Emergency Scenes Research Articles

A BIM centered indoor localization algorithm to support building fire emergency response operations

Abstract The ability to locate people quickly and accurately in buildings is critical to the success of building fire emergency response operations, and can potentially contribute to the reduction of various building fire-caused casualties and injuries. This paper introduces an environment aware beacon deployment algorithm designed by the authors to support a sequence based localization schema for locating first responders and trapped occupants at building fire emergency scenes. The algorithm is designed to achieve dual objectives of improving room-level localization accuracy and reducing the effort required to deploy an ad-hoc sensor network, as the required sensing infrastructure is presumably unavailable at most emergency scenes. The deployment effort is measured by the number of beacons to deploy, and the location accessibility to deploy the beacons. The proposed algorithm is building information modeling (BIM) centered, where BIM is integrated to provide the geometric information of the sensing area as input to the algorithm for computing space division quality, a metric that measures the likelihood of correct room-level estimations and associated deployment effort. BIM also provides a graphical interface for user interaction. Metaheuristics are integrated to efficiently search for a satisfactory solution in order to reduce the computational time, which is crucial for the success of emergency response operations. The algorithm was evaluated by simulation, where two building fire emergency scenarios were simulated. The tabu search, which employs dynamically generated constraints to guide the search for optimum solutions, was found to be the most efficient among three tuned tested metaheuristics. The algorithm yielded an average room-level accuracy of 87.1% and 32.1% less deployment effort on average compared with random beacon placements. The robustness of the algorithm was also examined as the deployed ad-hoc sensor network is subject to various hazards at emergency scenes. Results showed that the room-level accuracy could remain above 80% when up to 54% of all deployed nodes were damaged. The tradeoff between the space division quality and deployment effort was also examined, which revealed the relationship between the total deployment effort and localization accuracy.

A Survey of Wireless Indoor Positioning Technology for Fire Emergency Routing

Fire emergency response needs positioning solutions to assist evacuation and rescue operations. Therefore, we have to carefully review the candidates for this purpose. These indoor positioning technologies show different levels of applicability in fire emergency response. According to the varying demands of emergency response, flexible localization solutions should be provided. Thus, we guide a first step to implement this concept in three pre-defined emergency scenes. At last, we conclude several key features for indoor positioning solutions for emergency routing and three future research topics.

Situational awareness for supporting building fire emergency response: Information needs, information sources, and implementation requirements

Building fire emergencies are big threats to safety of building occupants and first responders, and they can result in significant property losses. During building fire emergency response operations, establishment and utilization of situational awareness are of essential importance, enabling first responders, especially incident commanders, to better assess changing on-scene situations and make informed decisions. The paper uses an interactive card game to guide first responders to establish situational awareness about an imaginary building fire emergency, and examines the information items needed by first responders in this process. An evaluation of the importance of each information item is performed. The results show that location and status of occupants and first responders, and status and development of fire and smoke are the foremost important information items. Information items in the “at emergency scene” category were updated on average five times more frequently than information items in other categories. In order to investigate sources for obtaining the above information, and examine requirements for better implementing situational awareness at emergency scenes, a nationwide survey was conducted with first responders in the United States. The results point out a discrepancy between current and desired information sources for establishing situational awareness at building fire emergency scenes. The paper also reports detailed implementation requirements, including type of assistance, level of details and format of representation for establishing situational awareness, and illustrates statistical impacts of location, years of experience and job title on the requirements.

The paramedic kairotope theory: findings

Scene-management is an important, yet under-researched aspect of paramedic practice. Using a grounded theory methodology, this qualitative inquiry acquired data from in-depth interviews with paramedics working in rural, suburban, and urban settings in Ontario, Canada. The findings comprise a theory of how expert paramedics accomplish the very difficult task of managing emergency scenes, which is a crucial pre- and co-requisite for the provision of patient care. This theory introduces a new term, the ‘paramedic kairotope’ as a conceptualization of this expertise, comprised of knowing when and where to act in a field/clinical situation. The theory further describes this competency as being informed by two social processes: substantial use of interpersonal communication and innovative problem solving.

Investigation of final destination hospitals for patients in helicopter emergency medical services (doctor–helicopter) in Fukushima Prefecture

In using an emergency medical service helicopter with an emergency medicine doctor on board (doctor-helicopter), transporting all patients to the University Hospital (base hospital for the helicopter) could cause a chronic bed shortage at the University Hospital. It is also disadvantageous for patients from distant areas. We investigated whether appropriate hospital selections are being carried out in Fukushima Prefecture. The subjects of the study were patients who were transported by doctor-helicopter since the services started. We investigated the medical conditions of patients at emergency scenes, whether they were transported to a hospital inside or outside the region, the means of transportation, and the final destination hospital. There were 450 flights, of which 295 were to emergency scenes, involving 307 patients. The majority were trauma patients (191 patients, 62.2%). The final destination hospital was the University Hospital for 104 patients (33.9%); 99 patients (30.3%) were transported to three emergency and critical care medical centers (ECCMCs) in other regions. Most patients were transported to appropriate hospitals in the respective regions. The means of transportation from the emergency scene was by doctor-helicopter in the largest number of cases (223 patients, 72.6%), and the final destination hospital was ECCMCs in 81.6% of cases. Patients from emergency scenes are transported by doctor-helicopter to appropriate hospitals in the region, and hospitals in each region are cooperating with the doctor-helicopter operations.

HELICOPTER EMERGENCY MEDICAL SERVICES (DOCTOR-HELICOPTER) IN FUKUSHIMA PREFECTURE: PRESENT STATE AND PROBLEMS

The purpose of this study is to identify the problems in operating an emergency medical service helicopter with an emergency medicine doctor on board (doctor-helicopter) in Fukushima Prefecture, Japan, which covers wide regions and many rural areas. The study looked at the numbers of flights and patients during the 523 days since the start of the doctor-helicopter service at the Fukushima Medical University Hospital. The items investigated were: number of flights, number of helicopter dispatches per month, number of patients, the hospitals where patients were taken to, the fire department dispatch centers that requested the doctor-helicopter, and the number of times each doctor flew on the helicopter. There were 450 flights. When the service was started, there were a few flights, but they gradually increased. The majority of the flights were to emergency scenes (295), while 75 flights were interfacility transports of critically ill patients, 79 flights were cancelled after take-off, and one flight was for a disaster relief operation. The nature of requests differed greatly depending on the fire department dispatch center requesting the service. The majority of patients were trauma patients (62.2%). Stroke (8.5%) and acute coronary syndrome (5.2%) patients requiring emergency treatment were fewer than anticipated. The final destination hospitals were appropriate hospitals in the region. Because the number of flight doctors is small, the burden on individual doctors is large. A system for early on-site diagnosis and helicopter request by emergency rescue team is required to maintain a high quality of emergency care.

The Space‐Control Theory of Paramedic Scene‐Management

Paramedics provide emergency service in physically hazardous and socially complex situations. These work settings present unique challenges in terms of managing resources and relationships in a multicrisis context, in order to enable the delivery of emergency patient care. Using data obtained from interviewing paramedics, this study demonstrates the usefulness of symbolic interaction theory for context analysis, by analyzing an important aspect of paramedic practice: scene management. Through grounded theory methodology, this study also presents the first interactionism‐based theory of how paramedics manage emergency scenes. This theory emphasizes the critical role of social processes in establishing social control in work spaces.

Out-of-Hospital Violence Injury Surveillance: Quality of Data Collection

Study objective: The recognized need to improve data collection for violence prevention may be met, in part, by using out-of-hospital data for injury surveillance. The purpose of the Prehospital Violence Injury Surveillance project was to examine the extent to which paramedics can adequately collect information about injuries, particularly intentional injuries, at emergency scenes. Methods: Paramedics in a large Midwestern metropolitan area were trained to assess violence-related events and collect relevant data using a modified ambulance run report form. Data collected from 8 violence-related training scenarios and from 13 ride-along observations were analyzed to estimate paramedic interrater reliability using the κ statistic. Data from 7,363 run report forms, filed during a 3-month study period, were abstracted and analyzed for completeness and quality. Results: Paramedics demonstrated fair to good, and sometimes excellent, interrater agreement when documenting the training scenarios. Paramedics revealed barriers to collecting violence-related out-of-hospital data. The paramedics and the observer disagreed in documenting 77% of the ride-along observations. Overall, 73% of abstracted run report forms showed documentation errors, with more than 99% of these reports containing errors of omission and 29% showing internal documentation inconsistencies. Despite the emphasis on violence-related data, documentation of domestic abuse screening was missing from more than 99% of run reports from female patients. Conclusion: Significant barriers to quality out-of-hospital data collection were identified during study implementation and in abstracted run reports. These barriers included the following: lack of organizational support; characteristics of the violence-related data elements; design of the ambulance run report form; and paramedic knowledge, attitudes, and behaviors regarding data collection. [Boergerhoff LA, Gerberich SG, Anderson A, Kochevar L, Waller L: Out-of-hospital violence injury surveillance: Quality of data collection. Ann Emerg Med December 1999;34:745-750.]

Medical communication from emergency scenes using a notepad computer.

We have developed a communication system in which data are transferred from the scene of an emergency in the form of an electronic record on a notepad computer by means of a satellite link (MODACOM). The data are received at the dispatch centre and transferred to the admitting hospital automatically. In a prospective study of 53 emergencies the technical suitability of the system was investigated. First-sight information could be fed into the computer in 15 s and transmitted within 3 min of arrival on the scene. For 16 patients with life-threatening conditions, the admitting hospital was notified on average after 13.6 min (SD 6.0), whereas by conventional VHF radio it took 35.5 min (SD 8.9). In addition, more precise information about the patient's condition was received at the hospital.

Study of water supply system on emergency scenes

The most drinking water resource in Kobe depends on the Yodo river basin, so self-water source is very limited. The Kobe earthquake gave big damage on water supply system. They did not get even their own drinking water on that day, however there are many rivers which flow down from Rokko mountain in Kobe city. These rivers had enough water even after the Kobe earth quake. In this case study of Kobe city we estimated potential of river water as emergency water after a terrible earthquake. After 2 weeks of the earthquake, total water volume in 8 rivers amounts to 104000m3 per day. It equals to the drinking water for about 35, 000, 000 people and domestic water for 520, 000 people, therefore potential of river water in emergency is quite high.From water quality points of view we can drink most rivers water by simple treatment. We clear that river water has higher potential in emergency compared with water tanks and water supply system.