Emergency Response Network Research Articles

Evaluating flood resilience in rural communities: a case-based assessment of Dyer County, Tennessee

Communities everywhere are being subjected to a variety of natural hazard events that can result in significant disruption to critical functions. As a result, community resilience assessment in these locations is gaining popularity as a means to help better prepare for, respond to, and recover from potentially disruptive events. The objective of this study was to identify key vulnerabilities relevant to addressing rural community resilience through conducting an initial flood impact analysis, with a specific focus on emergency response and transportation network accessibility. It included a use case involving the flooding of a rural community along the US inland waterway system. Special consideration was given to impacts experienced by at-risk populations (e.g., low economic status, youth, and elderly), given their unique vulnerabilities. An important backdrop to this work is recognition that Federal Emergency Management Agency’s Hazus, a free, publicly available tool, is commonly recommended by the agency for counties, particularly those with limited resources (i.e., rural areas), to use in developing their hazard mitigation plans. The case study results, however, demonstrate that Hazus, as currently utilized, has some serious deficiencies in that it: (1) likely underestimates the flood extent boundaries for study regions in a Level 1 analysis (which solely relies upon filling digital elevation models with precipitation), (2) may be incorrectly predicting the number and location of damaged buildings due to its reliance on out-of-date census data and the assumption that buildings are evenly distributed within a census block, and (3) is incomplete in its reporting of the accessibility of socially vulnerable populations and response capabilities of essential facilities. Therefore, if counties base their flood emergency response plans solely on Hazus results, they are likely to be underprepared for future flood events of significant magnitude. An approach in which Hazus results can be augmented with additional data and analyses is proposed to provide a more risk-informed assessment of community-level flood resilience.

Abstract TP255: Tackling Door in-Door Out Through a Statewide Initiative

Background: The AHA/ASA has determined thrombectomy is standard-of-care up to 24 hours after last seen normal (LSN) for ischemic stroke patients with anterior circulation large vessel occlusion (LVO), provided the perfusion imaging profile meets criteria. Many patients require secondary transfer to access thrombectomy centers. The door in-door out (DIDO) is a target for process improvement. Methods: The Louisiana Emergency Response Network (LERN)’s stroke system of care was initiated in 2010. Submission of quarterly emergency department stroke data to LERN was voluntary as of Q1 2014 and was mandated as of Q1 2018 for hospitals attesting to Acute Stroke Ready Hospital (ASRH) capability. Sites across the state were invited to pilot expanded variable in order to assess LVO screening and baseline DIDO for patients with LVO. Results: Of 56 ASRHs, 34 sites submitted one or more quarters of data during the pilot phase contributing a total of 1808 cases. LVO screening was performed in 992 (54.9%) cases; 172 (17.3%) were LVO screened positive. VAN was used in 75.6% of LVO positive patients and CTA was used in 20.3%. Most patients (71.3%) arrived via ambulance. The median NIHSS in LVO positive patients was 12 (IQR 5-20). Transfer time was available in 114 (66%) LVO positive patients; median DIDO was 146 minutes (IQR 89-243 minutes). Transfer request time was available in 30 (17.4%) of LVO positive patients; median interval from transfer request to departure was 47 minutes (IQR 31-65 minutes). Discussion: Given that most patients with ischemic stroke caused by LVO will not present initially to a thrombectomy center, DIDO must be minimized to preserve penumbra and maximize likelihood of eligibility for thrombectomy when the thrombectomy center is accessed. LERN’s pilot LVO screening study established a baseline from which DIDO is a necessary target for intervention. Only 25% of LVO positive patients were transferred with DIDO less than 90 minutes. LERN’s initial goal is to shift the median DIDO to 90 minutes. Participation in the expanded variables targeting LVO screening and DIDO was mandated by LERN effective Q3 2018.

Decision Assessment Algorithms for Location and Capacity Optimization under Resource Shortages

ABSTRACTEmergency response preparedness requires strategic and operational planning. As natural disasters, disease outbreaks, and bioterrorism continue to threaten public health and the global economic system, policy makers and businesses develop plans for improving their readiness. These emergencies present challenging problems that require evaluation of several trade‐offs due to insufficient resources and capacity with limited response time pressure. Finding an optimal strategy to these problems can be computationally difficult, since they are formulated as large‐scale service network design models with location‐allocation decisions. The facility location problems in disaster management literature are typically known as ‐hard problems. Therefore, heuristic algorithms can help find practically feasible solutions, but decision makers may have to sacrifice one of their objectives while trying to satisfy multiple of them. This paper presents a flexible algorithm to evaluate trade‐offs in resource scarce situations with a given response time. We formulate the location‐allocation problem with capacity and time constraints, and the objective of minimizing the service time for individuals in an affected area. Due to the complexity to solve the problem for large‐scale scenarios, the presented algorithm relaxes capacity and time constraints, simultaneously, and presents flexibility to assess trade‐offs. A modified NSGA‐II algorithm is used with a penalty function formulated to leverage resources. We analyze how values of the penalty parameters interact with a number of open sites in defining an efficient resource allocation strategy. Therefore, decision makers can expand their choices to design an emergency response network with their preferences taken into consideration.

Time dynamics of emergency response network for hazardous chemical accidents: A case study in China

Since currently hazardous chemical accidents occur frequently around the world, how to build up an effective emergency response network (ERN) for hazardous chemical accidents become an urgent issue. Given the truth that previous static ERN research could not reflect the dynamic interaction patterns among actors in emergency response process, this paper studied the emergency response network for hazardous chemical accidents from the perspective of temporal dynamics. Jiangsu Xiangshui 3.21 chemical plant explosion accident, a major hazardous chemical accident just happened in March 2019, was selected as a case in this paper. Based on the time slices of the accident emergency response process, the dynamic evolution of emergency response network, organization functions, and organization positions over time were analyzed by social network analysis (SNA). The results revealed the dynamics of emergency response network in the context of centralized administrative systems. Emergency response network became more decentralized over time, rather than centralized; central organization functions varied depending on the response needs in each period; and positions of participants in network changed as time passed. The results also showed that under the centralized administrative systems, public-sector organizations were the core of emergency response network; whilst non-profit organizations and private organizations were largely marginalized. A hybrid network with centralization and decentralization complement each other may be more effective. ERN for hazardous chemical accidents should be considered in a time-dynamic way and collaborations among public sector organizations, NPOs and private organizations should be paid more attention to improve the emergency response efficiency. These findings may expand knowledge for researchers and practitioners to understand emergency response network of hazardous chemical accidents from dynamic perspectives, having an important significance for reducing and controlling economic losses, social risks and environmental damage caused by hazardous chemical accidents.

Qualitative identification of imidacloprid in postmortem animal tissue by gas chromatography-tandem mass spectrometry

During an avian mass mortality event investigation at the National Fish and Wildlife Forensic Laboratory in Ashland, OR, imidacloprid became an insecticide of concern. A qualitative analytical toxicology screen of seeds, plucks (tongue, esophagus, and trachea), and ventricular contents was requested. A method for the extraction and qualitative analysis of the insecticide in animal tissues was therefore developed. The procedure relies on a combined Food Emergency Response Network (FERN) and QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) approach to sample extraction followed by qualitative analysis by gas chromatography-tandem mass spectrometry. Since imidacloprid is not amenable to the conditions of gas chromatography, a trimethylsilyl derivative was created and characterized. Proposed mechanisms for the creation of this derivative and its mass spectrum are described. The imidacloprid-trimethylsilyl (TMS) derivative was detected in all samples submitted.

Inductively Coupled Plasma Collision Cell Quadrupole Mass Spectrometric Determination of Extractible Arsenic, Cadmium, Chromium, Lead, Mercury, and Other Elements in Food Using Microwave-Assisted Digestion: Results from an FDA Interlaboratory Study

Background: An interlaboratory study was conducted to test U.S. Food and Drug Administration (FDA) Elemental Analysis Manual (EAM) Method 4.7, "Inductively Coupled Plasma-Mass Spectrometric Determination of Arsenic, Cadmium, Chromium, Lead, Mercury, and Other Elements in Food Using Microwave Assisted Digestion." Objective: The goal of the study was to demonstrate the performance of FDA EAM Method 4.7. Methods: Fourteen laboratories participated in the collaborative study, including nine Food Emergency Response Network state laboratories and five federal FDA laboratories. Laboratories tested 8 labeled standard reference materials and 12 blinded foods: mayonnaise, dark chocolate, sunflower seeds, hamburger with cheese, brown rice flour (blinded reference material included as a test food), infant formula, canned smoked oysters, sardines in tomato paste, swordfish, mineral water, cinnamon, and a multivitamin. The blinded test foods represented every sector of the AOAC food triangle. Participants measured the mass fraction of each element in each sample in triplicate. Results: Horwitz Ratio (HorRat) values were better than 1.5 for all As, Cd, Cu, Hg, Mo, Ni, Pb, and Se measurements when at least eight laboratories reported results greater than LOQ. The HorRat values were better than 1.5 for all Mn and Zn measurements except for the multivitamin and for all Cr measurements except for sunflower seeds, in which the nonhomogeneity was identified. The average HorRat value of the blinded test foods was 0.66 for results greater than LOQ (n = 4206). Conclusions: The study showed that the method performed satisfactorily as a standard method for extractible elemental analysis of food. Highlights: The method met or exceeded the performance expected.

Modeling and Analysis of Emergency Response Plan Based on Network Diagram

Modeling of emergency response plan is the basis for reducing the harm and adverse effects of sudden disasters on society. Multi-entity (unit) participate in emergency response plan has high synergy in workers and entities, strong logical relationship, etc. In this paper, the natural disaster emergency response plan is the research object, and the emergency rescue mission is directive, and rescue time is the main line, and model is builded by using the network diagram. This method aims to express all kinds of emergency response plans more flexibly and accurately, and the complex relationship between internal working rooms and the expression of structural networks. At the same time, this paper establishes a task which completion probability model to comprehensively evaluate emergency response capabilities based on time. The emergency response network diagram established in this paper has the characteristics of the network and can be combined with complex network theory for in-depth research.

Configuring emergency response networks

In the fog and chaos of an emergency it seems difficult to determine which organisations to involve in the response in order to ensure that the organisational network is fit for purpose. In this paper we study three emergencies in the Netherlands in order to find out what patterns are detectable in the network of the responding organisations. Based on qualitative analysis we develop insights about how the composition of the response networks relates to the nature of the emergencies, and the impact they have on the community. We find the community to be an intertwined constellation of networks. A failure in this constellation may result in an emergency situation. The failure itself and any collateral effects from responsive actions ripple through the constellation of networks. We found that the emergency situation and the emergency response network mutually shape each other and are a reflection of each other.

Configuring emergency response networks

Configuring emergency response networks

Study on Risk Analysis and Emergency Response of Problematic Vaccine Events in China

In recent years, frequent vaccine safety events in China have become a serious public health problem. Especially in the new media era, vaccine safety events have received close attention from the public as well as the government. If they are not handled properly, many potential risk factors will be brought to social stability, the credibility and authority of the government will be affected. And many negative impacts will be brought to China national immunization program. In this paper, we summarized the inadequacies of vaccine event research, and analyzed the risk factors of vaccine in R&D, transportation, storage, vaccination and other parts. Based on the double perspectives of supervision and disposal, we constructed a risk analysis framework for vaccine safety events. Taking the 2016 Shandong Vaccine Event as an example, we analyzed the mechanism of the occurrence, development, evolution and termination of vaccine evens, and summarized the possible social risks caused by vaccine events. Taking the 2018 Changchun Changsheng Vaccine Event as an example, we analyzed the emergency response network attributes of vaccine event based on the complex network theory, including structural characteristics, organizational functions and overall performance. In view of the above research conclusions, we put forward countermeasures for vaccine events that are suitable for China’s national conditions, with a view to improving the risk control and emergency response capabilities of public health emergencies.

Examining the Intergovernmental and Interorganizational Network of Responding to Major Accidents for Improving the Emergency Management System in China

Since the SARS crisis in 2003, institutionalized emergency management systems have been established in each government level for improving inter-organizational collaboration in China. Major accidents require participation of public organizations affiliated with multiple government levels, and the lack of collaboration and coordination among the involved organizations within the critical time constraints during the response process is an existing problem. In this research, a case study of examining the intergovernmental and cross-sectoral collaboration for responding to a well-known oil pipeline explosion accident in China by a complex network method is conducted. The aim is to obtain managerial insights in improving the existing emergency management system in a centralized political-administrative context, such as China. A mixed method of data collection is applied to identify the participating organizations and to determine the interaction spanning organizational boundaries in both hierarchical and horizontal dimensions. An emergency response network is built and visualized for representing intergovernmental and interorganizational collaboration during the response process of the major accident by social network analysis (SNA) tools. The SNA indicators are used to measure quantitatively the network structure at the levels of the whole network, subnetwork, and node. The obstacles of achieving intergovernmental collaboration are found, and managerial suggestions for improving the existing emergency management system are provided. This research indicates that the Chinese government should pay attention to establishing and sustaining partnerships with private and nonprofit organizations and conduct a blend of hierarchical, market, and network principles in fostering collaboration for addressing major accidents. The public organizations in the local government level are shown to be more active than other participators in coordinating their response operations, and their capability should be emphasized for improvement. Additionally, the interactive relationships among specific emergency function groups and between the affected communities and organizations performing emergency command and coordination function should be strengthened.

Development of a Quantitative Gas Chromatography-Tandem Mass Spectrometry Method for the Determination of Pentobarbital in Dog Food.

In 2017, a commercially available dog food was found by our laboratory to be adulterated with the euthanasia drug pentobarbital. An FDA class 1 voluntary recall by the company ensued. Since there is no set tolerance for pentobarbital in food or feed, a sensitive method for its detection was required. We describe a simple, yet efficient, method for the extraction and quantitative analysis of the barbiturate in dog food. The procedure relies on a combined food emergency response network (FERN) and QuEChERS (quick, easy, cheap, effective, rugged, and safe) approach to sample extraction followed by quantitative analysis by gas chromatography-tandem mass spectrometry (GC/MS/MS) using pentobarbital- d5 as an internal standard. This procedure improves upon other GC/MS methodologies in that derivatization of pentobarbital or its deuterated internal standard is unnecessary, and sensitivity to a calculated limit of detection (LOD) of 0.6 ppb and a limit of quantitation (LOQ) of 2 ppb is achieved.

Timely assessment of disaster and emergency response networks in the aftermath of superstorm Sandy, 2012

PurposeThe purpose of this paper is to elaborate pros and cons of two coding methods: the rapid network assessment (RNA) and the manual content analysis (MCA). In particular, it focuses on the applicability of a new rapid data extraction and utilization method, which can contribute to the timely coordination of disaster and emergency response operations.Design/methodology/approachUtilizing the data set of textual information on the Superstorm Sandy response in 2012, retrieved from the LexisNexis Academic news archive, the two coding methods, MCA and RNA, are subjected to social network analysis.FindingsThe analysis results indicate a significant level of similarity between the data collected using these two methods. The findings indicate that the RNA method could be effectively used to extract megabytes of electronic data, characterize the emerging disaster response network and suggest timely policy implications for managers and practitioners during actual emergency response operations and coordination processes.Originality/valueConsidering the growing needs for the timely assessment of real-time disaster response systems and the emerging doubts regarding the effectiveness of the RNA method, this study contributes to uncovering the potential of the RNA method to extract relevant data from the megabytes of digitally available information. Also this research illustrates the applicability of MCA for assessing real-time disaster response networks by comparing network analysis results from data sets built by both the RNA and the MCA.

The Impact of a Strong Commitment on Disaster Resilience: A Longitudinal Study of the 2012 Korean Typhoons

Abstract Natural and technical disasters are abrupt and have a huge impact on relatively broad regions, yet little research has examined how local organizations overcome institutional collective action dilemmas in collaborative emergency management. Since simply participating in collective agreements and adopting coordination plans are inadequate for achieving effective collaboration in emergency situations, this research aims to test whether organizations’ decisions to engage in joint emergency programs are sufficient for building resilient emergency response networks. We systemically design a Heckman selection model with two stages by utilizing data derived from the 2012 and 2013 emergency management surveys conducted before and after the 2012 Korean typhoons. The results demonstrate how a strong commitment though participation in joint exercises significantly influences disaster than formal planning and network affiliations. The findings imply that network interactions forged by such full-scale exercises reduce transaction costs of collaboration and improve community resilience.

Application of dispersive solid phase extraction for trace analysis of toxic chemicals in foods

The objectives of this study were to develop and validate a method for the identification of toxic organic chemicals, including groups of controlled substances, alkaloids and pesticides that are highly toxic and considered threats to public health. This project aims to ensure our laboratory's readiness to respond to emergencies involving our food supply in cooperation with the Food Emergency Response Network (FERN) program. The food matrices were homogenized in a blender or food processor prior to extraction with an acetonitrile-water mixture using a QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) procedure. The extracts were then analyzed by either gas chromatography–mass spectrometry (GC–MS) or liquid chromatography-electrospray tandem mass spectrometry (LC-ESI/MS/MS). Method validation was performed on a variety of food matrices including lettuce, grapes, milk, chicken, pork and beef. MDLs for the toxic compounds ranged from 0.01 to 0.66 mg/kg (ppm). The findings in this study will provide a valuable resource for the determination of toxic chemicals in food matrices for emergency response situations.

Railroad transportation of crude oil in Canada: Developing long-term forecasts, and evaluating the impact of proposed pipeline projects

Rail crude oil shipments have witnessed a steady increase over the past decade, which underscore the long-term viability of this transport mode. Although incidents involving these shipments could be catastrophic, having link-level information could be useful for designing appropriate emergency response network and responding to such episodes. We present a data-driven methodology that makes use of analytics to estimate the amount of crude oil on different rail-links in Canada until 2030. The resulting analyses facilitated identifying high-risk links around Canada based on the current practice of the railroad industry, and to suggest that incurring marginally higher transportation costs could reduce network risk. In addition, the availability of the proposed pipeline infrastructure would change the supply and demand location configurations over the forecast horizon, with the maximum changes to the current crude oil traffic flow pattern stemming from the completion of the Energy East pipeline project.

Abstract TP268: Distribution of Acute Ischemic Strokes After Implementation of Endovascular Guidelines in Louisiana

Objective: To highlight the distribution of acute ischemic strokes (AIS) after implementation of endovascular guidelines. Background: Louisiana Emergency Response Network (LERN) is an organization with a mission to build comprehensive statewide systems of care for time-sensitive conditions including stroke. Four levels of stroke centers were recognized in 2013. Level 1: Comprehensive stroke center; Level 2: Primary stroke center; Level 3: Acute stroke ready hospital and Level 4: Non-stroke hospitals. As of 2017, there are 2 comprehensive stroke centers in Louisiana and 15 primary stroke centers. Statewide education was provided regarding mechanical endovascular recanalization (MER) for large vessel occlusion (LVO) in AIS as AHA/ASA guidelines were updated in 2015. Design/Methods: Louisiana hospital inpatient discharge database for year 2014 and 2015 was retrospectively analyzed. Distribution of AIS and MER based on hospital level were explored. Results: A total of 9396 patients with AIS were identified in dataset for year 2014 and 10409 for the year 2015. Proportion of AIS treated in Level 1, 2 and 3 hospitals increased in 2015 {Level 1: 2014 VS 2015: 1034 (11%) VS 1342 (13%); Level 2: 3946 (42%) VS 5035 (48%); level 3: 3195 (34%) VS 3610 (35%)}. Proportion of AIS patients in level 4 hospitals declined in 2015 {Level 4: 2014 VS 2015: 1221 (13%) VS 422 (4%)}. In 2014, 8.2% (770/9396) received any form of recanalization therapy compared to 9.5% in 2015 (989/10409), with higher proportions in Level 1 (22.2% VS 26.2%) and 2 centers (9.4% VS 10.2%) than Level 3 (4.1% VS 3.2%) and 4 (2.6% VS 1.4%). In 2015, 1.8% of patients with AIS had MER; this compares to 0.8% in 2014. Conclusion: The reduction of patients treated in Level 4 hospitals in 2015 suggests our pre-hospital destination protocol facilitated transport to appropriate facilities. The proportion of patients with AIS receiving any form of recanalization increased in 2015, specifically in Level 1 and 2 centers. Improved destination of acute stroke patients likely contributed to increased recanalization rate and utility of MER. Statewide implementation of a revised initial destination protocol respecting the endovascular guidelines should lead to more LVO AIS patients receiving MER.

Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes

The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. Trauma patients directed by LERN from the field in 2014 were included. Patients who followed the LERN communication center direction were considered the compliant group. Patients brought to a hospital inconsistent with the LERN direction were considered the noncompliant group. Chi-square analysis was used to compare differences between groups and a p value of <0.05 was considered statistically significant. During the study period, LERN directed 14,071 patients to a destination hospital. Prehospital providers were compliant with the LERN direction in 13,037 (92.7%) patients and noncompliant in 1,034 (7.3%) patients. There were fewer patients in the compliant group (570 of 13,037 [4.3%]) requiring transfer to a second hospital than in the noncompliant group (312 of 1,034 [30.2%]) (p < 0.01). The mortality rate was lower in the compliant group (81 of 13,037 [0.6%]) than in the noncompliant group (21 of 1,034 [2.03%]) (p < 0.01). Following direction from a central communication center with real-time hospital capacity data yielded a 6-fold decrease in secondary transfer and a 3-fold decrease in mortality. These data emphasize the value of an organized statewide trauma network that routes patients to the appropriate facilities.

Combining Worst Case and Average Case Considerations in an Integrated Emergency Response Network Design Problem

We study an emergency response network design problem that integrates relief (supply) and evacuation (demand) sides under disaster location and intensity uncertainties which, in turn, dictate uncertainty in terms of the location and amount of demand. Representing these uncertainties by discrete scenarios, we present a stochastic programming framework in which two second stage objectives, the average and worst case costs, are combined. In our model, we minimize, over all of the scenarios, the fixed costs of opening supply centers and shelters, and the weighted sum of average and worst case flow costs. Thus, the model gives the decision maker the flexibility to put relative emphasis on the worst case and average flow cost minimization and explore outcomes in terms of total costs and network configurations. To solve large scale instances with varying relative weights, we devise alternative Benders Decomposition approaches. We implement these by using an advanced callback feature of the solver while simultaneously incorporating several performance-enhancing steps that help to improve runtimes significantly. We conduct a detailed computational study to highlight the efficiency of our proposed solution methodology. Furthermore, we apply our approach in a realistic case study based on Geographical Information Systems data on coastal Texas and present interesting insights about the problem and the resulting network structures for varying weights assigned to objectives.

Patterns of preference and practice: bridging actors in wildfire response networks in the American Northwest.

The roles of bridging actors in emergency response networks can be important to disaster response outcomes. This paper is based on an evaluation of wildfire preparedness and response networks in 21 large-scale wildfire events in the wildland-urban interface near national forests in the American Northwest. The study investigated how key individuals in responder networks anticipated seeking out specific people in perceived bridging roles prior to the occurrence of wildfires, and then captured who in fact assumed these roles during actual large-scale events. It examines two plausible, but contradictory, bodies of theory-similarity and dissimilarity-that suggest who people might seek out as bridgers and who they would really go to during a disaster. Roughly one-half of all pre-fire nominations were consistent with similarity. Yet, while similarity is a reliable indicator of how people expect to organise, it does not hold up for how they organise during the real incident.