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Medical Devices (Auckland, N.Z.) 2022The absence of ionizing radiation in MRI applications does not guarantee absolute safety. Implementing of safety guidelines can ensure high-quality practice in the...
PURPOSE
The absence of ionizing radiation in MRI applications does not guarantee absolute safety. Implementing of safety guidelines can ensure high-quality practice in the clinical MRI with the minimum risk. For this purpose, this cross-section quantitative study conducted in Jordan Kingdom aimed to assess current MRI safety guidelines in comparison with those of 2020 Manual on MR Safety of the American College of Radiology (ACR).
PATIENTS AND METHODS
A site observation study of 38 MRI units was undertaken in June 2021. A well-structured MRI safety questionnaire was the primary data collection method. Data were subjected to a descriptive statistics content analysis by the SPSS version 20. The results were analyzed to yield comprehensive discussions.
RESULTS
A total of 38 MRI facilities in participated in this study with the responding rate of 44.7%. Patient screening areas and changing rooms were available in about 29% (11/38) of the MRI facilities. Most facilities (55%, 21/38) conducted verbal screening only whereas 21% implemented both written and verbal screening for their patients and companions in zone II, which was present in a percentage of 29% in the approached facilities. Meanwhile, only 13 (43.2%) of 38 facilities used handheld magnets for physical screening, 25 (65.8%) of MRI units did not use any kind of ferromagnetic metal detection systems. Three (7.9%) participating centers had MR-safe wheelchairs, ventilators, anesthesia machines, and stretchers. Most MRI facilities participating in this study (71%) had emergency preparedness plans for alternative power outages. Despite a relatively low number of participating centers having an emergency exit or code (26.3% and 10.5%, respectively), none of them performed practice drills for such scenarios.
CONCLUSION
Investing in new MR-safe equipment requires introducing ferromagnetic detecting systems. More research is needed to establish the degree of MRI professional's safety-related education.
PubMed: 35592097
DOI: 10.2147/MDER.S360335 -
Journal of Accident & Emergency Medicine Jan 1996The aim was to evaluate seven evacuation support surfaces. These included the conventional spinal board, two designs of vacuum stretcher, a prototype support surface...
The aim was to evaluate seven evacuation support surfaces. These included the conventional spinal board, two designs of vacuum stretcher, a prototype support surface which was a combination of both principles, and three conventional stretchers. Interface pressures were evaluated in four healthy volunteers. The sacral and thoracic interface pressures were measured. Mean sacral readings were: spinal board 233.5 mm Hg, old vacuum stretcher 139 mm Hg, new design 94.8 mm Hg, prototype board 119.5 mm Hg, York Two stretcher 46 mm Hg, Army stretcher 61 mm Hg, and the PVC and aluminium stretcher 66 mm Hg. Thoracic pressure readings were: spinal board 82.9 mm Hg, old design vacuum stretcher 58 mm Hg, new design 37.8 mm Hg, prototype board 53.7 mm Hg, York two 21 mm Hg, army stretcher 35.4 mm Hg, and PVC stretcher 38.5 mm Hg. Analysis of variance showed both distributions to be highly significant (P < 0.001). The spinal board has several deficiencies, including lack of support for the lumbar lordosis. It should not be the preferred surface for the transfer of patients with spinal injuries.
Topics: Equipment Design; Equipment Safety; Humans; Self-Help Devices; Spinal Cord Injuries; Transportation of Patients
PubMed: 8821224
DOI: 10.1136/emj.13.1.34 -
Sensors (Basel, Switzerland) Feb 2020In the last years, the evolution of digital communications has been harnessed by medical applications. In that context, wireless communications are preferable over wired...
In the last years, the evolution of digital communications has been harnessed by medical applications. In that context, wireless communications are preferable over wired communications, as they facilitate the work of health technicians by reducing cabling on the stretchers. However, the use of wireless communications is challenging, especially when high data rates and low latencies are required. In those scenarios, multiple-input multiple-output (MIMO) techniques might have an important role, thanks to the high capacity gains that they can exhibit, which ideally increase with the MIMO size. In this work, we study the propagation scenario of a typical medical laboratory through ray-tracing techniques. By taking into account the derived channel model, we study the potential of MIMO techniques in an IEEE 802.11ax environment. Through a set of performance results regarding the system capacity, we show that the MIMO gains might not be as high as supposed in the medical laboratory, being far from the ideal scenario. Therefore, the large data rates required by the modern medical imaging applications might only be achieved with a combination of MIMO systems and large bandwidths.
Topics: Algorithms; Diagnostic Imaging; Wireless Technology
PubMed: 32050676
DOI: 10.3390/s20030938 -
International Journal of Emergency... Nov 2012A major incident has occurred when the number of live casualties, severity, type of incident or location requires extraordinary resources. Major incident management is...
BACKGROUND
A major incident has occurred when the number of live casualties, severity, type of incident or location requires extraordinary resources. Major incident management is interdisciplinary and involves triage, treatment and transport of patients. We aimed to investigate experiences within major incident preparedness and management among Norwegian rescue workers.
METHODS
A questionnaire was answered by 918 rescue workers across Norway. Questions rated from 1 (doesn't work) to 7 (works excellently) are presented as median and range.
RESULTS
Health-care personnel constituted 34.1% of the participants, firefighters 54.1% and police 11.8%. Training for major incident response scored 5 (1, 7) among health-care workers and 4 (1, 7) among firefighters and police. Preparedness for major incident response scored 5 (1, 7) for all professions. Interdisciplinary cooperation scored 5 (3, 7) among health-care workers and police and 5 (1, 7) among firefighters. Among health-care workers, 77.5% answered that a system for major-incident triage exists; 56.3% had triage equipment available. The majority - 45.1% of health-care workers, 44.7% of firefighters and 60.4% of police - did not know how long it would take to get emergency stretchers to the scene.
CONCLUSIONS
Rescue personnel find major incident preparedness and on-scene multidisciplinary cooperation to function well. Some shortcomings are reported with regard to systems for major incident triage, tagging equipment for triage and knowledge about access to emergency stretchers.
PubMed: 23134634
DOI: 10.1186/1865-1380-5-40 -
Korean Journal of Anesthesiology Feb 2020This study was performed to evaluate the effect of a wagon as a transport vehicle instead of the standard stretcher car to reduce children's anxiety of separation from... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
This study was performed to evaluate the effect of a wagon as a transport vehicle instead of the standard stretcher car to reduce children's anxiety of separation from parents. The secondary goal was to evaluate whether this anxiolytic effect was related to age.
METHODS
We divided 80 children (age 2-7 years) into two groups. The stretcher group was transferred to the operating room on a conventional stretcher car, whereas the wagon group was transferred using a wagon. The level of anxiety was evaluated three times using the Modified Yale Preoperative Anxiety Scale (mYPAS): in the waiting area (T0), in the hallway to the operating room (T1), and before induction of anesthesia (T2).
RESULTS
The mYPAS score was significantly lower in the wagon group (36.7 [31.7, 51.7]) than in the stretcher group (51.7 [36.7, 83.3]) at T1 (P = 0.007). However, there was no difference in the mYPAS score between the two groups at T2 (46.7 [32.5, 54.2] vs. 51.7 [36.7, 75.0], respectively, P = 0.057). The baseline anxiety tended to be lower with increasing age (r = -0.248, P = 0.031). During transportation to the operating room, the increase in the mYPAS score (T1-T0) was greater as the age of children decreased in the stretcher group (r = -0.340, P = 0.034). However, no correlation was observed in the wagon group (r = -0.053, P = 0.756).
CONCLUSION
The wagon method decreased preoperative anxiety, suggesting that it may be a good alternative for reducing preoperative anxiety in children.
Topics: Age Factors; Anxiety; Anxiety, Separation; Child; Child, Preschool; Female; Humans; Male; Parents; Preoperative Care; Transportation of Patients
PubMed: 31304694
DOI: 10.4097/kja.19191 -
Optics Express Feb 2024Modern X-ray free-electron lasers (XFELs) can generate pulses with durations ranging from femtoseconds to attoseconds. The numerical evaluation of ultra-short XFEL...
Modern X-ray free-electron lasers (XFELs) can generate pulses with durations ranging from femtoseconds to attoseconds. The numerical evaluation of ultra-short XFEL pulses through beamline systems is a critical process of beamline system design. However, the bandwidth of such ultra-short XFEL pulses is often non-negligible, and the propagation cannot be simply approximated using the central wavelength, especially in dispersive beamline systems. We developed a numerical model which is called Fourier optics based Ultrashort x-Ray pulse propagatION tool (FURION). This model can not only be used to simulate dispersive beamline systems but also to evaluate non-dispersive beamline systems. The FURION model utilizes Fresnel integral and angular spectrum integral to perform ultra-short XFEL pulse propagation in free space. We also present the method for XFEL pulse propagation through different types of dispersive gratings, which are commonly used in soft X-ray beamline systems. By using FURION, a start-to-end simulation of the FEL-1 beamline system at Shenzhen superconducting soft X-ray free electron laser (SFEL) is carried out. This model can also be used to evaluate gratings-based spectrometers, beam splitters, pulse compressors, and pulse stretchers. This work provides valuable insights into the start-to-end simulation of X-ray beamline systems.
PubMed: 38439240
DOI: 10.1364/OE.515133 -
Academic Emergency Medicine : Official... Mar 2006Emergency department (ED) triage prioritizes patients based on urgency of care. This study compared agreement between two blinded, independent users of a Web-based... (Comparative Study)
Comparative Study
OBJECTIVES
Emergency department (ED) triage prioritizes patients based on urgency of care. This study compared agreement between two blinded, independent users of a Web-based triage tool (eTRIAGE) and examined the effects of ED crowding on triage reliability.
METHODS
Consecutive patients presenting to a large, urban, tertiary care ED were assessed by the duty triage nurse and an independent study nurse, both using eTRIAGE. Triage score distribution and agreement are reported. The study nurse collected data on ED activity, and agreement during different levels of ED crowding is reported. Two methods of interrater agreement were used: the linear-weighted kappa and quadratic-weighted kappa.
RESULTS
A total of 575 patients were assessed over nine weeks, and complete data were available for 569 patients (99.0%). Agreement between the two nurses was moderate if using linear kappa (weighted kappa = 0.52; 95% confidence interval = 0.46 to 0.57) and good if using quadratic kappa (weighted kappa = 0.66; 95% confidence interval = 0.60 to 0.71). ED overcrowding data were available for 353 patients (62.0%). Agreement did not significantly differ with respect to periods of ambulance diversion, number of admitted inpatients occupying stretchers, number of patients in the waiting room, number of patients registered in two hours, or nurse perception of busyness.
CONCLUSIONS
This study demonstrated different agreement depending on the method used to calculate interrater reliability. Using the standard methods, it found good agreement between two independent users of a computerized triage tool. The level of agreement was not affected by various measures of ED crowding.
Topics: Adult; Alberta; Decision Making, Computer-Assisted; Emergency Nursing; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Observer Variation; Prospective Studies; Reproducibility of Results; Severity of Illness Index; Triage
PubMed: 16495428
DOI: 10.1197/j.aem.2005.10.014 -
Journal of Athletic Training 2012Health care providers must be prepared to manage all potential spine injuries as if they are unstable. Therefore, most sport teams devote resources to training for...
CONTEXT
Health care providers must be prepared to manage all potential spine injuries as if they are unstable. Therefore, most sport teams devote resources to training for sideline cervical spine (C-spine) emergencies.
OBJECTIVE
To determine (1) how accurately rescuers and simulated patients can assess motion during C-spine stabilization practice and (2) whether providing performance feedback to rescuers influences their choice of stabilization technique.
DESIGN
Crossover study.
SETTING
Training studio.
PATIENTS OR OTHER PARTICIPANTS
Athletic trainers, athletic therapists, and physiotherapists experienced at managing suspected C-spine injuries.
INTERVENTION(S)
Twelve lead rescuers (at the patient's head) performed both the head-squeeze and trap-squeeze C-spine stabilization maneuvers during 4 test scenarios: lift-and-slide and log-roll placement on a spine board and confused patient trying to sit up or rotate the head.
MAIN OUTCOME MEASURE(S)
Interrater reliability between rescuer and simulated patient quality scores for subjective evaluation of C-spine stabilization during trials (O = best, 10 = worst), correlation between rescuers' quality scores and objective measures of motion with inertial measurement units, and frequency of change in preference for the head-squeeze versus trap-squeeze maneuver.
RESULTS
Although the weighted κ value for interrater reliability was acceptable (0.71-0.74), scores varied by 2 points or more between rescuers and simulated patients for approximately 10% to 15% of trials. Rescuers' scores correlated with objective measures, but variability was large: 38% of trials scored as 0 or 1 by the rescuer involved more than 10° of motion in at least 1 direction. Feedback did not affect the preference for the lift-and-slide placement. For the log-roll placement, 6 of 8 participants who preferred the head squeeze at baseline preferred the trap squeeze after feedback. For the confused patient, 5 of 5 participants initially preferred the head squeeze but preferred the trap squeeze after feedback.
CONCLUSIONS
Rescuers and simulated patients could not adequately assess performance during C-spine stabilization maneuvers without objective measures. Providing immediate feedback in this context is a promising tool for changing behavior preferences and improving training.
Topics: Athletic Injuries; Cervical Vertebrae; Cross-Over Studies; Head Movements; Humans; Immobilization; Motion; Neck Injuries; Rescue Work; Self Report; Spinal Injuries; Spine; Stretchers
PubMed: 22488229
DOI: 10.4085/1062-6050-47.1.42 -
Saudi Medical Journal Nov 2014To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of...
OBJECTIVES
To evaluate infection control and the incidence of bacterial pathogens in Emergency Medical Service (EMS) ambulances in Riyadh, Saudi Arabia. The effectiveness of fumigation techniques used for these ambulances to minimize the spread of infection to transported patients and pre-hospital care providers was also assessed.
METHODS
Based on previous literature review indicating a higher propensity of microbial load, 3 areas within the ambulance, such as, stretcher handle, oxygen flow meter knob, and interior handle of the rear door were selected for specimen collection. Swab samples were collected both in the day and night shift, after the intended disinfection and cleaning (before and after fumigation). Micro-organisms were identified using standard procedures. This phase-I study was conducted at the Emergency Medical Services Department, Prince Sultan Bin AbdulAziz College of Emergency Medical Services, Al Malaz, King Saud University, Riyadh, Saudi Arabia between October and November 2013, wherein a total of 10 ambulances from the Saudi Red Crescent Authority in Riyadh were selected for inclusion in the study.
RESULTS
The specimens from all 10 ambulances showed similar results. In post disinfection and before fumigation, swab samples showed positive cultures that grew moderate to large quantities of environmental and skin flora. However, almost all organisms were susceptible to the fumigation technique.
CONCLUSION
This study confirms the importance of evaluating the frequency and efficiency of various fumigation techniques as an ambulance is a potential reservoir for microbial transmission to patients and staff.
Topics: Ambulances; Bacillus; Cross Infection; Disinfectants; Emergency Medical Services; Enterobacteriaceae; Equipment Contamination; Fomites; Fumigation; Humans; Saudi Arabia; Staphylococcus; Stretchers
PubMed: 25399212
DOI: No ID Found -
PloS One 2023The order Zoraptera contains relatively few species, but current molecular phylogenetic studies suggest an unexpectedly high level of cryptic diversity in the order with...
The order Zoraptera contains relatively few species, but current molecular phylogenetic studies suggest an unexpectedly high level of cryptic diversity in the order with many overlooked species based on morphology alone. Latinozoros Kukalova-Peck & Peck, 1993 represents the only genus of monotypic Latinozorinae (Zoraptera: Spiralizoridae) with only one species described, L. barberi (Gurney, 1938), until now. Although this species has been repeatedly reported from a number of locations in South and Central America, it is likely a complex of unrecognized species. Here, we present a molecular phylogenetic reconstruction revealing three genetically distinct lineages in Latinozoros, and we also present detailed morphological comparisons that prove the species status of Latinozoros cacaoensis sp. nov. from French Guiana and L. gimmeli sp. nov. from the Dominican Republic, Trinidad and Panama. The results indicate that the species previously referred to L. barberi is actually a species complex that includes L. barberi, the new species described here, and perhaps other species.
Topics: Animals; Phylogeny; Stretchers; Neoptera; Panama; Central America
PubMed: 36696450
DOI: 10.1371/journal.pone.0280113