Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2009
Scientific evidence for the effectiveness of virtual reality for pain reduction in adults with acute or chronic pain.
The objective of this systematic review was to determine the level of scientific evidence for the effectiveness of VR for pain management in adults with pain. A comprehensive systematic search involving major health care databases was undertaken to identify randomized clinical trials (RCTs) and descriptive studies. Twenty-seven studies were identified that fulfilled the inclusion criteria. ⋯ Moreover, there is limited evidence (Level 2a) of effectiveness of immersive VR compared to no VR for reducing chronic pain. There is currently no published study that has explored the effectiveness of non-immersive VR for chronic pain (level 5). It is concluded that VR can be recommended as a standard or adjunct clinical intervention for pain management at least in the management of acute pain.
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Stud Health Technol Inform · Jan 2009
Comparative StudyEndotracheal intubation in a medical transport helicopter - comparing direct laryngoscopy with the prototype Storz CMAC videolaryngoscope in a simulated difficult intubating position.
This pilot study examined backward intubation of the Laerdal Difficult Airway Manikin in a medical transport helicopter using the prototype (a new more compact) Storz CMAC videolaryngoscope. The standard manikin airway Cormack Lehane (CL) view scores were 2.00 +/- 1.00 for direct view and 1.375 +/- 0.517 for the indirect view (CMAC). Success rates for backward intubation in the standard airway were 100% (CMAC) and 87.5% (DV). ⋯ The success rates for backward intubation of the difficult airway were 12.5% (DV) and 63% (CMAC). Our results show that in backward intubation of the difficult airway in a helicopter setting, the prototype CMAC videolaryngoscope significantly improved the airway score by 1-2 grades and improved intubation success 5-fold. Studies using the portable CMAC videolaryngoscope under challenging rescue conditions and positions should be considered.
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Stud Health Technol Inform · Jan 2009
Randomized Controlled TrialVirtual reality on mobile phones to reduce anxiety in outpatient surgery.
When undergo ambulatory surgical operations, the majority of patients experience high level of anxiety. Different experimental studies have shown that distraction techniques are effective in reducing pain and related anxiety. Since Virtual reality (VR) has been demonstrated a good distraction technique, it has been repeatedly used in hospital contexts for reducing pain in burned patients, but it has never been used during surgical operations. ⋯ In particular, we measured the degree to which anxiety associated with surgical intervention was reduced by distracting patients with immersive VR provided through a cell phone connected to an HMD compared to a no-distraction control condition. A significant reduction of anxiety was obtained after 45 minutes of operation in the VR group, but not in the control group and, after 90 minutes, the reduction was larger in the experimental group than in other one. In conclusion, this study presents an innovative promising technique to reduce anxiety during surgical interventions, even if more studies are necessary to investigate its effectiveness in other kinds of operations and in larger numbers of patients.
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Stud Health Technol Inform · Jan 2009
Endotracheal intubation comparing a prototype Storz CMAC and a glidescope videolaryngoscope in a medical transport helicopter - a pilot study.
In this pilot study, experienced medical helicopter personnel evaluated and compared the prototype Storz CMAC and GlideScope (GS) videolaryngoscopes in intubating a Laerdal Difficult Airway Manikin in a helicopter. No significant differences were found between the devices in the standard airway mode with 100% success rates for the intubations. ⋯ The success rate for intubating the difficult airway was 0% with DV; compared to 63% with the CMAC and 50% with the GS (p = 0.03). The participants answered a post study questionnaire regarding the characteristics of the devices and indicated preference for the CMAC over the GS in intubation of the difficult airway.
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Stud Health Technol Inform · Jan 2009
Intensive care admission and discharge - critical decision-making points.
Delivery of intensive care has many critical points impacting the outcomes of critically ill patients. Two important key events in intensive care are patients' admission and discharge procedures. ⋯ To reveal the complex decision-making, we studied the decision-making processes and information needs of intensive care charge nurses during patients' admission and discharge procedures. We identified several interconnected decision-making steps during these procedures.