Conceptual and quantitative categorization of wave-induced flooding impacts for pedestrians and assets in urban beaches.

Beaches combined with sloping structures are frequently the first element of defense to protect urban areas from the impact of extreme coastal flooding events. However, these structures are rarely designed for null wave overtopping discharges, accepting that waves can pass above the crest and threat exposed elements in hinterland areas, such as pedestrians, urban elements and buildings, and vehicles. To reduce risks, Early Warning Systems (EWSs) can be used to anticipate and minimize the impacts of flooding episodes on those elements. A key aspect of these systems is the definition of non-admissible discharge levels that trigger significant impacts. However, large discrepancies in defining these discharge levels and the associated impacts are found among the existing methods to assess floodings. Due to the lack of standardization, a new conceptual and quantitative four-level (from no-impact to high-impact) categorization of flood warnings (EW-Coast) is proposed. EW-Coast integrates and unifies previous methods and builds on them by incorporating field-based information. Thus, the new categorization successfully predicted the impact level on 70%, 82%, and 85% of the overtopping episodes affecting pedestrians, urban elements and buildings, and vehicles, respectively. This demonstrates its suitability to support EWSs in areas vulnerable to wave-induced flooding.

Self-administered nitrous oxide analgesia for pediatric fracture reductions.

We prospectively studied the efficacy and safety of self-administered nitrous oxide analgesia for 54 children undergoing closed reductions of fractures in the emergency department. No child was excluded from entry into the study because of fracture type. Nitrous oxide was the sole source of analgesia. The average Children's Hospital of Eastern Ontario pain score (CHEOPS) rated by the emergency medicine physician observing the reduction was 9.1 (range 6-13). Ninety-one percent of children obtained an analgesic effect; however, 46% of children had a CHEOPS score of > or = 10, indicating significant pain. A statistically significantly higher proportion of failures using nitrous-oxide analgesia occurred in patients with completely displaced radius/ulna fractures (p = 0.027). No complications such as vomiting, respiratory depression, or a change in oxygen saturation resulted from the use of nitrous oxide.