Academic Journal
Patient Movement, En-Route Care, and Decontamination in Arctic Conditions: Engineering the System for Safe Control and Coordination.
| Τίτλος: | Patient Movement, En-Route Care, and Decontamination in Arctic Conditions: Engineering the System for Safe Control and Coordination. |
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| Συγγραφείς: | Bleakney EH; Air Force Institute of Technology, Wright-Patterson AFB, OH 45433, United States., Schraeder BE; Air Force Institute of Technology, Wright-Patterson AFB, OH 45433, United States., Johnson KE; Air Force Institute of Technology, Wright-Patterson AFB, OH 45433, United States. |
| Πηγή: | Military medicine [Mil Med] 2026 Aug 01; Vol. 191 (Supplement_1), pp. 511-519. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: England NLM ID: 2984771R Publication Model: Print Cited Medium: Internet ISSN: 1930-613X (Electronic) Linking ISSN: 00264075 NLM ISO Abbreviation: Mil Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2018- : Oxford : Oxford University Press Original Publication: Washington, D.C. : Association of Military Surgeons, United States, 1955- |
| Ιατρικοί όροι (MeSH): | Decontamination*/methods , Decontamination*/standards , Moving and Lifting Patients*/methods , Moving and Lifting Patients*/standards, Arctic Regions ; Humans |
| Περίληψη: | Introduction: Increasing interest in the Arctic demands that the Department of War be prepared for Cold Region Expeditionary Medical Operations (CREMO). Central to CREMO is the En-Route Care and Patient Movement (ERC/PM) system providing life-saving interventions. In addition, the Arctic is not immune to Chemical, Biological, Radiological, and Nuclear (CBRN) threats. Current doctrine, however, has limited integration of ERC/PM and decontamination systems. This study is the first to apply a novel hazard analysis, System-Theoretic Process Analysis extended for Coordination (STPA-Coordination) to engineer safe ERC/PM and decontamination systems, mitigating and removing identified risks. Materials and Methods: The study used STPA-Coordination to model and analyze the ERC/PM system in CREMO and CBRN conditions. According to Leveson and Thomas (2018), STPA is a 4-step process. Step 1 identifies stakeholder losses and system-level hazards. Step 2 graphically models the system showing control, feedback, and coordination relationships. Step 3 uncovers hazardous control actions. Finally, Step 4 finds loss scenarios for why the hazardous controls or unsafe behaviors occurred. As Johnson (2017) describes, STPA-Coordination provides additional guidance to develop Step 2 and find coordination-related loss scenarios in Step 4. Results: The paper highlights STPA-Coordination results from analysis of 16 unsafe control actions and 53 loss scenarios, which delivered 49 unique safety recommendations. The Top 5 recommendations are in the paper. The research also created a Triage Decision Matrix to assist in prioritizing the 49 recommendations, which allocated the recommendations based on Triage category and trauma event size. An inherent limitation in this study is the ability to refute the results. To mitigate, the authors incorporated feedback from medical and decontamination experts, which provided a form of results validation. Conclusions: In addition to the safety recommendations, the study provides a system-theoretic framework to engineer safe control and coordination into similar Military Health systems. (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2026.) |
| Grant Information: | Air Force Research Lab Human Effectiveness Directorate; RHM-24F17 711th Human Performance Wing, Wright-Patterson AFB |
| Entry Date(s): | Date Created: 20260806 Date Completed: 20260806 Latest Revision: 20260806 |
| Update Code: | 20260806 |
| DOI: | 10.1093/milmed/usag148 |
| PMID: | 42560251 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1930-613X |
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| DOI: | 10.1093/milmed/usag148 |