Emergency Care and Interventions for Construction Site Injuries: A Literature Review.

Wilderness First Responder: Are Skills Soon Forgotten?

- Construction Safety is an essential talk topic all over the world especially in countries like Nepal where the construction sector is a major contributor to the economy. Nepal is a developing country. The growth is driven by urbanization to a large degree. We are constructing buildings and all other infrastructures to satisfy the needs of the people who live in the city (water supply, power supply). The rate of construction of infrastructures is increasing. In Nepal most of the projects are labor intensive. The construction industry involves large skilled and unskilled personnel. Nepal is young in practicing construction and lacks experience. Any construction project has risk of accidents as they are inevitable. The site accidents are the most important factor to be considered for a project to be successful. We do not have the exact accident data recording system here in Nepal. The basic problem in Nepal is negligence towards the constructional safety and lack in use of proper safety equipment’s and tools. In addition to that labors are unskilled, illiterate and untrained. Accidents that result in the loss of life, damage of property and many injuries during construction are the major challenges of construction field. The major causes of accident in construction industries are physical, physiological, psychological and mental. One of the main causes of accidents is the unsafe working conditions. Also due to low level of awareness towards safety and importance of human values, development of effective safety management system etc. is the major problem of safety at construction sites in Nepal. Key Words: Construction Safety, Nepal, Safety Practices, Construction Industry, Workplace Safety, Safety Challenges, Safety Training Programs, Regulatory Frameworks, Safety Culture, Construction Accidents

The radiological management of bomb blast injury

Structural Allograft Implantation for Thoracic Spinal Impalement

Background: Postpartum mothers often face problems such as perineal wounds, surgery, and conditions that need to be watched out for. Lack of knowledge about wound care and emergency risks can lead to serious complications that affect maternal health and infant care. Health cadres have an important role in disseminating health information, but are often under-trained in providing appropriate education and support to postpartum mothers. This hinders the dissemination of accurate information, which can lead to inappropriate wound and emergency care, risking postpartum hemorrhage, infection, and embolism. Purpose: To improve the knowledge and skills of health cadres (Posyandu cadres) in providing education on wound care and emergency care for postpartum mothers to reduce the risk of complications. Method: The activity was carried out on November 15, 2024 in Cileunyi Wetan Village, Bandung Regency, attended by 32 cadres. The methods used included lectures, questions and answers, and demonstrations with ppt, leaflet, and video media. Results: Shows that the majority of cadres, 84.4%, managed to achieve a good category after participating in education. The increase from 59.4% before education to 84.4% after receiving education reflects the success of the program in improving cadre competence, educational activities ran smoothly, effectively and conducively. Participants were able to answer questions correctly. It is hoped that cadres who have participated in this activity can pass on information to the wider community, especially postpartum mothers. Conclusion: Community service activities by providing direct education are very effective and have a significant influence on increasing the knowledge, abilities, skills, and self-confidence of posyandu cadre mothers regarding wound care and emergency handling for postpartum mothers. Keywords: Emergency; Health education; Postpartum mothers; Wound care Pendahuluan: Ibu pasca melahirkan sering menghadapi masalah seperti luka perineum, bedah, dan kondisi yang perlu diwaspadai. Kurangnya pengetahuan tentang perawatan luka dan risiko kegawatdaruratan dapat mengakibatkan komplikasi serius yang mempengaruhi kesehatan ibu dan perawatan bayi. Kader kesehatan memiliki peran penting dalam menyebarkan informasi kesehatan, namun seringkali kurang terlatih dalam memberikan edukasi dan dukungan yang tepat kepada ibu pasca melahirkan. Hal ini menghambat penyebaran informasi akurat, yang dapat menyebabkan penanganan luka dan kegawatdaruratan yang kurang tepat, berisiko menimbulkan perdarahan postpartum, infeksi, dan emboli. Tujuan: Untuk meningkatkan pengetahuan dan keterampilan kader kesehatan (kader Posyandu) dalam memberikan edukasi perawatan luka dan penanganan kegawatdaruratan pada ibu pasca melahirkan untuk mengurangi resiko komplikasi. Metode: Kegiatan dilaksanakan pada 15 November 2024 di Desa Cileunyi Wetan, Kabupaten Bandung, dihadiri oleh 32 kader. Metode yang digunakan meliputi ceramah, tanya jawab, dan demonstrasi dengan media ppt, leaflet, dan video. Hasil: Menunjukkan mayoritas kader sebesar 84.4% berhasil mencapai kategori baik setelah mengikuti edukasi. Peningkatan dari sebesar 59.4%% pada sebelum edukasi menjadi sebesar 84.4% pada sesudah mendapatkan edukasi mencerminkan keberhasilan program dalam meningkatkan kompetensi kader, kegiatan edukasi berjalan lancar, efektif dan kondusif. Peserta dapat menjawab pertanyaan dengan benar. Diharapkan kader yang telah mengikuti kegiatan ini dapat meneruskan informasi kepada masyarakat luas, khususnya ibu pasca melahirkan. Simpulan: Kegiatan pengabdian masyarakat dengan pemberian edukasi langsung sangat efektif dan memiliki pengaruh yang signifikan terhadap peningkatan pengetahuan, kemampuan, keterampilan, dan kepercayaan diri ibu kader posyandu mengenai perawatan luka dan penanganan kegawatdaruratan pada ibu pasca melahirkan.

Objective To study the method of improve the first aid skills and level of emergency medical personnel.Methods The training of emergency theory,emergency skill,drill was conducted in 32 medical personnel.Before and after the training,the condition of emergence knowledge,basic skill,comprehensive abilities was compared.Results After the training,the theory knowledge,cardiopulmonary resuscitation,ETC,oropharynx,covering fixation,the use of respirator,electricity defibrillation technique the exam qualified rate of emergency care personnel were significantly improved than that of before training (x2 =7.860,6.335,5.379,9.143,7.819,9.692,8.892,respectively;P ＜0.05).And the basic skill and operation time (4.02±0.76) min and comprehensive ability score (23.15±1.45) were significantly improved than that of before the training (t=-19.60,-18.81,respectively; P＜0.01).Conclusions Medical staff integration training method can shorten the rescue time,improve the efficiency of rescue. Key words: Training on the job; Emergency department; Nurses; First aid skills

Due to the absence of the original building plan, low foreseeability and work environment uncertainty, workers do not have time to read building structure documents and specific work requirements and underestimate the complexity of the work; working for a refurbishment project is not safer than that for a new building. This study reviewed the construction accidents court cases in refurbishment and demolition work in Hong Kong from 1990 to 2019 in the legal databases Westlaw Asia and LexisHK. It found that some victims preferred to take risks, indicating low hazard awareness, while others were ignorant and did not know the causes of the accidents even after their injuries. Furthermore, many employers’ hazard awareness is low because they do not aware of hazardous areas. Some supervisors did not instruct their employees to use the protective equipment even though it is provided. As we may some construction sites have already utilised robots with weak artificial intelligence, this article raised a futuristic question regarding the hazard awareness responsibility of autonomous robots with strong artificial intelligence.

The construction industry is one of the most hazardous industries. Potential hazards are common in construction sites due to the variability and open elevated working environment. Hazard identification, detecting and correcting potential hazards before an accident occurs, is one of practical and effective methods that are commonly adopted. However, hazard identification relies on tacit knowledge that requires sufficient experience. The current training of trainees (e.g., inspectors and students) in general still relies on lectures to provide them with the knowledge on safety management, regulation, and past accidental cases. Such traditional lectures are not effective in nourishing the required identification ability. This research created a 3D digit construction site model, and developed an interactive hazard-identification game that allows trainees to have realistic hands-on identification experience. We also designed an experiment to evaluate the learning effects and satisfactions of the hazard-identification game as compared with the traditional lectures. The results showed that the hazard-identification game was significantly (p <; 0.001) better than the traditional lectures in safety education and training. Also, the students satisfied with the game-based training courses significantly (p <; 0.001) more than the other students satisfied with the traditional courses. Virtual environment provides the feasibility of creating various types of job sites and hazards depending on the training objectives, and allows trainees to learn by experiencing in a safe environment. This research establishes and develops a game-based hazard identification training system, which can improve trainees' learning effectiveness and learning satisfaction. The training system can also improve workers' and site managers' hazard awareness, and help them find hazards in their workplace.

Wilderness Medical Society Practice Guidelines for Spine Immobilization in the Austere Environment

Objective To explore the effects of prehospital-emergency department-intensive care unit (ICU) scene simulation teaching on first-aid thinking skills among nursing students. Methods We selected nursing students from two classes enrolled in 2016, in Suzhou Vocational Health College Nursing School as subjects by convenience sampling. All of the students were divided into experimental group (n=109) and control group (n=99) according to classes. Nursing students of control group adopted the traditional teaching model of case discussion, while nursing students of experimental group were taught with the prehospital-emergency department-ICU scene simulation teaching model. After class, the self-designed first-aid thinking skills questionnaire was used to assess nursing students between two groups. Results After implementation, the first-aid thinking skills of experimental group was better than that of control group with statistical difference (P<0.05) . Conclusions The application of prehospital-emergency department-ICU scene simulation teaching in emergency and critical care nursing education helps to cultivate the first-aid thinking skills for nursing students. Key words: Students, nursing; First-aid thinking skills; Prehospital; Emergency service, hospital; Intensive care units; Simulation

There are very few published studies evaluating the impact of safety and health training on injury outcomes in the construction industry. The aim of this study was to assess the impact of the training program on injury rates at a major railway construction project. The population consisted of 2,795 workers involved in a safety training program at the construction sites of the high-speed railway line Torino-Novara. Two types of analyses were carried out in order to assess the effectiveness of the training program in reducing the number of injuries: (i) a pre-post analysis, which took into account the fact that workers were enrolled at different times and the training intervention did not occur at the same time for all subjects; (ii) an interrupted time-series model, which corrected for the time trend and considered the autocorrelation between individual observations. Twenty-nine percent of workers who spent at least 1 day at the construction sites attended at least one training module. Pre-post analysis: At the end of the training program, the incidence of occupational injuries had fallen by 16% after the basic training module and by 25% following the specific modules. Time-series model: Training led to a 6% reduction in injury rates, which was not statistically significant. The training program that was implemented had a moderately positive impact on the health of workers. Further studies are being conducted to obtain a more complete assessment of the actual effectiveness of the program in reducing the incidence of injuries.

Legislation requires employers to provide health and safety (H&S) training to workers and communicate safety rules, policies and procedures to them in a way they understand. As the construction industry has an increasingly multicultural and multilingual workforce, conventional written and verbal safety communication is of limited effectiveness. CodeSafe Solutions, has developed an innovative method of communicating H&S information to field-based workers using digital media. The potential of the system was explored and two organizations in the Australian construction industry were used. Qualitative data from in-depth interviews of safety managers and workers involved in system implementation and quantitative data such as incident reports and video usage were analysed. Managers perceived the CodeSafe system to be beneficial and well received by workers. In one organization, the introduction of the CodeSafe system coincided with a reduction in injury rates. However, causal inferences about the impact of the system cannot be made. Workers involved in making the films believed films would be an effective communication tool. However, barriers to implementation of the technology include workers’ reluctance to use personal smart phones, limited internet connectivity, and organizational and national regulations on mobile phone use on construction sites.

Allocating Scarce Resources in Disasters: Emergency Department Principles

This is Part II of a 2-part series on wound care and laceration repair for advanced practice nurses. In Part I, the phases and categories of wound healing were outlined. The factors that affected wound healing were also discussed along with an approach for systematic wound management. Patient assessment, special circumstances involving underlying structures, and foreign bodies were also reviewed. Patient preparation, including wound cleansing, irrigation, scrubbing, and debridement were also covered along with anesthetic and analgesic tips and techniques for advanced practice nurses (APNs) in emergency care. In Part II, wound closure (e.g., sutures, staples, and adhesives) and wound closure techniques are discussed along with the pertinent aftercare instructions for patients with these wounds. Implications for APNs caring for patients with wounds in emergency care are also presented in this article.

For any industry to thrive, it must not only focus on production goals but also uphold the highest standards of safety for everyone involved. This requires continuously identifying potential hazards, evaluating the risks linked to them, and reducing those risks to acceptable levels. The construction sector, in particular, is inherently hazardous and poses significant safety challenges for workers. Unsafe site conditions and poor practices often result in accidents that cause injuries, loss of life, property damage, and disruptions to developmental activities. Risk assessment serves as a structured approach to pinpointing and analyzing hazards tied to specific tasks, while also determining the level of risk each hazard presents. Since it is impossible to eliminate all hazards completely, it becomes essential to define and estimate accident risk levels, whether expressed in quantitative or qualitative terms. Because construction sites record a high number of fatalities, the industry is recognized as one of the most hazardous occupations globally. Despite its crucial role, the construction sector is often associated with elevated accident rates and health issues that affect workers, professionals, and even end users. The industry faces considerable safety risks and financial losses as a result. Accurately estimating these risks, however, remains challenging due to the absence of comprehensive quantitative safety databases and the inherent uncertainty in construction projects. Many of the safety risk assessment tools currently used in this field do not always deliver reliable results, as it is difficult to evaluate hazardous events quantitatively. This limitation stems from the lack of detailed safety data, which makes it challenging to determine the likelihood and potential consequences of such incidents.Hazard identification and risk analysis involve recognizing undesirable events that may give rise to hazards, examining the mechanisms through which such events could occur, and estimating the extent, severity, and likelihood of their potential harmful effects. The purpose of this study is to examine current practices in health and safety risk assessment, risk communication, and risk control, while also seeking ways to strengthen the Environmental Health and Safety (EHS) management plan for construction sites. To achieve this, a case study approach was applied, with a construction site selected using convenience sampling. This research further investigates the methods adopted by organizations in India to ensure workplace safety and evaluates how risk assessment can be effectively employed to optimize safety management practices in the construction industry