scholarly journals From Mouth-to-Mouth to Bag-Valve-Mask Ventilation: Evolution and Characteristics of Actual Devices—A Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Abdo Khoury ◽  
Sylvère Hugonnot ◽  
Johan Cossus ◽  
Alban De Luca ◽  
Thibaut Desmettre ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Ventilatory Support ◽  
Adverse Outcomes ◽  
Manual Ventilation ◽  
Emergency Situations ◽  
Historical View ◽  
Respiratory Parameters ◽  
Single Use ◽  
Unidirectional Valve ◽  
New Generation

Manual ventilation is a vital procedure, which remains difficult to achieve for patients who require ventilatory support. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. We will give in this paper, a historical view on manual ventilation’s evolution throughout the last decades and describe the technical characteristics, advantages, and hazards of the main devices currently found in the market. Artificial ventilation has developed progressively and research is still going on to improve the actual devices used. Throughout the past years, a brand-new generation of ventilators was developed, but little was done for manual ventilation. Many adverse outcomes due to faulty valve or misassembly were reported in the literature, as well as some difficulties to ensure efficient insufflation according to usual respiratory parameters. These serious incidents underline the importance of BVM system routine check and especially the unidirectional valve reassembly after sterilization, by only experienced and trained personnel. Single use built-in devices may prevent disassembly problems and are safer than the reusable ones. Through new devices and technical improvements, the safety of BVM might be increased.

scholarly journals Evolution and Characteristics of Bag-Valve-Mask Ventilation During Pandemic: A Review of the Literature

2021 ◽  
Vol 9 (VII) ◽  
pp. 25-29
Author(s):  
Ankit D. Bhoyar
Keyword(s):  
Healthcare Providers ◽  
Ventilatory Support ◽  
Ventilation Rate ◽  
Mass Casualty ◽  
Automated System ◽  
Manual Ventilation ◽  
Emergency Situations ◽  
Historical View ◽  
Short Period ◽  
Novel Coronavirus

Mass casualty incidents such as those that are being experienced during the novel coronavirus disease (COVID-19) pandemic can overwhelm local healthcare systems, where the number of casualties exceeds local resources and capabilities in a short period of time. The introduction of patients with worsening lung function as a result of COVID-19 has strained traditional ventilator supplies. To bridge the gap during ventilator shortages and to help clinicians triage patients, manual resuscitator devices can be used to deliver respirations to a patient requiring breathing support. For patients who require ventilatory support, manual ventilation is a vital procedure. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. We will present, a historical view on manual ventilation’s evolution throughout the last decades. Artificial ventilation has developed progressively and research is still going on to improve the actual devices used. Throughout the past years, a brand-new generation of ventilators was developed, but little was done for manual ventilation. Manual ventilation through BVM can be replaced by automatic ventilation which illustrates that the Tidal Volume vs. Time graph of the automated system is similar to the graph produced by manual operation of the BVM and to the graph produced by a human subject. The use of an automatic manually operated device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.

RESEARCH: Dry Heat Processing of Single-Use Respirators and Surgical Masks

2020 ◽  
Vol 54 (6) ◽  
pp. 410-416
Author(s):  
Joyce M. Hansen ◽  
Scott Weiss ◽  
Terra A. Kremer ◽  
Myrelis Aguilar ◽  
Gerald McDonnell
Keyword(s):  
Microbial Contamination ◽  
Healthcare Providers ◽  
High Volume ◽  
Airborne Particles ◽  
Heat Processing ◽  
Protective Equipment ◽  
Healthcare Facilities ◽  
Dry Heat ◽  
Surgical Masks ◽  
Single Use

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged healthcare providers in maintaining the supply of critical personal protective equipment, including single-use respirators and surgical masks. Single-use respirators and surgical masks can reduce risks from the inhalation of airborne particles and microbial contamination. The recent high-volume demand for single-use respirators and surgical masks has resulted in many healthcare facilities considering processing to address critical shortages. The dry heat process of 80°C (176°F) for two hours (120 min) has been confirmed to be an appropriate method for single-use respirator and surgical mask processing.

To err is system; a comparison of methodologies for the investigation of adverse outcomes in healthcare

2021 ◽  
pp. 251604352199026
Author(s):  
Peter Isherwood ◽  
Patrick Waterson
Keyword(s):  
Patient Safety ◽  
System Performance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Real Life ◽  
Adverse Outcomes ◽  
System Level ◽  
Future Performance ◽  
System A ◽  
Regulatory Bodies

Patient safety, staff moral and system performance are at the heart of healthcare delivery. Investigation of adverse outcomes is one strategy that enables organisations to learn and improve. Healthcare is now understood as a complex, possibly the most complex, socio-technological system. Despite this the use of a 20th century linear investigation model is still recommended for the investigation of adverse outcomes. In this review the authors use data gathered from the investigation of a real life healthcare near incident and apply three different methodologies to the analysis of this data. They compare both the methodologies themselves and the outputs generated. This illustrates how different methodologies generate different system level recommendations. The authors conclude that system based models generate the strongest barriers to improve future performance. Healthcare providers and their regulatory bodies need to embrace system based methodologies if they are to effectively learn from, and reduce future, adverse outcomes.

scholarly journals Liver dysfunction in COVID-19: a useful prognostic marker of severe disease?

2020 ◽  
pp. flgastro-2020-101689
Author(s):  
James Lok ◽  
Markus Gess
Keyword(s):  
Liver Function ◽  
Acute Phase ◽  
Liver Dysfunction ◽  
Acute Phase Proteins ◽  
Severe Disease ◽  
Ventilatory Support ◽  
Length Of Hospital Stay ◽  
Abnormal Liver Function ◽  
Adverse Outcomes ◽  
High Dependency

BackgroundCOVID-19 is a global pandemic caused by the novel coronavirus SARS-CoV-2. Risk factors and prognostic markers of severe disease remain to be fully determined, although some studies have suggested a correlation between abnormal liver function and adverse outcomes. Further studies are needed to investigate this further.MethodsThis retrospective study enrolled patients with a confirmed diagnosis of COVID-19 who were admitted to Kingston Hospital in the UK. Data collected included age, sex, ethnicity, comorbidity profile, biochemical markers of liver function and the acute phase response, and overall outcome.ResultsBetween 16 March 2020 and 30 April 2020, a total of 343 patients were admitted to the acute medical team at Kingston Hospital. Excluding those with a history of liver disease, 299 patients had liver function tests performed with abnormalities demonstrated in 44.8% of individuals. Derangement of liver function was associated with greater need for ventilatory support (p<0.001), admission to high dependency unit or intensive care (p<0.001) and increased length of hospital stay (p<0.001). Of note, liver dysfunction was more common in those of non-white ethnicity (p=0.007) and correlated with higher levels of C reactive protein (p=0.01) and ferritin (p<0.001).ConclusionAbnormal liver function is associated with a negative outcome among those hospitalised with COVID-19. The cause for this association is unclear, but correlation between abnormal liver function and higher serum levels of acute phase proteins suggest that dysregulation of the immune system in response to SARS-CoV-2 may be contributory.

scholarly journals Military spouses with deployed partners are at greater risk of poor perinatal mental health: a scoping review

2019 ◽  
Vol 165 (5) ◽  
pp. 363-370 ◽  
Author(s):  
Lauren Rose Godier-McBard ◽  
L Ibbitson ◽  
C Hooks ◽  
M Fossey
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Scoping Review ◽  
Healthcare Providers ◽  
Well Being ◽  
Perinatal Period ◽  
Poor Mental Health ◽  
Adverse Outcomes ◽  
Military Spouses ◽  
Perinatal Mental Health

BackgroundPoor mental health in the perinatal period is associated with a number of adverse outcomes for the individual and the wider family. The unique circumstances in which military spouses/partners live may leave them particularly vulnerable to developing perinatal mental health (PMH) problems.MethodsA scoping review was carried out to review the literature pertaining to PMH in military spouses/partners using the methodology outlined by Arksey and O’Malley (2005). Databases searched included EBSCO, Gale Cengage Academic OneFile, ProQuest and SAGE.ResultsThirteen papers fulfilled the inclusion criteria, all from the USA, which looked a PMH or well-being in military spouses. There was a strong focus on spousal deployment as a risk factor for depressive symptoms and psychological stress during the perinatal period. Other risk factors included a lack of social/emotional support and increased family-related stressors. Interventions for pregnant military spouses included those that help them develop internal coping strategies and external social support.ConclusionsUS literature suggests that military spouses are particularly at risk of PMH problems during deployment of their serving partner and highlights the protective nature of social support during this time. Further consideration needs to be made to apply the findings to UK military spouses/partners due to differences in the structure and nature of the UK and US military and healthcare models. Further UK research is needed, which would provide military and healthcare providers with an understanding of the needs of this population allowing effective planning and strategies to be commissioned and implemented.

scholarly journals Protocol for a mixed method acceptability evaluation of a codesigned bundled COmmunication intervention for use in the adult ICU during the COVID-19 PandEmic: the COPE study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050347
Author(s):  
Laura Istanboulian ◽  
Louise Rose ◽  
Yana Yunusova ◽  
Craig M Dale
Keyword(s):  
Infection Control ◽  
Mixed Method ◽  
Phase 1 ◽  
Invasive Mechanical Ventilation ◽  
Healthcare Providers ◽  
Adverse Outcomes ◽  
Advisory Council ◽  
Communication Intervention ◽  
Adult Intensive Care Unit ◽  
Study Setting

IntroductionPatients requiring invasive mechanical ventilation via an artificial airway experience sudden voicelessness placing them at risk for adverse outcomes and increasing provider workload. Infection control precautions during the COVID-19 pandemic, including the use of personal protective equipment (eg, gloves, masks, etc), patient isolation, and visitor restrictions may exacerbate communication difficulty. The objective of this study is to evaluate the acceptability of a codesigned communication intervention for use in the adult intensive care unit when infection control precautions such as those used during COVID-19 are required.Methods and analysisThis three-phased, prospective study will take place in a medical surgical ICU in a community teaching hospital in Toronto. Participants will include ICU healthcare providers, adult patients and their family members. Qualitative interviews (target n: 20–25) will explore participant perceptions of the barriers to and facilitators for supporting patient communication in the adult ICU in the context of COVID-19 and infection control precautions (phase 1). Using principles of codesign, a stakeholder advisory council of 8–10 participants will iteratively produce an intervention (phase 2). The codesigned intervention will then be implemented and undergo a mixed method acceptability evaluation in the study setting (phase 3). Acceptability, feasibility and appropriateness will be evaluated using validated measures (target n: 60–65). Follow-up semistructured interviews will be analysed using the theoretical framework of acceptability (TFA). The primary outcomes of this study will be acceptability ratings and descriptions of a codesigned COmmunication intervention for use during and beyond the COVID-19 PandEmic.Ethics and disseminationThe study protocol has been reviewed, and ethics approval was obtained from the Michael Garron Hospital. Results will be made available to healthcare providers in the study setting throughout the study and through publications and conference presentations.

Discussing adverse outcomes with patients

2017 ◽  
Author(s):  
Andy S.L. Tan ◽  
Thomas H. Gallagher
Keyword(s):  
Adverse Events ◽  
Healthcare Providers ◽  
Adverse Outcomes ◽  
The Body ◽  
Professional Organizations ◽  
Open Communication ◽  
Healthcare Facilities ◽  
The United Kingdom ◽  
Communication Challenges

Few communication challenges are as difficult for healthcare providers as talking with patients about adverse events, especially when the adverse event was due to a medical error. Ethicists and professional organizations have long endorsed open communication with patients about adverse events and errors in their care. Over the past decade, however, there has been a substantial increase in attention being paid to transparent communication with patients. Many countries, including Australia, the United Kingdom, and Canada have undertaken major disclosure initiatives. The Joint Commission, the body responsible for the accreditation of most US healthcare facilities, requires that patients be informed of all outcomes in their care, including ‘unanticipated outcomes’. In this chapter, we will explore the special aspects of disclosure in the oncology context, among many other important aspects. The chapter concludes by considering a disclosure case study, and discussing next steps for disclosure in oncology.

Creating a Quality Management Program

2016 ◽  
Author(s):  
Richard P. Dutton
Keyword(s):  
Quality Improvement ◽  
Continuous Improvement ◽  
Healthcare Providers ◽  
Management Program ◽  
Adverse Outcomes ◽  
Culture Of Safety ◽  
Anesthesia Practice ◽  
Reference Guide ◽  
Or Practice ◽  
High Level

This chapter provides an overview of how to create a quality improvement (QI) program. It is intended as a high-level reference guide for a department, division or practice quality improvement officer. It covers the topics of recruiting allies; finding, aggregating and creating data; basic analytic techniques; mechanisms for feedback of QI data to healthcare providers; implementing cyclical QI activities; managing individual adverse events and complications; and benchmarking to outside data sources. A template quality capture form for an anesthesia practice is included, and examples of reporting graphics and strategies are included. Woven throughout the chapter are specific thoughts on how the QI officer can create a “culture of safety” within the group, such that practitioners feel safe in reporting adverse outcomes and expect to see continuous improvement efforts within their systems.

scholarly journals Ventilation feedback device for manual ventilation in simulated respiratory arrest: a crossover manikin study

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Abdo Khoury ◽  
Alban De Luca ◽  
Fatimata S. Sall ◽  
Lionel Pazart ◽  
Gilles Capellier
Keyword(s):  
Endotracheal Tube ◽  
Healthcare Providers ◽  
Random Order ◽  
Respiratory Arrest ◽  
Manual Ventilation ◽  
Ventilatory Parameters ◽  
The Mean ◽  
Ventilation Rates ◽  
Direct Feedback

Abstract Background Studies have shown that providing adequate ventilation during CPR is essential. While hypoventilation is often feared by most caregivers on the scene, the most critical problem remains hyperventilation. We developed a Ventilation Feedback Device (VFD) for manual ventilation which monitors ventilatory parameters and provides direct feedback about ventilation quality to the rescuer. This study aims to compare the quality of conventional manual ventilation to ventilation with VFD on a simulated respiratory arrest patient. Methods Forty healthcare providers were enrolled and instructed to ventilate a manikin simulating respiratory arrest. Participants were instructed to ventilate the manikin for 5 min with and without the VFD in random order. They were divided in two groups of 20 people, one group ventilating through a mask and the other through an endotracheal tube. Results Ventilation with the VFD improved from 15 to 90% (p < 0.001) with the mask and from 15 to 85% (p < 0.001) with the endotracheal tube (ETT) by significantly reducing the proportion of hyperventilation. The mean ventilation rates and tidal volumes were in the recommended ranges in respectively 100% with the mask and 97.5% of participants with the ETT when using the VFD. Conclusion VFD improves the performance of manual ventilation by over 70% in different simulated scenarios. By providing the rescuer direct feedback and analysis of ventilatory parameters, this device can significantly improve ventilation while performing CPR and thus save lives.

scholarly journals Development and Psychometric Properties of The Delayed Childbearing Questionnaire (DCBQ-55)

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 120 ◽  
Author(s):  
Samira Behboudi-Gandevani ◽  
Saeideh Ziaei ◽  
Anoshirvan Kazemnejad ◽  
Farideh Khalajabadi Farahani ◽  
Mojtaba Vaismoradi
Keyword(s):  
Psychometric Properties ◽  
Content Validity ◽  
Healthcare Providers ◽  
Correlation Coefficients ◽  
Internal Consistency Reliability ◽  
Adverse Outcomes ◽  
Delayed Childbearing ◽  
Factors Influencing ◽  
Reliable Instrument ◽  
The Face

The comprehensive assessment of delayed childbearing needs a valid and reliable instrument. Therefore, the aim of the present study was to develop an instrument to evaluate factors influencing delayed childbearing among women and to assess its psychometric properties. The current methodological study was performed in two phases of (i) qualitative instrument development, and (ii) quantitative psychometric assessment of the developed instrument. Face and content validity of the instrument was assessed by eligible women and a panel of experts. Construct validity was assessed using the exploratory factor analysis (EFA). For reliability, internal consistency reliability and intra-rater reliability analysis were used. The initial instrument developed from the qualitative phase consisted of 60 items, which were reduced to 55 items after the face and content validity processes. EFA (n = 300) using the Kaiser criteria (Eigenvalues > 1) and the scree plot led to a six-factor solution accounting for 61.24% of the observed variance. The Cronbach’s alpha coefficient, Spearman’s correlation, test–retest and intra-class correlation coefficients for the whole instrument were reported as 0.83, 0.86 and 0.81, respectively. The final instrument entitled the delayed childbearing questionnaire (DCBQ-55) included 50 items with six domains of ‘readiness for childbearing’, ‘stability in the partner relationship’, ‘awareness about the adverse outcomes of pregnancy in advanced maternal age’, ‘attitude toward delayed childbearing’, ‘family support’, and ‘social support’ on a five-point Likert scale. The DCBQ-55 as a simple, valid and reliable instrument can assess factors influencing delayed childbearing. It can be used by reproductive healthcare providers and policy makers to understand factors influencing delayed childbearing and devise appropriate strategies.

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