scholarly journals Emergency cricothyrotomy during the COVID-19 pandemic: how to suppress aerosolization

2020 ◽  
Vol 5 (1) ◽  
pp. e000542
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  
Keyword(s):  
Potential Risk ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Financial Resources ◽  
Risk Of Infection ◽  
X Ray ◽  
General Surgeons ◽  
Fluorescein Dye ◽  
Nose And Throat

BackgroundCricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.Methods5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.ResultsAll five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.ConclusionsWe present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.

scholarly journals Are healthcare professionals in Jordan willing to work and provide care for COVID-19 patients?

2021 ◽  
Vol 18 ◽  
Author(s):  
Mahmoud Alwidyan ◽  
Alaa Oteir ◽  
Anas Mohammad ◽  
Brett Williams
Keyword(s):  
Healthcare Professionals ◽  
Healthcare Providers ◽  
Healthcare Systems ◽  
The Novel ◽  
Risk Of Infection ◽  
Online Questionnaire ◽  
Lack Of Information ◽  
To Come ◽  
Novel Coronavirus ◽  
Willingness To Report

Introduction The outbreak of the novel coronavirus (COVID-19) has overwhelmed healthcare systems and exposed healthcare providers (and their families) to a high risk of infection and death. This study aimed to assess the willingness of healthcare providers in Jordan to report for duty and provide care to COVID-19 patients. Methods An online questionnaire was developed including questions about demographics, willingness to report to work and provide care to COVID-19 patients, and potential associated factors. Results A total of 253 participants completed the survey (mean age 33.8 years, 58.6% male). The sample included physicians (14.9%), nurses (61.1%) and paramedics (23%). Most participants (96.4%) were willing to come to work during the pandemic, although only 64.7% showed a willingness to provide care to COVID-19 patients. Being male (OR 3.21; 95% CI: 1.75-5.90) or having adequate training on COVID-19 (OR 5.16; 95% CI: 2.32-11.46) were the major predictors for willingness to care for COVID-19 patients, whereas concerns for family safety (OR 0.25; 95% CI: 0.14-0.47) or lack of information about COVID-19 (OR 0.43; 95% CI: 0.23-0.80) were the major predicting barriers for willingness to care for COVID-19 patients. Conclusion Although most participants were willing to report for duty, less than two-thirds were willing to care for COVID-19 patients. Being male and receiving training are associated with willingness; whereas concern for family is associated with less willingness to care for COVID-19 patients.

scholarly journals A novel box for aerosol and droplet guarding and evacuation in respiratory infection (BADGER) for COVID-19 and future outbreaks

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hau D. Le ◽  
Gordon A. Novak ◽  
Kevin C. Janek ◽  
Jesse Wang ◽  
Khang N. Huynh ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Healthcare Providers ◽  
Airborne Particles ◽  
Risk Of Infection ◽  
Indirect Contact ◽  
Vacuum Suction ◽  
Qualitative And Quantitative ◽  
Additional Layer ◽  
Increased Risk ◽  
Design Construction

AbstractThe coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions and killed more than 1.7 million people worldwide as of December 2020. Healthcare providers are at increased risk of infection when caring for patients with COVID-19. The mechanism of transmission of SARS-CoV-2 is beginning to emerge as airborne spread in addition to direct droplet and indirect contact as main routes of transmission. Here, we report on the design, construction, and testing of the BADGER (Box for Aerosol and Droplet Guarding and Evacuation in Respiratory Infection), an affordable, scalable device that contains droplets and aerosol particles, thus minimizing the risk of infection to healthcare providers. A semi-sealed environment is created inside the BADGER, which is placed over the head of the patient and maintains at least 12-air changes per hour using in-wall vacuum suction. Multiple hand-ports enable healthcare providers to perform essential tasks on a patient’s airway and head. Overall, the BADGER has the potential to contain large droplets and small airborne particles as demonstrated by simulated qualitative and quantitative assessments to provide an additional layer of protection for healthcare providers treating COVID-19 and future respiratory contagions.

scholarly journals Superficial Parotidectomy: Impact of Postoperative Drainage

2020 ◽  
pp. 014556132094238 ◽  
Author(s):  
Charlotte Fog Nielsen ◽  
Charlotte Bjerg Sand Riis ◽  
Anne Louise Bach Christensen ◽  
Frank Mirz ◽  
Kasper Basse Reinholdt ◽  
...  
Keyword(s):  
Tumor Size ◽  
Best Practice ◽  
Facial Nerve Palsy ◽  
Regional Hospital ◽  
Male Gender ◽  
Risk Of Infection ◽  
Superficial Parotidectomy ◽  
Suction Drain ◽  
Postoperative Drainage ◽  
Nose And Throat

Background: Use of suction drain after superficial parotidectomy (SP) is based on national consensus considered best practice, but there is no evidence on the effect of the treatment. The aim of the present study is to evaluate the effectiveness of drainage after SP by evaluating the rate of complications after SP in relation to the (ie, duration) of drainage and tumor size. Methods: Retrospective analysis was performed involving data from all consecutive patients undergoing SP at the Ear, Nose, and Throat department, Regional Hospital West Jutland, Denmark, between January 1, 2011, and December 31, 2017. Demographics including comorbidity, medication, tumor size, postoperative secretion through the drainage, as well as complications (hematoma, seroma, infection, fistulas, Frey syndrome, facial nerve palsy) were registered. Patients with secretion below 25 mL were compared to patients with secretion above 25 mL, that is, drainage less than 24 hours versus longer than 24 hours. Results: Two hundred five consecutive patients undergoing SP were enrolled. The overall risk of postoperative infection was 16.2%. Ten of 33 patients with infection were also diagnosed with an hematoma or seroma. The risk of infection increased with secretion above 25 mL (27.2%) compared to patients with less than 25 mL (13.1%; P = .0318). The same accounts for the risk of seromas/hematomas ( P = .0055). We found no evidence that demographics or comorbidity correlated to the secretion in the drainage, but there is a tendency toward male gender having a higher risk off secretion above 25 mL (odds ratio 1.39). Conclusion: Overall, the risk of complications after SP increased with secretion beyond 25 mL (ie, drainage for more than 24 hours). This applied in particular to infections and seromas/hematomas demanding treatment. The use of routine drainage after SP is questionable, and a randomized trial is warranted to unravel the necessity of postoperative drainage.

scholarly journals The Value of the Oral Medicine Specialty in the Modern Healthcare Systems

2021 ◽  
pp. 1-8
Author(s):  
Mohammed Bindakhil ◽  
Scarlet Charmelo-Silva ◽  
Alhanouf A. Bin Dakhil ◽  
Ibrahim A. ALOmair
Keyword(s):  
Saudi Arabia ◽  
Oral Health ◽  
Medical Training ◽  
Positive Impact ◽  
Healthcare Providers ◽  
Healthcare Systems ◽  
Medical Community ◽  
Oral Diseases ◽  
Oral Medicine ◽  
Training And Education

<b><i>Background:</i></b> Oral medicine is a subdiscipline of dentistry that concerns itself with the oral health of patients; it focuses on providing diagnosis and management of oral and maxillofacial diseases, as well as direct dental care for those in medically complex situations. As primary healthcare providers, physicians and dentists are often the first to evaluate patients with orofacial symptoms and make diagnoses related to oral health, whether explicit or manifested through systemic diseases. However, a lack of familiarity with oral medicine among healthcare providers often leads to significant delays in the accurate diagnosis and appropriate treatment of many oral and maxillofacial disorders. It has been well established that a lack of training and education in oral health among physicians is an impediment to alleviating the situation. <b><i>Summary:</i></b> Several studies and scientific reports in the medical community have shown a greater professional interest in oral health and medicine, with numerous recent articles reflecting a clear rise in multiple factors: an increased interest in additional training and a rise in oral diseases. This review focuses on the need for a multidisciplinary approach in modern healthcare systems that implements the oral medicine specialty. It also serves to emphasize the role of oral medicine in medical training and education, while simultaneously discussing the prevalence of oral diseases and awareness of oral health among physicians in Saudi Arabia. <b><i>Key Messages:</i></b> The prevalence of oral health conditions in Saudi Arabia appears to be high yet is accompanied by a scarcity of oral medicine specialists in this part of the world. Furthermore, numerous studies have revealed that physicians from different specialties in Saudi Arabia lack training in oral health and possess an insufficient awareness of the oral medicine specialty. This paucity of oral medicine specialists in Saudi Arabia presents a key issue as the clinical services and medical education provided by such specialists in healthcare systems can have a profound positive impact on each patient’s quality of life and health outcomes, as well as the standards of physicians’ training.

NCOG-42. SYMPTOM ONSET TO TIME OF DIAGNOSIS IN PRIMARY CENTRAL NERVOUS SYSTEM TUMOR PATIENTS: A REVIEW OF FINDINGS FROM THE NOB-NHS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi161-vi161
Author(s):  
Matthew Lindsley ◽  
Elizabeth Vera ◽  
Alvina Acquaye ◽  
Nicole Briceno ◽  
Anna Choi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Tumor Location ◽  
Low Grade ◽  
Central Nervous System Tumor ◽  
Tumor Patients ◽  
Patient Reported ◽  
Reported Data

Abstract Prior reports suggest the low prevalence of primary central nervous system (PCNS) tumors and the healthcare setting where patients seek care can contribute to diagnostic delays, potentially affecting prognosis. This descriptive report highlights findings from patient-reported data at presentation collected from a sample of 623 PCNS tumor patients. Participants were White (88%), males (56%), median age at diagnosis 41 (2-79) with high grade (HG) (66%) brain tumors (BT) (89%). Among BT patients, 30% reported ≥ 3 concurrent symptoms at presentation including headaches (40%), seizures (30%), and memory problems or difficulty with balance/walking (20% each). Over half (57%) had symptoms for &lt; 6 months before diagnosis and 60% presented to the Emergency Room. Sixty-five percent of HG BT patients had symptoms for &lt; 6 months prior to diagnosis compared to low grade (LG) tumors (40%) and had surgery in &lt; 1 month from presentation (68% vs 51%, p &lt; 0.01). More HG BT patients presented with weakness in the arms/legs than LG BT (14% vs 8%). Among spine tumor (ST) patients, 45% reported ≥ 3 concurrent symptoms at presentation including back pain (65%), sensory changes (45%), and weakness (40%). Almost half (46%) were symptomatic for &gt; 1 year before diagnosis, presented in an outpatient clinic (64%) with 41% having surgery &lt; 1 month from presentation. Younger (40% vs 16%) and HG ST patients (56% vs 21%) more often reported symptoms for &lt; 6 months before diagnosis. HG ST patients more often presented to Emergency Rooms (67% vs 25%) and had surgery &lt; 1 month from presentation (60% vs 36%). Further analysis of symptom presentation and clinical course is ongoing. Tumor location, grade, patient age and healthcare setting were associated with the time from clinical presentation to diagnosis. Development of aids providing guidance on diagnostic evaluation/treatment to front-line healthcare providers is warranted.

Coalitions

2015 ◽  
pp. 240-255
Author(s):  
Erinn N. Harris
Keyword(s):  
Federal Government ◽  
Quality Care ◽  
Healthcare Providers ◽  
Healthcare Systems ◽  
Public Private Partnerships ◽  
Federal Grants ◽  
Playing Field ◽  
Provide Quality Care ◽  
New Form ◽  
To Receive

Demands in healthcare have placed a strain on healthcare providers trying to provide quality care while maintaining accreditations and planning for the possibility of expansion of resources as well as patients. Public Private Partnerships (PPPs) have been used to help ease this strain and increase the capabilities of healthcare systems all over the country. In an effort to “level the playing field,” the federal government has recently decided to mandate the structure of these healthcare PPPs. That is, a new form of these partnerships (i.e. coalitions) has been designated the organizational model that healthcare PPPs must evolve into in order to receive certain types of federal grants. This chapter discusses these coalitions as well as challenges for PPPs that are just now in the process of forming. Also discussed is the increased effort required to form coalitions from PPPs that have already been in existence for any length of time.

Ethical Issues in Qualitative Data Collection Among Vulnerable Populations in Healthcare Setting

2018 ◽  
pp. 80-97
Author(s):  
Seng Fah Tong ◽  
Wen Ting Tong ◽  
Wah Yun Low
Keyword(s):  
Data Collection ◽  
Therapeutic Relationship ◽  
Vulnerable Populations ◽  
Qualitative Data ◽  
Ethical Issues ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Future Patient ◽  
Qualitative Data Collection

The chapter aims to highlight the ethical issues in qualitative data collection among vulnerable populations. Among the ethical issues are the conflict role of interviewers, adverse impact on future patient-therapist relationship, and emotional trauma both during and after data collection. The interviewers, usually healthcare providers, may subconsciously assume the role as a therapist during the interviews. Furthermore, the interviewers may encounter the participants (patients) in future clinical consultations; hence, information exchanges during the interviews could influence the therapeutic relationship. Recollection of experiences with an illness during the interviews can be a painful experience for patients. These ethical dilemmas can be addressed with appropriate sampling of participants and constant awareness of the researcher roles and relationships with the participants. Debriefing the participants with support is important to handle emotional upheavals.

scholarly journals Nurses on the Frontline against the COVID-19 Pandemic: An Integrative Review

2020 ◽  
Vol 3 (3) ◽  
pp. 87-92
Author(s):  
Abdullelah Al Thobaity ◽  
Farhan Alshammari
Keyword(s):  
Nursing Staff ◽  
Personal Protective Equipment ◽  
Critical Line ◽  
Healthcare Providers ◽  
Healthcare Systems ◽  
Integrative Review ◽  
Protective Equipment ◽  
Crisis Plans ◽  
Medical Supplies ◽  
The World

COVID-19 has affected the life and health of more than 1 million people across the world. This overwhelms many countries’ healthcare systems, and, of course, affects healthcare providers such as nurses fighting on the frontlines to safeguard the lives of everyone affected. Exploring the issues that nurses face during their battle will help support them and develop protocols and plans to improve their preparedness. Thus, this integrative review will explore the issues facing nurses during their response to the COVID-19 crisis. The major issues facing nurses in this situation are the critical shortage of nurses, beds, and medical supplies, including personal protective equipment and, as reviews indicate, psychological changes and fears of infection among nursing staff. The implications of these findings might help to provide support and identify the needs of nurses in all affected countries to ensure that they can work and respond to this crisis with more confidence. Moreover, this will help enhance preparedness for pandemics and consider issues when drawing up crisis plans. The recommendation is to support the nurses, since they are a critical line of defense. Indeed, more research must be conducted in the field of pandemics regarding nursing.

Key Considerations for the Adoption and Implementation of Knowledge Management in Healthcare Operations

2010 ◽  
pp. 125-142 ◽  
Author(s):  
Nilmini Wickramasinghe ◽  
Elie Geisler
Keyword(s):  
Knowledge Management ◽  
Healthcare System ◽  
Healthcare Costs ◽  
Cost Effective ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Healthcare Operations ◽  
Healthcare Settings ◽  
Adoption And Implementation ◽  
The U.S

The importance of knowledge management (KM) to organizations in today’s competitive environment is being recognized as paramount and significant. This is particularly evident for healthcare both globally and in the U.S. The U.S. healthcare system is facing numerous challenges in trying to deliver cost effective, high quality treatments and is turning to KM techniques and technologies for solutions in an attempt to achieve this goal. While the challenges facing the U.S. healthcare are not dissimilar to those facing healthcare systems in other nations, the U.S. healthcare system leads the field with healthcare costs more than 15% of GDP and rising exponentially. What is becoming of particular interest when trying to find a solution is the adoption and implementation of KM and associated KM technologies in the healthcare setting, an arena that has to date been notoriously slow to adopt technologies and new approaches for the practice management side of healthcare. We examine this issue by studying the barriers encountered in the adoption and implementation of specific KM technologies in healthcare settings. We then develop a model based on empirical data and using this model draw some conclusions and implications for orthopaedics.

scholarly journals Comparison of National and Local Approaches to Detecting Suicides in Healthcare Settings

2019 ◽  
Vol 184 (9-10) ◽  
pp. e555-e560
Author(s):  
Natalie B Riblet ◽  
Brian Shiner ◽  
Bradley V Watts ◽  
Peter Britton
Keyword(s):  
Healthcare Providers ◽  
Healthcare Setting ◽  
Veterans Affairs ◽  
Accidental Poisoning ◽  
Cause Analysis ◽  
Root Cause ◽  
Healthcare Settings ◽  
Suicide Case ◽  
Mental Health Unit

Abstract Introduction In order to address the problem of suicide, healthcare providers and researchers must be able to accurately identify suicide deaths. Common approaches to detecting suicide in the healthcare setting include the National Death Index (NDI) and Root-Cause Analysis (RCA) methodology. No study has directly compared these two methods. Materials and Methods Suicide reporting was evaluated within the Veterans Affairs (VA) healthcare system. All suicides were included that occurred within 7 days of discharge from an inpatient mental health unit and were reported to the VA through the NDI record linkage and/or RCA database between 2002 and 2014. The proportion of suicide deaths that were identified by NDI and found in the RCA database were calculated. Potential misclassification by the NDI was evaluated, whereby the RCA database identified a suicide case, but the NDI classified the death as a non-suicide. Results In the study period, the NDI identified 222 patients who died by suicide within 7 days of discharge, while the RCA database only detected 95 reports of suicide. A comparison of cases across the two methods indicated that the RCA database identified only 35% (N = 78) of NDI detected suicides (N = 222). Conversely, the RCA database detected 13 suicide cases that the NDI had coded as deaths due to accidental poisoning or other causes. Importantly, RCA accounted for 13% (N = 7) of overdose suicides identified in all databases (N = 52). Conclusions Combining national and local approaches to detect suicide may help to improve the classification of suicide deaths in the healthcare setting.

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