Emergency Drugs Research Articles

Usability Testing and Technology Acceptance of an mHealth App at the Point of Care During Simulated Pediatric In- and Out-of-Hospital Cardiopulmonary Resuscitations: Study Nested Within 2 Multicenter Randomized Controlled Trials.

BackgroundMobile apps are increasingly being used in various domains of medicine. Few are evidence-based, and their benefits can only be achieved if end users intend to adopt and use them. To date, only a small fraction of mobile apps have published data on their field usability and end user acceptance results, especially in emergency medicine.ObjectiveThis study aims to determine the usability and acceptance of an evidence-based mobile app while safely preparing emergency drugs at the point of care during pediatric in- and out-of-hospital cardiopulmonary resuscitations by frontline caregivers.MethodsIn 2 multicenter randomized controlled parent trials conducted at 6 pediatric emergency departments from March 1 to December 31, 2017, and 14 emergency medical services from September 3, 2019, to January 21, 2020, the usability and technology acceptance of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app were evaluated among skilled pediatric emergency nurses and advanced paramedics when preparing continuous infusions of vasoactive drugs and direct intravenous emergency drugs at pediatric dosages during standardized, simulation-based, pediatric in- and out-of-hospital cardiac arrest scenarios, respectively. Usability was measured using the 10-item System Usability Scale. A 26-item technology acceptance self-administered survey (5-point Likert-type scales), adapted from the Unified Theory of Acceptance and Use of Technology model, was used to measure app acceptance and intention to use.ResultsAll 100% (128/128) of nurses (crossover trial) and 49.3% (74/150) of paramedics (parallel trial) were assigned to the mobile app. Mean total scores on the System Usability Scale were excellent and reached 89.5 (SD 8.8; 95% CI 88.0-91.1) for nurses and 89.7 (SD 8.7; 95% CI 87.7-91.7) for paramedics. Acceptance of the technology was very good and rated on average >4.5/5 for 5 of the 8 independent constructs evaluated. Only the image construct scored between 3.2 and 3.5 by both participant populations.ConclusionsThe results provide evidence that dedicated mobile apps can be easy to use and highly accepted at the point of care during in- and out-of-hospital cardiopulmonary resuscitations by frontline emergency caregivers. These findings can contribute to the implementation and valorization of studies aimed at evaluating the usability and acceptance of mobile apps in the field by caregivers, even in critical situations.Trial RegistrationClinicalTrials.gov NCT03021122; https://clinicaltrials.gov/ct2/show/NCT03021122. ClinicalTrials.gov NCT03921346; https://clinicaltrials.gov/ct2/show/NCT03921346International Registered Report Identifier (IRRID)RR2-10.1186/s13063-019-3726-4

Percutaneous radiofrequency ablation of peripheral maxillary nerve: Description of new methodology.

Sir, Maxillary nerve is the second most affected branch in trigeminal neuralgia. It is treated with medical drugs like carbamazepine and baclofen. For long-term pain relief, chemical neurolysis and radiofrequency ablation (RFA) are commonly undertaken, of which RFA results in longer duration of pain relief, shorter onset and increased safety.[1] Chemical neurolysis of maxillary nerve can also result in serious complications.[2] RFA in chronic facial pain is being increasingly used with promising results.[3] We describe two patients where percutaneous RFA of peripheral maxillary nerve was undertaken without fluoroscopic/computed tomography (CT) guidance. A 60-year-old female, a diagnosed case of idiopathic trigeminal neuralgia presented with electric, sharp shooting pain of Numerical rating scale (NRS) score 6/10 in the maxillary area with frequent exacerbations for the last two years. She had inadequate pain relief with oral medications such as carbamazepine, pregabalin, baclofen and tramadol/acetaminophen. For long-term relief, RFA of maxillary nerve via percutaneous approach was planned in the block area of the out-patient department (OPD). Anaesthesia machine, resuscitation equipment, monitor and emergency drugs were available in the OPD block area. After taking consent, intravenous line was secured and monitors (pulse oximetry, non-invasive blood pressure, electrocardiography) were attached. Under aseptic precautions, a 22 G radiofrequency needle (Cosman, 10 cm length, active tip – 1 cm) was inserted via coronoid notch on right side, in supine and neutral head position, after infiltration of local anaesthesia. After hitting lateral pterygoid plate, needle was directed 2–3 mm beyond the pterygoid plate antero-superiorly towards the root of the nose [Figure 1]. To identify maxillary nerve, sensory stimulation (50 Hz, 1 mA) was used to elicit paraesthesia in maxillary area, achieved in first attempt at 0.3 mV. Motor involvement was ruled out by 2 Hz and 2 mA. 1 ml of 1% lignocaine was injected which caused paraesthesia in affected area and was followed by RFA of maxillary neve of 3 cycles at 65° for 60 s followed by injection dexamethasone 4 mg. This patient became pain-free for the next six months. All medications were reduced and tablet baclofen and tramadol were stopped.Figure 1: Infrazygomatic approach of maxillary nerve block (left); Radiofrequency generator for ablation of nerve (right)The second case was a 66-year-old male patient of idiopathic trigeminal neuralgia of one year duration with pain refractory to medical management. Maxillary nerve RFA was performed with similar methodology as above. Sensory stimulation was achieved at 0.4 mV and RFA was performed after excluding motor response. The patient was pain-free for the next eight months and his oral medications were considerably reduced. RFA of peripheral branches of the trigeminal nerve (infraorbital, supraorbital, mental and mandibular nerves) was found equally efficacious to RFA of gasserian ganglion through foramen ovale for trigeminal neuralgia; however, RFA of maxillary nerve was not undertaken in the study.[4] In the commonly practised percutaneous infrazygomatic maxillary nerve blockade,[5] a reliable block requires the patient to report paraesthesia by block needle. Electrical stimulation has reported higher sensitivity of nerve identification than paraesthesia[6] which was utilised for RFA of maxillary nerve via CT- guided percutaneous infrazygomatic approach through foramen rotundum.[7] However, this is invasive, has radiation hazards and requires special area. We propose RFA of maxillary nerve via percutaneous infrazygomatic approach and locating it by electrical stimulation. Added advantages are that it has no radiation hazards, is less invasive and it is an OPD block procedure. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Development and validation of a length- and habitus-based method of total body weight estimation in adults.

Erroneous weight estimation during the management of emergency presentations in adults may contribute to patient harm and poor outcomes. Patients can often not be weighed during emergencies and a weight estimation is required to facilitate weight-based therapies. Many existing methods of weight estimation are either unacceptably inaccurate or very difficult to use during the provision of emergency care. The weight estimation system developed in this study was based on and modified from the PAWPER XL-MAC method, a pediatric weight estimation system that uses recumbent length and mid-arm circumference (MAC) to predict total body weight. This model was validated in the 2015-2018 National Health and Nutrition Examination Survey (NHANES) datasets. The primary outcome measure was to achieve >95% of estimations within 20% of measured weight (P20>95%). The modified PAWPER XL-MAC model achieved a P20 of 96.0% and a P10 of 71.3% in the validation dataset (N=11,520). This accuracy (P20>95%) was maintained in both sexes, all ages, all ethnic groups, all lengths and in all habitus-types, except for the subgroup of severely obese individuals. The modified PAWPER XL-MAC model proved to be a very accurate method of weight estimation. It is more accurate than most other published reports of existing methods of weight estimation, except for patients' own estimations. It therefore could have a role in facilitating emergency drug dose calculations, if prospective studies bear out the accuracy found in this study.

Preparedness of Dentists and Dental Clinics for Medical Emergencies in Jordan.

Background:Dentistry, as most clinical specialties, has a wide range of invasive procedures in which patients are at risk of having a medical emergency (ME). The stress induced at clinic during treatment, the medically compromised elderly patients whom are increasing in number due to the new advancements in medicine and the invasive techniques such as injections, surgical flaps, devitalization or extractions are risk factors for medical emergencies’ occurrence.Objective:The aim of this study was to assess the knowledge and the training of dentists and the availability of the emergency drugs and equipment in a sample of dental clinics in Jordan.Methods:A questionnaire was designed and distributed using an online service to dentists all over Jordan. It included different question categories; Demographic, Medical emergencies, emergency equipment and medications and dentists’ self confidence and training to manage medical emergencies.Results:Number of 180 completed questionnaires were accepted for the study, 102 were females and 92 were specialists. 158 (87.8%) responders faced a medical emergency at their work place. Most common medical emergency faced in the clinic was the vasovagal attack 81(45%). Major emergencies were witnessed by 79(43.9%) of the dentists. 110 (61.1%) of the responding dentists had their training in medical emergency management after graduation from dental school while 49(27.7%) had their training during dental school. 156(86.7%) found themselves still in need for further training. Blood pressure meter was the most available device at clinics 33(18.3%) and was the most used. Defibrillators were only used by 13(11.3%) of the responders. Epinephrine, steroids and nitro-glycerine were the available drugs for medical emergencies management in the practices (27.8%, 26.7% and 18.9%) respectively. Most dentists were not confident enough to handle medical emergencies.Conclusion:Preparedness of dentists and dental clinics to handle and manage medical emergencies needs further attention and focus to assure prevention and management of such incidents.

Dihydropyrimidinone imidazoles as unique structural antibacterial agents for drug-resistant gram-negative pathogens

The health crisis caused by severe multidrug resistance increasingly compels the exploitation of new alternative antibacterial drugs. A library of structurally unique dihydropyrimidinone imidazoles as novel potential antibacterial agents was developed with the aim to confront drug resistance. Some target compounds exhibited strong antibacterial activities, especially, sulfamethoxazole hybridized dihydropyrimidinone imidazole 8b was found to be extremely active against multidrug-resistant K. pneumonia and A. baumanii at a low concentration of 0.5 μg/mL, which outperformed norfloxacin even clinafloxacin. This active compound not only exhibited low cytotoxicity to mammalian cells (human red blood cells, HepG2 and ECs), but also possessed rapid bactericidal property, good biofilm inhibition ability, and a low propensity to induce K. pneumonia and A. baumanii resistance. Further studies revealed that the inhibitory effect of the active compound 8b might be achieved by disrupting membrane integrity, increasing ROS generation, reducing GSH activity and interacting with DNA. These findings provided a bright hope for developing dihydropyrimidinone imidazoles to combat emergent drug resistance.

Emergency Drugs for the Oral and Maxillofacial Surgeon Office.

This article illustrates the indications and mechanism of action of core emergency medications as well as emergency medications for intravenous sedation in the oral and maxillofacial surgeon office. The recognition of medical emergencies and comprehensive knowledge of pharmaceutical medical intervention can prevent deterioration in medical emergencies. In addition, this article also reviews common dosages as well as administration techniques that should be regularly reviewed and be fundamental knowledge to the oral surgeon and staff.

Popularity of Delta-8 THC on the Internet Across US States, 2021.

Objectives. To assess the popularity of an emergent drug, delta-8 tetrahydrocannabinol (THC), and compare interest levels between US states with or without legalized recreational cannabis. Methods. We used Google Trends to assess the growth of interest among delta-8 THC-related search terms from May 17, 2020, to May 9, 2021. We examined differences between states with or without legalized cannabis using state-level Google Trends data from February 13 to May 13, 2021, and policy data from the National Conference of State Legislatures. Results. Interest in delta-8 THC increased starting in mid-June 2020, with search volumes for delta-8 THC queries currently at 35% of the "marijuana" query. States where recreational cannabis is illegal had higher relative queries than did states with legalized recreational cannabis (52.3 vs 14.8; t = 40.9; P < .001). Conclusions. There has been rapid growth in interest in delta-8 THC. Findings between state policy contexts likely indicate delta-8 THC's role as a substitute good for delta-9 THC. Public Health Implications. Digital signals such as search volumes may point to an emergent use trend in the substance delta-8 THC. Further studies are needed to assess potential harms and correlates of delta-8 THC use. (Am J Public Health. 2022;112(2):296-299. https://doi.org/10.2105/AJPH.2021.306586).

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the FDA Adverse Event Reporting System (FAERS) from 1995-2020

There is a lack of knowledge of patterns of long-standing versus emergent drug causes of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and their epidemiology and mortality over time.

P148 Subclinical inflammatory bowel disease precedes the diagnosis and leads to an increase on healthcare resources utilization: multicentric case-control study in the Basque Country

Abstract Background The inflammatory process associated to ulcerative colitis (UC) and Crohn’s disease (CD) starts before the onset of symptoms and the diagnosis, but this period has not yet been well defined. Our aim was to determine if patients with an incidental diagnosis of UC or CD have an increase in healthcare utilization in the years preceding the symptomatic onset of the disease. Methods All asymptomatic patients with a diagnosis of UC or CD during the colorectal cancer screening program between October 2010-January 2021 were included in this multicentric retrospective case-control study. Cases were matched 1:3 with controls adjusted by sex, age and date, excluding subjects with any visit to Gastroenterology. The main outcomes were the number of outpatient or Emergency Rooms visits, admissions, radiological examinations (US, CT, MRI), sick-leaves, and drug prescriptions (antibiotics, systemic steroids) up to 5 years before the diagnosis. Descriptive statistics were used, with chi-square tests and a multivariable hurdle or negative binomial regression model, adjusted by smoking habits and Charlson index. Results A total of 124 patients were included (87 UC, 30 CD, 7 IBD-U; median 56 years (IQR, 53–62); 56% male), compared with 372 controls. Baseline characteristics including comorbidities were balanced between both cohorts. Patients demonstrated an increase in the number of visits to Primary Care physician during both 3 and 5 years before the diagnosis, but there were no differences in the remaining outcomes including hospital admissions, Emergency Room or outpatients visits, and sick-leaves (Figure 1 and 2). Systemic steroids were more frequently prescribed to patients in the preceding 3 to 5 years before diagnosis. Patients underwent US and/or CT scan less frequently in the preceding 5-year period. Conclusion Patients with IBD show an increased need of medical assistance in the years prior to the diagnosis, even during the presymptomatic phase of the disease. Tools focused on early identification of IBD may start on Primary Care facilities, but certain factors as steroids may alter the development of symptoms and the full spectrum of the disease.

Barry Logan, a prominent toxicologist and forensic analytical chemist, kindly spoke with BrJAC about his research into drugs of abuse, the legacy and inspiration for future

Dr Barry Logan is a world leading forensic toxicologist currently serving as Chief Scientist at NMS Labs, and Executive Director at the Center for Forensic Science Research and Education (CSFRE) in Willow Grove, Pennsylvania. He was born and completed his undergraduate and graduate education in Glasgow, Scotland, completed a postdoctoral fellowship at the University of Tennessee in Memphis TN, then served for eighteen years as State Toxicologist for the State of Washington, with an appointment at the University of Washington in Seattle. For nine of those years he also served as Director of the Washington State Crime Laboratory System, which provided services in forensic biology, toxicology, chemistry, document examination, serology, DNA analysis, firearms and crime scene support. In 2008, Logan joined the United States leading forensic toxicology and chemistry reference laboratory - NMS labs - in Pennsylvania to direct their toxicology services. In 2010 he founded the CFSRE and in 2017, established www.NPSDiscovery.org the leading clearing-house for the dissemination of newly emergent drugs in the United States. He has over 150 publications and 600 presentations in forensic toxicology and analytical chemistry, including work on the effects of methamphetamine, cocaine and marijuana on drivers, and drug caused and related death. His recent work has focused on the analytical and interpretive toxicology of novel psychoactive substances (NPS). Dr Logan’s other appointments include Executive Director of the Robert F. Borkenstein course at Indiana University, and academic appointments at Arcadia University, and Thomas Jefferson University in Philadelphia. In recognition of his work and contributions, Dr. Logan has received numerous national and international awards, and in 2013-14 served as President of the American Academy of Forensic Sciences (AAFS). A recent bibliometric analysis of the impact of the world’s forensic scientists, positioned him as the leading contributor to research in the field of forensic toxicology in the United States, and sixth in the world. In the last ten years he has had extensive involvement with forensic scientists in Brazil, hosting graduate students from the Federal University of Rio Grande do Sul, USP, and Campinas University at his laboratory in the United States, and visiting scientists from the Federal Police and State Crime Laboratories. He has presented multiple times at Interforensics, ENQFor, and Brazilian Academy of Forensic Sciences meetings. The CSFRE supports participation of young scientists from Brazil in the AAFS meeting and a reciprocal opportunity for young US scientists to attend Interforensics.

Evolution of the emergency drug innovation network and policy implications: Evidence from COVID-19 drug patents

Abstract Developing emergency drugs in time is key to responding to public health emergencies such as the coronavirus disease 2019 (COVID-19) pandemic. This research constructs patent assignee citation networks based on COVID-19 drug patents and applies technology life cycle analysis and social network analysis to examine these networks. The results reveal the evolution and structure of the emergency drug innovation network and identify innovation entities with different research and development (R&amp;D) capabilities or a foundation for cooperation. This study attempts to provide the basis for theories and policies to accelerate R&amp;D of emergency drugs. The key results are as follows: (1) Technologies of the emergency drug innovation network show fluctuating growth aligned closely with public health emergencies. (2) The network presents a sparse structure with many active factions, whose members have the advantage of cooperating. (3) Three types of innovation entities are identified: the main technology suppliers, potential suppliers of other supporting technologies, and peripheral suppliers of other supporting technologies.

A Study to Assess the Effectiveness of Video-assisted Teaching Program on Knowledge Regarding Selected Emergency Pre-cardiac Medications among Staff Nurses at Selected Hospital in Bangalore

Background: Coronary heart disease is now the leading cause of mortality worldwide and accounts for the death of 3.8 million men and 3.4 million women each year. In developing countries, coronary artery diseases have been recognized as a major public health problem. Cardiovascular emergencies account for at least 30% of all medical emergencies. During cardiovascular emergencies, the survival of the patient depends on a rapid response that provides high quality treatment based on latest guideline. Administration of the correct drugs is an important aspect of this process and among the health team members nurses are taking an increasingly important role. However, most of the studies done by the various researchers found that the majority of the nurses are unaware about the vital drugs used in the cardiac emergencies. Methods: In the present study, one group pre-test and post-test research design was used to assess effectiveness of video-assisted teaching program (VATP) on knowledge of emergency drugs among 30 staff nurses by purposive sampling method working in selected hospital. Structured knowledge questionnaire was used. Results: Finding revealed that the majority of respondents 70% had only average knowledge whose percentage of score ranged between (35 and 70). Only 10% of the respondents had good knowledge (70–100) and 20% of the respondents had poor knowledge (0–35) regarding emergency drugs. Conclusion: Finding of the study showed that the post-test knowledge scores showed a significant increase in knowledge. The research was conducted with the VATP improved knowledge of the staff nurses on emergency drugs

Efficacy of N Acetyl Cysteine in Remdesvir Induced Hepatotoxicity in COVID-19 Patients

Background: Remdesvir has been approved as an emergency drug in SARS COVID infection. One of the side effects of remdesvir was found t be drug induced liver injury. There are case reports of progression to Acute Liver Failure in such patients. One of the treatments proposed is the withdrawal of the drug. N-acetyl Cysteine has been proposed in non acetaminophenan induced liver injury for the prevention of acute liver failure. The scope of N acetyl cysteine in remdesvir induced DILI has been investigated through this study. Aims: 1. Response to N Acetyl cysteine in patients with Remdesvir induced hepatotoxicity 2. Role of N Acetyl cysteine in progression of acute liver failure in DILI patients due to Remdesvir.3. Improvement of liver parameters after withdrawal of the drug in remdesvir induced liver injury patients.4.recovery from acute liver failure in NAC group. Methods: Patients without prior history of liver disease who develop DILI after giving remdesvir is divided into study and control group. The study population started on inj N Acetyl Cysteine 1g twice a day for 7 days and ALT was monitored on the 7th day. The complete LFT at the time of admission, day of intitation of NAC and day 7 was recorded. The results are compared. Results: NAC is potent in reducing serum ALT(control-76.4 ± 68.7 vs NAC- 50.4 ± 19.1, P<0.0001) and AST (control -67.2 ± 44.38 vs NAC-43.6 ± 13.8), P<0.0001)levels when compared to withdrawal group. No progression to acute liver failure was noted in both the groups. In patients with acute liver failure, the recovery was higher and more reduction in liver enzymes was noted when compared to control group. Conclusion: In our study, N- acetyl cysteine was found to be effective in Remdesvir induced hepatotoxicity and also found to be effective in recovery of acute liver failure.

Outcomes and Associated Factors Among Adult Patients Admitted to Adult Intensive Care Unit, Retrospective Cohort Study

ABSTRACT Background: Intensive care unit represent a multidisciplinary and inter-professional specialty dedicated to the total management of patients with acute life threatening condition. Now a day the care is advancing; however, in resource limited country like Ethiopia the care is very poor if any and mortality still high because of numerous reasons. Objective: To determine outcome with its associated factors of adult patient admitted to adult intensive care unit (AICU), Ambo University Referral Hospital, and Ambo. Ethiopia. Method: After obtaining ethical clearance, a retrospective institution-based cohort study was used. Data were retrieved from all intensive care unit (ICU) admitted patients (from September 2019 to December 2021) using a pre-tested structured questionnaire and the collected data was entered into Epi info and transported to SPSS for analysis. Risk factors and their associations were assessed by logistic regression, bivariate and multivariate logistic regression was used, P value 0.05 on multivariate logistic regression was considered statistically significant. Result: Five hundred and fifty patients have been admitted to the intensive care unit. However; only 390 patients had completed data and were analyzed. Majority 203 (52.1%) of participants were men and 155 patients were supplied by the medical service. The overall mortality rate was 46.9%, and significantly associated with Glasgow coma scale &lt; 9 (AOR = 3.7, P value &lt; 0.001), patient with coexisting disease (AOR = 2.2, P value 0.001). AOR = 1.9, P-value 0.011). mechanical ventilation requirements (AOR = 2.6, P-value 0.001) and patients who stayed less than four days in intensive care are more likely to die than patients who stayed longer than four days (AOR = 2.4, P value &lt; 0.001). Conclusion and recommendation: The overall death rate in the intensive care unit is high and patient with low Glasgow coma scale, coexisting disease, need of mechanical ventilation short duration of stay are associated with mortality in intensive care unit. Therefore; we recommend the improvement of acute intensive care through the expansion of care, the provision of emergency equipment, drugs and human resources from different disciplines. Highlights

Innovative Folding Bed Cum Chair Based on IoT-Cloud Technology

Aim: The method of utilization of IoT and other evolving techniques in medical equipment design field is discussed in the present paper. A remotely managed interface equipped in a wheelchair cum bed is embedded for elderly or physically challenged people. With the help of a camera embedded in the proposed solution, a real-time remote monitoring of the patient is achieved using an android application on the concerned person. For achieving the above mentioned purpose, the use of linear actuators has been done. This paper further aims to explore the hidden potentials of the merger of all these fields to benefit the end users. Objectives: Remote monitoring of health of the patient through a cloud-based android application. Automatic adjustment of the wheelchair into bed and vice-versa. Automatic stool passing chamber facility is available under the proposed model. Injuries during transportation of the patient from one chair to another (or chair to bed) have been limited in our designed model. Methods: The basic mechanism of proposed wheelchair has been designed using the computer-aided design software. The basic methodology adopted for development of prototype &amp; subsequent “user review analysis” is displayed. The CAD Model of the wheelchair cum stretcher was designed using the “Solid works solid modelling techniques”. The basic structure has been designed with several modifications when compared to the conventional wheelchair design. The computer made design was then utilized for final fabrication of the prototype. The prototype was tested for endurance, load bearing capacity and customer comfort during various phases of development. The feedbacks of several subjects were recorded for future utilization in improved design &amp; fabrication. Results: The proposed model is of utmost importance as the number of critical patients like accident cases, critical pre and post-surgery cases is increasing day by day. Sometimes these patients need intime medication during transition in ambulance while they are picked up from houses and referred to nearby big hospitals. During transition or in hospital, critical patients can be handled efficiently by a specialist doctor through his/her smart phone applications. It also optimizes the services of specialist doctors as we can find the shortage of specialists in Indian hospitals. In a nutshell, this WheelChair system can be moved anywhere due to its portability. Following are the most highlighted features: 1. Authorized relatives and Doctors can see and interact with the patient remotely at any time on his/her smart phone. 2. Authorized relatives and Doctors can see the Vital Sign of patient like BP, ECG, and Pulse etc. at any time through Smart Phone. 3. Doctor can instruct the caretaker to release the emergency drugs through Infusion Pump. 4. Doctor can plan the exceptions, drug infusion, alarm, etc. 5. System is portable and can easily be shifted to ambulance. All transmissions are wireless, so there is no hassle of wires and connectivity. Conclusion: The presented work is limited to the design and fabrication of a new model of wheelchair, which works as a stretcher and has locomotive capabilities. The key feature of the design is its versatility and adaptability to various working conditions. The feedback obtained from various subjects during the testing of wheelchair shows their confidence and a fair degree of comfort which they felt while using the wheelchair. The easy and user-friendly use of the android application helps to monitor the health of the patient. The smartphone camera helped to achieve this data. The analysis of the data can be done in the cloud-based station. The linear actuator has proved to be the low cost and highly reliable equipment to propel the wheelchair.

Reconsidering essential emergency drugs for dental clinics

Reconsidering essential emergency drugs for dental clinics

Safety and sagacious use of remdesivir: Paramount focus on contemporary perspectives

The outbreak of COVID-19 has severely impacted the viability on the earth. Its pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has manifested catastrophic effect on the world's demographics and emerged as the most epizootic agent for human beings. Even though considerable progress in research has led to a better understanding of the virus, there is no specific and potent treatment or cure has been proven effective for this disease. Based on the available scientific evidences, U. S. Food and Drug Administration has issued an emergency use authorization for the emergency use of remdesivir against SARS-CoV-2 virus in critical and hospitalized patients. Remdesivir is a prodrug form of a nucleoside analog GS-441524. It is given intravenously because of its poor absorption through oral route. Remdesivir acts against viral RNA-dependent RNA polymerase targeting viral genome replication. It has been used in many countries as an emergency drug for the treatment of COVID-19 in hospitalized patients. However, in order to substantiate the result through suitable statistics, large-scale clinical trials are required. As per existing studies, the most common adverse effects reported after intravenous administration of remdesivir are elevation in the level of aminotransferase enzymes and bilirubin. Renal impairment, hypotension, and diarrhea have also been revealed in few patients. As of now, there is limited trial data available on remdesivir, so irrevocable epilogues cannot be drawn. However, it is believed by many therapists that irrational use of remdesivir should be prohibited. The erroneous use of remdesivir can lead to the SARS-CoV-2 virus mutating, and its consequence may be ill-starred in future.

Perspectives of Dental Practitioners Regarding Their Readiness for Medical Emergencies: A Study in Saudi Arabia

Background: Training dental practitioners on emergency preparedness and response is essential for the successful management of medical emergencies. Objectives: To assess the perceptions of dental practitioners in Saudi Arabia about their readiness to manage medical emergencies in the dental practices. Methods: This cross-sectional survey was conducted among dental practitioners working in 52 dental centers in Saudi Arabia. Questionnaires mainly gathered data on the measures taken by dental practitioners to prevent medical emergencies, BLS certification, availability of essential drugs and equipment, and perceptions of dental practitioners regarding the adequacy of their training for medical emergencies. Results: Of the total 270 participants, the majority reported that they take medical history (94%), perform visual inspection (90%), consult with patients’ physician when needed (89%), and modify treatment plan as necessary (94%). However, only 19% of them routinely take baseline vital signs for their patients and 52.6% have valid BLS certification. Only 29.6% and 16.3% of dental practitioners have reported that they have all essential drugs and equipment, respectively. Conclusion: The preventive measures for medical emergency appears to be deficient because most dental practitioners are not routinely taking baseline vital signs for their patients. This important issue is combined with shortage of BLS certification among dental practitioners and inadequate availability of all medical emergency drugs and equipment in dental practices.

13 Medical Emergency &lt;i&gt;in situ&lt;/i&gt; Simulation Training for Dental Hygiene Therapists

simulation, in the clinical environment, can help detect any issues with the systems, policies and practices within an organization that may not work. Many system errors go unnoticed until there is a real incident. Conducting simulation This simulation exercise is designed to develop the skillset of foundation dental therapists in respect of Medical Emergency recognition and management in their own working environment. The parameters for assessment included teamwork, knowledge, communication, effectiveness of actions and situational awareness.Research methods for this project included a learning needs analysis, surveying and interviewing previous cohorts of hygiene therapists. The conclusions of which highlighted the need for further training in managing medical emergencies. The learning needs identified from stakeholders relating to this course have been used to develop the learning outcomes using Blooms’ taxonomy Using GIBBs model of reflection, the 2021 delegates recognized personal learning needs including improvement in leadership and management skills, delivery of chest compressions and teamwork. Changes to practice were also recognized, for example, placing their emergency drugs in a more appropriate location. Using video, a ‘Hot Debrief’ method of evaluation was carried out whilst the experience was fresh. This proved to be powerful and enhanced personal reflection to support future learning and development. Later, an evaluation method in the form of a survey took place. Results of which showed that 50% of delegates had never partaken in simulation-based education before and 100% gave an excellent rating on the benefits to team and individual. One participant stated ‘this was such a good, real-life experience! I hope this can either be introduced into undergraduate training or as part of the practice annual BLS CPD!!’.A successful session needed prior communications with the practice staff to free up a surgery for use, inform present patients of the activity and understand where the emergency equipment was during the session for patient safety. The benefits of conducting

AI-Enabled, Ultrasound-Guided Handheld Robotic Device for Femoral Vascular Access.

Hemorrhage is a leading cause of trauma death, particularly in prehospital environments when evacuation is delayed. Obtaining central vascular access to a deep artery or vein is important for administration of emergency drugs and analgesics, and rapid replacement of blood volume, as well as invasive sensing and emerging life-saving interventions. However, central access is normally performed by highly experienced critical care physicians in a hospital setting. We developed a handheld AI-enabled interventional device, AI-GUIDE (Artificial Intelligence Guided Ultrasound Interventional Device), capable of directing users with no ultrasound or interventional expertise to catheterize a deep blood vessel, with an initial focus on the femoral vein. AI-GUIDE integrates with widely available commercial portable ultrasound systems and guides a user in ultrasound probe localization, venous puncture-point localization, and needle insertion. The system performs vascular puncture robotically and incorporates a preloaded guidewire to facilitate the Seldinger technique of catheter insertion. Results from tissue-mimicking phantom and porcine studies under normotensive and hypotensive conditions provide evidence of the technique’s robustness, with key performance metrics in a live porcine model including: a mean time to acquire femoral vein insertion point of 53 ± 36 s (5 users with varying experience, in 20 trials), a total time to insert catheter of 80 ± 30 s (1 user, in 6 trials), and a mean number of 1.1 (normotensive, 39 trials) and 1.3 (hypotensive, 55 trials) needle insertion attempts (1 user). These performance metrics in a porcine model are consistent with those for experienced medical providers performing central vascular access on humans in a hospital.