RESUMEN
BACKGROUND: The Committee on En Route Combat Casualty Care recently ranked the patient handoff as their fourth research priority. Bluetooth technology has been introduced to the battlefield and has the potential to improve the tactical patient handoff. The purpose of this study is to compare the traditional methods of communication used in tactical medical evacuation by Special Operations medical personnel (radio push-to-talk [PTT] and Tactical Medic Intercom System [TM-ICS]) to Bluetooth communication. METHODS: Twenty-four simulated tactical patient handoffs were performed to compare Bluetooth and traditional methods of communication used in tactical medical evacuation. Patient scenario order and method of communication were randomized. Accuracy and time required to complete the patient handoff were determined. The study took place using a rotary-wing aircraft kept at level 2 to simulate real-world background noise. Preferred method of communication for each study participant was determined. RESULTS: There were no differences in accuracy of the received patient handoffs between groups or patient handoff transmission times at the ramp of the aircraft. However, when comparing patient handoff times to the medical team within the aircraft, Bluetooth communication was significantly faster than both TM-ICS and radio PTT, while Bluetooth PTT and radio PTT were also significantly faster than TM-ICS. Bluetooth communication was ranked as the preferred method of handoff by all study participants. CONCLUSION: The study demonstrated that utilization of Bluetooth technology for patient handover results in faster handoffs compared with traditional methods without sacrificing any accuracy in a scenario with high levels of noise.
Asunto(s)
Pase de Guardia , Humanos , ComunicaciónRESUMEN
Pyogenic flexor tenosynovitis (PFT) is an orthopedic emergency that necessitates prompt diagnosis and treatment. Unfortunately, the diagnosis is largely clinically based on Kanavel's four cardinal signs with all four symptoms being present approximately 22% to 56% of the time. Evidence suggests that PFT diagnosed within 48 h of onset does not need surgical intervention. Ultrasonography can be used to aid in the diagnosis of PFT. It has a sensitivity of 94.4% and a negative predictive value of 96.7%. This illustrative case report demonstrates ultrasound's utility to not only aid in diagnosis but also serve as a tool for monitoring patient response.
Asunto(s)
Mano/diagnóstico por imagen , Tenosinovitis/diagnóstico por imagen , Ultrasonografía , Adulto , Antibacterianos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Cefalexina/uso terapéutico , Diagnóstico Diferencial , Humanos , Masculino , Personal Militar , Naproxeno/uso terapéutico , Tenosinovitis/tratamiento farmacológicoRESUMEN
A 31-yr-old soldier presented with an 8-mo history of right prepatellar bursitis with 1-mo history of pain and loss of range of motion. His symptoms did not respond to activity modification, compression, nonsteroidal anti-inflammatory agents, or repeated aspirations with fenestration. After thorough discussion, the soldier and his provider reviewed the literature and found a single case report of intrabursal sclerotherapy in two patients with recalcitrant prepatellar bursitis. After informed consent, the patient wished to proceed with the scelerotherapy. Utilizing ultrasound guidance, the bursal sac was aspirated then injected with the scerlosing agent polidocanol. The patient had a much slower reaccumulation of swelling and at the two week follow-up the procedure was repeated. The patient has had no reaccumulation of the fluid as of 10 mo post-procedure and has resumed all his normal activities with no symptom limitation. This case demonstrates that sclerotherapy has utility in the management of recurrent non-septic prepatellar bursitis.