Use of a Digital Cognitive Aid Improves Memorization of Military Caregivers After High-Fidelity Simulations of Combat Casualty Care

2021 ◽  
Author(s):  
Andrei-Petru Paraschiv ◽  
Baptiste Balança ◽  
Marc Lilot ◽  
Luc Aigle ◽  
Jean-Jacques Lehot ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Emergency Situation ◽  
High Fidelity ◽  
Care Providers ◽  
High Stakes ◽  
Emergency Situations ◽  
Combat Casualty ◽  
Complex Emergency ◽  
Combat Casualties ◽  
Operational Constraints

ABSTRACT Introduction High-fidelity simulation is widely used in the ongoing education of caregivers. However, the complex high-stakes simulated crisis environment affects memorization. This study investigated whether participants would remember more key training messages 3 months after a simulated complex emergency situation if they had used a digital cognitive aid (CA) during the simulations. Materials and Methods This randomized controlled trial was performed during a combat casualty training course for military physicians and nurses. Each pair of care providers completed two scenarios randomized to be undertaken either with or without a digital CA. At the end of each debriefing, instructors gave five scenario-specific key messages aloud. Three months later, learners were asked to recall the messages from their two scenarios and were scored for each scenario. The primary endpoint was the number of key messages recalled. The secondary endpoints were the influence on the results of the profession and the scenario block and age of the leader. Results Thirty-six pairs of participants were included. Due to operational constraints, only 34 completed the study. The use of the digital CA was associated with a positive effect on memorization at 3 months (F = 82.2, P < .001), unrelated to the leader’s profession, age, or the scenario block. The median of the memorization scores was 2/5 [1-3] with the digital CA and 1/5 [1-1] without it, which represents a difference of one memorized element (95% CI, 1-2; η2 = 0.39). Conclusions The digital CA allowed learners to remember twice as many key elements 3 months after simulated training of medical care for military combat casualties. A dedicated digital CA might be an asset for better care in a combat environment and for learning and memorizing critical care procedures following complex emergency situations.

IMPLEMENTATIONS EMERGENCY RESPONSE SYSTEM IN CASE OF ACCIDENTS AND EMERGENCY SITUATIONS (ERA-GLONASS) FOR CARS AND TRUCKS IN UZBEKISTAN

2020 ◽  
Author(s):  
Akmal Rustamov
Keyword(s):  
Emergency Response ◽  
Call Center ◽  
Emergency Services ◽  
Main Idea ◽  
Emergency Situation ◽  
High Mountain ◽  
Additional Information ◽  
Emergency Situations ◽  
Emergency Response System ◽  
Response System

The paper addresses the problem of increasing transportation safety due to usage of new possibilities provided by modern technologies. The proposed approach extends such systems as ERA-GLONASS and eCall via service network composition enabling not only transmitting additional information but also information fusion for defining required emergency means as well as planning for a whole emergency response operation. The main idea of the approach is to model the cyber physical human system components by sets of services representing them. The services are provided with the capability of self- contextualization to autonomously adapt their behaviors to the context of the car-driver system. The approach is illustrated via an accident emergency situation response scenario. “ERA-GLONASS” is the Russian state emergency response system for accidents, aimed at improving road safety and reducing the death rate from accidents by reducing the time for warning emergency services. In fact, this is a partially copied European e Call system with some differences in the data being transmitted and partly backward compatible with the European parent. The principle of the system is quite simple and logical: in the event of an accident, the module built into the car in fully automatic mode and without human intervention determines the severity of the accident, determines the vehicle’s location via GLONASS or GPS, establishes connection with the system infrastructure and in accordance with the protocol, transfers the necessary data on the accident (a certain distress signal). Having received the distress signal, the employee of the call center of the system operator should call the on-board device and find out what happened. If no one answers, send the received data to Sistema-112 and send it to the exact coordinates of the team of rescuers and doctors, and the last one to arrive at the place is given 20 minutes. And all this, I repeat, without the participation of a person: even if people caught in an accident will not be able to independently call emergency services, the data on the accident will still be transferred. In this work intended to add some information about applying system project in Uzbek Roads especially mountain regions like “Kamchik” pass. The Kamchik Pass is a high mountain pass at an elevation of 2.306 m above the sea level, located in the Qurama Mountains in eastern Uzbekistan and its length is about 88km.The road to reach the pass is asphalted, but there are rough sections where the asphalt has disappeared. It’s called A373. The old road over the pass was by passed by a tunnel built in 1999. On the horizon, the snow-capped peaks of the Fan Mountains come into view. The pass is located in the Fergana Valley between the Tashkent and Namangan Regions.

Examining the Effect of Three Low-Intensity Pediatric Obesity Interventions

2014 ◽  
Vol 53 (14) ◽  
pp. 1367-1374 ◽  
Author(s):  
Shannon M. Looney ◽  
Hollie A. Raynor
Keyword(s):  
Primary Care ◽  
Pediatric Obesity ◽  
Controlled Trial ◽  
Primary Care Providers ◽  
Growth Monitoring ◽  
Care Providers ◽  
Behavioral Counseling ◽  
Low Intensity ◽  
Contact Hours ◽  
Obesity Treatments

Background. Primary care is an ideal setting to treat pediatric obesity. Effective, low-intensity (≤25 contact hours over 6 months) interventions that reduce standardized body mass index ( z-BMI) and can be delivered by primary care providers are needed. Objective. This pilot randomized controlled trial investigated the effect of 3 low-intensity (≤25 contact hours over 6 months) pediatric obesity treatments on z-BMI. Methods. Twenty-two families (children 8.0 ± 1.8 years, z-BMI of 2.34 ± 0.48) were randomized into 1 of 3, 6-month, low-intensity conditions: newsletter (N), newsletter and growth monitoring (N + GM), or newsletter and growth monitoring plus family-based behavioral counseling (N + GM + BC). Anthropometrics and child eating and leisure-time behaviors were measured. Results. Mixed-factor analyses of variance found a significant ( P < .05) main effect of time for z-BMI and servings per day of sugar sweetened beverages, with both decreasing over time. Conclusion. Low-intensity obesity treatments can reduce z-BMI and may be more feasible in primary care.

scholarly journals Mobile Application Design Emergency Medical Call for the Deaf using UCD Method

2018 ◽  
Vol 12 (3) ◽  
pp. 168 ◽  
Author(s):  
Risald Risald ◽  
Suyoto Suyoto ◽  
Albertus Joko Santoso
Keyword(s):  
Hearing Loss ◽  
Emergency Situation ◽  
Emergency Call ◽  
Medical Emergency ◽  
Deaf People ◽  
User Centered Design ◽  
Emergency Situations ◽  
The People ◽  
Emergency Event ◽  
Audio Communication

<p>Deaf or hearing loss is a condition of inability to hear something, either totally or partially. Hearing loss greatly affects the life of a person in communicating with the people around him. Deaf people will be very difficult when in a medical emergency, this is because the medical emergency situation requires fast action.</p><p>          The Healthy Phone application is a mobile medical emergency call application that can help people with hearing impaired when in emergency situations. With the Healthy Phone application, the user only needs to select an icon that suits the situation encountered in touchscreen mobile device then the message will be sent to the nearest hospital.</p>                To search for icons corresponding to emergencies, the User Centered Design (UCD) method is used. This application is very helpful for deaf people because this application does not require audio communication and user location is also sent automatically to the nearest hospital. The results were analyzed using four emergency event scenarios with a total score of 87% and an average user time of less than 0:42 sec indicating that the study was successful in designing a mobile medical emergency call application according to user requirements.

Documenting Patients’ and Providers’ Preferences When Proposing a Randomized Controlled Trial: A Qualitative Exploration

2021 ◽  
Author(s):  
Devesh Oberoi ◽  
Cynthia Kwok ◽  
Yong Li ◽  
Cindy Railton ◽  
Susan Horsman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Study Design ◽  
Controlled Trial ◽  
Primary Care Providers ◽  
Referral Letter ◽  
Care Providers ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Follow Up Care

Abstract Background With advances in cancer diagnosis and treatment, women with early-stage breast cancer (ESBC) are living longer, increasing the number of patients receiving post-treatment follow-up care. Best-practice survivorship models recommend transitioning ESBC patients from oncology-provider (OP) care to community-based care. While developing materials for a randomized controlled trial (RCT) to test the feasibility of a nurse-led Telephone Survivorship Clinic (TSC) for a smooth transition of ESBC survivors to follow-up care, we sought to explore patients’ and OPs’ reactions to our proposed recruitment methods. Methods We used a qualitative study design with content analysis, and a two-pronged approach. We interviewed OPs, seeking feedback on ways to recruit their ESBC patients for the trial, and ESBC patients, seeking input on a questionnaire package assessing outcomes and processes in the trial. Results OPs identified facilitators and barriers and offered suggestions for study design and recruitment process improvement. Facilitators included the novelty and utility of the study and simplicity of methods; barriers included lack of coordination between treating and discharging clinicians, time constraints, language barriers, motivation, and using a paper-based referral letter. OPs suggested using a combination of electronic and paper referral letters and supporting clinicians to help with recruitment. Patient advisors reported satisfaction with the content and length of the assessment package. However, they questioned the relevance of some questions (childhood trauma) while adding questions about trust in physicians and proximity to primary-care providers. Conclusion OPs and patient advisors rated our methods for the proposed trial highly for their simplicity and relevance then suggested changes. These findings document processes that could be effective for cancer-patient recruitment in survivorship clinical trials.

Abstract WP462: Improving Nurses’ Comfort and Practice Towards Neuroscience Patients Utilizing High-fidelity Simulation

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Erin Supan ◽  
Lauren Patton ◽  
Julie M Fussner ◽  
Colin Beilman ◽  
Martha Sajatovic
Keyword(s):  
Survey Design ◽  
Comfort Level ◽  
High Fidelity ◽  
Care Hospital ◽  
High Fidelity Simulation ◽  
University Hospitals ◽  
Experienced Nurses ◽  
Emergency Situations ◽  
Neurologic Emergencies ◽  
Strongly Agree

Introduction: University Hospitals Health System (UHHS) has seen an interest by nursing in using simulation and case studies as an adjunct to classroom education to instruct in emergency situations and mock codes. UHHS is currently expanding neuroscience services at 2 community hospitals while maintaining services at the quaternary care hospital. There is a need for further neuroscience education of both experienced nurses who have limited neuroscience exposure and novice nurses employed in neuroscience specialty areas. Patient simulators have been used in a variety of education settings, yet their effectiveness in training nurses to manage neurologic patients and neurologic emergencies has not been widely examined. The purpose of this project is to evaluate the use of high-fidelity simulation on nurses’ assessment skills, critical thinking and comfort in caring for neuroscience patients. Methods: A pre and post survey design was used for this project with nurses completing a survey immediately prior to and after participating in 3 simulation scenarios: intracerebral hemorrhage with intracranial pressure, subdural hematoma with seizures, and brain tumor complicated by pulmonary embolism. After completion of each scenario a debriefing occurred. Surveys allowed nurses to assess their confidence levels in responding to neurologic emergencies using a 5-point Likert-type scale (1= strongly disagree to 5 = strongly agree). Results: Comfort level was assessed in five different categories. Comfort in performing a neurologic assessment improved from a pre-survey average of 4.02 to a post-survey average of 4.59, a variance of 11.4%. Comfort in managing a stroke patient improved from 3.98 to 4.45, a variance of 9.5%. Comfort in administering emergency medications improved from 3.02 to 3.98, a variance of 19.1%. Comfort in identifying neurologic changes improved from 3.82 to 4.43, a variance of 12.3%. Comfort in communicating neurologic changes to the provider improved from 4.00 to 4.66, a variance of 13.2%. There was an overall improvement in the variance in all 5 categories of 13.1%. Conclusion: The use of high-fidelity simulation allowed nurses to gain comfort in assessment, management, and provider communication specific to neuroscience patients.

scholarly journals Probabilistic-deterministic approach of controlling the functionality of a technical system in normal and emergency operation modes

2018 ◽  
Vol 226 ◽  
pp. 04008
Author(s):  
Vladimir M. Zababurin ◽  
Marina A. Egorova ◽  
Yuliya A. Polyakova
Keyword(s):  
Open Systems ◽  
System Development ◽  
Emergency Situation ◽  
Emergency Operation ◽  
Technical System ◽  
Emergency Situations ◽  
Recovery Processes ◽  
Current State ◽  
Self Organized Criticality ◽  
Technical Systems

The main disadvantages of the existing methods of managing the current state of technical systems are revealed. A non-standard approach is proposed for managing the functionality of the system in emergency situations. The character of the dynamics of the recovery processes of the technical system is determined as its state approaches the emergency one on the basis of the recommendations of the theory of self-organized criticality (SOC). The physical criteria for assessing the current state of the technical system are revealed. The rationale for using the physical indicator of the functional destabilization of the system is given. The signs of the pre-emergency state of the technical system are considered. A grapho-analytical model for the development of an emergency situation has been developed. The fact of the inevitable increase in the entropy of the system upon its transition to an emergency state is established. Structuring of the system development process in an emergency situation is carried out in three stages. The methodology for estimating the pre-emergency state of complex open systems is presented. The advantages of the proposed approach to managing the state of technical systems in comparison with traditional ones are established.

scholarly journals Emergency: definitions, problems and solutions

2021 ◽  
Vol 17 (7) ◽  
pp. 15-19
Author(s):  
V.P. Мiroshnychenko
Keyword(s):  
External Environment ◽  
Emergency Situation ◽  
Anthropogenic Activity ◽  
Emergency Situations ◽  
Problems And Solutions ◽  
The Subject ◽  
Definition Of

Emergency situations constantly accompany the external environment and society bringing major material losses and human casualties. The definitions and general patterns for the development of emergency situations and their role in accidents and disasters were discussed. Actually, there is no single concept in the definition of an emergency. Based on the ana-lysis, the content of the subject was formulated: an emergency is a state of natural and anthropogenic activity in the external environment and society. The mechanism of the emergency situation development is presented. The reason for changing the normative definition of the concept of emergency situation has been substantiated.

scholarly journals Blood Group Detection using Matlab

2021 ◽  
Vol 9 (VI) ◽  
pp. 3089-3093
Author(s):  
Sujatha C. N
Keyword(s):  
Image Processing ◽  
Blood Group ◽  
Human Error ◽  
Group Identification ◽  
Group Testing ◽  
Emergency Situation ◽  
Blood Type ◽  
Morphological Operations ◽  
Laboratory Staff ◽  
Emergency Situations

Blood group testing is one of the vital tasks in the area of medicine, in which it is very important during emergency situation before victim requires blood transfusion. Presently, the blood tests are conducted manually by laboratory staff members, which is time consuming process in the emergency situations. Blood group identification within shortest possible time without any human error is an important factor and very much essential. Image processing paves a way in determining blood type without human intervention. Images which are captured using high resolution microscopic camera during the blood slide test in the laboratory which are used for blood type evaluation. The image processing techniques which include thresholding and morphological operations are used. The blood image is separated into sample wise and blood type is decided based on the agglutination effects in those sample images. This project facilitates the identification of blood group even by common people who are unaware of the blood typing procedure.

scholarly journals Influence of VANET System on Movement of Traffic Flows in Emergency Situations

2015 ◽  
Vol 27 (3) ◽  
pp. 237-246 ◽  
Author(s):  
Algimantas Kajackas ◽  
Vidas Žuraulis ◽  
Edgar Sokolovskij
Keyword(s):  
Reaction Time ◽  
Ad Hoc Network ◽  
Ad Hoc ◽  
Emergency Situation ◽  
Traffic Flows ◽  
Residual Velocity ◽  
Vehicle Collisions ◽  
Emergency Braking ◽  
Emergency Situations ◽  
Vehicle To Vehicle

The paper presents Vehicular Ad Hoc Network (VANET) system based on an analysis of the movement of a motorcade in an emergency situation. This analysis seeks to answer the question: when and under what conditions Emergency Message (EM) sent by Vehicle-to-Vehicle (V2V) system reaches the final target to help in preventing of serious accidents, such as multi-vehicle collisions. The model of calculation based on the key principles of vehicle braking enables finding the time to possible collision and the residual velocity of the vehicle. In the calculations, the average values of the driver’s reaction time are accepted; in addition, a sent emergency message is considered to be free of interference. Upon choosing different road and driving conditions, it is found what vehicle of the motorcade stops before the possible obstacle on emergency braking. The performance of vehicles with and without VANET system is compared.

scholarly journals Land subsidence modelling for decision making on groundwater abstraction under emergency situation

2020 ◽  
Vol 382 ◽  
pp. 403-408
Author(s):  
Masaatsu Aichi
Keyword(s):  
Decision Making ◽  
Monte Carlo ◽  
Uncertainty Analysis ◽  
Real Time ◽  
Land Subsidence ◽  
Null Space ◽  
Emergency Situation ◽  
Computational Time ◽  
Groundwater Abstraction ◽  
Emergency Situations

Abstract. This study presents an inversion scheme with uncertainty analysis for a land subsidence modelling by a Monte Carlo filter in order to contribute to the decision-making on the groundwater abstraction. For real time prediction and uncertainty analysis under the limited computational resources and available information in emergency situations, one dimensional vertical land subsidence simulation was adopted for the forward modelling and the null-space Monte Carlo method was applied for the effective resampling. The proposed scheme was tested with the existing land subsidence monitoring data in Tokyo lowland, Japan. The results demonstrated that the prediction uncertainty converges and the prediction accuracy improves as the observed data increased with time. The computational time was also confirmed to be acceptable range for a real time execution with a laptop.

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