Blue Team Research Articles

Secure Cloud Migration Strategy (SCMS): A Safe Journey to the Cloud

The state of cloud security is evolving. Many organizations are migrating their on-premises data centers to cloud networks at a rapid pace due to the benefits like cost-effectiveness, scalability, reliability, and flexibility. Yet, cloud environments also raise certain security concerns that may hinder their adoption. Cloud security threats may include data breaches/leaks, data loss, access management, insecure APIs, and misconfigured cloud storage. The security challenges associated with cloud computing have been widely studied in previous literature and different research groups. This paper conducted a systematic literature review and examined the research studies published between 2010 and 2023 within popular digital libraries. The paper then proposes a comprehensive Secure Cloud Migration Strategy (SCMS) that organizations can adopt to secure their cloud environment. The proposed SCMS consists of three main repeatable phases/processes, which are preparation; readiness and adoption; and testing. Among these phases, the author addresses tasks/projects from the different perspectives of the three cybersecurity teams, which are the blue team (defenders), the red team (attackers), and the yellow team (developers). This can be used by the Cloud Center of Excellence (CCoE) as a checklist that covers defending the cloud; attacking and abusing the cloud; and applying the security shift left concepts. In addition to that, the paper addresses the necessary cloud security documents/runbooks that should be developed and automated such as incident response runbook, disaster recovery planning, risk assessment methodology, and cloud security controls. Future research venues and open cloud security problems/issues were addressed throughout the paper. The ultimate goal is to support the development of a proper security system to an efficient cloud computing system to help harden organizations’ cloud infrastructures and increase the cloud security awareness level, which is significant to national security. Furthermore, practitioners and researchers can use the proposed solutions to replicate and/or extend the proposed work.

Implementation of Code Blue In Hospitals

Cardiac Arrest is a form of emergency due to malfunction of electrical waves in the heart that cause arrhythmias, so that the heart cannot pump blood to the brain, lungs, and other organs that can occur to anyone and at any time so that it needs proper and immediate treatment to be able to save the patient's life. In the case of hospitals, an activation code system to respond to cardiac arrest, called Code blue, was established to provide an appropriate, fast, and systematic Basic Life Support. The Code blue system was formed by the local hospital by establishing a code blue system, including code blue teams, BLS equipment and equipment, code blue activation through communication systems in hospitals, and regular education and training to ensure quality control.
 Cardiac Arrest treatment is the ability to be able to detect and react quickly and correctly to restore the heart rate to a normal condition as soon as possible to prevent brain death and permanent death, The patient's chances of survival are reduced by 7 to 10 percent every minute that runs without cardiopulmonary resuscitation and defibrillation

The implementation of code blue by nurses as first responders in outpatient and inpatient rooms at Malang Indonesia Hospital

Introduction: In-Hospital Cardiac Arrest (IHCA) is a frequent occurrence that necessitates prompt and appropriate assistance to improve survival rates. Nurses in public care rooms and outpatients are expected to be first responders to IHCA until an activated hospital code blue team arrives. Therefore, this study aims to analyze the implementation of code blue response by nurses in outpatient and hospital inpatient rooms in Malang.
 Design and Methods: This is a quantitative study that uses observational methods with a cross-sectional approach comprising of 109 inpatient and outpatient care room nurses from 9 hospitals in Malang. The implementation of code blue was measured by a simulated case of adult cardiac arrest in a hospital inpatient room.
 Results: The nurses involved were 67.0% female, where the majority have a D3 education qualification (57.7%), with more than ten years working experience (45%). Furthermore, 83.5% of nurses work in regular care rooms and 16.5% come from outpatient rooms. The results showed that the implementation of code blue by nurses in regular care and inpatient rooms was 66.7% and 65.9%, respectively in the insufficient categories. In addition, the Mann-Whitney U test obtained a p-value of 0.929.
 Conclusions: In conclusion, there was no significant difference in the implementation of code blue that occurred in the inpatient and outpatient rooms. Further studies were recommended to observe code blue events directly and take samples with balanced proportions.

Comparison of code blue application and results in a training and research hospital before and during the COVID-19 pandemic

Background & Objective: Code blue is an emergency management system that allows for a rapid professional response to the patients of cardiopulmonary arrest (CPA) in hospitals. The time to initiate the call and the response of the ‘Code Blue Team’ may vary in different hospitals, and it me be linked with the survival of the victim. We examined and compared the code blue application utilized in our hospital before and during the COVID-19 pandemic.
 Methodology: Code Blue Call (CBC) logs from March 01, 2018 to March 31, 2022 were retrospectively analyzed. The study period was divided into two parts: March 01, 2018–February 28, 2020 (Group I, pre-pandemic period) and March 01, 2020–March 31, 2022 (Group II, pandemic period).
 Results: During the study period, a total of 1542 CBC’s were received, of which 837 (54.3%) were ‘true’ CBC’s. Of the 837 true CBC’s included in the study, 477 (56.7%) were for male patients and 360 (43.3%) were for the females. We evaluated the month-wise distribution of the CBC’s; the month with the highest number of calls in Group I was January 2019 (n = 29, 17.3%), while in Group II it was December 2020 (n = 59, 23.1%). The arrival time of the code blue team was significantly different between the groups, e.g., 3.15 ± 0.52 vs. 3.81 ± 0.58 min in Group I vs. Group II respectively.
 Conclusion: The intervention times of the code blue team and the success of cardiopulmonary resuscitation were observed to be comparable during the pre-pandemic and pandemic periods. The duration of commencement of intervention is important for the efficacy of cardiopulmonary resuscitation during a pandemic.
 Abbreviations: CBC: Code Blue Call; CBT: code blue team; COVID-19: Coronavirus Disease-19; CPA: cardiopulmonary arrest
 Key words: COVID-19; CPR; Code Blue; Pandemic
 Citation: Çelik HK, Kuşderci HS. Comparison of code blue application and results in a training and research hospital before and during the COVID-19 pandemic. Anaesth. pain intensive care 2022;27(1):123−130. DOI: 10.35975/apic.v27i1.2121
 Received: September 20, 2022; Reviewed: November 30, 2022; Accepted: December 01, 2022

A comparison of code blue calls in a tertiary pediatric hospital in the pre-pandemic and pandemic periods

This study compares the code blue calls (CBCs) used in our hospital before and during the COVID-19 pandemic. CBCs made between 31.03.2018 and 31.03.2022 in the Samsun Maternity and Child Health Training and Research Hospital were examined retrospectively. The study period was subdivided into two sections, one from March 31, 2018, to March 30, 2020 (Group 1, the pre-pandemic period) and the other from March 31, 2020, to March 31, 2022 (Group 2, the pandemic period). Patients' demographic data, the reason for the CBC and where it was issued, the time elapsed before the team arrived on the scene, and the outcomes were then compared between the groups. Seventy-nine CBCs, 34 (43.1%) of which were ‘false,’ were included in the study. Forty-six calls were made in the pre-pandemic period, 26 (56.5%) of which were true calls, while 33 calls were made during the pandemic, of which 19 (57.6%) were true calls. Twenty-seven (60%) of the 45 true CBCs were for boys and 18 (40%) for girls. The children’s mean age was 73.06±66.85 months, and 57.7% of the CBCs were issued during the pre-pandemic period. No significant difference was observed between groups 1 and 2 in terms of code blue team arrival times (114.03±59.14 vs. 138.1±95.96 sec, respectively (P=.305). The total mortality rate at the end of 30 days was 13.3% (P=.679). No difference was observed in CBC results between the pre-pandemic and pandemic periods in this study. We think that some blue code parameters, such as false calls and blue code team arrival times, can be improved through effective training against potential future pandemics.

KAN ALMA ÜNİTESİNDE KAN ÖRNEĞİ VERİRKEN BAYILAN HASTALAR VE BİR STRESS MEDYATÖRÜ: KORTİZOL

OBJECTIVE: Cortisol is a glucocorticoid and can be used as a stress mediator in association with adrenal insufficiency. A diagnosis of adrenal insufficiency is made when the episodically released cortisol levels are below 3 mcg/dl by making a single measurement at any time of the day. We aimed to determine the presence of underlying adrenal insufficiency by measuring cortisol levels in patients brought to the emergency room by the hospital code blue team that firstly performed their critical care, who fainted whilst giving blood samples in the blood collection unit. MATERIAL AND METHODS: Observational, prospective study; It consists of 28 patients brought to emergency department by Code Blue Team between 2017 and 2020. After physical examination and electrocardiogram(ECG) evaluation, samples were taken for complete blood count, biochemical parameters, venous blood gas, cardiac biomarkers and cortisol measurement. Obtained results were analyzed with SPSS 22. RESULTS: The lowest cortisol level was 9 mcg/dL, and the highest cortisol level was 40,4 mcg/dL. Cortisol levels were higher in women than men. But T-test analysis revealed that gender is not a determining factor in cortisol levels (p=0,26). The correlation between blood collection time and cortisol values was calculated close to zero (r2=0.09). The patient diagnosed with adrenal insufficiency with a single measurement was not defined in the study population. CONCLUSIONS: Patients with acute adrenal insufficiency may come to the emergency department with orthostatic hypotension, agitation, syncope, abdominal pain and fever, and may result in death if left untreated (1). Although emotional stress is 20% among the precipitating factors of adrenal crisis, no significant relationship was found between stress and cortisol in our study (2). The limitations of our study are that it can only be carried out during working hours, and advanced diagnostic tests can not be performed in the emergency room.

Automating the Generation of Cyber Range Virtual Scenarios with VSDL

A cyber range (CR) is an environment used for training security experts and testing attack and defense tools and procedures. Usually, a cyber range simulates one or more critical infrastructures that attacking (red) and defending (blue) teams must compromise and protect, respectively. The infrastructure can be physically assembled, but much more convenient is to rely on the Infrastructure as a Service (IaaS) paradigm. Although some modern technologies support the IaaS, the design and deployment of scenarios of interest are mostly manual. As a consequence, it is a common practice to have a cyber range hosting few (sometimes only one), consolidated scenarios. However, reusing the same scenario may significantly reduce the effectiveness of the training and testing sessions. In this paper, we propose a framework for automating the definition and deployment of arbitrarily complex cyber range scenarios. The framework relies on the virtual scenario description language (VSDL), i.e., a domain-specific language for defining high-level features of the desired infrastructure while hiding low-level details. The semantics of VSDL is given in terms of constraints that must be satisfied by the virtual infrastructure. These constraints are then submitted to an SMT solver to check the satisfiability of the specification. If satisfiable, the specification gives rise to a model that is automatically converted to a set of deployment scripts to be submitted to the IaaS provider.

Design of a Purple Team for the Colombian Financial Sector Focused on Stock Brokerage Companies (SBK)

Private and public sector companies are suffering cyber attacks globally, so the need to invest in cybersecurity has become a priority. In this sense, several supervisors have formulated regulations around cybersecurity, with a particular emphasis on banks and their challenges but not much on the Stockbrokers (SBK) entities that are the subject of this research work. Although one of the most common methodologies is the simulation of offensive (red team) and defensive (blue team) security, purple teams are emerging as an alternative that enables a broader spectrum of learning and analysis for companies, particularly SBKs This article details a methodological guide for the design and implementation of a purple team in SBKs in order to strengthen cybersecurity governance in the face of contemporary cyber threats.

A Clinical Audit to Assess the Adherence of the Code Blue Team to Advanced Cardiac Life Support Protocol and its Effect on the Patient Outcome in a Tertiary Care Hospital in Kochi, Kerala

Introduction: Cardiopulmonary resuscitation is a sequence of techniques that combines chest compression with artificial ventilation to manually maintain the circulation to preserve intact brain function. The aim is to maintain circulation and breathing in a person who is in cardiac arrest until emergency aid arrives. Effective teamwork by Code Blue team raises chances of a successful outcome. The advanced cardiac life support (ACLS) guidelines were developed by the American Heart Association using the comprehensive review of resuscitation literature performed by the International Liaison Committee on Resuscitation. Aim: To assess adherence of Code Blue team to ACLS protocol, to assess outcome of resuscitation, and to compare outcome between those where ACLS guidelines were followed and those not followed. Patients and Methods: A clinical audit was done between 2014 and 2015 at Lourdes Hospital, Kochi, on inpatients aged between 30 and 80 years, with witnessed cardiac arrests/respiratory arrest. Pregnant and unwilling patients were excluded. Results: The common arrest rhythm was pulseless electrical activity, followed by asystole. ACLS protocol was followed in 58.7%. The most common deviation was usage of inappropriate drugs. Return of spontaneous circulation (ROSC) was attained in 53.3%, of which 28.5% were discharged (P

Mediating role of employee engagement between Blue Ocean Leadership and team performance

<span lang="EN-US">The study examined the mediating effect of employee engagement between blue ocean leadership and team performance among lecturers. A cross-sectional study design was used, and quantitative data were collected using a structured survey from 2,580 lecturers from the population across the 22 vocational colleges in Malaysia's north zone. Structural Equation Modeling (SEM) was used for data analysis. The results revealed a considerable positive relationship between blue ocean leadership and employee engagement, as well as between employee engagement and team performance. Employee engagement, as demonstrated through the use of bootstrapping analysis, acts as a mediator between blue ocean leadership and team performance. The finding supported the Blue Ocean Leadership theory and Social Exchange theory in this study. Future research is be recommended to conduct in other states as well as private institutions to get a comprehensive understanding.</span>

MASAC-based confrontation game method of UAV clusters

With the improvement in the intelligence level of UAVs and the development of cluster control technology, the intelligent decision-making method of UAV cluster confrontation will become the key technology of UAV combat in the future. The UAV cluster confrontation learning environment is of complex characteristics of high dimension, non-linearity, incomplete information, continuous action space, and so on. Recently, artificial intelligence technology represented by deep learning and reinforcement learning has made a great breakthrough. Deep reinforcement learning has shown a great ability to solve intelligent decision-making problems in complex environments. In this paper, enlightened by the multi-agent centralized training distributed execution framework and the idea of maximum policy entropy, we propose a deep reinforcement learning method of the multi-agent soft actor-critic (MASAC) with incomplete information. A game model for UAV cluster confrontation based on multi-agent deep reinforcement learning is established, and a continuous space multiple UAV combat environment is constructed. Simulation experiments are performed on the asymmetric confrontation of UAV clusters with red and blue teams. The experimental results show that MASAC outperforms the existing popular multi-agent deep reinforcement learning methods, making the game players converge to a higher return equilibrium point of the game. Moreover, the convergence of MASAC is investigated and analyzed extensively, and the results show that MASAC is of good convergence and stability, ensuring the practicability of MASAC in intelligent decision-making regarding UAV cluster confrontation.

Abstract 309: Exploring Competencies For The Family Facilitator During Resuscitation

Title: Exploring Competencies for the Family Facilitator in Resuscitation Authors: Carolina D. Tennyson, John P. Oliver, Karen R. Jooste Character Count (1,474 of 1,700) Introduction: During instances of family presence during resuscitation (FPDR), the family facilitator (FF) acts as a partner, advocate, and support person for the family as well as a liason between the family and care team. This role is widely recommended when implementing FPDR, however standard competencies for the FF have not been clearly described. To develop competency-based education or a certification for the role, FF skills and knowledge need to be detailed by those who currently work with the resuscitation team in this capacity. Hypothesis: The skills of the FF include timely assessment, communication with diverse populations (verbal and nonverbal), psychosocial and emotional support, and crisis management skills. Methods: Inpatient Chaplains who routinely respond to Code Blue events gathered in a focus group to review their current role responsibilities while caring for family members during resuscitation events. Qualitative data were collected and categorized by theme. Results: Fifteen Chaplains with FF role experience attended the focus group. Identified skills fell into the following 6 categories; Responding rapidly, Recognition of space, sterility, and safety elements in the resuscitation arena; Performing an ongoing assessment of family’s response to crisis; The ability to provide active listening and partnering; Facilitating communication between family and the Code Blue team leader; and interprofessional communication with the Code Blue team. Conclusions: Competency-based education and training for the FF role requires an understanding of the job demands and responsibilities. The described skills will be used to shape competencies and educational objectives for future FF training.

Abstract 06: Feasibility Of Accelerated Code Team Activation With Code Button Triggered Smartphone Notifications

Introduction: In-hospital cardiac arrest mortality has improved only modestly in the past decade. Prior studies support the role of earlier defibrillation and epinephrine administration to improve outcomes. Timely code team activation facilitates expedient interventions and may provide an opportunity for quality improvement. We sought to accelerate the time to code team activation and increase the early distribution of patient-specific data to improve targeted treatments. Methods: We mapped code blue buttons present behind each patient bed to patient data through the Electronic Health Record. Use of the code blue button sent patient-specific data including admitting diagnosis, recent procedural history, presence of difficult airway, and most recent potassium, bicarbonate, troponin, and hemoglobin levels through a secure text messaging system to the code blue teams’ smartphones. Simultaneously, the code blue button contacted the hospital operator who activated the code blue team through traditional methods including overhead page and pager alerts. We piloted the system on four medicine inpatient units from November 2019 through May 2022. In our analysis, we evaluated the time from code blue button press to smartphone message receipt vs overhead page, time to epinephrine administration, and survival to hospital discharge. Results: There were 35 cardiac arrest events on the participating hospital units. The code blue button was the primary mode of code team activation for 12/35 (34.3%) of the events. The code team received smartphone notifications a median of 78 seconds (IQR = 47-127 seconds) before traditional notifications. The initial rhythm was non-shockable for 34/35 (97.1%) of the patients. The median time to documented epinephrine administration for codes activated with or without the code button was 2:57 and 4:00 (IQR = 0:34-6:07 vs. 2:07-4:30; p = 0.89). Survival to hospital discharge was 3/12 (25.0%) for codes activated with the code button and 4/23 (17.4%) when activated by other methods (p = 0.61). Conclusion: Implementation of a smartphone-based code button activated notification system reduced the time to code team activation by over one minute. Further evaluation in larger cohorts is necessary to assess the effect on patient outcomes.

Evaluation of Anxiety, Depression, and Work-Related Strain Inventory of Code Blue Teams in Turkey During the COVID-19 Pandemic: A Cross-Sectional Survey Study.

Objective:This study aimed to evaluate the anxiety, depression, and work-related strain inventory with a cross-sectional electronic questionnaire in code blue teams during the coronavirus disease-2019 pandemic in Turkey.Methods:A web-based electronic questionnaire was sent to healthcare workers registered in the database of the Turkish Society of Anaesthesiology and Reanimation and the Turkish Resuscitation Council who are in the code blue teams of the hospital where they work. An electronic questionnaire including the hospital anxiety-depression scale and the work-related strain inventory was sent to healthcare professionals. A total of 259 participants who answered the questionnaire were included in the study.Results:It was determined that 41.3% (n = 107) of all participants were at risk in terms of anxiety and 64.1% (n = 166) were at risk in terms of depression by taking above the threshold value. The mean work-related strain inventory score of the participants was found to be 41.19 ± 6.31. The mean work-related strain inventory values of the participants who received above-threshold values from both the anxiety and depression subscales were also found to be statistically significantly higher than the participants who received below-threshold values (P < .001).Conclusion:It was determined that approximately half of the code blue teams were at risk for anxiety and two-thirds of them for depression.

Pediatic code blue event anaylsis: Performance of non-acute health-care providers

ABSTRACT In-hospital pediatric cardiopulmonary arrest is rare. With more than 50% of patients not surviving to discharge following cardiopulmonary arrest, it is important that health-care providers (HCPs) respond appropriately to deteriorating patients. Our study evaluated the performance of basic life support skills using non-acute HCPs during pediatric inpatient resuscitation events. We conducted a retrospective chart review of all code blue team (CBT) activations in non-acute care areas of a tertiary care children’s hospital from 2008 to 2017. The main outcomes were frequency of life support algorithmic assessments and interventions (critical actions) performed by non-acute HCPs prior to the arrival of CBT. CBT activation and outcome data were summarized descriptively. Logistic regression was used to assess for an association of outcomes with the presence of established leadership. A total of 60 CBT activations were retrieved, 48 of which had data available on isolated non-acute HCP performance. Most children (93%) survived to discharge. Critical action performance review revealed that an airway, breathing and pulse assessment was documented to have occurred in 33%, 69% and 29% of cases, respectively. A full primary assessment was documented in 6% of cases. The presence of established leadership was associated with the performance of a partial ABC assessment. Our results suggest that resuscitation performance of pediatric inpatient non-acute HCPs often does not adhere to standard life support guidelines. These results highlight the need to reconsider the current approaches used for non-acute HCP resuscitation training.

“Electromagnetic barrier” assisted dynamic spectrum access in satellite internet communication confrontation

In this paper, the dynamic spectrum access is investigated in satellite internet. Firstly, to describe the confrontation characteristics of the electromagnetic environment, two opposing teams denoted as the blue team (BT) and red team (RT), are designed. In addition, an “electromagnetic barrier” jamming strategy is proposed to achieve the effect of promoting approach defence with the attack. Precisely, the “electromagnetic barrier” can significantly weaken the communication ability of enemies (i.e. RT) while protecting the (i.e. BT) communication quality. Secondly, internal interference, external interference and malicious jamming of BT and RT are considered, and expected weighted aggregate interference and jamming (EWAIJ) are introduced to integrate these interference. Moreover, minimising interference is taken as the optimisation goal. Thirdly, Game theory is introduced to describe the combinatorial optimisation problem. The process of each team finding the optimal spectrum access strategy is proved to be an exact potential energy game. These two sub-games together constitute the Stackelberg game framework. Finally, a distributed hierarchical confrontation channel selection algorithm (DHCCSA) is proposed to find the Stackelberg equilibrium solution. The simulation results show that the proposed algorithm can converge to a better effect compared with other algorithms. In addition, with the assistance of the “electromagnetic barrier,” BT is more robust than RT in terms of convergence rate, total utility, and total network throughput.

COVİD-19 Dönemine ait Mavi Kod Uygulama Sonuçlarının Değerlendirilmesi

Giriş ve Amaç: Mavi Kod, hastanelerde yaşanabilecek ani dolaşım ve solunum durmasında, hastanın en kısa sürede resüsite edilmesini sağlamaya yönelik kullanılan acil durum hastane kodudur. Mavi kod ekibi hastanede kardiyopulmoner resüsitasyon (KPR) konusunda deneyimli ve eğitimli uzman hekim ve hemşirelerden oluşan kalbi yeniden canlandırma müdahale ekibidir. &#x0D; Gereç ve Yöntemler: Bu çalışmada Mart 2020- Eylül 2021 tarihleri arasında mavi kod çağrısı verilen hastaların verileri retrospektif olarak analiz edildi. Bu süreçte 58 olgu için mavi kod çağrısı verildi, yaş ortalaması 54.78±21.7 yıl olarak bulunmuştur. Pandemi servisleri mavi kod çağrısı verilen birimler arasında üst sıralarda yer almaktadır. Bulgular: Mavi kodlarda uygulanan KPR sonucu 7 hasta (%53) eksitus kabul edilirken, 6 hastada (%47) ritm sağlandıktan sonra yoğun bakım ünitesine nakli sağlanmıştır. &#x0D; Sonuç: Sonuç olarak; en kısa sürede ve eğitimli ve tecrübeli bir ekiple uygulanan KPR, insan hayatına gösterilen önem ve saygı, yasal sorumluluk ve kaliteli sağlık hizmeti sunumu açısından isabetli ve vazgeçilmez bir standarttır.

Developing and Testing a Protocol for Managing Cardiopulmonary Resuscitation of Patients with Suspected or Confirmed COVID-19: In Situ Simulation Study.

BackgroundResuscitating patients with suspected or confirmed COVID-19 imposes unique challenges to organizations and code blue teams. Studies that applied the American Heart Association (AHA) COVID-19–related Interim Resuscitation Guideline and similar European guidelines are scarce.ObjectiveThis study aimed to develop and test a cardiopulmonary resuscitation protocol based on the AHA COVID-19–related Interim Resuscitation Guideline.MethodsThe study was conducted as an in situ simulation in a medical intensive care unit. The COVID-19 cardiopulmonary resuscitation protocol was created and validated by 11 health care team members and tested using 4 simulation sessions where 46 code blue team members participated. During the simulation, we observed role clarity, the effectiveness of communication, team dynamics, infection control measures, and the availability of essential supplies and equipment.ResultsThe main issues identified in each simulation session were debriefed to the code blue teams and used to further revise the protocol. These include the assignment of tasks, availability of equipment and supplies, and failure of communication between the in-room and out-of-room teams. Solutions included changes in the placement of team members and roles and responsibilities; the creation of an isolation code medication package, a respiratory therapy kit, and an isolation code blue bag; and the use of two-way radios and N-95 masks with eye goggles to enhance communication between the teams.ConclusionsThis study shed light on the challenges to implement the AHA COVID-19–related Interim Resuscitation Guideline. The in situ simulation was an effective approach for rapid training, identifying unreliable equipment and ineffective and inefficient workflow, and managing the complexity of the physical environment.

Developing a Cyber Incident Exercises Model to Educate Security Teams

Since cyber attacks are increasing and evolving rapidly, the need to enhance cyber-security defense is crucial. A cyber incident exercise model is a learning technique to provide knowledge about cyber security to enhance a security team’s incident response. In this research work, we proposed a cyber incident model to handle real-time security attacks in various scenarios. The proposed model consisted of three teams: (1) the black team, (2) the red team, and (3) the blue team. The black team was a group of instructors responsible for setting up the environment. They had to educate the red and blue teams about cyber security and train them on facing cyber attacks. Once the training period was completed, the members were divided into two teams to conduct a cyber-security competition in a cyber game scenario. Each of the two teams performed a different task. The red team was the offensive team that was responsible for launching cyber-security attacks. The blue team was the defensive team that was responsible for countering attacks and minimizing the damage caused by attackers; they had to conduct both cyber-security configuration and incident handling. During the scenario, the black team was responsible for guiding and monitoring both the red and the blue teams, ensuring the rules were applied throughout the competition. At the end of the competition, the members of each team changed with each other to make sure every team member was using the knowledge they gained from the training period and every participant was evaluated impartially. Finally, we showed the security team’s offensive and defensive skills via the red team and the blue team, respectively.

Describing the Cardiopulmonary Resuscitation Factors and Outcomes

This study is a retrospective, descriptive review of all cardiopulmonary resuscitation (CPR) attempts at Al Wakra Hospital (AWH) conducted for one year i.e. 1st Jan 2020 to 31st Dec 2020. AWH is a 329-bedded, multispecialty secondary care facility, part of Hamad Medical Corporation (HMC), Qatar’s Governmental Healthcare organization in Qatar. In 2020, AWH had 11,862 inpatient admissions which are inclusive of Adult, Pediatric, Neonatal, Geriatric populations. There were also 1,184 admissions to the different Intensive Care Units (Medical, Surgical, Pediatric, and Neonatal). AWH has a Rapid Response Team (RRT) and Code Blue (CPR) team which is responsible for the respective codes. Code Blue team comprises one ICU Physician, one Respiratory Therapist, one Registered Nurse, all trained in Advanced Life Support. All CPR attempts were documented and recorded in CPR Record Sheets which were reviewed and the Electronic Medical Records (Cerner) were sourced for data gathering. One copy of CPR record sheets was kept in Cerner (Patient File) and one was sent to the Quality department for review/audit. After obtaining the list of CPR attempts over 2020, patients were identified, and medical records reviewed. The parameters recorded were demographic information, location, comorbidities and other relevant history, duration of CPR, initial CPR outcome, patient disposition, patient status on disposition (quality of life), etc. All these variables were considered to support the objective of this study i.e. to perform a descriptive analysis of in-hospital CPR. Based on the analysis of 110 patients for whom CPR was done, the percentage of immediate survival on the initial CPR was 53.64%. However, only 8.18% were eventually discharged to home while 11.82% were discharged to other HMC facilities.