Review of On-Scene Management of Mass-Casualty Attacks

Background: The scene of a mass-casualty attack (MCA) entails a crime scene, a hazardous space, and a great number of people needing medical assistance. Public transportation has been the target of such attacks and involves a high probability of generating mass casualties. The review aimed to investigate challenges for on-scene responses to MCAs and suggestions made to counter these challenges, with special attention given to attacks on public transportation and associated terminals. Methods: Articles were found through PubMed and Scopus, "relevant articles" as defined by the databases, and a manual search of references. Inclusion criteria were that the article referred to attack(s) and/or a public transportation-related incident and issues concerning formal on-scene response. An appraisal of the articles' scientific quality was conducted based on an evidence hierarchy model developed for the study. Results: One hundred and five articles were reviewed. Challenges for command and coordination on scene included establishing leadership, inter-agency collaboration, multiple incident sites, and logistics. Safety issues entailed knowledge and use of personal protective equipment, risk awareness and expectations, cordons, dynamic risk assessment, defensive versus offensive approaches, and joining forces. Communication concerns were equipment shortfalls, dialoguing, and providing information. Assessment problems were scene layout and interpreting environmental indicators as well as understanding setting-driven needs for specialist skills and resources. Triage and treatment difficulties included differing triage systems, directing casualties, uncommon injuries, field hospitals, level of care, providing psychological and pediatric care. Transportation hardships included scene access, distance to hospitals, and distribution of casualties. Conclusion: Commonly encountered challenges during unintentional incidents were added to during MCAs, implying specific issues for safety, assessment, triage, and treatment, which require training. Effectively increasing readiness for MCAs likely entail struggles to overcome fragmentation between the emergency services and the broader crisis management system as well as enabling critical and prestige-less, context-based assessments of needed preparatory efforts

Review of On-Scene Management of Mass-Casualty Attacks

Background: The scene of a mass-casualty attack (MCA) entails a crime scene, a hazardous space, and a great number of people needing medical assistance. Public transportation has been the target of such attacks and involves a high probability of generating mass casualties. The review aimed to investigate challenges for on-scene responses to MCAs and suggestions made to counter these challenges, with special attention given to attacks on public transportation and associated terminals. Methods: Articles were found through PubMed and Scopus, “relevant articles” as defined by the databases, and a manual search of references. Inclusion criteria were that the article referred to attack(s) and/or a public transportation-related incident and issues concerning formal on-scene response. An appraisal of the articles’ scientific quality was conducted based on an evidence hierarchy model developed for the study. Results: One hundred and five articles were reviewed. Challenges for command and coordination on scene included establishing leadership, inter-agency collaboration, multiple incident sites, and logistics. Safety issues entailed knowledge and use of personal protective equipment, risk awareness and expectations, cordons, dynamic risk assessment, defensive versus offensive approaches, and joining forces. Communication concerns were equipment shortfalls, dialoguing, and providing information. Assessment problems were scene layout and interpreting environmental indicators as well as understanding setting-driven needs for specialist skills and resources. Triage and treatment difficulties included differing triage systems, directing casualties, uncommon injuries, field hospitals, level of care, providing psychological and pediatric care. Transportation hardships included scene access, distance to hospitals, and distribution of casualties. Conclusion: Commonly encountered challenges during unintentional incidents were added to during MCAs, implying specific issues for safety, assessment, triage, and treatment, which require training. Effectively increasing readiness for MCAs likely entail struggles to overcome fragmentation between the emergency services and the broader crisis management system as well as enabling critical and prestige-less, context-based assessments of needed preparatory efforts

Advanced space system concepts and their orbital support needs (1980 - 2000). Volume 3: Detailed data. Part 1: Catalog of initiatives, functional options, and future environments and goals

The following areas were discussed in relation to a study of the commonality of space vehicle applications to future national needs: (1) index of initiatives (civilian observation, communication, support), brief illustrated description of each initiative, time periods (from 1980 to 2000+) for implementation of these initiatives; (2) data bank of functional system options, presented in the form of data sheets, one for each of the major functions, with the system option for near-term, midterm, and far-term space projects applicable to each subcategory of functions to be fulfilled; (3) table relating initiatives and desired goals (public service and humanistic, materialistic, scientific and intellectual); and (4) data on size, weight and cost estimations

Economic Crisis in Argentina and no way out?

Argentina has made the headlines of international media not only for its successful return to democratic political rules in December 1983 but also for its renewed slump into economic crisis. The country is no longer able to meet the debt servicing requirements and to repay loans due this year while auspices for rescheduling and extending foreign debt are bleak. As a corollary tovexternal problems, there are high public sector deficits, inflation is accelerating at a galopping pace, and net private investment has turned negative. Up to now, the new democratic government has not lived up to expectations since it did not present a reform package designed to overcome the severe economic problems of the country. Rather, the government has relied on some ad-hoc emergency measures in an attempt to prevent the crisis from turning into catastrophy.

Extravehicular Crewman Work System (ECWS) study program. Volume 3: Satellite service

The satellite service portion of the Extravehicular Crewman Work System Study defines requirements and service equipment concepts for performing satellite service from the space shuttle orbiter. Both normal and contingency orbital satellite service is required. Service oriented satellite design practices are required to provide on orbit satellite service capability for the wide variety of satellites at the subsystem level. Development of additional satellite service equipment is required. The existing space transportation system provides a limited capability for performing satellite service tasks in the shuttle payload bay area

Haiti Earthquake January 2010: What Actions and Policies Can the Government of Haiti Implement to Improve Emergency Management Response

In 2010, Haiti experienced a devastating earthquake that destroyed much of its capital city and the governmental offices that should have guided the response to the disaster. This research focuses on how Haiti can benefit from the Caribbean Disaster Management Agency’s standards for disaster resilience as it works to recover from the earthquake. Unfortunately, Haiti has long been dependent on assistance from non-governmental organizations due to its extreme poverty; its recovery is complicated by the need to integrate disaster assistance and on-going economic and social assistance into its development of a more resilient society

Advanced space system concepts and their orbital support needs (1980 - 2000). Volume 2: Final report

The results are presented of a study which identifies over 100 new and highly capable space systems for the 1980-2000 time period: civilian systems which could bring benefits to large numbers of average citizens in everyday life, much enhance the kinds and levels of public services, increase the economic motivation for industrial investment in space, expand scientific horizons; and, in the military area, systems which could materially alter current concepts of tactical and strategic engagements. The requirements for space transportation, orbital support, and technology for these systems are derived, and those requirements likely to be shared between NASA and the DoD in the time period identified. The high leverage technologies for the time period are identified as very large microwave antennas and optics, high energy power subsystems, high precision and high power lasers, microelectronic circuit complexes and data processors, mosaic solid state sensing devices, and long-life cryogenic refrigerators