BACKGROUND: At the time of the COVID-19 pandemic, devastating incidents increased due to frequent oxygen administration to patients. The dangers associated with the use of oxygen, especially through local enrichments and formation of \"oxygen clouds\", have been well understood for years. Nevertheless, dramatic incidents continue to occur, since fire hazard increases exponentially with oxygen concentrations above 23%. Rescue helicopters are at a particular high risk, because of technical reasons such as oxygen use in a very small space, surrounded by kerosene lines, electronic relays and extremely hot surfaces.
METHODS: In this study three different sized rescue helicopter models (Airbus H135, H145 and MD902) were examined. Oxygen enrichment in the cabin was measured with an oxymeter during a delivery rate of 15 l/min constant flow for 60 min. Furthermore, the clearance of the enriched atmosphere was tested in different situations and with different ventilation methods. To make the airflow visible, a fog machine was used to fill the helicopter cabin.
RESULTS: Oxygen accumulation above 21% was detected in every helicopter. After 10-15 min, the critical 23% threshold was exceeded in all three aircrafts. The highest concentration was detected in the smallest machine (MD902) after 60 min with 27.4%. Moreover, oxygen clouds persisted in the rear and the bottom of the aircrafts, even when the front doors were opened. This was most pronounced in the largest aircraft, the H145 from Airbus Helicopters. Complete and rapid removal of elevated oxygen concentrations was achieved only by cross-ventilation within 1 min.
CONCLUSIONS: Oxygen should be handled with particular care in rescue helicopters. Adapted checklists and precautions can help to prevent oxygen accumulation, and thus, fatal incidents. To our knowledge, this is the first study, which analyzed oxygen concentrations in different settings in rescue helicopters.

Severe burns related to fires and explosions of lithium-ion batteries of electric motorcycles have not been reported to date. We retrospectively studied 419 patients admitted to our burn intensive care unit from January 2016 to December 2021. Of these 419 patients, 26 (22 male, 4 female; median age, 42 years) had burns related to lithium-ion battery fires and explosions, and all of their injury characteristics were similar to those of traditional flame burns. Lithium-ion battery-related burns were the eighth most common cause of burn injuries among all hospitalized patients. The 26 patients comprised 10 unemployed and 16 employed individuals. Twenty-three patients were injured at home during the battery charging process, and three were injured outdoors (one by a fire while the electric motorcycle was stationary and the others two by a fire while riding the motorcycle). The burn sites were distributed over the whole body; the burn area ranged from 10 % to 100 % of the total body surface area, and the burn depth ranged from superficial second-degree burns to third-degree burns. Twenty-three patients had inhalation injuries, and ten underwent prophylactic tracheostomy and intubation. Multiple operations were required for wound repair. Although convenient, lithium-ion electric motorcycles can also cause severe burns. To prevent these injuries, we must increase public safety awareness and education, develop new battery energy storage systems and battery management systems, and ensure the safety of batteries. Consumers should be aware of the potential dangers of lithium-ion batteries and comply with related security measures.

Forensic archaeology and anthropology have developed significantly over past decades and now provide considerable assistance to the investigation process of disaster victim recovery and identification. In what are often chaotic death and crime scenes, the formal process of utilizing archaeological methods can bring control, order, and ensure systematic search. Procedures assist in defining scene extent, locating victims and evidence, rule out areas for consideration, and provide standardized recording and quality assurance through dedicated use of standardized forms (pro formas). Combined archaeological and anthropological search methods maximize opportunities to recovery the missing through identifying remains, mapping distributions, and providing accounting of victims at the scene. Anthropological assistance in examinations contributes to individual assessment, resolving commingling and fragmentation issues, and utilizing DNA sampling methods and matching data to reassociate and account for the missing. Utilization of archaeology, anthropology, and DNA matching data provides scope to review crime scene recovery and determine requirements and potential for further survey and retrieval. Adopting the most suitable methods for a particular context can maximize recovery, efficiency, and resource use. Case studies demonstrate the utility of archaeological methods in a range of scenarios. They exemplify the success of multidisciplinary analysis in providing evidence of the sequence of events, the timing of events, the impact of taphonomic processes, the location and accounting of victims, and the demonstration of systematic scene search. The considerations provided in this article, utilizing archaeology and anthropology processes, may assist investigators in planning and implementing responses to mass fatalities.

Incidents involving chemical storage tanks in the petrochemical industry are significant events with severe consequences. Within the petrochemical industry, EDC is a sector that produces ethylene dichloride through the reaction of chlorine and ethylene. The present research was conducted to evaluate the consequences of chlorine gas released from the EDC reactor in a petrochemical industry in southern Iran. Data regarding reactor specifications were obtained from the factory\'s technical office, while climatic data was acquired from the Meteorological Organization. The consequences of chlorine gas release from the reactor were assessed in four predefined scenarios using numerical calculation methods and modeling with the ALOHA software. The numerical calculation method involved thermodynamic fluid path analysis, discharge coefficient calculations, and wind speed impact analysis. The hazard radius was determined based on the ERPG1-2-3 index. Results showed that in the scenario of chlorine gas release from EDC reactors, according to the ALOHA model, an increase in wind speed from 3 to 7 m/h led to an expanded dispersion radius. At a radius of 700 m from the reactor, the maximum outdoor concentration reached 3.12 ppm, decreasing to 2.27 ppm at 800 m and further to 1.53 ppm at 1000 m. The comparison of numerical calculations and modeling using the ALOHA software indicates the desirable conformity of the results with each other. The R2 coefficient for evaluating the conformity of the results was 0.9964, indicating the desired efficiency of the model in evaluating the consequences of the release of toxic gasses from the EDC tank. The results of this research can be useful in designing the site and emergency response plan.

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The explosion of headphones is a rare incident, not reported in the literature, and is responsible for serious burns involving functional and aesthetic consequences with a major psychological impact. We report here the case of a young boy in order to raise awareness in the population and draw attention to these risks.

The incidence of explosions in large agglomerations is high even during peacetime and continues rising. Blast syndrome injuries are complex, with shock wave causing severe injuries of multiple organ systems. In situations with large numbers of injured persons, effective triage allows an early diagnosis and treatment of the highest number of victims. Treatment is challenging, and potentially conflicting therapeutic goals may alternate. This review provides an overview of the pathophysiology of blast injuries, current diagnostic algorithms and therapeutic procedures.

OBJECTIVE: Determine the prevalence of otological symptoms and tympanic membrane perforation, healing rates of tympanic membrane perforation with surgical and conservative management, and hearing function in civilian victims of terrorist explosions.
METHODS: A systematic review was conducted with searches on Medline, Embase, EMCare and CINAHL for publications between the 1st January 1945 and 26th May 2023. Studies with quantitative data addressing our aims were included. This review is registered with PROSPERO: CRD42020166768. Among 2611 studies screened, 18 studies comprising prospective and retrospective cohort studies were included.
RESULTS: The percentage of eardrums perforated in patients admitted to hospital, under ENT follow up and attending the emergency department is 69.0% (CI 55.5-80.5%), 38.7% (CI 19.0-63.0%, I2 0.715%) and 21.0% (CI 11.9-34.3%, I2 0.718%) respectively. Perforated eardrums heal spontaneously in 62.9% (CI 50.4-73.8%, I2 0.687%) of cases and in 88.8% (CI 75.9-96.3%, I2 0.500%) of cases after surgery. Common symptoms present within one month of bombings are tinnitus 84.7% (CI 70.0-92.9%, I2 0.506%), hearing loss 83.0% (CI 64.5-92.9%, I2 0.505%) and ear fullness 59.7% (CI 13.4-93.4%, I2 0.719). Symptomatic status between one and six months commonly include no symptoms 57.5% (CI 46.0-68.3%), hearing loss 35.4% (CI 21.8-51.8%, I2 0.673%) and tinnitus 15.6% (CI 4.9-40.0%, I2 0.500%). Within one month of bombings, the most common hearing abnormality is sensorineural hearing loss affecting 26.9% (CI 16.9-40.1%, I2 0.689%) of ears 43.5% (CI 33.4-54.2%, I2 0.500) of people.
CONCLUSIONS: Tympanic membrane perforation, subjective hearing loss, tinnitus, ear fullness and sensorineural hearing loss are common sequelae of civilian terrorist explosions.

The structure of underground coal mines is vulnerable to many mishaps because of the challenging conditions of production and the unique features of the earth. These incidents could cause significant financial and production losses for the mines in addition to worker injury, disability, or death. In coal mines, methane explosions are a frequent threat. Establishing a safe work environment requires managing these problems with an accident control method. The current study used the fuzzy TOPSIS and fuzzy AHP techniques for this aim. The framework was used to tackle the four-alternative problem of underground coal mine explosion control method selection. To identify potential risks of a methane explosion, a data gathering survey was conducted as part of the suggested hybrid methodology. The fuzzy AHP was used to compute the fuzzy weights of the hazards. \"Improper ventilation system\" is ranked highest out of the 34 sub-risk factors. The fuzzy TOPSIS was then utilized to rank the explosion control methods using the weights. To assess the viability of the study\'s conclusions, a sensitivity analysis was carried out. The findings indicate that \"improving safety technology\" and \"financial investments\" are the best ways to reduce such events. The results additionally indicate that the fuzzy TOPSIS approach in combination with the fuzzy AHP provides a helpful framework for dynamically assessing mine methane explosion accidents.

Air balloons are a ubiquitous presence in our daily lives, and their rupture may release a substantial quantity of debris, as investigated herein. We employ Raman imaging to capture the fragments resulting from balloon explosions, enabling the identification and direct visualisation of minute microplastic particles / fragments with an improved signal-to-noise ratio for precise quantification. To circumvent the generation of misleading confocal Raman images, we recommend employing terrain mapping to scan the three-dimensional surface of the sample. It is important to acknowledge that the analysis of microplastics at the micro-scale inherently poses limitations in terms of throughput, as it necessitates a trade-off between low and high magnifications. We conduct explosive experiments on ten-to-hundred balloons, collecting debris from various angles and positions. Our investigation involves the random testing of multiple samples / sample positions at the micro-scale, with subsequent extrapolation to estimate the total amount of microplastics. The amalgamation of these results through statistical analysis indicates that each balloon explosion can potentially release tens-to-thousands of microplastics, highlighting a concern that has hitherto received insufficient attention. The characterisation approach, particularly the random Raman scanning method in combination with SEM and the statistical analysis on accumulated samples employed in this report, has the potential to serve as a useful tool in future research on microplastics and even nanoplastics.