Rescue Coordination Research Articles

The Use of Medical Services for Low-Acuity Emergency Cases in Germany: Protocol for a Multicenter Observational Pilot Study.

The increasing number of requests for help for acutely ill patients and their management is a major problem in the health systems of many countries, but especially in Germany. Rescue coordination centers and ambulances in Germany are increasingly overloaded. As a result, rides as a part of rescue operations have been increasing in length for years, yet a relevant proportion of these operations represent low-acuity calls (LACs). The basic objective of this pilot study is the quantitative analysis of the potential misuse of requests to the rescue control center. Indications for alternative treatment options and how to handle these treatment options in nonacute, non-life-threatening health conditions, such as minor injuries or minor infectious diseases, will be assessed. The identification of these LACs is vital in order to prevent health care resources in emergency medical care becoming inadequate. The overarching goal of this study is to determine the percentage of unnecessary rescue missions on site and subsequently to obtain an impression of the paramedics' assessment of alternative treatment options or alternative methods of rescue transportation. This will be an exploratory, noninterventional, cross-sectional study with a quantitative approach. The study is multicentric, with 21 ambulances in 12 different locations. The data for this study were collected via a questionnaire, newly developed for this study, for rescue personnel. Additionally, secondary data from the responsible control center will be linked and processed in an initial descriptive analysis. This descriptive analysis will form the basis for a subsequent variance analysis. Data collection started as projected on September 18, 2023, and was ongoing until end of November 2023. We expect the documentation of several thousand rescue operations. We expect the following study results: (1) many unnecessary rescue operations, (2) immediate on-site assessment of correct care and treatment, and (3) patients' reasons for calling a rescue coordination center. To our knowledge, this is the first observational study in which acute rescue operations are recorded on site. The focus of this study is on the trained paramedics' assessment of whether rescue operations are necessary or not. Additionally, alternative treatments, such as out-of-hours care service or primary care service, are shown for each individual case. The study also intends to cover the question of which factors are relevant and statistically significantly connected to the misuse of ambulances. German Register for Clinical Studies (Deutsches Register für Klinische Studien) DRKS00032510; https://drks.de/search/en/trial/DRKS00032510. DERR1-10.2196/54002.

Multi-Level Emergency Rescue Coordination Scheduling Model

Multi-Level Emergency Rescue Coordination Scheduling Model

Documenting Maritime Accidents of Recreational Vessels in the Republic of Croatia

Nautical tourism in the Republic of Croatia represents an important segment of Croatian tourism. Due to the natural conditions that Croatia possesses, it is recognized as one of the most desirable European and world destinations for boaters. The increase of nautical tourism activities in the Adriatic in recent years also increases the possibility of accidents at sea. In order to reduce the risk of accidents, analyses of available data on accidents from the National Maritime Rescue Coordination Center (MRCC) were carried out. In the aforementioned database, recreational vessels were selected and analyzed. The compiled data refers to sailing vessels, yachts, small fishing vessels, boats, and inflatable boats regardless of their flag state. Based on the research conducted, suggestions were made to optimize the existing way of filling out reports in order to better manage statistical data, and potentially identify the causes of recreational vessel accidents.

Impact of independent early stage extracorporeal cardiopulmonary resuscitation in the emergency department following the establishment of an extracorporeal life support team

ObjectiveIn this paper, we present a comprehensive overview of our experience in establishing and leading distinct extracorporeal cardiopulmonary resuscitation (ECPR)-related teams to independently handle ECPR in the early stages in the emergency department. MethodsA retrospective analysis was conducted on the clinical data of 29 patients who underwent ECPR treatment in the emergency room between May 2018 and April 2022. A control group, consisting of 10 patients treated between May 2018 and September 2019 was managed using a standard rescue coordination mode. The 19 patients who received ECPR between October 2019 and April 2022 were treated by members of the department's 24-h extracorporeal life support team. We compared the implementation and operational challenges faced by the two groups, including item preparation, circuit setup, and ECPR initiation times, among other factors. ResultsGender, age, cardiac arrest risk factors, and other baseline data did not significantly differ between the two groups. Extracorporeal membrane oxygenation (ECMO) pipeline prefilling time (from 35.27±10.34 to 13.46±5.32), ECPR establishment time (from 62.35±29.61 to 30.98±13.41), and item preparation time (from 16.42±9.78 to 3.19±1.49) all considerably decreased when compared to the control group. The rate of return of spontaneous circulation recovery rose from 37.50 % to 77.78 % (P < 0.05). The consequences of gastrointestinal and pulmonary bleeding were greatly reduced while ECPR was being used, and the difference was statistically significant (P < 0.05). Significant improvements were made in the ECPR weaning rate (from 25.00 % to 38.89 %) and survival rate (from 20.0 % to 36.8 %). ConclusionThe establishment of a 24-h extracorporeal life support team significantly reduced the time needed for rescue during the early stage of independent setup of ECPR in the emergency department and serves as a guide for effective care of critically ill patients.

Navigating maps in the Arctic: tracing more-than-human interactions of mapping practices in Norwegian rescue services

ABSTRACT When responding to an incident, Norwegian rescue services in the Arctic have to consider weather conditions, surface features, infrastructure scarcity, and technological availability. To some extent, safe navigation is based on the use of digital maps. In this article, I analyze how maps are assembled for their role as navigation tools and how this interlinks with the capacity for timely incident response in the Arctic context. My study is based on new materialism, which pays attention to interactions. I investigate maps as processes, focusing on how they are constituted through practices. Therefore, I follow heterogeneous entanglements of more-than-human actors. In this article, I focus on localities related to the Svalbard archipelago, including incident response on land, the Joint Rescue Coordination Centre, and information support services. I explore the assemblages of maps through three aspects: institutional mapping of Svalbard, avalanche observations around Longyearbyen, and mapping practices of the local rescue services on land. I argue that safe navigation, and consequently a timely incident response, is embedded in more-than-human networks and depends on their flexibility and durability. Divergence of mapping practices between those in Svalbard and on the mainland further highlights the need for an analysis of socio-technological entanglements in the Arctic.

Fatigue as a key human factor in complex sociotechnical systems: Vessel Traffic Services.

Vessel Traffic Services (VTS) are considered a subsystem of people, whose mission is to improve the effectiveness and efficiency of maritime transport within the maritime system. VTS operate as a control system where Vessel Traffic Services Operators (VTSOs) must cope with a complex environment to make up for safe and efficient maritime transport, so it is essential to understand how these operators maintain control through adapting to the uncertain and dynamic environment of maritime traffic. This multidisciplinary study explores how human factors within this complex sociotechnical system, means VTS, play a role in maritime safety, specifically focusing on fatigue, which is considered a key variable for VTSOs' performance. In this context, the research has focused on the assessment of fatigue with psychological and operational instruments to highlight the importance of the human element in CSSs. To study the intra and inter-individual differences in fatigue ratings and their relationships with other personal and environmental variables: mental workload, work shifts, reaction time, and hours of usual sleep. The study was conducted in two of the 19 Spanish Maritime Rescue Coordination Centers (MRCCs) with a sample of 23 active VTSOs (82.14% of the staff). Both objective and standardized subjective measures were used to assess fatigue and associated sleepiness (Borg RPE, Nasa-TLX, Stanford Sleepiness Scale, and Self-Assessment Manikin Scale). A significant positive correlation between fatigue and mental workload was found, being more prevalent in the night shift, which shows a bigger variation in these variables. A significant difference was found in the increase in fatigue experienced throughout the shift depending on the hours of usual sleep, being smaller in the group of subjects reporting to sleep more. The human element is key to maritime safety related to Vessel Traffic Services, so it is of paramount importance to consider certain measures to counteract the negative effects of fatigue. A proper organization of duties on/off periods, assessment of work and rest schedules, and the implementation of fatigue management programs based on sleep education are recommended.

Global interest in the Arctic region: Naval operations impacting scientific-commercial activities

Abstract The Arctic region is rapidly changing as a result of climate alteration, political tensions and ambitions of the Arctic and non-Arctic states. Is the existing governance considered to be adequate for effective international security cooperation in the region? On the one hand, we look optimistic at the evolution of international relations in the areas of science and technology, conservation, search and rescue coordination, tourism, etc. On the other hand, there is a significantly increased militarisation of the Arctic region. The recent rise in military activities in the North has resulted in numerous regional deployments, patrols and other incidents in the maritime Arctic. In general, militarisation together with climate change are impacting scientific-commercial activities. Also, the absence of an adequate legal regime that may respond to climate change and interruption of civil activities by military exercises in a fast and effective way hampers international cooperation. This paper problematises various aspects of interaction between scientific-commercial activities and naval operations in the Arctic region.

State of Implementation of Telephone Cardiopulmonary Resuscitation by Rescue Coordination Centers in Germany.

State of Implementation of Telephone Cardiopulmonary Resuscitation by Rescue Coordination Centers in Germany.

İstanbul Boğazı’ nda deniz kazalarının seyir emniyeti perspektifinde incelenmesi: İSTANBULMAKS gemi tipi önerisi

In this study, maritime accidents that occurred in the Strait of Istanbul over a 10-year period were evaluated in terms of ship-based risk factors. The frequency analysis was performed using the R - Studio program language. In this context, the accident data obtained from the Ministry of Transport and Infrastructure Main Search and Rescue Coordination Center were matched with the ship information accessed from Türk Loydu database. Thus, ship origin risk factors to be used within the scope of the study were determined and 10 different criteria were included in the analysis. These are ship length, ship breadth, ship draught, ship age, ship DWT, turning point, turning radius, L/B ratio, B/T ratio and number of propellers. The process of creating a data set was completed by spatially filtering the data and classifying of the ship-based causes accidents. The variables were examined with frequency analysis in the perspective of the Law of Large Numbers. With the results obtained, optimum characteristics based on ship origin risk factors have been revealed for each ship type that will pass through the Strait.

Middle power South Korea’s disaster response contributions: A case of good international citizenship?

Middle powers tend to display their expertise in areas where they possess a significant advantage, and this results in the creation of new international norms, especially on non-security issues. Disaster response is one area of international relations where middle powers project their images as good international citizens. This article discusses how middle power South Korea has displayed good international citizenship through its various contributions to global disaster response, such as participation in search and rescue operations, management and coordination of relief operations, and funding for humanitarian emergencies. South Korea’s involvement in disaster response is a middle power behaviour that demonstrates good international citizenship by allocating resources for global public goods. South Korea has utilized disaster response as part of its public diplomacy to promote its identity as a middle power and in seeking recognition as a reliable contributor to international development and stability.

Evaluation of maritime accident reports of main search and rescue coordination centre between 2001 and 2012.

The aim of the study was to evaluate the marine accident and incident reports between 2001 and 2012 by the Main Search and Rescue Coordination Centre (MSARCM). The method of the study was a descriptive-cross-sectional epidemiological study. The data of the research were composed of MSARCM's marine accident, incident and medical evacuation reports between 2001 and 2012. In the research, 1796 marine accident/incident reports were examined. The data were evaluated statistically by frequency distribution, univariate and bivariate regression analysis and multidimensional scaling analysis. The highest number of cases in the study occurred in 2010 (n = 228, 12.7%). Considering the time of realisation of the cases, the highest number of cases occurred between 12:00 and 17:59 (n = 538, 30.0%). In the total of 1796 cases, there were 150 injured, 6046 rescued, 311 deaths, 202 missing and 73 patients. Considering the causes of accidents, the first three places were bad weather conditions (n = 287, 16.0%), human errors (n = 241, 13.4%) and machine malfunctions (n = 232, 12.9%). In the univariate and bivariate analysis of the data, it was seen that injuries in the Istanbul region were statistically more significant than those in the international region (8.5 fold, 95% confidence interval). The risk management activities on injuries and accidents need to be carried out more carefully particularly in the areas with a high occurrence of marine accidents/events and medical evacuations (such as strait traffic, ports, shipyards), in the hotspots for shipping accidents.

Wireless Access Control in Edge-Aided Disaster Response: A Deep Reinforcement Learning-Based Approach

The communication infrastructure is most likely to be damaged after a major disaster occurred, which would lead to further chaos in the disaster stricken area. Modern rescue activities heavily rely on the wireless communications, such as safety status report, disrupted area monitoring, evacuation instruction, rescue coordination, etc. Large amount of data generated from victims, sensors and responders must be delivered and processed in a fast and reliable way, even when the normal communication infrastructure is degraded or destroyed. To this end, reconstructing the post-disaster network by deploying MDRU (Movable and Deployable Resource Unit) and relay unit at edge is a very promising solution. However, the optimal wireless access control in this heterogeneous hastily formed network is extremely challenging, due to the frequent varying environment and the lack of statistics information in advance in post-disaster scenarios. In this paper, we propose a learning based wireless access control approach for edge-aided disaster response network. More specifically, we model the wireless access control procedure as a discrete-time single agent Markov decision process, and solve the problem by exploiting deep reinforcement learning technique. By extensive simulation results, we show that the proposed mechanism significantly outperforms the baseline schemes in terms of delay and packet drop rate.

Analysis of shipboard fire/explosion accidents occurred in the Turkish search and rescue area

A shipboard fire/explosion may be occurred due to various causal factors such as actions, omissions, events or conditions. In this study, it is aimed to carry out an analysis focused on shipboard fire/explosion casualties. With this aim, the data on 127 shipboard fire/explosion casualties occurred in the Turkish Search and Rescue area, which were reported to the Main Search and Rescue Coordination Center between 2006-2015, have been analyzed. As a result of the statistical analysis (descriptive statistics), it has been observed that majority of the shipboard fire/explosion casualties were occurred on-board the Turkish flagged ships, on-board small passenger vessels/recreational vessels/private-commercial yachts among the classified ship types, in the regions of İstanbul, İzmir and Çanakkale, in the summer season, during the night-time, and in machinery spaces of the ships by described locations. It has been also observed that main events caused shipboard fires/explosion casualties were electricity contact/leakage, gas accumulation/leakage, cargo ignition, welding/hot works and other undescribed factors. Additionally, by examining the existing shipboard fire &amp; explosion accident investigation reports of Transportation Safety Investigation Center between 2014-2020, it has been observed that the main possible causal/contributing factors for the shipboard fire/explosion casualties were related with the violations of the ISM-Safety Management System (SMS) requirements. Many previous studies in the relevant literature point out to the ISM/SMS-related causal/contributing factors as well. In conclusion, special attention should be paid to the effective implementation and continuous improvement of the ISM/SMS procedures related with shipboard fire safety for the prevention of shipboard fire/explosion casualties as well.

İstanbul Boğazı’ndaki ticari gemi kazalarının karar ağacı yöntemiyle analizi

In this study merchant vessel accidents which occured between 2001 and 2016 in the sectors of Türkeli, Kandilli, Kadıköy, Marmara which constitutes Istanbul Strait region under Istanbul Vessel Traffic Services scope have been examined. Data was obtained from database of Ministry of Transport and Infrastructure Main Search and Rescue Coordination Center, and after data cleansing process, 535 vessel accidents which involve merchant cargo vessels of above 500 grosston have been analyzed. Merchant cargo vessel accidents which were taken place in the specified sectors have been examined with CHAID (Chi-square Automatic Interaction Detector) Decision Tree method. CHAID Decision Tree method is one of the most common used decision tree algorithms in extracting meaningful rules from big datasets and for classification. Through conducting CHAID Decision Tree method for merchant vessel accidents relationship between accident type (collision/contact, grounding and other) and vessel factors (vessel type, Length overall (LOA), vessel gross tonnage, vessel age, flag, loading condition), time factors (accident time, season of accident) and other factors (sector where accident occured, pilot on board or not) has been analyzed. Accident occuring sector, pilot on board/not, vessel type and accident time have been found as the most important input variables. Based on the result of the Decision Tree method applied to the data set, it was observed that the accidents occurring in the Kadıköy sector were collision / contact with 86% probability, the accidents occurring in the Kandilli or Marmara sectors were collision / contact with 48% probability and in the Türkeli sector, both collision / contact and other accident types had 36% occurring probability.

Key Factors and Coupling Relationships of Collaborative Governance for Disaster Prevention in China's Coastal Cities.

In order to discover the key factors for the successful implementation of the collaborative management of disaster prevention and mitigation in coastal cities and their causal coupling, based on the hypothesis, the main factor analysis method was used to analyze the key factors of the various subsystems of disaster prevention and mitigation, and to verify the correlation between the main factors and the successful implementation of coordinated governance for disaster prevention and mitigation in coastal cities. Interpretative structural model (ISM) is used to explore the coupling relationship between subsystems and key factors within each subsystem. The results show that there have 6 factors, including emergency organization coordination, plan construction coordination, monitoring and early warning coordination, information sharing coordination, emergency command coordination, and emergency resource coordination are positively related to the successful implementation of coastal city disaster prevention and mitigation collaborative governance; emergency rescue coordination and emergency decision-making coordination are not directly related to the successful implementation of disaster prevention and mitigation collaborative governance in coastal cities. When the main factors work together, the impact on the successful implementation of disaster prevention and mitigation collaborative governance in coastal cities is not obvious. There are obvious hierarchical relationships and clear influence paths between key factors within each main factor.

Shipping Safety in the Arctic

Ensuring the safety of shipping in the Arctic and along the Northern Sea Route has some specifics associated with adverse climatic conditions. The presence of ice makes navigation difficult, and the interannual and interseasonal variability of its condition makes the timing of the start and duration of navigation in clear water uncertain. Collisions of ships and other accidents in northern waters can lead to more negative environmental consequences than in the southern seas, since there is a particularly vulnerable ecosystem, the restoration of which is very slow. The fishing fleet has traditionally posed security concerns for major shipping in the Arctic. In recent years, an increase in the intensity of shipping has been associated with exploration and production of hydrocarbon raw materials on the sea shelf. To support the technological processes of drilling platforms, a specialized supply fleet is used here, which creates additional risks of a technical, technological and technogenic nature, and also increases the risks of emergency situations associated with the human factor. This work is devoted to the development of measures to improve the information and telecommunications support of navigation safety systems in the Arctic. The issues of improving the electromagnetic accessibility of ship communication systems during navigation in the waters of the Northern Sea Route, the reliability of the GMDSS system, the information and technological support for navigation safety have been considered. To solve these problems, it has been proposed to accompany the construction of marine rescue coordination centers and sub-centers with the deployment of NAVTEX automated systems and equipping the RF radio frequency range with coastal radio communication equipment. To eliminate the predicted areas with reduced electromagnetic accessibility, it is recommended to replenish ship’s antenna systems with antiaircraft antennas. The issues of incorporating the IRIDIUM satellite system into the GMDSS radio equipment to expand the coverage area of global satellite communications in the navigation safety system have been studied. It has been proposed to supplement the existing vessel traffic services (VTS) systems with an intellectual component – a mobile VTS, which will expand the functional and technological capabilities of traditional VTSs and remove territorial restrictions on use.

The U.S. National Search and Rescue School – Inland

The Inland Search and Rescue (SAR) Planning Course is a 5-day course for experienced SAR decision makers and planners taught free of charge across the United States. It presents a broad understanding of inland search theory and its application for air and ground searches for missing persons and aircraft with a focus on wilderness and rural area searches. The course consists of classroom instruction and practical, tabletop exercises. Emphasis is on the planning necessary for effective area-type search planning during an extended search using Probability of Success (POS), rather than just a few elements of Probability of Containment (POC)/Probability of Area (POA), or Probability of Detection (POD), to predictively allocate limited resources to their best effect. An additional objective of the course is to strengthen the U.S. Federal Government’s role in its support to civil SAR through education, including promoting the capabilities of the Rescue Coordination Centers (RCCs), and requesting and coordinating the use of other federal resources with the goal of saving lives. Keywords: Inland SAR School

Towards Fairness-Aware Disaster Informatics: an Interdisciplinary Perspective

Collection of information from crowdsourced and traditional sensing techniques during a disaster offers opportunities to exploit this new data source to enhance situational awareness, relief, and rescue coordination, and impact assessment. The evolution of disaster/crisis informatics affords the capability to process multi-modal data and to implement analytics in support of disaster management tasks. Little is known, however, about fairness in disaster informatics and the extent to which this issue affects disaster response. Often ignored is whether existing data analytics approaches reflect the impact of communities with equality, especially the underserved communities (i.e., minorities, the elderly, and the poor). We argue that disaster informatics has not systematically identified fairness issues, and such gaps may cause issues in decision making for and coordination of disaster response and relief. Furthermore, the isolating siloed nature of the domains of fairness, machine learning, and disaster informatics prevents interchange between these pursuits. This paper bridges the knowledge gap by evaluating potential fairness issues in disaster informatics tasks based on existing disaster informatics approaches and fairness assessment criteria. Specifically, we identify potential fairness issues in disaster event detection and impact assessment tasks. We review existing approaches that address potential fairness issues by modifying the data, analytics, and outputs. Finally, this paper proposes an overarching fairness-aware disaster informatics framework to structure the workflow of mitigating fairness issues. This paper not only unveils both the ignored and essential aspects of fairness issues in disaster informatics approaches but also bridges the silos which prevent the understanding of fairness between disaster informatics researchers and machine-learning researchers.

Denizyolu Tehlikeli Madde Taşımacılığına Yönelik Kazaların Analizi

The use of hazardous chemicals that cause fire, explosion and toxic release effects is an important factor in transportation and shipping. In this study, it was aimed to determine the causes of accidents caused by dangerous goods of maritime transportation in our country (Turkey). First of all, the Main Search and Rescue Coordination Center (ECRC) 2001-2016 data were evaluated in detail, and the ship accident / incidents likely to carry dangerous goods and the accidents / incidents resulting from fire and explosion due to dangerous goods were selected and the statistics were determined. 16 out of 43 accidents / incidents of fire and explosion caused by hazardous materials after June 2005 were related to dangerous cargo transportation. Filled with dangerous cargo, it was observed that most cargo fires caused an accident. Before 2005, the known causes of these accidents / incidents were identified as electrical failure and spark. In the second stage, the causes of accidents / incidents related to dangerous goods / freight transportation were analyzed with the fault tree. It was determined that existing accidents / incidents resulting from fire and explosion caused by dangerous goods occured on the basis of human error, machine failure, thermal reaction and electrical failure. It is believed that the results of this study will contribute to the more effective realization of emergency plans and related accident data records.

Search and Rescue System in Poland

Abstract On 25th of January 2018 Civil and Military Aeronautical Rescue Coordination Centre (ARCC) commenced operations in Polish Air Navigation Services Agency (PANSA). PANSA increased significantly its contribution in the domain of coordination of search and rescue activities in ASAR service in the Polish area of responsibility. Up to this date all tasks of ARCC Centre were conducted mainly by Armed Forces of Republic of Poland, which performed coordination function in ASAR (Aeronautical Search and Rescue) service. The bodies responsible were Aeronautical Search And Rescue Centre located in Air Operations Centre – Air Component Headquarter in Warsaw and sub-centre in Gdynia, part of Naval Operations Centre of Naval Component Headquarter. According to international commitments resulting mainly from Convention on International Civil Aviation signed on 7th of December 1944 in Chicago and ratified by Poland together with Annex 12 “Search And Rescue”, Poland committed to establish aeronautical search and rescue service called ASAR within Polish region and to assure its operation. ASAR service is the only service in Poland for rescue purposes and is designated to search and rescue of aircraft in distress, provision of help for aircraft crews and passengers and other victims of aeronautical accidents (regardless to nationality of these aircraft and persons). ASAR service tasks include search of designated area to find location of aircraft and victims of aeronautical accidents, determination of their status and commencement of rescue actions at the location using dedicated forces and measures as well as forces and measures of another systems, mainly from State Medical Rescue, National Firefighting and Rescue System and Maritime Search and Rescue Service. ASAR service consists of: a)commanding element – Civil-Military Aeronautical Rescue and Coordination Centre, b)executive elements – Aeronautical Search and Rescue Teams (LZPR), and c)supporting elements – alerting points (air traffic services units operating in the framework of alerting service).