Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2011
Improving fiberoptic intubation with a novel tongue retraction device.
This study examined the utility of a novel tongue retractor created with a wider working blade and a more ergonomic curve to provide jaw lift and tongue management with one hand during intubation. Anesthesia providers participated in simulated intubation of a difficult manikin using the novel tongue retractor with the Bonfils video fiberscope. Results show that the tongue retractor improved placement success and was well received by the study participants.
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This research explored the decision-making process of selecting medicines for prescription on hospital ward-rounds. We aimed to determine when and with whom medications were discussed, and in particular, whether shared decision making (SDM) occurred on ward-rounds. As a low level of computerized decision support was in place in the hospital at the time, we also examined whether the decision support aided in any medication discussions. ⋯ More frequently, doctors informed patients of the medications they would be or were currently taking. The computerized decision support had little impact on treatment decision-making. While the value of SDM is often acknowledged in the literature, it appears to be rarely practiced on hospital ward-rounds.
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Stud Health Technol Inform · Jan 2011
Anesthesia residents' preference for learning interscalene brachial plexus block (ISBPB): traditional Winnie's technique vs. ultrasound-guided technique.
There is a recent shift from traditional nerve stimulation (NS) to ultrasound-guided (UG) techniques in regional anesthesia (RA). This shift prompted educators to readdress the best way to teach these two modalities. Development of a more structured curriculum requires an understanding of student preferences and perceptions. ⋯ The residents completed a questionnaire regarding their impression of each technique and the learning experience. UG technique was perceived to be safer and to have more educational value than NS. However, residents felt both techniques should be mandatory in the teaching curriculum.
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Stud Health Technol Inform · Jan 2011
Toward a comprehensive hybrid physical-virtual reality simulator of peripheral anesthesia with ultrasound and neurostimulator guidance.
We are developing a simulator of peripheral nerve block utilizing a mixed-reality approach: the combination of a physical model, an MRI-derived virtual model, mechatronics and spatial tracking. Our design uses tangible (physical) interfaces to simulate surface anatomy, haptic feedback during needle insertion, mechatronic display of muscle twitch corresponding to the specific nerve stimulated, and visual and haptic feedback for the injection syringe. ⋯ This model provides the subsurface anatomy and, combined with electromagnetic tracking of a sham ultrasound probe and a standard nerve block needle, supports simulated ultrasound display and measurement of needle location and proximity to nerves and vessels. The needle tracking and virtual model also support objective performance metrics of needle targeting technique.
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Stud Health Technol Inform · Jan 2011
VR-based training and assessment in ultrasound-guided regional anesthesia: from error analysis to system design.
If VR-based medical training and assessment is to improve patient care and safety (i.e. a genuine health gain), it has to be based on clinically relevant measurement of performance. Metrics on errors are particularly useful for capturing and correcting undesired behaviors before they occur in the operating room. However, translating clinically relevant metrics and errors into meaningful system design is a challenging process. This paper discusses how an existing task and error analysis was translated into the system design of a VR-based training and assessment environment for Ultrasound Guided Regional Anesthesia (UGRA).