3 resultados para Trauma severity indices
em Iowa Publications Online (IPO) - State Library, State of Iowa (Iowa), United States
Resumo:
This research project covered a wide range of activities that allowed researchers to understand the relationship between stability, pavement distress, and recycled portland cement concrete (RPCC) subbase aggregate materials. Detailed laboratory and field tests, including pavement distress surveys, were conducted at 26 sites in Iowa. Findings show that specific gravities of RPCC are lower than those of crushed limestone. RPCC aggregate material varies from poorly or well-graded sand to gravel. A modified Micro-Deval test procedure showed that abrasion losses of virgin aggregate materials were within the maximum Micro-Deval abrasion loss of 30% recommended by ASTM D6028-06. Micro-Deval abrasion loss of RPCC aggregate materials, however, was much higher than that of virgin materials and exceeded 30% loss. Modulus of elasticity of RPCC subbase materials is high but variable. RPCC subbase layers normally have low permeability. The pavement surfaces for both virgin and RPCC subbase across Iowa were evaluated to fulfill the objectives of this study related to field evaluation. Visual distress surveys were conducted to gather the detailed current pavement condition information including the type, extent, and severity of the pavement distresses. The historical pavement condition information for the surveyed field sections was extracted from the Iowa DOT's Pavement Management Information System (PMIS). The current surface condition of existing field pavements with RPCC subbase was compared with the virgin aggregate subbase sections using two different approaches. The changes in pavement condition indices (PCI and IRI) with time for both types of pavements (subbases) were compared.
Resumo:
In the previous study, moisture loss indices were developed based on the field measurements from one CIR-foam and one CIR-emulsion construction sites. To calibrate these moisture loss indices, additional CIR construction sites were monitored using embedded moisture and temperature sensors. In addition, to determine the optimum timing of an HMA overlay on the CIR layer, the potential of using the stiffness of CIR layer measured by geo-gauge instead of the moisture measurement by a nuclear gauge was explored. Based on the monitoring the moisture and stiffness from seven CIR project sites, the following conclusions are derived: 1. In some cases, the in-situ stiffness remained constant and, in other cases, despite some rainfalls, stiffness of the CIR layers steadily increased during the curing time. 2. The stiffness measured by geo-gauge was affected by a significant amount of rainfall. 3. The moisture indices developed for CIR sites can be used for predicting moisture level in a typical CIR project. The initial moisture content and temperature were the most significant factors in predicting the future moisture content in the CIR layer. 4. The stiffness of a CIR layer is an extremely useful tool for contractors to use for timing their HMA overlay. To determine the optimal timing of an HMA overlay, it is recommended that the moisture loss index should be used in conjunction with the stiffness of the CIR layer.
Resumo:
Photographic documentation of crashed vehicles at the scene can be used to improve triage of crash victims. A U.S. expert panel developed field triage rules to determine the likelihood of occupants sustaining serious injuries based on vehicle damage that would require transport to a trauma center (Sasser et al., 2011). The use of photographs for assessing vehicle damage and occupant compartment intrusion as it correlates to increased injury severity has been validated (Davidson et al., 2014). Providing trauma staff with crash scene photos remotely could assist them in predicting injuries. This would allow trauma care providers to assess the appropriate transport, as well as develop mental models of treatment options prior to patient arrival at the emergency department (ED). Crash-scene medical response has improved tremendously in the past 20-30 years. This is in part due to the increasing number of paramedics who now have advanced life support (ALS) training that allows independence in the field. However, while this advanced training provides a more streamlined field treatment protocol, it also means that paramedics focused on treating crash victims may not have time to communicate with trauma centers regarding crash injury mechanisms. As a result, trauma centers may not learn about severe trauma patients until just a few minutes before they arrive. The information transmitted by the TraumaHawk app allows interpretation of injury mechanisms from crash scene photos at the trauma center, providing clues about the type and severity of injury. With strategic crash scene photo documentation, trained trauma professionals can assess the severity and patterns of injury based on exterior crush and occupant intrusion. Intrusion increases the force experienced by vehicle occupants, which translates into a higher level of injury severity (Tencer et al., 2005; Assal et al., 2002; Mandell et al., 2010). First responders have the unique opportunity to assess the damaged vehicle at the crash scene, but often the mechanism of injury is limited or not even relayed to ED trauma staff. To integrate photographic and scene information, an app called TraumaHawk was created to capture images of crash vehicles and send them electronically to the trauma center. If efficiently implemented, it provides the potential advantage of increasing lead-time for preparation at the trauma center through the crash scene photos. Ideally, the result is better treatment outcomes for crash victims. The objective of this analysis was to examine if the extra lead-time granted by the TraumaHawk app could improve trauma team activation time over the current conventional communication method.