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PURPOSE: This study examines, with clinical end users, the features of a visualization system in transmitting real-time patient data from the ambulance to the emergency trauma room (ETR) to determine if the real-time data provides the basis for more informed and timely interventions in the ETR before and after patient arrival. METHODS: We conducted a qualitative in-depth interview study with 32 physicians in six German and Swiss hospitals. A visualization system was developed as prototype to display the transfer of patient data, and it serves as a basis for evaluation by the participating physicians. RESULTS: The prototype demonstrated the potential benefits of improving workflow within the ETR by providing critical patient information in real-time. Physicians highlighted the importance of features such as the ABCDE scheme and vital signs that directly impact patient care. Configurable and mobile versions of the prototype were suggested to meet the specific needs of each clinic or specialist, allowing for the transfer of only essential information. CONCLUSION: The results highlight on the one hand the potential need for adaptable interfaces in medical communication technologies that balance efficiency with minimizing additional workload for emergency medical services and show that the use of pre-notification systems in communication between ambulance and hospital can be supportive. Further research is recommended to assess practical application and support in clinical practice, including a re-evaluation of the enhanced prototype by professionals.
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BACKGROUND: Neglect can be a long-term consequence of chronic stroke that can impede an individual's ability to perform daily activities, but chronic and discrete forms can be difficult to detect. We developed and evaluated the "immersive virtual road-crossing task" (iVRoad) to identify and quantify discrete neglect symptoms in chronic stroke patients. METHOD: The iVRoad task requires crossing virtual intersections and placing a letter in a mailbox placed either on the left or right. We tested three groups using the HTC Vive Pro Eye: (1) chronic right hemisphere stroke patients with (N = 20) and (2) without (N = 20) chronic left-sided neglect, and (3) age and gender-matched healthy controls (N = 20). We analyzed temporal parameters, errors, and head rotation to identify group-specific patterns, and applied questionnaires to measure self-assessed pedestrian behavior and usability. RESULTS: Overall, the task was well-tolerated by all participants with fewer cybersickness-induced symptoms after the VR exposure than before. Reaction time, left-sided errors, and lateral head movements for traffic from left most clearly distinguished between groups. Neglect patients committed more dangerous crossings, but their self-rated pedestrian behavior did not differ from that of stroke patients without neglect. This demonstrates their reduced awareness of the risks in everyday life and highlights the clinical relevance of the task. CONCLUSIONS: Our findings suggest that a virtual road crossing task, such as iVRoad, has the potential to identify subtle symptoms of neglect by providing virtual scenarios that more closely resemble the demands and challenges of everyday life. iVRoad is an immersive, naturalistic virtual reality task that can measure clinically relevant behavioral variance and identify discrete neglect symptoms.
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Trastornos de la Percepción , Accidente Cerebrovascular , Realidad Virtual , Humanos , Masculino , Femenino , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Persona de Mediana Edad , Anciano , Trastornos de la Percepción/etiología , Trastornos de la Percepción/diagnóstico , Trastornos de la Percepción/fisiopatología , Tiempo de Reacción/fisiología , Pruebas Neuropsicológicas/normas , Enfermedad Crónica , Lateralidad Funcional/fisiología , Adulto , Interfaz Usuario-Computador , Desempeño Psicomotor/fisiologíaRESUMEN
BACKGROUND: In emergency trauma room, adequate preparation of all resources prior to the patient's arrival is essential to ensure optimal continuation of the treatment. Therefore, a good transfer of information between pre-hospital and hospital is very important, for example through networking technologies. OBJECTIVES: The aim is to identify what pre-hospital information is needed to ensure that all necessary resources in the ETR are optimally prepared for the incoming trauma patient. METHODS: A qualitative, semi structured interview was conducted with physicians of ETR team at four trauma centers. RESULTS: Physicians mentioned similar requests for pre-hospital information. The workflow in ETRs differed in alerting of team members and transferring of pre-notification information. CONCLUSION: Clinical needs for pre-hospital information for future development of support systems in the networking of accident site and hospital could be identified.
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Servicios Médicos de Urgencia , Heridas y Lesiones , Humanos , Ambulancias , Centros Traumatológicos , Servicio de Urgencia en Hospital , Hospitales , Investigación Cualitativa , Heridas y Lesiones/terapiaRESUMEN
The prediction of colloid transport in unsaturated porous media in the presence of large energy barrier is hampered by scant information of the proportional retention by straining and attractive interactions at surface energy minima. This study aims to fill this gap by performing saturated and unsaturated column experiments in which colloid pulses were added at various ionic strengths (ISs) from 0.1 to 50 mM. Subsequent flushing with deionized water released colloids held at the secondary minimum. Next, destruction of the column freed colloids held by straining. Colloids not recovered at the end of the experiment were quantified as retained at the primary minimum. Results showed that net colloid retention increased with IS and was independent of saturation degree under identical IS and Darcian velocity. Attachment rates were greater in unsaturated columns, despite an over 3-fold increase in pore water velocity relative to saturated columns, because additional retention at the readily available air-associated interfaces (e.g., the air-water-solid [AWS] interfaces) is highly efficient. Complementary visual data showed heavy retention at the AWS interfaces. Retention by secondary minima ranged between 8% and 46% as IS increased, and was greater for saturated conditions. Straining accounted for an average of 57% of the retained colloids with insignificant differences among the treatments. Finally, retention by primary minima ranged between 14% and 35% with increasing IS, and was greater for unsaturated conditions due to capillary pinning.