ABSTRACT
INTRODUCTION: This study sought to examine the efficacy of integrating medical device alarms into the intercommunication set of a simulated HH-60, allowing medics to hear the alarms over the ambient noise of the aeromedical environment. MATERIALS AND METHODS: U.S. Army critical care flight paramedics were recruited as subjects for this study. Subjects participated in two testing scenarios: One with patient monitor alarms integrated into their communication lines and one without integrated alarms (the control condition). Testing took place in a simulated HH-60 interior with two priority-level patients per testing scenario, one on either side of the interior. Subjects provided care to these two patients for 30 minutes per scenario. After both scenarios were complete, the subjects were given a questionnaire to obtain their feedback on alarm integration. RESULTS: Six subjects took part in this study, so the results do not have sufficient power to represent the population. No statistically significant results were found. Looking at the trends in the data, implementing alarm integration showed the indications of reducing reaction time to alarms, decreasing or matching the amount of time spent with the patient monitor, and equivalent amounts of time dedicated to patient treatment when compared to the nonintegrated scenario.The feedback obtained from the subjects provided a list of perceived benefits, drawbacks, and improvements related to the integration of medical device alarms into the intercommunication set. CONCLUSIONS: Although the study was underpowered, the trends in the data indicate a benefit to the medics when integrating medical device alarms. When coupled with strongly favorable end-user feedback, the results provide justification for pursuing the effort of integrating alarms and performing future studies with improved integration systems to optimize the potential of the system.
Subject(s)
Communication , Hearing , Humans , Reaction Time , Monitoring, PhysiologicABSTRACT
INTRODUCTION: An anonymous online survey was presented to active duty U.S. Army, Reserve, and National Guard Soldiers with experience as en route care medical providers with the intent of identifying factors which contribute to musculoskeletal disorders in U.S. Army en route care medical providers. The survey looked at transport vehicle design, equipment, and awkward postures that could play a role in causing injuries. MATERIALS AND METHODS: Survey responses were received from 60 en route care providers regarding postures assumed during administration of en route critical care tasks, routine medical transport scenarios, and patient loading. Care providers reported gender, height, weight, experience, tasks, and awkward postures experienced. They also reported occupational injuries that occurred as a result of performing job duties, such as back, neck, and joint pain, injuries, and discomfort. RESULTS: The survey was answered by 56 (93.3%) males and 4 females (6.7%) with an average of 7.34 years of experience as en route care personnel. Lower back injuries were suffered by 87% of respondents. The most common causes were awkward positions and lifting patients. There are statistically significant relationships between shoulder injuries and overextending, lower back injuries and overextending, and lower back injuries and reaching backwards, ankle injuries and care provider height, and knee injuries and the frequency at which care providers utilized the postures of kneeling, squatting, reaching behind themselves, and straining to lift a heavy weight. Loading and unloading patients from evacuation platforms was among the top causes of all awkward postures among respondents. CONCLUSION: Results of this survey emphasize the need for injury mitigation and prevention strategies to reduce impacts on soldier health and readiness.
Subject(s)
Military Personnel , Posture , Back Injuries , Female , Humans , Male , Occupational Diseases , Surveys and QuestionnairesABSTRACT
BACKGROUND: The addition of direct-acting antivirals to pegylated interferon-α plus ribavirin for the treatment of chronic HCV infection can result in an increased sustained viral response rate and may permit reduction in treatment duration. IDX320 is a potent non-covalent macrocyclic inhibitor of the HCV NS3/4A protease. METHODS: This was a randomized double-blind placebo-controlled single- and multiple-dose study to assess the safety, tolerability, antiviral activity and pharmacokinetics of IDX320 in healthy volunteers (HV) and patients with chronic HCV genotype 1 infection. HV (n=48) received single or multiple ascending doses of IDX320. Two HCV-infected patients received a single dose of 200 mg IDX320. Dosages for other HCV-infected patients were as follows: placebo, 50, 100, 200 or 400 mg of IDX320 orally once daily for 3 days (n=30) or placebo/200 mg of IDX320 twice-daily for 3 days (n=8). RESULTS: In total, 48 HV and 40 HCV-infected patients were enrolled and all completed the study. There were no serious adverse events. The majority of adverse events were of mild or moderate intensity. Pharmacokinetics supported a once-daily dosing regimen. A rapid decline in plasma HCV RNA was observed in all patients. In the multiple-dose study, mean HCV RNA reductions were 2.6, 3.1, 3.1, 3.3 and 3.8 log(10) IU/ml after 3 days in the IDX320 50, 100, 200, 400 mg once-daily and 200 mg twice-daily treatment groups, respectively. This compared to a mean HCV RNA reduction of 0.04 log(10) in the placebo group. CONCLUSIONS: Once-daily IDX320 dosing demonstrated potent dose-dependent antiviral activity in treatment-naive HCV genotype-1-infected patients.