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Medical scenario simulation

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https://www.readbyqxmd.com/read/28211003/an-easy-to-build-low-budget-point-of-care-ultrasound-simulator-from-linux-to-a-web-based-solution
#1
Domagoj Damjanovic, Ulrich Goebel, Benedikt Fischer, Martin Huth, Hartmut Breger, Hartmut Buerkle, Axel Schmutz
BACKGROUND: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28207594/using-high-technology-simulators-to-prepare-anesthesia-providers-before-implementation-of-a-new-electronic-health-record-module-a-technical-report
#2
Ari Y Weintraub, Ellen S Deutsch, Roberta L Hales, Newton A Buchanan, Whitney L Rock, Mohamed A Rehman
Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components...
February 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28202839/cost-outcome-description-of-peg-ifn-%C3%AE-2b-rbv-for-hepatitis-c-results-based-on-the-interferon-database
#3
Maiko Akutagawa, Yohei Kawasaki, Atsuko Kawasaki, Kazuki Ide, Hiroshi Yamada, Naohiko Masaki
Economic evaluation of drugs is used in decision-making on medical care and public policy. Recently, real-world data (RWD) have been used in the analysis. In this study, we discuss the risk and benefits of using RWD for economic evaluation. We conducted a cost-outcome description with RWD from a nationwide registry providing information on hepatitis treatment in Japan and estimated the utility of the analysis. We evaluated the cost-outcome description of peginterferon plus ribavirin (PEG-IFN-α2b + RBV) treatment in hepatitis C virus (HCV)-infected patients...
February 15, 2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#4
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28168128/three-dimensional-printing-of-a-hemorrhagic-cervical-cancer-model-for-postgraduate-gynecological-training
#5
Michael Bartellas, Stephen Ryan, Gregory Doucet, Deanna Murphy, Jacqueline Turner
INTRODUCTION: A realistic hemorrhagic cervical cancer model was three-dimensionally (3D) printed and used in a postgraduate medical simulation training session. MATERIALS AND METHODS: Computer-assisted design (CAD) software was the platform of choice to create and refine the cervical model. Once the prototype was finalized, another software allowed for the addition of a neoplastic mass, which included openings for bleeding from the neoplasm and cervical os. 3D printing was done using two desktop printers and three different materials...
January 1, 2017: Curēus
https://www.readbyqxmd.com/read/28164362/mri-based-transfer-function-determination-for-the-assessment-of-implant-safety
#6
J P Tokaya, A J E Raaijmakers, P R Luijten, J F Bakker, C A T van den Berg
PURPOSE: We introduce a new MR-based method to determine the transfer function (TF) for radiofrequency (RF) safety assessment of active implantable medical devices. Transfer functions are implant-specific measures that relate the incident tangential electric field on an (elongated) implant to a scattered electric field at its tip. The proposed method allows for TF determination with a high spatial resolution in relatively fast measurements without requiring dedicated bench setups from MRI images...
February 5, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28163662/stochastic-extended-lqr-for-optimization-based-motion-planning-under-uncertainty
#7
Wen Sun, Jur van den Berg, Ron Alterovitz
We introduce a novel optimization-based motion planner, Stochastic Extended LQR (SELQR), which computes a trajectory and associated linear control policy with the objective of minimizing the expected value of a user-defined cost function. SELQR applies to robotic systems that have stochastic non-linear dynamics with motion uncertainty modeled by Gaussian distributions that can be state- and control-dependent. In each iteration, SELQR uses a combination of forward and backward value iteration to estimate the cost-to-come and the cost-to-go for each state along a trajectory...
April 2016: IEEE Transactions on Automation Science and Engineering: a Publication of the IEEE Robotics and Automation Society
https://www.readbyqxmd.com/read/28152760/patients-as-partners-in-managing-cancer-treatment-related-toxicity
#8
Kathy Vu, Meaghan Wright, Colleen Fox, Noor Ahmad, Vicky Simanovski, Leonard Kaizer, Monika K Krzyzanowska
: 215 Background: Cancer Care Ontario is the government agency responsible for improving cancer services across Ontario's 14 regions. To promote advances in best practices related to systemic treatment, Cancer Care Ontario hosts annual Systemic Treatment Safety Symposia, which serve as a platform to discuss quality and safety issues and results of quality improvement (QI) initiatives in alignment with the Systemic Treatment Provincial Plan. For the first time, the 2015 Symposium brought together patients and providers to discuss gaps and opportunities for improvement in relation to toxicity management (TM) during chemotherapy...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151877/impact-of-standardized-patients-on-the-training-of-medical-students-to-manage-emergencies
#9
Frank Herbstreit, Stefanie Merse, Rainer Schnell, Marcel Noack, Daniel Dirkmann, Anna Besuch, Jürgen Peters
BACKGROUND: Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach. METHODS: Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings ("acute chest pain," "stroke," and "acute dyspnea/asthma") or traditional small group seminars...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28148473/a-mobile-device-app-to-reduce-time-to-drug-delivery-and-medication-errors-during-simulated-pediatric-cardiopulmonary-resuscitation-a-randomized-controlled-trial
#10
Johan N Siebert, Frederic Ehrler, Christophe Combescure, Laurence Lacroix, Kevin Haddad, Oliver Sanchez, Alain Gervaix, Christian Lovis, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusion is both complex and time-consuming, placing children at higher risk than adults for medication errors. Following an evidence-based ergonomic-driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
February 1, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28146451/training-effectiveness-of-a-wide-area-virtual-environment-in-medical-simulation
#11
Grady S Wier, Rebekah Tree, Rasha Nusr
INTRODUCTION: The success of war fighters and medical personnel handling traumatic injuries largely depends on the quality of training they receive before deployment. The purpose of this study was to gauge the utility of a Wide Area Virtual Environment (WAVE) as a training adjunct by comparing and evaluating student performance, measuring sense of realism, and assessing the impact on student satisfaction with their training exposure in an immersive versus a field environment. METHODS: This comparative prospective cohort study examined the utility of a three-screen WAVE where subjects were immersed in the training environment with medical simulators...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28145564/cost-effectiveness-of-diabetes-screening-initiated-through-a-dental-visit
#12
Matthew Neidell, Ira B Lamster, Barbara Shearer
OBJECTIVE: To analyse the cost-effectiveness of a screening programme and follow-up interventions for persons with dysglycemia who are identified during a dental visit. METHODS: This study is a secondary analysis utilizing data from two relevant publications. Those studies identified persons with dysglycemia who were seen in a dental school clinic for routine dental care and determined compliance with a recommendation to seek medical care. The response site was 59...
February 1, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28139309/comparison-of-macintosh-and-intubrite-laryngoscopes-for-intubation-performed-by-novice-physicians-in-a-difficult-airway-scenario
#13
Lukasz Szarpak, Jacek Smereka, Jerzy R Ladny
INTRODUCTION: In the difficult airway, the intubation skills are critically important. In selected cases, particularly in airway edema, laryngeal or tongue edema, endotracheal intubation can turn out very difficult, and repeated attempts may even worsen the airway edema, causing trauma and bleeding, and finally leading to complete airway obstruction and inability to ventilate the patient. AIM OF THE STUDY: The aim of the study was to compare the efficacy of endotracheal intubation performed by novice physicians using a standard Macintosh laryngoscope and an Intubrite videolaryngoscope...
January 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28133751/feasibility-of-external-beam-radiation-therapy-to-deep-seated-targets-with-kilovoltage-x-rays
#14
Magdalena Bazalova-Carter, Michael D Weil, Dylan Yamabe Breitkreutz, Brian P Wilfley, Edward E Graves
PURPOSE: Radiation therapy to deep-seated targets is typically delivered with megavoltage x-ray beams generated by medical linear accelerators or (60) Co sources. Here, we used computer simulations to design and optimize a lower energy kilovoltage x-ray source generating acceptable dose distributions to a deep-seated target. METHODS: The kilovoltage arc therapy (KVAT) x-ray source was designed to treat a 4-cm diameter target located at a 10-cm depth in a 40-cm diameter homogeneous cylindrical phantom...
December 9, 2016: Medical Physics
https://www.readbyqxmd.com/read/28132766/piloting-a-pediatric-trauma-course-in-western-jamaica-lessons-learned-and-future-directions
#15
Hadley K Wesson, Valerie Plant, Marieka Helou, Karen Wharton, Delroy Fray, Jeffrey Haynes, Charles Bagwell
INTRODUCTION: Pediatric injuries are a leading cause of death in low- and middle-income countries (LMICs). Despite this, there are few formal pediatric-specific trauma educational initiatives available in LMICs. While new educational tools are being developed to address this, they have not been piloted in LMICs. In Jamaica, pediatric injuries are a leading cause of hospital admission but care is limited by a lack of training in triage and stabilization. Our objective was to implement and evaluate a pediatric trauma course in Jamaica to determine the impact this may have on further course development...
January 10, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28123919/mock-code-a-code-blue-scenario-requested-by-and-developed-for-registered-nurses
#16
Kerry-Lynn Williams, Janice Rideout, Sherry Pritchett-Kelly, Melissa McDonald, Paula Mullins-Richards, Adam Dubrowski
The use of simulation in medical training is quickly becoming more common, with applications in emergency, surgical, and nursing education. Recently, registered nurses working in surgical inpatient units requested a mock code simulation to practice skills, improve knowledge, and build self-confidence in a safe and controlled environment. A simulation scenario using a high-fidelity mannequin was developed and will be discussed herein.
December 23, 2016: Curēus
https://www.readbyqxmd.com/read/28117517/trade-offs-between-efficacy-and-cardiac-toxicity-of-adjuvant-chemotherapy-in-early-stage-breast-cancer-patients-do-competing-risks-matter
#17
Fernando Alarid-Escudero, Anne H Blaes, Karen M Kuntz
Evidence about treatment efficacy and long-term toxicities for adjuvant chemotherapy in patients with early-stage breast cancer is often presented in different formats and studies. This leads to challenges for patients and their physicians to adequately weigh the trade-offs between effectiveness and long-term cardiac toxicity when making decisions about adjuvant chemotherapy. We used a decision-analytic framework to quantify these trade-offs by combining the available evidence into a single, comparable metric...
January 24, 2017: Breast Journal
https://www.readbyqxmd.com/read/28116006/development-of-an-assessment-for-entrustable-professional-activity-epa-10-emergent-patient-management
#18
Laura R Thompson, Cynthia G Leung, Brad Green, Jonathan Lipps, Troy Schaffernocker, Cynthia Ledford, John Davis, David P Way, Nicholas E Kman
INTRODUCTION: Medical schools in the United States are encouraged to prepare and certify the entrustment of medical students to perform 13 core entrustable professional activities (EPAs) prior to graduation. Entrustment is defined as the informed belief that the learner is qualified to autonomously perform specific patient-care activities. Core EPA-10 is the entrustment of a graduate to care for the emergent patient. The purpose of this project was to design a realistic performance assessment method for evaluating fourth-year medical students on EPA-10...
January 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28102933/what-if-a-tumor-is-significantly-enlarged-just-before-stereotactic-body-radiation-therapy-a-case-report-and-review-of-the-literature
#19
Hung-Jen Chen, Ji-An Liang, Chih-Yi Chen, Yang-Hao Yu, Chun-Ru Chien
Stereotactic body radiation therapy (SBRT) plays an important role in early stage non-small cell lung cancer. Tumor growth before radiotherapy planning (RTP) or during SBRT has been reported in lung cancer patients; however, little is known of growth during the period in-between (i.e. after RTP but before SBRT). An 83-year-old man referred to our hospital and diagnosed with medically inoperable non-small cell lung cancer was noted to have significant tumor progression on day 1 of cone beam computed tomography just before the planned SBRT delivery...
November 18, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#20
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
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