Red Cross Research Articles

Analysis of non-ventriculoperitoneal shunts at Red Cross War Memorial Children’s Hospital

BackgroundAt Red Cross War Memorial Children’s Hospital (RCCH), it is the preferred practice to use non-ventriculoperitoneal (non-VP) shunts when the peritoneum is ineffective or contraindicated for cerebrospinal fluid (CSF) diversion and when endoscopy is not an option. The objective of this study is to evaluate the clinical course of patients having undergone these procedures.MethodA single-centre retrospective review at RCCH wherein 43 children with a total of 59 episodes of non-VP shunt placement over a 12-year period were identified for inclusion.ResultsTwenty-five ventriculoatrial (VA) and 32 ventriculopleural (VPL) shunts were analysed with a median age at insertion of 2.9 (0.3–14.9) and 5.3 years (0.5–13.4), respectively. The median number of previous shunt procedures prior to VA or VPL shunt insertion was 6.0 (2–28) versus 4.5 (2–17), respectively. Three VA (12.0%) and three VPL (9.4%) shunt patients were lost to follow-up. Of those remaining, 10 VA shunts (45.5%) compared to 19 (65,5%) VPL shunts required revision. One ventriculovesical shunt and one ventriculocholecystic shunt were placed in the same patient after 21 and 25 shunt-related procedures, respectively, and both were revised within 3 weeks of insertion. Median shunt survival was 8 months longer for the VA compared to the VPL shunts, being 13.5 (0–67) and 5 months (0–118), respectively. Complications for VA shunts were low, with the overall shunt sepsis rate in the VA group at 4% (n = 1) compared to 15.6% (n = 5) in the VPL group.ConclusionOur findings support that VA and VPL shunts are acceptable second-line options in an already compromised group of patients where safe treatment options are limited, provided attention is paid to the technical details specific to their placement.

Change to persist - The adaptation of European Red Cross societies to changing patterns of volunteering

Non-profit organizations active in disaster relief depend on the engagement of volunteers. Yet, society changes, and so do engagement patterns of volunteering. We examine in this paper how Red Cross societies across Europe perceive these processes and adapt to changes. As major aid organizations, Red Cross societies need to attract volunteers in various fields between disaster relief and social services. They are consequently particularly vulnerable to changes in volunteer engagement. Organizational learning is one way to mitigate this vulnerability by adapting to these changes. We analyze these organizational learning processes with a mixed-methods research design that embraces a quantitative survey as well as in-depth interviews with various Red Cross societies. The study, which refers to the 4I-Theory, demonstrates how perceived adaptation pressure is a key driver of organizational change. Red Cross societies experiencing this pressure spark an adaptation process, scrutinizing and potentially changing their structures and standards to stay the same regarding their essential characteristics.

A Comprehensive Review of ICRC's Role in Promoting the Applicability of International Humanitarian Law

This article provides an in-depth examination of the International Committee of the Red Cross's (ICRC) multifaceted role in promoting the applicability of International Humanitarian Law (IHL). With a unique and distinctive nature, the ICRC, which has been in existence for 150 years, plays a crucial role in encouraging compliance with International Humanitarian Law (IHL). It functions as a direct advocate for the Conventions in various conflicts around the globe. Before the establishment of the Conventions, the ICRC has been instrumental in the development of International Humanitarian Law (IHL) since the mid-1800s. The author also examines how historical influence continues to shape the ICRC's obligations under the Conventions. Despite the Conventions' limited function for the ICRC, its actual operations differ greatly from its authorised duties. States and non-state actors recognise the ICRC's unique status as a Swiss NGO with an international presence and accept its actions. The ICRC's history of using discretion and flexibility to navigate a treaty with a weak mandate supports this acceptance.

Performance of a safe and dignified burial intervention during an Ebola epidemic in the eastern Democratic Republic of the Congo, 2018–2019

BackgroundA protracted Ebola Virus Disease (EVD) epidemic in the eastern Ituri, North and South Kivu provinces of the Democratic Republic of Congo (DRC) caused 3470 confirmed and probable cases between July 2018 and April 2020. During the epidemic, the International Federation of Red Cross and Red Crescent Societies (IFRC) supported the DRC Red Cross and other local actors to offer safe and dignified burials (SDB) for suspected and confirmed EVD cases, so as to reduce transmission associated with infectious dead bodies. We conducted a retrospective cohort study of the SDB service’s performance in order to inform future applications of this intervention.MethodsWe analysed data on individual SDB responses to quantify performance based on key indicators and against pre-specified service standards. Specifically, we defined SDB timeliness as response within 24 h and success as all components of the service being implemented. Combining the database with other information sources, we also fit generalised linear mixed binomial models to explore factors associated with unsuccessful SDB.ResultsOut of 14,624 requests for SDB, 99% were responded to, 89% within 24 h. Overall, 61% of SDBs were successful, somewhat below target (80%), with failures clustered during a high-insecurity period. Factors associated with increased odds of unsuccessful SDB included reported community and/or family nonacceptance, insecurity and suspensions of the EVD response, low health facility coverage and high coverage of radio and telephony. Burials supported by mobile Civil Protection (local authorities) and/or static, community-based ‘harm reduction’ teams were associated with lower odds of failure.ConclusionsA large-scale, timely and moderately performant SDB service proved feasible during the challenging eastern DRC EVD response. Burial teams that are managed by community actors and operate locally, and supported rather than owned by the Red Cross or other humanitarian organisations, are a promising modality of delivering this pillar of EVD control.

Organizing Community Participation in Humanitarian Blood Donation Activities

Aim: To organize and to encourage community participation in humanitarian blood donation held by the Indonesian Red Cross in collaboration with local church.
 Discussion: The culture of voluntary blood donation must always be encourage, in order to guarantee timely access to safe blood and blood products and help save lives. Compliment and appreciation given to noble donation of voluntary donors who receive no remuneration but are always ready and available to donate blood to help save other lives most of whom they never meet. Using popular social media, action taken to promote, mobilize, and publish educational materials on voluntary blood donation campaigns as well as encourage local potential donor to donate voluntarily. This activity is also the implementation of the noble human values ​​of sharing, giving and caring
 Conclusion: Connecting all stakeholders helps to make the blood donation succesfull.

Neutrality as a Contested Concept in International Humanitarian Law: Red Cross Men in the South African War, 1899–1902

Neutrality as a Contested Concept in International Humanitarian Law: Red Cross Men in the South African War, 1899–1902

Implementation of A Blood Donor Information System Using Mobile Applications Gunung Kidul District

Blood donation is a common charitable activity in many communities. Consequently, the Indonesian Red Cross (PMI) in the Gunung Kidul district frequently organizes such humanitarian events across various locations. However, not everyone is aware of these events or is able to participate in blood donation. The lack of information dissemination and blood donation events are significant factors contributing to the low community participation. The existing system for searching, processing, and creating data is still manual, which hinders the efficiency of administrative tasks. Addressing these issues, the aim of this research is to develop an Android-based blood donation information application. This initiative is particularly vital as the PMI in Gunung Kidul lacks the necessary infrastructure to disseminate information about the availability of blood bags efficiently. In the current era of digital advancement, the slow pace of information distribution is notably ineffective, thus integrating the system with Android technology is a strategic solution. sThis blood donation application is designed for donors who lack information about blood donation activities and for organizations wishing to conduct such events. The development of this Android application system involves experimental data collection methods, including observation, interviews, literature study, and documentation. The unit testing employs the Waterfall methodology. The application is developed using the Kotlin programming language, with the aid of Android Studio software

Armenians in 1920s Greece: Turkey’s Unwanted Minority, the League of Nations’ Burden, Greece’s “Other” Refugees

Abstract This article sheds light upon the history of an underresearched group of refugees who settled in Greece in the 1920s. It focuses on Armenians from Anatolia who fled to Greece in 1921–22, during and after the Greek-Turkish War of 1919–22. The article examines how the Greek government and international humanitarian organizations (Near East Relief, American Red Cross, etc.) approached the Armenian refugees, including orphans. The study further highlights practices such as transfers of Armenians within Greece, repatriation programs supported by Greece to send the Armenian refugees to Soviet Armenia, and citizenship policies regarding them.

Vaikų, sergančių didžiąja beta talasemija, mitybos būklė

Background. Children with beta thalassemia major are at risk for poor nutritional status, which can lead to signifcant health problems. It is essential to evaluate the level of malnutrition among individuals.
 The aim. To assess the nutritional status of children with beta thalassemia major using body mass index.
 Methods. This cross-sectional study was conducted at the District Branch of the Indian Red Cross Society in Ahmedabad, Gujarat. The purposive sampling technique was used to select 119 children with beta thalassemia major as participants. The nutritional status of children aged 8 to 18 years was assessed from September 2021 to December 2021.
 Results. Out of the 119 participants, 56 (47%) were female and 63 (53%) were male. The mean height was 150.82 ± 22.44 cm, the mean weight was 34.71 ± 11.62 kg, and the mean BMI was 15.28 ± 4.25. Out of a total of 119 patients, 62.18% were underweight, 31.93% were healthy, and 5.88% were overweight. 55% of females and 68% of males were underweight. There is a statistically signifcant association between age and nutrition status (P=0.04). The data depicts a statistically significant association between family monthly income and nutrition status (P=0.013).
 Conclusion. Results of this study showed that the majority of the children with thalassemia were underweight. There is a statistical association between age, economic status, and nutritional status. There is a need to raise awareness about food and nutrition for children with beta thalassemia major.
 Keywords: thalassemia major, body mass index (BMI), underweight, nutrition.

A study on the Textbook on Nursing published in Korea in 1918

Purpose: The purpose of this study is to better understand nursing education in the early years of the Japanese colonial rule.Methods: We compared the 1918 <i>Textbook on Nursing</i> with the first <i>Textbook on Nursing</i> and to the original text, <i>Grade A Textbook on Nursing</i>, by the Japanese Red Cross Society (JRCS) using the historical research method. The background of its publication and its use in nursing education were exploring, too.Results: After Korea’s annexation by Japan, the nursing textbook by the JRCS was appointed as the standard textbook in nursing education by the Government-General in Korea (GGK). Missionary nurse got the permission for the nursing textbook by JRCS and the <i>Textbook on Nursing</i> was published in 1918 using Korean and Chinese characters in combination. This book, an adaptation of the original text, explained the responsibilities and roles of nurses to guide them in serving patients as well as assisting in treatment or directly performing emergency medical treatment when necessary, with a focus on the treatment of the war wounded. It would have been partially used in actual nursing education among the missionary community.Conclusion: <i>Textbook on Nursing</i> in 1918 was published not only for the nursing students of missionary nursing schools but also for other nursing trainees of diverse hospitals, nurses and missionary volunteers and to help them to acquire the licenses. It reflects the enforcement on nursing education by GGK and the reality and resistance in terms of the content of education of nursing in Korea during that period.

Red Blood Cell Aliquoting: Improving O Negative Red Blood Cell Utilization in Neonate and Pediatric Inpatients at UC Davis Medical Center

Abstract Introduction/Objective UC Davis Medical Center (UCDMC) is the Sacramento region’s only level 1 adult and pediatric trauma center. It serves a 65,000 square mile area that includes 6 million residents from 33 counties across Northern and Central California. Nearly 7000 patients are transfused annually at UCDMC. Blood supply restrictions, especially on group O negative red blood cells (RBCs), escalated by the COVID-19 pandemic, posed significant patient safety risk. We sought to mitigate this risk by employing restrictive O negative RBC transfusions as recommended by AABB Choosing Wisely, through ABO matched small volume transfusions in neonate and pediatric patients. Methods/Case Report We conducted monthly audits starting in January 2021 to identify trends in O negative RBC use at UCDMC. We partnered with our blood supplier, American Red Cross (ARC), to modify hospital blood inventory. In 2022, we implemented the RBC aliquoting procedure using AS-3 RBCs to facilitate ABO matched small volume transfusions in neonates and children to conserve O negative blood supply. We reviewed regulatory standards, developed standard operating procedures, performed extensive technical validations, and worked with IT to enhance laboratory information system for product manufacturing, labeling, and traceability. We developed education documents for physicians, other providers, nurses, and transfusion services staff including sustainable competency and training. We conducted audits post implementation to measure goal performance in Q4 of FY22, compared to pre- implementation baseline data from Q1 of FY22. Results (if a Case Study enter NA) N/A Conclusion We achieved 57% reduction in O negative RBC utilization post implementation of the RBC aliquoting procedure in Q4 of FY22. Overall O negative RBC use trend at UCDMC improved with a 58% reduction between January 2021 to December 2022. Subsequent reduction of orders was achieved.We conclude that ABO matched RBC aliquot transfusion in neonates and pediatrics is an effective laboratory practice to reduce O negative RBC usage.

Produksi Komponen Darah Packed-Red Cell (PRC), Liquid Plasma (LP), Thombocytes Concentrates (TC) dan Fresh-Frozen-Plasma (FFP) di UDD PMI Kabupaten Bojonegoro

The processing of blood components is an act of separating the components of donor blood through a process by taking into account the quality and safety of blood component products. Its process produce various type of blood component, such as Packed Red Cell, Liquid Plasma, Thrombocytes Concentrate and Fresh Frozen Plasma. The quantity of each blood production depends on the mount of demant from hospital to threat the patient for transfusion. Indonesia Red Cross especially in Blood Donor Unit of each region have a important duty to collect and process the whole blood component as much as it needed. This type of research is a descriptive study with a cross sectional approach. The population used was the production of PRC, LP, TC and FFP Â at UDD PMI Bojonegoro from June to July 2022 as many as 2124 kolf. The sampling technique used purposive sampling. Data analysis using univariate analysis which is presented in the form of a frequency distribution table and ghraphic for daily production. Production of blood components as much as 2124 kolf, Production of PRC as 984 kolf (46%), LP as 904 kolf (43%0, TC as 200 kolf (9%), and FFP as 36 kolf (2%). The highest blood component production is PRC, followed by LP, TC and FFP, respectfully. Â

Blood Shortage Monitoring: Comparison of the Supply Situation During the Omicron Surge and at the Tail End of the COVID-19 Pandemic this Year

Abstract Introduction/Objective The COVID-19 pandemic was marked by the first-ever declaration of a severe blood crisis by the American Red Cross in 2022. During this blood crisis, the, there were significant shortages of blood products that required precise monitoring of the current stock for communication and collaboration with the clinical team to ensure uninterrupted patient care. The blood supply gradually improved since 2022’s blood crisis, particularly as the public health emergency related to COVID-19 ended on May 11th, 2023. However, published literature on the comparison of the blood supply in the last calendar months of the public health emergency versus during the blood shortage is sparse. Methods/Case Report From January 28th, 2022, to February 28th, 2022, the amount of red blood cell (RBC) inventory was noted along with the percentage reduction from usual pre-crisis inventory level. This inventory information was communicated with the clinical services to coordinate clinical care during the blood supply crisis. Additionally, a separate inventory comparison to cover the last 5 calendar months (including May) until the end of the Public Health Emergency on May 11th, 2023, was performed from January 1st, 2023, to May 11th, 2023. Results (if a Case Study enter NA) During the crisis from January 28th, 2022, to February 28th, 2022, there were significant reductions in red blood cell inventory (up to 67% reduction in O+ units and 75% for A+ units). Collaboration with the clinical team and efforts to procure and conserve blood products enabled continuity of clinical care. On the other hand, there was documented improvement in the blood inventory at the tail end of the pandemic (January 1st, 2023, to May 11th, 2023) with average inventory reductions of only 19% in O+ units and 43% in A+ units. Conclusion There was a significant blood shortage during the Omicron surge of 2022 that required inventory monitoring, collaboration with the clinical team, and efforts to procure and conserve blood products to ensure continued successful clinical care. As the pandemic’s public health emergency neared its end, the blood supply situation has been improving substantially.

The value of multimodal ultrasound in diagnosis of cervical lymphadenopathy: can real-time elastography help identify benign and malignant lymph nodes?

AimTo investigate the multimodal ultrasound(MMUS) features of cervical lymphadenopathy and to assess its value in the differential diagnosis of benign and malignant cervical lymph nodes.MethodsA retrospective analysis of 169 patients with cervical lymph node enlargement who attended Hangzhou Red Cross Hospital from March 2020 to October 2022. All patients underwent conventional ultrasound (CUS), contrast-enhanced ultrasound (CEUS), and real-time elastography (RTE), and were divided into training set and validation set. Univariate analysis was applied to screen out statistically significant parameters, and CUS model and MMUS model were constructed by multifactorial logistic regression analysis. The receiver operator characteristic (ROC) curve was established, and the area under the curve (AUC) was used to compare CUS model with MMUS model to assess the value of MMUS.ResultsOf the cervical 169 lymph nodes in 169 patients included in the study. The 169 enrolled patients were divided into a training set (132 patients) and a validation set (37 patients). In the training set, univariate analysis showed statistically significant differences in long diameter/short diameter(L/S), border, margin, hilus, dermal medulla boundary, blood flow type, enhancement mode, enhancement type, and RTE score (all p< 0.05). Multifactor logistic analysis showed that L/S, blood flow type, enhancement mode and enhancement type were correlates of malignant lymph nodes (all p< 0.05). The comparison of AUC demonstrated that the discriminative ability of the MMUS model was superior to using the CUS model, both in the training set(p = 0.004) and validation set (p<0.001).ConclusionIn this study, MMUS shows higher diagnostic efficiency than CUS. Ultrasound features such as L/S, blood flow type, mode of enhancement, type of enhancement are helpful in distinguishing benign and malignant lymphadenopathy. The addition of CEUS can greatly improve the sensitivity and specificity of ultrasonic diagnosis of malignant cervical lymph nodes. RTE score is of limited value in the diagnosis of malignant cervical lymph nodes.

Self-Sustainability with Therapeutic Phlebotomy, a Solution to the National Blood Crisis?

CONCLUSION Hereditary hemochromatosis (HH) is a genetic condition associated with iron overload in the human body. The mainstay of treatment remains therapeutic phlebotomy. On August 1st, 2022, the American Red Cross approved using blood obtained from therapeutic phlebotomy for transfusion. While normal individuals can donate blood only as often as once in 56 days, individuals with HH can have phlebotomy as often as once weekly. Utilizing the blood collected from these patients could be a significant resource to mitigate the shortage of blood needed for transfusion. We aimed to quantify the number of units of blood removed by therapeutic phlebotomy from individuals with HH and assess its potential contribution to total units of blood required in a community hospital for two years (2021 and 2022). We retrospectively reviewed electronic medical records of adult individuals who underwent therapeutic phlebotomy at Saint Vincent Hospital between January 1, 2021, and December 31, 2022. Patients with hereditary hemochromatosis were identified based on a positive genetic test for HFE gene mutations. We collected data including gender, race, age at diagnosis, and the number of units of blood removed from patients during the study period. The total number of units transfused in the in-patient care services and operating room was obtained. A descriptive statistic was performed using R version 4.2.2 statistics software. A total of 112 patients received therapeutic phlebotomy over two years (2021 and 2022) of whom 65% (N=73) had a diagnosis of HH. A majority of the patients were males (60%, 44/73) and were non-Hispanic/Latino (85%, 62/73). The mean age at diagnosis of HH was 62 [standard deviation (SD): 17] years. The median number of units of blood removed by phlebotomy per patient with HH was 3 (2-5), the annual distribution is as displayed in Table 1. A total of 504 units of whole blood was removed through therapeutic phlebotomy from 73 patients during the study period. The total requirement for blood transfusion across all the departments in the hospital was 6065 units (2,733 units in 2021 and 3,332 units in 2022). The total number of units removed through therapeutic phlebotomy in HH patients represented 8.31% (504/6065 Units) and 82.49% (504/611 Units) of total units of blood requirement for the entire hospital and operating room respectively (Table 2). The units of blood removed through therapeutic phlebotomy of patients with HH, could potentially help sustain 8.31% of total blood requirement of the hospital. Primarily, over 82% of the demand from the operating room could be fulfilled if the entirety of the blood from therapeutic phlebotomy were to be transfused. Overcoming technical challenges in utilizing the blood from therapeutic phlebotomy for transfusion in routine clinical practice could help mitigate the national blood crisis and aid in self-sustainability of blood products at a community level. Our study highlights the need for broader efforts to create awareness and incentivizing re-utilization of blood obtained from therapeutic phlebotomy.

Real-World Clinical Outcomes in Patients with Relapse and Refractory Multiple Myeloma Received VTD-PACE Treatment in the Era of Monoclonal Antibody

The treatment outcomes of multiple myeloma (MM) have drastically improved with the use of novel agents, including proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and monoclonal antibodies. However, ultimately, the disease relapses and results in a fatal outcome. Even in cases of relapse, treatment outcomes have improved with the use of novel agents. However, in situations where novel agents have been exhausted or when the disease rapidly progresses, bortezomib (Velcade), thalidomide, dexamethasone, platinum (cisplatin), adriamycin (doxorubicin), cyclophosphamide, and etoposide (VTD-PACE) is frequently utilized, with reported effectiveness. However, its outcomes in the era of monoclonal antibodies remain unclear. Therefore, this retrospective cohort study assessed the clinical outcomes of 60 patients with RRMM (median four prior treatment lines) administered VTD-PACE at the Japanese Red Cross Medical Center between June 2016 and April 2023. The characteristics of the 60 patients are shown in Table 1. The VTD-PACE regimen consisted of 1 mg/m 2 of bortezomib on days 1, 4, 8, and 11 administered subcutaneously; 200 mg of thalidomide administered orally on days 1-4; 40 mg of dexamethasone administered orally on days 1-4; and a 4-day continuous intravenous infusion of 10 mg/m 2 cisplatin, 40 mg/m 2 cyclophosphamide, 40 mg/m 2 etoposide, and 10 mg/m 2 doxorubicin. The cisplatin dose was adjusted based on renal function, as determined by the treating physician. The responses were evaluated according to the International Myeloma Working Group response criteria. High-risk cytogenetic abnormalities (HRCA) included del (17p), t(4;14), and t(14;16). Double-class refractory disease was defined as refractoriness to PIs and IMiDs, whereas triple-class refractory disease was defined as refractoriness to PIs, IMIDs, and anti-CD38 monoclonal antibodies. Penta-drug refractory disease was defined as refractoriness to bortezomib, carfilzomib, lenalidomide, pomalidomide, and anti-CD38 antibodies. The median follow-up period was 11.1 months (range, 0.5-72.0 months), during which they received a median of two cycles of VTD-PACE. The overall response (ORR), stringent complete response, complete response, and very good partial response rates were 66.7% (40 patients), 13.3% (8 patients), 5% (3 patients), and 20% (12 patients), respectively. The results of univariate analysis for factors associated with response rate are shown in Table 2. The ORRs in patients with ≥4 and ≤3 prior lines were 53.1% and 82.1%, respectively ( P = 0.027). Extramedullary disease (EMD), refractoriness to anti-CD38 antibody, HRCA, and triple-class/penta-drug refractory disease did not significantly reduce the ORR. The median overall survival (OS) was 17 months with a median progression-free survival (PFS) of 9.8 months. The median PFS in patients with and without receiving hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor T-cell therapy (CART) following VTD-PACE were 9.8 and 5.1 months, respectively ( P = 0.023). The median OS in patients with and without renal dysfunction were 10.7 months and 21.5 months, respectively ( P = 0.0091). A trend for longer OS was observed in patients with HSCT or CART following VTD-PACE (P = 0.18). Therefore, VTD-PACE is useful as a bridging therapy for HSCT or CART, as a response is expected regardless of organ damage, disease risk, or history of anti-CD38 antibody use. However, the response rate decreased in late lines; therefore, its use in early lines is recommended.

'I know you like the back of my hand': biometric practices of humanitarian organisations in international aid.

Humanitarian organisations are increasingly utilising biometric data. However, we know little about the extent and scope of this practice, as its benefits and risks have attracted all the attention so far. This paper explores the biometric practices of the United Nations Refugee Agency, the United Nations World Food Programme, the International Committee of the Red Cross, Médecins Sans Frontières, and World Vision International. The study analysed relevant documents published over the past two decades and 17 semi-structured interviews with humanitarian workers conducted between June 2021 and June 2022. The findings reveal that humanitarian organisations use diverse types and functions of biometric data for different services, collaborate with many actors, and employ various data protection measures. Ultimately, challenging the straightforward generalisations about the use of such data, the paper argues that variational applications of biometrics in the humanitarian context require case-by-case analysis, as each instance will likely produce a different outcome.

Edukasi Penanganan Pertama Cedera Olahraga Pada Anggota PMR SMPN 5 Malang

Engaging in physical activities among adolescent students offers numerous benefits, one of which is the enhancement of brain function leading to improved cognitive abilities and focus during school learning. However, sports-related injuries are prevalent in school environments. Factors contributing to these injuries include inadequate warm-up, a lack of proper facilities, and high levels of physical activity. The higher the intensity of physical activity, the greater the risk of injuries. In school settings, the Youth Red Cross (PMR) plays a crucial role in providing basic medical assistance to individuals experiencing health issues. However, some PMR members lack proficiency in offering first aid for sports-related injuries. Therefore, it is essential to raise awareness about the correct and timely application of first aid in the event of sports injuries. This essay aims to discuss the importance of increasing understanding of first aid for sports injuries, with a specific focus on the PRICE method.

Evaluation for Blood Concentration and Efficacy/Safety of Continuous Administration of Thiamylal in Children.

Thiamylal exerts excellent sedative effects. However, it is not routinely used because of its serious adverse effects. This study aimed to clarify the target blood concentration range and infusion rate of thiamylal in children by measuring its blood concentration and evaluating its relationship with efficacy and adverse effects. This study was approved by the Ethics Committee of Japanese Red Cross Kumamoto Hospital. The authors included 10 children aged between 1 and 7 years who had received continuous intravenous (IV) infusion of thiamylal for the management of refractory status epilepticus, excluding those who met the exclusion criteria. After a 2 mg/kg bolus injection of thiamylal, continuous IV infusion was initiated at a rate of 2-3 mg/kg/h. Thiamylal concentration in the blood was measured using high-performance liquid chromatography. The State Behavioral Scale and the frequency of bolus injections were used to evaluate efficacy. Blood pressure and heart rate were measured to evaluate adverse effects. Statistical analyses of the time to awakening and the factors affecting it were also conducted. The State Behavioral Scale score during thiamylal administration was -2 or lower in all cases, suggesting that the depth of sedation was sufficient. The frequency of bolus injections decreased in a blood concentration-dependent manner, suggesting that the frequency tended to decrease, especially at thiamylal blood concentrations of 20 mcg/mL or higher. An increase of the infusion rate to 3 mg/kg/h was recommended, because the blood concentration may not reach 20 mcg/mL at an infusion rate of 2 mg/kg/h. There was also a case in which a rapid increase in blood concentration accompanied by a decrease in blood pressure and heart rate was observed when the infusion rate was increased to 4 mg/kg/h. Furthermore, the time to awakening after the end of administration correlated with the highest blood concentration during administration; therefore, delayed awakening was noted when using a high dose of thiamylal. The target blood concentration of thiamylal in children should be 20-30 mcg/mL, and the infusion rate should be based on 3 mg/kg/h.

Plasma disinfection procedures for surfaces in emergency service vehicles: a field trial at the German Red Cross

The demand for thorough disinfection within ambulances is essential, given the in-vehicle medical procedures and the potential high risk of infections due to patients' open wounds. One solution that can address this hygiene challenge involves the application of reactive products generated from atmospheric (air) oxygen and water vapor, activated through the use of cold plasma. Cold plasma's charged particles perforate the cell membranes of microorganisms. This process does not work in human cells, as proteins in the form of enzymes within the body break down the cold plasma and protect the cells. The study was done on an ambulance that was contaminated in eight places. Samples were taken from each site, and two surfaces measuring approximately 8 × 8 cm were carefully sealed and marked. These surfaces were deliberately contaminated by applying an Enterococcus faecium suspension of 8.5 × 107 CFU/mL using a sterile cotton swab. It was followed by the disinfection procedure, that was initiated with the PLASMOCAR device. It was positioned on the front workspace and operated for a duration of 30 min, utilizing the vehicle's onboard voltage. Throughout the operation, all doors and windows were closed and the vehicle's air conditioning system remained active. After the completion of the disinfection process, samples were collected from the surfaces for bacterial counts. A reduction of 3.73 log levels in initial bacteria was accomplished within the rescue vehicle for Enterococcus faecium, equivalent to a 10–fourfold reduction in bacteria, eliminating up to 99.99% of the initial microorganisms. This success makes the process well-suited and convenient as an ongoing "background" procedure to enhance the established disinfection procedures. The established disinfection procedures outlined in the hygiene plan must be promptly implemented whenever mechanical surface cleaning is required. The use of PLASMOCAR offers an extra layer of protection and security, significantly decreasing the risk of microorganism transmission through cross-contamination and aerosols. This is a significant benefit for the well-being of both staff and patients.