First National Remote Emergency System for Malignant Hyperthermia (MH-NRES) in China: Protocol for a WeChat applet Design, Development, and Evaluation (Preprint)

BACKGROUND Malignant hyperthermia (MH) is a rare life-threatening anesthetic emergency. With respect to the high fatality rate, difficulty in early recognition and the lack of disease-specific drug (i.e., dantrolene) in China, more effort is need to strengthen early diagnosis and effective treatment of MH emergency. Nowadays, mobile health applications (mHealth apps) are changing the way of medical practice, which are an accessible tool for helping anesthesiologists to deal with MH crisis. However, no related mHealth-based emergency system is available now. OBJECTIVE The aim of this study is to outline the methods for a WeChat applet development used to design National Remote Emergency System for Malignant Hyperthermia (MH-NRES) in China, as well as the methods for evaluation of the user experience and perception of the system. METHODS The system adopts client-server architecture, with a custom user interface operating as clients and the back-end system operating as the server. The client-side software was developed using uni-app technology with Vue.js-based framework, which consists of six modules: quick diagnosis, dantrolene mobilization, instruction on dantrolene use, MH treatment, recovery period treatment, and DNA test and Biopsy. The back-end system was developed based on the Spring framework. The system will be evaluated by administrating a modified user version of the Mobile App Rating Scale (uMARS). The pilot testing in Sichuan Province of China and the following evaluation on a national scale are planned. RESULTS The theoretical framework design of this system took a total of 4 months (May-August 2021). The development of the system is planned to take 4 months (September-December 2021). The pilot testing in Sichuan Province is planned to take 2 month and the following evaluation to take 6 months. CONCLUSIONS We have described a novel approach using the WeChat applet to develop the MH-NRES which can help anesthesiologists in China to make rapid diagnosis, effectively management and dantrolene mobilization in real time when MH cases occur, and provide subsequently gene diagnostic services and family counselling. Findings from the evaluation process is expected to suggest that this system is both feasible and welcomed by anesthesiologists.

Analysis of Abusive 112 Emergency Calls in Romania

The abusive calls subdivision of the non-emergency calls made to the 112-emergency system represent a concern for the administrators of other such services worldwide, since they generate suboptimal use or even waste of resources. Preventing this scenario requires countermeasures to limit the impact of such calls on the operational performance of handling genuine emergency cases.

An emergency system for monitoring pulse oximetry, peak expiratory flow, and body temperature of patients with COVID-19 at home: Development and preliminary application

Background COVID-19 is characterized by a rapid change in the patient’s condition, with major changes occurring over a few days. We aimed to develop and evaluate an emergency system for monitoring patients with COVID-19, which may be useful in hospitals where more severe patients stay in their homes. Methodology/Principal findings The system consists of the home-based patient unit, which is set up around the patient and the hospital unit, which enables the medical staff to telemonitor the patient’s condition and help to send medical recommendations. The home unit allows the data transmission from the patient to the hospital, which is performed using a cell phone application. The hospital unit includes a virtual instrument developed in LabVIEW® environment that can provide a real-time monitoring of the oxygen saturation (SpO2), beats per minute (BPM), body temperature (BT), and peak expiratory flow (PEF). Abnormal events may be fast and automatically identified. After the design details are described, the system is validated by a 30-day home monitoring study in 12 controls and 12 patients with COVID-19 presenting asymptomatic to mild disease. Patients presented reduced SpO2 (p<0.0001) and increased BPM values (p<0.0001). Three patients (25%) presented PEF values between 50 and 80% of the predicted. Three of the 12 monitored patients presented events of desaturation (SpO2<92%). The experimental results were in close agreement with the involved pathophysiology, providing clear evidence that the proposed system can be a useful tool for the remote monitoring of patients with COVID-19. Conclusions An emergency system for home monitoring of patients with COVID-19 was developed in the current study. The proposed system allowed us to quickly respond to early abnormalities in these patients. This system may contribute to conserving hospital resources for those most in need while simultaneously enabling early recognition of patients under acute deterioration, requiring urgent assessment.