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1 Canadian Field Hospital in Haiti: surgical experience in earthquake relief.

https://arctichealth.org/en/permalink/ahliterature122035
Source
Can J Surg. 2012 Aug;55(4):271-4
Publication Type
Article
Date
Aug-2012
Author
Max Talbot
Bethann Meunier
Vincent Trottier
Michael Christian
Tracey Hillier
Chris Berger
Vivian McAlister
Scott Taylor
Author Affiliation
1 Canadian Field Hospital, Canadian Forces, Montreal, QC. max_talbot@hotmail.com
Source
Can J Surg. 2012 Aug;55(4):271-4
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Canada
Disaster Planning - organization & administration
Earthquakes
Female
Haiti
Hospitals, Packaged - organization & administration
Humans
International Cooperation
Male
Multiple Trauma - etiology - surgery
Operating Rooms
Relief Work - organization & administration
Surgical Procedures, Operative - statistics & numerical data
Abstract
The Canadian Forces' (CF) deployable hospital, 1 Canadian Field Hospital, was deployed to Haiti after an earthquake that caused massive devastation. Two surgical teams performed 167 operations over a 39-day period starting 17 days after the index event. Most operations were unrelated to the earthquake. Replacing or supplementing the destroyed local surgical capacity for a brief period after a disaster can be a valuable contribution to relief efforts. For future humanitarian operations/disaster response missions, the CF will study the feasibility of accelerating the deployment of surgical capabilities.
Notes
Cites: Disasters. 2000 Sep;24(3):262-7011026159
Cites: Prehosp Disaster Med. 2003 Oct-Dec;18(4):278-9015310039
Cites: Disaster Manag Response. 2005 Jan-Mar;3(1):11-615627125
Cites: Mil Med. 2007 May;172(5):471-717521092
Cites: Prehosp Disaster Med. 2008 Mar-Apr;23(2):144-51; discussion 152-318557294
Cites: Ann Intern Med. 2010 Jun 1;152(11):733-720197507
Cites: Prehosp Disaster Med. 2009 Jan-Feb;24(1):9-1019557952
Cites: Science. 2010 Feb 5;327(5966):638-920133550
Cites: Nature. 2010 Feb 18;463(7283):878-920164905
Cites: N Engl J Med. 2010 Mar 18;362(11):e3820200362
Cites: Prehosp Disaster Med. 2009 Jan-Feb;24(1):3-819557951
PubMed ID
22854149 View in PubMed
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[Air quality and microbiologic contamination in operating theatres].

https://arctichealth.org/en/permalink/ahliterature204398
Source
Tidsskr Nor Laegeforen. 1998 Aug 30;118(20):3148-51
Publication Type
Article
Date
Aug-30-1998
Author
B M Andersen
R T Røed
N. Solheim
F. Levy
A. Bratteberg
K. Kristoffersen
I. Moløkken
Author Affiliation
Avdeling for sykdomsforebygging hos risikogrupper, Ullevål sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1998 Aug 30;118(20):3148-51
Date
Aug-30-1998
Language
Norwegian
Publication Type
Article
Keywords
Air Conditioning
Air Microbiology
Air pollution, indoor
Cardiac Surgical Procedures
Colony Count, Microbial
Humans
Norway
Operating Rooms
Particle Size
Thoracic Surgical Procedures
Urologic Surgical Procedures
Ventilation
Abstract
The present study concerns the air quality and microbiological contamination in two newly built operating theatres; one with laminar air flow (LAF) equipment for cardio-thoracic operations, and one with conventional ventilation for urological operations. Both theatres had an identical number of air exchanges (17/h), identical microclimatic conditions and they employed the same cleaning procedures. In the LAF-ventilated operating theatre bacterial contamination of the air was effectively reduced to less than 10 colony-forming units (CFU)/m3 in all 125 samples (1 m3 per sample) tested. In most samples, 118/125, the bacterial count was less than 5 CFU/m3, despite the presence of ten persons. The conventionally ventilated theatre reached values up to 120 CFU/m3 during the most active period of the day when approximately seven persons were present. The LAF ventilation reduced both the content of particles in the air and contamination by bacteria on the floor. In both theatres cleaning procedures had only a low impact on CFU in the air and on the floor. The use of diathermia markedly increased the level of small particles in the air, and this may influence the air quality in the operating theatres.
PubMed ID
9760859 View in PubMed
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Source
American Journal of Psychiatry. 1964 Oct;121(4):313-317
Publication Type
Article
Date
Oct-1964
Author
Bowman, KM
Author Affiliation
Alaska Psychiatric Institute, Anchorage, Alaska
Source
American Journal of Psychiatry. 1964 Oct;121(4):313-317
Date
Oct-1964
Language
English
Geographic Location
U.S.
Publication Type
Article
Keywords
Alaska Psychiatric Institute
Anchorage
Good Friday
Alaska
Disasters
Dogs
Fear
Earthquakes
Emergency Service, Hospital
Abstract
"On Good Friday, March 27, 1964, the Alaska earthquake occurred which was probably the largest or equal to the largest earthquake that has ever been recorded," Dr. Karl Bowman writes. "Those of us living in Anchorage were quickly isolated, and, since the badly damaged part of the city was roped off and no one allowed inside of it, and since I was completely occupied with things at the Alaska Psychiatric Institute, I have very little firsthand information about some of the early days of the earthquake except in this one special site."
PubMed ID
14211402 View in PubMed
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Alaska's obstetrical delivery systems: a descriptive epidemiologic study.

https://arctichealth.org/en/permalink/ahliterature4519
Source
Alaska Med. 2000 Jul-Sep;42(3):78-84
Publication Type
Article
Author
D W Smith
N J Murphy
Author Affiliation
University of Washington School of Medicine, Anchorage, Alaska 99508, USA. dsmith@afpr.fammed.washington.edu
Source
Alaska Med. 2000 Jul-Sep;42(3):78-84
Language
English
Publication Type
Article
Keywords
Alaska
Anesthesia, Obstetrical
Cesarean Section
Comparative Study
Delivery, Obstetric - methods
Emergencies
Female
Hospitals, Rural
Humans
Obstetrics - manpower
Operating Rooms
Pregnancy
Research Support, Non-U.S. Gov't
Risk factors
Rural Population
Ultrasonography, Prenatal
Abstract
Delivery of obstetrical care in rural Alaska can be very challenging, due to remoteness, lack of medical resources and transportation difficulties. This descriptive study looks at what the current delivery systems for obstetrical care in Alaska are. Alaska's obstetrical delivery systems can be divided into three basic systems. 1) Full comprehensive obstetrical care limited only by lack of neonatal ICU capability. 2) Cesarean delivery capable, but with limited resources. 3) Low risk vaginal deliveries with no cesarean delivery capability except by transports approaching 6 hours. This study raises questions about which system is most effective for which communities. Further studies need to be undertaken to better understand how to provide effective obstetrical care in rural and bush Alaska at an acceptable risk, and at reasonable cost.
PubMed ID
11042940 View in PubMed
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The Anaesthetic Services Programme Encompassing Nova Scotia (ASPENS)

https://arctichealth.org/en/permalink/ahliterature217671
Source
Can J Anaesth. 1994 Aug;41(8):716-24
Publication Type
Article
Date
Aug-1994
Author
A J Clark
Author Affiliation
Department of Anaesthesia, Victoria General Hospital, Halifax, Nova Scotia, Canada.
Source
Can J Anaesth. 1994 Aug;41(8):716-24
Date
Aug-1994
Language
English
Publication Type
Article
Keywords
Anesthesia Department, Hospital - organization & administration - standards
Anesthesiology - education - organization & administration - standards
Education, Medical, Continuing
Forms and Records Control
Hospital Administration
Hospital records
Humans
Nova Scotia
Operating Rooms
Outcome and Process Assessment (Health Care)
Peer Review, Health Care - methods - standards
Policy Making
Professional Review Organizations - organization & administration - standards
Quality Assurance, Health Care
Societies, Medical
Abstract
A comprehensive peer review programme for anaesthesia departments in Nova Scotia was implemented in 1987 by the anaesthesia community. Departments are reviewed by peers at the request of the Head, Department of Anaesthesia, and the President of the Medical Staff. A confidential report with recommendations is written. Twenty-six reviews have been completed (to June 1993) and have most often documented deficiencies in: design of the anaesthesia record, anaesthesia staff recruitment, inadequate documentation of policies for anaesthesia and post-anaesthesia care, peer review/quality assurance processes, organizational structure of hospital medical staffs and operating room committees, and use of anaesthesia equipment that does not meet current (at date of review) CSA standards. In the four hospitals that have been reviewed twice, 24 of the 30 deficiencies noted on the first review had been corrected before the second review which occurred three to five years later. Nine new deficiencies were noted. Departments are encouraged to request a review every four or five years.
Notes
Comment In: Can J Anaesth. 1994 Aug;41(8):661-67605416
PubMed ID
7923520 View in PubMed
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An evaluation of an expert system for detecting critical events during anesthesia in a human patient simulator: a prospective randomized controlled study.

https://arctichealth.org/en/permalink/ahliterature112960
Source
Anesth Analg. 2013 Aug;117(2):380-91
Publication Type
Article
Date
Aug-2013
Author
Matthias Görges
Pamela Winton
Valentyna Koval
Joanne Lim
Jonathan Stinson
Peter T Choi
Stephan K W Schwarz
Guy A Dumont
J Mark Ansermino
Author Affiliation
Department of Electrical and Computer Engineering in Medicine Pediatric Anesthesia Research Team, BC Children's Hospital, 1L7-4480 Oak St., Vancouver, BC V6H 3V4, Canada. mgorges@cw.bc.ca
Source
Anesth Analg. 2013 Aug;117(2):380-91
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anaphylaxis - etiology - therapy
Anesthesia, General - adverse effects - instrumentation
Anesthetics, Inhalation - adverse effects
British Columbia
Clinical Alarms
Clinical Competence
Computer simulation
Drug Overdose - therapy
Equipment Design
Equipment Failure
Expert Systems
Female
Humans
Linear Models
Male
Manikins
Middle Aged
Multivariate Analysis
Operating Rooms
Pneumothorax - etiology - therapy
Prospective Studies
Questionnaires
Signal Processing, Computer-Assisted
Task Performance and Analysis
Time Factors
Time-to-Treatment
Workload
Young Adult
Abstract
Perioperative monitoring systems produce a large amount of uninterpreted data, use threshold alarms prone to artifacts, and rely on the clinician to continuously visually track changes in physiological data. To address these deficiencies, we developed an expert system that provides real-time clinical decisions for the identification of critical events. We evaluated the efficacy of the expert system for enhancing critical event detection in a simulated environment. We hypothesized that anesthesiologists would identify critical ventilatory events more rapidly and accurately with the expert system.
We used a high-fidelity human patient simulator to simulate an operating room environment. Participants managed 4 scenarios (anesthetic vapor overdose, tension pneumothorax, anaphylaxis, and endotracheal tube cuff leak) in random order. In 2 of their 4 scenarios, participants were randomly assigned to the expert system, which provided trend-based alerts and potential differential diagnoses. Time to detection and time to treatment were measured. Workload questionnaires and structured debriefings were completed after each scenario, and a usability questionnaire at the conclusion of the session. Data were analyzed using a mixed-effects linear regression model; Fisher exact test was used for workload scores.
Twenty anesthesiology trainees and 15 staff anesthesiologists with a combined median (range) of 36 (29-66) years of age and 6 (1-38) years of anesthesia experience participated. For the endotracheal tube cuff leak, the expert system caused mean reductions of 128 (99% confidence interval [CI], 54-202) seconds in time to detection and 140 (99% CI, 79-200) seconds in time to treatment. In the other 3 scenarios, a best-case decrease of 97 seconds (lower 99% CI) in time to diagnosis for anaphylaxis and a worst-case increase of 63 seconds (upper 99% CI) in time to treatment for anesthetic vapor overdose were found. Participants were highly satisfied with the expert system (median score, 2 on a scale of 1-7). Based on participant debriefings, we identified avoidance of task fixation, reassurance to initiate invasive treatment, and confirmation of a suspected diagnosis as 3 safety-critical areas.
When using the expert system, clinically important and statistically significant decreases in time to detection and time to treatment were observed for the endotracheal tube cuff Leak scenario. The observed differences in the other 3 scenarios were much smaller and not statistically significant. Further evaluation is required to confirm the clinical utility of real-time expert systems for anesthesia.
PubMed ID
23780423 View in PubMed
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"An improved system for narcotic control in the operating room".

https://arctichealth.org/en/permalink/ahliterature229121
Source
Can J Anaesth. 1990 May;37(4 Pt 2):S83
Publication Type
Article
Date
May-1990
Author
J A Johnson
W E Code
P G Duncan
Author Affiliation
Department of Pharmacy, University of Saskatchewan, Saskatoon, Canada.
Source
Can J Anaesth. 1990 May;37(4 Pt 2):S83
Date
May-1990
Language
English
Publication Type
Article
Keywords
Anesthesia
Drug Utilization
Drug and Narcotic Control - legislation & jurisprudence
Humans
Inventories, Hospital
Narcotics
Operating Rooms
Pharmacy Service, Hospital
Saskatchewan
PubMed ID
2361321 View in PubMed
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An infant surgical table for laser photocoagulation: ergonomic improvement analysis.

https://arctichealth.org/en/permalink/ahliterature98577
Source
J Med Eng Technol. 2010;34(2):124-33
Publication Type
Article
Date
2010
Author
K A Ryland
C A Nelson
T W Hejkal
Author Affiliation
Stryker Endoscopy, 5900 Optical Court, San Jose, CA 95138, USA.
Source
J Med Eng Technol. 2010;34(2):124-33
Date
2010
Language
English
Publication Type
Article
Keywords
Equipment Design
General Surgery - instrumentation
Humans
Infant
Infant, Newborn
Laser Coagulation - instrumentation
Operating Rooms
Surgical Equipment
Abstract
Current methods of treatment for retinopathy of prematurity, using laser photocoagulation, require surgeons to assume awkward standing positions, which can result in occupational injury. A new infant surgical table was designed for improving this surgical procedure. To quantify its benefits, an ergonomic comparison of the standard and modified procedures was carried out, using specialized checklists, Nordic Musculoskeletal Questionnaires, and analysis of videotaped procedures using an Ovako Working Posture Analysing System method. Analysis of the typical laser photocoagulation procedure revealed a high risk for cumulative trauma disorders. The majority of the risk factors were lowered considerably with use of the new table. Improvement was largely due to the new table allowing seated postures during surgery, relieving muscular stress on the back, shoulders and legs. This study demonstrates risk reduction through engineering design of new medical devices, and illustrates how combining different assessment approaches can help evaluate ergonomic impact of medical technologies.
PubMed ID
20017713 View in PubMed
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An in-use evaluation of an alcohol-based pre-surgical hand disinfectant.

https://arctichealth.org/en/permalink/ahliterature192006
Source
Infect Control Hosp Epidemiol. 2001 Oct;22(10):635-9
Publication Type
Article
Date
Oct-2001
Author
E A Bryce
D. Spence
F J Roberts
Author Affiliation
Division of Infection Control/Medical Microbiology, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
Source
Infect Control Hosp Epidemiol. 2001 Oct;22(10):635-9
Date
Oct-2001
Language
English
Publication Type
Article
Keywords
2-Propanol - standards
British Columbia
Chlorhexidine - standards
Colony Count, Microbial
Disinfectants - standards
Hand Disinfection
Humans
Operating Rooms
Povidone-Iodine - standards
Preoperative Care
Prospective Studies
Solvents - standards
Surgical Wound Infection - microbiology - prevention & control
Abstract
To determine whether alcohol hand disinfection is an effective alternative to traditional agents for the pre-surgical scrub.
A prospective clinical trial of a 70% isopropanol pre-surgical hand disinfectant.
The operating room suites at two hospital sites in British Columbia.
Cases were selected to evaluate both short and longer procedures. The hand disinfectant was compared to agents in current use as surgical scrubs (4% chlorhexidine and 7.5% povidone-iodine). Surgical technique and glove use were not modified. Pre- and postoperative fingertip impression and "glove-juice" cultures were used to determine microbial burden, and hands were evaluated for skin integrity.
There was no statistical difference between the microbial hand counts following use of the alcohol-based product or the current agents, for cases less than 2 hours' duration. Comparison of longer surgical cases revealed significantly better pre- and postoperative culture results with the alcohol hand rinse, but analysis of matched pairs showed no significant difference in microbial counts. The alcohol hand rinse was equivalent to the operative scrub in terms of skin integrity and user acceptability.
An alcohol hand rinse was equivalently effective in reducing microbial hand counts as the traditional pre-surgical scrub, both immediately after hand disinfection and at the end of the surgical procedure.
PubMed ID
11776350 View in PubMed
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110 records – page 1 of 11.