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Emergency simulation

Rossella Letizia Mancusi, Massimo Andreoni, Daniela d'Angela, Cesare Sarrecchia, Federico Spandonaro
Between western European countries, the hepatitis C virus (HCV) endemic is highest in Italy. The main objective of this paper is to estimate the endemic diffusion of hepatitis C at the national level and by geographical area, with an extrapolation at the regional level and by uniform cohorts of subjects (by sex and year of birth). The secondary objective is a stratification by gravity of the estimated statistical figures to provide an overview of possible targets of the new anti-HCV treatments.PubMed and the Cochrane Library were searched for relevant Italian populations studies regarding HCV prevalence...
October 2016: Medicine (Baltimore)
Tae Nyoung Chung, Sun Wook Kim, Je Sung You, Hyun Soo Chung
OBJECTIVE: Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator. METHODS: This is a simulation study...
March 2016: Clin Exp Emerg Med
Jonathan Kei, Donald P Mebust
BACKGROUND: It has been suggested that an adult 8.0 endotracheal tube (ETT) connected to a neonatal meconium aspirator would improve suctioning during emergent endotracheal intubation compared to the Yankauer suction instrument, the standard tool used by emergency physicians. OBJECTIVES: This study was designed to compare the effectiveness of a Yankauer vs. an ETT-meconium aspirator set-up in suctioning liquids of different viscosities. METHODS: The Yankauer and ETT-meconium aspirator device underwent a head-to-head timed comparison, suctioning 250 mL of three different fluids, varying in viscosity...
October 14, 2016: Journal of Emergency Medicine
Richard A Gray, Pras Pathmanathan
Elucidating the underlying mechanisms of fatal cardiac arrhythmias requires a tight integration of electrophysiological experiments, models, and theory. Existing models of transmembrane action potential (AP) are complex (resulting in over parameterization) and varied (leading to dissimilar predictions). Thus, simpler models are needed to elucidate the "minimal physiological requirements" to reproduce significant observable phenomena using as few parameters as possible. Moreover, models have been derived from experimental studies from a variety of species under a range of environmental conditions (for example, all existing rabbit AP models incorporate a formulation of the rapid sodium current, INa, based on 30 year old data from chick embryo cell aggregates)...
October 2016: PLoS Computational Biology
Sandeep Gangadharan, Gunjan Tiyyagura, Marcie Gawel, Barbara M Walsh, Linda L Brown, Megan Lavoie, Khoon-Yen Tay, Marc A Auerbach
OBJECTIVE: The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. METHODS: This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed...
October 4, 2016: Pediatric Emergency Care
Mark Xavier Cicero, Travis Whitfill, Frank Overly, Janette Baird, Barbara Walsh, Jorge Yarzebski, Antonio Riera, Kathleen Adelgais, Garth D Meckler, Carl Baum, David Christopher Cone, Marc Auerbach
OBJECTIVE: Paramedics and emergency medical technicians (EMTs) triage pediatric disaster victims infrequently. The objective of this study was to measure the effect of a multiple-patient, multiple-simulation curriculum on accuracy of pediatric disaster triage (PDT). METHODS: Paramedics, paramedic students, and EMTs from three sites were enrolled. Triage accuracy was measured three times (Time 0, Time 1 [two weeks later], and Time 2 [6 months later]) during a disaster simulation, in which high and low fidelity manikins and actors portrayed 10 victims...
October 17, 2016: Prehospital Emergency Care
Andrew Petrosoniak, Marc Auerbach, Ambrose H Wong, Christopher M Hicks
In situ simulation (ISS), a point of care training strategy that occurs within the patient care environment involving actual healthcare team members, provides additional benefits to centre-based simulation. ISS can serve several roles within emergency medicine (EM): improves provider/team performance, identifies and mitigates threats to patient safety and improves systems and infrastructure. The effective use of ISS fosters inter-professional team training and a culture of safety essential for high performance EM teams and resilient systems...
October 17, 2016: Emergency Medicine Australasia: EMA
Lindsay Johnston, Gary Oldenburg
Extracorporeal membrane oxygenation (ECMO) is a highly technical and complex method of life support. Patient and circuit emergencies on ECMO are rare, but in these cases, prompt and correct actions to address the crisis are needed to prevent morbidity and mortality. ECMO simulation programs have gained popularity in recent years, as they provide a standardized educational experience for all members of the inter-professional care team. In addition to providing a context in which to solidify knowledge of ECMO support, participants are also able to focus on vital technical and behavioral skills that are not highlighted in other training methodologies...
October 13, 2016: Seminars in Perinatology
Sharon MacLean, Michelle Kelly, Fiona Geddes, Phillip Della
BACKGROUND: Registered nurses are expected to communicate effectively with patients. To improve on this skill education programmes in both hospital and tertiary settings are increasingly turning to simulation modalities when training undergraduate and registered nurses. The roles simulated patients (SPs) assume can vary according to training purposes and approach. AIMS: The first aim is to analyse how SPs are used in nursing education to develop communication skills...
September 28, 2016: Nurse Education Today
Samuel Smith
Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance...
October 12, 2016: Clinical Obstetrics and Gynecology
Isabelle Bragard, Marie-Christine Seghaye, Nesrine Farhat, Marie Solowianiuk, Mariane Saliba, Anne-Marie Etienne, Katharina Schumacher
OBJECTIVES: Residents beginning their specialization in pediatrics and emergency medicine (EM) are rapidly involved in oncall duties. Early acquisition of crisis resource management by novice residents is essential for patient safety, but traditional training may be insufficient. Our aim was to investigate the impact of a 2-day simulation-based course on residents to manage pediatric and neonatal patients. METHODS: First year residents participated in the course...
October 6, 2016: Pediatric Emergency Care
Amin Chabchoub
Breather solutions of the nonlinear Schrödinger equation (NLSE) are known to be considered as backbone models for extreme events in the ocean as well as in Kerr media. These exact deterministic rogue wave (RW) prototypes on a regular background describe a wide range of modulation instability configurations. Alternatively, oceanic or electromagnetic wave fields can be of chaotic nature and it is known that RWs may develop in such conditions as well. We report an experimental study confirming that extreme localizations in an irregular oceanic Joint North Sea Wave Project wave field can be tracked back to originate from exact NLSE breather solutions, such as the Peregrine breather...
September 30, 2016: Physical Review Letters
Janne Ruostekoski, Juha Javanainen
We analyze the emergence of correlated optical phenomena in the transmission of light through a waveguide that confines classical or ultracold quantum degenerate atomic ensembles. The conditions of the correlated collective response are identified in terms of atom density, thermal broadening, and photon losses by using stochastic Monte Carlo simulations and transfer matrix methods of transport theory. We also calculate the "cooperative Lamb shift" for the waveguide transmission resonance, and discuss line shifts that are specific to effectively one-dimensional waveguide systems...
September 30, 2016: Physical Review Letters
Annette R Waznonis
AIM: A study was conducted to describe simulation debriefing practices of faculty in accredited, traditional, baccalaureate nursing programs in the United States. BACKGROUND: Best debriefing practices include debriefing by a competent facilitator in a safe environment using a structured framework. Yet, structured frameworks and evaluation of debriefing are lacking in nursing education. METHOD: This article reports the interview findings from the qualitative component of a large-scale mixed-methods study...
September 2016: Nursing Education Perspectives
Marco A Amaral, Lucas Wardil, Matjaž Perc, Jafferson K L da Silva
In times of plenty expectations rise, just as in times of crisis they fall. This can be mathematically described as a win-stay-lose-shift strategy with dynamic aspiration levels, where individuals aspire to be as wealthy as their average neighbor. Here we investigate this model in the realm of evolutionary social dilemmas on the square lattice and scale-free networks. By using the master equation and Monte Carlo simulations, we find that cooperators coexist with defectors in the whole phase diagram, even at high temptations to defect...
September 2016: Physical Review. E
José A Reinoso, M C Torrent, Cristina Masoller
In sensory neurons the presence of noise can facilitate the detection of weak information-carrying signals, which are encoded and transmitted via correlated sequences of spikes. Here we investigate the relative temporal order in spike sequences induced by a subthreshold periodic input in the presence of white Gaussian noise. To simulate the spikes, we use the FitzHugh-Nagumo model and to investigate the output sequence of interspike intervals (ISIs), we use the symbolic method of ordinal analysis. We find different types of relative temporal order in the form of preferred ordinal patterns that depend on both the strength of the noise and the period of the input signal...
September 2016: Physical Review. E
Iliana I Karipidis, Georgette Pleisch, Martina Röthlisberger, Christoph Hofstetter, Dario Dornbierer, Philipp Stämpfli, Silvia Brem
Learning letter-speech sound correspondences is a major step in reading acquisition and is severely impaired in children with dyslexia. Up to now, it remains largely unknown how quickly neural networks adopt specific functions during audiovisual integration of linguistic information when prereading children learn letter-speech sound correspondences. Here, we simulated the process of learning letter-speech sound correspondences in 20 prereading children (6.13-7.17 years) at varying risk for dyslexia by training artificial letter-speech sound correspondences within a single experimental session...
October 14, 2016: Human Brain Mapping
Alexey Petrushin, Lorenzo Ferrara, Axel Blau
OBJECTIVE: In light of recent progress in mapping neural function to behavior, we briefly and selectively review past and present endeavors to reveal and reconstruct nervous system function in Caenorhabditis elegans through simulation. APPROACH: Rather than presenting an all-encompassing review on the mathematical modeling of C. elegans, this contribution collects snapshots of pathfinding key works and emerging technologies that recent single- and multi-center simulation initiatives are building on...
October 14, 2016: Journal of Neural Engineering
Kevin P Delaney, Debra L Hanson, Silvina Masciotra, Steven F Ethridge, Laura Wesolowski, S Michele Owen
BACKGROUND:  Understanding the period of time between an exposure resulting in infection with HIV and when a test can reliably detect the presence of that infection, i.e. the test window period, may benefit testing programs and clinicians in counseling patients about when the clinician and the patient can be confident a suspected exposure did not result in HIV infection. METHODS:  We evaluated the intervals between reactivity of the Aptima HIV-1 RNA nucleic acid test (Aptima) and 20 FDA-approved HIV immunoassays using 222 longitudinally collected plasma specimens from HIV-1 seroconverters from the United States...
October 12, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
John F Kragh, James K Aden, Michael A Dubick
BACKGROUND: Pneumatic field tourniquets have been recommended for Military medics to stop bleeding from limb wounds, but no comparison of commercially available pneumatic models of tourniquet has been reported. The purpose of this study is to provide laboratory data on the differential performance of models of pneumatic tourniquets to inform decision-making of potential field assessment by military users. METHODS: Models included the Emergency and Military Tourniquet (EMT), Tactical Pneumatic Tourniquet 2-inch (TPT2), and Tactical Pneumatic Tourniquet 3-inch (TPT3)...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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