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Simulation ATLS

Ingrid Digernes, Atle Bjørnerud, Svein Are S Vatnehol, Grete Løvland, Frédéric Courivaud, Einar Vik-Mo, Torstein R Meling, Kyrre E Emblem
Mapping the complex heterogeneity of vascular tissue in the brain is important for understanding cerebrovascular disease. In this translational study, we build on previous work using vessel architectural imaging (VAI) and present a theoretical framework for determining cerebral vascular function and heterogeneity from dynamic susceptibility contrast magnetic resonance imaging (MRI). Our tissue model covers realistic structural architectures for vessel branching and orientations, as well as a range of hemodynamic scenarios for blood flow, capillary transit times and oxygenation...
June 2017: Journal of Cerebral Blood Flow and Metabolism
Cuan M Harrington, Dara O Kavanagh, John F Quinlan, Donncha Ryan, Patrick Dicker, Dara O'Keeffe, Oscar Traynor, Sean Tierney
BACKGROUND: Consumer-available virtual-reality technology was launched in 2016 with strong foundations in the entertainment-industry. We developed an innovative medical-training simulator on the Oculus™ Gear-VR platform. This novel application was developed utilising internationally recognised Advanced Trauma Life Support (ATLS) principles, requiring decision-making skills for critically-injured virtual-patients. METHODS: Participants were recruited in June, 2016 at a single-centre trauma-course (ATLS, Leinster, Ireland) and trialled the platform...
February 10, 2017: American Journal of Surgery
Martin D Smith, Atle Oglend, A Justin Kirkpatrick, Frank Asche, Lori S Bennear, J Kevin Craig, James M Nance
Coastal hypoxia (dissolved oxygen ≤ 2 mg/L) is a growing problem worldwide that threatens marine ecosystem services, but little is known about economic effects on fisheries. Here, we provide evidence that hypoxia causes economic impacts on a major fishery. Ecological studies of hypoxia and marine fauna suggest multiple mechanisms through which hypoxia can skew a population's size distribution toward smaller individuals. These mechanisms produce sharp predictions about changes in seafood markets. Hypoxia is hypothesized to decrease the quantity of large shrimp relative to small shrimp and increase the price of large shrimp relative to small shrimp...
February 14, 2017: Proceedings of the National Academy of Sciences of the United States of America
Anju Priya Toolaram, Jakob Menz, Tushar Rastogi, Christoph Leder, Klaus Kümmerer, Mandy Schneider
The identification of toxic components in cocktail mixtures of pollutants, their metabolites and transformation products (TPs) generated from environmental and treatment processes remains an arduous task. This study expanded in this area by applying a combination of chemical analytics, a battery of in vitro bioassays and an in silico "testing battery" to UV photolysis mixtures of active pharmaceutical ingredients. The objectives were to understand the toxic nature of the mixtures and to prioritize photo-TPs for risk analysis...
February 1, 2017: Science of the Total Environment
Kelsey Ford, Michael Menchine, Elizabeth Burner, Sanjay Arora, Kenji Inaba, Demetrios Demetriades, Bertrand Yersin
INTRODUCTION: Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1...
September 2016: Western Journal of Emergency Medicine
Namita Jayaprakash, Rashid Ali, Rahul Kashyap, Courtney Bennett, Alexander Kogan, Ognjen Gajic
BACKGROUND: Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool that facilitates timely and error-free evaluation of critically ill patients. While the focused history is an essential part of the CERTAIN framework, it is not clear how best to choreograph this step in the process of evaluation and treatment of the acutely decompensating patient...
August 31, 2016: BMC Emergency Medicine
Luca Daniele, Andrew McLean, Nicholas Cocks, Michael Kalamaras, Randy Bindra, S L Ezekiel Tan
PURPOSE: The aim of distal radial fracture treatment is to achieve optimal function through the restoration of normal anatomy, including volar tilt. The accuracy of assessing volar tilt on standard lateral radiographs compared with anatomic tilt lateral (ATL) radiographs is uncertain. This study aimed to investigate the anatomy of the articular surface of the distal radius, in particular measuring the angle between the dorsal and volar rims at several points from radial to ulnar, to ascertain whether volar tilt is uniform between the scaphoid and lunate facet and to explore consistency between standard lateral and ATL views...
November 2016: Journal of Hand Surgery
Jia Yu, Duo Wai-Chi Wong, Hongtao Zhang, Zong-Ping Luo, Ming Zhang
High-heeled shoes have the capability to alter the strain and tension of ligamentous structures between the foot and ankle, which may result in ankle instability. However, high-heeled shoes can also reduce the strain on plantar fascia, which may be beneficial for the treatment of plantar fasciitis. In this study, the influence of heel height on strain and tension force applied to the anterior talofibular ligament (ATL) and plantar fascia were investigated. A three-dimensional finite element model of coupled foot-ankle-shoe complex was constructed...
October 2016: Medical Engineering & Physics
Rohit Abraham, Dinesh Vyas, Mayur Narayan, Arpita Vyas
Trauma-related injury in fast developing countries are linked to 90% of international mortality rates, which can be greatly reduced by improvements in often non-existent or non-centralized emergency medical systems (EMS)-particularly in the pre-hospital care phase. Traditional trauma training protocols-such as Advanced Trauma Life Support (ATLS), International Trauma Life Support (ITLS), and Basic Life Support (BLS)-have failed to produce an effective pre-hospital ground force of medical first responders. To overcome these barriers, we propose a new four-tiered set of trauma training protocols: Massive Open Online Course (MOOC) Trauma Training, Acute Trauma Training (ATT), Broad Trauma Training (BTT), and Cardiac and Trauma Training (CTT)...
December 2015: American Journal of Robotic Surgery
L Zhao, M A Ashraf
Background: The main reason for biomaterial related refractory infections is biofilm formation caused by bacterial adhesion on the surface of materials. Silver-hydroxyapatite (Ag/HA) nanocomposite coating can inhibit the formation of biofilm, but its mechanism is not clear. Material and method: In order to clarify the mechanism, the amounts of biofilm on the Ag/HA composite coating and HA coating were determined, the release rates of silver nanoparticles in simulated body fluid (SBF) were detected by atomic absorption spectrometry, and the expression values of atlE, fbe, sap, iapB genes of Staphylococcus aureus were studied when they grew on Ag/HA composite coating and HA coating...
December 2015: West Indian Medical Journal
Hamid Reza Abbasi, Mitra Amini, Shahram Bolandparvaz, Shahram Paydar, Jameel Ali, Sepideh Sefidbakht
OBJECTIVE: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE). METHODS: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test...
April 2016: Bulletin of Emergency and Trauma
Kelly N Salb, Daniel M Wido, Thomas E Stewart, Denis J DiAngelo
Ankle instantaneous axis of rotation (IAR) measurements represent a more complete parameter for characterizing joint motion. However, few studies have implemented this measurement to study normal, injured, or pathological foot ankle biomechanics. A novel testing protocol was developed to simulate aspects of in vivo foot ankle mechanics during mid-stance gait in a human cadaveric specimen. A lower leg was mounted in a robotic testing platform with the tibia upright and foot flat on the baseplate. Axial tibia loads (ATLs) were controlled as a function of a vertical ground reaction force (vGRF) set at half body weight (356 N) and a 50% vGRF (178 N) Achilles tendon load...
2016: Applied Bionics and Biomechanics
Fabiana Ortiz Figueroa, Yasmin Moftakhar, Arthur L Dobbins Iv, Ramisha Khan, Rahul Dasgupta, Rachel Blanda, Tiffany Marchand, Rami Ahmed
INTRODUCTION: Interns are often unprepared to effectively communicate in the acute trauma setting. Despite the many strengths of the Advanced Trauma Life Support (ATLS) program, the main shortcoming within the course is the deficiency of teamwork and leadership training. In this study, we describe the creation of an interdisciplinary boot camp in which interns' basic trauma knowledge, level of confidence, and teamwork skills are assessed. METHODS: We designed a one-day, boot camp curriculum for interns of various specialties with the purpose of improving communication and teamwork skills for effective management of acute trauma patients...
2016: Curēus
M Muenzberg, T Paffrath, G Matthes, L Mahlke, B Swartman, M Hoffman, R Lefering, C G Wölfl
BACKGROUND: With over 2 million certified physicians worldwide, the Advanced Trauma Life Support (ATLS) program is one of the most successful international medical education programs. Germany joined the ATLS program in 2003. Before implementation of the program, there was a controversial discussion as to whether a country like Germany with a long history of trauma care needed ATLS at all. 197 courses with nearly 3,000 providers were performed until December 2010. AIM: We assessed the course evaluations since the implementation of ATLS in Germany using the participants' systematic feedback...
October 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Rifat Ahmed, Rishad Arfin, Monir Hossan Rubel, Kazi Khairul Islam, Congxian Jia, Dimitris Metaxas, Brian S Garra, S Kaisar Alam
In this paper, we have evaluated the use of smooth windows for ultrasound elastography. In ultrasound elastography, local tissue strain is estimated using operations such as cross-correlation on local segments of RF data. In this process, local data segments are selected by multiplying the RF data by a rectangular window. Such data truncation causes non-ideal spectral behavior, which can be mitigated by using smooth windows. Accordingly, we hypothesize that the use of smooth windows may improve the elastographic signal-to-noise ratio (SNRe) and contrast-to-noise ratio (CNRe) of strain images...
March 2016: Ultrasonics
Ruud Van Thienen, Peter Hespel
High rate of muscular oxygen utilization facilitates the development of hypoxemia during exercise at altitude. Because endurance training stimulates oxygen extraction capacity, we investigated whether endurance athletes are at higher risk to developing hypoxemia and thereby acute mountain sickness symptoms during exercise at simulated high altitude. Elite athletes (ATL; n = 8) and fit controls (CON; n = 7) cycled for 20 min at 100 W (EX100W), as well as performed an incremental maximal oxygen consumption test (EXMAX) in normobaric hypoxia (0...
February 1, 2016: Journal of Applied Physiology
Ying-ying Ma, Yu-lan Wu, En-wei Zhu, Gui-yuan Lv, Su-hong Chen, Min-xi Pang
Due to the irregular of diet and overfeeding greasy and surfeit flavor closely associated with hyperuricemia disease, the lipid emulsion containing high cholesterol was used to model. To obtain a more stable and sustained animal model for the efficacy evaluation of traditional Chinese herbs, we observed the influence on the serum uric acid of rat induced by the lipid emulsion compared with high purine diet. 36 SD male rats were randomized to the normal control group, high purine diet group and lipid emulsion group respectively...
May 2015: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Itai Shavit, Barak Levit, Nofar Ben Basat, Dekel Lait, Mostafa Somri, Luis Gaitini
BACKGROUND: Establishing a definitive airway, defined as a tube placed in the trachea with cuff inflated below the vocal cords, is standard of care in pre-hospital airway management of the trauma patient. However, in this setting, and using manual in-line stabilisation of the neck, success rate of intubation by inexperience providers is suboptimal. The use of supraglottic airway devices that allow blind tracheal intubation has been suggested as an alternative method by the Advanced Trauma Life Support (ATLS) programme of the American College of Surgeons...
November 2015: Injury
Luis Teodoro da Luz, Bartolomeu Nascimento, Homer Tien, Michael J Kim, Avery B Nathens, Savvas Vlachos, Elon Glassberg
BACKGROUND: Growing public concern for animal welfare, advances in computerized simulation and economic barriers have drawn a critical eye to the use of live tissue training (LTT) in trauma skills acquisition. As a consequence, other simulation methods have replaced LTT, for example, in the Advanced Trauma Life Support (ATLS) course. Owing to the lack of clear conclusions in the literature, we conducted a systematic review to determine the value of LTT alone and in comparison to other simulation methods in trauma...
June 2015: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Gianni R Lorello, Christopher M Hicks, Sana-Ara Ahmed, Zoe Unger, Deven Chandra, Megan A Hayter
INTRODUCTION: Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated. METHODS: We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group...
March 2016: CJEM
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