Management Of Emergency Situations Research Articles

The impact of educational programmes on building safety culture in modern society

Safety culture is an important element in the development of human thinking before making decisions in emergency situations. The aim of the study is to determine the specifics of the impact of educational programmes on building safety culture in modern society. The authors achieved the aim of the study by employing of the method of analysis, the Likert scale, the impact ratio calculations, the criterion of psychological training, the response coefficient, the J. Phillips’ correlation coefficient. The study determined that it is necessary to take into account the development of psychological stability, the impact of possible risks for building a safety culture. It is also necessary to ensure consideration of simulated situations for identifying response mechanisms. The study established that the influence of educational programmes on building safety culture is related to the development of logical thinking. The practical significance of the work consists in determining the mechanisms that have the greatest impact on the possibility of forming a safety culture in the educational process. The research prospects will be related to the comparison of the effectiveness of the proposed mechanisms during the management of emergency situations in the context of martial law and the influence of adverse weather conditions.

Pelatihan Pertolongan Pertama Dan Cidera Olahraga Di Sekolah Menengah Kejuruan Negeri 5 Bengkulu Selatan

The report on first aid and sports injury training at State Vocational High School 5 Bengkulu Selatan in 2024 describes efforts to enhance awareness and skills in handling sports injuries among students. This training highlights the importance of prompt response and proper handling when dealing with minor or serious injuries during sports activities. Participants are trained to identify signs of injury, provide effective first aid, and manage emergency situations calmly and systematically. Additionally, the training also provides understanding of preventive measures for sports injuries. It is hoped that with the improvement of these skills and knowledge, the school can create a safer and supportive environment for students to engage in sports activities.

. Medical waste management and disposal in emergency military service situations

The article aims to analyze and justify the need for improving the safety system for handling and recycling medical waste in order to optimize the medical waste management in emergency situations of military service. The legal acts of the Russian Federation and the regulatory acts of the Ministry of Defense of the Russian Federation providing for the service safety requirements for military personnel, including the medical waste management system and their disposal, were analyzed. The concept of medical waste and its role in the structure of production and consumption waste was explored. The features of medical waste management in military emergencies were identified. The requirements for medical waste disposal plants, including productivity, compactness, reliability, safety for the personnel and the environment and mobility, were specified. A high-temperature installation for the medical waste disposal was developed, its technical characteristics and examples of positive testing in medical institutions were identified. The analysis and the results obtained are an obligatory condition for improving the medical waste management system in emergency military situations.

Disaster Management in the Western Balkans Territory – Condition Analysis and Conceptualisation of the Cross-Border Cooperation Model

Abstract The main objective of the paper is analysis and proposal of a concept for establishing an efficient system for disaster management in the Western Balkan countries. After the breakup of Yugoslavia (1992), there has been no effective system for managing emergency situations, while cross-border cooperation in this respect does not exist at all. The paper provides an overview of the situation in the field of emergency and crisis management in five countries of the region and a concept of promotion and cross-border cooperation in this field. The results of the research show that no country in the region has adequate emergency and disaster management system and that, regardless of the negative experiences, an efficient multilateral cooperation system has not been established so far in this field (there is neither regulatory framework nor proposals for the model of organization and for the procedures or technical mechanisms that would make the above possible). Therefore, the concept of establishing the Regional Center for Disaster Management in the Western Balkans territory (RCDM-WB) is proposed as a first step in handling disaster situations that arise from natural phenomena or technical and technological accidents. This is the first scientifically developed proposal of this kind for the above-mentioned region.

The Astroworld tragedy as an argument for proactive crisis management

PurposeThe Astroworld concert tragedy is used as an example of crisis (mis)management and the potential utility of the 4R model. Although the 4R model has been implemented in high-risk emergency management situations, it is useful in the PR field because of its actionable approach, creating a way for practitioners to prepare for and manage crisis situations.Design/methodology/approachThis is an analysis of the crisis that occurred at Astroworld, spanning preparation, day-of events, casualties and enduring reputational impact. The paper applies the 4R method to the Astroworld tragedy to show how it could have lessened or even prevented the tragedy. Finally, the SCCT model is used to explain why the official post-crisis statements were ineffective.FindingsSocial media has heightened the importance of a quick and effective organizational response to risk and crisis situations because poor responses can go viral quickly. However, social media also provides intelligence and crowd sourced information that can inform PR practitioners of emerging crisis scenarios. It is also an underutilized tool for two-way communication during crises.Practical implicationsThe 4R approach is beneficial to general practitioners as it simplifies crisis best-practices, something essential for quick action. As our world changes and becomes less predictable, practitioners must have a clear plan to protect their organizations and the public surrounding them. This approach includes reduction, readiness, response and recovery, which are all essential in crisis communication.Originality/valueThe 4R method has not been explored or applied in the PR field. This paper highlights how the model has been utilized in the emergency management field and illustrates the way 4R can serve the PR field.

Risk management of emergency situations caused by flooding of built‐up mountain areas

The purpose of this research work is to develop scientific approaches to solving the problem of increasing the sustainability of urbanised territories through flexible regulation of the groundwater regime. The development of a management solution for flexible regulation is carried out on the basis of the application of methods for solving problems of incorrectness.Materials for the study were data from the study of dangerous hydrogeological processes, systematised, among other matters, based on the results of monitoring natural emergencies at the Research Institute for Civil Defense and Emergency Situations. The approach proposed by the authors is based on the application of a set of methods, including methods of: system analysis, forecasting, numerical modeling, followed by the development of an optimal management solution of emergency situations at the municipal level.As a result of the numerical modeling carried out in the work, the variants of drainage systems and their operating mode are determined within the framework of the implementation of the proposed approach in the simulation mode. This makes it possible to increase the level o f environmental safety of historically developed built‐up areas, including mountainous ones.The article presents a new approach to managing the risk of emergencies in case of flooding of buildings and structures in built‐up mountainous territories, including historical territories. In such territories, the watered soil preserves the cultural layer, which determines the need for flexible regulation of the groundwater regime. The results of the study are used in carrying out research work of the State Research Institute of the Russian Academy of Sciences (GOChS) on the study of dangerous hydrogeological processes and their impact on the environment, life safety, stability of the functioning of economic facilities, monitoring and forecasting of natural emergencies.

MEDICAL EMERGENCIES PREPAREDNESS IN DENTAL CLINIC AMONG POSTGRADUATE RESIDENTS IN NEPAL

Background: Serious medical emergencies in dental practices are generally rare (one in 3-5 years) but if it happens it is life threatening to the patient. Adequate knowledge and competency, training of the dental practitioners is necessary to avoid such life-threatening conditions. The study was conducted to assess the preparedness of medical emergencies among postgraduate dental students of Nepal. Methods: An online questionnaire based cross-sectional study was conducted among all post graduate dental students from all the dental colleges of Nepal. Pretested, validated, close ended questionnaire was used. Questionnaire consisted of twenty medical emergency situations and five questions regarding self-evaluation of training regarding the management of medical emergencies. Chi-square test was used to assess association between competency in managing medical emergency situations and years of academic experience during post-graduation. P- value <0.05 was considered statistically significant. Results: More than 70% participants answered correct management of medical emergency situations. Almost 20% disagreed and 20% don’t know about the management of such situations. Only 28% received training in the management of medical emergencies during undergraduate dental program. More than 50% were moderately satisfied with their knowledge about medical emergencies. Conclusions: The results of the study showed that knowledge to handle commonly occurring medical emergencies was higher. Most of the participants did not attend any training regarding medical emergencies. And those who attended felt there is need for further training in the management of emergency medical cases in the dental chair.

Evaluation and associated factors of public health emergency management among medical college students in a city in Southwest China: a cross-sectional study

BackgroundColleges and universities face an increased risk of public health emergencies. Among them, medical colleges and universities deserve more attention as they serve as the play a fundamental role in providing public health emergency services and in cultivating medical professionals. Effectively managing infectious disease prevention and control, as well as responding to public health emergencies in medical colleges and universities, is of great importance for enhancing the capacity of social emergency governance and improving the completeness of the public health system. This study aims to understand the management of public health emergencies in medical colleges in a city in southwest China, explore the factors associated with medical college students’ evaluations, and provide recommendations for emergency management mechanisms in colleges and universities.MethodsIn total, 781 medical college students were selected through stratified random sampling and surveyed using a questionnaire. The main factors affecting students’ evaluation of emergency management were analyzed using multiple linear regression and structural equation modeling.ResultsThe overall emergency management situation in medical colleges was relatively complete, with satisfactory results. Medical college students’ satisfaction with the timeliness of prevention measures was the highest, while the publicity and education were the lowest. Multiple linear regression analysis showed that grades, emergency education, -simulation training, -information reporting, and dynamic adjustment measures were associated with the evaluation of emergency management by medical students.ConclusionsAlthough the evaluation of emergency management in medical colleges was generally positive, certain limitations still existed. To improve the development of the public health system, colleges and universities should constantly reform and innovate emergency management mechanisms according to the important links in the prevention and control processes.

Subjective health status and health literacy of African refugees and asylum seekers in Germany: a cross-sectional survey

PurposeMany refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African refugees and asylum seekers in Bavaria, Germany. The authors evaluated their self-perceived health status and health literacy, and identified barriers and gaps in health care utilization, intending to improve health care services for this group.Design/methodology/approachThe authors conducted a cross-sectional, questionnaire-based study involving 69 refugees and asylum seekers from Ethiopia, Eritrea and Nigeria. The authors performed descriptive and exploratory statistical analyses.FindingsThe authors found a substantial disease burden in the early stages of resettlement in Germany, particularly mental health symptoms (53.6%) and musculoskeletal problems (47.8%). Challenges in health literacy were observed, such as difficulties in understanding health information and managing emergency situations. Access to interpreters was limited, and understanding treatment certificates was more challenging than using electronic health cards, with 18.2% of participants reporting denial of medical treatment.Practical implicationsThese findings highlight the need for early and tailored health support for refugees, with a particular focus on mental health. Efforts should be made to reduce language barriers and improve navigational skills within the health-care system, particularly in emergency situations. Addressing the restricted access to health care and bureaucratic obstacles is crucial for improved health outcomes among refugees.Originality/valueTo the best of the authors’ knowledge, this research is the first to specifically explore the self-reported health status and health literacy of African refugees and asylum seekers in Bavaria, Germany, providing valuable insights into the unique healthcare challenges of this often underrepresented and overlooked population.

Nursing Management in Emergency and Urgency Services

This article’s theme is the role of the nurse in managing urgency and emergency actions. The nursing team that works in urgency and emergency care has as characteristics of the profession a high workload and speed of care, however, there are also functions who need autonomy in carrying out activities that do not only concern practices related to care, but that contribute to the process, such as filling out protocols, reporting on actions carried out and monitoring and evolution of care, as well as referrals that they proceeded. There is still a lot of bureaucracy in your daily life to be added to the institution’s work activities. To carry out studies relating to the quality of nurse management in urgent and emergency situations, we seek to achieve the objective of determining what attitudes the nursing professional should have to manage their actions with the purpose of achieving quality in care, knowing which are the functions and real characteristics that must permeate your work, establishing parameters so that quality of service is prioritized. The study is justified by the need for nursing professionals to reflect on their practice, valuing their knowledge with the application of skills that establish self-confidence and proactivity. This is a literature review study of an exploratory descriptive nature carried out on documents available for access in the Virtual Health Library (VHL), Pubmed, Lilacs, Medlaine. The Final Considerations point out that discussions about the factors related to the situation of emergency emergency care in our country require a new look at how to manage the actions carried out in this context

ESARS: A Situation-Aware Multi-Agent System for Real-Time Emergency Response Management

This paper describes ESARS, a real-time situation-aware social media- enabled emergency situation alert and reporting system, as a decision support system built on multi-agent software design architecture for emergency situation management. The impact of an incident or disruption due to the incident could be minimized by implementing real-time intervention strategies that involve event monitoring, detection and situation identification via classification and prediction, notification, visualization and reporting that culminate in providing emergency support within time. The nature of agent behavior, which is autonomous, proactive and cooperative, makes them a suitable method for the design and deployment of a dynamic system of this nature. The system relies on historical and streamed real-time geolocation-enabled Twitter data stream for the target emergency events to provide decision-makers with dynamic, comprehensive, and timely information specific to the emergency situation.

Multi-Modal Information Fusion for Localization of Emergency Vehicles

In urban and city environments, road transportation contributes significantly to the generation of substantial traffic. However, this surge in vehicles leads to complex issues, including hindered emergency vehicle movement due to high density and congestion. Scarcity of human personnel amplifies these challenges. As traffic conditions worsen, the need for automated solutions to manage emergency situations becomes more evident. Intelligent traffic monitoring can identify and prioritize emergency vehicles, potentially saving lives. However, categorizing emergency vehicles through visual analysis faces difficulties such as clutter, occlusions, and traffic variations. Visual-based techniques for vehicle detection rely on clear rear views, but this is problematic in dense traffic. In contrast, audio-based methods are resilient to the Doppler Effect from moving vehicles, but handling diverse background noises remains unexplored. Using acoustics for emergency vehicle localization presents challenges related to sensor range and real-world noise. Addressing these issues, this study introduces a novel solution: combining visual and audio data for enhanced detection and localization of emergency vehicles in road networks. Leveraging this multi-modal approach aims to bolster accuracy and robustness in emergency vehicle management. The proposed methodology consists of several key steps. The presence of an emergency vehicle is initially detected through the preprocessing of visual images, involving the removal of clutter and occlusions via an adaptive background model. Subsequently, a cell-wise classification strategy utilizing a customized Visual Geometry Group Network (VGGNet) deep learning model is employed to determine the presence of emergency vehicles within individual cells. To further reinforce the accuracy of emergency vehicle presence detection, the outcomes from the audio data analysis are integrated. This involves the extraction of spectral features from audio streams, followed by classification utilizing a support vector machine (SVM) model. The fusion of information derived from both visual and audio sources is utilized in the construction of a more comprehensive and refined traffic state map. This augmented map facilitates the effective management of emergency vehicle transit. In empirical evaluations, the proposed solution demonstrates its capability to mitigate challenges like visual clutter, occlusions, and variations in traffic density common issues encountered in traditional visual analysis methods. Notably, the proposed approach achieves an impressive accuracy rate of approximately 98.15% in the localization of emergency vehicles.

АНАЛІЗ СУЧАСНОГО СТАНУ ТА ТЕНДЕНЦІЇ РОЗВИТКУ СФЕРИ ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ

The paper analyzes the current state of the healthcare sector in Ukraine. The development of the healthcare sector in Ukraine is analyzed, the peculiarities and prospects of reforming the healthcare system in Ukraine, methods of management in emergency situations, in particular the Russian-Ukrainian war, and the latest research on this topic is analyzed. The author assesses the development of the public and private sectors of the health care market, identifies the main trends in health care reform, and assesses the impact of the Russian-Ukrainian war on this process. The management of the healthcare system in wartime is defined as a complex process, and ways to improve the management of this area to organize quality medical care for the population of Ukraine are proposed. Namely, the development of e-health, telemedicine, qualified personnel, and the introduction of innovative technologies. The author characterizes the public and private sectors of the healthcare market and the medical tourism market. The article presents a classification of obstacles to reforming the health care system, substantiates the use of the Organizational Structure of the public administration system based on the cluster model, and identifies key aspects of managing the development of health care in war conditions, based on an assessment of investment attractiveness, level of economic independence and stability of the relevant structures. Prospects for further research based on the development of new management models are presented, including the study of the impact of war on the health care system, evaluation of the effectiveness of reforms and the development of new models of medical care in conflict.

Capacity Building for Maternal Emergency Services Using Low Tech High Fidelity (LTHF) Simulator Method and Interprofessional Collaboration for Health Workers on Bawean Island

Background - Maternal emergencies encompass a wide range of conditions that can endanger the lives of pregnant women or newborns, so the speed and availability of quality care is crucial in saving the lives of mothers and babies, especially in remote areas such as Bawean Island. Objective - Capacity building for maternal emergency services is a strategic step aimed at improving the ability and efficiency of the health care system to handle emergency situations related to pregnancy and childbirth. Design / methodology / approach - The method used in capacity building is training on the ability to conduct interprofessional collaboration among health workers with lecture, discussion and simulation methods with the use of LTHF simulators so that it is expected that during capacity building activities, participants can experience conditions that resemble real life. This capacity building activity consists of: Providing refreshing material related to maternal emergencies and simulating interprofessional collaboration using the LTHF simulator. Findings - Training participants stated that the above training method was very interesting and provided new experiences to prepare themselves in handling maternal neonatal emergencies that can occur at any time. The increased capacity to manage maternal neonatal emergencies can improve the effectiveness of medical actions and case management in emergency situations involving maternal health during pregnancy, childbirth, or the postpartum period after the training. Maternal neonatal emergencies that are often found are heavy bleeding, eclampsia, infection, asphyxia or other complications that can endanger the lives of pregnant women and their babies. Conclusion - Increasing the capacity of maternal emergency services through the Low Tech High Fidelity (LTHF) Simulator method and Interprofessional Collaboration is a significant step to improve the quality of services and safety of pregnant women and newborns on the island of Bawean.

Determinants for university students’ location data sharing with public institutions during COVID-19: The Italian case

Abstract Data on real-time individuals’ location may provide significant opportunities for managing emergency situations. For example, in the case of outbreaks, besides informing on the proximity of people, hence supporting contact tracing activities, location data can be used to understand spatial heterogeneity in virus transmission. However, individuals’ low consent to share their data, proved by the low penetration rate of contact tracing apps in several countries during the coronavirus disease-2019 (COVID-19) pandemic, re-opened the scientific and practitioners’ discussion on factors and conditions triggering citizens to share their positioning data. Following the Antecedents → Privacy Concerns → Outcomes (APCO) model, and based on Privacy Calculus and Reasoned Action Theories, the study investigates factors that cause university students to share their location data with public institutions during outbreaks. To this end, an explanatory survey was conducted in Italy during the second wave of COVID-19, collecting 245 questionnaire responses. Structural equations modeling was used to contemporary investigate the role of trust, perceived benefit, and perceived risk as determinants of the intention to share location data during outbreaks. Results show that respondents’ trust in public institutions, the perceived benefits, and the perceived risk are significant predictor of the intention to disclose personal tracking data with public institutions. Results indicate that the latter two factors impact university students’ willingness to share data more than trust, prompting public institutions to rethink how they launch and manage the adoption process for these technological applications.

Ten Top Topics That Neuro-Otologists Think General Practitioners and Family Medicine Specialists Must Know: A Multi-Center Study Using Delphi Method

In order to decrease medical errors and improve organized, targeted education pre- and post-graduation, we intended to detect 10 most important concepts that neuro-otologists believe family physicians and general practitioners must know. A multi-center study based on Delphi’s method was designed and conducted in three stages. Of 31 topics gathered by expert panel, 10 top priorities were ranked based on 50 neuro-otologists’ opinion over the country. Early diagnosis and management of sudden sensorineural hearing loss, foreign body removal from external ear canal, proper management of otitis extern, and management of emergency situations in chronic otitis media gained the highest scores among all. Also, some topics, such as managing serous and acute otitis media, differentiating peripheral vs. central vertigos, and early hearing screening at birth were among top topics, contrary to others, such as surgery in only hearing ears, or hearing losses after COM surgeries. Almost all of the top-ranked topics are among critical/organ saving, or most prevalent medical concerns in all of the world. Sudden deafness, complicated COM, and mis-diagnosing vertigo may be organ/life threatening, while foreign bodies or inflammations of external ear, acute or serous otitis media, and congenital hearing loss are among the most prevalent medical problems worldwide, with numerous malpractices in their diagnosis and management. Regarding educational and practical priorities should be considered a basic step in neurotology field, and targeted programming policies.

Методы поддержки принятия решений в оперативном управлении при чрезвычайных ситуациях: обзор исследований

The article examines the problem of operational management in emergencies. At the content level, an analysis of strategic, tactical and operational management in emergency situations was carried out, and their intended purpose was determined. The content of operational management decisions at different stages of emergency situations has been studied. Limitations that directly affect operational management in emergencies have been identified. 
 A systematic analysis of scientific research is carried out and examples are given in the context of work related to operational management in emergencies regarding the stages of emergency development. Research highlights include articles in the fields of mathematical modeling, simulation modeling, game theory and decision making, artificial intelligence and knowledge management. The main promising directions for further research have been identified.

Changing the stroke network during pandemic scenarios does not affect the management of patients with a positive Cincinnati prehospital stroke scale.

Time plays a crucial role in the management of stroke, and changing the prehospital emergency network, altering the HUB and spoke relationship in pandemic scenarios, might have an impact on time to fibrinolysis or thrombectomy. The aim of this study was to evaluate the time-dependent stroke emergency network in Lombardy region (Italy) by comparing 2019 with 2020 and early 2021. Three parameters were investigated: (i) time of arrival of the first vehicle at the scene, (ii) overall duration of missions, and (iii) number of patients transported by emergency vehicles. Data analysis process conducted using the SAS-AREU portal (SAS Institute, USA). The number of patients with a positive CPSS was similar among the different pandemic waves. Mission duration increased from a mean time (SD) of 52.9 (16.1) min in 2019 to 64.1 (19.7) in 2020 and 55.0 (16.8) in 2021. Time to first vehicle on scene increased to 15.7 (8.4) min in 2020 and 16.0 (7.0) in 2021 compared to 2019, 13.6 (7.2) (P < 0.05). The number of hospital with available stroke units decreased from 46 in 2019 to 10 during the first pandemic wave. The pandemic forced changes in the clinical mission of many hospitals by reducing the number of stroke units. Despite this, the organization of the emergency system allowed to identify strategic hospitals and thus avoid excessive transport time. The result was an adequate time for fibrinolysis/thrombectomy, in agreement with the guidelines. Coordinated management in emergency situations makes it possible to maintain service quality standards, despite the unfavorable scenario.

Exploring senior managers’ experiences preparedness to respond to COVID-19: a qualitative study in Iran

BackgroundEpidemics caused by emerging respiratory viruses are challenging for the health system of most societies, and preparedness of the health system in responding to such epidemics is important. Therefore, the aim of this study was identifying different fields and key issues of the senior managers’ experiences preparedness to respond to the COVID-19 epidemic from the Iranian senior managers’ point of view.MethodsThis is a qualitative descriptive study. Eighteen in-depth and semi-structured individual interviews were conducted for data collection. For this purpose, 18 senior managers with work experience in managing the COVID-19 crisis were enrolled in the study using purposive sampling. The collected data were analyzed according to Graneheim and Lundman’s approach.ResultsAnalysis of the data resulted in the emergence of five themes and twelve sub-themes. The main themes and sub-themes included: (1) capacity improvement consisting of performance improvement and logistic improvement; (2) resource and infrastructure management including supply and support of human resources, infrastructure improvement, and supply of equipment; (3) an increase in epidemiology capacity including epidemiology improvement and emerging disease surveillance; (4) application of the principles of disaster and emergency management including intra- and extra-organizational interaction management, disaster risk management, and data management; and (5) society resilience increase including improving adaptation skill and maintaining health and social participation.ConclusionThe results of this study present the key issues for the management of future emergency situations. Health system managers and policymakers in Iran and other countries should be aware of these key issues and apply them in practice to prepare the health systems to respond to next outbreaks. Indeed, the study results can help policymakers and health system managers to plan to achieve acceptable preparedness for the management of such outbreaks.

NEO-SAFE: a clinical model forpatients andhealthcare personnel safety inprimary level hospitals.

Patient safety is a major concern in medicine. Approximately, 4 million infants die each year worldwide and 23% of these deaths are caused by perinatal asphyxia. To prevent the long-term damage of asphyxia, the resuscitation flowchart must be perfectly and promptly performed. However, high effectiveness in performing resuscitation can only be achieved and maintained if the algorithm is frequently executed. Therefore, maintaining a high level of patient care is difficult in some remote centres. The aim of this study was to evaluate the effectiveness of a new organizational model of care-network between Hub & Spoke hospitals to improve both the safety of the newborns in hospitals with a low number of births and the well-being of operators. Our project, NEO-SAFE (NEOnatal SAFety and training Elba), began in 2017 and involved the neonatal intensive care unit and the NINA Center of the Pisa University Hospital (hub) and the Hospital of Elba Island (spoke). It consisted of a continuous training program, both with 'classic' training course and 'on-job tutoring' (on side and remotely), of the health workers at spoke (i.e. nurses, midwives, and paediatricians). All four milestones of the study design were achieved. During the project, NINA Center instructors organized training courses for the staff in Portoferraio. These courses were based on learning technical and non-technical skills in a training course of increasing difficulty. Staff training needs were also monitored during the project by means of periodic questionnaires, sentinel events, and specific requests. The curve described by the rate of newborns transfer to the Pisa neonatal intensive care unit (hub) shows a monotonous decreasing trend line. On the other hand, this project allowed operators to develop greater self-confidence and greater safety in managing emergency situations, reducing stress for them and improving patient safety. The project allowed the creation of a safe, effective, low-cost, and reproducible organizational model for centres with a low number of births. Moreover, the tele-medicine approach is an important improvement in the assistance and is a window on the future.