Rescue Unit Research Articles

Определение стоимости обслуживания опасного производственного объекта профессиональными аварийно-спасательными формированиями

The existing methodologies to determine the costs of service for a hazardous production facility provided by emergency and rescue units have been analyzed. The issues hampering the calculations were identified, and the criteria to be incorporated into the calculation procedure, considering the identified shortcomings, have been proposed. Throughout the study, the following problems were resolved: The analysis of accidents at hazardous production facilities, federal laws in the sphere of industrial safety, and the existing methodologies to determine the cost of service for a hazardous production facility provided by emergency and rescue services or units; Identification of issues hampering the calculations; Proposing criteria incorporated into the procedure of calculation of costs of service for a hazardous production facility provided by emergency and rescue services or units. The authors refer to the statistics on emergencies at hazardous production facilities and focus on the fact that similar accidents cause devastating consequences requiring emergency and rescue operations. When operating a hazardous production facility, its operating company is required to enter into servicing agreements with professional emergency and rescue services or professional emergency and rescue units. Maintaining a servicing agreement with professional services is more cost-efficient compared with maintaining an in-house emergency and rescue unit. At the same time, the issue of determining a justified cost of the agreement with professional emergency and rescue services (units) for servicing a hazardous production facility becomes crucial. The article analyzes the Rules of calculation of costs of service for mining facilities provided by professional emergency and rescue services (units) and the Norms of minimum equipping of emergency and rescue units. The procedure of calculation of expenses on maintenance of personnel of professional services and the respective operational costs have been analyzed. It has been demonstrated that the calculated service cost is significantly higher than the service costs specified for tenders. The criteria incorporated into the cost calculation procedure for servicing a hazardous production facility by emergency and rescue services or units have been developed.

Decentralized Protocol for Organizing Sustainable Interaction between Subscribers in Networks with High Dynamics of Topology Changes

Emergency services often have to carry out rescue and liquidation operations in the absence of centralized communications. The inability to ensure stable communication between members of the rescue unit significantly reduces the quality of work. Moreover, in modern realities, stable communication means not only voice exchange, which can be provided by shortwave radio transmitters, but also intensive exchange of large volumes of traffic. The use of standard solutions based on standard network equipment (Wi-Fi, satellite communications, etc.) and existing algorithms for ensuring quality of service in the conditions under consideration does not allow quickly ensuring information exchange between heterogeneous subscribers. Moreover, operation in high-Hz bands can be very difficult in the presence of obstacles, which reduces the overall coverage area and the quality of data transmission. We propose a network layer routing protocol designed to organize decentralized communication in an emergency service department, where subscribers have different degrees of mobility and types of transmitted traffic. This protocol includes algorithms for connecting to the network, detecting optimal and alternative communication routes, and transmitting and balancing traffic along the found routes. The original route search algorithm analyzes the performance of communication channels and determines all possible paths for transmitting traffic between subscribers. Using the route evaluation function based on gradient boosting of decision trees, optimal and alternative communication routes are formed, and when transmitting data, traffic balancing is performed based on the received information. An experimental study of the proposed protocol showed an improvement in the speed of deployment and quality of service in scenarios with varying degrees of subscriber mobility.

Evolution of military evacuation activity in French Guiana over 10 years: a retrospective observational study

BackgroundThree permanent military operations are established in French Guiana. The Cayenne medical unit is a French military search and rescue unit and provides MEDEVAC and CASEVAC for ill and injured...

Comparative analysis of rescue operations to rescue a victims at a height

A quantitative comparative assessment of the influence of the size of the rescue teams, as well as the level of preparedness of the rescuers-climbers on the time of implementation of various options for rescuing the victim by evacuation in an unsupported space, was carried out, which will contribute to solving the problem of reducing the time of rescue work at height without reducing the level of safety as a personnel rescue teams, as well as victims who require evacuation in an unsupported space. A comparative assessment of various options for height rescue operations was carried out, taking into account both the level of training of rescuers and the completeness of the rescue unit. with the help of both a spinal immobilization shield and rescue stretchers by the personnel of rescuers of the basic and initial level of training in groups of full and part-time staff in accordance with the criteria of Shapiro-Wilkie, Fisher and Student. It is shown that the time distribution of height rescue operations according to the options considered with a significance level of =0,05 can be considered normal. At the same time, the mathematical expectation of the time of height rescue work at height for the specified options differs significantly not only depending on the technical capabilities of the special equipment and safety devices used, but also on the level of preparedness of the rescuer-climber and the size of the rescue team. These properties must be taken into account when drawing up methodological recommendations for performing rescue work at height, as well as professional training of a rescuer-climber. The reliability of the obtained estimates was confirmed by comparison with the results of research conducted in 2018–2019.

Trauma Laparotomy for the Cirrhotic Patient: An Outcome-Based Analysis

IntroductionThere is a lack of large-scale data on outcomes of cirrhotic patients undergoing trauma laparotomy. We aimed to compare outcomes of cirrhotic versus noncirrhotic trauma patients undergoing laparotomy. MethodsWe analyzed 2018 American College of Surgeons Trauma Quality Improvement Program. We included blunt trauma patients (≥18 y) who underwent a laparotomy. Patients who were transferred, dead on arrival, or had penetrating injuries were excluded. Patients were matched in a 1:2 ratio (cirrhotic and noncirrhotic). Outcomes included mortality, complications, failure to rescue, transfusion requirements, and hospital and intensive care unit (ICU) lengths of stay. Multivariable backward stepwise regression analysis was performed. ResultsFour hundred and seventy-one patients (cirrhotic, 157; noncirrhotic, 314) were matched. Mean age was 57 ± 15 y, 78% were male, and median injury severity score was 24. Cirrhotic patients had higher rates of mortality (60% versus 30%, P value <0.001), complications (49% versus 37%; P value = 0.01), failure to rescue (66% versus 36%, P value<0.001), and pRBC (units, median, 11 [7-18] versus 7 [4-11], P value <0.001) transfusion requirements. There were no significant differences in hospital and intensive care unit (ICU) lengths of stay (P value ≥0.05). On multivariate analysis, increasing age (adjusted odds ratio [aOR] 1.02, P value <0.001), Glasgow Coma Scale score ≤8 at presentation (aOR 3.3, P value <0.001), and total splenectomy (aOR 5.7, P value <0.001) were associated with higher odds of mortality. Platelet transfusion was associated with lower odds of mortality (aOR 0.84, P value = 0.044). ConclusionsOn a national scale, mortality following trauma laparotomy is twice as high for cirrhotic patients compared to noncirrhotic patients with higher rates of major complications and failure to rescue. Our finding of a protective effect of platelet transfusion may be explained by the platelet dysfunction associated with cirrhosis. Liver cirrhosis among trauma patients warrants heightened surveillance.

Empty Forest Syndrome: Are we there yet? A preliminary Analysis of the Hunting and Poaching Activities in Selected Areas in Sabah, Malaysia.

Hunting poses a longstanding threat to tropical wildlife conservation, now reaching critical levels. In Borneo, Malaysia, around six million animals were hunted yearly in the 1990s, about 36 per sq. km. High demand for game meat, facilitated by improved transportation, drives unsustainable consumption across the tropics. Depletion of animal populations leads hunters to new areas. Roughly 18% of rainforests are protected, yet pressures persist, endangering species due to weak regulations, limited resources, and external threats. This study examines wildlife hunting trends in Sabah, uncovering insights from community interviews regarding hunting impact and resource dependence. A total of 45 people were interviewed in six study areas: Sandakan, Tawau, Kota Belud, Tambunan, Keningau and Tenom. It was found that local communities hunt for food and that hunting is a common way of life for them. Based on the arrests of hunters by the Wildlife Rescue Unit, a report on animal hunting was compiled by the Sabah Wildlife Department and analysed. The most commonly hunted animal is the bearded pig. Parts of bearded pigs were found in the cars of 76.97% of hunters arrested, followed by parts of sambar deer (13.7%). Throughout Sabah, the empty forest syndrome (EFS) is becoming a dangerous silent disaster. While most "simple" forest features are attractive to the eye, they are gradually losing their ecological function. Although this study is not exhaustive, the preliminary findings point to a serious EFS scenario in Sabah if everyone continues to neglect the syndrome and do nothing about it.

Risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry

Introduction. In the coal industry, 78.7% of employees work in places with harmful working conditions, which play a leading role in the development of not only professional, but also industrial diseases, the leading of which are diseases of the cardiovascular system. The identification of preclinical systolic dysfunction of the left ventricle and the assessment of the role of traditional and professionally determined risk factors for the development of systolic dysfunction of the left ventricle in workers of the main professions of the coal industry is of scientific interest.&#x0D; The study aims to assess the risk factors for the development of heart failure with a preserved left ventricular ejection fraction in workers of the main professions of the coal industry.&#x0D; Materials and methods. The study included 101 employees of the main professions of the coal industry and 80 employees of the paramilitary mine rescue unit. The subjects had no somatic pathology, which could lead to structural and functional changes of the heart. The scientists performed echocardiographic and ultrasound examinations of the main arteries according to standard methods and assessed the generally accepted risk factors for the development of cardiovascular pathology (smoking, abdominal obesity, body mass index, total cholesterol, triglycerides, high and low density lipoprotein cholesterol, glycated hemoglobin).&#x0D; Results. The researchers revealed systolic dysfunction of the left ventricle significantly in miners more often in the form of a decrease in longitudinal deformation (27.7% of miners versus 7.6% of paramilitary rescuers, p=0.0005), while its average value is also significantly lower in miners and has a value below the established norm (–17.2±0.044 and –19.3±0.03, p=0.0005). The authors found no significant differences in the frequency of commonly accepted risk factors: abdominal obesity, smoking, atherosclerosis of the main arteries, dyslipidemia and the level of glycated hemoglobin in miners and workers of the mine rescue unit, as well as in miners, depending on the index of longitudinal deformation of the left ventricle.&#x0D; Conclusion. The obtained results indicate the need for a prenosological diagnosis of systolic dysfunction of the left ventricle, studying it in dynamics and simultaneously expanding the search for risk factors, which will allow early prevention of this complication in workers in harmful working conditions.&#x0D; Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Association "Ethical Principles of Scientific Medical Research with Human Participation" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order of the Ministry of Health of the Russian Federation dated 01.04.2016 No. 200n. The subjects signed an informed consent to participate in the study.

AlarmaPh: A Mobile Swiss Knife for Quick Response Incidents

Accidents can happen at any time, even if you follow traffic rules and practice safe driving. That's why it's important to be prepared for the unexpected. This study aims to provide emergency quick response and enable government agencies to track and manage emergencies all over Cebu City. As we all know, communication is the heart of any unwanted situation. So for Filipinos to be equipped with better and improved knowledge in preparing for disasters and emergencies such as earthquakes and road accidents, respectively, AlarmaPh will let each individual send distress calls to the fire department, police department, and call for ambulance assistance with just a click away. Moreover, AlarmaPh provides basic first aid manuals and before/during/after incident guides. More importantly, the system will let each individual connect with their families and be notified if the family that is registered in the system is involved in an accident or otherwise. On the other hand, other disaster applications have a high rate of subscription fee. As a result, individuals won't have access to the necessary features that they need. AlarmaPh gives you fast access to incident information, remote content management, easy maintenance, and a scalable platform for future growth. The descriptive developmental method of research was used to gather data from the Philippine National Police, Emergency Rescue Unit Foundation, Bureau of Fire Protection, barangay officials, and constituents of Cebu City. The data was analyzed using frequency, simple percentage, and weighted mean. The results showed that the application prototype was highly acceptable to the users. The researchers strongly recommend that the system be implemented and evaluated to solve the existing problems relating to emergency quick response.

ORGANISATION OF ACCOUNTING AND ANALYSIS OF THE USE OF BUDGETARY FUNDS BY THE UKRAINIAN SSNS

The article summarises and substantiates methodological issues related to improvement of the organisation of the accounting process of budgetary institutions and analyses the use of budgetary funds under conditions of uncertainty (martial law). Based on the materials of reliable accounting and financial statements of the 1st State Fire and Rescue Unit of the Main Directorate of the State Emergency Service of Ukraine in the Dnipro region, methodological approaches to accounting for exchange and non-exchange transactions are determined. The basic principles of accounting organisation and elements of formation of the accounting policy of a strategic budgetary institution are analysed. The form of accounting as locally unified (automated) is evaluated and the accounting registers and their method of formation are presented. The study of the regulation of accounting records has made it possible to identify certain features in terms of regulatory and legislative subordination. In particular, it is emphasised that the Methodological Council on Accounting in the Ministry of Internal Affairs of Ukraine contributes to ensuring uniform methodological approaches to the organisation of the accounting process. It is established that the formation of accounting records in the institution is carried out on the basis of the Working Chart of Accounts, which is formed with the preservation of the account classes of the Chart of Accounts in the public sector. It has been proved that local automation of accounting for all business transactions facilitates control over the use of budgetary funds and promotes the introduction of uniform methodological accounting principles. Based on the reliable financial statements of a budgetary institution, an analysis of dynamic changes in the structure of expenditures by elements of expenditures on exchange operations is carried out. The results of the analysis led to forecasts of expenditures for a short-term period of one year.&#x0D; The paper develops methodological approaches to forecasting calculations. It proves the impossibility of using trend equations as the main method of forecasting economic phenomena under conditions of uncertainty (martial law). An algorithm for forecasting the volume of expenditures based on the use of the rate of acceleration of dynamics as a multiplier is presented. The methodology of calculation was used in the course of the study and the forecasting of expenditures for the next reporting period was carried out. It is proposed to apply the obtained results as a calculation of the institution's allocation plan for the next reporting period under conditions of uncertainty (martial law).

THE TERM COMBINATION AND THE METAPHOR IN THE OFFICIAL BUSINESS DOCUMENT: COGNITIVE ASPECT

THE TERM COMBINATION AND THE METAPHOR IN THE OFFICIAL BUSINESS DOCUMENT: COGNITIVE ASPECT

GUEST ESSAY Vive l'Horticulture de Conservation

Conservation horticulture is an emerging and increasingly important function for all botanic gardens, but it is an activity that can be difficult to explain and to promote. Part of that difficulty lies in its name, and a few alternatives are suggested in this Guest Essay – such as Care for the Rare, Raising Rarity, and Plant Rescue and Care Unit – all currently in use at Royal Botanic Gardens Victoria (RBGV) for more narrowly scoped but pioneering projects. In reimagining conservation horticulture at RBGV we want to draw on the public’s intrinsic interest in and affinity with plants, rather than taking a defensive stand against what is often called ‘plant blindness’. Raising Rarity 2.0 is likely to combine commercialisation of rare species, innovative blending of amenity and conservation horticulture, and even stronger partnerships with schools and local government. As I prepare to leave RBGV after 25 years in senior management of botanic gardens, I’m supporting a grassroots push from horticultural and research staff to add conservation horticulture (whatever we call it) to our already potent mix of nature, culture and science.

An evolutionary approach comprising tailor-made variation operators for rescue unit allocation and scheduling with fuzzy processing times

This paper addresses the rescue unit allocation and scheduling problem (RUASP) with fuzzy processing times through an evolutionary approach. The goal of RUASP is to efficiently assign and schedule the rescue units to process the incidents in the event of a natural disaster. This problem can be considered as a variant of the unrelated parallel-machine scheduling problem with sequence and machine-dependent setup times. A steady-state grouping genetic algorithm (SSGGA) approach is presented to minimize the total weighted completion time of the incidents, where the weights correspond to the severity levels of the incidents. The crossover and mutation operators used in this approach are designed as per the characteristics of RUASP and its objective. The proposed approach uses a combination of greedy and random heuristics while generating the initial solutions, thereby yielding superior quality diverse initial solutions. The performance of the proposed approach is compared with the state-of-the-art approach available in the literature. The proposed approach always yields better results in much shorter execution times in comparison to the state-of-the-art approach. Moreover, the robustness analysis test demonstrates the proposed approach to be more robust in comparison to the state-of-the-art approach.

Socialize, Eat More, and Feel Better: Communal Eating in Acute Neurological Care.

Stroke commonly leads to feelings of isolation and loneliness, especially during the hospital period. The aim of the Communal Eating program was to support patient well-being through introducing opportunities for patients to eat lunch together. Patients admitted to the Brain Rescue Unit who were identified as appropriate by their attending physicians, nurses, or other clinicians were recruited to attend communal lunch. Their mood, quality of life, loneliness, communication, swallowing safety, and eating behavior were examined. Those who attended two or more sessions tended to have been lonelier and more psychosocially impaired at baseline. Patients who had one or fewer lunch showed no significant differences from baseline to posthospitalization on any measure. However, for those who ate two or more lunches, changes in loneliness and quality of life trended toward improvement. There was scant evidence of changes to communication or eating habits. Implementing a communal eating program in the acute hospital setting was very feasible and widely supported by patients, families, and staff. The results thus far show modest trends toward fulfilling the goal of supporting emotional well-being, while potentially supporting increased intake and, importantly, do not evidence any measurable harm.

Актуальные аспекты управления обеспечением технической готовности мобильных средств пожаротушения

Introduction. Currently, a situation is emerging that requires new solutions to problems by the management bodies of organizational and staff structures at various levels, since their volume and nature are constantly changing. To solve emerging problems, it is necessary to introduce new methods and algorithms for assessing the readiness of units, which will allow the use of technologies that are relevant at a given time. Today, there are no unified approaches to assessing the readiness of technical means of EMERCOM of Russia, which affects the subjectivity of the readiness assessment. As a result, operability failure can lead to the impossibility of performing the assigned tasks of rescuing people, extinguishing fires and carrying out actions in emergency situations. Therefore, the assessment of the readiness of fire and rescue units for action requires the development of new specific solutions. Goals and objectives of the study. Development of an assessment of the technical readiness of the fire and rescue unit using the proposed algorithms. The study of existing models for assessing the readiness of fire and rescue units in the EMERCOM of Russia. Research methods. During the study, methods of system analysis were used Results and their discussion. Based on the results of the analysis, the most significant requirements were identified that determine the readiness of fire and rescue units that affect the process of managing technical support when maintaining the readiness of mobile fire extinguishing equipment during their operation. Presented are modern approaches to assessing the readiness of fire and rescue units, the parameters for assessing the readiness of fire and rescue units, which are one of the main elements of organizing the operation of technical equipment in fire and rescue units. An algorithm for assessing the technical readiness of fire and rescue units is proposed. Conclusion. The results obtained in the course of the research are proposed to be used in determining the technical readiness of fire and rescue units that are part of the EMERCOM of Russia system and in determining promising areas of research in this area. Keywords: fire and rescue division; state of readiness (object); criteria for assessing the state of the technical facility; coefficient of technical readiness.

Применение методов планирования эксперимента в экспертных процедурах для машинного обучения модели распределения ресурсов при ликвидации пожара

Introduction. Intellectualization of control systems, including decision support systems, is an urgent need in the field of fire management. There are various types of support for decision makers. The paper focuses on mathematical and referential support, which makes it possible, on the basis of machine-learned optimization models, to prepare for the decision maker a set of suboptimal solutions consistent with his system of preferences. As a basis for the distribution of limited resources of fire and rescue units with simultaneous calls, a transport model is used, the parameters of the payoff function of which are trained on a sample of retrospective data formed with the participation of an experienced decision maker. To select solutions, expert procedures are used that are optimized by experiment planning methods, which can significantly reduce the time to prepare a decision without losing its quality, which makes the study relevant. Purpose of research. The purpose of the article is to construct and illustrate algorithms for applying the principles of optimal design of an experiment in the procedures for expert evaluation of options for distributing homogeneous resources of fire and rescue units over simultaneous calls. Methods. Methods of optimization, expert evaluation, machine learning of optimization models, simulation modeling, experiment planning were used. Results and discussion. The proposed technology for accelerating expert procedures for choosing the optimal distribution of homogeneous resources of fire and rescue units for simultaneous calls based on the principles of optimal planning of the experiment is illustrated by the example of two fire and rescue units and three calls. This example shows the effect of reducing the number of necessary assessments performed by decision makers by more than 70 %. In the case of distribution of different types of resources for each of them, a separate procedure should be built, similar to that described in this article. Conclusion. The results of a study of the application of the principles of optimal design of an experiment to speed up expert procedures for choosing by a decision maker the best option for distributing limited resources of fire and rescue units between simultaneous calls are presented. The proposed algorithm seems appropriate to be included in the expert system for supporting the management of fires. Keywords: fire and rescue unit; simultaneous calls; resources; transportation task; expert assessments; experiment planning; decision maker.

Предложения по нормированию численности специализированных пожарно-спасательных частей ФПС ГПС МЧС России

Introduction. The article considers approaches to the organizational and staff structure of specialized fire and rescue units of the federal fire service of the state fire service. On the basis of the studied literature devoted to the analysis of the staff structure of specialized fire and rescue, units from the point of view of the expediency of creating separate structural units, taking into account the risks available in the territory of the subject of the forces of the unified state system of prevention and liquidation of emergency situations, units performing similar functions are identified. The insufficiency of the forces of the Unified State System of Prevention and Liquidation of Emergency Situations capable of sufficiently prompt response in the initial stage of an emergency situation has been revealed. It is proposed to revise the organizational structure of specialized fire and rescue units from the currently existing one distributed by services to a structure focused on the concentration of forces of specialized fire and rescue units on the implementation of the existing task in a given period of time. Methods. To obtain the results, general scientific and special methods of scientific cognition were used - analysis, generalization, comparisons, descriptions. Results. The insufficiency of the forces of the Unified State System of Prevention and Liquidation of Emergency Situations capable of sufficiently prompt response in the initial stage of an emergency situation has been revealed. The approximate arrangement of personnel of specialized fire and rescue units of the federal fire service of the state fire service on the basis of the discharge is proposed. Research application field. The results of the study can be put into the formation of a structure to expand the capabilities of specialized fire and rescue units of the federal fire service of the state fire service, as a component of the most operational of life support services, which will contribute to increasing the level of response of the unified state system of emergency prevention and response in general. Conclusions. The data obtained during the study will form part of the work on the scientific justification of the creation, equipment and long-term development of services (groups) of specialized emergency rescue units. Keywords: fire protection; specialized fire and rescue unit; staff structure; types of work; discharge.

FORMATION OF A SET OF GOALS FOR THE SIMULATION EVALUATION OF THE SYSTEM "RESCUER - MEANS OF PROTECTION AND PROVISION OF EMERGENCY AND RESCUE WORK - EMERGENCY SITUATION"

It was noted that an important and unsolved part of the problem of the inconsistency of the new tasks faced by the rescuers working under the conditions of today's additional restrictions to the conditions of using a wide variety of fire and rescue equipment in the rescue unit is the lack of a general approach to the formation of a set of goals for assessing what how well the "emergency situation - emergency rescue operations - rescuer" system functions, according to the results of simulation (both physical and with the help of computer) modeling. It is emphasized that the assignment of the properties of the system "emergency situation - emergency rescue operations - rescuer" is a necessary but not sufficient condition for solving the problems of evaluating this system. These properties must be combined into defined aggregates or expressed in the form of generalized integral characteristics. Such generalized characteristics are the quality indicators of such a system, i.e., a set of its properties that express the degree of usefulness of the system for the external environment at the output of the simulation system. It is noted that the tasks of evaluating the system "emergency situation - emergency rescue work - rescuer" can be checking the suitability of this system for its purpose, comparing such systems of the same type, deciding on the continuation (termination) of the development of such a system or adopting a ready-made system, determining the prospects of a specific system and evaluating compliance of its real state with the normative one. At the same time, the external efficiency criterion represents the regularity of personnel activity in the "emergency situation - emergency rescue operations - rescuer" system, as it reflects the functioning of this system, establishing an objective, repeated under certain conditions connection between the quality indicators of the system and those inherent in it effects The goals of the simulation evaluation of the system "emergency situation - emergency rescue operations - rescuer" are substantiated, as which it is necessary to consider the establishment of cause-and-effect relationships between the activities of rescuers and the results of the functioning of this system, the determination of the functional dependence of the system's generalized efficiency indicator on a set of selected initial indicators and further clarification based on the obtained functional dependence of such system organization rules, in which the specified value of the generalized efficiency indicator will be exceeded. Keywords: simulation assessment, system, emergency rescue operations, efficiency.

Air Ambulance Drone for Medical Surveillance

Rescue teams during a calamity or road accident on a highway and a lot more emergency- type situations require proper and speedy communication between the rescue unit and the patient. Usually, the need for patient data like the vitals is very much important for the ambulance and the hospital to prepare for the necessary healthcare facilities. As cities develop traffic hinders the distribution of healthcare support to the needy. Hence drones/air ambulances can solve this issue by navigating to the exact location of the patient and collecting their vitals with the help of certain sensors. The acquired data is shared with the healthcare providers and paramedics via the Internet of Things. Cloud backup helps in retrieving the data anytime and anywhere with certain safety regulations.

COV1: Cannula-Associated Deep Vein Thromboses are Prevalent in COVID-19 Veno-venous Extracorporeal Membrane Oxygenation Patients

Background: Patients with severe COVID-19 related respiratory failure may require veno-venous extracorporeal membrane oxygenation (VV ECMO). After decannulation, patients on VV ECMO have historically had high percentages of cannula-associated deep vein thrombosis (CaDVT). Due to their hypercoagulable state and prolonged course on VV ECMO, we hypothesized that patients with COVID-19 would experience a higher rate of CaDVT when compared to their non-COVID-19 counterparts. We also described the association between location and size of cannula in the development of CaDVTs. Methods: This was a single center retrospective review of patients ≥ 18 years old who were treated with VV ECMO and decannulated from January 1, 2014, to January 10, 2022. Patients who were placed on VV ECMO due to trauma and patients who were cannulated for veno-arterial ECMO were excluded. Patients were managed in a dedicated Lung Rescue Unit and anticoagulated with a heparin infusion at a goal partial thromboplastin time (aPTT) of 45-55 or 60-80 depending on the presence of clotting complications. Post-decannulation venous duplexes were performed 24 hours after decannulation and if positive for DVT, performed again in 2 weeks. Univariate and multivariate analyses were conducted to analyze our primary outcome of the development of CaDVT. Results: A total of 291 patients met our inclusion criteria: 76 COVID-19 VV ECMO patients and 215 non-COVID-19 VV ECMO patients. Decannulated COVID-19 VV ECMO patients had a significantly higher body mass index (BMI) (35.8, 32.9, p= 0.03) and length of ECMO run (hours) (660, 312, p< 0.001) than their non-COVID-19 counterparts. Most decannulated patients in both groups received post-decannulation duplexes (96%, 99%, p= 0.45). COVID-19 and non-COVID-19 patients decannulated from VV ECMO both experienced high incidences of CaDVT on initial post-decannulation ultrasound (95%, 88%, p= 0.13). COVID-19 patients were more likely to have multiple CaDVTs (32%, 11%, p< 0.001). Patients with COVID-19 experienced a higher rate of right common femoral CaDVT (47%, 17%, p< 0.001) and a higher percentage of 25 French drainage cannula CaDVT (48%, 18%, p< 0.001). COVID-19 VV ECMO patients had a significantly higher incidence of persistent CaDVT on repeat ultrasound (78%, 56%, p= 0.03). A logistic regression was performed with all decannulated patients. Age, BMI, hours on ECMO, COVID-19 status, and size and location of ECMO cannulas did not predict the presence of DVT. Conclusion: Both COVID-19 and non-COVID-19 VV ECMO patients had high rates of CaDVTs. The utilization of VV ECMO in COVID-19 respiratory failure was associated with a higher incidence of CaDVTs on repeat ultrasound as compared to patients with non-COVID-19 related respiratory failure. Regular post-decannulation screening, treatment, and follow up imaging should be performed. Further investigation into the effect of anticoagulation strategy is needed.

Research on Location-Routing Problem of Maritime Emergency Materials Distribution Based on Bi-Level Programming

To solve the location-routing problem of maritime emergency materials distribution (MEMD-LRP) of multi-agent joint decision, a bi-level programming model of MEMD-LRP is constructed. The model is established on the premise of considering the rescue time window and emergency materials distribution priority, aiming at the strong regional characteristics of maritime accidents, strong timeliness of maritime rescue, great difficulty of rescue, high cost of rescue, and so on. From the point of view of the emergency management department, the upper level makes the location decision to minimize the construction cost of the shore-based emergency materials reserves and the time satisfaction loss cost of the accident point. From the point of view of the commercial rescue unit, the lower level plans the routes by minimizing the cost of emergency material distribution, ship transportation, ship dispatch, and time penalty. A hybrid algorithm of the ant colony and tabu search is designed to solve the model, and an example is designed and analyzed based on the case of the Bohai Sea to verify the effectiveness of the model and algorithm. Modeling and algorithm design based on bi-level programming can help decision-makers at different levels in maritime emergency logistics systems to make more scientific and reasonable decisions to improve the service capability of the maritime emergency logistics system.