Tara Underwood Aeromedical Ultrasound: The Evaluation of Point-of-care Ultrasound During Helicopter Transport Original Abstract Introduction This study correlated the eFAST findings performed in-flight by the flight crew with the findings obtained by the trauma team upon initial evaluation at a level 1 trauma center and with the subsequent CT scans that were performed or the surgeon's operative note. We hypothesize that aeromedical eFAST examinations are highly correlated with the trauma teams findings. Methods This prospective, observational study evaluated 190 traumatically injured patients from June 2014 to December 2015 in Southeast Virginia and Northeast North Carolina. Results For 190 trauma patients the Flight Crew POCUS examinations obtained a Positive Predictive Value (PPV) of 100% and a Negative Predictive Value (NPV) of 98.3% for the identification of pneumothorax, …show more content…
Discussion Because the early recognition of potentially life-threatening conditions is critical to providing appropriate care to the traumatically injured patient this study provides solid statistical data that flight crews can adequately perform and interpret POCUS results as well as out trauma team colleagues. This study could lead to a reduction of iatrogenic injuries from unnecessary invasive prehospital procedures, allow for early initiation of Massive Transfusion Protocols (MTP) prior to the patient's arrival at the Trauma Center, and potentially develop a change in trauma systems notification and transportation directly to the operating room. Conclusion Despite this study developing a very positive outlook on performing aeromedical POCUS for the evaluation and care of trauma patients additional
Note and answer to yourself, the factor that are involved at the incident, the mechanisms and circumstances on the injury, as well as the extent and type of injury. Assessing the situation identify what happened, a number of people involved, as their age, there is a child and or elderly.
Pritesh has a previous medical history of asthma and has experienced right-sided haemothorax as he got hit by a hockey ball during a competition. Currently, the nurse suspects that Prithesh may be developing tension pneumothorax which is a life-threatening medical emergency (Brown & Edwards, 2012). Tension pneumothorax develops when a hole in the airway structures or the chest wall allows air to enter but not leave the thoracic cavity (Rodgers, 2008). The pressure in the intrathoracic space will continue increase until the lung collapses, place tension on the heart and the opposite lung leading to respiratory and cardiac function impairment, and eventually shock may result (Professional guide to pathophysiology, 2011; Rodgers, 2008). Tension pneumothorax usually results from a penetrating injury to the chest, blunt trauma to the chest, or during use of a mechanical ventilator (Brown & Edwards, 2012; Rodgers, 2008).
...severe head injury. Journal of Trauma [serial online]. December 2000; 49(6):1065-1070. Available from: CINAHL Plus, Ipswich, MA. Accessed March 7, 2014.
Diagnostic medical sonography is a profession where sonographers direct high-frequency sound waves into a patient’s body through the use of specific equipment to diagnose or monitor a patient’s medical condition. As described by the Bureau of Labor Statistics, this examination is referred to as an ultrasound, sonogram, or echocardiogram. The high-frequency sound waves emitted from the handheld device, called a transducer, bounce back creating an echo and therefore produce an image that can be viewed on the sonographers computer screen. This image provides the sonographer and physician with an internal image of the patient’s body that will be used in the diagnosis. The most familiar use of ultrasound is used in monitoring pregnancies and is provided by obstetric and gynecologic sonographers, who also provide imaging of the female reproductive system. Other types of sonography include; abdominal sonography, breast sonography, musculoskeletal sonography, neurosonography and cardiovascular sonography. Due to the vast nature of uses in sonography, most professionals study one field that they choose to specialize in. Diagnostic medical sonography is a rapidly growing field because of the increase in medical advances. The area of Cleveland, Ohio has continued to rise in the medical field with great strides, providing better career prospects with the availability of numerous employment positions.
There is nothing traumatizing in the world has adding pain to where it already exists. This is the hell situation which every medical error victim is exposed. As the statistics are currently showing, the fatalities are increasing day by day. The trend seems to be hiding on the old ideology of “man is to error”. However this is not being tolerated any more and the American medical facilities are being held 100% accountable for the mistakes they make in their service delivery. Professional diligence is not a matter of negotiation in this generation and probably future generations. If a medical facility cannot treat people diligently, then the only better option remaining for that facility is to be made to account for the losses they have caused on affected patients and be closed down immediately.
Adjusting your workstation equipment heavily influences the ability to perform an exam with proper ergonomic techniques. Examples of adjustments that can be made to the work station include, chair type, chair height, keyboard position, monitor position, as well as table position (HSA, 2014). Different equipment modifications will need to be made to suit the sonographer’s ergonomic needs for every exam. For example, Carolyn Coffin discuses techniques related to endovaginal scanning. She explains that while performing an endovaginal exam you should move the ultrasound machine to the end of the table providing close access to the machine and keyboard. She also suggests that you move your chair to sit between the patient’s legs; this will provide an ergonomically proper position for the sonographer. By making proper ergonomic changes based off exam type sonographers will alleviate pain as well as aid in MSI prevention (Coffin, 2014).
Vital improvement for patient safety has triggered an enormous amount of positive change in the healthcare system. There were “1.6 million adverse events each year that led to 180,000 deaths” (Liang & Mackey, 2011). In a review, avoidable errors led to $19.5 billion dollars in healthcare expenses (Liang & Mackey, 2011). The National Patient Safety Agency analyzed 425 deaths from acute care hospitals and found “15% of the deaths were related to unrecognized patient deterioration” (Higgins, Maries-Tillot, Quinton, & Richmond, 2008). This finding led to the Institute for Health Care Improvement’s promotion for the use of an early warning scoring system to assist with identifying deteriorating patients (Albert & Huesman, 2011).
One of them is the Crew Resource Management (CRM) present in the Aviation field that experts have come up. It is safety training that focuses team management that is very effective. The CRM programs essentially educate the crew members on how human competency may be limited. The operational perceptions emphasized include examination, promotion, seeking information related to operations, communicating projected exploits, decision-making and conflict resolution. The improvements on the safety records, which were observed after the implementation of this new safety training on commercial aviation, were tremendous compared to the previous record where 70 percent of the commercial flight accidents were as a result poor communication among crew members. Secondly, there is the Kaiser Permanente, SABR (Situation, Background, Assessment, and Recommendation) Tool 2002 which reveals that indeed doctors and nurses more often than not have different communication styles partly owing to their training. Physicians are taught to be concise while nurses to be able to vividly describe medical conditions. SABR was created by a physician co-coordinator of the informatics at the Kaiser Permanente, Michael Leonard together with his colleagues and it has been used vastly in the healthcare systems, one of them being the Kaiser Permanente. It provides a framework of communication between medical
The hypotheses in this study indicated that the use of comorbidities along with severity of injury in trauma patients as compared with a severity score alone would help to determine the hospital ranking. The null hypothesis was accepted in this case as there was no difference in the comparison.
With patient safety always being the number one priority FTR is the worst case scenario for the hospitalized patient. In an article titled “Failure to Rescue: The Nurse’s Impact” from the Medsurg Nursing Journal author Garvey explains ways FTR can occur “including organizational failure, provider lack of knowledge and failure to realize clinical injury, lack of supervision, and failure to get advice.” Nurses are problem solvers by nature, they heal the sick and help save lives. FTR is a tragic experience for everyone involved. The recent surge in this happening across the country has given FTR cases widespread media coverage. Hospitals are trying to figure out what the root cause is and how they can be prevented. Fortunately, with the advancement of technology and extensive research many hospitals have developed action plans and procedures to help prevent the early warning signs from being
Healthcare Professionals in Intensive Care Units: A Systematic Review.” PLOS Medicine, Public Library of Science, journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0136955.
One of the most important criterion in emergency medical treatment is response time. With crowded streets and highways, civil unrest and the aftermath of terrorist attacks, it can become a serious challenge to transport the critically injured to hospitals. Fortunately, there are unique hospitals in the air that can circumvent roadblocks in life and death circumstances. Within minutes a medical emergency team can be on the scene, doing what they do best... saving lives.
Delaney JS, Drummond R. Mass casualty and triage at a sporting event. Br J Sport Med 2002;36:85-88
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture. A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
Yanagawa, Y., & Miyawaki, H. (2012). Importance of checking prehospital neurological findings to reveal incidence of spinal cord concussion. Spinal Cord, 50, 278-280. doi:10.1038/sc.2011.151