Health devices
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Automated external defibrillators, or AEDs, will automatically analyze a patient's ECG and, if needed, deliver a defibrillating shock to the heart. We sometimes refer to these devices as AED-only devices or stand-alone AEDs. The basic function of AEDs is similar to that of defibrillator/monitors, but AEDs lack their advanced capabilities and generally don't allow manual defibrillation. ⋯ In this Evaluation, we present our findings for a newly evaluated model, the Zoll AED Plus. We also summarize our findings for the previously evaluated model that is still on the market and describe other AEDs that are also available but that we haven't evaluated. We rate the models collectively for first-responder use and public access defibrillation (PAD) applications.
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While mammography is regarded as the best means available to screen for breast cancer, reading mammograms is a tedious, error-prone task. Given the repetitiveness of the process and the fact that less than 1% of mammograms in the average screening population contain cancer, it's no wonder that a significant number of breast cancers--about 28%--are missed by radiologists. The fact that human error is such a significant obstacle makes mammography screening an ideal application for computer-aided detection (CAD) systems. ⋯ In this Evaluation, we describe the challenges posed by screening mammography, the operating principles and overall efficacy of CAD systems, and the characteristics to consider when purchasing a system. We also compare the performance of two commercially available systems, iCAD's MammoReader and R2's ImageChecker. Because the two systems offer comparable sensitivity, our judgments are based on other performance characteristics, including their ease of use, the number of false marks they produce, the degree to which they can integrate with hospital information systems, and their processing speed.
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Pulse oximetry is a noninvasive monitoring technique used to assess a patient's arterial blood oxygen saturation and pulse rate. This technology has been shown to be effective at helping clinicians detect hypoxemia. However, conventional pulse oximeters are known to have difficulty obtaining accurate readings during periods of motion and low perfusion, resulting in frequent nuisance alarms. ⋯ Our laboratory testing focused on the technologies' ability to monitor saturation and pulse rate during periods of motion and low perfusion--and thus their ability to reduce nuisance alarms compared with conventional technology. We also looked for evidence of missed alarm events, we examined susceptibility to light interference, we analyzed the literature, and we spoke with current users. In addition to Product Profiles for each evaluated technology and a Conclusions section that describes our comparative ratings, we present a detailed discussion of our test results, a selection guide to help healthcare facilities make implementation decisions, and a comprehensive review of the literature on next-generation pulse oximetry.
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Review
A clinician's guide to surgical fires. How they occur, how to prevent them, how to put them out.
Surgical fires--fires that occur on or in a surgical patient--are a rare but devastating complication of surgical procedures. They can happen during almost any kind of operation and can have dire consequences for both the patient and the hospital. The risk of surgical fires can be minimized as long as everyone on the surgical team understands how fires start and what to do when they occur. ⋯ Through a series of case histories, we illustrate the many ways in which fires can start in the operating room. We also provide a detailed list of prevention methods. Finally, we describe the steps to take and the equipment to use--and not use--when a fire does occur.
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Intensive care ventilators provide temporary ventilatory support to critically ill patients who cannot breathe on their own or who require assistance to maintain adequate ventilation. These ventilators offer a wide range of capabilities and can meet the needs of many types of patients. We last evaluated intensive care ventilators for adult use in our July-August 2000 issue. ⋯ Several units have added new features and capabilities since we last examined them. As a result, we have rated them higher in this study. Conversely, a few models have been given lower ratings because they haven't kept up with the advances in the technology; although they perform adequately, we can no longer recommend their purchase because better choices are available.