Introduction: Hurricane Florence made landfall in North Carolina as a Category 1 hurricane on September 14, 2018 causing catastrophic flooding throughout much of eastern North Carolina. Large numbers of evacuees were housed in evacuation shelters established by state emergency management and county governments. The purpose of this study was to evaluate the implementation of a telemedicine service in evacuation shelters to determine whether the presence of telemedicine could alter EMS and ED utilization. Methods: We conducted a cross-sectional study that described the EMS and Emergency Department utilization of patients housed in disaster shelters during a 12 day period following Hurricane Florence. Subjects were those shelter residents in Wake or Orange counties utilizing emergency services. Data were collected from Wake County EMS, Orange County EMS, and RelyMD, the telemedicine service utilized in the shelters. Data included subject demographics, chief complaint, case disposition, telemedicine processing times, and an after-call survey to assess satisfaction and emergency department avoidance rates. De-identified data were compiled into Excel spread sheets. Results: There were a total of 194 combined telemedicine and EMS patient encounters, including 63 EMS transports, 25 refusals, 13 referrals (Wake County EMS), and 93 telemedicine patient encounters. Of the telemedicine encounters, 64 evaluations took place in Wake County shelters and 29 evaluations in the Orange County shelter. Average patient age was 49 years old; 67% were female. Forty three patients (46%) utilized the telemedicine service for obtaining medication refills, of whom 19 (44%) indicated they would have otherwise utilized an ED to refill their medication. Forty patients (43%) indicated they would have otherwise gone to an ED for care had the service not been provided, with the needs of 33 (83%) of these patients successfully managed without evaluation in an ED. Only 9 (9.7%) patients were referred by the telemedicine service to an ED for an evaluation, with 3 (3.2%) being admitted. Conclusion: Our descriptive findings suggest telemedicine can be effectively utilized in a general population evacuation shelter to reduce EMS and ED utilization and address the medical needs of the population. Further studies should be performed to assess applicability to other disaster settings.
This Hurricane Uses A Novel Technique
The GPS signal frequency is nearly optimal for soil moisture sensing, providing deeper penetration into the soil compared with commonly used remote sensing microwave bands. Assimilation of soil moisture observations are now being considered by the Office of Hydrologic Development as one way to improve streamflow forecasts for flooding in the short term, and for water supply and agricultural irrigation in the long term. Because of the sparsity of airborne soil moisture forecasts, the development of this technique will greatly improve the availability of observations.
The GPS-based ocean reflection experiments performed to date from airplanes and fixed sites have demonstrated precision and spatial resolution suitable for altimetric applications that require higher spatial resolutions and more frequent repeat times than are feasible with the current generation of radar altimeter satellites. Such applications include measurements of the storm surge height during a hurricane season, monitoring of the mesoscale eddies, and, possibly, tsunami wave propagation and dynamics. However, more work is needed to fully characterize the measurement error, particularly to quantify the impact of the wind waves and tropospheric delays on the ultimate attainable accuracy. To prove the feasibility of measuring storm surge heights we proposed testing the novel technique during the hurricane season of 2006 using a NOAA P-3 aircraft to measure a storm surge in the coastal area (Fig. 6).
In additive manufacturing (AM), three-dimen sional objects are built layer by layer by joining each layer to the previous one. Those layers can be formed from the direct deposition of metallic drops resulting from the breakage of a micrometer jet. The jet is produced by ejecting through a nozzle/orifice a metal melted in a crucible. In this paper, we propose a novel technique to produce a continuous droplet stream of a low-melting-point alloy for additive manufacturing. Our technique does not make use of a crucible. Instead, the tip of a metal wire is melted by an induction heating system as it is introduced in the nozzle. If the values of the control parameters are chosen appropriately, a quasi-steady jetting regime is established. This method is much more energetically efficient than its counterparts because it consumes just the energy necessary to melt the demanded material at any times.
The 3D approach enables viewers to see patterns in global data and across a long period of time that may be obscured when displayed on 2D map. While this particular use case involves hurricanes, using 3D visualizations can work for summarizing many large datasets and continuous or live feed data as well. This blog will explain why we chose to display the hurricane data in a three-dimensional format and offer some introductory steps to telling your own story with this type of data.
This is exactly the sort of weather event Z. George Xue of the Department of Oceanography and Coastal Sciences, or DOCS, believes his novel coupled computer modeling approach can more accurately predict, and thereby assist communities with disaster planning. Xue said as far as he knows, his lab is the only one using this technique.
The coastal flooding that occurred during Hurricane Florence is what is known as a compound flooding event, where two or more sources of flooding--in this case, rivers deluged with rainwater and the rising storm surge of the hurricane--converge.
There are many literary techniques, but for this lesson, we will examine literary techniques relevant to style, plot, and narrative perspective, or point of view. Common techniques relevant to style, or the language chosen to tell a story, include metaphors, similes, personification, imagery, hyperbole, and alliteration.
Alliteration is seen when the writer uses the same letters together in a sentence. Here is a classic example: 'Peter Piper picked a peck of pickled peppers.' Some writers use alliteration to help readers remember phrases or concepts, while some writers simply use this technique because it is 'catchy' and appealing to readers.
Let's review. In this lesson, we defined narrative techniques used in writing and identified several types and examples for each category. Also known as literary devices, narrative techniques provide deeper meaning for the reader and help the reader to use imagination to visualize situations.
Although rarer, some East Pacific names have been retired from the list. The climatology of this basin has most hurricanes moving away from the shore, so chances are rare that these storms would adversely affect people necessitating the name be retired.
Internally a number of parallel SLOSH runs with same intensity, forward speed, storm trajectory, and initial tide level are performed for the basin. The only difference in runs is that each is conducted at some distance to the left or to the right of the main track (typically at the center of the grid). Each component run computes a storm surge value for each grid cell. For example, five parallel runs may yield storm surge values of 4.1, 7.1, 5.3, 6.3, and 3.8 feet. In this case, the MEOW for the cell is 7.1 ft. It is unknown (to the user) which track generated the MEOW for a particular cell, so it is entirely possible that the MEOW values for adjacent cells may have come from different runs. MEOWs are used to incorporate the uncertainties associated with a given forecast and help eliminate the possibility that a critical storm track will be missed in which extreme storm surge values are generated. MEOWs provide a worst case scenario for a particular category, forward speed, storm trajectory, and initial tide level incorporating uncertainty in forecast landfall location. The results are typically generated from several thousand SLOSH runs for each basin. Over 80 MEOWs have been generated for some basins. This product provides useful information aiding in hurricane evacuation planning.
Hurricane forecasters estimate tropical cyclone strength from satellite using a method called the Dvorak technique. Vern Dvorak developed the scheme in the early 1970s using a pattern recognition decision tree (Dvorak 1975, 1984). Utilizing the current satellite picture of a tropical cyclone, one matches the image versus a number of possible pattern types: Curved band Pattern, Shear Pattern, Eye Pattern, Central Dense Overcast (CDO) Pattern, Embedded Center Pattern or Central Cold Cover Pattern. If infrared satellite imagery is available for Eye Patterns (generally the pattern seen for hurricanes, severe tropical cyclones and typhoons), then the scheme utilizes the difference between the temperature of the warm eye and the surrounding cold cloud tops. The larger the difference, the more intense the tropical cyclone is estimated to be.
The errors for using the above Dvorak technique in comparison to aircraft measurements taken in the Northwest Pacific average 10 mb with a standard deviation of 9 mb (Martin and Gray 1993). Atlantic tropical cyclone estimates likely have similar errors. Thus an Atlantic hurricane that is given a CI number of 4.5 (winds of 77 kt and pressure of 979 mb) could in reality be anywhere from winds of 60 to 90 kt and pressures of 989 to 969 mb. These would be typical ranges to be expected; errors could be worse. However, in the absence of other observations, the Dvorak technique does at least provide a consistent estimate of what the true intensity is.
Lastly, while the Dvorak technique is primarily designed to provide estimates of the current intensity of the storm, a 24 h forecast of the intensity can be obtained also by extrapolating the trend of the CI number. Whether this methodology provides skillful forecasts is unknown. 2ff7e9595c
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