total of 2242 SMS text messages were sent to 59 hospital workers divided into 3 groups (n=21, n=19, n=19). Messages were sent from a Samsung GT-S8500 Wave cell phone and Orange Poland was chosen as the telecommunication provider. During a 3-month trial period, messages were sent between 3:35 PM and midnight with no regular pattern. Employees were asked to respond by telling how much time it would take them to reach the hospital in case of a mass casualty incident. The mean reaction time (SMS reply) was 36.41 minutes. The mean declared time of arrival to the hospital was 100.5 minutes. After excluding 10% of extreme values for declared arrival time, the mean arrival time was estimated as 38.35 minutes. Short text messages (SMS) can be considered an additional tool for notifying medical staff in case of a mass casualty incident.

  1. Virtual-world hospital simulation for real-world disaster response: Design and validation of a virtual reality simulator for mass casualty incident management.

    PubMed

    Pucher, Philip H; Batrick, Nicola; Taylor, Dave; Chaudery, Muzzafer; Cohen, Daniel; Darzi, Ara

    2014-08-01

    Mass casualty incidents are unfortunately becoming more common. The coordination of mass casualty incident response is highly complex. Currently available options for training, however, are limited by either lack of realism or prohibitive expense and by a lack of assessment tools. Virtual worlds represent a potentially cost-effective, immersive, and easily accessible platform for training and assessment. The aim of this study was to assess feasibility of a novel virtual-worlds-based system for assessment and training in major incident response. Clinical areas were modeled within a virtual, online hospital. A major incident, incorporating virtual casualties, allowed multiple clinicians to simultaneously respond with appropriate in-world management and transfer plans within limits of the hospital's available resources. Errors, delays, and completed actions were recorded, as well as Trauma-NOnTECHnical Skills (T-NOTECHS) score. Performance was compared between novice and expert clinician groups. Twenty-one subjects participated in three simulations: pilot (n = 7), novice (n = 8), and expert groups (n = 6). The novices committed more critical events than the experts, 11 versus 3, p = 0.006; took longer to treat patients, 560 (299) seconds versus 339 (321) seconds, p = 0.026; and achieved poorer T-NOTECHS scores, 14 (2) versus 21.5 (3.7), p = 0.003, and technical skill, 2.29 (0.34) versus 3.96 (0.69), p = 0.001. One hundred percent of the subjects thought that the simulation was realistic and superior to existing training options. A virtual-worlds-based model for the training and assessment of major incident response has been designed and validated. The advantages of customizability, reproducibility, and recordability combined with the low cost of implementation suggest that this potentially represents a powerful adjunct to existing training methods and may be applicable to further areas of surgery as well.

  2. Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned From the Crash of Asiana Airlines Flight 214.

    PubMed

    Campion, Eric M; Juillard, Catherine; Knudson, M Margaret; Dicker, Rochelle; Cohen, Mitchell J; Mackersie, Robert; Campbell, Andre R; Callcut, Rachael A

    2016-06-01

    To date, a substantial portion of multiple casualty incident literature has focused exclusively on prehospital and emergency department resources needed for optimal disaster response. Thus, inpatient resources required to care for individuals injured in multiple casualty events are not well described. To highlight the resources beyond initial emergency department triage needed for multiple casualty events, using one of the largest commercial aviation disasters in modern US history as a case study. Prospective case series of injured individuals treated at an urban level I trauma center following the crash of Asiana Airlines flight 214 on July 6, 2013. This analysis was conducted between June 1, 2014, and December 1, 2015. Commercial jetliner crash. Medical records, imaging data, nursing overtime, blood bank records, and trauma registry data were analyzed. Disaster logs, patient injuries, and blood product data were prospectively collected during the incident. Among 307 people aboard the flight, 192 were injured; 63 of the injured patients were initially evaluated at San Francisco General Hospital and Trauma Center (the highest number at any of the receiving medical facilities; age range, 4-74 years [23 were aged <17 years and 3 were aged >60 years]; median injury severity score of 19 admitted patients, 9 [range, 9-45]), including the highest number of critically injured patients (10 of 12). Despite the high impact of the crash, only 3 persons (<1%) died, including 1 in-hospital death. Among the 63 patients, 32 (50.8%) underwent a computed tomographic imaging study, with imaging of the abdomen and pelvis being the most common. Sixteen of the 32 patients undergoing computed tomography (50.0%) had a positive finding on at least 1 scan. Nineteen patients had major injuries and required admission, with 5 taken directly from the emergency department to the operating room. The most frequent injury was spinal fracture (13 patients). In the first 48 hours, 15 operations were

  3. Leadership as a component of crowd control in a hospital dealing with a mass-casualty incident: lessons learned from the October 2000 riots in Nazareth.

    PubMed

    Pinkert, Moshe; Bloch, Yuval; Schwartz, Dagan; Ashkenazi, Isaac; Nakhleh, Bishara; Massad, Barhoum; Peres, Michal; Bar-Dayan, Yaron

    2007-01-01

    Crowd control is essential to the handling of mass-casualty incidents (MCIs). This is the task of the police at the site of the incident. For a hospital, responsibility falls on its security forces, with the police assuming an auxiliary role. Crowd control is difficult, especially when the casualties are due to riots involving clashes between rioters and police. This study uses data regarding the October 2000 riots in Nazareth to draw lessons about the determinants of crowd control on the scene and in hospitals. Data collected from formal debriefings were processed to identify the specifics of a MCI due to massive riots. The transport of patients to the hospital and the behavior of their families were considered. The actions taken by the Hospital Manager to control crowds on the hospital premises also were analyzed. During 10 days of riots (01-10 October 2000), 160 casualties, including 10 severely wounded, were evacuated to the Nazareth Italian Hospital. The Nazareth English Hospital received 132 injured patients, including one critically wounded, nine severely wounded, 26 moderately injured, and 96 mildly injured. All victims were evacuated from the scene by private vehicles and were accompanied by numerous family members. This obstructed access to hospitals and hampered the care of the casualties in the emergency department. The hospital staff was unable to perform triage at the emergency department's entrance and to assign the wounded to immediate treatment areas or waiting areas. All of the wounded were taken by their families directly into the "immediate care"location where a great effort was made to prioritize the severely injured. In order to control the events, the hospital's managers enlisted prominent individuals within the crowds to aid with control. At one point, the mayor was enlisted to successfully achieve crowd control. During riots, city, community, and even makeshift leaders within a crowd can play a pivotal role in helping hospital management

  4. Sample Tracking in an Automated Cytogenetic Biodosimetry Laboratory for Radiation Mass Casualties.

    PubMed

    Martin, P R; Berdychevski, R E; Subramanian, U; Blakely, W F; Prasanna, P G S

    2007-07-01

    Chromosome aberration-based dicentric assay is expected to be used after mass casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput.This paper focuses on our efforts to eliminate data transcription errors, increase efficiency, and maintain samples' positive chain-of-custody by sample tracking during sample processing and data analysis. This sample tracking system represents a "beta" version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and medical

  5. Epidemiology of Emergency Medical Services-Assessed Mass Casualty Incidents according to Causes.

    PubMed

    Park, Ju Ok; Shin, Sang Do; Song, Kyoung Jun; Hong, Ki Jeong; Kim, Jungeun

    2016-03-01

    To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs' epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved ≥ 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6-5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals' resources.

  6. Epidemiology of Emergency Medical Services-Assessed Mass Casualty Incidents according to Causes

    PubMed Central

    2016-01-01

    To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs’ epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved ≥ 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6–5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals’ resources. PMID:26955248

  7. Sample Tracking in an Automated Cytogenetic Biodosimetry Laboratory for Radiation Mass Casualties

    PubMed Central

    Martin, P.R.; Berdychevski, R.E.; Subramanian, U.; Blakely, W.F.; Prasanna, P.G.S.

    2007-01-01

    Chromosome aberration-based dicentric assay is expected to be used after mass casualty life-threatening radiation exposures to assess radiation dose to individuals. This will require processing of a large number of samples for individual dose assessment and clinical triage to aid treatment decisions. We have established an automated, high-throughput, cytogenetic biodosimetry laboratory to process a large number of samples for conducting the dicentric assay using peripheral blood from exposed individuals according to internationally accepted laboratory protocols (i.e., within days following radiation exposures). The components of an automated cytogenetic biodosimetry laboratory include blood collection kits for sample shipment, a cell viability analyzer, a robotic liquid handler, an automated metaphase harvester, a metaphase spreader, high-throughput slide stainer and coverslipper, a high-throughput metaphase finder, multiple satellite chromosome-aberration analysis systems, and a computerized sample tracking system. Laboratory automation using commercially available, off-the-shelf technologies, customized technology integration, and implementation of a laboratory information management system (LIMS) for cytogenetic analysis will significantly increase throughput. This paper focuses on our efforts to eliminate data transcription errors, increase efficiency, and maintain samples’ positive chain-of-custody by sample tracking during sample processing and data analysis. This sample tracking system represents a “beta” version, which can be modeled elsewhere in a cytogenetic biodosimetry laboratory, and includes a customized LIMS with a central server, personal computer workstations, barcode printers, fixed station and wireless hand-held devices to scan barcodes at various critical steps, and data transmission over a private intra-laboratory computer network. Our studies will improve diagnostic biodosimetry response, aid confirmation of clinical triage, and medical

  8. Dynamic 3D visual analytic tools: a method for maintaining situational awareness during high tempo warfare or mass casualty operations

    NASA Astrophysics Data System (ADS)

    Lizotte, Todd E.

    2010-04-01

    Maintaining Situational Awareness (SA) is crucial to the success of high tempo operations, such as war fighting and mass casualty events (bioterrorism, natural disasters). Modern computer and software applications attempt to provide command and control manager's situational awareness via the collection, integration, interrogation and display of vast amounts of analytic data in real-time from a multitude of data sources and formats [1]. At what point does the data volume and displays begin to erode the hierarchical distributive intelligence, command and control structure of the operation taking place? In many cases, people tasked with making decisions, have insufficient experience in SA of high tempo operations and become overwhelmed easily as vast amounts of data begin to be displayed in real-time as an operation unfolds. In these situations, where data is plentiful and the relevance of the data changes rapidly, there is a chance for individuals to target fixate on those data sources they are most familiar. If these individuals fall into this type of pitfall, they will exclude other data that might be just as important to the success of the operation. To counter these issues, it is important that the computer and software applications provide a means for prompting its users to take notice of adverse conditions or trends that are critical to the operation. This paper will discuss a new method of displaying data called a Crisis ViewTM, that monitors critical variables that are dynamically changing and allows preset thresholds to be created to prompt the user when decisions need to be made and when adverse or positive trends are detected. The new method will be explained in basic terms, with examples of its attributes and how it can be implemented.

  9. Developing and organizing a trauma system and mass casualty management: some useful observations from the israeli trauma model.

    PubMed

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care.

  10. Developing and Organizing a Trauma System and Mass Casualty Management: Some Useful Observations from the Israeli Trauma Model

    PubMed Central

    Borgohain, B; Khonglah, T

    2013-01-01

    A trauma system is a chain of arrangements and preparedness to provide quality response to injured from the site of injury to the appropriate hospital for the full range of care. Israel has a unique trauma system developed from the experience gained in peace and in war. The system is designed to fit the state's current health system, which is different from the European and American systems. An effective trauma system may potentially manage mass casualty incidence better. The aim of this paper is to discuss learning points to develop a trauma system based on the Israeli trauma model. After participating in a course on developing a trauma system organized by a top Israeli trauma center, a literature search on the topic on the Internet was done using relevant key words like trauma system and disaster management in Israel using the Google search engine in the pubmed, open access journals and websites of trauma organizations. Israel has a unique trauma system of organizing and managing an emergency event, characterized by a central national organization responsible for management, coordination and ongoing quality control. Because of its unique geopolitical situation, the armed forces has a significant role in the system. Investing adequate resources on continuous education, manpower training, motivation, team-work and creation of public volunteers through advocacy is important for capacity building to develop a trauma system. Wisdom, motivation and pragmatism of the Israeli model may be useful to streamline work in skeletal trauma services of developing countries having fewer resources to bring consistency and acceptable standards in trauma care. PMID:23634336

  11. Design of a model to predict surge capacity bottlenecks for burn mass casualties at a large academic medical center.

    PubMed

    Abir, Mahshid; Davis, Matthew M; Sankar, Pratap; Wong, Andrew C; Wang, Stewart C

    2013-02-01

    To design and test a model to predict surge capacity bottlenecks at a large academic medical center in response to a mass-casualty incident (MCI) involving multiple burn victims. Using the simulation software ProModel, a model of patient flow and anticipated resource use, according to principles of disaster management, was developed based upon historical data from the University Hospital of the University of Michigan Health System. Model inputs included: (a) age and weight distribution for casualties, and distribution of size and depth of burns; (b) rate of arrival of casualties to the hospital, and triage to ward or critical care settings; (c) eligibility for early discharge of non-MCI inpatients at time of MCI; (d) baseline occupancy of intensive care unit (ICU), surgical step-down, and ward; (e) staff availability-number of physicians, nurses, and respiratory therapists, and the expected ratio of each group to patients; (f) floor and operating room resources-anticipating the need for mechanical ventilators, burn care and surgical resources, blood products, and intravenous fluids; (g) average hospital length of stay and mortality rate for patients with inhalation injury and different size burns; and (h) average number of times that different size burns undergo surgery. Key model outputs include time to bottleneck for each limiting resource and average waiting time to hospital bed availability. Given base-case model assumptions (including 100 mass casualties with an inter-arrival rate to the hospital of one patient every three minutes), hospital utilization is constrained within the first 120 minutes to 21 casualties, due to the limited number of beds. The first bottleneck is attributable to exhausting critical care beds, followed by floor beds. Given this limitation in number of patients, the temporal order of the ensuing bottlenecks is as follows: Lactated Ringer's solution (4 h), silver sulfadiazine/Silvadene (6 h), albumin (48 h), thrombin topical (72 h), type

  12. Coping with war mass casualties in a hospital under fire: the radiology experience.

    PubMed

    Engel, Ahuva; Soudack, Michalle; Ofer, Amos; Nitecki, Samy S; Ghersin, Eduard; Fischer, Doron; Gaitini, Diana E

    2009-11-01

    We report the role of the imaging department at a level 1 trauma center during the Second Lebanon War (summer 2006). Our institution received 849 military and civilian casualties, an average of 25 war-injured patients per day, 338 with acute traumatic stress disorders and 511 physically injured, coming in waves after a rocket attack or a battle confrontation. About 12 potentially critical physically injured patients per day were referred to the imaging department for sometimes complex imaging procedures. The unpredictable waves of casualties and nature of the injuries forced us to reorganize our routine workflow to provide adequate care to casualties and to nonemergent patients. Our nurses' station was transformed into a small emergency department. The radiology staff was distributed into 12 diagnostic stations, providing 24-hour service. Communication was improved by means of walkie-talkies. Three ultrasound units were placed at the emergency department for immediate focused assessment with sonography for trauma performance enabling initial triage of patients. The site and extent of injuries were accurately diagnosed on CT and CT angiography. Digital angiography allowed definitive vascular diagnosis and interventional procedures. Adequate communication, strict workflow, and correct use of imaging protocols ensured optimal triage, diagnosis, and therapy of casualties while maintaining care for nonwar patients.

  13. Regional health system response to the Virginia Tech mass casualty incident.

    PubMed

    Kaplowitz, Lisa; Reece, Morris; Hershey, Jody Henry; Gilbert, Carol M; Subbarao, Italo

    2007-09-01

    On April 16, 2007 a mass shooting occurred on the campus of Virginia Polytechnic Institute and State University (Virginia Tech). Due to both distance and weather, air transport of the injured directly to a level 1 trauma center was not possible. The injured received all of their care or were initially stabilized at 3 primary hospitals that either had a level 3 trauma center designation or no trauma center designation. This article is a retrospective analysis of the regional health system (prehospital, hospital, regional hospital emergency operations center, and public health local and state) response. Data records from all of the regional responding emergency medical services, hospitals, and coordinating services were reviewed and analyzed. Records for all 26 patients were reviewed and analyzed using triage designations, injury severity scores (ISS), and critical mortality. Twenty-five of the 26 patients were triaged in the field. Excluding 1 patient (asthma), the average ISS for victims presenting was 8.2. Twelve patients had an ISS of > or = 9, and 5 had an ISS score of > or = 15. Ten of the 26 patients (38%) required urgent intervention and surgery in the first 24 hours. The overall regional health system mortality of victims received was 3.8% (1 death [excluding 1 dead on arrival {DOA}]/ 26 victims from scene). The regional health system critical mortality rate (excluding 1 victim who was DOA) was 20% (1/5). The outcomes of the Virginia Tech mass casualty incident, as evidenced by the low overall regional health system mortality of victims received at 3.8% (1/26) and low critical mortality rate (excluding 1 victim who was DOA) of 20%, coupled with a need to treat a significant amount of moderately injured victims 46% (12/26 with ISS > or = 9) gives credence to the successful response. The successful response occurred as a consequence of regional collaborative planning, training, and exercising, which resulted not only in increased expertise and improved

  14. Creating order from chaos: part II: tactical planning for mass casualty and disaster response at definitive care facilities.

    PubMed

    Baker, Michael S

    2007-03-01

    Current events highlight the need for disaster preparedness. We have seen tsunamis, hurricanes, terrorism, and combat in the news every night. There are many variables in a disaster, such as damage to facilities, loss of critical staff members, and overwhelming numbers of casualties. Each medical treatment facility should have a plan for everything from caring for staff members to getting the laundry done and providing enhanced security or mortuary services. Communication and agreements with local, regional, and federal agencies are vital. Then we must train and drill to shape the tools to impose order on chaos and to provide the most care to the greatest number.

  15. [Ethical Debates Related to the Allocation of Medical Resources During the Response to the Mass Casualty Incident at Formosa Fun Coast Water Park].

    PubMed

    Tang, Jing-Shia; Chen, Chia-Jung; Huang, Mei-Chih

    2017-02-01

    Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources. The present article focused on the 2015 explosion at Formosa Fun Coast, a recreational water park in Bali, New Taipei City, Taiwan as a way to explore the dilemma over the triage and resource allocation for casualties with burns over 90% and 50-60% of their bodies. The principles of utilitarianism and deontology in Western medicine were used to discuss the reasons and rationale behind the allocation of medical resources during this incident. Confucianism, a philosophical mindset that significantly influences Taiwanese society today, was then discussed to describe the "miracles" that happened during the incident, including the acquisition of assistance from the public and medical professionals. External supplies and professional help (social resources) were provided voluntarily after this incident, which had a profound impact on both the immediate response and the longer-term recovery efforts.

  16. An epidemiological approach to mass casualty incidents in the Principality of Asturias (Spain).

    PubMed

    Castro Delgado, Rafael; Naves Gómez, Cecilia; Cuartas Álvarez, Tatiana; Arcos González, Pedro

    2016-02-24

    Mass Casualty Incidents (MCI) have been rarely studied from epidemiological approaches. The objective of this study is to establish the epidemiological profile of MCI in the autonomous region of the Principality of Asturias (Spain) and analyse ambulance deployment and severity of patients. This is a population-based prospective study run in 2014. Inclusion criteria for MCI is "every incident with four or more people affected that requires ambulance mobilisation". Thirty-nine MCI have been identified in Asturias in 2014. Thirty-one (79%) were road traffic accidents, three (7.5%) fires and five (12.8%) other types. Twenty-one incidents (56.7%) had four patients, and only three of them (8%) had seven or more patients. An average of 2.41 ambulances per incident were deployed (standard error = 0.18). Most of the patients per incident were minor injured patients (mean = 4; standard error = 0.2), and 0,26 were severe patients (standard error = 0.08). There was a positive significant correlation (p < 0.01) between the total number of patients and the total number of ambulances deployed and between the total number of patients and Advanced Life Support (ALS) ambulances deployed (p < 0.001). The total number of non-ALS ambulances was not related with the total number of patients. Population based research in MCI is essential to define MCI profile. Quantitative definition of MCI, adapted to resources, avoid selection bias and present a more accurate profile of MCI. As espected, road traffic accidents are the most frequent MCI in our region. This aspect is essential to plan training and response to MCI. Analysis of total response to MCI shows that for almost an hour, we should plan extra resources for daily emergencies. This data is an important issue to bear in mind when planning MCI response. The fact that most patients are classified as minor injured and more advanced life support units than needed are deployed shows that analysis of resources

  17. Development of a staff recall system for mass casualty incidents using cell phone text messaging.

    PubMed

    Epstein, Richard H; Ekbatani, Ali; Kaplan, Javier; Shechter, Ronen; Grunwald, Zvi

    2010-03-01

    After a mass casualty incident (MCI), rapid mobilization of hospital personnel is required because of an expected surge of victims. Risk assessment of our department's manual phone tree recall system revealed multiple weaknesses that would limit an effective response. Because cell phone use is widespread within the department, we developed and tested a staff recall system, based in our anesthesia information management system (AIMS), using Short Message Service (SMS) text messaging. We sent test text messages to anesthesia staff members' cell phone numbers, determined the distance from their home to the hospital, and stored this information in our AIMS. Latency testing for the time from transmission of SMS test messages from the server to return of an e-mail reply was determined at 2 different times on 2 different dates, 1 of which was a busy holiday weekend, using volunteers within the department. Two unannounced simulated disaster recall drills were conducted, with text messages sent asking for the anticipated time to return to the hospital. A timeline of available staff on site was determined. Reasons for failure to respond to the disaster notification message were tabulated. Latency data were fit by a log-normal distribution with an average of 82 seconds from message transmission to e-mail reply. Replies to the simulated disaster alert were received from approximately 50% of staff, with 16 projecting that they would have been able to be back at the hospital within 30 minutes on both dates. There would have been 21 and 23 staff in-house at 30 minutes, and 32 and 37 staff in-house at 60 minutes on the first and second test date, respectively, including in-house staff. Of the nonresponders to the alert, 48% indicated that their cell phone was not with them or was turned off, whereas 22% missed the message. Our SMS staff recall system is likely to be able to rapidly mobilize sufficient numbers of anesthesia personnel in response to an MCI, but actual performance

  18. A Wireless First Responder Handheld Device for Rapid Triage, Patient Assessment and Documentation during Mass Casualty Incidents

    PubMed Central

    Killeen, James P.; Chan, Theodore C.; Buono, Colleen; Griswold, William G.; Lenert, Leslie A.

    2006-01-01

    Medical care at mass casualty incidents and disasters requires rapid patient triage and assessment, acute care and disposition often in the setting of overwhelming numbers of victims, limited time, and little resources. Current systems rely on a paper triage tag on which rescuers and medical providers mark the patient’s triage status and record limited information on injuries and treatments administered in the field. In this manuscript, we describe the design, development and deployment of a wireless handheld device with an electronic medical record (EMR) for use by rescuers responding to mass casualty incidents (MCIs) and disasters. The components of this device, the WIISARD First Responder (WFR), includes a personal digital assistant (PDA) with 802.11 wireless transmission capabilities, microprocessor and non-volatile memory, and a unique EMR software that replicates the rapidity and ease of use of the standard paper triage tag. WFR also expands its functionality by recording real-time medical data electronically for simultaneous access by rescuers, mid-level providers and incident commanders on and off the disaster site. WFR is a part of the Wireless Information System for Medical Response in Disasters (WIISARD) architecture. PMID:17238377

  19. Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire*

    PubMed Central

    Shen, Wei-feng; Jiang, Li-bing; Jiang, Guan-yu; Zhang, Mao; Ma, Yue-feng; He, Xiao-jun

    2014-01-01

    Objective: In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. Methods: We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: ‘mass casualty incident’, ‘MCI’, ‘research method’, ‘Wenchuan’, ‘earthquake’, ‘research paradigm’, ‘science of surge’, ‘surge’, ‘surge capacity’, and ‘vulnerability’. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. Results: The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored—vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. Conclusions: This new paradigm breaks through the

  20. Development of the science of mass casualty incident management: reflection on the medical response to the Wenchuan earthquake and Hangzhou bus fire.

    PubMed

    Shen, Wei-feng; Jiang, Li-bing; Jiang, Guan-yu; Zhang, Mao; Ma, Yue-feng; He, Xiao-jun

    2014-12-01

    In this paper, we review the previous classic research paradigms of a mass casualty incident (MCI) systematically and reflect the medical response to the Wenchuan earthquake and Hangzhou bus fire, in order to outline and develop an improved research paradigm for MCI management. We searched PubMed, EMBASE, China Wanfang, and China Biology Medicine (CBM) databases for relevant studies. The following key words and medical subject headings were used: 'mass casualty incident', 'MCI', 'research method', 'Wenchuan', 'earthquake', 'research paradigm', 'science of surge', 'surge', 'surge capacity', and 'vulnerability'. Searches were performed without year or language restriction. After searching the four literature databases using the above listed key words and medical subject headings, related articles containing research paradigms of MCI, 2008 Wenchuan earthquake, July 5 bus fire, and science of surge and vulnerability were independently included by two authors. The current progresses on MCI management include new golden hour, damage control philosophy, chain of survival, and three links theory. In addition, there are three evaluation methods (medical severity index (MSI), potential injury creating event (PICE) classification, and disaster severity scale (DSS)), which can dynamically assess the MCI situations and decisions for MCI responses and can be made based on the results of such evaluations. However, the three methods only offer a retrospective evaluation of MCI and thus fail to develop a real-time assessment of MCI responses. Therefore, they cannot be used as practical guidance for decision-making during MCI. Although the theory of surge science has made great improvements, we found that a very important factor has been ignored-vulnerability, based on reflecting on the MCI response to the 2008 Wenchuan earthquake and July 5 bus fire in Hangzhou. This new paradigm breaks through the limitation of traditional research paradigms and will contribute to the development

  1. The incidence of heat casualties in sprint triathlon: the tale of two Melbourne race events.

    PubMed

    Gosling, Cameron McR; Gabbe, Belinda J; McGivern, Jeanne; Forbes, Andrew B

    2008-01-01

    Triathlon is a popular participation sport combining swimming, cycling and running into a single event. The Triathlon Australia medical policy advocates the use of wet bulb globe temperature as the criterion for altering race distance and an ambient temperature of 35 degrees C as a criterion for consideration of cancellation of an event, but there is little empirical evidence detailing the effectiveness of this policy. Nor has the impact of environmental thermal stress on triathletes in shorter duration events been determined. During an injury surveillance investigation of a triathlon race series over the 2006/2007 seasons, two events with similar environmental conditions were completed. One thousand eight hundred and eighty-four participants competed in event 1 (December 2006) and 2000 competed in event 2 (February 2007). Maximum dry bulb (DBT), minimum vapour pressure (VP) and minimum relative humidity (RH) for event 1 were 37 degrees C DBT, 0.56 kPa VP and 9% RH measured by the Bureau of Meteorology. Fifty-three participants presented for medical aid, 15 due to heat-related collapse. The conditions measured for event 2 were 33 degrees C DBT, 1.16 kPa VP and 24% RH and there were no heat illness presentations despite 38 individuals presenting for medical aid. These observations suggest that the risk of heat-related collapse is greatest when high-environmental temperatures occur early in the competitive season when participants may be inadequately prepared and have not yet acquired natural acclimatisation to heat. Any Triathlon Australia policy revision could place stronger emphasis on the use of ambient temperature as a limiting criterion for race organisers.

  2. Casualty management: scud missile attack, Dhahran, Saudi Arabia.

    PubMed

    Humphrey, J C

    1999-05-01

    On the evening of February 25, 1991, an Iraqi scud missile plunged into a "barracks/warehouse" used to house U.S. Army soldiers assigned to the 475th Quartermaster Group in Dhahran, Saudi Arabia. As a consequence of this scud attack, 28 soldiers died, 110 were hospitalized, and 150 experienced minor physical injuries and/or subsequent mental health problems. This one scud's impact accounted for more than one-third of all U.S. soldiers killed during the war. Fortunately, there were very few "models" of mass casualty experiences during the Persian Gulf War to evaluate the critical clinical outcomes to the soldiers. An analysis of this event has important implications for future military operations that feature a multinational medical force structure. This article summarizes the medical preparations before the war, the key, chronological events, and the medical outcomes of the mass casualty event. Lessons learned in casualty management for future Army contingency medical planners are identified.

  3. Surgeon and hospital leadership during terrorist-related multiple-casualty events: a coup d'état.

    PubMed

    Einav, Sharon; Spira, Ram M; Hersch, Moshe; Reissman, Petachia; Schecter, William

    2006-08-01

    During terrorist-related multiple-casualty events (TMCEs), the role of the surgeon expands beyond providing traditional trauma care. Survey and expert opinion poll. Interviews (structured, open/closed questions) conducted in 14 Israeli hospitals. Sixty hospital physicians selected for their experience in TMCEs. Identification of key staff members and their roles during TMCEs and development of recommendations for hospital management. During TMCEs, hospitals are comanaged by a physician hospital administrator and a clinical medical director (usually a surgeon) responsible for prioritization of patient care. Primary triage is often performed by a general surgeon experienced in trauma. Trauma specialists supervise other physicians providing patient care. Key staff members to recruit to the hospital at event onset include the chiefs of surgery and anesthesiology, attending surgeons and anesthesiologists, critical care physicians, and radiologists. Paramedics stationed in-hospital as emergency medical services liaisons improve communication between the field and the hospital. Operating room and intensive care unit (ICU) management remain unchanged. Controversies exist regarding continuation of planned and ongoing elective surgery and ICU triage despite use of the postanesthesia care unit as an extension of the ICU. During TMCEs, surgeons fill pivotal roles in hospital command and control and hands-on clinical care. Anesthesiology services and ICUs are relied on heavily for provision of patient care and should be included in information flow and decision making. Operating room and ICU management should remain unchanged since the care of patients who are already in these locations at the time disaster strikes is a subject of controversy with ethical implications.

  4. Creating order from chaos: part I: triage, initial care, and tactical considerations in mass casualty and disaster response.

    PubMed

    Baker, Michael S

    2007-03-01

    How do we train for the entire spectrum of potential emergency and crisis scenarios? Will we suddenly face large numbers of combat casualties, an earthquake, a plane crash, an industrial explosion, or a terrorist bombing? The daily routine can suddenly be complicated by large numbers of patients, exceeding the ability to treat in a routine fashion. Disaster events can result in patients with penetrating wounds, burns, blast injuries, chemical contamination, or all of these at once. Some events may disrupt infrastructure or result in loss of essential equipment or key personnel. The chaos of a catastrophic event impedes decision-making and effective treatment of patients. Disasters require a paradigm shift from the application of unlimited resources for the greatest good of each individual patient to the allocation of care, with limited resources, for the greatest good for the greatest number of patients. Training and preparation are essential to remain effective during crises and major catastrophic events. Disaster triage and crisis management represent a tactical art that incorporates clinical skills, didactic information, communication ability, leadership, and decision-making. Planning, rehearsing, and exercising various scenarios encourage the flexibility, adaptability, and innovation required in disaster settings. These skills can bring order to the chaos of overwhelming disaster events.

  5. [Current state of medical care of polytrauma and mass casualty incidents in Germany. Are we well-prepared?].

    PubMed

    Brodauf, L; Heßing, K; Hoffmann, R; Friemert, B

    2015-10-01

    The white paper on the medical care of the severely injured published in 2006 is a collection of proposals and recommendations concerning structure, organization and equipment for the medical care of severely injured patients. Since its publication 50 networks ( http://www.dgu-traumanetzwerk.de/index ) have been established as part of the trauma network. This and the trauma register have helped to continuously improve the medical care of severely injured patients since 1993 [26]. Numerous studies have documented the progress made in measures required by the trauma network [4, 6]. For example, the mortality rate of severely injured patients has dropped from 25 % to approximately 10 % in the past 15 years. From the register and network data it is difficult to tell how each of these measures is implemented in the participating hospitals, who provides medical treatment to patients when, and how medical care is organized in detail. This is why a survey on medical care for polytrauma and in mass casualty situations was conducted among medical directors in German surgical hospitals who are members of the German Society for Trauma Surgery (DGU). Thanks to the 211 participants (most of whom specialize in orthopedic and trauma surgery) a detailed description of how medical treatment is currently organized and performed could be acquired. The survey showed that care of patients with polytrauma (i.e. medical treatment and management) is important irrespective of the level of training of physicians and of the level of patient treatment in hospitals. The central role of traumatologists was emphasized not only in terms of actual treatment but also as an administrator for organizational and management matters. Almost all hospitals have plans for a mass casualty situation; however, the levels of preparedness show considerable variation. A highly critical view is taken of the new surgical specialists with respect to interdisciplinary and comprehensive emergency medical treatment

  6. Basic Disaster Life Support (BDLS) Training Improves First Responder Confidence to Face Mass-Casualty Incidents in Thailand.

    PubMed

    Kuhls, Deborah A; Chestovich, Paul J; Coule, Phillip; Carrison, Dale M; Chua, Charleston M; Wora-Urai, Nopadol; Kanchanarin, Tavatchai

    2017-06-13

    Medical response to mass-casualty incidents (MCIs) requires specialized training and preparation. Basic Disaster Life Support (BDLS) is a course designed to prepare health care workers for a MCI. The purpose of this study was to evaluate the confidence of health care professionals in Thailand to face a MCI after participating in a BDLS course. Basic Disaster Life Support was taught to health care professionals in Thailand in July 2008. Demographics and medical experience were recorded, and participants rated their confidence before and after the course using a five-point Likert scale in 11 pertinent MCI categories. Survey results were compiled and compared with P<.05 statistically significant. A total of 162 health care professionals completed the BDLS course and surveys, including 78 physicians, 70 nurses, and 14 other health care professionals. Combined confidence increased among all participants (2.1 to 3.8; +1.7; P<.001). Each occupation scored confidence increases in each measured area (P<.001). Nurses had significantly lower pre-course confidence but greater confidence increase, while physicians had higher pre-course confidence but lower confidence increase. Active duty military also had lower pre-course confidence with significantly greater confidence increases, while previous disaster courses or experience increased pre-course confidence but lower increase in confidence. Age and work experience did not influence confidence. Basic Disaster Life Support significantly improves confidence to respond to MCI situations, but nurses and active duty military benefit the most from the course. Future courses should focus on these groups to prepare for MCIs. Kuhls DA , Chestovich PJ , Coule P , Carrison DM , Chua CM , Wora-Urai N , Kanchanarin T . Basic Disaster Life Support (BDLS) training improves first responder confidence to face mass-casualty incidents in Thailand. Prehosp Disaster Med. 2017;32(5):1-9 .

  7. Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

    PubMed

    Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

    2017-07-01

    Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

  8. Incidence and Mortality Rates of Disasters and Mass Casualty Incidents in Korea: A Population-Based Cross-Sectional Study, 2000-2009

    PubMed Central

    Kim, Soo Jin; Shin, Sang Do; Lee, Seung Chul; Park, Ju Ok; Sung, Joohon

    2013-01-01

    The objective of study was to evaluate the incidence and mortality rates of disasters and mass casualty incidents (MCIs) over the past 10 yr in the administrative system of Korea administrative system and to examine their relationship with population characteristics. This was a population-based cross-sectional study. We calculated the nationwide incidence, as well as the crude mortality and injury incidence rates, of disasters and MCIs. The data were collected from the administrative database of the National Emergency Management Agency (NEMA) and from provincial fire departments from January 2000 to December 2009. A total of 47,169 events were collected from the NEMA administrative database. Of these events, 115 and 3,079 cases were defined as disasters and MCIs that occurred in Korea, respectively. The incidence of technical disasters/MCIs was approximately 12.7 times greater than that of natural disasters/MCIs. Over the past 10 yr, the crude mortality rates for disasters and MCIs were 2.36 deaths per 100,000 persons and 6.78 deaths per 100,000 persons, respectively. The crude injury incidence rates for disasters and MCIs were 25.47 injuries per 100,000 persons and 152 injuries per 100,000 persons, respectively. The incidence and mortality of disasters/MCIs in Korea seem to be low compared to that of trend around the world. PMID:23678255

  9. Incidence and mortality rates of disasters and mass casualty incidents in Korea: a population-based cross-sectional study, 2000-2009.

    PubMed

    Kim, Soo Jin; Kim, Chu Hyun; Shin, Sang Do; Lee, Seung Chul; Park, Ju Ok; Sung, Joohon

    2013-05-01

    The objective of study was to evaluate the incidence and mortality rates of disasters and mass casualty incidents (MCIs) over the past 10 yr in the administrative system of Korea administrative system and to examine their relationship with population characteristics. This was a population-based cross-sectional study. We calculated the nationwide incidence, as well as the crude mortality and injury incidence rates, of disasters and MCIs. The data were collected from the administrative database of the National Emergency Management Agency (NEMA) and from provincial fire departments from January 2000 to December 2009. A total of 47,169 events were collected from the NEMA administrative database. Of these events, 115 and 3,079 cases were defined as disasters and MCIs that occurred in Korea, respectively. The incidence of technical disasters/MCIs was approximately 12.7 times greater than that of natural disasters/MCIs. Over the past 10 yr, the crude mortality rates for disasters and MCIs were 2.36 deaths per 100,000 persons and 6.78 deaths per 100,000 persons, respectively. The crude injury incidence rates for disasters and MCIs were 25.47 injuries per 100,000 persons and 152 injuries per 100,000 persons, respectively. The incidence and mortality of disasters/MCIs in Korea seem to be low compared to that of trend around the world.

  10. Mass casualties on the modern battlefield: a view from the 1st Armored Division (US).

    PubMed

    Nguyen, D

    1994-11-01

    Operations Desert Shield/Desert Storm will go down in history as a resounding success. However, future successes will depend on how much we take away from this experience in the form of lessons learned. This article is a warning message on the need for medical preparedness. The medical personnel shortage remains a problem for both commanders of field units and medical staff. The Professional Filler System, which provides clinicians to deploying combat medical and line units, is not aggressively administered and maintained. Medical Tactical Standard Operating Procedures are not fully integrated, nor are they used in Mission Essential Task List training. LOGOVERWATCH has potential but needs refinement. Finally, important medical and communication equipment needs upgrading to current state-of-the-art standards. On the plus side, the Combat LifeSaver program works well for intensive training on chemical casualties care. Combined with the high state of training and motivation of soldiers and medical professionals, many of the current shortcomings have been masked. This situation cannot go on indefinitely without a degradation of mission capability.

  11. Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia

    PubMed Central

    Shalhoub, Abdullah A. Bin; Khan, Anas A.; Alaska, Yaser A.

    2017-01-01

    Objectives: To identify and describe the hospital disaster preparedness (HDP) in major private hospitals in Riyadh, Saudi Arabia. Methods: This is an observational cross-sectional survey study performed in Riyadh city, Saudi Arabia between December 2015 and April 2016. Thirteen major private hospitals in Riyadh with more than 100 beds capacity were included in this investigation. Results: The 13 hospitals had HDP plan and reported to have an HDP committee. In 12 (92.3%) hospitals, the HDP covered both internal and external disasters and HDP was available in every department of the hospital. There were agreements with other hospitals to accept patients during disasters in 9 facilities (69.2%) while 4 (30.8%) did not have such agreement. None of the hospitals conducted any unannounced exercises in previous year. Conclusion: Most of the weaknesses were apparent particularly in the education, training and monitoring of the hospital staff to the preparedness for disaster emergency occasion. Few hospitals had conducted an exercise with casualties, few had drilled evacuation of staff and patients in the last 12 months, and none had any unannounced exercise in the last year. PMID:28251227

  12. Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia.

    PubMed

    Bin Shalhoub, Abdullah A; Khan, Anas A; Alaska, Yaser A

    2017-03-01

    To identify and describe the hospital disaster preparedness (HDP) in major private hospitals in Riyadh, Saudi Arabia. Methods: This is an observational cross-sectional survey study performed in Riyadh city, Saudi Arabia between December 2015 and April 2016. Thirteen major private hospitals in Riyadh with more than 100 beds capacity were included in this investigation. Results: The 13 hospitals had HDP plan and reported to have an HDP committee. In 12 (92.3%) hospitals, the HDP covered both internal and external disasters and HDP was available in every department of the hospital. There were agreements with other hospitals to accept patients during disasters in 9 facilities (69.2%) while 4 (30.8%) did not have such agreement. None of the hospitals conducted any unannounced exercises in previous year.  Conclusion: Most of the weaknesses were apparent particularly in the education, training and monitoring of the hospital staff to the preparedness for disaster emergency occasion. Few hospitals had conducted an exercise with casualties, few had drilled evacuation of staff and patients in the last 12 months, and none had any unannounced exercise in the last year.

  13. Data collection in a live mass casualty incident simulation: automated RFID technology versus manually recorded system.

    PubMed

    Ingrassia, Pier Luigi; Carenzo, Luca; Barra, Federico Lorenzo; Colombo, Davide; Ragazzoni, Luca; Tengattini, Marco; Prato, Federico; Geddo, Alessandro; Della Corte, Francesco

    2012-02-01

    To demonstrate the applicability and the reliability of a radio frequency identification (RFID) system to collect data during a live exercise. A rooftop collapse of a crowded building was simulated. Fifty-three volunteers were trained to perform as smart victims, simulating clinical conditions, using dynamic data cards, and capturing delay times and triage codes. Every victim was also equipped with a RFID tag. RFID antenna was placed at the entrance of the advanced medical post (AMP) and emergency department (ED) and recorded casualties entering the hospital. A total of 12 victims entered AMP and 31 victims were directly transferred to the ED. 100% (12 of 12 and 31 of 31) of the time cards reported a manually written hospital admission time. No failures occurred in tag reading or data transfers. A correlation analysis was performed between the two methods plotting the paired RFID and manual times and resulted in a r=0.977 for the AMP and r=0.986 for the ED with a P value of less than 0.001. We confirmed the applicability of RFID system to the collection of time delays. Its use should be investigated in every aspect of data collection (triage, treatments) during a disaster exercise.

  14. The Boston Marathon Bombings Mass Casualty Incident: One Emergency Department's Information Systems Challenges and Opportunities.

    PubMed

    Landman, Adam; Teich, Jonathan M; Pruitt, Peter; Moore, Samantha E; Theriault, Jennifer; Dorisca, Elizabeth; Harris, Sheila; Crim, Heidi; Lurie, Nicole; Goralnick, Eric

    2015-07-01

    Emergency department (ED) information systems are designed to support efficient and safe emergency care. These same systems often play a critical role in disasters to facilitate real-time situation awareness, information management, and communication. In this article, we describe one ED's experiences with ED information systems during the April 2013 Boston Marathon bombings. During postevent debriefings, staff shared that our ED information systems and workflow did not optimally support this incident; we found challenges with our unidentified patient naming convention, real-time situational awareness of patient location, and documentation of assessments, orders, and procedures. As a result, before our next mass gathering event, we changed our unidentified patient naming convention to more clearly distinguish multiple, simultaneous, unidentified patients. We also made changes to the disaster registration workflow and enhanced roles and responsibilities for updating electronic systems. Health systems should conduct disaster drills using their ED information systems to identify inefficiencies before an actual incident. ED information systems may require enhancements to better support disasters. Newer technologies, such as radiofrequency identification, could further improve disaster information management and communication but require careful evaluation and implementation into daily ED workflow. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  15. Clinical guidelines for responding to chemical, biological, radiological, nuclear and trauma/burn mass casualty incidents: Quick reference guides for emergency department staff.

    PubMed

    Albanese, Joseph; Burich, David; Smith, Deborah; Hayes, Lynn; Paturas, James; Tomassoni, Anthony

    The word 'DISASTER' may be used as a mnemonic for listing the critical elements of emergency response. The National Disaster Life Support Education Foundation's (NDLSEC) DISASTER paradigm emphasises out-of-hospital emergency response and includes the following elements: (1) detect; (2) incident command system; (3) security and safety; (4) assessment; (5) support; (6) triage and treatment; (7) evacuate; and (8) recovery. This paper describes how the DISASTER paradigm was used to create a series of clinical guidelines to assist the preparedness effort of hospitals for mitigating chemical, biological, radiological, nuclear incidents or explosive devices resulting in trauma/burn mass casualty incidents (MCIs) and their initial response to these events. Descriptive information was obtained from observations and records associated with this project. The information contributed by a group of subject matter experts in disaster medicine, at the Yale New Haven Health System Center for Emergency Preparedness and Disaster Response was used to author the clinical guidelines. Akin to the paradigm developed by the NDLSEC for conducting on-scene activities, the clinical guidelines use the letters in the word 'disaster' as a mnemonic for recalling the main elements required for mitigating MCIs in the hospital emergency department.

  16. Tsunami Casualty Model

    NASA Astrophysics Data System (ADS)

    Yeh, H.

    2007-12-01

    More than 4500 deaths by tsunamis were recorded in the decade of 1990. For example, the 1992 Flores Tsunami in Indonesia took away at least 1712 lives, and more than 2182 people were victimized by the 1998 Papua New Guinea Tsunami. Such staggering death toll has been totally overshadowed by the 2004 Indian Ocean Tsunami that claimed more than 220,000 lives. Unlike hurricanes that are often evaluated by economic losses, death count is the primary measure for tsunami hazard. It is partly because tsunamis kill more people owing to its short lead- time for warning. Although exact death tallies are not available for most of the tsunami events, there exist gender and age discriminations in tsunami casualties. Significant gender difference in the victims of the 2004 Indian Ocean Tsunami was attributed to women's social norms and role behavior, as well as cultural bias toward women's inability to swim. Here we develop a rational casualty model based on humans' limit to withstand the tsunami flows. The application to simple tsunami runup cases demonstrates that biological and physiological disadvantages also make a significant difference in casualty rate. It further demonstrates that the gender and age discriminations in casualties become most pronounced when tsunami is marginally strong and the difference tends to diminish as tsunami strength increases.

  17. Management of the Formosa Color Dust Explosion: Lessons Learned from the Treatment of 49 Mass Burn Casualty Patients at Chang Gung Memorial Hospital.

    PubMed

    Cheng, Ming-Huei; Mathews, Alexandra L; Chuang, Shiow-Shuh; Lark, Meghan E; Hsiao, Yen-Chang; Ng, Chip-Jin; Chung, Kevin C

    2016-06-01

    This article reports the emergency management of a mass casualty disaster occurring on June 27, 2015, in New Taipei, Taiwan, as a fire erupted over a large crowd, injuring 499 people. Lessons learned in burn care treatment and disaster preparedness are analyzed through following the specific surgical response and patient outcomes of one hospital involved in the disaster response. Information regarding the fire and emergency management was obtained from the Ministry of Health and Welfare of Taiwan. Patient-specific data were obtained from Chang Gung Memorial Hospital's patient records. A mass casualty management system was immediately initiated by the Ministry of Health and Welfare, which contacted local hospitals to prepare for the influx of patients with severe burn injuries. In response, Chang Gung Memorial Hospital called 336 medical personnel to the emergency room for the management of 49 burn patients and divided emergency management roles among chief physicians. The mean burn total body surface area of patients presenting to this hospital was 44.2 percent (range, 10 to 90 percent). No deaths occurred in the first 48 hours after the explosion. As of 3 months after the incident, only 12 deaths had resulted from this accident, all resulting from sepsis and organ failure. Taiwan's effective mass casualty preparation plans, highly trained medical personnel, and large centers capable of treating burn patients allowed 499 injured patients to be successfully transferred and treated in hospitals across Taiwan. Lessons learned from this disaster response can be integrated into existing disaster management plans to aid in the response to mass casualty tragedies. Therapeutic, IV.

  18. Preparedness for the Evaluation and Management of Mass Casualty Incidents Involving Anticholinesterase Compounds: A Survey of Emergency Department Directors in the 12 Largest Cities in the United States

    DTIC Science & Technology

    2010-11-01

    and only 4.9 percent were very confident that drills had given them the preparation that they needed. Only 45. 7 percent of reporting hospitals had a...board·certified medical toxi- cologist to help in such an emergency. Almost two-thirds (73.6 percent) of those familiar with the online Radiation ...Center attacks of2001, many hospitals recognized the consequences of failing to prepare for mass casualty incidents (MCls) of low probability but

  19. [Organizational problems of disaster victim identification in mass casualties as exemplified by Tu 154-M and Airbus A310 passenger plane crashes].

    PubMed

    Volkov, A V; Kolkutin, V V; Klevno, V A; Shkol'nikov, B V; Kornienko, I V

    2008-01-01

    Managerial experience is described that was gained during the large-scale work on victim identification following mass casualties in the Tu 154-M and Airbus A310 passenger plane crashes. The authors emphasize the necessity to set up a specialized agency of constant readiness meeting modern requirements for the implementation of a system of measures for personality identification. This agency must incorporate relevant departments of the Ministries of Health, Defense, and Emergency Situations as well as investigative authorities and other organizations.

  20. [Treatment strategies for mass casualty incidents and terrorist attacks in trauma and vascular surgery : Presentation of a treatment concept].

    PubMed

    Friemert, B; Franke, A; Bieler, D; Achatz, A; Hinck, D; Engelhardt, M

    2017-08-11

    The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs. terrorist attack MCI= dynamic situation) and the different security positions (rescue services vs. police services). This article is concerned with question of which changes in the surgical treatment of patients are made necessary by these new challenges. In this case it is necessary that physicians are familiar with the different injury patterns, whereby priority must be given to gunshot and explosion (blast) injuries. Furthermore, altered strategic and tactical approaches (damage control surgery vs. tactical abbreviated surgical care) are necessary to ensure survival for as many victims of terrorist attacks as possible and also to achieve the best possible functional results. It is only possible to successfully counter these new challenges by changing the mindset in the treatment of terrorist MCI compared to MCI incidents. An essential component of this mindset is the acquisition of a maximum of flexibility. This article would like to make a contribution to this problem.

  1. Biological dosimetry by the triage dicentric chromosome assay: potential implications for treatment of acute radiation syndrome in radiological mass casualties.

    PubMed

    Romm, Horst; Wilkins, Ruth C; Coleman, C Norman; Lillis-Hearne, Patricia K; Pellmar, Terry C; Livingston, Gordon K; Awa, Akio A; Jenkins, Mark S; Yoshida, Mitsuaki A; Oestreicher, Ursula; Prasanna, Pataje G S

    2011-03-01

    Biological dosimetry is an essential tool for estimating radiation dose. The dicentric chromosome assay (DCA) is currently the tool of choice. Because the assay is labor-intensive and time-consuming, strategies are needed to increase throughput for use in radiation mass casualty incidents. One such strategy is to truncate metaphase spread analysis for triage dose estimates by scoring 50 or fewer metaphases, compared to a routine analysis of 500 to 1000 metaphases, and to increase throughput using a large group of scorers in a biodosimetry network. Previously, the National Institutes for Allergies and Infectious Diseases (NIAID) and the Armed Forces Radiobiology Research Institute (AFRRI) sponsored a double-blinded interlaboratory comparison among five established international cytogenetic biodosimetry laboratories to determine the variability in calibration curves and in dose measurements in unknown, irradiated samples. In the present study, we further analyzed the published data from this previous study to investigate how the number of metaphase spreads influences dose prediction accuracy and how this information could be of value in the triage and management of people at risk for the acute radiation syndrome (ARS). Although, as expected, accuracy decreased with lower numbers of metaphase spreads analyzed, predicted doses by the laboratories were in good agreement and were judged to be adequate to guide diagnosis and treatment of ARS. These results demonstrate that for rapid triage, a network of cytogenetic biodosimetry laboratories can accurately assess doses even with a lower number of scored metaphases.

  2. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries.

    PubMed

    Sheng, Z Y

    1987-10-01

    The Tangshan earthquake was probably the worst catastrophe in this century. It took a death toll of 242,769, with 164,851 injured in addition. This presentation describes the organization of disaster relief work after the earthquake, the rescue of buried victims, the organization of medical resources, and the sanitation work to forestall epidemics. It also presents the author's reflections on the management of three major injuries, namely, crush syndrome, fracture of pelvis, and traumatic paraplegia, by reviewing the available data pertaining to these injuries. The author concurs with the prevailing opinion that fasciotomy plays an important role in the successful management of crush injury. It not only prevented acute renal failure subsequent to intracompartmental increase of pressure, but also the occurrence of Volkmann's ischemic contracture as a late sequela. Herbs to induce catharsis and diuresis were used to alleviate intracompartmental pressure. For the management of pelvic fractures, two newly developed treatment techniques are described. On analysis of clinical data, it is the author's opinion that traumatic paraplegia should not be given the priority of early surgery in the circumstances of mass casualties. The primary concern should be the stability and restoration of normal curvature of the spine, especially in cases of complete paraplegia. Decompression of the spinal cord through an anterolateral approach gave promising results in hyperflexion type of spinal fracture.

  3. Design and characterisation of a novel in vitro skin diffusion cell system for assessing mass casualty decontamination systems.

    PubMed

    Matar, H; Larner, J; Kansagra, S; Atkinson, K L; Skamarauskas, J T; Amlot, R; Chilcott, R P

    2014-06-01

    The efficient removal of contaminants from the outer surfaces of the body can provide an effective means of reducing adverse health effects associated with incidents involving the accidental or deliberate release of hazardous materials. Showering with water is frequently used by first responders as a rapid method of mass casualty decontamination (MCD). However, there is a paucity of data on the generic effectiveness and safety of aqueous decontamination systems. To address these issues, we have developed a new in vitro skin diffusion cell system to model the conditions of a common MCD procedure ("ladder pipe system"). The new diffusion cell design incorporates a showering nozzle, an air sampling port for measurement of vapour loss and/aerosolisation, adjustable (horizontal to vertical) skin orientation and a circulating manifold system (to maintain a specified flow rate, temperature and pressure of shower water). The dermal absorption characteristics of several simulants (Invisible Red S, curcumin and methyl salicylate) measured with the new in vitro model were in good agreement with previous in vitro and in vivo studies. Moreover, these initial studies have indicated that whilst flow rate and water temperature are important factors for MCD, the presence of clothing during showering may (under certain circumstances) cause transfer and spreading of contaminants to the skin surface.

  4. Radiologic diagnosis of explosion casualties.

    PubMed

    Eastridge, Brian J; Blackbourne, Lorne; Wade, Charles E; Holcomb, John B

    2008-01-01

    The threat of terrorist events on domestic soil remains an ever-present risk. Despite the notoriety of unconventional weapons, the mainstay in the armament of the terrorist organization is the conventional explosive. Conventional explosives are easily weaponized and readily obtainable, and the recipes are widely available over the Internet. According to the US Department of State and the Federal Bureau of Investigation, over one half of the global terrorist events involve explosions, averaging two explosive events per day worldwide in 2005 (Terrorism Research Center. Available at www.terrorism.com. Accessed April 1, 2007). The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads, published by the Institute of Medicine, states that explosions were the most common cause of injuries associated with terrorism (Institute of Medicine Report: The Future of Emergency Care in the United States Health System: Emergency Medical Services at the Crossroads. Washington DC: National Academic Press, 2007). Explosive events have the potential to inflict numerous casualties with multiple injuries. The complexity of this scenario is exacerbated by the fact that few providers or medical facilities have experience with mass casualty events in which human and material resources can be rapidly overwhelmed. Care of explosive-related injury is based on same principles as that of standard trauma management paradigms. The basic difference between explosion-related injury and other injury mechanisms are the number of patients and multiplicity of injuries, which require a higher allocation of resources. With this caveat, the appropriate utilization of radiology resources has the potential to impact in-hospital diagnosis and triage and is an essential element in optimizing the management of the explosive-injured patients.

  5. An assessment of telemedicine possibilities in massive casualties situations.

    PubMed

    Paunksnis, A; Barzdziukas, V; Kurapkiene, S; Vaicaitiene, R; Sereika, V

    2005-01-01

    The use of existing possibilities of Telemedicine Center of Kaunas University of Medicine allows the live distant consultations from high-level medical specialised centers to rural areas. On July 2004 the Telemedicine Center took part in the RESCUER/MEDCEUR project exercise. A special objective was the use of telemedicine facilities for distant consultations and sorting of victims directly at the event place. Telemedicine Center used appropriate telecommunication devices for joint activities of civil and multinational military services in critical situations such as mass casualty events. There were used ISDN lines and IP radio-connection. On the final and most intensive day of the anti-terrorism drills, the multinational force of medics at the Kairiu Training Range in Lithuania reacted to a large mass casualty event--treating hundreds of victims from a simulated train crash. Using on-line telemedicine facilities from Kaunas Medical University Hospital there were corrected the tactics of giving the first help and sorting of casualties. The most complicated initiated cases of eye trauma, neurosurgical trauma, maxilloface trauma and traumatic amputation of limbs evaluated and selected for emergent evacuation to the third level hospitals. All those cases transported to Kaunas and Vilnius Universities Hospitals by helicopters (200 and 300 km from the event place). The common use of existing military and civil telemedicine infrastructure showed the possibilities of interaction in management, giving the first help and sorting of casualties between military and civil medical services during the rescue operations.

  6. 77 FR 52746 - Medical Countermeasures for a Burn Mass Casualty Incident

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ..., affiliation, address, email, and telephone number. Those without Internet access should contact Suzanne... participants will be sent technical system requirements after registration and will be sent connection access... Internet at http://www.fda.gov/MedicalDevices/NewsEvents/WorkshopsConferences/default.htm . (Select...

  7. Disaster metrics: quantification of acute medical disasters in trauma-related multiple casualty events through modeling of the Acute Medical Severity Index.

    PubMed

    Bayram, Jamil D; Zuabi, Shawki

    2012-04-01

    The interaction between the acute medical consequences of a Multiple Casualty Event (MCE) and the total medical capacity of the community affected determines if the event amounts to an acute medical disaster. There is a need for a comprehensive quantitative model in MCE that would account for both prehospital and hospital-based acute medical systems, leading to the quantification of acute medical disasters. Such a proposed model needs to be flexible enough in its application to accommodate a priori estimation as part of the decision-making process and a posteriori evaluation for total quality management purposes. The concept proposed by de Boer et al in 1989, along with the disaster metrics quantitative models proposed by Bayram et al on hospital surge capacity and prehospital medical response, were used as theoretical frameworks for a new comprehensive model, taking into account both prehospital and hospital systems, in order to quantify acute medical disasters. A quantitative model called the Acute Medical Severity Index (AMSI) was developed. AMSI is the proportion of the Acute Medical Burden (AMB) resulting from the event, compared to the Total Medical Capacity (TMC) of the community affected; AMSI = AMB/TMC. In this model, AMB is defined as the sum of critical (T1) and moderate (T2) casualties caused by the event, while TMC is a function of the Total Hospital Capacity (THC) and the medical rescue factor (R) accounting for the hospital-based and prehospital medical systems, respectively. Qualitatively, the authors define acute medical disaster as "a state after any type of Multiple Casualty Event where the Acute Medical Burden (AMB) exceeds the Total Medical Capacity (TMC) of the community affected." Quantitatively, an acute medical disaster has an AMSI value of more than one (AMB / TMC > 1). An acute medical incident has an AMSI value of less than one, without the need for medical surge. An acute medical emergency has an AMSI value of less than one with

  8. Mass casualty incidents and disasters in Nigeria: The need for better management strategies.

    PubMed

    Ehiawaguan, I P

    2007-12-01

    The aim of this article is to discuss principles involved in disaster management, disasters in Nigeria, examine the current level of preparedness in the country and make recommendations for improvement. An overview of various disaster events in the country coupled with review of the literature. Fatality figures for disaster in Nigeria are high. There is need for a strong political will from government at all levels regarding disaster management in order to mitigate its occurrence and impact.

  9. Description of procedures performed on patients by emergency medical services during mass casualty incidents in the United States.

    PubMed

    El Sayed, Mazen; Tamim, Hani; Mann, N Clay

    2015-08-01

    Emergency medical services (EMS) preparedness is essential to reduce morbidity and mortality from mass casualty incidents (MCIs). We sought to describe types and frequencies of common procedures performed during MCIs by EMS providers at different service levels. This study was carried out using the 2012 US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System. Emergency medical services activations coded as MCI at dispatch or by EMS personnel were included. The Center for Medicare and Medicaid Services service level was used for the level of service provided. A descriptive analysis characterizing the most common procedure types and frequencies by service level was carried out. Among the 19831189 EMS activations in the 2012 national data set, 53334 activations had an MCI code, of which 26110 activations were included. There were 8179 advanced life support (31.3%), 5811 basic life support (22.3%), 399 air medical transport (air transport fixed or rotary) (1.5%), and 38 specialty care transport (0.2%) activations. A total of 107 different procedure types were reported. The most common procedures by procedure count were "spine immobilization" (21.8%) followed by "venous access extremity" (14.1%) and "assessment adult" (13.4%). A similar order was found for procedure frequencies by included EMS activations (24.1%, 19.3%, and 18.3%, respectively). Top 20 procedures had different frequencies by levels of care except for "medical director control" (P = .19). Advanced EMS interventions are not frequent during MCIs in the United States. Emergency medical services systems with other types of providers or MCI response patterns might report different findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States.

    PubMed

    El Sayed, Mazen; Tamim, Hani; Mann, N Clay

    2016-04-01

    Emergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs). This study describes prehospital medication administration during MCIs by different EMS service levels. The US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out. Among the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (P<.01) except for "Analgesia (other)" (P=.40) and "Pain medications (nonsteroidal anti-inflammatory drug; NSAID)" (P=.07). Medications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.

  11. PATTERN OF INJURIES SEEN IN MASS CASUALTIES IN TERRORIST ATTACKS IN BALUCHISTAN, PAKISTAN--A THREE YEARS EXPERIENCE.

    PubMed

    Maqsood, Rasikh; Rasikh, Alia; Abbasi, Tariq; Shukr, Irfan

    2015-01-01

    As a front line state in war against terror, Pakistan has been a victim of terrorism, for the last many years & Baluchistan has been the hub of all such terror activities. The objective of this study was to determine the incidence and type of injuries in mass casualties in terrorist activities in Baluchistan. The study was done by the review of the record of all patients of terrorist attacks who were admitted in Combined Military Hospital (CMH) Quetta from 27th Aug 2012 to 31st Jul 2015. The final injuries sustained by the victims were documented in the patient charts after repeated examination. The data was collected from these patient charts. Data was analysed using SPSS-21. Frequency & percentages of different injuries was calculated to determine the injury pattern. A total of 3034 patients reported to the hospital (n-3034), 2228 were admitted (73.4%). Out of the injured, 1720 (56.69%) were patients of multi system trauma, whereas 1314 (43.3%) had a single site injury. Out of these 537 patients had fractures of long bones (17.6%), those with head & spinal injuries with neurological deficit were 455 (14.9%), 266 had abdominal injuries requiring surgical intervention (8.7%), 75 (2.47%) had thoracic injuries were whereas 25 (0.82%) were vascular injuries, requiring emergent limb saving surgeries. Sex ratio was M/F=5.7: 1 Mean hospital stay was 6.31 days. Majority of the injured had multisystem injuries; therefore the hospital should have a well-trained multi-disciplinary team of surgeons. In addition to general surgery, the subspecialties' should include orthopaedics, vascular, thoracic and neurosurgery.

  12. Preparedness for the evaluation and management of mass casualty incidents involving anticholinesterase compounds: a survey of emergency department directors in the 12 largest cities in the United States.

    PubMed

    Madsen, James M; Greenberg, Michael I

    2010-01-01

    Anticholinesterases include carbamate and organophosphorus (OP) insecticides and nerve agents. Release of these compounds can flood emergency departments (EDs) with large numbers of poisoned victims and worried individuals. It was hypothesized that despite the focus of disaster preparedness on large metropolitan areas, EDs in these cities would still report self-perceptions of deficiencies in preparedness for mass casualty incidents (MCIs) involving these chemicals. A secure and anonymous online survey was prepared and piloted, and E-mail invitations were sent to the physician directors of the 220 continuously staffed EDs in the 12 most populous incorporated cities in the United States. Forty-six ED directors could not be contacted despite repeated attempts. Of the remaining 174 directors, eight declined and 89 took the survey, for a response rate of 51.1 percent. Fewer than 20 percent were very confident in the effectiveness of their training, and only 4.9 percent were very confident that drills had given them the preparation that they needed. Only 45. 7 percent of reporting hospitals had a board-certified medical toxicologist to help in such an emergency. Almost two-thirds (73.6 percent) of those familiar with the online Radiation Event Medical Management (REMM) module from the National Library of Medicine and the National Institutes of Health thought that a chemical counterpart to REMM would be either moderately or very helpful for MCIs involving anticholinesterases. This study demonstrates that physician ED directors perceived marked deficiencies in their abilities to respond to this kind of toxicological emergency and suggests critical directions for remediation of these deficiencies.

  13. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    PubMed Central

    2009-01-01

    Background Hospitals have a critically important role in the management of mass causality incidents (MCI), yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%), pelvic injuries (11.5%), thoracic injuries (5.0%) and major amputations (3.1%). The mean cut to suture time was 130 min (IQR 65-165 min). Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00), ISS ≥ 35 (OR 2,94), hemoglobin level ≤ 8 mg/dL (OR 1,40), pulse rate on hospital admission < 40 or > 120/min (OR 1,39), blood pressure on hospital admission < 90 mmHg (OR 1,35), prehospital infusion volume ≥ 2000 ml (OR 1,34), GCS ≤ 8 (OR 1,32) and anisocoria (OR 1,28) on-scene. Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI. PMID:20149987

  14. Prairie North: a joint civilian/military mass casualty exercise highlights the role of the National Guard in community disaster response.

    PubMed

    Vukotich, George; Bayram, Jamil D; Miller, Miriam I

    2012-01-01

    In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. Additionally, military communication and medical equipment compatibility with the civilian infrastructure was identified as one of the top areas for the improvement of this joint exercise. Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.

  15. Triage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident: a prospective cross-sectional survey

    PubMed Central

    2013-01-01

    Background In a mass casualty situation, medical personnel must rapidly assess and prioritize patients for treatment and transport. Triage is an important tool for medical management in disaster situations. Lack of common international and Swedish triage guidelines could lead to confusion. Attending the Advanced Trauma Life Support (ATLS) provider course is becoming compulsory in the northern part of Europe. The aim of the ATLS guidelines is provision of effective management of single critically injured patients, not mass casualties incidents. However, the use of the ABCDE algorithms from ATLS, has been proposed to be valuable, even in a disaster environment. The objective for this study was to determine whether the mnemonic ABCDE as instructed in the ATLS provider course, affects the ability of Swedish physician’s to correctly triage patients in a simulated mass casualty incident. Methods The study group included 169 ATLS provider students from 10 courses and course sites in Sweden; 153 students filled in an anonymous test just before the course and just after the course. The tests contained 3 questions based on overall priority. The assignment was to triage 15 hypothetical patients who had been involved in a bus crash. Triage was performed according to the ABCDE algorithm. In the triage, the ATLS students used a colour-coded algorithm with red for priority 1, yellow for priority 2, green for priority 3 and black for dead. The students were instructed to identify and prioritize 3 of the most critically injured patients, who should be the first to leave the scene. The same test was used before and after the course. Results The triage section of the test was completed by 142 of the 169 participants both before and after the course. The results indicate that there was no significant difference in triage knowledge among Swedish physicians who attended the ATLS provider course. The results also showed that Swedish physicians have little experience of real mass

  16. Triage performance of Swedish physicians using the ATLS algorithm in a simulated mass casualty incident: a prospective cross-sectional survey.

    PubMed

    Lampi, Maria; Vikström, Tore; Jonson, Carl-Oscar

    2013-12-20

    In a mass casualty situation, medical personnel must rapidly assess and prioritize patients for treatment and transport. Triage is an important tool for medical management in disaster situations. Lack of common international and Swedish triage guidelines could lead to confusion. Attending the Advanced Trauma Life Support (ATLS) provider course is becoming compulsory in the northern part of Europe. The aim of the ATLS guidelines is provision of effective management of single critically injured patients, not mass casualties incidents. However, the use of the ABCDE algorithms from ATLS, has been proposed to be valuable, even in a disaster environment. The objective for this study was to determine whether the mnemonic ABCDE as instructed in the ATLS provider course, affects the ability of Swedish physician's to correctly triage patients in a simulated mass casualty incident. The study group included 169 ATLS provider students from 10 courses and course sites in Sweden; 153 students filled in an anonymous test just before the course and just after the course. The tests contained 3 questions based on overall priority. The assignment was to triage 15 hypothetical patients who had been involved in a bus crash. Triage was performed according to the ABCDE algorithm. In the triage, the ATLS students used a colour-coded algorithm with red for priority 1, yellow for priority 2, green for priority 3 and black for dead. The students were instructed to identify and prioritize 3 of the most critically injured patients, who should be the first to leave the scene. The same test was used before and after the course. The triage section of the test was completed by 142 of the 169 participants both before and after the course. The results indicate that there was no significant difference in triage knowledge among Swedish physicians who attended the ATLS provider course. The results also showed that Swedish physicians have little experience of real mass casualty incidents and exercises

  17. Guidelines for Mass Casualty Decontamination During a HAZMAT/Weapon of Mass Destruction Incident. Volumes 1 and 2 (Update)

    DTIC Science & Technology

    2013-08-01

    be applied to Toxic In- dustrial Chemicals (TICs), Toxic Industrial Materials (TIMs), and toxins (collectively re- ferred to in this document as...for First Responders when arriving at an incident scene. A risk -based response strategy is recommended before and upon arrival at the incident scene...A risk -based re- sponse process is defined as a systematic process by which responders analyze a problem involving HAZMAT/weapons of mass

  18. Human casualties in earthquakes: modelling and mitigation

    USGS Publications Warehouse

    Spence, R.J.S.; So, E.K.M.

    2011-01-01

    Earthquake risk modelling is needed for the planning of post-event emergency operations, for the development of insurance schemes, for the planning of mitigation measures in the existing building stock, and for the development of appropriate building regulations; in all of these applications estimates of casualty numbers are essential. But there are many questions about casualty estimation which are still poorly understood. These questions relate to the causes and nature of the injuries and deaths, and the extent to which they can be quantified. This paper looks at the evidence on these questions from recent studies. It then reviews casualty estimation models available, and finally compares the performance of some casualty models in making rapid post-event casualty estimates in recent earthquakes.

  19. Evaluation of a Scalable Information Analytics System for Enhanced Situational Awareness in Mass Casualty Events

    PubMed Central

    Yang, Zhuorui; Ciottone, Gregory

    2016-01-01

    We investigate the utility of DIORAMA-II system which provides enhanced situational awareness within a disaster scene by using real-time visual analytics tools and a collaboration platform between the incident commander and the emergency responders. Our trials were conducted in different geographical areas (feature-rich and featureless regions) and in different lighting conditions (daytime and nighttime). DIORAMA-II obtained considerable time gain in efficiency compared to conventional paper based systems. DIORAMA-II time gain was reflected in reduction of both average triage time per patient (up to 34.3% average triage time reduction per patient) and average transport time per patient (up to 76.3% average transport time reduction per red patient and up to 66.3% average transport time reduction per yellow patient). In addition, DIORAMA-II ensured that no patients were left behind or transported in the incorrect order compared to the conventional method which resulted in patients being left behind and transported in the incorrect order. PMID:27433161

  20. Evaluation of a Scalable Information Analytics System for Enhanced Situational Awareness in Mass Casualty Events.

    PubMed

    Ganz, Aura; Schafer, James M; Yang, Zhuorui; Yi, Jun; Lord, Graydon; Ciottone, Gregory

    2016-01-01

    We investigate the utility of DIORAMA-II system which provides enhanced situational awareness within a disaster scene by using real-time visual analytics tools and a collaboration platform between the incident commander and the emergency responders. Our trials were conducted in different geographical areas (feature-rich and featureless regions) and in different lighting conditions (daytime and nighttime). DIORAMA-II obtained considerable time gain in efficiency compared to conventional paper based systems. DIORAMA-II time gain was reflected in reduction of both average triage time per patient (up to 34.3% average triage time reduction per patient) and average transport time per patient (up to 76.3% average transport time reduction per red patient and up to 66.3% average transport time reduction per yellow patient). In addition, DIORAMA-II ensured that no patients were left behind or transported in the incorrect order compared to the conventional method which resulted in patients being left behind and transported in the incorrect order.

  1. A survey assessment of the level of preparedness for domestic terrorism and mass casualty incidents among Eastern Association for the Surgery of Trauma members.

    PubMed

    Ciraulo, David L; Frykberg, Eric R; Feliciano, David V; Knuth, Thomas E; Richart, Charles M; Westmoreland, Christy D; Williams, Kathryn A

    2004-05-01

    The goal of this survey was to establish a benchmark for trauma surgeons' level of operational understanding of the command structure for a pre-hospital incident, a mass casualty incident (MCI), and weapons of mass destruction (WMD). The survey was distributed before the World Trade Center destruction on September 11, 2001. The survey was developed by the authors and reviewed by a statistician for clarity and performance. The survey was sent to the membership of the 2000 Eastern Association for the Surgery of Trauma spring mailing, with two subsequent mailings and a final sampling at the Eastern Association for the Surgery of Trauma 2001 meeting. Of 723 surveys mailed, 243 were returned and statistically analyzed (significance indicated by p < 0.05). No statistical difference existed between level of designation of a trauma center (state or American College of Surgeons) and a facility's level of pre-paredness for MCIs or WMD. Physicians in communities with chemical plants, railways, and waterway traffic were statistically more likely to work at facilities with internal disaster plans addressing chemical and biological threats. Across all variables, physicians with military training were significantly better prepared for response to catastrophic events. With the exception of cyanide (50%), less than 30% of the membership was prepared to manage exposure to a nerve agent, less than 50% was prepared to manage illness from intentional biological exposure, and only 73% understood and were prepared to manage blast injury. Mobile medical response teams were present in 46% of the respondents' facilities, but only 30% of those teams deployed a trauma surgeon. Approximately 70% of the membership had been involved in an MCI, although only 60% understood the command structure for a prehospital incident. Only 33% of the membership had training regarding hazardous materials. Of interest, 76% and 65%, respectively, felt that education about MCIs and WMD should be included in

  2. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios.

    PubMed

    Wiley, Albert L

    2016-09-01

    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations.

  3. Biomarker Records Associated with Mass Extinction Events

    NASA Astrophysics Data System (ADS)

    Whiteside, Jessica H.; Grice, Kliti

    2016-06-01

    The history of life on Earth is punctuated by a series of mass extinction episodes that vary widely in their magnitude, duration, and cause. Biomarkers are a powerful tool for the reconstruction of historical environmental conditions and can therefore provide insights into the cause and responses to ancient extinction events. In examining the five largest mass extinctions in the geological record, investigators have used biomarkers to elucidate key processes such as eutrophy, euxinia, ocean acidification, changes in hydrological balance, and changes in atmospheric CO2. By using these molecular fossils to understand how Earth and its ecosystems have responded to unusual environmental activity during these extinctions, models can be made to predict how Earth will respond to future changes in its climate.

  4. The "RTR" medical response system for nuclear and radiological mass-casualty incidents: a functional TRiage-TReatment-TRansport medical response model.

    PubMed

    Hrdina, Chad M; Coleman, C Norman; Bogucki, Sandy; Bader, Judith L; Hayhurst, Robert E; Forsha, Joseph D; Marcozzi, David; Yeskey, Kevin; Knebel, Ann R

    2009-01-01

    Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe perimeters are established, RTR sites should be determined in real-time that are based on the extent of destruction, environmental factors, residual radiation, available infrastructure, and transportation routes. Such RTR sites are divided into three types depending on their physical/situational relationship to the incident. The RTR1 sites are near the epicenter with residual radiation and include victims with blast injuries and other major traumatic injuries including radiation exposure; RTR2 sites are situated in relationship to the plume with varying amounts of residual radiation present, with most victims being ambulatory; and RTR3 sites are collection and transport sites with minimal or no radiation present or exposure risk and a victim population with a potential variety of injuries or radiation exposures. Medical Care sites are predetermined sites at which definitive medical care is given to those in immediate need of care. They include local/regional hospitals, medical centers, other

  5. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK’s Initial Operational Response (IOR)

    PubMed Central

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard

    2017-01-01

    The UK’s Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method (“rinse-wipe-rinse”) for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants. PMID:28152053

  6. Evaluation of absorbent materials for use as ad hoc dry decontaminants during mass casualty incidents as part of the UK's Initial Operational Response (IOR).

    PubMed

    Kassouf, Nick; Syed, Sara; Larner, Joanne; Amlôt, Richard; Chilcott, Robert P

    2017-01-01

    The UK's Initial Operational Response (IOR) is a revised process for the medical management of mass casualties potentially contaminated with hazardous materials. A critical element of the IOR is the introduction of immediate, on-scene disrobing and decontamination of casualties to limit the adverse health effects of exposure. Ad hoc cleansing of the skin with dry absorbent materials has previously been identified as a potential means of facilitating emergency decontamination. The purpose of this study was to evaluate the in vitro oil and water absorbency of a range of materials commonly found in the domestic and clinical environments and to determine the effectiveness of a small, but representative selection of such materials in skin decontamination, using an established ex vivo model. Five contaminants were used in the study: methyl salicylate, parathion, diethyl malonate, phorate and potassium cyanide. In vitro measurements of water and oil absorbency did not correlate with ex vivo measurements of skin decontamination. When measured ex vivo, dry decontamination was consistently more effective than a standard wet decontamination method ("rinse-wipe-rinse") for removing liquid contaminants. However, dry decontamination was ineffective against particulate contamination. Collectively, these data confirm that absorbent materials such as wound dressings and tissue paper provide an effective, generic capability for emergency removal of liquid contaminants from the skin surface, but that wet decontamination should be used for non-liquid contaminants.

  7. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs.

    PubMed

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean-René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

    2015-11-02

    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative's Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident.

  8. Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs

    PubMed Central

    Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G.; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean- René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

    2015-01-01

    Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative’s Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident. PMID:26635995

  9. The end-triassic mass extinction event

    NASA Technical Reports Server (NTRS)

    Hallam, A.

    1988-01-01

    The end-Triassic is the least studied of the five major episodes of mass extinction recognized in the Phanerozoic, and the Triassic-Jurassic boundary is not precisely defined in most parts of the world, with a paucity of good marine sections and an insufficiency of biostratigraphically valuable fossils. Despite these limitations it is clear that there was a significant episode of mass extinction, affecting many groups, in the Late Norian and the existing facts are consistent with it having taken place at the very end of the period. The best record globally comes from marine strata. There was an almost complete turnover of ammonites across the T-J boundary, with perhaps no more than one genus surviving. About half the bivalve genera and most of the species went extinct, as did many archaeogastropods. Many Paleozoic-dominant brachiopods also disappeared, as did the last of the conodonts. There was a major collapse and disappearance of the Alpine calcareous sponge. Among terrestrial biota, a significant extinction event involving tetrapods was recognized. With regard to possible environmental events that may be postulated to account for the extinctions, there is no evidence of any significant global change of climate at this time. The existence of the large Manicouagan crater in Quebec, dated as about late or end-Triassic, has led to the suggestion that an impact event might be implicated, but so far despite intensive search no unequivocal iridium anomaly or shocked quartz was discovered. On the other hand there is strong evidence for significant marine regression in many parts of the world. It is proposed therefore that the likeliest cause of the marine extinctions is severe reduction in habitat area caused either by regression of epicontinental seas, subsequent widespread anoxia during the succeeding transgression, or a combination of the two.

  10. Population and energy elasticity of tornado casualties

    NASA Astrophysics Data System (ADS)

    Fricker, Tyler; Elsner, James B.; Jagger, Thomas H.

    2017-04-01

    Tornadoes are capable of catastrophic destruction and mass casualties, but there are yet no estimates of how sensitive the number of casualties are to changes in the number of people in harm's way or to changes in tornado energy. Here the relationship between tornado casualties (deaths and injuries), population, and energy dissipation is quantified using the economic concept of "elasticity." Records of casualties from individual tornadoes over the period 2007-2015 are fit to a regression model. The coefficient on the population term (population elasticity) indicates that a doubling in population increases the casualty rate by 21% [(17, 24)%, 95% credible interval]. The coefficient on the energy term (energy elasticity) indicates that a doubling in energy dissipation leads to a 33% [(30, 35)%, 95% credible interval] increase in the casualty rate. The difference in elasticity values show that on average, changes in energy dissipation have been relatively more important in explaining tornado casualties than changes in population. Assuming no changes in warning effectiveness or mitigation efforts, these elasticity estimates can be used to project changes in casualties given the known population trends and possible trends in tornado activity.

  11. Development of a national burn network: providing a co-ordinated response to a burn mass casualty disaster within the Australian health system

    PubMed Central

    Wood, F; Edgar, D; Robertson, AG

    2008-01-01

    With the threat of terrorist activity ever present since the incidents in Bali and Jakarta, the Australian health system must be prepared to manage another mass burn casualty disaster. The Australian and New Zealand Burns Association (ANZBA) highlighted the lack of a national burn disaster response before the 2000 Olympics. With the limited number of burn beds available and the protracted length of stay after such injuries, any state or territory could be overwhelmed with relatively few patient admissions. In 2002, the Australian Health Minister's Conference called for a solution. The objective of this paper is to provide an overview of the process and development of the Australian National Burn Network, which underpins the National Burn Disaster Response (AUSBURNPLAN). PMID:22460213

  12. Bushfire disaster burn casualty management: the Australian "Black Saturday" bushfire experience.

    PubMed

    Seifman, Marc; Ek, Edmund W; Menezes, Hana; Rozen, Warren M; Whitaker, Iain S; Cleland, Heather J

    2011-11-01

    Mass burn disasters are among the most difficult disasters to manage, with major burns requiring complex management in a multidisciplinary setting and specialist burns services having limited capacity to deal with large numbers of complex patients. There is a paucity of literature addressing health system responses to mass burn disasters resulting from wildfires, with the events of the "Black Saturday" disaster in the state of Victoria, Australia, able to provide a unique opportunity to draw lessons and increase awareness of key management issues arising in mass burn casualty disasters. The event comprised the worst natural disaster in the state's history and one of the worst wildfire disasters in world history, claiming 173 lives and costing more than AUD 4 billion. This article draws on the national burns disaster plan instituted, Australian Mass Casualty Burn Disaster Plan (AUSBURNPLAN), and details the management of mass burn cases through a systems-based perspective.

  13. Differences in medical care usage between two mass-gathering sporting events.

    PubMed

    Burton, James O; Corry, Stephen J; Lewis, Gareth; Priestman, William S

    2012-10-01

    Event planning for mass gatherings involves the utilization of methods that prospectively can predict medical resource use. However, there is growing recognition that historical data for a specific event can help to accurately forecast medical requirements. This study was designed to investigate the differences in medical usage rates between two popular mass-gathering sports events in the UK: rugby matches and horse races. A retrospective study of all attendee consultations with the on-site medical teams at the Leicester Tigers Rugby Football Club and the Leicester Racecourse from September 2008 through August 2009 was undertaken. Patient demographics, medical usage rates, level of care, as well as professional input and the effects of alcohol use were recorded. Medical usage rates were higher at the Leicester Racecourse (P < .01), although the demographics of the patients were similar and included 24% children and 16% staff. There was no difference in level of care required between the two venues with the majority of cases being minor, although a higher proportion of casualties at the Leicester Tigers event were seen by a health care professional compared with the Leicester Racecourse (P < .001). Alcohol was a contributing factor in only 5% of consultations. These two major sporting venues had similar attendance requirements for medical treatment that are comparable to other mass-gathering sports events. High levels of staff and pediatric presentations may have an impact on human resource planning for events on a larger scale, and the separation of treatment areas may help to minimize the number of unnecessary or opportunistic reviews by the on-site health care professionals.

  14. Orthopaedic management in a mega mass casualty situation. The Israel Defence Forces Field Hospital in Haiti following the January 2010 earthquake.

    PubMed

    Bar-On, Elhanan; Lebel, Ehud; Kreiss, Yitshak; Merin, Ofer; Benedict, Shaike; Gill, Amit; Lee, Evgeny; Pirotsky, Anatoly; Shirov, Taras; Blumberg, Nehemia

    2011-10-01

    Following the January 2010 earthquake in Haiti, the Israel Defence Forces (IDF) established a field hospital in Port au Prince. The hospital started operating 89 h after the earthquake. We describe the experience of the orthopaedic department in a field hospital operating in an extreme mass casualty situation. The hospital contained 4 operating table and 72 hospitalization beds. The orthopaedic department included 8 orthopaedic surgeons and 3 residents. 1111 patients were treated in the hospital, 1041 of them had adequate records for inclusion. 684 patients were admitted due to trauma with a total of 841 injuries. 320 patients sustained 360 fractures, 18 had joint dislocations and 22 patients were admitted after amputations. 207 patients suffered 315 soft tissue injuries. 221 patients were operated on under general or regional anaesthesia. External fixation was used for stabilization of 48 adult femoral shaft fractures, 24 open tibial fractures and 1 open humeral fracture. All none femoral closed fractures were treated non-operatively. 18 joint reductions and 23 amputations were performed. Appropriate planning, training, operational versatility, and adjustment of therapeutic guidelines according to a constantly changing situation, enabled us to deliver optimal care to the maximal number of patients, in an overwhelming mass trauma situation.

  15. Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents

    PubMed Central

    Klein, Kelly R.; Burkle Jr., Frederick M.; Swienton, Raymond; King, Richard V.; Lehman, Thomas; North, Carol S.

    2016-01-01

    Introduction: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. Methods: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage. Results: 403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used “gestalt”.(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category. Conclusion: Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics. PMID:27651979

  16. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

    PubMed Central

    Körner, Markus; Bernstein, Mark P; Sodickson, Aaron D; Beenen, Ludo F; McLaughlin, Patrick D; Kool, Digna R; Bilow, Ronald M

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs. PMID:26781837

  17. Assessment of hospital disaster plans for conventional mass casualty incidents following terrorist explosions using a live exercise based upon the real data of actual patients.

    PubMed

    Ashkenazi, I; Ohana, A; Azaria, B; Gelfer, A; Nave, C; Deutch, Z; Gens, I; Fadlon, M; Dahan, Y; Rapaport, L; Kishkinov, D; Bar, A; Tal-Or, E; Vaknin, N; Blumenfeld, A; Kessel, B; Alfici, R; Olsha, O; Michaelson, M

    2012-04-01

    The National Committee for Hospital Preparedness for Conventional Mass Casualty Incidents and the Hospital Preparedness Division of the Home Front Command are in charge of preparing live exercises held yearly in public hospitals in Israel. Our experience is that live exercises are limited in their ability to test clinical decision making and its influence upon incident management. A live exercise was designed upon real patient data and tested in several public hospitals. The aim of the manuscript is to describe the impact of this new format on clinical decision making in large-scale live exercises. A database of histories, physical examination findings, laboratory results and imaging results for 420 patients treated following terrorist explosions was created using information derived from actual patient encounters. Similar information for 100 patients treated following motor vehicle accidents was also collected. Information from the database was used to create victim profiles used during the course of exercises held in eight public hospitals with 60-800-bed capacities. Before implementing the new injury tags, no conclusions could be made concerning the quality of clinical decision making. Conducting the exercise using the new format helped identify deficiencies in the hospital disaster plan in triage, emergency department management and in the proper utilisation of resources such as radiology, operating rooms and the secondary transfer of patients. Previous knowledge of patient diagnoses and resource needs allow the identification and quantification of deficiencies and problems identified in clinical decision making, resource utilisation and incident management.

  18. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan.

    PubMed

    Berger, Ferco H; Körner, Markus; Bernstein, Mark P; Sodickson, Aaron D; Beenen, Ludo F; McLaughlin, Patrick D; Kool, Digna R; Bilow, Ronald M

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs.

  19. Prompt solar proton events and coronal mass ejections

    NASA Technical Reports Server (NTRS)

    Kahler, S. W.; Hildner, E.; Van Hollebeke, M. A. I.

    1978-01-01

    Data from the HAO white-light coronagraph and the X-ray telescope on Skylab have been used to investigate the coronal manifestations of 18 prompt solar proton events observed on the IMP 7 spacecraft during the Skylab period. Evidence is found that a mass-ejection event is a necessary condition for the occurrence of a prompt proton event. Mass-ejection events can be observed directly in the white-light coronagraph when they occur near the limb and inferred from the presence of a long-decay X-ray event when they occur on the disk. It is suggested that: (1) the occurrence of mass-ejection events facilitates the escape of protons - whether accelerated at low or high altitudes - to the interplanetary medium; and (2) there may exist a proton acceleration region above or around the outward moving ejecta far above the flare site.

  20. Analysis of driver casualty risk for different work zone types.

    PubMed

    Weng, Jinxian; Meng, Qiang

    2011-09-01

    Using driver casualty data from the Fatality Analysis Report System, this study examines driver casualty risk and investigates the risk contributing factors in the construction, maintenance and utility work zones. The multiple t-tests results show that the driver casualty risk is statistically different depending on the work zone type. Moreover, construction work zones have the largest driver casualty risk, followed by maintenance and utility work zones. Three separate logistic regression models are developed to predict driver casualty risk for the three work zone types because of their unique features. Finally, the effects of risk factors on driver casualty risk for each work zone type are examined and compared. For all three work zone types, five significant risk factors including road alignment, truck involvement, most harmful event, vehicle age and notification time are associated with increased driver casualty risk while traffic control devices and restraint use are associated with reduced driver casualty risk. However, one finding is that three risk factors (light condition, gender and day of week) exhibit opposing effects on the driver casualty risk in different types of work zones. This may largely be due to different work zone features and driver behavior in different types of work zones. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Environmental and Health Consideration for Mass Gatherings at Football Events

    ERIC Educational Resources Information Center

    Fodero, Severio D.

    1976-01-01

    University health services along with local and state agencies have the responsibility through a coordinated effort to insure that acceptable environmental sanitation standards are maintained during mass gatherings at athletic events. (MB)

  2. Catastrophic Events and Mass Extinctions: Impacts and Beyond

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This volume contains extended abstracts that have been accepted for presentation at the conference on Catastrophic Events and Mass Extinctions: Impacts and Beyond, July 9-12, 2000, in Vienna, Austria.

  3. Personal factors affecting ethical performance in healthcare workers during disasters and mass casualty incidents in Iran: a qualitative study.

    PubMed

    Kiani, Mehrzad; Fadavi, Mohsen; Khankeh, Hamidreza; Borhani, Fariba

    2017-02-20

    In emergencies and disasters, ethics are affected by both personal and organizational factors. Given the lack of organizational ethical guidelines in the disaster management system in Iran, the present study was conducted to explain the personal factors affecting ethics and ethical behaviors among disaster healthcare workers. The present qualitative inquiry was conducted using conventional content analysis to analyze the data collected from 21 in-depth unstructured interviews with healthcare workers with an experience of attending one or more fields of disaster. According to the data collected, personal factors can be classified into five major categories, including personal characteristics such as age and gender, personal values, threshold of tolerance, personal knowledge and reflective thinking. Without ethical guidelines, healthcare workers are intensely affected by the emotional climate of the event and guided by their beliefs. A combination of personal characteristics, competences and expertise thus form the basis of ethical conduct in disaster healthcare workers.

  4. Three years experience with forward-site mass casualty triage-, evacuation-, operating room-, ICU-, and radiography-enabled disaster vehicles: development of usage strategies from drills and deployments.

    PubMed

    Griffiths, Jane L; Kirby, Neil R; Waterson, James A

    2014-01-01

    Delineation of the advantages and problems related to the use of forward-site operating room-, Intensive Care Unit (ICU)-, radiography-, and mass casualty-enabled disaster vehicles for site evacuation, patient stabilization, and triage. The vehicles discussed have six ventilated ICU spaces, two ORs, on-site radiography, 21 intermediate acuity spaces with stretchers, and 54 seated minor acuity spaces. Each space has piped oxygen with an independent vehicle-loaded supply. The vehicles are operated by the Dubai Corporate Ambulance Services. Their support hospital is the main trauma center for the Emirate of Dubai and provides the vehicles' surgical, intensivist, anesthesia, and nursing staff. The disaster vehicles have been deployed 264 times in the last 5 years (these figures do not include deployments for drills). Introducing this new service required extensive initial planning and ongoing analysis of the performance of the disaster vehicles that offer ambulance services and receiving hospitals a large array of possibilities in terms of triage, stabilization of priority I and II patients, and management of priority III patients. In both drills and in disasters, the vehicles were valuable in forward triage and stabilization and in the transport of large numbers of priority III patients. This has avoided the depletion of emergency transport available for priority I and II patients. The successful utilization of disaster vehicles requires seamless cooperation between the hospital staffing the vehicles and the ambulance service deploying them. They are particularly effective during preplanned deployments to high-risk situations. These vehicles also potentially provide self-sufficient refuges for forward teams in hostile environments.

  5. Indoor fire in a nursing home: evaluation of the medical response to a mass casualty incident based on a standardized protocol.

    PubMed

    Koning, S W; Ellerbroek, P M; Leenen, L P H

    2015-04-01

    This retrospective study reports the outcome of a mass casualty incident (MCI) caused by a fire in a nursing home. Data from the medical charts and registration system of the Major Incident Hospital (MIH) and ambulance service were analyzed. The evaluation reports from the MIH and an independent research institute were used. The protocol for reports from major accidents and disaster was used to standardize the reporting [Lennquist, in Int J Disaster Med 1(1):79-86, 2003]. The emergency services were quickly at the scene. The different levels of pre-hospital management performed a tight coordination. However, miscommunication led to confusion in the registration and tracking of patients. In total, 49 persons needed medical treatment, 46 were treated in the MIH. Because of (possible) inhalation injury nine patients needed mechanical ventilation and nine patients were hospitalized to exclude delayed onset of pulmonary symptoms. No incident related deaths occurred. The intensive care unit of the MIH was initially understaffed despite the efforts of the automated calling system and switchboard operators. The handwritten registration of incoming staff was incomplete and should be performed digitally. Some staff members were unfamiliar with the MIH procedures. The medical chart appeared too extensive. Miscommunication between chain partners resulted in the delayed sharing of (semi) medical information. The different levels of incident managers performed a tight coordination. The MIH demonstrated its potency to provide emergency care for 46 patients and 9 intubated patients. No deaths or persistent disabilities occurred. Areas of improvement were recognized both in the pre-hospital as the hospital phase.

  6. Enteral resuscitation of burn shock using World Health Organization oral rehydration solution: a potential solution for mass casualty care.

    PubMed

    Michell, Michael W; Oliveira, Hermes M; Kinsky, Michael P; Vaid, Sumreen U; Herndon, David N; Kramer, George C

    2006-01-01

    Enteral resuscitation could provide a means to resuscitate burn shock when intravenous (IV) therapy is unavailable, such as in mass disasters. We evaluated the extent of intestinal absorption and resuscitative effects of World Health Organization Oral Rehydration Solution after a 40% TBSA burn in anesthetized swine compared with the IV infusion of lactated Ringer's infused by Parkland formula. Plasma volume (PV) was measured using indocyanine green dye dilution. Intestinal absorption was assessed using phenol red as a nonabsorbable marker. Changes in hematocrit, hemodynamics, and measured PV showed equivalent resuscitative effects of enteral and IV resuscitation. The duodenal fluid absorption rate started at 77 +/- 32 ml/hr per meter of intestine during the first hour and increased to 296 +/- 40 ml/hr during the fourth hour of resuscitation, with a total of 93 +/- 2% of World Health Organization Oral Rehydration Solution infused into the intestine being absorbed. Intestinal absorption rates after burn injury are sufficient to resuscitate a 40% TBSA burn.

  7. The Haiti earthquake: the provision of wound care for mass casualties utilizing negative-pressure wound therapy.

    PubMed

    Gabriel, Allen; Gialich, Shelby; Kirk, Julie; Edwards, Sheriden; Beck, Brooke; Sorocéanu, Alexandra; Nelson, Scott; Gabriel, Cassie; Gupta, Subhas

    2011-10-01

    Many months after the devastating earthquake in January 2010, wounds remain a major disease burden in Haiti. Since January 2010, through the efforts of corporations, nonprofit charitable organizations, and medical professionals, advanced wound care techniques, including negative-pressure wound therapy (NPWT), have been introduced into the wound care regimens of various hospitals in Haiti. In June 2010, the authors completed their second volunteer trip at a Haitian hospital specializing in orthopedic wounds. The medical team was composed of a plastic surgeon, orthopedic surgeon, anesthesiologist, medical assistant, scrub technician, and registered nurse (specializing in plastic surgery and orthopedics). The authors' team supplied NPWT devices, reticulated open-cell foam dressings, and canisters donated by Kinetic Concepts, Inc, San Antonio, Texas, for use at the hospital. This report describes the medical challenges in postearthquake Haiti (including limb salvage and infection), benefits of adjunctive use of NPWT/reticulated open-cell foam, and current wound care status in a Haitian orthopedic hospital. The future role of NPWT in Haiti and during mass catastrophe in a least-developed country is also discussed.

  8. [Fatal incidents by crowd crush during mass events. (Un)preventable phenomenon?].

    PubMed

    Wagner, U; Fälker, A; Wenzel, V

    2013-01-01

    Crowd crushes with dozens or even hundreds of casualties have occurred several times at the Hajj in Saudi Arabia and also in soccer stadiums in Western Europe. As fatal accidents after human stampedes during mass events occur very rarely and are usually accompanied by many years of criminal court proceedings in order to identify underlying responsible mechanisms and culprits, it is very difficult to draw conclusions and formulate precautions from an emergency medical point of view. This study analyzed a fatal crowd crush which occurred on 4 December 1999 following the "Air & Style" snowboard contest with approximately 22,000 people attending in the Bergisel stadium in Innsbruck, Austria. Firstly, focused interviews were conducted with professional rescuers, police and physicians and secondly publicly available court records dealing with this incident in the district court of Innsbruck, Austria were analyzed. During the snowboard contest 87 emergency medical technicians, 6 emergency physicians, 1 leading emergency physician, 21 policemen and 140 security personnel were present. Following the accident additionally some 100 emergency medical technicians, 36 emergency medical service vehicles and 4 physician-staffed emergency medical service vehicles responded to the scene. The deadly crowd crush resulting in 6 fatalities, 4 patients still in a vegetative state and 38 injured, was due to a severe crowd accumulation at one stadium exit, which was not recognized and dispersed in time. Construction of the exit in line with darkness, steep slope and slippery surface contributed adversely to this dangerous situation, although panic did not occur at any time. Unfortunately, there is no patent remedy to completely prevent fatal accidents by a crowd crush at mass events. If planning is initiated early, sufficient material and personnel reserves are kept in reserve and despite conflicting interests of the organizers, the host community, security, police and emergency medical

  9. Mass gathering medicine: event factors predicting patient presentation rates.

    PubMed

    Locoh-Donou, Samuel; Yan, Guofen; Berry, Thomas; O'Connor, Robert; Sochor, Mark; Charlton, Nathan; Brady, William

    2016-08-01

    This study was conducted to identify the event characteristics of mass gatherings that predict patient presentation rates held in a southeastern US university community. We conducted a retrospective review of all event-based emergency medical services (EMS) records from mass gathering patient presentations over an approximate 23 month period, from October 24, 2009 to August 27, 2011. All patrons seen by EMS were included. Event characteristics included: crowd size, venue percentage filled seating, venue location (inside/outside), venue boundaries (bounded/unbounded), presence of free water (i.e., without cost), presence of alcohol, average heat index, presence of climate control (i.e., air conditioning), and event category (football, concerts, public exhibitions, non-football athletic events). We identified 79 mass gathering events, for a total of 670 patient presentations. The cumulative patron attendance was 917,307 persons. The patient presentation rate (PPR) for each event was calculated as the number of patient presentations per 10,000 patrons in attendance. Overdispersed Poisson regression was used to relate this rate to the event characteristics while controlling for crowd size. In univariate analyses, increased rates of patient presentations were strongly associated with outside venues [rate ratio (RR) = 3.002, p < 0.001], unbounded venues (RR = 2.839, p = 0.001), absence of free water (RR = 1.708, p = 0.036), absence of climate control (RR = 3.028, p < 0.001), and a higher heat index (RR = 1.211 per 10-unit heat index increase, p = 0.003). The presence of alcohol was not significantly associated with the PPR. Football events had the highest PPR, followed sequentially by public exhibitions, concerts, and non-football athletic events. In multivariate models, the strong predictors from the univariate analyses retained their predictive significance for the PPR, together with heat index and percent seating. In the setting of mass event

  10. Wilderness event medicine: planning for mass gatherings in remote areas.

    PubMed

    Burdick, Timothy E

    2005-11-01

    An increasing number of large recreational events are taking place in remote environments where medical care is far away. Such events include adventure races and large outdoor trips. Wilderness event medicine (WEM) has been previously defined as the healthcare response at any discrete event with more than 200 persons located more than 1h from hospital treatment. However, there is little literature describing the steps for providing medical care at such events. This article provides a framework for planning and executing WEM. It reviews the published data on wilderness injury and illness rates and describes the nature of injuries as they relate to specific activities. The article then discusses the three stages of WEM: pre-event planning, medical treatment at the event, and post-event tasks. Wilderness events include myriad activities, including orienteering, mountain biking, mountaineering, and whitewater paddling. The injury and illness rates are in the range of 1-10 per 1000 person-days of exposure, with rates one order of magnitude greater for events which last many days, include extremes of environment (heat, altitude), or are competitive in nature. Professional adventure racers may present for medical evaluation at rates as high as 1000 encounters per 1000 racer-days. Injuries depend largely on activity. Illnesses are mostly gastrointestinal, 'flu-like' malaise, or related to the event environment, such as humidity or altitude. Providing medical care requires the proper staff, equipment, and contingency plans. The remoteness of these events mandates different protocols than would be used at an urban mass gathering. WEM will likely continue to grow and evolve as a specialty. Additional reports from wilderness events, perhaps facilitated through a web-based incident reporting system, will allow medical providers to improve the quality of care given at remote events. Research into wilderness activity physiology will also be useful in understanding the prevention

  11. Taking a Regional Healthcare Coalition Approach to Mitigating Surge Capacity Needs of Mass Casualty or Pandemic Events

    DTIC Science & Technology

    2012-06-01

    facility. The Palm Beach County Medical Society immediately organized a Hurricane Preparedness Task Force focused on preparing the local hospitals for...delivered by a full-time staff member of the medical society . With 38 different jurisdictions located within the county of Palm Beach, organizing the...c)(3) nonprofit organization . 42 Palm Beach County Medical Society ; HERC Mission Statement; http

  12. Empirical study of crowd behavior during a real mass event

    NASA Astrophysics Data System (ADS)

    Zhang, X. L.; Weng, W. G.; Yuan, H. Y.

    2012-08-01

    The study of crowd behavior is essential for the safe organization of mass events. However, precise quantitative empirical data are insufficient due to the lack of mass event scenarios suitable for observation. In this paper, crowd behavior during a mass event in which many people go through a door and then pass a bridge is studied by a new method based on a flow field visualization algorithm widely used in fluid experiments. Two important movement phases, laminar flow on a bridge and stop-and-go waves in a bottleneck area, are investigated. The results show that the velocity profile on the bridge is similar to that of fully developed laminar flow in a pipe. Quantitative analysis of the stop-and-go wave in the bottleneck area shows that the dominant fluctuation frequencies are mainly below 0.1 Hz and the peak frequency is around 0.05 Hz the wave propagation speed is about - 0.69 m s-1. The absolute decrease in speed as the wave propagates is also indicated. By a combination of shock wave theory and a fundamental diagram, an analytical model of a shock wave in a crowd is established to theoretically investigate the stop-and-go wave, and the model can be used to explain the measurement results. This study provides a new method and fundamental data for understanding crowd behavior. The results are also expected to be useful for the design of crowd management strategies during mass events.

  13. Top quark mass measurement from dilepton events at CDF II

    SciTech Connect

    Abulencia, A.; Acosta, D.; Adelman, Jahred A.; Affolder, Anthony A.; Akimoto, T.; Albrow, M.G.; Ambrose, D.; Amerio, S.; Amidei, D.; Anastassov, A.; Anikeev, K.; /Taiwan, Inst. Phys. /Argonne /Barcelona, IFAE /Baylor U. /INFN, Bologna /Brandeis U. /UC, Davis /UCLA /UC, San Diego /UC, Santa Barbara /Cantabria Inst. of Phys.

    2005-12-01

    We report a measurement of the top quark mass using events collected by the CDF II Detector from p{bar p} collisions at {radical}s = 1.96 TeV at the Fermilab Tevatron. We calculate a likelihood function for the top mass in events that are consistent with t{bar t} {yields} {bar b}{ell}{sup -}{bar {nu}}{sub {ell}}b{ell}{prime}{sup +}{nu}{sub {ell}}{prime} decays. The likelihood is formed as the convolution of the leading-order matrix element and detector resolution functions. The joint likelihood is the product of likelihoods for each of 33 events collected in 340 pb{sup -1} of integrated luminosity, yielding a top quark mass M{sub t} = 165.2 {+-} 6.1(stat.) {+-} 3.4(syst.) GeV/c{sup 2}. This first application of a matrix-element technique to t{bar t} {yields} b{ell}{sup +}{nu}{sub {ell}}{bar b}{ell}{prime}{sup -}{bar {nu}}{sub {ell}}, decays gives the most precise single measurement of M{sub t} in dilepton events. Combined with other CDF Run II measurements using dilepton events, we measure M{sub t} = 167.9 {+-} 5.2(stat.) {+-} 3.7(syst.) GeV/c{sup 2}.

  14. Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR)

    PubMed Central

    Riddle, Lorna; Larner, Joanne

    2017-01-01

    Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an “Initial Operational Response” by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer’s forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions

  15. Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK'S Initial Operational Response (IOR).

    PubMed

    Amlôt, Richard; Carter, Holly; Riddle, Lorna; Larner, Joanne; Chilcott, Robert P

    2017-01-01

    Previous studies have demonstrated that rapid evacuation, disrobing and emergency decontamination can enhance the ability of emergency services and acute hospitals to effectively manage chemically-contaminated casualties. The purpose of this human volunteer study was to further optimise such an "Initial Operational Response" by (1) identifying an appropriate method for performing improvised skin decontamination and (2) providing guidance for use by first responders and casualties. The study was performed using two readily available, absorbent materials (paper towels and incontinence pads). The decontamination effectiveness of the test materials was measured by quantifying the amount of a chemical warfare agent simulant (methyl salicylate) removed from each volunteer's forearm skin. Results from the first study demonstrated that simulant recovery was lower in all of the dry decontamination conditions when compared to matched controls, suggesting that dry decontamination serves to reduce chemical exposure. Blotting in combination with rubbing was the most effective form of decontamination. There was no difference in effectiveness between the two absorbent materials. In the following study, volunteers performed improvised dry decontamination, either with or without draft guidelines. Volunteers who received the guidance were able to carry out improvised dry decontamination more effectively, using more of the absorbent product (blue roll) to ensure that all areas of the body were decontaminated and avoiding cross-contamination of other body areas by working systematically from the head downwards. Collectively, these two studies suggest that absorbent products that are available on ambulances and in acute healthcare settings may have generic applicability for improvised dry decontamination. Wherever possible, emergency responders and healthcare workers should guide casualties through decontamination steps; in the absence of explicit guidance and instructions, improvised

  16. Reconstructing ~2,200 years of mass movement and tsunami events in a deep fjord-type lake, western Norway

    NASA Astrophysics Data System (ADS)

    Waldmann, Nicolas; Vasskog, Kristian; Simpson, Guy; Hansen, Louise; Ariztegui, Daniel; Chapron, Emmanuel; Nesje, Atle

    2016-04-01

    Rock avalanches are one of the most devastating geohazards in Norway. A recent example can be given by the September 1936 rock fall that released ca. 1 million m3 of gneissic bedrock from the Ramnefjell Mountain, 800 m above Lake Lovatnet in inner Nordfjord, western Norway. The rock fall plunged into the lake causing a tsunami with a maximum run-up of 74 m and causing 74 casualties. This rock failure opened a deep-seated fracture that may serve as a sliding surface threatening for the generation of potential new series of failures. Lake Lovatnet was surveyed combining simultaneously 1 in3 airgun multi-channel and 3.5 kHz (pinger) single-channel systems. The seismic survey was complemented by piston cores. The general seismic stratigraphy of the lake was reconstructed using the 1 in3 airgun multi-channel survey. The seismic data shows an overall succession of glaciomarine sediments deposited during glacier retreat at the termination of the last ice age and a transition to marine and lacustrine sedimentation, as glacio-isostatic rebound turned the fjord into a land-locked lake. Furthermore, a record of ~2200 years of mass wasting events were identified and dated in the sedimentary record and the events were further mapped in the geophysical data. A specially tailored physically-based numerical simulation was carried out on the 1936 rock fall and related tsunami event in Lake Lovatnet. This model allowed us to reconstruct the effects of such an event on a small lacustrine basin. The outcome of the model has been further validated against historical, marine and terrestrial information. Results from this study further permit to extend the record of mass wasting events beyond historical times, providing a data set that can be applied to comparable basins at various temporal and geographical scales.

  17. Innovative Operations Measures and Nutritional Support for Mass Endurance Events.

    PubMed

    Chiampas, George T; Goyal, Anita V

    2015-11-01

    Endurance and sporting events have increased in popularity and participation in recent years worldwide, and with this comes the need for medical directors to apply innovative operational strategies and nutritional support to meet such demands. Mass endurance events include sports such as cycling and running half, full and ultra-marathons with over 1000 participants. Athletes, trainers and health care providers can all agree that both participant outcomes and safety are of the utmost importance for any race or sporting event. While demand has increased, there is relatively less published guidance in this area of sports medicine. This review addresses public safety, operational systems, nutritional support and provision of medical care at endurance events. Significant medical conditions in endurance sports include heat illness, hyponatraemia and cardiac incidents. These conditions can differ from those typically encountered by clinicians or in the setting of low-endurance sports, and best practices in their management are discussed. Hydration and nutrition are critical in preventing these and other race-related morbidities, as they can impact both performance and medical outcomes on race day. Finally, the command and communication structures of an organized endurance event are vital to its safety and success, and such strategies and concepts are reviewed for implementation. The nature of endurance events increasingly relies on medical leaders to balance safety and prevention of morbidity while trying to help optimize athlete performance.

  18. Mass-gathering health research foundational theory: part 2 - event modeling for mass gatherings.

    PubMed

    Turris, Sheila A; Lund, Adam; Hutton, Alison; Bowles, Ron; Ellerson, Elizabeth; Steenkamp, Malinda; Ranse, Jamie; Arbon, Paul

    2014-12-01

    Current knowledge about mass-gathering health (MGH) fails to adequately inform the understanding of mass gatherings (MGs) because of a relative lack of theory development and adequate conceptual analysis. This report describes the development of a series of event lenses that serve as a beginning "MG event model," complimenting the "MG population model" reported elsewhere. Existing descriptions of "MGs" were considered. Analyzing gaps in current knowledge, the authors sought to delineate the population of events being reported. Employing a consensus approach, the authors strove to capture the diversity, range, and scope of MG events, identifying common variables that might assist researchers in determining when events are similar and might be compared. Through face-to-face group meetings, structured breakout sessions, asynchronous collaboration, and virtual international meetings, a conceptual approach to classifying and describing events evolved in an iterative fashion. Findings Embedded within existing literature are a variety of approaches to event classification and description. Arising from these approaches, the authors discuss the interplay between event demographics, event dynamics, and event design. Specifically, the report details current understandings about event types, geography, scale, temporality, crowd dynamics, medical support, protective factors, and special hazards. A series of tables are presented to model the different analytic lenses that might be employed in understanding the context of MG events. Interpretation The development of an event model addresses a gap in the current body of knowledge vis a vis understanding and reporting the full scope of the health effects related to MGs. Consistent use of a consensus-based event model will support more rigorous data collection. This in turn will support meta-analysis, create a foundation for risk assessment, allow for the pooling of data for illness and injury prediction, and support methodology for

  19. Medical support at a large-scale motorsports mass-gathering event: the inaugural Formula One United States Grand Prix in Austin, Texas.

    PubMed

    Sabra, John P; Cabañas, José G; Bedolla, John; Borgmann, Shirley; Hawley, James; Craven, Kevin; Brown, Carlos; Ziebell, Chris; Olvey, Steve

    2014-08-01

    Formula One returned to the United States on November 16-18, 2012, with the inaugural United States Grand Prix in Austin, Texas. Medical preparedness for motorsports events represents a unique challenge due to the potential for a high number of spectators seeking medical attention, and the possibility for a mass-casualty situation. Adequate preparation requires close collaboration across public safety agencies and hospital networks to minimize impact on Emergency Medical Services (EMS) resources. To report the details of preparation for an inaugural mass-gathering motorsports event, and to describe the details of the medical care rendered during the 3-day event. A retrospective analysis was completed utilizing postevent summaries, provided by the medical planning committee, by the Federation Internationale de L'Automobile (FIA), and Austin Travis County Emergency Medical Services (ATCEMS). Patient data were collected from standardized patient care records for descriptive analysis. Medical usage rates (MURs) are reported as a rate of patients per 10,000 (PPTT) participants. A total of 566 patients received medical care over the 3-day period with the on-site care rate of 95%. Overall, MUR was 21.3 PPTT attendees. Most patients had minor problems, and there were no driver injuries or deaths. This mass-gathering motorsport event had a moderate number of patients requiring medical attention. The preparedness plan was implemented successfully with minimal impact on EMS resources and local medical facilities. This medical preparedness plan may serve as a model to other cities preparing for an inaugural motorsports event.

  20. Chronology of magmatic and biological events during mass extinctions

    NASA Astrophysics Data System (ADS)

    Schaltegger, U.; Davies, J.; Baresel, B.; Bucher, H.

    2016-12-01

    For mass extinctions, high-precision geochronology is key to understanding: 1) the age and duration of mass extinction intervals, derived from palaeo-biodiversity or chemical proxies in marine sections, and 2) the age and duration of the magmatism responsible for injecting volatiles into the atmosphere. Using high-precision geochronology, here we investigate the sequence of events linked to the Triassic-Jurassic boundary (TJB) and the Permian-Triassic boundary (PTB) mass extinctions. At the TJB, the model of Guex et al. (2016) invokes degassing of early magmas produced by thermal erosion of cratonic lithosphere as a trigger of climate disturbance in the late Rhaetian. We provide geochronological evidence that such early intrusives from the CAMP (Central Atlantic Magmatic Province), predate the end-Triassic extinction event (Blackburn et al. 2013) by 100 kyr (Davies et al., subm.). We propose that these early intrusions and associated explosive volcanism (currently unidentified) initiate the extinction, followed by the younger basalt eruptions of the CAMP. We also provide accurate and precise calibration of the PTB in marine sections in S. China: The PTB and the extinction event coincide within 30 kyr in deep water settings; a hiatus followed by microbial limestone deposition in shallow water settings is of <100 kyr duration. The PTB extinction interval is preceded by up to 300 kyr by the onset of partly alkaline explosive, extrusive and intrusive rocks, which are suggested as the trigger of the mass extinction, rather than the subsequent basalt flows of the Siberian Traps (Burgess and Bowring 2015). From temporal constraints, the main inferences that can be made are: The duration of extinction events is in the x10 kyr range during the initial intrusive activity of a Large Igneous Province, and is postdated by the majority of basalt flows over several 100 kyr. For modeling climate change associated with mass extinctions, volatiles released from the basalt flows may

  1. Measurement of the Top Quark Mass Using Dilepton Events

    NASA Astrophysics Data System (ADS)

    Abbott, B.; Abolins, M.; Acharya, B. S.; Adam, I.; Adams, D. L.; Adams, M.; Ahn, S.; Aihara, H.; Alves, G. A.; Amidi, E.; Amos, N.; Anderson, E. W.; Astur, R.; Baarmand, M. M.; Baden, A.; Balamurali, V.; Balderston, J.; Baldin, B.; Banerjee, S.; Bantly, J.; Barberis, E.; Bartlett, J. F.; Bazizi, K.; Belyaev, A.; Beri, S. B.; Bertram, I.; Bezzubov, V. A.; Bhat, P. C.; Bhatnagar, V.; Bhattacharjee, M.; Biswas, N.; Blazey, G.; Blessing, S.; Bloom, P.; Boehnlein, A.; Bojko, N. I.; Borcherding, F.; Borders, J.; Boswell, C.; Brandt, A.; Brock, R.; Bross, A.; Buchholz, D.; Burtovoi, V. S.; Butler, J. M.; Carvalho, W.; Casey, D.; Casilum, Z.; Castilla-Valdez, H.; Chakraborty, D.; Chang, S.-M.; Chekulaev, S. V.; Chen, L.-P.; Chen, W.; Choi, S.; Chopra, S.; Choudhary, B. C.; Christenson, J. H.; Chung, M.; Claes, D.; Clark, A. R.; Cobau, W. G.; Cochran, J.; Cooper, W. E.; Cretsinger, C.; Cullen-Vidal, D.; Cummings, M. A.; Cutts, D.; Dahl, O. I.; Davis, K.; de, K.; del Signore, K.; Demarteau, M.; Denisov, D.; Denisov, S. P.; Diehl, H. T.; Diesburg, M.; di Loreto, G.; Draper, P.; Ducros, Y.; Dudko, L. V.; Dugad, S. R.; Edmunds, D.; Ellison, J.; Elvira, V. D.; Engelmann, R.; Eno, S.; Eppley, G.; Ermolov, P.; Eroshin, O. V.; Evdokimov, V. N.; Fahland, T.; Fatyga, M.; Fatyga, M. K.; Featherly, J.; Feher, S.; Fein, D.; Ferbel, T.; Finocchiaro, G.; Fisk, H. E.; Fisyak, Y.; Flattum, E.; Forden, G. E.; Fortner, M.; Frame, K. C.; Fuess, S.; Gallas, E.; Galyaev, A. N.; Gartung, P.; Geld, T. L.; Genik, R. J., II; Genser, K.; Gerber, C. E.; Gibbard, B.; Glenn, S.; Gobbi, B.; Goforth, M.; Goldschmidt, A.; Gómez, B.; Gómez, G.; Goncharov, P. I.; González Solís, J. L.; Gordon, H.; Goss, L. T.; Gounder, K.; Goussiou, A.; Graf, N.; Grannis, P. D.; Green, D. R.; Green, J.; Greenlee, H.; Grim, G.; Grinstein, S.; Grossman, N.; Grudberg, P.; Grünendahl, S.; Guglielmo, G.; Guida, J. A.; Guida, J. M.; Gupta, A.; Gurzhiev, S. N.; Gutierrez, P.; Gutnikov, Y. E.; Hadley, N. J.; Haggerty, H.; Hagopian, S.; Hagopian, V.; Hahn, K. S.; Hall, R. E.; Hansen, S.; Hauptman, J. M.; Hedin, D.; Heinson, A. P.; Heintz, U.; Hernández-Montoya, R.; Heuring, T.; Hirosky, R.; Hobbs, J. D.; Hoeneisen, B.; Hoftun, J. S.; Hsieh, F.; Hu, Ting; Hu, Tong; Huehn, T.; Ito, A. S.; James, E.; Jaques, J.; Jerger, S. A.; Jesik, R.; Jiang, J. Z.-Y.; Joffe-Minor, T.; Johns, K.; Johnson, M.; Jonckheere, A.; Jones, M.; Jöstlein, H.; Jun, S. Y.; Jung, C. K.; Kahn, S.; Kalbfleisch, G.; Kang, J. S.; Kehoe, R.; Kelly, M. L.; Kim, C. L.; Kim, S. K.; Klatchko, A.; Klima, B.; Klopfenstein, C.; Klyukhin, V. I.; Kochetkov, V. I.; Kohli, J. M.; Koltick, D.; Kostritskiy, A. V.; Kotcher, J.; Kotwal, A. V.; Kourlas, J.; Kozelov, A. V.; Kozlovski, E. A.; Krane, J.; Krishnaswamy, M. R.; Krzywdzinski, S.; Kunori, S.; Lami, S.; Lan, H.; Lander, R.; Landry, F.; Landsberg, G.; Lauer, B.; Leflat, A.; Li, H.; Li, J.; Li-Demarteau, Q. Z.; Lima, J. G.; Lincoln, D.; Linn, S. L.; Linnemann, J.; Lipton, R.; Liu, Q.; Liu, Y. C.; Lobkowicz, F.; Loken, S. C.; Lökös, S.; Lueking, L.; Lyon, A. L.; Maciel, A. K.; Madaras, R. J.; Madden, R.; Magaña-Mendoza, L.; Mani, S.; Mao, H. S.; Markeloff, R.; Markosky, L.; Marshall, T.; Martin, M. I.; Mauritz, K. M.; May, B.; Mayorov, A. A.; McCarthy, R.; McDonald, J.; McKibben, T.; McKinley, J.; McMahon, T.; Melanson, H. L.; Merkin, M.; Merritt, K. W.; Miettinen, H.; Mincer, A.; de Miranda, J. M.; Mishra, C. S.; Mokhov, N.; Mondal, N. K.; Montgomery, H. E.; Mooney, P.; da Motta, H.; Murphy, C.; Nang, F.; Narain, M.; Narasimham, V. S.; Narayanan, A.; Neal, H. A.; Negret, J. P.; Nemethy, P.; Nicola, M.; Norman, D.; Oesch, L.; Oguri, V.; Oltman, E.; Oshima, N.; Owen, D.; Padley, P.; Pang, M.; Para, A.; Park, Y. M.; Partridge, R.; Parua, N.; Paterno, M.; Perkins, J.; Peters, M.; Piegaia, R.; Piekarz, H.; Pischalnikov, Y.; Podstavkov, V. M.; Pope, B. G.; Prosper, H. B.; Protopopescu, S.; Qian, J.; Quintas, P. Z.; Raja, R.; Rajagopalan, S.; Ramirez, O.; Rasmussen, L.; Reucroft, S.; Rijssenbeek, M.; Rockwell, T.; Roe, N. A.; Rubinov, P.; Ruchti, R.; Rutherfoord, J.; Sánchez-Hernández, A.; Santoro, A.; Sawyer, L.; Schamberger, R. D.; Schellman, H.; Sculli, J.; Shabalina, E.; Shaffer, C.; Shankar, H. C.; Shivpuri, R. K.; Shupe, M.; Singh, H.; Singh, J. B.; Sirotenko, V.; Smart, W.; Smith, A.; Smith, R. P.; Snihur, R.; Snow, G. R.; Snow, J.; Snyder, S.; Solomon, J.; Sood, P. M.; Sosebee, M.; Sotnikova, N.; Souza, M.; Spadafora, A. L.; Stephens, R. W.; Stevenson, M. L.; Stewart, D.; Stoianova, D. A.; Stoker, D.; Strauss, M.; Streets, K.; Strovink, M.; Sznajder, A.; Tamburello, P.; Tarazi, J.; Tartaglia, M.; Thomas, T. L.; Thompson, J.; Trippe, T. G.; Tuts, P. M.; Varelas, N.; Varnes, E. W.; Vititoe, D.; Volkov, A. A.; Vorobiev, A. P.; Wahl, H. D.; Wang, G.; Warchol, J.; Watts, G.; Wayne, M.; Weerts, H.; White, A.; White, J. T.; Wightman, J. A.; Willis, S.; Wimpenny, S. J.; Wirjawan, J. V.; Womersley, J.; Won, E.; Wood, D. R.; Xu, H.; Yamada, R.; Yamin, P.; Yanagisawa, C.; Yang, J.; Yasuda, T.; Yepes, P.; Yoshikawa, C.; Youssef, S.; Yu, J.; Yu, Y.; Zhu, Z. H.; Zieminska, D.; Zieminski, A.; Zverev, E. G.; Zylberstejn, A.

    1998-03-01

    The D0 Collaboration has performed a measurement of the top quark mass mt based on six candidate events for the process tt¯-->bW+b¯W-, where the W bosons decay to eν or μν. This sample was collected during an exposure of the D0 detector to an integrated luminosity of 125 pb-1 of s = 1.8 TeV pp¯ collisions. We obtain mt = 168.4+/-12.3\\(stat\\)+/-3.6\\(syst\\) GeV/c2, consistent with the measurement obtained using single-lepton events. Combination of the single-lepton and dilepton results yields mt = 172.0+/-7.5 GeV/c2.

  2. Associations between coronal mass ejections and solar energetic proton events

    NASA Technical Reports Server (NTRS)

    Kahler, S. W.; Sheeley, N. R., Jr.; Howard, R. A.; Michels, D. J.; Koomen, M. J.; Mcguire, R. E.; Von Rosenvinge, T. T.; Reames, D. V.

    1984-01-01

    A comparison between proton events and coronal mass ejections (CMEs) based on nearly three years of observations around the recent maximum of solar activity is presented. Peak proton fluxes are found to correlate with both the speeds and the angular sizes of the associated CMEs. It is shown that CME speeds do not significantly correlate with CME angular sizes, so that peak proton fluxes are correlated with two independent CME parameters. With larger angular sizes, CMEs are more likely to be loops and fans rather than jets and spikes and are more likely to intersect the ecliptic.

  3. End-Cretaceous mass extinction event - Argument for terrestrial causation

    NASA Astrophysics Data System (ADS)

    Hallam, Anthony

    1987-11-01

    The end-Cretaceous mass extinctions were not a geologically instantaneous event and were selective in character. These features are incompatible with the original Alvarez hypothesis of their being caused by a single asteroid impact that produced a world-embracing dust cloud with devastating environmental consequences. By analysis of physical and chemical evidence from the stratigraphic record it is shown that a modified extraterrestrial model in which stepwise extinctions resulted from encounter with a comet shower is less plausible than one intrinsic to the earth, involving significant disturbance in the mantle.

  4. End-cretaceous mass extinction event: argument for terrestrial causation.

    PubMed

    Hallam, A

    1987-11-27

    The end-Cretaceous mass extinctions were not a geologically instantaneous event and were selective in character. These features are incompatible with the original Alvarez hypothesis of their being caused by a single asteroid impact that produced a world-embracing dust cloud with devastating environmental consequences. By analysis of physical and chemical evidence from the stratigraphic record it is shown that a modified extraterrestrial model in which stepwise extinctions resulted from encounter with a comet shower is less plausible than one intrinsic to the earth, involving significant disturbance in the mantle.

  5. Black hole masses of tidal disruption event host galaxies

    NASA Astrophysics Data System (ADS)

    Wevers, Thomas; van Velzen, Sjoert; Jonker, Peter G.; Stone, Nicholas C.; Hung, Tiara; Onori, Francesca; Gezari, Suvi; Blagorodnova, Nadejda

    2017-10-01

    The mass of the central black hole in a galaxy that hosted a tidal disruption event (TDE) is an important parameter in understanding its energetics and dynamics. We present the first homogeneously measured black hole masses of a complete sample of 12 optically/UV-selected TDE host galaxies (down to ghost ≤ 22 mag and z = 0.37) in the Northern sky. The mass estimates are based on velocity dispersion measurements, performed on late time optical spectroscopic observations. We find black hole masses in the range of 3 × 105 M⊙ ≤ MBH ≤ 2 × 107 M⊙. The TDE host galaxy sample is dominated by low-mass black holes (∼ 106 M⊙), as expected from theoretical predictions. The blackbody peak luminosity of TDEs with MBH ≤ 107.1 M⊙ is consistent with the Eddington limit of the supermassive black hole (SMBH), whereas the two TDEs with MBH ≥ 107.1 M⊙ have peak luminosities below their SMBH Eddington luminosity, in line with the theoretical expectation that the fallback rate for MBH ≥ 107.1 M⊙ is sub-Eddington. In addition, our observations suggest that TDEs around lower mass black holes evolve faster. These findings corroborate the standard TDE picture in 106 M⊙ black holes. Our results imply an increased tension between observational and theoretical TDE rates. By comparing the blackbody emission radius with theoretical predictions, we conclude that the optical/UV emission is produced in a region consistent with the stream self-intersection radius of shallow encounters, ruling out a compact accretion disc as the direct origin of the blackbody radiation at peak brightness.

  6. The Frasnian-Famennian mass killing event(s), methods of identification and evaluation

    NASA Technical Reports Server (NTRS)

    Geldsetzer, H. H. J.

    1988-01-01

    The absence of an abnormally high number of earlier Devonian taxa from Famennian sediments was repeatedly documented and can hardly be questioned. Primary recognition of the event(s) was based on paleontological data, especially common macrofossils. Most paleontologists place the disappearance of these common forms at the gigas/triangularis contact and this boundary was recently proposed as the Frasnian-Famennian (F-F) boundary. Not unexpectedly, alternate F-F positions were suggested caused by temporary Frasnian survivors or sudden post-event radiations of new forms. Secondary supporting evidence for mass killing event(s) is supplied by trace element and stable isotope geochemistry but not with the same success as for the K/T boundary, probably due to additional 300 ma of tectonic and diagenetic overprinting. Another tool is microfacies analysis which is surprisingly rarely used even though it can explain geochemical anomalies or paleontological overlap not detectable by conventional macrofacies analysis. The combination of microfacies analysis and geochemistry was applied at two F-F sections in western Canada and showed how interdependent the two methods are. Additional F-F sections from western Canada, western United States, France, Germany and Australia were sampled or re-sampled and await geochemical/microfacies evaluation.

  7. [Effect of application of pulse contour cardiac output monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty].

    PubMed

    Yang, W X; Guo, G H; Shen, G L; Lin, W; Zhao, X Y; Qi, Q; Qian, H G; Xie, W Z; Wang, Z X

    2016-03-01

    To investigate the effect of the application of pulse contour cardiac output (PiCCO) monitoring technology on delayed resuscitation of patients with extensive burn in a mass casualty. The clinical data of 41 patients injured in Kunshan dash explosion hospitalized in the First Affiliated Hospital of Soochow University, the 100th Hospital of the People's Liberation Army, and Suzhou Municipal Hospital were retrospectively analyzed. The patients were divided into traditional monitoring group (T, n=22) and PiCCO monitoring group (P, n=19) according to the monitoring technic during delayed resuscitation. The input volumes of electrolyte, colloids, and water of patients in the two groups within 2 hours after admission, the first, second, and third 8 hours post injury (HPI), and the first 24 HPI were recorded. The fluid infusion coefficients of patients in the two groups within 2 hours after admission, the first, second, and third 8 HPI, and the first, second, third, and fourth 24 HPI were calculated. The urine volume, mean arterial pressure (MAP), and central venous pressure (CVP) of patients in the two groups at post injury hour (PIH) 8, 16, 24, 48, 72, and 96 were recorded. The blood lactate, base excess, hematocrit (HCT), and platelet count of patients in the two groups at PIH 24, 48, 72, and 96 were recorded. Complications and death of patients in the two groups were recorded. Data were processed with analysis of variance for repeated measurement, Chi-square test, t test, and Wilcoxon test. The deviations between figure 2 and the fluid infusion coefficients of the first or second 24 HPI, and the deviations between figure 1 and the fluid infusion coefficients of the second, third or fourth 24 HPI were calculated, and the three groups deviations were analyzed by Pearson correlation analysis. (1) The input volumes of electrolyte of patients in group P were significantly more than those in group T within the first 8 and 24 HPI (with Z values respectively -3.506 and -2

  8. Casualties from terrorist bombings.

    PubMed

    Cooper, G J; Maynard, R L; Cross, N L; Hill, J F

    1983-11-01

    The physical factors responsible for injury following an explosion in a room or building are: direct exposure to overpressure; blast-induced whole body displacement; impact of blast-energized debris; burns from flash and hot gases. The patterns of injury seen in the casualties from four terrorist bombings are described to illustrate the types and severity of particular wounds. The most common fatal injury is brain damage; 'blast lung' is uncommon in civilian terrorist bombings; flash burns, fractures, serious soft-tissue damage, and eardrum injuries are seen in people close to the bomb, who usually require hospital admission; many others taken to hospital can be treated for injury by debris and released. The environment and its internal structure and the position of the occupants of the space can influence the type and severity of injuries.

  9. User-managed inventory: an approach to forward-deployment of urgently needed medical countermeasures for mass-casualty and terrorism incidents.

    PubMed

    Coleman, C Norman; Hrdina, Chad; Casagrande, Rocco; Cliffer, Kenneth D; Mansoura, Monique K; Nystrom, Scott; Hatchett, Richard; Caro, J Jaime; Knebel, Ann R; Wallace, Katherine S; Adams, Steven A

    2012-12-01

    The user-managed inventory (UMI) is an emerging idea for enhancing the current distribution and maintenance system for emergency medical countermeasures (MCMs). It increases current capabilities for the dispensing and distribution of MCMs and enhances local/regional preparedness and resilience. In the UMI, critical MCMs, especially those in routine medical use ("dual utility") and those that must be administered soon after an incident before outside supplies can arrive, are stored at multiple medical facilities (including medical supply or distribution networks) across the United States. The medical facilities store a sufficient cache to meet part of the surge needs but not so much that the resources expire before they would be used in the normal course of business. In an emergency, these extra supplies can be used locally to treat casualties, including evacuees from incidents in other localities. This system, which is at the interface of local/regional and federal response, provides response capacity before the arrival of supplies from the Strategic National Stockpile (SNS) and thus enhances the local/regional medical responders' ability to provide life-saving MCMs that otherwise would be delayed. The UMI can be more cost-effective than stockpiling by avoiding costs due to drug expiration, disposal of expired stockpiled supplies, and repurchase for replacement.

  10. Natural Organic Matter and the Event Horizon of Mass Spectrometry

    NASA Astrophysics Data System (ADS)

    Hertkorn, N.; Frommberger, M.; Witt, M.; Koch, B. P.; Schmitt-Kopplin, P.; Perdue, E. M.

    2009-05-01

    are observed using six different modes of ionization (APCI, APPI, ESI in positive and negative modus) imply considerable selectivity of the ionization process and suggest that the observed mass spectra represent simplified projections of still more complex mixtures. N. Hertkorn, M. Frommberger, M. Witt, B. Koch, Ph. Schmitt-Kopplin, E. M. Perdue, Natural Organic Matter and the Event Horizon of Mass Spectrometry, Anal. Chem., 80 (2008) 8908-8919.

  11. Children and terror casualties receive preference in ICU admissions.

    PubMed

    Peleg, Kobi; Rozenfeld, Michael; Dolev, Eran

    2012-03-01

    Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events. Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005. Of the 10 hospitals included in the registry, 6 were level I trauma centers and 4 were regional trauma centers. Patients who were hospitalized or died in the ED or were transferred between hospitals were included in the registry. All analyses were controlled for Injury Severity Score (ISS). All patients with ISS 1-24 terror casualties had the highest frequency of intensive care unit (ICU) admissions when compared with patients after road traffic accidents (RTA) and other trauma. Among patients with terror-related casualties, children were admitted to ICU disproportionally to the severity of their injury. Logistic regression adjusted for injury severity and trauma type showed that both terror casualties and children have a higher probability of being admitted to the ICU. Injured children are admitted to ICU more often than other age groups. Also, terror-related casualties are more frequently admitted to the ICU compared to those from other types of injury events. These differences were not directly related to a higher proportion of severe injuries among the preferred groups.

  12. A SOLAR CORONAL JET EVENT TRIGGERS A CORONAL MASS EJECTION

    SciTech Connect

    Liu, Jiajia; Wang, Yuming; Shen, Chenglong; Liu, Kai; Pan, Zonghao; Wang, S.

    2015-11-10

    In this paper, we present multi-point, multi-wavelength observations and analysis of a solar coronal jet and coronal mass ejection (CME) event. Employing the GCS model, we obtained the real (three-dimensional) heliocentric distance and direction of the CME and found it to propagate at a high speed of over 1000 km s{sup −1}. The jet erupted before the CME and shared the same source region. The temporal and spacial relationship between these two events lead us to the possibility that the jet triggered the CME and became its core. This scenario hold the promise of enriching our understanding of the triggering mechanism of CMEs and their relations to coronal large-scale jets. On the other hand, the magnetic field configuration of the source region observed by the Solar Dynamics Observatory (SDO)/HMI instrument along with the off-limb inverse Y-shaped configuration observed by SDO/AIA in the 171 Å passband provide the first detailed observation of the three-dimensional reconnection process of a large-scale jet as simulated in Pariat et al. The eruption process of the jet highlights the importance of filament-like material during the eruption of not only small-scale X-ray jets, but likely also of large-scale EUV jets. Based on our observations and analysis, we propose the most probable mechanism for the whole event, with a blob structure overlaying the three-dimensional structure of the jet, to describe the interaction between the jet and the CME.

  13. Flood basalt eruptions, comet showers, and mass extinction events

    NASA Technical Reports Server (NTRS)

    Rampino, Michael R.; Stothers, Richard B.

    1988-01-01

    A chronology of initiation dates of the major continental flood basalt episodes has been established from compilation of published K-Ar and Ar-Ar ages of basaltic flows and related basic intrusions. The dating is therefore independent of the biostratigraphic and paleomagnetic time scales, and the estimated errors of the inititation dates are approximately + or - 4 pct. There are 11 distinct episodes of continental flood basalts known during the past 250 Myr. The data show that flood basalt episodes are generally relatively brief geologic events, with intermittent eruptions during peak output periods lasting ony 2 to 3 Myr or less. Statistical analyses suggest that these episodes may have occurred quasi-periodically with a mean cycle time of 32 + or - 1 Myr. The initiation dates of the flood basalts are close to the estimated dates of marine mass extinctions and impact-crater clusters. Although a purely internal forcing might be argued for the flood basalt volcanism, quasi-periodic comet impacts may be the trigger for both the flood basalts and the extinctions. Impact cratering models suggest that large-body impactors lead to deep initial cratering, and therefore may cause mantle disturbances and initiate mantle plume activity. The flood basalt episodes commonly mark the initiation or jump of a mantle hotspot, and are often followed by continental rifting and separation. Evidence from dynamical studies of impacts, occurrences of craters and hotspots, and the geochemistry of boundary layers is synthesized to provide a possible model of impact-generated volcanism. Flood basalt eruptions may themselves have severe effects on climate, and possibly on life. Impacts might, as a result, have led to mass extinctions through direct atmospheric disturbances, and/or indirectly through prolonged flood basalt volcanism.

  14. Coral population dynamics across consecutive mass mortality events.

    PubMed

    Riegl, Bernhard; Purkis, Sam

    2015-11-01

    Annual coral mortality events due to increased atmospheric heat may occur regularly from the middle of the century and are considered apocalyptic for coral reefs. In the Arabian/Persian Gulf, this situation has already occurred and population dynamics of four widespread corals (Acropora downingi, Porites harrisoni, Dipsastrea pallida, Cyphastrea micropthalma) were examined across the first-ever occurrence of four back-to-back mass mortality events (2009-2012). Mortality was driven by diseases in 2009, bleaching and subsequent diseases in 2010/2011/2012. 2009 reduced P. harrisoni cover and size, the other events increasingly reduced overall cover (2009: -10%; 2010: -20%; 2011: -20%; 2012: -15%) and affected all examined species. Regeneration was only observed after the first disturbance. P. harrisoni and A. downingi severely declined from 2010 due to bleaching and subsequent white syndromes, while D. pallida and P. daedalea declined from 2011 due to bleaching and black-band disease. C. microphthalma cover was not affected. In all species, most large corals were lost while fission due to partial tissue mortality bolstered small size classes. This general shrinkage led to a decrease of coral cover and a dramatic reduction of fecundity. Transition matrices for disturbed and undisturbed conditions were evaluated as Life Table Response Experiment and showed that C. microphthalma changed the least in size-class dynamics and fecundity, suggesting they were 'winners'. In an ordered 'degradation cascade', impacts decreased from the most common to the least common species, leading to step-wise removal of previously dominant species. A potentially permanent shift from high- to low-coral cover with different coral community and size structure can be expected due to the demographic dynamics resultant from the disturbances. Similarities to degradation of other Caribbean and Pacific reefs are discussed. As comparable environmental conditions and mortality patterns must be

  15. Is rapid hepatitis C virus testing from corpses a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field?

    PubMed

    Hagen, Ralf M; Wulff, B; Loderstaedt, U; Fengler, I; Frickmann, H; Schwarz, N G; Polywka, S

    2014-09-01

    We tested a commercially available rapid hepatitis C virus (HCV) test assay for its potential use for analyses of corpses as a screening option for index persons who have died after mass-casualty incidents in high-prevalence settings in the field. 50 blood samples were drawn from 16 recently deceased confirmed HCV-positive patients whose corpses were stored at 4°C in the mortuary and were analysed at admission and up to 48 h post mortem by rapid serological testing using the ImmunoFlow HCV test (Core Diagnostics, Birmingham, UK) in comparison with automated serological assays and PCR. Samples from 50 HCV-negative corpses were also analysed. The blood of only four of the 16 HCV-positive corpses reacted clearly with the ImmunoFlow HCV test, while in five cases the result was only weakly reactive and three cases showed very weak reactivity. Four of the infected corpses showed initially negative results, three of which became very weakly reactive 48 h post mortem. 49 out of 50 samples (98%) from HCV-negative corpses tested negative. The rapid test system we investigated showed insufficient sensitivity regarding the identification of HCV positivity. Automated serological testing or PCR should be preferred if it is realistically available in the deployed military setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Reducing and Mitigating Civilian Casualties: Enduring Lessons

    DTIC Science & Technology

    2013-04-12

    was not completely resolved: later in the conflict, Multinational Forces – Iraq ( MNF -I) 2 Off...Target: The Conduct of the War and Civilian Casualties in Iraq, report, Human Rights Watch, December 2003. 3 Though Multinational Forces-Iraq ( MNF ...I) did not establish a dedicated tracking cell for civilian casualties (CIVCAS) as did ISAF, the MNF -I Headquarters (HQ) tracked these casualties

  17. Mass-gathering medicine: creation of an online event and patient registry.

    PubMed

    Lund, Adam; Turris, Sheila A; Amiri, Neda; Lewis, Kerrie; Carson, Michael

    2012-12-01

    INTRODUCTION/PROBLEM: A review of the mass-gathering medicine literature confirms that the research community currently lacks a standardized approach to data collection and reporting in relation to large-scale community events. This lack of consistency, particularly with regard to event characteristics, patient characteristics, acuity determination, and reporting of illness and injury rates makes comparisons between and across events difficult. In addition, a lack of access to good data across events makes planning medical support on-site, for transport, and at receiving hospitals, challenging. This report describes the development of an Internet-hosted, secure registry for event and patient data in relation to mass gatherings. Descriptive; development and pilot testing of a Web-based event and patient registry. Several iterations of the registry have resulted in a cross-event platform for standardized data collection at a variety of events. Registry and reporting field descriptions, successes, and challenges are discussed based on pilot testing and early implementation over two years of event enrollment. The Mass-Gathering Medicine Event and Patient Registry provides an effective tool for recording and reporting both event and patient-related variables in the context of mass-gathering events. Standardizing data collection will serve researchers and policy makers well. The structure of the database permits numerous queries to be written to generate standardized reports of similar and dissimilar events, which supports hypothesis generation and the development of theoretical foundations in mass-gathering medicine.

  18. 33 CFR 150.820 - When must a written report of casualty be submitted, and what must it contain?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., operator, or person in charge of a deepwater port must submit a written report of the event to the nearest... casualty be submitted, and what must it contain? 150.820 Section 150.820 Navigation and Navigable Waters... Reports and Records Reports § 150.820 When must a written report of casualty be submitted, and what must...

  19. 33 CFR 150.820 - When must a written report of casualty be submitted, and what must it contain?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in charge of a deepwater port must submit a written report of the event to the nearest Officer in... casualty be submitted, and what must it contain? 150.820 Section 150.820 Navigation and Navigable Waters... Reports and Records Reports § 150.820 When must a written report of casualty be submitted, and what must...

  20. Surge Capacity and Capability. A Review of the History and Where the Science is Today Regarding Surge Capacity during a Mass Casualty Disaster

    PubMed Central

    Kearns, Randy D.; Cairns, Bruce A.; Cairns, Charles B.

    2014-01-01

    Disasters which include countless killed and many more injured, have occurred throughout recorded history. Many of the same reports of disaster also include numerous accounts of individuals attempting to rescue those in great peril and render aid to the injured and infirmed. The purpose of this paper is to briefly discuss the transition through several periods of time with managing a surge of many patients. This review will focus on the triggering event, injury and illness, location where the care is provided and specifically discuss where the science is today. PMID:24795873

  1. [Treatment of mass burns].

    PubMed

    Zhou, Y

    1999-07-01

    Present paper aims at summing up the experience from 42 cases over a four year period(1993-1997) in ten events of mass burn casualties. 42 cases were analyzed retrospectively, in whom 15 cases sustained III degree burn over 50% TBSA. Among them 7 cases had III degree burn over 70% and 3 cases with III degree burn over 90%. One case (70% TBSA) died of acute respiratory distress syndrome on third postburn day. Another (III degree 70%) died of acute renal failure on seventh postburn day. The remaining 40 cases were successfully cured. Experiences gained in burn care in these ten mass casualties included: sending forward the medical expertise to the site of disaster; airlifting to accelerate transportation, adequate resuscitation in shock stage; early massive excision of eschar and skin grafting; control of burn infection; prevention of Curling ulcer hemorrhage, emphasis on supportive therapy; and the establishment of a skin bank.

  2. A comparison of solar helium-3-rich events with type II bursts and coronal mass ejections

    NASA Technical Reports Server (NTRS)

    Kahler, S.; Reames, D. V.; Sheeley, N. R., Jr.; Howard, R. A.; Michels, D. J.; Koomen, M. J.

    1985-01-01

    The acceleration process for energetic particles in He-3-rich events and for particles in normal-abundance events are compared. A list of 66 He-3-rich events observed with the Goddard Space Flight Center particle detector on ISEE 3 is presented, and it is shown that these events are not statistically associated with either of the two common signatures of normal-abundance events, metric type II and coronal mass ejections. This result indicates that enhanced abundance events may be produced only in the impulsive phases of flares, while normal abundance events are produced in subsequent flare shock waves.

  3. An Analysis of the Relationship between Casualty Risk Per Crash and Vehicle Mass and Footprint for Model Year 2000-2007 Light-Duty Vehicles

    SciTech Connect

    Wenzel, Tom

    2012-08-01

    NHTSA recently completed a logistic regression analysis (Kahane 2012) updating its 2003 and 2010 studies of the relationship between vehicle mass and US fatality risk per vehicle mile traveled (VMT). The new study updates the previous analyses in several ways: updated FARS data for 2002 to 2008 involving MY00 to MY07 vehicles are used; induced exposure data from police reported crashes in several additional states are added; a new vehicle category for car-based crossover utility vehicles (CUVs) and minivans is created; crashes with other light-duty vehicles are divided into two groups based on the crash partner vehicle’s weight, and a category for all other fatal crashes is added; and new control variables for new safety technologies and designs, such as electronic stability controls (ESC), side airbags, and methods to meet voluntary agreement to improve light truck compatibility with cars, are included.

  4. Flood risk assessment of potential casualties in a global scale

    NASA Astrophysics Data System (ADS)

    Diaz Loaiza, Andres; Englhardt, Johanna; Boekhorst, Ellen; Ward, Philip; Aerts, Jeroen

    2017-04-01

    Flood risk assessment of potential casualties in a global scale. M. Andres Diaz-Loaiza (1), Johanna Englhardt (1), Ellen de Boekhorst (1), Philip J. Ward (1) and Jeroen Aerts (1) (1) Institute for Environmental Studies, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands. andres.diazloaiza@vu.nl Floods are one of the most dangerous natural disasters for humanity, affecting many people every year. Quantitative risk models on a global scale are nowadays available tools for institutions and actors in charge of risk management in order to plan possible mitigation measures in case of flood risk events. Many of these models have been focus on potential economic damage, population and GDP exposure, but the potential casualties assessment has been left aside. This is partially due to the complexity of the problem itself, in which several variables like the age of a pedestrian (drag/exposed to a flood event), or his weight and swimming experience can be decisive for the complete understanding of the problem. In the present work is presented the advances for the development of a methodology in order to include in the GLOFRIS model a new indicator in case of flood risk events. Preliminary analysis relating the GDP with the potential casualties shows that undeveloped countries have more susceptibility to loss of life in case of flood events. This because the GDP indicator evidences as well the protection measures available in a country.

  5. Contribution of forensic autopsy to scene reconstruction in mass fire casualties: a case of alleged arson on a floor consisting of small compartments in a building.

    PubMed

    Michiue, Tomomi; Ishikawa, Takaki; Oritani, Shigeki; Maeda, Hitoshi

    2015-01-01

    A fire is an important cause of mass disasters, involving various forensic issues. Before dawn on an early morning, 16 male visitors in their twenties to sixties were killed in a possibly incendiary fire at a 'private video parlor' consisting of small compartments in a building. The main causes of death as determined by forensic autopsy were acute carbon monoxide (CO) intoxication for all of the 15 found-dead victims, and hypoxic-ischemic encephalopathy following acute CO intoxication for a victim who died in hospital. Burns were mild (<20% of body surface) in most victims, except for three victims found between the entrance and the estimated fire-outbreak site; thus, identification was completed without difficulty, supported by DNA analysis. Blood carboxyhemoglobin saturation (COHb) was higher for victims found dead in the inner area. Blood cyanide levels were sublethal, moderately correlated to COHb, but were higher in victims found around the estimated fire-outbreak site. There was no evidence of thinner, alcohol or drug abuse, or an attack of disease as a possible cause of an accidental fire outbreak. These observations contribute to evidence-based reconstruction of the fire disaster, and suggest how deaths could have been prevented by appropriate disaster measures. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  7. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  8. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  9. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  10. 33 CFR 173.55 - Report of casualty or accident.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Report of casualty or accident... (CONTINUED) BOATING SAFETY VESSEL NUMBERING AND CASUALTY AND ACCIDENT REPORTING Casualty and Accident Reporting § 173.55 Report of casualty or accident. (a) The operator of a vessel shall submit the casualty...

  11. Viewing Events in the Center-of-Mass System

    ERIC Educational Resources Information Center

    Ruby, Lawrence

    2010-01-01

    In elementary physics, collisions are usually studied by employing the conservation of momentum, and sometimes also the conservation of kinetic energy. However, in nuclear reactions, changes of mass that complicate the situation often occur. To illustrate the latter, we shall cite two examples of endoergic nuclear reactions, i.e., those for which…

  12. Viewing Events in the Center-of-Mass System

    ERIC Educational Resources Information Center

    Ruby, Lawrence

    2010-01-01

    In elementary physics, collisions are usually studied by employing the conservation of momentum, and sometimes also the conservation of kinetic energy. However, in nuclear reactions, changes of mass that complicate the situation often occur. To illustrate the latter, we shall cite two examples of endoergic nuclear reactions, i.e., those for which…

  13. Iraq: U.S. Casualties

    DTIC Science & Technology

    2009-05-14

    compiled by the Department of Defense (DOD), as tallied from the agency’s press releases. Table 1 provides statistics on fatalities during Operation...Iraqi Freedom, which began on March 19, 2003, and is ongoing, as well as on the number of fatalities since May 1, 2003, plus statistics on those wounded...http://siadapp.dmdc.osd.mil/ personnel/CASUALTY/castop.htm. Table 1. Operation Iraqi Freedom, U.S. Fatalities and Wounded as of May 14, 2009, 10

  14. Iraq: U.S. Casualties

    DTIC Science & Technology

    2009-01-29

    was compiled by the Department of Defense (DOD), as tallied from the agency’s press releases. Table 1 provides statistics on fatalities during...Operation Iraqi Freedom, which began on March 19, 2003, and is ongoing, as well as on the number of fatalities since May 1, 2003, plus statistics on...website at http://siadapp.dmdc.osd.mil/ personnel/CASUALTY/castop.htm. Table 1. Operation Iraqi Freedom, U.S. Fatalities and Wounded as of January

  15. Iraq: U.S. Casualties

    DTIC Science & Technology

    2009-06-26

    were compiled by the Department of Defense (DOD), as tallied from the agency’s press releases. Table 1 provides statistics on fatalities during...Operation Iraqi Freedom, which began on March 19, 2003, and is ongoing, as well as on the number of fatalities since May 1, 2003, plus statistics on those...website at http://siadapp.dmdc.osd.mil/ personnel/CASUALTY/castop.htm. Table 1. Operation Iraqi Freedom, U.S. Fatalities and Wounded as of June 25, 2009

  16. Iraq: U.S. Casualties

    DTIC Science & Technology

    2008-08-28

    was compiled by the Department of Defense (DOD), as tallied from the agency’s press releases. Table 1 provides statistics on fatalities during...Operation Iraqi Freedom, which began on March 19, 2003, and is ongoing, as well as on the number of fatalities since May 1, 2003, plus statistics on those...following DOD website: [http://siadapp.dmdc.osd.mil/personnel/CASUALTY/castop.htm]. Table 1. Operation Iraqi Freedom, U.S. Fatalities and Wounded as of

  17. Viewing Events in the Center-of-Mass System

    NASA Astrophysics Data System (ADS)

    Ruby, Lawrence

    2010-02-01

    In elementary physics, collisions are usually studied by employing the conservation of momentum, and sometimes also the conservation of kinetic energy. However, in nuclear reactions, changes of mass that complicate the situation often occur. To illustrate the latter, we shall cite two examples of endoergic nuclear reactions, i.e., those for which energy must be supplied to make the reaction proceed. A typical situation is given by the equation A + B → C + D + Q, (1) where particles A, B, C, and D are expressed in terms of the energy-equivalent of the particle masses, according to the Einstein relation E = mc2, and where Q is a negative energy quantity, corresponding to the excess of mass of (C + D) over that of (A + B). Equation (1) is just an alternate statement of the conservation of total energy. Typically, in the lab system (L), energy is supplied as kinetic energy "T" of particle A, and particle B is at rest. Thus, to conserve momentum, particles C and D must compensate for the momentum corresponding to T. Often, it is desirable to know the minimum value of T that will conserve both energy and momentum, i.e., the threshold value of T, known as Tth, that will just allow the reaction to proceed. At threshold, the particles C and D will have their minimum possible kinetic energies. In the center-of-mass system of coordinates (Z) in which the input momentum is zero, at threshold, the products C and D are each stationary, and this requirement will allow us to calculate the corresponding Tth in the lab system (L). The Z system is often termed the "center-of-mass" system, but it is more properly termed the "zero-momentum" system.

  18. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  19. An Alternative Health Care Facility: Concept of Operations for the Off-site Triage, Treatment, and Transportation Center (OST3C). Mass Casualty Care Strategy for a Chemical Terrorism Incident

    DTIC Science & Technology

    2001-03-01

    develop non- cardiogenic pulmonary edema within 6 hours after exposure to a “choking” agent such as phosgene. These patients should be transported to a...admitted for observation, as they may develop pulmonary edema . E. Psychological Casualties Disasters have a tremendous emotional and psychological

  20. Natural organic matter and the event horizon of mass spectrometry.

    PubMed

    Hertkorn, N; Frommberger, M; Witt, M; Koch, B P; Schmitt-Kopplin, Ph; Perdue, E M

    2008-12-01

    Soils, sediments, freshwaters, and marine waters contain natural organic matter (NOM), an exceedingly complex mixture of organic compounds that collectively exhibit a nearly continuous range of properties (size-reactivity continuum). NOM is composed mainly of carbon, hydrogen, and oxygen, with minor contributions from heteroatoms such as nitrogen, sulfur, and phosphorus. Suwannee River fulvic acid (SuwFA) is a fraction of NOM that is relatively depleted in heteroatoms. Ultrahigh resolution Fourier transform ion cyclotron (FTICR) mass spectra of SuwFA reveal several thousand molecular formulas, corresponding in turn to several hundred thousand distinct chemical environments of carbon even without accountancy of isomers. The mass difference deltam among adjoining C,H,O-molecules between and within clusters of nominal mass is inversely related to molecular dissimilarity: any decrease of deltam imposes an ever growing mandatory difference in molecular composition. Molecular formulas that are expected for likely biochemical precursor molecules are notably absent from these spectra, indicating that SuwFA is the product of diagenetic reactions that have altered the major components of biomass beyond the point of recognition. The degree of complexity of SuwFA can be brought into sharp focus through comparison with the theoretical limits of chemical complexity, as constrained and quantized by the fundamentals of chemical binding. The theoretical C,H,O-compositional space denotes the isomer-filtered complement of the entire, very vast space of molecular structures composed solely of carbon, hydrogen, and oxygen. The molecular formulas within SuwFA occupy a sizable proportion of the theoretical C,H,O-compositional space. A 100 percent coverage of the theoretically feasible C,H,O-compositional space by SuwFA molecules is attained throughout a sizable range of mass and H/C and O/C elemental ratios. The substantial differences between (and complementarity of) the SuwFA molecular

  1. 19 CFR 158.27 - Accidental fire or other casualty.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... be, at the time of the casualty; and (3) That it was totally destroyed and there is no probability of... the time of casualty, stating: (1) The time, place, and nature of such casualty; (2) That...

  2. Air Mass Frequency during Precipitation Events in the United States Northern Plains

    NASA Astrophysics Data System (ADS)

    Loveless, D. M.; Sharr, N. J.; Baum, A.; Contract, J. S.; DePasquale, R.; Godek, M. L.

    2013-12-01

    Since 1980, numerous billion-dollar disasters have affected the Northern Plains of the United States, including nine droughts and four floods. Given the region's large agricultural sector, the ability to accurately forecast the frequency and quantity of precipitation events here is imperative as it has a major impact on the economy of states in the region. The atmospheric environment present during precipitation events can largely be described by the presiding air mass conditions since air masses characterize a multitude of meteorological variables at one time over a large region. Therefore, understanding the relationship between air masses and rainfall episodes can contribute to improved precipitation forecasts. The goal of this research is to add knowledge to current understandings of the factors responsible for precipitation in the Northern Plains through an assessment of synoptic air mass conditions. The Spatial Synoptic Classification is used to categorize 30 years of daily air mass types across the region and daily precipitation is acquired from the United States Historical Climatological Network at stations in close proximity. Air mass frequencies are then analyzed for all regional precipitation events and rainfall categories are developed based on precipitation quantity. Both annual and seasonal air mass frequencies are assessed at the time of precipitation events. Additionally, air mass frequencies are obtained for positive and negative phases of the Pacific/North American Pattern to examine the influence of a teleconnection forcing factor on the air mass types responsible for producing precipitation quantities. Results indicate that the Transitional (TR) air mass, associated with changing air mass conditions commonly related to passing fronts, is not the leading producer of rainfall in the region. The TR is generally responsible for only 10-20% of regional precipitation, which often is classed in a heavy rainfall category. All moist air mass varieties are

  3. Top-Quark Mass Measurement Using Events with Missing Transverse Energy and Jets at CDF

    SciTech Connect

    Aaltonen, T.; Brucken, E.; Devoto, F.; Mehtala, P.; Orava, R.; Alvarez Gonzalez, B.; Casal, B.; Cuevas, J.; Gomez, G.; Palencia, E.; Rodrigo, T.; Ruiz, A.; Scodellaro, L.; Vila, I.; Vilar, R.; Vizan, J.; Amerio, S.; Dorigo, T.; Totaro, P.; Amidei, D.

    2011-12-02

    We present a measurement of the top-quark mass using a sample of tt events in 5.7 fb{sup -1} of integrated luminosity from pp collisions at the Fermilab Tevatron with {radical}(s)=1.96 TeV and collected by the CDF II Detector. We select events having large missing transverse energy, and four, five, or six jets with at least one jet tagged as coming from a b quark, and reject events with identified charged leptons. This analysis considers events from the semileptonic tt decay channel, including events that contain tau leptons. The measurement is based on a multidimensional template method. We fit the data to signal templates of varying top-quark masses and background templates, and measure a top-quark mass of M{sub top}=172.32{+-}2.4(stat){+-}1.0(syst) GeV/c{sup 2}.

  4. Mass Casualty Triage Performance Assessment Tool

    DTIC Science & Technology

    2015-02-01

    Jonathan J. Bryson Heidi Keller-Glaze ICF International Christopher L. Vowels U.S. Army Research Institute February 2015 United...Christopher L. Vowels 5c. PROJECT NUMBER A790 5d. TASK NUMBER 5e. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...Contracting Officer’s Representative and Subject Matter POC: Dr. Christopher L. Vowels 14. ABSTRACT (Maximum 200 words): This report

  5. Training Israeli medical personnel to treat casualties of nuclear, biologic and chemical warfare.

    PubMed

    Rubinshtein, Ronen; Robenshtok, Eyal; Eisenkraft, Arik; Vidan, Aviv; Hourvitz, Ariel

    2002-07-01

    Recent events have significantly increased concern about the use of biologic and chemical weapons by terrorists and other countries. Since weapons of mass destruction could result in a huge number of casualties, optimizing our diagnostic and therapeutic skills may help to minimize the morbidity and mortality. The national demands for training in medical aspects of nuclear, biologic and chemical warfare have increased dramatically. While Israeli medical preparedness for non-conventional warfare has improved substantially in recent years especially due to extensive training programs, a standardized course and course materials were not available until recently. We have developed a core curriculum and teaching materials for a 1 or 2 day modular course, including printed materials.

  6. Holy Shroud Exhibition 2010: health services during a 40-day mass-gathering event.

    PubMed

    Bortolin, Michelangelo; Ulla, Marco; Bono, Alessia; Ferreri, Enrico; Tomatis, Mariano; Sgambetterra, Sergio

    2013-06-01

    Mass-gathering events require varying types and amounts of medical resources to deal with patient presentations as well as careful planning for environmental health management. The Holy Shroud Exhibition was hosted in Torino, Italy, between April and May 2010. The venue was a unique mass-gathering event which lasted several weeks. It was held in a limited area in the center of the city and it was attended by a large and heterogeneous population. A dedicated Health Care Service was created for the event. This study is a retrospective analysis of clinical presentations of patients who were managed by the Medical Services during the event. The main study outcomes included Patient Presentation Rate (PPR), type of injuries and illnesses, and the Transport to Hospital Rate (TTHR). The PPR and TTHR were both low (0.27 and 0.039 respectively). The majority of patients presented with low severity codes and no sudden cardiac death (SCD) or cardiac arrest occurred. Cardiac and trauma emergencies were most frequent categories of presentation. A number of pediatric patients (19.37%) were treated by the event Medical Service. Approximately two million persons participated in the 40-day event. The experience for this 40-day event supported having an on-site, organized, dedicated Medical Service that decreased overcrowding of the local Emergency Medical System and hospitals. It is recommended that, for such events, there be recruitment of emergency physicians with experience in mass-gathering events, recruitment of pediatricians, and training for professionals during the planning process.

  7. 33 CFR 146.40 - Diving casualties.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Diving casualties. 146.40 Section 146.40 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OUTER CONTINENTAL SHELF ACTIVITIES OPERATIONS OCS Facilities § 146.40 Diving casualties. Diving related...

  8. Prospective impact of forest fire on Mass Movement events

    NASA Astrophysics Data System (ADS)

    Ziade, Rouba; Abdallah, Chadi; Baghdadi, Nicolas

    2013-04-01

    Mass Movement (MM) has always been one of the main natural hazards that threatened both the natural and human environments of Lebanon and their occurrence has increased by almost 60% between 1956 and 2008. On the other hand, Forest Fire (FF) has emerged to impose as another natural hazard that has destroyed more than 25 % of Lebanon's forests in less than 40 years. The increased FF occurrence is one of the potential detrimental impacts of anthropogenic climate change where high temperatures and current-year drought are strongly associated with an increase in the number of fires and area burned in a variety of forest types. A simple observation shows the coincident trends between MM and FF. This paper investigates the potential impact of FF on MM occurrence in Damour and Nahr Ibrahim watersheds in Lebanon. Preconditioning factors taken into consideration were topography, soil, geology, mean annual precipitation and land cover maps. MM and FF inventory maps were produced through Remote Sensing (RS) using aerial (1956 and 2008) and satellite images (2005 and 2011) in addition to Google Earth Timeline. Furthermore, FF was introduced as the inducing factor whose impact was assessed by the calculation of FF burn severity. This burn severity was extracted from Landsat images (1986-2011) through the Normalized Burn Ratio (NBR) index. A field study was carried out in order to substantiate the MM inventory. Furthermore, the burn index maps were validated through the Mini-Disk Infiltrometer (MDI), a device which supplies the soil infiltration rate usually after a fire. Following the standardization of the impact factors into layers using Geographic Information System (GIS), the relative importance of these layers for causing MM has been evaluated using modified InfoVal method and a MM Susceptibility Map (MMSM) was generated. Hence, every factor obtained a weight that shows its impact on MM occurrence. Preceded only by Land Cover change, NBR obtained the highest weight making

  9. Do people's goals for mass participation sporting events matter? A self-determination theory perspective.

    PubMed

    Coleman, S J; Sebire, S J

    2016-09-27

    Non-elite mass participation sports events (MPSEs) may hold potential as a physical activity promotion tool. Research into why people participate in these events and what goals they are pursuing is lacking. Grounded in self-determination theory, this study examined the associations between MPSE participants' goals, event experiences and physical activity. A prospective cohort study was conducted; pre-event, participants reported their goals for the event. Four weeks post-event, participants reported their motivation for exercise, perceptions of their event achievement and moderate-to-vigorous intensity physical activity (MVPA). Bivariate correlations and path analysis were performed on data from 114 adults. Intrinsic goals (e.g. health, skill and social affiliation) for the event were positively associated with perceptions of event achievement, whereas extrinsic goals (e.g. appearance or social recognition) were not. Event achievement was positively associated with post-event autonomous motivation, which in turn was positively associated with MVPA. Pursuing intrinsic but not extrinsic goals for MPSEs is associated with greater perceptions of event achievement, which in turn is associated with post-event autonomous motivation and MVPA. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Measurement of the top quark mass in lepton+jets events with secondary vertex tagging

    SciTech Connect

    Harrington, Robert Duane

    2007-02-01

    A measurement of the top quark mass with the matrix element method in the lepton + jets final state in D0 Run II is presented. Events with single isolated energetic charged lepton (electron or muon), exactly four calorimeter jets, and significant missing transverse energy are selected. Probabilities used to discriminate between signal and background are assumed to be proportional to differential cross-sections, calculated using event kinematics and folding in object resolutions and parton distribution functions. The event likelihoods constructed using these probabilities are varied with the top quark mass, m{sub t}, and the jet energy scale, JES, to give the smallest possible combined statistical + JES uncertainty.

  11. Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload?

    PubMed

    Woodall, John; Watt, Kerrianne; Walker, Damien; Tippett, Vivienne; Enraght-Moony, Emma; Bertolo, Chris; Mildwaters, Brett; Morrison, Glen

    2010-01-01

    Workforce planning for first aid and medical coverage of mass gatherings is hampered by limited research. In particular, the characteristics and likely presentation patterns of low-volume mass gatherings of between several hundred to several thousand people are poorly described in the existing literature. This study was conducted to: 1. Describe key patient and event characteristics of medical presentations at a series of mass gatherings, including events smaller than those previously described in the literature; 2. Determine whether event type and event size affect the mean number of patients presenting for treatment per event, and specifically, whether the 1:2,000 deployment rule used by St John Ambulance Australia is appropriate; and 3. Identify factors that are predictive of injury at mass gatherings. A retrospective, observational, case-series design was used to examine all cases treated by two Divisions of St John Ambulance (Queensland) in the greater metropolitan Brisbane region over a three-year period (01 January 2002-31 December 2004). Data were obtained from routinely collected patient treatment forms completed by St John officers at the time of treatment. Event-related data (e.g., weather, event size) were obtained from event forms designed for this study. Outcome measures include: total and average number of patient presentations for each event; event type; and event size category. Descriptive analyses were conducted using chi-square tests, and mean presentations per event and event type were investigated using Kruskal-Wallis tests. Logistic regression analyses were used to identify variables independently associated with injury presentation (compared with non-injury presentations). Over the three-year study period, St John Ambulance officers treated 705 patients over 156 separate events. The mean number of patients who presented with any medical condition at small events (less than or equal to 2,000 attendees) did not differ significantly from that of

  12. The impact of warm weather on mass event medical need: a review of the literature.

    PubMed

    Baird, Matthew B; O'Connor, Robert E; Williamson, Allen L; Sojka, Benjamin; Alibertis, Kostas; Brady, William J

    2010-02-01

    Over the last 20 years, interest in medical need at mass events has increased. Many studies have been published identifying the characteristics of such events that significantly impact the number of patients who seek care. Investigators agree that weather is one of the most important variables. We performed a literature search using several biomedical databases (MEDLINE via PubMed, the Cochrane database, BMJ's Clinical Evidence compendium, and Google Scholar) for articles addressing the effect of weather on medical need at mass events. This search resulted in 8 focused articles and several other resources from the reference sections of these publications. We found that the early literature is composed of case reports and predominantly subjective observations concerning the impact of weather on medical need. Most investigators agree upon a positive relationship between heat/humidity and the frequency of patient presentation. More recent authors make attempts at quantifying the relationship and propose prediction models for patient volume and medical personnel requirements. We present an ancestral review of these studies, discuss their results collectively, and propose a simplified algorithm for predicting patient volume at mass events. This review is intended for event planners and mass event emergency medical personnel for planning future events. We also hope to stimulate further study to develop and verify prediction models.

  13. Events and the ontology of individuals: verbs as a source of individuating mass and count nouns.

    PubMed

    Barner, David; Wagner, Laura; Snedeker, Jesse

    2008-02-01

    What does mass-count syntax contribute to the interpretation of noun phrases (NPs), and how much of NP meaning is contributed by lexical items alone? Many have argued that count syntax specifies reference to countable individuals (e.g., cats) while mass syntax specifies reference to unindividuated entities (e.g., water). We evaluated this claim using the quantity judgment method, and tested the interpretation of words used in mass and count syntax that described either protracted, "durative" events (e.g., mass: some dancing; count: a dance), or instantaneous, "punctual" events (e.g., mass: some jumping; count: a jump). For durative words, participants judged, for example, that six brief dances are more dances but less dancing than two long dances, thus showing a significant difference in their interpretation of the count and mass usages. However, for punctual words, participants judged, for example, that six small jumps are both more jumps and more jumping than two long jumps, resulting in no difference due to mass-count syntax. Further, when asked which dimensions are important for comparing quantities of durative and punctual events, participants ranked number as first in importance for durative and punctual words presented in count syntax, but also for punctual words presented in mass syntax. These results indicate that names for punctual events individuate when used in either mass or count syntax, and thus provide evidence against the idea that mass syntax forces an unindividuated construal. They also indicate that event punctuality as encoded by verbs is importantly linked to the individuation of NPs, and may access a common underlying ontology of individuals.

  14. Top-quark mass measurement using events with missing transverse energy and jets at CDF

    DOE PAGES

    Aaltonen, T.

    2011-11-30

    We present a measurement of the top-quark mass with tt events using a data sample corresponding to an integrated luminosity of 5.7 fb -1 of pp collisions at the Fermilab Tevatron with √s = 1.96 TeV and collected by the CDF II Detector. We select events having no identified charged leptons, large missing transverse energy, and four, five, or six jets with at least one jet containing a secondary vertex consistent with the decay of a b quark. This analysis considers events from the semileptonic tt decay channel, including events that contain tau leptons, which are usually not included inmore » the top-quark mass measurements. The measurement uses as kinematic variables the invariant mass of two jets consistent with the mass of the W boson, and the invariant masses of two different three-jet combinations. We fit the data to signal templates of varying top-quark masses and background templates, and measure a top-quark mass of Mtop = 172.3 ± 2.4 (stat) ± 1.0 (syst) GeV/c2.« less

  15. Top-quark mass measurement using events with missing transverse energy and jets at CDF

    SciTech Connect

    Aaltonen, T.

    2011-11-30

    We present a measurement of the top-quark mass with tt events using a data sample corresponding to an integrated luminosity of 5.7 fb -1 of pp collisions at the Fermilab Tevatron with √s = 1.96 TeV and collected by the CDF II Detector. We select events having no identified charged leptons, large missing transverse energy, and four, five, or six jets with at least one jet containing a secondary vertex consistent with the decay of a b quark. This analysis considers events from the semileptonic tt decay channel, including events that contain tau leptons, which are usually not included in the top-quark mass measurements. The measurement uses as kinematic variables the invariant mass of two jets consistent with the mass of the W boson, and the invariant masses of two different three-jet combinations. We fit the data to signal templates of varying top-quark masses and background templates, and measure a top-quark mass of Mtop = 172.3 ± 2.4 (stat) ± 1.0 (syst) GeV/c2.

  16. Canadian emergency department preparedness for a nuclear, biological or chemical event.

    PubMed

    Kollek, Daniel

    2003-01-01

    Since the terror attacks of September 11th, emergency departments across North America have become more aware of the need to be prepared to deal with a mass casualty terror event, particularly one involving nuclear, biological or chemical contaminants. The effects of such an attack could also be mimicked by accidental release of toxic chemicals, radioactive substances or biological agents unrelated to terrorist activity. The purpose of this study was to review the risks and characteristics of these events and to assess the preparedness of Canadian emergency departments to respond. This was done by means of a survey, which showed a significant risk of a mass casualty event (most likely chemical) coupled with a deficiency in preparedness -- most notably in the availability of appropriate equipment, antidotal therapy and decontamination capability. There were also significant deficiencies in the ability to respond to a major biologic or nuclear event.

  17. CONNECTING FLARES AND TRANSIENT MASS-LOSS EVENTS IN MAGNETICALLY ACTIVE STARS

    SciTech Connect

    Osten, Rachel A.; Wolk, Scott J.

    2015-08-10

    We explore the ramification of associating the energetics of extreme magnetic reconnection events with transient mass-loss in a stellar analogy with solar eruptive events. We establish energy partitions relative to the total bolometric radiated flare energy for different observed components of stellar flares and show that there is rough agreement for these values with solar flares. We apply an equipartition between the bolometric radiated flare energy and kinetic energy in an accompanying mass ejection, seen in solar eruptive events and expected from reconnection. This allows an integrated flare rate in a particular waveband to be used to estimate the amount of associated transient mass-loss. This approach is supported by a good correspondence between observational flare signatures on high flaring rate stars and the Sun, which suggests a common physical origin. If the frequent and extreme flares that young solar-like stars and low-mass stars experience are accompanied by transient mass-loss in the form of coronal mass ejections, then the cumulative effect of this mass-loss could be large. We find that for young solar-like stars and active M dwarfs, the total mass lost due to transient magnetic eruptions could have significant impacts on disk evolution, and thus planet formation, and also exoplanet habitability.

  18. Safety, security, and preparing for disaster at sporting events.

    PubMed

    Rubin, Aaron L

    2004-06-01

    There is a heightened awareness of terrorism in this country. There always remains the possibility of nonterrorist disasters at sporting venues. The team physician will be among the first medical responders to a disaster at a sporting venue. By being involved in the creation of an emergency action plan, learning the incident command system, understanding triage, and obtaining basic trauma life support skills, the team physician can be prepared to respond to mass casualty incidents at sporting events.

  19. Predicting casualties implied by TIPs

    NASA Astrophysics Data System (ADS)

    Trendafiloski, G.; Wyss, M.; Wyss, B. M.

    2009-12-01

    When an earthquake is predicted, forecast, or expected with a higher than normal probability, losses are implied. We estimated the casualties (fatalities plus injured) that should be expected if earthquakes in TIPs (locations of Temporarily Increased Probability of earthquakes) defined by Kossobokov et al. (2009) should occur. We classified the predictions of losses into the categories red (more than 400 fatalities or more than 1,000 injured), yellow (between 100 and 400 fatalities), green (fewer than 100 fatalities), and gray (undetermined). TIPs in Central Chile, the Philippines, Papua, and Taiwan are in the red class, TIPs in Southern Sumatra, Nicaragua, Vanatu, and Honshu in the yellow class, and TIPs in Tonga, Loyalty Islands, Vanatu, S. Sandwich Islands, Banda Sea, and the Kuriles, are classified as green. TIPs where the losses depend moderately on the assumed point of major energy release were classified as yellow; TIPs such as in the Talaud Islands and in Tonga, where the losses depend very strongly on the location of the epicenter, were classified as gray. The accuracy of loss estimates after earthquakes with known hypocenter and magnitude are affected by uncertainties in transmission and soil properties, the composition of the building stock, the population present, and the method by which the numbers of casualties are calculated. In the case of TIPs, uncertainties in magnitude and location are added, thus we calculate losses for a range of these two parameters. Therefore, our calculations can only be considered order of magnitude estimates. Nevertheless, our predictions can come to within a factor of two of the observed numbers, as in the case of the M7.6 earthquake of October 2005 in Pakistan that resulted in 85,000 fatalities (Wyss, 2005). In subduction zones, the geometrical relationship between the earthquake source capable of a great earthquake and the population is clear because there is only one major fault plane available, thus the epicentral

  20. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  1. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty....

  2. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty....

  3. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  4. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty....

  5. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty....

  6. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  7. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  8. 46 CFR 4.03-1 - Marine casualty or accident.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Marine casualty or accident. 4.03-1 Section 4.03-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-1 Marine casualty or accident. Marine casualty or accident...

  9. 46 CFR 4.05-1 - Notice of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Notice of marine casualty. 4.05-1 Section 4.05-1 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Notice of Marine Casualty and Voyage Records § 4.05-1 Notice of marine casualty....

  10. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  11. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  12. 48 CFR 552.270-7 - Fire and Casualty Damage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Fire and Casualty Damage... Fire and Casualty Damage. As prescribed in 570.703, insert the following clause: Fire and Casualty Damage (JUN 2011) If the entire premises are destroyed by fire or other casualty, this lease...

  13. 46 CFR 28.80 - Report of casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accordance with paragraph (c) of this section, as soon as possible after the casualty, to the underwriter of... the casualty involves any of the following. (1) Loss of life. (2) An injury that requires professional... involved in the casualty; and (13) The monetary amount paid for an injury or a death. (d) A casualty to a...

  14. A redundant resource: a pre-planned casualty clearing station for a FIFA 2010 Stadium in Durban.

    PubMed

    Hardcastle, Timothy C; Samlal, Sanjay; Naidoo, Rajen; Hendrikse, Steven; Gloster, Alex; Ramlal, Melvin; Ngema, Sibongiseni; Rowe, Michael

    2012-10-01

    This report details the background, planning, and establishment of a mass-casualty management area for the Durban Moses Mabhida Stadium at the Natal Mounted Rifles base, by the Department of Health and the eThekwini Fire and Rescue Service, for the Fédération Internationale de Football Association (FIFA) 2010 Soccer World Cup. The report discusses the use of the site during the seven matches played at that stadium, and details the aspects of mass-gathering major incident site planning for football (soccer). The area also was used as a treatment area for other single patient incidents outside of the stadium, but within the exclusion perimeter, and the 22 patients treated by the Casualty Clearing Station (CCS) team are described and briefly discussed. A site-specific patient presentation rate of 0.48 per 10,000 and transport-to-hospital rate (TTHR) of 0.09/10,000 are reported. Lessons learned and implications for future event planning are discussed in the light of the existing literature.

  15. Measurement of the Top-Quark Mass with Dilepton Events Selected Using Neuroevolution at CDF

    NASA Astrophysics Data System (ADS)

    Aaltonen, T.; Adelman, J.; Akimoto, T.; Albrow, M. G.; Álvarez González, B.; Amerio, S.; Amidei, D.; Anastassov, A.; Annovi, A.; Antos, J.; Apollinari, G.; Apresyan, A.; Arisawa, T.; Artikov, A.; Ashmanskas, W.; Attal, A.; Aurisano, A.; Azfar, F.; Azzurri, P.; Badgett, W.; Barbaro-Galtieri, A.; Barnes, V. E.; Barnett, B. A.; Bartsch, V.; Bauer, G.; Beauchemin, P.-H.; Bedeschi, F.; Bednar, P.; Beecher, D.; Behari, S.; Bellettini, G.; Bellinger, J.; Benjamin, D.; Beretvas, A.; Beringer, J.; Bhatti, A.; Binkley, M.; Bisello, D.; Bizjak, I.; Blair, R. E.; Blocker, C.; Blumenfeld, B.; Bocci, A.; Bodek, A.; Boisvert, V.; Bolla, G.; Bortoletto, D.; Boudreau, J.; Boveia, A.; Brau, B.; Bridgeman, A.; Brigliadori, L.; Bromberg, C.; Brubaker, E.; Budagov, J.; Budd, H. S.; Budd, S.; Burkett, K.; Busetto, G.; Bussey, P.; Buzatu, A.; Byrum, K. L.; Cabrera, S.; Calancha, C.; Campanelli, M.; Campbell, M.; Canelli, F.; Canepa, A.; Carlsmith, D.; Carosi, R.; Carrillo, S.; Carron, S.; Casal, B.; Casarsa, M.; Castro, A.; Catastini, P.; Cauz, D.; Cavaliere, V.; Cavalli-Sforza, M.; Cerri, A.; Cerrito, L.; Chang, S. H.; Chen, Y. C.; Chertok, M.; Chiarelli, G.; Chlachidze, G.; Chlebana, F.; Cho, K.; Chokheli, D.; Chou, J. P.; Choudalakis, G.; Chuang, S. H.; Chung, K.; Chung, W. H.; Chung, Y. S.; Ciobanu, C. I.; Ciocci, M. A.; Clark, A.; Clark, D.; Compostella, G.; Convery, M. E.; Conway, J.; Copic, K.; Cordelli, M.; Cortiana, G.; Cox, D. J.; Crescioli, F.; Cuenca Almenar, C.; Cuevas, J.; Culbertson, R.; Cully, J. C.; Dagenhart, D.; Datta, M.; Davies, T.; de Barbaro, P.; de Cecco, S.; Deisher, A.; de Lorenzo, G.; Dell'Orso, M.; Deluca, C.; Demortier, L.; Deng, J.; Deninno, M.; Derwent, P. F.; di Giovanni, G. P.; Dionisi, C.; di Ruzza, B.; Dittmann, J. R.; D'Onofrio, M.; Donati, S.; Dong, P.; Donini, J.; Dorigo, T.; Dube, S.; Efron, J.; Elagin, A.; Erbacher, R.; Errede, D.; Errede, S.; Eusebi, R.; Fang, H. C.; Farrington, S.; Fedorko, W. T.; Feild, R. G.; Feindt, M.; Fernandez, J. P.; Ferrazza, C.; Field, R.; Flanagan, G.; Forrest, R.; Franklin, M.; Freeman, J. C.; Furic, I.; Gallinaro, M.; Galyardt, J.; Garberson, F.; Garcia, J. E.; Garfinkel, A. F.; Genser, K.; Gerberich, H.; Gerdes, D.; Gessler, A.; Giagu, S.; Giakoumopoulou, V.; Giannetti, P.; Gibson, K.; Gimmell, J. L.; Ginsburg, C. M.; Giokaris, N.; Giordani, M.; Giromini, P.; Giunta, M.; Giurgiu, G.; Glagolev, V.; Glenzinski, D.; Gold, M.; Goldschmidt, N.; Golossanov, A.; Gomez, G.; Gomez-Ceballos, G.; Goncharov, M.; González, O.; Gorelov, I.; Goshaw, A. T.; Goulianos, K.; Gresele, A.; Grinstein, S.; Grosso-Pilcher, C.; Group, R. C.; Grundler, U.; Guimaraes da Costa, J.; Gunay-Unalan, Z.; Haber, C.; Hahn, K.; Hahn, S. R.; Halkiadakis, E.; Han, B.-Y.; Han, J. Y.; Handler, R.; Happacher, F.; Hara, K.; Hare, D.; Hare, M.; Harper, S.; Harr, R. F.; Harris, R. M.; Hartz, M.; Hatakeyama, K.; Hauser, J.; Hays, C.; Heck, M.; Heijboer, A.; Heinemann, B.; Heinrich, J.; Henderson, C.; Herndon, M.; Heuser, J.; Hewamanage, S.; Hidas, D.; Hill, C. S.; Hirschbuehl, D.; Hocker, A.; Hou, S.; Houlden, M.; Hsu, S.-C.; Huffman, B. T.; Hughes, R. E.; Husemann, U.; Huston, J.; Incandela, J.; Introzzi, G.; Iori, M.; Ivanov, A.; James, E.; Jayatilaka, B.; Jeon, E. J.; Jha, M. K.; Jindariani, S.; Johnson, W.; Jones, M.; Joo, K. K.; Jun, S. Y.; Jung, J. E.; Junk, T. R.; Kamon, T.; Kar, D.; Karchin, P. E.; Kato, Y.; Kephart, R.; Keung, J.; Khotilovich, V.; Kilminster, B.; Kim, D. H.; Kim, H. S.; Kim, J. E.; Kim, M. J.; Kim, S. B.; Kim, S. H.; Kim, Y. K.; Kimura, N.; Kirsch, L.; Klimenko, S.; Knuteson, B.; Ko, B. R.; Koay, S. A.; Kondo, K.; Kong, D. J.; Konigsberg, J.; Korytov, A.; Kotwal, A. V.; Kreps, M.; Kroll, J.; Krop, D.; Krumnack, N.; Kruse, M.; Krutelyov, V.; Kubo, T.; Kuhr, T.; Kulkarni, N. P.; Kurata, M.; Kusakabe, Y.; Kwang, S.; Laasanen, A. T.; Lami, S.; Lammel, S.; Lancaster, M.; Lander, R. L.; Lannon, K.; Lath, A.; Latino, G.; Lazzizzera, I.; Lecompte, T.; Lee, E.; Lee, S. W.; Leone, S.; Lewis, J. D.; Lin, C. S.; Linacre, J.; Lindgren, M.; Lipeles, E.; Lister, A.; Litvintsev, D. O.; Liu, C.; Liu, T.; Lockyer, N. S.; Loginov, A.; Loreti, M.; Lovas, L.; Lu, R.-S.; Lucchesi, D.; Lueck, J.; Luci, C.; Lujan, P.; Lukens, P.; Lungu, G.; Lyons, L.; Lys, J.; Lysak, R.; Lytken, E.; Mack, P.; MacQueen, D.; Madrak, R.; Maeshima, K.; Makhoul, K.; Maki, T.; Maksimovic, P.; Malde, S.; Malik, S.; Manca, G.; Manousakis-Katsikakis, A.; Margaroli, F.; Marino, C.; Marino, C. P.; Martin, A.; Martin, V.; Martínez, M.; Martínez-Ballarín, R.; Maruyama, T.; Mastrandrea, P.; Masubuchi, T.; Mattson, M. E.; Mazzanti, P.; McFarland, K. S.; McIntyre, P.; McNulty, R.; Mehta, A.; Mehtala, P.; Menzione, A.; Merkel, P.; Mesropian, C.; Miao, T.; Miladinovic, N.; Miller, R.; Mills, C.; Milnik, M.; Mitra, A.; Mitselmakher, G.; Miyake, H.; Moggi, N.; Moon, C. S.; Moore, R.; Morello, M. J.; Morlok, J.; Movilla Fernandez, P.; Mülmenstädt, J.; Mukherjee, A.; Muller, Th.; Mumford, R.; Murat, P.; Mussini, M.; Nachtman, J.; Nagai, Y.; Nagano, A.; Naganoma, J.; Nakamura, K.; Nakano, I.; Napier, A.; Necula, V.; Neu, C.; Neubauer, M. S.; Nielsen, J.; Nodulman, L.; Norman, M.; Norniella, O.; Nurse, E.; Oakes, L.; Oh, S. H.; Oh, Y. D.; Oksuzian, I.; Okusawa, T.; Orava, R.; Osterberg, K.; Pagan Griso, S.; Pagliarone, C.; Palencia, E.; Papadimitriou, V.; Papaikonomou, A.; Paramonov, A. A.; Parks, B.; Pashapour, S.; Patrick, J.; Pauletta, G.; Paulini, M.; Paus, C.; Pellett, D. E.; Penzo, A.; Phillips, T. J.; Piacentino, G.; Pianori, E.; Pinera, L.; Pitts, K.; Plager, C.; Pondrom, L.; Poukhov, O.; Pounder, N.; Prakoshyn, F.; Pronko, A.; Proudfoot, J.; Ptohos, F.; Pueschel, E.; Punzi, G.; Pursley, J.; Rademacker, J.; Rahaman, A.; Ramakrishnan, V.; Ranjan, N.; Redondo, I.; Reisert, B.; Rekovic, V.; Renton, P.; Rescigno, M.; Richter, S.; Rimondi, F.; Ristori, L.; Robson, A.; Rodrigo, T.; Rodriguez, T.; Rogers, E.; Rolli, S.; Roser, R.; Rossi, M.; Rossin, R.; Roy, P.; Ruiz, A.; Russ, J.; Rusu, V.; Saarikko, H.; Safonov, A.; Sakumoto, W. K.; Saltó, O.; Santi, L.; Sarkar, S.; Sartori, L.; Sato, K.; Savoy-Navarro, A.; Scheidle, T.; Schlabach, P.; Schmidt, A.; Schmidt, E. E.; Schmidt, M. A.; Schmidt, M. P.; Schmitt, M.; Schwarz, T.; Scodellaro, L.; Scott, A. L.; Scribano, A.; Scuri, F.; Sedov, A.; Seidel, S.; Seiya, Y.; Semenov, A.; Sexton-Kennedy, L.; Sfyrla, A.; Shalhout, S. Z.; Shears, T.; Shekhar, R.; Shepard, P. F.; Sherman, D.; Shimojima, M.; Shiraishi, S.; Shochet, M.; Shon, Y.; Shreyber, I.; Sidoti, A.; Sinervo, P.; Sisakyan, A.; Slaughter, A. J.; Slaunwhite, J.; Sliwa, K.; Smith, J. R.; Snider, F. D.; Snihur, R.; Soha, A.; Somalwar, S.; Sorin, V.; Spalding, J.; Spreitzer, T.; Squillacioti, P.; Stanitzki, M.; St. Denis, R.; Stelzer, B.; Stelzer-Chilton, O.; Stentz, D.; Strologas, J.; Stuart, D.; Suh, J. S.; Sukhanov, A.; Suslov, I.; Suzuki, T.; Taffard, A.; Takashima, R.; Takeuchi, Y.; Tanaka, R.; Tecchio, M.; Teng, P. K.; Terashi, K.; Thom, J.; Thompson, A. S.; Thompson, G. A.; Thomson, E.; Tipton, P.; Tiwari, V.; Tkaczyk, S.; Toback, D.; Tokar, S.; Tollefson, K.; Tomura, T.; Tonelli, D.; Torre, S.; Torretta, D.; Totaro, P.; Tourneur, S.; Tu, Y.; Turini, N.; Ukegawa, F.; Vallecorsa, S.; van Remortel, N.; Varganov, A.; Vataga, E.; Vázquez, F.; Velev, G.; Vellidis, C.; Veszpremi, V.; Vidal, M.; Vidal, R.; Vila, I.; Vilar, R.; Vine, T.; Vogel, M.; Volobouev, I.; Volpi, G.; Würthwein, F.; Wagner, P.; Wagner, R. G.; Wagner, R. L.; Wagner-Kuhr, J.; Wagner, W.; Wakisaka, T.; Wallny, R.; Wang, S. M.; Warburton, A.; Waters, D.; Weinberger, M.; Wester, W. C., III; Whitehouse, B.; Whiteson, D.; Whiteson, S.; Wicklund, A. B.; Wicklund, E.; Williams, G.; Williams, H. H.; Wilson, P.; Winer, B. L.; Wittich, P.; Wolbers, S.; Wolfe, C.; Wright, T.; Wu, X.; Wynne, S. M.; Xie, S.; Yagil, A.; Yamamoto, K.; Yamaoka, J.; Yang, U. K.; Yang, Y. C.; Yao, W. M.; Yeh, G. P.; Yoh, J.; Yorita, K.; Yoshida, T.; Yu, G. B.; Yu, I.; Yu, S. S.; Yun, J. C.; Zanello, L.; Zanetti, A.; Zaw, I.; Zhang, X.; Zheng, Y.; Zucchelli, S.

    2009-04-01

    We report a measurement of the top-quark mass Mt in the dilepton decay channel t tmacr →bl'+νl' bmacr l-ν¯l. Events are selected with a neural network which has been directly optimized for statistical precision in top-quark mass using neuroevolution, a technique modeled on biological evolution. The top-quark mass is extracted from per-event probability densities that are formed by the convolution of leading order matrix elements and detector resolution functions. The joint probability is the product of the probability densities from 344 candidate events in 2.0fb-1 of p pmacr collisions collected with the CDF II detector, yielding a measurement of Mt=171.2±2.7(stat)±2.9(syst)GeV/c2.

  16. Measurement of the top-quark mass with dilepton events selected using neuroevolution at CDF.

    PubMed

    Aaltonen, T; Adelman, J; Akimoto, T; Albrow, M G; Alvarez González, B; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Apollinari, G; Apresyan, A; Arisawa, T; Artikov, A; Ashmanskas, W; Attal, A; Aurisano, A; Azfar, F; Azzurri, P; Badgett, W; Barbaro-Galtieri, A; Barnes, V E; Barnett, B A; Bartsch, V; Bauer, G; Beauchemin, P-H; Bedeschi, F; Bednar, P; Beecher, D; Behari, S; Bellettini, G; Bellinger, J; Benjamin, D; Beretvas, A; Beringer, J; Bhatti, A; Binkley, M; Bisello, D; Bizjak, I; Blair, R E; Blocker, C; Blumenfeld, B; Bocci, A; Bodek, A; Boisvert, V; Bolla, G; Bortoletto, D; Boudreau, J; Boveia, A; Brau, B; Bridgeman, A; Brigliadori, L; Bromberg, C; Brubaker, E; Budagov, J; Budd, H S; Budd, S; Burkett, K; Busetto, G; Bussey, P; Buzatu, A; Byrum, K L; Cabrera, S; Calancha, C; Campanelli, M; Campbell, M; Canelli, F; Canepa, A; Carlsmith, D; Carosi, R; Carrillo, S; Carron, S; Casal, B; Casarsa, M; Castro, A; Catastini, P; Cauz, D; Cavaliere, V; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chang, S H; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, K; Chokheli, D; Chou, J P; Choudalakis, G; Chuang, S H; Chung, K; Chung, W H; Chung, Y S; Ciobanu, C I; Ciocci, M A; Clark, A; Clark, D; Compostella, G; Convery, M E; Conway, J; Copic, K; Cordelli, M; Cortiana, G; Cox, D J; Crescioli, F; Cuenca Almenar, C; Cuevas, J; Culbertson, R; Cully, J C; Dagenhart, D; Datta, M; Davies, T; de Barbaro, P; De Cecco, S; Deisher, A; De Lorenzo, G; Dell'orso, M; Deluca, C; Demortier, L; Deng, J; Deninno, M; Derwent, P F; di Giovanni, G P; Dionisi, C; Di Ruzza, B; Dittmann, J R; D'Onofrio, M; Donati, S; Dong, P; Donini, J; Dorigo, T; Dube, S; Efron, J; Elagin, A; Erbacher, R; Errede, D; Errede, S; Eusebi, R; Fang, H C; Farrington, S; Fedorko, W T; Feild, R G; Feindt, M; Fernandez, J P; Ferrazza, C; Field, R; Flanagan, G; Forrest, R; Franklin, M; Freeman, J C; Furic, I; Gallinaro, M; Galyardt, J; Garberson, F; Garcia, J E; Garfinkel, A F; Genser, K; Gerberich, H; Gerdes, D; Gessler, A; Giagu, S; Giakoumopoulou, V; Giannetti, P; Gibson, K; Gimmell, J L; Ginsburg, C M; Giokaris, N; Giordani, M; Giromini, P; Giunta, M; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldschmidt, N; Golossanov, A; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Goulianos, K; Gresele, A; Grinstein, S; Grosso-Pilcher, C; Grundler, U; Guimaraes da Costa, J; Gunay-Unalan, Z; Haber, C; Hahn, K; Hahn, S R; Halkiadakis, E; Han, B-Y; Han, J Y; Handler, R; Happacher, F; Hara, K; Hare, D; Hare, M; Harper, S; Harr, R F; Harris, R M; Hartz, M; Hatakeyama, K; Hauser, J; Hays, C; Heck, M; Heijboer, A; Heinemann, B; Heinrich, J; Henderson, C; Herndon, M; Heuser, J; Hewamanage, S; Hidas, D; Hill, C S; Hirschbuehl, D; Hocker, A; Hou, S; Houlden, M; Hsu, S-C; Huffman, B T; Hughes, R E; Husemann, U; Huston, J; Incandela, J; Introzzi, G; Iori, M; Ivanov, A; James, E; Jayatilaka, B; Jeon, E J; Jha, M K; Jindariani, S; Johnson, W; Jones, M; Joo, K K; Jun, S Y; Jung, J E; Junk, T R; Kamon, T; Kar, D; Karchin, P E; Kato, Y; Kephart, R; Keung, J; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, J E; Kim, M J; Kim, S B; Kim, S H; Kim, Y K; Kimura, N; Kirsch, L; Klimenko, S; Knuteson, B; Ko, B R; Koay, S A; Kondo, K; Kong, D J; Konigsberg, J; Korytov, A; Kotwal, A V; Kreps, M; Kroll, J; Krop, D; Krumnack, N; Kruse, M; Krutelyov, V; Kubo, T; Kuhr, T; Kulkarni, N P; Kurata, M; Kusakabe, Y; Kwang, S; Laasanen, A T; Lami, S; Lammel, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; Lazzizzera, I; Lecompte, T; Lee, E; Lee, S W; Leone, S; Lewis, J D; Lin, C S; Linacre, J; Lindgren, M; Lipeles, E; Lister, A; Litvintsev, D O; Liu, C; Liu, T; Lockyer, N S; Loginov, A; Loreti, M; Lovas, L; Lu, R-S; Lucchesi, D; Lueck, J; Luci, C; Lujan, P; Lukens, P; Lungu, G; Lyons, L; Lys, J; Lysak, R; Lytken, E; Mack, P; Macqueen, D; Madrak, R; Maeshima, K; Makhoul, K; Maki, T; Maksimovic, P; Malde, S; Malik, S; Manca, G; Manousakis-Katsikakis, A; Margaroli, F; Marino, C; Marino, C P; Martin, A; Martin, V; Martínez, M; Martínez-Ballarín, R; Maruyama, T; Mastrandrea, P; Masubuchi, T; Mattson, M E; Mazzanti, P; McFarland, K S; McIntyre, P; McNulty, R; Mehta, A; Mehtala, P; Menzione, A; Merkel, P; Mesropian, C; Miao, T; Miladinovic, N; Miller, R; Mills, C; Milnik, M; Mitra, A; Mitselmakher, G; Miyake, H; Moggi, N; Moon, C S; Moore, R; Morello, M J; Morlok, J; Movilla Fernandez, P; Mülmenstädt, J; Mukherjee, A; Muller, Th; Mumford, R; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Nagano, A; Naganoma, J; Nakamura, K; Nakano, I; Napier, A; Necula, V; Neu, C; Neubauer, M S; Nielsen, J; Nodulman, L; Norman, M; Norniella, O; Nurse, E; Oakes, L; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Orava, R; Osterberg, K; Pagan Griso, S; Pagliarone, C; Palencia, E; Papadimitriou, V; Papaikonomou, A; Paramonov, A A; Parks, B; Pashapour, S; Patrick, J; Pauletta, G; Paulini, M; Paus, C; Pellett, D E; Penzo, A; Phillips, T J; Piacentino, G; Pianori, E; Pinera, L; Pitts, K; Plager, C; Pondrom, L; Poukhov, O; Pounder, N; Prakoshyn, F; Pronko, A; Proudfoot, J; Ptohos, F; Pueschel, E; Punzi, G; Pursley, J; Rademacker, J; Rahaman, A; Ramakrishnan, V; Ranjan, N; Redondo, I; Reisert, B; Rekovic, V; Renton, P; Rescigno, M; Richter, S; Rimondi, F; Ristori, L; Robson, A; Rodrigo, T; Rodriguez, T; Rogers, E; Rolli, S; Roser, R; Rossi, M; Rossin, R; Roy, P; Ruiz, A; Russ, J; Rusu, V; Saarikko, H; Safonov, A; Sakumoto, W K; Saltó, O; Santi, L; Sarkar, S; Sartori, L; Sato, K; Savoy-Navarro, A; Scheidle, T; Schlabach, P; Schmidt, A; Schmidt, E E; Schmidt, M A; Schmidt, M P; Schmitt, M; Schwarz, T; Scodellaro, L; Scott, A L; Scribano, A; Scuri, F; Sedov, A; Seidel, S; Seiya, Y; Semenov, A; Sexton-Kennedy, L; Sfyrla, A; Shalhout, S Z; Shears, T; Shekhar, R; Shepard, P F; Sherman, D; Shimojima, M; Shiraishi, S; Shochet, M; Shon, Y; Shreyber, I; Sidoti, A; Sinervo, P; Sisakyan, A; Slaughter, A J; Slaunwhite, J; Sliwa, K; Smith, J R; Snider, F D; Snihur, R; Soha, A; Somalwar, S; Sorin, V; Spalding, J; Spreitzer, T; Squillacioti, P; Stanitzki, M; St Denis, R; Stelzer, B; Stelzer-Chilton, O; Stentz, D; Strologas, J; Stuart, D; Suh, J S; Sukhanov, A; Suslov, I; Suzuki, T; Taffard, A; Takashima, R; Takeuchi, Y; Tanaka, R; Tecchio, M; Teng, P K; Terashi, K; Thom, J; Thompson, A S; Thompson, G A; Thomson, E; Tipton, P; Tiwari, V; Tkaczyk, S; Toback, D; Tokar, S; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Totaro, P; Tourneur, S; Tu, Y; Turini, N; Ukegawa, F; Vallecorsa, S; van Remortel, N; Varganov, A; Vataga, E; Vázquez, F; Velev, G; Vellidis, C; Veszpremi, V; Vidal, M; Vidal, R; Vila, I; Vilar, R; Vine, T; Vogel, M; Volobouev, I; Volpi, G; Würthwein, F; Wagner, P; Wagner, R G; Wagner, R L; Wagner-Kuhr, J; Wagner, W; Wakisaka, T; Wallny, R; Wang, S M; Warburton, A; Waters, D; Weinberger, M; Wester, W C; Whitehouse, B; Whiteson, D; Whiteson, S; Wicklund, A B; Wicklund, E; Williams, G; Williams, H H; Wilson, P; Winer, B L; Wittich, P; Wolbers, S; Wolfe, C; Wright, T; Wu, X; Wynne, S M; Xie, S; Yagil, A; Yamamoto, K; Yamaoka, J; Yang, U K; Yang, Y C; Yao, W M; Yeh, G P; Yoh, J; Yorita, K; Yoshida, T; Yu, G B; Yu, I; Yu, S S; Yun, J C; Zanello, L; Zanetti, A; Zaw, I; Zhang, X; Zheng, Y; Zucchelli, S

    2009-04-17

    We report a measurement of the top-quark mass M_{t} in the dilepton decay channel tt[over ] --> bl;{'+} nu_{l};{'}b[over ]l;{-}nu[over ]_{l}. Events are selected with a neural network which has been directly optimized for statistical precision in top-quark mass using neuroevolution, a technique modeled on biological evolution. The top-quark mass is extracted from per-event probability densities that are formed by the convolution of leading order matrix elements and detector resolution functions. The joint probability is the product of the probability densities from 344 candidate events in 2.0 fb;{-1} of pp[over ] collisions collected with the CDF II detector, yielding a measurement of M_{t} = 171.2 +/- 2.7(stat) +/- 2.9(syst) GeV / c;{2}.

  17. Global warming-enhanced stratification and mass mortality events in the Mediterranean.

    PubMed

    Coma, Rafel; Ribes, Marta; Serrano, Eduard; Jiménez, Eroteida; Salat, Jordi; Pascual, Josep

    2009-04-14

    Summer conditions in the Mediterranean Sea are characterized by high temperatures and low food availability. This leads to "summer dormancy" in many benthic suspension feeders due to energetic constraints. Analysis of the most recent 33-year temperature time series demonstrated enhanced stratification due to global warming, which produced a approximately 40% lengthening of summer conditions. Many biological processes are expected to be affected by this trend, culminating in such events as mass mortality of invertebrates. Climatic anomalies concomitant with the occurrence of these events represent prolonged exposure to warmer summer conditions coupled with reduced food resources. Simulation of the effects of these conditions on a model organism demonstrated a biomass loss of >35%. Losses of this magnitude result in mortality similar to that noted in field observations during mass mortality events. These results indicate that temperature anomalies are the underlying cause of the events, with energetic constraints serving as the main triggering mechanism.

  18. Identification of Stress Change Within a Rock Mass Through Apparent Stress of Local Seismic Events

    NASA Astrophysics Data System (ADS)

    Brown, Laura; Hudyma, Martin

    2017-01-01

    Mine blasting produces excavation geometry changes which induce stress change that can be observed in the seismic source parameter apparent stress calculated for local seismic events. Using high apparent stress as a proxy for increasing stress within a rock mass, areas experiencing increases in the local stress conditions can be determined. This paper presents the use of apparent stress of seismic events to identify areas within a rock mass experiencing local stress change. Examples from a deep Canadian mine, operating in excess of 2900 m below surface, are provided.

  19. Top Quark Mass Calibration for Monte Carlo Event Generators.

    PubMed

    Butenschoen, Mathias; Dehnadi, Bahman; Hoang, André H; Mateu, Vicent; Preisser, Moritz; Stewart, Iain W

    2016-12-02

    The most precise top quark mass measurements use kinematic reconstruction methods, determining the top mass parameter of a Monte Carlo event generator m_{t}^{MC}. Because of hadronization and parton-shower dynamics, relating m_{t}^{MC} to a field theory mass is difficult. We present a calibration procedure to determine this relation using hadron level QCD predictions for observables with kinematic mass sensitivity. Fitting e^{+}e^{-} 2-jettiness calculations at next-to-leading-logarithmic and next-to-next-to-leading-logarithmic order to pythia 8.205, m_{t}^{MC} differs from the pole mass by 900 and 600 MeV, respectively, and agrees with the MSR mass within uncertainties, m_{t}^{MC}≃m_{t,1  GeV}^{MSR}.

  20. What would you do? Managing a metro network during mass crowd events.

    PubMed

    Barr, Andy C; Lau, Raymond C M; Ng, Nelson W H; da Silva, Marco Antônio; Baptista, Marcia; Oliveira, Vinícius Floriano; Barbosa, Maria Beatriz; Batistini, Estela; de Toledo Ramos, Nancy

    2010-03-01

    Major public events, such as sporting events, carnivals and festivals, are common occurrences in urban and city environments. They are characterised by the mass movement of people in relatively small areas, far in excess of normal daily activity. This section reviews how different metro systems across the globe respond to such peaks of activity, ensuring that people are moved swiftly, efficiently and safely. To this end, representatives from four major public metro systems (London, Hong Kong, Rio de Janeiro and São Paulo) describe how their respective metro systems respond to the capacity demands of a major annual event.

  1. Medical treatment of radiological casualties: current concepts.

    PubMed

    Koenig, Kristi L; Goans, Ronald E; Hatchett, Richard J; Mettler, Fred A; Schumacher, Thomas A; Noji, Eric K; Jarrett, David G

    2005-06-01

    The threat of radiologic or nuclear terrorism is increasing, yet many physicians are unfamiliar with basic treatment principles for radiologic casualties. Patients may present for care after a covert radiation exposure, requiring an elevated level of suspicion by the physician. Traditional medical and surgical triage criteria should always take precedence over radiation exposure management or decontamination. External contamination from a radioactive cloud is easily evaluated using a simple Geiger-Muller counter and decontamination accomplished by prompt removal of clothing and traditional showering. Management of surgical conditions in the presence of persistent radioactive contamination should be dealt with in a conventional manner with health physics guidance. To be most effective in the medical management of a terrorist event involving high-level radiation, physicians should understand basic manifestations of the acute radiation syndrome, the available medical countermeasures, and the psychosocial implications of radiation incidents. Health policy considerations include stockpiling strategies, effective use of risk communications, and decisionmaking for shelter-in-place versus evacuation after a radiologic incident.

  2. How can mass participation physical activity events engage low-active people? A qualitative study.

    PubMed

    Early, Frances; Corcoran, Paula

    2013-08-01

    Regular, moderate physical activity reduces the risk of mortality and morbidity; however increasing the physical activity levels of less active people is a public health challenge. This study explores the potential of mass participation physical activity events to engage less active people, through analyzing the accounts of participants in 2 events who identified themselves as low-active before entering. Seven participants in a sponsored run and 7 in a sponsored walk were interviewed and transcripts were analyzed using grounded theory techniques. Participants had positive experiences encapsulated in 3 categories: Performing (physical completion of the event culminating in a sense of achievement); Relating (enjoying relationships); Soaking up the Atmosphere (enjoying the event ambience). The way in which these categories were manifested was affected by the event context. Mass participation events have potential to engage low-active people. The impact of participation resonated with factors that are positively associated with physical activity in other settings, and event characteristics matched key criteria for attracting low-active groups identified through social marketing research. Suggestions are given for how to capitalize on the findings for health promotion.

  3. Entrance and exit wounds of high velocity bullet: An autopsy analysis in the event of dispersing the mass rally in Bangkok Thailand, May 2010.

    PubMed

    Peonim, Vichan; Srisont, Smith; Udnoon, Jitta; Wongwichai, Sompong; Thapon, Arisa; Worasuwannarak, Wisarn

    2016-11-01

    Fatal mass casualties by high velocity bullets (HVBs) are rare events in peaceful countries. This study presents 27 forensic autopsy cases with 32 shots fired by 5.56×45mm. HVB (M-16 rifle bullets) during the dispersing the mass rally in Bangkok Thailand, May 2010. It was found that twenty-three (71.88%) typical entrance HVB wounds had round sizes less than the bullet diameters. Most entrance wounds had microtears but no collar abrasion since a HVB has a small streamlined spitzer tip and full metal jacket. For exit wounds, there were various sizes and shapes depending on which section of wound ballistics presented when the bullet exited the body. If a bullet exited in the section of temporally cavity formation, there would be a large size exit wound in accordance with the degree of bullet yaw. This is different from civilian bullets whereby the shape looks like a cylindrical round nose and at low velocity that causes entrance wounds with a similar size to the bullet diameter and is usually round or oval shape with collar abrasion. The temporary cavity is not as large as in a HVB so exit wounds are not quite as large and present a ragged border compared to a HVB. We also reported 9 out of 32 shots (28.13%) of atypical entrance wounds that had various characteristics depending on site of injury and destabilization of bullets. These findings may be helpful to forensic pathologists and to give physicians, who need to diagnose HVB wounds, more confidence.

  4. Friendly Combat Casualties and Operational Narratives

    DTIC Science & Technology

    2015-06-21

    ABSTRACT A complex relationship exists between friendly combat casualties and public support, in the context of 21st century limited wars. A myth persists... creation and communication at the strategic level. To bridge the gap, the author proposes the term “operational narrative,” as a means of...limited wars. A myth persists that Western civilian populations are casualty phobic, and as such military leaders are often risk-averse. In reality

  5. Measurement of the top quark mass using the invariant mass of lepton pairs in soft muon b-tagged events

    NASA Astrophysics Data System (ADS)

    Aaltonen, T.; Adelman, J.; Akimoto, T.; Álvarez González, B.; Amerio, S.; Amidei, D.; Anastassov, A.; Annovi, A.; Antos, J.; Apollinari, G.; Apresyan, A.; Arisawa, T.; Artikov, A.; Ashmanskas, W.; Attal, A.; Aurisano, A.; Azfar, F.; Badgett, W.; Barbaro-Galtieri, A.; Barnes, V. E.; Barnett, B. A.; Barria, P.; Bartos, P.; Bartsch, V.; Bauer, G.; Beauchemin, P.-H.; Bedeschi, F.; Beecher, D.; Behari, S.; Bellettini, G.; Bellinger, J.; Benjamin, D.; Beretvas, A.; Beringer, J.; Bhatti, A.; Binkley, M.; Bisello, D.; Bizjak, I.; Blair, R. E.; Blocker, C.; Blumenfeld, B.; Bocci, A.; Bodek, A.; Boisvert, V.; Bolla, G.; Bortoletto, D.; Boudreau, J.; Boveia, A.; Brau, B.; Bridgeman, A.; Brigliadori, L.; Bromberg, C.; Brubaker, E.; Budagov, J.; Budd, H. S.; Budd, S.; Burke, S.; Burkett, K.; Busetto, G.; Bussey, P.; Buzatu, A.; Byrum, K. L.; Cabrera, S.; Calancha, C.; Campanelli, M.; Campbell, M.; Canelli, F.; Canepa, A.; Carls, B.; Carlsmith, D.; Carosi, R.; Carrillo, S.; Carron, S.; Casal, B.; Casarsa, M.; Castro, A.; Catastini, P.; Cauz, D.; Cavaliere, V.; Cavalli-Sforza, M.; Cerri, A.; Cerrito, L.; Chang, S. H.; Chen, Y. C.; Chertok, M.; Chiarelli, G.; Chlachidze, G.; Chlebana, F.; Cho, K.; Chokheli, D.; Chou, J. P.; Choudalakis, G.; Chuang, S. H.; Chung, K.; Chung, W. H.; Chung, Y. S.; Chwalek, T.; Ciobanu, C. I.; Ciocci, M. A.; Clark, A.; Clark, D.; Compostella, G.; Convery, M. E.; Conway, J.; Cordelli, M.; Cortiana, G.; Cox, C. A.; Cox, D. J.; Crescioli, F.; Cuenca Almenar, C.; Cuevas, J.; Culbertson, R.; Cully, J. C.; Dagenhart, D.; Datta, M.; Davies, T.; de Barbaro, P.; de Cecco, S.; Deisher, A.; de Lorenzo, G.; Dell'Orso, M.; Deluca, C.; Demortier, L.; Deng, J.; Deninno, M.; Derwent, P. F.; di Canto, A.; di Giovanni, G. P.; Dionisi, C.; di Ruzza, B.; Dittmann, J. R.; D'Onofrio, M.; Donati, S.; Dong, P.; Donini, J.; Dorigo, T.; Dube, S.; Efron, J.; Elagin, A.; Erbacher, R.; Errede, D.; Errede, S.; Eusebi, R.; Fang, H. C.; Farrington, S.; Fedorko, W. T.; Feild, R. G.; Feindt, M.; Fernandez, J. P.; Ferrazza, C.; Field, R.; Flanagan, G.; Forrest, R.; Frank, M. J.; Franklin, M.; Freeman, J. C.; Furic, I.; Gallinaro, M.; Galyardt, J.; Garcia, J. E.; Garfinkel, A. F.; Garosi, P.; Genser, K.; Gerberich, H.; Gerdes, D.; Gessler, A.; Giagu, S.; Giakoumopoulou, V.; Giannetti, P.; Gibson, K.; Gimmell, J. L.; Ginsburg, C. M.; Giokaris, N.; Giordani, M.; Giromini, P.; Giunta, M.; Giurgiu, G.; Glagolev, V.; Glenzinski, D.; Gold, M.; Goldschmidt, N.; Golossanov, A.; Gomez, G.; Gomez-Ceballos, G.; Goncharov, M.; González, O.; Gorelov, I.; Goshaw, A. T.; Goulianos, K.; Gresele, A.; Grinstein, S.; Grosso-Pilcher, C.; Group, R. C.; Grundler, U.; Guimaraes da Costa, J.; Gunay-Unalan, Z.; Haber, C.; Hahn, K.; Hahn, S. R.; Halkiadakis, E.; Han, B.-Y.; Han, J. Y.; Happacher, F.; Hara, K.; Hare, D.; Hare, M.; Harper, S.; Harr, R. F.; Harris, R. M.; Hartz, M.; Hatakeyama, K.; Hays, C.; Heck, M.; Heijboer, A.; Heinrich, J.; Henderson, C.; Herndon, M.; Heuser, J.; Hewamanage, S.; Hidas, D.; Hill, C. S.; Hirschbuehl, D.; Hocker, A.; Hou, S.; Houlden, M.; Hsu, S.-C.; Huffman, B. T.; Hughes, R. E.; Husemann, U.; Hussein, M.; Huston, J.; Incandela, J.; Introzzi, G.; Iori, M.; Ivanov, A.; James, E.; Jang, D.; Jayatilaka, B.; Jeon, E. J.; Jha, M. K.; Jindariani, S.; Johnson, W.; Jones, M.; Joo, K. K.; Jun, S. Y.; Jung, J. E.; Junk, T. R.; Kamon, T.; Kar, D.; Karchin, P. E.; Kato, Y.; Kephart, R.; Ketchum, W.; Keung, J.; Khotilovich, V.; Kilminster, B.; Kim, D. H.; Kim, H. S.; Kim, H. W.; Kim, J. E.; Kim, M. J.; Kim, S. B.; Kim, S. H.; Kim, Y. K.; Kimura, N.; Kirsch, L.; Klimenko, S.; Knuteson, B.; Ko, B. R.; Kondo, K.; Kong, D. J.; Konigsberg, J.; Korytov, A.; Kotwal, A. V.; Kreps, M.; Kroll, J.; Krop, D.; Krumnack, N.; Kruse, M.; Krutelyov, V.; Kubo, T.; Kuhr, T.; Kulkarni, N. P.; Kurata, M.; Kwang, S.; Laasanen, A. T.; Lami, S.; Lammel, S.; Lancaster, M.; Lander, R. L.; Lannon, K.; Lath, A.; Latino, G.; Lazzizzera, I.; Lecompte, T.; Lee, E.; Lee, H. S.; Lee, S. W.; Leone, S.; Lewis, J. D.; Lin, C.-S.; Linacre, J.; Lindgren, M.; Lipeles, E.; Liss, T. M.; Lister, A.; Litvintsev, D. O.; Liu, C.; Liu, T.; Lockyer, N. S.; Loginov, A.; Loreti, M.; Lovas, L.; Lucchesi, D.; Luci, C.; Lueck, J.; Lujan, P.; Lukens, P.; Lungu, G.; Lyons, L.; Lys, J.; Lysak, R.; MacQueen, D.; Madrak, R.; Maeshima, K.; Makhoul, K.; Maki, T.; Maksimovic, P.; Malde, S.; Malik, S.; Manca, G.; Manousakis-Katsikakis, A.; Margaroli, F.; Marino, C.; Marino, C. P.; Martin, A.; Martin, V.; Martínez, M.; Martínez-Ballarín, R.; Maruyama, T.; Mastrandrea, P.; Masubuchi, T.; Mathis, M.; Mattson, M. E.; Mazzanti, P.; McFarland, K. S.; McIntyre, P.; McNulty, R.; Mehta, A.; Mehtala, P.; Menzione, A.; Merkel, P.; Mesropian, C.; Miao, T.; Miladinovic, N.; Miller, R.; Mills, C.; Milnik, M.; Mitra, A.; Mitselmakher, G.; Miyake, H.; Moed, S.; Moggi, N.; Mondragon, M. N.; Moon, C. S.; Moore, R.; Morello, M. J.; Morlock, J.; Movilla Fernandez, P.; Mülmenstädt, J.; Mukherjee, A.; Muller, Th.; Mumford, R.; Murat, P.; Mussini, M.; Nachtman, J.; Nagai, Y.; Nagano, A.; Naganoma, J.; Nakamura, K.; Nakano, I.; Napier, A.; Necula, V.; Nett, J.; Neu, C.; Neubauer, M. S.; Neubauer, S.; Nielsen, J.; Nodulman, L.; Norman, M.; Norniella, O.; Nurse, E.; Oakes, L.; Oh, S. H.; Oh, Y. D.; Oksuzian, I.; Okusawa, T.; Orava, R.; Osterberg, K.; Pagan Griso, S.; Pagliarone, C.; Palencia, E.; Papadimitriou, V.; Papaikonomou, A.; Paramonov, A. A.; Parks, B.; Pashapour, S.; Patrick, J.; Pauletta, G.; Paulini, M.; Paus, C.; Peiffer, T.; Pellett, D. E.; Penzo, A.; Phillips, T. J.; Piacentino, G.; Pianori, E.; Pinera, L.; Pitts, K.; Plager, C.; Pondrom, L.; Poukhov, O.; Pounder, N.; Prakoshyn, F.; Pronko, A.; Proudfoot, J.; Ptohos, F.; Pueschel, E.; Punzi, G.; Pursley, J.; Rademacker, J.; Rahaman, A.; Ramakrishnan, V.; Ranjan, N.; Redondo, I.; Renton, P.; Renz, M.; Rescigno, M.; Richter, S.; Rimondi, F.; Ristori, L.; Robson, A.; Rodrigo, T.; Rodriguez, T.; Rogers, E.; Rolli, S.; Roser, R.; Rossi, M.; Rossin, R.; Roy, P.; Ruiz, A.; Russ, J.; Rusu, V.; Rutherford, B.; Saarikko, H.; Safonov, A.; Sakumoto, W. K.; Saltó, O.; Santi, L.; Sarkar, S.; Sartori, L.; Sato, K.; Savoy-Navarro, A.; Schlabach, P.; Schmidt, A.; Schmidt, E. E.; Schmidt, M. A.; Schmidt, M. P.; Schmitt, M.; Schwarz, T.; Scodellaro, L.; Scribano, A.; Scuri, F.; Sedov, A.; Seidel, S.; Seiya, Y.; Semenov, A.; Sexton-Kennedy, L.; Sforza, F.; Sfyrla, A.; Shalhout, S. Z.; Shears, T.; Shepard, P. F.; Shimojima, M.; Shiraishi, S.; Shochet, M.; Shon, Y.; Shreyber, I.; Simonenko, A.; Sinervo, P.; Sisakyan, A.; Slaughter, A. J.; Slaunwhite, J.; Sliwa, K.; Smith, J. R.; Snider, F. D.; Snihur, R.; Soha, A.; Somalwar, S.; Sorin, V.; Spreitzer, T.; Squillacioti, P.; Stanitzki, M.; St. Denis, R.; Stelzer, B.; Stelzer-Chilton, O.; Stentz, D.; Strologas, J.; Strycker, G. L.; Suh, J. S.; Sukhanov, A.; Suslov, I.; Suzuki, T.; Taffard, A.; Takashima, R.; Takeuchi, Y.; Tanaka, R.; Tecchio, M.; Teng, P. K.; Terashi, K.; Thom, J.; Thompson, A. S.; Thompson, G. A.; Thomson, E.; Tipton, P.; Ttito-Guzmán, P.; Tkaczyk, S.; Toback, D.; Tokar, S.; Tollefson, K.; Tomura, T.; Tonelli, D.; Torre, S.; Torretta, D.; Totaro, P.; Tourneur, S.; Trovato, M.; Tsai, S.-Y.; Tu, Y.; Turini, N.; Ukegawa, F.; Vallecorsa, S.; van Remortel, N.; Varganov, A.; Vataga, E.; Vázquez, F.; Velev, G.; Vellidis, C.; Vidal, M.; Vidal, R.; Vila, I.; Vilar, R.; Vine, T.; Vogel, M.; Volobouev, I.; Volpi, G.; Wagner, P.; Wagner, R. G.; Wagner, R. L.; Wagner, W.; Wagner-Kuhr, J.; Wakisaka, T.; Wallny, R.; Wang, S. M.; Warburton, A.; Waters, D.; Weinberger, M.; Weinelt, J.; Wester, W. C., III; Whitehouse, B.; Whiteson, D.; Wicklund, A. B.; Wicklund, E.; Wilbur, S.; Williams, G.; Williams, H. H.; Wilson, P.; Winer, B. L.; Wittich, P.; Wolbers, S.; Wolfe, C.; Wright, T.; Wu, X.; Würthwein, F.; Xie, S.; Yagil, A.; Yamamoto, K.; Yamaoka, J.; Yang, U. K.; Yang, Y. C.; Yao, W. M.; Yeh, G. P.; Yi, K.; Yoh, J.; Yorita, K.; Yoshida, T.; Yu, G. B.; Yu, I.; Yu, S. S.; Yun, J. C.; Zanello, L.; Zanetti, A.; Zhang, X.; Zheng, Y.; Zucchelli, S.

    2009-09-01

    We present the first measurement of the mass of the top quark in a sample of t tmacr →ℓν¯b bmacr q qmacr events (where ℓ=e,μ) selected by identifying jets containing a muon candidate from the semileptonic decay of heavy-flavor hadrons (soft muon b tagging). The p pmacr collision data used correspond to an integrated luminosity of 2fb-1 and were collected by the CDF II detector at the Fermilab Tevatron Collider. The measurement is based on a novel technique exploiting the invariant mass of a subset of the decay particles, specifically the lepton from the W boson of the t→Wb decay and the muon from a semileptonic b decay. We fit template histograms, derived from simulation of t tmacr events and a modeling of the background, to the mass distribution observed in the data and measure a top quark mass of 180.5±12.0(stat)±3.6(syst)GeV/c2, consistent with the current world average value.

  6. Measurement of the Top Quark Mass Using the Invariant Mass of Lepton Pairs in Soft Muon b-tagged Events

    SciTech Connect

    Aaltonen, T.; Adelman, Jahred A.; Akimoto, T.; Alvarez Gonzalez, B.; Amerio, S.; Amidei, Dante E.; Anastassov, A.; Annovi, Alberto; Antos, Jaroslav; Apollinari, G.; Apresyan, A.; /Purdue U. /Waseda U.

    2009-06-01

    We present the first measurement of the mass of the top quark in a sample of t{bar t} {yields} {ell}{bar {nu}}b{bar b}q{bar q} events (where {ell} = e, {mu}) selected by identifying jets containing a muon candidate from the semileptonic decay of heavy-flavor hadrons (soft muon b-tagging). The p{bar p} collision data used corresponds to an integrated luminosity of 2 fb{sup -1} and was collected by the CDF II detector at the Fermilab Tevatron. The measurement is based on a novel technique exploiting the invariant mass of a subset of the decay particles, specifically the lepton from the W boson of the t {yields} Wb decay, and the muon from a semileptonic b decay. We fit template histograms, derived from simulation of t{bar t} events and a modeling of the background, to the mass distribution observed in the data and measure a top quark mass of 180.5 {+-} 12.0(stat.) {+-} 3.6(syst.) GeV/c{sup 2}, consistent with the current world average.

  7. Cross-section-constrained top-quark mass measurement from dilepton events at the Tevatron.

    PubMed

    Aaltonen, T; Adelman, J; Akimoto, T; Albrow, M G; Alvarez González, B; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Aoki, M; Apollinari, G; Apresyan, A; Arisawa, T; Artikov, A; Ashmanskas, W; Attal, A; Aurisano, A; Azfar, F; Azzi-Bacchetta, P; Azzurri, P; Bacchetta, N; Badgett, W; Barbaro-Galtieri, A; Barnes, V E; Barnett, B A; Baroiant, S; Bartsch, V; Bauer, G; Beauchemin, P-H; Bedeschi, F; Bednar, P; Behari, S; Bellettini, G; Bellinger, J; Belloni, A; Benjamin, D; Beretvas, A; Beringer, J; Berry, T; Bhatti, A; Binkley, M; Bisello, D; Bizjak, I; Blair, R E; Blocker, C; Blumenfeld, B; Bocci, A; Bodek, A; Boisvert, V; Bolla, G; Bolshov, A; Bortoletto, D; Boudreau, J; Boveia, A; Brau, B; Bridgeman, A; Brigliadori, L; Bromberg, C; Brubaker, E; Budagov, J; Budd, H S; Budd, S; Burkett, K; Busetto, G; Bussey, P; Buzatu, A; Byrum, K L; Cabrera, S; Campanelli, M; Campbell, M; Canelli, F; Canepa, A; Carlsmith, D; Carosi, R; Carrillo, S; Carron, S; Casal, B; Casarsa, M; Castro, A; Catastini, P; Cauz, D; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chang, S H; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, K; Chokheli, D; Chou, J P; Choudalakis, G; Chuang, S H; Chung, K; Chung, W H; Chung, Y S; Ciobanu, C I; Ciocci, M A; Clark, A; Clark, D; Compostella, G; Convery, M E; Conway, J; Cooper, B; Copic, K; Cordelli, M; Cortiana, G; Crescioli, F; Cuenca Almenar, C; Cuevas, J; Culbertson, R; Cully, J C; Dagenhart, D; Datta, M; Davies, T; de Barbaro, P; DeCecco, S; Deisher, A; De Lentdecker, G; De Lorenzo, G; Dell'Orso, M; Demortier, L; Deng, J; Deninno, M; De Pedis, D; Derwent, P F; Di Giovanni, G P; Dionisi, C; Di Ruzza, B; Dittmann, J R; D'Onofrio, M; Donati, S; Dong, P; Donini, J; Dorigo, T; Dube, S; Efron, J; Erbacher, R; Errede, D; Errede, S; Eusebi, R; Fang, H C; Farrington, S; Fedorko, W T; Feild, R G; Feindt, M; Fernandez, J P; Ferrazza, C; Field, R; Flanagan, G; Forrest, R; Forrester, S; Franklin, M; Freeman, J C; Furic, I; Gallinaro, M; Galyardt, J; Garberson, F; Garcia, J E; Garfinkel, A F; Gerberich, H; Gerdes, D; Giagu, S; Giakoumopolou, V; Giannetti, P; Gibson, K; Gimmell, J L; Ginsburg, C M; Giokaris, N; Giordani, M; Giromini, P; Giunta, M; Glagolev, V; Glenzinski, D; Gold, M; Goldschmidt, N; Golossanov, A; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Goulianos, K; Gresele, A; Grinstein, S; Grosso-Pilcher, C; Grundler, U; Guimaraes da Costa, J; Gunay-Unalan, Z; Haber, C; Hahn, K; Hahn, S R; Halkiadakis, E; Hamilton, A; Han, B-Y; Han, J Y; Handler, R; Happacher, F; Hara, K; Hare, D; Hare, M; Harper, S; Harr, R F; Harris, R M; Hartz, M; Hatakeyama, K; Hauser, J; Hays, C; Heck, M; Heijboer, A; Heinemann, B; Heinrich, J; Henderson, C; Herndon, M; Heuser, J; Hewamanage, S; Hidas, D; Hill, C S; Hirschbuehl, D; Hocker, A; Hou, S; Houlden, M; Hsu, S-C; Huffman, B T; Hughes, R E; Husemann, U; Huston, J; Incandela, J; Introzzi, G; Iori, M; Ivanov, A; Iyutin, B; James, E; Jayatilaka, B; Jeans, D; Jeon, E J; Jindariani, S; Johnson, W; Jones, M; Joo, K K; Jun, S Y; Jung, J E; Junk, T R; Kamon, T; Kar, D; Karchin, P E; Kato, Y; Kephart, R; Kerzel, U; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, J E; Kim, M J; Kim, S B; Kim, S H; Kim, Y K; Kimura, N; Kirsch, L; Klimenko, S; Klute, M; Knuteson, B; Ko, B R; Koay, S A; Kondo, K; Kong, D J; Konigsberg, J; Korytov, A; Kotwal, A V; Kraus, J; Kreps, M; Kroll, J; Krumnack, N; Kruse, M; Krutelyov, V; Kubo, T; Kuhlmann, S E; Kuhr, T; Kulkarni, N P; Kusakabe, Y; Kwang, S; Laasanen, A T; Lai, S; Lami, S; Lammel, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; Lazzizzera, I; LeCompte, T; Lee, J; Lee, J; Lee, Y J; Lee, S W; Lefèvre, R; Leonardo, N; Leone, S; Levy, S; Lewis, J D; Lin, C; Lin, C S; Linacre, J; Lindgren, M; Lipeles, E; Lister, A; Litvintsev, D O; Liu, T; Lockyer, N S; Loginov, A; Loreti, M; Lovas, L; Lu, R-S; Lucchesi, D; Lueck, J; Luci, C; Lujan, P; Lukens, P; Lungu, G; Lyons, L; Lys, J; Lysak, R; Lytken, E; Mack, P; MacQueen, D; Madrak, R; Maeshima, K; Makhoul, K; Maki, T; Maksimovic, P; Malde, S; Malik, S; Manca, G; Manousakis, A; Margaroli, F; Marino, C; Marino, C P; Martin, A; Martin, M; Martin, V; Martínez, M; Martínez-Ballarín, R; Maruyama, T; Mastrandrea, P; Masubuchi, T; Mattson, M E; Mazzanti, P; McFarland, K S; McIntyre, P; McNulty, R; Mehta, A; Mehtala, P; Menzemer, S; Menzione, A; Merkel, P; Mesropian, C; Messina, A; Miao, T; Miladinovic, N; Miles, J; Miller, R; Mills, C; Milnik, M; Mitra, A; Mitselmakher, G; Miyake, H; Moed, S; Moggi, N; Moon, C S; Moore, R; Morello, M; Movilla Fernandez, P; Mülmenstädt, J; Mukherjee, A; Muller, Th; Mumford, R; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Nagano, A; Naganoma, J; Nakamura, K; Nakano, I; Napier, A; Necula, V; Neu, C; Neubauer, M S; Nielsen, J; Nodulman, L; Norman, M; Norniella, O; Nurse, E; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Oldeman, R; Orava, R; Osterberg, K; Pagan Griso, S; Pagliarone, C; Palencia, E; Papadimitriou, V; Papaikonomou, A; Paramonov, A A; Parks, B; Pashapour, S; Patrick, J; Pauletta, G; Paulini, M; Paus, C; Pellett, D E; Penzo, A; Phillips, T J; Piacentino, G; Piedra, J; Pinera, L; Pitts, K; Plager, C; Pondrom, L; Portell, X; Poukhov, O; Pounder, N; Prakoshyn, F; Pronko, A; Proudfoot, J; Ptohos, F; Punzi, G; Pursley, J; Rademacker, J; Rahaman, A; Ramakrishnan, V; Ranjan, N; Redondo, I; Reisert, B; Rekovic, V; Renton, P; Rescigno, M; Richter, S; Rimondi, F; Ristori, L; Robson, A; Rodrigo, T; Rogers, E; Rolli, S; Roser, R; Rossi, M; Rossin, R; Roy, P; Ruiz, A; Russ, J; Rusu, V; Saarikko, H; Safonov, A; Sakumoto, W K; Salamanna, G; Saltó, O; Santi, L; Sarkar, S; Sartori, L; Sato, K; Savoy-Navarro, A; Scheidle, T; Schlabach, P; Schmidt, E E; Schmidt, M A; Schmidt, M P; Schmitt, M; Schwarz, T; Scodellaro, L; Scott, A L; Scribano, A; Scuri, F; Sedov, A; Seidel, S; Seiya, Y; Semenov, A; Sexton-Kennedy, L; Sfyria, A; Shalhout, S Z; Shapiro, M D; Shears, T; Shepard, P F; Sherman, D; Shimojima, M; Shochet, M; Shon, Y; Shreyber, I; Sidoti, A; Sinervo, P; Sisakyan, A; Slaughter, A J; Slaunwhite, J; Sliwa, K; Smith, J R; Snider, F D; Snihur, R; Soderberg, M; Soha, A; Somalwar, S; Sorin, V; Spalding, J; Spinella, F; Spreitzer, T; Squillacioti, P; Stanitzki, M; St Denis, R; Stelzer, B; Stelzer-Chilton, O; Stentz, D; Strologas, J; Stuart, D; Suh, J S; Sukhanov, A; Sun, H; Suslov, I; Suzuki, T; Taffard, A; Takashima, R; Takeuchi, Y; Tanaka, R; Tecchio, M; Teng, P K; Terashi, K; Thom, J; Thompson, A S; Thompson, G A; Thomson, E; Tipton, P; Tiwari, V; Tkaczyk, S; Toback, D; Tokar, S; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Tourneur, S; Trischuk, W; Tu, Y; Turini, N; Ukegawa, F; Uozumi, S; Vallecorsa, S; van Remortel, N; Varganov, A; Vataga, E; Vázquez, F; Velev, G; Vellidis, C; Veszpremi, V; Vidal, M; Vidal, R; Vila, I; Vilar, R; Vine, T; Vogel, M; Volobouev, I; Volpi, G; Würthwein, F; Wagner, P; Wagner, R G; Wagner, R L; Wagner-Kuhr, J; Wagner, W; Wakisaka, T; Wallny, R; Wang, S M; Warburton, A; Waters, D; Weinberger, M; Wester, W C; Whitehouse, B; Whiteson, D; Wicklund, A B; Wicklund, E; Williams, G; Williams, H H; Wilson, P; Winer, B L; Wittich, P; Wolbers, S; Wolfe, C; Wright, T; Wu, X; Wynne, S M; Yagil, A; Yamamoto, K; Yamaoka, J; Yamashita, T; Yang, C; Yang, U K; Yang, Y C; Yao, W M; Yeh, G P; Yoh, J; Yorita, K; Yoshida, T; Yu, G B; Yu, I; Yu, S S; Yun, J C; Zanello, L; Zanetti, A; Zaw, I; Zhang, X; Zheng, Y; Zucchelli, S

    2008-02-15

    We report the first top-quark mass measurement that uses a cross-section constraint to improve the mass determination. This measurement is made with a dilepton tt event candidate sample collected with the Collider Detector II at Fermilab. From a data sample corresponding to an integrated luminosity of 1.2 fb(-1), we measure a top-quark mass of 170.7(-3.9)(+4.2)(stat)+/-2.6(syst)+/-2.4(theory) GeV/c(2). The measurement without the cross-section constraint is 169.7(-4.9)(+5.2)(stat)+/-3.1(syst) GeV/c(2).

  8. A Measurement of the Mass of the Top Quark in Lepton + Jets Events at CDF

    SciTech Connect

    Brubaker, Erik Matthews

    2004-01-01

    This document presents a measurement of the top quark mass using the CDF run II detector at Fermilab. Colliding beams of protons and anti-protons at Fermilab's Tevatron (√s = 1.96 TeV) produce top/anti-top pairs, which decay to W+W- b$\\bar{b}$; events are selected where one W decays hadronically, and one W decays to either e or μ plus a neutrino. The data sample was collected between March 2002 and September 2003, and corresponds to an integrated luminosity of approximately 162 pb-1. Thirty-seven candidate t$\\bar{t}$ events are found with at least one b jet identified by its displaced vertex. In each event, the best fit top quark invariant mass is determined by minimizing a Χ2 for the overconstrained kinematic system. A likelihood fit of the reconstructed masses in the data sample to distributions from simulated signal and background events gives a top mass of 174.9$+7.1\\atop{-7.7}$(stat.) ± 6.5(syst.) GeV/c2. The dominant systematic error is due to uncertainties in the jet energy measurements.

  9. Top quark mass measurement from dilepton events at CDF II with the matrix-element method

    SciTech Connect

    Abulencia, A.; Acosta, D.; Adelman, Jahred A.; Affolder, T.; Akimoto, T.; Albrow, M.G.; Ambrose, D.; Amerio, S.; Amidei, D.; Anastassov, A.; Anikeev, K.; /Taiwan, Inst. Phys. /Argonne /Barcelona, IFAE /Baylor U. /INFN, Bologna /Bologna U. /Brandeis U. /UC, Davis /UCLA /UC, San Diego /UC, Santa Barbara

    2006-05-01

    We describe a measurement of the top quark mass using events with two charged leptons collected by the CDF II detector from p{bar p} collisions with {radical}s = 1.96 TeV at the Fermilab Tevatron. The likelihood in top mass is calculated for each event by convoluting the leading order matrix element describing q{bar q} {yields} t{bar t} {yields} b{ell}{nu}{sub {ell}}{bar b}{ell}{prime} {nu}{sub {ell}}, with detector resolution functions. The presence of background events in the data sample is modeled using similar calculations involving the matrix elements for major background processes. In a data sample with integrated luminosity of 340 pb{sup -1}, we observe 33 candidate events and measure M{sub top} = 165.2 {+-} 6.1(stat.) {+-} 3.4(syst.) GeV/c{sup 2}. This measurement represents the first application of this method to events with two charged leptons and is the most precise single measurement of the top quark mass in this channel.

  10. Top-quark mass measurement using events with missing transverse energy and jets at CDF.

    PubMed

    Aaltonen, T; Álvarez González, B; Amerio, S; Amidei, D; Anastassov, A; Annovi, A; Antos, J; Apollinari, G; Appel, J A; Apresyan, A; Arisawa, T; Artikov, A; Asaadi, J; Ashmanskas, W; Auerbach, B; Aurisano, A; Azfar, F; Badgett, W; Barbaro-Galtieri, A; Barnes, V E; Barnett, B A; Barria, P; Bartos, P; Bauce, M; Bauer, G; Bedeschi, F; Beecher, D; Behari, S; Bellettini, G; Bellinger, J; Benjamin, D; Beretvas, A; Bhatti, A; Binkley, M; Bisello, D; Bizjak, I; Bland, K R; Blumenfeld, B; Bocci, A; Bodek, A; Bortoletto, D; Boudreau, J; Boveia, A; Brigliadori, L; Brisuda, A; Bromberg, C; Brucken, E; Bucciantonio, M; Budagov, J; Budd, H S; Budd, S; Burkett, K; Busetto, G; Bussey, P; Buzatu, A; Calancha, C; Camarda, S; Campanelli, M; Campbell, M; Canelli, F; Carls, B; Carlsmith, D; Carosi, R; Carrillo, S; Carron, S; Casal, B; Casarsa, M; Castro, A; Catastini, P; Cauz, D; Cavaliere, V; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, K; Chokheli, D; Chou, J P; Chung, W H; Chung, Y S; Ciobanu, C I; Ciocci, M A; Clark, A; Clarke, C; Compostella, G; Convery, M E; Conway, J; Corbo, M; Cordelli, M; Cox, C A; Cox, D J; Crescioli, F; Cuenca Almenar, C; Cuevas, J; Culbertson, R; Dagenhart, D; d'Ascenzo, N; Datta, M; de Barbaro, P; De Cecco, S; De Lorenzo, G; Dell'Orso, M; Deluca, C; Demortier, L; Deng, J; Deninno, M; Devoto, F; d'Errico, M; Di Canto, A; Di Ruzza, B; Dittmann, J R; D'Onofrio, M; Donati, S; Dong, P; Dorigo, M; Dorigo, T; Ebina, K; Elagin, A; Eppig, A; Erbacher, R; Errede, D; Errede, S; Ershaidat, N; Eusebi, R; Fang, H C; Farrington, S; Feindt, M; Fernandez, J P; Ferrazza, C; Field, R; Flanagan, G; Forrest, R; Frank, M J; Franklin, M; Freeman, J C; Funakoshi, Y; Furic, I; Gallinaro, M; Galyardt, J; Garcia, J E; Garfinkel, A F; Garosi, P; Gerberich, H; Gerchtein, E; Giagu, S; Giakoumopoulou, V; Giannetti, P; Gibson, K; Ginsburg, C M; Giokaris, N; Giromini, P; Giunta, M; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldin, D; Goldschmidt, N; Golossanov, A; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Goulianos, K; Grinstein, S; Grosso-Pilcher, C; Group, R C; Guimaraes da Costa, J; Gunay-Unalan, Z; Haber, C; Hahn, S R; Halkiadakis, E; Hamaguchi, A; Han, J Y; Happacher, F; Hara, K; Hare, D; Hare, M; Harr, R F; Hatakeyama, K; Hays, C; Heck, M; Heinrich, J; Herndon, M; Hewamanage, S; Hidas, D; Hocker, A; Hopkins, W; Horn, D; Hou, S; Hughes, R E; Hurwitz, M; Husemann, U; Hussain, N; Hussein, M; Huston, J; Introzzi, G; Iori, M; Ivanov, A; James, E; Jang, D; Jayatilaka, B; Jeon, E J; Jha, M K; Jindariani, S; Johnson, W; Jones, M; Joo, K K; Jun, S Y; Junk, T R; Kamon, T; Karchin, P E; Kasmi, A; Kato, Y; Ketchum, W; Keung, J; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, H W; Kim, J E; Kim, M J; Kim, S B; Kim, S H; Kim, Y K; Kimura, N; Kirby, M; Klimenko, S; Kondo, K; Kong, D J; Konigsberg, J; Kotwal, A V; Kreps, M; Kroll, J; Krop, D; Krumnack, N; Kruse, M; Krutelyov, V; Kuhr, T; Kurata, M; Kwang, S; Laasanen, A T; Lami, S; Lammel, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; LeCompte, T; Lee, E; Lee, H S; Lee, J S; Lee, S W; Leo, S; Leone, S; Lewis, J D; Limosani, A; Lin, C-J; Linacre, J; Lindgren, M; Lipeles, E; Lister, A; Litvintsev, D O; Liu, C; Liu, Q; Liu, T; Lockwitz, S; Loginov, A; Lucchesi, D; Lueck, J; Lujan, P; Lukens, P; Lungu, G; Lys, J; Lysak, R; Madrak, R; Maeshima, K; Makhoul, K; Malik, S; Manca, G; Manousakis-Katsikakis, A; Margaroli, F; Marino, C; Martínez, M; Martínez-Ballarín, R; Mastrandrea, P; Mattson, M E; Mazzanti, P; McFarland, K S; McIntyre, P; McNulty, R; Mehta, A; Mehtala, P; Menzione, A; Mesropian, C; Miao, T; Mietlicki, D; Mitra, A; Miyake, H; Moed, S; Moggi, N; Mondragon, M N; Moon, C S; Moore, R; Morello, M J; Morlock, J; Movilla Fernandez, P; Mukherjee, A; Muller, Th; Murat, P; Mussini, M; Nachtman, J; Nagai, Y; Naganoma, J; Nakano, I; Napier, A; Nett, J; Neu, C; Neubauer, M S; Nielsen, J; Nodulman, L; Norniella, O; Nurse, E; Oakes, L; Oh, S H; Oh, Y D; Oksuzian, I; Okusawa, T; Orava, R; Ortolan, L; Pagan Griso, S; Pagliarone, C; Palencia, E; Papadimitriou, V; Paramonov, A A; Patrick, J; Pauletta, G; Paulini, M; Paus, C; Pellett, D E; Penzo, A; Phillips, T J; Piacentino, G; Pianori, E; Pilot, J; Pitts, K; Plager, C; Pondrom, L; Poprocki, S; Potamianos, K; Poukhov, O; Prokoshin, F; Pronko, A; Ptohos, F; Pueschel, E; Punzi, G; Pursley, J; Rahaman, A; Ramakrishnan, V; Ranjan, N; Redondo, I; Renton, P; Rescigno, M; Riddick, T; Rimondi, F; Ristori, L; Robson, A; Rodrigo, T; Rodriguez, T; Rogers, E; Rolli, S; Roser, R; Rossi, M; Rubbo, F; Ruffini, F; Ruiz, A; Russ, J; Rusu, V; Safonov, A; Sakumoto, W K; Sakurai, Y; Santi, L; Sartori, L; Sato, K; Saveliev, V; Savoy-Navarro, A; Schlabach, P; Schmidt, A; Schmidt, E E; Schmidt, M P; Schmitt, M; Schwarz, T; Scodellaro, L; Scribano, A; Scuri, F; Sedov, A; Seidel, S; Seiya, Y; Semenov, A; Sforza, F; Sfyrla, A; Shalhout, S Z; Shears, T; Shepard, P F; Shimojima, M; Shiraishi, S; Shochet, M; Shreyber, I; Simonenko, A; Sinervo, P; Sissakian, A; Sliwa, K; Smith, J R; Snider, F D; Soha, A; Somalwar, S; Sorin, V; Squillacioti, P; Stancari, M; Stanitzki, M; St Denis, R; Stelzer, B; Stelzer-Chilton, O; Stentz, D; Strologas, J; Strycker, G L; Sudo, Y; Sukhanov, A; Suslov, I; Takemasa, K; Takeuchi, Y; Tang, J; Tecchio, M; Teng, P K; Thom, J; Thome, J; Thompson, G A; Thomson, E; Ttito-Guzmán, P; Tkaczyk, S; Toback, D; Tokar, S; Tollefson, K; Tomura, T; Tonelli, D; Torre, S; Torretta, D; Totaro, P; Trovato, M; Tu, Y; Ukegawa, F; Uozumi, S; Varganov, A; Vázquez, F; Velev, G; Vellidis, C; Vidal, M; Vila, I; Vilar, R; Vizán, J; Vogel, M; Volpi, G; Wagner, P; Wagner, R L; Wakisaka, T; Wallny, R; Wang, S M; Warburton, A; Waters, D; Weinberger, M; Wester, W C; Whitehouse, B; Whiteson, D; Wicklund, A B; Wicklund, E; Wilbur, S; Wick, F; Williams, H H; Wilson, J S; Wilson, P; Winer, B L; Wittich, P; Wolbers, S; Wolfe, H; Wright, T; Wu, X; Wu, Z; Yamamoto, K; Yamaoka, J; Yang, T; Yang, U K; Yang, Y C; Yao, W-M; Yeh, G P; Yi, K; Yoh, J; Yorita, K; Yoshida, T; Yu, G B; Yu, I; Yu, S S; Yun, J C; Zanetti, A; Zeng, Y; Zucchelli, S

    2011-12-02

    We present a measurement of the top-quark mass using a sample of t ̄t events in 5.7 fb(-1) of integrated luminosity from p ̄p collisions at the Fermilab Tevatron with √s=1.96 TeV and collected by the CDF II Detector. We select events having large missing transverse energy, and four, five, or six jets with at least one jet tagged as coming from a b quark, and reject events with identified charged leptons. This analysis considers events from the semileptonic t ̄t decay channel, including events that contain tau leptons. The measurement is based on a multidimensional template method. We fit the data to signal templates of varying top-quark masses and background templates, and measure a top-quark mass of M(top)=172.32±2.4(stat)±1.0(syst)  GeV/c(2).

  11. Top-quark mass measurement from dilepton events at CDF II.

    PubMed

    Abulencia, A; Acosta, D; Adelman, J; Affolder, T; Akimoto, T; Albrow, M G; Ambrose, D; Amerio, S; Amidei, D; Anastassov, A; Anikeev, K; Annovi, A; Antos, J; Aoki, M; Apollinari, G; Arguin, J-F; Arisawa, T; Artikov, A; Ashmanskas, W; Attal, A; Azfar, F; Azzi-Bacchetta, P; Azzurri, P; Bacchetta, N; Bachacou, H; Badgett, W; Barbaro-Galtieri, A; Barnes, V E; Barnett, B A; Baroiant, S; Bartsch, V; Bauer, G; Bedeschi, F; Behari, S; Belforte, S; Bellettini, G; Bellinger, J; Belloni, A; Ben-Haim, E; Benjamin, D; Beretvas, A; Beringer, J; Berry, T; Bhatti, A; Binkley, M; Bisello, D; Bishai, M; Blair, R E; Blocker, C; Bloom, K; Blumenfeld, B; Bocci, A; Bodek, A; Boisvert, V; Bolla, G; Bolshov, A; Bortoletto, D; Boudreau, J; Bourov, S; Boveia, A; Brau, B; Bromberg, C; Brubaker, E; Budagov, J; Budd, H S; Budd, S; Burkett, K; Busetto, G; Bussey, P; Byrum, K L; Cabrera, S; Campanelli, M; Campbell, M; Canelli, F; Canepa, A; Carlsmith, D; Carosi, R; Carron, S; Casarsa, M; Castro, A; Catastini, P; Cauz, D; Cavalli-Sforza, M; Cerri, A; Cerrito, L; Chang, S H; Chapman, J; Chen, Y C; Chertok, M; Chiarelli, G; Chlachidze, G; Chlebana, F; Cho, I; Cho, K; Chokheli, D; Chou, J P; Chu, P H; Chuang, S H; Chung, K; Chung, W H; Chung, Y S; Ciljak, M; Ciobanu, C I; Ciocci, M A; Clark, A; Clark, D; Coca, M; Connolly, A; Convery, M E; Conway, J; Cooper, B; Copic, K; Cordelli, M; Cortiana, G; Cruz, A; Cuevas, J; Culbertson, R; Cyr, D; DaRonco, S; D'Auria, S; D'Onofrio, M; Dagenhart, D; de Barbaro, P; De Cecco, S; Deisher, A; De Lentdecker, G; Dell'Orso, M; Demers, S; Demortier, L; Deng, J; Deninno, M; De Pedis, D; Derwent, P F; Dionisi, C; Dittmann, J; Dituro, P; Dörr, C; Dominguez, A; Donati, S; Donega, M; Dong, P; Donini, J; Dorigo, T; Dube, S; Ebina, K; Efron, J; Ehlers, J; Erbacher, R; Errede, D; Errede, S; Eusebi, R; Fang, H C; Farrington, S; Fedorko, I; Fedorko, W T; Feild, R G; Feindt, M; Fernandez, J P; Field, R; Flanagan, G; Flores-Castillo, L R; Foland, A; Forrester, S; Foster, G W; Franklin, M; Freeman, J C; Fujii, Y; Furic, I; Gajjar, A; Gallinaro, M; Galyardt, J; Garcia, J E; Garcia Sciverez, M; Garfinkel, A F; Gay, C; Gerberich, H; Gerchtein, E; Gerdes, D; Giagu, S; Giannetti, P; Gibson, A; Gibson, K; Ginsburg, C; Giolo, K; Giordani, M; Giunta, M; Giurgiu, G; Glagolev, V; Glenzinski, D; Gold, M; Goldschmidt, N; Goldstein, J; Gomez, G; Gomez-Ceballos, G; Goncharov, M; González, O; Gorelov, I; Goshaw, A T; Gotra, Y; Goulianos, K; Gresele, A; Griffiths, M; Grinstein, S; Grosso-Pilcher, C; Grundler, U; Guimaraes da Costa, J; Haber, C; Hahn, S R; Hahn, K; Halkiadakis, E; Hamilton, A; Han, B-Y; Handler, R; Happacher, F; Hara, K; Hare, M; Harper, S; Harr, R F; Harris, R M; Hatakeyama, K; Hauser, J; Hays, C; Hayward, H; Heijboer, A; Heinemann, B; Heinrich, J; Hennecke, M; Herndon, M; Heuser, J; Hidas, D; Hill, C S; Hirschbuehl, D; Hocker, A; Holloway, A; Hou, S; Houlden, M; Hsu, S-C; Huffman, B T; Hughes, R E; Huston, J; Ikado, K; Incandela, J; Introzzi, G; Iori, M; Ishizawa, Y; Ivanov, A; Iyutin, B; James, E; Jang, D; Jayatilaka, B; Jeans, D; Jensen, H; Jeon, E J; Jones, M; Joo, K K; Jun, S Y; Junk, T R; Kamon, T; Kang, J; Karagoz-Unel, M; Karchin, P E; Kato, Y; Kemp, Y; Kephart, R; Kerzel, U; Khotilovich, V; Kilminster, B; Kim, D H; Kim, H S; Kim, J E; Kim, M J; Kim, M S; Kim, S B; Kim, S H; Kim, Y K; Kirby, M; Kirsch, L; Klimenko, S; Klute, M; Knuteson, B; Ko, B R; Kobayashi, H; Kondo, K; Kong, D J; Konigsberg, J; Kordas, K; Korytov, A; Kotwal, A V; Kovalev, A; Kraus, J; Kravchenko, I; Kreps, M; Kreymer, A; Kroll, J; Krumnack, N; Kruse, M; Krutelyov, V; Kuhlmann, S E; Kusakabe, Y; Kwang, S; Laasanen, A T; Lai, S; Lami, S; Lami, S; Lammel, S; Lancaster, M; Lander, R L; Lannon, K; Lath, A; Latino, G; Lazzizzera, I; Lecci, C; LeCompte, T; Lee, J; Lee, J; Lee, S W; Lefèvre, R; Leonardo, N; Leone, S; Levy, S; Lewis, J D; Li, K; Lin, C; Lin, C S; Lindgren, M; Lipeles, E; Liss, T M; Lister, A; Litvintsev, D O; Liu, T; Liu, Y; Lockyer, N S; Loginov, A; Loreti, M; Loverre, P; Lu, R-S; Lucchesi, D; Lujan, P; Lukens, P; Lungu, G; Lyons, L; Lys, J; Lysak, R; Lytken, E; Mack, P; MacQueen, D; Madrak, R; Maeshima, K; Maki, T; Maksimovic, P; Manca, G; Margaroli, F; Marginean, R; Marino, C; Martin, A; Martin, M; Martin, V; Martínez, M; Maruyama, T; Matsunaga, H; Mattson, M E; Mazini, R; Mazzanti, P; McFarland, K S; McGivern, D; McIntyre, P; McNamara, P; McNulty, R; Mehta, A; Menzemer, S; Menzione, A; Merkel, P; Mesropian, C; Messina, A; von der Mey, M; Miao, T; Miladinovic, N; Miles, J; Miller, R; Miller, J S; Mills, C; Milnik, M; Miquel, R; Miscetti, S; Mitselmakher, G; Miyamoto, A; Moggi, N; Mohr, B; Moore, R; Morello, M; Movilla Fernandez, P; Mülmenstädt, J; Mukherjee, A; Mulhearn, M; Muller, Th; Mumford, R; Murat, P; Nachtman, J; Nahn, S; Nakano, I; Napier, A; Naumov, D; Necula, V; Neu, C; Neubauer, M S; Nielsen, J; Nigmanov, T; Nodulman, L; Norniella, O; Ogawa, T; Oh, S H; Oh, Y D; Okusawa, T; Oldeman, R; Orava, R; Osterberg, K; Pagliarone, C; Palencia, E; Paoletti, R; Papadimitriou, V; Papikonomou, A; Paramonov, A A; Parks, B; Pashapour, S; Patrick, J; Pauletta, G; Paulini, M; Paus, C; Pellett, D E; Penzo, A; Phillips, T J; Piacentino, G; Piedra, J; Pitts, K; Plager, C; Pondrom, L; Pope, G; Portell, X; Poukhov, O; Pounder, N; Prakoshyn, F; Pronko, A; Proudfoot, J; Ptohos, F; Punzi, G; Pursley, J; Rademacker, J; Rahaman, A; Rakitin, A; Rappoccio, S; Ratnikov, F; Reisert, B; Rekovic, V; van Remortel, N; Renton, P; Rescigno, M; Richter, S; Rimondi, F; Rinnert, K; Ristori, L; Robertson, W J; Robson, A; Rodrigo, T; Rogers, E; Rolli, S; Roser, R; Rossi, M; Rossin, R; Rott, C; Ruiz, A; Russ, J; Rusu, V; Ryan, D; Saarikko, H; Sabik, S; Safonov, A; Sakumoto, W K; Salamanna, G; Salto, O; Saltzberg, D; Sanchez, C; Santi, L; Sarkar, S; Sato, K; Savard, P; Savoy-Navarro, A; Scheidle, T; Schlabach, P; Schmidt, E E; Schmidt, M P; Schmitt, M; Schwarz, T; Scodellaro, L; Scott, A L; Scribano, A; Scuri, F; Sedov, A; Seidel, S; Seiya, Y; Semenov, A; Semeria, F; Sexton-Kennedy, L; Sfiligoi, I; Shapiro, M D; Shears, T; Shepard, P F; Sherman, D; Shimojima, M; Shochet, M; Shon, Y; Shreyber, I; Sidoti, A; Sill, A; Sinervo, P; Sisakyan, A; Sjolin, J; Skiba, A; Slaughter, A J; Sliwa, K; Smirnov, D; Smith, J R; Snider, F D; Snihur, R; Soderberg, M; Soha, A; Somalwar, S; Sorin, V; Spalding, J; Spinella, F; Squillacioti, P; Stanitzki, M; Staveris-Polykalas, A; St Denis, R; Stelzer, B; Stelzer-Chilton, O; Stentz, D; Strologas, J; Stuart, D; Suh, J S; Sukhanov, A; Sumorok, K; Sun, H; Suzuki, T; Taffard, A; Tafirout, R; Takashima, R; Takeuchi, Y; Takikawa, K; Tanaka, M; Tanaka, R; Tecchio, M; Teng, P K; Terashi, K; Tether, S; Thom, J; Thompson, A S; Thomson, E; Tipton, P; Tiwari, V; Tkaczyk, S; Toback, D; Tollefson, K; Tomura, T; Tonelli, D; Tönnesmann, M; Torre, S; Torretta, D; Tourneur, S; Trischuk, W; Tsuchiya, R; Tsuno, S; Turini, N; Ukegawa, F; Unverhau, T; Uozumi, S; Usynin, D; Vacavant, L; Vaiciulis, A; Vallecorsa, S; Varganov, A; Vataga, E; Velev, G; Veramendi, G; Veszpremi, V; Vickey, T; Vidal, R; Vila, I; Vilar, R; Vollrath, I; Volobouev, I; Würthwein, F; Wagner, P; Wagner, R G; Wagner, R L; Wagner, W; Wallny, R; Walter, T; Wan, Z; Wang, M J; Wang, S M; Warburton, A; Ward, B; Waschke, S; Waters, D; Watts, T; Weber, M; Wester, W C; Whitehouse, B; Whiteson, D; Wicklund, A B; Wicklund, E; Williams, H H; Wilson, P; Winer, B L; Wittich, P; Wolbers, S; Wolfe, C; Worm, S; Wright, T; Wu, X; Wynne, S M; Yagil, A; Yamamoto, K; Yamaoka, J; Yamashita, Y; Yang, C; Yang, U K; Yao, W M; Yeh, G P; Yoh, J; Yorita, K; Yoshida, T; Yu, I; Yu, S S; Yun, J C; Zanello, L; Zanetti, A; Zaw, I; Zetti, F; Zhang, X; Zhou, J; Zucchelli, S

    2006-04-21

    We report a measurement of the top-quark mass using events collected by the CDF II detector from pp collisions at square root of s = 1.96 TeV at the Fermilab Tevatron. We calculate a likelihood function for the top-quark mass in events that are consistent with tt --> bl(-)nu(l)bl'+ nu'(l) decays. The likelihood is formed as the convolution of the leading-order matrix element and detector resolution functions. The joint likelihood is the product of likelihoods for each of 33 events collected in 340 pb(-1) of integrated luminosity, yielding a top-quark mass M(t) = 165.2 +/- 6.1(stat) +/- 3.4(syst) GeV/c2. This first application of a matrix-element technique to tt --> bl+ nu(l)bl'- nu(l') decays gives the most precise single measurement of M(t) in dilepton events. Combined with other CDF run II measurements using dilepton events, we measure M(t) = 167.9 +/- 5.2(stat) +/- 3.7(syst) GeV/c2.

  12. DEFLECTIONS OF FAST CORONAL MASS EJECTIONS AND THE PROPERTIES OF ASSOCIATED SOLAR ENERGETIC PARTICLE EVENTS

    SciTech Connect

    Kahler, S. W.; Akiyama, S.; Gopalswamy, N.

    2012-08-01

    The onset times and peak intensities of solar energetic particle (SEP) events at Earth have long been thought to be influenced by the open magnetic fields of coronal holes (CHs). The original idea was that a CH lying between the solar SEP source region and the magnetic footpoint of the 1 AU observer would result in a delay in onset and/or a decrease in the peak intensity of that SEP event. Recently, Gopalswamy et al. showed that CHs near coronal mass ejection (CME) source regions can deflect fast CMEs from their expected trajectories in space, explaining the appearance of driverless shocks at 1 AU from CMEs ejected near solar central meridian (CM). This suggests that SEP events originating in CME-driven shocks may show variations attributable to CH deflections of the CME trajectories. Here, we use a CH magnetic force parameter to examine possible effects of CHs on the timing and intensities of 41 observed gradual E {approx} 20 MeV SEP events with CME source regions within 20 Degree-Sign of CM. We find no systematic CH effects on SEP event intensity profiles. Furthermore, we find no correlation between the CME leading-edge measured position angles and SEP event properties, suggesting that the widths of CME-driven shock sources of the SEPs are much larger than the CMEs. Independently of the SEP event properties, we do find evidence for significant CME deflections by CH fields in these events.

  13. Deflections of Fast Coronal Mass Ejections and the Properties of Associated Solar Energetic Particle Events

    NASA Technical Reports Server (NTRS)

    Kahler, S. W.; Akiyama, S.; Gopalswamy, N.

    2012-01-01

    The onset times and peak intensities of solar energetic particle (SEP) events at Earth have long been thought to be influenced by the open magnetic fields of coronal holes (CHs). The original idea was that a CH lying between the solar SEP source region and the magnetic footpoint of the 1 AU observer would result in a delay in onset and/or a decrease in the peak intensity of that SEP event. Recently, Gopalswamy et al. showed that CHs near coronal mass ejection (CME) source regions can deflect fast CMEs from their expected trajectories in space, explaining the appearance of driverless shocks at 1 AU from CMEs ejected near solar central meridian (CM). This suggests that SEP events originating in CME-driven shocks may show variations attributable to CH deflections of the CME trajectories. Here, we use a CH magnetic force parameter to examine possible effects of CHs on the timing and intensities of 41 observed gradual E approx 20 MeV SEP events with CME source regions within 20 deg. of CM. We find no systematic CH effects on SEP event intensity profiles. Furthermore, we find no correlation between the CME leading-edge measured position angles and SEP event properties, suggesting that the widths of CME-driven shock sources of the SEPs are much larger than the CMEs. Independently of the SEP event properties, we do find evidence for significant CME deflections by CH fields in these events

  14. United States military casualty comparison during the Persian Gulf War.

    PubMed

    Helmkamp, J C

    1994-06-01

    The United States undertook an extensive mobilization of military forces in Southwest Asia after the invasion of Kuwait by Iraq in August 1990. With this massive buildup and the short duration of the Persian Gulf War, an epidemiological comparison of military casualties was of interest. Information extracted from the Worldwide Casualty System maintained by the Department of Defense was used to describe the casualties. Of the 219 (212 men and 7 women) US casualties, 154 were killed in battle and 65 died from nonbattle causes. Thirty-five of the battle deaths were a result of friendly fire. Eighty-three percent of all casualties were white and the mean age at death for all casualties was 26.9 years. The Army had the highest proportion of both battle (58%) and nonbattle (71%) casualties and the Marine Corps had the highest battle casualty rate (0.52 per 1000 personnel) and nonbattle casualty rate (0.31).

  15. A data-based model to locate mass movements triggered by seismic events in Sichuan, China.

    PubMed

    de Souza, Fabio Teodoro

    2014-01-01

    Earthquakes affect the entire world and have catastrophic consequences. On May 12, 2008, an earthquake of magnitude 7.9 on the Richter scale occurred in the Wenchuan area of Sichuan province in China. This event, together with subsequent aftershocks, caused many avalanches, landslides, debris flows, collapses, and quake lakes and induced numerous unstable slopes. This work proposes a methodology that uses a data mining approach and geographic information systems to predict these mass movements based on their association with the main and aftershock epicenters, geologic faults, riverbeds, and topography. A dataset comprising 3,883 mass movements is analyzed, and some models to predict the location of these mass movements are developed. These predictive models could be used by the Chinese authorities as an important tool for identifying risk areas and rescuing survivors during similar events in the future.

  16. Solar energetic proton events and coronal mass ejections near solar minimum

    NASA Technical Reports Server (NTRS)

    Kahler, S. W.; Cliver, E. W.; Cane, H. V.; Mcguire, R. E.; Reames, D. V.; Sheeley, N. R., Jr.; Howard, R. A.

    1987-01-01

    We have examined the association of coronal mass ejections (CME's) with solar energetic (9-23 MeV) proton (SEP) events during the 1983-1985 approach to solar minimum. Twenty-two of 25 SEP events were associated with CME's, a result comparable to that previously found for the period 1979-1982 around solar maximum. Peak SEP fluxes were correlated with CME speeds but not with CME angular sizes. In addition, many associated CME's lay well out of the ecliptic plane. In a reverse study using all west hemisphere CME's of speeds exceeding 800 km/s and covering the period 1979-1985, we found that 29 of 31 events originating on the solar disk or limb were associated with observed SEP's. However, in contrast to the previous study, we found no cases of SEP events associated with magnetically well connected flares of short duration that lacked CME's.

  17. The Expected Number of Background Disease Events during Mass Immunization in China

    PubMed Central

    Wang, YouXin; Wu, LiJuan; Yu, XinWei; Zhao, FeiFei; Russell, Alyce; Song, ManShu; Wang, Wei

    2013-01-01

    It is critical to distinguish events that are temporarily associated with, but not caused by, vaccination from those caused by vaccination during mass immunization. We performed a literature search in China National Knowledge Infrastructure and Pubmed databases. The number of coincident events was calculated based on its incidence rate and periods after receipt of a dose of hypothesized vaccine. We included background incidences of Guillain-Barré syndrome, anaphylaxis, seizure, sudden adult death syndrome, sudden cardiac death, spontaneous abortion, and preterm labour or delivery. In a cohort of 10 million individuals, 7.71 cases of Guillain-Barré syndrome would be expected to occur within six weeks of vaccination as coincident background cases. Even for rare events, a large number of events can be expected in a short period because of the large population targeted for immunization. These findings may encourage health authorities to screen the safety of vaccines against unpredictable pathogens. PMID:23977153

  18. The Vulnerability of People to Landslides: A Case Study on the Relationship between the Casualties and Volume of Landslides in China

    PubMed Central

    Lin, Qigen; Wang, Ying; Liu, Tianxue; Zhu, Yingqi; Sui, Qi

    2017-01-01

    The lack of a detailed landslide inventory makes research on the vulnerability of people to landslides highly limited. In this paper, the authors collect information on the landslides that have caused casualties in China, and established the Landslides Casualties Inventory of China. 100 landslide cases from 2003 to 2012 were utilized to develop an empirical relationship between the volume of a landslide event and the casualties caused by the occurrence of the event. The error bars were used to describe the uncertainty of casualties resulting from landslides and to establish a threshold curve of casualties caused by landslides in China. The threshold curve was then applied to the landslide cases occurred in 2013 and 2014. The validation results show that the estimated casualties of the threshold curve were in good agreement with the real casualties with a small deviation. Therefore, the threshold curve can be used for estimating potential casualties and landslide vulnerability, which is meaningful for emergency rescue operations after landslides occurred and for risk assessment research. PMID:28230810

  19. The Vulnerability of People to Landslides: A Case Study on the Relationship between the Casualties and Volume of Landslides in China.

    PubMed

    Lin, Qigen; Wang, Ying; Liu, Tianxue; Zhu, Yingqi; Sui, Qi

    2017-02-21

    The lack of a detailed landslide inventory makes research on the vulnerability of people to landslides highly limited. In this paper, the authors collect information on the landslides that have caused casualties in China, and established the Landslides Casualties Inventory of China. 100 landslide cases from 2003 to 2012 were utilized to develop an empirical relationship between the volume of a landslide event and the casualties caused by the occurrence of the event. The error bars were used to describe the uncertainty of casualties resulting from landslides and to establish a threshold curve of casualties caused by landslides in China. The threshold curve was then applied to the landslide cases occurred in 2013 and 2014. The validation results show that the estimated casualties of the threshold curve were in good agreement with the real casualties with a small deviation. Therefore, the threshold curve can be used for estimating potential casualties and landslide vulnerability, which is meaningful for emergency rescue operations after landslides occurred and for risk assessment research.

  20. Should physicians prepare for war? 1. The obligation to care for the casualties.

    PubMed

    Bisgard, J C

    1982-04-01

    This is an introduction to a set of four commentaries on the controversy that has arisen over whether physicians should cooperate in Defense Department planning for the care of military casualties, airlifted to U.S. civilian hospitals, in the event of a large-scale war. The commentaries are by Jay C. Bisgard, H. Jack Geiger, James T. Johnson, and Thomas H. Murray.

  1. Diversification events and the effects of mass extinctions on Crocodyliformes evolutionary history.

    PubMed

    Bronzati, Mario; Montefeltro, Felipe C; Langer, Max C

    2015-05-01

    The rich fossil record of Crocodyliformes shows a much greater diversity in the past than today in terms of morphological disparity and occupation of niches. We conducted topology-based analyses seeking diversification shifts along the evolutionary history of the group. Our results support previous studies, indicating an initial radiation of the group following the Triassic/Jurassic mass extinction, here assumed to be related to the diversification of terrestrial protosuchians, marine thalattosuchians and semi-aquatic lineages within Neosuchia. During the Cretaceous, notosuchians embodied a second diversification event in terrestrial habitats and eusuchian lineages started diversifying before the end of the Mesozoic. Our results also support previous arguments for a minor impact of the Cretaceous/Palaeogene mass extinction on the evolutionary history of the group. This argument is not only based on the information from the fossil record, which shows basal groups surviving the mass extinction and the decline of other Mesozoic lineages before the event, but also by the diversification event encompassing only the alligatoroids in the earliest period after the extinction. Our results also indicate that, instead of a continuous process through time, Crocodyliformes diversification was patchy, with events restricted to specific subgroups in particular environments and time intervals.

  2. Impacts of the 1998 and 2010 mass coral bleaching events on the Western Gulf of Thailand

    NASA Astrophysics Data System (ADS)

    Sutthacheep, Makamas; Yucharoen, Mathinee; Klinthong, Wanlaya; Pengsakun, Sittiporn; Sangmanee, Kanwara; Yeemin, Thamasak

    2013-11-01

    A long-term study of coral reef ecology in the Gulf of Thailand provides a good opportunity to examine the temporal variation on the impact of mass coral bleaching at those reef sites. We compared the bleaching and mortality of corals between the mass bleaching events in 1998 and 2010 at a coral community in the Western Gulf of Thailand. The aim was to identify the coral species which were most likely to suffer from (and to be able to tolerate) changes in seawater temperature. Significant differences in the susceptibility of the coral taxa to bleaching events between the years 1998 and 2010 and among coral species were documented. Bleaching was significantly different between the most dominant corals. Diploastrea heliopora was the most resistant coral to bleaching in both years. Some coral species showed more resistance to bleaching in 2010. The coral mortality following the mass bleaching events in 1998 and 2010 varied significantly between the years and the coral taxa. Mortality of some dominant coral taxa was also lower in 2010. Seven coral species, i.e. Astreopora myriophthalma, Pachyseris rugosa, Turbinaria mesenterina, Goniastrea pectinata, Favia pallida, F. maritima, Favites halicora, Platygyra daedalea and Galaxea fascicularis, were tolerant to the coral bleaching events. An ecosystem-based approach to managing coral reefs in the Gulf of Thailand is needed to identify appropriate marine protected area networks and to strengthen marine and coastal resource policies in order to build coral reef resilience.

  3. The Role of Intra-Island Temperature Variability at Palmyra Atoll in Mass Coral Bleaching Events

    NASA Astrophysics Data System (ADS)

    Urmy, S.; McNally, J.; Bartz, J.; Dunbar, R.

    2008-12-01

    Mass coral bleaching events have been reported in Palmyra Atoll during severe El Niños in the last 30 years, and are thought to be increasing both in frequency and magnitude. During these events, bleaching is highly localized, with some parts of the reef showing a much greater effect than others. NOAA's Coral Reef Watch monitors thermal stress on corals by calculating degree heating weeks (DHW) from satellite sea surface temperature in a 50 km pixel around each reef group or atoll of interest. While this technique allows some predictive capacity, especially for mass bleaching events, it does not consider the effects of reef geometry on bleaching susceptibility at different reef groups (Hoeke et al., 2006). Furthermore, because of its large scale, it cannot differentiate between open ocean, backreef, or lagoon temperatures. This project compiles high resolution temperature time series recorded in situ at a number of locations on the reef at Palmyra from 2002-2008, with surprising results. At any one given time, corals at different locations around the atoll may be experiencing temperature stresses that are significantly different both between locations and from the satellite DHW product. Shallow reef flats appear to be a source of heated water that, if advected elsewhere on the reef, may stress corals in normally cooler locations. A more thorough understanding of these mechanisms could improve our predictive capability as to which areas of the reef are at greatest risk if mass bleaching events continue to increase in severity and frequency.

  4. [Mass gatherings: a systematic review of the literature on large events].

    PubMed

    Llorente Nieto, Pedro; González-Alcaide, Gregorio; Ramos, José M

    2017-07-01

    We reviewed the literature on mass gatherings published worldwide to determine event types and topics or epidemiologic aspects covered. Articles using the term mass gatherings indexed in the Scopus database between 2000 and 2015 were reviewed. Of the 518 returned, we selected 96 with relevant information. The main event types studied were related to sports (46%), music (25%) or religious/social content (23%), and the most commonly studied locations were the United States (n=21), the Kingdom of Saudi Arabia (n=17), Australia (n=11), and the United Kingdom (n=10). The four most often studied events were the Hajj (n=17), the Olympic games (n=13), World Youth Day (n=8), and the FIFA World Cup (n=6). The main topics studied were models of health care (n=55), health care evaluation by means of rates of patients presenting for care or transferred to hospitals (n=21), respiratory pathogens (n=18), syndromic surveillance (n=10), and the global spread of diseases (n=10). Mass gatherings are an emerging area of study addressed by various medical specialties that have focused on studying the health care models used at such events. Emergency medicine is particularly involved with this research topic.

  5. Diversification events and the effects of mass extinctions on Crocodyliformes evolutionary history

    PubMed Central

    Bronzati, Mario; Montefeltro, Felipe C.; Langer, Max C.

    2015-01-01

    The rich fossil record of Crocodyliformes shows a much greater diversity in the past than today in terms of morphological disparity and occupation of niches. We conducted topology-based analyses seeking diversification shifts along the evolutionary history of the group. Our results support previous studies, indicating an initial radiation of the group following the Triassic/Jurassic mass extinction, here assumed to be related to the diversification of terrestrial protosuchians, marine thalattosuchians and semi-aquatic lineages within Neosuchia. During the Cretaceous, notosuchians embodied a second diversification event in terrestrial habitats and eusuchian lineages started diversifying before the end of the Mesozoic. Our results also support previous arguments for a minor impact of the Cretaceous/Palaeogene mass extinction on the evolutionary history of the group. This argument is not only based on the information from the fossil record, which shows basal groups surviving the mass extinction and the decline of other Mesozoic lineages before the event, but also by the diversification event encompassing only the alligatoroids in the earliest period after the extinction. Our results also indicate that, instead of a continuous process through time, Crocodyliformes diversification was patchy, with events restricted to specific subgroups in particular environments and time intervals. PMID:26064649

  6. Pattern of eye casualty clinic cases

    PubMed Central

    2008-01-01

    Introduction/Background The purpose of the eye casualty clinic (ECC) is to manage patients with ocular emergencies, however a large number of patients attended the eye casualty clinic did not have an acute problem and could have been treated by their General Practitioner (GP) or referred to the eye outpatient clinic. Aim To identify the number of patients attending the ECC every day and their route of referral and to estimate the number of patients who could have be seen and managed by a competent ophthalmic nurse practitioner. Methods A retrospective analysis was conducted using the notes and history of all patients who attended the eye casualty clinic at the Princess Margaret Hospital in Swindon during two weeks in March 2006. Results The average daily attendance was 21 patients who were seen between morning and afternoon sessions in the Eye Casualty Clinic.112 (54%) patients were female. The median patient age was 50 years with an age range of 1 to 91 years. 68 (34.2%) patients attended as self referrals without GP letters as our eye casualty clinic is open to the general public from 9.00 a.m. to 5.00 p.m. A & E referred 28 (14.1%) patients of which only 3 had a General Practitioner (GP) letter and only 1 patient had a walk-in centre letter. There was insufficient information to assess whether 14 patients could have been managed by a nurse; of the remaining 195 visits, 50 (25.6%) patients could have been managed by an Ophthalmic Nurse Practitioner and 145 (74.4%) patients could not have been managed by an Ophthalmic Nurse Practitioner. Conclusion The workload of the eye casualty doctors could be decreased by 38.6% if defined categories of patients were managed by the ophthalmic nurse practitioner, appropriate referrals were directed to the General Clinic and casualty patients were not followed up inappropriately. PMID:18655718

  7. Pattern of eye casualty clinic cases.

    PubMed

    Wasfi, Ehab I; Sharma, Randeep; Powditch, Emma; Abd-Elsayed, Alaa A

    2008-07-26

    The purpose of the eye casualty clinic (ECC) is to manage patients with ocular emergencies, however a large number of patients attended the eye casualty clinic did not have an acute problem and could have been treated by their General Practitioner (GP) or referred to the eye outpatient clinic. To identify the number of patients attending the ECC every day and their route of referral and to estimate the number of patients who could have be seen and managed by a competent ophthalmic nurse practitioner. A retrospective analysis was conducted using the notes and history of all patients who attended the eye casualty clinic at the Princess Margaret Hospital in Swindon during two weeks in March 2006. The average daily attendance was 21 patients who were seen between morning and afternoon sessions in the Eye Casualty Clinic.112 (54%) patients were female. The median patient age was 50 years with an age range of 1 to 91 years. 68 (34.2%) patients attended as self referrals without GP letters as our eye casualty clinic is open to the general public from 9.00 a.m. to 5.00 p.m. A & E referred 28 (14.1%) patients of which only 3 had a General Practitioner (GP) letter and only 1 patient had a walk-in centre letter. There was insufficient information to assess whether 14 patients could have been managed by a nurse; of the remaining 195 visits, 50 (25.6%) patients could have been managed by an Ophthalmic Nurse Practitioner and 145 (74.4%) patients could not have been managed by an Ophthalmic Nurse Practitioner. The workload of the eye casualty doctors could be decreased by 38.6% if defined categories of patients were managed by the ophthalmic nurse practitioner, appropriate referrals were directed to the General Clinic and casualty patients were not followed up inappropriately.

  8. Active for a day: predictors of relapse among previously active mass event participants.

    PubMed

    Lane, Aoife; Murphy, Niamh; Bauman, Adrian; Chey, Tien

    2012-01-01

    To promote maintenance of sufficient physical activity (PA), better understanding of factors associated with behavioral relapse is needed. To identify PA relapsers and predictors of this state in a large community sample of women who participated in 2 mass 10-km events in Ireland. Relapsers to 'low active' were identified at 3-month follow-up, and factors associated with relapse investigated. 11% of the sample decreased their participation by at least 60 minutes of moderate-intensity PA per week and regressed to 'insufficiently active.' Adjusted analysis indicated relapse was associated with walking the event (OR = 1.40; 95% CI = 1.05-1.85) and not achieving tertiary education (OR = 1.49; 95% CI = 1.18-1.88). Normal-range BMI, training continuously, urban residence, and increases in self efficacy and positive perceptions of the physical environment were related to lower incidence of relapse. Education, living in an urban area, BMI, walking the event, training, and self efficacy are all associated with relapse and while mass events are a useful motivator for PA, strategies are required following events to maintain participation levels and generate a lasting public health impact.

  9. The velocity field of a coronal mass ejection: The event of September 1, 1980

    SciTech Connect

    Low, B.C.; Hundhausen, A.J. )

    1987-03-01

    A coronal mass ejection with the appearance of two sets of overlapping loops occurred at about 0600 UT on September 1, 1980, over the northwest limb of the sun. It was one of the fastest events observed by the Solar Maximum Mission coronagraph during the 1980 epoch, with apparent radial velocity components of several features approaching 1,000 km s{sup {minus}1}. A study of the slow evolution of H{sub {alpha}} prominence filaments and coronal structures in the northwest solar sector suggests that the mass ejection resulted form the disruption of a helmet streamer in association with, possibly, two filaments to give rise to the double-loop structure. This event is well covered by 10 coronagraph images of good quality so that the complex velocity field, defined by the apparent motions of many different parts of the mass ejection, can be mapped out as a function of space and time. The results of such an analysis are presented and related to current concerns in the theoretical understanding of mass ejections In particular, it is concluded that a self-similar description of the velocity field is a gross oversimplification and that although some evidence of wave propagation can be found, the bright features in this mass ejection are plasma structures moving (presumably) with frozen-in magnetic fields, rather that waves propagating through plasma and magnetic fields.

  10. Precise measurement of the top-quark mass from lepton + jets events.

    PubMed

    Abazov, V M; Abbott, B; Abolins, M; Acharya, B S; Adams, M; Adams, T; Aguilo, E; Ahsan, M; Alexeev, G D; Alkhazov, G; Alton, A; Alverson, G; Alves, G A; Anastasoaie, M; Ancu, L S; Andeen, T; Andrieu, B; Anzelc, M S; Aoki, M; Arnoud, Y; Arov, M; Arthaud, M; Askew, A; Asman, B; Jesus, A C S Assis; Atramentov, O; Avila, C; Badaud, F; Bagby, L; Baldin, B; Bandurin, D V; Banerjee, P; Banerjee, S; Barberis, E; Barfuss, A-F; Bargassa, P; Baringer, P; Barreto, J; Bartlett, J F; Bassler, U; Bauer, D; Beale, S; Bean, A; Begalli, M; Begel, M; Belanger-Champagne, C; Bellantoni, L; Bellavance, A; Benitez, J A; Beri, S B; Bernardi, G; Bernhard, R; Bertram, I; Besançon, M; Beuselinck, R; Bezzubov, V A; Bhat, P C; Bhatnagar, V; Biscarat, C; Blazey, G; Blekman, F; Blessing, S; Bloch, D; Bloom, K; Boehnlein, A; Boline, D; Bolton, T A; Boos, E E; Borissov, G; Bose, T; Brandt, A; Brock, R; Brooijmans, G; Bross, A; Brown, D; Bu, X B; Buchanan, N J; Buchholz, D; Buehler, M; Buescher, V; Bunichev, V; Burdin, S; Burnett, T H; Buszello, C P; Butler, J M; Calfayan, P; Calvet, S; Cammin, J; Carrera, E; Carvalho, W; Casey, B C K; Castilla-Valdez, H; Chakrabarti, S; Chakraborty, D; Chan, K M; Chandra, A; Cheu, E; Chevallier, F; Cho, D K; Choi, S; Choudhary, B; Christofek, L; Christoudias, T; Cihangir, S; Claes, D; Clutter, J; Cooke, M; Cooper, W E; Corcoran, M; Couderc, F; Cousinou, M-C; Crépé-Renaudin, S; Cuplov, V; Cutts, D; Cwiok, M; da Motta, H; Das, A; Davies, G; De, K; de Jong, S J; De La Cruz-Burelo, E; De Oliveira Martins, C; Degenhardt, J D; Déliot, F; Demarteau, M; Demina, R; Denisov, D; Denisov, S P; Desai, S; Diehl, H T; Diesburg, M; Dominguez, A; Dong, H; Dorland, T; Dubey, A; Dudko, L V; Duflot, L; Dugad, S R; Duggan, D; Duperrin, A; Dyer, J; Dyshkant, A; Eads, M; Edmunds, D; Ellison, J; Elvira, V D; Enari, Y; Eno, S; Ermolov, P; Evans, H; Evdokimov, A; Evdokimov, V N; Ferapontov, A V; Ferbel, T; Fiedler, F; Filthaut, F; Fisher, W; Fisk, H E; Fortner, M; Fox, H; Fu, S; Fuess, S; Gadfort, T; Galea, C F; Garcia, C; Garcia-Bellido, A; Gavrilov, V; Gay, P; Geist, W; Gelé, D; Geng, W; Gerber, C E; Gershtein, Y; Gillberg, D; Ginther, G; Gollub, N; Gómez, B; Goussiou, A; Grannis, P D; Greenlee, H; Greenwood, Z D; Gregores, E M; Grenier, G; Gris, Ph; Grivaz, J-F; Grohsjean, A; Grünendahl, S; Grünewald, M W; Guo, F; Guo, J; Gutierrez, G; Gutierrez, P; Haas, A; Hadley, N J; Haefner, P; Hagopian, S; Haley, J; Hall, I; Hall, R E; Han, L; Harder, K; Harel, A; Hauptman, J M; Hauser, R; Hays, J; Hebbeker, T; Hedin, D; Hegeman, J G; Heinson, A P; Heintz, U; Hensel, C; Herner, K; Hesketh, G; Hildreth, M D; Hirosky, R; Hobbs, J D; Hoeneisen, B; Hoeth, H; Hohlfeld, M; Hossain, S; Houben, P; Hu, Y; Hubacek, Z; Hynek, V; Iashvili, I; Illingworth, R; Ito, A S; Jabeen, S; Jaffré, M; Jain, S; Jakobs, K; Jarvis, C; Jesik, R; Johns, K; Johnson, C; Johnson, M; Jonckheere, A; Jonsson, P; Juste, A; Kajfasz, E; Kalk, J M; Karmanov, D; Kasper, P A; Katsanos, I; Kau, D; Kaushik, V; Kehoe, R; Kermiche, S; Khalatyan, N; Khanov, A; Kharchilava, A; Kharzheev, Y M; Khatidze, D; Kim, T J; Kirby, M H; Kirsch, M; Klima, B; Kohli, J M; Konrath, J-P; Kozelov, A V; Kraus, J; Kuhl, T; Kumar, A; Kupco, A; Kurca, T; Kuzmin, V A; Kvita, J; Lacroix, F; Lam, D; Lammers, S; Landsberg, G; Lebrun, P; Lee, W M; Leflat, A; Lellouch, J; Li, J; Li, L; Li, Q Z; Lietti, S M; Lim, J K; Lima, J G R; Lincoln, D; Linnemann, J; Lipaev, V V; Lipton, R; Liu, Y; Liu, Z; Lobodenko, A; Lokajicek, M; Love, P; Lubatti, H J; Luna, R; Lyon, A L; Maciel, A K A; Mackin, D; Madaras, R J; Mättig, P; Magass, C; Magerkurth, A; Mal, P K; Malbouisson, H B; Malik, S; Malyshev, V L; Mao, H S; Maravin, Y; Martin, B; McCarthy, R; Melnitchouk, A; Mendoza, L; Mercadante, P G; Merkin, M; Merritt, K W; Meyer, A; Meyer, J; Millet, T; Mitrevski, J; Mommsen, R K; Mondal, N K; Moore, R W; Moulik, T; Muanza, G S; Mulhearn, M; Mundal, O; Mundim, L; Nagy, E; Naimuddin, M; Narain, M; Naumann, N A; Neal, H A; Negret, J P; Neustroev, P; Nilsen, H; Nogima, H; Novaes, S F; Nunnemann, T; O'Dell, V; O'Neil, D C; Obrant, G; Ochando, C; Onoprienko, D; Oshima, N; Osman, N; Osta, J; Otec, R; Y Garzón, G J Otero; Owen, M; Padley, P; Pangilinan, M; Parashar, N; Park, S-J; Park, S K; Parsons, J; Partridge, R; Parua, N; Patwa, A; Pawloski, G; Penning, B; Perfilov, M; Peters, K; Peters, Y; Pétroff, P; Petteni, M; Piegaia, R; Piper, J; Pleier, M-A; Podesta-Lerma, P L M; Podstavkov, V M; Pogorelov, Y; Pol, M-E; Polozov, P; Pope, B G; Popov, A V; Potter, C; da Silva, W L Prado; Prosper, H B; Protopopescu, S; Qian, J; Quadt, A; Quinn, B; Rakitine, A; Rangel, M S; Ranjan, K; Ratoff, P N; Renkel, P; Reucroft, S; Rich, P; Rieger, J; Rijssenbeek, M; Ripp-Baudot, I; Rizatdinova, F; Robinson, S; Rodrigues, R F; Rominsky, M; Royon, C; Rubinov, P; Ruchti, R; Safronov, G; Sajot, G; Sánchez-Hernández, A; Sanders, M P; Sanghi, B; Savage, G; Sawyer, L; Scanlon, T; Schaile, D; Schamberger, R D; Scheglov, Y; Schellman, H; Schliephake, T; Schlobohm, S; Schwanenberger, C; Schwartzman, A; Schwienhorst, R; Sekaric, J; Severini, H; Shabalina, E; Shamim, M; Shary, V; Shchukin, A A; Shivpuri, R K; Siccardi, V; Simak, V; Sirotenko, V; Skubic, P; Slattery, P; Smirnov, D; Snow, G R; Snow, J; Snyder, S; Söldner-Rembold, S; Sonnenschein, L; Sopczak, A; Sosebee, M; Soustruznik, K; Spurlock, B; Stark, J; Steele, J; Stolin, V; Stoyanova, D A; Strandberg, J; Strandberg, S; Strang, M A; Strauss, E; Strauss, M; Ströhmer, R; Strom, D; Stutte, L; Sumowidagdo, S; Svoisky, P; Sznajder, A; Tamburello, P; Tanasijczuk, A; Taylor, W; Tiller, B; Tissandier, F; Titov, M; Tokmenin, V V; Torchiani, I; Tsybychev, D; Tuchming, B; Tully, C; Tuts, P M; Unalan, R; Uvarov, L; Uvarov, S; Uzunyan, S; Vachon, B; van den Berg, P J; Van Kooten, R; van Leeuwen, W M; Varelas, N; Varnes, E W; Vasilyev, I A; Vaupel, M; Verdier, P; Vertogradov, L S; Verzocchi, M; Vilanova, D; Villeneuve-Seguier, F; Vint, P; Vokac, P; Von Toerne, E; Voutilainen, M; Wagner, R; Wahl, H D; Wang, L; Wang, M H L S; Warchol, J; Watts, G; Wayne, M; Weber, G; Weber, M; Welty-Rieger, L; Wenger, A; Wermes, N; Wetstein, M; White, A; Wicke, D; Wilson, G W; Wimpenny, S J; Wobisch, M; Wood, D R; Wyatt, T R; Xie, Y; Yacoob, S; Yamada, R; Yang, W-C; Yasuda, T; Yatsunenko, Y A; Yin, H; Yip, K; Yoo, H D; Youn, S W; Yu, J; Zeitnitz, C; Zelitch, S; Zhao, T; Zhou, B; Zhu, J; Zielinski, M; Zieminska, D; Zieminski, A; Zivkovic, L; Zutshi, V; Zverev, E G

    2008-10-31

    We measure the mass of the top quark using top-quark pair candidate events in the lepton+jets channel from data corresponding to 1 fb;{-1} of integrated luminosity collected by the D0 experiment at the Fermilab Tevatron collider. We use a likelihood technique that reduces the jet energy scale uncertainty by combining an in situ jet energy calibration with the independent constraint on the jet energy scale (JES) from the calibration derived using photon+jets and dijet samples. We find the mass of the top quark to be 171.5+/-1.8(stat.+JES)+/-1.1(syst.) GeV.

  11. Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens.

    PubMed

    Hall, Jessica L; Alpers, Kathrin; Bown, Kevin J; Martin, Stephen J; Birtles, Richard J

    2017-03-01

    Mapping the public health threat of tickborne pathogens requires quantification of not only the density of infected host-seeking ticks but also the rate of human exposure to these ticks. To efficiently sample a high number of persons in a short time, we used a mass-participation outdoor event. In June 2014, we sampled ≈500 persons competing in a 2-day mountain marathon run across predominantly tick-infested habitat in Scotland. From the number of tick bites recorded and prevalence of tick infection with Borrelia burgdoferi sensu lato and B. miyamotoi, we quantified the frequency of competitor exposure to the pathogens. Mass-participation outdoor events have the potential to serve as excellent windows for epidemiologic study of tickborne pathogens; their concerted use should improve spatial and temporal mapping of human exposure to infected ticks.

  12. Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens

    PubMed Central

    Hall, Jessica L.; Alpers, Kathrin; Bown, Kevin J.; Martin, Stephen J.

    2017-01-01

    Mapping the public health threat of tickborne pathogens requires quantification of not only the density of infected host-seeking ticks but also the rate of human exposure to these ticks. To efficiently sample a high number of persons in a short time, we used a mass-participation outdoor event. In June 2014, we sampled ≈500 persons competing in a 2-day mountain marathon run across predominantly tick-infested habitat in Scotland. From the number of tick bites recorded and prevalence of tick infection with Borrelia burgdoferi sensu lato and B. miyamotoi, we quantified the frequency of competitor exposure to the pathogens. Mass-participation outdoor events have the potential to serve as excellent windows for epidemiologic study of tickborne pathogens; their concerted use should improve spatial and temporal mapping of human exposure to infected ticks. PMID:28221107

  13. Empirical study of a unidirectional dense crowd during a real mass event

    NASA Astrophysics Data System (ADS)

    Zhang, X. L.; Weng, W. G.; Yuan, H. Y.; Chen, J. G.

    2013-06-01

    Many tragic crowd disasters have happened across the world in recent years, such as the Phnom Penh stampede in Cambodia, crowd disaster in Mina/Makkah, and the Love Parade disaster in Germany, showing that management of mass events is a tough task for organizers. The study of unidirectional flow, one of the most common forms of motion in mass activities, is essential for safe organization of such events. In this paper, the properties of unidirectional flow in a crowded street during a real mass event in China are quantitatively investigated with sophisticated active infrared counters and an image processing method. A complete dataset of flow rates during the whole celebration is recorded, and a time series analysis gives new insight into such activities. The spatial analysis shows that the velocity and density of the crowd are inhomogeneous due to the boundary effect, whereas the flux is uniform. The estimated capacity of the street indicates that the maximum flow rate under normal condition should be between 1.73 and 1.98 /m/s, which is in good agreement with several field studies available in the existing literature. In consideration of the significant deviation among different studies, fundamental diagrams of dense crowds are also re-verified, and the results here are consistent with those from other field studies of unidirectional flow, but different from the bidirectional and experimental results. It is suggested that the data from multidirectional flow and experiments cannot be directly applied to unidirectional dense flow in a real mass event. The results also imply that the density of a similar unidirectional marching crowd should be controlled to be under 5 /m2, which can produce optimal efficiency and have more possibility to ensure safety. The field study data given here provide a good example of a database for crowd studies.

  14. Coronal Mass Ejections and Solar Proton Events During the Great March 1989 Disturbances

    NASA Technical Reports Server (NTRS)

    Feynman, J.

    1995-01-01

    The great active region of March 1989 was the most prolific in X- rays in the preceding 15 years, and produced very large bright optical solar flares. The accompanying solar energetic particle event was one of the four most intense episodes since 1963. These increases in particle fluxes are compared to the major X-ray and optical flares and to the major coronal mass ejections in order to test hypothesis.

  15. Coronal Mass Ejections and Solar Proton Events During the Great March 1989 Disturbances

    NASA Technical Reports Server (NTRS)

    Feynman, J.

    1995-01-01

    The great active region of March 1989 was the most prolific in X- rays in the preceding 15 years, and produced very large bright optical solar flares. The accompanying solar energetic particle event was one of the four most intense episodes since 1963. These increases in particle fluxes are compared to the major X-ray and optical flares and to the major coronal mass ejections in order to test hypothesis.

  16. 46 CFR 308.410 - Reporting casualties and filing claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 308.410 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Builder's Risk Insurance § 308.410 Reporting casualties and filing claims. Casualties... Subsidy and Insurance, Washington, DC 20590....

  17. The correlation of coronal mass ejections with energetic flare proton events

    NASA Technical Reports Server (NTRS)

    Kahler, S. W.; Mcguire, R. E.; Reames, D. V.; Von Rosenvinge, T. T.; Sheeley, N. R., Jr.; Howard, R. A.; Michels, D. J.; Koomen, M. J.

    1983-01-01

    Proton events of energies of at least 4 MeV presumed due to solar flares are compared with coronal mass ejections (CMEs) observed with an orbiting coronagraph. H alpha flares are associated with 27 of the 50 flare proton events of the study. Each of these 27 flares is then associated temporally and spatially with a CME, confirming the earlier conclusion, based on Skylab data, that a CME may be a necessary condition for a flare proton event. Peak 4-22 MeV proton fluxes correlate with both the speeds and the angular sizes of the associated CMEs. CMEs of larger angular sizes are more likely to be loops or fans rather than jets or spikes and are more likely to intersect the ecliptic.

  18. Precision measurement of the top quark mass from dilepton events at CDF II

    SciTech Connect

    Abulencia, A.; Adelman, J.; Affolder, T.; Akimoto, T.; Albrow, M.G.; Ambrose, D.; Amerio, S.; Amidei, D.; Anastassov, A.; Anikeev, K.; Annovi, A.; /Taiwan, Inst. Phys. /Argonne /Barcelona, IFAE /Baylor U. /INFN, Bologna /Bologna U. /Brandeis U. /UC, Davis /UCLA /UC, San Diego /UC, Santa Barbara

    2006-12-01

    We report a measurement of the top quark mass, M{sub t}, in the dilepton decay channel of t{bar t} {yields} b{ell}{prime}{sup +} {nu}{sub {ell}}, {bar b}{ell}{sup -}{bar {nu}}{sub {ell}} using an integrated luminosity of 1.0 fb{sup -1} of p{bar p} collisions collected with the CDF II detector. We apply a method that convolutes a leading-order matrix element with detector resolution functions to form event-by-event likelihoods; we have enhanced the leading-order description to describe the effects of initial-state radiation. The joint likelihood is the product of the likelihoods from 78 candidate events in this sample, which yields a measurement of M{sub t} = 164.5 {+-} 3.9(stat.) {+-} 3.9(syst.) GeV/c{sup 2}, the most precise measurement of M{sub t} in the dilepton channel.

  19. Avian evolution, Gondwana biogeography and the Cretaceous-Tertiary mass extinction event.

    PubMed Central

    Cracraft, J.

    2001-01-01

    The fossil record has been used to support the origin and radiation of modern birds (Neornithes) in Laurasia after the Cretaceous-Tertiary mass extinction event, whereas molecular clocks have suggested a Cretaceous origin for most avian orders. These alternative views of neornithine evolution are examined using an independent set of evidence, namely phylogenetic relationships and historical biogeography. Pylogenetic relationships of basal lineages of neornithines, including ratite birds and their allies (Palaleocognathae), galliforms and anseriforms (Galloanserae), as well as lineages of the more advanced Neoves (Gruiformes, (Capimulgiformes, Passeriformes and others) demonstrate pervasive trans-Antarctic distribution patterns. The temporal history of the neornithines can be inferred from fossil taxa and the ages of vicariance events, and along with their biogeographical patterns, leads to the conclusion that neornithines arose in Gondwana prior to the Cretaceous Tertiary extinction event. PMID:11296857

  20. Domoic Acid Poisoning as a Possible Cause of Seasonal Cetacean Mass Stranding Events in Tasmania, Australia.

    PubMed

    Bengtson Nash, S M; Baddock, M C; Takahashi, E; Dawson, A; Cropp, R

    2017-01-01

    The periodic trend to cetacean mass stranding events in the Australian island state of Tasmania remains unexplained. This article introduces the hypothesis that domoic acid poisoning may be a causative agent in these events. The hypothesis arises from the previously evidenced role of aeolian dust as a vector of iron input to the Southern Ocean; the role of iron enrichment in Pseudo-nitzschia bloom proliferation and domoic acid production; and importantly, the characteristic toxicosis of domoic acid poisoning in mammalian subjects leading to spatial navigation deficits. As a pre-requisite for quantitative evaluation, the plausibility of this hypothesis was considered through correlation analyses between historical monthly stranding event numbers, mean monthly chlorophyll concentration and average monthly atmospheric dust loading. Correlation of these variables, which under the domoic acid stranding scenario would be linked, revealed strong agreement (r = 0.80-0.87). We therefore advocate implementation of strategic quantitative investigation of the role of domoic acid in Tasmanian cetacean mass stranding events.

  1. Late Frasnian mass extinction: Conodont event stratigraphy, global changes, and possible causes

    NASA Technical Reports Server (NTRS)

    Sandberg, Charles A.; Ziegler, Willi; Dreesen, Roland; Butler, Jamie L.

    1988-01-01

    Several abrupt changes in conodont biofacies are documented to occur synchronously at six primary control sections across the Frasnian-Famennian boundary in Euramerica. These changes occurred within a time-span of only about 100,000 years near the end of the latest Frasnian linguiformis Zone, which is formally named to replace the Uppermost gigas Zone. The conodont-biofacies changes are interpreted to reflect a eustatic rise followed by an abrupt eustatic fall immediately preceding the late Frasnian mass extinction. Two new conodont species are named and described. Ancyrognathus ubiquitus n.sp. is recorded only just below and above the level of late Frasnian extinction and hence is a global marker for that event. Palmatolepispraetriangularis n.sp. is the long-sought Frasnian ancestor of the formerly cryptogenic species, Pa. triangularis, indicator of the earliest Famennian Lower triangularis Zone. The actual extinction event occurred entirely within the Frasnian and is interpreted to have been of brief duration-from as long as 20,000 years to as short as several days. The eustatic rise-and-fall couplet associated with the late Frasnian mass extinction is similar to eustatic couplets associated with the demise of most Frasnian (F2h) reefs worldwide about 1 m.y. earlier and with a latest Famennian mass extinction about 9.5 m.y. later. All these events may be directly or indirectly attributable to extraterrestrial triggering mechanisms. An impact of a small bolide or a near miss of a larger bolide may have caused the earlier demise of Frasnian reefs. An impact of possibly the same larger bolide in the Southern Hemisphere would explain the late Frasnian mass extinction. Global regression during the Famennian probably resulted from Southern-Hemisphere glaciation triggered by the latest Frasnian impact. Glaciation probably was the indirect cause of the latest Famennian mass extinction.

  2. Precise measurement of the top-quark mass from lepton+jets events at D0

    DOE PAGES

    Abazov, Victor Mukhamedovich

    2011-08-09

    We report a measurement of the mass of the top quark in lepton+jets final states of pp&3772; → tt̄ data corresponding to 2.6 fb-1 of integrated luminosity collected at the D0 experiment at the Fermilab Tevatron Collider. Using a matrix element method, we combine an in situ jet energy calibration with the standard jet energy scale derived in studies of Γ + jet and dijet events and employ a novel flavor-dependent jet response correction to measure a top-quark mass of mt = 176.01 ± 1.64 GeV. Combining this result with a previous result obtained on an independent data set, wemore » measure a top-quark mass of mt = 174.94 ± 1.49 GeV for a total integrated luminosity of 3.6 fb-1.« less

  3. Widespread habitat change through paludification as an interactive mechanism in mass extinction events

    NASA Technical Reports Server (NTRS)

    Klinger, L. F.

    1988-01-01

    The study of mass extinction events has largely focused on defining an environmental factor or factors that might account for specific patterns of faunal demise. Several hypotheses elaborate on how a given environmental factor might affect fauna directly, but differentially, causing extinction in certain taxa but not others. Yet few studies have considered specific habitat changes that might result from natural vegetation processes or from perturbations of vegetation. The role of large-scale habitat change induced by natural successional change from forest to bog (paludification) is examined and how large perturbations (e.g., volcanism, bolide impacts) might favor increased rates of paludification and consequent mass extinctions is considered. This hypothesis has an advantage over other hypotheses for mass extinctions in that modern day analogs of paludification are common throughout the world, thus allowing for considerable testing.

  4. Cross-Section-Constrained Top-Quark Mass Measurement from Dilepton Events at the Tevatron

    NASA Astrophysics Data System (ADS)

    Aaltonen, T.; Adelman, J.; Akimoto, T.; Albrow, M. G.; Álvarez González, B.; Amerio, S.; Amidei, D.; Anastassov, A.; Annovi, A.; Antos, J.; Aoki, M.; Apollinari, G.; Apresyan, A.; Arisawa, T.; Artikov, A.; Ashmanskas, W.; Attal, A.; Aurisano, A.; Azfar, F.; Azzi-Bacchetta, P.; Azzurri, P.; Bacchetta, N.; Badgett, W.; Barbaro-Galtieri, A.; Barnes, V. E.; Barnett, B. A.; Baroiant, S.; Bartsch, V.; Bauer, G.; Beauchemin, P.-H.; Bedeschi, F.; Bednar, P.; Behari, S.; Bellettini, G.; Bellinger, J.; Belloni, A.; Benjamin, D.; Beretvas, A.; Beringer, J.; Berry, T.; Bhatti, A.; Binkley, M.; Bisello, D.; Bizjak, I.; Blair, R. E.; Blocker, C.; Blumenfeld, B.; Bocci, A.; Bodek, A.; Boisvert, V.; Bolla, G.; Bolshov, A.; Bortoletto, D.; Boudreau, J.; Boveia, A.; Brau, B.; Bridgeman, A.; Brigliadori, L.; Bromberg, C.; Brubaker, E.; Budagov, J.; Budd, H. S.; Budd, S.; Burkett, K.; Busetto, G.; Bussey, P.; Buzatu, A.; Byrum, K. L.; Cabrera, S.; Campanelli, M.; Campbell, M.; Canelli, F.; Canepa, A.; Carlsmith, D.; Carosi, R.; Carrillo, S.; Carron, S.; Casal, B.; Casarsa, M.; Castro, A.; Catastini, P.; Cauz, D.; Cavalli-Sforza, M.; Cerri, A.; Cerrito, L.; Chang, S. H.; Chen, Y. C.; Chertok, M.; Chiarelli, G.; Chlachidze, G.; Chlebana, F.; Cho, K.; Chokheli, D.; Chou, J. P.; Choudalakis, G.; Chuang, S. H.; Chung, K.; Chung, W. H.; Chung, Y. S.; Ciobanu, C. I.; Ciocci, M. A.; Clark, A.; Clark, D.; Compostella, G.; Convery, M. E.; Conway, J.; Cooper, B.; Copic, K.; Cordelli, M.; Cortiana, G.; Crescioli, F.; Cuenca Almenar, C.; Cuevas, J.; Culbertson, R.; Cully, J. C.; Dagenhart, D.; Datta, M.; Davies, T.; de Barbaro, P.; Dececco, S.; Deisher, A.; de Lentdecker, G.; de Lorenzo, G.; Dell'Orso, M.; Demortier, L.; Deng, J.; Deninno, M.; de Pedis, D.; Derwent, P. F.; di Giovanni, G. P.; Dionisi, C.; di Ruzza, B.; Dittmann, J. R.; D'Onofrio, M.; Donati, S.; Dong, P.; Donini, J.; Dorigo, T.; Dube, S.; Efron, J.; Erbacher, R.; Errede, D.; Errede, S.; Eusebi, R.; Fang, H. C.; Farrington, S.; Fedorko, W. T.; Feild, R. G.; Feindt, M.; Fernandez, J. P.; Ferrazza, C.; Field, R.; Flanagan, G.; Forrest, R.; Forrester, S.; Franklin, M.; Freeman, J. C.; Furic, I.; Gallinaro, M.; Galyardt, J.; Garberson, F.; Garcia, J. E.; Garfinkel, A. F.; Gerberich, H.; Gerdes, D.; Giagu, S.; Giakoumopolou, V.; Giannetti, P.; Gibson, K.; Gimmell, J. L.; Ginsburg, C. M.; Giokaris, N.; Giordani, M.; Giromini, P.; Giunta, M.; Glagolev, V.; Glenzinski, D.; Gold, M.; Goldschmidt, N.; Golossanov, A.; Gomez, G.; Gomez-Ceballos, G.; Goncharov, M.; González, O.; Gorelov, I.; Goshaw, A. T.; Goulianos, K.; Gresele, A.; Grinstein, S.; Grosso-Pilcher, C.; Group, R. C.; Grundler, U.; Guimaraes da Costa, J.; Gunay-Unalan, Z.; Haber, C.; Hahn, K.; Hahn, S. R.; Halkiadakis, E.; Hamilton, A.; Han, B.-Y.; Han, J. Y.; Handler, R.; Happacher, F.; Hara, K.; Hare, D.; Hare, M.; Harper, S.; Harr, R. F.; Harris, R. M.; Hartz, M.; Hatakeyama, K.; Hauser, J.; Hays, C.; Heck, M.; Heijboer, A.; Heinemann, B.; Heinrich, J.; Henderson, C.; Herndon, M.; Heuser, J.; Hewamanage, S.; Hidas, D.; Hill, C. S.; Hirschbuehl, D.; Hocker, A.; Hou, S.; Houlden, M.; Hsu, S.-C.; Huffman, B. T.; Hughes, R. E.; Husemann, U.; Huston, J.; Incandela, J.; Introzzi, G.; Iori, M.; Ivanov, A.; Iyutin, B.; James, E.; Jayatilaka, B.; Jeans, D.; Jeon, E. J.; Jindariani, S.; Johnson, W.; Jones, M.; Joo, K. K.; Jun, S. Y.; Jung, J. E.; Junk, T. R.; Kamon, T.; Kar, D.; Karchin, P. E.; Kato, Y.; Kephart, R.; Kerzel, U.; Khotilovich, V.; Kilminster, B.; Kim, D. H.; Kim, H. S.; Kim, J. E.; Kim, M. J.; Kim, S. B.; Kim, S. H.; Kim, Y. K.; Kimura, N.; Kirsch, L.; Klimenko, S.; Klute, M.; Knuteson, B.; Ko, B. R.; Koay, S. A.; Kondo, K.; Kong, D. J.; Konigsberg, J.; Korytov, A.; Kotwal, A. V.; Kraus, J.; Kreps, M.; Kroll, J.; Krumnack, N.; Kruse, M.; Krutelyov, V.; Kubo, T.; Kuhlmann, S. E.; Kuhr, T.; Kulkarni, N. P.; Kusakabe, Y.; Kwang, S.; Laasanen, A. T.; Lai, S.; Lami, S.; Lammel, S.; Lancaster, M.; Lander, R. L.; Lannon, K.; Lath, A.; Latino, G.; Lazzizzera, I.; Lecompte, T.; Lee, J.; Lee, J.; Lee, Y. J.; Lee, S. W.; Lefèvre, R.; Leonardo, N.; Leone, S.; Levy, S.; Lewis, J. D.; Lin, C.; Lin, C. S.; Linacre, J.; Lindgren, M.; Lipeles, E.; Lister, A.; Litvintsev, D. O.; Liu, T.; Lockyer, N. S.; Loginov, A.; Loreti, M.; Lovas, L.; Lu, R.-S.; Lucchesi, D.; Lueck, J.; Luci, C.; Lujan, P.; Lukens, P.; Lungu, G.; Lyons, L.; Lys, J.; Lysak, R.; Lytken, E.; Mack, P.; MacQueen, D.; Madrak, R.; Maeshima, K.; Makhoul, K.; Maki, T.; Maksimovic, P.; Malde, S.; Malik, S.; Manca, G.; Manousakis, A.; Margaroli, F.; Marino, C.; Marino, C. P.; Martin, A.; Martin, M.; Martin, V.; Martínez, M.; Martínez-Ballarín, R.; Maruyama, T.; Mastrandrea, P.; Masubuchi, T.; Mattson, M. E.; Mazzanti, P.; McFarland, K. S.; McIntyre, P.; McNulty, R.; Mehta, A.; Mehtala, P.; Menzemer, S.; Menzione, A.; Merkel, P.; Mesropian, C.; Messina, A.; Miao, T.; Miladinovic, N.; Miles, J.; Miller, R.; Mills, C.; Milnik, M.; Mitra, A.; Mitselmakher, G.; Miyake, H.; Moed, S.; Moggi, N.; Moon, C. S.; Moore, R.; Morello, M.; Movilla Fernandez, P.; Mülmenstädt, J.; Mukherjee, A.; Muller, Th.; Mumford, R.; Murat, P.; Mussini, M.; Nachtman, J.; Nagai, Y.; Nagano, A.; Naganoma, J.; Nakamura, K.; Nakano, I.; Napier, A.; Necula, V.; Neu, C.; Neubauer, M. S.; Nielsen, J.; Nodulman, L.; Norman, M.; Norniella, O.; Nurse, E.; Oh, S. H.; Oh, Y. D.; Oksuzian, I.; Okusawa, T.; Oldeman, R.; Orava, R.; Osterberg, K.; Pagan Griso, S.; Pagliarone, C.; Palencia, E.; Papadimitriou, V.; Papaikonomou, A.; Paramonov, A. A.; Parks, B.; Pashapour, S.; Patrick, J.; Pauletta, G.; Paulini, M.; Paus, C.; Pellett, D. E.; Penzo, A.; Phillips, T. J.; Piacentino, G.; Piedra, J.; Pinera, L.; Pitts, K.; Plager, C.; Pondrom, L.; Portell, X.; Poukhov, O.; Pounder, N.; Prakoshyn, F.; Pronko, A.; Proudfoot, J.; Ptohos, F.; Punzi, G.; Pursley, J.; Rademacker, J.; Rahaman, A.; Ramakrishnan, V.; Ranjan, N.; Redondo, I.; Reisert, B.; Rekovic, V.; Renton, P.; Rescigno, M.; Richter, S.; Rimondi, F.; Ristori, L.; Robson, A.; Rodrigo, T.; Rogers, E.; Rolli, S.; Roser, R.; Rossi, M.; Rossin, R.; Roy, P.; Ruiz, A.; Russ, J.; Rusu, V.; Saarikko, H.; Safonov, A.; Sakumoto, W. K.; Salamanna, G.; Saltó, O.; Santi, L.; Sarkar, S.; Sartori, L.; Sato, K.; Savoy-Navarro, A.; Scheidle, T.; Schlabach, P.; Schmidt, E. E.; Schmidt, M. A.; Schmidt, M. P.; Schmitt, M.; Schwarz, T.; Scodellaro, L.; Scott, A. L.; Scribano, A.; Scuri, F.; Sedov, A.; Seidel, S.; Seiya, Y.; Semenov, A.; Sexton-Kennedy, L.; Sfyria, A.; Shalhout, S. Z.; Shapiro, M. D.; Shears, T.; Shepard, P. F.; Sherman, D.; Shimojima, M.; Shochet, M.; Shon, Y.; Shreyber, I.; Sidoti, A.; Sinervo, P.; Sisakyan, A.; Slaughter, A. J.; Slaunwhite, J.; Sliwa, K.; Smith, J. R.; Snider, F. D.; Snihur, R.; Soderberg, M.; Soha, A.; Somalwar, S.; Sorin, V.; Spalding, J.; Spinella, F.; Spreitzer, T.; Squillacioti, P.; Stanitzki, M.; St. Denis, R.; Stelzer, B.; Stelzer-Chilton, O.; Stentz, D.; Strologas, J.; Stuart, D.; Suh, J. S.; Sukhanov, A.; Sun, H.; Suslov, I.; Suzuki, T.; Taffard, A.; Takashima, R.; Takeuchi, Y.; Tanaka, R.; Tecchio, M.; Teng, P. K.; Terashi, K.; Thom, J.; Thompson, A. S.; Thompson, G. A.; Thomson, E.; Tipton, P.; Tiwari, V.; Tkaczyk, S.; Toback, D.; Tokar, S.; Tollefson, K.; Tomura, T.; Tonelli, D.; Torre, S.; Torretta, D.; Tourneur, S.; Trischuk, W.; Tu, Y.; Turini, N.; Ukegawa, F.; Uozumi, S.; Vallecorsa, S.; van Remortel, N.; Varganov, A.; Vataga, E.; Vázquez, F.; Velev, G.; Vellidis, C.; Veszpremi, V.; Vidal, M.; Vidal, R.; Vila, I.; Vilar, R.; Vine, T.; Vogel, M.; Volobouev, I.; Volpi, G.; Würthwein, F.; Wagner, P.; Wagner, R. G.; Wagner, R. L.; Wagner-Kuhr, J.; Wagner, W.; Wakisaka, T.; Wallny, R.; Wang, S. M.; Warburton, A.; Waters, D.; Weinberger, M.; Wester, W. C., III; Whitehouse, B.; Whiteson, D.; Wicklund, A. B.; Wicklund, E.; Williams, G.; Williams, H. H.; Wilson, P.; Winer, B. L.; Wittich, P.; Wolbers, S.; Wolfe, C.; Wright, T.; Wu, X.; Wynne, S. M.; Yagil, A.; Yamamoto, K.; Yamaoka, J.; Yamashita, T.; Yang, C.; Yang, U. K.; Yang, Y. C.; Yao, W. M.; Yeh, G. P.; Yoh, J.; Yorita, K.; Yoshida, T.; Yu, G. B.; Yu, I.; Yu, S. S.; Yun, J. C.; Zanello, L.; Zanetti, A.; Zaw, I.; Zhang, X.; Zheng, Y.; Zucchelli, S.

    2008-02-01

    We report the first top-quark mass measurement that uses a cross-section constraint to improve the mass determination. This measurement is made with a dilepton tt¯ event candidate sample collected with the Collider Detector II at Fermilab. From a data sample corresponding to an integrated luminosity of 1.2fb-1, we measure a top-quark mass of 170.7-3.9+4.2(stat)±2.6(syst)±2.4(theory)GeV/c2. The measurement without the cross-section constraint is 169.7-4.9+5.2(stat)±3.1(syst)GeV/c2.

  5. A data base approach for prediction of deforestation-induced mass wasting events

    NASA Technical Reports Server (NTRS)

    Logan, T. L.

    1981-01-01

    A major topic of concern in timber management is determining the impact of clear-cutting on slope stability. Deforestation treatments on steep mountain slopes have often resulted in a high frequency of major mass wasting events. The Geographic Information System (GIS) is a potentially useful tool for predicting the location of mass wasting sites. With a raster-based GIS, digitally encoded maps of slide hazard parameters can be overlayed and modeled to produce new maps depicting high probability slide areas. The present investigation has the objective to examine the raster-based information system as a tool for predicting the location of the clear-cut mountain slopes which are most likely to experience shallow soil debris avalanches. A literature overview is conducted, taking into account vegetation, roads, precipitation, soil type, slope-angle and aspect, and models predicting mass soil movements. Attention is given to a data base approach and aspects of slide prediction.

  6. A data base approach for prediction of deforestation-induced mass wasting events

    NASA Technical Reports Server (NTRS)

    Logan, T. L.

    1981-01-01

    A major topic of concern in timber management is determining the impact of clear-cutting on slope stability. Deforestation treatments on steep mountain slopes have often resulted in a high frequency of major mass wasting events. The Geographic Information System (GIS) is a potentially useful tool for predicting the location of mass wasting sites. With a raster-based GIS, digitally encoded maps of slide hazard parameters can be overlayed and modeled to produce new maps depicting high probability slide areas. The present investigation has the objective to examine the raster-based information system as a tool for predicting the location of the clear-cut mountain slopes which are most likely to experience shallow soil debris avalanches. A literature overview is conducted, taking into account vegetation, roads, precipitation, soil type, slope-angle and aspect, and models predicting mass soil movements. Attention is given to a data base approach and aspects of slide prediction.

  7. Precise measurement of the top-quark mass from lepton+jets events at D0

    SciTech Connect

    Abazov, Victor Mukhamedovich

    2011-08-09

    We report a measurement of the mass of the top quark in lepton+jets final states of pp&3772; → tt̄ data corresponding to 2.6 fb-1 of integrated luminosity collected at the D0 experiment at the Fermilab Tevatron Collider. Using a matrix element method, we combine an in situ jet energy calibration with the standard jet energy scale derived in studies of Γ + jet and dijet events and employ a novel flavor-dependent jet response correction to measure a top-quark mass of mt = 176.01 ± 1.64 GeV. Combining this result with a previous result obtained on an independent data set, we measure a top-quark mass of mt = 174.94 ± 1.49 GeV for a total integrated luminosity of 3.6 fb-1.

  8. Building vulnerability and human casualty estimation for a pyroclastic flow: a model and its application to Vesuvius

    NASA Astrophysics Data System (ADS)

    Spence, Robin J. S.; Baxter, Peter J.; Zuccaro, Giulio

    2004-05-01

    Pyroclastic flows clearly present a serious threat to life for the inhabitants of settlements on the slopes of volcanoes with a history of explosive eruptions; but it is increasingly realised that buildings can provide a measure of protection to occupants trapped by such flows. One important example is Vesuvius, whose eruption history includes many events which were lethal for the inhabitants of the neighbouring Vesuvian villages. Recent computational fluid dynamics computer modelling for Vesuvius [Todesco et al., Bull. Volcanol. 64 (2002) 155-177] has enabled a realistic picture of an explosive eruption to be modelled, tracing the time-dependent development of the physical parameters of a simulated flow at a large three-dimensional mesh of points, based on assumed conditions of temperature, mass-flow rate and particle size distribution at the vent. The output includes mapping of temperature, mixture density and mixture velocity over the whole adjacent terrain. But to date this information has not been used to assess the impacts of such flows on buildings and their occupants. In the project reported in this paper, estimates of the near-ground flow parameters were used to assess the impact of a particular simulated pyroclastic flow (modelled roughly on the 1631 eruption) on the buildings and population in four of the Vesuvian villages considered most at risk. The study had five components. First, a survey of buildings and the urban environment was conducted to identify the incidence of characteristics and elements likely to affect human vulnerability, and to classify the building stock. The survey emphasised particularly the number, location and type of openings characteristic of the major classes of the local building stock. In the second part of the study, this survey formed the basis for estimates of the probable impact of the pyroclastic flow on the envelope and internal air conditions of typical buildings. In the third part, a number of distinct ways in which

  9. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  10. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.202 Notice of marine casualty. (a) Immediately after addressing...

  11. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  12. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.202 Notice of marine casualty. (a) Immediately after addressing...

  13. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  14. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.202 Notice of marine casualty. (a) Immediately after addressing...

  15. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  16. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  17. 46 CFR 122.202 - Notice of marine casualty.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Notice of marine casualty. 122.202 Section 122.202... THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.202 Notice of marine casualty. (a) Immediately after addressing...

  18. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  19. 46 CFR 122.206 - Written report of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Written report of marine casualty. 122.206 Section 122... MORE THAN 150 PASSENGERS OR WITH OVERNIGHT ACCOMMODATIONS FOR MORE THAN 49 PASSENGERS OPERATIONS Marine Casualties and Voyage Records § 122.206 Written report of marine casualty. (a) The owner, master, agent,...

  20. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  1. 46 CFR 185.206 - Written report of marine casualty.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Written report of marine casualty. 185.206 Section 185... 100 GROSS TONS) OPERATIONS Marine Casualties and Voyage Records § 185.206 Written report of marine... of any marine casualty. This written report is in addition to the immediate notice required by...

  2. The impact of Saharan dust events on long-term glacier mass balance in the Alps

    NASA Astrophysics Data System (ADS)

    Bauder, A.; Gabbi, J.; Huss, M.; Schwikowski, M.

    2014-12-01

    Saharan dust falls are frequently observed in the Alpine region and are easily recognized by the unique yellowish coloration of the snow surface. Such Saharan dust events contribute to a large part to the total mineral dust deposited in snow and impact the surface energy budget by reducing the snow and ice albedo. In this study we investigate the long-term effect of such Saharan dust events on the surface albedo and the glacier's mass balance. The analysis is performed over the period 1914-2013 for two field sites on Claridenfirn, Swiss Alps, where an outstanding 100-year record of seasonal mass balance measurements is available. Based on the detailed knowledge about the mass balance, annual melt and accumulation rates are derived. A firn/ice core drilled at the glacier saddle of Colle Gnifetti (Swiss Alps) provides information on the impurity concentration in precipitation over the last century. A mass balance model combined with a parameterization for snow and ice albedo based on the specific surface area of snow and the snow impurity concentration is employed to assess the dust-albedo feedback. In order to track the position and thickness of snow layers a snow density model is implemented. Atmospheric dust enters the system of snow layers by precipitation and remains in the corresponding layer as long as there is no melt. When melt occurs, the water-insoluble part of the dust of the melted snow is supposed to accumulate in the top surface layer. The upper site has experienced only positive net mass balance and dust layers are continuously buried so that the impact of strong Saharan dust events is mainly restricted to the corresponding year. In the case of the lower site, the surface albedo is more strongly influenced by dust events of previous years due to periods with negative mass balances. Model results suggest that the enhanced melting in the 1940s yield even higher dust concentrations in 1947 compared to years with exceptional high Saharan dust deposition

  3. Propagation of Solar Energetic Particles During Multiple Coronal Mass Ejection Events

    NASA Astrophysics Data System (ADS)

    Pohjolainen, Silja; Al-Hamadani, Firas; Valtonen, Eino

    2016-02-01

    We study solar energetic particle (SEP) events during multiple solar eruptions. The analysed sequences, on 24 - 26 November 2000, 9 - 13 April 2001, and 22 - 25 August 2005, consisted of halo-type coronal mass ejections (CMEs) that originated from the same active region and were associated with intense flares, EUV waves, and interplanetary (IP) radio type II and type III bursts. The first two solar events in each of these sequences showed SEP enhancements near Earth, but the third in the row did not. We observed that in these latter events the type III radio bursts were stopped at much higher frequencies than in the earlier events, indicating that the bursts did not reach the typical plasma density levels near Earth. To explain the missing third SEP event in each sequence, we suggest that the earlier-launched CMEs and the CME-driven shocks either reduced the seed particle population and thus led to inefficient particle acceleration, or that the earlier-launched CMEs and shocks changed the propagation paths or prevented the propagation of both the electron beams and SEPs, so that they were not detected near Earth even when the shock arrivals were recorded.

  4. Coronal mass ejections, magnetic clouds, and relativistic magnetospheric electron events: ISTP

    SciTech Connect

    Baker, D.N.; Pulkkinen, T.I.; Li, X.; Kanekal, S.G.; Blake, J.B.; Selesnick, R.S.; Henderson, M.G.; Reeves, G.D.; Spence, H.E.

    1998-08-01

    The role of high-speed solar wind streams in driving relativistic electron acceleration within the Earth{close_quote}s magnetosphere during solar activity minimum conditions has been well documented. The rising phase of the new solar activity cycle (cycle 23) commenced in 1996, and there have recently been a number of coronal mass ejections (CMEs) and related {open_quotes}magnetic clouds{close_quotes} at 1 AU. As these CME/cloud systems interact with the Earth{close_quote}s magnetosphere, some events produce substantial enhancements in the magnetospheric energetic particle population while others do not. This paper compares and contrasts relativistic electron signatures observed by the POLAR, SAMPEX, Highly Elliptical Orbit, and geostationary orbit spacecraft during two magnetic cloud events: May 27{endash}29, 1996, and January 10{endash}11, 1997. Sequences were observed in each case in which the interplanetary magnetic field was first strongly southward and then rotated northward. In both cases, there were large solar wind density enhancements toward the end of the cloud passage at 1 AU. Strong energetic electron acceleration was observed in the January event, but not in the May event. The relative geoeffectiveness for these two cases is assessed, and it is concluded that large induced electric fields ({partial_derivative}B/{partial_derivative}t) caused in situ acceleration of electrons throughout the outer radiation zone during the January 1997 event. {copyright} 1998 American Geophysical Union

  5. The hematologist and radiation casualties.

    PubMed

    Dainiak, Nicholas; Waselenko, Jamie K; Armitage, James O; MacVittie, Thomas J; Farese, Ann M

    2003-01-01

    Since the terrorist attack of September 11, 2001, preparation by the health care system for an act of terrorism has been mandated by leaders of governments. Scenarios for terrorist acts involving radioactive material have been identified, and approaches to management (based on past experience from atomic weapons detonations and radiation accidents) have been developed. Because of their experience in managing patients with profound cytopenia and/or marrow aplasia, hematologists will be asked to play a significant role in evaluating and treating victims of mass accidental or deliberate exposure to radiation. This review provides a framework for understanding how radiation levels are quantified, how radiation alters the function of hematopoietic (and nonhematopoietic) cells and tissues, and how victims receiving a significant radiation dose can be identified and managed. In Section I, Dr. Nicholas Dainiak reviews four components of the Acute Radiation Syndrome: the hematopoietic, neurovascular, gastrointestinal and cutaneous subsyndromes. Clinical signs and symptoms are discussed for exposed individuals at the time of initial presentation (the prodromal phase) and during their course of disease (the manifest illness). In Section II, he presents clinical and laboratory methods to assess radiation doses, including time to onset and severity of vomiting, rate of decline in absolute blood lymphocyte count and the appearance of chromosome aberrations such as dicentrics and ring forms. Potential scenarios of a radiation terrorist event are reviewed, and methods for initial clinical assessment, triage, and early management of the acute radiation syndrome and its component subsyndromes are summarized. In Section III, Dr. Jamie Waselenko reviews the hematopoietic syndrome, and presents guidelines for the use of cytokine therapy, antibiotics, and supportive care that have been developed by the Strategic National Pharmaceutical Stockpile Working Group. Results of preclinical and

  6. Benefits of multidisciplinary collaboration for earthquake casualty estimation models: recent case studies

    NASA Astrophysics Data System (ADS)

    So, E.

    2010-12-01

    Earthquake casualty loss estimation, which depends primarily on building-specific casualty rates, has long suffered from a lack of cross-disciplinary collaboration in post-earthquake data gathering. An increase in our understanding of what contributes to casualties in earthquakes involve coordinated data-gathering efforts amongst disciplines; these are essential for improved global casualty estimation models. It is evident from examining past casualty loss models and reviewing field data collected from recent events, that generalized casualty rates cannot be applied globally for different building types, even within individual countries. For a particular structure type, regional and topographic building design effects, combined with variable material and workmanship quality all contribute to this multi-variant outcome. In addition, social factors affect building-specific casualty rates, including social status and education levels, and human behaviors in general, in that they modify egress and survivability rates. Without considering complex physical pathways, loss models purely based on historic casualty data, or even worse, rates derived from other countries, will be of very limited value. What’s more, as the world’s population, housing stock, and living and cultural environments change, methods of loss modeling must accommodate these variables, especially when considering casualties. To truly take advantage of observed earthquake losses, not only do damage surveys need better coordination of international and national reconnaissance teams, but these teams must integrate difference areas of expertise including engineering, public health and medicine. Research is needed to find methods to achieve consistent and practical ways of collecting and modeling casualties in earthquakes. International collaboration will also be necessary to transfer such expertise and resources to the communities in the cities which most need it. Coupling the theories and findings from

  7. Top Quark Mass in Events with two Charged Leptons at the D0 Experiment

    SciTech Connect

    Boline, Daniel Dooley

    2010-01-01

    The top quark is the most massive observed fundamental subatomic particle, and at the Tevatron accelerator is produced mostly in top-antitop (t$\\bar{t}$) quark pairs from the collisions of protons and anti-protons. Each top quark decays into a bottom quark and a W boson. The W boson can then decay into a pair of quarks, or into a charged lepton and a neutrino. The various decays can be broken up into three different channels based on the number of leptons from the decay of the W bosons: all-jets (with no leptons), lepton+jets (with one lepton), and dilepton (with two leptons). This dissertation will present a measurement of the top quark mass in the dilepton channel. The dilepton channel is characterized by two leptons, two neutrinos and two b-quarks. The neutrinos are not directly observed, but their absence is felt as missing transverse momentum (pT) in the detector. The combination of two leptons and large pT produces an easily isolated signal, giving the dilepton channel a high signal over background ratio. Having two neutrinos means that we cannot know what the transverse momenta of either neutrino is. This means that even if we knew the momenta of the leptons and b-quarks perfectly, we would be unable to reconstruct the mass of the top quark. This measurement gets around this problem by scanning over all possible values of the top mass, finding all consistent t{bar t} combinations, assigning a kinematic weight to each, and then adding the weights for each combination at a given possible top mass. The lepton momenta, jet momenta, and pT are only known to within some finite precision, so for a given top mass, I also vary each of these momenta within their resolutions and add the weights for a given possible top mass. After scanning over possible top masses, I choose the top mass with the largest sum of weights mtmax as an observable for the event. I then perform a template based likelihood fit of m

  8. Solar flares, coronal mass ejections and solar energetic particle event characteristics

    NASA Astrophysics Data System (ADS)

    Papaioannou, Athanasios; Sandberg, Ingmar; Anastasiadis, Anastasios; Kouloumvakos, Athanasios; Georgoulis, Manolis K.; Tziotziou, Kostas; Tsiropoula, Georgia; Jiggens, Piers; Hilgers, Alain

    2016-12-01

    A new catalogue of 314 solar energetic particle (SEP) events extending over a large time span from 1984 to 2013 has been compiled. The properties as well as the associations of these SEP events with their parent solar sources have been thoroughly examined. The properties of the events include the proton peak integral flux and the fluence for energies above 10, 30, 60 and 100 MeV. The associated solar events were parametrized by solar flare (SF) and coronal mass ejection (CME) characteristics, as well as related radio emissions. In particular, for SFs: the soft X-ray (SXR) peak flux, the SXR fluence, the heliographic location, the rise time and the duration were exploited; for CMEs the plane-of-sky velocity as well as the angular width were utilized. For radio emissions, type III, II and IV radio bursts were identified. Furthermore, we utilized element abundances of Fe and O. We found evidence that most of the SEP events in our catalogue do not conform to a simple two-class paradigm, with the 73% of them exhibiting both type III and type II radio bursts, and that a continuum of event properties is present. Although, the so-called hybrid or mixed events are found to be present in our catalogue, it was not possible to attribute each SEP event to a mixed/hybrid sub-category. Moreover, it appears that the start of the type III burst most often precedes the maximum of the SF and thus falls within the impulsive phase of the associated SF. At the same time, type III bursts take place within ≈5.22 min, on average, in advance from the time of maximum of the derivative of the SXR flux (Neupert effect). We further performed a statistical analysis and a mapping of the logarithm of the proton peak flux at E > 10 MeV, on different pairs of the parent solar source characteristics. This revealed correlations in 3-D space and demonstrated that the gradual SEP events that stem from the central part of the visible solar disk constitute a significant radiation risk. The velocity of

  9. Genetic Diversity and Local Connectivity in the Mediterranean Red Gorgonian Coral after Mass Mortality Events

    PubMed Central

    Pilczynska, Joanna; Cocito, Silvia; Boavida, Joana; Serrão, Ester; Queiroga, Henrique

    2016-01-01

    Estimating the patterns of connectivity in marine taxa with planktonic dispersive stages is a challenging but crucial task because of its conservation implications. The red gorgonian Paramuricea clavata is a habitat forming species, characterized by short larval dispersal and high reproductive output, but low recruitment. In the recent past, the species was impacted by mass mortality events caused by increased water temperatures in summer. In the present study, we used 9 microsatellites to investigate the genetic structure and connectivity in the highly threatened populations from the Ligurian Sea (NW Mediterranean). No evidence for a recent bottleneck neither decreased genetic diversity in sites impacted by mass mortality events were found. Significant IBD pattern and high global FST confirmed low larval dispersal capability in the red gorgonian. The maximum dispersal distance was estimated at 20–60 km. Larval exchange between sites separated by hundreds of meters and between different depths was detected at each site, supporting the hypothesis that deeper subpopulations unaffected by surface warming peaks may provide larvae for shallower ones, enabling recovery after climatically induced mortality events. PMID:26982334

  10. Genetic Diversity and Local Connectivity in the Mediterranean Red Gorgonian Coral after Mass Mortality Events.

    PubMed

    Pilczynska, Joanna; Cocito, Silvia; Boavida, Joana; Serrão, Ester; Queiroga, Henrique

    2016-01-01

    Estimating the patterns of connectivity in marine taxa with planktonic dispersive stages is a challenging but crucial task because of its conservation implications. The red gorgonian Paramuricea clavata is a habitat forming species, characterized by short larval dispersal and high reproductive output, but low recruitment. In the recent past, the species was impacted by mass mortality events caused by increased water temperatures in summer. In the present study, we used 9 microsatellites to investigate the genetic structure and connectivity in the highly threatened populations from the Ligurian Sea (NW Mediterranean). No evidence for a recent bottleneck neither decreased genetic diversity in sites impacted by mass mortality events were found. Significant IBD pattern and high global FST confirmed low larval dispersal capability in the red gorgonian. The maximum dispersal distance was estimated at 20-60 km. Larval exchange between sites separated by hundreds of meters and between different depths was detected at each site, supporting the hypothesis that deeper subpopulations unaffected by surface warming peaks may provide larvae for shallower ones, enabling recovery after climatically induced mortality events.

  11. Partnered disaster preparedness: lessons learned from international events.

    PubMed

    Born, Christopher T; Cullison, Thomas R; Dean, Jeffrey A; Hayda, Roman A; McSwain, Norman; Riddles, Lawrence M; Shimkus, Albert J

    2011-01-01

    Military, governmental, and civilian agencies routinely respond to disasters around the world, including large-scale mass casualty events such as the earthquake in Pakistan in 2005, Hurricane Katrina in the United States in 2005, and the earthquake in Haiti in 2010. Potential exists for improved coordination of medical response between civilian and military sectors and for the creation of a planned and practiced interface. Disaster preparedness could be enhanced with more robust disaster education for civilian responders; creation of a database of precredentialed, precertified medical specialists; implementation of a communication bridge; and the establishment of agreements between military and civilian medical/surgical groups in advance of major catastrophic events.

  12. The Tactical Combat Casualty Care Casualty Card TCCC Guidelines - Proposed Change 13-01

    DTIC Science & Technology

    2013-04-30

    Tactical (BMIS-T)—a PDA device . Neither format was felt to sufficiently meet the needs of the prehospital providers in the tactical environment. The...documentation on pain level 4 - Incorporates a section for supraglottic airway use - Provides a space for the type of supraglottic airway - Provides a...improve performance at the prehospital level of care. Tactical Combat Casualty Care (TCCC) based casualty cards, TCCC after action reports, and unit

  13. Exploring mass extinction events and their association with global warming events from muliproxy biomarker and isotopic approaches

    NASA Astrophysics Data System (ADS)

    Grice, K.; Nabbefeld, B.; Maslen, E.; Jaraula, C.; Holman, A.; Melendez, I.; Tulipani, S.; Twitchett, R.; Hays, L. E.; Summons, R. E.; Mella, L.; Williford, K. H.; McElwain, J.; Böttcher, M.

    2011-12-01

    The Late Permian mass extinction event was the most profound extinctions of the entire Phanerozoic. Biomarker evidence for photic zone euxinic (PZE) conditions within Permian/Triassic (P/Tr) setions, where concentrations of sulfide, are sufficient to support anoxygenic photosynthesis, come from components derived from pigments of Chlorobi. Evidence for such conditions occurred at 6 global localities from shallow marine settings. Perturbations in the redox-state of the ancient seas are also reflected in d34S of pyrite (e.g. from China, Italy, Iran, Western Australia, East Greenland, Western Canada and Spitsbergen) supporting widespread euxinic conditions in both Palaeotethys and Panthalassa oceans. The aromatic biomarkers, dibenzothiophene, dibenzofuran and biphenyl have been detected in high abundances in samples just before the onset of the marine ecosystem collapse in East Greenland, Spitsbergen, South China and Western Canada . We have proposed that lignin derived from land plants, present during the Late Permian is their likely source. We provide sedimentological data, biomarker abundances and compound specific isotopic data (δ13C and δD) along with bulk isotopes (δ34Spyrite, δ13Ccarbonate, δ13Corg) for several sections. At two localities sedimentological and geochemical data supports a marine transgression and collapse of the marine ecosystem occurring in the Late Permian. δ13C data of algal and land-plant derived biomarkers, δ13C carbonate and organic matter support synchronous changes in δ13C of marine and atmospheric CO2, attributed to a 13C-depleted source (13C depleted methane and/or CO2 derived from degradation of organic matter due to the marine ecosystem collapse). Evidence for waxing and waning of PZE throughout the Late Permian is provided by Chlorobi derived biomarkers and δ34S pyrite implying multiple phases of H2S outgassing and potentially several prolonged pulses of extinction at several global localities. We suggest that high levels of

  14. Triage of casualties after nuclear attack.

    PubMed

    Pledger, H G

    1986-09-20

    Casualties from a nuclear attack on the United Kingdom would overwhelm the health services, and health workers would be faced with many more people seeking help than could be offered treatment. Discussion is needed to determine which methods of medical and non-medical triage would be acceptable and feasible.

  15. Military Medical Revolution: Prehospital Combat Casualty Care

    DTIC Science & Technology

    2012-01-01

    Military medical revolution: Prehospital combat casualty care Lorne H. Blackbourne, MD, David G. Baer, PhD, Brian J. Eastridge, MD, Bijan Kheirabadi...sur- vival for patients with combat-related traumatic injuries. J Trauma. 2009;66(suppl 4):S69 S76. 33. Eastridge BJ, Hardin M, Cantrell J, Oetjen

  16. A comparison of solar energetic particle event timescales with properties of associated coronal mass ejections

    SciTech Connect

    Kahler, S. W.

    2013-06-01

    The dependence of solar energetic proton (SEP) event peak intensities Ip on properties of associated coronal mass ejections (CMEs) has been extensively examined, but the dependence of SEP event timescales is not well known. We define three timescales of 20 MeV SEP events and ask how they are related to speeds v {sub CME} or widths W of their associated CMEs observed by LASCO/SOHO. The timescales of the EPACT/Wind 20 MeV events are TO, the onset time from CME launch to SEP onset; TR, the rise time from onset to half the peak intensity (0.5Ip); and TD, the duration of the SEP intensity above 0.5Ip. This is a statistical study based on 217 SEP-CME events observed during 1996-2008. The large number of SEP events allows us to examine the SEP-CME relationship in five solar-source longitude ranges. In general, we statistically find that TO declines slightly with v {sub CME}, and TR and TD increase with both v {sub CME} and W. TO is inversely correlated with log Ip, as expected from a particle background effect. We discuss the implications of this result and find that a background-independent parameter TO+TR also increases with v {sub CME} and W. The correlations generally fall below the 98% significance level, but there is a significant correlation between v {sub CME} and W which renders interpretation of the timescale results uncertain. We suggest that faster (and wider) CMEs drive shocks and accelerate SEPs over longer times to produce the longer TR and TD SEP timescales.

  17. A Comparison of Solar Energetic Particle Event Timescales with Properties of Associated Coronal Mass Ejections

    NASA Astrophysics Data System (ADS)

    Kahler, S. W.

    2013-06-01

    The dependence of solar energetic proton (SEP) event peak intensities Ip on properties of associated coronal mass ejections (CMEs) has been extensively examined, but the dependence of SEP event timescales is not well known. We define three timescales of 20 MeV SEP events and ask how they are related to speeds v CME or widths W of their associated CMEs observed by LASCO/SOHO. The timescales of the EPACT/Wind 20 MeV events are TO, the onset time from CME launch to SEP onset; TR, the rise time from onset to half the peak intensity (0.5Ip); and TD, the duration of the SEP intensity above 0.5Ip. This is a statistical study based on 217 SEP-CME events observed during 1996-2008. The large number of SEP events allows us to examine the SEP-CME relationship in five solar-source longitude ranges. In general, we statistically find that TO declines slightly with v CME, and TR and TD increase with both v CM