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Introduction In Germany, improvement of quality of care is associated with improvement of health and longevity but threatened in several dimensions by economic and demographic trends. In offshore wind parks, these threats are particularly tangible with an already large gap of emergency medical care. Telemedicine may be an approach to a solution. In Landgraf et al. [1] we reported on the effect of telemedical support on the first subprocess of emergency first response. Methods In simulated, identical wind power plants, teams of two medical non-professionals (offshore maintenance engineers) and teams of two medical professionals (paramedics) faced a simulated polytraumatized patient in a simulated offshore emergency scenario. The teams were random- ized into independent groups (intervention versus no intervention). Teams in the intervention groups were telemedically supported by transmission technology with connection to a remote physician. All teams were to conduct a primary survey of the patient. Using videorecordings, reviewers scored their itemized performance and required time. These scores and times were explored for effects of expertise and telemedical support, culminating in a non-inferiority trial of supported medical non-professionals against unsupported medical professionals. Results 36 offshore engineers in teams of two staffed 18, 34 paramedics in teams of two staffed 17 simulated, identical wind power plants. After randomization, nine teams of two engineers as well as nine teams of two paramedics were telemedically supported, leaving nine teams of two engineers as well as eight teams of two paramedics unsupported. Supported engineers’ performance was better than that by unsupported engineers (p < .01) and non-inferior (at one item margin) to that by unsupported paramedics (p = .03). The difference between supported and unsupported paramedics was not significant (p = .11). “Without support, paramedics outperformed engineers (p < .01). Supported groups were slower than unsupported groups (p < .01)” [1]. Conclusion “First response to medical emergencies in offshore wind farms with substantially delayed professional care may be improved by telemedical support. Future work should test our result during additional scenarios and explore interdisciplinary” [1] as well as systemic aspects., In Deutschland wird eine Verbesserung der medizinischen Versorgungsqualität mit einer Verbesserung von Gesundheit und Langlebigkeit assoziiert. Sie wird allerdings durch ökonomische und demographische Entwicklungen gefährdet. In Offshore-Windparks sind diese Gefahren besonders greifbar, da bereits eine groSSe Lücke in der medizinischen Notfallversorgung besteht. Telemedizin könnte einen Lösungsansatz darstellen. In Landgraf et al. [1] haben wir über die Auswirkung telemedizinischer Unterstützung auf den ersten Teilprozess der Erstreaktion im Notfall berichtet. Methoden In simulierten, identischen Windkraftanlagen wurden Teams von zwei medizinischen Laien (Offshore-Wartungsingenieure) und Teams von zwei medizinischen Fachleuten (Rettungsassistenten) in einem simulierten Offshore-Notfallszenario mit einem simulierten, polytraumatisierten Patienten konfrontiert. Die Teams wurden nach dem Zufallsprinzip in unabhängige Gruppen eingeteilt (Intervention versus keine Intervention). Die Teams in den Interventionsgruppen wurden telemedizinisch durch Übertragungstechnik mit Verbindung zu einem entfernten Arzt unterstützt. Alle Teams sollten eine Primärbefragung des Patienten durchführen. Mithilfe von Videoaufzeichnungen bewerteten Rezensenten ihre in Einheiten aufgegliederte Leistung sowie benötigte Zeit. Diese Leistungswerte und Zeiten wurden auf Auswirkungen von Fachwissen und telemedizinischer Unterstützung untersucht. Kern der Untersuchung war eine Nichtunterlegenheitsprüfung von unterstützten medizinischen Laien gegenüber nicht unterstützten medizinischen Fachkräften. Ergebnisse 36 Offshore-Ingenieure in Zweierteams besetzten 18, 34 Rettungsassistenten in Zweierteams besetzten 17 simulierte, identische Windkraftanlagen. Nach Randomisierung wurden neun Ingenieurteams sowie neun Rettungsassistententeams telemedizinisch unterstützt, sodass neun Ingenieurteams sowie acht Rettungsassistententeams nicht unterstützt wurden. Die Leistung der unterstützten Ingenieure war besser als die der nicht unterstützten Ingenieure (p < 0.01) und derjenigen von nicht unterstützten Rettungsassistenten (bei einer Unterlegenheitsschwelle von einem Leistungspunkt) nicht unterlegen (p = 0.03). Der Unterschied zwischen unterstützten und nicht unterstützten Rettungsassistenten war nicht signifikant (p = 0.11). Ohne Unterstützung haben Rettungsassistenten Ingenieure übertroffen (p < 0.01). Unterstützte Gruppen waren langsamer als nicht unterstützte Gruppen (p < 0.01) [1]. Fazit Die erste Reaktion auf medizinische Notfälle in Offshore-Windparks mit erheblich verzögerter professioneller Hilfe kann durch telemedizinische Unterstützung verbessert werden. Zukünftige Arbeiten sollten unser Ergebnis in zusätzlichen Szenarien testen und interdisziplinäre sowie systemische Aspekte untersuchen [1].

OBJECTIVE: To investigate, in a simulator-based prospective study, whether telemedical support improves quality of emergency first response (performance) by medical non-professionals to being non-inferior to medical professionals. SETTING: In a simulated offshore wind power plant, duos (teams) of offshore engineers and teams of paramedics conducted the primary survey of a simulated patient. PARTICIPANTS: 38 offshore engineers and 34 paramedics were recruited by the general email invitation. INTERVENTION: Teams (randomised by lot) were supported by transmission technology and a remote emergency physician in Berlin. OUTCOME MEASURES: From video recordings, performance (17 item checklist) and required time (up to 15 min) were quantified by expert rating for analysis. Differences were analysed using two-sided exact Mann-Whitney U tests for independent measures, non-inferiority was analysed using Schuirmann one-sided test. The significance level of 5 % was Holm-Bonferroni adjusted in each family of pairwise comparisons. RESULTS: Nine teams of engineers with, nine without, nine teams of paramedics with and eight without support completed the task. Two experts quantified endpoints, insights into rater dependence were gained. Supported engineers outperformed unsupported engineers (p

Reprinted from Journal of Loss Prevention in the Process Industries, vol. 25 /4, Jan-Erik Vinnem, On the analysis of hydrocarbon leaks in the Norwegian offshore industry, Pages No. 709-717, Copyright (2012), with permission from Elsevier. There have been several major offshore accidents in different offshore regions since 2005. In Norway there have been several very serious near-misses during the last ten years, several of which involving serious hydrocarbon leaks with catastrophic fire and explosion potential. All these severe occurrences demonstrate the importance of learning from major accident precursors in order to appraise the risk potential involved in critical offshore operations. This paper is based on analysis of about 175 hydrocarbon leaks in the period 2001–2010. Regulatory requirements in Norway are aimed at preventing as far as possible such occurrences during night time, but the analysis shows that this has been far from successful. The industry has for many years claimed that the maintenance personnel are the main group of employees involved in causing these leaks. This study has shown that leaks during the execution of maintenance and modification are less than half of the leaks, and that failures during the preparation for carrying out maintenance tasks are more frequent. Such preparations have often been conducted during night shift. The analysis gives a strong incentive to change this practice.

This paper examines the following aspects of offshore safety in oil and gas production systems before and after the Piper Alpha Disaster: · Regulation/legislation; · Research/risk modelling; · General safety trends. It shows that the change from prescriptive regulation to self-regulation has produced better designs and that the research and risk modelling before and after Piper Alpha cover the same fields but are now more focused. There is clear evidence of a desire to minimize human exposure to risk through automatic systems and devise the safest design option as early as possible, for more detailed development. The evidence points to steady reduction of fatalities and injury rates over at least 15 years, but the highest individual risk is still transport to and from the installation.