Most patients with trauma-hemorragic shock, prior to ICU admission, have been resuscitated and stabilized in the emergency room (ER) and/or operation room (OR). Many of them suffer from systemic edema. This extra-vasc...Most patients with trauma-hemorragic shock, prior to ICU admission, have been resuscitated and stabilized in the emergency room (ER) and/or operation room (OR). Many of them suffer from systemic edema. This extra-vascular fluid is caused by massive infusion of fluid and blood for the maintenance of blood pressure. During the recovery stage, the patients exhibit spontaneous diuresis followed by negative fluid balance. Urine volumes of some patients are more than 10000 ml/d. Do we need to maintain a balance between daily input and output of water at this situation? There are many references in the medical literature and textbooks about fluid resuscitation and the principles in maintaining the balance between input and output of water, but rarely about when and how to restrict it, that is, when and how to permit a negative balance. In this retrospective review, we examined the resuscitation records of 205 patients with systemic edema after trauma-hemorragic shock.展开更多
The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creat...The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creating tiers of analysis where the greater the risk,the more sophisticated the analysis.In a risk-informed root cause analysis process,a situation is normally not analyzed at a level less than what actually occurred.However,a situation may be investigated as though the consequence were greater than actually happened,especially if only slight differences in circumstances could result in a significantly higher consequence.While operational events or safety issues are normally expected to result only with negligible or marginal actual consequences,many of those would actually have certain potential to develop or propagate into catastrophic events.This potential can be expressed qualitatively or quantitatively.Risk-informing of root cause analysis relies on mapping the event or safety issue into a risk matrix which,traditionally,is a two-dimensional probability-consequence matrix.A new concept employed in the risk matrix for root cause analysis is that,while the probability reflects the observed or expected range of values(retaining,thus,its“traditional”meaning),the consequence reflects not only the observed or materialized impact(such as failure of equipment)but,also,its potential to propagate or develop into highly undesirable final state.The paper presents main elements of risk-informed root cause analysis process and discusses qualitative and quantitative aspects and approaches to determination of risk significance of operational events or safety issues.展开更多
近年来,蒙东地区110 k V输电线路常由于鸟害而发生跳闸故障,其中鸟粪闪络是引起鸟害跳闸故障的主要原因。为探究鸟粪滴落通道对闪络的影响,本文通过自主设计试验平台,模拟了110 kV线路复合绝缘子鸟闪试验,试验利用鸟粪模拟液研究了不同...近年来,蒙东地区110 k V输电线路常由于鸟害而发生跳闸故障,其中鸟粪闪络是引起鸟害跳闸故障的主要原因。为探究鸟粪滴落通道对闪络的影响,本文通过自主设计试验平台,模拟了110 kV线路复合绝缘子鸟闪试验,试验利用鸟粪模拟液研究了不同鸟粪滴落通道下鸟粪电导率、粘度、均压环、对鸟闪概率的影响,试验发现电导率越大、粘度越高,鸟闪概率越严重,加装均压环会加剧闪络概率;鸟粪通道与导线共面时闪络最严重,异面时闪络概率最小。目前防鸟罩、大盘径伞群等盘径设计多由异面闪络试验得出,其防护效果还有待进一步改善提高。展开更多
文摘Most patients with trauma-hemorragic shock, prior to ICU admission, have been resuscitated and stabilized in the emergency room (ER) and/or operation room (OR). Many of them suffer from systemic edema. This extra-vascular fluid is caused by massive infusion of fluid and blood for the maintenance of blood pressure. During the recovery stage, the patients exhibit spontaneous diuresis followed by negative fluid balance. Urine volumes of some patients are more than 10000 ml/d. Do we need to maintain a balance between daily input and output of water at this situation? There are many references in the medical literature and textbooks about fluid resuscitation and the principles in maintaining the balance between input and output of water, but rarely about when and how to restrict it, that is, when and how to permit a negative balance. In this retrospective review, we examined the resuscitation records of 205 patients with systemic edema after trauma-hemorragic shock.
文摘The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creating tiers of analysis where the greater the risk,the more sophisticated the analysis.In a risk-informed root cause analysis process,a situation is normally not analyzed at a level less than what actually occurred.However,a situation may be investigated as though the consequence were greater than actually happened,especially if only slight differences in circumstances could result in a significantly higher consequence.While operational events or safety issues are normally expected to result only with negligible or marginal actual consequences,many of those would actually have certain potential to develop or propagate into catastrophic events.This potential can be expressed qualitatively or quantitatively.Risk-informing of root cause analysis relies on mapping the event or safety issue into a risk matrix which,traditionally,is a two-dimensional probability-consequence matrix.A new concept employed in the risk matrix for root cause analysis is that,while the probability reflects the observed or expected range of values(retaining,thus,its“traditional”meaning),the consequence reflects not only the observed or materialized impact(such as failure of equipment)but,also,its potential to propagate or develop into highly undesirable final state.The paper presents main elements of risk-informed root cause analysis process and discusses qualitative and quantitative aspects and approaches to determination of risk significance of operational events or safety issues.
文摘近年来,蒙东地区110 k V输电线路常由于鸟害而发生跳闸故障,其中鸟粪闪络是引起鸟害跳闸故障的主要原因。为探究鸟粪滴落通道对闪络的影响,本文通过自主设计试验平台,模拟了110 kV线路复合绝缘子鸟闪试验,试验利用鸟粪模拟液研究了不同鸟粪滴落通道下鸟粪电导率、粘度、均压环、对鸟闪概率的影响,试验发现电导率越大、粘度越高,鸟闪概率越严重,加装均压环会加剧闪络概率;鸟粪通道与导线共面时闪络最严重,异面时闪络概率最小。目前防鸟罩、大盘径伞群等盘径设计多由异面闪络试验得出,其防护效果还有待进一步改善提高。
