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Introduction: To improve the quality of criteria for trauma-team-activation it is necessary to identify patients who benefited from the treatment by a trauma team. Therefore, we evaluated a post hoc criteria catalogue for trauma-team-activation which was developed in a consensus process by an expert group and published recently. The objective was to examine whether the catalogue can identify patients that died after admission to the hospital and therefore can benefit from a specialized trauma team mostly. Materials and methods: The catalogue was applied to the data of 75,613 patients from the TraumaRegister DGU® between the 01/2007 and 12/2016 with a maximum abbreviated injury score (AIS) severity ≥ 2. The endpoint was hospital mortality, which was defined as death before discharge from acute care. Results: The TraumaRegister DGU® dataset contains 18 of the 20 proposed criteria within the catalogue which identified 99.6% of the patients who were admitted to the trauma room following an accident and who died during their hospital stay. Moreover, our analysis showed that at least one criterion was fulfilled in 59,785 cases (79.1%). The average ISS in this group was 21.2 points (SD 9.9). None of the examined criteria applied to 15,828 cases (average ISS 8.6; SD 5). The number of consensus-based criteria correlated with the severity of injury and mortality. Of all deceased patients (8,451), only 31 (0.37%) could not be identified on the basis of the 18 examined criteria. Where only one criterion was fulfilled, mortality was 1.7%; with 2 or more criteria, mortality was at least 4.6%. Discussion: The consensus-based criteria identified nearly all patients who died as a result of their injuries. If only one criterion was fulfilled, mortality was relatively low. However, it increased to almost 5% if two criteria were fulfilled. Further studies are necessary to analyse and examine the relative weighting of the various criteria. Our instrument is capable to identify severely

Mass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.

Mass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.

The location of the peak pressure can serve as a control parameter to adjust ignition timing and optimize engine performance. The ionization sensor, an electrical probe for combustion diagnostics, can provide information about the peak pressure location. However, the reliability of such information is rather poor. In-cylinder gas flow at the electrodes may be one reason for this. We present results from an investigation of the relationship between ionization sensor current and pressure under various gas flow conditions. The gas flow velocity in the vicinity of the electrode gap was measured by LDA. From the results one may infer how the in-cylinder gas flow affects the reliability of the prediction of pressure peak location from the ionization sensor signal. One finding is that high bulk gas flow impairs the precision of the prediction in certain configurations.

NQC 2015

NR 20151123

Basic optical properties have been investigated in order to characterize the HCCI-combustion process. Basic optical properties of a Homogeneous Charge Compression Ignition (HCCI) engine have been investigated in order to characterize the combustion process. The absorption of light propagating through the combustion chamber has been spectrally resolved for four different fuels. Significant differences between the fuels could be detected. Complementary information could be obtained by recording spontaneous emission of radiation during combustion. Raman point measurements were used to quantify cycle-to-cycle variations of the equivalence ratio. The homogeneity of the charge was monitored by the use of two-dimensional tracer LIF. That method was also utilized to investigate the flame development. The experiments were performed in a six-cylinder, truck-sized engine with one cylinder modified to allow for optical access. The results obtained are believed to be valuable in future applications of optical diagnostics in similar environments., QC 20151124

An experimental study of the Homogeneous Charge Compression Ignition (HCCI) combustion process has been conducted by using chemiluminescence imaging. The major intent was to characterize the flame structure and its transient behavior. To achieve this, time resolved images of the naturally emitted light were taken. Emitted light was studied by recording its spectral content and applying different filters to isolate species like OH and CH. Imaging was enabled by a truck-sized engine modified for optical access. An intensified digital camera was used for the imaging. Some imaging was done using a streak-camera, capable of taking eight arbitrarily spaced pictures during a single cycle, thus visualizing the progress of the combustion process. All imaging was done with similar operating conditions and a mixture of n-heptane and iso-octane was used as fuel. Some 20 crank angles before Top Dead Center (TDC), cool flames were found to exist. They appear with a faint structure, evenly distributed throughout the combustion chamber. There was no luminosity recorded between the end of cool flames and the start of the main heat release. Around TDC the main heat release starts. Looking at a macro scale, we find that the charge starts to burn simultaneously at arbitrary points throughout the charge. Since the thermal boundary layer is colder than the bulk of the charge, the local heat release is delayed close to the walls. As a result, the total heat release is slowed down. Ensemble averaged 1 images show this wall boundary effect clearly when plotted against CAD. The peak intensity at the main combustion event is one order of magnitude greater than that of the cool flame and the structure is a lot more protruding. Since spontaneous emission imaging is a line-of-sight integration, the flame structure appears a bit smeared. The micro scale structure is very similar from one cycle to another, but there are large variations between cycles on the macro scale., QC 20151123