Improve the success rate of inserting and intubating the spiral nasojejunal tube with bare hands

[Objective] To improve the success rate of spiral nasojejunal tube insertion through training of blind insertion of spiral nasojejunal tube with bare hands. [Methods] A total of 49 patients (5 of them were secondary intubation) who were admitted to the emergency department of our hospital from April 2, 2019 to June 17, 2021 needed to undergo blind hand intubation treatment with a nasal jejunal tube. The nurses who were recruited to participate in Guangdong. The enteral nutrition intubation training class hosted by the Provincial Nursing Society Critical Care Committee has been divided into two groups: the experimental group after training (n=28) and the control group before training (n=21) at the aim of comparing the success rate of one-time catheterization of patients in the two groups. [Results] The success rate of nurses' bare-handed blind insertion of the nasal jejunal tube increased from 43% to 86% (p<0.01). [Conclusion] Carrying out the training of blind insertion of nasal jejunal tube with bare hands can improve the success rate of tube placement for nurses in emergency department.

Effectiveness of Augmented Reality Guides for Blind Insertion Tasks

Although many augmented reality (AR)-based assembly support systems have been proposed in academic research and industry, the effectiveness of AR to resolve the occlusion issue in the context of a blind assembly process remains an unexplored topic. Therefore, the present work investigates how AR can assist operators during the execution of blind manual assembly tasks. Specifically, an AR research set-up was designed to provide assistance in occlusion situations during a peg-in-hole task. The set-up featured a see-through device (HoloLens), which provides operators with two modes of visual augmentations that directly overlay on the assembly objects. The first mode referred to as the “wireframe overlay” displays the inner part of the objects, providing an inside view of the occluded parts, and the second one referred to as the “axes overlay,” displays the axes of the objects and their slots, indicating how to align the different parts during the assembly. The effectiveness of these AR visualizations was compared to a baseline augmentation-free situation in a controlled experiment. Thus, following a within-subject design, 30 participants performed a two-stages blind insertion task. Their performances represented by task completion time, insertion errors, and smoothness of the insertions were recorded. In addition, a post-questionnaire reported their subjective perception of task difficulty during the task and their preferences. Results indicated a strong acceptance of participants for AR visualizations that they rated as allowing them to perform the task more easily. However, no statistically significant differences in terms of objective performance measures were found. Yet, it was found that axes overlay produced smoother trajectories compared to the wireframe overlay, highlighting the potential effect of more abstract visualization aids.

Embolization in Patient with Hypovolemic Shock after Transobturator Sling Procedure

The placement of a suburethral sling is standard treatment for stress urinary incontinence. The transobturator technique (TOT) emerged as an alternative to minimize the risks of the blind insertion of needles, leading to a lower rate of perforation complications compared with the retropubic approach. We present a case of injury to a branch of the left obturator artery following the placement of a urethral sling using TOT, followed by intense bleeding and hemodynamic instability, which was treated with embolization.

Fluoroscopy-Guided Placement of Endobronchial Blockers: A Case Series

ABSTRACT Three cases from a single institution are presented demonstrating a novel technique of endobronchial blocker insertion under fluoroscopic guidance in patients with massive hemoptysis. This article discusses advantages and limitations compared with bronchoscopic and blind insertion techniques. In all three cases, fluoroscopic guidance demonstrated successful insertion with technically appropriate positioning, allowing for hemodynamic stabilization and more definitive interventional treatment. In one case, endobronchial blocker tamponade, itself, was definitive treatment, without recurrence of hemoptysis during the patient's hospital course. All patients had resolution of their hemoptysis and were eventually discharged from the hospital. Fluoroscopy-guided endobronchial blocker insertion was demonstrated to be both technically feasible and effective in these cases of massive hemoptysis. Moving forward, this can be a valuable tool when emergent endobronchial control of hemoptysis is required in certain instances.

Traumatic Epiglottitis following a Blind Insertion of the Hand during Convulsion

Traditionally, it has been recommended that first-responders should place chopsticks or their hand in a child’s mouth to prevent the child from biting their tongue during convulsion. The practice persists locally in parts of Japan and can cause adverse events. We report a traumatic epiglottitis following the thrusting of a guardians’ hand into a 13-month-old girl’s mouth to prevent her from biting her tongue.