Audit of Caesarean section Documentation

Background: To study the standard of caesarean section surgical documentationMethods : In this retrospective study 30 consecutive cases who underwent cesarean section were studied. The surgical documentation was analyzed on 16 parameters under three major categories. Category 1 was regarding the personnel. This included the documentation of name of surgeon, assistant and anesthetist. Category 2 was surgical procedure giving detail about Status of uterine cavity, skin and uterine incision, uterine and skin closure, Venous thrombosis risk , blood loss and finally the instrument count, swab count and post op plan. Category 3 was regarding the baby gender , weight, Apgar score and cord pH.Results: There were deficiencies in the surgical detail documentation of caesarean section .The documentation of personnel was 95%.The surgical documentation regarding uterine cavity and blood loss during surgery were 90%.Documentation regarding swab and instrument count being complete was only in 25% of the cases. Post op plan was documented in only 60% of the cases. Notes regarding the newborn were insufficient. The documentation of baby gender, weight and Apgar score were 85%, 45% and 65% respectively.Conclusion: Caesarean section surgical documentation needs to meet international standard of minimal documentation. It is required to introduce a minimal standard surgical document to be attached in the notes of all patients undergoing caesarean section to be completed by the operating surgeon within 24 hrs of surgery

Power Supply Reliability Estimates for Experimental Fusion Facilities

This paper presents the results of a task to analyze the operating experience data for large, pulsed power supplies used at the DIII-D tokamak. This activity supports the International Thermonuclear Experimental Reactor (ITER) project by giving fusion-specific reliability values for large power supplies that energize neutral beams and magnets. These failure rate data are necessary to perform system availability calculations and to make estimates of the frequency of safety-significant events (e.g., power supply arcs or fires) that might occur in other fusion facilities such as ITER. The analysis shows that the DIII-D data results compare well with the results of similar data analysis work that the Italian National Agency for New Technologies, Energy and the Environment (ENEA) has performed on the JET tokamak and compare fairly with data from two accelerators

Identification of accident sequences for the DEMO plant

Safety studies are performed in the frame of the conceptual design studies for the European Demonstration Fusion Power Plant (DEMO) to assess the safety and environmental impact of design options. An exhaustive set of reference accident sequences are defined in order to evaluate plant response in the most challenging events and compliance with safety requirements.The Functional Failure Mode and Effect Analysis (FFMEA) has been chosen as analytical tool, as it is a suitable methodology to define possible accident initiators when insufficient design detail is available to allow for more specific evaluation at component level. The main process, safety and protection functions related to the DEMO plant are defined through a functional breakdown structure (FBS). Then, an exhaustive set of high level accident initiators is defined referring to loss of functions, rather than to specific failures of systems and components, overcoming the lack of detailed design information. Nonetheless reference to systems or main components is always highlighted, as much as possible, in order to point out causes and safety consequences. Through the FFMEA a complete list of postulated initiating events (PIEs) is selected as the most representative events in terms of challenging conditions for the plant safety. All the four blanket concepts of the European DEMO reactor have been analysed

Preliminary Assessment of Radiolysis for the Cooling Water System in the Rotating Target of {SORGENTINA}-{RF}

The SORGENTINA-RF project aims at developing a 14 MeV fusion neutron source featuring an emission rate in the order of 5-7 x 10(13) s(-1). The plant relies on a metallic water-cooled rotating target and a deuterium (50%) and tritium (50%) ion beam. Beyond the main focus of medical radioisotope production, the source may represent a multi-purpose neutron facility by implementing a series of neutron-based techniques. Among the different engineering and technological issues to be addressed, the production of incondensable gases and corrosion product into the rotating target deserves a dedicated investigation. In this study, a preliminary analysis is carried out, considering the general layout of the target and the present choice of the target material

The IFMIF-DONES facility: a fusion-oriented 5 MW superconducting CW linear accelerator

IFMIF-DONES (International Fusion Materials Irradiation Facility, DEMO-Oriented Neutron Early Source) – a powerful neutron irradiation facility for irradiation of materials to be used in fusion reactors – is planned as part of the European roadmap to fusion electricity. Its main goal will be to characterize and qualify materials under a neutron field similar to the one faced in a fusion reactor, developing a material database for the future fusion nuclear reactors. The facility is based on an intense neutron source produced by a high current deuteron beam impinging on a liquid lithium curtain, aiming to generate by stripping reactions neutrons with an energy spectrum and flux similar to those expected to be seen by the first wall of a fusion reactor. The IFMIF-DONES facility has accomplished the preliminary design phase and currently in its detailed design phase. The next phase will be the preparation for the construction of the facility. This contribution presents the status of IFMIF-DONES design developed in the framework of the EUROfusion work programme, integrating the lesson learnt from the IFMIF/EVEDA Project (International Fusion Materials Irradiation Facility/ Engineering Validation and Engineering Design Activities - Broader Approach (BA) Agreement signed between EURATOM and Japanese Government), through a common program which includes the different commonalties and interfaces of the two projects. An overview of the present design status of the facility will be provided putting emphasis on the design status of the high current superconducting LINAC, responsible for delivering the 5 MW D+ beam at 40 MeV with very high inherent availability, focusing on the main challenges and the related R&D programme. The prospects for the construction and the commissioning of the facility in Granada (Spain) will be also reviewed

DEMO Divertor Cassette and Plasma facing Unit in Vessel Loss-of-Coolant Accident

As part of the pre-conceptual design activities for the European DEMOnstration plant, a carefully selected set of safety analyses have been performed to assess plant integrated performance and the capability to achieve expected targets while keeping it in a safe operation domain. The DEMO divertor is the in-vessel component in charge of exhausting the major part of the plasma ions’ thermal power in a region far from the plasma core to control plasma pollution. The divertor system accomplishes this goal by means of assemblies of cassette and target plasma facing units modules, respectively cooled with two independentheat-transfer systems. A deterministic assessment of a divertor in-vessel Loss-of-Coolant Accident is here considered. Both Design Basis Accident case simulating the rupture of an in-vessel pipe for the divertor cassette cooling loop, and a Design Extension Conditions accident case considering the additional rupture of an independent divertor target cooling loop are assessed. The plant response to such accidents is investigated, a comparison of the transient evolution in the two cases is provided, and design robustness with respect to safety objectives is discussed

Safety Issues related to the Intermediate Heat Storage for the EU DEMO

The functional deviations able to compromise system safety in the EU DEMO Primary Heat Transfer System (PHTS) with intermediate heat storage (IHS) based on molten salts are identified and compared to the deviations identified with PHTS without IHS. The resulting safety issues for the Balance of Plant (BoP) have been taken into account. Functional Failure Mode and Effects Analysis (FFMEA) is used to highlight the Postulated Initiating Events (PIE) of incident/accident sequences and to provide some safety insights during the preliminary design. The architecture of the system with IHS does not introduce new PIE with respect to the case without IHS, but it modifies some of them. In particular the two Postulated Initiating Events that are affected by the presence of IHS are the LOCA in the tubes of the HX between primary and intermediate circuit and the loss of heat sink for the first wall or the breeding zone. In fact the IHS introduces some advantages concerning the stability of the secondary circuit, but some weaknesses are associated to the physical-chemical nature of molten salts, especially oxidizing power, corrosive nature and risk of solidification. These issues can be managed in the design by the introduction of new safety functions

Risk Management of a Fusion Facility: Radiation Protection and Safety Integrated Approach for the Sorgentina-RF Project

The Sorgentina-RF project will use fusion neutrons to produce 99Mo, a precursor of 99mTc, by irradiating natural molybdenum. 99Mo is produced by means of the inelastic reaction 100Mo(n, 2n)99Mo on 100Mo, which is an isotope of natural Mo. From a functional point of view, the project consists of two parts: an irradiation neutron source at 14 MeV and a radiochemistry facility dedicated to the extraction of 99Mo from the solid sample irradiated by the neutron source. Given the degree of complexity of such a facility, the risk management strategy is based on an integrated approach that combines the engineering method of safety with that of radiation protection. Therefore, design issues were studied and systems were planned according to both radiation protection and safety criteria already in the preliminary phase, allowing a general strengthening of the safety of the plant. This work discusses the preventive analysis and the related activities to identify the ways in which potential exposures to radiation may occur. In particular, the preliminary safety analysis is presented for the innovative rotating target, developed for the project, and, accordingly, some specific technical solutions are given to refine the initial design of the facility