3 results
Integration of Energy Analytics and Smart Energy Microgrid into Mobile Medicine Operations for the 2012 Democratic National Convention
- Peter W. McCahill, Erin E. Noste, AJ Rossman, David W. Callaway
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- Journal:
- Prehospital and Disaster Medicine / Volume 29 / Issue 6 / December 2014
- Published online by Cambridge University Press:
- 12 November 2014, pp. 600-607
- Print publication:
- December 2014
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Introduction
Disasters create major strain on energy infrastructure in affected communities. Advances in microgrid technology offer the potential to improve “off-grid” mobile disaster medical response capabilities beyond traditional diesel generation. The Carolinas Medical Center's mobile emergency medical unit (MED-1) Green Project (M1G) is a multi-phase project designed to demonstrate the benefits of integrating distributive generation (DG), high-efficiency batteries, and “smart” energy utilization in support of major out-of-hospital medical response operations.
MethodsCarolinas MED-1 is a mobile medical facility composed of a fleet of vehicles and trailers that provides comprehensive medical care capacities to support disaster response and special-event operations. The M1G project partnered with local energy companies to deploy energy analytics and an energy microgrid in support of mobile clinical operations for the 2012 Democratic National Convention (DNC) in Charlotte, North Carolina (USA). Energy use data recorded throughout the DNC were analyzed to create energy utilization models that integrate advanced battery technology, solar photovoltaic (PV), and energy conservation measures (ECM) to improve future disaster response operations.
ResultsThe generators that supply power for MED-1 have a minimum loading ratio (MLR) of 30 kVA. This means that loads below 30 kW lead to diesel fuel consumption at the same rate as a 30 kW load. Data gathered from the two DNC training and support deployments showed the maximum load of MED-1 to be around 20 kW. This discrepancy in MLR versus actual load leads to significant energy waste. The lack of an energy storage system reduces generator efficiency and limits integration of alternative energy generation strategies. A storage system would also allow for alternative generation sources, such as PV, to be incorporated. Modeling with a 450 kWh battery bank and 13.5 kW PV array showed a 2-fold increase in potential deployment times using the same amount of fuel versus the current conventional system.
ConclusionsThe M1G Project demonstrated that the incorporation of a microgrid energy management system and a modern battery system maximize the MED-1 generators’ output. Using a 450 kWh battery bank and 13.5 kW PV array, deployment operations time could be more than doubled before refueling. This marks a dramatic increase in patient care capabilities and has significant public health implications. The results highlight the value of smart-microgrid technology in developing energy independent mobile medical capabilities and expanding cost-effective, high-quality medical response.
. ,McCahill PW ,Noste EE ,Rossman AJ .Callaway DW Integration of Energy Analytics and Smart Energy Microgrid into Mobile Medicine Operations for the 2012 Democratic National Convention . Prehosp Disaster Med.2014 ;29 (6 ):1 -8
Time for a Revolution: Smart Energy and Microgrid Use in Disaster Response
- David Wayne Callaway, Erin Noste, Peter Woods McCahill, A.J. Rossman, Dominique Lempereur, Kathleen Kaney, Doug Swanson
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 8 / Issue 3 / June 2014
- Published online by Cambridge University Press:
- 11 June 2014, pp. 252-259
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Modern health care and disaster response are inextricably linked to high volume, reliable, quality power. Disasters place major strain on energy infrastructure in affected communities. Advances in renewable energy and microgrid technology offer the potential to improve mobile disaster medical response capabilities. However, very little is known about the energy requirements of and alternative power sources in disaster response. A gap analysis of the energy components of modern disaster response reveals multiple deficiencies. The MED-1 Green Project has been executed as a multiphase project designed to identify energy utilization inefficiencies, decrease demands on diesel generators, and employ modern energy management strategies to expand operational independence. This approach, in turn, allows for longer deployments in potentially more austere environments and minimizes the unit's environmental footprint. The ultimate goal is to serve as a proof of concept for other mobile medical units to create strategies for energy independence. (Disaster Med Public Health Preparedness. 2014;0:1–8)
Use of Point-of-Care Lactate in the Prehospital Aeromedical Environment
- Marie Mullen, Gianluca Cerri, Ryan Murray, Angela Talbot, Alexandra Sanseverino, Peter McCahill, Virginia Mangolds, Jesse Volturo, Chad Darling, Marc Restuccia
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- Journal:
- Prehospital and Disaster Medicine / Volume 29 / Issue 2 / April 2014
- Published online by Cambridge University Press:
- 19 March 2014, pp. 200-203
- Print publication:
- April 2014
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Introduction
Lactate measurement has been used to identify critical medical illness and initiate early treatment strategies. The prehospital environment offers an opportunity for very early identification of critical illness and commencement of care.
HypothesisThe investigators hypothesized that point-of-care lactate measurement in the prehospital aeromedical environment would: (1) identify medical patients with high mortality; (2) influence fluid, transfusion, and intubation; and (3) increase early central venous catheter (CVC) placement.
MethodsCritically ill, medical, nontrauma patients who were transported from September 2007 through February 2009 by University of Massachusetts (UMass) Memorial LifeFlight, a university-based emergency medical helicopter service, were eligible for enrollment. Patients were prospectively randomized to receive a fingerstick whole-blood lactate measurement on an alternate-day schedule. Flight crews were not blinded to results. Flight crews were asked to inform the receiving attending physician of the results. The primary endpoint was the ability of a high, prehospital lactate value [> 4 millimoles per liter (mmol/L)] to identify mortality. Secondary endpoints included differences in post-transport fluid, transfusion, and intubation, and decrease in time to central venous catheter (CVC) placement. Categorical variables were compared between groups by Fisher's Exact Test, and continuous variables were compared by t-test.
ResultsPatients (N = 59) were well matched for age, gender, and acuity. In the lactate cohort (n = 20), mean lactate was 7 mmol/L [Standard error of the mean, SEM = 1]. Initial analysis revealed that prehospital lactate levels of ≥4 mmol/L did show a trend toward higher mortality with an odds ratio of 2.1 (95% CI, 0.3-13.8). Secondary endpoints did not show a statistically significant change in management between the lactate and non lactate groups. There was a trend toward decreased time to post-transport CVC in the non lactate faction.
ConclusionPrehospital aeromedical point-of-care lactate measurement levels ≥4 mmol/L may help stratify mortality. Further investigation is needed, as this is a small, limited study. The initial analysis did not find a significant change in post-transport management.
. ,Mullen M ,Cerri G ,Murray R ,Talbot A ,Sanseverino A ,McCahill P ,Mangolds V ,Volturo J ,Darling C .Restuccia M Use of Point-of-Care Lactate in the Prehospital Aeromedical Environment . Prehosp Disaster Med.2014 ;29 (1 ):1 -4
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