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An e-learning Course Effect on Swedish Ambulance Commanders' Decision-making in Simulated Road Tunnel incidents–Preliminary findings
- Johan Hylander, Lina Gyllencreutz, Michael Haney, Anton Westman
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- Journal:
- Prehospital and Disaster Medicine / Volume 38 / Issue S1 / May 2023
- Published online by Cambridge University Press:
- 13 July 2023, pp. s175-s176
- Print publication:
- May 2023
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Introduction:
Road tunnel systems are becoming increasingly complex. Regardless of incident, the confined nature of the road tunnel impairs responding emergency services accessibility, with a risk for delay in treatment of time-sensitive injuries such as pneumothorax or internal hemorrhage. Consequently, the need for rapid decision-making by the emergency services commanders is increased. However, in Sweden ambulance commanders lack experience and training in managing road tunnel incidents. This may further delay the medical response.
The aim is to investigate if the ambulance commander decision-making in simulated road tunnel incidents may be improved by a specific road tunnel incident e-learning course.
Method:A web-based intervention study was performed with 20 participants; 10 participants in the intervention and control group, respectively. The control group received a pre-recorded general lecture on incident management. The intervention group received a specific road tunnel incident e-learning course, consisting of five interactive modules with learning materials (e.g. road tunnel structures, collaboration and safety). All participants participated in web-based simulations of major road tunnel incidents at one and six months post-intervention. In these simulations, participants acted as ambulance commanders and decided on the best course of action in 15 dissimilar and multiple choice-based management decisions. For each decision, time and choice of decision were recorded as outcome measurements.
Results:Preliminary analysis from the one-month follow up simulation indicates that none of the participants decided to enter the road tunnel system at the early stage of the incident. The motivation for the participants decision-making was not clear.
Conclusion:The cautiousness to enter the road tunnel system will impair the emergency medical services response, including delaying vital medical care. Further research into the reasoning behind this decision is needed and identified causes may be further addressed in updated educational materials and collaborative discussions.
Evacuation Preparedness in the Event of Fire in Intensive Care Units in Sweden: More is Needed
- Erika Löfqvist, Åsa Oskarsson, Helge Brändström, Alpo Vuorio, Michael Haney
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- Journal:
- Prehospital and Disaster Medicine / Volume 32 / Issue 3 / June 2017
- Published online by Cambridge University Press:
- 10 March 2017, pp. 317-320
- Print publication:
- June 2017
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Introduction
Hospitals, including intensive care units (ICUs), can be subject to threat from fire and require urgent evacuation.
HypothesisThe hypothesis was that the current preparedness for ICU evacuation for fire in the national public hospital system in a wealthy country was very good, using Sweden as model.
MethodsAn already validated questionnaire for this purpose was adapted to national/local circumstances and translated into Swedish. It aimed to elicit information concerning fire response planning, personnel education, training, and exercises. Questionnaire results (yes/no answers) were collected and answers collated to assess grouped responses. Frequencies of responses were determined.
ResultsWhile a written hospital plan for fire response and evacuation was noted by all responders, personnel familiarity with the plan was less frequent. Deficiencies were reported concerning all categories: lack of written fire response plan for ICU, lack of personnel education in this, and lack of practical exercises to practice urgent evacuation in the event of fire.
ConclusionsThese findings were interpreted as an indication of risk for worse consequences for patients in the event of fire and ICU evacuation among the hospitals in the country that was assessed, despite clear regulations and requirements for these. The exact reasons for this lack of compliance with existing laws was not clear, though there are many possible explanations. To remedy this, more attention is needed concerning recognizing risk related to lack of preparedness. Where there exists a goal of high-quality work in the ICU, this should include general leadership and medical staff preparedness in the event of urgent ICU evacuation.
,Löfqvist E ,Oskarsson A ,Brändström H ,Vuorio A .Haney M Evacuation Preparedness in the Event of Fire in Intensive Care Units in Sweden: More is Needed . Prehosp Disaster Med.2017 ;32 (3 ):317 –320 .
Chapter 5 - Coronary physiology
- from Section 1 - Anatomy and physiology
- Edited by Jonathan H. Mackay, Joseph E. Arrowsmith
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- Core Topics in Cardiac Anesthesia
- Published online:
- 05 April 2012
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- 15 March 2012, pp 22-27
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Contributors
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- By Yasir Abu-Omar, Matthew E. Atkins, Joseph E. Arrowsmith, Alan Ashworth, Rubia Baldassarri, Craig R. Bailey, David J. Barron, Christiana C. Burt, David Cardone, Coralie Carle, Jose Coddens, Alan M. Cohen, Simon Colah, Sarah Conolly, David J. Daly, Helen M. Daly, Stefan G. De Hert, Ravi J. De Silva, Mark Dougherty, John J. Dunning, Maros Elsik, Betsy Evans, Florian Falter, Nigel Farnum, Jens Fassl, Juliet E. Foweraker, Simon P. Fynn, Andrew I. Gardner, Margaret I. Gillham, Martin J. Goddard, Maximilien J. Gourdin, Jon Graham, Stephen J. Gray, Cameron Graydon, Fabio Guarracino, Roger M. O. Hall, Michael Haney, Charles W. Hogue, Ben W. Howes, Bevan Hughes, Siân I. Jaggar, David P. Jenkins, Jörn Karhausen, Todd Kiefer, Khalid Khan, Andrew A. Klein, John D. Kneeshaw, Andrew C. Knowles, Catherine V. Koffel, R. Clive Landis, Trevor W. R. Lee, Clive J. Lewis, Jonathan H. Mackay, Amod Manocha, Jonathan B. Mark, Sarah Marstin, William T. McBride, Kenneth H. McKinlay, Alan F. Merry, Berend Mets, Britta Millhoff, Kevin P. Morris, Samer A. M. Nashef, Andrew Neitzel, Stephane Noble, Rabi Panigrahi, Barbora Parizkova, J. M. Tom Pierce, Mihai V. Podgoreanu, Hans-Joachim Priebe, Paul Quinton, C. Ramaswamy Rajamohan, Doris M. Rassl, Tom Rawlings, Fiona E. Reynolds, Andrew J. Richardson, David Riddington, Andrew Roscoe, Paul H. M. Sadleir, Ving Yuen See Tho, Herve Schlotterbeck, Maura Screaton, Shitalkumar Shah, Harjot Singh, Jon H. Smith, M. L. Srikanth, Yeewei W. Teo, Kamen P. Valchanov, Jean-Pierre van Besouw, Isabeau A. Walker, Stephen T. Webb, Francis C. Wells, John Whitbread, Charles Willmott, Patrick Wouters
- Edited by Jonathan H. Mackay, Joseph E. Arrowsmith
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- Core Topics in Cardiac Anesthesia
- Published online:
- 05 April 2012
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- 15 March 2012, pp x-xiii
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6 - Smart metering: technology, economics and international experience
- from Part II - Technology
- Edited by Tooraj Jamasb, Heriot-Watt University, Edinburgh, Michael G. Pollitt, University of Cambridge
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- The Future of Electricity Demand
- Published online:
- 05 March 2014
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- 15 September 2011, pp 161-184
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Summary
Introduction
As we have seen particularly from Part I of this volume, the participation of the demand side is essential in improving the overall efficiency of energy markets. In liberalized electricity markets, active demand-side participation has been limited to date, although there is increasing emphasis on its importance in contributing to a number of energy policy challenges (Bilton et al., 2008; Borenstein et al., 2002; Spees and Lave, 2007). Climate change, security of supply and fuel poverty are the three main areas where a more active demand side has the potential to have both significant and cost-effective impacts (Ofgem, 2006b). The widespread recent interest in smart electricity and gas metering can best be understood in this context. Innovative forms of metering allow for more detailed information to be collected on consumption. Communications technology facilitates greater interaction between the end-user and the rest of the supply chain. Both information and interaction allow for end-users to become more actively involved by, for example, responding to price signals.
Smaller users (domestic, small and medium-sized enterprises (SMEs)) have been the focus of recent smart metering policy debate around the world as they have traditionally not been given the appropriate incentives, means or information to become active participants in energy markets. In the European Union (EU), the 2006 Energy Services Directive (2006/32/EC) has given impetus to the debate by requiring member states to incorporate metering and billing policies into their National Energy Efficiency Action Plans. This has prompted a number of EU countries to explore the costs and benefits of implementing smart metering as well as the appropriate models and regulatory frameworks for deployment. The recent interest in smart grids in both the EU and the US provides a broader framework for looking at some of these issues. Although the definition of a smart grid is a work in progress, the overall aim of developing smart grids is to modernize the electricity system in such a way that it will be able to deal with increased complexity in an efficient and reliable manner. Part of this complexity comes from a more active demand side. Other important factors include the integration of greater amounts of renewable generation, distributed generation and the use of more advanced network control technologies to reduce losses (ERGEG, 2009).
14 - Demand-side management strategies and the residential sector: lessons from the international experience
- from Part IV - Policy and regulation
- Edited by Tooraj Jamasb, Heriot-Watt University, Edinburgh, Michael G. Pollitt, University of Cambridge
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- The Future of Electricity Demand
- Published online:
- 05 March 2014
- Print publication:
- 15 September 2011, pp 337-378
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Summary
Introduction
Policies and measures targeting energy demand took off over the last three decades in response to the oil shocks of the 1970s. Since then, concerns about the sensitivity of economies to energy prices, oil dependency and more recently climate change, contributed to the development of energy efficiency (EE) policies. Demand-related policies that aim to influence quantities or patterns of energy use have traditionally been referred to as demand-side management (DSM) programmes. They include both energy efficiency policies and demand response (DR). Energy efficiency improvements can bring many benefits in terms of reduced energy infrastructure investments, decrease in electricity prices, increased energy security, improved environmental quality and other ancillary benefits. Scientists estimate that by 2050, we will need to have reduced our greenhouse gas emissions (GHG) by 50 per cent to avoid the worst-case scenarios of climate change. In such a context, the building sector appears as the ‘cornerstone of every national climate change strategy’, as it is responsible for up to 30 per cent of global annual GHG emissions, and 40 per cent of all energy consumption (UNEP, 2009). Furthermore, there is widespread evidence of the cost-effectiveness of energy efficiency measures as compared to renewable programmes (IEA, 2006). In parallel, load growth; increased intermittency due to renewable generation; and, in the UK in particular, the renewal and reconfiguration of the electricity network pose challenges to the electricity sector never seen before. These challenges increasingly lead to the recognition of the importance of active consumer participation in load shifting, and hence interest in influencing quantities or patterns of energy demand.
There is now substantial experience particularly among OECD countries in using policy instruments to improve the overall efficiency with which energy is used. Several recent studies have assessed these experiences. For example, Geller et al. (2006) review energy intensity trends in the OECD from 1973 to 2003. They focus on the specific policies adopted by Japan, the US and a selection of European countries to improve energy use per unit of GDP across sectors. The World Energy Council (WEC) has conducted a review of energy efficiency policies using a survey of seventy countries, including examples of the most effective types of policy measures (WEC, 2008). Similarly, the United National Environment Programme Sustainable Buildings & Climate Initiative (UNEP-SBCI) published several reports assessing the implemented policies in various countries. A number of International Energy Agency (IEA) publications have also looked at energy use trends (IEA, 2007; IEA, 2008); reviewed the implementation of energy efficiencies policies in general (IEA, 2009b); and in the residential sector in particular (IEA, 2008).