Human Factors Aspects Research Articles

Prehospital ultrasound constitutes a potential distraction from the observation of critically ill patients: a prospective simulation study

BackgroundPrehospital point-of-care ultrasound allows an unstable patient to be rapidly and accurately assessed. However, we are concerned that an excessive focus on the ultrasound device, in an already demanding emergency medical service environment, may distract from patient care, potentially leading to reduced situational awareness and the neglect of other crucial instruments, such as the patient monitor. Thus, in this study, we examined the influence of prehospital ultrasound on situational awareness, by studying the degree to which physicians were distracted from the patient monitor.MethodsWe observed HEMS physicians in a simulated setting and analysed their gaze behaviour using an eye tracker placed on three areas of interests: the ultrasound device, the patient and the patient monitor. In the course of the experiment, the simulated patient desaturated, which was presented on the patient monitor. The primary outcome was the fraction of gaze distribution across the three areas of interest, while secondary outcomes were different gaze metrics (dwell time, revisits, average duration of visual intake and entry time) on the patient monitor. We then compared the participants who noticed the patient’s deterioration with those who did not.ResultsIn 75% of cases, the severely decreased oxygen saturation went unnoticed during the test. Moreover, the gaze distribution of the two groups differed, with the group that recognised the deterioration focusing longer on the patient monitor (7.8% (95% CI 5–10.7) vs 0.1% (95% CI 0–0.3), p: 0.124).ConclusionsThe task of performing an ultrasound examination appears to overwhelm some participants and distract them from other aspects of the scenario. Efforts to mitigate distractions and optimise the use of prehospital ultrasound, such as education, a focus on human factors aspects and standardisation, are crucial for maximising the potential benefits of prehospital ultrasound.

Automating execution of surveillance procedures for NPP main control rooms

ABSTRACT For the past 30 years, progress in the automation of control processes in the nuclear industry has been much slower compared to other industries. In the same timeframe, other complex industrial and/or high-risk processes (e.g., aviation) have been revolutionized by the exponential increase of technology capability in computing and information systems. The reason for the relatively slow trickling of technology advancements in the nuclear field is multi-faceted: i) resistance to change from a traditionally proven solution (partially due to very specific regulation requirements); ii) the cost to adopt Computerized Procedure Systems for existing NPPs, without having a quantified and proven safety benefit; iii) relatively low number of new NPPs being built following the Chernobyl and Fukushima disasters; iv) possible negative impact on the human factors aspect. After a short introduction to automation in another high-risk industry (aviation), this paper focuses on the practical approach required for automating Surveillance Procedures, and at the same time taking into consideration the human factors impact of this approach.

Strategi Penanganan Resiko Terjadinya Kecelakaan Kerja Dengan Metode HFACS, HIRARC, dan Fuzzy Logic

Occupational Health and Safety (OHS) is an absolute necessity for humans when working. The purpose of this study is to determine the identification of negligence at work that results in errors and causes accidents and determine prevention strategies. The HFACS method is an accident analysis tool used to analyze an accident on the Human Factor aspect. Then continue with limiting the event of mishaps with the HIRARC technique which comprises of Peril Distinguishing proof, Chance Evaluation, and Hazard Control. HIRARC's point is that the perils that exist in each activity can be recognized and controlled rapidly so the potential for work mishaps can be restricted, then endeavors are made to order wellbeing utilizing the fluffy rationale technique. In view of the consequences of consolidating the HFACS and HIRARC strategies utilizing the Fuzzy, it tends to be presumed that the three techniques get a gamble rating worth of 6.33 which is remembered for the Moderate boundary class.

Incorporating a Hands-On Device-Based Activity in a Human Factors Biomedical Engineering Course in Sub-Saharan Africa

A challenge in building the biomedical engineering human factors course at Malawi University of Business and Applied Sciences was integrating meaningful direct experiences with medical products. The instructor also noticed a significant gap between the topics in the course and their surrounding clinical context, a low-income setting. Recognizing that devices should be designed and evaluated in the context of the local users’ needs and situations, new hands-on modules were created and implemented in this BME human factors course. Students were asked to critically evaluate and make recommendations to improve the human factors aspects of the software and hardware of the IMPALA, a vital signs monitoring device developed for use in Malawi. Engaging with this medical device, students observed and understood many issues discussed in human factors, including the design of ports, controls, and other user interfaces. The collaboration between the course and the IMPALA project harnessed the local expertise of students to improve the design of a new patient monitoring system. Thus, the IMPALA project itself benefited from this collaboration. Second, students greatly benefited from applying the class concepts to the IMPALA. Students were engaged far more during the interactive components than during the lecture components. Many students successfully translated their knowledge on human factors to their final-year design project.

Exploring the Implementation of Unpredictability in the Field of Aviation Security

Regulations for aviation security have tended to be reactionary, responding to terrorist attacks by implementing more stringent measures. This has resulted in a more predictable system that can make it easier for unlawful interference. To address risks from both external (terrorist attacks) and internal (insider threats) sources, introducing unpredictability – such as varying security controls – proactively could be beneficial. A study conducted semi-structured interviews with security experts in order to explore how and why unpredictability is implemented at airports. The results revealed that European airport stakeholders apply unpredictable measures for various reasons: complementing the security system, outmaneuvering opponents, and improving human factor aspects of the security system. Unpredictable measures are applied at different locations by various controlling authorities across different forms; however, their deployment lacks systematic evaluation. Additionally, findings indicated that varying security controls may help mitigate insider threats by reducing insider knowledge. Further research should focus on evaluating the deterrent effect of unpredictability and providing recommendations on how unpredictable measures can be effectively realized proactively to address emerging risks.

Human factors in cybersecurity: Navigating the fintech landscape

The dynamic landscape of financial technology (Fintech) introduces a myriad of challenges and opportunities, with human factors playing a pivotal role in shaping the cybersecurity ecosystem within this domain. This review explores the intricate relationship between human factors and cybersecurity in the context of Fintech, aiming to navigate the evolving landscape. In the realm of Fintech, where the fusion of finance and technology is reshaping traditional banking and investment practices, understanding human behavior becomes paramount. Human factors encompass a spectrum of elements, including cognitive abilities, decision-making processes, and user behaviors, all of which significantly impact the effectiveness of cybersecurity measures. This paper delves into the nuances of these factors and their implications for securing financial transactions and sensitive data in Fintech platforms. One key aspect of human factors in Fintech cybersecurity is the user interface design. Intuitive and user-friendly interfaces enhance security by minimizing human errors and fostering a secure user experience. Conversely, poorly designed interfaces can inadvertently contribute to vulnerabilities. This paper explores the intersection of user experience design and cybersecurity protocols, aiming to strike a balance that promotes both usability and security. Moreover, the study investigates the psychological aspects of cybersecurity awareness and education in the Fintech sector. As financial transactions increasingly migrate to digital platforms, users' awareness of potential cyber threats becomes a critical line of defense. Analyzing the effectiveness of training programs and awareness campaigns, the paper explores strategies to enhance cybersecurity consciousness among Fintech users. The research illuminates the symbiotic relationship between human factors and cybersecurity within the dynamic Fintech landscape. By comprehensively understanding and addressing human elements in interface design, user awareness, and decision-making processes, the paper aims to provide insights that contribute to the development of robust cybersecurity frameworks tailored to the evolving needs of Fintech platforms.

An Integrated Risk Assessment Methodology of In-Service Hydrogen Storage Tanks Based on Connection Coefficient Algorithms and Quintuple Subtraction Set Pair Potential

At present, there have been a number of hydrogen storage tank explosions in hydrogen filling stations, causing casualties and property losses, and having a bad social impact. This has made people realize that the risk assessment and preventive maintenance of hydrogen storage tanks are crucial. Therefore, this paper innovatively proposes a comprehensive risk assessment model based on connection coefficient algorithms and quintuple subtractive set pair potential. First of all, the constructed index system contains five aspects of corrosion factors, material factors, environmental factors, institutional factors and human factors. Secondly, a combined weighting analysis method based on FAHP and CRITIC is proposed to determine the weight of each indicator. The basic indicators influencing hydrogen storage tanks are analyzed via the quintuple subtraction set pair potential and full partial connection coefficient. Finally, the risk level and development trend of hydrogen storage tanks in hydrogen filling stations are determined by a combination of the three-category connection coefficient algorithms and the risk level eigenvalue method. The results of our case analysis show that the proposed risk assessment model can identify the main weak indicators affecting the safety of hydrogen storage tanks, including installation quality, misoperation and material quality. At the same time, it is found that the risk of high-pressure hydrogen storage tanks is at the basic safety level, and the development trend of safety conditions holds a critical value. The evaluation results can help establish targeted countermeasures for the prevention and maintenance of hydrogen storage tanks.

Looking beyond the screen: A systematic review of safety in control rooms

As a complex socio-technical system, the Control Room (CR) is central to many industries, such as process, aviation, transportation, and mining. CRs' complexity impacts the safety, operational, engineering, regulatory, and financial performance of the system. In this study, a search strategy was defined and applied to three reputable databases: Scopus, Web of Science, and PubMed. The search results underwent a two-stage screening process based on inclusion and exclusion criteria. The inclusion criteria were investigating the safety in the CR, full-text availability, and writing in English. The exclusion criteria were unrelated to the safety in the CR, non-English Language, and non-original studies. A total of 59 studies were included in the analysis. The included articles were systematically reviewed from the Human Reliability Assessment (HRA) and Human Factors Engineering (HFE) perspectives. Since these records covered various subjects related to human reliability and human factor aspects, a categorization step was added to the study process. In this step, all included studies were categorized based on their subjects. A total of 7 categories were identified, including reliability (17 documents), safety performance (13 documents), decision-support systems (7 documents), fire safety (2 documents), communication/teamwork (11 documents), situation awareness (4 documents), and others (5 documents). Finally, the included studies in each category were analyzed and discussed. The results of this study help identify different aspects of safety in the control room and plan to improve their safety weaknesses, which ultimately leads to an increase in the efficiency of employees and various industries.

Leadership Impact on Employee Well-being: The Order Picker’s Voice

Although automation and digitalisation are ascending in warehouses, humans still play a crucial role in getting the job done. This study focuses on the underexposed angle of psychosocial aspects of human factors, with order pickers’ well-being considered one of them. This study uses semi-structured interviews to understand how leadership affects warehouse employees’ well-being. We see that most components of transformational and empowering leadership, the most potent predictors of employee well-being, are reflected in the data. However, we identify some additional essential leadership components not mentioned in the literature, like feeling respected and being treated equally compared to colleagues.

A40The importance of human factors and the implementation of the ‘Social GRACES’ in simulation training: a 6-month review of foundation simulation training at Guys and St Thomas’ (GSTT) NHS Foundation Trust

Traditionally the focus of simulation has been centred on clinical management. More recently there has been a drive to enhance training on ‘human factors’ [1]. In simulation, human factors can be challenging to replicate, particularly with regards to how individuals interact within a system. At GSTT we introduced a concept known as ‘social GRACES’ into simulation training. Social GRACES, first described by John Burnham in 1992 [2], outline a framework to understand an individual’s personal and social identity. An abundance of research into the development of human factors skills exists in the literature. Our aim was to integrate social GRACES into our simulation programme as a novel approach to engage trainees with human factors. Between October 2022- April 2023, there were 23 full-day simulation training days. The course started with an introduction on human factors and the social GRACES. This was followed by a ‘lost at sea’ activity where trainees worked individually and in teams to prioritize the items they would take if lost at sea. This was followed by 4 clinical scenarios with debriefs related to clinical management, human factors and social GRACES. Pre and post course questionnaires were disseminated, and delegates were consented for data being used for quality improvement. Unique identifiers allowed for paired data analysis. 101 pre-course and 138 post-course feedback forms were received. To allow for paired analysis, only completion of both questionnaires was included, leaving 83 responses. There was a statistically significant increase in the percentage of responders who strongly agreed they felt confident in recognizing (7.2%-35.2%), assessing (15.7%-43.4%), managing (3.6%-20.5%) and escalating care (15.7%-35%), in acutely unwell patients. Additionally, confidence improved in understanding the impact of human factors in delivering care (9.6%-35%) and the performance of healthcare professionals (9.6%-39.8%). We explored confidence with regards to the practical implementation of human factors in healthcare ( 10 questions were devised to assess confidence relating to practical aspects of human factors in healthcare with regards to teamwork, communication, and leadership. Following paired data analysis, we found a statistically significant improvement in confidence in all areas investigated. The results demonstrate that the interplay between managing acute clinical scenarios & human factors can effectively be taught through simulation and enhanced with an understanding of social GRACES. An increased understanding of human factors and simulation training was useful in improving 3 crucial skills; teamwork, communication and leadership, which are instrumental in improving clinician confidence and patient outcomes. Future direction should look to include awareness and implementation of human factors within mainstream simulation to effectively replicate real time clinical scenarios & pressures. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A qualitative exploration of the spiritual wellbeing of women with advanced cervical cancer in Ghana.

Spiritual wellbeing is one of the most important aspects of human health, alongside physical, psychological and social factors. Religiosity/spirituality can play a critical role in the lives of people experiencing life-threatening illnesses, such as cervical cancer. Most women with cervical cancer in Africa, including Ghana, are diagnosed at the advanced stage. These women lean on their spiritual connections for strength during their illness. Despite the fact that numerous studies have been conducted on the relevance of religiosity/spirituality in the experience of cancer in other jurisdictions, the same cannot be said about Ghana. The study aims to fill this gap in the literature. To explore the spiritual wellbeing of women diagnosed with advanced cervical cancer in Ghana. A qualitative explorative design was employed, with purposive sampling used to recruit 15 women with advanced cervical cancer from a cancer treatment centre of a teaching hospital in Ghana. Individual face-to-face interviews, lasting between 45-90 minutes, were used to gather information. Interviews were audio taped with participants' consent. Data were analysed using thematic content analysis. The following sub-themes were identified within one overarching theme of the spiritual wellbeing of women with advanced cervical cancer: the meaning of illness and acceptance; a sense of hope and religiosity; uncertainty; and the will to live. Many participants believed they were bewitched, and the devil was responsible for their cervical cancer. Healthcare providers should adopt a multi-disciplinary approach and widen their care strategies to include spirituality, to enhance the treatment outcomes of women living with advanced cervical cancer.

Designing dual ontological products for human factors: a machine learning and harmonistic knowledge-based computational support tool

The physical construct of a dual ontological product is essential for those products which physically interact directly with humans, whereas the product's emotional construct interconnects with human cognition. Multitude of human factor aspects must be considered when designing dual ontological products. To increase the product's impact and reach, designers should also understand the requirements of potential users. Designers find it difficult to achieve the right compromise between these constructions. This research therefore contributes a novel harmonistic knowledge-based computational support tool which makes designers aware of design stage conflicts and consequences of commitments made on human factors in the use phase of the artefact. This paper describes in detail the machine learning and harmonistic knowledge-based system which exploits information collected directly from potential users to proactively assist, guide, and motivate product designers. The paper takes the motorcycle artefact as a case of dual ontological product. The prototype support tool has been evaluated with 28 motorcycle design engineers. The results obtained from this evaluation have shown that the approach and design computational-based tool meet their goals, are beneficial, and are required in design engineering practice.

The Impact of Covid-19 on Human Factors in the Aircraft Maintenance Environment - Effects within Approved Aircraft Maintenance Organisations Operating in Malta

Since the aviation industry itself creates a risky environment, a high levelof safety must be ensured during the flight of an aircraft. Aircraft maintenance up tohigh standards is a main requirement intended to ensure the safety of flights and hascontributed to drastically reduce the number of aviation accidents. In addition, for everyaviation accident the cause must be identified to prevent re-occurrence and reduce thenumber further down the line. Statistically, most aviation accidents occurring nowadaysare due to human errors, making awareness of human factors in every area of aviation veryimportant, including the maintenance area. With the outbreak of COVID-19 pandemic in2020, peoples everyday life across the whole world was affected. The aviation industrywas heavily impacted by this pandemic with reduction in aviation operations, affectingairports, airlines, as well as approved aircraft maintenance organisations. The effect ofCOVID-19 on human factors has been both physiological and psychological. Since thephysiological and psychological aspects of human factors are known to have considerableeffects on the human error element in aviation, it can be concluded that with COVID-19the risk of committing errors in aviation has increased. This research is aimed to discoverthe element of such increased risk in aviation, particularly within the aircraft maintenanceenvironment. Research participants are people working in the aircraft maintenanceenvironment. Several independent variables identified from the literature review, known toaffect an identified dependent variable, form an initial conceptual framework. A survey hasbeen conducted through which exploratory statements have been set up to address theindependent variables, each in a context of the impact of human factors on the requiredsafety standards in aircraft maintenance. Data collected from a total of 75 respondents hasbeen checked for validity using a test question inserted in the survey. This has given a totalof 68 valid responses which have been analysed. Analysis has been conducted using SPSSSoftware. Analysis for data consistency revealed an acceptable Cronbachs Alpha value ofover 0.8. SPSS which was then used to carry out dimension reduction using ExploratoryFactor Analysis (EFA). Through the EFA technique the number of independent variableshas been reduced for further research from 22 to 6. Final analysis of the data shows thatmost of the respondents agree that in general Covid-19 has had a similar impact on humanfactors in aircraft maintenance, as it has had on the rest of the aviation industry. Based onthis research it is suggested that measures should be taken so that a phenomenon likea pandemic situation, that would affect the physiological and psychological aspects ofpeople, is addressed in the human factors element of aviation, in particular the aircraftmaintenance environment. The pilot-study conducted also sets up a basis for futureresearch in human factors in aircraft maintenance, and how they can be influenced bysituations that can pose higher risks for a person to commit errors while performing workrelated to aviation, particularly while carrying out aircraft maintenance performance andcertification activities before an aircraft can be released for further flights.

Why and how unpredictability is implemented in aviation security – A first qualitative study

In the past, aviation security regulations have mostly been reactive, responding to terrorist attacks by adding more stringent measures. In combination with the standardization of security control processes, this has resulted in a more predictable system that makes it easier to plan and execute acts of unlawful interference. The implementation of unpredictability, that is, variation of security controls, as a proactive approach could be beneficial for addressing risks coming from outside (terrorist attacks) and inside the system (insider threats). By conducting semi-structured interviews with security experts, this study explored why and how unpredictability is applied at airports. Results show that European airport stakeholders apply unpredictability measures for many reasons: To complement the security system, defeat the opponent, and improve human factor aspects of the security system. Unpredictability is applied at various locations, by different controlling authorities, to different target groups and application forms; nevertheless, the deployment is not evaluated systematically. Results also show how the variation of security controls can contribute to mitigating insider threats, for example, by reducing insider knowledge. Future research should focus on the evaluation of the deterrent effect of unpredictability to further give suggestions on how unpredictable measures should be realized to proactively address upcoming risks.

Smart Grid Cyber-Physical Situational Awareness of Complex Operational Technology Attacks: A Review

The smart grid (SG), regarded as the complex cyber-physical ecosystem of infrastructures, orchestrates advanced communication, computation, and control technologies to interact with the physical environment. Due to the high rewards that threats to the grid can realize, adversaries can mount complex cyber-attacks such as advanced persistent threats-based and coordinated attacks to cause operational malfunctions and power outages in the worst scenarios: The latter of which was reflected in the Ukrainian power grid attack. Despite widespread research on smart grid security, the impact of targeted attacks on control and power systems is anecdotal. This article reviews the smart grid security from collaborative factors, emphasizing the situational awareness (SA). Specifically, we propose a threat modeling framework and review the nature of cyber-physical attacks to understand their characteristics and impacts on the smart grid’s control and physical systems. We examine the existing threats detection and defense capabilities, such as intrusion detection systems (IDSs), moving target defense (MTD), and co-simulation techniques, along with discussing the impact of attacks through situational awareness and power system metrics. We discuss the human factor aspects for power system operators in analyzing the impacts of cyber-attacks. Finally, we investigate the research challenges with key research gaps to shed light on future research directions.

METHOD OF ASSESSING THE EFFICIENCY OF ENSURING INFORMATION SECURITY OF THE EDUCATIONAL INFORMATION SYSTEM

In the modern conditions of the development of information technologies, the issue of ensuring information security is becoming more and more relevant. Information has become a key resource that affects the success and stability of the functioning of organizations, enterprises and institutions. Despite the fact that a significant part of efforts is aimed at creating and maintaining effective information protection systems, the issue of assessing their effectiveness remains relevant and important. The article examines a complex methodology for assessing the effectiveness of information security, which is based on the use of modern approaches and tools for analyzing the security of information systems. The proposed methodology covers various aspects of information security, including technical, organizational, procedural and human factors. The evaluation of efficiency is based on a complex analysis of multiple indicators, which allows to obtain an objective picture of the state of information security of the organization. The main part of the methodology is the development and application of mathematical models that allow quantitative assessment of the level of information security. Such models take into account various factors, including the level of technical protection of information systems, information security policy, the level of training of personnel, response to incidents and other important aspects. In addition, the article considers the issue of optimizing costs for ensuring information security by applying economic models and approaches. The proposed methodology includes several stages: determination of key security indicators, data collection and analysis, development of mathematical models for performance evaluation, interpretation of results and development of recommendations for increasing the level of protection. An important component of the methodology is a systematic approach that allows taking into account the interaction of various elements of the information security system and their impact on the overall level of protection. The practical application of the developed methodology makes it possible to timely identify vulnerabilities in the information security system, optimize the costs of its provision, increase the overall level of security of the organization and reduce the risks associated with information threats. The results of the study confirm the effectiveness of the proposed approach and demonstrate its applicability in various fields of activity, including business, public sector, education and other areas. Thus, the proposed methodology for assessing the effectiveness of information security is an important tool for organizations seeking to ensure reliable protection of their information. Its use contributes to increasing the level of information security, which, in turn, has a positive effect on the general level of functioning and stability of organizations in the face of modern challenges and threats.

The Challenges of Applying Ergonomics to Small Medium Enterprises

One of the important roles of small medium enterprise (SMEs) is to contribute to solving challenges in the field of employment through the provision of employment. The uptake of labor in SMEs is not far inferior to large-scale industries. With the ease of access to information today, some business actors have begun to be aware of the role of ergonomics in the production aspect. This is inversely proportional to the condition of workers in the scope of SMEs. Workers in the SMEs sector have a sense of reluctance in doing ergonomics-based work principles. This research aims to review the work patterns carried out by workers at the SMEs level and investigate how workers understand ergonomic aspects and review the challenges of applying ergonomics in the future. This research was conducted using qualitative methods of phenomenology using deep interview techniques to several workers at the SMEs level. In this study also used triangulation against data obtained. The results showed that workers have a mini understanding of ergonomics-based work principles. The challenges of applying ergonomics in addition to being faced by the quality of human resources, including human factor aspects and sustainable risk management.

Human Factors in Road Design: A Review of Italian Design Standards

Human Factors are stable psychological, psychophysical, and physiological limits that influence the performance and safety of technical systems managed by humans. Roads are made for human use, but nowadays not completely on a human scale. Many studies demonstrate that Human Factors are a key factor in accident occurrence and thus it is mandatory to consider them in the definition of design standards. This research provides a methodological approach to reviewing design standards based on Human Factors. The methodology identifies which Human Factors aspects are relevant for each specific design feature. The reviewer is then able to judge if those aspects are considered using checklists. Moreover, the paper presents a review of the Italian design standards using the proposed methodology. This identifies to what extent Human Factors are considered in the Italian design standards, analyzing if they match the requirements of the three rules of Human Factors proposed by PIARC (Permanent International Association of Road Congresses). The results identify where Italian design standards consider Human Factors and where they do not. This is where further improvements should be made so that engineering solutions could match psychological requirements, for safer and ergonomic road infrastructures. The proposed approach provides a structured and systematic procedure for the analysis which has been found to be suitable also for road safety audits procedures.

Disaster-Causing Mechanism of Hidden Disaster-Causing Factors of Major and Extraordinarily Serious Gas Explosion Accidents in Coal Mine Goafs

Hidden disaster-causing factors (HDCFs) in coal mines can be identified via the rerefinement and classification of disaster-causing factors (DCFs) in coal mines. The study of the disaster-causing mechanism of accidents from the perspective of HDCFs in coal mines could be helpful to analyze the accident occurrence process from a new perspective, and new ideas for accident prevention and control could then be proposed. To clarify the disaster-causing mechanism of HDCFs of major and extraordinarily serious gas explosion accidents (MESGEAs) in coal mine goafs, 32 MESGEAs in coal mine goafs in China from 2000 to 2021 were adopted as a data source. By redefining the definition, connotation and characteristics of HDCFs in coal mines, 10 HDCFs were identified. Consequently, an improved decision-making trial and evaluation laboratory (DEMATEL)-interpretive structural model (ISM)-matrix of cross impact multiplications applied to classification (MICMAC) model was used to comprehensively analyze HDCFs in 3 aspects, including the centrality and cause degrees, hierarchical structure, and driving and dependence powers, from a completely objective perspective. The results demonstrated that (1) the considered MESGEAs in coal mine goafs were caused by DCFs in the management aspect by affecting the DCFs in the 3 aspects of human factors, equipment and environment, as well as under the combined effect of DCFs internal interaction contained in itself. (2) There were 2 types of disaster-causing mechanisms of HDCFs of MESGEAs in coal mine goafs: (a) the indirect disaster-causing by HDCFs in the management aspect and (b) the random coupling disaster-causing by HDCFs in human factors, equipment and environment 3 aspects.

Sicherheitsaspekte invasiver thorakaler Maßnahmen in der prähospitalen Notfallmedizin – Ergebnisse einer Umfrage unter deutschen Notärzt:innen

BackgroundThe safe indication and performance of thoracic emergency procedures are crucial and potentially lifesaving in prehospital emergency care. This study aims to investigate issues of patient safety and quality assurance of prehospital invasive thoracic interventions. The survey does not represent the actual medical care situation but explores reasons for security concerns among emergency physicians. MethodsUsing a pre-validated questionnaire, prehospital emergency physicians of three prehospital rescue associations (Zweckverband) in Southwest Saxony, Greifswald, and Vechta, Germany, were queried via the online survey service limesurvey. The survey was conducted between January and March 2022. Results104 emergency physicians participated (response rate 42.4%) 71 of which fully completed the survey (68%). 79% of the participants stated that they felt safe in performing pleural punction. Common reasons for postponing prehospital thoracic interventions included fear of complications or individual patient characteristics. 90% said that they were familiar with the on-board equipment options, and 60% reported that resources were sufficient to perform double-sided procedures. While in all three regions there is sufficient on-board equipment to perform procedures on two sides, one out of two participants said that lack of equipment deters them from performing prehospital invasive thoracic procedures. Emergency physicians who graduated from trauma courses and/or participate in air rescue are more likely to perform invasive thoracic procedures. More than half of the participants wanted more training in chest tube placement or pleural punction. ConclusionSafety in prehospital invasive thoracic procedures needs improvement in structural, procedural, as well as human factors aspects. Safe handling of these rare but vital techniques requires more training. A lack of knowledge of equipment is a significant safety gap. Prehospital ultrasound constitutes a structural element of prehospital diagnostics.