Use of Unmanned Aerial Vehicles in Wilderness Search and Rescue Operations: A Scoping Review.

Wilderness Search and Rescue (WSAR) focuses on locating and extricating missing persons in remote settings. As unmanned aerial vehicle (UAV) or "drone" technology has evolved, so has the literature describing its application in WSAR operations. We conducted a scoping review of literature that describes the use of UAVs in WSAR contexts. The Joanna Briggs Institute Framework for scoping reviews was followed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews method. Additional individual databases, article reference lists, and relevant grey literature were also included in the search to provide an impartial scope. Seven hundred forty-seven articles were identified. Of these, 56 were found to be duplicates. The remaining 691 were further screened and checked for eligibility. Ultimately, 21 studies were found that met our inclusion criteria. This literature supports the use of UAVs to increase the safety and efficiency of a WSAR operation for locating victims, assessing risks, carrying equipment, and restoring communication systems. Unmanned aerial vehicles are a potentially useful adjunct in the management of WSAR operations. Their limitations include objects obscuring victims, weather changes, uneven terrain, battery-limited flight time, and susceptibility to environmental damage.

Drones reduce the treatment-free interval in search and rescue operations with telemedical support - A randomized controlled trial.

INTRODUCTION: Response to medical incidents in mountainous areas is delayed due to the remote and challenging terrain. Drones could assist in a quicker search for patients and can facilitate earlier treatment through delivery of medical equipment. We aim to assess the effects of using drones in search and rescue (SAR) operations in challenging terrain. We hypothesize that drones can reduce the search time and treatment-free interval of patients by delivering an emergency kit and telemedical support. METHODS: In this randomized controlled trial with a cross-over design two methods of searching for and initiating treatment of a patient were compared. The primary outcome was a comparison of the times for locating a patient through visual contact and starting treatment on-site between the drone-assisted intervention arm and the conventional ground-rescue control arm. A linear mixed model (LMM) was used to evaluate the effect of using a drone on search and start of treatment times. RESULTS: Twenty-four SAR missions, performed by six SAR teams each with four team members, were analyzed. The mean time to locate the patient was 14.6 min (95% CI 11.3-17.9) in the drone-assisted intervention arm and 20.6 min (95% CI 17.3-23.9) in the control arm. The mean time to start treatment was 15.7 min (95% CI 12.4-19.0) in the drone-assisted arm and 22.4 min (95% CI 19.1-25.7) in the control arm (p < 0.01 for both comparisons). CONCLUSION: The successful use of drones in SAR operations leads to a reduction in search time and treatment-free interval of patients in challenging terrain, which could improve outcomes in patients suffering from traumatic injuries, the most commonly occurring incident requiring mountain rescue operations.

An agent-based model reveals lost person behavior based on data from wilderness search and rescue.

Thousands of people are reported lost in the wilderness in the United States every year and locating these missing individuals as rapidly as possible depends on coordinated search and rescue (SAR) operations. As time passes, the search area grows, survival rate decreases, and searchers are faced with an increasingly daunting task of searching large areas in a short amount of time. To optimize the search process, mathematical models of lost person behavior with respect to landscape can be used in conjunction with current SAR practices. In this paper, we introduce an agent-based model of lost person behavior which allows agents to move on known landscapes with behavior defined as independent realizations of a random variable. The behavior random variable selects from a distribution of six known lost person reorientation strategies to simulate the agent's trajectory. We systematically simulate a range of possible behavior distributions and find a best-fit behavioral profile for a hiker with the International Search and Rescue Incident Database. We validate these results with a leave-one-out analysis. This work represents the first time-discrete model of lost person dynamics validated with data from real SAR incidents and has the potential to improve current methods for wilderness SAR.

Does a short intervention with vibration foam roller recover lifeguards better after a water rescue? A pilot study.

PURPOSE: The aim of this study was to analyze the effects of a recovery program based on foam roller with and without vibration on blood lactate clearance and perceived fatigue after a water rescue. METHODS: A quasi-experimental crossover design was carried out to compare passive (PR) recovery and a short protocol of foam roller (FR) and vibration foam roller (VFR) recovery after a 100 m water rescue in 7 volunteer lifeguards. Blood lactate and perceived exertion were measured before and after the rescue, and also after the 5-min recovery intervention. RESULTS: Blood lactate levels decrease significantly with foam roller (p = 0.013; effect size = 0.97) and vibration foam roller recovery (p < 0.001; effect size = 1.62). Passive recovery did not show significant differences clearing out blood lactate. Fatigue perceived decrease significantly with all the recovery methods, but foam roller has higher effects on the global fatigue and VFR on the legs. CONCLUSION: FR and VFR clear out more blood lactate and decrease fatigue more than PR, with the subsequently increase of the physical conditioning to perform another effort.

An autonomous drone for search and rescue in forests using airborne optical sectioning.

Autonomous drones will play an essential role in human-machine teaming in future search and rescue (SAR) missions. We present a prototype that finds people fully autonomously in densely occluded forests. In the course of 17 field experiments conducted over various forest types and under different flying conditions, our drone found, in total, 38 of 42 hidden persons. For experiments with predefined flight paths, the average precision was 86%, and we found 30 of 34 cases. For adaptive sampling experiments (where potential findings are double-checked on the basis of initial classification confidences), all eight hidden persons were found, leading to an average precision of 100%, whereas classification confidence was increased on average by 15%. Thermal image processing, classification, and dynamic flight path adaptation are computed on-board in real time and while flying. We show that deep learning-based person classification is unaffected by sparse and error-prone sampling within straight flight path segments. This finding allows search missions to be substantially shortened and reduces the image complexity to 1/10th when compared with previous approaches. The goal of our adaptive online sampling technique is to find people as reliably and quickly as possible, which is essential in time-critical applications, such as SAR. Our drone enables SAR operations in remote areas without stable network coverage, because it transmits to the rescue team only classification results that indicate detections and can thus operate with intermittent minimal-bandwidth connections (e.g., by satellite). Once received, these results can be visually enhanced for interpretation on remote mobile devices.

Multiple imputation of maritime search and rescue data at multiple missing patterns.

Based on the missing situation and actual needs of maritime search and rescue data, multiple imputation methods were used to construct complete data sets under different missing patterns. Probability density curves and overimputation diagnostics were used to explore the effects of multiple imputation. The results showed that the Data Augmentation (DA) algorithm had the characteristics of high operation efficiency and good imputation effect, but the algorithm was not suitable for data imputation when there was a high data missing rate. The EMB algorithm effectively restored the distribution of datasets with different data missing rates, and was less affected by the missing position; the EMB algorithm could obtain a good imputation effect even when there was a high data missing rate. Overimputation diagnostics could not only reflect the data imputation effect, but also show the correlation between different datasets, which was of great importance for deep data mining and imputation effect improvement. The Expectation-Maximization with Bootstrap (EMB) algorithm had a poor estimation effect on extreme data and failed to reflect the dataset's variability characteristics.

Utilizing Drones to Restore and Maintain Radio Communication During Search and Rescue Operations.

INTRODUCTION: The ability of rescuers to maintain contact with incident command (IC) and each other is a critical component of search and rescue (SAR) operations. When rescuers lose radio communication with operation leaders, the effectiveness of operations may be substantially affected. This often occurs owing to the limitations of standard communications equipment in difficult terrain or when victims are beyond line-of-sight. This study investigates the viability of using an aerial drone-repeater system configuration to restore and maintain radio communications between IC and deployed rescuers. METHODS: SAR operators in Southern Utah identified 10 areas where radio communication is compromised during live rescue operations. Trained SAR personnel were deployed to these areas in a mock exercise. After confirmed loss of communication, a repeater-equipped aerial drone was piloted 122 m above IC to restore communication. Once restored, communication was assessed at regular intervals for the duration of the mock deployment. RESULTS: In all 10 areas tested, communication was successfully restored. In all cases, once communication was restored, no additional loss of radio contact occurred. The time between communication loss and restoration across the 10 scenarios was 6.5±1.1 (4.4-9.3) min (mean±SD with range). CONCLUSIONS: This method of restoring radio communication among SAR personnel could drastically improve the ability to assist victims and help mitigate the risks faced by rescuers. SAR leaders should be made aware of the useful applications of drones during SAR operations, especially in instances where communication is compromised.

Lay-rescuers in drowning incidents: A scoping review.

OBJECTIVE: Many victims of drowning fatalities are lay-people attempting to rescue another. This review aims to identify the safest techniques and equipment (improved or purpose made) for an untrained bystander to use when attempting a water rescue. METHOD: A sample of 249 papers were included after the bibliographic search, in which 19 were finally selected following PRISMA methodology and 3 peer review proceeding presented at international conferences. A total of 22 documents were added to qualitative synthesis. RESULTS: Geographical location, economic level, physical fitness, or experience may vary the profile of the lay-rescuers and how to safely perform a water rescue. Four lay-rescuers profiles were identified: 1) Children rescuing children in low- and middle-income countries (LMICs), 2) Adults rescuing adults or children, 3) Lay-people with some experience and rescue training, 4) Lay-people with cultural or professional motivations. Three types of techniques used by those lay-rescuers profiles: a) non-contact techniques for rescues from land: throw and reach, b) non-contact techniques for rescue using a flotation device and, c) contact techniques for rescue into the water: swim and tow with or without fins. CONCLUSION: The expert recommendation of the safest technique for a lay-rescuer is to attempt rescue using a pole, rope, or flotation equipment without entering the water. However, despite the recommendations of non-contact rescues from land, there is a global tendency to attempt contact rescues in the water, despite a lack of evidence on which technique, procedure or equipment contributes to a safer rescue. Training strategies for lay-people should be considered.

Measuring the physiological impact of extreme heat on lifeguards during cardiopulmonary resuscitation. Randomized simulation study.

OBJECTIVE: Lifeguard teams carry out their work in extremely hot conditions in many parts of the world. The aim of this study was to analyze the impact of high temperatures on physiological parameters during cardiopulmonary resuscitation (CPR). METHOD: A randomized quasi-experimental cross-over design was used to test physiological lifesaving demands (50 min acclimatization +10 min CPR) in two different thermal environments: Thermo-neutral environment (25 °C) vs Hyperthermic environment (37 °C). RESULTS: The data obtained from 21 lifeguards were included, this covers a total of 420 min of resuscitation. The CPR performance was constantly maintained during the 10 min. The Oxygen uptake (VO 2) ranged from 17 to 18 ml/min/kg for chest compressions (CC) and between 13 and 14 ml/min/kg for ventilations (V) at both 25 °C and 37 °C, with no significant difference between environments (p > 0.05). The percentage of maximum heart rate (%HR max) increased between 7% and 8% at 37 °C (p < 0.001), ranging between 75% and 82% of HR max. The loss of body fluids (LBF) was higher in the hyperthermic environment; LBF: (37 °C: 400 ± 187 g vs 25 °C: 148 ± 81 g, p < 0.001). Body temperature was 1 °C higher at the end of the test (p < 0.001). The perceived fatigue (RPE) increased by 37° an average of 2 points on a scale of 10 (p = 0.001). CONCLUSIONS: Extreme heat is not a limiting factor in CPR performance with two lifeguards. Metabolic consumption is sustained, with an increase in CC, so V can serve as active rest. Nevertheless, resuscitation at 37 °C results in a higher HR, is more exhausting and causes significant loss of fluids due to sweating.

Field Methods to Quantify Emergency Responder Fatigue: Lessons Learned from sUAS Deployment at the 2018 Kilauea Volcano Eruption.

OCCUPATIONAL APPLICATIONS There has been increasing use of small unmanned aerial systems in disaster and incident response. We evaluated sUAS pilot states during the tactical response to the 2018 Kilauea Volcano Lower East Rift Zone event, using a 3-minute psychomotor vigilance test (PVT) and wrist worn heart rate sensor. The field data, collected over four days, indicated that the sUAS pilots did not recover to baseline vigilance and physiological levels. Some pilots stopped participating over time, owing to logistical constraints of performing the 3-minute PVT test. Additionally, all pilots refrained from rating their perceived workload levels. We summarize the utility of and challenges associated with collecting performance, physiological, and subjective measures of pilot fatigue during real disaster response.

Excluded but not forgotten: Veterinary emergency care during emergencies and disasters.

BACKGROUND: Disasters or crises impact humans, pets, and service animals alike. Current preparation at the federal, state, and local level focuses on preserving human life. Hospitals, shelters, and other human care facilities generally make few to no provisions for companion care nor service animal care as part of their disaster management plan. Aban-doned animals have infectious disease, safety and psychologic impact on owners, rescue workers, and those involved in reclamation efforts. Animals working as first responder partners may be injured or exposed to biohazards and require care. DATA SOURCES: English language literature available via PubMed as well as lay press publications on emergency care, veterinary care, disaster management, disasters, biohazards, infection, zoonosis, bond-centered care, prepared-ness, bioethics, and public health. No year restrictions were set. CONCLUSIONS: Human clinician skills share important overlaps with veterinary clinician skills; similar overlaps occur in medical and surgical emergency care. These commonalities offer the potential to craft-specific and disaster or crisis-deployable skills to care for humans, pets (dogs and cats), service animals (dogs and miniature horses) and first-responder partners (dogs) as part of national disaster healthcare preparedness. Such a platform could leverage the skills and resources of the existing US trauma system to underpin such a program.

The influence of experiences of involvement in the COVID-19 rescue task on the professional identity among Chinese nurses: A qualitative study.

AIMS: To explore the influence of experiences of involvement in the COVID-19 rescue task on professional identity among Chinese nurses from a qualitative method perspective. BACKGROUND: Professional identity of nurses is not static and easily affected by many factors. The COVID-19 epidemic brings the tremendous physical and psychological challenges for rescue nurses. At present, there are limited data on the influence of rescue experiences on the nurses' professional identity. METHODS: This study used a face-to-face interview with semi-structured questions to learn about the influence of rescue experiences on the professional identity of nurses. Purposeful sampling was used to collect participants (n = 14), and interview data were analysed following the Colaizzi's phenomenological analysis. RESULTS: The 'impression of exhaustion and fear', 'feeling the unfairness', 'perceiving incompetence in rescue task' and 'unexpected professional benefits' were the main factors affecting the professional identity of rescue nurses. CONCLUSION: The present study showed that special attention and targeted support measures should be provided to improve the professional identity of rescue nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should make a post-epidemic recovery plan to help nurses to improve the professional identity. Designed education programmes and complete disaster response system should be developed to deal with infection disease in the future.

[Healthcare for migrants on the high seas. The case of the operation EUNAVFOR MED "Sophia".] / El caso de la operación EUNAVFOR MED "Sophia".

Since 2015, the Spanish Navy participates in the Operation EUNAVFOR MED Sophia, a naval operation of the European Union against the trafficking of human beings in the Mediterranean in which our ships carry out an important humanitarian work in the rescue and assistance of migrants on the sea. The attention and health care of these migrants lies mainly in the military Health Group and it is based on a series of principles and procedures among which the application of a triage adapted to the special conditions of rescue and assistance on the sea and in the diagnosis and treatment of various pathologies present among migrants. In this context, a series of epidemiological data is provided, especially the most frequent pathologies attended by rescued migrants and emphasizing the importance of adopting a series of measures to prevent the transmission of infectious pathologies that are rare or already eradicated in our country.

Desde 2015, la Armada española participa en la operación EUNAVFOR MED Sophia, una operación naval de la Unión Europea contra el tráfico de seres humanos en el Mediterráneo, en la que nuestros buques realizan una importante labor humanitaria en el rescate y asistencia de migrantes en la mar. La atención y asistencia sanitaria de estos migrantes recae principalmente en el Grupo de Sanidad militar, y se basa en una serie de principios y procedimientos entre los que destacan la aplicación de un triaje adaptado a las especiales condiciones del rescate y asistencia en alta mar, así como en el diagnóstico y tratamiento de diversas patologías presentes entre los migrantes. En este sentido, este trabajo proporciona una serie de datos epidemiológicos, incidiendo en las patologías más frecuentes entre los migrantes rescatados, y destacando la importancia de la adopción de una serie de medidas para prevenir la transmisión de patologías infecciosas poco frecuentes o ya erradicadas en nuestro país.

Unattended Hoist Extraction of an Intubated Patient From Mountainous Terrain.

Airway management and maintenance of adequate ventilation during a patient's unattended helicopter rescue hoist extraction present unique challenges to the air medical provider. We present the case of a critically injured patient requiring emergent airway management and subsequent extrication via hoist from challenging, near-vertical terrain, which illustrates the logistical challenges of providing high-quality, neuroprotective mechanical ventilation in an austere air medical scenario.

A Rescue-Assistance Navigation Method by Using the Underground Location of WSN after Disasters.

A challenging rescue task for the underground disaster is to guide survivors in getting away from the dangerous area quickly. To address the issue, an escape guidance path developing method is proposed based on anisotropic underground wireless sensor networks under the condition of sparse anchor nodes. Firstly, a hybrid channel model was constructed to reflect the relationship between distance and receiving signal strength, which incorporates the underground complex communication characteristics, including the analytical ray wave guide model, the Shadowing effect, the tunnel size, and the penetration effect of obstacles. Secondly, a trustable anchor node selection algorithm with node movement detection is proposed, which solves the problem of high-precision node location in anisotropic networks with sparse anchor nodes after the disaster. Consequently, according to the node location and the obstacles, the optimal guidance path is developed by using the modified minimum spanning tree algorithm. Finally, the simulations in the 3D scene are conducted to verify the performance of the proposed method on the localization accuracy, guidance path effectiveness, and scalability.

Critical Separation Versus Effective Sweep Width: Bridging the Old and New Search-and-Rescue Worlds.

INTRODUCTION: "Critical separation" is a simple method for spacing searchers intended to produce a predictable probability of detection (POD). A more precise method, based on effective sweep width (W), has been adopted only slowly. Accurate PODs are critical in planning priorities in future operational periods. Therefore, it would be useful to know what POD a critical separation determination actually produces. METHODS: Detection ranges (Rd) were measured on high- and low-visibility adult mannequins (stuffed Tyvek suits of varying colors) and a red helmet detected by 6 searcher volunteers. Conversion factors previously described in the literature were used to convert Rds into predicted Ws and the previously described logit model to convert Ws into PODs. RESULTS: The Rds were 26±6 m (mean±SD) for the high-visibility mannequin, 15±5 m for the low-visibility mannequin, and 24±6 m for the helmet used in the critical separation determination. The predicted Ws were 47±15 m, 16±8 m, and 42±14 m, respectively. Critical separation would therefore result in predicted PODs of 67±17% or 32±16% for nonresponsive adults in high- versus low-visibility clothing. CONCLUSIONS: Critical separation is a simple, quick way to array searchers in the field. The current study suggests that the value of critical separation in producing the 50% target POD will depend on the whether the search object used for the critical separation determination has a similar detectability/W to the actual target of the search effort. Still, the results from a critical separation determination may offer more predictability and reliability than the common practice of POD estimation by team leaders.

Is it feasible "scoop and run while playing" resuscitation on a rescue water craft? A randomized simulation study with lifeguards.

OBJECTIVE: Response time is a predictive factor for survival of drowning victims and lifesaving. Rescue Water Craft (RWC) are lifeboats very common in lifeguards operations. The aim of this study was to analyze the feasibility of providing effective mouth-to-mouth ventilations and/or cardiopulmonary resuscitation (CPR) on the RWC while sailing at different speeds. METHOD: A quasi-experimental cross-over block design was used to test during one minute efforts the effectiveness of Mouth to Mouth ventilation (MM-only) and CRP, at the beach and sailing at two diferents speeds 5 knots(kn) and 10 kn with calm sea. Quality CPR reference were 2015 ERC guidelines. RESULTS: The data obtained from 13 lifeguards were included, that means that 78 resuscitation test were completed. The MM-only performance skills reached 69.7% ± 40.4 for 5 kn and 60.0% ± 41.8 for 10 kn (p = .59). For full CPR, performance was 74.4% ± 24.2 and 68.5% ± 23.9 respectively. Quality of MM and CPR decreased, not significantly, while sailing at 5 kn and 10 kn [(Q-MM; 5 kn: 59.9% ± 37.8 vs. 10 kn: 43.2% ± 41.4, p = .42)(Q-CPR; 5 kn: 64.8% ± 21.2 and 10 kn: 60.6% ± 21.0, p = .44)]. MM-only and CC variables were significantly worse on RJS when compared with resuscitation at the beach (p < .05). A trend for better results by lifeguards previously training on RJS was observed. CONCLUSIONS: Resuscitation techniques on board of a RWC are feasible and therefore they could be an option for lifeguards when their training, sea conditions, distance and the victim's characteristics allow it. CPR maneuvers may be highly effective at 10 kn, both for MM-only and CPR, however, the quality of the ventilations dramatically worsen with increasing speed.

Impact of Crisis Intervention on the Mental Health Status of Emergency Responders Following the Berlin Terrorist Attack in 2016.

OBJECTIVE: The most common crisis intervention used with German rescue workers is Critical Incident Stress Management (CISM). Results regarding its effectiveness are inconsistent. A negative reinforcement of avoidance, due to premature termination of strong emotions during the Critical Incident Stress Debriefing (CISD), may explain this. The effectiveness of the CISD after terror attacks in Germany has not yet been investigated. METHODS: All emergency responders deployed at the terror attack on Breitscheidplatz in Berlin were invited to take part in the study; 37 of the N = 55 participants had voluntarily participated in CISD; 18 had not. RESULTS: Participants with CISD showed lower quality of life in psychological health and higher depressive symptomatology. Of these, females had lower quality of life in social relationships, whereas males showed more posttraumatic stress symptoms. Emergency responders from non-governmental organizations had higher phobic anxiety. Emergency medical technicians showed more somatic and depressive symptoms. CONCLUSION: There is no conclusive explanation for why rescue workers with CISD score worse on certain measures. It is possible that CISD has a harmful influence due to negative reinforcement, or that there was a selection effect. Further research differentiating occupational group, sex, and type of event is necessary.

What do we know about best police practices for lost persons with dementia? A scoping review.

Aim: To examine the efficacy of strategies used by the police for missing persons with dementia. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, we searched peer-reviewed and gray literature of existing police practices used for missing persons with dementia. Data from the studies were analyzed descriptively. Results: The literature described 16 articles and 18 websites. Strategies ranged from identification tools, successful field techniques, locating technologies and community engagement/education. Overall scientific evidence was low, with only three studies evaluating the usability and effectiveness of the suggested strategies. Conclusion: More rigorous research is required to demonstrate the efficacy of best police practices for missing persons with dementia, which in turn could assist in the development of a best practice guideline.

An Innovative Technique for Identification of Missing Persons in Natural Disaster Based on Drone-Femtocell Systems.

The recent development of the IoT (Internet of Things), which has enabled new types of sensors that can be easily interconnected to the Internet, will also have a significant impact in the near future on the management of natural disasters (mainly earthquakes and floods) with the aim of improving effectiveness in research, identification, and recovery of missing persons, and therefore increasing the possibility of saving lives. In this paper, more specifically, an innovative technique is proposed for the search and identification of missing persons in natural disaster scenarios by employing a drone-femtocell system and devising an algorithm capable of locating any mobile terminal in a given monitoring area. In particular, through a series of power measurements based on the reference signal received power (RSRP), the algorithm allows for the classification of the terminal inside or outside the monitoring area and subsequently identify the position with an accuracy of about 1 m, even in the presence of obstacles that act in such a way as to make the propagation of the radio signal non-isotropic.