Explosion-related deaths: An overview on forensic evaluation and implications

Purpose Explosion-related deaths are uncommon events which require expertise and confidence so that an appropriate death investigation can be performed. The present study aims to provide a detailed forensic analysis of the issues and implications arising in the event of an explosion. Methods A retrospective review of casualty data was conducted on electronic literature databases. Cases concerning deadly explosions registered at the Milan Institute of Legal Medicine were examined and analyzed altogether. Results Explosions may involve closed or open systems. A security assessment of the site is always necessary. Alterations of the site due to rescue procedures can occur; thus, on-site forensic investigation should be adapted to the environment. Then, a study protocol based on autopsy procedures is presented. Application of the postmortem radiology enforces forensic procedures both for the analysis of blast injuries and skeleton fractures, and for identification purposes. Blast injuries typically cause lacerations of the lungs, intestine and major vessels; moreover, hyoid fractures can be documented. Histopathology may help to define blast injuries effectively. Forensic chemistry, toxicology and ballistics provide useful investigative evidence as well as anthropology and genetics. Different forensic topics regarding explosions are discussed through five possible scenarios that forensic pathologists may come across. Scenarios include self-inflicted explosion deaths, domestic explosions, work-related explosions, terrorist events, and explosions caused by accidents involving heavy vehicles. Conclusion The scenarios presented offer a useful instrument to avoid misinterpretations and evaluation errors. Procedural notes and technical aspects are provided to the readers, with an insight on collaboration with other forensic experts.

The impact of a patient trolley's intra-hospital speed and position on the quality of ventilation performed by a self-inflating bag.

Purpose: The aim of the study is to make a quantitative and qualitative assessment of selected parameters connected with a patient's ventilation using a self-inflating bag during simulated 'head-first' or ‘legs-first' directions of patient transport. Methods: Seventeen people participated in the conducted study. Their task included conducting alternative ventilation during the transport of the patient (Airway Management Simulator BT Inc.) by using the head or the legs technique: in the transport trolley's movement direction. At all times during the transport, video recording was carried out non–stop, and the spectrum of generated vibrations was recorded using the SVAN 958 vibration spectrum analyser, with a three-direction SVANTEK SV 39A disc for measuring whole body vibrations. Additionally, a survey was carried out. The task of the research participants was to indicate the degree of performer comfort related to the ventilation and the transport process. The assessment of the results was then subjected to statistical analysis. Results: The duration of the patient transport by using the legs-first technique was shorter (57.5 s on average) in comparison with the head-first one (62.5 s on average). The subjective assessment of performer comfort on the transport and ventilation process with the legs-first technique was perceived as higher compared to the head-first one. During the patient transport, the highest a RMS acceleration values in the vertical direction were obtained for frequencies 8-25 [Hz], corresponding to the resonance frequencies of the head (17-25 Hz), trachea and bronchi (12-16 Hz), lungs (4-11 Hz) and the spine (8-12 Hz). According to other authors, vibrations with a frequency of 8-10 Hz lead to a decrease in blood pressure, bradycardia and bradypnoe; vibrations at a frequency of 11-12 Hz cause increased heart rate, peripheral vasoconstriction, fatigue, abnormal temperature, nausea, abdominal and chest pain, while vibrations above 12 Hz cause dangerous arrhythmia, muscle tremors, pain and bleeding. Conclusions: The recommended position of intra-hospital patient transport is the legs-first technique. At the stage of preparation for transport, it is necessary to keep in mind the ergonomic aspects of carrying out possible rescue procedures, e.g. artificial ventilation, the effectiveness of which depends on the height of the patient’s trolley, the elbow-shoulder angle of the paramedic, and their back inclination in the thoracolumbar section. The training of medical staff should include conducting high fidelity simulation of activities connected with e.g. transport, enabling future paramedics to acquaint themselves with the working conditions in terms of the effectiveness of actions and ensuring adequate work ergonomics.

Preparedness for peer first response to mining emergencies resulting in injuries: a cross-sectional study

ObjectiveIdentify factors of preparedness for peer first response to underground mining emergencies with injured victims.DesignCross-sectional questionnaire study of Swedish underground mineworkers.SettingSeven out of nine Swedish underground mines.ParticipantsA total of 741 mineworkers out of 1022 (73%) participated in this study.InterventionsNone.Outcome measuresLevel of preparedness for emergencies with injuries in underground mines.ResultsThree factors influenced the preparedness of mineworkers for a peer first response: (1) familiarity with rescue procedures during emergencies with injuries; (2) risk perception of emergencies with injuries and (3) experience of using self-protective and first aid equipment. Mineworkers who believed that they knew how to handle emergencies with injuries (OR 1.30, 95% CI 1.22 to 1.38) and those who were trained in the use of self-protective and first aid equipment (OR 1.19, 95% CI 1.07 to 1.32) considered themselves to be better prepared for a peer first response than those who were unfamiliar with the rescue procedures or who had not used self-protective and first aid equipment. However, mineworkers who rated the risk for emergencies with injuries as high considered themselves to be less prepared than those who rated the risk as low (OR 0.95, 95% CI 0.91 to 0.98).ConclusionThis study identified three factors that were important for the peer-support preparedness of underground mineworkers. More research is needed to adapt and contextualise first aid courses to the needs of underground peer responders.

Pendampingan Mitigasi Bencana Gempa Bumi dan Tsunami Berbasis Pengetahuan Lokal pada Masyarakat Rentan Bencana di Kabupaten Mukomuko Bengkulu

The first objective of this activity is to increase knowledge and understanding of the rescue procedures, evacuation routes, and emergency response plans when a large earthquake occurs. The second objective is to increase the knowledge and ability to mobilize available resources. With this knowledge and capability, the community can choose and sort out the resources that must be prioritized, so that losses can be reduced as little as possible. Referring to the results of the study, reducing the impact of earthquake and tsunami disaster risk is greatly influenced by emergency response plan factors, disaster warning system factors, knowledge factors, policy and guidance factors, and the ability of team mobilization. The conclusion obtained from the results of this activity is that the Air Rami Sub-district community gained increased knowledge and understanding of earthquake and tsunami mitigation. This can be seen from the enthusiasm of stakeholders and the public in participating in socialization activities. It is also supported by the Wilcoxon statistical test, the result showed that socialization increases public knowledge in understanding disaster mitigation, especially earthquakes and tsunamis.

Analysis of the Effectiveness of Decontamination Fluids on the Level of Biological Contamination of Firefighter Suits

The scope of tasks of chemical and ecological rescue procedures includes prevention of terrorist attacks with biological weapons. After each action, firefighters are obliged to clean and disinfect their outfits to prevent the potential spreading of harmful microorganisms. This study aimed to analyze the effectiveness of decontamination fluids used to disinfect firefighter’s suits. Two types of clothes were analyzed: special combat clothing (NOMEX), and the heavy gas-tight chemical type 1a suit. Swabbed places were cut out and sterilized mechanically using detergent and alcohol. Each time, smears were made on sterile glass, fixed in pure ethanol and stained using the Gram method. After this, the staining samples were air dried and photographed under a light microscope at magnification 1000×. Each smear was made in triplicate and the relative number of stained microorganisms was analyzed using ImageJ software. The results showed that detergent significantly decreased the number of pathogens in the chest area on the NOMEX suit and the type 1a-gas-tight clothing and was more effective than alcohol, especially in case of the NOMEX suit. In conclusion, the detergent was more efficient in decontaminating the NOMEX outfit than the heavy gas-tight clothing, whose surface was better cleaned by the alcohol.

The role and responsibilities of the raramedic in the State Medical Rescue System

The profession of paramedic is a recent profession functioning in Poland since 1992. Over those 27 years the training, the role and responsibilities given to paramedics have undergone many changes. Initially, paramedics were trained in two-year colleges (post-secondary schools) and were not qualified to administer medical emergency treatment (medical rescue procedures) at the place of accidents. At present, they are educated at universities and are qualified to apply emergency medical treatment by themselves, inter alia to ensure the safe transport of the injured person in a life-threatening emergency, provide mental support to the injured, and carry out health education and promotion. Moreover, they are the core personnel of the State Medical Rescue System (PRM). The goal of the study was to present the history of the establishment of paramedical profession and its current role and responsibilities in the PRM.

Corporate Insolvency Law and Reforms in South Africa

Every country has provided business recuse system and a regime for the protection of insolvent debtors. South Africa has had this legal infrastructure since 1926 when the statutory procedure of judicial management was introduced by the Companies Act 1926. The chapter discusses the judicial management, mechanisms to secure unpaid debts, carrying on business during insolvency, and the new corporate rescue procedures applicable for South African companies as provided in Companies Act 2008. The chapter also puts a light on corporate insolvency informs in South Africa.