Journal of clinical monitoring and computing
-
J Clin Monit Comput · May 2021
Development of an aviation-style computerized checklist displayed on a tablet computer for improving handoff communication in the post-anesthesia care unit.
Critical patient care information is often omitted or misunderstood during handoffs, which can lead to inefficiencies, delays, and sometimes patient harm. We implemented an aviation-style post-anesthesia care unit (PACU) handoff checklist displayed on a tablet computer to improve PACU handoff communication. We developed an aviation-style computerized checklist system for use in procedural rooms and adapted it for tablet computers to facilitate the performance of PACU handoffs. ⋯ A total of 209 PACU handoffs were observed before and 210 after the implementation of the tablet-based PACU handoff checklist. The average proportion of PACU handoff items communicated increased from 49.3% (95% CI 47.7-51.0%) before checklist implementation to 72.0% (95% CI 69.2-74.9%) after checklist implementation (p < 0.001). A tablet-based aviation-style handoff checklist resulted in an increase in PACU handoff items communicated, but did not have an effect on patient outcomes.
-
J Clin Monit Comput · May 2021
Inadvertent strangulation of inflation line of the pilot balloon during submental endotracheal intubation: a rare complication.
Submental intubation is the preferred type of intubation in patients with complex maxillofacial fractures where oral or nasal intubation cannot be performed. It is also less invasive than tracheostomy in securing the airways. We report a case where an inadvertent strangulation of inflation line of the pilot balloon resulted in inadequate ventilation during submental intubation.
-
J Clin Monit Comput · May 2021
Letter Case ReportsFirst, do no harm: bilateral radial artery occlusion in a COVID-19 patient.
Objective of this case report is to draw attention to a less known thrombotic complication associated with COVID-19, i.e., thrombosis of both radial arteries, with possible (long-term) consequences. ⋯ Since COVID-19 patients are at increased risk for arterial occlusion, it appears advisable to meticulously check for adequacy of collateral (hand-) perfusion, avoiding the harm of hand ischemia if interventions (e.g., catheterizations) at the radial or ulnar artery are intended.
-
J Clin Monit Comput · May 2021
Neurally adjusted ventilatory assist preserves cerebral blood flow velocity in patients recovering from acute brain injury.
Neurally adjusted ventilatory assist (NAVA) has never been applied in patients recovering from acute brain injury (ABI) because neural respiratory drive could be affected by intracranial disease with detrimental effects on cerebral blood flow (CBF) velocity. Our primary aim was to assess the impact of NAVA and pressure support ventilation (PSV) on CBF velocity. In fifteen adult patients recovering from ABI and undergoing invasive assisted ventilation, PSV and NAVA were applied over 30-min-lasting trials, in the following sequence: PSV1, NAVA, and PSV2. ⋯ No differences were detected for pH (p = 0.0551), arterial carbon dioxide tension (p = 0.8142), and oxygenation (p = 0.0928) over the entire study duration. NAVA and PSV preserved CBF velocity in patients recovering from ABI. Trial registration: The present trial was prospectively registered at www.clinicatrials.gov (NCT03721354) on October 18th, 2018.
-
J Clin Monit Comput · May 2021
Observational StudyPreoperative bedside ultrasound assessment of gastric volume and evaluation of predisposing factors for delayed gastric emptying: a case-control observational study.
Perioperative pulmonary aspiration of gastric content is a serious complication. Fasting guidelines try to ensure an empty stomach before intervention. Certain medications or pathologies may cause delayed gastric emptying. ⋯ Perfect correlation (R = 0.91; p < 0.01) and concordance (0.91; 95% CI 0.83; 0.95) was found between tracing methods. Minimal gastric content was observed in scheduled surgery in spite of predisposing factors for delayed gastric emptying. Ultrasound clear gastric volume estimation was useful to assess preoperative bedside gastric content.