Evacuation Methods Research Articles

Navigating Concurrent Disasters: Lessons learned from a Hospital Evacuation Amidst a Pandemic and an Earthquake.

The concurrent challenges of the COVID-19 pandemic and a significant earthquake in Izmir on October 30, 2020, presented a unique scenario for disaster management and response. This study focuses on the impact of the earthquake, which resulted in 117 fatalities, including 1 due to drowning, and injured 1034 individuals, alongside widespread structural damage including to the Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital. The objective is to assess the activation and implementation of the hospital disaster plan amidst the ongoing pandemic. Through a retrospective evaluation of all actions undertaken as per the Hospital Disaster Emergency Plan within the Disaster Management cycle, this study examines the decision-making process for the hospital evacuation on October 30, 2020, the evacuation of COVID-19 patients, and the strategies employed to increase hospital capacity. Of 216 patients hospitalized at the time of the earthquake, 65 were transferred to other facilities under COVID-19 protocols. The prolonged nature of pandemics and the likelihood of secondary disasters underscore the importance of comprehensive risk assessments and dynamic disaster planning, considering simultaneous multiple hazards. This study suggests the inclusion of multi hazard scenarios and diverse evacuation methods by using types of ambulances, such as ground, helicopter, and boat.

Current aspects of the organization of first aid to military personnel of the NATO bloc (using the example of the Bundeswehr army)

The study examines the most pressing issues of the organization of first aid to military personnel in the countries of the NATO bloc (using the example of the Bundeswehr army). It has been established that the system of first aid to the wounded and injured is based on the principles of “tactical medicine”, including the possession by military personnel of algorithms for providing assistance in the “red” and “yellow” combat zones, as well as methods of evacuation to the stage of medical care. It is emphasized that in order to quickly and effectively carry out self- and mutual assistance activities on the battlefield, NATO military personnel have appropriate training in the use of a standard individual first aid kit. It is shown that the Bundeswehr army has successfully implemented a training program consisting of two consecutive and logically related medical training courses: an initial training cycle (course “A”) and a special medical training course (course “B”). Only military personnel who have successfully completed both training courses are allowed to provide first aid in combat and emergency situations. It was revealed that within the framework of initial military training, students master a set of measures for phased first aid to the wounded and injured in accordance with the “C–A–B–C–D–E” scheme. The subsequent course of special medical training is aimed at training military personnel in emergency resuscitation measures in conditions as close as possible to combat. The purpose of the study was to analyze the literature data devoted to the study of the peculiarities of the existing system of first aid to the wounded and injured in the armies of NATO countries, including in the aspect of the organization of the training process for servicemen. The research methodology included the analysis of scientific publications selected from domestic and foreign databases, such as e-Library and PubMed. The methods of content analysis, synthesis, method of historical comparison, and bibliographic research method were used.

Assessing the Need for Additional Evacuation Measures in Deep Underground Stations

Underground railroad stations face evacuation challenges owing to the rapid spread of smoke and extended escape routes during fires. Evacuation in deeply underground domestic railroad stations relies solely on stairways, with no legal standards for additional evacuation methods. In contrast, international standards such as NFPA 130 and Japan’s Fire Protection Engineering Association (JAFPE) recommend using evacuation elevators as a supplementary means of evacuation. This study analyzed smoke behavior in deep underground railroad stations through fire simulations at the Soongsil University and Guryong station. It also examined additional evacuation measures to enhance evacuation safety through evacuation simulations. The results show that during a fire, smoke spread follows the same path as the passenger evacuation routes because of the chimney effect. Even with smoke control and ventilation systems in operation, smoke follows the same evacuation routes, such as stairways or escalators. Therefore, the study concluded that evacuation elevators should be installed as an additional means to improve evacuation efficiency, and placed in smoke-protected evacuation routes. The study also found that combining evacuation stairways and elevators significantly enhances the evacuation efficiency.

Anesthetic Gas Scavenging System for Gas Evacuation in the ICU.

Inhaled sedation is increasing in ICUs, with active carbon filters (ACFs) commonly used for evacuating halogenated gases. However, the potential benefits of a waste anesthetic gas system (WAGS) similar to the ones used in operating rooms should be explored. To limit the suction over the flow sensor where the WAGS is connected on ICU ventilators, an anesthetic gas receiving system (AGRS) is required, constituting with the WAGS an active gas receiving and scavenging system (AGRSS). Ensuring that this whole device does not compromise the flow sensor reliability is crucial. The aim of this study was to compare various gas evacuation devices and assess the reliability of AGRSS on ICU ventilators. In this experimental study, pressures and flows were recorded during the ventilation of a test lung using various ventilator settings and gas evacuation methods: no device (reference condition), ACF, the WAGS alone, AGRSS (WAGS and AGRS together), and the expiratory valve connected to the medical vacuum system with the AGRS in between. Visual comparisons of the pressure and flow curves followed by a statistical analysis comparing median pressures and flows of each device to the reference were performed. The test lung model demonstrated consistent comparability in pressures and flows among all devices, except for the WAGS alone, which exhibited discordance through significant overestimation or underestimation. These findings indicate that using a WAGS with the AGRS system appeared to be reliable for managing gas evacuation in ICUs without compromising pressure or flow delivery. The data from this experimental trial should be confirmed with clinical studies involving human subjects. Given the increasing use of inhaled sedation in ICUs, these results support the daily application of the WAGS with the AGRS for gas evacuation, similar to its established use in anesthesiology.

Evacuation of the Injured Using Unmanned Systems

This article explores the use of unmanned systems for evacuating wounded personnel from the battlefield. It focuses on conclusions drawn from conventional medical evacuation methods, particularly when wounded soldiers are still in the enemy’s operational zone, following the principles of Tactical Combat Casualty Care (TCCC). Then, general conditions of the injured were determined, which would require evacuation to a safe zone. This allowed us to define the critical capabilities needed for unmanned systems to perform these tasks. The ability of the unmanned system to pick up an injured person who is unconscious and unable to cooperate was identified as crucial. In the further part of the work, existing unmanned systems intended for rescue tasks were collected and critically analysed.

Evacuation safety assessment in corridor-type high-rise building under fires

This study aims to elucidate the characteristics of personnel evacuation in corridor-type high-rise building under fires and to assess their evacuation performance. Utilizing Building EXODUS software, the study simulated the evacuation behavior of occupants, particularly focusing on the impact of corridor structures on the building's fire evacuation capabilities. A performance evaluation model was developed, which incorporates factors such as building conditions and natural environments. This model employs an enhanced Analytic Hierarchy Process (AHP) combined with Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) analysis for more accurate assessment. The findings reveal that traditional evacuation performance assessment methods, which often overlook the impacts of corridor location, time of day, and illumination conditions, are not adequately suited for the evaluation of evacuation performance in corridor-type high-rise building under fires. Under similar external conditions, the evacuation time for buildings with connecting corridors is significantly shorter than that for conventional high-rise buildings, showing reductions of 25.0 %–34.0 % at the same time of day and 26.0 %–37.8 % under the same illumination conditions. Additionally, nighttime evacuations are 29.4 % longer than those conducted during daytime. The implementation of a layered evacuation strategy reduces evacuation time by 9.7 % compared with free evacuation methods. The enhanced model proposed in this study provides a more effective framework for assessing the evacuation performance of corridor-type high-rise buildings.

Quantitative Evaluation of Evacuation Efficiency during Disasters according to the Operation of Human Resources in Medical Facilities

Intensive care patients are among those most vulnerable during disasters, as they are unable to evacuate independently and often rank lowest in evacuation priority due to their low survival rates. Consequently, evacuation protocols in medical facilities prioritize patients with better survival prospects. However, quantitative research on whether such evacuation methods improve efficiency remains insufficient. This study utilized Flexsim Healthcare to calculate the Required Safe Evacuation Time for medical facilities accommodating patients with various evacuation needs, including those who are walkable, in a wheelchair, and bedridden. The findings indicate that the deployment of over 40% of resident nurses as per legal standards is necessary to significantly enhance the evacuation efficiency for vulnerable populations. Additionally, the study found that the highest evacuation efficiency is achieved when 75% of all evacuation assistants are assigned to bedridden patients and 25% to those in wheelchairs.

Strategi Komunikasi Badan Nasional Penanggulangan Bencana dalam Program Desa Tangguh Bencana

This research aims to determine the communication strategy of the national disaster management agency in the Bengkulu City disaster resilient village village program. The method used in this research is a qualitative method with data collection techniques, namely observation, interviews and documentation. The research results show an increase in public awareness and knowledge, becoming more aware of the various types of disaster risks that may occur. Knowledge about disasters: The community gets more in-depth information about the causes, impacts and types of natural disasters such as earthquakes and tsunamis. Community emergency response skills are trained on safe and effective evacuation methods when a disaster occurs. First aid, training on how to provide first aid to disaster victims. Development of emergency response plans, with family plans and community plans. The use of technological equipment is trained by using fire extinguishers, flashlights, radio communications. Formation and strengthening of disaster volunteers. Increasing community resilience and preparedness, training is accompanied by simulations and disaster response exercises that help the community practice what they have learned. In conclusion, one of the efforts made by BNPB is to implement the IDRIP-DESTANA project, Diffusion (diffusio) Project by increasing community preparedness by providing education and training to the community regarding disasters, meeting 29 times. Keywords: Communication Strategy, Diffusion of Innovation, BNPB, DESTANA

Intelligent planning of fire evacuation routes in buildings based on improved adaptive ant colony algorithm

Intelligent planning of fire evacuation routes is an important guarantee for rapid emergency response. Ant colony optimization, as an intelligent bionic algorithm, has notable advantages in route planning. However, traditional ant colony optimization corresponds to a low convergence rate, is easily caught in local optimal solution, and regards route length as the only constraint. To resolve these problems, an improved adaptive ant colony optimization (IAACO) algorithm was proposed in this study. Risk, energy consumption, and route length were taken as key factors to improve the heuristic function, optimize the pheromone update function, and establish multi-objective constraints, The standards for fire evacuation better align with practical requirements. Meanwhile, the adaptive pheromone volatile coefficient was introduced to balance convergence and global searching ability. In addition, the hazard range on the grid map was visualized. The results indicate that under various complex obstacle grid maps, the path inferiority of IAACO is reduced by 61.7% and 58.4%, 43.6% and 36.7%, and 41.6% and 67.7% compared to ACO and IACO, respectively; under the condition of multiple exits, the inferiority is reduced by 63.8% and 54.6%; under the condition of multiple fire sources, the inferiority is reduced by 40.1% and 34.6%; compared with other algorithms, IAACO shows the lowest path inferiority index, 26.6. IAACO is applicable to both the dynamic planning of fire evacuation routes and the evacuation simulation software, Pathfinder, and it performs better than the built-in algorithms of Pathfinder. Facts have proved that the IAACO algorithm significantly improves the safety level of evacuation compared to traditional evacuation methods and other optimization algorithms.

The Effect of Herding Behavior on the Efficiency of Pedestrian Evacuation in Subway Stations

In the emergency evacuation of pedestrians in subway stations, most people do not know the correct evacuation routes and methods, and tend to follow others blindly, resulting in herding behavior. To study the process of pedestrian evacuation with herding behavior in subway stations, a cellular automata pedestrian evacuation model is established to simulate the pedestrian evacuation with herding behavior in subway stations, and the effects of the weight coefficients of the parameters in the model on the overall evacuation time and the distribution of people’s positions are investigated to quantify the effects of herding on the efficiency of the pedestrian evacuation and the movement behavior. The simulation results show that moderate (kC < 40) crowd behavior can play a beneficial role in reducing reaction time and guiding the direction of evacuation; on the contrary, excessive crowd behavior (kC > 40) will lead to an increase in evacuation time and a decrease in evacuation efficiency. The conclusions presented in this paper can help to improve the efficiency of pedestrian evacuation in emergencies and provide a theoretical basis and practical guidance for the management of safety evacuation in subway stations.

Spontaneous intracerebral hemorrhage: a review of the prevalence, trigger factors, therapeutic and surgical treatment

Spontaneous intracerebral hemorrhage is the second most common subtype of stroke and is a significant cause of mortality and morbidity worldwide. Trigger factors that “accelerate” disease onset may include hypertension, excessive alcohol consumption, constant smoking, hypocholesterolemia, medications, male sex, advanced age, living in an underdeveloped country, ethnicity, chronic kidney disease, cerebral amyloid angiopathy, and microhemorrhages. Therapeutic solutions for spontaneous intracerebral hemorrhage aimed at stopping the progression of hemorrhage, reducing the clot volume of intraventricular and parenchymal hematoma, combating perihematomal edema and inflammation, rapidly reducing blood pressure, and providing hemostatic therapy with transfusion of platelets and other coagulation complexes. Clinical trials on minimally invasive methods of surgical evacuation (endoscopic surgery, stereotactic aspiration, and invasive craniopuncture) are ongoing and may provide positive results because of the shorter operation time and use of local anesthesia. Minimally invasive surgery methods can theoretically improve the outcomes of open surgery by reducing damage to collateral tissues and reducing anesthesia time; however, they cannot be a full-fledged alternative.

대형화재 피난안전의 영향요인 실증분석

The purpose of this study is to prepare measures to prevent casualties when a large-scale fire occurs in a multi-building, and establish an analytical framework for the study through theoretical exploration and analysis of previous research on evacuation safety with an empirical analysis of influencing factors. As a result of the study, among the significant variables affecting evacuation safety of large-scale fires in multi-building, evacuation knowledge, evacuation behavior, and evacuation training were found to have relative influence, in that order. This tells us that for evacuation safety in a large-scale fire in a multi-building, people must know evacuation methods and take evacuation actions, such as evacuating in a low position. In addition, it is necessary to receive early education about fire evacuation from a young age.

Current learning strategies in fire evacuation for seniors and people with disabilities in private seniors' residences and long-term care homes: a scoping review.

Current strategies for teaching evacuation methods in private seniors' residences (PSR) and long-term care (LTCH) homes may pose risks to people with disabilities (PWD) and seniors' physical and psychological health. This study aimed to address the following questions: (1) Which are the current fire evacuation learning strategies used with PWD or seniors? (2) What are the barriers and facilitators for PWD and seniors' during fire evacuation and learning strategies in PSR and LTCH? (3) What is the existing equipment that could be used with PWD seniors?. A scoping review of grey and scientific literature was done in six databases and Google scholar. Additional information was found on Québec government websites. This review identified 13 scientific papers and 22 documents. Twenty barriers (personal = 9, environmental = 11), and 14 facilitators (personal = 4, environmental = 10) were extracted. The current fire evacuation learning strategies currently used can be grouped into three categories: drills; training; promotion of a fire safety plan. Six types of evacuation equipment were found; however, their use has been scarcely documented. Safety for seniors during fire evacuation is still an important issue to be improved. Increasing awareness and creating new practices and tools that consider the strengths and difficulties of seniors seems to be a promising avenue for improving evacuation.

ИНТЕГРАЦИЯ ТЕХНОЛОГИИ ИСКУССТВЕННОГО ИНТЕЛЛЕКТА ДЛЯ ПОВЫШЕНИЯ ЭФФЕКТИВНОСТИ ЭВАКУАЦИИ ЛЮДЕЙ ПРИ ПОЖАРЕ

The application of artificial intelligence technology to improve the evacuation control system at fires is considered. The focus is on the shortcomings of traditional evacuation methods and the potential of artificial intelligence in big data processing to optimize the flow of people. 
 The integration of artificial intelligence algorithms with models of human behavior to develop more effective evacuation scenarios that take into account the psychological and physiological aspects of human behavior in emergency situations is discussed.

Analysis of uterine evacuation methods in postabortion care after implementation of a surveillance network (CLAP MUSA-Network) at a university hospital

Background Management of uterine evacuation is essential for increasing safe abortion care. Monitoring through surveillance systems tracks changes in clinical practice and provides information to improve equity in abortion care quality. Objective This study aimed to evaluate the frequency of manual vacuum aspiration (MVA) and medical abortion (MA), and identify the factors associated with each uterine evacuation method after surveillance network installation at a Brazilian hospital. Methods This cross-sectional study included women admitted for abortion or miscarriage to the University of Campinas Women’s Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the use of MVA and MA with misoprostol. The independent variables were the patients’ clinical and sociodemographic data. The Cochran–Armitage, chi-square, and Mann–Whitney U tests, as well as multiple logistic regression analysis, were used to compare uterine evacuation methods. Results We enrolled 474 women in the study, 91.35% of whom underwent uterine evacuation via uterine curettage (78.75%), MVA (9.46%), or MA (11.54%). MVA use increased during the study period (Z = 9.85, p < 0.001). Admission in 2020 (odds ratio [OR] 64.22; 95% confidence interval [CI] 3.79–1086.69) and lower gestational age (OR 0.837; 95% CI 0.724–0.967) were independently associated with MVA, whereas the only factor independently associated with MA was a higher education level (OR 2.66; 95% CI 1.30–5.46). Conclusion MVA use increased following the installation of a surveillance network for good clinical practice. Being part of a network that encourages the use of evidence-based methods provides an opportunity for healthcare facilities to increase access to safe abortions.

Superior oxygen-resistance and intrinsic mechanisms of coherent Pd/Pd3Zr@ZrCo structure with excellent cycling durability

As a promising candidate for hydrogen isotopes storage, ZrCo alloy suffers tremendously from the poisoning of impurity gases, especially in oxygen-containing atmospheres, but related effective modification method for long cycling durability is still lacking. In this work, the anti-oxygen-poisoning behaviors and mechanisms of virginal ZrCo and palladium-coated ZrCo with different heating evacuation methods were detailly investigated. Notably, the phase transition occurs during traditional heating evacuation (550 °C for 60 min) with the gradual generation of Pd3Zr from original Pd coating and ZrCo substrate. According to absorption behaviors and degeneration state of O πp-orbital peak from theoretical calculations, O2 undergoes spontaneous dissociation and strong hybridization at the surface of ZrCo and Pd3Zr, especially for ZrCo, while much weak surface absorption is recognized on Pd. Considering the superior anti-poisoning properties but weak substrate anchoring strength of Pd, it’s valuable to reconstruct the Pd/ZrCo interface to generate transition Pd3Zr layer that is less susceptible to hydrogen embrittlement. Accordingly, a coherent structure of Pd/Pd3Zr@ZrCo was successfully obtained by high temperature short time pretreatment (550 °C for 10 min), and its cycling capacity retention in O2-containg hydrogen atmosphere is significantly enhanced from initial 74.87 % after 5 cycles to 90.83 % after 10 cycles, which is superior to Pd-plating hydrogen storage alloys ever reported. The interface reconstruction of coherent structure proposed here can function as a promising strategy for construction of protective layer for all related surface engineering.

Investigation of pedestrian speed in formation evacuating in two specific water depths

The implementation of a well-organized formation for evacuation plays a critical role in ensuring the safety of individuals during flood events. To investigate the effectiveness of formation evacuating, this study conducted experiments under two specific water depths (0.35 m up to the knee and 0.60 m above the knee). The efficiency of two common evacuation methods, namely single-file formation without a rescue rope (referred to as “without rope”) and single-file formation with a rescue rope (referred to as “with rope”), was discussed through questionnaire and trajectory analysis. The findings indicate that the majority of pedestrians (over 60 %) perceive a reduced level of fatigue in single-file formation compared to individual walking (referred to as “individual”) in both 0.35 m and 0.60 m water. Not only was the fatigue level the lowest, but it also exhibited the highest speed growth rate in “with rope”. Specifically, pedestrian speed increased by 11.24 % in 0.60 m water and by 4.85 % in 0.35 m water compared to “individual”. Analysis of pedestrian step characteristics revealed that the increase in pedestrian step frequency was the primary factor contributing to the speed increase in “with rope”. Moreover, the step length and step frequency of pedestrians were effectively harmonized in “with rope”, particularly in 0.60 m water. Considering factors such as fatigue level and evacuation speed, it is evident that single-file formation evacuating with rescue rope significantly improves evacuation efficiency. This study provides fundamental data and offers practical recommendations for the development of effective flood evacuation strategies.

REVIEWING THE LITERATURE ON DAM-BREAK INVESTIGATIONS AND FLOOD MAPPING THROUGH THE USE OF HYDRAULIC MODELS AND GIS

Nowadays, it is essential to store water to meet the demands of human consumption and to mitigate flooding, which reduces the risk of inundation downstream of the river. The failure of dams can result in disastrous consequences in the surrounding areas downstream. Causing loss of human lives and properties valuedfrom millions to billions. Therefore, it is crucial to conduct dam break studies to understand the behavior of floods generated from such incidents and to identify the areas that may become inundated. This information can be utilized to prepare emergency plans for the evacuation of residents and to minimize property damage. While the floods themselves cannot be prevented, proper evacuation methods can help to minimize losses. This paper reviews various literature on dam break studies that have utilized numerical models to create inundation maps, and also discuss some hydraulic models commonly used in such studies.

Dynamic Weighted Road Network Based Multi-Vehicles Navigation and Evacuation

Many events such as large-scale activities and traffic accidents could cause an increase in vehicle density in an area, which makes the evacuation of vehicles important. However, the existing evacuation methods are not efficient limit to multi-vehicles sequences or destinations. In this paper, we introduce a novel dynamic weighted road network model for route planning. Based on the model, the route planning algorithm can obtain higher search efficiency while avoiding congested roads. For multi-vehicles evacuation, we propose a spatial diversity theory to evaluate the overlaps of routes between vehicles to be evacuated and those already evacuated. To verify the efficiency and effectiveness of our model, we conducted experiments on real road network. The results showed that our methods and algorithms can provide more reasonable paths and manage the process more efficiently.

Abstract Number ‐ 104: Outcomes after middle meningeal artery embolization using n‐butyl‐2 cyanoacrylate for subdural hematomas: a case‐series

Introduction Chronic subdural hematomas (SDH) have a higher prevalence among the elderly population and can cause significant morbidity and mortality when they recur after surgical intervention. Use of n‐butyl‐2‐cyanoacrylate (n‐BCA) has proven to be an effective and safe therapeutic agent for embolization of the middle meningeal artery (MMA). In our study, we present a retrospective analysis of 31 patients who underwent MMA embolization for chronic SDH. Methods In a prospectively maintained database in a single center, we retrospectively analyzed 31 patients admitted to our institution who were diagnosed with chronic SDH, acute on chronic SDH, and acute SDH, and underwent MMA embolization with n‐BCA between May 20th, 2021, and June 28th, 2022. Our primary endpoint was >50% SDH reduction on follow‐up imaging. Our secondary endpoint was all‐cause mortality. Patients were separated into outcome groups and their baseline demographic, clinical, and procedural variables were compared using t‐test, Wilcoxon rank‐sum test, chi‐squared test, and Fisher’s exact test. Through univariate logistic regression, we attempted to determine if these variables directly influenced SDH reduction and mortality. Results In our study, a total of 42 MMA embolizations for 31 patients were included. We found that a greater number of patients with hypertension (n = 23; p = 0.04), use of antiplatelet (AP) medication (n = 8; p = 0.02), and those who underwent MMA embolization via the radial approach (n = 18; p = 0.004) were among those with < 50% SDH reduction. We also found that MMA embolization via the femoral approach (n = 13; p = 0.004) were more likely seen in those with >50% SDH reduction. The mean fluoroscopy time was longer in patients with >50% SDH reduction compared to those with < 50% reduction (43.2 minutes vs. 28.2 minutes, respectively; p = 0.03). On linear regression analysis, history of hypertension showed a non‐significant trend towards < 50% resolution of SDH (OR 5.67; 95% CI 0.99, 32.43; p = 0.05). Femoral approach for MMA embolization was associated with >50% of hematoma reduction (OR 12.00; 95% CI 1.89, 76.38; p = 0.004). Longer fluoroscopy time showed the same association (OR 1.05, 95% CI 1.00, 1.11; p = 0.03). All‐cause mortality was seen in 6 of the 31 patients, none of them associated with the SDH or the n‐BCA embolization procedure with no significant difference between groups. Conclusions MMA embolization with n‐BCA appears to be an effective and safe method for management of SDH as has been shown in prior retrospective studies. Our small sample size may underestimate the effect some variables have on radiographic and clinical outcomes. Hypertension and use of AP seem to play a role in hematoma resolution; however, a bigger cohort is needed to confirm these hypotheses. Femoral approach and longer fluoroscopy time were associated with hematoma resolution, but other variables should be considered to rule out any procedure‐related confounders. Future randomized controlled trials may help establish MMA embolization as the primary method for SDH management given its safety and morbidity compared to traditional methods of SDH evacuation.