Unfallchirurg最新文献

Background: The search for and rescue of missing persons is always coupled with a high demand on human resources. In cases of suspected drowning it is often necessary to search huge expanses of water. For depths of more than 3-5 m the search and rescue procedure needs to be performed by specialist rescue divers. Due to saturation with nitrogen caused by the higher ambient pressure during the dive, the operating time for each rescue diver is limited. In addition, each dive is linked with an increased risk.

Objective: Miniaturization of sensors, higher performance of embedded systems and high energy density of modern accumulators offer the chance to operate with unmanned flying and diving vehicles for search and rescue even with moderate financial investment.

Material and methods: Based on funding by the Federation of the German Live Saving Association (DLRG) the DLRG national association of Bavaria procured three different models of remotely operated underwater vehicles (ROUV) and two different systems for underwater positioning. These systems will be offered to local associations of the DLRG in Bavaria for intense testing in their waters based on a common implementation strategy to ensure comparability and reproducibility.

Results: Initial tests with different types of ROUV and underwater positioning have been performed in preparation of the survey. As a result, mini-ROUVs found in the lower consumer segment have been identified as insufficient as they are not able to carry the additional payload of the underwater positioning systems whilst maintaining controllability. In contrast, more complex drones are difficult to handle and require longer preparation times before they are ready for use. The ROUVs in the median range, preferably with a streamlined structure, have so far been found to be optimal; however, operating the vehicle without a positioning system is not recommended.

Conclusion: In combination with an underwater positioning system, remotely operated underwater vehicles are identified as a reasonable supplement for rescue divers. Fast time to operation enables a preview of the operating area before starting the rescue operation and can therefore support the rescue diver team.

Informative, participatory clinical decision-making needs to combine both skills and expertise as well as current scientific evidence. The flood of digital information makes it difficult in everyday clinical practice to keep up to date with the latest publications. This article provides assistance for coping with this problem. A basic understanding of prior and posterior probabilities as well as systematic error (bias) makes it easier to weigh up the benefits and risks, e.g. of a (surgical) intervention compared to a nonsurgical treatment. Randomized controlled trials (RCT, with all modern modifications) deliver undistorted results but in orthopedic and trauma surgery can lead to a heavily selected nonrepresentative sample and the results must be confirmed or refuted by further, independent RCTs. Large-scale observational data (e.g. from registries) can be modelled in a quasi-experimental manner and accompany RCTs in health technology assessment.

The market for drones has been growing for years and the prognosis for the future assumes a further increase in growth. Currently, drones deliver retail goods, foodstuffs, industrial and medicinal goods. Furthermore, drones can relieve rescue services and first responders in difficult situations, such as the assessment of the situation at scenes of accidents. They can be at the scene more quickly than ambulances or helicopters: this is particularly important in built-up areas with traffic jam problems and difficult to access or remote areas. Drones must be integrated as a meaningful supplement into existing safety and rescue chains. This article presents research projects and specific cases of application, which range from the needs-based supply of regional hospitals with medicaments using drones, the delivery of blood conserves in rural areas of South Africa by drones and many scenarios in the rescue service. The next developmental steps affect the scalability and automation of drone-supported missions; however, technical progress alone is insufficient; the legal and regulatory frameworks must be set for certain drone scenarios. In order to safely and efficiently administrate the European airspace and to achieve further possible applications for drones, the U‑Space concept of the European Union represents a possible essential prerequisite.