scholarly journals MP27: Designing team success - an engineering solution to avoid chest tube equipment chaos using best available evidence, consensus and prototyping

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S52
Author(s):  
R. Hanlon ◽  
J. French ◽  
P. Atkinson ◽  
J. Fraser ◽  
S. Benjamin ◽  
...  
Keyword(s):  
Medical Student ◽  
Chest Tube ◽  
Storage System ◽  
Original Design ◽  
Safety Critical ◽  
Interprofessional Team ◽  
Team Success ◽  
Evidence Review ◽  
Cadaver Testing ◽  
Set Up

Background: Chest tube insertion is a time and safety critical procedure with a significant complication rate (up to 30%). Industry routinely uses Lean and ergonomic methodology to improve systems. This process improvement study used best evidence review, small group consensus, process mapping and prototyping in order to design a lean and ergonomically mindful equipment solution. Aim Statement: By simplifying and reorganising chest tube equipment, we aim to provide users with adequate equipment, reduce equipment waste, and wasted effort locating equipment. Measures & Design: The study was conducted between March 2018 and November 2018. An initial list of process steps from the best available evidence was produced. This list was then augmented by multispecialty team consensus (3 Emergency Physicians, 1 Thoracic Surgeon, 1 medical student, 2 EM nurses). Necessary equipment was identified. Next, two prototyping phases were conducted using a task trainer and a realistic interprofessional team (1 EM Physician, 1 ER Nurse, 1 Medical student) to refine the equipment list and packaging. A final equipment storage system was produced and evaluated by an interprofessional team during cadaver training using a survey and Likert scales. Evaluation/Results: There were 47 equipment items in the pre-intervention ED chest tube tray. After prototyping 21 items were removed while nine critical items were added. The nine items missing from the original design were found in four different locations in the department. Six physicians and seven RNs participated in cadaver testing and completed an evaluation survey of the new layout. Participants preferred the new storage design (Likert median 5, IQR of 1) over the current storage design (median of 1, IQR of 1). Discussion/Impact: The results suggest that the lean equipment storage is preferred by ED staff compared to the current set-up, may reduce time finding missing equipment, and will reduce waste. Future simulation work will quantitatively understand compliance with safety critical steps, user stress, wasted user time and cost.

scholarly journals P062: Designing team success - an engineering approach to capture team procedural steps to develop microskills for interprofessional skills education

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S85-S86
Author(s):  
R. Hanlon ◽  
J. French ◽  
P. Atkinson ◽  
J. Fraser ◽  
S. Benjamin ◽  
...  
Keyword(s):  
Medical Student ◽  
Chest Tube ◽  
Educational Video ◽  
Proof Of Concept ◽  
Emergency Physicians ◽  
Operational Environment ◽  
Tube Insertion ◽  
Process Map ◽  
Interprofessional Team ◽  
Chest Tube Insertion

Introduction: Chest tube insertion, a critical procedure with a published complication rate (30%), is a required competency for emergency physicians. Microskills training has been shown to identify steps that require deliberate practice. Objectives were: 1. Develop a chest tube insertion microskills checklist to facilitate IPE, 2. Compare the microskills checklist with published best available evidence, 3. Develop an educational video based on the process map, 4. Evaluate the video in an interprofessional team prior to cadaver training as a proof of concept. Methods: The study was conducted between March 2018 and November 2018. An initial list of process steps from the best available evidence was produced. This list was then augmented by multispecialty team consensus (3 Emergency Physicians, 1 Thoracic Surgeon, 1 medical student, 2 EM nurses). Two prototyping phases were conducted using a task trainer and a realistic interprofessional team (1 EM Physician, 1 ER Nurse, 1 Medical student). A final microskills list was produced and compared to the procedural steps described in consensus publications. An educational video was produced and evaluated by an interprofessional team prior to cadaver training using a survey and Likert scales as a proof of concept. Participants were 7 EM RNs and 6 ATLS trained physicians. Participants were asked to fill out a nine-question survey, using a 5-point Likert Scale (1-strongly disagree to 5 strongly agree). Results: The final process map contained 54 interdisciplinary steps, compared to ATLS that describes 14 main steps and peer reviewed articles that describe 9 main steps. The microskills checklist described, in more detail, the steps that relate to team interaction and the operational environment. Physicians rated the training video were able to apply what they learned in the video with an average of 4.67 (median of 5, mode of 5, and an IQR of 0.75). Conclusion: The development of the process maps and microkills checklists provides interprofessional teams with more information about chest tube insertion than instructions described in commonly available courses and procedural steps derived by consensus.

Experimental and numerical investigations on a high-density polyethylene (HDPE) blown film cooling with a new design of the counter-flow/radial jet air-ring

2021 ◽  
pp. 875608792110260
Author(s):  
ME Ismail ◽  
MM Awad ◽  
AM Hamed ◽  
MY Abdelaal ◽  
EB Zeidan
Keyword(s):  
Heat Transfer ◽  
Numerical Simulations ◽  
Film Cooling ◽  
Radiation Heat Transfer ◽  
Absolute Error ◽  
Numerical Results ◽  
Upper Lip ◽  
Original Design ◽  
Blown Film ◽  
Set Up

This study experimentally and numerically investigates a typical HDPE blown film production process cooled via a single-lip air-ring. The processing observations are considered for the proposed subsequent modifications on the air-ring design and the location relative to the die to generate a radial jet, directly impinging on the bubble. Measurements are performed to collect the actual operating parameters to set up the numerical simulations. The radiation heat transfer and the polymer phase change are considered in the numerical simulations. The velocity profile at the air-ring upper-lip is measured via a five-hole Pitot tube to compare with the numerical results. The comparison between the measurements and the numerical results showed that the simulations with the STD [Formula: see text] turbulence model are more accurate with a minimum relative absolute error (RAE) of 1.6%. The numerical results indicate that the peak Heat Transfer Coefficient (HTC) at the impingement point for the modified design with radial jet and longer upper-lip is 29.1% higher than the original design at the same conditions. Besides, increasing the air-ring upper-lip height increased the averaged HTC, which is 13.4% higher than the original design.

A Framework for the Management of Ageing of Safety Critical Elements Offshore

2011 ◽  
Author(s):  
John V. Sharp ◽  
Edmund G. Terry ◽  
John Wintle
Keyword(s):  
Life Extension ◽  
Original Design ◽  
Safety Critical ◽  
Critical Elements ◽  
The North ◽  
Design Life ◽  
Offshore Installations ◽  
Management Processes ◽  
The North Sea ◽  
And Performance

Many offshore installations in the North Sea have now exceeded their original design life and are in a life extension phase. A Framework of six processes has been developed for the management of ageing of Safety Critical Elements (SCEs) in offshore installations. The processes include an analysis of the effect of ageing modes on SCE performance. Examples of performance indicators for typical SCEs are proposed based on how their condition and performance as may be affected by physical deterioration and other effects of ageing. Indicators for calibrating the maturity and effectiveness of the management processes are also suggested.

Genetic Progress in the Camda Group Breeding Scheme Nucleus

1994 ◽  
Vol 1994 ◽  
pp. 19-19
Author(s):  
G.E. Pollott ◽  
D. Croston ◽  
D.R. Guy
Keyword(s):  
Environmental Changes ◽  
Original Design ◽  
Breeding Scheme ◽  
Genetic Progress ◽  
Group Breeding ◽  
Set Up ◽  
Mature Size ◽  
Lamb Growth ◽  
Selection Of ◽  
Genetic Trends

A group breeding scheme was set up in 1976 by 10 Welsh Mountain breeders. The objective of the scheme was to improve lamb growth rate, mature size, mothering ability and litter size by selection in a nucleus flock. The original design of the scheme involved two control flocks. The Genetic Control flock was set up from the original base population and was used to monitor environmental changes in the nucleus flock. A Commercial Control flock comprised of a random selection of ewes mated to rams, which were purchased annually and represented the average animal available in the breed. An analysis of genetic progress in lamb growth in the first 9 years of the scheme was reported by Guy et al (1986). This paper presents genetic parameters and genetic trends for three traits recorded between 1977 and 1992.

ESWL and informatics

1994 ◽  
Vol 61 (1) ◽  
pp. 60-62
Author(s):  
S. Cavalleri ◽  
M. Rahmati ◽  
D. Schiavone
Keyword(s):  
Shock Waves ◽  
Clinical Data ◽  
Storage System ◽  
Set Up

Some functions of the lithotriptor, like the targeting of the stone, the generation and synchronisation of shock waves, the recognition of errors in the system and printing of the description of the treatment, couldn't be done without a computerised control. As the lithotriptor lacks an interface with a storage system for the treatments, we set up a specific database for ESWL which makes it possible to verify the result of previous treatments and to correlate the data of extracorporeal treatments with clinical data. Finally our programme generates an automatised report, producing a more complete document than that printed by the lithotriptor.

Important Components Analysis of Ceramic Rapid Molding Machine

2014 ◽  
Vol 633-634 ◽  
pp. 360-363
Author(s):  
Xiu Duan Gong ◽  
Zhou Wen ◽  
Jun Ling Zhang
Keyword(s):  
Element Model ◽  
Digital Design ◽  
Molding Machine ◽  
Original Design ◽  
Design Data ◽  
Mechanical Products ◽  
Design Requirements ◽  
Components Analysis ◽  
Set Up ◽  
The Finite Element Model

The digital design of mechanical products is usually first reference existing parts, drawings, and experience to make original design data and design requirements, according to the design of digital model is set up, after an analysis of the finite element model according to the analysis results contrast design goal to design or structure parameter changes, to the expected design purpose. Analysis of the product is an essential part of product design.

Destructive Vibration of Trashracks due to Fluid-Structure Interaction

1975 ◽  
Vol 97 (4) ◽  
pp. 1359-1365 ◽  
Author(s):  
S. H. Crandall ◽  
S. Vigander ◽  
P. A. March
Keyword(s):  
Vortex Shedding ◽  
Storage System ◽  
Water Channel ◽  
Scale Model ◽  
Original Design ◽  
Cross Sectional ◽  
Flow Rates ◽  
Pumped Storage ◽  
Sectional Shape ◽  
Lock In

Trashracks in pumped storage systems with high flow rates can develop fatigue failures due to excessive vibration excited by the flow past the rods in the rack. An experimental study of trashrack vibration was made on a half-scale model of a prototype rack design for the TVA Raccoon Mountain pumped storage system. The natural frequencies and loss factors of the first dozen natural modes of the rack were determined in air before placing the rack in a water channel. Under normal flow rates the rack developed “locked-in” pure tone vibrations of sufficient amplitude to cause early fatigue failure. Unexpectedly, the frequency of the vibration was not close to the vortex-shedding frequency and the motion of the rods was not transverse to the flow. The “locked-in” modes were identified as modes in which the bending displacements of the rods were parallel to the flow. Further investigation showed that the excitation mechanism involved synchronization between the fluctuating drag involved in vortex shedding and the fore-and-aft motion of the rods in sharply resonant modes. Modifications of the original design were introduced to defeat the identified mechanism. In order to completely eliminate the “lock-in” phenomenon it was necessary to change the bar cross-sectional shape and to introduce additional damping into the rack structure. A half-scale model of the modified design was built and tested to verify the absence of destructive vibrations.

scholarly journals Radiation of Heat in an Insulating Vacuum Layer

2017 ◽  
Vol 69 (1) ◽  
pp. 87-100
Author(s):  
Mária Minárová
Keyword(s):  
Heat Transfer ◽  
Mathematical Model ◽  
Heat Exchange ◽  
Heat Storage ◽  
Storage System ◽  
Heat Accumulation ◽  
Insulating Layer ◽  
System A ◽  
Set Up ◽  
Heat Transfer By Radiation

Abstract The paper is motivated by the previous research concerning the heat transfer in a heat accumulation device. The device had been explored, built up and tested with the aim of utilization of cheap solar energy and its storage. In this heat storage system, a vacuum-like gap between two concentric containers acts as an insulating layer, radiation being the predominant heat transfer type in the gap. The better knowledge and understanding of the heat exchange by radiation, the more effectiveness of the insulation of the layer can be reached. Heat transfer by radiation is explored in the paper, mathematical model is set up, the algorithm of non-linear transient computation is introduced, and some illustrative results of this computation are performed.

scholarly journals Exploring the significance of control atmosphere of vegetables

2021 ◽  
Vol 8 (3) ◽  
pp. 109-114
Author(s):  
Aijaz Ahmed ◽  
Uzma Gul ◽  
Shabeena Akhtar
Keyword(s):  
Storage System ◽  
Secondary Data ◽  
Storage Conditions ◽  
Control Atmosphere ◽  
Cold Environments ◽  
Set Up ◽  
The One ◽  
Central Pillar ◽  
And Control ◽  
Atmosphere Storage

The development and production of vegetables are increasing in every corner of the globe. Besides fresh and quality vegetables, which are the central pillar of generating economies and business, there is also demand and requirement to differentiate and create post harvest storage, transport, publicity, and preparing the foundation to broaden the utilization of vegetables beyond rising seasons and localities. However, numerous Western nations have created vegetables appropriate for cold environments, including potatoes and tomatoes, to tackle the issue. The countries of tropical areas, like China, India, Brazil, Pan American nations, and nations of Africa, South-East Asia, and Central Asia, have an appropriate environment and assets to cultivate numerous kinds of vegetables. However, the present paper examines the significance of control the atmosphere storage of vegetables and how it affects various foodstuff quality and marketing. The study is based on secondary data. The study systematically reviews many articles, reports and books. The results reveal that the control atmosphere storage enhances the quality of the product that increases the product's suppy and demand. Furthermore, it shows that controlled atmosphere storage is the one most appropriate innovation that can guarantee long storage of vegetables that enhances the freshness and best marketing of the products. The vegetables are kept up through the utilization of explicit CA storage conditions to every product and control of the gas elements, temperature, and relative humidity of the climate. Notwithstanding these components, digestion changes of vegetables have been considered to set up the ideal storage conditions. This is enlarging the improvement of a quick storage system.

scholarly journals Experimental and Numerical Investigation of River Closure Project

Water ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 241
Author(s):  
Jinbo Lin ◽  
Sheng Jin ◽  
Congfang Ai ◽  
Weiye Ding
Keyword(s):  
Finite Volume ◽  
Flow Rate ◽  
Similarity Criterion ◽  
Momentum Conservation ◽  
Physical Experiment ◽  
Finite Volume Scheme ◽  
Original Design ◽  
Volume Scheme ◽  
Set Up ◽  
2D Model

The success or failure of river closure is directly related to the construction period and project benefit. Therefore, it is very necessary to study the river closure by an appropriate method. In this paper, a 1D–2D coupled river closure model is established to optimize the closure flow rate, closure period, and layout of a real closure project. The 1D transition model between open channel flow and pressurized flow is established by a finite volume scheme. For the 2D model, 2D shallow water equations are solved using an unstructured finite volume scheme. The 1D model and 2D model are coupled by considering the mass and momentum conservation. To validate the model, a physical experiment of a real river closure project is set up according to the gravity similarity criterion with a scale of 1:80. Then, the experimental data obtained by the calibrated physical experiment is compared with the numerical results. Good agreements are achieved in terms of surface elevation, velocity, and flow rate. Finally, the real river closure project is further investigated by the model. The layout, closure flow rate and closure period of this project is analyzed and optimized. The original design of the berm is more suitable to discharge the flow. Moreover, the first stage cofferdam should be removed to floor elevation upstream and downstream of the dam. The river closure flow rate should not exceed 2380 m3/s.

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