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At least 19 recordsLinked to original sources
PubMed2003

Cold exposure during helicopter rescue operations in the Western Alps.

OBJECTIVE: The study evaluates exposure to the cold of personnel involved in helicopter rescue operations in an alpine environment. METHODS: Rescue operations over a period of 15 months in the Oberwallis region (Switzerland) were analysed with special regard to the weather conditions, the locality and its altitude, and the duration. The equivalent chill temperature was estimated with two independent models. "Mean exposure" as well as the "worst-case situation" (based on maximum windspeed) were calculated. The results were evaluated according to the "classic" Siple-Passel model, the more recent model of Danielsson, ISO 11079, ISO 9920, the German industrial standard DIN 33403.5, and the German government regulations for work in cold environments ("G21"). RESULTS: The temperature models showed only marginal differences in chill temperature. Assuming "worst-case conditions", the Siple-Passel model showed that 87.1% of the operations occurred at chill temperatures > -30 degrees C, 12.1% in the range of -30 to -45 degrees C, and 0.8% at <-45 degrees C. The lowest temperature was -54.6 degrees C. The Danielson model resulted in 77.6% without the risk of frostbite, 20.1% with >5% risk, 6% with >50% risk and 1.8% with >95% risk. According to DIN 33403.5, 1.5% of the operations were performed at chill temperatures higher than cold class 1: 2.3% are class 1, 13.3% class 2, 34.7% class 3, 34.6% class 4 and 13.7% class 5. The maximum exposure times of DIN 33404.5 are exceeded in at least 0.5% of the missions. According to ISO 11079, clothing with 2.0 clo is sufficient in 40.2 and 23.9% of the operations [summer, required clothing insulation (IREQ) min. and IREQ neutr., respectively]. In winter the corresponding results are 0.3 and 0.0%. Duration of limited exposure is exceeded in 9.1 (IREQ min.) and 19.8% (IREQ neutr.) of the operations in summer and in 10.3 and 19.8% in winter. According to ISO 9920, ICL min. as well as ICL neutr. is exceeded in 100% in summer and winter operations. CONCLUSIONS: Alpine rescue operations are typical of a place of work in a cold--sometimes extremely cold--environment. Because of the limited time of exposure during the majority of the operations, the most important danger for rescue personnel is frostbite, although hypothermia cannot be excluded in cases of prolonged operations. Special advice to avoid the specific risks must be given to the crews and an examination by occupational medicine, e.g. according to "Working in cold environments, G21" of the German Berufsgenossenschaften, is recommended. Recommendations for adequate clothing are given.

Air Ambulances↗
PubMed2004

[Rescue operations of the recurrent nasal and paranasal sinus neoplasms].

OBJECTIVE: To investigate the symptoms, factors relating to recurrences, the styles of the rescue operation and the reconstructive methods of the surgical defects in patients with recurrent nasal and paranasal sinus neoplasms. METHODS: Excluding the primary neoplasm, only patients with recurrent tumors and suitable for rescue operations entered the group. Kaplan-Meier method was used to estimate the survival probability. RESULTS: Twenty-five patients receiving rescue operations from 1993 to 2002 who met the above inclusion criteria were reviewed. The age ranged from 13 - 66 years. All the patients had once surgery or radiation therapy at least. The time between the last treatments and the recurrences ranged from 2 weeks to 46 months. 80 per cent of the recurrences were within the first 2 years after the last therapy. The recurrent symptoms included headache (10 patients), eminences in or around the operation fields (9 patients), diminution of vision (7 patients), and so on. The patients were followed 1 to 65 months. There were no patients died during the rescue operations. Five patients were alive without recurrences and 3 alive with local or regional recurrences. Thirteen died of local recurrences and 1 died of metastasis to lung. The one-year, 2-year and 3-year survival rate were 62.5%, 43.7% and 29.1%, respectively. The median survival time was 18 months. Complications included cerebrospinal rhinorrhea (3 patients), central diabetes insipidus (1 patient) and necrosis of part of the flap (1 patient). CONCLUSIONS: Most of the local recurrences occur within 2 years after the last therapies. The recurrent symptoms are commonly headache and eminences in or around the operation fields. The recurrences are closely related to pathological types and differential degrees of the neoplasms. The reasonable and timely combined treatment may help to decrease the frequencies of the recurrences. The rescue operations with effective methods can improved the patients' life qualities and lengthen their life spans. The main complications are cerebrospinal rhinorrhea most of which can be cured by conservative treatment.

Adolescent↗
PubMed2005

Scientific management of Mediterranean coastal zone: a hybrid ocean forecasting system for oil spill and search and rescue operations.

The oil spill from Prestige tanker showed the importance of scientifically based protocols to minimize the impacts on the environment. In this work, we describe a new forecasting system to predict oil spill trajectories and their potential impacts on the coastal zone. The system is formed of three main interconnected modules that address different capabilities: (1) an operational circulation sub-system that includes nested models at different scales, data collection with near-real time assimilation, new tools for initialization or assimilation based on genetic algorithms and feature-oriented strategic sampling; (2) an oil spill coastal sub-system that allows simulation of the trajectories and fate of spilled oil together with evaluation of coastal zone vulnerability using environmental sensitivity indexes; (3) a risk management sub-system for decision support based on GIS technology. The system is applied to the Mediterranean Sea where surface currents are highly variable in space and time, and interactions between local, sub-basin and basin scale increase the non-linear interactions effects which need to be adequately resolved at each one of the intervening scales. Besides the Mediterranean Sea is a complex reduced scale ocean representing a real scientific and technological challenge for operational oceanography and particularly for oil spill response and search and rescue operations.

Disaster Planning↗
PubMed2002

Stress reactions in police officers after a disaster rescue operation.

This study intended to determine the prevalence of posttraumatic stress disorder symptoms and to report subjective well-being, general distress, and social functioning among police officers 18 months after a rescue operation during a fire at a discotheque. Emotional responses, including self-reported reactions, recorded during and after the fire were analysed. Forty-one police officers participated in the study. They completed a questionnaire and a battery of self-report measures. Psychological distress was recorded using the PTSS-10, IES-R, and GHQ-28. The three scales had a high internal consistency. The police officers were not unaffected by their experiences, and a few officers were still under stress. One police officer had IES-R intrusion and an avoidance score greater than 20, suggesting a stress reaction of clinical significance. When compared with the PTSS-10 scale, two (5%) officers showed a high level of psychological distress. Measured with the GHQ-28, three officers (7%) still had a high level of psychological distress. On one of the four different subscales most of the officers show various degrees of reduced social functioning. Debriefing was carried out by the police department after the fire, and 75% thought debriefing was positive. Eighteen months after the disaster a few police officers are still under stress.

Adult↗
PubMedDate not supplied

Medical helicopters in wilderness search and rescue operations.

Medical helicopters may be asked to assist in wilderness search and rescue (SAR) operations to quickly reach patients in remote areas and provide medical care and transport of sick or injured persons. The number 1 priority for any medical helicopter involved in an SAR operation is safety, which is considered at each decision point. The involvement of a medical helicopter service begins with a request from a local agency for support. Obtaining key information about the SAR operation from the local agency is essential for deciding whether to accept the mission and for making appropriate preparations for the mission. While en route to the SAR location, the medical crew can review the information regarding location and patient status. Once on location, the crew can survey the scene from the air before landing at the command post to brief with SAR personnel regarding the mission. An initial survey of the scene from the air is important for identifying landing zones and evaluating the terrain where the rescue will occur. A face-to-face briefing with SAR personnel is preferable to learn specifically what type of mission is requested. The medical helicopter crew is empowered to decline the mission for safety reasons at any step. The actual rescue may be done by inserting the helicopter at the scene in nontechnical terrain or by having SAR personnel extricate the patient and deliver him or her to the medical helicopter crew at the nearest safe landing zone. Medical care and transport of the patient as indicated by injuries or illness then occurs. Finally, a postmission debriefing is essential for identifying problems that occurred during the mission and implementing corrections for improvement.

Air Ambulances↗
PubMed2001

[Rescue operations with helicopter ambulances in the Barents sea].

BACKGROUND: Search and rescue helicopters from the Royal Norwegian Air Force conduct ambulance and search and rescue missions in the Barents Sea. The team on board includes an anaesthesiologist and a paramedic. Operations in this area are challenging due to long distances, severe weather conditions and winter darkness. MATERIAL AND METHODS: 147 ambulance and 29 search and rescue missions in the Barents Sea during 1994-99 were studied retrospectively with special emphasis on operative conditions and medical results. RESULTS AND INTERPRETATION: 35% of the missions were carried out in darkness. Median time from alarm to first patient contact was 3.3 hours and median duration of the missions was 7.3 hours. 48% of the missions involved ships of foreign nationality. About half of the patients had acute illness, dominated by gastrointestinal and heart diseases. Most of the injuries resulted from on-board accidents; open or closed fractures, amputations, and soft tissue damage. 90% of the patients were hospitalised; 7.5% would probably not have survived without early medical treatment and rapid transportation to hospital.

Air Ambulances↗
PubMed2004

Noise exposure during alpine helicopter rescue operations.

OBJECTIVES: We estimated the noise exposure of crews working in alpine helicopter rescue systems. METHODS: Noise levels of the the helicopters used (Alouette III, Alouette II 'Lama', Ecureuil and BK 117) were measured with a device according to class 2 DIN IEC 651. These data were combined with the flight data of the personnel to evaluate the equivalent noise level according to DIN 45645-2. RESULTS AND CONCLUSIONS: While the risk to patients should be limited to temporary threshold shifts the crew members are regularly exposed to equivalent noise levels of >85 dB(A) and, therefore, are at risk of permanent threshold shifts. Consequences for crew fitness to fly and for noise prevention (crew and patients) are discussed.

Air Ambulances↗
PubMedDate not supplied

Bedside blood gas analysis in airborne rescue operations.

The alveolar partial oxygen pressure (Pao(2)) recorded from 20 ventilated patients was found to decrease by 16 mm Hg during airborne rescue helicopter transport at an average altitude of 1780 feet mean sea level. The initial departure altitude was 192 feet, and the flight ascended to 2200 feet above ground level. Hence, the Pao(2) drop in patients was exclusively attributable to cruising altitude (atmospheric pressure = -42 mm Hg). Pathophysiological alterations include drops in the oxygenation index (-50 mm Hg), arterial partial oxygen pressure (-34 mm Hg), and heart rate (+7 beats per minute) and are attributable to growing disproportions in ventilation and perfusion. The absolute Pao(2) level does depend largely on the Fio(2) value.

Air Ambulances↗
PubMed2006

Laparoscopic gastric re-banding versus laparoscopic gastric bypass as a rescue operation for patients with pouch dilatation.

BACKGROUND: The authors assessed whether laparoscopic rebanding or laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the best approach for failed gastric banding after pouch dilatation. METHODS: Between January 2000 and June 2005, 489 patients underwent laparoscopic gastric banding, and of these, 33 (6.7%) required rescue procedures for pouch dilatation. Each reoperated patient was contacted to obtain information about their postoperative course. Additionally, preoperative weight and BMI, weight loss at 1 year postoperatively, weight at time of pouch dilatation and the time-period between the primary operation and pouch dilatation were analyzed. RESULTS: The most common operation for pouch dilatation was band repositioning or rebanding (16 patients). Band removal without replacement was performed in 7 patients. 8 patients underwent conversion to a LRYGBP. 1 patient underwent laparoscopic gastric sleeve resection and 1 patient received an intragastric balloon. Patients who underwent conversion to LRYGBP are very content and, although weight loss has been nearly the same as after gastric banding, they would prefer the gastric bypass operation to the gastric banding. CONCLUSION: Conversion to LRYGBP appears to offer significant advantages, and appears to be the rescue therapy of choice after failed laparoscopic gastric banding.

Dilatation, Pathologic↗
PubMed2006

Effects of chemical protective equipment on team process performance in small unit rescue operations.

In the event of a nuclear, biological, or chemical terrorist attack against civilians, both military and civilian emergency response teams must be able to respond and operate efficiently while wearing protective equipment. Chemical protective equipment protects the user by providing a barrier between the individual and hazardous environment. Unfortunately, the same equipment that is designed to support the user can potentially cause heat stress, reduced task efficiency, and reduced range-of-motion. Targeted Acceptable Responses to Generated Events of Tasks (TARGETS), an event-based team performance measurement methodology was used to investigate the effects of Mission Oriented Protective Posture (MOPP) on the behavioral processes underlying team performance during simulated rescue tasks. In addition, this study determined which team processes were related to team performance outcomes. Results of six primary analyses indicated that team process performance was not degraded by MOPP 4 on any rescue task and that the team processes critical for successful task performance are task-dependent. This article discusses the implications of these results with respect to the study design and the limitations of using an event-based team performance measurement methodology.

Adolescent↗
PubMed1997

GPS signal reception under snow cover: a pilot study establishing the potential usefulness of GPS in avalanche search and rescue operations.

Avalanches are one of the major threats to life in high-mountain terrain and account every year for approximately 150 accidents causing injury or death in the United States alone. Every year avalanches cause significant property damages and a death toll of approximately 15 people in the United States. The specific characteristic of the avalanche accident is the extreme importance of getting to the buried victim as soon as, possible to improve survival. Approximately 40% of all buried victims survive 1 hour, and only about 20% survive 2 hours. Newer studies from Europe indicate that the initial survival probability is 92% at 15 minutes, 30% at 35 minutes, 27% at 90 minutes, and finally drops to 3% at 130 minutes. Unless prompt and efficient search and rescue are ensured, the prospect of buried victims is rather grim. Many tools have been used in the past to aid in retrieving buried victims including the avalanche cord, probing techniques, and in more recent time, the use of electronic beacon devices that allow search teams to locate the buried victim. The advent of satellite navigational aids (GPS, GLONASS) makes it possible to determine one's position with remarkable accuracy. We studied the degree to which the GPS satellite signal could penetrate through snow and be received by a commercially available GPS receiver. This information may lead to the development of an additional tool for precise and quick localization of buried victims in avalanche accidents and thus may substantially improve their survival by shortening the search time at the accident site. In this study we used a Motorola Traxar six-channel GPS receiver with amplifier unit connected to an antenna by means of a shielded coaxial cable. The antenna was buried under incremental covers of compact snow, and the reception of the GPS signal was measured at each burial depth: 5 cm, 15 cm, 25 cm, 35 cm, 45 cm, 55 cm, 1 m, and 1.5 m. The variables that were measured included signal quality, number of satellites received by the receiver, and their respective signal strength. A reference reading was taken from the GPS receiver above the testing site before measurements under snow cover were started. The satellite signals were received with good quality and precise readings up to a burial depth of 1 m. Under 1.5 m of snow the receiver was able to lock on only one satellite, making a positional reading impossible. The reception of the GPS signals under snow cover is possible and warrants further study directed toward the development of a search and rescue device using this technology.

Asphyxia↗
PubMedDate not supplied

Lung function during hoist rescue operations.

INTRODUCTION: A case is presented in which a 43-year-old man suffering from a severe asthma attack, had ventilatory arrest during a hoisting procedure. Based on this experience, the influence of three hoisting techniques on lung function was tested. METHODS: The ventilatory capacity of 12 healthy volunteers was tested during three commonly used hoisting techniques: 1) single sling; 2) double sling; or 3) strapped to a stretcher. RESULTS: The vital capacity (VC) and the one-second, forced expiratory volume (FEV1) were reduced significantly during all hoisting techniques compared to the standing position. The reduction was significantly more pronounced on a stretcher than in either sling position. There were no differences in the FEV1 to VC ratio between the positions. CONCLUSION: The small reduction in ventilatory capacity during hoisting procedures is tolerated easily by healthy individuals, but should be taken into account when planning such procedures on patients with severe pulmonary disease.

Adult↗
PubMed2002

Carotid artery reconstruction combined with myocutaneous flap coverage: a complex and durable rescue operation.

Carotid reconstruction combined with myocutaneous flap coverage is a rare and challenging operation. We reviewed our experience to define the indications and outcome of this complex procedure. Clinical data and neurologic, wound, and vascular complications of all patients who underwent carotid artery reconstruction combined with myocutaneous flap coverage over a 17-year period were retrospectively reviewed. Results from this procedure indicate that pectoralis major myocutaneous flap is a safe and durable option for wound coverage in patients who undergo carotid endarterectomy, resection, and/or reconstruction for neck malignancy, previous irradiation or graft infection. Late outcome is favorable with low neurologic, vascular, and wound complication rates.

Adult↗