A dynamic logistics coordination model for evacuation and support in disaster response activities

BackgroundBefore patients are admitted into the emergency department, it is important to undertake a pre-hospital process, both in terms of treatment performance and a request for resources from an emergency unit. The existing system to triage patients in Thailand is not functioning to its full capacity in either the primary medical system or pre-hospital treatment with shortcomings in the areas of speed, features, and appropriate systems. There is a high possibility of issuing a false Initial Dispatch Code (IDC), which will cause the over or underutilisation of emergency resources, such as rescue teams, community hospitals and emergency medical volunteers.MethodsA usability system design, together with a reliability test, was applied to develop an application to optimise the pre-hospital process, specifically to sort patients, using an IDC to improve the request for emergency resources. The triage mobile application was developed on both iOS and Android operating systems to support patient triage based on Criteria Based Dispatch (CBD). The 25 main symptom categories covered by CBD were used to design and develop the application, and 12 emergency medical staff, including doctors and nurses, were asked to test the system in the aspects of triage protocol correction, triage reliability, usability and user satisfaction.ResultsThe results of testing the proposed triage application were compared with the time used to triage by experienced staff and it was found that, in non-trauma cases, it was faster and more effective to use the application for emergency operations and to correct the IDC code representation.ConclusionsThe triage application will be utilised to support the pre-hospital process and to classify patients’ conditions before they are admitted to the Emergency Department (ED). The application is suitable for users who are not medical emergency staff. Patients with non-trauma symptoms may be a suitable group to use the application in terms of time used to identify IDC for their own symptoms. The use of the application can be beneficial for those who wish to self-identify their symptoms before requesting medical services.

Objective To explore the quality management of critical patients in the process of medical helicopter rescue and transshipment. Methods After receiving the rescue and transshipment task for 10 critically ill patients, the Emergency Department quickly established the rescue quality management team under the direction of the dean: with helicopter on-site rescue and transshipment team, in-hospital pick-up and transshipment team, logistic support team and coordination command group; full medical security assessment: to prepare all emergency supplies, drugs, instruments and equipment in a predictable manner, and all within the effective period, completed. The success rate is 100%. The formulation of rescue plan: formulating individualized emergency plan, pre-examination and triage evaluation plan, transporting and implementing process plan; unblocked green channel: setting up rescue room as rescue preparation area; radiology department, laboratory department, pharmacy, B-ultrasound room, electrocardiogram room, emergency transfer elevator, medical housekeeper and other departments ensure the green channel unblocked, safety logistic support team dedicated personnel management. To manage the area from apron to emergency hall and rescue room, smooth transit routes, and prepare for emergency treatment in emergency intensive care unit and specialized intensive care unit. Specialized organizations are responsible for: Department directors, head nurses and quality control team leaders to organize and coordinate quality management work. Results All 10 critically ill patients were safely and smoothly transported to hospital for emergency treatment without any adverse events. Six patients received emergency intensive care, three orthopaedic care, one hand-foot surgery care, and 10 critically ill patients were discharged from hospital in time and safely through various specialties. Conclusion The successful rescue and safe transshipment of 10 critically ill patients reflects the good beginning of the development of medical helicopter rescue in our province, and forms a complete, organized, targeted, planned and implemented team rescue system, which greatly improves the quality management level of medical helicopter rescue and transshipment. Key words: Helicopter rescue transfer; Quality management

On 21 June 2005, a passenger train collided with a truck near Revadim, Israel. The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report. A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted. The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision. Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The air-medical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time. Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region. This operation highlighted the necessity for flexibility in medical decision-making and the need for nonconventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.

The main objective of our project is to provide an optimum solution to the traffic hazards and the road accidents. According to this project when a vehicle meets with an accident, immediately vibration sensor will detect the signal and sends it to Arduino. Arduino sends the alert message through the GSM MODEM including the location to police control room or a rescue team. So the police can immediately trace the location through the GPS MODEM after receiving the information. This system is based on new technology, its main purpose is to detect an accident and alert the nearby hospitals with message over GSM, so the victim can find some help. It can detect accidents the intensity of the accident without any visual contact from control room. If this system is inserted in every vehicle then it is easy to understand how many vehicles are involved in a particular accident and how intense is it. The present board designed has both vehicle tracking and accident alert systems, which make it more valuable and useful. This board alerts us from theft and as well as accident detection. It also detects fire accidents by placing fire detector in one of the interrupt pins.

In the recent years, hundreds to thousands of people have been killed in many calamities across Asian region, such as tsunami, floods, earthquake and so on. These natural disasters have become great challenges, particularly to those developing countries as many are lacking of an efficient disaster management system and disaster recovery plan that will help in times of need. Among the common challenges in managing emergency relief response is the coordination of logistics distribution on the field. Often there is hoarding of assistance from a number of institutions at a particular location or village but not well distributed to other areas, thus led to waste and inefficiencies. As a result, many of the aids supplied could not reach its intended target. Therefore, it is the aim of this study to propose a coordination framework for logistics distribution in disaster management, and to overcome communication problems among and between rescue, volunteers and humanitarian teams, particularly in logistics distribution. The proposed framework will be implemented in the form of a prototype for mobile application.

INTRODUCTION: Head injuries in children pose a serious challenge both in terms of the management and di- agnostics. Due to technological progress and thus the development of motorization, despite the decreasing overall injury rate, the incidence of high-energy injuries increases. The aim of the study was to assess the frequency of intervention of emergency medical teams to paediatric patients due to head injuries. METHODS: The study was a retrospective study. The material consisted of medical interventions of medical rescue teams from the regions of Piaseczno and Pruszków from the period 11.2016–10.2017. 422 medical emergency records were analyzed. RESULTS: Median age of study group was 7.7 years (IQR; 3–12) — females 7.6 years (IQR; 2–13) and males 7.9 years (IQR; 4–12). The injuries occurred most frequently in March (n = 43; 11.8%), and least frequently in February (n = 22; 5.2%). The above relation occurred regardless of gender. Injuries occur most frequently in spring (n = 132; 31.3%), and least frequently in summer (n=88; 20.8%; Tab. 1). In the afternoon an increase in the incidence of injuries was observed. Differences in the incidence of injuries in the group of males and females depending on the time of day were not significantly statistical (p = 0.206). Superficial head injury was the most common injury (n = 122; 28.9%) followed by open head wounds in both males and females. CONCLUSIONS: The most frequent head injuries were superficial head injuries followed by open head inju- ries. Injuries occurred more often on weekdays, less frequently at weekends. In the afternoon an increase in the incidence of injuries was observed. Injuries occur most frequently in spring and least frequently in summer on a monthly basis they occurred most frequently in March, and least frequently in February re- gardless of gender.