Misuse Of Equipment Research Articles

Non-Productive Time Reduction during Oil Wells Drilling Operations

Often there is no well drilling without problems. The solution lies in managing and evaluating these problems and developing strategies to manage and scale them. Non-productive time (NPT) is one of the main causes of delayed drilling operations. Many events or possibilities can lead to a halt in drilling operations or a marginal decrease in the advancement of drilling, this is called (NPT). Reducing NPT has an important impact on the total expenditure, time and cost are considered one of the most important success factors in the oil industry. In other words, steps must be taken to investigate and eliminate loss of time, that is, unproductive time in the drilling rig in order to save time and cost and reduce wasted time. The data of six oil wells were approved for the purpose of the study, where it was noted that there are many factors affecting the NPT, which differ from one well to another. Its impact was limited to drilling rig, mud pump and equipment failure. There is also a difference between the planned program and what is actually happening on the ground, due to several reasons, including human errors during the implementation of the drilling program and others due to technical errors, Misuse of equipment, in addition to human errors related to the failure to implement the drilling program.

Development of dual access energy monitoring for the smart control system

The rapid growth of smart manufacturing leads to an increase in the power consumption of the equipment used and has the challenges like misuse of equipment, operator safety, and protection of equipment from any electrical disturbances or sudden power surge. This paper aims in creating a smart access control unit with a Dual Access Energy Monitoring (DAEM) system. Here, the equipment is restricted to use by the authorized individual under its working limits. The access control for energy monitoring has been carried out using Radio Frequency Identification (RFID) and IEEE 802.11ac with the design of customized breakout board. The DAEM has been carried out by comparing the electrical characteristics like current, voltage, active power, apparent power, and power factor with their preset warning and trip threshold values. Using DAEM, the electrical circuit overload is prevented ensuring the operator’s safety. Moreover, the timer in the circuit will automatically disconnect the load from the mains after a timeout to prevent unnecessary wastage of energy.

Management factors affecting physical health and welfare of tourist camp elephants in Thailand.

BackgroundVariation in management across elephant camps likely has differential effects on the well-being of elephants.MethodsThis study calculated body condition, foot health and skin wound scores (WSs) for 122 elephants from 15 elephant camps in Chiang Mai province, and examined relationships to management factors using a multi-variable modeling approach.ResultsThe majority of elephants had high body condition scores (BCS) indicative of being overweight or obese, mild foot problems, but few visible wounds. Females had higher BCSs than males, as did elephants provided a water source at night. Increasing age was associated with higher foot and WSs. Higher WSs were observed in about a quarter of the cases where mahouts carried a hook. Wounds related to saddle riding were rare. Elephants that rested on sand floors at night had a decreased risk of high WSs compared to elephants that rested on compact dirt floors.DiscussionFindings emphasize the need for elephant camps to adjust management activities that negatively affect body condition (e.g., feeding too many sweet treats), foot health (e.g., hard substrates) and wounding (e.g., misuse of equipment) to improve health and welfare of this population.

Dwelling Fire Safety Evacuation (DFSE): A Conceptual Approach

Fire ignition needs three elements consisting of heat, oxygen and fuel that may lead to a significant threat to life and property, in urban and rural areas. Various researches have produced statistics on fire breakouts around the globe that paid attention to residential fire. In the case of Malaysia, residential or dwellings have contributed to increased fire casualties especially related to the accidental fire that was caused by electrical origins, cooking appliances, faulty or misuse of equipment, careless handling of fire or hot substances as well as negligence. Due to that fact, the most critical features of safety in building in the fire event is evacuation or probability of safe escape. Building Information Modelling (BIM) can be utilized as it is effectively making sure that the evacuation plan is kept up to date and facilitate communications. Therefore, this paper aims to establish a conceptual framework for Dwelling Fire Safety Evacuation (DFSE). The method used for this paper is reviewing literature including journals, conference proceedings, reports and guidelines. The findings of this paper are the components of DSFE conceptual framework which consist of three elements including Fire Scenarios (i.e., design fire and boundary condition), Survival Strategies (i.e., extinguish, shelter and evacuation), and Safety (i.e., shortest time). The conceptual framework is expected to assist in future data collection for the development of the DSFE framework.

Medical Device Guidebook: A browser information resource for medical device users

A web based information resource – the ‘Medical Device Guidebook’ – for the enabling of safe use of medical devices is described. Medical devices are described within a ‘catalogue’ of specific models and information on a specific model is provided within a consistent set of information ‘keys’. These include ‘user manuals’, ‘points of caution’, ‘clinical use framework’, ‘training/assessment material’, ‘frequently asked questions’, ‘authorised user comments’ and ‘consumables’. The system allows identification of known risk/hazards associated with specific devices, triggered, for example, by national alerts or locally raised safety observations. This provides a mechanism for more effective briefing of equipment users on the associated hazards of equipment. A feature of the system is the inclusion of a specific ‘Operational Procedure’ for each device, where the lack of this focus is shown in the literature to often be a key factor in equipment misuse and associated patient injury. The 'Guidebook' provides a mechanism for the development of an information resource developed within local clinical networks and encourages a consistent approach to medical device use.

Road Traffic Injuries and Road Safety Measures-Can We Do Any Better?

Purpose: Road traffic injuries are the leading cause of death under 30 years, causing over a million deaths every year. Helmets, seat-belts and child-restraints have an important role in death and injury prevention. Our purpose was to analyze how safety measures relate to pediatric polytrauma severity in road traffic injury. Methods: A retrospective observational study was conducted, including polytraumatized pediatric patients, hospitalized after road traffic accidents, from January 2011 to December 2015. Comparison groups were classified according to protective equipment use. Logistic regression and generalized liner models describe the probability of safety equipment use, head trauma, higher injury severity score and permanent sequelae. Results: Of a total of 149 inpatients, 63.8% were male with a median age of 11 years. Absence of personal protective equipment was predictive for head trauma (p-value=0.014) and diffuse axonal injury associated with neurologic sequelae and death (p-value<0.01). Multivariate analysis confirmed a higher risk of protective equipment misuse in unsupervised children and in two-wheel accidents (p-value<0.05). Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) were inversely proportional (p-value<0.001). Sequelae were more frequent with lower GCS (p<0.001) and diffuse axonal lesion (p<0.001). Conclusions: Despite increasing alertness, helmet use in road accidents remains limited, reflecting on head trauma severity and subsequent neurological impairment. Absence of protective equipment on car collisions provoked more severe injury scores and prolonged hospital stay. In the Decade of Action for Road Safety we still find important handicaps in road safety measures, demanding more effective laws and alerting campaigns.

Fatal Falls in New York City: An Autopsy Analysis of Injury Patterns.

Falls from heights are an important cause of unintentional fatal injury. We investigated the relationship between the characteristics of fatal falls and resulting injury patterns. We reviewed prospectively collected data from the Office of Chief Medical Examiner in New York City between 2000 and 2010. Data included fall height, work or non-work related, use of safety equipment, intentionality, specific organ injuries, and death on impact. The primary outcome was organ injury based on fall height. Higher falls were associated with hemorrhage as well as rib and various organ injuries. Organ injury pattern did not differ based on work status. The presence of equipment misuse or malfunction was associated with more deaths upon impact. Victims of falls from 200 ft or higher were 11.59 times more likely to die on impact than from lower than 25 ft. Fall height and work-related falls were significantly associated with death on impact. This is a public health issue, as 13% of falls were work related and 4% of falls were due to improper use of safety equipment. Some work-related falls are potentially preventable with proper safety equipment use. Understanding patterns of injury may play a role in prevention and management of survivors in the acute period.

What happanes when a large dose of magnesium sulphate is infused intravenously?

Introduction: During hospital admission, various drugs are prescribed. Most of these medications are high-alert medications, which can cause significant damage to the patient’s body due to its unintentional usage. Unfamiliarity with safe dosage ranges, confusion between similar looking drugs, mislabeling of drugs, equipment misuse, or malfunction and communication problems could induce this kind of errors. We want to report a case of accidental injection of a high dose of magnesium sulfate (MgSO4) in a girl with diabetes mellitus (DM). Case Report: A 17-year-old girl was admitted to the internal ward for close observation of poorly control DM with complication of hypoglycemia. The patient had muscle weakness and loss of deep tendon reflexes (DTRs) and severe constipation hypoventilation following the accidental infusion of 20 mg of magnesium sulfate (MgSO4). But, the patient was lucky to survive with medical treatment. Conclusion: MgSO4 is among one of the most frequently used drugs in medical practice. However, despite years of use and provider familiarity, the prescription of MgSO4 occasionally results in accidental overdose and patient damage.

Using Simulation of Apparatus Set-up to Improve Safety

There is increased focus on improving both safety and learning outcomes of undergraduate chemistry laboratory experiences. Incorrect setting and/or misuse of equipment occurs commonly and can even lead to accidents. This article describes how this was addressed by the development of pre-lab activities that require students to read a detailed step by step word document with instructions and appropriate diagrams describing the set-up of the apparatus, watch a video demonstrating the same and then demonstrating that they could set-up the apparatus by successfully completing an online simulated assembly of the apparatus. Following the pre-lab activities, students undertook the lab and were required to set up the apparatus on their own but to seek instructor’s help as needed. It was observed that the class was able to set-up the apparatus within fifteen minutes. This is in contract to the usual time of around one hour taken traditionally. The time saved was used was used to link the theory underlying the lab to a novel application of nanoparticles to accomplish distillation at room temperature. Students were also surveyed on their perception of the pre-laboratory activities. An overwhelming majority of the students felt that the pre-lab activities were valuable and better prepared them to set-up the simple distillation apparatus correctly and that similar pre-lab activities be developed for other laboratory exercises.

EQUIPMENT AND ENVIRONMENT OF FITNESS FACILITIES: THE PERSPECTIVE OF FITNESS INDUSTRY EMPLOYEES

BackgroundFitness facilities provide an avenue for people to engage in physical activity, however it is important that these facilities do all in their power to reduce the likelihood of injuries...

Accidental intravenous infusion of a large dose of magnesium sulphate during labor: A case report

During labor and child delivery, a wide range of drugs are administered. Most of these medications are high-alert medications, which can cause significant harm to the patient due to its inadvertent use. Errors could be caused due to unfamiliarity with safe dosage ranges, confusion between similar looking drugs, mislabeling of drugs, equipment misuse, or malfunction and communication errors. We report a case of inadvertent infusion of a large dose of magnesium sulphate in a pregnant woman.

Person-Environment Interactions Contributing to Nursing Home Resident Falls

Although approximately 50% of nursing home residents fall annually, the surrounding circumstances remain inadequately understood. This study explored nursing staff perspectives of person, environment, and interactive circumstances surrounding nursing home falls. Focus groups were conducted at two nursing homes in the mid-Atlantic region with the highest and lowest fall rates among corporate facilities. Two focus groups were conducted per facility: one with licensed nurses and one with geriatric nursing assistants. Thematic and content analysis revealed three themes and 11 categories. Three categories under the Person theme were Change in Residents' Health Status, Decline in Residents' Abilities, and Residents' Behaviors and Personality Characteristics. There were five Nursing Home Environment categories: Design Safety, Limited Space, Obstacles, Equipment Misuse and Malfunction, and Staff and Organization of Care. Three Interactions Leading to Falls categories were identified: Reasons for Falls, Time of Falls, and High-Risk Activities. Findings highlight interactions between person and environment factors as significant contributors to resident falls.

Strength training in children and adolescents: raising the bar for young athletes?

Context:Strength training in children, in combination with plyometric and/or agility training, has become an increasingly popular tactic for athletes to gain a competitive edge during the off-season. The present review clarifies some common myths associated with strength training in children, and it outlines the most current recommendations.Evidence Acquisition:Relevant studies on strength training in children and adolescents were reviewed (search results included studies indexed in PubMed and MEDLINE from 1980 through 2008). Also reviewed were recommendations from consensus guidelines and position statements applicable to strength training in youth.Results:Children can improve strength by 30% to 50% after just 8 to 12 weeks of a well-designed strength training program. Youth need to continue to train at least 2 times per week to maintain strength. The case reports of injuries related to strength training, including epiphyseal plate fractures and lower back injuries, are primarily attributed to the misuse of equipment, inappropriate weight, improper technique, or lack of qualified adult supervision.Conclusion:Youth—athletes and nonathletes alike—can successfully and safely improve their strength and overall health by participating in a well-supervised program. Trained fitness professionals play an essential role in ensuring proper technique, form, progression of exercises, and safety in this age group.

Unanticipated difficult airway management in anaesthetised patients: a prospective study of the effect of mannequin training on management strategies and skill retention

This prospective study on a medium-fidelity simulator (SimMan, Laerdal Medical Corporation, Wappingers Falls, NY, USA) examined the management of unanticipated difficult airway by 21 anaesthetists and the effect of training in this context. There were two scenarios investigated: 'cannot intubate, can ventilate' (CI) and 'cannot intubate, cannot ventilate' (CICV). Following initial evaluation, volunteers underwent training in the 'Difficult Airway Society' (DAS) algorithms and associated technical skills. At 6-8 weeks and 6-8 months, performance was compared with the initial evaluation. There was a more structured approach following training (p < 0.05), which was sustained at 6-8 months, but only for the CICV scenario (p < 0.01). In CI, use of standard and intubating laryngeal mask airway increased following training (p = 0.021). This was sustained over time (p = 0.01). In both scenarios there was a reduced incidence of equipment misuse (p < 0.0005), which was sustained over time (p < 0.0001). We conclude that simulation-based training significantly improves performance for at least 6-8 weeks. Training should be repeated at intervals of 6 months or less.

Keep It Flowing: A Simulation Involving Defective Anesthetic Gas Delivery Equipment

Keep It Flowing: A Simulation Involving Defective Anesthetic Gas Delivery Equipment

Drug error in anaesthetic practice: a review of 896 reports from the Australian Incident Monitoring Study database

Eight hundred and ninety-six incidents relating to drug error were reported to the Australian Incident Monitoring Study. Syringe and drug preparation errors accounted for 452 (50.4%) incidents, including 169 (18.9%) involving syringe swaps where the drug was correctly labelled but given in error, and 187 (20.8%) due to selection of the wrong ampoule or drug labelling errors. The drugs most commonly involved were neuromuscular blocking agents, followed by opioids. Equipment misuse or malfunction accounted for a further 234 (26.1%) incidents; incorrect route of administration 126 (14.1%) incidents; and communication error 35 (3.9%) incidents. The outcomes of these events included minor morbidity in 105 (11.7%), major morbidity in 42 (4.7%), death in three (0.3%) and awareness under anaesthesia in 40 (4.4%) incidents. Contributing factors included inattention, haste, drug labelling error, communication failure and fatigue. Factors minimising the events were prior experience and training, rechecking equipment and monitors capable of detecting the incident. The information gained suggests areas where improved guidelines are required to reduce the incidence of drug error. Further research is required into the effectiveness of preventive strategies.

Anesthesia safety: model or myth? A review of the published literature and analysis of current original data.

Anesthesia Safety: Model or Myth?: A Review of the Published Literature and Analysis of Current Original Data Robert Lagasse; Anesthesiology

Adverse Anesthetic Outcomes Arising from Gas Delivery Equipment

Anesthesia gas delivery equipment is a potentially important source of patient injury. To better define the contribution of gas delivery equipment to professional liability in anesthesia, the authors conducted an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project. The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims resulting from the use of gas delivery equipment were reviewed for recurrent patterns of injury. Gas delivery equipment was associated with 72 (2%) of 3,791 claims in the database. Death and permanent brain damage accounted for almost all adverse outcomes (n = 55, 76%). Equipment misuse was defined as fault or human error associated with the preparation, maintenance, or deployment of a medical device. Equipment failure was defined as unexpected malfunction of a medical device, despite routine maintenance and previous uneventful use. Misuse of equipment (n = 54, 75%) was three times more common than equipment failure (n = 17, 24%). Misconnects and disconnects of the breathing circuit made the largest contribution to injury (n = 25, 35%). Reviewers judged that 38 of 72 claims (53%) could have been prevented by pulse oximetry, capnography, or a combination of these two monitors. Overall, 56 of 72 gas delivery claims (78%) were deemed preventable with the use or better use of monitors. The year of occurrence for claims involving gas delivery equipment ranged from 1962 to 1991 and did not differ significantly from claims involving other adverse respiratory events. Claims associated with gas delivery equipment are infrequent but severe and continue to occur in the 1990s. Educational and preventive strategies that focus on equipment misuse and breathing circuit configuration may have the greatest potential for enhancing the safety of anesthesia gas delivery equipment.

Recall after total intravenous anaesthesia due to an equipment misuse

To present a case of recall after total intravenous anaesthesia (TIVA) with propofol-alfentanil infusions to point out an uncommon misuse of the Bard InfusOR syringe driver. A healthy patient underwent diagnostic dilatation and curettage and laparoscopy for lysis of peritoneal adhesions. After induction, anaesthesia was maintained with propofol-alfentanil infusions using the Bard InfusOR syringe drivers. Ten minutes into maintenance, the patient was moving. The flashing green light confirmed delivery of the medication and the alarms were not activated. However, the latch of the movable lever in the propofol syringe driver was found to be improperly positioned at the top of the plunger and only a small amount of propofol had been delivered. Postoperatively, the patient could recall the abdomen being touched during laparoscopy. An explanation was given and the patient was satisfied. The Bard InfusOR syringe driver is not designed to detect a malposition of the lever on the syringe plunger. The anaesthetist must ensure proper placement of the lever and visual confirmation of medication delivery in order to prevent awareness due to this particular problem.

Skin Burn Associated with Pulse Oximetry during Perioperative Photodynamic Therapy

IT was reported in 1967 that tumor destruction could be accomplished with the use of a porphyrin substance when exposed to light 1 . Individually, the light and the chemical may be relatively innocuous, whereas the combination can have significant effects. This principle has been applied to cancer treatment with a technique called photodynamic therapy (PDT). 2,3 PDT is a relatively new cancer treatment modality undergoing clinical trials in the United States. The treatment involves a drug (photosensitizer) that accumulates preferentially in tumor cells and subsequently kills cells on activation by light. We present a case in which the use of conventional perioperative monitoring with a pulse oximeter during PDT resulted in the loss of skin integrity at the site of the pulse oximeter probe.