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1.
Brazilian Administration Review ; 19(4):1-22, 2022.
Article in English | ProQuest Central | ID: covidwho-2065228

ABSTRACT

This article analyzes the differences between public and private health services regarding infrastructure and human resources at the state (subnational) and macro-regional levels in Brazil. The research collected monthly data on inpatient beds and the number of nurses, physiotherapists, and doctors from Brazilian states for 2020. Indicators were created following quarterly changes and comparing the actions of public and private healthcare entities. Variations were analyzed using temporal graphs based on means and standard deviation. The findings suggest: (1) exponential growth in health care infrastructure and human resources led by public sector investment in the second quarter, followed by a slowdown;(2) a more significant variation in the acceleration and deceleration of the public sector response in the North of Brazil and the states of Maranhäo, Rio Grande do Norte, and the Federal District;(3) the public sector was the primary response mechanism to the pandemic considering the variations throughout the year. The study concludes that the government was the leading actor in response to the COVID-19 pandemic in Brazil in 2020, pointing out that responses were uneven in the states.

2.
Emergency Medicine Journal : EMJ ; 39(10):795-796, 2022.
Article in English | ProQuest Central | ID: covidwho-2064195

ABSTRACT

Correspondence to Dr Gabrielle Prager, Emergency Department, Wythenshawe Hospital, Manchester, Greater Manchester, UK;lgprager@doctors.org.uk This month’s update has been prepared by the Emergency Medicine & Intensive Care Research Group (EMERGING) from Manchester. Head turner Predicting which patients will survive an out-of-hospital cardiac arrest (OHCA) with good functional outcomes could help guide resuscitative efforts. Lack of blinding is a potential source of bias, but the apparent preference of parents for immobilisation may influence physician choice of treatment.2 Bottom line In children treated for Torus fractures, there is no difference in self-reported pain or function using a simple bandage versus a splint or cast. Notably, since this paper was published, the UK RECOVERY trial suggested a probable benefit in using them together.5 6 Bottom line In patients with COVID-19 requiring oxygen and receiving remdesivir, there was no difference in ventilator-free survival between those treated with baricitinib or dexamethasone.

3.
Heliyon ; 8(9): e10736, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2041776

ABSTRACT

In response to COVID-19 global crisis and arising from social responsibility, efforts have been exerted to promptly research, develop and manufacture ICU ventilators locally to meet the spike in demand. This study aimed at : Evaluating the safety and performance of a newly developed mechanical ventilator; EZVent compared to a commercial ventilator regarding hemodynamics, arterial blood gases (ABG), lung inflammatory markers, and histopathology in a healthy pig model using three different ventilation modes. Methods: Eight adult male pigs were anesthetized and randomly assigned into two equal groups: Commercial vent and EZVent group, the animals of which were ventilated using a standard commercial ventilator and EZVent, respectively. On every animal, three ventilation modes were tested, each mode for 30 min: CMV-VC, CMV-PC, and CPAP-PS modes. Vital signs, ECG, Lung Mechanics (LM), and ABG were measured before ventilation and after 30 min of ventilation of each mode. After animals' euthanasia, histological examinations of lung samples including morphometric assessment of alveolar edema, alveolar wall thickening, and the mean number of inflammatory cellular infiltrate/cm2 of lung tissue were analyzed. TNF-α and Il-6 expression and localization in lung tissue were assessed by western blot and immunohistochemistry. Results: The vital signs, LM, ABG, morphometric analysis, and histopathological score during the different ventilation modes showed non-significant differences between the study groups. TNF-α and IL-6 were minimally expressed in the bronchiolar epithelium and the alveolar septa. Their increased expression level was insignificant. Conclusion: EZVent is equivalent to the commercial ventilator regarding its safety and efficacy.

4.
Journal of Physics: Conference Series ; 2335(1):012061, 2022.
Article in English | ProQuest Central | ID: covidwho-2037308

ABSTRACT

The demand of ventilators has been increasing dramatically from the past few years due to the spike in the COVID-19 cases globally. Around the World, the abscence of availability of ventilators have taken a lot of lives in just the past couple of years. The use of ventilators has been proven to be helpful from preventing the danger of lung harm through low- quantity airflow and helps us to get the adequate amount of influx of pure air. The ventilators available are expensive and scarce in supply. They are heavy and would normally weigh around 7 to 8 kgs, which makes it inconvenient to carry from place to place due to its enormous size. Our project aims at developing a smart ventilator system using a microcontroller board and sensors based on Internet of Things (IOT). The smart ventilator will be portable and very light in weight, which makes it handy to use and requires no additional expertise to handle it. The usage of the high torque motor enables us to change the pressure as per the requirement. The sensors used collects the temperature and the Pulse oximetry levels and the same is updated on the LCD display.

5.
Boletin de Malariologia y Salud Ambiental ; 62(2):251-259, 2022.
Article in Spanish | CAB Abstracts | ID: covidwho-2034476

ABSTRACT

Background: Invasive mechanical ventilation as a therapeutic strategy is not without complications. It is imperative to have protective ventilation parameters in those patients who are subjected to it. We aim to demonstrate whether mechanical power as a ventilatory parameter has prognostic validity for mortality in critically ill patients with prolonged invasive mechanical ventilation. Material and Methods: An analytical cross-sectional study was carried out of critically ill patients on prolonged invasive mechanical ventilation due to Acute Respiratory Distress Syndrome due to COVID-19 who were admitted to the Intensive Care Unit of the Hospital Regional de Trujillo during the March 2020 to March 2021 period.

6.
Acta Astronaut ; 201: 576-579, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2031069

ABSTRACT

In response to the COVID-19 pandemic, NASA Jet Propulsion Laboratory (JPL) engineers had embarked on an ambitious project to design a reliable, easy-to-use, and low-cost ventilator that was made of readily available parts to address the unexpected global shortage of these lifesaving devices. After successfully designing and building the VITAL (Ventilator Intervention Technology Accessible Locally) ventilator in record time, FDA Emergency Use Authorization (EUA) was obtained and then the license to manufacture and sell these ventilators was made available to select companies through a competitive process. STARK Industries, LLC (STARK), located in Columbus, OH, USA, was one of only eight U.S. companies to be selected to receive this worldwide license. Motivated by its mission to improve human health and well-being through innovated medical technologies, STARK accepted the challenge of further developing the VITAL technology and manufacturing the ventilators in large quantities and making them available to those in need around the world. To this end, Spiritus Medical, Inc (Spiritus) was spun off from STARK to focus on the ventilator business. Through collaborative efforts with various corporate, academic, governmental, and non-profit partners, Spiritus was able to successfully begin manufacturing and selling its ventilators. Due to its low-cost nature and its straightforward design, this ventilator is ideal for use in developing countries where ventilators are in short supply and affordability is a major consideration. This is a story of how NASA's ingenuity, based on space-based know-how and experience, was used to rapidly design this innovative ventilator. And by forging partnerships with highly qualified and motivated partners such as STARK and Spiritus, NASA has succeeded in translating this work into technology that could potentially save thousands of lives in the fight against the COVID-19 pandemic.

7.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(9):1393-1398, 2022.
Article in English | ProQuest Central | ID: covidwho-2025154

ABSTRACT

Over use of steroids, uncontrolled blood sugar levels, oxygen therapy, long hospital stay, and ICU procedures and ventilators also contribute to the increased occurrence of post-COVID Mucormycosis. Hot and humid climate favors the growth of such molds. [...]many studies have found that hospitals in our country have very heavy mold spore count. [...]steroid-induced hyperglycemia may also be an important risk factor for COVID-associated Mucormycosis. [...]the present retrospective cross-sectional study was planned to study and analyze the risk factors of COVID 19 associated Mucormycosis infection.

8.
Thorax ; 2022.
Article in English | ProQuest Central | ID: covidwho-2020316

ABSTRACT

Correspondence to Dr Mark E Howard, Respiratory and Sleep Medicine, Austin Hospital, Heidelberg, Victoria, Australia;mark.howard@austin.org.au Models of care that minimise the use of acute hospital beds have become increasingly important during the COVID-19 pandemic, not only to optimise capacity for acute care, but also to minimise infection transmission risks and meet the needs of patients who avoid care due to concerns regarding attending healthcare facilities. An important contribution to designing models for NIV initiation, Murphy and colleagues1 demonstrate that initiating ventilation using auto-titrating NIV at home combined with oximetry monitoring was clinically effective and safe in comparison with in-hospital titration of fixed pressure NIV in patients with stable OHS.1 Interestingly, the healthcare costs over 3 months were similar in both models, with higher set-up costs for the inpatient model, but higher healthcare utilisation costs post set-up in the home-based implementation, including more outpatient and emergency department visits. In addition to cost savings, home implementation reduces the potential risk of infection transmission given the aerosol-generating properties of NIV and enhances capacity for high-dependency acute hospital beds which are critical in the current environment.

9.
Archives of Disease in Childhood ; 107(Suppl 2):A358-A359, 2022.
Article in English | ProQuest Central | ID: covidwho-2019899

ABSTRACT

95 Figure 1[Figure omitted. See PDF] 95 Figure 2[Figure omitted. See PDF]ConclusionA large cohort of children were admitted with COVID-19, with a significant over-representation of BAME, neonates and children with multiple co-morbidities. Fever was the most common symptom. In regards to critical care requirements, over 11% of admissions required PICU input. Interestingly, in regards to PIMS-TS, those requiring intervention often had no co-morbidities and were likely to be normal at baseline. Long term follow up will be required for these patients to truly understand the effects both COVID-19 and PIMS-TS have had on the paediatric population.

10.
AANA Journal ; 89(1):62-69, 2021.
Article in English | ProQuest Central | ID: covidwho-2011630

ABSTRACT

The coronavirus disease 2019 (COVID-19) respiratory illness has increased the amount of people needing airway rescue and the support of mechanical ventilators. In doing so, the pandemic has increased the demand of healthcare professionals to manage these critically ill individuals. Certified Registered Nurse Anesthetists (CRNAs), who are trained experts in airway management and mechanical ventilation with experience in intensive care units (ICUs), rise to this challenge. However, many CRNAs may be unfamiliar with advancements in critical care ventilators. The purpose of this review is to provide a resource for CRNAs returning to the ICU to manage patients requiring invasive mechanical ventilation. The most common ventilator modes found in anesthesia machine ventilators and ICU ventilators are reviewed, as are the lung-protective ventilation strategies, including positive end-expiratory pressure, used to manage patients with COVID-19-induced acute respiratory distress syndrome. Adjuncts to mechanical ventilation, recruitment maneuvers, prone positionIng, and extracorporeal membrane oxygenation are also reviewed. More research is needed concerning the management of COVID-19-infected patients, and CRNAs must become familiar with their ICU units' individual ventilator machine, but this brief review provides a good place to start for those returning to the ICU.

11.
Medsurg Nursing ; 31(4):262-264, 2022.
Article in English | ProQuest Central | ID: covidwho-2011522

ABSTRACT

Similar to many hospital systems throughout the United States, the acute rehabilitation (AR) unit at Rush University Medical Center (RUMC) in Chi - cago, Illinois, was transformed into a COVID-19 rehabilitation unit during the spring 2020 surge. Because COVID-19 presented as a novel virus (Wang et al., 2020) with substantial acuity, an immediate interprofessional approach to rehabilitation was required in a context of a lack of evidence-based literature or best practices. Educational preparation provides a background in physical disability and mental health training, which positions OTs uniquely to collaborate with patients in identifying their priority goals, and ways to promote independence and success with these goals. [...]they worked closely with physicians to ensure patients with memory loss understood their treatment timeline. RUMC leaders initiated an innovative program to address this isolation while patients were in the AR unit, in which videoconferences facilitated communication between patients and their loved ones.

12.
AANA Journal ; 88(3):171-172, 2020.
Article in English | ProQuest Central | ID: covidwho-2010946

ABSTRACT

Consider that it was anesthesia providers who brought to the attention of hospital officials and critical care clinicians that every modern anesthesia machine has a functioning ventilator, that with minor modifications, can be repurposed anywhere to serve those needing respiratory support. The AANA has urged Congress to provide frontline healthcare workers proper compensaton during the pandemic and has lobbied hard to pave the way for state governors to issue executive orders to remove physican supervision of nurse anesthetists. In this issue of AANA Journal, along with our usual diverse and relevant content targeting our ever-expanding practice landscape, we have included a number of COVID-19-related innovations by CRNAs;documentation of their provided care;a Journal cover depicting a few of the many who are working daily under extreme conditions;and a challenge and critique in the form of a letter by non-anesthesia, internationally known authorities of recent WHO guidance regarding transmission vectors.

13.
AANA Journal ; 89(5):378-383, 2021.
Article in English | ProQuest Central | ID: covidwho-2010799

ABSTRACT

Meticulous attention was placed on measuring 2.5 cm from the skin to the cricothyroid membrane to be approximately the distance of 18 mm (1.8 cm) to the CTM reported in the obese patient.2 CTM depth was found by Gadd et al to have a linear relationship with neck circumference.2 The pork tenderloin costs $6.59 per pound with a weight of approximately one pound per model. Hand washing alone reduces the risk of viral transmission by 55%, wearing the mask by 68% and hand washing, wearing masks and protective gear altogether by 91%.2 Hence the need for masks among the doctors, other healthcare providers, and the public led to severe shortages, and the production of fake masks was being introduced into the markets.3 This can lead to the transmission of the infection among the healthcare workers who needed it the most. Centers for Disease Control and Prevention, https://www.cdc.gov/flu/professionals/infectioncontrol/maskguidance. htm. Centers for Disease Control and Prevention, https:// www.cdc.gov/niosh/docs/2018-130/ default.html.

14.
Health Science Journal ; 16(7):1-5, 2022.
Article in English | ProQuest Central | ID: covidwho-2002882

ABSTRACT

Keywords: Core Muscles;Functional Capacity;Peak Cough Flow;Hospitalized Patients;Case Report Introduction The "core" has been used to refer a three-dimensional space, the lumbopelvic-hip complex, which involves deeper muscles, such as the internal oblique, transverses abdominals, transversospinalis (multifidus, rotators, semispinalis), quadratus lumborum, and psoas major and minor, and superficial muscles, such as the rectus abdominis, external oblique, erector spinae (iliocostalis, spinalis, longissimus) latissimus dorsi, gluteus maximus and medius, hamstrings, and rectus femoris [1, 2]. At the beginning of the session HR, respiratory rate (RR), SpO2, Blood pressure (BP), dyspnea (using the MBS) was monitored for all patients and for those who have diabetes was also monitored glucose levels. Personal history (PH) of SARS-CoV2 pneumonia in March 2021 (hospitalized for 1 month in the Intensive Care Unit (ICU) using mechanically invasive ventilation), type 2 diabetes mellitus (DM) treated with premixed insulin, polyneuropathy for more than 10 years, arterial hypertension (AH), chronic kidney disease (CKD), coronary heart disease (placement stent in 2010), dyslipidaemia, chronic gastritis, lithiasis and renal cysts.

15.
Technology and Innovation ; 22(2):199-217, 2022.
Article in English | ProQuest Central | ID: covidwho-2002774

ABSTRACT

In the first quarter of 2020, SARs-CoV-2 (COVID-19) infections began to grow at an alarming rate despite drastic measures to reduce infection rates. Severe COVID-19 cases required mechanical ventilation, resulting in ventilator shortages worldwide. To address the ventilator shortages, the authors developed the CoreVent 2020, an emergency-use ventilator for adult patients that was designed, built, and tested in ten days. The CoreVent 2020 is a pressure-cycled, time-limited ventilator with a breath-assist mode that operates on standard pressurized oxygen and medical air. It provides adjustable peak inspiratory pressure (PIP) and positive end-expiratory pressure (PEEP). A medical-grade commercially available breathing circuit is used to minimize non-medical component requirements. The CoreVent 2020 was fabricated in-house at Stony Brook University Hospital and tested on three mechanical lung simulators in which the operating modes and alarm features were demonstrated. Animal studies were also performed in both normal breathing mode and breath-assisted modes. Arterial blood gas measurements confirmed that the ventilator provided satisfactory ventilation for the test subjects. The COVID-19 pandemic presented unique constraints on the design and innovation process not normally encountered in typical practice. Design decisions such as component choice, delivery time, and ease of high-volume, rapid manufacturing influenced all aspects of the design process. This aspect of the design/innovation process is also discussed, as well as an introductory discussion on how training and simulations can be developed so that innovation can occur efficiently in future crises situations.

16.
Technology and Innovation ; 22(2):181-187, 2022.
Article in English | ProQuest Central | ID: covidwho-2002772

ABSTRACT

The Texas Tech University Center for Emerging Energy Sciences Research Group implemented rapid translation and analytics of Chinese COVID-19 medical literature in February 2020, which enabled emerging innovations in patient care. Specifically, techniques to optimize patient care through improved ventilation and oxygenation recognizing newly discovered pathophysiology were designed and prototyped in this invention. COVID-19 respiratory distress distinguishes itself from acute respiratory distress syndrome (ARDS) and pathophysiology of SARS-COV-2 by requiring higher O2 and lower pressure requirements for adequate oxygenation. Specifically, low positive end-expiratory pressure ventilator parameters are necessary to optimize patient care. Paradoxically, COVID-19 patients display severe "silent" hypoxemia often associated with near normal respiratory compliance. This clinical presentation is considered unusual for severe ARDS patients and implies non-uniformity in disease management of acute respiratory and pre-hospital patients. A clinical need for new innovative approaches to management that may also benefit decompression sickness, high altitude pulmonary edema and other chronic respiratory disease patients. We present these observations as an example of the need for closely-collaborating, plinary teams to rapid innovation when sudden, severe health threats first emerge. This approach is invaluable to medical innovations needed to counter threats due natural to man-made conditions.

17.
SciDev.net ; 2021.
Article in English | ProQuest Central | ID: covidwho-1998621

ABSTRACT

Speed read WHO compendium of innovations aims to help low-resource settings respond to COVID-19 Collection of tools doesn’t require specialists or electricity, says WHO Grassroots capacity building crucial for scale-up — expert Easy-to-use equipment including portable respiratory monitoring systems and ventilators with extended battery life are among a collection of new health innovations identified by the World Health Organization (WHO) to help manage COVID-19 in low-resource settings. Jeremiah Owiti, executive director, Centre for Independent Research, Nairobi Adriana Velazquez Berumen, WHO senior advisor for medical devices, said: “WHO has been collecting innovative technologies that can be impactful at places where there is unstable electricity and a lack of specialised health workforce.” According to Anuraj Shankar, lead researcher at the Eijkman-Oxford Clinical Research Unit in Jakarta, Indonesia, enabling anyone to asses blood pressure accurately with an already available device such as a smartphone opens the door to personal monitoring of many acute and chronic medical conditions.

18.
American Family Physician ; 106(2), 2022.
Article in English | ProQuest Central | ID: covidwho-1989759

ABSTRACT

Learn more about awake prone positioning for noninubated patients with COVID-19.

19.
Conference on Global Medical Engineering Physics Exchanges/Pan American Health Care Exchanges (GMEPE/PAHCE) ; 2022.
Article in English | Web of Science | ID: covidwho-1985448

ABSTRACT

The expanded use of the Masi ventilators to more regions of Peru is important, particularly for regions located at high altitudes, due to the ventilatory support latent need, which also represents a challenge in the calibration and the adjustment of metrological parameters to ensure its correct performance. In a previous study, in Puno city at 3800 m.a.s.l., it was found an error above 15.0% (minimum tolerance) in the tidal volume, for which a negative correction of 25.0% was applied. In the present study, a Masi ventilator was transported to Chachapoyas city, at an altitude of 2400 m.a.s.l. to continue evaluating the effect of altitude on the parameters of the device. Once there, ventilators were acclimated and calibrated. Tidal volume, inspiration-expiration ratio (LE), positive endexpiratory pressure (PEEP), peak inspiratory flow (PIF) and peak inspiratory pressure (PIP) were tested, and the maximum percentages errors presented were 13.5% and 13.9% in the tidal volume and the PIF, respectively. For that reason, although errors were under 15.0%, an update of the software of Masi was needed, applying a negative correction of 14.0%. Then, the parameters were tested again obtaining results with errors below 6.0% and 8.0% in volume controlled an pressure controlled ventilation modes, respectively. These results allowed the use of the Masi ventilator at ICU area. Finally, a software update for the Masi ventilator is performed by applying a linear equation that relates altitudes and percentage errors tested.

20.
Asia Policy ; 17(3):5-17, 2022.
Article in English | ProQuest Central | ID: covidwho-1970967
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