Telepharmacy Robotic Medicine Delivery Unit TRMDU" Assessment"

2011 ◽  
Author(s):  
Daniel Touchette
Keyword(s):  
Delivery Unit

scholarly journals Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center

2020 ◽  
Vol 10 (03) ◽  
pp. e281-e287
Author(s):  
Sangeeta Kumaraswami ◽  
Tana S. Pradhan ◽  
Sorana Vrabie-Wolf ◽  
Sadaf Lodhi ◽  
Geetha P. Rajendran ◽  
...  
Keyword(s):  
New York ◽  
Care Center ◽  
Tertiary Care ◽  
New York State ◽  
York State Department ◽  
Obstetrical Care ◽  
Expert Opinions ◽  
Department Of Health ◽  
Delivery Unit ◽  
Westchester County

Abstract Objective To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges. Methods With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans. Results We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic. Conclusion The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York.

scholarly journals Clincial Experience with Patient-Controlled and Staff-Administered Intermittent Bolus Epidural Analgesia in Labour

1995 ◽  
Vol 23 (4) ◽  
pp. 459-463 ◽  
Author(s):  
M. J. Paech ◽  
T. J. G. Pavy ◽  
C. Sims ◽  
M. D. Westmore ◽  
J. M. Storey ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Randomized Study ◽  
Obstetric Delivery ◽  
Second Stage ◽  
Intermittent Bolus ◽  
Second Stage Of Labour ◽  
Pain Scores ◽  
Maximum Pain ◽  
Delivery Unit ◽  
Ib Method

A prospective randomized study was Performed to detail clinical experience with both patient-controlled epidural analgesia (PCEA) and midwife-administered intermittent bolus (IB) epidural analgesia during labour, under the conditions pertaining in a busy obstetric delivery unit. Both methods used 0.125% bupivacaine plus fentanyl, and similar rescue supplementation although management decisions related to epidural analgesia were made principally by attending midwives One hundred and ninety-eight women were recruited and data analysed from 167 (PCEA n = 82 IB n=85) The groups were demographically similar. Median hourly pain scores, ratings of analgesia and satisfaction did not differ Maximum pain scores were significantly higher in those receiving IB epidural analgesia (P<0.05). The PCEA group had a significantly higher rate of supplementation and bupivacaine use (P<0.01), and a longer duration of the second stage of labour (P<0.03) The relative risk of instrumental delivery with PCEA versus the IB method was 1.57 (CI 1.07–2.38) Experience within our unit with PCEA is contrasted with that of IB epidural analgesia, the method most commonly used; and with that of controlled trials comparing these two methods.

Hydrogen-driven denitrification of wastewater in an anaerobic submerged membrane bioreactor: potential for water reuse

2006 ◽  
Vol 54 (11-12) ◽  
pp. 207-214 ◽  
Author(s):  
B. Rezania ◽  
J.A. Oleszkiewicz ◽  
N. Cicek
Keyword(s):  
Organic Carbon ◽  
Water Reuse ◽  
Biological Treatment ◽  
Membrane Bioreactor ◽  
Hydrogen Transfer ◽  
Produced Water ◽  
Treatment Unit ◽  
Submerged Membrane Bioreactor ◽  
Delivery Unit ◽  
Final Effluent

An anaerobic submerged membrane bioreactor was coupled with a novel hydrogen delivery system for hydrogenotrophic denitrification of municipal final effluent containing nitrate. The biological treatment unit and hydrogen delivery unit were proven successful in removing nitrate and delivering hydrogen, respectively. Complete hydrogen transfer resulted in reducing nitrate below detectable levels at a loading of 0.14 kg N m−3 d−1. The produced water met all drinking water guidelines except for color and organic carbon. However, the organic carbon was removed by 72% mostly by membrane rejection. To reduce the organic carbon and color of the effluent, post treatment of the produced water is required.

Relationship Between Labor and Delivery Unit Management Practices and Maternal Outcomes

2017 ◽  
Vol 130 (2) ◽  
pp. 358-365 ◽  
Author(s):  
Avery C. Plough ◽  
Grace Galvin ◽  
Zhonghe Li ◽  
Stuart R. Lipsitz ◽  
Shehnaz Alidina ◽  
...  
Keyword(s):  
Management Practices ◽  
Maternal Outcomes ◽  
Labor And Delivery ◽  
Unit Management ◽  
Delivery Unit ◽  
Labor And Delivery Unit

Abstract 2244: A Novel Micropace-Ablate Protocol Eliminates Coagulum Formation in Radiofrequency Ablation

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Bernard Lim ◽  
K.l. Venkatachalam ◽  
Susan Johnson ◽  
Arshad Jahangir ◽  
Samuel Asirvatham
Keyword(s):  
Surface Coverage ◽  
Negative Charge ◽  
Fibrin Clot ◽  
List Type ◽  
Rf Ablation ◽  
Persistent Problem ◽  
Significant Difference ◽  
Catheter Tip ◽  
Delivery Unit ◽  
Rf Energy

Radiofrequency (RF) ablation for cardiac arrythmias is an established curative therapy. However, catheter-tip coagulum formation leading to thromboembolic stroke is a persistent problem despite heparinization. Recent studies demonstrated an up to 70% incidence of thrombus formation on the catheter tip during ablation and a 10 % incidence of thromboembolic events. Catheter tip thrombus can impede the delivery of RF energy to the tissue, resulting in reduced efficacy and longer procedure times. Here we report on a novel method to prevent coagulum formation on ablation catheters by delivering a negative charge to the catheter tip to repel negatively charged fibrinogen molecules during RF ablation. A novel circuit was built with a charge delivery unit using a 9 voltage battery to deliver a fixed offset direct current charge, placed in parallel to the RF delivery unit for negative charge placement during RF delivery. In in-vivo canine experiments (n=50) standard 6/4, 8/5 ablation catheters and catheters with abraded tips were advanced from right femoral veins into atria and ventricles under intra-cardiac echo (ICE) and biplane fluoroscopic guidance. The dogs received 1 of 2 therapies: no RF energy delivered with and without negative charge delivery, RF energy delivery with and without negative charge delivery. The presence of thrombus was identified with ICE. The catheter tips were examined also macroscopically with visual inspection and also with field emission scanning electron microscopy (FESEM). FESEM of the catheter tips showed surface coverage of fibrin clot of the catheter tip to be 90 % for non-charged catheters compared to 0 % (p< 0.01) in negatively-charged catheters. There was no significant difference in surface coverage of fibrin clot between negatively-charged catheters with the abraded tips (98.8%) and non-charged catheters with smooth tips (90.7 %, p=ns). Clot volume formed on the catheter tip decreased with increased amount of charge. Application of a negative charge did not affect the quality of the intracardiac electrograms or induce malignant ventricular arrhythmias. Negative charge delivery during RF ablation is feasible and safe and can eliminate coagulum formation, potentially reducing thromboembolic complications.

scholarly journals How far is too far? A nationwide cross-sectional study for establishing optimal hospital access time for Korean pregnant women

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031882 ◽  
Author(s):  
Mi Young Kwak ◽  
Seung Mi Lee ◽  
Hyun Joo Kim ◽  
Sang Jun Eun ◽  
Won Mo Jang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Maternal Morbidity ◽  
Cross Sectional Study ◽  
Obstetric Complications ◽  
Access Time ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital Access ◽  
Maternal Morbidity And Mortality ◽  
Delivery Unit

ObjectivesAccess to a delivery unit is a major factor in determining maternal morbidity and mortality. However, there is little information about the optimal access time to a delivery unit. This study aimed to establish the optimal hospital access time (OHAT) for pregnant women in South Korea.DesignNationwide cross-sectional study.SettingWe used the National Health Insurance System database of South Korea.ParticipantsWe analysed the data of 371 341 women who had experienced pregnancy in 2013.Primary and secondary outcome measuresAccess time to hospital was defined as the time required to travel from the patient’s home to the delivery unit. The incidence of obstetric complications was plotted against the access time to hospital. Change-point analysis was performed to identify the OHAT by determining a point wherein the incidence of obstetric complications changed significantly. As a final step, the risk of obstetric complications was compared by type among pregnant women who lived within the OHAT against those who lived outside the OHAT.ResultsThe OHAT associated with each adverse pregnancy outcomes were as follows: inadequate prenatal care, 41–50 min; preeclampsia, 51–60 min; placental abruption, 51–60 min; preterm delivery, 31–40 min; postpartum transfusion, 31–40 min; uterine artery embolisation, 31–40 min; admission to intensive care unit, 31–40 min; and caesarean hysterectomy, 31–40 min. Pregnant women who lived outside the OHAT had significantly higher risk for obstetric complications than those who lived within the OHAT.ConclusionsOur results showed that the OHAT for each obstetric complication ranged between 31 and 60 min. The Korean government should take the OHAT under consideration when establishing interventions for pregnant women who live outside OHAT to reduce maternal morbidity and mortality.

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