Comparison of severe trauma treatment standards in civilian China with current practice in the Chinese military peacekeeping Level 2 Military Hospital in Gao, Mali

2018 ◽  
Vol 164 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Jian Li ◽  
J Tian ◽  
Y B Wang ◽  
H Zhang
Keyword(s):  
Current Practice ◽  
High Standard ◽  
Standard Of Care ◽  
Severe Trauma ◽  
Trauma Treatment ◽  
Military Hospital ◽  
Treatment Standards ◽  
Emergency Rescue ◽  
Medical Teams ◽  
Level 2

IntroductionThe People’s Republic of China has been successfully deploying medical teams to support the peacekeeping mission at the Level 2 Military Hospital in Mali since December 2013. The aim of this paper was to compare the current practice in Chinese Peacekeeping Level 2 Military Hospital with the severe trauma treatment standards reported in China.MethodsA retrospective analysis was conducted between 26 April 2014 and 18 May 2016 using records stored in the Chinese Peacekeeping Level 2 Hospital (CHN L2). From 19 May 2016 to 31 March 2017, the data were prospectively collected for all casualties presenting in the hospital. Emergency response time, prehospital transit time, emergency rescue time, consultation call time and mortality were compared with the data from a study that evaluated the effects of standard rescue procedure (SRP) in improving severe trauma treatment in different hospitals across China.ResultsIndexes obtained from the analysis of CHN L2 data were equal or surpassed indexes reported in the study evaluating the implementation of SRP in Chinese hospitals.ConclusionThe deployed CHN L2 delivered a high standard of care in Gao, Mali, and generally surpasses the Chinese standards. This can mostly be attributed to an efficient coordination of work during both prehospital and in-hospital stages of rescue.

scholarly journals Educational needs of severe trauma treatment simulation based on mixed reality: Applying focus group interviews to military hospital nurses

2021 ◽  
Vol 27 (4) ◽  
pp. 423-435
Author(s):  
Seon Mi Jang ◽  
Sinwoo Hwang ◽  
Yoomi Jung ◽  
Eunyoung Jung
Keyword(s):  
Teaching Methods ◽  
Mixed Reality ◽  
Severe Trauma ◽  
Educational Needs ◽  
Teaching Evaluation ◽  
Trauma Treatment ◽  
Military Hospital ◽  
Hospital Nurses ◽  
Focus Group Interviews ◽  
Group Interviews

Purpose: The purpose of this study is to identify the educational needs of a severe trauma treatment simulation program based on mixed reality which combines element of both virtual reality and augmented reality.Methods: Focus group interviews were conducted with ten military hospital nurses on February 4 and 5, 2021. The collected data were analyzed using a qualitative content analysis. As a framework for data analysis, the educational needs were clustered into the following four categories: teaching contents, teaching methods, teaching evaluation, and teaching environment.Results: The educational needs for each category that emerged were as follows: three subcategories including “realistic education reflecting actual clinical practice” and “motivating education” for teaching contents; five subcategories including “team-based education,” “repeated education that acts as embodied learning,” and “stepwise education” for teaching methods; six subcategories including “debriefing through video conferences,” “team evaluation and evaluator in charge of the team,” “combination of knowledge and practice evaluation” for teaching evaluation; six subcategories including “securing safety,” “similar settings to real clinical environments,” “securing of convenience and accessibility for learners,” and “operating as continuing education” for teaching environment.Conclusion: The findings of this study can provide a guide for the development and operation of a severe trauma treatment simulation program based on mixed reality. Moreover, it suggests that research to identify the educational needs of various learners should be conducted.

scholarly journals P094 CPAP Service Patient Experience Survey

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A51-A52
Author(s):  
R Mihai ◽  
K Ellis ◽  
N Verginis ◽  
M Davey ◽  
G Nixon
Keyword(s):  
Support Groups ◽  
Online Survey ◽  
Positive Airway Pressure ◽  
High Standard ◽  
Standard Of Care ◽  
Sleep Apnoea ◽  
Information Support ◽  
Obstructive Sleep ◽  
Experience Survey

Abstract Introduction Increasing numbers of children with obstructive sleep apnoea require continuous positive airway pressure (CPAP) treatment. We aimed to collect feedback from parents/carers about our CPAP education and follow-up programme. Methods An online survey link was texted to families of children starting outpatient CPAP from Jan 2019 -Feb 2021. Questions assessed satisfaction with the CPAP initiation process, including education by our nurse educator (NE), mask fitting, using equipment, accessing help, confidence using CPAP and follow up. Open-ended feedback was invited. Results 17/55 (31%) of eligible families responded. “Very satisfied” responses regarding CPAP education ranged from 76% (discussion of costs) to 94% (machine use and maintenance). All families felt confident starting CPAP at home. Two reported issues starting CPAP, but reported feeling fully supported by staff remotely to troubleshoot. All families were “somewhat” or “very satisfied” with NE follow-up, with 2 families more neutral about physician follow-up. Two families reported lower satisfaction (“somewhat dissatisfied” or neutral) with the range of paediatric masks, rather than with the mask fitting process itself. Of 14 general comments, 64% were positive (most common theme was high standard of care from the NE); 21% negative (lack of mask choices, location of consulting suites); and 15% neutral. Suggestions for improvement included financial support information, support groups and online consumable ordering. Discussion Families feel confident and well supported to commence outpatient CPAP, highlighting the care, knowledge and support provided by our team. Findings emphasize the importance of a dedicated NE. Suggestions provided will inform future service improvements.

Sir James Crichton Browne, 1840-1938

1939 ◽  
Vol 2 (7) ◽  
pp. 519-521
Keyword(s):  
Mental Disorders ◽  
Royal Society ◽  
Mental Hospital ◽  
Charles Darwin ◽  
High Standard ◽  
Standard Of Care ◽  
The West ◽  
Mental Hospitals ◽  
Medical Superintendent ◽  
Care And Treatment

On 31 January 1938, Sir James Crichton-Browne died a few months after his 97th birthday. In him the Royal Society lost its oldest Fellow, both in age and in membership, for he was elected Fellow in 1883, Charles Darwin being one of his proposers. His father, Dr W. A. F. Browne, who was the first Medical Superintendent of the Crichton Royal Mental Hospital at Dumfries, was largely responsible for the high standard of care and treatment of the insane for which this institution has since been famous ; later he became Commissioner in Lunacy in Scotland. It was therefore not surprising that after qualifying in medicine in Edinburgh University at the age of 22, his son decided to devote himself to the study of mental disorders. After serving in junior posts in various county Mental Hospitals he was appointed in 1866 Medical Superintendent of the West Riding Asylum, at Wakefield, a post he held until 1875. It was here his most valuable researches and pioneering work was done.

scholarly journals An Analysis of State Telehealth Laws and Regulations for Occupational Therapy and Physical Therapy

2014 ◽  
Vol 6 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Christine Calouro ◽  
Mei Wa Kwong ◽  
Mario Gutierrez
Keyword(s):  
Physical Therapy ◽  
Occupational Therapy ◽  
Physical Therapists ◽  
Occupational Therapists ◽  
High Standard ◽  
Standard Of Care ◽  
Potential Effect ◽  
State Laws ◽  
Do So ◽  
Laws And Regulations

This study conducted a scan of telehealth physical and occupational therapy state laws and regulations. The laws and regulations were analyzed to determine the potential effect they could have on physical therapists (PTs) and occupational therapists’ (OTs) utilization of telehealth. The results indicate that the majority of physical and occupational therapy boards are silent on telehealth. A handful of physical therapy laws and regulations address “consultation by means of telecommunication,” but do not provide any guidance for PTs or OTs seeking to provide direct telehealth-delivered services to patients.  Of the few states that do provide guidance, policy had the potential to provide clarity, or inhibit adoption. The findings suggest that as state boards look at crafting telehealth regulation, they should do so in a way that facilitates, rather than hampers adoption, while upholding their providers to a high standard of care.

Stentless hypospadias repair: The way forward

2020 ◽  
pp. 205141582093126
Author(s):  
Gursev Sandlas ◽  
Charu Tiwari ◽  
Jyoti Bothra ◽  
Bhushan Jadhav ◽  
Hemanshi Shah
Keyword(s):  
Randomized Study ◽  
Surgical Site Infections ◽  
Slight Modification ◽  
Standard Of Care ◽  
Hypospadias Repair ◽  
Level Of Evidence ◽  
Tubularized Incised Plate ◽  
Age At Surgery ◽  
Level 2

Background: Stentless repair of hypospadias has been previously described in the literature for distal penile hypospadias repair. This was a prospective non-randomized study with the aim of assessing the efficacy of stentless repair in our health-care system. Methods: A total of 104 patients managed prospectively for hypospadias over a 30-month period who met the inclusion criteria were included in the study and underwent a stentless modified tubularized incised plate (TIP) urethroplasty repair (with a slight modification described subsequently) by three surgeons and were followed up for a minimum period of six months. Results: The median age at surgery was eight months. The site of meatus was glanular in 20 patients, coronal in 36 patients, sub-coronal in 38 patients and mid-penile in 10 patients. The median operative time was 47 minutes (range 32–76 minutes). The median time to first micturition was 140 minutes (range 10–300 minutes). Voiding difficulty was encountered in two patients, requiring catheterization. Three patients had superficial surgical site infections which were conservatively managed. All patients were discharged on the second postoperative day, except for the three patients with surgical site infection. On follow-up, two patients had a fistula. Conclusion: Stentless repair of hypospadias is the future and the new standard of care and should be used in every case where a modified TIP repair is feasible. This decreases complications from urethral stenting and decreases the duration of hospital stay. Both patient and parents are comfortable with this procedure. Level of evidence Level 2.

The role of specialist inpatient rehabilitation services for people with intellectual disability, autism and mental health, behavioural or forensic needs

2019 ◽  
Vol 13 (5) ◽  
pp. 204-215
Author(s):  
Mahesh Odiyoor ◽  
Samuel Joseph Tromans ◽  
Regi T. Alexander ◽  
Srinaveen Akbari ◽  
Gill Bell ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Outcome Measures ◽  
Community Support ◽  
Inpatient Rehabilitation ◽  
High Standard ◽  
Standard Of Care ◽  
Rehabilitation Services ◽  
Content Type ◽  
The Uk

Purpose The purpose of this paper is to provide a professional consensus position with regard to the provision of specialist inpatient rehabilitation services for people with intellectual disability (ID), autism and mental health, behavioural or forensic needs in the UK. Design/methodology/approach The concept of rehabilitation is discussed, as well as the functions and goals of specialist inpatient rehabilitation services with regard to the aforementioned contexts. Current use of rehabilitation beds is considered, both on a regional and national scale, as well as various outcome measures, including effectiveness, patient safety and patient experience. Findings There is a clear need for specialist inpatient rehabilitation services, though historically there have been instances of inappropriate admissions, as well as lengthy inpatient stays that could have been significantly reduced with the right type of community support package. Such services should be subjected to rigorous measurement of outcome measures, to determine that patients within such services are receiving a consistently high standard of care. Additionally, amendments to current legal frameworks should be considered, with a view to accommodating for individuals with capacity who require continuous community-based supervision. Originality/value To the best of the author’s knowledge, this is the first article detailing a professional consensus position for specialist inpatient rehabilitation services for people with ID, autism and mental health, behavioural or forensic needs.

scholarly journals Laparoscopy in Emergency: Why Not? Advantages of Laparoscopy in Major Emergency: A Review

Life ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 917
Author(s):  
Giuseppe Ietto ◽  
Francesco Amico ◽  
Giuseppe Pettinato ◽  
Valentina Iori ◽  
Giulio Carcano
Keyword(s):  
Laparoscopic Approach ◽  
High Standard ◽  
Standard Of Care ◽  
Multiple Organ ◽  
Surgical Emergencies ◽  
Grade Of Recommendation ◽  
Molecular Patterns ◽  
Damage Associated Molecular Patterns ◽  
Organ Dysfunctions

A laparoscopic approach is suggested with the highest grade of recommendation for acute cholecystitis, perforated gastroduodenal ulcers, acute appendicitis, gynaecological disorders, and non-specific abdominal pain (NSAP). To date, the main qualities of laparoscopy for these acute surgical scenarios are clearly stated: quicker surgery, faster recovery and shorter hospital stay. For the remaining surgical emergencies, as well as for abdominal trauma, the role of laparoscopy is still a matter of debate. Patients might benefit from a laparoscopic approach only if performed by experienced teams and surgeons which guarantee a high standard of care. More precisely, laparoscopy can limit damage to the tissue and could be effective for the reduction of the overall amount of cell debris, which is a result of the intensity with which the immune system reacts to the injury and the following symptomatology. In fact, these fragments act as damage-associated molecular patterns (DAMPs). DAMPs, as well as pathogen associated molecular patterns (PAMPs), are recognised by both surface and intracellular receptors of the immune cells and activate the cascade which, in critically ill surgical patients, is responsible for a deranged response. This may result in the development of progressive and multiple organ dysfunctions, manifesting with acute respiratory distress syndrome (ARDS), coagulopathy, liver dysfunction and renal failure. In conclusion, none of the emergency surgical scenarios preclude laparoscopy, provided that the surgical tactic could ensure sufficient cleaning of the abdomen in addition to resolving the initial tissue damage caused by the “trauma”.

scholarly journals Acting and knowledge of emergency rescue teams in dental trauma

2019 ◽  
Vol 22 (3) ◽  
pp. 329-334
Author(s):  
Amjad Abu Hasna ◽  
Carlos Henrique Ferrari ◽  
Tatiane Sampaio Bittencourt ◽  
Carlos Henrique Ribeiro Camargo ◽  
Cláudio Antonio Talge Carvalho
Keyword(s):  
Dental Trauma ◽  
Trauma Patients ◽  
Dental Tissue ◽  
Emergency Rescue ◽  
Tooth Avulsion ◽  
Emergency Units ◽  
Level Of Knowledge ◽  
Medical Teams ◽  
High Level ◽  
Educational Campaigns

Dental trauma is common in patients assisted by rescue teams at sites of accidents and by emergency teams in hospitals. However, these professionals are given little or no information about taking care of the injured teeth and mouth. The aim of this study was to evaluate the level of knowledge of rescue and emergency teams’ professionals (physicians, Nurses, and Paramedics) concerning dental trauma first management. Material and methods: 196 professionals of rescue and emergency units had received a standard questionnaire of 5 questions concerning dental trauma first management and reserving avulsed dental tissue (tooth or its fragment). The results showed high level of attendance of dental trauma patients by paramedics, nurses, and physicians, with very low-level knowledge about dealing with such cases, and with moderate results about the best medium to reserve the avulsed tooth, and the actions taken during the rescue process. Conclusions: Our results show a high occurrence of cases of dental trauma attended by rescue and emergency medical teams, with a lack of knowledge. This suggests a need for more educational campaigns for these professionals with a long-term follow-up.Keywords: Traumatic dental injury, Tooth Avulsion, Emergence rescue teams.

scholarly journals Efficacy of Ivermectin in COVID-19 Patients with Mild to Moderate Disease

2021 ◽  
Author(s):  
Karamat Hussain Shah Bukhari ◽  
Asma Asghar ◽  
Najma Perveen ◽  
Arshad Hayat ◽  
Sermad Ahmad Mangat ◽  
...  
Keyword(s):  
Side Effects ◽  
Standard Of Care ◽  
Viral Clearance ◽  
Secondary Outcome ◽  
Military Hospital ◽  
Laboratory Parameters ◽  
Function Tests ◽  
Moderate Disease ◽  
Group A ◽  
Group B

AbstractObjectiveTo evaluate the efficacy of ivermectin (IVM) as an addition to the standard of care (SOC) treatment in COVID-19 patients with mild and moderate diseaseMaterials and MethodsA randomized clinical trial (Trial registration # NCT04392713) was carried out at Combined Military Hospital Lahore from March 15, 2020, to June 15, 2020. Eighty-six patients with reverse transcriptase-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection completed the trial protocol. Patients were stratified via the lottery method into two groups. Group A was administered standard of care (SOC) treatment as per existing hospital guidelines whereas group B was given ivermectin (single dose of 12 milligrams) along with SOC treatment. PCR was repeated at 72 hours, 7th day, and at 14th day of admission for both the groups and the point at which the PCR became negative was noted. Complete blood counts, liver function tests and renal function tests were done at recruitment, 7th day, and 14th day. The primary outcome was the viral clearance, measured as days to achieve PCR negativity. The secondary outcome was the development of any adverse side effects pertinent to ivermectin or derangement in baseline laboratory parameters.ResultsIn group A, 36 (80%) participants were males, and 9 (20%) were females, whereas in group B, 37 (90.2%) were males and 4 (9.8%) were females. Mean age was 39.0± 12.6 and 42.2 ± 12.0 years for groups A and B, respectively (p= 0.394). There was early viral clearance in group B as compared to group A (p=0.001). No adverse reaction or derangements in laboratory parameters was noted in the intervention arm during the trial period.ConclusionIn the intervention arm, early viral clearance was observed and no side effects were documented. Therefore ivermectin is a potential addition to the standard care of treatment in COVID-19 patients.

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