Behavior of pediatric medical residents during a clinical simulation of a violent mother in a pediatric emergency.

PubMed

Enríquez, Diego; Gómez Traverso, Raúl; Szyld, Edgardo

2016-06-01

Physicians are frequently victims of both physical and verbal violence. Specific training is required for staff so that they are able to deal with these situations. To assess the clinical management and behavior of pediatric medical residents towards a violent mother during a pediatric emergency simulation. To assess the clinical management and behavior of pediatric medical residents towards a violent mother during a pediatric emergency simulation. Sixty-eight pediatric medical residents divided into 15 groups were observed. Twelve handled the episode appropriately; only two groups asked the security staff to remove the mother from the scene (recommended behavior). Other two groups managed to remove the mother from the clinical scenario but in the midst of struggles. Out of all physicians, 54.4% (n = 37) came into physical contact with the mother, and 95.6% had not previously received guidelines on how to manage violent situations. Only a few groups managed to remove the violent mother from the scene. Unconsented physical contact with the mother was one of the most commonly observed behaviors. A lack of institutional guidelines on how to handle violent situations was detected. patient simulation, violence, workplace violence. Sociedad Argentina de Pediatría.

A virtual reality system for the training of volunteers involved in health emergency situations.

PubMed

De Leo, Gianluca; Ponder, Michal; Molet, Tom; Fato, Marco; Thalmann, Daniel; Magnenat-Thalmann, Nadia; Bermano, Francesco; Beltrame, Francesco

2003-06-01

In order to guarantee an effective and punctual medical intervention to injured people involved in health emergency situations, where usually both professional and non-professional health operators are involved, a fast and accurate treatment has to be carried out. In case of catastrophic or very critical situations, non-professional operators who did not receive proper training (volunteers are among them) could be affected by psychological inhibitions. Their performances could slow down in such way that would affect the quality of the treatment and increase both direct and indirect costs. Our virtual reality system that is currently in use at the health care emergency center of San Martino Hospital in Genoa, Italy, has been designed and developed to check health emergency operators' capabilities to adopt correct decision-making procedures, to make optimal use of new technological equipment and to overcome psychological barriers. Our system is composed of (1) a high-end simulation PC, whose main functions are execution of the main software module, rendering of 3D scenes in stereo mode, rendering of sound, and control of data transmission from/to VR devices; (2) a low-end control PC, which controls the VR simulation running on the simulation PC, manages medical emergency simulation scenarios, introduces unexpected events to the simulation and controls the simulation difficulty level; (3) a magnetic-based motion tracking device used for head and hand tracking; (4) a wireless pair of shutter glasses together with a cathode ray tube wall projector; and (5) a high-end surround sound system. The expected benefits have been verified through the design and implementation of controlled clinical trials.

Effects of competing environmental variables and signage on route-choices in simulated everyday and emergency wayfinding situations.

PubMed

Vilar, Elisângela; Rebelo, Francisco; Noriega, Paulo; Duarte, Emília; Mayhorn, Christopher B

2014-01-01

This study examined the relative influence of environmental variables (corridor width and brightness) and signage (directional and exit signs), when presented in competition, on participants' route-choices in two situational variables (everyday vs. emergency), during indoor wayfinding in virtual environments. A virtual reality-based methodology was used. Thus, participants attempted to find a room (everyday situation) in a virtual hotel, followed by a fire-related emergency egress (emergency situation). Different behaviours were observed. In the everyday situation, for no-signs condition, participants choose mostly the wider and brighter corridors, suggesting a heavy reliance on the environmental affordances. Conversely, for signs condition, participants mostly complied with signage, suggesting a greater reliance on the signs rather than on the environmental cues. During emergency, without signage, reliance on environmental affordances seems to be affected by the intersection type. In the sign condition, the reliance on environmental affordances that started strong decreases along the egress route.

[Improvement of emergency physician education through simulator training. Consideration on the basis of the model project "NASimSaar25"].

PubMed

Armbruster, W; Kubulus, D; Schlechtriemen, T; Adler, J; Höhn, M; Schmidt, D; Duchêne, S; Steiner, P; Volk, T; Wrobel, M

2014-09-01

Prehospital emergency medicine is a challenge for trainee emergency physicians. Rare injuries and diseases as well as patients in extreme age groups can unexpectedly face emergency physicians. In the regulations on medical education the German Medical Association requires participation in 50 emergency missions under the supervision of an experienced emergency physician. This needs to be improved because on-the-job training does not generally represent the whole spectrum of emergency medicine and a good and structured training under on call conditions is nearly impossible. The subject of the model project described was whether practical training for emergency physicians can be achieved by participation in simulation training instead of real emergency situations. After modification of the Saarland regulations on medical education it was possible to replace up to 25 participations in emergency missions by simulation training. The concept of the course NASimSaar25 requires participants to complete 25 simulator cases in 3 days in small training groups. Emergency situations from all medical disciplines need to be treated. A special focus is on the treatment of life-threatening and rare diseases and injuries. Modern simulators and actors are used. The debriefings are conducted by experienced tutors based on approved principles. Medical contents, learning targets from the field of crew resource management (CRM) and soft skills are discussed in these debriefings. Education in the field of emergency medicine can be improved by simulator-based learning and training. However, practical work under a tutor in real and clinical experience cannot be completely replaced by simulation. Simulator training can only be successful if theoretical knowledge has already been acquired. A simulator-based course concept can result in an improvement of emergency medical education. The model project NASimSaar25 was well received by the target audience and mostly very well evaluated in terms of learning and reality. If this project becomes established the demand on simulation-based training will increase. The training should achieve a consistent standard of quality.

High-fidelity hybrid simulation of allergic emergencies demonstrates improved preparedness for office emergencies in pediatric allergy clinics.

PubMed

Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M

2013-01-01

Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P < .003). Follow-up in situ scenarios 10-12 months later demonstrated retention of skills training at both clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

ERCMExpress. Volume 2, Issue 3

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This issue of the Emergency Response and Crisis Management (ERCM) Technical Assistance Center's "ERCMExpress" promotes emergency exercises as an effective way to validate school safety plans. Simulations of emergency situations, or emergency exercises, are integral to a sound school safety plan. They offer opportunities for district and schools to…

A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study.

PubMed

Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M; Brolliar, Sarah; Golden, Simon J; Jones, Kerin A; Shah, Sachita; Grand, James A; Kozlowski, Steve W J; Chao, Georgia T; Fernandez, Rosemarie

2018-02-01

Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine (EM) teams. We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement. Interprofessional emergency medical teams, consisting of EM resident physicians, nurses, and medical students, were recruited from the University of Washington (Seattle, WA) and Wayne State University (Detroit, MI). Each team completed a simulated emergency resuscitation scenario. Immediately following the simulation, team members completed a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. Subject matter expert reviews and pilot testing of the TSA measure provided evidence of content and response process validity. Simulations were recorded and independently coded for team performance using a previously validated measure. The relationships between the TSA measure and other variables (team clinical performance, team perception of shared understanding, team leader effectiveness, and team experience) were explored. The TSA agreement metric was indexed by averaging the pairwise agreement for each dyad on a team and then averaging across dyads to yield agreement at the team level. For the team perception of shared understanding and team leadership effectiveness measures, individual team member scores were aggregated within a team to create a single team score. We computed descriptive statistics for all outcomes. We calculated Pearson's product-moment correlations to determine bivariate correlations between outcome variables with two-tailed significance testing (p < 0.05). A total of 123 participants were recruited and formed three-person teams (n = 41 teams). All teams completed the assessment scenario and postsimulation measures. TSA agreement ranged from 0.19 to 0.9 and had a mean (±SD) of 0.61 (±0.17). TSA correlated with team clinical performance (p < 0.05) but did not correlate with team perception of shared understanding, team leader effectiveness, or team experience. Team situational awareness supports adaptive teams and is critical for high reliability organizations such as healthcare systems. Simulation can provide a platform for research aimed at understanding and measuring TSA. This study provides a feasible method for simulation-based assessment of TSA in interdisciplinary teams that addresses prior measure limitations and is appropriate for use in highly dynamic, uncertain situations commonly encountered in emergency department systems. Future research is needed to understand the development of and interactions between individual-, team-, and system (distributed)-level cognitive processes. © 2017 by the Society for Academic Emergency Medicine.

Emergency Response Virtual Environment for Safe Schools

NASA Technical Reports Server (NTRS)

Wasfy, Ayman; Walker, Teresa

2008-01-01

An intelligent emergency response virtual environment (ERVE) that provides emergency first responders, response planners, and managers with situational awareness as well as training and support for safe schools is presented. ERVE incorporates an intelligent agent facility for guiding and assisting the user in the context of the emergency response operations. Response information folders capture key information about the school. The system enables interactive 3D visualization of schools and academic campuses, including the terrain and the buildings' exteriors and interiors in an easy to use Web..based interface. ERVE incorporates live camera and sensors feeds and can be integrated with other simulations such as chemical plume simulation. The system is integrated with a Geographical Information System (GIS) to enable situational awareness of emergency events and assessment of their effect on schools in a geographic area. ERVE can also be integrated with emergency text messaging notification systems. Using ERVE, it is now possible to address safe schools' emergency management needs with a scaleable, seamlessly integrated and fully interactive intelligent and visually compelling solution.

Social validation and training of emergency fire safety skills for potential injury prevention and life saving.

PubMed Central

Jones, R T; Kazdin, A E; Haney, J I

1981-01-01

A multifaceted behavioral program designed to teach emergency fire escape procedures to children was evaluated in a multiple-baseline design. Five children were trained to respond correctly to nine home emergency fire situations under simulated conditions. The situations and responses focused upon in training were identified by a social validation procedure involving consultation with several safety agencies, including the direct input of firefighters. Training, carried out in simulated bedrooms at school, resulted in significant improvements in both overt behavior and self-report of fire safety skills. The gains were maintained at a post-check assessment 2 weeks after training had been terminated. The results are discussed in relation both to the importance of social validation of targets and outcomes and the implications for further research in assessing and developing emergency response skills. PMID:7298537

PTSD, Acute Stress, Performance and Decision-Making in Emergency Service Workers.

PubMed

Regehr, Cheryl; LeBlanc, Vicki R

2017-06-01

Despite research identifying high levels of stress and traumatic stress symptoms among those in the emergency services, the impact of these symptoms on performance and hence public safety remains uncertain. This review paper discusses a program of research that has examined the effects of prior critical incident exposure, acute stress, and current post-traumatic symptoms on the performance and decision-making during an acutely stressful event among police officers, police communicators, paramedics and child protection workers. Four studies, using simulation methods involving video simulators, human-patient simulators, and/or standardized patients, examined the performance of emergency workers in typical workplace situations related to their individual profession. Results varied according to level of acuity of stress and the nature of performance and decision-making. There was no evidence that PTSD had a direct impact on global performance on tasks for which emergency responders are highly trained. However, PTSD was associated with assessment of risk in situations that required professional judgement. Further, individuals experiencing PTSD symptoms reported higher levels of acute stress when faced with high acuity situations. Acute stress in these studies was associated with performance deficits on complex cognitive tasks, verbal memory impairment and heightened assessment of risk. © 2017 American Academy of Psychiatry and the Law.

77 FR 38248 - Passenger Train Emergency Preparedness

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... plans to be excluded from the formal review and approval process required for more substantive... full-scale simulations of emergency situations; and Remove as unnecessary the section on the preemptive... proposed regulatory changes would enhance the emergency planning process currently in place in part 239...

Training program for the management of two obstetric emergencies within a French perinatal care network.

PubMed

Noblot, Edouard; Raia-Barjat, Tiphaine; Lajeunesse, Cecile; Trombert, Béatrice; Weiss, Stéphanie; Colombié, Maud; Chauleur, Céline

2015-06-01

To evaluate the effectiveness of an interdisciplinary team training program based on simulated scenarios and focusing on two obstetrical emergency situations: shoulder dystocia and complicated breech vaginal delivery (CBVD). These situations are rare, so there are few opportunities for real-life training, yet their competent and efficient management is crucial to minimizing the risks to mother and child. The target population for training comprised the 450 professionals working in the French regional perinatal care network ELENA. An expert committee defined the topics for the training program, selected the simulated scenarios and developed the evaluation grids. The training sessions were conducted by two qualified and experienced professionals in each maternity unit. They comprised a theoretical introduction followed by practical exercises in management of simulated emergency situations by the participant teams, with the aid of a mannequin. Each team completed the exercises twice, their performances being filmed, reviewed and evaluated in each case. The training sessions took place over 9 months between September 2012 and June 2013. A total of 298 professionals (obstetricians, residents in obstetrics, midwives and nursery nurses) were trained, representing 75% of the staff working in the ELENA perinatal care network. The results showed substantial and significant increases in the overall scores for management of the two emergency situations (from 74.5% to 91.4% for shoulder dystocia [p<0.0001], and from 67.2% to 88.4% [p<0.0001] for CBVD) as well as in the scores for all the specific areas of expertise assessed: safety, know-how, technique, team communication and communication with the patient. This study demonstrated the value of multidisciplinary team training for obstetric emergencies, encouraging the ELENA perinatal care network to implement an annual training program for its staff. Over and above our experience, the future establishment of a national education program to optimize the management of obstetric emergencies seems to be essential. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Simulation and Shoulder Dystocia.

PubMed

Shaddeau, Angela K; Deering, Shad

2016-12-01

Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury. Given the evidence, simulation training for shoulder dystocia should be conducted at all institutions that provide delivery services.

Measuring situation awareness in emergency settings: a systematic review of tools and outcomes

PubMed Central

Cooper, Simon; Porter, Joanne; Peach, Linda

2014-01-01

Background Nontechnical skills have an impact on health care outcomes and improve patient safety. Situation awareness is core with the view that an understanding of the environment will influence decision-making and performance. This paper reviews and describes indirect and direct measures of situation awareness applicable for emergency settings. Methods Electronic databases and search engines were searched from 1980 to 2010, including CINAHL, Ovid Medline, Pro-Quest, Cochrane, and the search engine, Google Scholar. Access strategies included keyword, author, and journal searches. Publications identified were assessed for relevance, and analyzed and synthesized using Oxford evidence levels and the Critical Appraisal Skills Programme guidelines in order to assess their quality and rigor. Results One hundred and thirteen papers were initially identified, and reduced to 55 following title and abstract review. The final selection included 14 papers drawn from the fields of emergency medicine, intensive care, anesthetics, and surgery. Ten of these discussed four general nontechnical skill measures (including situation awareness) and four incorporated the Situation Awareness Global Assessment Technique. Conclusion A range of direct and indirect techniques for measuring situation awareness is available. In the medical literature, indirect approaches are the most common, with situation awareness measured as part of a nontechnical skills assessment. In simulation-based studies, situation awareness in emergencies tends to be suboptimal, indicating the need for improved training techniques to enhance awareness and improve decision-making. PMID:27147872

Leading teams during simulated pediatric emergencies: a pilot study

PubMed Central

Coolen, Ester H; Draaisma, Jos M; den Hamer, Sabien; Loeffen, Jan L

2015-01-01

Purpose Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. PMID:25610010

EEG potentials predict upcoming emergency brakings during simulated driving

NASA Astrophysics Data System (ADS)

Haufe, Stefan; Treder, Matthias S.; Gugler, Manfred F.; Sagebaum, Max; Curio, Gabriel; Blankertz, Benjamin

2011-10-01

Emergency braking assistance has the potential to prevent a large number of car crashes. State-of-the-art systems operate in two stages. Basic safety measures are adopted once external sensors indicate a potential upcoming crash. If further activity at the brake pedal is detected, the system automatically performs emergency braking. Here, we present the results of a driving simulator study indicating that the driver's intention to perform emergency braking can be detected based on muscle activation and cerebral activity prior to the behavioural response. Identical levels of predictive accuracy were attained using electroencephalography (EEG), which worked more quickly than electromyography (EMG), and using EMG, which worked more quickly than pedal dynamics. A simulated assistance system using EEG and EMG was found to detect emergency brakings 130 ms earlier than a system relying only on pedal responses. At 100 km h-1 driving speed, this amounts to reducing the braking distance by 3.66 m. This result motivates a neuroergonomic approach to driving assistance. Our EEG analysis yielded a characteristic event-related potential signature that comprised components related to the sensory registration of a critical traffic situation, mental evaluation of the sensory percept and motor preparation. While all these components should occur often during normal driving, we conjecture that it is their characteristic spatio-temporal superposition in emergency braking situations that leads to the considerable prediction performance we observed.

EEG potentials predict upcoming emergency brakings during simulated driving.

PubMed

Haufe, Stefan; Treder, Matthias S; Gugler, Manfred F; Sagebaum, Max; Curio, Gabriel; Blankertz, Benjamin

2011-10-01

Emergency braking assistance has the potential to prevent a large number of car crashes. State-of-the-art systems operate in two stages. Basic safety measures are adopted once external sensors indicate a potential upcoming crash. If further activity at the brake pedal is detected, the system automatically performs emergency braking. Here, we present the results of a driving simulator study indicating that the driver's intention to perform emergency braking can be detected based on muscle activation and cerebral activity prior to the behavioural response. Identical levels of predictive accuracy were attained using electroencephalography (EEG), which worked more quickly than electromyography (EMG), and using EMG, which worked more quickly than pedal dynamics. A simulated assistance system using EEG and EMG was found to detect emergency brakings 130 ms earlier than a system relying only on pedal responses. At 100 km h(-1) driving speed, this amounts to reducing the braking distance by 3.66 m. This result motivates a neuroergonomic approach to driving assistance. Our EEG analysis yielded a characteristic event-related potential signature that comprised components related to the sensory registration of a critical traffic situation, mental evaluation of the sensory percept and motor preparation. While all these components should occur often during normal driving, we conjecture that it is their characteristic spatio-temporal superposition in emergency braking situations that leads to the considerable prediction performance we observed.

Pedestrians’ behavior in emergency evacuation: Modeling and simulation

NASA Astrophysics Data System (ADS)

Wang, Lei; Zheng, Jie-Hui; Zhang, Xiao-Shuang; Zhang, Jian-Lin; Wang, Qiu-Zhen; Zhang, Qian

2016-11-01

The social force model has been widely used to simulate pedestrian evacuation by analyzing attractive, repulsive, driving, and fluctuating forces among pedestrians. Many researchers have improved its limitations in simulating behaviors of large-scale population. This study modifies the well-accepted social force model by considering the impacts of interaction among companions and further develops a comprehensive model by combining that with a multi-exit utility function. Then numerical simulations of evacuations based on the comprehensive model are implemented in the waiting hall of the Wulin Square Subway Station in Hangzhou, China. The results provide safety thresholds of pedestrian density and panic levels in different operation situations. In spite of the operation situation and the panic level, a larger friend-group size results in lower evacuation efficiency. Our study makes important contributions to building a comprehensive multi-exit social force model and to applying it to actual scenarios, which produces data to facilitate decision making in contingency plans and emergency treatment. Project supported by the National Natural Science Foundation of China (Grant No. 71471163).

In situ medical simulation investigation of emergency department procedural sedation with randomized trial of experimental bedside clinical process guidance intervention.

PubMed

Siegel, Nathan A; Kobayashi, Leo; Dunbar-Viveiros, Jennifer A; Devine, Jeffrey; Al-Rasheed, Rakan S; Gardiner, Fenwick G; Olsson, Krister; Lai, Stella; Jones, Mark S; Dannecker, Max; Overly, Frank L; Gosbee, John W; Portelli, David C; Jay, Gregory D

2015-06-01

Patient safety during emergency department procedural sedation (EDPS) can be difficult to study. Investigators sought to delineate and experimentally assess EDPS performance and safety practices of senior-level emergency medicine residents through in situ simulation. Study sessions used 2 pilot-tested EDPS scenarios with critical action checklists, institutional forms, embedded probes, and situational awareness questionnaires. An experimental informatics system was separately developed for bedside EDPS process guidance. Postgraduate year 3 and 4 subjects completed both scenarios in randomized order; only experimental subjects were provided with the experimental system during second scenarios. Twenty-four residents were recruited into a control group (n = 12; 6.2 ± 7.4 live EDPS experience) and experimental group (n = 12; 11.3 ± 8.2 live EDPS experience [P = 0.10]). Critical actions for EDPS medication selection, induction, and adverse event recognition with resuscitation were correctly performed by most subjects. Presedation evaluations, sedation rescue preparation, equipment checks, time-outs, and documentation were frequently missed. Time-outs and postsedation assessments increased during second scenarios in the experimental group. Emergency department procedural sedation safety probe detection did not change across scenarios in either group. Situational awareness scores were 51% ± 7% for control group and 58% ± 12% for experimental group. Subjects using the experimental system completed more time-outs and scored higher Simulation EDPS Safety Composite Scores, although without comprehensive improvements in EDPS practice or safety. Study simulations delineated EDPS and assessed safety behaviors in senior emergency medicine residents, who exhibited the requisite medical knowledge base and procedural skill set but lacked some nontechnical skills that pertain to emergency department microsystem functions and patient safety. The experimental system exhibited limited impact only on in-simulation time-out compliance.

What the drivers do and do not tell you: using verbal protocol analysis to investigate driver behaviour in emergency situations.

PubMed

Banks, Victoria A; Stanton, Neville A; Harvey, Catherine

2014-01-01

Although task analysis of pedestrian detection can provide us with useful insights into how a driver may behave in emergency situations, the cognitive elements of driver decision-making are less well understood. To assist in the design of future Advanced Driver Assistance Systems, such as Autonomous Emergency Brake systems, it is essential that the cognitive elements of the driving task are better understood. This paper uses verbal protocol analysis in an exploratory fashion to uncover the thought processes underlying behavioural outcomes represented by hard data collected using the Southampton University Driving Simulator.

Performance recovery following startle : a laboratory approach to the study of behavioral response to sudden aircraft emergencies.

DOT National Transportation Integrated Search

1988-08-01

This paper deals with the use of response/recovery rate to auditory startle as a laboratory technique for simulating some of the principal aspects of the initial shock phase of sudden emergency situations. It is submitted that auditory startle, with ...

14 CFR 121.417 - Crewmember emergency training.

Code of Federal Regulations, 2014 CFR

2014-01-01

... fire extinguishers, with emphasis on type of extinguisher to be used on different classes of fires; and... handling of emergency situations including— (i) Rapid decompression; (ii) Fire in flight or on the surface... crewmember combats an actual or simulated fire using at least one type of installed hand fire extinguisher or...

14 CFR 121.417 - Crewmember emergency training.

Code of Federal Regulations, 2013 CFR

2013-01-01

... fire extinguishers, with emphasis on type of extinguisher to be used on different classes of fires; and... handling of emergency situations including— (i) Rapid decompression; (ii) Fire in flight or on the surface... crewmember combats an actual or simulated fire using at least one type of installed hand fire extinguisher or...

14 CFR 121.417 - Crewmember emergency training.

Code of Federal Regulations, 2012 CFR

2012-01-01

... fire extinguishers, with emphasis on type of extinguisher to be used on different classes of fires; and... handling of emergency situations including— (i) Rapid decompression; (ii) Fire in flight or on the surface... crewmember combats an actual or simulated fire using at least one type of installed hand fire extinguisher or...

Simulating large-scale pedestrian movement using CA and event driven model: Methodology and case study

NASA Astrophysics Data System (ADS)

Li, Jun; Fu, Siyao; He, Haibo; Jia, Hongfei; Li, Yanzhong; Guo, Yi

2015-11-01

Large-scale regional evacuation is an important part of national security emergency response plan. Large commercial shopping area, as the typical service system, its emergency evacuation is one of the hot research topics. A systematic methodology based on Cellular Automata with the Dynamic Floor Field and event driven model has been proposed, and the methodology has been examined within context of a case study involving the evacuation within a commercial shopping mall. Pedestrians walking is based on Cellular Automata and event driven model. In this paper, the event driven model is adopted to simulate the pedestrian movement patterns, the simulation process is divided into normal situation and emergency evacuation. The model is composed of four layers: environment layer, customer layer, clerk layer and trajectory layer. For the simulation of movement route of pedestrians, the model takes into account purchase intention of customers and density of pedestrians. Based on evacuation model of Cellular Automata with Dynamic Floor Field and event driven model, we can reflect behavior characteristics of customers and clerks at the situations of normal and emergency evacuation. The distribution of individual evacuation time as a function of initial positions and the dynamics of the evacuation process is studied. Our results indicate that the evacuation model using the combination of Cellular Automata with Dynamic Floor Field and event driven scheduling can be used to simulate the evacuation of pedestrian flows in indoor areas with complicated surroundings and to investigate the layout of shopping mall.

Integrating team training strategies into obstetrical emergency simulation training.

PubMed

Daniel, Linda T; Simpson, Ellen K

2009-01-01

Successful management of obstetrical emergencies such as shoulder dystocia requires the coordinated efforts of a multidisciplinary team of professionals. Simulation education provides an opportunity to learn and master simple as well as complex technical skills needed in emergent situations. Team training has been shown to improve the quality of communication among team members and consequently has an enormous impact on human performance. In the healthcare environment, especially obstetrics where the stakes are high, integrating team training into simulation education can advance efforts to create and sustain a culture of safety. With over 7,100 deliveries annually, our 1,100-bed, two-hospital regional healthcare system embarked on this journey to advance the culture of safety.

Theorising Simulation in Higher Education: Difficulty for Learners as an Emergent Phenomenon

ERIC Educational Resources Information Center

Abrandt Dahlgren, Madeleine; Fenwick, Tara; Hopwood, Nick

2016-01-01

Despite the widespread interest in using and researching simulation in higher education, little discussion has yet to address a key pedagogical concern: difficulty. A "sociomaterial" view of learning, explained in this paper, goes beyond cognitive considerations to highlight dimensions of material, situational, representational and…

Emerging Team Leader Dynamics in Contingent Situations: A Doctoral-Level Simulation

ERIC Educational Resources Information Center

Rojas, Ronald

2017-01-01

The literature on how a team leader emerges during the initial stages of a team formation presents a divergent landscape of possibilities. Most of the approaches focus on attributes, personality types, the influence of social tendencies, or relational capabilities. Yet these different theories and models suggest that many questions remain on this…

The effect of a performance-based intra-procedural checklist on a simulated emergency laparoscopic task in novice surgeons.

PubMed

El Boghdady, Michael; Tang, Benjie; Alijani, Afshin

2017-05-01

Surgical checklists are in use as means to reduce errors. Checklists are infrequently applied during emergency situations in surgery. We aimed to study the effect of a simple self-administered performance-based checklist on the laparoscopic task when applied during an emergency-simulated scenario. The aviation checklist for unexpected situations is commonly used for simulated training of pilots to handle emergency during flights. This checklist was adopted for use as a standardised-performance-based checklist during emergency surgical tasks. Thirty consented laparoscopic novices were exposed unexpectedly to a bleeding vessel in a laparoscopic virtual reality simulator as an emergency scenario. The task consisted of using laparoscopic clips to achieve haemostasis. Subjects were randomly allocated into two equal groups; those using the checklist that was applied once every 20 s (checklist group) and those without (control group). The checklist group performed significantly better in 5 out of 7 technical factors when compared to the control group: right instrument path length (m), median (IQR) 1.44 [1.22] versus 2.06 [1.70] (p = 0.029), right instrument angular path (degree) 312.10 (269.44 versus 541.80 [455.16] (p = 0.014), left instrument path length (m) 1.20 [0.60] versus 2.08 [2.02] (p = 0.004), and left instrument angular path (degree) 277.62 [132.11] versus 385.88 [428.42] (p = 0.017). The checklist group committed significantly fewer number of errors in the application of haemostatic clips, 3 versus 28 (p = 0.006). Although statistically not significant, total blood loss (lit) decreased in the checklist group from 0.83 [1.23] to 0.78 [0.28] (p = 0.724) and total time (sec) from 186.51 [145.69] to 125.14 [101.46] (p = 0.165). The performance-based intra-procedural checklist significantly enhanced the surgical task performance of novices in an emergency-simulated scenario.

Design of a Serious Game for Handling Obstetrical Emergencies.

PubMed

Jean Dit Gautier, Estelle; Bot-Robin, Virginie; Libessart, Aurélien; Doucède, Guillaume; Cosson, Michel; Rubod, Chrystèle

2016-12-21

The emergence of new technologies in the obstetrical field should lead to the development of learning applications, specifically for obstetrical emergencies. Many childbirth simulations have been recently developed. However, to date none of them have been integrated into a serious game. Our objective was to design a new type of immersive serious game, using virtual glasses to facilitate the learning of pregnancy and childbirth pathologies. We have elaborated a new game engine, placing the student in some maternity emergency situations and delivery room simulations. A gynecologist initially wrote a scenario based on a real clinical situation. He also designed, along with an educational engineer, a tree diagram, which served as a guide for dialogues and actions. A game engine, especially developed for this case, enabled us to connect actions to the graphic universe (fully 3D modeled and based on photographic references). We used the Oculus Rift in order to immerse the player in virtual reality. Each action in the game was linked to a certain number of score points, which could either be positive or negative. Different pathological pregnancy situations have been targeted and are as follows: care of spontaneous miscarriage, threat of preterm birth, forceps operative delivery for fetal abnormal heart rate, and reduction of a shoulder dystocia. The first phase immerses the learner into an action scene, as a doctor. The second phase ask the student to make a diagnosis. Once the diagnosis is made, different treatments are suggested. Our serious game offers a new perspective for obstetrical emergency management trainings and provides students with active learning by immersing them into an environment, which recreates all or part of the real obstetrical world of emergency. It is consistent with the latest recommendations, which clarify the importance of simulation in teaching and in ongoing professional development. ©Estelle Jean dit Gautier, Virginie Bot-Robin, Aurélien Libessart, Guillaume Doucède, Michel Cosson, Chrystèle Rubod. Originally published in JMIR Serious Games (http://games.jmir.org), 21.12.2016.

Using Simulation to Examine the Effect of Physician Heterogeneity on the Operational Efficiency of an Overcrowded Hospital Emergency Department

NASA Astrophysics Data System (ADS)

Kuo, Y.-H.; Leung, J. M. Y.; Graham, C. A.

2015-05-01

In this paper, we present a case study of modelling and analyzing the patient flow of a hospital emergency department in Hong Kong. The emergency department is facing the challenge of overcrowding and the patients there usually experience a long waiting time. Our project team was requested by a senior consultant of the emergency department to analyze the patient flow and provide a decision support tool to help improve their operations. We adopt a simulation approach to mimic their daily operations. With the simulation model, we conduct a computational study to examine the effect of physician heterogeneity on the emergency department performance. We found that physician heterogeneity has a great impact on the operational efficiency and thus should be considered when developing simulation models. Our computational results show that, with the same average of service rates among the physicians, variation in the rates can improve overcrowding situation. This suggests that emergency departments may consider having some efficient physicians to speed up the overall service rate in return for more time for patients who need extra medical care.

EEG-Based Detection of Braking Intention Under Different Car Driving Conditions

PubMed Central

Hernández, Luis G.; Mozos, Oscar Martinez; Ferrández, José M.; Antelis, Javier M.

2018-01-01

The anticipatory recognition of braking is essential to prevent traffic accidents. For instance, driving assistance systems can be useful to properly respond to emergency braking situations. Moreover, the response time to emergency braking situations can be affected and even increased by different driver's cognitive states caused by stress, fatigue, and extra workload. This work investigates the detection of emergency braking from driver's electroencephalographic (EEG) signals that precede the brake pedal actuation. Bioelectrical signals were recorded while participants were driving in a car simulator while avoiding potential collisions by performing emergency braking. In addition, participants were subjected to stress, workload, and fatigue. EEG signals were classified using support vector machines (SVM) and convolutional neural networks (CNN) in order to discriminate between braking intention and normal driving. Results showed significant recognition of emergency braking intention which was on average 71.1% for SVM and 71.8% CNN. In addition, the classification accuracy for the best participant was 80.1 and 88.1% for SVM and CNN, respectively. These results show the feasibility of incorporating recognizable driver's bioelectrical responses into advanced driver-assistance systems to carry out early detection of emergency braking situations which could be useful to reduce car accidents. PMID:29910722

Assessing physician leadership styles: application of the situational leadership model to transitions in patient acuity.

PubMed

Skog, Alexander; Peyre, Sarah E; Pozner, Charles N; Thorndike, Mary; Hicks, Gloria; Dellaripa, Paul F

2012-01-01

The situational leadership model suggests that an effective leader adapts leadership style depending on the followers' level of competency. We assessed the applicability and reliability of the situational leadership model when observing residents in simulated hospital floor-based scenarios. Resident teams engaged in clinical simulated scenarios. Video recordings were divided into clips based on Emergency Severity Index v4 acuity scores. Situational leadership styles were identified in clips by two physicians. Interrater reliability was determined through descriptive statistical data analysis. There were 114 participants recorded in 20 sessions, and 109 clips were reviewed and scored. There was a high level of interrater reliability (weighted kappa r = .81) supporting situational leadership model's applicability to medical teams. A suggestive correlation was found between frequency of changes in leadership style and the ability to effectively lead a medical team. The situational leadership model represents a unique tool to assess medical leadership performance in the context of acuity changes.

Prototyping and validating requirements of radiation and nuclear emergency plan simulator

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

Hamid, AHA., E-mail: amyhamijah@nm.gov.my; Faculty of Computing, Universiti Teknologi Malaysia; Rozan, MZA.

2015-04-29

Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation wasmore » carried on to endorse the correctness of the model itself against the stakeholder’s intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties’ absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.« less

Prototyping and validating requirements of radiation and nuclear emergency plan simulator

NASA Astrophysics Data System (ADS)

Hamid, AHA.; Rozan, MZA.; Ibrahim, R.; Deris, S.; Selamat, A.

2015-04-01

Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder's intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties' absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.

Integrated Modeling, Mapping, and Simulation (IMMS) Framework for Exercise and Response Planning

NASA Technical Reports Server (NTRS)

Mapar, Jalal; Hoette, Trisha; Mahrous, Karim; Pancerella, Carmen M.; Plantenga, Todd; Yang, Christine; Yang, Lynn; Hopmeier, Michael

2011-01-01

EmergenCy management personnel at federal, stale, and local levels can benefit from the increased situational awareness and operational efficiency afforded by simulation and modeling for emergency preparedness, including planning, training and exercises. To support this goal, the Department of Homeland Security's Science & Technology Directorate is funding the Integrated Modeling, Mapping, and Simulation (IMMS) program to create an integrating framework that brings together diverse models for use by the emergency response community. SUMMIT, one piece of the IMMS program, is the initial software framework that connects users such as emergency planners and exercise developers with modeling resources, bridging the gap in expertise and technical skills between these two communities. SUMMIT was recently deployed to support exercise planning for National Level Exercise 2010. Threat, casualty. infrastructure, and medical surge models were combined within SUMMIT to estimate health care resource requirements for the exercise ground truth.

Simulation trainer for practicing emergent open thoracotomy procedures.

PubMed

Hamilton, Allan J; Prescher, Hannes; Biffar, David E; Poston, Robert S

2015-07-01

An emergent open thoracotomy (OT) is a high-risk, low-frequency procedure uniquely suited for simulation training. We developed a cost-effective Cardiothoracic (CT) Surgery trainer and assessed its potential for improving technical and interprofessional skills during an emergent simulated OT. We modified a commercially available mannequin torso with artificial tissue models to create a custom CT Surgery trainer. The trainer's feasibility for simulating emergent OT was tested using a multidisciplinary CT team in three consecutive in situ simulations. Five discretely observable milestones were identified as requisite steps in carrying out an emergent OT; namely (1) diagnosis and declaration of a code situation, (2) arrival of the code cart, (3) arrival of the thoracotomy tray, (4) initiation of the thoracotomy incision, and (5) defibrillation of a simulated heart. The time required for a team to achieve each discrete step was measured by an independent observer over the course of each OT simulation trial and compared. Over the course of the three OT simulation trials conducted in the coronary care unit, there was an average reduction of 29.5% (P < 0.05) in the times required to achieve the five critical milestones. The time required to complete the whole OT procedure improved by 7 min and 31 s from the initial to the final trial-an overall improvement of 40%. In our preliminary evaluation, the CT Surgery trainer appears to be useful for improving team performance during a simulated emergent bedside OT in the coronary care unit. Copyright © 2015 Elsevier Inc. All rights reserved.

Error Detection-Based Model to Assess Educational Outcomes in Crisis Resource Management Training: A Pilot Study.

PubMed

Bouhabel, Sarah; Kay-Rivest, Emily; Nhan, Carol; Bank, Ilana; Nugus, Peter; Fisher, Rachel; Nguyen, Lily Hp

2017-06-01

Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors. Some examples of CRM principles include cultivating situational awareness; promoting proper use of available resources; and improving rapid decision making, particularly in high-acuity, low-frequency clinical situations. Our pilot project sought to integrate CRM principles into an airway simulation course for OTL-HNS residents, but most important, it evaluated whether learning objectives were met, through use of a novel error identification model.

Helicopter Evacuation Following a Rural Trauma: An Emergency Medicine Simulation Scenario Using Innovative Simulation Technology

PubMed Central

Whalen, Desmond; Harty, Chris; Ravalia, Mohamed; Renouf, Tia; Alani, Sabrina; Brown, Robert

2016-01-01

The relevance of simulation as a teaching tool for medical professionals working in rural and remote contexts is apparent when low-frequency, high-risk situations are considered. Simulation training has been shown to enhance learning and improve patient outcomes in urban settings. However, there are few simulation scenarios designed to teach rural trauma management during complex medical transportation. In this technical report, we present a scenario using a medevac helicopter (Replica of Sikorsky S-92 designed by Virtual Marine Technology, St. John's, NL) at a rural community. This case can be used for training primary care physicians who are working in a rural or remote setting, or as an innovative addition to emergency medicine and pre-hospital care training programs. PMID:27081585

Nursing students' experiences of being video-recorded during examination in a fictive emergency care situation.

PubMed

Nyström, Anita; Pålsson, Ylva; Hofsten, Anna; Häggström, Elisabeth

2014-10-01

Promoting undergraduate nursing students' learning in simulated care can be achieved through dynamic scenario-based training sessions that are documented using simple video equipment. One valuable aspect of this kind of training is the subsequent reflective dialogue that takes place between the teacher and the students during the examination. The aim of the present paper is to describe bachelor nursing students' experiences of being video-recorded during an examination with a simulated patient in emergency care. The study was descriptive in design and used a qualitative approach with written answers to open-ended questions; 44 undergraduate nursing students participated. A latent content analysis resulted in three themes: (i) visualization might cause nervousness at first; (ii) visualization promotes dialogue and acknowledgement; and (iii) visualization promotes increased self-knowledge and professional growth. The conclusion is that video-recording is a good way for undergraduate nursing students to develop skills in emergency care situations and to understand their own actions; it might also help them increase their self-knowledge. © 2013 Wiley Publishing Asia Pty Ltd.

Task management skills and their deficiencies during care delivery in simulated medical emergency situation: A classification.

PubMed

Morineau, Thierry; Chapelain, Pascal; Quinio, Philippe

2016-06-01

Our objective was to develop the analysis of task management skills by proposing a framework classifying task management stages and deficiencies. Few studies of non-technical skills have detailed the components of task management skills through behavioural markers, despite their central role in care delivery. A post hoc qualitative behavioural analysis was performed of recordings made of professional training sessions based upon simulated scenarios. Four recorded sessions in a high-fidelity simulation setting were observed and recorded. Two scenarios were used (cardiac arrest and respiratory failure), and there were two training sessions per scenario. Four types of task management deficiencies were identified with regards to task constraints: constraint relaxation, unsatisfied constraints, additional constraints and constraint transgression. Both equipment and space constraints were also identified. The lack of prerequisite actions when preparing the environment, corequisite actions for equipment and protocol monitoring, or postrequisite actions to restore the environment were associated with task management deficiencies. Deficiencies in task management behaviours can be identified in simulated as well as actual medical emergency settings. This framework opens perspectives for both training caregivers and designing ergonomic work situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Multitasking simulation: Present application and future directions.

PubMed

Adams, Traci Nicole; Rho, Jason C

2017-02-01

The Accreditation Council for Graduate Medical Education lists multi-tasking as a core competency in several medical specialties due to increasing demands on providers to manage the care of multiple patients simultaneously. Trainees often learn multitasking on the job without any formal curriculum, leading to high error rates. Multitasking simulation training has demonstrated success in reducing error rates among trainees. Studies of multitasking simulation demonstrate that this type of simulation is feasible, does not hinder the acquisition of procedural skill, and leads to better performance during subsequent periods of multitasking. Although some healthcare agencies have discouraged multitasking due to higher error rates among multitasking providers, it cannot be eliminated entirely in settings such as the emergency department in which providers care for more than one patient simultaneously. Simulation can help trainees to identify situations in which multitasking is inappropriate, while preparing them for situations in which multitasking is inevitable.

Development of a simulation program for two-lane highway analysis.

DOT National Transportation Integrated Search

2009-12-30

In this research, a multimodal transportation model was developed attending the needs of emergency situations, and the solutions provided by the model could be used to moderate congestion during such events. The model incorporated features such as la...

A randomized controlled trial of simulation-based training for ear, nose, and throat emergencies.

PubMed

Smith, Matthew Edward; Navaratnam, Annakan; Jablenska, Lily; Dimitriadis, Panagiotis A; Sharma, Rishi

2015-08-01

Life-threatening ear, nose, and throat (ENT) emergencies are uncommon but require immediate skilled management. We investigated if traditional lecture-based teaching can be improved by a simulation and lecture hybrid approach. A single-blinded, prospective, randomized controlled trial. Two groups of interns with no previous ENT experience were randomized to one of two training groups: a simulation/lecture hybrid group or a lecture-only control group. Both groups received 90 minutes of training covering the assessment of critically ill patients and four ENT emergency topics. Both groups received the same initial lecture slides. The control group received additional slides, and the simulation group received simulated emergency scenario training using basic mannequins. Following the training, candidates were asked to provide feedback on their perception of training, and they were formally assessed with a standardized one-to-one viva. Thirty-eight interns were recruited: 18 in the control group and 20 in the simulation group. The candidates in the simulation group performed significantly better in all viva situations (P < .05) and had better perception of learning (P < .05). Additionally, the simulation group was more likely to recommend the training to a colleague (P < .05). We have demonstrated that replacing traditional lecture-based training with a mixture of lectures and emergency scenario simulation is more effective at preparing junior doctors for ENT emergencies, and better met their learning needs. Implementing this kind of teaching is feasible with a minimum of additional resources or time. 1b © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Ventilation through a small-bore catheter: optimizing expiratory ventilation assistance.

PubMed

Hamaekers, A E W; Borg, P A J; Götz, T; Enk, D

2011-03-01

Emergency ventilation through a small-bore transtracheal catheter can be lifesaving in a 'cannot intubate, cannot ventilate' situation. Ejectors, capable of creating suction by the Bernoulli principle, have been proposed to facilitate expiration through small-bore catheters. In this bench study, we compared a novel, purpose-built ventilation ejector (DE 5) with a previously proposed, modified industrial ejector (SBP 07). The generated insufflation pressures, suction pressures in static and dynamic situations, and also suction capacities and entrainment ratios of the SBP 07 and the DE 5 were determined. The DE 5 was also tested in a lung simulator with a simulated complete upper airway obstruction. Inspiratory and expiratory times through a transtracheal catheter were measured at various flow rates and achievable minute volumes were calculated. In a static situation, the SBP 07 showed a more negative pressure build-up compared with the DE 5. However, in a dynamic situation, the DE 5 generated a more negative pressure, resulting in a higher suction capacity. Employment of the DE 5 at a flow rate of 18 litre min(-1) allowed a minute volume through the transtracheal catheter of up to 8.27 litre min(-1) at a compliance of 100 ml cm H(2)O(-1). The efficiency of the DE 5 depended on the flow rate of the driving gas and the compliance of the lung simulator. In laboratory tests, the DE 5 is an optimized ventilation ejector suitable for applying expiratory ventilation assistance. Further research may confirm the clinical applicability as a portable emergency ventilator for use with small-bore catheters.

Three-dimensional Virtual Simulation of Oil Spill of Yangtze River in Chongqing Area Based on Emergency Decision

NASA Astrophysics Data System (ADS)

Chen, Shuzhe; Huang, Liwen

the river of Yangtze River in Chongqing area is continuous curved. Hydrology and channel situation is complex, and the transportation is busy. With the increasing of shipments of hazardous chemicals year by year, oil spill accident risk is rising. So establishment of three-dimensional virtual simulation of oil spill and its application in decision-making has become an urgent task. This paper detailed the process of three-dimensional virtual simulation of oil spill and established a system of three-dimensional virtual Simulation of oil spill of Yangtze River in Chongqing area by establishing an oil spill model of the Chongqing area based on oil particles model, and the system has been used in emergency decision to provide assistance for the oil spill response.

Acute stress in residents during emergency care: a study of personal and situational factors.

PubMed

Dias, Roger Daglius; Scalabrini Neto, Augusto

2017-05-01

Providing care for simulated emergency patients may induce considerable acute stress in physicians. However, the acute stress provoked in a real-life emergency room (ER) is not well known. Our aim was to assess acute stress responses in residents during real emergency care and investigate the related personal and situational factors. A cross-sectional observational study was carried out at an emergency department of a tertiary teaching hospital. All second-year internal medicine residents were invited to voluntarily participate in this study. Acute stress markers were assessed at baseline (T1), before residents started their ER shift, and immediately after an emergency situation (T2), using heart rate, systolic, and diastolic blood pressure, salivary α-amylase activity, salivary interleukin-1 β, and the State-Trait Anxiety Inventory (STAI-s and STAI-t). Twenty-four residents were assessed during 40 emergency situations. All stress markers presented a statistically significant increase between T1 and T2. IL-1 β presented the highest percent increase (141.0%, p < .001), followed by AA (99.0%, p = .002), HR (81.0%, p < .001), DBP (8.0%, p < .001), and SBP (3.0%, p < .001). In the multivariable analysis, time of residency had a negative correlation with HR during the emergency (adjusted R-square = .168; F = 8.69; p = .006), SBP response (adjusted R-square = .210; F = 6.19; p = .005) and DBP response (adjusted R-square = .293; F = 9.09; p = .001). Trait anxiety (STAI-t) was positively correlated with STAI-s (adjusted R-square = .326; F = 19.9; p < .001), and number of procedures performed during emergency care had a positive association with HR response (adjusted R-square = .241; F = 5.02; p = .005). In the present study, emergency care provoked substantial acute stress in residents. Resident experience, trait anxiety, and number of emergency procedures were independently associated with acute stress response.

Neuro-Cognitive Assessment, Symptoms of Attention Deficit and Hyperactivity Disorder, and Soldier Performance during 68W Advanced Individual Training

DTIC Science & Technology

2007-10-01

Disorder ( ADHD ). When distinctions are made, they are clearly identified by type: inattentive or hyperactive-impulsive. A third grouping of symptoms...and emergency medical training, followed by nine weeks of classroom lecture, interactive computer training, and life-sized patient simulation, to...his seat in the classroom or in other situations in which remaining seated is expected. Often runs about or climbs in situations when it is

Addressing Dual Patient and Staff Safety Through A Team-Based Standardized Patient Simulation for Agitation Management in the Emergency Department.

PubMed

Wong, Ambrose H; Auerbach, Marc A; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

2018-06-01

Emergency departments (EDs) have seen harm rise for both patients and health workers from an increasing rate of agitation events. Team effectiveness during care of this population is particularly challenging because fear of physical harm leads to competing interests. Simulation is frequently employed to improve teamwork in medical resuscitations but has not yet been reported to address team-based behavioral emergency care. As part of a larger investigation of agitated patient care, we designed this secondary study to examine the impact of an interprofessional standardized patient simulation for ED agitation management. We used a mixed-methods approach with emergency medicine resident and attending physicians, Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs), ED nurses, technicians, and security officers at two hospital sites. After a simulated agitated patient encounter, we conducted uniprofessional and interprofessional focus groups. We undertook structured thematic analysis using a grounded theory approach. Quantitative data consisted of responses to the KidSIM Questionnaire addressing teamwork and simulation-based learning attitudes before and after each session. We reached data saturation with 57 participants. KidSIM scores revealed significant improvements in attitudes toward relevance of simulation, opportunities for interprofessional education, and situation awareness, as well as four of six questions for roles/responsibilities. Two broad themes emerged from the focus groups: (1) a team-based agitated patient simulation addressed dual safety of staff and patients simultaneously and (2) the experience fostered interprofessional discovery and cooperation in agitation management. A team-based simulated agitated patient encounter highlighted the need to consider the dual safety of staff and patients while facilitating interprofessional dialog and learning. Our findings suggest that simulation may be effective to enhance teamwork in behavioral emergency care.

A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation.

PubMed

Munroe, Belinda; Curtis, Kate; Murphy, Margaret; Strachan, Luke; Considine, Julie; Hardy, Jennifer; Wilson, Mark; Ruperto, Kate; Fethney, Judith; Buckley, Thomas

2016-08-01

The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. A pre-post design was used. The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care. © 2016 John Wiley & Sons Ltd.

Theory of mind: mechanisms, methods, and new directions

PubMed Central

Byom, Lindsey J.; Mutlu, Bilge

2013-01-01

Theory of Mind (ToM) has received significant research attention. Traditional ToM research has provided important understanding of how humans reason about mental states by utilizing shared world knowledge, social cues, and the interpretation of actions; however, many current behavioral paradigms are limited to static, “third-person” protocols. Emerging experimental approaches such as cognitive simulation and simulated social interaction offer opportunities to investigate ToM in interactive, “first-person” and “second-person” scenarios while affording greater experimental control. The advantages and limitations of traditional and emerging ToM methodologies are discussed with the intent of advancing the understanding of ToM in socially mediated situations. PMID:23964218

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

PubMed

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

2000-01-01

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

Studies of planning behavior of aircraft pilots in normal, abnormal, and emergency situations

NASA Technical Reports Server (NTRS)

Johannsen, G.; Rouse, W. B.; Hillmann, K.

1981-01-01

A methodology for the study of human planning behavior in complex dynamic systems is presented and applied to the study of aircraft pilot behavior in normal, abnormal and emergency situations. The method measures the depth of planning, that is the level of detail employed with respect to a specific task, according to responses to a verbal questionnaire, and compares planning depth with variables relating to time, task criticality and the probability of increased task difficulty. In two series of experiments, depth of planning was measured on a five- or ten-point scale during various phases of flight in a HFB-320 simulator under normal flight conditions, abnormal scenarios involving temporary runway closure due to snow removal or temporary CAT-III conditions due to a dense fog, and emergency scenarios involving engine shut-down or hydraulic pressure loss. Results reveal a dichotomy between event-driven and time-driven planning, different effects of automation in abnormal and emergency scenarios and a low correlation between depth of planning and workload or flight performance.

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

PubMed

Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry

2010-07-01

Team performance has been studied in many safety-critical organizations including aviation, nuclear power plant, offshore oil platforms and health organizations. This study looks into teamwork strategies that air traffic controllers employ to manage emergencies and abnormal situations. Two field studies were carried out in the form of observations of simulator training in emergency and unusual scenarios of novices and experienced controllers. Teamwork strategies covered aspects of team orientation and coordination, information exchange, change management and error handling. Several performance metrics were used to rate the efficiency of teamwork and test the construct validity of a prototype model of teamwork. This is a companion study to an earlier investigation of taskwork strategies in the same field (part I) and contributes to the development of a generic model for Taskwork and Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). Suggestions are made on how to use T(2)EAM to develop training programs, assess team performance and improve mishap investigations. Copyright 2010 Elsevier Ltd. All rights reserved.

Hazardous Materials Management and Emergency Response Training Center at Hanford

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

Ollero, J.; Muth, G.; Bergland, R.

1994-12-31

The Hanford Site will provide high-fidelity training using simulated job-site situations to prepare workers for known and unknown hazards. Hanford is developing the Hazardous Materials Management and Emergency Response (HAMMER) Training Center to operate as a user facility for the site, region and international labor unions. The center will focus on providing hands-on, realistic training situations. The Training Center is a partnership among U.S. Department of Energy (DOE); its contractors; labor; local, state, and tribal governments; Xavier and Tulane Universities of Louisiana and other Federal agencies. The hands-on training aids at HAMMER is justified based on regulatory training requirements, themore » desire for enhanced safety, and the commitment to continuous improvement of training quality.« less

Emergency in the clinic: a simulation curriculum to improve outpatient safety.

PubMed

Espey, Eve; Baty, Gillian; Rask, John; Chungtuyco, Michelle; Pereda, Brenda; Leeman, Lawrence

2017-12-01

Emergency response skills are essential when events such as seizure, anaphylaxis, or hemorrhage occur in the outpatient setting. As services and procedures increasingly move outside the hospital, training to manage complications may improve outcomes. The objective of this study was to evaluate a simulation-based curriculum in outpatient emergency management skills with the outcome measures of graded objective performance and learner self-efficacy. This pre- and postcurriculum study enrolled residents and fellows in Obstetrics and Gynecology and Family Medicine in a simulation-based, outpatient emergency management curriculum. Learners completed self-efficacy questionnaires and were videotaped managing 3 medical emergency scenarios (seizure, over-sedation/cardiopulmonary arrest, and hemorrhage) in the simulation laboratory both before and after completion of the curriculum. Evaluators who were blinded to training level scored the simulation performance videotapes using a graded rubric with critical action checklists. Scenario scores were assigned in 5 domains and globally. Paired t-tests were used to determine differences pre- and postcurriculum. Thirty residents completed the curriculum and pre- and postcurriculum testing. Subjects' objective performance scores improved in all 5 domains (P<.05) in all scenarios. When scores were stratified by level of training, all participants demonstrated global improvement. When scores were stratified by previous outpatient simulation experience, subjects with previous experience improved in all but management of excess sedation. Pre- and postcurriculum self-efficacy evaluations demonstrated improvement in all 7 measured areas: confidence, use of appropriate resources, communication skills, complex airway management, bag mask ventilation, resuscitation, and hemorrhage management. Self-efficacy assessment showed improvement in confidence managing outpatient emergencies (P=.001) and ability to communicate well in emergency situations (P<.001). A simulation-based curriculum improved both self-efficacy and objectively rated performance scores in management of outpatient medical emergencies. Simulation-based curricula should be incorporated into residency education. Copyright © 2017 Elsevier Inc. All rights reserved.

Consistency and Enhancement Processes in Understanding Emotions

ERIC Educational Resources Information Center

Stets, Jan E.; Asencio, Emily K.

2008-01-01

Many theories in the sociology of emotions assume that emotions emerge from the cognitive consistency principle. Congruence among cognitions produces good feelings whereas incongruence produces bad feelings. A work situation is simulated in which managers give feedback to workers that is consistent or inconsistent with what the workers expect to…

Pilot Subjective Assessments During an Investigation of Separation Function Allocation Using a Human-In-The-Loop Simulation

NASA Technical Reports Server (NTRS)

Burke, Kelly A.; Wing, David J.; Lewis, Timothy

2013-01-01

Two human-in-the-loop simulation experiments were conducted to investigate allocation of separation assurance functions between ground and air and between humans and automation. The experiments modeled a mixed-operations concept in which aircraft receiving ground-based separation services shared the airspace with aircraft providing their own separation service (i.e., self-separation). The two experiments, one pilot-focused and the other controller-focused, addressed selected key issues of mixed operations and modeling an emergence of NextGen technologies and procedures. This paper focuses on the results of the subjective assessments of pilots collected during the pilot-focused human-in-the-loop simulation, specifically workload and situation awareness. Generally the results revealed that across all conditions, pilots' perceived workload was low to medium, with the highest reported levels of workload occurring when the pilots experienced a loss of separation during the scenario. Furthermore, the results from the workload data and situation awareness data were complimentary such that when pilots reported lower levels of workload they also experienced higher levels of situation awareness.

Development and evaluation of a simulation exercise to prepare midwifery students for neonatal resuscitation.

PubMed

Carolan-Olah, Mary; Kruger, Gina; Brown, Vera; Lawton, Felicity; Mazzarino, Melissa

2016-01-01

Simulation provides opportunities for midwifery students to enhance their performance in emergency situations. Neonatal resuscitation is one such emergency and its management is a major concern for midwifery students. This project aimed to develop and evaluate a simulation exercise, for neonatal resuscitation, for 3rd year midwifery students. A quantitative survey design was employed using questions from two previously validated questionnaires: (1.) Student Satisfaction and Self-Confidence in Learning and (2.) the Clinical Teamwork Scale (CTS). Australian university. 40 final year midwifery students were invited to participate and 36 agreed to take part in the project. In pre-simulation questionnaires, students reported low levels of confidence in initiating care of an infant requiring resuscitation. Most anticipated that the simulation exercise would be useful to better prepare them respond to a neonatal emergency. Post-simulation questionnaires reported an increase in student confidence, with 30 of 36 students agreeing/ strongly agreeing that their confidence levels had improved. Nonetheless, an unexpected number of students reported a lack of familiarity with the equipment. The single simulation exercise evaluated in this project resulted in improved student confidence and greater knowledge and skills in neonatal resuscitation. However, deficits in handling emergency equipment, and in understanding the role of the student midwife/midwife in neonatal resuscitation, were also noted. For the future, the development and evaluation of a programme of simulation exercises, over a longer period, is warranted. This approach may reduce stress and better address student learning needs. Copyright © 2015. Published by Elsevier Ltd.

Hazardous Materials Management and Emergency Response training Center needs assessment

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

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

1993-09-01

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

21 CFR 290.10 - Definition of emergency situation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Definition of emergency situation. 290.10 Section...) DRUGS: GENERAL CONTROLLED DRUGS General Provisions § 290.10 Definition of emergency situation. For the... Controlled Substances Act, the term emergency situation means those situations in which the prescribing...

SITE EMERGING TECHNOLOGY SUMMARY: INTEGRATION OF PHOTOCATALYTIC OXIDATION WITH AIR STRIPPING OF CONTAMINATED AQUIFERS

EPA Science Inventory

In a recently completed test program, bench-scale laboratory studies at Arizona State University (ASU) in Tempe, AZ, and pilot-scale studies in a simulated field test situation at Zentox Corp in Ocala, FL, were performed to evaluate the integration of gas-solid ultraviolet (UV) p...

Supporting Collaboration with Technology: Does Shared Cognition Lead to Co-Regulation in Medicine?

ERIC Educational Resources Information Center

Lajoie, Susanne P.; Lu, Jingyan

2012-01-01

The theoretical distinctions between metacognition, self-regulation and self-regulated learning are often blurred which makes the definition of co-regulation in group learning situations even more difficult. We have started to explore co-regulation in the context of decision making in simulated emergencies where medical teams work together to…

Effects of Peer Presence on Helping in Introverted and Extroverted Children.

ERIC Educational Resources Information Center

Suda, William; Fouts, Gregory

1980-01-01

In a simulated emergency situation, 38 introverted and 38 extroverted sixth-grade children were tested in the presence or absence of same-sex confederate peer. In the presence of a peer, more extroverts actively helped than introverts, with no difference occurring for children tested alone. Introverts and extroverts preferred passive and active…

Automated Driving System Architecture to Ensure Safe Delegation of Driving Authority

NASA Astrophysics Data System (ADS)

YUN, Sunkil; NISHIMURA, Hidekazu

2016-09-01

In this paper, the architecture of an automated driving system (ADS) is proposed to ensure safe delegation of driving authority between the ADS and a driver. Limitations of the ADS functions may activate delegation of driving authority to a driver. However, it leads to severe consequences in emergency situations where a driver may be drowsy or distracted. To address these issues, first, the concept model for the ADS in the situation for delegation of driving authority is described taking the driver's behaviour and state into account. Second, the behaviour / state of a driver and functional flow / state of ADS and the interactions between them are modelled to understand the context where the ADS requests to delegate the driving authority to a driver. Finally, the proposed architecture of the ADS is verified under the simulations based on the emergency braking scenarios. In the verification process using simulation, we have derived the necessary condition for safe delegation of driving authority is that the ADS should assist s driver even after delegating driving authority to a driver who has not enough capability to regain control of the driving task.

Evaluating the cascading impacts of sea level rise and coastal flooding on emergency response spatial accessibility in Lower Manhattan, New York City

NASA Astrophysics Data System (ADS)

Yin, Jie; Yu, Dapeng; Lin, Ning; Wilby, Robert L.

2017-12-01

This paper describes a scenario-based approach for evaluating the cascading impacts of sea level rise (SLR) and coastal flooding on emergency responses. The analysis is applied to Lower Manhattan, New York City, considering FEMA's 100- and 500-year flood scenarios and New York City Panel on Climate Change (NPCC2)'s high-end SLR projections for the 2050s and 2080s, using the current situation as the baseline scenario. Service areas for different response timeframes (3-, 5- and 8-min) and various traffic conditions are simulated for three major emergency responders (i.e. New York Police Department (NYPD), Fire Department, New York (FDNY) and Emergency Medical Service (EMS)) under normal and flood scenarios. The modelling suggests that coastal flooding together with SLR could result in proportionate but non-linear impacts on emergency services at the city scale, and the performance of operational responses is largely determined by the positioning of emergency facilities and the functioning of traffic networks. Overall, emergency service accessibility to the city is primarily determined by traffic flow speed. However, the situation is expected to be further aggravated during coastal flooding, with is set to increase in frequency and magnitude due to SLR.

Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study.

PubMed

Bogossian, Fiona; Cooper, Simon; Cant, Robyn; Beauchamp, Alison; Porter, Joanne; Kain, Victoria; Bucknall, Tracey; Phillips, Nicole M

2014-05-01

Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios (p=.032 cardiac and p=.006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness. © 2013 Elsevier Ltd. All rights reserved.

Emergency obstetric simulation training: how do we know where we are going, if we don't know where we have been?

PubMed

Calvert, Katrina L; McGurgan, Paul M; Debenham, Edward M; Gratwick, Frances J; Maouris, Panos

2013-12-01

Obstetric emergencies contribute significantly to maternal morbidity and mortality. Current training in the management of obstetric emergencies in Australia and internationally focusses on utilising a multidisciplinary simulation-based model. Arguments for and against this type of training exist, using both economic and clinical reasoning. To identify the evidence base for the clinical impact of simulation training in obstetric emergencies and to address some of the concerns regarding appropriate delivery of obstetric emergency training in the Australian setting. A literature search was performed to identify research undertaken in the area of obstetric emergency training. The initial literature search using broad search terms identified 887 articles which were then reviewed and considered for inclusion if they provided original research with a specific emphasis on the impact of training on clinical outcomes. Ninety-two articles were identified, comprising evidence in the following clinical situations: eclampsia, shoulder dystocia, postpartum haemorrhage, maternal collapse, cord prolapse and teamwork training. Evidence exists for a benefit in knowledge or skills gained from simulation training and for the benefit of training in small units without access to high-fidelity equipment or facilities. Evidence exists for a positive impact of training in obstetric emergencies, although the majority of the available evidence applies to evaluation at the level of participants' confidence, knowledge or skills rather than at the level of impact on clinical outcomes. The model of simulation-based training is an appropriate one for the Australian setting and should be further utilised in rural and remote settings. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Implementation of Enhanced Propulsion Control Modes for Emergency Flight Operation

NASA Technical Reports Server (NTRS)

Csank, Jeffrey T.; Chin, Jeffrey C.; May, Ryan D.; Litt, Jonathan S.; Guo, Ten-Huei

2011-01-01

Aircraft engines can be effective actuators to help pilots avert or recover from emergency situations. Emergency control modes are being developed to enhance the engines performance to increase the probability of recovery under these circumstances. This paper discusses a proposed implementation of an architecture that requests emergency propulsion control modes, allowing the engines to deliver additional performance in emergency situations while still ensuring a specified safety level. In order to determine the appropriate level of engine performance enhancement, information regarding the current emergency scenario (including severity) and current engine health must be known. This enables the engine to operate beyond its nominal range while minimizing overall risk to the aircraft. In this architecture, the flight controller is responsible for determining the severity of the event and the level of engine risk that is acceptable, while the engine controller is responsible for delivering the desired performance within the specified risk range. A control mode selector specifies an appropriate situation-specific enhanced mode, which the engine controller then implements. The enhanced control modes described in this paper provide additional engine thrust or response capabilities through the modification of gains, limits, and the control algorithm, but increase the risk of engine failure. The modifications made to the engine controller to enable the use of the enhanced control modes are described, as are the interaction between the various subsystems and importantly, the interaction between the flight controller/pilot and the propulsion control system. Simulation results demonstrate how the system responds to requests for enhanced operation and the corresponding increase in performance.

Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

PubMed

Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

2012-02-01

In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

Power law of distribution of emergency situations on main gas pipeline

NASA Astrophysics Data System (ADS)

Voronin, K. S.; Akulov, K. A.

2018-05-01

The article presents the results of the analysis of emergency situations on a main gas pipeline. A power law of distribution of emergency situations is revealed. The possibility of conducting further scientific research to ensure the predictability of emergency situations on pipelines is justified.

10 CFR 835.1302 - Emergency exposure situations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Emergency exposure situations. 835.1302 Section 835.1302 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Emergency Exposure Situations § 835.1302 Emergency exposure situations. (a) The risk of injury to those individuals involved in rescue and recovery...

10 CFR 835.1302 - Emergency exposure situations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Emergency exposure situations. 835.1302 Section 835.1302 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Emergency Exposure Situations § 835.1302 Emergency exposure situations. (a) The risk of injury to those individuals involved in rescue and recovery...

10 CFR 835.1302 - Emergency exposure situations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Emergency exposure situations. 835.1302 Section 835.1302 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Emergency Exposure Situations § 835.1302 Emergency exposure situations. (a) The risk of injury to those individuals involved in rescue and recovery...

10 CFR 835.1302 - Emergency exposure situations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Emergency exposure situations. 835.1302 Section 835.1302 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Emergency Exposure Situations § 835.1302 Emergency exposure situations. (a) The risk of injury to those individuals involved in rescue and recovery...

10 CFR 835.1302 - Emergency exposure situations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Emergency exposure situations. 835.1302 Section 835.1302 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Emergency Exposure Situations § 835.1302 Emergency exposure situations. (a) The risk of injury to those individuals involved in rescue and recovery...

Information Dissemination of Public Health Emergency on Social Networks and Intelligent Computation

PubMed Central

Hu, Hongzhi; Mao, Huajuan; Hu, Xiaohua; Hu, Feng; Sun, Xuemin; Jing, Zaiping; Duan, Yunsuo

2015-01-01

Due to the extensive social influence, public health emergency has attracted great attention in today's society. The booming social network is becoming a main information dissemination platform of those events and caused high concerns in emergency management, among which a good prediction of information dissemination in social networks is necessary for estimating the event's social impacts and making a proper strategy. However, information dissemination is largely affected by complex interactive activities and group behaviors in social network; the existing methods and models are limited to achieve a satisfactory prediction result due to the open changeable social connections and uncertain information processing behaviors. ACP (artificial societies, computational experiments, and parallel execution) provides an effective way to simulate the real situation. In order to obtain better information dissemination prediction in social networks, this paper proposes an intelligent computation method under the framework of TDF (Theory-Data-Feedback) based on ACP simulation system which was successfully applied to the analysis of A (H1N1) Flu emergency. PMID:26609303

Information Dissemination of Public Health Emergency on Social Networks and Intelligent Computation.

PubMed

Hu, Hongzhi; Mao, Huajuan; Hu, Xiaohua; Hu, Feng; Sun, Xuemin; Jing, Zaiping; Duan, Yunsuo

2015-01-01

Due to the extensive social influence, public health emergency has attracted great attention in today's society. The booming social network is becoming a main information dissemination platform of those events and caused high concerns in emergency management, among which a good prediction of information dissemination in social networks is necessary for estimating the event's social impacts and making a proper strategy. However, information dissemination is largely affected by complex interactive activities and group behaviors in social network; the existing methods and models are limited to achieve a satisfactory prediction result due to the open changeable social connections and uncertain information processing behaviors. ACP (artificial societies, computational experiments, and parallel execution) provides an effective way to simulate the real situation. In order to obtain better information dissemination prediction in social networks, this paper proposes an intelligent computation method under the framework of TDF (Theory-Data-Feedback) based on ACP simulation system which was successfully applied to the analysis of A (H1N1) Flu emergency.

Study on Mine Emergency Mechanism based on TARP and ICS

NASA Astrophysics Data System (ADS)

Xi, Jian; Wu, Zongzhi

2018-01-01

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

Distributed virtual environment for emergency medical training

NASA Astrophysics Data System (ADS)

Stytz, Martin R.; Banks, Sheila B.; Garcia, Brian W.; Godsell-Stytz, Gayl M.

1997-07-01

In many professions where individuals must work in a team in a high stress environment to accomplish a time-critical task, individual and team performance can benefit from joint training using distributed virtual environments (DVEs). One professional field that lacks but needs a high-fidelity team training environment is the field of emergency medicine. Currently, emergency department (ED) medical personnel train by using words to create a metal picture of a situation for the physician and staff, who then cooperate to solve the problems portrayed by the word picture. The need in emergency medicine for realistic virtual team training is critical because ED staff typically encounter rarely occurring but life threatening situations only once in their careers and because ED teams currently have no realistic environment in which to practice their team skills. The resulting lack of experience and teamwork makes diagnosis and treatment more difficult. Virtual environment based training has the potential to redress these shortfalls. The objective of our research is to develop a state-of-the-art virtual environment for emergency medicine team training. The virtual emergency room (VER) allows ED physicians and medical staff to realistically prepare for emergency medical situations by performing triage, diagnosis, and treatment on virtual patients within an environment that provides them with the tools they require and the team environment they need to realistically perform these three tasks. There are several issues that must be addressed before this vision is realized. The key issues deal with distribution of computations; the doctor and staff interface to the virtual patient and ED equipment; the accurate simulation of individual patient organs' response to injury, medication, and treatment; and an accurate modeling of the symptoms and appearance of the patient while maintaining a real-time interaction capability. Our ongoing work addresses all of these issues. In this paper we report on our prototype VER system and its distributed system architecture for an emergency department distributed virtual environment for emergency medical staff training. The virtual environment enables emergency department physicians and staff to develop their diagnostic and treatment skills using the virtual tools they need to perform diagnostic and treatment tasks. Virtual human imagery, and real-time virtual human response are used to create the virtual patient and present a scenario. Patient vital signs are available to the emergency department team as they manage the virtual case. The work reported here consists of the system architectures we developed for the distributed components of the virtual emergency room. The architectures we describe consist of the network level architecture as well as the software architecture for each actor within the virtual emergency room. We describe the role of distributed interactive simulation and other enabling technologies within the virtual emergency room project.

Emergency Management Computer-Aided Trainer (EMCAT)

NASA Technical Reports Server (NTRS)

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

1986-01-01

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

On the usefulness of the concept of presence in virtual reality applications

NASA Astrophysics Data System (ADS)

Mestre, Daniel R.

2015-03-01

Virtual Reality (VR) leads to realistic experimental situations, while enabling researchers to have deterministic control on these situations, and to precisely measure participants' behavior. However, because more realistic and complex situations can be implemented, important questions arise, concerning the validity and representativeness of the observed behavior, with reference to a real situation. One example is the investigation of a critical (virtually dangerous) situation, in which the participant knows that no actual threat is present in the simulated situation, and might thus exhibit a behavioral response that is far from reality. This poses serious problems, for instance in training situations, in terms of transfer of learning to a real situation. Facing this difficult question, it seems necessary to study the relationships between three factors: immersion (physical realism), presence (psychological realism) and behavior. We propose a conceptual framework, in which presence is a necessary condition for the emergence of a behavior that is representative of what is observed in real conditions. Presence itself depends not only on physical immersive characteristics of the Virtual Reality setup, but also on contextual and psychological factors.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses.

PubMed

Han, Myong-Ja; Lee, Ju-Ry; Shin, Yu-Jung; Son, Jeong-Suk; Choi, Eun-Joo; Oh, Yun-Hee; Lee, Soon-Haeng; Choi, Hye-Ran

2017-12-21

To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units. A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared. After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations. Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education. © 2017 Japan Academy of Nursing Science.

Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2017-04-01

Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

The Trauma Patient Tracking System: implementing a wireless monitoring infrastructure for emergency response.

PubMed

Maltz, Jonathan; C Ng, Thomas; Li, Dustin; Wang, Jian; Wang, Kang; Bergeron, William; Martin, Ron; Budinger, Thomas

2005-01-01

In mass trauma situations, emergency personnel are challenged with the task of prioritizing the care of many injured victims. We propose a trauma patient tracking system (TPTS) where first-responders tag all patients with a wireless monitoring device that continuously reports the location of each patient. The system can be used not only to prioritize patient care, but also to determine the time taken for each patient to receive treatment. This is important in training emergency personnel and in identifying bottlenecks in the disaster response process. In situations where biochemical agents are involved, a TPTS may be employed to determine sites of cross-contamination. In order to track patient location in both outdoor and indoor environments, we employ both Global Positioning System (GPS) and Television/ Radio Frequency (TVRF) technologies. Each patient tag employs IEEE 802.11 (Wi-Fi)/TCP/IP networking to communicate with a central server via any available Wi-Fi basestation. A key component to increase TPTS fault-tolerance is a mobile Wi-Fi basestation that employs redundant Internet connectivity to ensure that tags at the disaster scene can send information to the central server even when local infrastructure is unavailable for use. We demonstrate the robustness of the system in tracking multiple patients in a simulated trauma situation in an urban environment.

Team communication patterns in emergency resuscitation: a mixed methods qualitative analysis.

PubMed

Calder, Lisa Anne; Mastoras, George; Rahimpour, Mitra; Sohmer, Benjamin; Weitzman, Brian; Cwinn, A Adam; Hobin, Tara; Parush, Avi

2017-12-01

In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations. We interviewed 18 resuscitation team members about shared mental models, roles and goals of team members and procedural expectations. We observed 30 simulated resuscitation video recordings and documented the timing, source and destination of communication and the information category. We observed 12 live resuscitations in the emergency department and recorded baseline characteristics of the type of resuscitations, nature of teams present and type and content of information exchanges. The data were analyzed using a qualitative communication analysis method. We found that resuscitation team members described a shared mental model. Respondents understood the roles and goals of each team member in order to provide rapid, efficient and life-saving care with an overall need for situational awareness. The information flow described in the interviews was reflected during the simulated and live resuscitations with the most responsible physician and charting nurse being central to team communication. We consolidated communicated information into six categories: (1) time; (2) patient status; (3) patient history; (4) interventions; (5) assistance and consultations; 6) team members present. Resuscitation team members expressed a shared mental model and prioritized situational awareness. Our findings support a need for cognitive aids to enhance team communication during resuscitations.

Managing patient deterioration: assessing teamwork and individual performance.

PubMed

Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth

2013-05-01

To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

[A new age of mass casuality education? : The InSitu project: realistic training in virtual reality environments].

PubMed

Lorenz, D; Armbruster, W; Vogelgesang, C; Hoffmann, H; Pattar, A; Schmidt, D; Volk, T; Kubulus, D

2016-09-01

Chief emergency physicians are regarded as an important element in the care of the injured and sick following mass casualty accidents. Their education is very theoretical; practical content in contrast often falls short. Limitations are usually the very high costs of realistic (large-scale) exercises, poor reproducibility of the scenarios, and poor corresponding results. To substantially improve the educational level because of the complexity of mass casualty accidents, modified training concepts are required that teach the not only the theoretical but above all the practical skills considerably more intensively than at present. Modern training concepts should make it possible for the learner to realistically simulate decision processes. This article examines how interactive virtual environments are applicable for the education of emergency personnel and how they could be designed. Virtual simulation and training environments offer the possibility of simulating complex situations in an adequately realistic manner. The so-called virtual reality (VR) used in this context is an interface technology that enables free interaction in addition to a stereoscopic and spatial representation of virtual large-scale emergencies in a virtual environment. Variables in scenarios such as the weather, the number wounded, and the availability of resources, can be changed at any time. The trainees are able to practice the procedures in many virtual accident scenes and act them out repeatedly, thereby testing the different variants. With the aid of the "InSitu" project, it is possible to train in a virtual reality with realistically reproduced accident situations. These integrated, interactive training environments can depict very complex situations on a scale of 1:1. Because of the highly developed interactivity, the trainees can feel as if they are a direct part of the accident scene and therefore identify much more with the virtual world than is possible with desktop systems. Interactive, identifiable, and realistic training environments based on projector systems could in future enable a repetitive exercise with changes within a decision tree, in reproducibility, and within different occupational groups. With a hard- and software environment numerous accident situations can be depicted and practiced. The main expense is the creation of the virtual accident scenes. As the appropriate city models and other three-dimensional geographical data are already available, this expenditure is very low compared with the planning costs of a large-scale exercise.

Emergency Flight Control of a Twin-Jet Commercial Aircraft using Manual Throttle Manipulation

NASA Technical Reports Server (NTRS)

Cole, Jennifer H.; Cogan, Bruce R.; Fullerton, C. Gordon; Burken, John J.; Venti, Michael W.; Burcham, Frank W.

2007-01-01

The Department of Homeland Security (DHS) created the PCAR (Propulsion-Controlled Aircraft Recovery) project in 2005 to mitigate the ManPADS (man-portable air defense systems) threat to the commercial aircraft fleet with near-term, low-cost proven technology. Such an attack could potentially cause a major FCS (flight control system) malfunction or other critical system failure onboard the aircraft, despite the extreme reliability of current systems. For the situations in which nominal flight controls are lost or degraded, engine thrust may be the only remaining means for emergency flight control [ref 1]. A computer-controlled thrust system, known as propulsion-controlled aircraft (PCA), was developed in the mid 1990s with NASA, McDonnell Douglas and Honeywell. PCA's major accomplishment was a demonstration of an automatic landing capability using only engine thrust [ref 11. Despite these promising results, no production aircraft have been equipped with a PCA system, due primarily to the modifications required for implementation. A minimally invasive option is TOC (throttles-only control), which uses the same control principles as PCA, but requires absolutely no hardware, software or other aircraft modifications. TOC is pure piloting technique, and has historically been utilized several times by flight crews, both military and civilian, in emergency situations stemming from a loss of conventional control. Since the 1990s, engineers at NASA Dryden Flight Research Center (DFRC) have studied TOC, in both simulation and flight, for emergency flight control with test pilots in numerous configurations. In general, it was shown that TOC was effective on certain aircraft for making a survivable landing. DHS sponsored both NASA Dryden Flight Research Center (Edwards, CA) and United Airlines (Denver, Colorado) to conduct a flight and simulation study of the TOC characteristics of a twin-jet commercial transport, and assess the ability of a crew to control an aircraft down to a survivable runway landing using TOC. The PCAR project objective was a set of pilot procedures for operation of a specific aircraft without hydraulics that (a) have been validated in both simulation and flight by relevant personnel, and (b) mesh well with existing commercial operations, maintenance, and training at a minimum cost. As a result of this study, a procedure has been developed to assist a crew in making a survivable landing using TOC. In a simulation environment, line pilots with little or no previous TOC experience performed survivable runway landings after a few practice TOC approaches. In-flight evaluations put line pilots in a simulated emergency situation where TOC was used to recover the aircraft, maneuver to a landing site, and perform an approach down to 200 feet AGL. The results of this research, including pilot observations, procedure comments, recommendations, future work and lessons learned, will he discussed. Flight data and video footage of TOC approaches may also be shown.

Immersive virtual reality simulations in nursing education.

PubMed

Kilmon, Carol A; Brown, Leonard; Ghosh, Sumit; Mikitiuk, Artur

2010-01-01

This article explores immersive virtual reality as a potential educational strategy for nursing education and describes an immersive learning experience now being developed for nurses. This pioneering project is a virtual reality application targeting speed and accuracy of nurse response in emergency situations requiring cardiopulmonary resuscitation. Other potential uses and implications for the development of virtual reality learning programs are discussed.

The simulation of emergent dispatch of cars for intelligent driving autos

NASA Astrophysics Data System (ADS)

Zheng, Ziao

2018-03-01

It is widely acknowledged that it is important for the development of intelligent cars to be widely accepted by the majority of car users. While most of the intelligent cars have the system of monitoring itself whether it is on the good situation to drive, it is also clear that studies should be performed on the way of cars for the emergent rescue of the intelligent vehicles. In this study, writer focus mainly on how to derive a separate system for the car caring teams to arrive as soon as they get the signal sent out by the intelligent driving autos. This simulation measure the time for the rescuing team to arrive, the cost it spent on arriving on the site of car problem happens, also how long the queue is when the rescuing auto is waiting to cross a road. This can be definitely in great use when there are a team of intelligent cars with one car immediately having problems causing it's not moving and can be helpful in other situations. Through this way, the interconnection of cars can be a safety net for the drivers encountering difficulties in any time.

The comparing analysis of simulation of emergent dispatch of cars for intelligent driving autos in crossroads

NASA Astrophysics Data System (ADS)

Zheng, Ziao

2018-03-01

It is widely acknowledged that it is important for the development of intelligent cars to be widely accepted by the majority of car users. While most of the intelligent cars have the system of monitoring itself whether it is on the good situation to drive, it is also clear that studies should be performed on the way of cars for the emergent rescue of the intelligent vehicles. In this study, writer focus mainly on how to derive a separate system for the car caring teams to arrive as soon as they get the signal sent out by the intelligent driving autos. This simulation measure the time for the rescuing team to arrive, the cost it spent on arriving on the site of car problem happens, also how long the queue is when the rescuing auto is waiting to cross a road. This can be definitely in great use when there are a team of intelligent cars with one car immediately having problems causing its not moving and can be helpful in other situations. Through this way, the interconnection of cars can be a safety net for the drivers encountering difficulties in any time.

Effectiveness and driver acceptance of a semi-autonomous forward obstacle collision avoidance system.

PubMed

Itoh, Makoto; Horikome, Tatsuya; Inagaki, Toshiyuki

2013-09-01

This paper proposes a semi-autonomous collision avoidance system for the prevention of collisions between vehicles and pedestrians and objects on a road. The system is designed to be compatible with the human-centered automation principle, i.e., the decision to perform a maneuver to avoid a collision is made by the driver. However, the system is partly autonomous in that it turns the steering wheel independently when the driver only applies the brake, indicating his or her intent to avoid the obstacle. With a medium-fidelity driving simulator, we conducted an experiment to investigate the effectiveness of this system for improving safety in emergency situations, as well as its acceptance by drivers. The results indicate that the system effectively improves safety in emergency situations, and the semi-autonomous characteristic of the system was found to be acceptable to drivers. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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

Shawver, D.M.; Stansfield, S.

This overview presents current research at Sandia National Laboratories in the Virtual Reality and Intelligent Simulation Lab. Into an existing distributed VR environment which we have been developing, and which provides shared immersion for multiple users, we are adding virtual actor support. The virtual actor support we are adding to this environment is intended to provide semi-autonomous actors, with oversight and high-level guiding control by a director/user, and to allow the overall action to be driven by a scenario. We present an overview of the environment into which our virtual actors will be added in Section 3, and discuss themore » direction of the Virtual Actor research itself in Section 4. We will briefly review related work in Section 2. First however we need to place the research in the context of what motivates it. The motivation for our construction of this environment, and the line of research associated with it, is based on a long-term program of providing support, through simulation, for situational training, by which we mean a type of training in which students learn to handle multiple situations or scenarios. In these situations, the student may encounter events ranging from the routine occurance to the rare emergency. Indeed, the appeal of such training systems is that they could allow the student to experience and develop effective responses for situations they would otherwise have no opportunity to practice, until they happened to encounter an actual occurance. Examples of the type of students for this kind of training would be security forces or emergency response forces. An example of the type of training scenario we would like to support is given in Section 4.2.« less

High emergency organ allocation rule in lung transplantation: a simulation study.

PubMed

Riou, Julien; Boëlle, Pierre-Yves; Christie, Jason D; Thabut, Gabriel

2017-10-01

The scarcity of suitable organ donors leads to protracted waiting times and mortality in patients awaiting lung transplantation. This study aims to assess the short- and long-term effects of a high emergency organ allocation policy on the outcome of lung transplantation. We developed a simulation model of lung transplantation waiting queues under two allocation strategies, based either on waiting time only or on additional criteria to prioritise the sickest patients. The model was informed by data from the United Network for Organ Sharing. We compared the impact of these strategies on waiting time, waiting list mortality and overall survival in various situations of organ scarcity. The impact of a high emergency allocation strategy depends largely on the organ supply. When organ supply is sufficient (>95 organs per 100 patients), it may prevent a small number of early deaths (1 year survival: 93.7% against 92.4% for waiting time only) without significant impact on waiting times or long-term survival. When the organ/recipient ratio is lower, the benefits in early mortality are larger but are counterbalanced by a dramatic increase of the size of the waiting list. Consequently, we observed a progressive increase of mortality on the waiting list (although still lower than with waiting time only), a deterioration of patients' condition at transplant and a decrease of post-transplant survival times. High emergency organ allocation is an effective strategy to reduce mortality on the waiting list, but causes a disruption of the list equilibrium that may have detrimental long-term effects in situations of significant organ scarcity.

High emergency organ allocation rule in lung transplantation: a simulation study

PubMed Central

Boëlle, Pierre-Yves; Christie, Jason D.; Thabut, Gabriel

2017-01-01

The scarcity of suitable organ donors leads to protracted waiting times and mortality in patients awaiting lung transplantation. This study aims to assess the short- and long-term effects of a high emergency organ allocation policy on the outcome of lung transplantation. We developed a simulation model of lung transplantation waiting queues under two allocation strategies, based either on waiting time only or on additional criteria to prioritise the sickest patients. The model was informed by data from the United Network for Organ Sharing. We compared the impact of these strategies on waiting time, waiting list mortality and overall survival in various situations of organ scarcity. The impact of a high emergency allocation strategy depends largely on the organ supply. When organ supply is sufficient (>95 organs per 100 patients), it may prevent a small number of early deaths (1 year survival: 93.7% against 92.4% for waiting time only) without significant impact on waiting times or long-term survival. When the organ/recipient ratio is lower, the benefits in early mortality are larger but are counterbalanced by a dramatic increase of the size of the waiting list. Consequently, we observed a progressive increase of mortality on the waiting list (although still lower than with waiting time only), a deterioration of patients’ condition at transplant and a decrease of post-transplant survival times. High emergency organ allocation is an effective strategy to reduce mortality on the waiting list, but causes a disruption of the list equilibrium that may have detrimental long-term effects in situations of significant organ scarcity. PMID:29181383

Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

PubMed

Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

2012-01-01

Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation.

Network-aware scalable video monitoring system for emergency situations with operator-managed fidelity control

NASA Astrophysics Data System (ADS)

Al Hadhrami, Tawfik; Nightingale, James M.; Wang, Qi; Grecos, Christos

2014-05-01

In emergency situations, the ability to remotely monitor unfolding events using high-quality video feeds will significantly improve the incident commander's understanding of the situation and thereby aids effective decision making. This paper presents a novel, adaptive video monitoring system for emergency situations where the normal communications network infrastructure has been severely impaired or is no longer operational. The proposed scheme, operating over a rapidly deployable wireless mesh network, supports real-time video feeds between first responders, forward operating bases and primary command and control centers. Video feeds captured on portable devices carried by first responders and by static visual sensors are encoded in H.264/SVC, the scalable extension to H.264/AVC, allowing efficient, standard-based temporal, spatial, and quality scalability of the video. A three-tier video delivery system is proposed, which balances the need to avoid overuse of mesh nodes with the operational requirements of the emergency management team. In the first tier, the video feeds are delivered at a low spatial and temporal resolution employing only the base layer of the H.264/SVC video stream. Routing in this mode is designed to employ all nodes across the entire mesh network. In the second tier, whenever operational considerations require that commanders or operators focus on a particular video feed, a `fidelity control' mechanism at the monitoring station sends control messages to the routing and scheduling agents in the mesh network, which increase the quality of the received picture using SNR scalability while conserving bandwidth by maintaining a low frame rate. In this mode, routing decisions are based on reliable packet delivery with the most reliable routes being used to deliver the base and lower enhancement layers; as fidelity is increased and more scalable layers are transmitted they will be assigned to routes in descending order of reliability. The third tier of video delivery transmits a high-quality video stream including all available scalable layers using the most reliable routes through the mesh network ensuring the highest possible video quality. The proposed scheme is implemented in a proven simulator, and the performance of the proposed system is numerically evaluated through extensive simulations. We further present an in-depth analysis of the proposed solutions and potential approaches towards supporting high-quality visual communications in such a demanding context.

Simulation-based otolaryngology - head and neck surgery boot camp: 'how I do it'.

PubMed

Chin, C J; Chin, C A; Roth, K; Rotenberg, B W; Fung, K

2016-03-01

In otolaryngology, surgical emergencies can occur at any time. An annual surgical training camp (or 'boot camp') offers junior residents from across North America the opportunity to learn and practice these skills in a safe environment. The goals of this study were to describe the set-up and execution of a simulation-based otolaryngology boot camp and to determine participants' confidence in performing routine and emergency on-call procedures in stressful situations before and after the boot camp. There were three main components of the boot camp: task trainers, simulations and an interactive panel discussion. Surveys were given to participants before and after the boot camp, and their confidence in performing the different tasks was assessed via multiple t-tests. Participants comprised 22 residents from 12 different universities; 10 of these completed both boot camp surveys. Of the nine tasks, the residents reported a significant improvement in confidence levels for six, including surgical airway and orbital haematoma management. An otolaryngology boot camp gives residents the chance to learn and practice emergency skills before encountering the emergencies in everyday practice. Their confidence in multiple skillsets was significantly improved after the boot camp. Given the shift towards competency-based learning in medical training, this study has implications for all surgical and procedural specialties.

Application of a plume model for decision makers' situation awareness during an outdoor airborne HAZMAT release.

PubMed

Meris, Ronald G; Barbera, Joseph A

2014-01-01

In a large-scale outdoor, airborne, hazardous materials (HAZMAT) incident, such as ruptured chlorine rail cars during a train derailment, the local Incident Commanders and HAZMAT emergency responders must obtain accurate information quickly to assess the situation and act promptly and appropriately. HAZMAT responders must have a clear understanding of key information and how to integrate it into timely and effective decisions for action planning. This study examined the use of HAZMAT plume modeling as a decision support tool during incident action planning in this type of extreme HAZMAT incident. The concept of situation awareness as presented by Endsley's dynamic situation awareness model contains three levels: perception, comprehension, and projection. It was used to examine the actions of incident managers related to adequate data acquisition, current situational understanding, and accurate situation projection. Scientists and engineers have created software to simulate and predict HAZMAT plume behavior, the projected hazard impact areas, and the associated health effects. Incorporating the use of HAZMAT plume projection modeling into an incident action plan may be a complex process. The present analysis used a mixed qualitative and quantitative methodological approach and examined the use and limitations of a "HAZMAT Plume Modeling Cycle" process that can be integrated into the incident action planning cycle. HAZMAT response experts were interviewed using a computer-based simulation. One of the research conclusions indicated the "HAZMAT Plume Modeling Cycle" is a critical function so that an individual/team can be tasked with continually updating the hazard plume model with evolving data, promoting more accurate situation awareness.

Use of a Virtual Learning Platform for Distance-Based Simulation in an Acute Care Nurse Practitioner Curriculum.

PubMed

Carman, Margaret; Xu, Shu; Rushton, Sharron; Smallheer, Benjamin A; Williams, Denise; Amarasekara, Sathya; Oermann, Marilyn H

Acute care nurse practitioner (ACNP) programs that use high-fidelity simulation as a teaching tool need to consider innovative strategies to provide distance-based students with learning experiences that are comparable to those in a simulation laboratory. The purpose of this article is to describe the use of virtual simulations in a distance-based ACNP program and student performance in the simulations. Virtual simulations using iSimulate were integrated into the ACNP course to promote the translation of content into a clinical context and enable students to develop their knowledge and decision-making skills. With these simulations, students worked as a team, even though they were at different sites from each other and from the faculty, to manage care of an acutely ill patient. The students were assigned to simulation groups of 4 students each. One week before the simulation, they reviewed past medical records. The virtual simulation sessions were recorded and then evaluated. The evaluation tools assessed 8 areas of performance and included key behaviors in each of these areas to be performed by students in the simulation. More than 80% of the student groups performed the key behaviors. Virtual simulations provide a learning platform that allows live interaction between students and faculty, at a distance, and application of content to clinical situations. With simulation, learners have an opportunity to practice assessment and decision-making in emergency and high-risk situations. Simulations not only are valuable for student learning but also provide a nonthreatening environment for staff to practice, receive feedback on their skills, and improve their confidence.

Identification of Barriers to Pediatric Care in Limited-Resource Settings: A Simulation Study.

PubMed

Shilkofski, Nicole; Hunt, Elizabeth A

2015-12-01

Eighty percent of the 10 million annual deaths in children aged <5 years in developing countries are estimated to be avoidable, with improvements in education for pediatric emergency management being a key factor. Education must take into account cultural considerations to be effective. Study objectives were: (1) to use simulation to identify factors posing barriers to patient care in limited resource settings (LRS); and (2) to understand how simulations in LRS can affect communication and decision-making processes. A qualitative study was conducted at 17 different sites in 12 developing countries in Asia, Latin America, and Africa. Data from observations of 68 in situ simulated pediatric emergencies were coded for thematic analysis. Sixty-two different "key informants" were interviewed regarding perceived benefit of simulations. Coding of observations and interviews yielded common themes: impact of culture on team hierarchy, impact of communication and language barriers on situational awareness, systematic emergency procedures, role delineation, shared cognition and resource awareness through simulation, logistic barriers to patient care, and use of recognition-primed decision-making by experienced clinicians. Changes in clinical environments were implemented as a result of simulations. Ad hoc teams in LRS face challenges in caring safely for patients; these include language and cultural barriers, as well as environmental and resource constraints. Engaging teams in simulations may promote improved communication, identification of systems issues and latent threats to target for remediation. There may be a role for training novices in use of recognition-primed or algorithmic decision-making strategies to improve rapidity and efficiency of decisions in LRS. Copyright © 2015 by the American Academy of Pediatrics.

Use of a simulation laboratory to train radiology residents in the management of acute radiologic emergencies.

PubMed

Sarwani, Nabeel; Tappouni, Rafel; Flemming, Donald

2012-08-01

Simulation laboratories use realistic clinical scenarios to train physicians in a controlled environment, especially in potentially life-threatening complications that require prompt management. The objective of our study was to develop a comprehensive program using the simulation laboratory to train radiology residents in the management of acute radiologic emergencies. All radiology residents attended a dedicated simulation laboratory course lasting 3 hours, divided over two sessions. Training included basic patient management skills, management of a tension pneumothorax, massive hemorrhage, and contrast agent reactions. Participants were presented with 20 multiple-choice questions before and after the course. Pre- and posttest results were analyzed, and the McNemar test was used to compare correct responses by individual question. Twenty-six radiology residents attended the class. The average pre- and posttest scores and the average difference between the scores for all residents were 13.8, 17.1, and 3.3, respectively (p < 0.0001). Incorrect answers on the pretest examination that were subsequently answered correctly concerned administration of epinephrine for severe reactions, management of a tension pneumothorax, oxygen therapy, ECG placement, cardiopulmonary resuscitation technique, and where to stand during a code situation. Persistent incorrect answers concerned vasovagal reactions and emergency telephone numbers at an off-site imaging center. Simulation laboratories can be used to teach crisis management and crisis resource management for radiology residents and should be part of the education toolbox. Defined objectives lead to a comprehensive course dealing with the management of acute radiologic emergencies. Such programs can improve the role of radiologists as members of the health care team.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

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

An emergency-adaptive routing scheme for wireless sensor networks for building fire hazard monitoring.

PubMed

Zeng, Yuanyuan; Sreenan, Cormac J; Sitanayah, Lanny; Xiong, Naixue; Park, Jong Hyuk; Zheng, Guilin

2011-01-01

Fire hazard monitoring and evacuation for building environments is a novel application area for the deployment of wireless sensor networks. In this context, adaptive routing is essential in order to ensure safe and timely data delivery in building evacuation and fire fighting resource applications. Existing routing mechanisms for wireless sensor networks are not well suited for building fires, especially as they do not consider critical and dynamic network scenarios. In this paper, an emergency-adaptive, real-time and robust routing protocol is presented for emergency situations such as building fire hazard applications. The protocol adapts to handle dynamic emergency scenarios and works well with the routing hole problem. Theoretical analysis and simulation results indicate that our protocol provides a real-time routing mechanism that is well suited for dynamic emergency scenarios in building fires when compared with other related work.

An Emergency-Adaptive Routing Scheme for Wireless Sensor Networks for Building Fire Hazard Monitoring

PubMed Central

Zeng, Yuanyuan; Sreenan, Cormac J.; Sitanayah, Lanny; Xiong, Naixue; Park, Jong Hyuk; Zheng, Guilin

2011-01-01

Fire hazard monitoring and evacuation for building environments is a novel application area for the deployment of wireless sensor networks. In this context, adaptive routing is essential in order to ensure safe and timely data delivery in building evacuation and fire fighting resource applications. Existing routing mechanisms for wireless sensor networks are not well suited for building fires, especially as they do not consider critical and dynamic network scenarios. In this paper, an emergency-adaptive, real-time and robust routing protocol is presented for emergency situations such as building fire hazard applications. The protocol adapts to handle dynamic emergency scenarios and works well with the routing hole problem. Theoretical analysis and simulation results indicate that our protocol provides a real-time routing mechanism that is well suited for dynamic emergency scenarios in building fires when compared with other related work. PMID:22163774

Individual differences in airline captains' personalities, communication strategies, and crew performance

NASA Technical Reports Server (NTRS)

Orasanu, Judith

1991-01-01

Aircrew effectiveness in coping with emergencies has been linked to captain's personality profile. The present study analyzed cockpit communication during simulated flight to examine the relation between captains' discourse strategies, personality profiles, and crew performance. Positive Instrumental/Expressive captains and Instrumental-Negative captains used very similar communication strategies and their crews made few errors. Their talk was distinguished by high levels of planning and strategizing, gathering information, predicting/alerting, and explaining, especially during the emergency flight phase. Negative-Expressive captains talked less overall, and engaged in little problem solving talk, even during emergencies. Their crews made many errors. Findings support the theory that high crew performance results when captains use language to build shared mental models for problem situations.

The development and implementation of cockpit resource management in UAL recurrent training

NASA Technical Reports Server (NTRS)

Shroyer, David H.

1987-01-01

Line Oriented Flight Training (LOFT) for United Airlines started in 1976. At that time it was basically no more than a line-simulated training function conducted in a full-mission simulator with no attention or stress on its human factor content. Very soon after the implementation of the LOFT program concerns were voiced about certain crew behavioral situations they were observing in the flight crew's execution of cockpit duties. These duties involved emergency procedures as well as irregular and normal procedures and situations. It was evident that new information was surfacing concerning crew interaction, or its lack thereof, in the cockpit and its effect on satisfactory performance. These observations naturally raised the question of how this information translated into the safety of aircraft operations. A training system had to be repetitive, the crew interactive, and the training had to be conducted under the crew concept. The foundation had to have two other factors: (1) it was necessary to have adequate human factor content, and (2) an advanced state-of-the-art simulator and appropriate electronic devices were required. These concepts are further discussed.

Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

PubMed

Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

2015-03-01

The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence doing procedures and 29 of 37 (78%) reported knowing when the procedure should be applied. Oxford Non-Technical Skills evaluation demonstrated significant improvement in PGY 2 resident performance assessed during the 2 study periods: communication score increased from 3 to 3.71 (P=.01), leadership score increased from 2.77 to 3.86 (P<.001), teamwork score increased from 3.15 to 3.86 (P=.007), and procedural ability score increased from 2.23 to 3.43 (P=.03). There were no statistically significant improved scores in PGY 2 decision making or situation awareness. No improvements in skills were seen among PGY 1 participants. The PGY 2 residents improved their skills, but the PGY 1 residents did not. Participants found interprofessional simulations to be realistic and a valuable educational tool. Interprofessional simulation provides a valuable means of educating surgical residents and evaluating their skills in real-life clinical scenarios.

14 CFR 99.5 - Emergency situations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Emergency situations. 99.5 Section 99.5 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SECURITY CONTROL OF AIR TRAFFIC General § 99.5 Emergency situations. In an...

Visualization and classification of physiological failure modes in ensemble hemorrhage simulation

NASA Astrophysics Data System (ADS)

Zhang, Song; Pruett, William Andrew; Hester, Robert

2015-01-01

In an emergency situation such as hemorrhage, doctors need to predict which patients need immediate treatment and care. This task is difficult because of the diverse response to hemorrhage in human population. Ensemble physiological simulations provide a means to sample a diverse range of subjects and may have a better chance of containing the correct solution. However, to reveal the patterns and trends from the ensemble simulation is a challenging task. We have developed a visualization framework for ensemble physiological simulations. The visualization helps users identify trends among ensemble members, classify ensemble member into subpopulations for analysis, and provide prediction to future events by matching a new patient's data to existing ensembles. We demonstrated the effectiveness of the visualization on simulated physiological data. The lessons learned here can be applied to clinically-collected physiological data in the future.

7 CFR 3431.23 - Service to Federal government in emergency situations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2014-01-01 2014-01-01 false Service to Federal government in emergency situations...

7 CFR 3431.23 - Service to Federal government in emergency situations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2013-01-01 2013-01-01 false Service to Federal government in emergency situations...

7 CFR 3431.23 - Service to Federal government in emergency situations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2012-01-01 2012-01-01 false Service to Federal government in emergency situations...

7 CFR 3431.23 - Service to Federal government in emergency situations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23 Service to Federal government in emergency situations... 7 Agriculture 15 2011-01-01 2011-01-01 false Service to Federal government in emergency situations...

49 CFR 211.45 - Petitions for emergency waiver of safety rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... imminent threat of, an emergency event or an emergency situation. For purposes of this section, the terms “emergency event” and “emergency situation” mean a natural or manmade disaster, such as a hurricane, flood... number. (c) Determining the existence of an emergency event or an emergency situation. If the...

76 FR 5053 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-28

... January 26, 2011 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with... constituted by the situation in or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking...

75 FR 5675 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

... February 2, 2010 Continuation of the National Emergency With Respect to the Situation in or in Relation to... emergency, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with... constituted by the situation in or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking...

Influence of marine engine simulator training to marine engineer's competence

NASA Astrophysics Data System (ADS)

Wang, Peng; Cheng, Xiangxin; Ma, Qiang; Song, Xiufu; Liu, Xinjian; Wang, Lianhai

2011-12-01

Marine engine simulator is broadly used in maritime education and training. Maritime education and training institutions usually use this facility to cultivate the hands-on ability and fault-treat ability of marine engineers and students. In this study, the structure and main function of DMS-2005 marine engine simulator is briefly introduced, several teaching methods are discussed. By using Delphi method and AHP method, a comprehensive evaluation system is built and the competence of marine engineers is assessed. After analyzing the calculating data, some conclusions can be drawn: comprehensive evaluation system could be used to assess marine engineer's competence; the training of marine engine simulator is propitious to enhance marine engineers' integrated ability, especially on the aspect of judgment of abnormal situation capacity, emergency treatment ability and safe operation ability.

Influence of marine engine simulator training to marine engineer's competence

NASA Astrophysics Data System (ADS)

Wang, Peng; Cheng, Xiangxin; Ma, Qiang; Song, Xiufu; Liu, Xinjian; Wang, Lianhai

2012-01-01

Marine engine simulator is broadly used in maritime education and training. Maritime education and training institutions usually use this facility to cultivate the hands-on ability and fault-treat ability of marine engineers and students. In this study, the structure and main function of DMS-2005 marine engine simulator is briefly introduced, several teaching methods are discussed. By using Delphi method and AHP method, a comprehensive evaluation system is built and the competence of marine engineers is assessed. After analyzing the calculating data, some conclusions can be drawn: comprehensive evaluation system could be used to assess marine engineer's competence; the training of marine engine simulator is propitious to enhance marine engineers' integrated ability, especially on the aspect of judgment of abnormal situation capacity, emergency treatment ability and safe operation ability.

Situational Awareness in Mass Emergency: A Behavioral and Linguistic Analysis of Microblogged Communications

ERIC Educational Resources Information Center

Vieweg, Sarah Elizabeth

2012-01-01

In times of mass emergency, users of Twitter (a popular microblogging service) often communicate information about the event, some of which contributes to situational awareness. Situational awareness refers to a state of understanding the "big picture" in time- and safety-critical situations. The more situational awareness people have,…

Asymmetric cellular memory in bacteria exposed to antibiotics.

PubMed

Mathis, Roland; Ackermann, Martin

2017-03-09

The ability to form a cellular memory and use it for cellular decision-making could help bacteria to cope with recurrent stress conditions. We analyzed whether bacteria would form a cellular memory specifically if past events are predictive of future conditions. We worked with the asymmetrically dividing bacterium Caulobacter crescentus where past events are expected to only be informative for one of the two cells emerging from division, the sessile cell that remains in the same microenvironment and does not migrate. Time-resolved analysis of individual cells revealed that past exposure to low levels of antibiotics increases tolerance to future exposure for the sessile but not for the motile cell. Using computer simulations, we found that such an asymmetry in cellular memory could be an evolutionary response to situations where the two cells emerging from division will experience different future conditions. Our results raise the question whether bacteria can evolve the ability to form and use cellular memory conditionally in situations where it is beneficial.

Enhancing Evacuation Plans with a Situation Awareness System Based on End-User Knowledge Provision

PubMed Central

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-01-01

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating. PMID:24961212

Enhancing evacuation plans with a situation awareness system based on end-user knowledge provision.

PubMed

Morales, Augusto; Alcarria, Ramon; Martin, Diego; Robles, Tomas

2014-06-24

Recent disasters have shown that having clearly defined preventive procedures and decisions is a critical component that minimizes evacuation hazards and ensures a rapid and successful evolution of evacuation plans. In this context, we present our Situation-Aware System for enhancing Evacuation Plans (SASEP) system, which allows creating end-user business rules that technically support the specific events, conditions and actions related to evacuation plans. An experimental validation was carried out where 32 people faced a simulated emergency situation, 16 of them using SASEP and the other 16 using a legacy system based on static signs. From the results obtained, we compare both techniques and discuss in which situations SASEP offers a better evacuation route option, confirming that it is highly valuable when there is a threat in the evacuation route. In addition, a study about user satisfaction using both systems is presented showing in which cases the systems are assessed as satisfactory, relevant and not frustrating.

Personalized Alert Notifications and Evacuation Routes in Indoor Environments

PubMed Central

Aedo, Ignacio; Yu, Shuxin; Díaz, Paloma; Acuña, Pablo; Onorati, Teresa

2012-01-01

The preparedness phase is crucial in the emergency management process for reaching an adequate level of readiness to react to potential threats and hazards. During this phase, emergency plans are developed to establish, among other procedures, evacuation and emergency escape routes. Information and Communication Technologies (ICT) can support and improve these procedures providing appropriate, updated and accessible information to all people in the affected zone. Current emergency management and evacuation systems do not adapt information to the context and the profile of each person, so messages received in the emergency might be useless. In this paper, we propose a set of criteria that ICT-based systems could achieve in order to avoid this problem adapting emergency alerts and evacuation routes to different situations and people. Moreover, in order to prove the applicability of such criteria, we define a mechanism that can be used as a complement of traditional evacuation systems to provide personalized alerts and evacuation routes to all kinds of people during emergency situations in working places. This mechanism is composed by three main components: CAP-ONES for notifying emergency alerts, NERES for defining emergency plans and generating personalized evacuation routes, and iNeres as the interface to receive and visualize these routes on smartphones. The usability and understandability of proposed interface has been assessed through a user study performed in a fire simulation in an indoor environment. This evaluation demonstrated that users considered iNeres easy to understand, to learn and to use, and they also found very innovative the idea to use smartphones as a support for escaping instead of static signals on walls and doors. PMID:22969373

The Aircraft Simulation Role in Improving Flight Safety Through Control Room Training

NASA Technical Reports Server (NTRS)

Shy, Karla S.; Hageman, Jacob J.; Le, Jeanette H.; Sitz, Joel (Technical Monitor)

2002-01-01

NASA Dryden Flight Research Center uses its six-degrees-of-freedom (6-DOF) fixed-base simulations for mission control room training to improve flight safety and operations. This concept is applied to numerous flight projects such as the F-18 High Alpha Research Vehicle (HARV), the F-15 Intelligent Flight Control System (IFCS), the X-38 Actuator Control Test (XACT), and X-43A (Hyper-X). The Dryden 6-DOF simulations are typically used through various stages of a project, from design to ground tests. The roles of these simulations have expanded to support control room training, reinforcing flight safety by building control room staff proficiency. Real-time telemetry, radar, and video data are generated from flight vehicle simulation models. These data are used to drive the control room displays. Nominal static values are used to complete information where appropriate. Audio communication is also an integral part of training sessions. This simulation capability is used to train control room personnel and flight crew for nominal missions and emergency situations. Such training sessions are also opportunities to refine flight cards and control room display pages, exercise emergency procedures, and practice control room setup for the day of flight. This paper describes this technology as it is used in the X-43A and F-15 IFCS and XACT projects.

Collecting data from a sensor network in a single-board computer

NASA Astrophysics Data System (ADS)

Casciati, F.; Casciati, S.; Chen, Z.-C.; Faravelli, L.; Vece, M.

2015-07-01

The EU-FP7 project SPARTACUS, currently in progress, sees the international cooperation of several partners toward the design and implementation of a satellite based asset tracking for supporting emergency management in crisis operations. Due to the emergency environment, one has to rely on a low power consumption wireless communication. Therefore, the communication hardware and software must be designed to match requirements which can only be foreseen at the level of more or less likely scenarios. The latter aspect suggests a deep use of a simulator (instead of a real network of sensors) to cover extreme situations. The former power consumption remark suggests the use of a minimal computer (Raspberry Pi) as data collector. In this paper, the results of a broad simulation campaign are reported in order to investigate the accuracy of the received data and the global power consumption for each of the considered scenarios.

[Teaching basic life support to the general population. Alumni intervention analysis].

PubMed

Díaz-Castellanos, M A; Fernández-Carmona, A; Díaz-Redondo, A; Cárdenas-Cruz, A; García-del Moral, R; Martín-Lopez, J; Díaz-Redondo, T

2014-12-01

The aim of this study was to investigate the rate at which the alumni of basic life support courses witnessed and intervened in out-of-hospital emergency situations, and to identify the variables characterizing those alumni associated with a greater number of witnessing events and interventions. An analysis of the efficiency of the courses was also carried out. A descriptive, cross-sectional study was made. A district in the province of Almería (Spain). Alumni of a mass basic life support training program targeted to the general population «Plan Salvavidas» conducted between 2003-2009. In 2010 the alumni were administered a telephone survey asking whether they had witnessed an emergency situation since attending the program, with the collection of information related to this emergency situation. Rate of out-of-hospital emergencies witnessed by the alumni. Rate of intervention of the alumni in emergency situations. Variables characterizing alumni with a greater likelihood of witnessing an emergency situation. A total of 3,864 trained alumni were contacted by telephone. Of 1,098 respondents, 63.9% were women, and the mean age was 26.61±10.6 years. Of these alumni, 11.75% had witnessed emergency situations, an average of three years after completing the course. Of these emergencies, 23.3% were identified as cardiac arrest. The alumni intervened in 98% of the possible cases. In 63% of the cases, there was no connection between the alumni and the victim. The majority of the emergency situations occurred in the street and in public spaces. A greater likelihood of witnessing an emergency situation was associated with being a healthcare worker and with being over 18 years of age. The rate of out-of-hospital emergencies witnessed by these alumni after the course was 11.75%. The level of intervention among the alumni was high. The most efficient target population consisted of healthcare workers. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Team play in surgical education: a simulation-based study.

PubMed

Marr, Mollie; Hemmert, Keith; Nguyen, Andrew H; Combs, Ronnie; Annamalai, Alagappan; Miller, George; Pachter, H Leon; Turner, James; Rifkind, Kenneth; Cohen, Steven M

2012-01-01

Simulation-based training provides a low-stress learning environment where real-life emergencies can be practiced. Simulation can improve surgical education and patient care in crisis situations through a team approach emphasizing interpersonal and communication skills. This study assessed the effects of simulation-based training in the context of trauma resuscitation in teams of trainees. In a New York State-certified level I trauma center, trauma alerts were assessed by a standardized video review process. Simulation training was provided in various trauma situations followed by a debriefing period. The outcomes measured included the number of healthcare workers involved in the resuscitation, the percentage of healthcare workers in role position, time to intubation, time to intubation from paralysis, time to obtain first imaging study, time to leave trauma bay for computed tomography scan or the operating room, presence of team leader, and presence of spinal stabilization. Thirty cases were video analyzed presimulation and postsimulation training. The two data sets were compared via a 1-sided t test for significance (p < 0.05). Nominal data were analyzed using the Fischer exact test. The data were compared presimulation and postsimulation. The number of healthcare workers involved in the resuscitation decreased from 8.5 to 5.7 postsimulation (p < 0.001). The percentage of people in role positions increased from 57.8% to 83.6% (p = 0.46). The time to intubation from paralysis decreased from 3.9 to 2.8 minutes (p < 0.05). The presence of a definitive team leader increased from 64% to 90% (p < 0.05). The rate of spine stabilization increased from 82% to 100% (p < 0.08). After simulation, training adherence to the advanced trauma life support algorithm improved from 56% to 83%. High-stress situations simulated in a low-stress environment can improve team interaction and educational competencies. Providing simulation training as a tool for surgical education may enhance patient care. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The effectiveness of virtual simulation in improving student nurses' knowledge and performance during patient deterioration: A pre and post test design.

PubMed

Borg Sapiano, Alexis; Sammut, Roberta; Trapani, Josef

2018-03-01

Preparing nursing students to perform competently in complex emergency situations, such as during rapid patient deterioration, is challenging. Students' active engagement in such scenarios cannot be ensured, due to the unexpected nature of such infrequent events. Many students may consequently not experience and integrate the management of patient deterioration into their knowledge and practical competency by the end of their studies, making them unprepared to manage such situations as practicing nurses. This study investigated the effectiveness of virtual simulation in improving performance during rapid patient deterioration. To investigate the effectiveness of virtual simulation in improving student nurses' knowledge and performance during rapid patient deterioration. A pre- and post-test design was used. Nursing students at a university in Malta were invited to participate in a virtual simulation program named FIRST 2 ACTWeb™, using their own computer devices. A total of 166 (response rate=50%) second and third year diploma and degree nursing students participated in the study. The simulation included three scenarios (Cardiac-Shock-Respiratory) portraying deteriorating patients. Performance feedback was provided at the end of each scenario. Students completed pre- and post-scenario knowledge tests and performance during each scenario was recorded automatically on a database. Findings showed a significant improvement in the students' post-scenario knowledge (z=-6.506, p<0.001). Highest mean performance scores were obtained in the last scenario (M=19.7, median: 20.0, s.d. 3.41) indicating a learning effect. Knowledge was not a predictor of students' performance in the scenarios. This study supports virtual simulation as an effective learning tool for pre-registration nursing students in different programs. Simulation improves both knowledge about and performance during patient deterioration. Virtual simulation of rare events should be a key component of undergraduate nurse education, to prepare students to manage complex situations as practicing nurses. Copyright © 2018 Elsevier Ltd. All rights reserved.

Wet 'n' Safe. Water and Boating Safety. Grades 4-6.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

These lessons contain information that applies to almost every emergency situation involving water. Each lesson has three main components: depiction of an emergency situation, descriptions of actions that will avoid or remedy the emergency situation, and review and discussion questions with suggested answers. Part 1 has lessons on rescuing oneself…

Sentence-Based Attentional Mechanisms in Word Learning: Evidence from a Computational Model

PubMed Central

Alishahi, Afra; Fazly, Afsaneh; Koehne, Judith; Crocker, Matthew W.

2012-01-01

When looking for the referents of novel nouns, adults and young children are sensitive to cross-situational statistics (Yu and Smith, 2007; Smith and Yu, 2008). In addition, the linguistic context that a word appears in has been shown to act as a powerful attention mechanism for guiding sentence processing and word learning (Landau and Gleitman, 1985; Altmann and Kamide, 1999; Kako and Trueswell, 2000). Koehne and Crocker (2010, 2011) investigate the interaction between cross-situational evidence and guidance from the sentential context in an adult language learning scenario. Their studies reveal that these learning mechanisms interact in a complex manner: they can be used in a complementary way when context helps reduce referential uncertainty; they influence word learning about equally strongly when cross-situational and contextual evidence are in conflict; and contextual cues block aspects of cross-situational learning when both mechanisms are independently applicable. To address this complex pattern of findings, we present a probabilistic computational model of word learning which extends a previous cross-situational model (Fazly et al., 2010) with an attention mechanism based on sentential cues. Our model uses a framework that seamlessly combines the two sources of evidence in order to study their emerging pattern of interaction during the process of word learning. Simulations of the experiments of (Koehne and Crocker, 2010, 2011) reveal an overall pattern of results that are in line with their findings. Importantly, we demonstrate that our model does not need to explicitly assign priority to either source of evidence in order to produce these results: learning patterns emerge as a result of a probabilistic interaction between the two clue types. Moreover, using a computational model allows us to examine the developmental trajectory of the differential roles of cross-situational and sentential cues in word learning. PMID:22783211

EMERGENCY BRAKING IN ADULTS VERSUS NOVICE TEEN DRIVERS: RESPONSE TO SIMULATED SUDDEN DRIVING EVENTS.

PubMed

Loeb, Helen S; Kandadai, Venk; McDonald, Catherine C; Winston, Flaura K

Motor vehicle crashes remain the leading cause of death in teens in the United States. Newly licensed drivers are the group most at risk for crashes. Their driving skills are very new, still very often untested, so that their ability to properly react in an emergency situation remains a research question. Since it is impossible to expose human subjects to critical life threatening driving scenarios, researchers have been increasingly using driving simulators to assess driving skills. This paper summarizes the results of a driving scenario in a study comparing the driving performance of novice teen drivers (n=21) 16-17 year olds with 90 days of provisional licensure with that of experienced adult drivers (n=17) 25-50 year olds with at least 5 years of PA licensure, at least 100 miles driven per week and no self-reported collisions in the previous 3 years. As part of a 30 to 35 simulated drive that encompassed the most common scenarios that result in serious crashes, participants were exposed to a sudden car event. As the participant drove on a suburban road, a car surged from a driveway hidden by a fence on the right side of the road. To avoid the crash, participants must hard brake, exhibiting dynamic control over both attentional and motor resources. The results showed strong differences between the experienced adult and novice teen drivers in the brake pressure applied. When placed in the same situation, the novice teens decelerated on average 50% less than the experienced adults (p<0.01).

EMERGENCY BRAKING IN ADULTS VERSUS NOVICE TEEN DRIVERS: RESPONSE TO SIMULATED SUDDEN DRIVING EVENTS

PubMed Central

Kandadai, Venk; McDonald, Catherine C.; Winston, Flaura K.

2015-01-01

Motor vehicle crashes remain the leading cause of death in teens in the United States. Newly licensed drivers are the group most at risk for crashes. Their driving skills are very new, still very often untested, so that their ability to properly react in an emergency situation remains a research question. Since it is impossible to expose human subjects to critical life threatening driving scenarios, researchers have been increasingly using driving simulators to assess driving skills. This paper summarizes the results of a driving scenario in a study comparing the driving performance of novice teen drivers (n=21) 16–17 year olds with 90 days of provisional licensure with that of experienced adult drivers (n=17) 25–50 year olds with at least 5 years of PA licensure, at least 100 miles driven per week and no self-reported collisions in the previous 3 years. As part of a 30 to 35 simulated drive that encompassed the most common scenarios that result in serious crashes, participants were exposed to a sudden car event. As the participant drove on a suburban road, a car surged from a driveway hidden by a fence on the right side of the road. To avoid the crash, participants must hard brake, exhibiting dynamic control over both attentional and motor resources. The results showed strong differences between the experienced adult and novice teen drivers in the brake pressure applied. When placed in the same situation, the novice teens decelerated on average 50% less than the experienced adults (p<0.01). PMID:26709330

The Challenge of Aviation Emergency and Abnormal Situations

NASA Technical Reports Server (NTRS)

Burian, Barbara K.; Barshi, Immanuel; Dismukes, Key

2005-01-01

Emergency and abnormal situations occur on flights everyday around the world. They range from minor situations readily managed to extremely serious and highly time-critical situations that deeply challenge the skills of even the most effective crews. How well crews respond to these situations is a function of several interacting sets of issues: (1) the design of non-normal procedures and checklists, (2) design of aircraft systems and automation, (3) specific aspects of the non-normal situation, such as time criticality and complexity of the situation, (4) human performance capabilities and cognitive limitations under high workload and stress, (5) design of training for non-normal situations, (6) philosophies, policies and practices within the industry, and (7) economic and regulatory constraints. Researchers and pilots working on NASA's Emergency and Abnormal Situations project are addressing these issues in a long-range study. In this paper we discuss these issues and illustrate them with examples from recent incidents and accidents.

3 CFR - Continuation of the National Emergency With Respect to the Situation in Zimbabwe

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 1, 2013 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003, by Executive Order 13288, the President...

3 CFR - Continuation of the National Emergency With Respect to the Situation in Zimbabwe

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Situation in Zimbabwe Presidential Documents Other Presidential Documents Notice of March 2, 2012 Continuation of the National Emergency With Respect to the Situation in Zimbabwe On March 6, 2003, by Executive Order 13288, the President...

Decisions on control of foot-and-mouth disease informed using model predictions.

PubMed

Halasa, T; Willeberg, P; Christiansen, L E; Boklund, A; Alkhamis, M; Perez, A; Enøe, C

2013-11-01

The decision on whether or not to change the control strategy, such as introducing emergency vaccination, is perhaps one of the most difficult decisions faced by the veterinary authorities during a foot-and-mouth disease (FMD) epidemic. A simple tool that may predict the epidemic outcome and consequences would be useful to assist the veterinary authorities in the decision-making process. A previously proposed simple quantitative tool based on the first 14 days outbreaks (FFO) of FMD was used with results from an FMD simulation exercise. Epidemic outcomes included the number of affected herds, epidemic duration, geographical size and costs. The first 14 days spatial spread (FFS) was also included to further support the prediction. The epidemic data was obtained from a Danish version (DTU-DADS) of a pre-existing FMD simulation model (Davis Animal Disease Spread - DADS) adapted to model the spread of FMD in Denmark. The European Union (EU) and Danish regulations for FMD control were used in the simulation. The correlations between FFO and FFS and the additional number of affected herds after day 14 following detection of the first infected herd were 0.66 and 0.82, respectively. The variation explained by the FFO at day 14 following detection was high (P-value<0.001). This indicates that the FFO may take a part in the decision of whether or not to intensify FMD control, for instance by introducing emergency vaccination and/or pre-emptive depopulation, which might prevent a "catastrophic situation". A significant part of the variation was explained by supplementing the model with the FFS (P-value<0.001). Furthermore, the type of the index-herd was also a significant predictor of the epidemic outcomes (P-value<0.05). The results of the current study suggest that national veterinary authorities should consider to model their national situation and to use FFO and FFS to help planning and updating their contingency plans and FMD emergency control strategies. Copyright © 2013 Elsevier B.V. All rights reserved.

The Tuscan Mobile Simulation Program: a description of a program for the delivery of in situ simulation training.

PubMed

Ullman, Edward; Kennedy, Maura; Di Delupis, Francesco Dojmi; Pisanelli, Paolo; Burbui, Andrea Giuliattini; Cussen, Meaghan; Galli, Laura; Pini, Riccardo; Gensini, Gian Franco

2016-09-01

Simulation has become a critical aspect of medical education. It allows health care providers the opportunity to focus on safety and high-risk situations in a protected environment. Recently, in situ simulation, which is performed in the actual clinical setting, has been used to recreate a more realistic work environment. This form of simulation allows for better team evaluation as the workers are in their traditional roles, and can reveal latent safety errors that often are not seen in typical simulation scenarios. We discuss the creation and implementation of a mobile in situ simulation program in emergency departments of three hospitals in Tuscany, Italy, including equipment, staffing, and start-up costs for this program. We also describe latent safety threats identified in the pilot in situ simulations. This novel approach has the potential to both reduce the costs of simulation compared to traditional simulation centers, and to expand medical simulation experiences to providers and healthcare organizations that do not have access to a large simulation center.

A Time-Aware Routing Map for Indoor Evacuation †

PubMed Central

Zhao, Haifeng; Winter, Stephan

2016-01-01

Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making. PMID:26797610

Naturalistic Decision Making in Power Grid Operations: Implications for Dispatcher Training and Usability Testing

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

Greitzer, Frank L.; Podmore, Robin

2008-11-17

The focus of the present study is on improved training approaches to accelerate learning and improved methods for analyzing effectiveness of tools within a high-fidelity power grid simulated environment. A theory-based model has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The theoretical foundation for the method is based on the concepts of situation awareness, the methods of cognitive task analysis, and the naturalistic decision making (NDM) approach of Recognition Primed Decision Making. The method has been systematically explored and refined as part of a capability demonstration ofmore » a high-fidelity real-time power system simulator under normal and emergency conditions. To examine NDM processes, we analyzed transcripts of operator-to-operator conversations during the simulated scenario to reveal and assess NDM-based performance criteria. The results of the analysis indicate that the proposed framework can be used constructively to map or assess the Situation Awareness Level of the operators at each point in the scenario. We can also identify the mental models and mental simulations that the operators employ at different points in the scenario. This report documents the method, describes elements of the model, and provides appendices that document the simulation scenario and the associated mental models used by operators in the scenario.« less

Closing emergency operating rooms improves efficiency.

PubMed

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

2007-12-01

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

Emergency medicine: beyond the basics.

PubMed

Malamed, S F

1997-07-01

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

The simulation method in learning interpersonal communication competence--experiences of masters' degree students of health sciences.

PubMed

Saaranen, Terhi; Vaajoki, Anne; Kellomäki, Marjaana; Hyvärinen, Marja-Leena

2015-02-01

This article describes the experiences of master students of nursing science in learning interpersonal communication competence through the simulation method. The exercises reflected challenging interactive situations in the field of health care. Few studies have been published on using the simulation method in the communication education of teachers, managers, and experts in this field. The aim of this study is to produce information which can be utilised in developing the simulation method to promote the interpersonal communication competence of master-level students of health sciences. This study used the qualitative, descriptive research method. At the Department of Nursing Science, the University of Eastern Finland, students major in nursing science specialise in nursing leadership and management, preventive nursing science, or nurse teacher education. Students from all three specialties taking the Challenging Situations in Speech Communication course participated (n=47). Essays on meaningful learning experiences collected using the critical incident technique, underwent content analysis. Planning of teaching, carrying out different stages of the simulation exercise, participant roles, and students' personal factors were central to learning interpersonal communication competence. Simulation is a valuable method in developing the interpersonal communication competence of students of health sciences at the masters' level. The methods used in the simulation teaching of emergency care are not necessarily applicable as such to communication education. The role of teacher is essential to supervising students' learning in simulation exercises. In the future, it is important to construct questions that help students to reflect specifically on communication. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sparse approximation problem: how rapid simulated annealing succeeds and fails

NASA Astrophysics Data System (ADS)

Obuchi, Tomoyuki; Kabashima, Yoshiyuki

2016-03-01

Information processing techniques based on sparseness have been actively studied in several disciplines. Among them, a mathematical framework to approximately express a given dataset by a combination of a small number of basis vectors of an overcomplete basis is termed the sparse approximation. In this paper, we apply simulated annealing, a metaheuristic algorithm for general optimization problems, to sparse approximation in the situation where the given data have a planted sparse representation and noise is present. The result in the noiseless case shows that our simulated annealing works well in a reasonable parameter region: the planted solution is found fairly rapidly. This is true even in the case where a common relaxation of the sparse approximation problem, the G-relaxation, is ineffective. On the other hand, when the dimensionality of the data is close to the number of non-zero components, another metastable state emerges, and our algorithm fails to find the planted solution. This phenomenon is associated with a first-order phase transition. In the case of very strong noise, it is no longer meaningful to search for the planted solution. In this situation, our algorithm determines a solution with close-to-minimum distortion fairly quickly.

E-DECIDER Disaster Response and Decision Support Cyberinfrastructure: Technology and Challenges

NASA Astrophysics Data System (ADS)

Glasscoe, M. T.; Parker, J. W.; Pierce, M. E.; Wang, J.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

2014-12-01

Timely delivery of critical information to decision makers during a disaster is essential to response and damage assessment. Key issues to an efficient emergency response after a natural disaster include rapidly processing and delivering this critical information to emergency responders and reducing human intervention as much as possible. Essential elements of information necessary to achieve situational awareness are often generated by a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. A key challenge is the current state of practice does not easily support information sharing and technology interoperability. NASA E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) has worked with the California Earthquake Clearinghouse and its partners to address these issues and challenges by adopting the XChangeCore Web Service Data Orchestration technology and participating in several earthquake response exercises. The E-DECIDER decision support system provides rapid delivery of advanced situational awareness data products to operations centers and emergency responders in the field. Remote sensing and hazard data, model-based map products, information from simulations, damage detection, and crowdsourcing is integrated into a single geospatial view and delivered through a service oriented architecture for improved decision-making and then directly to mobile devices of responders. By adopting a Service Oriented Architecture based on Open Geospatial Consortium standards, the system provides an extensible, comprehensive framework for geospatial data processing and distribution on Cloud platforms and other distributed environments. While the Clearinghouse and its partners are not first responders, they do support the emergency response community by providing information about the damaging effects earthquakes. It is critical for decision makers to maintain a situational awareness that is knowledgeable of potential and current conditions, possible impacts on populations and infrastructure, and other key information. E-DECIDER and the Clearinghouse have worked together to address many of these issues and challenges to deliver interoperable, authoritative decision support products.

44 CFR 4.11 - What are the Administrator's obligations in interstate situations?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false What are the Administrator's obligations in interstate situations? 4.11 Section 4.11 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL INTERGOVERNMENTAL REVIEW OF FEDERAL EMERGENCY...

Emergency Situation Prediction Mechanism: A Novel Approach for Intelligent Transportation System Using Vehicular Ad Hoc Networks

PubMed Central

Gokulakrishnan, P.

2015-01-01

In Indian four-lane express highway, millions of vehicles are travelling every day. Accidents are unfortunate and frequently occurring in these highways causing deaths, increase in death toll, and damage to infrastructure. A mechanism is required to avoid such road accidents at the maximum to reduce the death toll. An Emergency Situation Prediction Mechanism, a novel and proactive approach, is proposed in this paper for achieving the best of Intelligent Transportation System using Vehicular Ad Hoc Network. ESPM intends to predict the possibility of occurrence of an accident in an Indian four-lane express highway. In ESPM, the emergency situation prediction is done by the Road Side Unit based on (i) the Status Report sent by the vehicles in the range of RSU and (ii) the road traffic flow analysis done by the RSU. Once the emergency situation or accident is predicted in advance, an Emergency Warning Message is constructed and disseminated to all vehicles in the area of RSU to alert and prevent the vehicles from accidents. ESPM performs well in emergency situation prediction in advance to the occurrence of an accident. ESPM predicts the emergency situation within 0.20 seconds which is comparatively less than the statistical value. The prediction accuracy of ESPM against vehicle density is found better in different traffic scenarios. PMID:26065014

[Learning together for working together: interprofessionalism in simulation training for collaborative skills development].

PubMed

Policard, Florence

2014-06-01

The use of simulation as an educational tool is becoming more widespread in healthcare. Such training gathers doctors and nurses together, which is a rare opportunity in such a sector. The present research focuses on the contribution of inter-professional training to the development of collaborative skills when managing an emergency situation in the context of anesthesia or intensive care. From direct observations of post-simulation debriefing sessions and interviews held with learners in post graduate or in-service training, either in single or multi-professional groups, this study shows that these sessions, based on experiential learning and reflective practice, help to build a shared vision of the problem and of common operative patterns, supporting better communication and the "ability to work in a team".

Two-Graph Building Interior Representation for Emergency Response Applications

NASA Astrophysics Data System (ADS)

Boguslawski, P.; Mahdjoubi, L.; Zverovich, V.; Fadli, F.

2016-06-01

Nowadays, in a rapidly developing urban environment with bigger and higher public buildings, disasters causing emergency situations and casualties are unavoidable. Preparedness and quick response are crucial issues saving human lives. Available information about an emergency scene, such as a building structure, helps for decision making and organizing rescue operations. Models supporting decision-making should be available in real, or near-real, time. Thus, good quality models that allow implementation of automated methods are highly desirable. This paper presents details of the recently developed method for automated generation of variable density navigable networks in a 3D indoor environment, including a full 3D topological model, which may be used not only for standard navigation but also for finding safe routes and simulating hazard and phenomena associated with disasters such as fire spread and heat transfer.

SCALING AN URBAN EMERGENCY EVACUATION FRAMEWORK: CHALLENGES AND PRACTICES

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

Karthik, Rajasekar; Lu, Wei

2014-01-01

Critical infrastructure disruption, caused by severe weather events, natural disasters, terrorist attacks, etc., has significant impacts on urban transportation systems. We built a computational framework to simulate urban transportation systems under critical infrastructure disruption in order to aid real-time emergency evacuation. This framework will use large scale datasets to provide a scalable tool for emergency planning and management. Our framework, World-Wide Emergency Evacuation (WWEE), integrates population distribution and urban infrastructure networks to model travel demand in emergency situations at global level. Also, a computational model of agent-based traffic simulation is used to provide an optimal evacuation plan for traffic operationmore » purpose [1]. In addition, our framework provides a web-based high resolution visualization tool for emergency evacuation modelers and practitioners. We have successfully tested our framework with scenarios in both United States (Alexandria, VA) and Europe (Berlin, Germany) [2]. However, there are still some major drawbacks for scaling this framework to handle big data workloads in real time. On our back-end, lack of proper infrastructure limits us in ability to process large amounts of data, run the simulation efficiently and quickly, and provide fast retrieval and serving of data. On the front-end, the visualization performance of microscopic evacuation results is still not efficient enough due to high volume data communication between server and client. We are addressing these drawbacks by using cloud computing and next-generation web technologies, namely Node.js, NoSQL, WebGL, Open Layers 3 and HTML5 technologies. We will describe briefly about each one and how we are using and leveraging these technologies to provide an efficient tool for emergency management organizations. Our early experimentation demonstrates that using above technologies is a promising approach to build a scalable and high performance urban emergency evacuation framework that can improve traffic mobility and safety under critical infrastructure disruption in today s socially connected world.« less

Aircraft Emergencies: Challenge and Response

NASA Technical Reports Server (NTRS)

Burian, Barbara K.

2010-01-01

Emergency and abnormal situations in aviation present flight crews with a number of challenges. Checklists are essential tools that have been developed to assist them to meet these challenges. However, in order for checklists to be most effective in these situations they must be designed with the operational and situational demands of emergencies and abnormal conditions in mind as well as human performance capabilities and limitations under high stress and workload.

Multi-Satellite Scheduling Approach for Dynamic Areal Tasks Triggered by Emergent Disasters

NASA Astrophysics Data System (ADS)

Niu, X. N.; Zhai, X. J.; Tang, H.; Wu, L. X.

2016-06-01

The process of satellite mission scheduling, which plays a significant role in rapid response to emergent disasters, e.g. earthquake, is used to allocate the observation resources and execution time to a series of imaging tasks by maximizing one or more objectives while satisfying certain given constraints. In practice, the information obtained of disaster situation changes dynamically, which accordingly leads to the dynamic imaging requirement of users. We propose a satellite scheduling model to address dynamic imaging tasks triggered by emergent disasters. The goal of proposed model is to meet the emergency response requirements so as to make an imaging plan to acquire rapid and effective information of affected area. In the model, the reward of the schedule is maximized. To solve the model, we firstly present a dynamic segmenting algorithm to partition area targets. Then the dynamic heuristic algorithm embedding in a greedy criterion is designed to obtain the optimal solution. To evaluate the model, we conduct experimental simulations in the scene of Wenchuan Earthquake. The results show that the simulated imaging plan can schedule satellites to observe a wider scope of target area. We conclude that our satellite scheduling model can optimize the usage of satellite resources so as to obtain images in disaster response in a more timely and efficient manner.

Age-related differences in decision-making for digital escape route signage under strenuous emergency conditions of tilted passenger ships.

PubMed

Kwee-Meier, Sonja Th; Mertens, Alexander; Schlick, Christopher M

2017-03-01

This age-differentiated study investigated preferences for new digital, situation-adaptive escape route signage with informative and flashing elements under simulated emergency conditions of tilted passenger ships. The decision-making behaviour of 26 young (20-30 years) and 26 elderly (60-77 years) participants was observed in four conditions varying in applied stressors and in level versus uphill walking at 7° and 14°. In line with previous studies, decisions of young participants were significantly influenced by flashing elements on signs. In contrast, elderly participants based their decisions significantly stronger on integrated information about the sign's updatedness and reported irritation by flashing elements. These preferences were also persistent under increased mental, emotional and physical strain, evaluated by ratings and (psycho-)physiological measures. The findings demonstrate the importance to carefully design digital, situation-adaptive signage for passenger ships in a way that it not only attracts attention but also inspires trust especially for the elderly population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Modified two-layer social force model for emergency earthquake evacuation

NASA Astrophysics Data System (ADS)

Zhang, Hao; Liu, Hong; Qin, Xin; Liu, Baoxi

2018-02-01

Studies of crowd behavior with related research on computer simulation provide an effective basis for architectural design and effective crowd management. Based on low-density group organization patterns, a modified two-layer social force model is proposed in this paper to simulate and reproduce a group gathering process. First, this paper studies evacuation videos from the Luan'xian earthquake in 2012, and extends the study of group organization patterns to a higher density. Furthermore, taking full advantage of the strength in crowd gathering simulations, a new method on grouping and guidance is proposed while using crowd dynamics. Second, a real-life grouping situation in earthquake evacuation is simulated and reproduced. Comparing with the fundamental social force model and existing guided crowd model, the modified model reduces congestion time and truly reflects group behaviors. Furthermore, the experiment result also shows that a stable group pattern and a suitable leader could decrease collision and allow a safer evacuation process.

The Persuasive Power of Virtual Reality: Effects of Simulated Human Distress on Attitudes towards Fire Safety

NASA Astrophysics Data System (ADS)

Chittaro, Luca; Zangrando, Nicola

Although virtual reality (VR) is a powerful simulation tool that can allow users to experience the effects of their actions in vivid and memorable ways, explorations of VR as a persuasive technology are rare. In this paper, we focus on different ways of providing negative feedback for persuasive purposes through simulated experiences in VR. The persuasive goal we consider concerns awareness of personal fire safety issues and the experiment we describe focuses on attitudes towards smoke in evacuating buildings. We test two techniques: the first technique simulates the damaging effects of smoke on the user through a visualization that should not evoke strong emotions, while the second is aimed at partially reproducing the anxiety of an emergency situation. The results of the study show that the second technique is able to increase user's anxiety as well as producing better results in attitude change.

Surgical resource utilization in urban terrorist bombing: a computer simulation.

PubMed

Hirshberg, A; Stein, M; Walden, R

1999-09-01

The objective of this study was to analyze the utilization of surgical staff and facilities during an urban terrorist bombing incident. A discrete-event computer model of the emergency room and related hospital facilities was constructed and implemented, based on cumulated data from 12 urban terrorist bombing incidents in Israel. The simulation predicts that the admitting capacity of the hospital depends primarily on the number of available surgeons and defines an optimal staff profile for surgeons, residents, and trauma nurses. The major bottlenecks in the flow of critical casualties are the shock rooms and the computed tomographic scanner but not the operating rooms. The simulation also defines the number of reinforcement staff needed to treat noncritical casualties and shows that radiology is the major obstacle to the flow of these patients. Computer simulation is an important new tool for the optimization of surgical service elements for a multiple-casualty situation.

Numerical simulation of DPF filter for selected regimes with deposited soot particles

NASA Astrophysics Data System (ADS)

Lávička, David; Kovařík, Petr

2012-04-01

For the purpose of accumulation of particulate matter from Diesel engine exhaust gas, particle filters are used (referred to as DPF or FAP filters in the automotive industry). However, the cost of these filters is quite high. As the emission limits become stricter, the requirements for PM collection are rising accordingly. Particulate matters are very dangerous for human health and these are not invisible for human eye. They can often cause various diseases of the respiratory tract, even what can cause lung cancer. Performed numerical simulations were used to analyze particle filter behavior under various operating modes. The simulations were especially focused on selected critical states of particle filter, when engine is switched to emergency regime. The aim was to prevent and avoid critical situations due the filter behavior understanding. The numerical simulations were based on experimental analysis of used diesel particle filters.

Design and evaluation of simulation scenarios for a program introducing patient safety, teamwork, safety leadership, and simulation to healthcare leaders and managers.

PubMed

Cooper, Jeffrey B; Singer, Sara J; Hayes, Jennifer; Sales, Michael; Vogt, Jay W; Raemer, Daniel; Meyer, Gregg S

2011-08-01

We developed a training program to introduce managers and informal leaders of healthcare organizations to key concepts of teamwork, safety leadership, and simulation to motivate them to act as leaders to improve safety within their sphere of influence. This report describes the simulation scenario and debriefing that are core elements of that program. Twelve teams of clinician and nonclinician managers were selected from a larger set of volunteers to participate in a 1-day, multielement training program. Two simulation exercises were developed: one for teams of nonclinicians and the other for clinicians or mixed groups. The scenarios represented two different clinical situations, each designed to engage participants in discussions of their safety leadership and teamwork issues immediately after the experience. In the scenarios for nonclinicians, participants conducted an anesthetic induction and then managed an ethical situation. The scenario for clinicians simulated a consulting visit to an emergency room that evolved into a problem-solving challenge. Participants in this scenario had a limited time to prepare advice for hospital leadership on how to improve observed safety and cultural deficiencies. Debriefings after both types of scenarios were conducted using principles of "debriefing with good judgment." We assessed the relevance and impact of the program by analyzing participant reactions to the simulation through transcript data and facilitator observations as well as a postcourse questionnaire. The teams generally reported positive perceptions of the relevance and quality of the simulation with varying types and degrees of impact on their leadership and teamwork behaviors. These kinds of clinical simulation exercises can be used to teach healthcare leaders and managers safety leadership and teamwork skills and behaviors.

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of January 26, 2011 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 4, 2013 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 3 The President 1 2011-01-01 2011-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 2, 2010 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 3, 2012 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 3 The President 1 2010-01-01 2010-01-01 false Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire Presidential Documents Other Presidential Documents Notice of February 4, 2009 Continuation of the National Emergency With Respect to the Situation in or in Relation to Côte d'Ivoire On February 7...

An interplay model for authorities' actions and rumor spreading in emergency event

NASA Astrophysics Data System (ADS)

Huo, Liang-an; Huang, Peiqing; Fang, Xing

2011-10-01

Rumor spreading influences how rational individuals assess risks and evaluate needs, especially, it affects authorities to make decisions in an emergency-affected environments. Conversely, authorities' response to emergency will induct public opinions as well. In this paper, we present a simple model to describe the interplay between rumor spreading and authorities' actions in emergency situation based on utility theory. By drawing from differential equations we found that it is possible to minimize negative social utility of rumor spreading in the control of situation. At the same time, authorities' proactive actions can improve rumor management in emergency situation and yield positive social utility. Finally, we outline strategies for authorities that can contribute to rumor management in an emergency event.

Method and system for conserving power in a telecommunications network during emergency situations

DOEpatents

Conrad, Stephen H [Algodones, NM; O'Reilly, Gerard P [Manalapan, NJ

2011-10-11

Disclosed is a method and apparatus for conserving power in a telecommunications network during emergency situations. A permissible number list of emergency and/or priority numbers is stored in the telecommunications network. In the event of an emergency or power failure, input digits of a call to the telecommunications network are compared to the permissible number list. The call is processed in the telecommunications network and routed to its destination if the input digits match an entry in the permissible number list. The call is dropped without any further processing if the input digits do not match an entry in the permissible number list. Thus, power can be conserved in emergency situations by only allowing emergency and/or priority calls.

40 CFR 166.40 - Authorization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND STATE AGENCIES FOR USE OF PESTICIDES UNDER EMERGENCY CONDITIONS Crisis Exemptions § 166.40... issue a crisis exemption in situations involving an unpredictable emergency situation when: (a) An...

A Cognitive Task Analysis for an Emergency Management Serious Game.

PubMed

Dass, Susan; Barnieu, Joanne; Cummings, Paul; Cid, Victor

2016-01-01

The Bethesda Hospitals' Emergency Preparedness Partnership identified a need to design training systems for hospital emergency management scenarios that included incident command situations. As part of this partnership, the National Library of Medicine (NLM) was challenged to develop an engaging, learner-centered simulation to specifically address hospital procedures for highly infectious diseases (HIDs) for multiple hospital roles. A serious game approach was selected for the simulation because collaborative (multiplayer) immersive, game-based simulations have been proven to generate realistic and engaging learning experiences and, when properly designed, can enhance training while minimizing cost compared to full-scale disaster exercises (Spain et al., 2013). Although substantial research effort has been put into design and evaluation of serious games, less time has been spent on developing sound instructional design methodologies to support serious game development. So how does one collect the appropriate, relevant, contextualized content and then align with serious game design elements? This paper describes how a cognitive task approach supported by a live demonstration with a think-aloud protocol was used to collect the rich psychomotor, procedural, and cognitive data necessary for the design of a serious game for handling HIDs. Furthermore, the paper presents a process to translate the collected data into meaningful content to support rapid prototyping. Recommendations for data collection and translation for a serious game close the paper.

A Cognitive Task Analysis for an Emergency Management Serious Game

PubMed Central

Dass, Susan; Barnieu, Joanne; Cummings, Paul; Cid, Victor

2017-01-01

The Bethesda Hospitals' Emergency Preparedness Partnership identified a need to design training systems for hospital emergency management scenarios that included incident command situations. As part of this partnership, the National Library of Medicine (NLM) was challenged to develop an engaging, learner-centered simulation to specifically address hospital procedures for highly infectious diseases (HIDs) for multiple hospital roles. A serious game approach was selected for the simulation because collaborative (multiplayer) immersive, game-based simulations have been proven to generate realistic and engaging learning experiences and, when properly designed, can enhance training while minimizing cost compared to full-scale disaster exercises (Spain et al., 2013). Although substantial research effort has been put into design and evaluation of serious games, less time has been spent on developing sound instructional design methodologies to support serious game development. So how does one collect the appropriate, relevant, contextualized content and then align with serious game design elements? This paper describes how a cognitive task approach supported by a live demonstration with a think-aloud protocol was used to collect the rich psychomotor, procedural, and cognitive data necessary for the design of a serious game for handling HIDs. Furthermore, the paper presents a process to translate the collected data into meaningful content to support rapid prototyping. Recommendations for data collection and translation for a serious game close the paper. PMID:29629430

The optimization of nuclear power plants operation modes in emergency situations

NASA Astrophysics Data System (ADS)

Zagrebayev, A. M.; Trifonenkov, A. V.; Ramazanov, R. N.

2018-01-01

An emergency situations resulting in the necessity for temporary reactor trip may occur at the nuclear power plant while normal operating mode. The paper deals with some of the operation c aspects of nuclear power plant operation in emergency situations and during threatened period. The xenon poisoning causes limitations on the variety of statements of the problem of calculating characteristics of a set of optimal reactor power off controls. The article show a possibility and feasibility of new sets of optimization tasks for the operation of nuclear power plants under conditions of xenon poisoning in emergency circumstances.

Onboard autonomous mission re-planning for multi-satellite system

NASA Astrophysics Data System (ADS)

Zheng, Zixuan; Guo, Jian; Gill, Eberhard

2018-04-01

This paper presents an onboard autonomous mission re-planning system for Multi-Satellites System (MSS) to perform onboard re-planing in disruptive situations. The proposed re-planning system can deal with different potential emergency situations. This paper uses Multi-Objective Hybrid Dynamic Mutation Genetic Algorithm (MO-HDM GA) combined with re-planning techniques as the core algorithm. The Cyclically Re-planning Method (CRM) and the Near Real-time Re-planning Method (NRRM) are developed to meet different mission requirements. Simulations results show that both methods can provide feasible re-planning sequences under unforeseen situations. The comparisons illustrate that using the CRM is average 20% faster than the NRRM on computation time. However, by using the NRRM more raw data can be observed and transmitted than using the CRM within the same period. The usability of this onboard re-planning system is not limited to multi-satellite system. Other mission planning and re-planning problems related to autonomous multiple vehicles with similar demands are also applicable.

Analysis of Braking Behavior of Train Drivers to Detect Unusual Driving

NASA Astrophysics Data System (ADS)

Marumo, Yoshitaka; Tsunashima, Hitoshi; Kojima, Takashi; Hasegawa, Yasushi

The safety devices for train systems are activated in emergency situations when a risk becomes obvious, and the emergency brake is applied. If such systems are faulty, the drivers' operating errors may cause immediate accidents. So it is necessary to evaluate potential risks by detecting improper driving behavior before overt risks appear. This study analyzes the driving behavior of train drivers using a train-driving simulator. We focus on braking behavior when approaching a station. Two methods for detecting unusual braking operation are examined by giving drivers mental calculation problems as a mental workload. The first is a method monitoring the driver's brake handle operation, and the second is a method measuring vehicle deceleration. These methods make it possible to detect unusual driving.

Design and Demonstration of Emergency Control Modes for Enhanced Engine Performance

NASA Technical Reports Server (NTRS)

Liu, Yuan; Litt, Jonathan S.; Guo, Ten-Huei

2013-01-01

A design concept is presented for developing control modes that enhance aircraft engine performance during emergency flight scenarios. The benefits of increased engine performance to overall vehicle survivability during these situations may outweigh the accompanied elevated risk of engine failure. The objective involves building control logic that can consistently increase engine performance beyond designed maximum levels based on an allowable heightened probability of failure. This concept is applied to two previously developed control modes: an overthrust mode that increases maximum engine thrust output and a faster response mode that improves thrust response to dynamic throttle commands. This paper describes the redesign of these control modes and presents simulation results demonstrating both enhanced engine performance and robust maintenance of the desired elevated risk level.

Evolving mobile robots able to display collective behaviors.

PubMed

Baldassarre, Gianluca; Nolfi, Stefano; Parisi, Domenico

2003-01-01

We present a set of experiments in which simulated robots are evolved for the ability to aggregate and move together toward a light target. By developing and using quantitative indexes that capture the structural properties of the emerged formations, we show that evolved individuals display interesting behavioral patterns in which groups of robots act as a single unit. Moreover, evolved groups of robots with identical controllers display primitive forms of situated specialization and play different behavioral functions within the group according to the circumstances. Overall, the results presented in the article demonstrate that evolutionary techniques, by exploiting the self-organizing behavioral properties that emerge from the interactions between the robots and between the robots and the environment, are a powerful method for synthesizing collective behavior.

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

PubMed

Wattel, Francis; Dubois, François

2012-01-01

In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas, fewer voluntary firemen, hospital reorganization, tight funding, difficulties of medical dispatching, and the varying skills of "first-on-the-scene "emergency workers. Grievances include late emergency responses, inappropriate medical care, and dispatching to the wrong facility. This raises the question of equal opportunity for all in a country with widely varying geographic features and population density. Improvement in the system's efficiency will require a series of objectives to be met in varied and complementary--Enhanced functional coordination, by speeding up the deployment of the ANTARES digital radio-frequency transmission network (Adaptation Nationale des Transmissions Aux Risques Et aux Secours).--Implementation of a network of emergency services with varying degrees of emergency healthcare management related to the technical nature of the facilities. Three levels of emergency healthcare must be made available: level 1 is provided by local hospitals, level 2 includes support facilities available in general hospitals (not necessarily the nearest hospital), and level 3 provides specialized healthcare in large and/or training hospitals with specialized departments. Life-threatening emergency situations are to be handled by level 2 or 3 facilities. Specific facilities must be selected as reference centers. In France, the ARS (Agences Régionales de Santé) is in charge of this procedure, as it provide funding for healthcare continuity--Reducing inequalities in access to emergency care. This will involve improving the network of SDIS brigades, making local medical facilities more responsive, delegating more medical procedures, on-site telemedicine, providing more helicopters equipped with healthcare facilities, more automated external defibrillators, and more dedicated neuro-vascular units.--First aid training must be made widely available. The French National Academy of Medicine has approved ten recommendations regarding organization and facilities.

Leveraging social media for flood emergency management: an experience in Campania region (southern Italy)

NASA Astrophysics Data System (ADS)

Biafore, Mauro

2017-04-01

Campania is the Italian region with the highest population density (419 inhabitants/km2). Almost 20% of its territory (13669 km2) is exposed to severe hydrogeological risk scenarios, triggered by extreme rainfall events with duration ranging from a few tens of minutes to several hours. Many of these risk scenarios can only be mitigated by non-structural measures, which are mainly designed to increase the resilience of the exposed communities. Several studies have evidenced that the effectiveness of civil protection actions can be enhanced by using social media for disseminating and collecting information relevant for crisis preparedness, response and recovery. However, the application of social media in the management of hydrogeological risks is still in its infancy. The civil protection of Campania Region, as part of a FP7 project called SUPER (Social sensors for secUrity Assessments and Proactive EmeRgencies management), has been validating an integrated framework enabling optimal blending of social media in the emergency management processes. The SUPER project is a joint effort of social media experts (including social network providers) and security experts (including security and civil protection agencies), towards introducing an integrated and privacy-friendly approach to the use of social media in emergencies and security incidents. As part of the project outcomes, the "SUPER platform" has been developed. It consists of a set of social media processing components integrated in a Common Operational Picture, designed for supporting security and emergency management. A demonstration was primarily setup to evaluate how the SUPER platform can effectively facilitate the exploitation of social media data for improving civil protection actions during a simulated emergency scenario. To this purpose, a civil protection exercise took place in the city of Sorrento (Naples, Italy), involving tens of volunteers and emergency operators. The simulated emergency scenario was represented by simultaneous flash floods associated with shallow landslides, triggered by a severe thunderstorm in the city centre of Sorrento. Volunteers on the field simulated the social media engagement during such an event. The SUPER platform was successfully evaluated with respect to the following real-time operations: i) filtering the relevant information posted on Twitter during the simulated emergency; ii) geo-localising the relevant information within the Command Operational Picture; iii) enhancing the situation awareness at Command and Control level.

The effect of a standardised source of divided attention in airway management: A randomised, crossover, interventional manikin study.

PubMed

Prottengeier, Johannes; Petzoldt, Marlen; Jess, Nikola; Moritz, Andreas; Gall, Christine; Schmidt, Joachim; Breuer, Georg

2016-03-01

Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty. We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management. A randomised, crossover, interventional simulation study. Center for Training and Simulation, Department of Anaesthesiology, Erlangen University Hospital, Germany. One hundred and fifty volunteer medical students, paramedics and anaesthesiologists of all levels of training. Participants secured the airway of a manikin using a supraglottic airway, conventional endotracheal intubation and video-assisted endotracheal intubation with and without the Paced Auditory Serial Addition Test (PASAT), which served as a quantifiable source of divided attention. Primary endpoint was the time for the completion of each airway task. Secondary endpoints were the number of procedural mistakes made and the perceived workload as measured by the National Aeronautics and Space Administration's task load index (NASA-TLX). This is a six-dimensional questionnaire, which assesses the perception of demands, performance and frustration with respect to a task on a scale of 0 to 100. All 150 participants completed the tests. Volunteers perceived our test to be challenging (99%) and the experience of stress and distraction true to an emergency situation (80%), but still fair (98%) and entertaining (95%). The negative effects of divided attention were reproducible in participants of all levels of expertise. Time consumption and perceived workload increased and almost half the participants make procedural mistakes under divided attention. The supraglottic airway technique was least affected by divided attention. The scenario was effective for simulation training involving divided attention in acute care medicine. The significant effects on performance and perceived workload demonstrate the validity of the model, which was also characterised by high acceptability, technical simplicity and a novel degree of standardisation.

New method for distance-based close following safety indicator.

PubMed

Sharizli, A A; Rahizar, R; Karim, M R; Saifizul, A A

2015-01-01

The increase in the number of fatalities caused by road accidents involving heavy vehicles every year has raised the level of concern and awareness on road safety in developing countries like Malaysia. Changes in the vehicle dynamic characteristics such as gross vehicle weight, travel speed, and vehicle classification will affect a heavy vehicle's braking performance and its ability to stop safely in emergency situations. As such, the aim of this study is to establish a more realistic new distance-based safety indicator called the minimum safe distance gap (MSDG), which incorporates vehicle classification (VC), speed, and gross vehicle weight (GVW). Commercial multibody dynamics simulation software was used to generate braking distance data for various heavy vehicle classes under various loads and speeds. By applying nonlinear regression analysis to the simulation results, a mathematical expression of MSDG has been established. The results show that MSDG is dynamically changed according to GVW, VC, and speed. It is envisaged that this new distance-based safety indicator would provide a more realistic depiction of the real traffic situation for safety analysis.

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

PubMed

Malamed, Stanley F

2015-12-01

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

KSC-2011-2705

NASA Image and Video Library

2011-04-01

CAPE CANAVERAL, Fla. -- During a simulated pad emergency on Launch Pad 39A at NASA's Kennedy Space Center in Florida, STS-134 Mission Specialist Roberto Vittori, with the European Space Agency, front, and a fellow crewmate make their way toward a slidewire basket that would take them to a safe bunker below the pad in an unlikely emergency situation. The emergency training while aboard space shuttle Endeavour is part of a week-long Terminal Countdown Demonstration Test (TCDT). Endeavour's six crew members are targeted to launch April 19 at 7:48 p.m. EDT. They will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. This will be the final spaceflight for Endeavour. For more information visit, www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Kim Shiflett

KSC-2011-2702

NASA Image and Video Library

2011-04-01

CAPE CANAVERAL, Fla. - During a simulated pad emergency on Launch Pad 39A at NASA's Kennedy Space Center in Florida, STS-134 Mission Specialist Roberto Vittori, with the European Space Agency, hops in a slidewire basket that would take him to a safe bunker below the pad in an unlikely emergency situation. The emergency training while aboard space shuttle Discovery is part of a week-long Terminal Countdown Demonstration Test (TCDT). Endeavour's six crew members are targeted to launch April 19 at 7:48 p.m. EDT. They will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. This will be the final spaceflight for Endeavour. For more information visit, www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Kim Shiflett

From bioterrorism exercise to real-life public health crisis: lessons for emergency hotline operations.

PubMed

Uscher-Pines, Lori; Bookbinder, Sylvia H; Miro, Suzanne; Burke, Thomas

2007-01-01

Although public health agencies routinely operate hotlines to communicate key messages to the public, they are rarely evaluated to improve hotline management. Since its creation in 2003, the New Jersey Department of Health & Senior Services' Emergency Communications Center has confronted two large-scale incidents that have tested its capabilities in this area. The influenza vaccine shortage of 2004 and the April 2005 TOPOFF 3 full-scale bioterrorism exercise provided both real-life and simulated crisis situations from which to derive general insights into the strengths and weaknesses of hotline administration. This article identifies problems in the areas of staff and message management by analyzing call volume data and the qualitative observations of group feedback sessions and semistructured interviews with hotline staff. It also makes recommendations based on lessons learned to improve future hotline operations in public health emergencies.

Simulation of asteroid impact on ocean surfaces, subsequent wave generation and the effect on US shorelines

DOE PAGES

Ezzedine, Souheil M.; Lomov, Ilya; Miller, Paul L.; ...

2015-05-19

As part of a larger effort involving members of several other organizations, we have conducted numerical simulations in support of emergency-response exercises of postulated asteroid ocean impacts. We have addressed the problem from source (asteroid entry) to ocean impact (splash) to wave generation, propagation and interaction with the U.S. shoreline. We simulated three impact sites. The first site is located off the east coast by Maryland's shoreline. The second site is located off of the West coast, the San Francisco bay. The third set of sites are situated in the Gulf of Mexico. Asteroid impacts on the ocean surface aremore » conducted using LLNL's hydrocode GEODYN to create the impact wave source for the shallow water wave propagation code, SWWP, a shallow depth averaged water wave code.« less

Simulation of asteroid impact on ocean surfaces, subsequent wave generation and the effect on US shorelines

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

Ezzedine, Souheil M.; Lomov, Ilya; Miller, Paul L.

As part of a larger effort involving members of several other organizations, we have conducted numerical simulations in support of emergency-response exercises of postulated asteroid ocean impacts. We have addressed the problem from source (asteroid entry) to ocean impact (splash) to wave generation, propagation and interaction with the U.S. shoreline. We simulated three impact sites. The first site is located off the east coast by Maryland's shoreline. The second site is located off of the West coast, the San Francisco bay. The third set of sites are situated in the Gulf of Mexico. Asteroid impacts on the ocean surface aremore » conducted using LLNL's hydrocode GEODYN to create the impact wave source for the shallow water wave propagation code, SWWP, a shallow depth averaged water wave code.« less

SU-F-E-16: A Specific Training Package for Medical Physicists in Support to Nuclear and Radiological Emergency Situations

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

Meghzifene, A; Berris, T

Purpose: To provide the professional medical physicists with adequate competencies and skills in order to help them get prepared to support Nuclear or Radiological Emergency (NRE) situations. Methods: Although clinical medical physicists working have in-depth knowledge in radiation dosimetry, including dose reconstruction and dose measurements, they are usually not involved in NRE situations. However, in a few instances where medical physicists were involved in NREs, it appeared that many lacked specific knowledge and skills that are required in such situations. This lack of specific knowledge and skills is probably due to the fact that most current medical physics curricula domore » not include a specific module on this topic. As a response to this finding, the IAEA decided to initiate a project to develop a specific training package to help prepare medical physicists to support NRE situations. The training package was developed with the kind support of the Government of Japan and in collaboration with Fukushima Medical University (FMU) and the National Institute of Radiological Sciences (NIRS). Results: The first International Workshop to test the training package was held in Fukushima, Japan in June 2015. It consisted of lectures, demonstrations, simulation, role play, and practical sessions followed by discussions. The training was delivered through 14 modules which were prepared with the support of 12 lecturers. A knowledge assessment test was done before the workshop, followed by the same test done at the end of the Workshop, to assess the knowledge acquired during the training. Conclusion: The Workshop was successfully implemented. The overall rating of the workshop by the participants was excellent and all participants reported that they acquired a good understanding of the main issues that are relevant to medical physics support in case of NRE situations. They are expected to disseminate the knowledge to other medical physicists in their countries.« less

Modeling operators' emergency response time for chemical processing operations.

PubMed

Murray, Susan L; Harputlu, Emrah; Mentzer, Ray A; Mannan, M Sam

2014-01-01

Operators have a crucial role during emergencies at a variety of facilities such as chemical processing plants. When an abnormality occurs in the production process, the operator often has limited time to either take corrective actions or evacuate before the situation becomes deadly. It is crucial that system designers and safety professionals can estimate the time required for a response before procedures and facilities are designed and operations are initiated. There are existing industrial engineering techniques to establish time standards for tasks performed at a normal working pace. However, it is reasonable to expect the time required to take action in emergency situations will be different than working at a normal production pace. It is possible that in an emergency, operators will act faster compared to a normal pace. It would be useful for system designers to be able to establish a time range for operators' response times for emergency situations. This article develops a modeling approach to estimate the time standard range for operators taking corrective actions or following evacuation procedures in emergency situations. This will aid engineers and managers in establishing time requirements for operators in emergency situations. The methodology used for this study combines a well-established industrial engineering technique for determining time requirements (predetermined time standard system) and adjustment coefficients for emergency situations developed by the authors. Numerous videos of workers performing well-established tasks at a maximum pace were studied. As an example, one of the tasks analyzed was pit crew workers changing tires as quickly as they could during a race. The operations in these videos were decomposed into basic, fundamental motions (such as walking, reaching for a tool, and bending over) by studying the videos frame by frame. A comparison analysis was then performed between the emergency pace and the normal working pace operations to determine performance coefficients. These coefficients represent the decrease in time required for various basic motions in emergency situations and were used to model an emergency response. This approach will make hazardous operations requiring operator response, alarm management, and evacuation processes easier to design and predict. An application of this methodology is included in the article. The time required for an emergency response was roughly a one-third faster than for a normal response time.

[Palliative care and end-of-life patients in emergency situations. Recommendations on optimization of out-patient care].

PubMed

Wiese, C H R; Vagts, D A; Kampa, U; Pfeiffer, G; Grom, I-U; Gerth, M A; Graf, B M; Zausig, Y A

2011-02-01

At the end of life acute exacerbations of medical symptoms (e.g. dyspnea) in palliative care patients often result in emergency medical services being alerted. The goals of this study were to discuss cooperation between emergency medical and palliative care structures to optimize the quality of care in emergencies involving palliative care patients. For data collection an open discussion of the main topics by experts in palliative and emergency medical care was employed. Main outcome measures and recommendations included responses regarding current practices related to expert opinions and international literature sources. As the essential points of consensus the following recommendations for optimization of care were named: (1) integration of palliative care in the emergency medicine curricula for pre-hospital emergency physicians and paramedics, (2) development of outpatient palliative care, (3) integration of palliative care teams into emergency medical structures, (4) cooperation between palliative and emergency medical care, (5) integration of crisis intervention into outpatient palliative emergency medical care, (6) provision of emergency plans and emergency medical boxes, (7) provision of palliative crisis cards and do not attempt resuscitation (DNAR) orders, (8) psychosocial aspects concerning palliative emergencies and (9) definition of palliative patients and their special situation by the physician responsible for prior treatment. Prehospital emergency physicians are confronted with emergencies in palliative care patients every day. In the treatment of these emergencies there are potentially serious conflicts due to the different therapeutic concepts of palliative medical care and emergency medical services. This study demonstrates that there is a need for regulated criteria for the therapy of palliative patients and patients at the end of life in emergency situations. Overall, more clinical investigations concerning end-of-life care and unresponsive palliative care patients in emergency medical situations are necessary.

Multidisciplinary obstetric simulated emergency scenarios (MOSES): promoting patient safety in obstetrics with teamwork-focused interprofessional simulations.

PubMed

Freeth, Della; Ayida, Gubby; Berridge, Emma Jane; Mackintosh, Nicola; Norris, Beverley; Sadler, Chris; Strachan, Alasdair

2009-01-01

We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined. Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e-mail interviews with MOSES course participants and facilitators were conducted, and video-recorded debriefings that formed integral parts of this 1-day course were analyzed. The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants' learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training. Interprofessional, team-based simulations promote new learning.

What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel.

PubMed

Brezis, Mayer; Lahat, Yael; Frankel, Meir; Rubinov, Alan; Bohm, Davina; Cohen, Matan J; Koslowsky, Meni; Shalomson, Orit; Sprung, Charles L; Perry-Mezare, Henia; Yahalom, Rina; Ziv, Amitai

2017-11-06

Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care. We analyzed perceptions emerging from group discussions following simulations, from questionnaires before and after each workshop, and from video-recorded simulations using a validated coding system. We used the simulation setting as a novel tool for action research. We used a participatory inquiry paradigm, with repetitive cycles of exploring barriers and challenges with participants in an iterative pattern of observation, discussion and reflection - including a description of our own responses and evolution of thought as well as system effects. The themes transpiring included lack of training, knowledge and time, technology overuse, uncertainty in decision-making, poor skills for communication and teamwork. Specific scenarios demonstrated lack of experience at eliciting preferences for EOL care and at handling conflicts or dilemmas. Content analysis of simulations showed predominance of cognitive utterances - by an order of magnitude more prevalent than emotional expressions. Providers talked more than actors did and episodes of silence were rare. Workshop participants acknowledged needs to improve listening skills, attention to affect and teamwork. They felt that the simulation-based workshop is likely to ameliorate future handling of EOL situations. We observed unanticipated consequences from our project manifested as a field study of preparedness to EOL in nursing homes, followed by a national survey on quality of care, leading to expansion of palliative care services and demand for EOL care education in various frameworks and professional areas. Reflective simulation exercises show barriers and paths to improvement among staff providers. When facing EOL situations, physicians and nurses use cognitive language far more often than emotions related expressions, active listening, or presence in silence. Training a critical mass of staff providers may be valuable to induce a cultural shift in EOL care.

[Current Situation and Prospects of Emergency Medical Equipment in Our Country].

PubMed

Qi, Lijing; Cheng, Feng

2016-03-01

This article analyzes the new demand of emergency medical equipment in the current development trend based on the analysis of the development and current situation of emergency medicine in our country. At the same time it introduces the current industrial characteristics of our country. Finally it analyzes the development trend of this kind of equipment in the new emergency medicine field.

Determining the appropriate strategies for emergency planning through AHP-SWOT.

PubMed

Kalatpour, Omid

2017-01-01

During an unexpected incident, companies should demonstrate appropriate behaviour based on predetermined and rehearsed emergency strategies. This paper describes how to select the proper strategies for emergency situations via means of the AHP-SWOT tool, where the initial SWOT analysis is conducted for the emergency management system, and the final strategies are selected via the analytic hierarchy process (AHP). Alternative response strategies comprise internal, shared and external responses. Most of the scenarios investigated for this study demanded a shared response. These findings highlight the importance of mutual aid agreements, cooperative exercises and the improvement of communication systems. Organisations can take advantage of integrated approaches to select the best strategies and tactics for normal situations in general and emergency situations in particular.

Developing Online Emergency Room Case Study Role Play for Medical Students.

ERIC Educational Resources Information Center

Doiron, J. A. Gilles; Isaac, John R.

In the face of panic and life-threatening situations in a hospital emergency room (ER), doctors must rely on well-defined procedures to assess the situation and respond appropriately. Because decisions to act must not only be timely, but also ingrained and swift, practice and experience in a wide range of situations is essential. This paper…

36 CFR 215.5 - Legal notice of proposed actions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... emergency situation determination or it has been determined that an emergency situation exists for the..., title, telephone number, and addresses (street, postal, facsimile, and e-mail) to whom comments are to...

A Multi Agent Based Approach for Prehospital Emergency Management.

PubMed

Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh

2017-07-01

To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities.  The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement.

A Multi Agent Based Approach for Prehospital Emergency Management

PubMed Central

Safdari, Reza; Shoshtarian Malak, Jaleh; Mohammadzadeh, Niloofar; Danesh Shahraki, Azimeh

2017-01-01

Objective: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. Methods: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed. The proposed architecture was simulated using Anylogic simulation software. Anylogic Agent Model, State Chart and Process Model were used to model the system. Results: Multi agent systems (MAS) had a great success in distributed, complex and dynamic problem solving environments, and utilizing autonomous agents provides intelligent decision making capabilities.  The proposed architecture presents prehospital management operations. The main identified agents are: EMS Center, Ambulance, Traffic Station, Healthcare Provider, Patient, Consultation Center, National Medical Record System and quality of service monitoring agent. Conclusion: In a critical condition like prehospital emergency we are coping with sophisticated processes like ambulance navigation health care provider and service assignment, consultation, recalling patients past medical history through a centralized EHR system and monitoring healthcare quality in a real-time manner. The main advantage of our work has been the multi agent system utilization. Our Future work will include proposed architecture implementation and evaluation of its impact on patient quality care improvement. PMID:28795061

FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

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

Ronald L Boring; David I Gertman; Tuan Q Tran

2008-09-01

This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and riskmore » associated with human performance in next generation control rooms.« less

29 CFR 785.36 - Home to work in emergency situations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... is subsequently called out at night to travel a substantial distance to perform an emergency job for one of his employer's customers all time spent on such travel is working time. The Divisions are... Principles Traveltime § 785.36 Home to work in emergency situations. There may be instances when travel from...

29 CFR 785.36 - Home to work in emergency situations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... is subsequently called out at night to travel a substantial distance to perform an emergency job for one of his employer's customers all time spent on such travel is working time. The Divisions are... Principles Traveltime § 785.36 Home to work in emergency situations. There may be instances when travel from...

29 CFR 785.36 - Home to work in emergency situations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... is subsequently called out at night to travel a substantial distance to perform an emergency job for one of his employer's customers all time spent on such travel is working time. The Divisions are... Principles Traveltime § 785.36 Home to work in emergency situations. There may be instances when travel from...

29 CFR 785.36 - Home to work in emergency situations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... is subsequently called out at night to travel a substantial distance to perform an emergency job for one of his employer's customers all time spent on such travel is working time. The Divisions are... Principles Traveltime § 785.36 Home to work in emergency situations. There may be instances when travel from...

29 CFR 785.36 - Home to work in emergency situations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... is subsequently called out at night to travel a substantial distance to perform an emergency job for one of his employer's customers all time spent on such travel is working time. The Divisions are... Principles Traveltime § 785.36 Home to work in emergency situations. There may be instances when travel from...

[Directions of interdepartmental interaction in case of delivery of health care for injured in emergency situations in stationing sites of navy].

PubMed

Ivchenko, E V; Chernyĭ, V S; Toporkov, M T; Aleksandrov, M V

2012-09-01

In points basing of navy will remain probability of emergence of emergency situations which is connected with existence of the enterprises of the industry and objects of navy. As a result of emergency situations in places of basing of navy discrepancy of prospective sanitary losses to possibilities of forces and means of a health service of fleet that demands interaction with health services of other ministries and departments is probable. Criterion of need of interaction is the ratio of quantity struck and possibilities of a health service of navy. Plans of interaction of a health service of fleet with medical institutions of other departments should provide options of use of available forces and means of medical institutions in garrisons for joint assistance struck in an emergency situation. The questions solved during interaction should become: radiation, chemical, biological survey; allocation of forces and means for rendering of medical care; use of sanitary transport; organization of sanitary processing, etc.

Factors relating to the perceived management of emergency situations: a survey of former Advanced Life Support course participants' clinical experiences.

PubMed

Rasmussen, Maria B; Tolsgaard, Martin G; Dieckmann, Peter; Issenberg, S Barry; Ostergaard, Doris; Søreide, Eldar; Rosenberg, Jens; Ringsted, Charlotte V

2014-12-01

This study explored individual, team, and setting factors associated with the quality of management of in-hospital emergency situations experienced by former Advanced Life Support (ALS) course participants. This study was a survey of former ALS course participants' long-term experience of management of in-hospital, emergency situations. The survey was carried out in 2012 in Denmark and Norway. A questionnaire was send to 526 potential responders and (281/479 × 100) 58.7% responded. The results demonstrated that 75% of the emergency situations were perceived as "managed well". In general, the responders' confidence in being ALS providers was high, mean 4.3 (SD 0.8), scale 1-5. Significant differences between the perceived "well" and "not well" managed situations were found for all questions, p<0.001. The largest differences related to perception of co-workers' ability to apply ALS principles, the team atmosphere and communication. Responders' ratings of quality of management of emergency situations increased with intensity of setting. However, the 'clinical setting' was rated significantly lower as attributor to ability to apply ALS principles compared to 'co-workers familiarity with ALS principles', 'own confidence as ALS-provider' and 'own social/inter-personal skills'. The results of this survey emphasise that ALS providers' perceived ability to apply ALS skills were substantially affected by teamwork skills and co-workers' skills. Team related factors associated with successful outcome were related to clear role distribution, clear inter-personal communication and attentive listening, as well as respectful behaviour and positive team atmosphere. Although intensity of setting was attributed to ability to apply ALS principles, this did not affect management of emergency situations to the same extent as individual and team factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Crew decision making under stress

NASA Technical Reports Server (NTRS)

Orasanu, J.

1992-01-01

Flight crews must make decisions and take action when systems fail or emergencies arise during flight. These situations may involve high stress. Full-missiion flight simulation studies have shown that crews differ in how effectively they cope in these circumstances, judged by operational errors and crew coordination. The present study analyzed the problem solving and decision making strategies used by crews led by captains fitting three different personality profiles. Our goal was to identify more and less effective strategies that could serve as the basis for crew selection or training. Methods: Twelve 3-member B-727 crews flew a 5-leg mission simulated flight over 1 1/2 days. Two legs included 4 abnormal events that required decisions during high workload periods. Transcripts of videotapes were analyzed to describe decision making strategies. Crew performance (errors and coordination) was judged on-line and from videotapes by check airmen. Results: Based on a median split of crew performance errors, analyses to date indicate a difference in general strategy between crews who make more or less errors. Higher performance crews showed greater situational awareness - they responded quickly to cues and interpreted them appropriately. They requested more decision relevant information and took into account more constraints. Lower performing crews showed poorer situational awareness, planning, constraint sensitivity, and coordination. The major difference between higher and lower performing crews was that poorer crews made quick decisions and then collected information to confirm their decision. Conclusion: Differences in overall crew performance were associated with differences in situational awareness, information management, and decision strategy. Captain personality profiles were associated with these differences, a finding with implications for crew selection and training.

Guidance for Catastrophic Emergency Situations Involving Asbestos

EPA Pesticide Factsheets

This document addresses the types of asbestos issues that may arise during catastrophic events and how EPA has addressed such issues. It replaces the Guidelines for Catastrophic Emergency Situations Involving Asbestos which was issued in 1992.

Frequency-domain trade-offs for dielectric elastomer generators

NASA Astrophysics Data System (ADS)

Zanini, Plinio; Rossiter, Jonathan M.; Homer, Martin

2017-04-01

Dielectric Elastomer Generators (DEGs) are an emerging energy harvesting technology based on a the cyclic stretching of a rubber-like membrane. However, most design processes do not take into account different excitation frequencies; thus limits the applicability studies since in real-world situations forcing frequency is not often constant. Through the use of a practical design scenario we use modeling and simulation to determine the material frequency response and, hence, carefully investigate the excitation frequencies that maximize the performance (power output, efficiency) of DEGs and the factors that influence it.

Preparedness for radiological emergency situations in Austria.

PubMed

Ditto, Manfred

2012-02-01

This article presents the Austrian system of emergency preparedness for nuclear and radiological emergency situations. It demonstrates, in particular, the legal basis, the roles and competencies of the competent authorities, international and bilateral conventions on early notification of nuclear accidents, the Austrian emergency plans, the Austrian radiation monitoring system, the operated prognosis and decision support systems and the results of an estimation of possible impacts of nuclear power plant disasters on Austria.

Does teaching non-technical skills to medical students improve those skills and simulated patient outcome?

PubMed

Hagemann, Vera; Herbstreit, Frank; Kehren, Clemens; Chittamadathil, Jilson; Wolfertz, Sandra; Dirkmann, Daniel; Kluge, Annette; Peters, Jürgen

2017-03-29

The purpose of this study is to evaluate the effects of a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment. Seventy-seven students were randomized to either a non-technical skills seminar (NTS group, n=43) or a medical seminar (control group, n=34). The human patient simulation was used as an evaluation tool. Before the seminars, all students performed the same simulated emergency scenario to provide baseline measurements. After the seminars, all students were exposed to a second scenario, and behavioural markers for evaluating their non-technical skills were rated. Furthermore, teamwork-relevant attitudes were measured before and after the scenarios, and perceived stress was measured following each simulation. All simulations were also evaluated for various medical endpoints. Non-technical skills concerning situation awareness (p<.01, r=0.5) and teamwork (p<.01, r=0.45) improved from simulation I to II in the NTS group. Decision making improved in both groups (NTS: p<.01, r=0.39; control: p<.01, r=0.46). The attitude 'handling errors' improved significantly in the NTS group (p<.05, r=0.34). Perceived stress decreased from simulation I to II in both groups. Medical endpoints and patients´ outcome did not differ significantly between the groups in simulation II. This study highlights the effectiveness of a single brief seminar on non-technical skills to improve student's non-technical skills. In a next step, to improve student's handling of emergencies and patient outcomes, non-technical skills seminars should be accompanied by exercises and more broadly embedded in the medical school curriculum.

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2011 CFR

2011-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2013 CFR

2013-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

Psychobiological stress response to a simulated school shooting in police officers.

PubMed

Strahler, Jana; Ziegert, Thomas

2015-01-01

Police work is one of the most demanding professions with various sources of high occupational stress. Among the most demanding tasks are amok situations, such as school shootings. Hardly anything is known about endocrine and cardiovascular markers in safety professionals during emergency situations in real life and how this relates to stress perception and management. This study will therefore explore police officers' stress responses to a reality-based school shooting simulation assessing neuroendocrine, cardiovascular, and psychological stress markers. A convenience sample of 50 police officers (39.5 ± 8.7 yrs, 9 women) participating in a basic or refresher amok training session for the German uniformed and criminal police were recruited. Saliva samples were collected shortly before the simulation task (school shooting), immediately after, 20 and 45 min after finishing the task for the assessment of cortisol and alpha-amylase (sAA), as markers of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, respectively. Heart rate (variability) was assessed continuously. Officers rated their actual mood right before and 10 min after the simulation. Subjective experience of task stressfulness was assessed minutes after finishing the simulation. Overall, the simulated school shooting did not result in changes of mood, tiredness, or calmness but higher restlessness was experienced during the basic training, which was also experienced as more controllable. Female officers reported to experience more strain and anxiety. Cortisol showed highest levels at the beginning of the training and steadily decreasing values thereafter. In contrast, sAA increased substantially right after the simulation with officers on the front position showing most pronounced changes. Cardiovascular reactivity was highest in officers acting on the side positions while advancing to find the suspect. Furthermore higher self-efficacy as well as, by trend, controllability and relevance of results correlated with cardiovascular measures. Autonomic but not endocrine stress markers increased to a simulated school shooting, which were further related to the subjective experience of the simulation. Our results provide a more in-depth picture of stress responses in such situations, which will in the long run raise the possibility to refine training programs, design more effective stress-management strategies for these critical incidents, and improve performance but also coping with work-related stress. Copyright © 2014 Elsevier Ltd. All rights reserved.

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

PubMed Central

Wong, Ambrose H.; Wing, Lisa; Weiss, Brenda; Gang, Maureen

2015-01-01

Introduction While treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Methods Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs. Results One hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys. Constructs for internal/biomedical factors, external/staff factors and situational/interactional perspectives on patient aggression significantly improved (p<0.0001, p<0.002, p<0.0001 respectively). Staff attitudes toward management of patient aggression did not significantly change (p=0.542). Multiple quality improvement initiatives were successfully implemented, including the creation of an interprofessional crisis management alert and response protocol. Staff members described appreciation for our simulation-based curriculum and welcomed the interaction with SPs during their training. Conclusion A structured simulation-enhanced interprofessional intervention was successful in improving multiple facets of ED staff attitudes toward behavioral emergency care. PMID:26594279

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum.

PubMed

Wong, Ambrose H; Wing, Lisa; Weiss, Brenda; Gang, Maureen

2015-11-01

While treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs. One hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys. Constructs for internal/biomedical factors, external/staff factors and situational/interactional perspectives on patient aggression significantly improved (p<0.0001, p<0.002, p<0.0001 respectively). Staff attitudes toward management of patient aggression did not significantly change (p=0.542). Multiple quality improvement initiatives were successfully implemented, including the creation of an interprofessional crisis management alert and response protocol. Staff members described appreciation for our simulation-based curriculum and welcomed the interaction with SPs during their training. A structured simulation-enhanced interprofessional intervention was successful in improving multiple facets of ED staff attitudes toward behavioral emergency care.

Flight Simulator Evaluation of Enhanced Propulsion Control Modes for Emergency Operation

NASA Technical Reports Server (NTRS)

Litt, Jonathan, S; Sowers, T.; Owen, A., Karl; Fulton, Christopher, E.; Chicatelli, Amy, K.

2012-01-01

This paper describes piloted evaluation of enhanced propulsion control modes for emergency operation of aircraft. Fast Response and Overthrust modes were implemented to assess their ability to help avoid or mitigate potentially catastrophic situations, both on the ground and in flight. Tests were conducted to determine the reduction in takeoff distance achievable using the Overthrust mode. Also, improvements in Dutch roll damping, enabled by using yaw rate feedback to the engines to replace the function of a stuck rudder, were investigated. Finally, pilot workload and ability to handle the impaired aircraft on approach and landing were studied. The results showed that improvement in all aspects is possible with these enhanced propulsion control modes, but the way in which they are initiated and incorporated is important for pilot comfort and perceived benefit.

Federal Radiological Monitoring and Assessment Center Health and Safety Manual

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

FRMAC Health and Safety Working Group

2012-03-20

This manual is a tool to provide information to all responders and emergency planners and is suggested as a starting point for all organizations that provide personnel/assets for radiological emergency response. It defines the safety requirements for the protection of all emergency responders. The intent is to comply with appropriate regulations or provide an equal level of protection when the situation makes it necessary to deviate. In the event a situation arises which is not addressed in the manual, an appropriate management-level expert will define alternate requirements based on the specifics of the emergency situation. This manual is not intendedmore » to pertain to the general public.« less

An Independent Human Factors Analysis and Evaluation of the Emergency Medical Protocol Checklist for the International Space Station

NASA Technical Reports Server (NTRS)

Marshburn, Thomas; Whitmore, Mihriban; Ortiz, Rosie; Segal, Michele; Smart, Kieran; Hughes, Catherine

2003-01-01

Emergency medical capabilities aboard the ISS include a Crew Medical Officer (CMO) (not necessarily a physician), and back-up, resuscitation equipment, and a medical checklist. It is essential that CMOs have reliable, usable and informative medical protocols that can be carried out independently in flight. The study evaluates the existing ISS Medical Checklist layout against a checklist updated to reflect a human factors approach to structure and organization. Method: The ISS Medical checklist was divided into non-emergency and emergency sections, and re-organized based on alphabetical and a body systems approach. A desk-top evaluation examined the ability of subjects to navigate to specific medical problems identified as representative of likely non-emergency events. A second evaluation aims to focus on the emergency section of the Medical Checklist, based on the preliminary findings of the first. The final evaluation will use Astronaut CMOs as subjects comparing the original checklist against the updated layout in the task of caring for a "downed crewmember" using a Human Patient Simulator [Medical Education Technologies, Inc.]. Results: Initial results have demonstrated a clear improvement of the re-organized sections to determine the solution to the medical problems. There was no distinct advantage for either alternative, although subjects stated having a preference for the body systems approach. In the second evaluation, subjects will be asked to identify emergency medical conditions, with measures including correct diagnosis, time to completion and solution strategy. The third evaluation will compare the original and fully updated checklists in clinical situations. Conclusions: Initial findings indicate that the ISS Medical Checklist will benefit from a reorganization. The present structure of the checklist has evolved over recent years without systematic testing of crewmember ability to diagnose medical problems. The improvements are expected to enable ISS Crewmembers to more speedily and accurately respond to medical situations on the ISS.

Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

NASA Technical Reports Server (NTRS)

Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl (Compiler); Guo, Ten-Huei

2014-01-01

The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

Application and Evaluation of Control Modes for Risk-Based Engine Performance Enhancements

NASA Technical Reports Server (NTRS)

Liu, Yuan; Litt, Jonathan S.; Sowers, T. Shane; Owen, A. Karl; Guo, Ten-Huei

2015-01-01

The engine control system for civil transport aircraft imposes operational limits on the propulsion system to ensure compliance with safety standards. However, during certain emergency situations, aircraft survivability may benefit from engine performance beyond its normal limits despite the increased risk of failure. Accordingly, control modes were developed to improve the maximum thrust output and responsiveness of a generic high-bypass turbofan engine. The algorithms were designed such that the enhanced performance would always constitute an elevation in failure risk to a consistent predefined likelihood. This paper presents an application of these risk-based control modes to a combined engine/aircraft model. Through computer and piloted simulation tests, the aim is to present a notional implementation of these modes, evaluate their effects on a generic airframe, and demonstrate their usefulness during emergency flight situations. Results show that minimal control effort is required to compensate for the changes in flight dynamics due to control mode activation. The benefits gained from enhanced engine performance for various runway incursion scenarios are investigated. Finally, the control modes are shown to protect against potential instabilities during propulsion-only flight where all aircraft control surfaces are inoperable.

Estimating ICU bed capacity using discrete event simulation.

PubMed

Zhu, Zhecheng; Hen, Bee Hoon; Teow, Kiok Liang

2012-01-01

The intensive care unit (ICU) in a hospital caters for critically ill patients. The number of the ICU beds has a direct impact on many aspects of hospital performance. Lack of the ICU beds may cause ambulance diversion and surgery cancellation, while an excess of ICU beds may cause a waste of resources. This paper aims to develop a discrete event simulation (DES) model to help the healthcare service providers determine the proper ICU bed capacity which strikes the balance between service level and cost effectiveness. The DES model is developed to reflect the complex patient flow of the ICU system. Actual operational data, including emergency arrivals, elective arrivals and length of stay, are directly fed into the DES model to capture the variations in the system. The DES model is validated by open box test and black box test. The validated model is used to test two what-if scenarios which the healthcare service providers are interested in: the proper number of the ICU beds in service to meet the target rejection rate and the extra ICU beds in service needed to meet the demand growth. A 12-month period of actual operational data was collected from an ICU department with 13 ICU beds in service. Comparison between the simulation results and the actual situation shows that the DES model accurately captures the variations in the system, and the DES model is flexible to simulate various what-if scenarios. DES helps the healthcare service providers describe the current situation, and simulate the what-if scenarios for future planning.

75 FR 65933 - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Respect to the Situation in or in Relation to the Democratic Republic of the Congo #0; #0; #0... Republic of the Congo On October 27, 2006, by Executive Order 13413, the President declared a national emergency with respect to the situation in or in relation to the Democratic Republic of the Congo and...

What determines the take-over time? An integrated model approach of driver take-over after automated driving.

PubMed

Zeeb, Kathrin; Buchner, Axel; Schrauf, Michael

2015-05-01

In recent years the automation level of driver assistance systems has increased continuously. One of the major challenges for highly automated driving is to ensure a safe driver take-over of the vehicle guidance. This must be ensured especially when the driver is engaged in non-driving related secondary tasks. For this purpose it is essential to find indicators of the driver's readiness to take over and to gain more knowledge about the take-over process in general. A simulator study was conducted to explore how drivers' allocation of visual attention during highly automated driving influences a take-over action in response to an emergency situation. Therefore we recorded drivers' gaze behavior during automated driving while simultaneously engaging in a visually demanding secondary task, and measured their reaction times in a take-over situation. According to their gaze behavior the drivers were categorized into "high", "medium" and "low-risk". The gaze parameters were found to be suitable for predicting the readiness to take-over the vehicle, in such a way that high-risk drivers reacted late and more often inappropriately in the take-over situation. However, there was no difference among the driver groups in the time required by the drivers to establish motor readiness to intervene after the take-over request. An integrated model approach of driver behavior in emergency take-over situations during automated driving is presented. It is argued that primarily cognitive and not motor processes determine the take-over time. Given this, insights can be derived for further research and the development of automated systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

Gali, Emmanuel; Eidenbenz, Stephan; Mniszewski, Sue

The United States' Department of Homeland Security aims to model, simulate, and analyze critical infrastructure and their interdependencies across multiple sectors such as electric power, telecommunications, water distribution, transportation, etc. We introduce ActivitySim, an activity simulator for a population of millions of individual agents each characterized by a set of demographic attributes that is based on US census data. ActivitySim generates daily schedules for each agent that consists of a sequence of activities, such as sleeping, shopping, working etc., each being scheduled at a geographic location, such as businesses or private residences that is appropriate for the activity type andmore » for the personal situation of the agent. ActivitySim has been developed as part of a larger effort to understand the interdependencies among national infrastructure networks and their demand profiles that emerge from the different activities of individuals in baseline scenarios as well as emergency scenarios, such as hurricane evacuations. We present the scalable software engineering principles underlying ActivitySim, the socia-technical modeling paradigms that drive the activity generation, and proof-of-principle results for a scenario in the Twin Cities, MN area of 2.6 M agents.« less

An Architecture Framework for Orchestrating Context-Aware IT Ecosystems: A Case Study for Quantitative Evaluation †.

PubMed

Park, Soojin; Park, Sungyong; Park, Young B

2018-02-12

With the emergence of various forms of smart devices and new paradigms such as the Internet of Things (IoT) concept, the IT (Information Technology) service areas are expanding explosively compared to the provision of services by single systems. A new system operation concept that has emerged in accordance with such technical trends is the IT ecosystem. The IT ecosystem can be considered a special type of system of systems in which multiple systems with various degrees of autonomy achieve common goals while adapting to the given environment. The single systems that participate in the IT ecosystem adapt autonomously to the current situation based on collected data from sensors. Furthermore, to maintain the services supported by the whole IT ecosystem sustainably, the configuration of single systems that participate in the IT ecosystem also changes appropriately in accordance with the changed situation. In order to support the IT ecosystem, this paper proposes an architecture framework that supports dynamic configuration changes to achieve the goal of the whole IT ecosystem, while ensuring the autonomy of single systems through the collection of data from sensors so as to recognize the situational context of individual participating systems. For the feasibility evaluation of the proposed framework, a simulated example of an IT ecosystem for unmanned forest management was constructed, and the quantitative evaluation results are discussed in terms of the extent to which the proposed architecture framework can continuously provide sustainable services in response to diverse environmental context changes.

An Architecture Framework for Orchestrating Context-Aware IT Ecosystems: A Case Study for Quantitative Evaluation †

PubMed Central

Park, Young B.

2018-01-01

With the emergence of various forms of smart devices and new paradigms such as the Internet of Things (IoT) concept, the IT (Information Technology) service areas are expanding explosively compared to the provision of services by single systems. A new system operation concept that has emerged in accordance with such technical trends is the IT ecosystem. The IT ecosystem can be considered a special type of system of systems in which multiple systems with various degrees of autonomy achieve common goals while adapting to the given environment. The single systems that participate in the IT ecosystem adapt autonomously to the current situation based on collected data from sensors. Furthermore, to maintain the services supported by the whole IT ecosystem sustainably, the configuration of single systems that participate in the IT ecosystem also changes appropriately in accordance with the changed situation. In order to support the IT ecosystem, this paper proposes an architecture framework that supports dynamic configuration changes to achieve the goal of the whole IT ecosystem, while ensuring the autonomy of single systems through the collection of data from sensors so as to recognize the situational context of individual participating systems. For the feasibility evaluation of the proposed framework, a simulated example of an IT ecosystem for unmanned forest management was constructed, and the quantitative evaluation results are discussed in terms of the extent to which the proposed architecture framework can continuously provide sustainable services in response to diverse environmental context changes. PMID:29439540

3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2010 CFR

2010-01-01

... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic... that continue to threaten regional stability. Because this situation continues to pose an unusual and...

28 CFR 65.22 - Exclusions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Purpose of Emergency Federal Law Enforcement Assistance § 65.22 Exclusions. Excluded from the situations for which this... for general public safety projects; and, (b) A situation requiring the enforcement of laws associated...

28 CFR 65.22 - Exclusions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Purpose of Emergency Federal Law Enforcement Assistance § 65.22 Exclusions. Excluded from the situations for which this... for general public safety projects; and, (b) A situation requiring the enforcement of laws associated...

28 CFR 65.22 - Exclusions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Purpose of Emergency Federal Law Enforcement Assistance § 65.22 Exclusions. Excluded from the situations for which this... for general public safety projects; and, (b) A situation requiring the enforcement of laws associated...

28 CFR 65.22 - Exclusions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Purpose of Emergency Federal Law Enforcement Assistance § 65.22 Exclusions. Excluded from the situations for which this... for general public safety projects; and, (b) A situation requiring the enforcement of laws associated...

28 CFR 65.22 - Exclusions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) EMERGENCY FEDERAL LAW ENFORCEMENT ASSISTANCE Purpose of Emergency Federal Law Enforcement Assistance § 65.22 Exclusions. Excluded from the situations for which this... for general public safety projects; and, (b) A situation requiring the enforcement of laws associated...

Real-time emergency forecasting technique for situation management systems

NASA Astrophysics Data System (ADS)

Kopytov, V. V.; Kharechkin, P. V.; Naumenko, V. V.; Tretyak, R. S.; Tebueva, F. B.

2018-05-01

The article describes the real-time emergency forecasting technique that allows increasing accuracy and reliability of forecasting results of any emergency computational model applied for decision making in situation management systems. Computational models are improved by the Improved Brown’s method applying fractal dimension to forecast short time series data being received from sensors and control systems. Reliability of emergency forecasting results is ensured by the invalid sensed data filtering according to the methods of correlation analysis.

Implementing Liberia's poverty reduction strategy: An assessment of emergency and essential surgical care.

PubMed

Sherman, Lawrence; Clement, Peter T; Cherian, Meena N; Ndayimirije, Nestor; Noel, Luc; Dahn, Bernice; Gwenigale, Walter T; Kushner, Adam L

2011-01-01

To document infrastructure, personnel, procedures performed, and supplies and equipment available at all county hospitals in Liberia using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Survey of county hospitals using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Sixteen county hospitals in Liberia. Infrastructure, personnel, procedures performed, and supplies and equipment available. Uniformly, gross deficiencies in infrastructure, personnel, and supplies and equipment were identified. The World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care was useful in identifying baseline emergency and surgical conditions for evidenced-based planning. To achieve the Poverty Reduction Strategy and delivery of the Basic Package of Health and Social Welfare Services, additional resources and manpower are needed to improve surgical and anesthetic care.

Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick's framework: a mixed methods study.

PubMed

Kumar, Arunaz; Sturrock, Sam; Wallace, Euan M; Nestel, Debra; Lucey, Donna; Stoyles, Sally; Morgan, Jenny; Neil, Peter; Schlipalius, Michelle; Dekoninck, Philip

2018-02-17

The aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick's framework. We explored participants' acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants' perception of usefulness of PROMPT in their clinical practice. Mixed methods approach with a pre-test/post-test design. Healthcare network providing obstetric care in Victoria, Australia. Medical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011-2012 (n=15 361 births) and 2014-2015 (n=12 388 births). Attendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills. Clinical outcomes compared before and after embedding PROMPT in educational practice. Assessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice. There was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies. Participants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Responding To and Recovering From an Active Shooter Incident That Turns Into a Hostage Situation. Lessons Learned From School Crises and Emergencies, Volume 2, Issue 6, 2007

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

"Lessons Learned" is a series of publications that are a brief recounting of actual school emergencies and crises. This "Lessons Learned" issue focuses on an active shooter situation that escalated to a hostage situation that required multiple law enforcement agencies and other first responders and agencies to coordinate response and recovery…

Comparison between Simulation-based Training and Lecture-based Education in Teaching Situation Awareness. A Randomized Controlled Study.

PubMed

Lee Chang, Alfredo; Dym, Andrew A; Venegas-Borsellino, Carla; Bangar, Maneesha; Kazzi, Massoud; Lisenenkov, Dmitry; Qadir, Nida; Keene, Adam; Eisen, Lewis Ari

2017-04-01

Situation awareness has been defined as the perception of the elements in the environment within volumes of time and space, the comprehension of their meaning, and the projection of their status in the near future. Intensivists often make time-sensitive critical decisions, and loss of situation awareness can lead to errors. It has been shown that simulation-based training is superior to lecture-based training for some critical scenarios. Because the methods of training to improve situation awareness have not been well studied in the medical field, we compared the impact of simulation vs. lecture training using the Situation Awareness Global Assessment Technique (SAGAT) score. To identify an effective method for teaching situation awareness. We randomly assigned 17 critical care fellows to simulation vs. lecture training. Training consisted of eight cases on airway management, including topics such as elevated intracranial pressure, difficult airway, arrhythmia, and shock. During the testing scenario, at random times between 4 and 6 minutes into the simulation, the scenario was frozen, and the screens were blanked. Respondents then completed the 28 questions on the SAGAT scale. Sample items were categorized as Perception, Projection, and Comprehension of the situation. Results were analyzed using SPSS Version 21. Eight fellows from the simulation group and nine from the lecture group underwent simulation testing. Sixty-four SAGAT scores were recorded for the simulation group and 48 scores were recorded for the lecture group. The mean simulation vs. lecture group SAGAT score was 64.3 ± 10.1 (SD) vs. 59.7 ± 10.8 (SD) (P = 0.02). There was also a difference in the median Perception ability between the simulation vs. lecture groups (61.1 vs. 55.5, P = 0.01). There was no difference in the median Projection and Comprehension scores between the two groups (50.0 vs. 50.0, P = 0.92, and 83.3 vs. 83.3, P = 0.27). We found a significant, albeit modest, difference between simulation training and lecture training on the total SAGAT score of situation awareness mainly because of the improvement in perception ability. Simulation may be a superior method of teaching situation awareness.

Emergency Locator Transmitter System Performance During Three Full-Scale General Aviation Crash Tests

NASA Technical Reports Server (NTRS)

Littell, Justin D.; Stimson, Chad M.

2016-01-01

Full-scale crash tests were conducted on three Cessna 172 aircraft at NASA Langley Research Center's Landing and Impact Research facility during the summer of 2015. The purpose of the three tests was to evaluate the performance of commercially available Emergency Locator Transmitter (ELT) systems and support development of enhanced installation guidance. ELTs are used to provide location information to Search and Rescue (SAR) organizations in the event of an aviation distress situation, such as a crash. The crash tests simulated three differing severe but survivable crash conditions, in which it is expected that the onboard occupants have a reasonable chance of surviving the accident and would require assistance from SAR personnel. The first simulated an emergency landing onto a rigid surface, while the second and third simulated controlled flight into terrain. Multiple ELT systems were installed on each airplane according to federal regulations. The majority of the ELT systems performed nominally. In the systems which did not activate, post-test disassembly and inspection offered guidance for non-activation cause in some cases, while in others, no specific cause could be found. In a subset of installations purposely disregarding best practice guidelines, failure of the ELT-to-antenna cabling connections were found. Recommendations for enhanced installation guidance of ELT systems will be made to the Radio Technical Commission for Aeronautics (RTCA) Special Committee 229 for consideration for adoption in a future release of ELT minimum operational performance specifications. These recommendations will be based on the data gathered during this test series as well as a larger series of crash simulations using computer models that will be calibrated based on these data

Verifying the buildingEXODUS through an emergency response procedure (ERP) exercise at an underground intervention shaft

NASA Astrophysics Data System (ADS)

Tajedi, Noor Aqilah A.; Sukor, Nur Sabahiah A.; Ismail, Mohd Ashraf M.; Shamsudin, Shahrul A.

2017-10-01

An Emergency Response Plan (ERP) is an essential safety procedure that needs to be taken into account for railway operations, especially for underground railway networks. Several parameters need to be taken into consideration in planning an ERP such as the design of tunnels and intervention shafts, and operation procedures for underground transportation systems. Therefore, the purpose of this paper is to observe and analyse the Emergency Response Procedure (ERP) exercise for the underground train network at the LRT Kelana Jaya Line. The exercise was conducted at one of the underground intervention shaft exits, where the height of the staircase from the bottom floor to the upper floor was 24.59 metres. Four cameras were located at selected levels of the shaft, and 71 participants were assigned for the evacuation exercise. The participants were tagged with a number at the front and back of their safety vests. Ten respondents were randomly selected to give details of their height and weight and, at the same time, they had to self-record the time taken for them to evacuate from the bottom to the top of the shaft. The video footages that were taken during the ERP were analysed, and the data were used for the verification process on the buildingEXODUS simulation software. It was found that the results of the ERP experiment were significantly similar to the simulation results, thereby successfully verifying the simulation. This verification process was important to ensure that the results of the simulation were in accordance with the real situation. Therefore, a further evacuation analysis made use of the results from this verification.

Operative team communication during simulated emergencies: Too busy to respond?

PubMed

Davis, W Austin; Jones, Seth; Crowell-Kuhnberg, Adrianna M; O'Keeffe, Dara; Boyle, Kelly M; Klainer, Suzanne B; Smink, Douglas S; Yule, Steven

2017-05-01

Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status. We used the closed loop communication framework to code retrospectively the communication behavior of 7 operative teams (each comprising 2 surgeons, anesthesiologists, and nurses) during response to a simulated, postanesthesia care unit "code blue." We identified call outs, check backs, and closed loop episodes and applied descriptive statistics and a mixed-effects negative binomial regression to describe characteristics of communication in individuals and in different specialties. We coded a total of 662 call outs. The frequency and type of initiation and receipt of communication events varied between clinical specialties (P < .001). Surgeons and nurses initiated fewer and received more communication events than anesthesiologists. For the average participant, directed communication increased the likelihood of check back by at least 50% (P = .021) in periods preceding acute changes in the clinical setting, and exerted no significant effect in periods after acute changes in the clinical situation. Communication patterns vary by specialty during a simulated operative emergency, and the effect of directed communication in eliciting a response depends on the clinical status of the patient. Operative training programs should emphasize the importance of quality communication in the period immediately after an acute change in the clinical setting of a patient and recognize that communication patterns and needs vary between members of multidisciplinary operative teams. Copyright © 2016 Elsevier Inc. All rights reserved.

Are Pediatric Emergency Physicians More Knowledgeable and Confident to Respond to a Pediatric Disaster after an Experiential Learning Experience?

PubMed

Bank, Ilana; Khalil, Elene

2016-10-01

Pediatric hospital disaster responders must be well-trained and prepared to manage children in a mass-casualty incident. Simulations of various types have been the traditional way of testing hospital disaster plans and training hospital staff in skills that are used in rare circumstances. The objective of this longitudinal, survey-based, observational study was to assess the effect of disaster response and management-based experiential learning on the knowledge and confidence of advanced learners. A simulation-based workshop was created for practicing Pediatric Emergency Medicine (PEM) physicians, senior PEM physicians, and critical care and pediatric surgery residents to learn how to manage a disaster response. Given that this particular group of learners had never been exposed to such a disaster simulation, its educational value was assessed with the goal of improving the quality of the hospital pediatric medical response to a disaster by increasing the responders' knowledge and confidence. Objective and subjective measures were analyzed using both a retrospective, pre-post survey, as well as case-based evaluation grids. The simulation workshop improved the learners' perceived ability to manage patients in a disaster context and identified strengths and areas needing improvement for patient care within the disaster context. Advanced learners exposed to an experiential learning activity believed that it improved their ability to manage patients in a disaster situation and felt that it was valuable to their learning. Their confidence was preserved six months later. Bank I , Khalil E . Are pediatric emergency physicians more knowledgeable and confident to respond to a pediatric disaster after an experiential learning experience? Prehosp Disaster Med. 2016;31(5):551-556.

Filling the Gap: Simulation-based Crisis Resource Management Training for Emergency Medicine Residents.

PubMed

Parsons, Jessica R; Crichlow, Amanda; Ponnuru, Srikala; Shewokis, Patricia A; Goswami, Varsha; Griswold, Sharon

2018-01-01

In today's team-oriented healthcare environment, high-quality patient care requires physicians to possess not only medical knowledge and technical skills but also crisis resource management (CRM) skills. In emergency medicine (EM), the high acuity and dynamic environment makes CRM skills of physicians particularly critical to healthcare team success. The Accreditation Council of Graduate Medicine Education Core Competencies that guide residency program curriculums include CRM skills; however, EM residency programs are not given specific instructions as to how to teach these skills to their trainees. This article describes a simulation-based CRM course designed specifically for novice EM residents. The CRM course includes an introductory didactic presentation followed by a series of simulation scenarios and structured debriefs. The course is designed to use observational learning within simulation education to decrease the time and resources required for implementation. To assess the effectiveness in improving team CRM skills, two independent raters use a validated CRM global rating scale to measure the CRM skills displayed by teams of EM interns in a pretest and posttest during the course. The CRM course improved leadership, problem solving, communication, situational awareness, teamwork, resource utilization and overall CRM skills displayed by teams of EM interns. While the improvement from pretest to posttest did not reach statistical significance for this pilot study, the large effect sizes suggest that statistical significance may be achieved with a larger sample size. This course can feasibly be incorporated into existing EM residency curriculums to provide EM trainees with basic CRM skills required of successful emergency physicians. We believe integrating CRM training early into existing EM education encourages continued deliberate practice, discussion, and improvement of essential CRM skills.

Learning and Treatment of Anaphylaxis by Laypeople: A Simulation Study Using Pupilar Technology

PubMed Central

Fernandez-Mendez, Felipe; Barcala-Furelos, Roberto; Padron-Cabo, Alexis; Garcia-Magan, Carlos; Moure-Gonzalez, Jose; Contreras-Jordan, Onofre; Rodriguez-Nuñez, Antonio

2017-01-01

An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis. 50 subjects were randomly assigned to four groups: three groups watching different training videos with content supervised by sanitary personnel and one control group who received face-to-face training during paediatric practice. To evaluate the learning, a simulation scenario represented by an anaphylaxis' victim was designed. A device capturing eye movement as well as expert valuation was used to evaluate the performance. The subjects that underwent paediatric face-to-face training achieved better and faster recognition of the anaphylaxis. They also used the adrenaline injector with better precision and less mistakes, and they needed a smaller number of visual fixations to recognise the anaphylaxis and to make the decision to inject epinephrine. Analysing the different video formats, mixed results were obtained. Therefore, they should be tested to evaluate their usability before implementation. PMID:28758128

Learning and Treatment of Anaphylaxis by Laypeople: A Simulation Study Using Pupilar Technology.

PubMed

Fernandez-Mendez, Felipe; Saez-Gallego, Nieves Maria; Barcala-Furelos, Roberto; Abelairas-Gomez, Cristian; Padron-Cabo, Alexis; Perez-Ferreiros, Alexandra; Garcia-Magan, Carlos; Moure-Gonzalez, Jose; Contreras-Jordan, Onofre; Rodriguez-Nuñez, Antonio

2017-01-01

An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis. 50 subjects were randomly assigned to four groups: three groups watching different training videos with content supervised by sanitary personnel and one control group who received face-to-face training during paediatric practice. To evaluate the learning, a simulation scenario represented by an anaphylaxis' victim was designed. A device capturing eye movement as well as expert valuation was used to evaluate the performance. The subjects that underwent paediatric face-to-face training achieved better and faster recognition of the anaphylaxis. They also used the adrenaline injector with better precision and less mistakes, and they needed a smaller number of visual fixations to recognise the anaphylaxis and to make the decision to inject epinephrine. Analysing the different video formats, mixed results were obtained. Therefore, they should be tested to evaluate their usability before implementation.

Emergence of Leadership within a Homogeneous Group

PubMed Central

Eskridge, Brent E.; Valle, Elizabeth; Schlupp, Ingo

2015-01-01

Large scale coordination without dominant, consistent leadership is frequent in nature. How individuals emerge from within the group as leaders, however transitory this position may be, has become an increasingly common question asked. This question is further complicated by the fact that in many of these aggregations, differences between individuals are minor and the group is largely considered to be homogeneous. In the simulations presented here, we investigate the emergence of leadership in the extreme situation in which all individuals are initially identical. Using a mathematical model developed using observations of natural systems, we show that the addition of a simple concept of leadership tendencies which is inspired by observations of natural systems and is affected by experience can produce distinct leaders and followers using a nonlinear feedback loop. Most importantly, our results show that small differences in experience can promote the rapid emergence of stable roles for leaders and followers. Our findings have implications for our understanding of adaptive behaviors in initially homogeneous groups, the role experience can play in shaping leadership tendencies, and the use of self-assessment in adapting behavior and, ultimately, self-role-assignment. PMID:26226381

Emergence of Leadership within a Homogeneous Group.

PubMed

Eskridge, Brent E; Valle, Elizabeth; Schlupp, Ingo

2015-01-01

Large scale coordination without dominant, consistent leadership is frequent in nature. How individuals emerge from within the group as leaders, however transitory this position may be, has become an increasingly common question asked. This question is further complicated by the fact that in many of these aggregations, differences between individuals are minor and the group is largely considered to be homogeneous. In the simulations presented here, we investigate the emergence of leadership in the extreme situation in which all individuals are initially identical. Using a mathematical model developed using observations of natural systems, we show that the addition of a simple concept of leadership tendencies which is inspired by observations of natural systems and is affected by experience can produce distinct leaders and followers using a nonlinear feedback loop. Most importantly, our results show that small differences in experience can promote the rapid emergence of stable roles for leaders and followers. Our findings have implications for our understanding of adaptive behaviors in initially homogeneous groups, the role experience can play in shaping leadership tendencies, and the use of self-assessment in adapting behavior and, ultimately, self-role-assignment.

78 FR 8955 - Continuation of the National Emergency With Respect to the Situation in or in Relation to C[ocirc...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... the National Emergency With Respect to the Situation in or in Relation to C[ocirc]te d'Ivoire On... International Emergency Economic Powers Act (50 U.S.C. 1701-1706), to deal with the unusual and extraordinary... or in relation to C[ocirc]te d'Ivoire and ordered related measures blocking the property of certain...

Interprofessional Emergency Training Leads to Changes in the Workplace.

PubMed

Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D; Exadaktylos, Aristomenis K; Machner, Mareen; Hautz, Wolf E

2018-01-01

Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one's roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants' "Commitment to Change." In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication , behavior , knowledge and attitude . Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., "acknowledge other professions' work"), and these were equally distributed among professions. At the two-month follow-up, 32 participants (50%) provided written feedback on their original commitments: 57 of 62 (91.9%) commitments were at least partly realized at the follow-up, and only five (8.1%) commitments lacked realization entirely. A structured simulation-enhanced intervention was successful in promoting change to the practice of emergency care, while training teamwork and communication skills jointly.

Techniques for Improving Pilot Recovery from System Failures

NASA Technical Reports Server (NTRS)

Pritchett, Amy R.

2001-01-01

This project examined the application of intelligent cockpit systems to aid air transport pilots at the tasks of reacting to in-flight system failures and of planning and then following a safe four dimensional trajectory to the runway threshold during emergencies. Two studies were conducted. The first examined pilot performance with a prototype awareness/alerting system in reacting to on-board system failures. In a full-motion, high-fidelity simulator, Army helicopter pilots were asked to fly a mission during which, without warning or briefing, 14 different failures were triggered at random times. Results suggest that the amount of information pilots require from such diagnostic systems is strongly dependent on their training; for failures they are commonly trained to react to with a procedural response, they needed only an indication of which failure to follow, while for 'un-trained' failures, they benefited from more intelligent and informative systems. Pilots were also found to over-rely on the system in conditions were it provided false or mis-leading information. In the second study, a proof-of-concept system was designed suitable for helping pilots replan their flights in emergency situations for quick, safe trajectory generation. This system is described in this report, including: the use of embedded fast-time simulation to predict the trajectory defined by a series of discrete actions; the models of aircraft and pilot dynamics required by the system; and the pilot interface. Then, results of a flight simulator evaluation with airline pilots are detailed. In 6 of 72 simulator runs, pilots were not able to establish a stable flight path on localizer and glideslope, suggesting a need for cockpit aids. However, results also suggest that, to be operationally feasible, such an aid must be capable of suggesting safe trajectories to the pilot; an aid that only verified plans entered by the pilot was found to have significantly detrimental effects on performance and pilot workload. Results also highlight that the trajectories suggested by the aid must capture the context of the emergency; for example, in some emergencies pilots were willing to violate flight envelope limits to reduce time in flight - in other emergencies the opposite was found.

Detection of bremsstrahlung radiation of 90Sr-90Y for emergency lung counting.

PubMed

Ho, A; Hakmana Witharana, S S; Jonkmans, G; Li, L; Surette, R A; Dubeau, J; Dai, X

2012-09-01

This study explores the possibility of developing a field-deployable (90)Sr detector for rapid lung counting in emergency situations. The detection of beta-emitters (90)Sr and its daughter (90)Y inside the human lung via bremsstrahlung radiation was performed using a 3″ × 3″ NaI(Tl) crystal detector and a polyethylene-encapsulated source to emulate human lung tissue. The simulation results show that this method is a viable technique for detecting (90)Sr with a minimum detectable activity (MDA) of 1.07 × 10(4) Bq, using a realistic dual-shielded detector system in a 0.25-µGy h(-1) background field for a 100-s scan. The MDA is sufficiently sensitive to meet the requirement for emergency lung counting of Type S (90)Sr intake. The experimental data were verified using Monte Carlo calculations, including an estimate for internal bremsstrahlung, and an optimisation of the detector geometry was performed. Optimisations in background reduction techniques and in the electronic acquisition systems are suggested.

[Training of medical practitioners of Russian Federation for dealing with dangerous infections in Stavropol Institute for plague control and for working under the conditions of the emergency situation].

PubMed

Efremenko, V I; Kal'noĭ, S M; Shvetsova, N M; Bogdanov, I K; Grizhebovskiĭ, G M; Briukhanova, G D; Onatskaia, T G

2001-01-01

There are no doubts at present concerning the necessity of training medical practitioners in Russia for dealing with specially dangerous infections and for work under the conditions of emergency situations. From the day this institute was founded the training of the corresponding personnel was started: first physicians, then biologists and other specialists, including medical assistants and technicians. Additional programs for training specialists were developed, the State License for conducting the course of special post-diploma training was obtained. Research works on improving the methods of the indication and rapid diagnostics of the causative agents of dangerous infections, reflected in training programs for specialists and practically used in the process of the realization of antiepidemic measures in the zones of emergency situations, were carried out. In training the students the experience of the work of the institute on ensuring the epidemiological safety of the population under the conditions of different emergency situations was taken into consideration.

'We didn't know anything, it was a mess!' Emergent structures and the effectiveness of a rescue operation multi-team system.

PubMed

Fleştea, Alina Maria; Fodor, Oana Cătălina; Curşeu, Petru Lucian; Miclea, Mircea

2017-01-01

Multi-team systems (MTS) are used to tackle unpredictable events and to respond effectively to fast-changing environmental contingencies. Their effectiveness is influenced by within as well as between team processes (i.e. communication, coordination) and emergent phenomena (i.e. situational awareness). The present case study explores the way in which the emergent structures and the involvement of bystanders intertwine with the dynamics of processes and emergent states both within and between the component teams. Our findings show that inefficient transition process and the ambiguous leadership generated poor coordination and hindered the development of emergent phenomena within the whole system. Emergent structures and bystanders substituted leadership functions and provided a pool of critical resources for the MTS. Their involvement fostered the emergence of situational awareness and facilitated contingency planning processes. However, bystander involvement impaired the emergence of cross-understandings and interfered with coordination processes between the component teams. Practitioner Summary: Based on a real emergency situation, the present research provides important theoretical and practical insights about the role of bystander involvement in the dynamics of multi-team systems composed to tackle complex tasks and respond to fast changing and unpredictable environmental contingencies.

Methodology to explore emergent behaviours of the interactions between water resources and ecosystem under a pluralistic approach

NASA Astrophysics Data System (ADS)

García-Santos, Glenda; Madruga de Brito, Mariana; Höllermann, Britta; Taft, Linda; Almoradie, Adrian; Evers, Mariele

2018-06-01

Understanding the interactions between water resources and its social dimensions is crucial for an effective and sustainable water management. The identification of sensitive control variables and feedback loops of a specific human-hydro-scape can enhance the knowledge about the potential factors and/or agents leading to the current water resources and ecosystems situation, which in turn supports the decision-making process of desirable futures. Our study presents the utility of a system dynamics modeling approach for water management and decision-making for the case of a forest ecosystem under risk of wildfires. We use the pluralistic water research concept to explore different scenarios and simulate the emergent behaviour of water interception and net precipitation after a wildfire in a forest ecosystem. Through a case study, we illustrate the applicability of this new methodology.

7 CFR 3431.23 - Service to Federal Government in emergency situations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Service to Federal Government in emergency situations...) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.23...

[Personal emergency call system based on human vital and system technical parameters in a Smart Home environment].

PubMed

Hampicke, M; Schadow, B; Rossdeutscher, W; Fellbaum, K; Boenick, U

2002-11-01

Progress in microtechnology and radio transmission technology has enabled the development of highly reliable emergency-call systems. The present article describes systems that have been specially designed to improve the safety and independence of handicapped and elderly persons living at home. For such persons immediate help in an emergency situation is of crucial importance. The technical state of the art of emergency-call systems specially developed for use by the elderly, is briefly discussed, in particular the well-known radio emergency-call button, with the aid of which an alarm can be activated manually. This system, however, does not offer adequate safety in all emergency situations. Alternative or complementary systems designed to automatically trigger an alarm on the basis of the recording and evaluation of so-called vital parameters, are therefore proposed. In addition, in a smart-home environment with networked devices, further parameters--so-called environment parameters can be used. It is found that the identification of an emergency situation becomes more reliable as the number of parameters employed increases.

Pediatric advanced life support and sedation of pediatric dental patients.

PubMed

Kim, Jongbin

2016-03-01

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

49 CFR 177.823 - Movement of motor vehicles in emergency situations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 2 2012-10-01 2012-10-01 false Movement of motor vehicles in emergency situations. 177.823 Section 177.823 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HAZARDOUS MATERIALS REGULATIONS CARRIAGE BY PUBLIC HIGHWAY General Information...

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

PubMed

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

2014-01-01

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

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

Not Available

The Drawdown and Distribution Management Manual (DDMM) provides a comprehensive guide to the planning, preparation, and operational processes associated with an SPR system response to an energy emergency. Although parts of the process may be unique to a particular situation, the manual describes the end-to-end continuity of the response by including those activities that would be common to most situations. This manual follows DOE policy contained in DOE Office of Energy Emergencies (OEE) documents that define comprehensive DOE energy emergency response procedures, currently known as the Energy Emergency Response Management System (EERMS). 6 refs.

Abnormal/Emergency Situations. Impact of Unmanned Aircraft Systems Emergency and Abnormal Events on the National Airspace System

NASA Technical Reports Server (NTRS)

2006-01-01

Access 5 analyzed the differences between UAS and manned aircraft operations under five categories of abnormal or emergency situations: Link Failure, Lost Communications, Onboard System Failures, Control Station Failures and Abnormal Weather. These analyses were made from the vantage point of the impact that these operations have on the US air traffic control system, with recommendations for new policies and procedures included where appropriate.

Addressing the challenges of ECMO simulation.

PubMed

Alinier, Guillaume; Hassan, Ibrahim Fawzy; Alsalemi, Abdullah; Al Disi, Mohammed; Ait Hssain, Ali; Labib, Ahmed; Alhomsi, Yahya; Bensaali, Fayçal; Amira, Abbes; Ibrahim, Abdulsalam Saif

2018-05-01

The patient's condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants' suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.

An Interactive Logistics Centre Information Integration System Using Virtual Reality

NASA Astrophysics Data System (ADS)

Hong, S.; Mao, B.

2018-04-01

The logistics industry plays a very important role in the operation of modern cities. Meanwhile, the development of logistics industry has derived various problems that are urgent to be solved, such as the safety of logistics products. This paper combines the study of logistics industry traceability and logistics centre environment safety supervision with virtual reality technology, creates an interactive logistics centre information integration system. The proposed system utilizes the immerse characteristic of virtual reality, to simulate the real logistics centre scene distinctly, which can make operation staff conduct safety supervision training at any time without regional restrictions. On the one hand, a large number of sensor data can be used to simulate a variety of disaster emergency situations. On the other hand, collecting personnel operation data, to analyse the improper operation, which can improve the training efficiency greatly.

Developing protocols for obstetric emergencies.

PubMed

Roth, Cheryl K; Parfitt, Sheryl E; Hering, Sandra L; Dent, Sarah A

2014-01-01

There is potential for important steps to be missed in emergency situations, even in the presence of many health care team members. Developing a clear plan of response for common emergencies can ensure that no tasks are redundant or omitted, and can create a more controlled environment that promotes positive health outcomes. A multidisciplinary team was assembled in a large community hospital to create protocols that would help ensure optimum care and continuity of practice in cases of postpartum hemorrhage, shoulder dystocia, emergency cesarean surgical birth, eclamptic seizure and maternal code. Assignment of team roles and responsibilities led to the evolution of standardized protocols for each emergency situation. © 2014 AWHONN.

Performance Support Tools for Space Medical Operations

NASA Technical Reports Server (NTRS)

Byrne, Vicky E.; Schmidt, Josef; Barshi, Immanuel

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Human factors personnel at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground. This area of research involved the feasibility of Just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1, preliminary feasibility data was gathered for two types of prototype display technologies: a hand-held PDA, and a Head Mounted Display (HMD). The PDA and HMD were compared while performing a simulated medical procedure using ISS flight-like medical equipment. Based on the outcome of Phase 1, including data on user preferences, further testing was completed using the PDA only. Phase 2 explored a wrist-mounted PDA, and compared it to a paper cue card. For each phase, time to complete procedures, errors, and user satisfaction were captured. Information needed by the FS during ISS mission support, especially for an emergency situation (e.g. fire onboard ISS), may be located in many different places around the FS s console. A performance support tool prototype is being developed to address this issue by bringing all of the relevant information together in one place. The tool is designed to include procedures and other information needed by a FS during an emergency, as well as procedures and information to be used after the emergency is resolved. Several walkthroughs of the prototype with FSs have been completed within a mockup of an ISS FS console. Feedback on the current tool design as well as recommendations for existing ISS FS displays were captured.

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks.

PubMed

Kaleem, Zeeshan; Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq; Duong, Trung Q

2018-05-08

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme.

PS-CARA: Context-Aware Resource Allocation Scheme for Mobile Public Safety Networks

PubMed Central

Khaliq, Muhammad Zubair; Khan, Ajmal; Ahmad, Ishtiaq

2018-01-01

The fifth-generation (5G) communications systems are expecting to support users with diverse quality-of-service (QoS) requirements. Beside these requirements, the task with utmost importance is to support the emergency communication services during natural or man-made disasters. Most of the conventional base stations are not properly functional during a disaster situation, so deployment of emergency base stations such as mobile personal cell (mPC) is crucial. An mPC having moving capability can move in the disaster area to provide emergency communication services. However, mPC deployment causes severe co-channel interference to the users in its vicinity. The problem in the existing resource allocation schemes is its support for static environment, that does not fit well for mPC. So, a resource allocation scheme for mPC users is desired that can dynamically allocate resources based on users’ location and its connection establishment priority. In this paper, we propose a public safety users priority-based context-aware resource allocation (PS-CARA) scheme for users sum-rate maximization in disaster environment. Simulations results demonstrate that the proposed PS-CARA scheme can increase the user average and edge rate around 10.3% and 32.8% , respectively because of context information availability and by prioritizing the public safety users. The simulation results ensure that call blocking probability is also reduced considerably under the PS-CARA scheme. PMID:29738499

Principles and methods for ensuring safe operation of high-rise buildings

NASA Astrophysics Data System (ADS)

Korol, Oleg; Kustikova, Yuliya

2018-03-01

The purpose of monitoring the technical condition of high-rise buildings is to prevent possible negative situations leading to significant socio-economic losses by timely warning of the emergence of such situations. To achieve this goal, it is necessary to solve the following main tasks, such as: identifying the time and place of origin and development of negative processes that lead to the emergence of an emergency situation; analysis of the possible development of the situation in time; development of management decisions; formation and submission of warning signals; obtaining new knowledge about the operation of the object, the factors of influence on this object, the speed of development of destructive processes. When solving the above problems, an important role is played by constructing an adequate mathematical model of the object, the parameters of which should be calibrated according to the current monitoring results.

Modelling emergency decisions: recognition-primed decision making. The literature in relation to an ophthalmic critical incident.

PubMed

Bond, Susan; Cooper, Simon

2006-08-01

To review and reflect on the literature on recognition-primed decision (RPD) making and influences on emergency decisions with particular reference to an ophthalmic critical incident involving the sub-arachnoid spread of local anaesthesia following the peribulbar injection. This paper critics the literature on recognition-primed decision making, with particular reference to emergency situations. It illustrates the findings by focussing on an ophthalmic critical incident. Systematic literature review with critical incident reflection. Medline, CINAHL and PsychINFO databases were searched for papers on recognition-primed decision making (1996-2004) followed by the 'snowball method'. Studies were selected in accordance with preset criteria. A total of 12 papers were included identifying the recognition-primed decision making as a good theoretical description of acute emergency decisions. In addition, cognitive resources, situational awareness, stress, team support and task complexity were identified as influences on the decision process. Recognition-primed decision-making theory describes the decision processes of experts in time-bound emergency situations and is the foundation for a model of emergency decision making (Fig. 2). Decision theory and models, in this case related to emergency situations, inform practice and enhance clinical effectiveness. The critical incident described highlights the need for nurses to have a comprehensive and in-depth understanding of anaesthetic techniques as well as an ability to manage and resuscitate patients autonomously. In addition, it illustrates how the critical incidents should influence the audit cycle with improvements in patient safety.

43 CFR 423.12 - How will Reclamation notify the public of additional closed areas?

Code of Federal Regulations, 2011 CFR

2011-10-01

... additional closed areas? 423.12 Section 423.12 Public Lands: Interior Regulations Relating to Public Lands..., LANDS, AND WATERBODIES Areas Open and Closed to Public Use § 423.12 How will Reclamation notify the public of additional closed areas? (a) Non-emergency situations. In non-emergency situations, an...

43 CFR 423.12 - How will Reclamation notify the public of additional closed areas?

Code of Federal Regulations, 2010 CFR

2010-10-01

... additional closed areas? 423.12 Section 423.12 Public Lands: Interior Regulations Relating to Public Lands..., LANDS, AND WATERBODIES Areas Open and Closed to Public Use § 423.12 How will Reclamation notify the public of additional closed areas? (a) Non-emergency situations. In non-emergency situations, an...

40 CFR 1054.660 - What are the provisions for exempting emergency rescue equipment?

Code of Federal Regulations, 2010 CFR

2010-07-01

... certified to current emission standards under the following conditions if the equipment will be used solely in emergency rescue situations: (1) You must determine annually that no engines certified to current... situations” means firefighting or other situations in which a person is retrieved from imminent danger. (c...

76 FR 27697 - Self-Regulatory Organizations; Options Clearing Corporation; Notice of Filing of Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

... the Options Clearing Corporation With Respect to Its Obligations To Pay Settlement Amounts to Clearing... pay settlement amounts to clearing members generally as well as in emergency situations. II. Self... to pay settlement amounts to clearing members generally as well as in emergency situations. The...

A seamless ubiquitous emergency medical service for crisis situations.

PubMed

Lin, Bor-Shing

2016-04-01

In crisis situations, a seamless ubiquitous communication is necessary to provide emergency medical service to save people's lives. An excellent prehospital emergency medicine provides immediate medical care to increase the survival rate of patients. On their way to the hospital, ambulance personnel must transmit real-time and uninterrupted patient information to the hospital to apprise the physician of the situation and provide options to the ambulance personnel. In emergency and crisis situations, many communication channels can be unserviceable because of damage to equipment or loss of power. Thus, data transmission over wireless communication to achieve uninterrupted network services is a major obstacle. This study proposes a mobile middleware for cognitive radio (CR) for improving the wireless communication link. CRs can sense their operating environment and optimize the spectrum usage so that the mobile middleware can integrate the existing wireless communication systems with a seamless communication service in heterogeneous network environments. Eventually, the proposed seamless mobile communication middleware was ported into an embedded system, which is compatible with the actual network environment without the need for changing the original system architecture. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Trauma Induced Pain and Wound Management in Emergency Environment by Low Energy Photonic Therapy

DTIC Science & Technology

2004-09-01

Technology and Emergency Medical Procedures”, held in St. Pete Beach, USA, 16-18 August 2004, and published in RTO-MP-HFM-109. Report Documentation Page...Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures (Soins aux blessés au combat dans des situations...tactiques : technologies des traumas et procédures médicales durgence)., The original document contains color images. 14. ABSTRACT 15. SUBJECT TERMS 16

Transient modeling in simulation of hospital operations for emergency response.

PubMed

Paul, Jomon Aliyas; George, Santhosh K; Yi, Pengfei; Lin, Li

2006-01-01

Rapid estimates of hospital capacity after an event that may cause a disaster can assist disaster-relief efforts. Due to the dynamics of hospitals, following such an event, it is necessary to accurately model the behavior of the system. A transient modeling approach using simulation and exponential functions is presented, along with its applications in an earthquake situation. The parameters of the exponential model are regressed using outputs from designed simulation experiments. The developed model is capable of representing transient, patient waiting times during a disaster. Most importantly, the modeling approach allows real-time capacity estimation of hospitals of various sizes and capabilities. Further, this research is an analysis of the effects of priority-based routing of patients within the hospital and the effects on patient waiting times determined using various patient mixes. The model guides the patients based on the severity of injuries and queues the patients requiring critical care depending on their remaining survivability time. The model also accounts the impact of prehospital transport time on patient waiting time.

The virtual terrorism response academy: training for high-risk, low-frequency threats.

PubMed

Henderson, Joseph V

2005-01-01

The Virtual Terrorism Response Academy is a reusable virtual learning environment to prepare emergency responders to deal with high-risk, low-frequency events in general, terrorist attacks in particular. The principal learning strategy is a traditional one: apprenticeship. Trainees enter the Academy and travel through its halls, selecting different learning experiences under the guidance of instructors who are simultaneously master practitioners and master trainers. The mentors are real individuals who have been videotaped according to courseware designs; they are subsequently available at any time or location via broadband Internet or CD-ROM. The Academy features a Simulation Area where trainees are briefed on a given scenario, select appropriate resources (e.g., protective equipment and hazmat instruments), then enter a 3-dimensional space where they must deal with various situations. Simulations are done under the guidance of a master trainer who functions as a coach, asking questions, pointing out things, explaining his reasoning at various points in the simulation. This is followed by a debriefing and discussion of lessons that could be learned from the simulation and the trainee's decisions.

Mobile videoconferencing for enhanced emergency medical communication - a shot in the dark or a walk in the park? ‒‒ A simulation study.

PubMed

Melbye, Sigurd; Hotvedt, Martin; Bolle, Stein Roald

2014-06-02

Videoconferencing on mobile phones may enhance communication, but knowledge on its quality in various situations is needed before it can be used in medical emergencies. Mobile phones automatically activate loudspeaker functionality during videoconferencing, making calls particularly vulnerable to background noise. The aim of this study was to investigate if videoconferencing can be used between lay bystanders and Emergency Medical Dispatch (EMD) operators for initial emergency calls during medical emergencies, under suboptimal sound and light conditions. Videoconferencing was tested between 90 volunteers and an emergency medical dispatcher in a standardized scenario of a medical emergency. Three different environments were used for the trials: indoors with moderate background noise, outdoors with daylight and much background noise, and outdoors during nighttime with little background noise. Thirty participants were recruited for each of the three locations. After informed consent, each participant was asked to use a video mobile phone to communicate with an EMD operator. During the video call the EMD operator gave instructions for tasks to be performed by the participant. The video quality from the caller to the EMD was evaluated by the EMD operator and rated on a five step scale ranging from "not able to see" to "good video quality". Sound quality between participants and EMD operators was assessed by a method developed for this trial. Kruskal - Wallis and Chi-square tests were used for statistical analysis. Video quality was significantly different between the groups (p <0.001), and the nighttime group had lower video quality. For most sessions in the nighttime group it was still possible to see actions done at the simulated emergency site. All participants were able to perform their tasks according to the instructions given by dispatchers, although with a need for more repetitions during sessions with much background noise. No calls were rated by dispatchers as incomprehensible due to low sound quality and only 3% of the calls were considered somewhat difficult or very difficult to understand. Videoconferencing on mobile phones can be used for the initial emergency call during medical emergencies also in suboptimal conditions.

Investigating an outbreak of measles in Margibi County, Liberia, October 2015.

PubMed

Frimpong, Joseph Asamoah; Amo-Addae, Maame Pokuah; Adewuyi, Peter Adebayo; Park, Meeyoung Mattie; Hall, Casey Daniel; Nagbe, Thomas Knue

2017-01-01

The emergence and re-emergence of infectious diseases highlights the need to have well-trained field epidemiologists who will be at the forefront in the fight against these diseases, especially during an outbreak. Training for outbreak investigation is most effective when participants can develop their competencies in a practical exercise. To that end, this case study was based on a measles outbreak investigation conducted in Liberia during October 2015 by Liberia Frontline Field Epidemiology Training Program (FETP) residents, simulating steps to perform outbreak investigation in a real-life situation as a field epidemiologist. This case study is ideally suited to reinforce principles and skills already covered in a classroom lecture or in background reading by providing a practical training beyond the scope of theoretical learning. It is primarily intended for training novice public health practitioners who should be able to complete the exercises in approximately 3 hours.

Emergency operations program is an excellent platform to deal with in-hospital operation disaster.

PubMed

Rogers, Frederick B; McCune, William; Jammula, Shreya; Gross, Brian W; Bradburn, Eric H; Riley, Deborah K; Manning, Jeffrey

2017-01-01

Described herein is the utilization of the hospital's Emergency Operations Plan and incident command structure to mitigate damage caused by the sudden loss of the heating, ventilation, and air conditioning system within the entire operating room suite. The ability to ameliorate a devastating situation that occurred during working hours at a busy Level II trauma center can be ascribed to the dedication of the leadership and clinical teams working seamlessly together. Their concerted efforts were augmented by adherence to an established protocol that had been thoroughly substantiated and practiced during numerous training simulations. This resulted in successful and timely resolution of an internal crisis that crippled the surgical capabilities of the sole trauma center in the county. After thorough investigation and identification of the issues that contributed to the malfunction, redundancies were built into the system to ensure that a similar incident did not occur again.

What variables affect public perceptions for EMS meeting general community needs?

PubMed

Blau, Gary; Hochner, Arthur; Portwood, James

2012-01-01

In the fall, 2010, a phone survey of 928 respondents examined two research questions: does the general public perceive Emergency Medical Services (EMS) as meeting their community needs? And what factors or correlates help to explain EMS meeting community needs? To maximize geographical representation across the contiguous United States, a clustered stratified sampling strategy was used based upon zip codes across the 48 states. Results showed strong support by the sample for perceiving that EMS was meeting their general community needs. 17 percent of the variance in EMS meeting community needs was collectively explained by the demographic and perceptual variables in the regression model. Of the correlates tested, the strongest relationship was found between greater admiration for EMS professionals and higher perception of EMS meeting community needs. Study limitations included sampling households with only landline (no cell) phones, using a simulated emergency situation, and not collecting gender data.

Real-life experience with the specific reversal agent idarucizumab for the management of emergency situations in dabigatran-treated patients: a series of 11 cases.

PubMed

Vosko, Milan R; Bocksrucker, Christof; Drwiła, Rafał; Dulíček, Petr; Hauer, Tomas; Mutzenbach, Johannes; Schlimp, Christoph J; Špinler, David; Wolf, Thomas; Zugwitz, Daša

2017-04-01

Non-vitamin K antagonist oral anticoagulants (NOACs) have a favorable benefit-risk profile compared with vitamin K antagonists. However, the lack of specific reversal agents has made the management of some patients receiving long-term treatment with NOACs problematic in emergency situations such as major bleeding events or urgent procedures. Idarucizumab, a fully humanized Fab antibody fragment that binds specifically and with high affinity to dabigatran, was recently approved for use in adult patients treated with dabigatran when rapid reversal of its anticoagulant effect is required. Clinical experience with idarucizumab is currently limited. We report 11 real-life clinical cases in which idarucizumab was used after multidisciplinary consultation in a variety of emergency situations including severe postoperative bleeding, emergency high-bleeding-risk surgery (hip/spine surgery and neurosurgery), invasive diagnostic testing (lumbar puncture), intracranial bleeding (pre-pontine subarachnoid hemorrhage and lobar intracerebral hemorrhage) and thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke. This case series illustrates the role of idarucizumab in improving patient safety in rare emergency situations requiring rapid reversal of the anticoagulant effect of dabigatran, while highlighting the importance of information and education about the availability and appropriate use of this recently approved specific reversal agent.

Drilling Rig Operation Mode Recognition by an Artificial Neuronet

NASA Astrophysics Data System (ADS)

Abu-Abed, Fares; Borisov, Nikolay

2017-11-01

The article proposes a way to develop a drilling rig operation mode classifier specialized to recognize pre-emergency situations appearable in commercial oil-and-gas well drilling. The classifier is based on the theory of image recognition and artificial neuronet taught on real geological and technological information obtained while drilling. To teach the neuronet, a modified backpropagation algorithm that can teach to reach the global extremum of a target function has been proposed. The target function was a relative recognition error to minimize in the teaching. Two approaches to form the drilling rig pre-emergency situation classifier based on a taught neuronet have been considered. The first one involves forming an output classifier of N different signals, each of which corresponds to a single recognizable situation and, and can be formed on the basis of the analysis of M indications, that is using a uniform indication vocabulary for all recognized situations. The second way implements a universal classifier comprising N specialized ones, each of which can recognize a single pre-emergency situation and having a single output.

Naturalistic Decision Making For Power System Operators

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

Greitzer, Frank L.; Podmore, Robin; Robinson, Marck

2009-06-23

Abstract: Motivation -- As indicated by the Blackout of 2003, the North American interconnected electric system is vulnerable to cascading outages and widespread blackouts. Investigations of large scale outages often attribute the causes to the three T’s: Trees, Training and Tools. A systematic approach has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The approach has been developed and refined as part of a capability demonstration of a high-fidelity real-time power system simulator under normal and emergency conditions. To examine naturalistic decision making (NDM) processes, transcripts of operator-to-operatormore » conversations are analyzed to reveal and assess NDM-based performance criteria. Findings/Design -- The results of the study indicate that we can map the Situation Awareness Level of the operators at each point in the scenario. We can also identify clearly what mental models and mental simulations are being performed at different points in the scenario. As a result of this research we expect that we can identify improved training methods and improved analytical and visualization tools for power system operators. Originality/Value -- The research applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message -- The NDM approach provides an ideal framework for systematic training management and mitigation to accelerate learning in team-based training scenarios with high-fidelity power grid simulators.« less

Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.

PubMed

Nord-Ljungquist, Helena; Brännström, Margareta; Bohm, Katarina

2015-07-01

In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions. We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design. If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR. Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dynamic situation assessment and prediction (DSAP)

NASA Astrophysics Data System (ADS)

Sisti, Alex F.

2003-09-01

The face of war has changed. We no longer have the luxury of planning campaigns against a known enemy operating under a well-understood doctrine, using conventional weapons and rules of engagement; all in a well-charted region. Instead, today's Air Force faces new, unforeseen enemies, asymmetric combat situations and unconventional warfare (Chem/Bio, co-location of military assets near civilian facilities, etc.). At the same time, the emergence of new Air Force doctrinal notions (e.g., Global Strike Task Force, Effects-Based Operations, the desire to minimize or eliminate any collateral damage, etc.)- while propounding the benefits that can be expected with the adoption of such concepts - also impose many new technical and operational challenges. Furthermore, future mission/battle commanders will need to assimilate a tremendous glut of available information, and still be expected to make quick-response decisions - and to quantify the effects of those decisions - all in the face of uncertainty. All these factors translate to the need for dramatic improvements in the way we plan, rehearse, execute and dynamically assess the status of military campaigns. This paper addresses these crucial and revolutionary requirements through the pursuit of a new simulation paradigm that allows a user to perform real-time dynamic situation assessment and prediction.

General Linearized Theory of Quantum Fluctuations around Arbitrary Limit Cycles

NASA Astrophysics Data System (ADS)

Navarrete-Benlloch, Carlos; Weiss, Talitha; Walter, Stefan; de Valcárcel, Germán J.

2017-09-01

The theory of Gaussian quantum fluctuations around classical steady states in nonlinear quantum-optical systems (also known as standard linearization) is a cornerstone for the analysis of such systems. Its simplicity, together with its accuracy far from critical points or situations where the nonlinearity reaches the strong coupling regime, has turned it into a widespread technique, being the first method of choice in most works on the subject. However, such a technique finds strong practical and conceptual complications when one tries to apply it to situations in which the classical long-time solution is time dependent, a most prominent example being spontaneous limit-cycle formation. Here, we introduce a linearization scheme adapted to such situations, using the driven Van der Pol oscillator as a test bed for the method, which allows us to compare it with full numerical simulations. On a conceptual level, the scheme relies on the connection between the emergence of limit cycles and the spontaneous breaking of the symmetry under temporal translations. On the practical side, the method keeps the simplicity and linear scaling with the size of the problem (number of modes) characteristic of standard linearization, making it applicable to large (many-body) systems.

49 CFR 213.352 - Torch cut rail.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Torch cut rail. 213.352 Section 213.352... Torch cut rail. (a) Except as a temporary repair in emergency situations no rail having a torch cut end shall be used. When a rail end with a torch cut is used in emergency situations, train speed over that...

49 CFR 213.352 - Torch cut rail.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Torch cut rail. 213.352 Section 213.352... Torch cut rail. (a) Except as a temporary repair in emergency situations no rail having a torch cut end shall be used. When a rail end with a torch cut is used in emergency situations, train speed over that...

Situated Environmental Learning in Southern Africa at the Start of the UN Decade of Education for Sustainable Development

ERIC Educational Resources Information Center

O'Donoghue, Rob; Lotz-Sisitka, Heila

2006-01-01

Within the globalising trajectory of modernism, conservation, then environmental (EE) and now sustainability education (ESD) have each emerged as developing responses to risk produced by and in the modern state. Through adopting a long term process perspective, this paper narrates the emergence of situated learning perspectives and a developing…

Triage Decision Trees and Triage Protocols: Changing Strategies for Medical Rescue in Civilian Mass Casualty Situations.

DTIC Science & Technology

1984-02-06

MASS CASUALTY SITUATIONS FINAL REPORT for 0O FEDERAL EMERGENCY MANAGEMENT AGENCY WASHINGTON, D.C. 20472 FEMA CONTRACT NUMBER EMW-C-1202 e FEMA WORK UNIT...20006 FINAL REPORT for FEDERAL EMERGENCY MANAGEMENT AGENCY WASHINGTON, D.C. 20472 FEMA CONTRACT NUMBER EMW-C-1202 FEMA WORK UNIT NUMBER 2412G...February 1984 This repnrt has been reviewed in the Federal Emergency Management Agency and approved for publication. Approval does not signify that the

An Emergency Packet Forwarding Scheme for V2V Communication Networks

PubMed Central

2014-01-01

This paper proposes an effective warning message forwarding scheme for cooperative collision avoidance. In an emergency situation, an emergency-detecting vehicle warns the neighbor vehicles via an emergency warning message. Since the transmission range is limited, the warning message is broadcast in a multihop manner. Broadcast packets lead two challenges to forward the warning message in the vehicular network: redundancy of warning messages and competition with nonemergency transmissions. In this paper, we study and address the two major challenges to achieve low latency in delivery of the warning message. To reduce the intervehicle latency and end-to-end latency, which cause chain collisions, we propose a two-way intelligent broadcasting method with an adaptable distance-dependent backoff algorithm. Considering locations of vehicles, the proposed algorithm controls the broadcast of a warning message to reduce redundant EWM messages and adaptively chooses the contention window to compete with nonemergency transmission. Via simulations, we show that our proposed algorithm reduces the probability of rear-end crashes by 70% compared to previous algorithms by reducing the intervehicle delay. We also show that the end-to-end propagation delay of the warning message is reduced by 55%. PMID:25054181

The Effect of Keystone Individuals on Collective Outcomes Can Be Mediated through Interactions or Behavioral Persistence

PubMed Central

Pinter-Wollman, Noa; Keiser, Carl N.; Wollman, Roy; Pruitt, Jonathan N.

2017-01-01

Collective behavior emerges from interactions among group members who often vary in their behavior. The presence of just one or a few keystone individuals, such as leaders or tutors, may have a large effect on collective outcomes. These individuals can catalyze behavioral changes in other group members, thus altering group composition and collective behavior. The influence of keystone individuals on group function may lead to trade-offs between ecological situations, because the behavioral composition they facilitate may be suitable in one situation but not another. We use computer simulations to examine various mechanisms that allow keystone individuals to exert their influence on group members. We further discuss a trade-off between two potentially conflicting collective outcomes, cooperative prey attack and disease dynamics. Our simulations match empirical data from a social spider system and produce testable predictions for the causes and consequences of the influence of keystone individuals on group composition and collective outcomes. We find that a group’s behavioral composition can be impacted by the keystone individual through changes to interaction patterns or behavioral persistence over time. Group behavioral composition and the mechanisms that drive the distribution of phenotypes influence collective outcomes and lead to trade-offs between disease dynamics and cooperative prey attack. PMID:27420788

The ARAC-RODOS-WSPEEDI Information Exchange Project

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

Sullivan, T J

1999-09-01

Under the auspices of a US DOE-JAPAN Memorandum of Understanding JAERI and LLNL agreed to develop and evaluate a prototype information exchange protocol for nuclear accident emergency situations. This project received some interest from the US DOS and FEMA as it fits nicely under the umbrella of the G-7's GEMINI (Global Emergency Management Information Network Initiative) project. Because of LLNL/ARAC and JAERV WSPEEDI interest in nuclear accident consequence assessment and hazard prediction on all scales, to include global, we were happy to participate. Subsequent to the Spring 1997 RODOS-ARAC Workshop a Memorandum of Agreement was developed to enhance mutual collaborationmore » on matters of emergency systems development. In the summer of 1998 the project leaders of RODOS, WSPEEDI and ARAC met at FZK and agreed to join in a triangular collaboration on the development and demonstration of an emergency information exchange protocol. JAERI and FZK are engaged in developing a formal cooperation agreement. The purpose of this project is to evaluate the prototype information protocol application for technical feasibility and mutual benefit through simulated (real) event; quick exchange of atmospheric modeling products and environmental data during emergencies, distribution of predicted results to other countries having no prediction capabilities, and utilization of the link for collaborative studies.« less

[Innovative education: simulation-based training at the Institute of Health Sciences, Semmelweis University, Hungary].

PubMed

Csóka, Mária; Deutsch, Tibor

2011-01-02

In Hungary, the Institute of Health Sciences at Semmelweis University was the first institution to introduce patient simulation-based practical training of non-physician professionals. Before introducing this novel educational methodology, students could only practice particular examinations and interventions on demonstration tools. Using the simulator they can also follow and analyze the effects of the interventions that have been made. The high fidelity, adult Human Patients Emergency Care Simulator (HPS-ECS, Medical Education Technologies Incorporation, Sarasota, Florida, USA) is particularly suitable for acquiring skills related to the management of various emergency situations. The 180 cm and 34 kg mannequin which can operate in lying and sitting positions has both respiration and circulation which can be examined the same way as in a living person. It is capable to produce several physical and clinical signs such as respiration with chest movement, electric cardiac activity, palpable pulse, and measurable blood pressure. In addition, it can also exhibit blinking, swelling of the tongue and whole-body trembling while intestinal, cardiac and pulmonary sounds can equally be examined. The high fidelity simulator allows various interventions including monitoring, oxygen therapy, bladder catheterization, gastric tube insertion, injection, infusion and transfusion therapy to be practiced as part of complex patient management. Diagnostic instruments such as ECG recorder, sphygmomanometer, pulse-oxymeter can be attached to the simulator which can also respond to different medical interventions such as intubation, defibrillation, pacing, liquid supplementing, and blood transfusion. The mannequin's physiological response can be followed up and monitored over time to assess whether the selected intervention has been proven adequate to achieve the desired outcome. Authors provide a short overview of the possible applications of clinical simulation for education and training in health sciences, and present how patient simulator has been embedded in various practical courses as part of different curriculum designed for different health care specialties.

A Simulation of Strategic Decision Making in Situational Stereotype Conditions for Entrepreneurial Companies.

ERIC Educational Resources Information Center

West, G. Page, III; Wilson, E. Vance

1995-01-01

Examines simulation in entrepreneurial research, reviews cognitive structures and theories, and presents a computerized simulation of strategic decision-making in situational stereotype conditions for entrepreneurial companies. The study suggests repeated exposure to a pattern recognition issue in entrepreneurship may lead to a broader…

Simulation: What Is It?

ERIC Educational Resources Information Center

Laktasic, Stanley G.

Simulation is the duplication of the essential characteristics of a task or situation. It represents three elements of the teaching-learning process: (1) stimulus situation; (2) response; and (3) feedback. The uses of simulation may fall into one of three general categories: research--the generation of information about an operational or proposed…

Experiences of counselling in the emergency department during the waiting period: importance of family participation.

PubMed

Paavilainen, Eija; Salminen-Tuomaala, Mari; Kurikka, Sirpa; Paussu, Paula

2009-08-01

To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Descriptive quantitative study. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.

Interprofessional Emergency Training Leads to Changes in the Workplace

PubMed Central

Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D.; Exadaktylos, Aristomenis K.; Machner, Mareen; Hautz, Wolf E.

2018-01-01

Introduction Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. Methods We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one’s roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants’ “Commitment to Change.” In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. Results In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication, behavior, knowledge and attitude. Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., “acknowledge other professions’ work”), and these were equally distributed among professions. At the two-month follow-up, 32 participants (50%) provided written feedback on their original commitments: 57 of 62 (91.9%) commitments were at least partly realized at the follow-up, and only five (8.1%) commitments lacked realization entirely. Conclusion A structured simulation-enhanced intervention was successful in promoting change to the practice of emergency care, while training teamwork and communication skills jointly. PMID:29383079

Inappropriate drug donations: what has happened since the 1999 WHO guidelines?

PubMed

van Dijk, D P; Dinant, G; Jacobs, J A

2011-08-01

Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.

An Examination of the Social Influence Hypothesis of Bystander Intervention in Emergencies.

ERIC Educational Resources Information Center

Teger, Allan I.; Henderson James E.

Data is brought to bear on the social influence hypothesis, according to which the behavior of one bystander influences other bystanders by providing information leading to a definition of the situation. The study placed a subject in an emergency situation in which one of 3 confederates served as a model: (1) male peer; (2) female peer; or (3)…

Leveraging Emerging Technology to Maintain Corporate Situational Awareness

DTIC Science & Technology

2008-06-01

Abstract and Outline for 13th ICCRTS For the paper entitled: Leveraging Emerging Technology to Maintain Corporate ...Situational Awareness Topics: Topic 5. Organizational Issues Topic 4. Cognitive and Social Issues Topic: 2 Networks and Networking Mr. José...for the collection of information is estimated to average 1 hour per response , including the time for reviewing instructions, searching existing data

A Traction Control Strategy with an Efficiency Model in a Distributed Driving Electric Vehicle

PubMed Central

Lin, Cheng

2014-01-01

Both active safety and fuel economy are important issues for vehicles. This paper focuses on a traction control strategy with an efficiency model in a distributed driving electric vehicle. In emergency situation, a sliding mode control algorithm was employed to achieve antislip control through keeping the wheels' slip ratios below 20%. For general longitudinal driving cases, an efficiency model aiming at improving the fuel economy was built through an offline optimization stream within the two-dimensional design space composed of the acceleration pedal signal and the vehicle speed. The sliding mode control strategy for the joint roads and the efficiency model for the typical drive cycles were simulated. Simulation results show that the proposed driving control approach has the potential to apply to different road surfaces. It keeps the wheels' slip ratios within the stable zone and improves the fuel economy on the premise of tracking the driver's intention. PMID:25197697

A traction control strategy with an efficiency model in a distributed driving electric vehicle.

PubMed

Lin, Cheng; Cheng, Xingqun

2014-01-01

Both active safety and fuel economy are important issues for vehicles. This paper focuses on a traction control strategy with an efficiency model in a distributed driving electric vehicle. In emergency situation, a sliding mode control algorithm was employed to achieve antislip control through keeping the wheels' slip ratios below 20%. For general longitudinal driving cases, an efficiency model aiming at improving the fuel economy was built through an offline optimization stream within the two-dimensional design space composed of the acceleration pedal signal and the vehicle speed. The sliding mode control strategy for the joint roads and the efficiency model for the typical drive cycles were simulated. Simulation results show that the proposed driving control approach has the potential to apply to different road surfaces. It keeps the wheels' slip ratios within the stable zone and improves the fuel economy on the premise of tracking the driver's intention.

Evaluation of human body irradiation caused by radionuclides deposited in the filtration unit of gas mask.

PubMed

Cerny, R; Johnova, K; Otahal, P; Thinova, L; Kluson, J

2017-12-01

Radioactive aerosol particles represent a serious risk for people facing the consequences of nuclear accident of any kind. The first responders to emergency situation need to be protected by personal protective equipment which includes radiation protection suit supplemented with gas mask. The purpose of this work is to estimate the dose to the organs of responder's body as a result of radionuclide deposition in the filtration unit of the gas mask. The problem was analyzed using Monte Carlo simulations. The dose absorbed by different organs for five representative radionuclides and the dose distribution over the responder's body are presented in this paper. Based on presented MC simulations, we suggest a method of evaluating the irradiation of the responder by the radionuclides deposited in the filtration unit of the gas mask. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A large-scale mass casualty simulation to develop the non-technical skills medical students require for collaborative teamwork.

PubMed

Jorm, Christine; Roberts, Chris; Lim, Renee; Roper, Josephine; Skinner, Clare; Robertson, Jeremy; Gentilcore, Stacey; Osomanski, Adam

2016-03-08

There is little research on large-scale complex health care simulations designed to facilitate student learning of non-technical skills in a team-working environment. We evaluated the acceptability and effectiveness of a novel natural disaster simulation that enabled medical students to demonstrate their achievement of the non-technical skills of collaboration, negotiation and communication. In a mixed methods approach, survey data were available from 117 students and a thematic analysis undertaken of both student qualitative comments and tutor observer participation data. Ninety three per cent of students found the activity engaging for their learning. Three themes emerged from the qualitative data: the impact of fidelity on student learning, reflexivity on the importance of non-technical skills in clinical care, and opportunities for collaborative teamwork. Physical fidelity was sufficient for good levels of student engagement, as was sociological fidelity. We demonstrated the effectiveness of the simulation in allowing students to reflect upon and evidence their acquisition of skills in collaboration, negotiation and communication, as well as situational awareness and attending to their emotions. Students readily identified emerging learning opportunities though critical reflection. The scenarios challenged students to work together collaboratively to solve clinical problems, using a range of resources including interacting with clinical experts. A large class teaching activity, framed as a simulation of a natural disaster is an acceptable and effective activity for medical students to develop the non-technical skills of collaboration, negotiation and communication, which are essential to team working. The design could be of value in medical schools in disaster prone areas, including within low resource countries, and as a feasible intervention for learning the non-technical skills that are needed for patient safety.

Software Tools For Building Decision-support Models For Flood Emergency Situations

NASA Astrophysics Data System (ADS)

Garrote, L.; Molina, M.; Ruiz, J. M.; Mosquera, J. C.

The SAIDA decision-support system was developed by the Spanish Ministry of the Environment to provide assistance to decision-makers during flood situations. SAIDA has been tentatively implemented in two test basins: Jucar and Guadalhorce, and the Ministry is currently planning to have it implemented in all major Spanish basins in a few years' time. During the development cycle of SAIDA, the need for providing as- sistance to end-users in model definition and calibration was clearly identified. System developers usually emphasise abstraction and generality with the goal of providing a versatile software environment. End users, on the other hand, require concretion and specificity to adapt the general model to their local basins. As decision-support models become more complex, the gap between model developers and users gets wider: Who takes care of model definition, calibration and validation?. Initially, model developers perform these tasks, but the scope is usually limited to a few small test basins. Before the model enters operational stage, end users must get involved in model construction and calibration, in order to gain confidence in the model recommendations. However, getting the users involved in these activities is a difficult task. The goal of this re- search is to develop representation techniques for simulation and management models in order to define, develop and validate a mechanism, supported by a software envi- ronment, oriented to provide assistance to the end-user in building decision models for the prediction and management of river floods in real time. The system is based on three main building blocks: A library of simulators of the physical system, an editor to assist the user in building simulation models, and a machine learning method to calibrate decision models based on the simulation models provided by the user.

Access Control for Cooperation Systems Based on Group Situation

NASA Astrophysics Data System (ADS)

Kim, Minsoo; Joshi, James B. D.; Kim, Minkoo

Cooperation systems characterize many emerging environments such as ubiquitous and pervasive systems. Agent based cooperation systems have been proposed in the literature to address challenges of such emerging application environments. A key aspect of such agent based cooperation system is the group situation that changes dynamically and governs the requirements of the cooperation. While individual agent context is important, the overall cooperation behavior is more driven by the group context because of relationships and interactions between agents. Dynamic access control based on group situation is a crucial challenge in such cooperation systems. In this paper we propose a dynamic role based access control model for cooperation systems based on group situation. The model emphasizes capability based agent to role mapping and group situation based permission assignment to allow capturing dynamic access policies that evolve continuously.

[Experience of mismatched blood transfusion for an rh negative patient and reconsideration of emergency blood transfusion manual in the hospital].

PubMed

Yoshimatsu, Aya; Hoshi, Takuo; Nishikawa, Masashi; Aya, Daisuke; Ueda, Hiroshi; Yokouchi, Takako; Tanaka, Makoto

2013-08-01

We report a B Rh negative patient undergoing total pelvic exenteration, who received both ABO and Rh incompatible packed red blood cells in an emergency situation. After this experience, we revised the manual of emergency blood transfusion. We defined level of severity to share information with surgeon, nurses, anesthesiologists and the member of the blood center. We changed anesthesia information management system for showing blood type including Duffy blood group system and checking out whether we can transfuse Rh positive blood to Rh negative patient in an emergency situation at the timeout of surgery.

A Risk Management Architecture for Emergency Integrated Aircraft Control

NASA Technical Reports Server (NTRS)

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

2011-01-01

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

The Avenor Virtual Trainer Project--A 3D Interactive Training Module on Energy Control Procedures: Development and First Validation Results.

ERIC Educational Resources Information Center

Giardina, Max

This paper examines the implementation of 3D simulation through the development of the Avenor Virtual Trainer and how situated learning and fidelity of model representation become the basis for more effective Interactive Multimedia Training Situations. The discussion will focus of some principles concerned with situated training, simulation,…

Contingency Support Simulation for the Tracking and Data Relay Satellite System (TDRSS)

NASA Technical Reports Server (NTRS)

Dykes, Andy; Dunham, Joan; Ward, Douglas T.; Robertson, Mika; Nesbit, Gary

2007-01-01

In March 2006, the Tracking and Data Relay Satellite (TDRS)-3 experienced an unexpected thrusting event, which caused significant changes to its orbit. Recovery from this anomaly was protracted, raising concerns during the Independent Review Team (IRT) investigation of the anomaly regarding the contingency response readiness. The simulations and readiness exercises discussed in this paper were part of the response to the IRT concerns. This paper explains the various levels of simulation needed to enhance the proficiency of the Flight Dynamics Facility (FDF) and supporting elements in recovery from a TDRS contingency situation. The main emergency to address is when a TDRS has experienced uncommanded, unreported, or misreported thrusting, causing a ground station to lose the ability to acquire the spacecraft, as happened in 2006. The following levels of simulation are proposed: 1) Tests that would be performed by the individual support sites to verify that internal procedures and tools are in place and up to date; 2) Tabletop simulations that would involve all of the key support sites talking through their respective operating procedures to ensure that proper notifications are made and communications links are established; and 3) Comprehensive simulations that would be infrequent, but realistic, involving data exchanges between ground sites and voice and electronic communications among the supporting elements.

MINEXP, A Computer-Simulated Mineral Exploration Program

ERIC Educational Resources Information Center

Smith, Michael J.; And Others

1978-01-01

This computer simulation is designed to put students into a realistic decision making situation in mineral exploration. This program can be used with different exploration situations such as ore deposits, petroleum, ground water, etc. (MR)

The role of nontechnical skills in simulated trauma resuscitation.

PubMed

Briggs, Alexandra; Raja, Ali S; Joyce, Maurice F; Yule, Steven J; Jiang, Wei; Lipsitz, Stuart R; Havens, Joaquim M

2015-01-01

Trauma team training provides instruction on crisis management through debriefing and discussion of teamwork and leadership skills during simulated trauma scenarios. The effects of team leader's nontechnical skills (NTSs) on technical performance have not been thoroughly studied. We hypothesized that team's and team leader's NTSs correlate with technical performance of clinical tasks. Retrospective cohort study. Brigham and Women's Hospital, STRATUS Center for Surgical Simulation A total of 20 teams composed of surgical residents, emergency medicine residents, emergency department nurses, and emergency services assistants underwent 2 separate, high-fidelity, simulated trauma scenarios. Each trauma scenario was recorded on video for analysis and divided into 4 consecutive sections. For each section, 2 raters used the Non-Technical Skills for Surgeons framework to assess NTSs of the team. To evaluate the entire team's NTS, 2 additional raters used the Modified Non-Technical Skills Scale for Trauma system. Clinical performance measures including adherence to guidelines and time to perform critical tasks were measured independently. NTSs performance by both teams and team leaders in all NTS categories decreased from the beginning to the end of the scenario (all p < 0.05). There was significant correlation between team's and team leader's cognitive skills and critical task performance, with correlation coefficients between 0.351 and 0.478 (p < 0.05). The NTS performance of the team leader highly correlated with that of the entire team, with correlation coefficients between 0.602 and 0.785 (p < 0.001). The NTSs of trauma teams and team leaders deteriorate as clinical scenarios progress, and the performance of team leaders and teams is highly correlated. Cognitive NTS scores correlate with critical task performance. Increased attention to NTSs during trauma team training may lead to sustained performance throughout trauma scenarios. Decision making and situation awareness skills are critical for both team leaders and teams and should be specifically addressed to improve performance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

ALGE3D: A Three-Dimensional Transport Model

NASA Astrophysics Data System (ADS)

Maze, G. M.

2017-12-01

Of the top 10 most populated US cities from a 2015 US Census Bureau estimate, 7 of the cities are situated near the ocean, a bay, or on one of the Great Lakes. A contamination of the water ways in the United States could be devastating to the economy (through tourism and industries such as fishing), public health (from direct contact, or contaminated drinking water), and in some cases even infrastructure (water treatment plants). Current national response models employed by emergency response agencies have well developed models to simulate the effects of hazardous contaminants in riverine systems that are primarily driven by one-dimensional flows; however in more complex systems, such as tidal estuaries, bays, or lakes, a more complex model is needed. While many models exist, none are capable of quick deployment in emergency situations that could contain a variety of release situations including a mixture of both particulate and dissolved chemicals in a complex flow area. ALGE3D, developed at the Department of Energy's (DOE) Savannah River National Laboratory (SRNL), is a three-dimensional hydrodynamic code which solves the momentum, mass, and energy conservation equations to predict the movement and dissipation of thermal or dissolved chemical plumes discharged into cooling lakes, rivers, and estuaries. ALGE3D is capable of modeling very complex flows, including areas with tidal flows which include wetting and drying of land. Recent upgrades have increased the capabilities including the transport of particulate tracers, allowing for more complete modeling of the transport of pollutants. In addition the model is capable of coupling with a one-dimension riverine transport model or a two-dimension atmospheric deposition model in the event that a contamination event occurs upstream or upwind of the water body.

Investigation of the Bystander Effect in School Bullying: Comparison of Experiential, Psychological and Situational Factors

ERIC Educational Resources Information Center

Song, Jiyeon; Oh, Insoo

2017-01-01

The purpose of this study was to investigate whether the "bystander effect" known to occur in emergency situations is effective in bullying situations through examination of the individual experiences of 467 middle- and high-school students. While the bystander effect was not found to be valid in bullying situations, there were…

45 CFR 205.45 - Federal financial participation in relation to State emergency welfare preparedness.

Code of Federal Regulations, 2012 CFR

2012-10-01

... emergency welfare situations resulting from natural disasters, civil disorders, and enemy caused disasters... manpower; (6) Developing ability to assess emergency welfare resources and determining requirements...

45 CFR 205.45 - Federal financial participation in relation to State emergency welfare preparedness.

Code of Federal Regulations, 2010 CFR

2010-10-01

... emergency welfare situations resulting from natural disasters, civil disorders, and enemy caused disasters... manpower; (6) Developing ability to assess emergency welfare resources and determining requirements...

45 CFR 205.45 - Federal financial participation in relation to State emergency welfare preparedness.

Code of Federal Regulations, 2011 CFR

2011-10-01

... emergency welfare situations resulting from natural disasters, civil disorders, and enemy caused disasters... manpower; (6) Developing ability to assess emergency welfare resources and determining requirements...

45 CFR 205.45 - Federal financial participation in relation to State emergency welfare preparedness.

Code of Federal Regulations, 2013 CFR

2013-10-01

... emergency welfare situations resulting from natural disasters, civil disorders, and enemy caused disasters... manpower; (6) Developing ability to assess emergency welfare resources and determining requirements...

45 CFR 205.45 - Federal financial participation in relation to State emergency welfare preparedness.

Code of Federal Regulations, 2014 CFR

2014-10-01

... emergency welfare situations resulting from natural disasters, civil disorders, and enemy caused disasters... manpower; (6) Developing ability to assess emergency welfare resources and determining requirements...

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

DOT National Transportation Integrated Search

1999-01-01

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

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

PubMed

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

2011-10-01

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

Industrial Hardening: 1982 Technical Status Report.

DTIC Science & Technology

1983-05-01

for nuclear disaster ; establish additional contacts with industry to foster development of emergency preparedness, in general, and nuclear disaster preparedness...versatility for the situation following a nuclear disaster ). Recent governmat installations of such units have been made on an experimental basis...that industry could use to carry on vital functions now, in an emergency situation, and in event of a nuclear disaster . At its simplest, the

Pesticide Emergency Exemptions

EPA Pesticide Factsheets

A state or federal agency can request an emergency exemptions when a serious pest problem jeopardizes production of agricultural goods or public health but no pesticides are currently registered for that situation. Learn how to request emergency exemption.

Implications of Good Samaritan laws for physicians.

PubMed

Paterick, Timothy J; Paterick, Barbara B; Paterick, Timothy E

2008-01-01

Good Samaritan laws are designed to encourage individuals, including physicians, to gratuitously render medical care in emergency situations. Through these laws, immunity from civil liability is provided to physicians who act in good faith to provide emergency care gratis. Historically, emergency care involved medical assistance given to persons in motor vehicle crashes or other emergency situations in which bystanders were present. Protection of physicians from allegations of negligence was a tactic of the legislative and judicial systems to encourage active clinical participation, rather than cautious nonparticipation, in emergency care. In some states and under defined circumstances, the immunity may apply in the hospital setting, as well as in the physician's office. Legislatures have continued to amend the statutes to expand the protection provided to physicians who offer emergency care. Judicial construction of the nature and scope of physician immunity has similarly expanded.

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

ERIC Educational Resources Information Center

Apel, Laura

2009-01-01

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

Speeding response, saving lives : automatic vehicle location capabilities for emergency services

DOT National Transportation Integrated Search

1999-01-01

This brochure focuses on the application of automatic vehicle location systems to emergency services. It discusses how AVL works with emergency vehicles and how it accommodates a wide range of emergency situations, and the benefits of ITS use. (3 p.)

33 CFR 337.7 - Emergency actions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... measures to modify the emergency operation to reduce, avoid, or minimize adverse environmental impacts. If... DEFENSE PRACTICE AND PROCEDURE § 337.7 Emergency actions. After obtaining approval from the division..., as necessary, an environmental assessment, if this is practicable in view of the emergency situation...

33 CFR 337.7 - Emergency actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... measures to modify the emergency operation to reduce, avoid, or minimize adverse environmental impacts. If... DEFENSE PRACTICE AND PROCEDURE § 337.7 Emergency actions. After obtaining approval from the division..., as necessary, an environmental assessment, if this is practicable in view of the emergency situation...

33 CFR 337.7 - Emergency actions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... measures to modify the emergency operation to reduce, avoid, or minimize adverse environmental impacts. If... DEFENSE PRACTICE AND PROCEDURE § 337.7 Emergency actions. After obtaining approval from the division..., as necessary, an environmental assessment, if this is practicable in view of the emergency situation...

33 CFR 337.7 - Emergency actions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... measures to modify the emergency operation to reduce, avoid, or minimize adverse environmental impacts. If... DEFENSE PRACTICE AND PROCEDURE § 337.7 Emergency actions. After obtaining approval from the division..., as necessary, an environmental assessment, if this is practicable in view of the emergency situation...

[How deaf people cope in routine and emergency situations - suggested paths for thought and action].

PubMed

Tannenbaum-Baruchi, Carolina; Feder-Bubis, Paula; Adini-Weisel, Bruria; Aharonson-Daniel, Limor

2014-09-01

Deaf people have unique characteristics and needs. There is a limited amount of research regarding the needs of deaf people, and no studies were found concerning deaf people in emergency situations. The absence of the sense of hearing in deaf people is only one component of the complexity of their world. Many factors contribute to this complexity, but the most striking is the means of communication between the deaf and the hearing person and vice versa. Changes during emergency situations present a challenge for hearing individuals, and even more so, for deaf people. Deaf individuals experience difficulty in obtaining and transmitting information, accessing care and more. These difficulties often result in the dependency of the deaf person on others. The State of Israel enacted laws targeted to facilitate the access of individuals with disabilities in general, and deaf people in particular, to public services. In emergencies, the Home Front Command and the Ministry of Social Welfare distribute pagers to the deaf population, as a device to communicate warning alerts. However, these devices do not fulfil the need for accessible care, bi-directional flow of information, and additional needs that arise during times of emergency. The deaf population is a cultural minority, whose needs in emergency situations are unknown. Familiarity with the deaf population is the first step towards improving treatment and communication that are apt for this population. This paper reviews what is known in the literature about this topic and presents an attempt to bridge the gap of knowledge and barriers to communication between the deaf population and

Management of emergent conditions in palliative care.

PubMed

Wrede-Seaman, L D

2001-06-01

Emergent conditions arising in patients with advanced terminal disease are inevitable and create stressful situations for patients, caregivers, and health care personnel. Discussions regarding appropriate levels of intervention based on parameters such as patient wishes, proper access to documentation of those wishes, location of care, cognitive status and extent of clinical decline are important to have before crisis situations. Common emergencies to be addressed include those that may or may not be associated with advanced malignancies, including compression syndromes, superior vena cava syndrome, hypercalcemia, acute dyspnea, seizures, acute urinary and bowel obstructions, massive hemorrhage, cardiac tamponade, acute embolic phenomenon, and psychiatric emergencies. Although not all clinical scenarios will be addressed in this article, the more common ones will be discussed.

Preparing for the unexpected: violence in the home care environment, one agency's story.

PubMed

Browning, Sarah Via; Clark, Rebecca Culver; Glick, Roger E

2013-06-01

Home care and hospice agencies, bound by regulations, prepare for emergencies and disasters by creating policies and protocols for management of emergency situations, perhaps conducting table top or other types of drills, and discussing hazards likely to impact home care. Is this preparation merely an exercise to meet a requirement, or is it life-saving preparation? For one home care agency, the emergency exercise saved the day as the scenario enacted in the drill was actually lived out a few weeks after the exercise-a scenario the agency leaders hoped they would never face. This account explores how the agency prepared to meet the emergent situation and details lessons learned in the aftermath.

Improving the Effectiveness and Acquisition Management of Selected Weapon Systems: A Summary of Major Issues and Recommended Actions.

DTIC Science & Technology

1982-05-14

need for effective training--a situation which will be impaired until the AH-64 combat mission simulator , now under development, becomes available in...antisubmarine warfare system includes the capability to detect, classify, localize, and destroy the enemy. This capability includes multimillion dollar...to simulate combat situations will simulate only air-to-air activity. Air-to-ground and electronic counter countermeasures simulations were deleted

Epidemic classification of phytosanitary situations on cereal crops using mathematical modeling

USDA-ARS?s Scientific Manuscript database

Most plant protection researchers and experts divide emerging phytosanitary situations into three classes: epidemic, moderate development of disease, and yield depression. The known principles and methods for estimating these situations (Van der Plank J.E., Kranz J. et al.) do not fully describe th...

A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions

PubMed Central

Truszewski, Zenon; Krajewski, Paweł; Fudalej, Marcin; Smereka, Jacek; Frass, Michael; Robak, Oliver; Nguyen, Bianka; Ruetzler, Kurt; Szarpak, Lukasz

2016-01-01

Abstract Background: Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR. Methods: ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario. Results: The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5–22] sec, when compared to that of sETT at 21.5 [IQR, 20–25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5–24.5] sec (p < .001) and sETT was 27 [IQR, 24.5–31.5] sec. Time to first ventilation for scenario C was 23.5 [IQR, 19–25.5] sec for the ETView and 42.5 [IQR, 35–49.5] sec for sETT. Conclusions: In normal airways and situations with continuous chest compressions, the success rate for intubation of cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView. Trial Registration: clinicaltrials.gov Identifier: NCT02733536. PMID:27858851

A comparison of a traditional endotracheal tube versus ETView SL in endotracheal intubation during different emergency conditions: A randomized, crossover cadaver trial.

PubMed

Truszewski, Zenon; Krajewski, Paweł; Fudalej, Marcin; Smereka, Jacek; Frass, Michael; Robak, Oliver; Nguyen, Bianka; Ruetzler, Kurt; Szarpak, Lukasz

2016-11-01

Airway management is a crucial skill essential to paramedics and personnel working in Emergency Medical Services and Emergency Departments: Lack of practice, a difficult airway, or a trauma situation may limit the ability of paramedics to perform direct laryngoscopy during cardiopulmonary resuscitation. Videoscope devices are alternatives for airway management in these situations. The ETView VivaSight SL (ETView; ETView Ltd., Misgav, Israel) is a new, single-lumen airway tube with an integrated high-resolution imaging camera. To assess if the ETView VivaSight SL can be a superior alternative to a standard endotracheal tube for intubation in an adult cadaver model, both during and without simulated CPR. ETView VivaSight SL tube was investigated via an interventional, randomized, crossover, cadaver study. A total of 52 paramedics participated in the intubation of human cadavers in three different scenarios: a normal airway at rest without concomitant chest compression (CC) (scenario A), a normal airway with uninterrupted CC (scenario B) and manual in-line stabilization (scenario C). Time and rate of success for intubation, the glottic view scale, and ease-of-use of ETView vs. sETT intubation were assessed for each emergency scenario. The median time to intubation using ETView vs. sETT was compared for each of the aforementioned scenarios. For scenario A, time to first ventilation was achieved fastest for ETView, 19.5 [IQR, 16.5-22] sec, when compared to that of sETT at 21.5 [IQR, 20-25] sec (p = .013). In scenario B, the time for intubation using ETView was 21 [IQR, 18.5-24.5] sec (p < .001) and sETT was 27 [IQR, 24.5-31.5] sec. Time to first ventilation for scenario C was 23.5 [IQR, 19-25.5] sec for the ETView and 42.5 [IQR, 35-49.5] sec for sETT. In normal airways and situations with continuous chest compressions, the success rate for intubation of cadavers and the time to ventilation were improved with the ETView. The time to glottis view, tube insertion, and cuff block were all found to be shorter with the ETView. clinicaltrials.gov Identifier: NCT02733536.

Building a simulation-based crisis resource management course for emergency medicine, phase 1: Results from an interdisciplinary needs assessment survey.

PubMed

Hicks, Christopher M; Bandiera, Glen W; Denny, Christopher J

2008-11-01

Emergency department (ED) resuscitation requires the coordinated efforts of an interdisciplinary team. Human errors are common and have a negative impact on patient safety. Although crisis resource management (CRM) skills are utilized in other clinical domains, most emergency medicine (EM) caregivers currently receive no formal CRM training. The objectives were to compile and compare attitudes toward CRM training among EM staff physicians, nurses, and residents at two Canadian academic teaching hospitals. Emergency physicians (EPs), residents, and nurses were asked to complete a Web survey that included Likert scales and short answer questions. Focus groups and pilot testing were used to inform survey development. Thematic content analysis was performed on the qualitative data set and compared to quantitative results. The response rate was 75.7% (N = 84). There was strong consensus regarding the importance of core CRM principles (i.e., effective communication, team leadership, resource utilization, problem-solving, situational awareness) in ED resuscitation. Problems with coordinating team actions (58.8%), communication (69.6%), and establishing priorities (41.3%) were among factors implicated in adverse events. Interdisciplinary collaboration (95.1%), efficiency of patient care (83.9%), and decreased medical error (82.6%) were proposed benefits of CRM training. Communication between disciplines is a barrier to effective ED resuscitation for 94.4% of nurses and 59.7% of EPs (p = 0.008). Residents reported a lack of exposure to (64.3%), yet had interest in (96.4%) formal CRM education using human patient simulation. Nurses rate communication as a barrier to teamwork more frequently than physicians. EM residents are keen to learn CRM skills. An opportunity exists to create a novel interdisciplinary CRM curriculum to improve EM team performance and mitigate human error.

Aircrew perceived stress: examining crew performance, crew position and captains personality.

PubMed

Bowles, S; Ursin, H; Picano, J

2000-11-01

This study was conducted at NASA Ames Research Center as a part of a larger research project assessing the impact of captain's personality on crew performance and perceived stress in 24 air transport crews (5). Three different personality types for captains were classified based on a previous cluster analysis (3). Crews were comprised of three crewmembers: captain, first officer, and second officer/flight engineer. A total of 72 pilots completed a 1.5-d full-mission simulation of airline operations including emergency situations in the Ames Manned Vehicle System Research Facility B-727 simulator. Crewmembers were tested for perceived stress on four dimensions of the NASA Task Load Index after each of five flight legs. Crews were divided into three groups based on rankings from combined error and rating scores. High performance crews (who committed the least errors in flight) reported experiencing less stress in simulated flight than either low or medium crews. When comparing crew positions for perceived stress over all the simulated flights no significant differences were found. However, the crews led by the "Right Stuff" (e.g., active, warm, confident, competitive, and preferring excellence and challenges) personality type captains typically reported less stress than crewmembers led by other personality types.

[Mass maritime casualty incidents in German waters: structures and resources].

PubMed

Castan, J; Paschen, H-R; Wirtz, S; Dörges, V; Wenderoth, S; Peters, J; Blunk, Y; Bielstein, A; Kerner, T

2012-07-01

The Central Command for Maritime Emergencies was founded in Germany in 2003 triggered by the fire on board of the cargo ship "Pallas" in 1998. Its mission is to coordinate and direct measures at or above state level in maritime emergency situations in the North Sea and the Baltic Sea. A special task in this case is to provide firefighting and medical care. To face these challenges at sea emergency doctors and firemen have been specially trained. This form of organization provides a concept to counter mass casualty incidents and peril situations at sea. Since the foundation of the Central Command for Maritime Emergencies there have been 5 operations for firefighting units and 4 for medical response teams. Assignments and structure of the Central Command for Maritime Emergencies are unique in Europe.

Mobile emergency, an emergency support system for hospitals in mobile devices: pilot study.

PubMed

Bellini, Pierfrancesco; Boncinelli, Sergio; Grossi, Francesco; Mangini, Marco; Nesi, Paolo; Sequi, Leonardo

2013-05-23

Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings.

Understanding Emergency Care Delivery Through Computer Simulation Modeling.

PubMed

Laker, Lauren F; Torabi, Elham; France, Daniel J; Froehle, Craig M; Goldlust, Eric J; Hoot, Nathan R; Kasaie, Parastu; Lyons, Michael S; Barg-Walkow, Laura H; Ward, Michael J; Wears, Robert L

2018-02-01

In 2017, Academic Emergency Medicine convened a consensus conference entitled, "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes." This article, a product of the breakout session on "understanding complex interactions through systems modeling," explores the role that computer simulation modeling can and should play in research and development of emergency care delivery systems. This article discusses areas central to the use of computer simulation modeling in emergency care research. The four central approaches to computer simulation modeling are described (Monte Carlo simulation, system dynamics modeling, discrete-event simulation, and agent-based simulation), along with problems amenable to their use and relevant examples to emergency care. Also discussed is an introduction to available software modeling platforms and how to explore their use for research, along with a research agenda for computer simulation modeling. Through this article, our goal is to enhance adoption of computer simulation, a set of methods that hold great promise in addressing emergency care organization and design challenges. © 2017 by the Society for Academic Emergency Medicine.

Case studies of simulation models of recreation use

Treesearch

David N. Cole

2005-01-01

Computer simulation models can be usefully applied to many different outdoor recreation situations. Model outputs can also be used for a wide variety of planning and management purposes. The intent of this chapter is to use a collection of 12 case studies to illustrate how simulation models have been used in a wide range of recreation situations and for diverse...

Airline Crew Training

NASA Technical Reports Server (NTRS)

1989-01-01

The discovery that human error has caused many more airline crashes than mechanical malfunctions led to an increased emphasis on teamwork and coordination in airline flight training programs. Human factors research at Ames Research Center has produced two crew training programs directed toward more effective operations. Cockpit Resource Management (CRM) defines areas like decision making, workload distribution, communication skills, etc. as essential in addressing human error problems. In 1979, a workshop led to the implementation of the CRM program by United Airlines, and later other airlines. In Line Oriented Flight Training (LOFT), crews fly missions in realistic simulators while instructors induce emergency situations requiring crew coordination. This is followed by a self critique. Ames Research Center continues its involvement with these programs.

KSC-07pd1990

NASA Image and Video Library

2007-07-19

KENNEDY SPACE CENTER, Fla. --In the White Room on Launch Pad 39A, STS-118 Mission Specialist Rick Mastracchio is eager to enter Space Shuttle Endeavour for a simulated launch countdown, the culmination of terminal countdown demonstration test activities. The White Room is situated at the end of the orbiter access arm and provides entry into the orbiter. TCDT activities also include M-113 training, payload familiarization and emergency egress training at the pad. The mission is the 22nd flight to the International Space Station and Space Shuttle Endeavour will carry a payload including the S5 truss, a SPACEHAB module and external stowage platform 3. STS-118 is targeted for launch on Aug. 7. Photo credit: NASA/Amanda Diller

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

49 CFR 239.103 - Passenger train emergency simulations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Passenger train emergency simulations. 239.103....103 Passenger train emergency simulations. (a) General. Each railroad operating passenger train service shall conduct full-scale emergency simulations, in order to determine its capability to execute...

Hardware-in-the-loop environment facility to address pilot-vehicle-interface issues of a fighter aircraft

NASA Astrophysics Data System (ADS)

Pandurangareddy, Meenige

2002-07-01

The evolution of Pilot-Vehicle-Interface (PVI) of a fighter aircraft is a complex task. The PVI design involves both static and dynamic issues. Static issues involve the study of reach of controls and switches, ejection path clearance, readability of indicators and display symbols, etc. Dynamic issues involve the study of the effect of aircraft motion on display symbols, pilot emergency handling, situation awareness, weapon aiming, etc. This paper describes a method of addressing the above issues by building a facility with cockpit, which is ergonomically similar to the fighter cockpit. The cockpit is also fitted with actual displays, controls and switches. The cockpit is interfaced with various simulation models of aircraft and outside-window-image generators. The architecture of the facility is designed to represent the latencies of the aircraft and facilitates replacement of simulation models with actual units. A parameter injection facility could be used to induce faults in a comprehensive manner. Pilots could use the facility right from familiarising themselves with procedures to start the engine, take-off, navigate, aim the weapons, handling of emergencies and landing. This approach is being followed and further being enhanced on Cockpit-Environment-Facility (CEF) at Aeronautical Development Agency (ADA), Bangalore, India.

Real-time visual communication to aid disaster recovery in a multi-segment hybrid wireless networking system

NASA Astrophysics Data System (ADS)

Al Hadhrami, Tawfik; Wang, Qi; Grecos, Christos

2012-06-01

When natural disasters or other large-scale incidents occur, obtaining accurate and timely information on the developing situation is vital to effective disaster recovery operations. High-quality video streams and high-resolution images, if available in real time, would provide an invaluable source of current situation reports to the incident management team. Meanwhile, a disaster often causes significant damage to the communications infrastructure. Therefore, another essential requirement for disaster management is the ability to rapidly deploy a flexible incident area communication network. Such a network would facilitate the transmission of real-time video streams and still images from the disrupted area to remote command and control locations. In this paper, a comprehensive end-to-end video/image transmission system between an incident area and a remote control centre is proposed and implemented, and its performance is experimentally investigated. In this study a hybrid multi-segment communication network is designed that seamlessly integrates terrestrial wireless mesh networks (WMNs), distributed wireless visual sensor networks, an airborne platform with video camera balloons, and a Digital Video Broadcasting- Satellite (DVB-S) system. By carefully integrating all of these rapidly deployable, interworking and collaborative networking technologies, we can fully exploit the joint benefits provided by WMNs, WSNs, balloon camera networks and DVB-S for real-time video streaming and image delivery in emergency situations among the disaster hit area, the remote control centre and the rescue teams in the field. The whole proposed system is implemented in a proven simulator. Through extensive simulations, the real-time visual communication performance of this integrated system has been numerically evaluated, towards a more in-depth understanding in supporting high-quality visual communications in such a demanding context.

Situational Awareness Geospatial Application (iSAGA)

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

Sher, Benjamin

Situational Awareness Geospatial Application (iSAGA) is a geospatial situational awareness software tool that uses an algorithm to extract location data from nearly any internet-based, or custom data source and display it geospatially; allows user-friendly conduct of spatial analysis using custom-developed tools; searches complex Geographic Information System (GIS) databases and accesses high resolution imagery. iSAGA has application at the federal, state and local levels of emergency response, consequence management, law enforcement, emergency operations and other decision makers as a tool to provide complete, visual, situational awareness using data feeds and tools selected by the individual agency or organization. Feeds may bemore » layered and custom tools developed to uniquely suit each subscribing agency or organization. iSAGA may similarly be applied to international agencies and organizations.« less

Emergency motorcycle: has it a place in a medical emergency system?

PubMed

Soares-Oliveira, Miguel; Egipto, Paula; Costa, Isabel; Cunha-Ribeiro, Luis Manuel

2007-07-01

In an emergency medical service system, response time is an important factor in determining the prognosis of a victim. There are well-documented increases in response time in urban areas, mainly during rush hour. Because prehospital emergency care is required to be efficient and swift, alternative measures to achieve this goal should be addressed. We report our experience with a medical emergency motorcycle (MEM) and propose major criteria for dispatching it. This work presents a prospective analysis of the data relating to MEM calls from July 2004 to December 2005. The analyzed parameters were age, sex, reason for call, action, and need for subsequent transport. A comparison was made of the need to activate more means and, if so, whether the MEM was the first to arrive. There were 1972 calls. The average time of arrival at destination was 4.4 +/- 2.5 minutes. The main action consisted of administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport. The MEM can intervene in a wide variety of clinical situations and a quick response is guaranteed. Moreover, in specific situations, MEM safely and efficiently permits better management of emergency vehicles. We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.

Observers' focus of attention in the simulation of self-perception.

PubMed

Wegner, D M; Finstuen, K

1977-01-01

This research was designed to assess the effects of a manipulation of observers' focus of attention--from a focus on the actor to a focus on the actor's situation--upon observers' attributions of attitude to an actor in a simulation of a forced-compliance cognitive dissonance experiment. Observers induced through empathy instructions to focus attention on the actor's situation inferred less actor attitude positivity than did observers given no specific observational set. In addition, situation-focused observers inferred that the actor's attitude was directly related to reward magnitude, whereas actor-focused observers inferred that the actor's attitude was inversely related to reward magnitude. An extension of self-perception theory, offered as an interpretation of these and other results, suggested that motivation attribution made by actors and observers in dissonance and simulation studies are dependent on focus of attention. The attributions made by actor-focused observers simulate those of objectively self-aware actors and are based upon perceived intrinsic motivation; the attributions of situation-focused observers simulate those of subjectively self-aware actors and are based upon perceived extrinsic motivation.

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

ERIC Educational Resources Information Center

Andersson, Annika

2016-01-01

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

Intensive skills week for military medical students increases technical proficiency, confidence, and skills to minimize negative stress.

PubMed

Mueller, Genevieve; Hunt, Bonnie; Wall, Van; Rush, Robert; Molof, Alan; Schoeff, Jonathan; Wedmore, Ian; Schmid, James; Laporta, Anthony

2012-01-01

The effects of stress induced cortisol on learning and memory is well documented in the literature.1-3 Memory and learning are enhanced at low levels while high levels are detrimental. Repetitive training in stressful situations enables management of the stress response4 as demonstrated by the high intensity training military members undergo to prepare for tactical situations. Appropriate management of one?s stress response is critical in the medical field, as the negative effects of stress can potentially hinder life-saving procedures and treatments. This also applies to physicians-in-training as they learn and practice triage, emergency medicine, and surgical skills prior to graduation. Rocky Vista University?s Military Medicine Honor?s Track (MMHT) held a week long high-intensity emergency medicine and surgical Intensive Skills Week (ISW), facilitated by military and university physicians, to advance students? skills and maximize training using the Human Worn Partial Surgical Task Simulator (Cut Suit). The short-term goal of the ISW was to overcome negative stress responses to increase confidence, technical and non-technical knowledge, and skill in surgery and emergency medicine in an effort to improve performance as third-year medical students. The long-term goal was to enhance performance and proficiency in residency and future medical practice. The metrics for the short-term goals were the focus of this pilot study. Results show an increase in confidence and decrease in perceived stress as well as statistically significant improvements in technical and non-technical skills and surgical instrumentation knowledge throughout the week. There is a correlative benefit to physician and non-physician military personnel, especially Special Operations Forces (SOF) medical personnel, from developing and implementing similar training programs when live tissue or cadaver models are unavailable or unfeasible. 2012.

Crossover between structured and well-mixed networks in an evolutionary prisoner's dilemma game

NASA Astrophysics Data System (ADS)

Dai, Qionglin; Cheng, Hongyan; Li, Haihong; Li, Yuting; Zhang, Mei; Yang, Junzhong

2011-07-01

In a spatial evolutionary prisoner’s dilemma game (PDG), individuals interact with their neighbors and update their strategies according to some rules. As is well known, cooperators are destined to become extinct in a well-mixed population, whereas they could emerge and be sustained on a structured network. In this work, we introduce a simple model to investigate the crossover between a structured network and a well-mixed one in an evolutionary PDG. In the model, each link j is designated a rewiring parameter τj, which defines the time interval between two successive rewiring events for link j. By adjusting the rewiring parameter τ (the mean time interval for any link in the network), we could change a structured network into a well-mixed one. For the link rewiring events, three situations are considered: one synchronous situation and two asynchronous situations. Simulation results show that there are three regimes of τ: large τ where the density of cooperators ρc rises to ρc,∞ (the value of ρc for the case without link rewiring), small τ where the mean-field description for a well-mixed network is applicable, and moderate τ where the crossover between a structured network and a well-mixed one happens.

Mobile Emergency Response Water Treatment Technology Results

EPA Science Inventory

When natural disasters like hurricanes, floods and earthquakes occur, safe drinking water can be compromised, limited or unavailable. Under such situations, communities have emergency response plans. One of many options for providing safe drinking water during emergency situati...

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

PubMed

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

2014-01-01

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

A fuzzy-theory-based method for studying the effect of information transmission on nonlinear crowd dispersion dynamics

NASA Astrophysics Data System (ADS)

Fu, Libi; Song, Weiguo; Lo, Siuming

2017-01-01

Emergencies involved in mass events are related to a variety of factors and processes. An important factor is the transmission of information on danger that has an influence on nonlinear crowd dynamics during the process of crowd dispersion. Due to much uncertainty in this process, there is an urgent need to propose a method to investigate the influence. In this paper, a novel fuzzy-theory-based method is presented to study crowd dynamics under the influence of information transmission. Fuzzy functions and rules are designed for the ambiguous description of human states. Reasonable inference is employed to decide the output values of decision making such as pedestrian movement speed and directions. Through simulation under four-way pedestrian situations, good crowd dispersion phenomena are achieved. Simulation results under different conditions demonstrate that information transmission cannot always induce successful crowd dispersion in all situations. This depends on whether decision strategies in response to information on danger are unified and effective, especially in dense crowds. Results also suggest that an increase in drift strength at low density and the percentage of pedestrians, who choose one of the furthest unoccupied Von Neumann neighbors from the dangerous source as the drift direction at high density, is helpful in crowd dispersion. Compared with previous work, our comprehensive study improves an in-depth understanding of nonlinear crowd dynamics under the effect of information on danger.

School Emergencies--Preparation Not Panic.

ERIC Educational Resources Information Center

Sousa, Barbara

1982-01-01

A three-phase emergency recognition course was designed to train 26 faculty and staff members to recognize and respond to emergency school medical situations. Phase I included comprehensive first aid, cardiopulmonary resuscitation (CPR), and injections. Phase II dealt with recognition of medical emergencies, and Phase III recertified those who had…

Planning for School Emergencies.

ERIC Educational Resources Information Center

Della-Giustina, Daniel E.

This document is designed to provide civil leaders and school administrators with a resource that will enable them to develop comprehensive contingency plans for specific emergency situations. A discussion of disaster and emergency management planning includes an outline of the objectives of emergency planning that were established for this guide.…

Guidebook for Planning Education in Emergencies and Reconstruction

ERIC Educational Resources Information Center

International Institute for Educational Planning (IIEP) UNESCO, 2006

2006-01-01

This comprehensive guidebook will help educational planners during emergencies and reconstruction. The "Guidebook for Planning Education in Emergencies and Reconstruction" presents examples of the problems faced in emergencies, and suggests policy options and strategies that have been found useful in such situations. It is organized in six…

Scheduling for Emergency Tasks in Industrial Wireless Sensor Networks

PubMed Central

Xia, Changqing; Kong, Linghe; Zeng, Peng

2017-01-01

Wireless sensor networks (WSNs) are widely applied in industrial manufacturing systems. By means of centralized control, the real-time requirement and reliability can be provided by WSNs in industrial production. Furthermore, many approaches reserve resources for situations in which the controller cannot perform centralized resource allocation. The controller assigns these resources as it becomes aware of when and where accidents have occurred. However, the reserved resources are limited, and such incidents are low-probability events. In addition, resource reservation may not be effective since the controller does not know when and where accidents will actually occur. To address this issue, we improve the reliability of scheduling for emergency tasks by proposing a method based on a stealing mechanism. In our method, an emergency task is transmitted by stealing resources allocated to regular flows. The challenges addressed in our work are as follows: (1) emergencies occur only occasionally, but the industrial system must deliver the corresponding flows within their deadlines when they occur; (2) we wish to minimize the impact of emergency flows by reducing the number of stolen flows. The contributions of this work are two-fold: (1) we first define intersections and blocking as new characteristics of flows; and (2) we propose a series of distributed routing algorithms to improve the schedulability and to reduce the impact of emergency flows. We demonstrate that our scheduling algorithm and analysis approach are better than the existing ones by extensive simulations. PMID:28726738

Study of system-size effects on the emergent magnetic monopoles and Dirac strings in artificial kagome spin ice

NASA Astrophysics Data System (ADS)

Leon, Alejandro

2012-02-01

In this work we study the dynamical properties of a finite array of nanomagnets in artificial kagome spin ice at room temperature. The dynamic response of the array of nanomagnets is studied by implementing a ``frustrated celular aut'omata'' (FCA), based in the charge model. In this model, each dipole is replaced by a dumbbell of two opposite charges, which are situated at the neighbouring vertices of the honeycomb lattice. The FCA simulations, allow us to study in real-time and deterministic way, the dynamic of the system, with minimal computational resource. The update function is defined according to the coordination number of vertices in the system. Our results show that for a set geometric parameters of the array of nanomagnets, the system exhibits high density of Dirac strings and high density emergent magnetic monopoles. A study of the effect of disorder in the arrangement of nanomagnets is incorporated in this work.

The chimera state in colloidal phase oscillators with hydrodynamic interaction

NASA Astrophysics Data System (ADS)

Hamilton, Evelyn; Bruot, Nicolas; Cicuta, Pietro

2017-12-01

The chimera state is the incongruous situation where coherent and incoherent populations coexist in sets of identical oscillators. Using driven non-linear oscillators interacting purely through hydrodynamic forces at low Reynolds number, previously studied as a simple model of motile cilia supporting waves, we find concurrent incoherent and synchronised subsets in small arrays. The chimeras seen in simulation display a "breathing" aspect, reminiscent of uniformly interacting phase oscillators. In contrast to other systems where chimera has been observed, this system has a well-defined interaction metric, and we know that the emergent dynamics inherit the symmetry of the underlying Oseen tensor eigenmodes. The chimera state can thus be connected to a superposition of eigenstates, whilst considering the mean interaction strength within and across subsystems allows us to make a connection to more generic (and abstract) chimeras in populations of Kuramoto phase oscillators. From this work, we expect the chimera state to emerge in experimental observations of oscillators coupled through hydrodynamic forces.

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

PubMed

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

2015-01-01

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

Spatial evolutionary public goods game on complete graph and dense complex networks

NASA Astrophysics Data System (ADS)

Kim, Jinho; Chae, Huiseung; Yook, Soon-Hyung; Kim, Yup

2015-03-01

We study the spatial evolutionary public goods game (SEPGG) with voluntary or optional participation on a complete graph (CG) and on dense networks. Based on analyses of the SEPGG rate equation on finite CG, we find that SEPGG has two stable states depending on the value of multiplication factor r, illustrating how the ``tragedy of the commons'' and ``an anomalous state without any active participants'' occurs in real-life situations. When r is low (), the state with only loners is stable, and the state with only defectors is stable when r is high (). We also derive the exact scaling relation for r*. All of the results are confirmed by numerical simulation. Furthermore, we find that a cooperator-dominant state emerges when the number of participants or the mean degree, , decreases. We also investigate the scaling dependence of the emergence of cooperation on r and . These results show how ``tragedy of the commons'' disappears when cooperation between egoistic individuals without any additional socioeconomic punishment increases.

33 CFR 230.8 - Emergency actions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... major in scope with potentially significant environmental impacts shall be referred through the division... DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.8 Emergency actions. In responding to emergency situations... this regulation. District commanders shall consider the probable environmental consequences in...

33 CFR 230.8 - Emergency actions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... major in scope with potentially significant environmental impacts shall be referred through the division... DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.8 Emergency actions. In responding to emergency situations... this regulation. District commanders shall consider the probable environmental consequences in...

33 CFR 230.8 - Emergency actions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... major in scope with potentially significant environmental impacts shall be referred through the division... DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.8 Emergency actions. In responding to emergency situations... this regulation. District commanders shall consider the probable environmental consequences in...

33 CFR 230.8 - Emergency actions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... major in scope with potentially significant environmental impacts shall be referred through the division... DEFENSE PROCEDURES FOR IMPLEMENTING NEPA § 230.8 Emergency actions. In responding to emergency situations... this regulation. District commanders shall consider the probable environmental consequences in...

78 FR 14110 - Emergency Issuance of Endangered Species Permit

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

... issued an endangered species permit to address emergency veterinary care for an injured green sea turtle...] Emergency Issuance of Endangered Species Permit AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice... notice in an emergency situation where the life or health of an endangered animal is threatened and no...

15 CFR 705.9 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 15 Commerce and Foreign Trade 2 2011-01-01 2011-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

15 CFR 705.9 - Emergency action.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Emergency action. 705.9 Section 705.9 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF... IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.9 Emergency action. In emergency situations, or when in...

Global trends in satellite-based emergency mapping

USGS Publications Warehouse

Voigt, Stefan; Giulio-Tonolo, Fabio; Lyons, Josh; Kučera, Jan; Jones, Brenda; Schneiderhan, Tobias; Platzeck, Gabriel; Kaku, Kazuya; Hazarika, Manzul Kumar; Czaran, Lorant; Li, Suju; Pedersen, Wendi; James, Godstime Kadiri; Proy, Catherine; Muthike, Denis Macharia; Bequignon, Jerome; Guha-Sapir, Debarati

2016-01-01

Over the past 15 years, scientists and disaster responders have increasingly used satellite-based Earth observations for global rapid assessment of disaster situations. We review global trends in satellite rapid response and emergency mapping from 2000 to 2014, analyzing more than 1000 incidents in which satellite monitoring was used for assessing major disaster situations. We provide a synthesis of spatial patterns and temporal trends in global satellite emergency mapping efforts and show that satellite-based emergency mapping is most intensively deployed in Asia and Europe and follows well the geographic, physical, and temporal distributions of global natural disasters. We present an outlook on the future use of Earth observation technology for disaster response and mitigation by putting past and current developments into context and perspective.

Is there one optimal medical treatment and evacuation chain for all situations: "scoop-and-run" or "stay-and-play".

PubMed

Hoejenbos, Maarten J J; McManus, John; Hodgetts, Timothy

2008-01-01

In 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one "golden" treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization. A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion. Using the different experiences and the outcome of the discussions, it was concluded that there is not one "golden" medical emergency system, there are no "golden" timelines, and no "golden" skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems. The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.

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

PubMed

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

2003-01-01

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

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

PubMed

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

2009-06-01

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

Wargame Simulation Theory and Evaluation Method for Emergency Evacuation of Residents from Urban Waterlogging Disaster Area

PubMed Central

Chen, Peng; Zhang, Jiquan; Sun, Yingyue; Liu, Xiaojing

2016-01-01

Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation plans, we used a wargame exercise method, incorporating qualitative and quantitative aspects, to build an urban waterlogging disaster emergency shelter using a wargame exercise and evaluation model. The simulation was empirically tested in Daoli District of Harbin. The results showed that the wargame simulation scored 96.40 points, evaluated as good. From the simulation results, wargame simulation of urban waterlogging emergency procedures for disaster response can improve the flexibility and capacity for command, management and decision-making in emergency management departments. PMID:28009805

IMAGE: Simulation for Understanding Complex Situations and Increasing Future Force Agility

DTIC Science & Technology

2008-12-01

IMAGE: SIMULATION FOR UNDERSTANDING COMPLEX SITUATIONS AND INCREASING FUTURE FORCE AGILITY Michel Lizotte, François Bernier, Marielle Mokhtari ...Valcartier TM, 2008. [Bernier et al., 2007] Bernier, F., Boivin, E., DuCharme, M., Lizotte, M., Mokhtari , M., Pestov, I., and Pous- sart, D., Selection

The effect of role assignment in high fidelity patient simulation on nursing students: An experimental research study.

PubMed

Weiler, Dustin T; Gibson, Andrea L; Saleem, Jason J

2018-04-01

Previous studies have evaluated the effectiveness of high fidelity patient simulators (HFPS) on nursing training; however, a gap exists on the effects of role assignment on critical thinking, self-efficacy, and situation awareness skills in team-based simulation scenarios. This study aims to determine if role assignment and the involvement level related to the roles yields significant effects and differences in critical thinking, situation awareness and self-efficacy scores in team-based high-fidelity simulation scenarios. A single factorial design with five levels and random assignment was utilized. A public university-sponsored simulation center in the United States of America. A convenience sample of 69 junior-level baccalaureate nursing students was recruited for participation. Participants were randomly assigned one of five possible roles and completed pre-simulation critical thinking and self-efficacy assessments prior to the simulation beginning. Playing within their assigned roles, participants experienced post-partum hemorrhaging scenario using an HFPS. After completing the simulation, participants completed a situation awareness assessment and a post-simulation critical thinking and self-efficacy assessment. Role assignment was found to have a statistically significant effect on critical thinking skills and a statistically significant difference in various areas of self-efficacy was also noted. However, no statistical significance in situation awareness abilities was found. Results support the notion that certain roles required the participant to be more involved with the simulation scenario, which may have yielded higher critical thinking and self-efficacy scores than roles that required a lesser level of involvement. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

PubMed

2014-12-01

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

`G.A.T.E': Gap analysis for TTX evaluation

NASA Astrophysics Data System (ADS)

Cacciotti, Ilaria; Di Giovanni, Daniele; Pergolini, Alessandro; Malizia, Andrea; Carestia, Mariachiara; Palombi, Leonardo; Bellecci, Carlo; Gaudio, Pasquale

2016-06-01

A Table Top Exercise (TTX) gap analysis tool was developed with the aim to provide a complete, systematic and objective evaluation of TTXs organized in safety and security fields. A TTX consists in a discussion-based emergency management exercise, organized in a simulated emergency scenario, involving groups of players who are subjected to a set of solicitations (`injects'), in order to evaluate their emergency response abilities. This kind of exercise is devoted to identify strengths and shortfalls and to propose potential and promising changes in the approach to a particular situation. In order to manage the TTX derived data collection and analysis, a gap analysis tool would be very useful and functional at identifying the 'gap' between them and specific areas and actions for improvement, consisting the gap analysis in a comparison between actual performances and optimal/expected ones. In this context, a TTX gap analysis tool was designed, with the objective to provide an evaluation of Team players' competences and performances and TTX organization and structure. The influence of both the players' expertise and the reaction time (difference between expected time and time necessary to actually complete the injects) on the final evaluation of the inject responses was also taken into account.

Individual Pause-and-Go Motion Is Instrumental to the Formation and Maintenance of Swarms of Marching Locust Nymphs

PubMed Central

Ariel, Gil; Ophir, Yotam; Levi, Sagi; Ben-Jacob, Eshel; Ayali, Amir

2014-01-01

The principal interactions leading to the emergence of order in swarms of marching locust nymphs was studied both experimentally, using small groups of marching locusts in the lab, and using computer simulations. We utilized a custom tracking algorithm to reveal fundamental animal-animal interactions leading to collective motion. Uncovering this behavior introduced a new agent-based modeling approach in which pause-and-go motion is pivotal. The behavioral and modeling findings are largely based on motion-related visual sensory inputs obtained by the individual locust. Results suggest a generic principle, in which intermittent animal motion can be considered as a sequence of individual decisions as animals repeatedly reassess their situation and decide whether or not to swarm. This interpretation implies, among other things, some generic characteristics regarding the build-up and emergence of collective order in swarms: in particular, that order and disorder are generic meta-stable states of the system, suggesting that the emergence of order is kinetic and does not necessarily require external environmental changes. This work calls for further experimental as well as theoretical investigation of the neural mechanisms underlying locust coordinative behavior. PMID:24988464

A Study on Active Disaster Management System for Standardized Emergency Action Plan using BIM and Flood Damage Estimation Techniques

NASA Astrophysics Data System (ADS)

Jeong, C.; Om, J.; Hwang, J.; Joo, K.; Heo, J.

2013-12-01

In recent, the frequency of extreme flood has been increasing due to climate change and global warming. Highly flood damages are mainly caused by the collapse of flood control structures such as dam and dike. In order to reduce these disasters, the disaster management system (DMS) through flood forecasting, inundation mapping, EAP (Emergency Action Plan) has been studied. The estimation of inundation damage and practical EAP are especially crucial to the DMS. However, it is difficult to predict inundation and take a proper action through DMS in real emergency situation because several techniques for inundation damage estimation are not integrated and EAP is supplied in the form of a document in Korea. In this study, the integrated simulation system including rainfall frequency analysis, rainfall-runoff modeling, inundation prediction, surface runoff analysis, and inland flood analysis was developed. Using this system coupled with standard GIS data, inundation damage can be estimated comprehensively and automatically. The standard EAP based on BIM (Building Information Modeling) was also established in this system. It is, therefore, expected that the inundation damages through this study over the entire area including buildings can be predicted and managed.

44 CFR 352.20 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY PREPAREDNESS COMMERCIAL NUCLEAR POWER PLANTS: EMERGENCY PREPAREDNESS PLANNING Federal... for offsite radiological emergency planning and preparedness in a situation where Federal support... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Purpose and scope. 352.20...

Introducing Emergency Preparedness in Childbirth Education Classes

PubMed Central

DeWald, Lauren; Fountain, Lily

2006-01-01

In the wake of recent natural and man-made disasters and emergency situations, pregnant women are especially vulnerable. The authors of this column encourage childbirth educators to include disaster preparedness instruction and emergency childbirth techniques in their class content. PMID:17322945

Development of a Graphics Based Automated Emergency Response System (AERS) for Rail Transit Systems

DOT National Transportation Integrated Search

1989-05-01

This report presents an overview of the second generation Automated Emergency Response System (AERS2). Developed to assist transit systems in responding effectively to emergency situations, AERS2 is a microcomputer-based information retrieval system ...

The Role of Self-Efficacy for Bystander Helping Behaviors in Risky Alcohol Situations

PubMed Central

Krieger, Heather; Serrano, Surizaday; Neighbors, Clayton

2017-01-01

We examined the role of self-efficacy in preventing bystander inaction in dangerous alcohol situations. Participants (N = 504) completed an online survey that assessed whether they had previously witnessed or intervened in alcohol-related emergencies, their self-efficacy for intervening, and their likelihood of intervening in the future. Previously intervening was positively associated with self-efficacy and likelihood of intervening in the future. Furthermore, self-efficacy mediated the association between previously intervening and likelihood of intervening in the future. In conclusion, self-efficacy for intervening in social situations is associated with intervening in alcohol-related emergencies and is an important factor to consider when designing bystander interventions. PMID:29097835

The Role of Self-Efficacy for Bystander Helping Behaviors in Risky Alcohol Situations.

PubMed

Krieger, Heather; Serrano, Surizaday; Neighbors, Clayton

2017-04-01

We examined the role of self-efficacy in preventing bystander inaction in dangerous alcohol situations. Participants (N = 504) completed an online survey that assessed whether they had previously witnessed or intervened in alcohol-related emergencies, their self-efficacy for intervening, and their likelihood of intervening in the future. Previously intervening was positively associated with self-efficacy and likelihood of intervening in the future. Furthermore, self-efficacy mediated the association between previously intervening and likelihood of intervening in the future. In conclusion, self-efficacy for intervening in social situations is associated with intervening in alcohol-related emergencies and is an important factor to consider when designing bystander interventions.

Create an Emergency Kit

MedlinePlus

Facebook Twitter Instagram YouTube About PHA Contact Join Careers Store My Account Donate Patients About PH Diagnosis Treatments Newly Diagnosed Life With PH Emergency Situations Find a Doctor PH Care ...

Emergent Literacy as Sociocultural Practice: How Well Do New Zealand Parents Fit with "Te Whariki?"

ERIC Educational Resources Information Center

Zhang, Qilong

2017-01-01

A sociocultural approach to emergent literacy and growing concerns over the de-emphasis on literacy of the New Zealand early childhood education curriculum "Te Whariki" call for locally situated emergent literacy programmes co-constructed by teachers, parents and children. While teachers' approach to emergent literacy takes centre stage…

In the Wake of the Quake: Teaching the Emergency

ERIC Educational Resources Information Center

Sturm, Sean; Turner, Stephen

2018-01-01

The university today finds itself in a global state of emergency, at once financial, military and ecological. Teaching must assume this emergency as premise and responsibility: it must consider the grounds of the classroom, both figurative and literal, and generate emergent lines of inquiry that address the pressing global and local situation. For…

Responses to a Fire Emergency: Students' Knowledge and Willingness to Assist Another Student

ERIC Educational Resources Information Center

Varghese, Susan

2010-01-01

Recent statistics have shown an increasing trend in the frequency and severity of emergency situations around the world, with women and people with disabilities being disproportionally impacted by these emergencies. A review of the literature suggests that college campuses are particularly vulnerable during emergencies. With the increasing…

31 CFR 9.8 - Emergency action.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Emergency action. 9.8 Section 9.8 Money and Finance: Treasury Office of the Secretary of the Treasury EFFECTS OF IMPORTED ARTICLES ON THE NATIONAL SECURITY § 9.8 Emergency action. In emergency situations or when in his judgment national security...

Contraceptive availability during an emergency response in the United States.

PubMed

Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2013-03-01

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response.

Simulation-based evaluation of an in-vehicle smart situation awareness enhancement system.

PubMed

Gregoriades, Andreas; Sutcliffe, Alistair

2018-07-01

Situation awareness (SA) constitutes a critical factor in road safety, strongly related to accidents. This paper describes the evaluation of a proposed SA enhancement system (SAES) that exploits augmented reality through a head-up display (HUD). Two SAES designs were evaluation (information rich vs. minimal information) using a custom-made simulator and the Situation Awareness Global Assessment Technique with performance and EEG measures. The paper describes the process of assessing the SA of drivers using the SAES, through a series of experiments with participants in a Cave Automatic Virtual Environment. The effectiveness of the SAES was tested in a within-group research design. The results showed that the information rich (radar-style display) was superior to the minimal (arrow hazard indicator) design and that both SAES improved drivers' SA and performance compared to the control (no HUD) design. Practitioner Summary: Even though driver situation awareness is considered as one of the leading causes of road accidents, little has been done to enhance it. The current study demonstrates the positive effect of a proposed situation awareness enhancement system on driver situation awareness, through an experiment using virtual prototyping in a simulator.

Emergency situations and deaf people in Israel: Communication obstacles and recommendations

PubMed Central

Tannenbaum-Baruchi, Carolina; Feder-Bubis, Paula; Adini, Bruria; Aharonson-Daniel, Limor

2014-01-01

The absence of the ability to hear sounds in deaf people is an obstacle to optimal communication in a predominantly hearing world. Emergency situations harbor sufficient challenge for the hearing person and pose even greater barriers for the deaf and hard of hearing. During disasters and emergency situations, deaf people have great difficulty in obtaining and sharing information, increasing their dependence on others. This article focuses on the experience of deaf people during a period of security threat, when missiles from the Gaza strip were aimed at the civilian population in Southern Israel, in 2009. The aim of this article is to illustrate the complexities that deaf citizens experienced, and describe their coping mechanisms. A qualitative study including 15 heterogeneous-background Deaf participants interviewed by a researcher that belongs to the deaf community using a multiple-method facilitated questionnaire. Data was analyzed using grounded theory methodology principles. Main categories that arose from data analysis were communication problems during emergencies, the pager as a questionable warning device about emergencies (due to timing and content/context issues of its use), and the implications of the location of deaf people at time of emergency. Various channels for conveying information should be examined and created in order to maximize the heterogeneous deaf community's ability to receive vital information during an emergency. Professional sign language interpreters are necessary during emergencies, helping to reduce both dependence on informal sources (such as family members, including minors, friends, neighbors, by-standers) and risk. The development of new technologies may bear potential help for deaf persons during emergencies. Being a socio-linguistic minority, it is recommended to ensure these technologies will be accessible to the whole deaf community. PMID:28229005

Treating Estimation and Mental Computation as Situated Mathematical Processes.

ERIC Educational Resources Information Center

Silver, Edward A.

This paper discusses the central thesis that new research on estimation and mental computation will benefit from more focused attention on the situations in which they are used. In the first section of the paper, a brief discussion of cognitive theory, with special attention to the emerging notion of situated cognition is presented. Three sources…

Bringing the Emergency Room to the Classroom: Using "Grey's Anatomy" to Simplify Situational Leadership

ERIC Educational Resources Information Center

Torock, Jodi L.

2008-01-01

Situational leadership has been noted as one of the most recognizable leadership concepts (Northouse, 2007). Teaching the model to a college student audience may become more of monotony than a learning experience. Using popular media technology to teach situational leadership can appeal to more learning styles than the typical lecture, and make…

A Topology Control Strategy with Reliability Assurance for Satellite Cluster Networks in Earth Observation

PubMed Central

Chen, Qing; Zhang, Jinxiu; Hu, Ze

2017-01-01

This article investigates the dynamic topology control problem of satellite cluster networks (SCNs) in Earth observation (EO) missions by applying a novel metric of stability for inter-satellite links (ISLs). The properties of the periodicity and predictability of satellites’ relative position are involved in the link cost metric which is to give a selection criterion for choosing the most reliable data routing paths. Also, a cooperative work model with reliability is proposed for the situation of emergency EO missions. Based on the link cost metric and the proposed reliability model, a reliability assurance topology control algorithm and its corresponding dynamic topology control (RAT) strategy are established to maximize the stability of data transmission in the SCNs. The SCNs scenario is tested through some numeric simulations of the topology stability of average topology lifetime and average packet loss rate. Simulation results show that the proposed reliable strategy applied in SCNs significantly improves the data transmission performance and prolongs the average topology lifetime. PMID:28241474

A Topology Control Strategy with Reliability Assurance for Satellite Cluster Networks in Earth Observation.

PubMed

Chen, Qing; Zhang, Jinxiu; Hu, Ze

2017-02-23

This article investigates the dynamic topology control problemof satellite cluster networks (SCNs) in Earth observation (EO) missions by applying a novel metric of stability for inter-satellite links (ISLs). The properties of the periodicity and predictability of satellites' relative position are involved in the link cost metric which is to give a selection criterion for choosing the most reliable data routing paths. Also, a cooperative work model with reliability is proposed for the situation of emergency EO missions. Based on the link cost metric and the proposed reliability model, a reliability assurance topology control algorithm and its corresponding dynamic topology control (RAT) strategy are established to maximize the stability of data transmission in the SCNs. The SCNs scenario is tested through some numeric simulations of the topology stability of average topology lifetime and average packet loss rate. Simulation results show that the proposed reliable strategy applied in SCNs significantly improves the data transmission performance and prolongs the average topology lifetime.

Bandwidth management for mobile mode of mobile monitoring system for Indonesian Volcano

NASA Astrophysics Data System (ADS)

Evita, Maria; Djamal, Mitra; Zimanowski, Bernd; Schilling, Klaus

2017-01-01

Volcano monitoring requires the system which has high-fidelity operation and real-time acquisition. MONICA (Mobile Monitoring System for Indonesian Volcano), a system based on Wireless Sensor Network, mobile robot and satellite technology has been proposed to fulfill this requirement for volcano monitoring system in Indonesia. This system consists of fixed-mode for normal condition and mobile mode for emergency situation. The first and second modes have been simulated in slow motion earthquake cases of Merapi Volcano, Indonesia. In this research, we have investigated the application of our bandwidth management for high-fidelity operation and real time acquisition in mobile mode of a strong motion earthquake from this volcano. The simulation result showed that our system still could manage the bandwidth even when there were 2 died fixed node after had stroked by the lightning. This result (64% to 83% throughput in average) was still better than the bandwidth utilized by the existing equipment (0% throughput because of the broken seismometer).

Global trends in satellite-based emergency mapping.

PubMed

Voigt, Stefan; Giulio-Tonolo, Fabio; Lyons, Josh; Kučera, Jan; Jones, Brenda; Schneiderhan, Tobias; Platzeck, Gabriel; Kaku, Kazuya; Hazarika, Manzul Kumar; Czaran, Lorant; Li, Suju; Pedersen, Wendi; James, Godstime Kadiri; Proy, Catherine; Muthike, Denis Macharia; Bequignon, Jerome; Guha-Sapir, Debarati

2016-07-15

Over the past 15 years, scientists and disaster responders have increasingly used satellite-based Earth observations for global rapid assessment of disaster situations. We review global trends in satellite rapid response and emergency mapping from 2000 to 2014, analyzing more than 1000 incidents in which satellite monitoring was used for assessing major disaster situations. We provide a synthesis of spatial patterns and temporal trends in global satellite emergency mapping efforts and show that satellite-based emergency mapping is most intensively deployed in Asia and Europe and follows well the geographic, physical, and temporal distributions of global natural disasters. We present an outlook on the future use of Earth observation technology for disaster response and mitigation by putting past and current developments into context and perspective. Copyright © 2016, American Association for the Advancement of Science.

Features of microscopic pedestrian movement in a panic situation based on cellular automata model

NASA Astrophysics Data System (ADS)

Ibrahim, Najihah; Hassan, Fadratul Hafinaz

2017-10-01

Pedestrian movement is the one of the subset for the crowd management under simulation objective. During panic situation, pedestrian usually will create a microscopic movement that lead towards the self-organization. During self-organizing, the behavioral and physical factors had caused the mass effect on the pedestrian movement. The basic CA model will create a movement path for each pedestrian over a time step. However, due to the factors immerge, the CA model needs some enhancement that will establish a real simulation state. Hence, this concept paper will discuss on the enhanced features of CA model for microscopic pedestrian movement during panic situation for a better pedestrian simulation.

Procedural wound geometry and blood flow generation for medical training simulators

NASA Astrophysics Data System (ADS)

Aras, Rifat; Shen, Yuzhong; Li, Jiang

2012-02-01

Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.

Managing Emergency Situations in VANET Through Heterogeneous Technologies Cooperation.

PubMed

Santamaria, Amilcare Francesco; Tropea, Mauro; Fazio, Peppino; De Rango, Floriano

2018-05-08

Nowadays, the research on vehicular computing enhanced a very huge amount of services and protocols, aimed to vehicles security and comfort. The investigation of the IEEE802.11p, Wireless Access in Vehicular Environments (WAVE) and Dedicated Short Range Communication (DSRC) standards gave to the scientific world the chance to integrate new services, protocols, algorithms and devices inside vehicles. This opportunity attracted the attention of private/public organizations, which spent lot of resources and money to promote vehicular technologies. In this paper, the attention is focused on the design of a new approach for vehicular environments able to gather information during mobile node trips, for advising dangerous or emergency situations by exploiting on-board sensors. It is assumed that each vehicle has an integrated on-board unit composed of several sensors and Global Position System (GPS) device, able to spread alerting messages around the network, regarding warning and dangerous situations/conditions. On-board units, based on the standard communication protocols, share the collected information with the surrounding road-side units, while the sensing platform is able to recognize the environment that vehicles are passing through (obstacles, accidents, emergencies, dangerous situations, etc.). Finally, through the use of the GPS receiver, the exact location of the caught event is determined and spread along the network. In this way, if an accident occurs, the arriving cars will, probably, avoid delay and danger situations.

Managing Emergency Situations in VANET Through Heterogeneous Technologies Cooperation

PubMed Central

Tropea, Mauro; De Rango, Floriano

2018-01-01

Nowadays, the research on vehicular computing enhanced a very huge amount of services and protocols, aimed to vehicles security and comfort. The investigation of the IEEE802.11p, Wireless Access in Vehicular Environments (WAVE) and Dedicated Short Range Communication (DSRC) standards gave to the scientific world the chance to integrate new services, protocols, algorithms and devices inside vehicles. This opportunity attracted the attention of private/public organizations, which spent lot of resources and money to promote vehicular technologies. In this paper, the attention is focused on the design of a new approach for vehicular environments able to gather information during mobile node trips, for advising dangerous or emergency situations by exploiting on-board sensors. It is assumed that each vehicle has an integrated on-board unit composed of several sensors and Global Position System (GPS) device, able to spread alerting messages around the network, regarding warning and dangerous situations/conditions. On-board units, based on the standard communication protocols, share the collected information with the surrounding road-side units, while the sensing platform is able to recognize the environment that vehicles are passing through (obstacles, accidents, emergencies, dangerous situations, etc.). Finally, through the use of the GPS receiver, the exact location of the caught event is determined and spread along the network. In this way, if an accident occurs, the arriving cars will, probably, avoid delay and danger situations. PMID:29738453

Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study

PubMed Central

2013-01-01

Background Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. Objective The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. Methods The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. Results The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. Conclusions By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings. PMID:23702566

Modeling and Analysis of Realistic Fire Scenarios in Spacecraft

NASA Technical Reports Server (NTRS)

Brooker, J. E.; Dietrich, D. L.; Gokoglu, S. A.; Urban, D. L.; Ruff, G. A.

2015-01-01

An accidental fire inside a spacecraft is an unlikely, but very real emergency situation that can easily have dire consequences. While much has been learned over the past 25+ years of dedicated research on flame behavior in microgravity, a quantitative understanding of the initiation, spread, detection and extinguishment of a realistic fire aboard a spacecraft is lacking. Virtually all combustion experiments in microgravity have been small-scale, by necessity (hardware limitations in ground-based facilities and safety concerns in space-based facilities). Large-scale, realistic fire experiments are unlikely for the foreseeable future (unlike in terrestrial situations). Therefore, NASA will have to rely on scale modeling, extrapolation of small-scale experiments and detailed numerical modeling to provide the data necessary for vehicle and safety system design. This paper presents the results of parallel efforts to better model the initiation, spread, detection and extinguishment of fires aboard spacecraft. The first is a detailed numerical model using the freely available Fire Dynamics Simulator (FDS). FDS is a CFD code that numerically solves a large eddy simulation form of the Navier-Stokes equations. FDS provides a detailed treatment of the smoke and energy transport from a fire. The simulations provide a wealth of information, but are computationally intensive and not suitable for parametric studies where the detailed treatment of the mass and energy transport are unnecessary. The second path extends a model previously documented at ICES meetings that attempted to predict maximum survivable fires aboard space-craft. This one-dimensional model implies the heat and mass transfer as well as toxic species production from a fire. These simplifications result in a code that is faster and more suitable for parametric studies (having already been used to help in the hatch design of the Multi-Purpose Crew Vehicle, MPCV).

General cognitive principles for learning structure in time and space.

PubMed

Goldstein, Michael H; Waterfall, Heidi R; Lotem, Arnon; Halpern, Joseph Y; Schwade, Jennifer A; Onnis, Luca; Edelman, Shimon

2010-06-01

How are hierarchically structured sequences of objects, events or actions learned from experience and represented in the brain? When several streams of regularities present themselves, which will be learned and which ignored? Can statistical regularities take effect on their own, or are additional factors such as behavioral outcomes expected to influence statistical learning? Answers to these questions are starting to emerge through a convergence of findings from naturalistic observations, behavioral experiments, neurobiological studies, and computational analyses and simulations. We propose that a small set of principles are at work in every situation that involves learning of structure from patterns of experience and outline a general framework that accounts for such learning. (c) 2010 Elsevier Ltd. All rights reserved.

Monitoring of Carrying Cable in the Well by Electric Drive of Winch at the Logging Works

NASA Astrophysics Data System (ADS)

Odnokopylov, I. G.; Gneushev, V. V.; Larioshina, I. A.

2016-01-01

Emergency situations during logging operations are considered. The necessity of monitoring of the carrying cable in the well was shown, especially at the jet perforation and seismic researches of wells. The way of monitoring of logging cable and geophysical probe by means of the electric drive of tripping works of the logging winch is offered. This method allows timely to identify the wedges of geophysical equipment and the tension of the cable in well without interfering into construction of logging installation by means of algorithmic processing of sensors of electric drive. Research was conducted on the simulation model; these results indirectly confirm the possibility of using of electric drive for monitoring of downhole equipment.

MAP Fault Localization Based on Wide Area Synchronous Phasor Measurement Information

NASA Astrophysics Data System (ADS)

Zhang, Yagang; Wang, Zengping

2015-02-01

In the research of complicated electrical engineering, the emergence of phasor measurement units (PMU) is a landmark event. The establishment and application of wide area measurement system (WAMS) in power system has made widespread and profound influence on the safe and stable operation of complicated power system. In this paper, taking full advantage of wide area synchronous phasor measurement information provided by PMUs, we have carried out precise fault localization based on the principles of maximum posteriori probability (MAP). Large numbers of simulation experiments have confirmed that the results of MAP fault localization are accurate and reliable. Even if there are interferences from white Gaussian stochastic noise, the results from MAP classification are also identical to the actual real situation.

Contraceptive Availability During an Emergency Response in the United States

PubMed Central

Ellington, Sascha R; Kourtis, Athena P; Curtis, Kathryn M; Tepper, Naomi; Gorman, Susan; Jamieson, Denise J; Zotti, Marianne; Barfield, Wanda

2015-01-01

This article provides the evidence for contraceptive need to prevent unintended pregnancy during an emergency response, discusses the most appropriate types of contraceptives for disaster situations, and details the current provisions in place to provide contraceptives during an emergency response. PMID:23421580

School Emergency Planning Guide.

ERIC Educational Resources Information Center

Benedetto, Harry J.

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

Studies of planning behavior of aircraft pilots in normal, abnormal and emergency situations

NASA Technical Reports Server (NTRS)

Johannsen, G.; Rouse, W. B.; Hillmann, K.

1981-01-01

A methodology for the study of planning is presented and the results of applying the methodology within two experimental investigations of planning behavior of aircraft pilots in normal, abnormal, and emergency situations are discussed. Beyond showing that the methodology yields consistent results, these experiments also lead to concepts in terms of a dichotomy between event driven and time driven planning, subtle effects of automation on planning, and the relationship of planning to workload and flight performance.

Evidence-Centered Design for Simulation-Based Assessment. CRESST Report 800

ERIC Educational Resources Information Center

Mislevy, Robert J.

2011-01-01

Simulations provide opportunities for individuals to learn and develop skills for situations that may be expensive, time-consuming, or dangerous. Careful design can support a person's learning by tailoring the features of situations to his or her skill level(s), allowing repeated attempts, and by providing timely feedback. Furthermore, simulations…

Automatic optimisation of gamma dose rate sensor networks: The DETECT Optimisation Tool

NASA Astrophysics Data System (ADS)

Helle, K. B.; Müller, T. O.; Astrup, P.; Dyve, J. E.

2014-05-01

Fast delivery of comprehensive information on the radiological situation is essential for decision-making in nuclear emergencies. Most national radiological agencies in Europe employ gamma dose rate sensor networks to monitor radioactive pollution of the atmosphere. Sensor locations were often chosen using regular grids or according to administrative constraints. Nowadays, however, the choice can be based on more realistic risk assessment, as it is possible to simulate potential radioactive plumes. To support sensor planning, we developed the DETECT Optimisation Tool (DOT) within the scope of the EU FP 7 project DETECT. It evaluates the gamma dose rates that a proposed set of sensors might measure in an emergency and uses this information to optimise the sensor locations. The gamma dose rates are taken from a comprehensive library of simulations of atmospheric radioactive plumes from 64 source locations. These simulations cover the whole European Union, so the DOT allows evaluation and optimisation of sensor networks for all EU countries, as well as evaluation of fencing sensors around possible sources. Users can choose from seven cost functions to evaluate the capability of a given monitoring network for early detection of radioactive plumes or for the creation of dose maps. The DOT is implemented as a stand-alone easy-to-use JAVA-based application with a graphical user interface and an R backend. Users can run evaluations and optimisations, and display, store and download the results. The DOT runs on a server and can be accessed via common web browsers; it can also be installed locally.

Emerging collective behavior and local properties of financial dynamics in a public investment game

NASA Astrophysics Data System (ADS)

da Silva, Roberto; Bazzan, Ana L. C.; Baraviera, Alexandre T.; Dahmen, Sílvio R.

2006-11-01

In this paper we consider a simple model of a society of economic agents, namely a variation of the well known “public investment game”, where each agent can contribute with a discrete quantity, i.e., cooperate to increase the benefits of the group. Interactions take place among nearest neighbors and depend on the motivation level (insider information, economy prospects). The profit is used to update individual motivations. We first explore a deterministic scenario and the existence of fixed points and attractors. We also consider the presence of noise, where profits fluctuate stochastically. In this scenario we analyze the global persistence as a function of time-a measure of the probability that the amount of money of the entire group remains at least equal to its initial value. Our simulations show that this quantity has a power law behavior. We have also performed simulations with a population of heterogeneous agents, including deceivers and conservatives. We show that, although there is no regular pattern regarding the average wealth, robust power laws for persistence do exist and argue that this can be used to characterize the emerging collective behavior. The influence of the motivation updating and the presence of conservatives and deceivers on persistence is also studied. Simulations for the local persistence exploring two different versions of this concept: the probability of a particular agent not going bankrupt (i.e., remaining wealth ⩾0 up to time t) and the probability of a particular agent making more money than he initially had. Different power law behaviors are also observed in these situations.

The use of a checklist improves anaesthesiologists' technical and non-technical performance for simulated malignant hyperthermia management.

PubMed

Hardy, Jean-Baptiste; Gouin, Antoine; Damm, Cédric; Compère, Vincent; Veber, Benoît; Dureuil, Bertrand

2018-02-01

Anaesthesiologists may occasionally manage life-threatening operating room (OR) emergencies. Managing OR emergencies implies real-time analysis of often complicated situations, prompt medical knowledge retrieval, coordinated teamwork and effective decision making in stressful settings. Checklists are recommended to improve performance and reduce the risk of medical errors. This study aimed to assess the usefulness of the French Society of Anaesthesia and Intensive Care's (SFAR) "Malignant Hyperthermia" (MH) checklist on a simulated episode of MH crisis and management thereof by registered anesthesiologists. Twenty-four anaesthesiologists were allocated to 2 groups (checklist and control). Their technical performance in adherence with the SFAR guidelines was assessed by a 30-point score and their non-technical performance was assessed by the Anaesthetists' Non-Technical Skills (ANTS) score. Every task completion was assessed independently. Data are shown as median (first-third quartiles). Anaesthesiologists in the checklist group had higher technical performance scores (24/30 (21.5-25) vs 18/30 (15.5-19.5), P=0.002) and ANTS scores (56.5/60 (47.5-58) vs 48.5/60 (41-50.5), P=0.024). They administered the complete initial dose of dantrolene (2mg/kg) more quickly (15.7 minutes [13.9-18.3] vs 22.4 minutes [18.6-25]) than the control group (P=0.017). However, anaesthesiologists deemed the usability of the checklist to be perfectible. Registered anaesthesiologists' use of the MH checklist during a simulation session widely improved their adherence to guidelines and non-technical skills. This study strongly suggests the benefit of checklist tools for emergency management. Notwithstanding, better awareness and training for anaesthesiologists could further improve the use of this tool. Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Guidelines for catastrophic emergency situations involving asbestos

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

Not Available

These guidelines are intended to assist regional, state, and local agencies in managing potential asbestos hazards resulting from a catastrophic accident or disaster. The guidelines may be used as a reference for advanced planning or, once the emergency presents itself, to help ensure that, to the extent feasible and compatible with other emergency measures, all appropriate steps are taken to safely handle and dispose of all asbestos, while avoiding unnecessary exposures to asbestos. The guidelines provide information that may be helpful to EPA Regional offices and delegated NESHAP agencies that must respond to emergencies involving asbestos. The guidelines review themore » experiences of EPA Regional and state enforcement agencies in dealing with asbestos during recent emergencies. Information is included on statutes and regulations that may be applicable in emergency situations, including the emergency provisions of the asbestos NESHAP. Lines of communication within EPA and between EPA and emergency management agencies are discussed. A list of contacts responsible at the state level for emergency and disaster activities is provided. Information is provided to help identify potential sources of asbestos releases, and factors are identified that should be considered in planning for the cleanup and disposal of asbestos.« less

Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment.

PubMed

Scholes, Julie; Endacott, Ruth; Biro, MaryAnne; Bulle, Bree; Cooper, Simon; Miles, Maureen; Gilmour, Carole; Buykx, Penny; Kinsman, Leigh; Boland, Rosemarie; Jones, Jan; Zaidi, Fawzia

2012-03-23

This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. The students' clinical management of the situation varied considerably. Students struggled to prioritize their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development.

Real life safety benefits of increasing brake deceleration in car-to-pedestrian accidents: Simulation of Vacuum Emergency Braking.

PubMed

Jeppsson, Hanna; Östling, Martin; Lubbe, Nils

2018-02-01

The objective of this study is to predict the real-life benefits, namely the number of injuries avoided rather than the reduction in impact speed, offered by a Vacuum Emergency Brake (VEB) added to a pedestrian automated emergency braking (AEB) system. We achieve this through the virtual simulation of simplified mathematical models of a system which incorporates expected future advances in technology, such as a wide sensor field of view, and reductions in the time needed for detection, classification, and brake pressure build up. The German In-Depth Accident Study database and the related Pre Crash Matrix, both released in the beginning of 2016, were used for this study and resulted in a final sample of 526 collisions between passenger car fronts and pedestrians. Weight factors were calculated for both simulation model and injury risk curves to make the data representative of Germany as a whole. The accident data was used with a hypothetical AEB system in a simulation model, and injury risk was calculated from the new impact speed using injury risk curves to generate new situations using real accidents. Adding a VEB to a car with pedestrian AEB decreased pedestrian casualties by an additional 8-22%, depending on system setting and injury level, over the AEB-only system. The overall decrease in fatalities was 80-87%, an improvement of 8%. Collision avoidance was improved by 14-28%. VEB with a maximum deceleration in the middle of the modelled performance range has an effectiveness similar to that of an "early activation" system, where the AEB is triggered as early as 2 s before collision. VEB may therefore offer a substantial increase in performance without increasing false positive rates, which earlier AEB activation does. Most collisions and injuries can be avoided when AEB is supplemented by the high performance VEB; remaining cases are characterised by high pedestrian walking speed and late visibility due to view obstructions. VEB is effective in all analysed accident scenarios. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical decision-making: midwifery students' recognition of, and response to, post partum haemorrhage in the simulation environment

PubMed Central

2012-01-01

Background This paper reports the findings of a study of how midwifery students responded to a simulated post partum haemorrhage (PPH). Internationally, 25% of maternal deaths are attributed to severe haemorrhage. Although this figure is far higher in developing countries, the risk to maternal wellbeing and child health problem means that all midwives need to remain vigilant and respond appropriately to early signs of maternal deterioration. Methods Simulation using a patient actress enabled the research team to investigate the way in which 35 midwifery students made decisions in a dynamic high fidelity PPH scenario. The actress wore a birthing suit that simulated blood loss and a flaccid uterus on palpation. The scenario provided low levels of uncertainty and high levels of relevant information. The student's response to the scenario was videoed. Immediately after, they were invited to review the video, reflect on their performance and give a commentary as to what affected their decisions. The data were analysed using Dimensional Analysis. Results The students' clinical management of the situation varied considerably. Students struggled to prioritise their actions where more than one response was required to a clinical cue and did not necessarily use mnemonics as heuristic devices to guide their actions. Driven by a response to single cues they also showed a reluctance to formulate a diagnosis based on inductive and deductive reasoning cycles. This meant they did not necessarily introduce new hypothetical ideas against which they might refute or confirm a diagnosis and thereby eliminate fixation error. Conclusions The students response demonstrated that a number of clinical skills require updating on a regular basis including: fundal massage technique, the use of emergency standing order drugs, communication and delegation of tasks to others in an emergency and working independently until help arrives. Heuristic devices helped the students to evaluate their interventions to illuminate what else could be done whilst they awaited the emergency team. They did not necessarily serve to prompt the students' or help them plan care prospectively. The limitations of the study are critically explored along with the pedagogic implications for initial training and continuing professional development. PMID:22443712

History of Bioterrorism: Botulism

MedlinePlus Videos and Cool Tools

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Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes.

PubMed

Hunt, Elizabeth A; Walker, Allen R; Shaffner, Donald H; Miller, Marlene R; Pronovost, Peter J

2008-01-01

Outcomes of in-hospital pediatric cardiopulmonary arrest are dismal. Recent data suggest that the quality of basic and advanced life support delivered to adults is low and contributes to poor outcomes, but few data regarding pediatric events have been reported. The objectives of this study were to (1) measure the median elapsed time to initiate important resuscitation maneuvers in simulated pediatric medical emergencies (ie, "mock codes") and (2) identify the types and frequency of errors committed during pediatric mock codes. A prospective, observational study was conducted of 34 consecutive hospital-based mock codes. A mannequin or computerized simulator was used to enact unannounced, simulated crisis situations involving children with respiratory distress or insufficiency, respiratory arrest, hemodynamic instability, and/or cardiopulmonary arrest. Assessment included time elapsed to initiation of specific resuscitation maneuvers and deviation from American Heart Association guidelines. Among the 34 mock codes, the median time to assessment of airway and breathing was 1.3 minutes, to administration of oxygen was 2.0 minutes, to assessment of circulation was 4.0 minutes, to arrival of any physician was 3.0 minutes, and to arrival of first member of code team was 6.0 minutes. Among cardiopulmonary arrest scenarios, elapsed time to initiation of compressions was 1.5 minutes and to request for defibrillator was 4.3 minutes. In 75% of mock codes, the team deviated from American Heart Association pediatric basic life support protocols, and in 100% of mock codes there was a communication error. Alarming delays and deviations occur in the major components of pediatric resuscitation. Future educational and organizational interventions should focus on improving the quality of care delivered during the first 5 minutes of resuscitation. Simulation of pediatric crises can identify targets for educational intervention to improve pediatric cardiopulmonary resuscitation and, ideally, outcomes.

Making an "Attitude Adjustment": Using a Simulation-Enhanced Interprofessional Education Strategy to Improve Attitudes Toward Teamwork and Communication.

PubMed

Wong, Ambrose Hon-Wai; Gang, Maureen; Szyld, Demian; Mahoney, Heather

2016-04-01

Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P < 0.0001, P = 0.029, P = 0.014, and P = 0.003, respectively). For Hospital Survey on Patient Safety Culture, 3 of 6 composites directly related to teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to teamwork and communication.

From Test Scores to Language Use: Emergent Bilinguals Using English to Accomplish Academic Tasks

ERIC Educational Resources Information Center

Rodriguez-Mojica, Claudia

2018-01-01

Prominent discourses about emergent bilinguals' academic abilities tend to focus on performance as measured by test scores and perpetuate the message that emergent bilinguals trail far behind their peers. When we remove the constraints of formal testing situations, what can emergent bilinguals do in English as they engage in naturally occurring…

77 FR 43481 - Taking Additional Steps to Address the National Emergency With Respect to Somalia

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... Additional Steps to Address the National Emergency With Respect to Somalia #0; #0; #0; Presidential Documents... Additional Steps to Address the National Emergency With Respect to Somalia By the authority vested in me as... order to take additional steps to deal with the national emergency with respect to the situation in...

The Application of a Jet Fan for the Control of Air and Methane Streams Mixing at the Excavations Cross - The Results of Numerical Simulation

NASA Astrophysics Data System (ADS)

Wrona, Paweł; Różański, Zenon; Pach, Grzegorz; Domagała, Lech

2016-09-01

The paper presents the results of numerical simulations into the distribution of methane concentration at the intersection of two excavations with a fan (turned on) giving the air stream to the area of the crossing. Assumed case represents emergency situation related to the unexpected flow of methane from an excavation and its mixing with fresh air. It is possible when sudden gas outburst takes place, methane leaks from methane drainage system or gas leaks out the pipelines of underground coal gasification devices. Three options were considered - corresponding to three different speeds of the jet fan. They represent three stages of fan work. First - low air speed is forced by a pneumatic fan, when electricity is cut off after high methane concentration detection. Medium speed can be forced by pneumatic-electric device when methane concentration allows to turn on the electricity. Third, the highest speed is for electric fans. Simulations were carried out in the Fire Dynamics Simulator (FDS) belongs to the group of programs Computational Fluid Dynamics (CFD). The governing equations are being solved in a numerical way. It was shown that proposed solution allows partial dilution of methane in every variant of speed what should allow escape of the miners from hazardous area.

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

Code of Federal Regulations, 2011 CFR

2011-10-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

International Conference on Remote Emergency Medical Services

NASA Technical Reports Server (NTRS)

1975-01-01

An emergency medical system is characterized. Applications of NASA technology in biomedical telecommunication and bioinstrumentation are explored. The training and effectiveness of paramedics, technicians, nurses, and physicians are evaluated as applied to emergency situations and the operations of trauma centers. Civilian and military aeromedical evacuation is discussed.

Learning by Erring: fire!

PubMed

Bjugn, Roger; Hansen, Jarle

2013-08-01

Biorepositories may be affected by a number of emergencies ranging from bad publicity to natural disasters, and biorepositories should have plans for handling such situations. The emergency management process includes all phases from mitigation to recovery. Fire is one disaster that may cause extensive damage to both physical structures and humans. In this article, we analyze events related to a fire in a storage facility for mechanical freezers. The analysis covers both the pre-crisis stage, the fire itself, and the post-crisis stage. Even the best intended planning cannot stop a crisis from happening. However, an open-minded analysis of the crisis with focus on learning and quality improvement can improve an organization's ability to handle the next emergency situation.

Ethical reasoning through simulation: a phenomenological analysis of student experience.

PubMed

Lewis, Gareth; McCullough, Melissa; Maxwell, Alexander P; Gormley, Gerard J

2016-01-01

Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students' lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment. This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data. Four main themes emerged from the analysis: (1) 'Authentic on all levels?', (2)'Letting the emotions flow', (3) 'Ethical alarm bells' and (4) 'Voices of children and ghosts'. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences. This study provided deep insights into medical students' immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide.

PubMed

Tahtali, Damla; Bohmann, Ferdinand; Rostek, Peter; Wagner, Marlies; Steinmetz, Helmuth; Pfeilschifter, Waltraud

2017-01-15

Time is of the essence when caring for an acute stroke patient. The ultimate goal is to restore blood flow to the ischemic brain. This can be achieved by either thrombolysis with recombinant tissue-plasminogen activator (rt-PA), the standard therapy for stroke patients who present within the first hours of symptom onset without contraindications, or by an endovascular approach, if a proximal brain vessel occlusion is detected. As the efficacy of both therapies declines over time, every minute saved along the way will improve the patient's outcome. This critical situation requires thorough work and precise communication with the patient, the family and colleagues from different professions to acquire all relevant information and reach the right decision while carefully monitoring the patient. This is a high fidelity situation. In nonmedical high-fidelity environments such as aviation, Crew Resource Management (CRM) is used to enhance safety and team efficiency. This guide shows how a Stroke Team algorithm, which is transferable to other hospital settings, was established and how regular simulation-based trainings were performed. It requires determination and endurance to maintain these time-consuming simulation trainings on a regular basis over the course of time. However, the resulting improvement of team spirit and excellent door-to-needle times will benefit both the patients and the work environment in any hospital. A dedicated Stroke Team of 7 persons who are notified 24/7 by a collective call via speed dial and run a binding algorithm that takes approximately 20 min, was established. To train everybody involved in this algorithm, a simulation-based team training for all new Stroke Team members was conceived and conducted at monthly intervals. This led to a relevant and sustained reduction of the mean door-to-needle time to 25 min, and enhanced the feeling of stroke readiness especially in junior doctors and nurses.

Emergency Responder Personal Preparedness

DTIC Science & Technology

2011-12-01

11  D.  PRIOR RESEARCH AND THESIS ............................................................ 12   E...Assistance?..........................................................................................39  viii H.  QUESTION 12 ...40  1.  Question 12 : Have You Ever Been in a Public Emergency Situation When

Impact of conflict and violence on workers in a hospital emergency room.

PubMed

Lancman, Selma; Mângia, Elisabete Ferreira; Muramoto, Melissa Tieko

2013-01-01

Emergency room (ER) work includes dealing with situations of conflict and aggression. The diversity and unpredictability of these situations and the lack of pre-established procedures to guide workers in dealing with these phenomena affect and weaken their physical and mental health. The purpose of the article is to learn about conflict and aggression at work and its impact on the workers in a hospital emergency room. The method is a transversal, exploratory, descriptive and observational study, carried out from September to November 2008, using direct observation procedures and interviews. Two hundred and eighty emergency room workers participated in the observations and eleven interviews were carried out with workers from several professional categories. The work process is marked by overload, individualization of responsibilities, time pressures and deadlines for making decision, little space for exchange and sharing, lack of support or guidance. The strong pressure to provide care quickly causes conflict and aggression among users and the different professional teams. These situations arise from problems in work organization and users in excess of the ER service capacity. The article recommends changes in the work process that can simultaneously improve both the quality of care for patients and provide protective measures for workers.

An indoor augmented reality mobile application for simulation of building evacuation

NASA Astrophysics Data System (ADS)

Sharma, Sharad; Jerripothula, Shanmukha

2015-03-01

Augmented Reality enables people to remain connected with the physical environment they are in, and invites them to look at the world from new and alternative perspectives. There has been an increasing interest in emergency evacuation applications for mobile devices. Nearly all the smart phones these days are Wi-Fi and GPS enabled. In this paper, we propose a novel emergency evacuation system that will help people to safely evacuate a building in case of an emergency situation. It will further enhance knowledge and understanding of where the exits are in the building and safety evacuation procedures. We have applied mobile augmented reality (mobile AR) to create an application with Unity 3D gaming engine. We show how the mobile AR application is able to display a 3D model of the building and animation of people evacuation using markers and web camera. The system gives a visual representation of a building in 3D space, allowing people to see where exits are in the building through the use of a smart phone or tablets. Pilot studies were conducted with the system showing its partial success and demonstrated the effectiveness of the application in emergency evacuation. Our computer vision methods give good results when the markers are closer to the camera, but accuracy decreases when the markers are far away from the camera.

Improved representation of situational awareness within a dismounted small combat unit constructive simulation

NASA Astrophysics Data System (ADS)

Lee, K. David; Colony, Mike

2011-06-01

Modeling and simulation has been established as a cost-effective means of supporting the development of requirements, exploring doctrinal alternatives, assessing system performance, and performing design trade-off analysis. The Army's constructive simulation for the evaluation of equipment effectiveness in small combat unit operations is currently limited to representation of situation awareness without inclusion of the many uncertainties associated with real world combat environments. The goal of this research is to provide an ability to model situation awareness and decision process uncertainties in order to improve evaluation of the impact of battlefield equipment on ground soldier and small combat unit decision processes. Our Army Probabilistic Inference and Decision Engine (Army-PRIDE) system provides this required uncertainty modeling through the application of two critical techniques that allow Bayesian network technology to be applied to real-time applications. (Object-Oriented Bayesian Network methodology and Object-Oriented Inference technique). In this research, we implement decision process and situation awareness models for a reference scenario using Army-PRIDE and demonstrate its ability to model a variety of uncertainty elements, including: confidence of source, information completeness, and information loss. We also demonstrate that Army-PRIDE improves the realism of the current constructive simulation's decision processes through Monte Carlo simulation.

Design, development, and evaluation of an interactive simulator for engineering ethics education (SEEE).

PubMed

Chung, Christopher A; Alfred, Michael

2009-06-01

Societal pressures, accreditation organizations, and licensing agencies are emphasizing the importance of ethics in the engineering curriculum. Traditionally, this subject has been taught using dogma, heuristics, and case study approaches. Most recently a number of organizations have sought to increase the utility of these approaches by utilizing the Internet. Resources from these organizations include on-line courses and tests, videos, and DVDs. While these individual approaches provide a foundation on which to base engineering ethics, they may be limited in developing a student's ability to identify, analyze, and respond to engineering ethics situations outside of the classroom environment. More effective approaches utilize a combination of these types of approaches. This paper describes the design and development of an internet based interactive Simulator for Engineering Ethics Education. The simulator places students in first person perspective scenarios involving different types of ethical situations. Students must gather data, assess the situation, and make decisions. This requires students to develop their own ability to identify and respond to ethical engineering situations. A limited comparison between the internet based interactive simulator and conventional internet web based instruction indicates a statistically significant improvement of 32% in instructional effectiveness. The simulator is currently being used at the University of Houston to help fulfill ABET requirements.

Emergency Disinfection of Drinking Water

EPA Pesticide Factsheets

How to boil and disinfect water to kill most disease-causing microorganisms during emergency situations where regular water service has been interrupted and local authorities recommend using only bottled water, boiled water, or disinfected water.

Attachment stability and the emergence of unresolved representations during adolescence.

PubMed

Aikins, Julie Wargo; Howes, Carollee; Hamilton, Claire

2009-09-01

This 15-year longitudinal study examined the stability of attachment representations from infancy to adolescence and investigated the emergence of unresolved representations during adolescence in a sample of 47 16-year-olds. Attachment was assessed at 12 months using the Strange Situation Procedure, at 4 years using the modified Strange Situation Procedure, and again at 16 years with the Adult Attachment Projective (AAP). The emergence of unresolved classifications in adolescence (AAP) was associated with higher rates of negative life events, low levels of early mother-child relationship security (an aggregate measure of the 12-month and 4-year measures), negative teacher-child relationship experiences in middle childhood, and low early adolescent friendship quality. The results support the growing body of evidence suggesting that changes in attachment are lawful, while adding to the growing understanding of the emergence of unresolved attachment representations.

Dynamically downscaling predictions for deciduous tree leaf emergence in California under current and future climate.

PubMed

Medvigy, David; Kim, Seung Hee; Kim, Jinwon; Kafatos, Menas C

2016-07-01

Models that predict the timing of deciduous tree leaf emergence are typically very sensitive to temperature. However, many temperature data products, including those from climate models, have been developed at a very coarse spatial resolution. Such coarse-resolution temperature products can lead to highly biased predictions of leaf emergence. This study investigates how dynamical downscaling of climate models impacts simulations of deciduous tree leaf emergence in California. Models for leaf emergence are forced with temperatures simulated by a general circulation model (GCM) at ~200-km resolution for 1981-2000 and 2031-2050 conditions. GCM simulations are then dynamically downscaled to 32- and 8-km resolution, and leaf emergence is again simulated. For 1981-2000, the regional average leaf emergence date is 30.8 days earlier in 32-km simulations than in ~200-km simulations. Differences between the 32 and 8 km simulations are small and mostly local. The impact of downscaling from 200 to 8 km is ~15 % smaller in 2031-2050 than in 1981-2000, indicating that the impacts of downscaling are unlikely to be stationary.

Disaster Preparedness: Guidelines for School Nurses

ERIC Educational Resources Information Center

Doyle, Janice; Loyacono, Thomas R.

2007-01-01

These guidelines help school nurses understand their role in preparing for disasters and major emergencies. The guidelines are suitable for planning for a variety of emergency and disaster situations. Disaster Preparedness Guidelines for School Nurses is based on the four phases of disaster management as defined by the Federal Emergency Management…

3 CFR 8383 - Proclamation 8383 of May 20, 2009. Emergency Medical Services Week, 2009

Code of Federal Regulations, 2010 CFR

2010-01-01

... establish order and calm—and save lives in the process. They include educators, 911 dispatchers, first... unexpected life-threatening situations, emergency medical services (EMS) providers provide rapid help. Quality emergency medical care dramatically improves the survival and recovery prospects for those who...

50 CFR 17.106 - Emergency establishment of protection areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Simultaneously with the publication required by paragraph (b) of this section, the Director shall publish the...) Manatee Protection Areas § 17.106 Emergency establishment of protection areas. (a) The Director may... involved or the nature of a particular emergency situation, failure to publish notice in the Federal...

32 CFR 732.16 - Emergency care requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...

32 CFR 732.16 - Emergency care requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...

32 CFR 732.16 - Emergency care requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...

32 CFR 732.16 - Emergency care requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...

32 CFR 732.16 - Emergency care requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements. Only in a bona fide emergency will medical, maternity, or dental services be obtained under this part... dental care. A situation where the need or apparent need for medical or dental attention does not permit...

36 CFR 223.81 - Shorter advertising periods in emergencies.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Shorter advertising periods... and Bids § 223.81 Shorter advertising periods in emergencies. In emergency situations where prompt... the spread of insects, the approving officer may authorize shortening the formal advertising period to...

30 CFR 47.84 - Non-emergency disclosure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.84 Non-emergency disclosure. Upon request, the operator must disclose the identity of a trade secret chemical in a non-emergency situation to an exposed... reasonable detail an occupational health need for the information, as follows: (1) To assess the chemical...

30 CFR 47.84 - Non-emergency disclosure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.84 Non-emergency disclosure. Upon request, the operator must disclose the identity of a trade secret chemical in a non-emergency situation to an exposed... reasonable detail an occupational health need for the information, as follows: (1) To assess the chemical...

30 CFR 47.84 - Non-emergency disclosure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.84 Non-emergency disclosure. Upon request, the operator must disclose the identity of a trade secret chemical in a non-emergency situation to an exposed... reasonable detail an occupational health need for the information, as follows: (1) To assess the chemical...

30 CFR 47.84 - Non-emergency disclosure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMMUNICATION (HazCom) Trade Secret Hazardous Chemical § 47.84 Non-emergency disclosure. Upon request, the operator must disclose the identity of a trade secret chemical in a non-emergency situation to an exposed... reasonable detail an occupational health need for the information, as follows: (1) To assess the chemical...

Emergency Room Sudden Death: What Can be Done for the Survivors?

ERIC Educational Resources Information Center

Jones, William H.

1978-01-01

Persons called to a hospital emergency room as the result of a sudden death of a relative or friend are usually in need of emotional support while still at the emergency room. This article identifies characteristics of an effective emotional support model for use in such situations. (Author)

Recommended Procedures for Handling Emergency Illnesses and Accidents at School.

ERIC Educational Resources Information Center

North Dakota State Dept. of Health, Bismarck.

Recommended procedures for handling emergency illnesses and accidents are provided in this guide for school personnel prepared by the North Dakota State Department of Health. Following five general recommendations for steps to take in emergency situations, advice and techniques are given for handling: nose bleeds; abdominal pain; toothaches and…

Preparing Your Staff for Emergencies.

ERIC Educational Resources Information Center

Maurer-Starks, Suanne

2003-01-01

Camps should have emergency protocols in place and involve appropriate personnel in their development. Staff should be certified in first aid and CPR, a recordkeeping system should be established, and mock emergencies should be practiced during staff orientation. It may also be advisable to involve campers in practice situations. First aid/CPR…

50 CFR 100.19 - Special actions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Special actions. 100.19 Section 100.19... § 100.19 Special actions. (a) Emergency special actions. In an emergency situation, if necessary to... recommendations on the proposed emergency special action. Such a Council recommendation, if any, will be subject...

Personal Coping Strategies of the Elderly in Housing Emergencies: Clues to Interventions To Prevent Homelessness and Institutionalization.

ERIC Educational Resources Information Center

Keigher, Sharon M.; And Others

This study considered broadly the problem of homelessness by examining the housing difficulties of one at-risk population, the elderly, who presented needs to one city emergency service agency. A random sampling of some 500 emergency case files identified the prevalence of a wide range of emergency situations affecting the city's elderly. At least…

Multi-Agent Flight Simulation with Robust Situation Generation

NASA Technical Reports Server (NTRS)

Johnson, Eric N.; Hansman, R. John, Jr.

1994-01-01

A robust situation generation architecture has been developed that generates multi-agent situations for human subjects. An implementation of this architecture was developed to support flight simulation tests of air transport cockpit systems. This system maneuvers pseudo-aircraft relative to the human subject's aircraft, generating specific situations for the subject to respond to. These pseudo-aircraft maneuver within reasonable performance constraints, interact in a realistic manner, and make pre-recorded voice radio communications. Use of this system minimizes the need for human experimenters to control the pseudo-agents and provides consistent interactions between the subject and the pseudo-agents. The achieved robustness of this system to typical variations in the subject's flight path was explored. It was found to successfully generate specific situations within the performance limitations of the subject-aircraft, pseudo-aircraft, and the script used.

Social media in disaster risk reduction and crisis management.

PubMed

Alexander, David E

2014-09-01

This paper reviews the actual and potential use of social media in emergency, disaster and crisis situations. This is a field that has generated intense interest. It is characterised by a burgeoning but small and very recent literature. In the emergencies field, social media (blogs, messaging, sites such as Facebook, wikis and so on) are used in seven different ways: listening to public debate, monitoring situations, extending emergency response and management, crowd-sourcing and collaborative development, creating social cohesion, furthering causes (including charitable donation) and enhancing research. Appreciation of the positive side of social media is balanced by their potential for negative developments, such as disseminating rumours, undermining authority and promoting terrorist acts. This leads to an examination of the ethics of social media usage in crisis situations. Despite some clearly identifiable risks, for example regarding the violation of privacy, it appears that public consensus on ethics will tend to override unscrupulous attempts to subvert the media. Moreover, social media are a robust means of exposing corruption and malpractice. In synthesis, the widespread adoption and use of social media by members of the public throughout the world heralds a new age in which it is imperative that emergency managers adapt their working practices to the challenge and potential of this development. At the same time, they must heed the ethical warnings and ensure that social media are not abused or misused when crises and emergencies occur.

Nutrition systems for pressure suits.

NASA Technical Reports Server (NTRS)

Huber, C. S.; Heidelbaugh, N. D.; Rapp, R. M.; Smith, M. C., Jr.

1973-01-01

Nutrition systems were successfully developed in the Apollo Program for astronauts wearing pressure suits during emergency decompression situations and during lunar surface explorations. These nutrition systems consisted of unique dispensers, water, flavored beverages, nutrient-fortified beverages, and intermediate moisture food bars. The emergency decompression system dispensed the nutrition from outside the pressure suit by interfacing with a suit helmet penetration port. The lunar exploration system utilized dispensers stowed within the interior layers of the pressure suit. These systems could be adapted for provision of nutrients in other situations requiring the use of pressure suits.

Return to normality after a radiological emergency.

PubMed

Lochard, J; Prêtre, S

1995-01-01

Some preliminary considerations from the management of post-accident situations connected to large scale and high land contamination are presented. The return to normal, or at least acceptable living conditions, as soon as reasonably achievable, and the prevention of the possible emergence of a post-accident crisis is of key importance. A scheme is proposed for understanding the dynamics of the various phases after an accident. An attempt is made to characterize some of the parameters driving the acceptability of post-accident situations. Strategies to return to normal living conditions in contaminated areas are considered.

[Madagascar: public health situation on the "Big Island" at the beginning of the 21st century].

PubMed

Andrianarisoa, A C E; Rakotoson, J; Randretsa, M; Rakotondravelo, S; Rakotoarimanana, R D; Rakotomizao, J; Aubry, P

2007-02-01

The main public health issue in Madagascar at the beginning of the 21st century still involves transmissible infectious diseases including re-emerging diseases such as bubonic plague and emerging diseases such as HIV/AIDS, dengue fever and Chikungunya virus infection. Health and hygiene especially access to clean water is still poor especially in rural areas. No improvement in the public health situation with regard to malaria, schistomosomiais or cysticercosis as well as non-infectious diseases such as protein-energy malnutrition is expected within the next decade.

[The liaison psychiatry approach of the psychiatric crisis, urgencies and emergencies].

PubMed

Tenconi, Juan Cristóbal

2003-01-01

The purpose of this paper is to differentiate crisis, emergencies and urgencies within the frame of Liaison psychiatry. It begins with the definition of each one of the terms, later the emphasis is put in the clinical characteristics of each one of these situations. These characteristics are determined by the patient and the therapeutic team. At last therapeutic guidelines are stated, which allow more precision in the intervention, in function of the direct involvement of these situations in the development and evolution of the patients.

Evolution Model and Simulation of Profit Model of Agricultural Products Logistics Financing

NASA Astrophysics Data System (ADS)

Yang, Bo; Wu, Yan

2018-03-01

Agricultural products logistics financial warehousing business mainly involves agricultural production and processing enterprises, third-party logistics enterprises and financial institutions tripartite, to enable the three parties to achieve win-win situation, the article first gives the replication dynamics and evolutionary stability strategy between the three parties in business participation, and then use NetLogo simulation platform, using the overall modeling and simulation method of Multi-Agent, established the evolutionary game simulation model, and run the model under different revenue parameters, finally, analyzed the simulation results. To achieve the agricultural products logistics financial financing warehouse business to participate in tripartite mutually beneficial win-win situation, thus promoting the smooth flow of agricultural products logistics business.

Predictors and Outcomes of Situational Interest during a Science Learning Task

ERIC Educational Resources Information Center

Tapola, Anna; Veermans, Marjaana; Niemivirta, Markku

2013-01-01

In this study we examined change in students' situational interest as a function of student and task characteristics. Fifth- and sixth-graders (n = 52) were assigned to one of two task conditions that used a different version of a science simulation. The versions differed in how concrete vs. abstract the simulation elements were.…

Design, development, and evaluation of a second generation interactive Simulator for Engineering Ethics Education (SEEE2).

PubMed

Alfred, Michael; Chung, Christopher A

2012-12-01

This paper describes a second generation Simulator for Engineering Ethics Education. Details describing the first generation activities of this overall effort are published in Chung and Alfred (Sci Eng Ethics 15:189-199, 2009). The second generation research effort represents a major development in the interactive simulator educational approach. As with the first generation effort, the simulator places students in first person perspective scenarios involving different types of ethical situations. Students must still gather data, assess the situation, and make decisions. The approach still requires students to develop their own ability to identify and respond to ethical engineering situations. However, were as, the generation one effort involved the use of a dogmatic model based on National Society of Professional Engineers' Code of Ethics, the new generation two model is based on a mathematical model of the actual experiences of engineers involved in ethical situations. This approach also allows the use of feedback in the form of decision effectiveness and professional career impact. Statistical comparisons indicate a 59 percent increase in overall knowledge and a 19 percent improvement in teaching effectiveness over an Internet Engineering Ethics resource based approach.

Anthropogenic and technogenic factors of operational risk at hazardous industrial objects of fuel-power complex

NASA Astrophysics Data System (ADS)

Magid, S. I.; Arkhipova, E. N.; Kulichikhin, V. V.; Zagretdinov, I. Sh.

2016-12-01

Technogenic and anthropogenic accidence at hazardous industrial objects (HIO) in the Russian Federation has been considered. The accidence level at HIO, including power plants and network enterprises, is determined by anthropogenic reasons, so-called "human factor", in 70% of all cases. The analysis of incidents caused by personnel has shown that errors occur most often during accidental situations, launches, holdups, routine switches, and other effects on equipment controls. It has been demonstrated that skills needed to perform type and routine switches can be learned, to certain limits, on real operating equipment, while combating emergency and accidental situations can be learned only with the help of modern training simulators developed based on information technologies. Problems arising during the following processes have been considered: development of mathematical and software support of modern training equipment associated, in one way or another, with adequate power-generating object modeling in accordance with human operator specifics; modeling and/or simulation of the corresponding control and management systems; organization of the education system (functional supply of the instructor, education and methodological resources (EMR)); organization of the program-technical, scalable and adaptable, platform for modeling of the main and secondary functions of the training simulator. It has been concluded that the systemic approach principle on the necessity and sufficiency in the applied methodology allows to reproduce all technological characteristics of the equipment, its topological completeness, as well as to achieve the acceptable counting rate. The initial "rough" models of processes in the equipment are based on the normative techniques and equation coefficients taken from the normative materials as well. Then, the synthesis of "fine" models has been carried out following the global practice in modeling and training simulator building, i.e., verification of "rough" models based on experimental data available to the developer. Finally, the last stage of modeling is adaptation (validation) of "fine" models to the prototype object using experimental data on the power-generating object and tests of these models with operating and maintaining personnel. These stages determine adequacy of the used mathematical model for a particular training simulator and, thus, its compliance with such modern scientific criteria as objectivity and experimental verifiability.

Morphological Changes Along a Dike Landside Slope Sampled by 4d High Resolution Terrestrial Laser Scanning

NASA Astrophysics Data System (ADS)

Herrero-Huertaa, Mónica; Lindenbergh, Roderik; Ponsioen, Luc; van Damme, Myron

2016-06-01

Emergence of light detection and ranging (LiDAR) technology provides new tools for geomorphologic studies improving spatial and temporal resolution of data sampling hydrogeological instability phenomena. Specifically, terrestrial laser scanning (TLS) collects high resolution 3D point clouds allowing more accurate monitoring of erosion rates and processes, and thus, quantify the geomorphologic change on vertical landforms like dike landside slopes. Even so, TLS captures observations rapidly and automatically but unselectively. In this research, we demonstrate the potential of TLS for morphological change detection, profile creation and time series analysis in an emergency simulation for characterizing and monitoring slope movements in a dike. The experiment was performed near Schellebelle (Belgium) in November 2015, using a Leica Scan Station C10. Wave overtopping and overflow over a dike were simulated whereby the loading conditions were incrementally increased and 14 successful scans were performed. The aim of the present study is to analyse short-term morphological dynamic processes and the spatial distribution of erosion and deposition areas along a dike landside slope. As a result, we are able to quantify the eroded material coming from the impact on the terrain induced by wave overtopping which caused the dike failure in a few minutes in normal storm scenarios (Q = 25 l/s/m) as 1.24 m3. As this shows that the amount of erosion is measurable using close range techniques; the amount and rate of erosion could be monitored to predict dike collapse in emergency situation. The results confirm the feasibility of the proposed methodology, providing scalability to a comprehensive analysis over a large extension of a dike (tens of meters).

Care Situation for Female Victims of Sexual Violence in Metropolitan Emergency Departments with Charité/Berlin as an Example

PubMed Central

Hoffmann-Walbeck, H.; Möckel, M.; Etzold, S.; David, M.

2016-01-01

of the perpetrators were friends or relations; 17 % were (ex-)partners. The waiting time in the Charité emergency departments amounted to 58 minutes on average, the medical treatment time 55 minutes. About 80 % of the personnel evaluated the “stuprum kit” as being altogether good or very good. More than ⅓ considered the time and room conditions as being unsuitable or rather unsuitable for the situation. Two thirds expressed the desire for further training and supervision. Conclusion: The structured procedure by means of the “stuprum kit” has proved its value. A need for optimisation was seen especially for the examination facilities in the emergency departments. PMID:27904168

47 CFR 11.55 - EAS operation during a State or Local Area emergency.

Code of Federal Regulations, 2014 CFR

2014-10-01

... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

47 CFR 11.55 - EAS operation during a State or Local Area emergency.

Code of Federal Regulations, 2012 CFR

2012-10-01

... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

47 CFR 11.55 - EAS operation during a State or Local Area emergency.

Code of Federal Regulations, 2013 CFR

2013-10-01

... day-to-day emergency situations posing a threat to life and property. Examples of natural emergencies... Participants providing foreign language programming should transmit all EAS announcements in the same language as the primary language of the EAS Participant. (5) Upon completion of the State or Local Area EAS...

Emergency Management Standards for NCAA Division I-A Football Stadia

ERIC Educational Resources Information Center

Hoogstra, Joshua R.

2012-01-01

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