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Loeb J, Gray A. At crisis point: the challenges facing the UK's rescue and rehoming sector. Vet Rec 2024; 194:334-338. [PMID: 38700174 DOI: 10.1002/vetr.4227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
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Cornell S, Brander RW, Roberts A, Koon W, Peden AE, Lawes JC. 'I actually thought that I was going to die': Lessons on the rip current hazard from survivor experiences. Health Promot J Austr 2024; 35:551-564. [PMID: 37549041 DOI: 10.1002/hpja.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Rip currents are strong, narrow, fast-flowing currents of water that occur on many beaches and in Australia contributing to 26 drowning deaths and several thousand lifeguard/lifesaver rescues each year. Educating the public about the rip current hazard is a primary focus of beach safety practitioners, but there has been a lack of qualitative research exploring the firsthand experiences of being caught in a rip current to assist in this regard. The aim of this study was to analyse interviews of rip current survivors to understand more about how people react when unintentionally caught in a rip current in order to help guide future public education to mitigate rip current drowning. METHODS Semi-structured interviews were conducted with 56 individuals (primarily Australian-born) about their experience of being caught in a rip current. Interviewees were recruited via an online survey and varied in age and self-reported swimming ability. RESULTS Thematic analysis revealed three key temporal elements to the rip current experience: Before the Rip in which lack of awareness and knowledge, complacency, over-confidence, and attitude were prevalent themes; During the Rip which identified panic and temporary inhibition of decision-making, physical response, prior experience, and relationships with other beach users as themes; and After the Rip where post-rip effects and rip safety messaging and education were key themes. The importance of experiential immersion was a prevalent thread throughout all phases of the thematic analysis. DISCUSSION Our research shows that being caught in a rip current can be an intense and traumatic experience and that lessons learned from survivors have significant implications for improving existing and future rip current education efforts. In this regard, we provide several recommendations based on evidence-based insights gained from our interviews including the development of immersive rip current experience using virtual reality. SO WHAT Despite the prevalence of rip currents causing drowning deaths and rescues, there has been a lack of qualitative research on firsthand experiences to aid in public education. These interviews emphasise the intense and traumatic nature of being caught in a rip current, underscoring the need for improved rip current education to aid in prevention of this, often harrowing, experience.
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Affiliation(s)
- Samuel Cornell
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
| | - Robert W Brander
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amelia Roberts
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
| | - William Koon
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amy E Peden
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jasmin C Lawes
- Beach Safety Research Group, UNSW Sydney, Sydney, New South Wales, Australia
- School of Biological, Earth and Environmental Sciences, UNSW Sydney, Sydney, New South Wales, Australia
- Surf Life Saving Australia, Sydney, New South Wales, Australia
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Westnes E, Hjortdahl M. Firefighters and police search dog handlers' experiences working closely with paramedics in urban search and rescue incidents: a qualitative focus group study from Oslo. Scand J Trauma Resusc Emerg Med 2024; 32:22. [PMID: 38504344 PMCID: PMC10953160 DOI: 10.1186/s13049-024-01194-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. METHODS We conducted five focus group interviews with USAR-trained firefighters and police officers. The interviewees were those on duty on the agreed dates. The interviews were taped, transcribed, and analysed using thematic analysis as described by Braun & Clarke. RESULTS Three themes were identified; Feeling safe during missions, Building USAR capacity, and Trust-building within USAR-teams. The firefighters and police officers reported their and the patients' safety are best managed by EMS-personnel, whose presence strongly contributes to their own feeling of safety in a dangerous area. When EMS handles victims and injured emergency workers, firefighters and police officers can focus on their own primary tasks. Indeed, interviewees reported that building a USAR capacity depends on having USAR-trained EMS-personnel in the Hot Zone. The interviewees have clear and consistent opinions on how to establish an interagency USAR capacity effectively. Trust is paramount to the interviewees, and they express a high degree of trust within USAR Oslo. CONCLUSIONS Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.
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Affiliation(s)
- Erik Westnes
- Ambulance department, Division of Prehospital Services, Oslo University Hospital, Oslo, Norway.
- Department for Prehospital Education and Research, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Magnus Hjortdahl
- Department for Prehospital Education and Research, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department for Emergency Medical Coordination Centre, Division of Prehospital Services, Oslo University Hospital, Oslo, Norway
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Nguyen TN, Gonzalez C. Minimap: An interactive dynamic decision making game for search and rescue missions. Behav Res Methods 2024; 56:2311-2332. [PMID: 37553537 DOI: 10.3758/s13428-023-02149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2023] [Indexed: 08/10/2023]
Abstract
Many aspects of humans' dynamic decision-making (DDM) behaviors have been studied with computer-simulated games called microworlds. However, most microworlds only emphasize specific elements of DDM and are inflexible in generating a variety of environments and experimental designs. Moreover, despite the ubiquity of gridworld games for Artificial Intelligence (AI) research, only some tools exist to aid in the development of browser-based gridworld environments for studying the dynamics of human decision-making behavior. To address these issues, we introduce Minimap, a dynamic interactive game to examine DDM in search and rescue missions, which incorporates all the essential characteristics of DDM and offers a wide range of flexibility regarding experimental setups and the creation of experimental scenarios. Minimap specifically allows customization of dynamics, complexity, opaqueness, and dynamic complexity when designing a DDM task. Minimap also enables researchers to visualize and replay recorded human trajectories for the analysis of human behavior. To demonstrate the utility of Minimap, we present a behavioral experiment that examines the impact of different degrees of structural complexity coupled with the opaqueness of the environment on human decision-making performance under time constraints. We discuss the potential applications of Minimap in improving productivity and transparent replications of human behavior and human-AI teaming research. We made Minimap an open-source tool, freely available at https://github.com/DDM-Lab/MinimapInteractiveDDMGame .
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Affiliation(s)
- Thuy Ngoc Nguyen
- Carnegie Mellon University, 5000 Forbes Ave., Pittsburgh, PA, 15213, USA
| | - Cleotilde Gonzalez
- Carnegie Mellon University, 5000 Forbes Ave., Pittsburgh, PA, 15213, USA.
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Seeley AC, Isaksen KE, Lucas A, Cogger N, Otto CM. A 15-year longitudinal study of search-and-rescue dogs identifies the musculoskeletal, integumentary, and gastrointestinal systems as commonly affected. J Am Vet Med Assoc 2024; 262:1-8. [PMID: 37948846 DOI: 10.2460/javma.23.08.0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE A longitudinal study followed search-and-rescue (SAR) dogs for 15 years to determine the incidence of health events and whether factors of deployment during 9/11, breed, or sex altered the risk of specific events. ANIMALS 150 SAR dogs: 95 dogs deployed to the September 11 terrorist attack sites and 55 SAR dogs not deployed. METHODS Each year, a survey was sent to the handler to collect health information until the dog died or the handler withdrew from the study. The reported health events were then categorized according to the body system affected and etiology. Incidence risk rates, with 95% CIs, were calculated for the most common types of health events. Incidence rate ratios were calculated stratified by deployment status, sex, and breed and significance assessed. RESULTS 1 or more health event was recorded in 96 of the 150 enrolled dogs. The most affected systems were the musculoskeletal (31%; CI, 24 to 39), integumentary (22%; CI, 15 to 29), and gastrointestinal (20%; CI, 14 to 26). The health events were most commonly reported as inflammatory (45%; CI, 37 to 53) and degenerative (28%; CI, 21 to 35) in nature. There were no significant differences in incidence of health events based on deployment status to the September 11, 2001, terrorist attacks. Additionally, there was no significant effect of breed or sex on incidence of health events. CLINICAL RELEVANCE To improve the health and longevity of SAR dogs, disease prevention and management programs should focus on reducing the health problems involving the musculoskeletal system as well as the integumentary and gastrointestinal systems.
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Affiliation(s)
- Abigail C Seeley
- 1Department of Clinical Sciences and Advanced Medicine, PennVet Working Dog Center, Philadelphia, PA
| | - Katja E Isaksen
- 2School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Abigail Lucas
- 1Department of Clinical Sciences and Advanced Medicine, PennVet Working Dog Center, Philadelphia, PA
| | - Naomi Cogger
- 2School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Cynthia M Otto
- 1Department of Clinical Sciences and Advanced Medicine, PennVet Working Dog Center, Philadelphia, PA
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Khalifeh M, Goldfarb DG, Zeig-Owens R, Todd AC, Shapiro MZ, Carwile M, Dasaro CR, Li J, Yung J, Farfel MR, Brackbill RM, Cone JE, Qiao B, Schymura MJ, Prezant DJ, Hall C, Boffetta P. Cancer incidence in World Trade Center rescue and recovery workers by race and ethnicity. Am J Ind Med 2023; 66:1048-1055. [PMID: 37746817 DOI: 10.1002/ajim.23539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION It is unclear whether differences in health outcomes by racial and ethnic groups among World Trade Center (WTC) rescue and recovery workers reflect those of the population of New York State (NYS) or show distinct patterns. We assessed cancer incidence in WTC workers by self-reported race and ethnicity, and compared it to population figures for NYS. METHODS A total of 61,031 WTC workers enrolled between September 11, 2001 and January 10, 2012 were followed to December 31, 2015. To evaluate the association between race/ethnicity and cancer risk, Poisson regression analysis was used to estimate hazard ratios (HR) adjusted for WTC exposure, age, calendar year, sex and, for lung cancer, cigarette smoking. RESULTS In comparison to Whites, Black workers had a higher incidence of prostate cancer (HR = 1.99, 95% CI = 1.69-2.34) and multiple myeloma (HR = 3.57, 95% CI = 1.97-6.45), and a lower incidence of thyroid (HR = 0.41, 95% CI = 0.22-0.78) and colorectal cancer (HR = 0.57; 95% CI = 0.33-0.98). Hispanic workers had a higher incidence of liver cancer (HR = 4.03, 95% CI = 2.23-7.28). Compared with NYS population, White workers had significantly higher incidence of prostate cancer (HR = 1.26, 95% CI = 1.18-1.35) and thyroid cancer (HR = 1.80, 95% CI = 1.55-2.08), while Black workers had significantly higher incidence of prostate cancer (HR = 1.22, 95% CI = 1.05-1.40). CONCLUSION Cancer incidence in WTC workers generally reflects data from the NYS population, but some differences were identified that merit further investigation.
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Affiliation(s)
- Malak Khalifeh
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Moshe Z Shapiro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madeline Carwile
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jiehui Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Janette Yung
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Robert M Brackbill
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - James E Cone
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Baozhen Qiao
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - Maria J Schymura
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles Hall
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Greene M, Long G, Greene K, Wilkes M. Performance of a Chemical Heat Blanket in Dry, Damp, and Wet Conditions Inside a Mountain Rescue Hypothermia Wrap. Wilderness Environ Med 2023; 34:483-489. [PMID: 37696723 DOI: 10.1016/j.wem.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Casualties with accidental hypothermia are evacuated using multilayer wraps, typically including a chemical heat blanket (CHB), a vapor barrier, and an insulating outer bag. We investigated CHB performance against dry, damp, and wet fabric, in a multilayer wrap, in response to a case report indicating diminished performance when wet. METHODS We wrapped a torso manikin in a base layer, CHB, vapor barrier, casualty bag, and vacuum mattress, recording CHB panel temperatures at intervals of up to 7 h. Experimental conditions were dry, damp, and wet clothing, with 2 blankets tested in each condition. We subsequently used a forward-looking infrared camera to assess whether the panels heated evenly and heat flux sensors to quantify heat transfer across 2 dry, 1 damp, and 1 wet fleece under CHB panels. RESULTS Chemical heat blankets maintained heat output for >7 h inside the wraps. Median (IQR) panel steady state temperatures were 52°C (39-56°C) against dry fleece, 41°C (36-45°C) against damp fleece, and 30°C (29-33°C) against wet fleece. Peak panel temperature was 67°C. The heat flux results indicated that CHBs generated similar quantities of heat in dry and damp conditions, as the lower temperatures were compensated by more efficient transfer of heat across the moist clothing layer. Chemical heat blanket heat output was diminished in wet conditions. CONCLUSIONS Rescuers should cut off saturated clothing in a protected environment before wrapping casualties, but damp clothing need not be removed. Because of the high peak temperatures recorded on the surfaces of CHBs, they should not be placed directly against skin, and compression straps should not be placed directly over CHBs.
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Affiliation(s)
| | - Geoff Long
- School of Sport, Health and Exercise Science, University of Portsmouth, UK
| | | | - Matt Wilkes
- School of Sport, Health and Exercise Science, University of Portsmouth, UK.
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Lugnet V, McDonough M, Gordon L, Galindez M, Mena Reyes N, Sheets A, Zafren K, Paal P. Termination of Cardiopulmonary Resuscitation in Mountain Rescue: A Scoping Review and ICAR MedCom 2023 Recommendations. High Alt Med Biol 2023; 24:274-286. [PMID: 37733297 DOI: 10.1089/ham.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Lugnet, Viktor, Miles McDonough, Les Gordon, Mercedes Galindez, Nicolas Mena Reyes, Alison Sheets, Ken Zafren, and Peter Paal. Termination of cardiopulmonary resuscitation in mountain rescue: a scoping review and ICAR MedCom 2023 recommendations. High Alt Med Biol. 24:274-286, 2023. Background: In 2012, the International Commission for Mountain Emergency Medicine (ICAR MedCom) published recommendations for termination of cardiopulmonary resuscitation (CPR) in mountain rescue. New developments have necessitated an update. This is the 2023 update for termination of CPR in mountain rescue. Methods: For this scoping review, we searched the PubMed and Cochrane libraries, updated the recommendations, and obtained consensus approval within the writing group and the ICAR MedCom. Results: We screened a total of 9,102 articles, of which 120 articles met the inclusion criteria. We developed 17 recommendations graded according to the strength of recommendation and level of evidence. Conclusions: Most of the recommendations from 2012 are still valid. We made minor changes regarding the safety of rescuers and responses to primary or traumatic cardiac arrest. The criteria for termination of CPR remain unchanged. The principal changes include updated recommendations for mechanical chest compression, point of care ultrasound (POCUS), extracorporeal life support (ECLS) for hypothermia, the effects of water temperature in drowning, and the use of burial times in avalanche rescue.
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Affiliation(s)
- Viktor Lugnet
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden
- Swedish Mountain Guides Association (SBO), Gällivare, Sweden
| | - Miles McDonough
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Emergency Medicine, UCSF Fresno, Fresno, California, USA
| | - Les Gordon
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Langdale Ambleside Mountain Rescue Team, Ambleside, United Kingdom
- Department of Anaesthesia, University Hospitals of Morecambe Bay Trust, Lancaster, United Kingdom
| | - Mercedes Galindez
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Internal Medicine, Hospital Zonal Ramón Carrillo, San Carlos de Bariloche, Argentina
- Comisión de Auxilio Club Andino Bariloche, San Carlos de Bariloche, Argentina
| | - Nicolas Mena Reyes
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Emergency Medicine, Sótero del Río Hospital, Santiago de Chile, Chile
- Grupo de Rescate Médico en Montaña (GREMM), Santiago, Chile
- Emegency Medicine Section, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alison Sheets
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Emergency Medicine, Boulder Community Health, Boulder, Colorado, USA
- Wilderness Medicine Section, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Ken Zafren
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Himalayan Rescue Association, Kathmandu, Nepal
- Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA
- Alaska Native Medical Center, Anchorage, Alaska, USA
| | - Peter Paal
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
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Küpper T, Gieseler U, Morrison A, Schöffl V. Occupational Aspects of Alpine Helicopter Rescue Operations: Recommendation of the Medical Commission of the Union Internationale des Associations d'Alpinisme. Wilderness Environ Med 2023; 34:517-523. [PMID: 37778976 DOI: 10.1016/j.wem.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 05/23/2023] [Accepted: 07/11/2023] [Indexed: 10/03/2023]
Abstract
Helicopter rescue operations in the mountains or at high altitude are well-known as strenuous tasks often associated with some risk. However, there is no standardized procedure for preventive checkups of rescue personnel by occupational care professionals. Therefore, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom) suggests the procedure presented in this study. This comprehensive recommendation is based on more than 2 decades of research of MedCom members and extensive literature search. A total of 248 references were selected by the committee as relevant for the topic. To keep the recommendation handy, the complete list is available as supplemental material (see online Supplemental Material). This article recommends standardized procedures for occupational screening and better health of search and rescue personnel.
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Affiliation(s)
- Thomas Küpper
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Institute for Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, Aachen, Germany.
| | - Ulf Gieseler
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland
| | - Audry Morrison
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Royal Free London NHS Foundation Trust, London, UK
| | - Volker Schöffl
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany; Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Nuremberg, Germany
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Woyke S, Pawlak J, Cappello TD, Schultheiss G, Mayer H, Witt U, Strapazzon G, Brugger H, Jacob M. Shoulder reduction on the scene: current practice and outcome of the Bavarian Mountain Rescue Service-a prospective observational study. Sci Rep 2023; 13:20212. [PMID: 37980383 PMCID: PMC10657475 DOI: 10.1038/s41598-023-47464-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/14/2023] [Indexed: 11/20/2023] Open
Abstract
Out-of-hospital reduction of shoulder dislocations using the Campell method is recommended by the International Commission for Alpine Rescue and applied in the Bavarian Mountain Rescue Service (Bergwacht Bayern, BWB) protocols. This prospective observational study includes patients out-of-hospital with suspected shoulder dislocation and treated and evacuated by the BWB. Data were systematically collected using three questionnaires: one completed on-site by the rescuer, the second in hospital by the physician and the third within 28 (8-143) days after the accident by the patient. The suspected diagnosis of shoulder dislocation was confirmed in hospital in 37 (84%) of 44 cases. Concomitant injuries in other body regions were found in eight (16%) of 49 cases and were associated with incorrect diagnosis (p = 0.002). Younger age (p = 0.043) and first shoulder dislocation event (p = 0.038) were associated with a higher success rate for reduction attempts. Out-of-hospital reduction of shoulder dislocations leads to significant pain relief and no poorer long-term outcome. Signs that are associated with successful out-of-hospital reduction (younger age and first event), but also those that are associated with incorrect diagnosis (concomitant injuries) should be considered before trying to reduce shoulder dislocation on site. The considerable rate of incorrect first diagnosis on site should give rise to an intensive discussion around teaching and training for this intervention.Trial registration: This study is registered with the German Registry for Clinical Trials (DRKS00023377).
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Affiliation(s)
- Simon Woyke
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Johannes Pawlak
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany.
- Landesamt für Gesundheit und Lebensmittelsicherheit, Task Force Infectiology, Munich, Germany.
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Georg Schultheiss
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany
- Department of Anaesthesiology and Intensive Care Medicine, RoMed Clinic Bad Aibling, Bad Aibling, Germany
| | - Herbert Mayer
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany
- Department of Traumatology and Orthopedic Surgery, Clinic Immenstadt, Immenstadt, Germany
| | - Ulrike Witt
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany
- Emergency Department, Krankenhaus Agatharied, Hausham, Germany
| | - Giacomo Strapazzon
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland
| | - Hermann Brugger
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Zürich, Switzerland
| | - Matthias Jacob
- Bavarian Mountain Rescue Service, Am Sportpark 6, 83646, Bad Tölz, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Barmherzige Brüder Klinikum St. Elisabeth Straubing GmbH, Straubing, Germany
- Faculty of Medicine, Ludwig Maximilian University, Munich, Germany
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Mortimer AR, Mortimer RB. Psychological First Aid for Wilderness Trauma: Interventions for Expedition or Search and Rescue Team Members. Wilderness Environ Med 2023; 34:346-353. [PMID: 37105845 DOI: 10.1016/j.wem.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/03/2023] [Accepted: 02/22/2023] [Indexed: 04/29/2023]
Abstract
When exposed to actual or threatened death or serious injury in austere settings, expedition members are at risk of acute stress reactions, as are search and rescue members involved with extricating the patient. Acute stress reactions are a normal response to significant trauma and commonly resolve on their own. If they do not, they can lead to post-traumatic stress disorder (PTSD), a set of persistent symptoms that cause significant effects on the person's life. Medication has a limited preventive role in the field for treatment of stress partly because so few are trained to administer it. Contrastingly, psychological first aid can be performed by lay team members with minimal training. Psychological first aid consists of interventions attempting to encourage feelings of safety, calm, self-efficacy, connection, and hope. These are interventions that provide guidance to not make the situation emotionally worse and might have a preventive effect on later development of PTSD. They are valuable in the field not only for the patient but also for affected team members as well as for search and rescue team members who may be indirectly affected by the trauma and experience repercussions later.
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Affiliation(s)
- Amanda R Mortimer
- Department of Psychology, California State University, Fresno, Fresno, CA
| | - Roger B Mortimer
- Fresno Medical Education Program, Department of Family Medicine, University of California, San Francisco, San Francisco, CA.
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Pardo Ríos M, Morales Sánchez C, Parra Beneitez Y, López Guardiola P, Lanchares Ortiz A, Pedreño Rosique A, Roza Alonso C, Castro Delgado R. Urban search and rescue operations (USAR) in collapsed buildings after the 2023 earthquake in Türkiye. Emergencias 2023; 35:288-296. [PMID: 37439422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
TEXT The earthquakes that occurred in February 2023 in Türkiye had some of the worst consequences of recent years. The Turkish authorities first deployed local resources and then appealed for international help. The International Search and Rescue Group of the United Nations aims to establish minimum international standards for search and rescue teams and a methodology for coordinating responses to earthquakes, tsunamis, and other natural disasters. A main concern of the group is to coordinate operations on the ground. This article offers perspectives on the epidemiology of earthquakes, the management of emergency response teams and Türkiye’s disaster management agency (AFAD); it also explains how rescues are carried out in collapsed buildings. The experience of Firefighters Without Borders after the recent earthquakes and a rescue that took 14 hours are also described.
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Affiliation(s)
- Manuel Pardo Ríos
- Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España. UCAM Universidad Católica de Murcia, Grupo de Investigación de Nuevas Tecnologías en Salud (NT4H), Murcia, España. ONGD Bomberos Unidos Sin Fronteras (BUSF), España. RINVEMERSEMES (Red de Investigación en Emergencias Prehospitalarias)
| | - Cindia Morales Sánchez
- ONGD Bomberos Unidos Sin Fronteras (BUSF), España. SUAP del Almonte, Servicio Andaluz de Salud, Huelva, España
| | - Yassel Parra Beneitez
- Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España. ONGD Bomberos Unidos Sin Fronteras (BUSF), España
| | - Pablo López Guardiola
- UCAM Universidad Católica de Murcia, Grupo de Investigación de Nuevas Tecnologías en Salud (NT4H), Murcia, España
| | - Alberto Lanchares Ortiz
- UCAM Universidad Católica de Murcia, Grupo de Investigación de Nuevas Tecnologías en Salud (NT4H), Murcia, España
| | - Andrés Pedreño Rosique
- UCAM Universidad Católica de Murcia, Grupo de Investigación de Nuevas Tecnologías en Salud (NT4H), Murcia, España
| | - César Roza Alonso
- Servicio de Salud del Principado de Asturias (SAMU-Asturias), Instituto de Investigación Sanitaria del Principado de Asturias (Grupo de Investigación en Asistencia Prehospitalaria y Desastres), España
| | - Rafael Castro Delgado
- RINVEMERSEMES (Red de Investigación en Emergencias Prehospitalarias). Servicio de Salud del Principado de Asturias (SAMU-Asturias), Instituto de Investigación Sanitaria del Principado de Asturias (Grupo de Investigación en Asistencia Prehospitalaria y Desastres), España. Departamento de Medicina, Universidad de Oviedo, Oviedo, España
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Singh A, Zeig-Owens R, Cannon M, Webber MP, Goldfarb DG, Daniels RD, Prezant DJ, Boffetta P, Hall CB. All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters. Occup Environ Med 2023; 80:297-303. [PMID: 36972975 PMCID: PMC10523283 DOI: 10.1136/oemed-2022-108703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/10/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population. METHODS 10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race. RESULTS Between 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. CONCLUSION Both firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.
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Affiliation(s)
- Ankura Singh
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Madeline Cannon
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Mayris P Webber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David G Goldfarb
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Robert D Daniels
- Division of Science integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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van Veelen MJ, Roveri G, Regli IB, Dal Cappello T, Vögele A, Masè M, Falla M, Strapazzon G. Personal Protective Equipment Protocols Lead to a Delayed Initiation of Patient Assessment in Mountain Rescue Operations. High Alt Med Biol 2023; 24:127-131. [PMID: 37262193 DOI: 10.1089/ham.2022.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
van Veelen, Michiel J., Giulia Roveri, Ivo B. Regli, Tomas Dal Cappello, Anna Vögele, Michela Masè, Marika Falla, and Giacomo Strapazzon. Personal protective equipment protocols lead to a delayed initiation of patient assessment in mountain rescue operations. High Alt Med Biol. 24:127-131, 2023. Introduction: Mountain rescue operations can be challenging in austere environmental conditions and remote settings. Airborne infection prevention measures include donning of personal protective equipment (PPE), potentially delaying the approach to a patient. We aimed to investigate the time delay caused by these prevention measures. Methods: This randomized crossover trial consisted of 24 rescue simulation trials intended to be as realistic as possible, performed by mountain rescue teams in difficult terrain. We analyzed the time needed to perform an airborne infection prevention protocol during the approach to a patient. Time delays in scenarios involving patients already wearing versus not wearing face masks and gloves were compared using a linear mixed model Results: The airborne infection prevention measures (i.e., screening questionnaire, hand antisepsis, and donning of PPE) resulted in a time delay of 98 ± 48 (26-214) seconds on initiation of patient assessment. There was a trend to a shorter time to perform infection prevention measures if the simulated patient was already wearing PPE consisting of face mask and gloves (p = 0.052). Conclusion: Airborne infection prevention measures may delay initiation of patient assessment in mountain rescue operations and could impair clinical outcomes in time-sensitive conditions. Trial registration number 0105095-BZ Ethics Committee review board of Bolzano.
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Affiliation(s)
- Michiel J van Veelen
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria
| | - Giulia Roveri
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Ivo B Regli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Anna Vögele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Michela Masè
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Marika Falla
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Collins D, Crickmer M, Brolly K, Abrams D, Ritchie A, Milsom W. Epidemiology of Emergency Medical Search and Rescue in the North Shore Mountains of Vancouver, Canada, from 1995 to 2020. Wilderness Environ Med 2023; 34:55-62. [PMID: 36710126 DOI: 10.1016/j.wem.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/28/2022] [Accepted: 11/03/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Little is known about the epidemiology of emergency medical search and rescue incidents globally. The purpose of this study was to describe the epidemiology of emergency medical search and rescue incidents in the North Shore Mountains of Vancouver, British Columbia, Canada. METHODS This was a retrospective review and descriptive analysis of search and rescue incident reports created by North Shore Rescue over a 25 y period from 1995 to 2019, inclusive. Incident reports were screened for inclusion against a priori criteria defining a medical callout. The National Advisory Committee of Aeronautics (NACA) severity score was used as a method to grade medical acuity of included subjects. RESULTS We included 906 subjects. Their median age was 35 y (interquartile range, 24-53), and 65% of subjects were men. Forty-one percent (n=371) of subjects were classified as non-trauma and 54% (n=489) as trauma. The top 3 activities were hiking (53%), biking (10%), and snow sports (10%). Forty-nine percent of incidents were classified as having a NACA score of ≥3. For subjects with trauma, the top 3 body regions were lower limb (52%), head (18%), and torso (12%). For subjects with non-traumatic conditions, the top 3 causes were mental health crises (25%), exposure (25%), and cardiovascular incidents (11%). CONCLUSIONS Half of the incidents were serious enough to require medical assessment at a hospital (NACA score ≥3). Given this medical acuity, there is a need for evidence-based guidelines and core training competencies for mountain medical search and rescue. Standardized core data sets and outcomes are needed to monitor quality of care over time.
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Affiliation(s)
- Dylan Collins
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Michael Crickmer
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kayla Brolly
- North Shore Rescue, North Vancouver, British Columbia, Canada
| | - Daniel Abrams
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alec Ritchie
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; North Shore Rescue, North Vancouver, British Columbia, Canada
| | - William Milsom
- North Shore Rescue, North Vancouver, British Columbia, Canada; Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
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Bensi EAB, Spijkerman R, Brown PA, Knights S, Nellensteijn DR. Helicopter-Based Search and Rescue Operations in the Dutch Caribbean: A Retrospective Analysis. Wilderness Environ Med 2023; 34:31-37. [PMID: 36517391 DOI: 10.1016/j.wem.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Search and rescue (SAR) operations in the Dutch Caribbean offer basic and advanced prehospital care and transport for definitive care. Helicopter-based SAR in this geographic area has not been previously studied. Data from the Dutch Caribbean Coast Guard were analyzed with the aim of describing the current operational setting and optimizing SAR operations in the future. METHODS Data were collected retrospectively from March 2018 through April 2021. Epidemiologic data, patient demographics, details of flight operations, medical interventions, and outcomes were collected and analyzed for this period. RESULTS A total of 91 individuals were assisted through SAR, of whom 40 (44%) had a medical emergency. Most incidents occurred during high-tourism seasons. A yearly increase in helicopter tasking was observed. Boating was the most common activity (25%) requiring SAR. Injuries to the extremities were the most common injury (27%). The median time to reach the scene of SAR was 46 (interquartile range [IQR], 33-66) min. The most frequent reason for delay was the unavailability of a winch operator (15%). Of 16 fatalities, most (63%) were attributed to drowning. A total of 18 persons were transported to a hospital, with a median travel time of 63 (IQR, 47-79) min. CONCLUSIONS The number of SAR missions in the Dutch Caribbean is increasing. The response times might be reduced by the inclusion of an on-call winch operator. A hospital helipad would likely decrease the time to definitive care. Stand-by physicians might improve the quality of medical care. Collection of data should be optimized in the future.
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Affiliation(s)
| | - Roy Spijkerman
- Department of Surgery, Curaçao Medical Center, Willemstad, Curaçao
| | - Philip A Brown
- Dutch Caribbean Coast Guard, Ministry of Defense, Kingdom of the Netherlands
| | - Shaun Knights
- Dutch Caribbean Coast Guard, Ministry of Defense, Kingdom of the Netherlands
| | - David R Nellensteijn
- Department of Surgery, Curaçao Medical Center, Willemstad, Curaçao; Dutch Caribbean Coast Guard, Ministry of Defense, Kingdom of the Netherlands.
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18
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Li J, Hall CB, Yung J, Kehm RD, Zeig-Owens R, Singh A, Cone JE, Brackbill RM, Farfel MR, Qiao B, Schymura MJ, Shapiro MZ, Dasaro CR, Todd AC, Prezant DJ, Boffetta P. A 15-year follow-up study of mortality in a pooled cohort of World Trade Center rescue and recovery workers. Environ Res 2023; 219:115116. [PMID: 36549491 DOI: 10.1016/j.envres.2022.115116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Hazardous exposures from the World Trade Center (WTC) terrorist attacks have been linked to increased incidence of adverse health conditions, often associated with increased mortality. We assessed mortality in a pooled cohort of WTC rescue/recovery workers over 15 years of follow-up. MATERIALS AND METHODS We analyzed mortality through 2016 in a pooled and deduplicated cohort of WTC rescue/recovery workers from three WTC-exposed cohorts (N = 60,631): the Fire Department of the City of New York (FDNY); the WTC Health Registry (WTCHR); and the General Responder Cohort (GRC). Standardized mortality ratios (SMRs) were estimated to assess mortality vs. the US and NY state populations. Multivariable Cox proportional hazards models were used to examine associations of WTC exposures (date of first arrival, working on the WTC debris pile) with mortality risk. RESULTS There were 1912 deaths over 697,943.33 person-years of follow-up. The SMR for all-cause mortality was significantly lower-than-expected, both when using US (SMR 0.43, 95% confidence interval [CI] 0.42-0.45) and NYS (SMR 0.51, 95% CI 0.49-0.53) as reference populations. SMRs were not elevated for any of the 28 major causes of death. Arriving at the WTC site on 9/11-9/17/2001 vs. 9/18/2001-6/30/2002 was associated with 30-50% higher risk of all-cause, heart disease and smoking-related mortality in non-FDNY/non-GRC members. Conversely, arriving on 9/11/2001 vs. 9/18/2001-6/30/2002 was associated with 40% lower all-cause and smoking-related mortality risk in FDNY members. Working on vs. off the WTC pile was associated with an increased risk of all-cause mortality in non-FDNY/non-GRC members (adjusted hazard ratio [aHR] 1.25, 95% CI 1.04-1.50), and cancer-specific mortality in GRC members (aHR 1.39, 95% CI 1.05-1.84), but lower mortality risks were found in FDNY members. CONCLUSIONS We did not observe excess mortality among WTC rescue/recovery workers compared with general populations. However, significantly increased mortality risks among some sub-groups with high WTC exposure warrant further investigation.
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Affiliation(s)
- Jiehui Li
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States
| | - Charles B Hall
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Ave, Bronx, NY, 10461, United States
| | - Janette Yung
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States
| | - Rebecca D Kehm
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, United States
| | - Rachel Zeig-Owens
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Ave, Bronx, NY, 10461, United States; Fire Department of the City of New York (FDNY), 9 Metrotech Center 5E-63-K, Brooklyn, NY, 11201, United States; Montefiore Medical Center, Department of Medicine, 111 E. 210th St., The Bronx, NY, 10467, United States
| | - Ankura Singh
- Fire Department of the City of New York (FDNY), 9 Metrotech Center 5E-63-K, Brooklyn, NY, 11201, United States; Montefiore Medical Center, Department of Medicine, 111 E. 210th St., The Bronx, NY, 10467, United States
| | - James E Cone
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States
| | - Robert M Brackbill
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 42-09 28th Street, CN-6W, Long Island City, NY, 11101, United States
| | - Baozhen Qiao
- New York State Department of Health, Bureau of Cancer Epidemiology, 150 Broadway, Albany, NY, 12204, United States
| | - Maria J Schymura
- New York State Department of Health, Bureau of Cancer Epidemiology, 150 Broadway, Albany, NY, 12204, United States
| | - Moshe Z Shapiro
- WTC Health Program General Responder Data Center, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One, Gustave L. Levy Place, Mail Stop 1057, New York, NY, 10029, United States
| | - Christopher R Dasaro
- WTC Health Program General Responder Data Center, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One, Gustave L. Levy Place, Mail Stop 1057, New York, NY, 10029, United States
| | - Andrew C Todd
- WTC Health Program General Responder Data Center, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One, Gustave L. Levy Place, Mail Stop 1057, New York, NY, 10029, United States
| | - David J Prezant
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Ave, Bronx, NY, 10461, United States; Fire Department of the City of New York (FDNY), 9 Metrotech Center 5E-63-K, Brooklyn, NY, 11201, United States; Montefiore Medical Center, Department of Medicine, 111 E. 210th St., The Bronx, NY, 10467, United States
| | - Paolo Boffetta
- Stony Brook University, Stony Brook Cancer Center, Lauterbur Dr., Stony Brook, NY, 11794, United States; University of Bologna, Department of Medical and Surgical Sciences, Via Zamboni, 33, 40126, Bologna, BO, Italy.
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Gao Y, Liu H, Niu F, Tian Y, Wang J, Cheng W. Search and rescue system-of-systems influence degree evaluation of aviation equipment based on simulation. Sci Rep 2022; 12:22384. [PMID: 36572712 PMCID: PMC9792455 DOI: 10.1038/s41598-022-26098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022] Open
Abstract
Search and rescue (SAR) is an important part of joint operations, and also one of the key supports for ensuring combat effectiveness. Aviation equipment is a major component of SAR action. Therefore, the SAR capability of aviation equipment has become the key to affecting the overall SAR action. This paper proposes the concept of the system of systems influence degree (SoSID) and conducts a scientific quantitative evaluation to quantitatively measure the effect of aviation equipment used in SAR. First, according to the characteristics of SAR action in threat environments, the SAR capability of aviation equipment is analyzed, and an indicator decomposition hierarchy model based on this SAR capability is proposed. Second, based on the above model, the DECIDE (destroy, execute, cost, implement, defend, evade) SoSID evaluation model is proposed. Third, a comparative test is designed and a sensitivity analysis is conducted based on the sobol power sensitivity (SPS) analysis method to obtain the index sensitivity of the SAR capability. The sensitivity is then ranked to obtain key indicators. Finally, we build a simulation test environment to obtain multiple test plans for comparison and verify the rationality of the index decomposition hierarchy model and the SoSID evaluation model as well as the effectiveness of the SPS analysis method through analysis of the simulation results.
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Affiliation(s)
- Yan Gao
- School of Aeronautic Science and Engineering, Beihang University, Beijing, China
- Academy of Systems Engineering, Beijing, China
| | - Hu Liu
- School of Aeronautic Science and Engineering, Beihang University, Beijing, China
| | - Fu Niu
- Academy of Systems Engineering, Beijing, China
| | - Yongliang Tian
- School of Aeronautic Science and Engineering, Beihang University, Beijing, China.
| | - Jin Wang
- Academy of Systems Engineering, Beijing, China
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Vera-Ortega P, Vázquez-Martín R, Fernandez-Lozano JJ, García-Cerezo A, Mandow A. Enabling Remote Responder Bio-Signal Monitoring in a Cooperative Human-Robot Architecture for Search and Rescue. Sensors (Basel) 2022; 23:49. [PMID: 36616647 PMCID: PMC9823914 DOI: 10.3390/s23010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
The roles of emergency responders are challenging and often physically demanding, so it is essential that their duties are performed safely and effectively. In this article, we address real-time bio-signal sensor monitoring for responders in disaster scenarios. In particular, we propose the integration of a set of health monitoring sensors suitable for detecting stress, anxiety and physical fatigue in an Internet of Cooperative Agents architecture for search and rescue (SAR) missions (SAR-IoCA), which allows remote control and communication between human and robotic agents and the mission control center. With this purpose, we performed proof-of-concept experiments with a bio-signal sensor suite worn by firefighters in two high-fidelity SAR exercises. Moreover, we conducted a survey, distributed to end-users through the Fire Brigade consortium of the Provincial Council of Málaga, in order to analyze the firefighters' opinion about biological signals monitoring while on duty. As a result of this methodology, we propose a wearable sensor suite design with the aim of providing some easy-to-wear integrated-sensor garments, which are suitable for emergency worker activity. The article offers discussion of user acceptance, performance results and learned lessons.
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Heyerdahl F. New search-and-rescue helicopter and useful activity data. Tidsskr Nor Laegeforen 2022; 142:22-0732. [PMID: 36511737 DOI: 10.4045/tidsskr.22.0732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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22
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Ferraro JC, Mouloua M, Mangos PM, Matthews G. Gaming experience predicts UAS operator performance and workload in simulated search and rescue missions. Ergonomics 2022; 65:1659-1671. [PMID: 35297326 DOI: 10.1080/00140139.2022.2048896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
Unmanned aircraft systems (UAS) operator training and selection procedures are still being refined to effectively address challenges related to performance, workload, and stress in UAS operation. Research suggests that experience with commercial videogames may test skills relevant to modern UAS operation. This study investigated the ability of videogame experience to predict operator performance, workload, and stress. Forty-nine participants performed 9 trials of a simulated search and rescue mission. It was expected that participants who more frequently played videogames would report lower levels of distress and workload, higher task engagement, and better overall performance. Results showed that gaming experience was negatively correlated with subjective workload and positively correlated with multiple measures of performance. Furthermore, nearly all observed gender-related differences were not present when gaming experience was controlled for. These results have implications for the role of gaming experience in remotely operated systems operator recruitment, selection, and training. Practitioner summary: This study examined how gaming experience influences UAS operator success in simulated search and rescue missions. Participants reported on their experience playing videogames before completing multiple experimental trials on a desktop computer. Results indicated that experience playing videogames significantly impacted performance, workload, and stress.
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Affiliation(s)
- James C Ferraro
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Mustapha Mouloua
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | | | - Gerald Matthews
- Department of Psychology, George Mason University, Fairfax, VA, USA
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Lv J, Tang W, Hosseinzadeh H. Developed multiple-layer perceptron neural network based on developed search and rescue optimizer to predict iron ore price volatility: A case study. ISA Trans 2022; 130:420-432. [PMID: 35491252 DOI: 10.1016/j.isatra.2022.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 06/14/2023]
Abstract
In economic investment, the role of forecasting is very important because in an economic project, the investor must carefully examine the dimensions of the work such that one of the most important and perhaps the main factor of a future investor and an economic enterprise is the work done by Costs and revenues are determined. Due to the fact that the volatility of iron ore price is affected by various factors, so it is not possible to determine a simple and general function to predict its price. There are several methods for predicting price, but the most appropriate of these is a method that examines variables in a nonlinear and dynamic manner that is closer to reality. Therefore, in this research, an improved and optimized neural network is proposed to facilitate this task. The idea is to employ a developed version of Search and Rescue optimization algorithm to enhance the training ability of the neural network to present an efficient forecasting tool for iron ore price volatilities. Different variables are used for the method verification and its results are compared with basic neural network, particle swarm optimization-based, Intelligent Integrated Optimizer, Genetic Neural Network to show its superiority. Simulation results demonstrate that by the proposed method has a satisfying and better fitting with the data compared with the other methods.
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Affiliation(s)
- Jun Lv
- Department of Computer Science and Technology, Luliang University, Lvliang, Shanxi, 033000, China.
| | - Weidong Tang
- Institute of Artificial Intelligence, Guangxi University for Nationalities, Nanning, Guangxi, 530006, China
| | - Hasan Hosseinzadeh
- Department of Mathematics, Ardabil Branch, Islamic Azad University, Ardabil, Iran
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24
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Wallner B, Salchner H, Isser M, Schachner T, Wiedermann FJ, Lederer W. Rescue Blankets as Multifunctional Rescue Equipment in Alpine and Wilderness Emergencies-A Narrative Review and Clinical Implications. Int J Environ Res Public Health 2022; 19:12721. [PMID: 36232023 PMCID: PMC9566397 DOI: 10.3390/ijerph191912721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
The utilization of rescue blankets in pre-hospital emergency medicine exceeds protection from hypothermia and enhanced visibility by far. In this narrative review, we focus on emphasizing the alternative applications of these fascinating multifunctional tools in the pre-hospital setting. A literature search in PubMed® and Web of ScienceTM yielded 100 results (last update was on 8 July 2022), a total number of 26 of which were included in this narrative review. Nine articles assessing alternative functions of rescue blanket were further evaluated and described in more detail. In addition, we performed various experimental and observational trials to test the functionality of rescue practice in mountain emergency medicine. Newly fabricated rescue blankets proved to possess impressive robustness. We evaluated rescue blankets in their applicability to not only protect from hypothermia, but also as practical tools to treat catastrophic hemorrhage and bleeding limbs, to perform open pneumothorax chest seals in sucking chest wounds, to prevent damage to unprotected eyes on the glacier and as alternative instruments for transportation in the inaccessible areas. Rescue blankets are important rescue equipment in alpine and wilderness emergencies with multifunctional applications, and must be part of every personal medical kit.
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Affiliation(s)
- Bernd Wallner
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Hannah Salchner
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Markus Isser
- Austrian Mountain Rescue Service—Tyrol, Medical Division, Florianistr. 2, 6410 Telfs, Austria
| | - Thomas Schachner
- Department of Cardiac Surgery, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Franz J. Wiedermann
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
| | - Wolfgang Lederer
- Department of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria
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25
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Tai Y, Yu TT. Using Smartphones to Locate Trapped Victims in Disasters. Sensors (Basel) 2022; 22:7502. [PMID: 36236601 PMCID: PMC9572018 DOI: 10.3390/s22197502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Large and unaccounted numbers of victims in disasters, events, or fires are often trapped in buildings or debris, and must be located and rescued as soon as possible. This study transforms smartphones into indoor locating tools without extra modification or complicated program installation, considering smartphones are likely to be carried when disasters strike. The study creates a system that converts smartphones into a lifesaving tool for trapped victims and rescuers. This study employs the Bluetooth beacon in smartphones to send signals using its low power consumption feature. The signal could continue transmitting for rescuers to locate trapped victims for longer. Rescuers could use the Bluetooth function on a regular notebook computer to search such signals without any hardware implementation or modification, allowing them to locate and determine the position of many trapped victims simultaneously. Implementing this system will decrease the search and rescue team's need to enter unsafe areas and increase their rescue speed, a critical factor for the survival of trapped victims. Furthermore, when disasters strike, the smartphone calling function might not work, and the trapped victim might be too weak to call for help. Thus, autoreply messages from victims' smartphones could help them be located within a 2-m error, even if covered by fallen debris such as wood piles or tiles. This effort will increase the chance of finding trapped victims within the golden rescue hours and reduce the exposure time of search and rescue teams in unsafe environments.
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Pinedo-Jauregi A, Quinn T, Coca A, Mejuto G, Cámara J. Physiological stress in flat and uphill walking with different backpack loads in professional mountain rescue crews. Appl Ergon 2022; 103:103784. [PMID: 35489294 DOI: 10.1016/j.apergo.2022.103784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/01/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
This study aimed to determine the interactive physiological effect of backpack load carriage and slope during walking in professional mountain rescuers. Sixteen mountain rescuers walked on a treadmill at 3.6 km/h for 5 min in each combination of three slopes (1%, 10%, 20%) and five backpack loads (0%, 10%, 20%, 30%, and 40% body weight). Relative heart rate (%HRmax), relative oxygen consumption (%VO2max), and rating of perceived exertion (RPE, Borg 1-10 scale) were compared across conditions using two-way ANOVA. Significant differences in %VO2max, %HRmax, and RPE across slopes and loads were found where burden increased directly with slope and load (main effect of slope, p < 0.001 for all; main effect of load, p < 0.001 for all). Additionally, significant slope by load interactions were found for all parameters, indicating an additive effect (p < 0.001 for all). Mountain rescuers should consider the physiological interaction between slope and load when determining safe occupational walking capacity.
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Affiliation(s)
- Aitor Pinedo-Jauregi
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT) Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain.
| | - Tyler Quinn
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA, USA
| | - Aitor Coca
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007, Bizkaia, Spain
| | - Gaizka Mejuto
- Department of Didactics of Musical, Plastic and Body Expression, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Jesús Cámara
- GIzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT) Society, Sports, and Physical Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
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Pandey A, Singh SK, Udmale SS, Shukla KK. Epileptic Seizure Classification using Battle Royale Search and Rescue optimization based Deep LSTM. IEEE J Biomed Health Inform 2022; 26:5494-5505. [PMID: 36048978 DOI: 10.1109/jbhi.2022.3203454] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Epilepsy is a major threat to society regarding the treatment time, cost, and unpredictable nature of the disease, imposing an urgent need for intelligent analysis. Electroencephalogram (EEG) is a commonly deployed test for detecting epilepsy that analyses the electrical activity of an individual's brain. In this work, an optimized deep sequential model is proposed to improve the seizure classification performance based on a hybrid feature set derived from EEG signals. A novel hybridized algorithm called Battle Royale Search and Rescue optimization (BRRO) is proposed for optimizing the deep learning model. Also, a proposed hybrid feature set utilizes the empirical mode decomposition (EMD), variational mode decomposition (VMD), and empirical wavelet transform (EWT). This feature set is created to capture the discriminative temporal property of the dataset. The proposed method is validated using publically available datasets. The results manifest that the proposed optimized algorithm provides better results in comparison to other existing alternatives.
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Guo X, Wei B, Nie G, Su G. Application of Mobile Signaling Data in Determining the Seismic Influence Field: A Case Study of the 2017 Mw 6.5 Jiuzhaigou Earthquake, China. Int J Environ Res Public Health 2022; 19:10697. [PMID: 36078413 PMCID: PMC9518317 DOI: 10.3390/ijerph191710697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Seismic disasters are sudden and unpredictable, often causing massive damage, casualties and socioeconomic losses. Rapid and accurate determination of the scale and degree of destruction of the seismic influence field in an affected area can aid in timely emergency rescue work after an earthquake. In this study, the relationship between the changes in four types of mobile signaling data and the seismic influence field was explored in the 2017 Jiuzhaigou earthquake-hit area, China, by using the methods of comparative analysis, regression analysis and spatial autocorrelation analysis. The results revealed that after the earthquake, the number of mobile signaling significantly decreased. The higher the intensity, the more obvious the reduction of mobile signaling data and the later the recovery time. The Loginmac and WiFi data showed greater sensitivity than Gid and Station. There was a significant correlation between the changes in the mobile signaling numbers and the seismic intensity, which can more accurately reflect the approximate extent of the seismic influence field and the degree of actual damage. The changes in mobile signaling can provide a helpful reference for the rapid determination of seismic influence fields.
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Affiliation(s)
- Xinxin Guo
- Institute of Geology, China Earthquake Administration, Beijing 100029, China
| | - Benyong Wei
- Institute of Geology, China Earthquake Administration, Beijing 100029, China
- Key Laboratory of Seismic and Volcanic Hazards, China Earthquake Administration, Beijing 100029, China
| | - Gaozhong Nie
- Institute of Geology, China Earthquake Administration, Beijing 100029, China
- Key Laboratory of Seismic and Volcanic Hazards, China Earthquake Administration, Beijing 100029, China
| | - Guiwu Su
- Institute of Geology, China Earthquake Administration, Beijing 100029, China
- Key Laboratory of Seismic and Volcanic Hazards, China Earthquake Administration, Beijing 100029, China
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Cleven KL, Zeig-Owens R, Goldfarb DG, Schwartz T, Prezant DJ. Risk Factors for COVID-19 in a Retired FDNY WTC-Exposed Cohort. IJERPH 2022; 19:ijerph19158891. [PMID: 35897262 PMCID: PMC9331420 DOI: 10.3390/ijerph19158891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in published studies of hospitalized individuals. Participants were retired FDNY WTC-exposed rescue/recovery workers with ≥1 medical visit between 1 March 2020 and 1 August 2021. The cumulative incidence was calculated using self-reported COVID-19 diagnoses. Cox regression was performed to evaluate the association of WTC-exposure and COVID-19, adjusting for history of comorbidities, age, race, work assignment (emergency medical service providers vs. firefighter), and sex. The cumulative incidence of COVID-19 was 130 per 1000. The adjusted models showed the risk of infection was greater in those with highest WTC exposure versus less exposure (hazard ratio (HR) = 1.14 (95% CI 1.00–1.31)). Older age was associated with a lower risk of infection HR = 0.97 (95% CI 0.96–0.98). WTC-associated diseases (obstructive airways disease and interstitial lung disease) were not COVID-19 risk factors. This study is the first to show an association between WTC exposure and the risk of COVID-19. While participants are retired from FDNY work, the youngest individuals may still be in the workforce, explaining why younger age was a significant risk for COVID-19.
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Affiliation(s)
- Krystal L. Cleven
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- Correspondence: ; Tel.: +1-718-403-4416
| | - Rachel Zeig-Owens
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - David G. Goldfarb
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
| | - Theresa Schwartz
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
| | - David J. Prezant
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA; (R.Z.-O.); (D.G.G.); (T.S.); (D.J.P.)
- The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Yuan J, Go LK, Ang XQT, Teo ISZ, Soh FW. Republic of Singapore Air Force Helicopter Search-and-Rescue and Medical Evacuations: A 5-Year Review. Air Med J 2022; 41:350-358. [PMID: 35750441 DOI: 10.1016/j.amj.2022.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
The Republic of Singapore Air Force (RSAF) provides Helicopter Search-and-Rescue (SAR) and Helicopter Medical Evacuation (Heli-Medevac) coverage for the Singapore Aeronautical Search and Rescue Region (ASSR) in the South China Sea, spanning 840,000 km2. This region contains busy international shipping lanes and air traffic routes. Each year, Singapore's Helicopter SAR and Heli-Medevac service is activated multiple times to rescue personnel lost at sea or to evacuate ill and injured ship sailors or passengers to tertiary hospitals in Singapore for stabilization and advanced care. This is a retrospective review on all civilian SAR and Heli-medevac activations by the RSAF over a 5-year period from 2016 to 2020. Case profiles, presenting conditions, in-flight treatment, and patient outcomes are reviewed and discussed. Key operational observations made from RSAF's SAR and Heli-Medevac, as well as lessons learned from these missions, are discussed in this article.
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Affiliation(s)
- Jing Yuan
- Republic of Singapore Air Force, Singapore.
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Boffetta P, Hall CB, Todd AC, Goldfarb DG, Schymura MJ, Li J, Cone JE, Zeig-Owens R. Cancer risk among World Trade Center rescue and recovery workers: A review. CA Cancer J Clin 2022; 72:308-314. [PMID: 35325473 DOI: 10.3322/caac.21723] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Twenty years after the September 11th, 2001 terrorist attacks, the association between exposures present at the World Trade Center (WTC) site and the risk of several specific types of cancer has been reported among rescue and recovery workers. The authors' objective was to conduct an updated review of these data. Most studies have found elevated rates of both prostate and thyroid cancers compared with rates in the general population, and some have reported statistically significant differences for the rates of all cancers as well. Studies including a larger combined cohort of WTC-exposed rescue and recovery workers from 3 main cohorts have since replicated findings for these cancers, with additional years of follow-up. Among this combined cohort, although a lower-than-expected standardized incidence ratio for all cancers was observed, WTC exposure was also related to an increased risk of cutaneous melanoma and tonsil cancer. Importantly, another study found that WTC-exposed rescue and recovery workers who are enrolled in the federally funded medical monitoring and treatment program experienced improved survival post-cancer diagnosis compared with New York state patients with cancer. On the basis of these combined cohort studies, the full effect of WTC exposure on cancer risk is becoming clearer. Consequently, the authors believe that surveillance of those with WTC exposure should be continued, and in-depth analysis of epidemiologic, molecular, and clinical aspects of specific cancers in these workers should be pursued.
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Affiliation(s)
- Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David G Goldfarb
- Department of Medicine, Montefiore Medical Center, New York, New York
- Fire Department of the City of New York, Brooklyn, New York
| | - Maria J Schymura
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York
| | - Jiehui Li
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - James E Cone
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Rachel Zeig-Owens
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
- Department of Medicine, Montefiore Medical Center, New York, New York
- Fire Department of the City of New York, Brooklyn, New York
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Duncan CA, Bishop N, Komisar V, MacKinnon SN, Byrne JM. The Effect of Wave Motion Intensities on Performance in a Simulated Search and Rescue Task and the Concurrent Demands of Maintaining Balance. Hum Factors 2022; 64:579-588. [PMID: 32930010 DOI: 10.1177/0018720820952907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of this study was to examine how intensity of wave motions affects the performance of a simulated maritime search and rescue (SAR) task. BACKGROUND Maritime SAR is a critical maritime occupation; however, the effect of wave motion intensity on worker performance is unknown. METHODS Twenty-four participants (12 male, 12 female) performed a simulated search and rescue task on a six-degree-of-freedom motion platform in two conditions that differed in motion intensity (low and high). Task performance, electromyography (EMG), and number of compensatory steps taken by the individual were examined. RESULTS As magnitude of simulated motion increased, performance in the SAR task decreased, and was accompanied by increases in lower limb muscle activation and number of steps taken. CONCLUSIONS Performance of an SAR task and balance control may be impeded by high-magnitude vessel motions. APPLICATION This research has the potential to be used by maritime engineers, occupational health and safety professionals, and ergonomists to improve worker safety and performance for SAR operators.
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Affiliation(s)
| | - Nicole Bishop
- 7512 Memorial University of Newfoundland, St. John's, Canada
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Oshiro K, Murakami T. Causes of death and characteristics of non-survivors rescued during recreational mountain activities in Japan between 2011 and 2015: a retrospective analysis. BMJ Open 2022; 12:e053935. [PMID: 35115353 PMCID: PMC8814748 DOI: 10.1136/bmjopen-2021-053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to describe the cause of death and characteristics at the prehospital setting associated with care and rescue processes of non-survivors rescued in the mountain of Japan. DESIGN Retrospective analysis. SETTING Prehospital setting of mountain searches and rescues in Japan. A total of 10 prefectural police headquarters with >10 cases of mountain death from 2011 to 2015. PARTICIPANTS Data were generated from the existing records. Of the total 6159 rescued subjects, 548 mountain deaths were caused by recreational activities. RESULTS Among the 548 mountain deaths, 83% were men, and major causes of death were trauma (49.1%), hypothermia (14.8%), cardiac death (13.1%) and avalanche-related death (6.6%). The alive rate at rescue team arrival in all non-survivors was 3.5%, with 1, 4 and 14 cases of cardiac, hypothermia and trauma, respectively. Cardiac deaths occurred in 93.1% (67/72) of men and individuals aged >41 years, and 88.7% (63/71) were found on mountain trails. In hypothermia, callouts were made between 17:00 and 6:00 at 49% (40/81) and by persons not on-site in 59.7% (46/77). People with >6 hours in trauma or >1 hour in cardiac death already died on rescue team arrival, but some with hypothermia after 6 hours were alive. CONCLUSION This study is one of the first large-scale retrospective analyses of prehospital non-survivors in mountain emergencies. The alive rate at rescue arrival in all mountain deaths was only 3.5%. These data showed that the circumstances related to onset and the process until the rescue team arrives have different characteristics, depending on the cause of death. Survival may be enhanced by targeting better use of the time before rescue team arrival and by providing further education, particularly mountain rescue-related medical problems to rescuers including bystanders.
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Affiliation(s)
- Kazue Oshiro
- Department of Cardiovascular Medicine and Director of Mountain Medicine, Research, and Survey Division, Hokkaido Ono Memorial Hospital, Sapporo, Hokkaido, Japan
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
| | - Tomikazu Murakami
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
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van Boetzelaer E, Fotso A, Angelova I, Huisman G, Thorson T, Hadj-Sahraoui H, Kremer R, Kuehne A. Health conditions of migrants, refugees and asylum seekers on search and rescue vessels on the central Mediterranean Sea, 2016-2019: a retrospective analysis. BMJ Open 2022; 12:e053661. [PMID: 35017249 PMCID: PMC8753406 DOI: 10.1136/bmjopen-2021-053661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study will contribute to the systematic epidemiological description of morbidities among migrants, refugees and asylum seekers when crossing the Mediterranean Sea. SETTING Since 2015, Médecins sans Frontières (MSF) has conducted search and rescue activities on the Mediterranean Sea to save lives, provide medical services, to witness and to speak out. PARTICIPANTS Between November 2016 and December 2019, MSF rescued 22 966 migrants, refugees and asylum seekers. PRIMARY AND SECONDARY OUTCOME MEASURES We conducted retrospective data analysis of data collected between January 2016 and December 2019 as part of routine monitoring of the MSF's healthcare services for migrants, refugees and asylum seekers on two search and rescue vessels. RESULTS MSF conducted 12 438 outpatient consultations and 853 sexual and reproductive health consultations (24.9% of female population, 853/3420) and documented 287 consultations for sexual and gender-based violence (SGBV). The most frequently diagnosed health conditions among children aged 5 years or older and adults were skin conditions (30.6%, 5475/17 869), motion sickness (28.6%, 5116/17 869), headache (15.4%, 2 748/17 869) and acute injuries (5.7%, 1013/17 869). Of acute injuries, 44.7% were non-violence-related injuries (453/1013), 30.1% were fuel burns (297/1013) and 25.4% were violence-related injuries (257/1013). CONCLUSION The limited testing and diagnostics capacity of the outpatient department, space limitations, stigma and the generally short length of stay of migrants, refugees and asylum seekers on the ships have likely led to an underestimation of morbidities, including mental health conditions and SGBV. The main diagnoses on board were directly related to journey on land and sea and stay in Libya. We conclude that this population may be relatively young and healthy but displays significant journey-related illnesses and includes migrants, refugees and asylum seekers who have suffered significant violence during their transit and need urgent access to essential services and protection in a place of safety on land.
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Affiliation(s)
| | - Adolphe Fotso
- Medical Department, Medecins Sans Frontieres, Tripoli, Libya
| | - Ilina Angelova
- Medical Department, Medecins Sans Frontieres, Tripoli, Libya
| | - Geke Huisman
- Medical Department, Medecins Sans Frontieres, Tripoli, Libya
| | - Trygve Thorson
- Public Health Department, Medecins Sans Frontieres, Amsterdam, The Netherlands
| | | | - Ronald Kremer
- Public Health Department, Medecins Sans Frontieres, Amsterdam, The Netherlands
| | - Anna Kuehne
- Public Health Department, Medecins Sans Frontieres, Berlin, Germany
- Manson Unit, Medecins Sans Frontieres, London, UK
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Pedersen CB, Nielsen KG, Rosenkrands K, Vasegaard AE, Nielsen P, El Yafrani M. A GRASP-Based Approach for Planning UAV-Assisted Search and Rescue Missions. Sensors (Basel) 2021; 22:275. [PMID: 35009817 PMCID: PMC8749517 DOI: 10.3390/s22010275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Search and Rescue (SAR) missions aim to search and provide first aid to persons in distress or danger. Due to the urgency of these situations, it is important to possess a system able to take fast action and effectively and efficiently utilise the available resources to conduct the mission. In addition, the potential complexity of the search such as the ruggedness of terrain or large size of the search region should be considered. Such issues can be tackled by using Unmanned Aerial Vehicles (UAVs) equipped with optical sensors. This can ensure the efficiency in terms of speed, coverage and flexibility required to conduct this type of time-sensitive missions. This paper centres on designing a fast solution approach for planning UAV-assisted SAR missions. The challenge is to cover an area where targets (people in distress after a hurricane or earthquake, lost vessels in sea, missing persons in mountainous area, etc.) can be potentially found with a variable likelihood. The search area is modelled using a scoring map to support the choice of the search sub-areas, where the scores represent the likelihood of finding a target. The goal of this paper is to propose a heuristic approach to automate the search process using scarce heterogeneous resources in the most efficient manner.
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Akter R, Larose TL, Sandvik J, Fonne V, Meland A, Wagstaff AS. Excessive Daytime Sleepiness and Associated Factors in Military Search and Rescue Personnel. Aerosp Med Hum Perform 2021; 92:975-979. [PMID: 34986937 DOI: 10.3357/amhp.5946.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Abnormal excessive daytime sleepiness (EDS) has been reported worldwide, but too little is known about EDS and its determinants in Search and Rescue (SAR) populations. We aimed to determine the prevalence of abnormal EDS and contributing factors among Royal Norwegian Air Force (RNoAF) SAR helicopter personnel.METHODS: In this cross-sectional study, a total of N = 175 RNoAF SAR personnel completed an electronic survey including socio-demographic and lifestyle questions. The Epworth Sleepiness Scale (ESS) was used as both a continuous and categorical outcome variable to measure EDS.RESULTS: Abnormal EDS defined by ESS was found in 41% of the participants in this study. We observed no associations between socio-demographic and lifestyle factors and abnormal EDS in this study. DISCUSSION: There is a high prevalence of abnormal EDS in the current RNoAF SAR population. Despite this elevated level of fatigue, we did not find that the socio-demographic and lifestyle factors assessed in this study were associated with abnormal EDS in RNoAF SAR helicopter personnel. Also unusually, the study cohort did not demonstrate higher scores in factors found to change ESS scores in similar study populations (e.g., caffeine use, tobacco use, exercise level). Further research is required to investigate other factors (organizational, operational) that may be associated with abnormal EDS in this and other SAR populations.Akter R, Larose TL, Sandvik J, Fonne V, Meland A, Wagstaff AS. Excessive daytime sleepiness and associated factors in military search and rescue personnel. Aerosp Med Hum Perform. 2021; 92(12):975-979.
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Bravo-Arrabal J, Toscano-Moreno M, Fernandez-Lozano JJ, Mandow A, Gomez-Ruiz JA, García-Cerezo A. The Internet of Cooperative Agents Architecture (X-IoCA) for Robots, Hybrid Sensor Networks, and MEC Centers in Complex Environments: A Search and Rescue Case Study. Sensors (Basel) 2021; 21:s21237843. [PMID: 34883848 PMCID: PMC8659820 DOI: 10.3390/s21237843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/21/2021] [Indexed: 11/26/2022]
Abstract
Cloud robotics and advanced communications can foster a step-change in cooperative robots and hybrid wireless sensor networks (H-WSN) for demanding environments (e.g., disaster response, mining, demolition, and nuclear sites) by enabling the timely sharing of data and computational resources between robot and human teams. However, the operational complexity of such multi-agent systems requires defining effective architectures, coping with implementation details, and testing in realistic deployments. This article proposes X-IoCA, an Internet of robotic things (IoRT) and communication architecture consisting of a hybrid and heterogeneous network of wireless transceivers (H2WTN), based on LoRa and BLE technologies, and a robot operating system (ROS) network. The IoRT is connected to a feedback information system (FIS) distributed among multi-access edge computing (MEC) centers. Furthermore, we present SAR-IoCA, an implementation of the architecture for search and rescue (SAR) integrated into a 5G network. The FIS for this application consists of an SAR-FIS (including a path planner for UGVs considering risks detected by a LoRa H-WSN) and an ROS-FIS (for real-time monitoring and processing of information published throughout the ROS network). Moreover, we discuss lessons learned from using SAR-IoCA in a realistic exercise where three UGVs, a UAV, and responders collaborated to rescue victims from a tunnel accessible through rough terrain.
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Lu ZN, Briggs A, Saadat S, Algaze IM. The Associations Between Visitation, Social Media Use, and Search and Rescue in United States National Parks. Wilderness Environ Med 2021; 32:463-467. [PMID: 34629292 DOI: 10.1016/j.wem.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Search and rescue (SAR) is vital for visitor safety in US national parks, which are popular destinations for tourists. Previous studies have described SAR and seasonal visitation patterns, but not in the context of overall visitation. In addition, studies on the association between SAR and developed park areas remain limited. Concurrently, social media can be valuable for sharing information about conservation awareness and the joy of being outdoors. However, social media can potentially be an avenue for users to share risky and dangerous behaviors performed during attempts to obtain photos and videos. The associations between SAR and social media have not been discussed in existing literature. METHODS Variables included recreational visits, developed site stay visits, backcountry visits, SAR incidents, and tweets. Data from 2017 were obtained from National Park Service visitor use statistics, the SAR incident dashboard, and the University of California, Irvine, Cloudberry application. Correlation analysis was performed using nonparametric Kendall rank correlation coefficients. RESULTS Recreational visits were correlated with SAR incidents (rτ=0.415, P<0.001). Developed site stays were similarly correlated with SAR incidents (rτ=0.447, P<0.001), as were backcountry visits (rτ=0.428, P<0.001). Backcountry visits had a stronger correlation with fatalities (rτ=0.380, P<0.001) compared to developed site stays (rτ=0.304, P<0.001). Tweets were correlated with SAR incidents (rτ=0.468, P<0.001), recreational visits (rτ=0.403, P<0.001), and fatalities (rτ=0.367, P<0.001). CONCLUSIONS Our findings demonstrate associations between national park visitation, SAR incidents, fatalities, and Twitter use and provides a concept framework for future prospective studies to further investigate the relationships between visitation, SAR, and social media.
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Affiliation(s)
- Zachary N Lu
- Department of Emergency Medicine, University of California, Irvine, Irvine, California.
| | - Amy Briggs
- Department of Emergency Medicine, University of California, Irvine, Irvine, California
| | - Soheil Saadat
- Department of Emergency Medicine, University of California, Irvine, Irvine, California
| | - Isabel M Algaze
- Department of Emergency Medicine, University of California, Irvine, Irvine, California
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Lukesova G, Voslarova E, Vecerek V. Juvenile European hedgehogs (Erinaceus europaeus) at rescue centers and their release rate depending on their weight on admission. PLoS One 2021; 16:e0258273. [PMID: 34618876 PMCID: PMC8496866 DOI: 10.1371/journal.pone.0258273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022] Open
Abstract
This study aimed to assess the numbers of juvenile European hedgehogs admitted to rescue centers in the Czech Republic from the viewpoint of their weight on admission, the reason for their admission, and the success rate of their release back into the wild. The results of our study show varying levels of success in the rearing of hedgehogs admitted at different ages (weights) and a varying period required for their rehabilitation. The greatest chance of release was seen in hedgehogs with a weight on the admission of 500-599 g (64.22% released) and 400-499 g (63.31% released). In contrast, the smallest number of young hedgehogs successfully rehabilitated and released was seen in hoglets weighing 200-299 g (35.24% released) on admission, which corresponds to the weight of hedgehogs at the time of weaning. Time spent at a rescue center may pose an undesirable threat to the lives of animals in some categories. Hedgehogs weighing up to 99 g on admission spent the longest period time at rescue centers (a median of 48 days), while hedgehogs weighing 500-599 g on admission spent the shortest time (a median of 7 days). The majority of hedgehogs in the lowest weight categories were admitted due to their inability to survive on their own. A large percentage of hedgehogs of greater weight, in contrast, were juvenile hedgehogs brought to rescue centers needlessly. The percentage of released animals did not exceed 65%, however, even for entirely independent categories of older juveniles. From this perspective, the fact that hedgehogs are often brought to rescue centers in the belief that they are not self-sufficient young, though they are actually juvenile or even adult individuals that do not require human care, can be considered a significant finding.
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Affiliation(s)
- Gabriela Lukesova
- Faculty of Veterinary Hygiene and Ecology, Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czech Republic
| | - Eva Voslarova
- Faculty of Veterinary Hygiene and Ecology, Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czech Republic
| | - Vladimir Vecerek
- Faculty of Veterinary Hygiene and Ecology, Department of Animal Protection and Welfare and Veterinary Public Health, University of Veterinary Sciences Brno, Brno, Czech Republic
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Goldfarb DG, Colbeth HL, Skerker M, Webber MP, Prezant DJ, Dasaro CR, Todd AC, Kristjansson D, Li J, Brackbill RM, Farfel MR, Cone JE, Yung J, Kahn AR, Qiao B, Schymura MJ, Boffetta P, Hall CB, Zeig-Owens R. Impact of healthcare services on thyroid cancer incidence among World Trade Center-exposed rescue and recovery workers. Am J Ind Med 2021; 64:861-872. [PMID: 34275137 PMCID: PMC8796202 DOI: 10.1002/ajim.23277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND A recent study of World Trade Center (WTC)-exposed firefighters and emergency medical service workers demonstrated that elevated thyroid cancer incidence may be attributable to frequent medical testing, resulting in the identification of asymptomatic tumors. We expand on that study by comparing the incidence of thyroid cancer among three groups: WTC-exposed rescue/recovery workers enrolled in a New York State (NYS) WTC-medical monitoring and treatment program (MMTP); WTC-exposed rescue/recovery workers not enrolled in an MMTP (non-MMTP); and the NYS population. METHODS Person-time began on 9/12/2001 or at enrollment in a WTC cohort and ended at death or on 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. We used Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for MMTP and non-MMTP participants. NYS rates were used as the reference. To estimate potential changes over time in WTC-associated risk, change points in RRs were estimated using profile likelihood. RESULTS The thyroid cancer incidence rate among MMTP participants was more than twice that of NYS population rates (RR = 2.31; 95% CI = 2.00-2.68). Non-MMTP participants had a risk similar to NYS (RR = 0.96; 95% CI = 0.72-1.28). We observed no change points in the follow-up period. CONCLUSION Our findings support the hypothesis that no-cost screening (a benefit provided by WTC-MMTPs) is associated with elevated identification of thyroid cancer. Given the high survival rate for thyroid cancer, it is important to weigh the costs and benefits of treatment, as many of these cancers were asymptomatic and may have been detected incidentally.
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Affiliation(s)
- David G. Goldfarb
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA
- Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, New York, USA
- Department of Environmental, Occupational and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Hilary L. Colbeth
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA
- Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, New York, USA
| | - Molly Skerker
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA
- Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, New York, USA
| | - Mayris P. Webber
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David J. Prezant
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA
- Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Christopher R. Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew C. Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dana Kristjansson
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
- Center of Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jiehui Li
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, New York, USA
| | - Robert M. Brackbill
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, New York, USA
| | - Mark R. Farfel
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, New York, USA
| | - James E. Cone
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, New York, USA
| | - Janette Yung
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, New York, USA
| | - Amy R. Kahn
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - Baozhen Qiao
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - Maria J. Schymura
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B. Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rachel Zeig-Owens
- Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA
- Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
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Aranda-García S, Herrera-Pedroviejo E. Quick Rescue self-inflating flotation device for rescuing sea swimmers in distress versus conventional tube or buoy rescues. Emergencias 2021; 32:105-110. [PMID: 32125109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To compare the efficacy of the new self-inflatable Quick Rescue (QR) flotation device to conventional tube and buoy devices. To compare lifeguard fatigue after rescues with different flotation devices. MATERIAL AND METHODS Forty lifeguards participated in this quasi-experimental field study. Each performed simulated rescues of sea swimmers in distress under 4 conditions (no device, the QR device, a tube, and a buoy) assigned in random order. The swimmer in distress was located at a distance of 100 m. Ambient conditions, victim type, and beach were standardized. Participants underwent training to use the inflatable QR float and all other devices. Expertise was defined as a score of at least 3 on a Likert scale of 1 to 5. We recorded rescue times (total, and approaching, securing and towing back the distressed swimmer) as well as the lifeguards' perceptions of effort (overall and for each stage). RESULTS Most rescue times did not differ between conditions, with the exception of time needed to secure the victim, which was shorter by 3 seconds when no device was used (P<.05). The rescuers did not perceive differences between devices in overall effort or effort during any of the phases. CONCLUSION The new self-inflating QR device is as useful as other flotation devices in terms of rescue times and effort expended by lifeguards. We can therefore recommend its use for rescuing sea swimmers in distress.
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Affiliation(s)
- Silvia Aranda-García
- Grupo de Investigación en Actividad Física y Salud (GRAFIS), INEFC-Barcelona, España. Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, España
| | - Ernesto Herrera-Pedroviejo
- Grupo de Investigación GRFBE, UIC-Sant Cugat del Vallès, España. Universitat Internacional de Catalunya, Sant Cugat del Vallès, España. Facultad de Ciencias de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, España
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Kottmann A, Pasquier M, Strapazzon G, Zafren K, Ellerton J, Paal P. Quality Indicators for Avalanche Victim Management and Rescue. Int J Environ Res Public Health 2021; 18:ijerph18189570. [PMID: 34574495 PMCID: PMC8464975 DOI: 10.3390/ijerph18189570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/29/2022]
Abstract
Decisions in the management and rescue of avalanche victims are complex and must be made in difficult, sometimes dangerous, environments. Our goal was to identify indicators for quality measurement in the management and rescue of avalanche victims. The International Commission for Mountain Emergency Medicine (ICAR MedCom) convened a group of internal and external experts. We used brainstorming and a five-round modified nominal group technique to identify the most relevant quality indicators (QIs) according to the National Quality Forum Measure Evaluation Criteria. Using a consensus process, we identified a set of 23 QIs to measure the quality of the management and rescue of avalanche victims. These QIs may be a valuable tool for continuous quality improvement. They allow objective feedback to rescuers regarding clinical performance and identify areas that should be the foci of further quality improvement efforts in avalanche rescue.
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Affiliation(s)
- Alexandre Kottmann
- Rega—Swiss Air Ambulance, Zürich Airport, 8058 Zürich, Switzerland
- Emergency Department, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Correspondence:
| | - Mathieu Pasquier
- Emergency Department, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
| | - Giacomo Strapazzon
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
- CNSAS—Corpo Nazionale Soccorso Alpino e Speleologico, National Medical School, 20124 Milano, Italy
| | - Ken Zafren
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Alaska Native Medical Center, Department of Emergency Medicine, 4300 Diplomacy Drive, Anchorage, AK 99508, USA
- Stanford University Medical Center, Department of Emergency Medicine, 900 Welch Road, Palo Alto, CA 94304, USA
| | - John Ellerton
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
| | - Peter Paal
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Kajetanerplatz 1, 5020 Salzburg, Austria
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van Veelen MJ, Voegele A, Rauch S, Kaufmann M, Brugger H, Strapazzon G. COVID-19 Pandemic in Mountainous Areas: Impact, Mitigation Strategies, and New Technologies in Search and Rescue Operations. High Alt Med Biol 2021; 22:335-341. [PMID: 34319777 PMCID: PMC8558066 DOI: 10.1089/ham.2020.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/29/2021] [Indexed: 12/03/2022] Open
Abstract
van Veelen, Michiel J., Anna Voegele, Simon Rauch, Marc Kaufmann, Hermann Brugger, and Giacomo Strapazzon. COVID-19 pandemic in mountainous areas: impact, mitigation strategies, and new technologies in search and rescue operations. High Alt Med Biol. 22:335-341, 2021.-Mitigating the spread of COVID-19, an airborne infection, can lead to delays in the prehospital response and impair the performance of search and rescue (SAR) services in mountainous and remote areas. We provide an overview of the developing epidemiological situation related to the COVID-19 pandemic in mountainous areas and review current protocols to determine their suitability for mountain rescue teams. We also discuss using novel technologies to reduce the adverse effects caused by COVID-19 mitigation strategies such as delays caused by donning personal protective equipment (PPE) and reduced rescuer performance due to impaired movement and ventilation. COVID-19 has spread even in mountainous and remote locations. Dedicated protocols for the use of PPE appropriate for SAR rescuers exerting physical effort in remote areas and using technologies such as drones, telemedicine, and localization and contact tracing applications could contribute to an effective and timely emergency response in mountainous and remote settings.
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Affiliation(s)
- Michiel J. van Veelen
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
| | - Anna Voegele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesia and Intensive Care, “F. Tappeiner” Hospital, Merano, Italy
| | - Marc Kaufmann
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
- Emergency Medical Services 112, Health Care System Alto Adige, Bolzano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
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Huang YD, Wang T, Sun Y. [Progress of traumatic stress disorder in emergency rescue workers]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:631-634. [PMID: 34488280 DOI: 10.3760/cma.j.cn121094-20200601-00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Emergency rescue workers are the high risk group of traumatic stress disorder. A large number of intervention studies on traumatic stress disorder have been carried out at home and abroad, but there are few applied researches on the emergency rescue population. As an occupational hazard faced by the emergency rescue population, traumatic stress disorder has not attracted enough attention. In this paper, the psychological intervention, drug intervention, psychological training and social support were reviewed.
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Affiliation(s)
- Y D Huang
- Beijing Institute of Cabor protection science, Beijing 100054, China
| | - T Wang
- Beijing Institute of Cabor protection science, Beijing 100054, China
| | - Y Sun
- Beijing Institute of Cabor protection science, Beijing 100054, China
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45
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Zeig-Owens R, Singh A, Triplett S, Salako J, Skerker M, Napier A, Peele E, Stanley M, Sattaluri S, Prezant D, Webber MP. Assembling the Career Firefighter Health Study cohort: A methods overview. Am J Ind Med 2021; 64:680-687. [PMID: 34114224 DOI: 10.1002/ajim.23266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Studies of World Trade Center (WTC)-exposed rescue/recovery workers report the increased occurrence of health conditions after work at the WTC disaster site. However, the extent to which these associations are due to WTC exposure is unclear, in part due to the lack of suitable comparison groups. Accordingly, we identified a previously assembled National Institute for Occupational Safety and Health (NIOSH) cohort of career firefighters from three US cities (n = 29,992). Here, we document the challenges in establishing this non-WTC-exposed firefighter cohort for the goal of tracking and comparing cancer and chronic health conditions in WTC-exposed and non-WTC-exposed firefighters. METHODS Follow-up process included institutional review board applications, data use agreements, state cancer registry linkages and vital status determination for the NIOSH firefighter cohort. After completion of these steps, we undertook outreach to the three original city fire departments and union officials, before contact tracing and direct recruitment of 14,566 living firefighters to complete a confidential health survey. We staggered recruitment efforts by the city, using letters, postcards, emails, videos, and telephone outreach. Participants who completed the survey received $10. RESULTS A total of 4962 of 14,566 alive firefighters responded to the baseline survey (34.1% response rate). Respondents were older and more likely to be non-Hispanic white than nonrespondents. CONCLUSIONS We provide an overview of the process for the first survey to collect information on physical and mental health conditions among US firefighters. The data collected will have an important impact on studies of WTC rescue/recovery work, firefighting, and related health conditions.
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Affiliation(s)
- Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ankura Singh
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Suzanne Triplett
- Survey Research Division, RTI International, Research Triangle Park, North Carolina, USA
| | - Joke Salako
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Molly Skerker
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Ariana Napier
- Survey Research Division, RTI International, Research Triangle Park, North Carolina, USA
| | - Eric Peele
- Survey Research Division, RTI International, Research Triangle Park, North Carolina, USA
| | - Marshica Stanley
- Survey Research Division, RTI International, Research Triangle Park, North Carolina, USA
| | - Sridevi Sattaluri
- Survey Research Division, RTI International, Research Triangle Park, North Carolina, USA
| | - David Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mayris P Webber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
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Christensen RE, Ottosen CI, Sonne A, Noernberg B, Juul AH, Steinmetz J, Rasmussen LS. Search and Rescue Helicopters for Emergency Medical Service Assistance: A Retrospective Study. Air Med J 2021; 40:269-273. [PMID: 34172236 DOI: 10.1016/j.amj.2021.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/28/2021] [Accepted: 03/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The time until treatment is a crucial factor for the outcome after medical emergencies. One way of reducing transportation time is the use of helicopter-based emergency medical services, but poor weather conditions, commitment to another mission, or technical problems may limit the availability. In these cases, military search and rescue (SAR) helicopters can be used. The aim of this study was to investigate the role of SAR helicopters in the civilian emergency medical system. METHODS We conducted a retrospective study of SAR mission reports and SAR medical records collected from the archives of the Royal Danish Air Force for the years 2016 and 2017. RESULTS A total of 1,262 mission reports were included with a total of 628 medical records available in the study period. There were 490 of 1,246 (39.3%) missions involving patients. Interhospital transfers accounted for 306 of 604 (50.7%) of cases, whereas island evacuation constituted 110 of 604 (18.2%) cases. The most prevalent suspected diagnosis was acute coronary syndrome (14.4%). The 30-day survival rate was 87.6%. CONCLUSION The military SAR helicopters were most commonly activated for civilian emergency medical service mission assistance due to poor weather conditions. The most frequent medical condition was acute coronary syndrome.
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Affiliation(s)
- Rasmus Ejlersgaard Christensen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Camilla Ikast Ottosen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Asger Sonne
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bo Noernberg
- Danish Defence Medical Command, Helicopter Wing Karup, Karup, Denmark
| | - Anders Hagen Juul
- Danish Defence Medical Command, Helicopter Wing Karup, Karup, Denmark
| | - Jacob Steinmetz
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars S Rasmussen
- Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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47
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Guénot P, Coudreuse M, Lely L, Granger-Veyron N. Helicopter Rescue Missions for Emergency Medical Aid at Sea: A New Assignment for the French Military Medical Service? Air Med J 2021; 40:225-231. [PMID: 34172229 DOI: 10.1016/j.amj.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/10/2021] [Accepted: 03/30/2021] [Indexed: 06/13/2023]
Abstract
Historically in charge of the search and rescue of aircraft in distress alongside military aeronautical crews, the doctors and nurses of the French Military Medical Service (FMMS) also participate in helicopter rescue missions for emergency medical aid at sea off the French metropolitan coast. This public service mission is placed at the heart of force medicine because it can be transposed to external theaters of operations (OPEX). Recent changes in the regulation of medical aid at sea, in particular the creation in 2013 of maritime emergency mobile resuscitation services, initially weakened the role of the teams of the FMMS. However, their 2018 and 2019 activity report reflects the persistence of strong involvement. The "FMMS 2020" model, especially through its "openness" aspect, allows the FMMS the optimal conditions to maintain its position as a key player in this field, particularly through the development of institutional partnerships with the public health service. Associated with their mastery of the air-maritime environment, strengthening the skills in emergency medicine of the military medical teams in charge of this mission appears to be 1 of the main measures ensuring the achievement of this objective and a high quality of care for patients.
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Affiliation(s)
- Pierre Guénot
- French Military Medical Service, Air Force Medical Center, Reunion Island, France.
| | - Matthieu Coudreuse
- Basque Coast Hospital, Maritime Medical Emergency Co-ordination Service, Bayonne, France
| | - Laurent Lely
- French Military Medical Service, 7th Special forces Medical Service, Lanester, France
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Sheets A. Book Review of Mountain Emergency Medicine (1st Edition) by Hermann Brugger, Ken Zafren, Luigi Festi, Peter Paal, and Giacomo Strappazon. High Alt Med Biol 2021; 22:243. [PMID: 34166104 DOI: 10.1089/ham.2021.29023.she] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Roy S, Soteras I, Sheets A, Price R, Oshiro K, Rauch S, McPhalen D, Nerin MA, Strapazzon G, Allen M, Read A, Paal P. Guidelines for Mountain Rescue During the COVID-19 Pandemic: Official Guidelines of the International Commission for Alpine Rescue. High Alt Med Biol 2021; 22:128-141. [PMID: 34166103 PMCID: PMC8252899 DOI: 10.1089/ham.2021.0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/13/2021] [Indexed: 01/10/2023] Open
Abstract
Roy, Steven, Inigo Soteras, Alison Sheets, Richard Price, Kazue Oshiro, Simon Rauch, Don McPhalen, Maria Antonia Nerin, Giacomo Strapazzon, Myron Allen, Alistair Read, and Peter Paal. Guidelines for mountain rescue during the COVID-19 pandemic: official guidelines of the International Commission for Alpine Rescue. High Alt Med Biol. 22: 128-141, 2021. Background: In mountain rescue, uncertainty exists on the best practice to prevent coronavirus disease 2019 (COVID-19) transmission. The aim of this work was to provide a state-of-the-art overview of the challenges caused by the COVID-19 pandemic in mountain rescue. Methods: Original articles or reviews, published until December 27, 2020 in Cochrane COVID-19 Study Register, EMBASE, PubMed, and Google Scholar were included. Articles were limited to English, French, German, or Spanish with the article topic COVID-19 or other epidemics, addressing transmission, transport, rescue, or cardiopulmonary resuscitation. Results: The literature search yielded 6,190 articles. A total of 952 were duplicates and 5,238 were unique results. After exclusion of duplicates and studies that were not relevant to this work, 249 articles were considered for this work. Finally, 72 articles and other sources were included. Conclusions: Recommendations are provided for protection of the rescuer (including screening, personal protective equipment [PPE], and vaccination), protection of the patient (including general masking if low risk, specific PPE if high risk), equipment hygiene (including disinfection after every mission), use of single-use products, training and medical measures under COVID-19 precautions, and psychological wellbeing of rescuers during the COVID-19 pandemic. Adapted COVID-19 precautions for low-and-medium-income countries are also discussed.
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Affiliation(s)
- Steven Roy
- Department of Critical Care Medicine, University of Calgary, Calgary, Canada
- International Society for Mountain Medicine, Bern, Switzerland
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
| | - Inigo Soteras
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Emergency Medical System, University of Girona, Catalonia, Spain
| | - Alison Sheets
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Emergency Medicine, Boulder Community Health, Boulder, Colorado, USA
- School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Richard Price
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- LandSAR, Christchurch, New Zealand
| | - Kazue Oshiro
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Mountain Medicine, Research, and Survey Division, Department of Cardiovascular Medicine, Hokkaido Ohno Memorial Hospital, Sapporo, Japan
| | - Simon Rauch
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, F. Tappeiner Hospital, Merano, Italy
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Don McPhalen
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Department of Surgery, University of Calgary, Calgary, Canada
| | - Maria Antonia Nerin
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Jose Ramon Morandeira Mountain Medicine Association-CUEMUM, Chía, Spain
| | - Giacomo Strapazzon
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Corpo Nazionale Soccorso Alpino e Speleologico, National Medical School (CNSAS SNaMed), Milan, Italy
| | - Myron Allen
- National Ski Patrol, Lakewood, Colorado, USA
- Terrestrial Commission of the International Commission for Alpine Rescue (ICAR), Zurich, Switzerland
| | - Alistair Read
- Terrestrial Commission of the International Commission for Alpine Rescue (ICAR), Zurich, Switzerland
- Mountain Rescue, England and Wales, Tamworth, United Kingdom
| | - Peter Paal
- Medical Commission of the International Commission for Alpine Rescue (ICAR MEDCOM), Zurich, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria
- Austrian Board for Mountain Safety, Innsbruck, Austria
- Austrian Society of Mountain and High Altitude Medicine, Mieming, Austria
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Meadley B, Bowles KA, Smith K, Perraton L, Caldwell J. Defining the characteristics of physically demanding winch rescue in helicopter search and rescue operations. Appl Ergon 2021; 93:103375. [PMID: 33540207 DOI: 10.1016/j.apergo.2021.103375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
Helicopter emergency medical service search and rescue (HEMS SAR) paramedics perform physically demanding winch rescues. Rescue organisations require valid physical employment standards (PES) to ensure personnel can adequately perform duties. There are no studies describing validated PES for HEMS SAR. We convened a subject matter expert (SME) focus group to review historical case data and generate task descriptions for land and water winch rescue as the basis for development of task simulations to assess physiological workload. Sixteen helicopter rescue paramedics with a mean age of 47 (range, 36-52) years and 8 (2-20) years' experience in helicopter rescue participated in a SME focus group. When provided with data from historical cases, SMEs achieved consensus (≥80%) when generating descriptions of winch rescue. This method may be useful to develop simulations for assessment of physiological demands of winch rescue and similar tasks, and to enhance validity and reliability of PES for rescue organisations.
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Affiliation(s)
- Ben Meadley
- Monash University, Paramedic Health and Wellbeing Research Unit, McMahons Rd, Frankston, 3199, Australia; Monash University, Department of Paramedicine, McMahons Rd, Frankston, VIC, 3199, Australia; Ambulance Victoria, PO Box 2000, Doncaster, VIC, 3108, Australia.
| | - Kelly-Ann Bowles
- Monash University, Paramedic Health and Wellbeing Research Unit, McMahons Rd, Frankston, 3199, Australia; Monash University, Department of Paramedicine, McMahons Rd, Frankston, VIC, 3199, Australia
| | - Karen Smith
- Monash University, Paramedic Health and Wellbeing Research Unit, McMahons Rd, Frankston, 3199, Australia; Monash University, Department of Paramedicine, McMahons Rd, Frankston, VIC, 3199, Australia; Ambulance Victoria, PO Box 2000, Doncaster, VIC, 3108, Australia
| | - Luke Perraton
- Monash University, Paramedic Health and Wellbeing Research Unit, McMahons Rd, Frankston, 3199, Australia; Monash University, Department of Physiotherapy, McMahons Rd, Frankston, VIC, 3199, Australia
| | - Joanne Caldwell
- Monash University, Paramedic Health and Wellbeing Research Unit, McMahons Rd, Frankston, 3199, Australia; Monash University, Department of Physiology, Wellington Rd, Clayton, VIC, 3800, Australia
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