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Found 68 results
  1. Content Article
    Acute respiratory distress syndrome (ARDS) and respiratory failure are characterised by hypoxemia (i.e., low levels of blood oxygen). Infections such as influenza and COVID-19 can lead to ARDS or respiratory failure. Treatment is through supportive measures. In severe cases, patients receive oxygen through a ventilator and, when appropriate, are placed in a prone position for an extended period. A retrospective review of events submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) identified 98 prone position–related events in patients with ARDS, respiratory failure, distress, and pneumonia from 1 January 2010, through 30 June 2020; 30 events were associated with COVID-19. Skin integrity injuries accounted for 83.7% (82 of 98) of the events. The remaining events, 16.3% (16 of 98), involved unplanned extubations, cardiac arrests, displaced lines, enteral feedings, medication errors, a dental issue, and posterior ischemic optic neuropathy.
  2. Content Article
    The University of California, Irvine, health sciences researchers have created a machine-learning model to predict the probability that a COVID-19 patient will need a ventilator or ICU care. The tool is free and available online for any healthcare organisation to use. "The goal is to give an earlier alert to clinicians to identify patients who may be vulnerable at the onset," said Daniel S. Chow, an assistant professor in residence in radiological sciences and first author of the study, published in PLOS ONE. The tool predicts whether a patient's condition will worsen within 72 hours. Coupled with decision-making specific to the healthcare setting in which the tool is used, the model uses a patient's medical history to determine who can be sent home and who will need critical care. The study found that at UCI Health, the tool's predictions were accurate about 95% of the time.
  3. News Article
    Some disabled people in the UK have been struggling to obtain essentials such as medication and breathing equipment during the Covid pandemic, research for the BBC suggests. Some 60% of those who rely on social care told a YouGov survey they were finding it hard to obtain at least one of their necessities. Charity WellChild said people felt more "forgotten than they ever have been". But ministers say the needs of disabled people were being considered. The Department of Health and Social Care says it has sufficient stocks and patients should contact their local care provider. Like one in 20 of those survey respondents who receive social care, Fi Anderson, a mother of two with muscular dystrophy from Bolton in Greater Manchester, said she has faced problems obtaining breathing apparatus. Her local hospital told her to re-use the filter for her portable ventilator, recommending she boil it, because supplies were so short. Disabled people who rely on social care - which funds equipment and other support to allow them to live independent lives - also said they had struggled to obtain personal protective equipment (PPE) such as face masks. Many of them receive funding directly to employ carers in their home, so they also need to provide them with PPE during the coronavirus crisis. The survey, which the BBC commissioned to mark the 25th anniversary of the Disability Discrimination Act, asked more than 1,000 people about life in the UK with a disability and how it has changed in the shadow of a pandemic. More than 65% felt their rights had regressed, and 71% said disabled people's needs had been overlooked. The Coronavirus Act, which granted the government emergency powers, gave local councils the ability to reduce care, education and mental health provision for disabled people if it became necessary during the pandemic. According to the latest figures from the Office for National Statistics, nearly six out of 10 deaths from COVID-19 were of disabled people. Read full story Source: BBC News,
  4. News Article
    The most comprehensive picture so far of how covid’s second wave has hit the NHS in the north of England is revealed in new figures obtained by HSJ. The latest data confirms that parts of the North West region now have more coronavirus patients in hospital beds than they did in the spring. It comes amid intense public debate about the best way to fight covid, and whether or not it is close to swamping the NHS. Collected from local NHS sources in a joint HSJ and Independent investigation, the information shows for example that: Lancashire and South Cumbria had 544 confirmed covid hospital patients yesterday (around 15-18% of the bed base), about 20 more than during the April peak. Liverpool University Hospitals – which remains the most severely affected trust – had 408 confirmed covid patients yesterday (20-25% of bed base), whereas it never topped 400 in the spring. The data is sent routinely by trusts to NHS England but most of it is not published – something some politicians are now calling for. As of yesterday, there were nearly 6,100 confirmed-covid patients across England, about 650 of whom were in critical care, and 560 receiving mechanical ventilation, according to information shared with HSJ. The number of “unoccupied” hospital beds is much lower now than in the spring, when they were cleared out in anticipation of a major hit. In the North West, up to 5,500 acute beds were reported as “unoccupied” in the spring, whereas the figure now is about 2,500 (around 14-18% of the bed base). However, critical care is the major pinch point in the most affected areas, with nearly half of the mechanical ventilation beds open at Liverpool’s hospitals (29 of 62) occupied by confirmed covid patients; and a third of those across the North West (178 of 556). However, hospitals in the area have opened very few extra critical care “surge” beds so far. The total numbers of mechanical ventilation (a subset of critical care) beds open in LUH and the rest of the region has not increased much in recent weeks, and falls well short of what they have declared they could open as potential surge capacity, if they cancelled large amounts of non-urgent care and reorganised staffing and wards. Read full story Source: HSJ, 23 October 2020
  5. News Article
    Covid survivor Tam McCue is one of the lucky ones. Earlier in the year he was in intensive care in the Royal Alexandra Hospital in Paisley where he had been on a ventilator for nearly two weeks. At one point Mr McCue, who could barely speak, didn't think he would live. Fast forward five months and Mr McCue, of Barrhead, East Renfrewshire, is back from the brink. He became desperately ill but, thankfully, it only went as far as his lungs. With coronavirus some patients have have suffered multiple organ failure which also affected their heart, kidneys, brain and gut. Mr McCue describes his recovery as a "rollercoaster". He added: "It's a slow process. You think you can do things then the tiredness and fatigue sets in." He said: "It lies in the back of your mind. As years go on, how are you going to be? Is it going to get you again? It does play on you. It definitely does." As part of his recovery Mr McCue is attending the Ins:pire clinic online. It is normally a face-to-face rehabilitation clinic which involves multiple specialties, including pharmacists, physiotherapists and psychologists. Mr McCue is one of the first Covid survivors to take part in the five-week programme, which started earlier this month. Read full story Source: BBC Scotland News, 29 September 2020
  6. Content Article
    In March 2020 Philips Health Systems released an FSN concerning V60 ventilators. This FSN concerned a hardware fault in the device, which can result in an unexpected shutdown. There are two ways in which this shutdown can occur: The first will sound a warning to alert the user that the machine is shutting down. This will let the user know they need to switch to an alternative source of ventilation. There is a risk that the patient will be unventilated while this second source of ventilation is prepared. The second failure mode will cause the device to shut down with no warning to the user. If a device fails in use and does not alarm, the patient will not be adequately ventilated and there is a potential risk of brain damage or death, depending on how long it takes clinicians to become aware of the situation and respond. There has been a significant delay of replacement parts arriving in the United Kingdom, resulting in an increased risk of this failure occurring. The MHRA has decided to update the guidance issued in the Medical Device Alert published in June. The MHRA will continue to work with the manufacturer to improve the delivery time for replacement components.
  7. News Article
    Hospitals have been warned hundreds of ventilators used to keep sedated patients alive are at risk of suddenly shutting down because of a fault, in some cases without warning. The Medicines and Healthcare products Regulatory Agency, which said there were approximately 303 Philips Respironics V60 ventilators used in the UK, has warned hospitals over a delay in replacement parts arriving in the UK to fix the problem. It has issued a safety alert to hospitals to make them aware of the increased risk. The regulator said it had received one report of a ventilator suddenly shutting down but said there was no report of any injury to patients. Read full story Source: The Independent, 23 September 2020
  8. News Article
    The lungs and hearts of patients damaged by the coronavirus improve over time, a study has shown. Researchers in Austria recruited coronavirus patients who had been admitted to hospital. The patients were scheduled to return for evaluation 6, 12 and 24 weeks after being discharged, in what is said to be the first prospective follow-up of people infected with COVID-19, which will be presented at today's European Respiratory Society International Congress. Clinical examinations, laboratory tests, analysis of the amounts of oxygen and carbon dioxide in arterial blood, and lung function tests were carried out during these visits. At the time of their first visit, more than half of the patients had at least one persistent symptom, predominantly breathlessness and coughing, and CT scans still showed lung damage in 88% of patients. But by the time of their next visit, 12 weeks after discharge, the symptoms had improved, and lung damage was reduced to 56%. Dr Sabina Sahanic, a clinical PhD student at the University Clinic in Innsbruck and part of the team that carried out the study, said: "The bad news is that people show lung impairment from COVID-19 weeks after discharge; the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves." A separate presentation to the congress said that the sooner COVID-19 patients started a pulmonary rehabilitation programme after coming off ventilators, the better and faster their recovery. Yara Al Chikhanie, a PhD student at the Dieulefit Sante clinic for pulmonary rehabilitation and the Hp2 Lab at the Grenoble Alps University in France, used a walking test to evaluate the weekly progress of 19 patients who had spent an average of three weeks in intensive care and two weeks in a pulmonary ward before being transferred to a clinic for pulmonary rehabilitation. She said: "The most important finding was that patients who were admitted to pulmonary rehabilitation shortly after leaving intensive care progressed faster than those who spent a longer period in the pulmonary ward where they remained inactive. The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients' walking and breathing capacities and muscle gain." Read full story Source: The Independent, 7 September 2020
  9. News Article
    Death rates among seriously ill COVID-19 patients dropped sharply as doctors rejected the use of mechanical ventilators, analysis has found. The chances of dying in an intensive care unit (ICU) went from 43% before the pandemic peaked to 34% in the period after. In a report, the Intensive Care National Audit & Research Centre said that no new drugs nor changes to clinical guidelines were introduced in that period that could account for the improvement. However, the use of mechanical ventilators fell dramatically. Before the peak in admissions on 1 April, 75.9% of COVID-19 patients were intubated within 24 hours of getting to an ICU, a proportion which fell to 44.1% after the peak. Meanwhile, the proportion of ICU patients put on a ventilator at any point dropped 22 percentage points to 61% either side of the peak. Researchers suggested this could have been a result of “informal learning” among networks of doctors that patients on ventilators were faring worse than expected. Read full story Source: The Telegraph, 3 September 2020
  10. Content Article
    Hospital-acquired pneumonia, whether device associated or not, is the number one hospital-acquired infection in the United States and a major threat to the safety of patients. This blog by Patient Safety Movement discusses how engaging nurses in quality improvement around mouth care reduces ventilator acquired pneumonias.
  11. Content Article
    This toolkit has been produced by the National Tracheostomy Safety Project in collaboration with the Academic Health Science Networks in response to the COVID-19 pandemic, to support healthcare staff who are looking after this very vulnerable group of patients. Primarily it is for those working in hospitals. However, much of the material is also applicable to primary and community care settings. Wherever it is used, the toolkit’s key objective is the same: to ensure that healthcare staff caring for patients with tracheostomies in these challenging circumstances are able to do so safely. 
  12. Content Article
    The British Thoracic Society has published the results of their 2019 national audit of acute non-Invasive ventilation (NIV) in adult patients in NHS hospitals.   Data were collected in 2019, before the pandemic, and the audit did not look at things such as pandemic preparedness or numbers of NIV hardware available, but at the quality of the service provided. The audit analysed data provided from over 150 hospitals, for a total of over 3500 patient records, and looked for adherence to our quality standards in the provision of the service.
  13. News Article
    NASA scientists as well as other innovators are busy developing alternatives to the traditional ventilator being used worldwide to treat severe cases of COVID-19. The movement is in response to growing evidence that in some cases ventilators can cause more harm than good in some patients with low oxygen levels. Statistics tell the story: 80% of patients with the coronavirus die on such machines. Its VITAL machine is tailored for COVID-19 patients and is focused on providing air delicately to stiff lungs — a hallmark symptom of the virus. Eight U.S. manufacturers have been selected to make the ventilator that was made in 37 days by engineers at NASA’s Jet Propulsion Laboratory. Read full story Source: CNBC, 30 May 2020 Read f
  14. Content Article
    Duncan L Wyncoll and Peter J Young discuss 'Treating the symptom not the cause' of ventilator associated pneumonia.
  15. Content Article
    The PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. Doyle et al. aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System.
  16. Content Article
    This document highlights practical recommendations in a concise format to assist acute care hospitals in implementing and prioritising strategies to prevent ventilator-associated pneumonia (VAP) and other ventilator-associated events (VAEs) and to improve outcomes for mechanically ventilated adults, children, and neonates.
  17. Content Article
    Ventilator-associated pneumonia (VAP) continues to be a clinically important hospital-acquired infection. In this paper, Marin H. Kollef discusses the financial impact.
  18. Content Article
    Ventilator-associated pneumonia is an important healthcare-associated infection. Interventions for the prevention of ventilator-associated pneumonia are often used within bundles of care. Recent evidence has challenged widespread practices mandating a review of subject. This article outlines guidance for ventilator-associated pneumonia prevention.
  19. Content Article
    Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. Muscedere et al. systematically searched for all relevant randomised, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to 1 October 2006. in order to develop evidence-based guidelines for the prevention of VAP.
  20. Content Article
    The purpose of this document is to provide designers and manufacturers of ventilators with overarching advice and guidance on the key themes for consideration and specific Human Factors and Ergonomic (HFE) issues in a period of “crisis management” requiring rapid design and production.
  21. News Article
    Hundreds of ventilators the UK government bought from China to relieve a major shortage are the wrong type and could kill patients, senior doctors have warned in a newly uncovered letter. The medical staff behind the letter say the devices were designed for use in ambulances rather than hospitals, had an "unreliable" oxygen supply and were of "basic" quality. Seen by Sky News' partner organisation NBC, the document also claims the ventilators cannot be cleaned properly, are an unfamiliar design and come with a confusing instruction manual. Cabinet Office minister Michael Gove triumphantly announced the arrival of "300 ventilators from China" to help treat COVID-19 patients on 4 April. But the letter of warning from doctors was issued just nine days later. "We believe that if used, significant patient harm, including death, is likely," it says. Read full story Source: Sky News, 30 April 2020
  22. News Article
    The availability of dialysis equipment used to treat more than a quarter of ventilated COVID-19 patients has reached “critical” levels, HSJ has learned. Concerns are growing over an “exceptional shortage” of specialist dialysis machines used to treat intensive care patients with acute kidney failure. Although hospitals are able to deploy alternative machines which are not typically used in intensive care, this is logistically challenging and can carry increased risks for patients. Read full story Source: HSJ, 22 April 2020
  23. Content Article
    This document designed by the Patient Safety Movement is a dynamic document that gives a summary of therapies given to COVID patients in the US.
  24. News Article
    More than a quarter of patients with COVID-19 on ventilators also need renal support in the form of dialysis, raising concerns that there could be significant supply problems as countries attempt to stock up on the required fluid and plastic consumables. Nephrology consultant Graham Lipkin told The BMJ, “This is an under-recognised challenge. While the original focus has been on whether we have enough ventilators and intensive care beds, it has become apparent that there is a high incidence of acute kidney injury (AKI) requiring some form of renal replacement therapy (RRT) through dialysis. With the volume of people coming into intensive care, there are increasing challenges to capacity across the system.” Lipkin, who is president of the Renal Association, has been working with NHS England to develop new clinical guidelines for the prevention and optimal management of AKI in hospital. The guidance aims to reduce the incidence of AKI and therefore the demand for dialysis. Read full story Source: BMJ, 21 April 2020
  25. News Article
    According to an Allego press release, several of the world’s ventilator manufacturers have formed a Ventilator Training Alliance (VTA) and partnered with Allego to create a mobile app that front-line medical providers can use to access a centralised repository of ventilator training resources. Dräger, GE Healthcare, Getinge, Hamilton Medical, Medtronic, Nihon Kohden, and Philips have joined this humanitarian training coalition. The VTA app – powered by learning and readiness platform provider Allego – connects respiratory therapists, nurses and other medical professionals with ventilator training resources from alliance member companies, including instructional how-to videos, manuals, troubleshooting guides, and other ventilator-operation expertise critical to helping responders treat patients suffering from COVID-19-related respiratory distress. Read full story Source: American Association for Respiratory Care, 16 April 2020
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