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Journal articles on the topic 'Hemorrhage simulation'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Deering, Shad H., Michael Chinn, Jonathon Hodor, Thomas Benedetti, Lynn S. Mandel, and Barbara Goff. "Use of a Postpartum Hemorrhage Simulator for Instruction and Evaluation of Residents." Journal of Graduate Medical Education 1, no. 2 (December 1, 2009): 260–63. http://dx.doi.org/10.4300/jgme-d-09-00023.1.

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Abstract Objective Postpartum hemorrhage is a common and potentially life-threatening obstetric emergency. We sought to create a realistic simulation and validate a standardized grading form to evaluate competency in the management of postpartum hemorrhage. Methods Residents from 3 programs underwent training with a postpartum hemorrhage simulation using a standard obstetric birthing model equipped with an inflatable uterus to simulate uterine atony. All simulations were graded by staff physicians with a standardized grading sheet constructed from the current literature on the topic. Residents were expected to recognize the hemorrhage and take appropriate steps, including asking the assistant to administer medications, to correct the problem. Objective and subjective performance was measured with standardized grading sheets, and results were analyzed for reliability using Cronbach α and intraclass correlation coefficients. This project was conducted in accordance with the hospital Institutional Review Board policies at each institution. Results Forty residents from 3 institutions underwent simulation training. The majority were unable to correct the hemorrhage within 5 minutes and almost half also made at least 1 error, either the dose or route, in the medications they requested. Reliability was evaluated with Cronbach α and demonstrated the grading sheets were valid and had good interrater reliability. Discussion A simulated postpartum hemorrhage scenario can identify important deficiencies in resident knowledge and performance, with no risk to patients. The standardized grading form worked well for our purposes and was reliable in our study. Further testing is needed to evaluate whether the training improves performance in real-life hemorrhages.

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Robertson, Faith C., Muhammad M. Abd-El-Barr, Srinivasan Mukundan, and William B. Gormley. "Ventriculostomy-associated hemorrhage: a risk assessment by radiographic simulation." Journal of Neurosurgery 127, no. 3 (September 2017): 532–36. http://dx.doi.org/10.3171/2016.8.jns16538.

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OBJECTIVEVentriculostomy entry sites are commonly selected by freehand estimation of Kocher's point or approximations from skull landmarks and a trajectory toward the ipsilateral frontal horn of the lateral ventricles. A recognized ventriculostomy complication is intracranial hemorrhage from cortical vessel damage; reported rates range from 1% to 41%. In this report, the authors assess hemorrhagic risk by simulating traditional ventriculostomy trajectories and using CT angiography (CTA) with venography (CTV) data to identify potential complications, specifically from cortical draining veins.METHODSRadiographic analysis was completed on 50 consecutive dynamic CTA/CTV studies obtained at a tertiary-care academic neurosurgery department. Image sections were 0.5 mm thick, and analysis was performed on a venous phase that demonstrated high-quality opacification of the cortical veins and sagittal sinus. Virtual ventriculostomy trajectories were determined for right and left sides using medical diagnostic imaging software. Entry points were measured along the skull surface, 10 cm posteriorly from the nasion, and 3 cm laterally for both left and right sides. Cannulation was simulated perpendicular to the skull surface. Distances between the software-traced cortical vessels and the virtual catheter were measured. To approximate vessel injury by twist drill and ventricular catheter placement, veins within a 3-mm radius were considered a hemorrhage risk.RESULTSIn 100 virtual lines through Kocher's point toward the ipsilateral ventricle, 19% were predicted to cause cortical vein injury and suspected hemorrhage (radius ≤ 3 mm). Little difference existed between cerebral hemispheres (right 18%, left 20%). The average (± SD) distance from the trajectory line and a cortical vein was 7.23 ± 4.52 mm. In all 19 images that predicted vessel injury, a site of entry for an avascular zone near Kocher's point could be achieved by moving the trajectory less than 1.0 cm laterally and less than 1.0 cm along the anterior/posterior axis, suggesting that empirical measures are suboptimal, and that patient-specific coordinates based on preprocedural CTA/CVA imaging may optimize ventriculostomy in the future.CONCLUSIONSIn this institutional radiographic imaging analysis, traditional methods of ventriculostomy site selection predicted significant rates of cortical vein injury, matching described rates in the literature. CTA/CTV imaging potentiates identification of patient-specific cannulation sites and custom trajectories that avoid cortical vessels, which may lessen the risk of intracranial hemorrhage during ventriculostomy placement. Further development of this software is underway to facilitate stereotactic ventriculostomy and improve outcomes.

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Davis, Anjanetta, Alison Rudd, Jacqueline Lollar, and Amy McRae. "An interprofessional simulation for managing postpartum hemorrhage." Nursing 48, no. 5 (May 2018): 17–20. http://dx.doi.org/10.1097/01.nurse.0000531907.22973.f2.

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Bowles, Cayley, Daniel Canuto, Joseph Teran, Erik Dutson, David Plurad, Jeff Eldredge, and Peyman Benharash. "Current Methods and Advances in Simulation of Hemorrhage after Trauma." American Surgeon 83, no. 10 (October 2017): 1137–41. http://dx.doi.org/10.1177/000313481708301025.

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As animal models fall out of favor, there is demand for simulators to train medical personnel in the management of trauma and hemorrhage. Realism is essential to the development of simulators for training in the management of trauma and hemorrhage, but is difficult to achieve because it is difficult to create models that accurately represent bleeding organs. We present a simulation platform that uses real-time mathematical modeling of hemodynamics after hemorrhage and trauma and visually represents the injury described by the model. Using patient-specific imaging, 3D-mesh representations of the liver were created and merged with an anatomically accurate vascular tree. By using anatomically accurate representations of the vasculature, we were able to model the cardiovascular response to hemorrhage in a specific artery. The incorporation of autonomic tone allowed for the calculation of bleeding rate and aortic pressures. The 3D-mesh representation of the liver allowed us to simulate blood flow from the liver after trauma. For the first time, we have successfully incorporated tissue modeling and fluid dynamics with a model of the cardiovascular system to create a simulator. These simulations may aid in the creation of realistic virtual environments for training.

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Foglia, Lisa M., Allison Eubanks, Logan Peterson, Kimberly Hickey, Amanda Jackson, and Shad Deering. "Simulation to Teach Cesarean Section and Hemorrhage Management." Obstetrics & Gynecology 135 (May 2020): 80S—81S. http://dx.doi.org/10.1097/01.aog.0000664972.70722.e7.

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Shearer, Jessica, Cheryl Cicotti, Lois Hopkin, and Maureen Tremmel. "Post Partum Hemorrhage." Clinical Simulation in Nursing 5, no. 3 (May 2009): e149-e150. http://dx.doi.org/10.1016/j.ecns.2009.04.071.

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7

Pansuwan, Kornkarn, and Sirikanok Klankhajhon. "The Effect of Using Simulation-based Learning on Nursing Performances of Early Postpartum Hemorrhage in Nursing Students." Jurnal Keperawatan Padjadjaran 9, no. 3 (November 13, 2021): 175–80. http://dx.doi.org/10.24198/jkp.v9i3.1682.

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Background: Early postpartum haemorrhage (PPH) is a crucial problem in maternal and newborn care. The simulation-based learning has an important role to improve knowledge, practical skills, and attitude in realistic case-based scenarios. This study aims to examine the effect on using simulated scenario in the simulation laboratory on nursing performance of early postpartum hemorrhage of nursing students.Methods: The quasi-experimental research, one group pretest-posttest design was used to study with the nursing students from the Faculty of Nursing, Naresuan University in Academic Year 2019 during the period of December 1, 2019 to January 31, 2020. The subjects of thirty nursing students were selected by purposive sampling. The instruments were the the ability in nursing of early postpartum hemorrhage through the questionnaires which consists of the performance test and satisfaction before and after the early PPH simulation program. The content of scenario consists of the definition, etiology, risk factors, signa and symptoms, treatment, holistic nursing care, and continuous care. The data were analysed as the descriptive: numbers, percentages, frequency, mean and standard deviation. The paired t-test was used to compare the outcome between pre-test and post-test.Results: The data were analysed by t-test. The results illustrated that the students who learned through simulated scenario on performance in nursing care of women with early postpartum hemorrhage had, after learning, higher performance in nursing care of women with early postpartum hemorrhage than that before learning at the .01 level of significance. The students were satisfied learning by using the simulation program in the high level (x̄ = 4.26, S.D. = 0.54).Conclusion: The simulation-based learning improves the core competencies and performances of nursing students for management women with early postpartum hemorrhage as knowledge, potential clinical care skills, and attitude. It will be useful to implement for nursing care women regarding early postpartum hemorrhage in the real situations.

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Hammoud, Nadine, Emily K. Marko, Michael J. Sheridan, and Kelsey Nieves. "Objective Measures of Interval Postpartum Hemorrhage Simulation Training [29B]." Obstetrics & Gynecology 127 (May 2016): 26S. http://dx.doi.org/10.1097/01.aog.0000483348.40723.9a.

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Phillippi, Julia C., Margaret Buxton, and Maria Overstreet. "Interprofessional simulation of a retained placenta and postpartum hemorrhage." Nurse Education in Practice 15, no. 4 (July 2015): 333–38. http://dx.doi.org/10.1016/j.nepr.2015.02.001.

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Davis, Deborah E. "Postpartum Hemorrhage Simulation Project: Outcomes, Successes and Lessons Learned." Journal of Obstetric, Gynecologic & Neonatal Nursing 40 (June 2011): S49—S50. http://dx.doi.org/10.1111/j.1552-6909.2011.01242_67.x.

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Heine, Deborah M., Cheryl Lefaiver, Sylvia Parker, and Tina Davis-Larkin. "Perceptions of Nurses Participating in Obstetric Hemorrhage Simulation Training." Journal of Obstetric, Gynecologic & Neonatal Nursing 41 (June 2012): S155. http://dx.doi.org/10.1111/j.1552-6909.2012.01362_52.x.

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Hirshberg, Asher, Mark Dugas, Eugenio I. Banez, Bradford G. Scott, Matthew J. Wall, and Kenneth L. Mattox. "Minimizing Dilutional Coagulopathy in Exsanguinating Hemorrhage: A Computer Simulation." Journal of Trauma: Injury, Infection, and Critical Care 54, no. 3 (March 2003): 454–63. http://dx.doi.org/10.1097/01.ta.0000053245.08642.1f.

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Kerbage, Y., V. Debarge, J. P. Lucot, E. Clouqueur, and C. Rubod. "Simulation training to teach postpartum hemorrhage surgery to residents." European Journal of Obstetrics & Gynecology and Reproductive Biology 201 (June 2016): 27–30. http://dx.doi.org/10.1016/j.ejogrb.2016.03.013.

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Ramseyer, Abigail M., and Monica A. Lutgendorf. "Implementation of Low-Cost Obstetric Hemorrhage Simulation Training Models for Resident Education." Military Medicine 184, no. 11-12 (April 30, 2019): e637-e641. http://dx.doi.org/10.1093/milmed/usz098.

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Abstract Introduction Simulation is beneficial training for low frequency high acuity events such as management of obstetric hemorrhage. Our objective was to evaluate perceived competency in management of obstetric and pelvic hemorrhage following training with low fidelity task trainers using inexpensive and common medical supplies. Materials and Methods This was a prospective observational study of training residents for management of obstetric and pelvic hemorrhage using a brief didactic instruction and low-cost task trainers with inexpensive common medical supplies. Participants practiced placement of a uterine tamponade balloon, uterine packing with gauze, pelvic parachute packing and temporary abdominal closure. Following training, participants completed a self-report survey regarding perceived competency with each technique. The Wilcoxon Signed-Rank Test was used to compare results before and after training. Results Eighteen of 23 residents completed the training and completed the survey on perceived competencies. There was a statistically significant improvement in perceived competency for all participants before and after training, with scores improving by 1.5 points for Bakri placement, from 1.94 to 3.44 (p < 0.001), improving by 1.67 points for uterine packing, from 1.78 to 3.44 (p < 0.001), improving by 1.95 for pelvic parachute packing, from 1.16 to 3.11 (p < 0.001), and improving by 1.89 for temporary abdominal closure, from 1.22 to 3.11 (p < 0.001). Conclusions Low-cost supplies and task trainers can be utilized to simulate postpartum hemorrhage and improve perceived competency in managing obstetric and pelvic hemorrhage. Similar training programs can be used in small community programs with limited resources.

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Panova, I. "Simulation Is an Effective Method for Teaching Obstetric Hemorrhage Care." Virtual Technologies in Medicine, no. 3 (September 7, 2022): 189–90. http://dx.doi.org/10.46594/2687-0037_2022_3_1505.

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The analysis of the quality of simulation training of 72 obstetrician-gynecologists on the topic "Obstetric bleeding" was carried out. The quality of skill performance was assessed by analyzing test cards for self-assessment of the doctor's qualifications. Analysis of the results showed that the quality of mastering practical skills by students significantly improves when using simulation technologies.

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Kim, Miok, and Juyoung Ha. "Simulation-based education program on postpartum hemorrhage for nursing students." Korean Journal of Women Health Nursing 26, no. 1 (March 31, 2020): 19–27. http://dx.doi.org/10.4069/kjwhn.2020.03.04.

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Al-Saeed, Tarek A. "Modeling retinal detachment associated with hemorrhage by Monte Carlo simulation." Applied Optics 59, no. 12 (April 16, 2020): 3614. http://dx.doi.org/10.1364/ao.385247.

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Nathan, L., D. Patauli, M. Sanctus, K. Plewniak, J. Ghartey, I. Merkatz, and D. Goffman. "W434 SIMULATION TRAINING FOR POSTPARTUM HEMORRHAGE MANAGEMENT IN RURAL AFRICA." International Journal of Gynecology & Obstetrics 119 (October 2012): S846. http://dx.doi.org/10.1016/s0020-7292(12)62155-9.

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Stubbs, MD, James R., and Donald H. Jenkins, MD. "Blood transfusion preparedness for mass casualty incidents: Are we truly ready?" American Journal of Disaster Medicine 14, no. 3 (August 1, 2019): 201–18. http://dx.doi.org/10.5055/ajdm.2019.0332.

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Mass casualty incidents (MCI) are high profile contributors to the number of annual trauma-related deaths in the United States. A critical aspect of MCI care is the ability to provide blood components in sufficient types and quantities to prevent deaths due to hemorrhage. For transfusions to play an optimal role in the prevention of trauma-related hemorrhagic death, including MCI, there appears to be a very tight time window after injury to initiate transfusion therapy. In order to meet this tight window, blood components of appropriate numbers and quantities must be immediately available. Currently, it is questionable whether standing blood inventories at US healthcare facilities are sufficient to appropriately meet the transfusion needs of a surge of MCI victims. Previous models of blood supply adequacy have focused on the availability of red blood cells, and the ability to move blood components quickly from blood suppliers to impacted healthcare facilities. These models have not considered the adequacy of other critically necessary blood components, such as platelets. A recent simulation of blood product demand after MCI showed that, in order to meet the defined RBC needs of 100 percent of casualties, a hospital would need 13-14 units in inventory per casualty. This simulation did not evaluate requirements for platelets and plasma, which would likely be extensive. Meeting balanced resuscitation demands in the timeframe necessary to minimize the number of preventable hemorrhagic deaths is probably not realistically achievable for most healthcare facilities in the United States. Alternative approaches to treat hemorrhage are likely necessary to solve this problem.

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Rao, B. Nageswara, Sudhansu Mohanty, Kamal Sen, U. Rajendra Acharya, Kang Hao Cheong, and Sukanta Sabut. "Deep Transfer Learning for Automatic Prediction of Hemorrhagic Stroke on CT Images." Computational and Mathematical Methods in Medicine 2022 (April 16, 2022): 1–10. http://dx.doi.org/10.1155/2022/3560507.

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Intracerebral hemorrhage (ICH) is the most common type of hemorrhagic stroke which occurs due to ruptures of weakened blood vessel in brain tissue. It is a serious medical emergency issues that needs immediate treatment. Large numbers of noncontrast-computed tomography (NCCT) brain images are analyzed manually by radiologists to diagnose the hemorrhagic stroke, which is a difficult and time-consuming process. In this study, we propose an automated transfer deep learning method that combines ResNet-50 and dense layer for accurate prediction of intracranial hemorrhage on NCCT brain images. A total of 1164 NCCT brain images were collected from 62 patients with hemorrhagic stroke from Kalinga Institute of Medical Science, Bhubaneswar and used for evaluating the model. The proposed model takes individual CT images as input and classifies them as hemorrhagic or normal. This deep transfer learning approach reached 99.6% accuracy, 99.7% specificity, and 99.4% sensitivity which are better results than that of ResNet-50 only. It is evident that the deep transfer learning model has advantages for automatic diagnosis of hemorrhagic stroke and has the potential to be used as a clinical decision support tool to assist radiologists in stroke diagnosis.

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Kleinmann, Whitney, Yevgenia Y. Fomina, Bethany Werner, Don D. McIntire, David B. Nelson, and Shena Dillon. "647 Does simulation improve clinical performance in management of postpartum hemorrhage?" American Journal of Obstetrics and Gynecology 224, no. 2 (February 2021): S406—S407. http://dx.doi.org/10.1016/j.ajog.2020.12.671.

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Vodovotz, Yoram, Claudio Lagoa, Rukmini Kumar, Carson Chow, and Gilles Clermont. "MATHEMATICAL SIMULATION OF POST-HEMORRHAGE ENDOTOXEMIA: TIMING IS CRITICAL FOR SURVIVAL." Shock 19, Supplement (June 2003): 42. http://dx.doi.org/10.1097/00024382-200306001-00124.

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Michelet, Daphné, Jessy Barré, Anais Job, Jennifer Truchot, Philippe Cabon, Catherine Delgoulet, and Antoine Tesnière. "Benefits of Screen-Based Postpartum Hemorrhage Simulation on Nontechnical Skills Training." Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare 14, no. 6 (December 2019): 391–97. http://dx.doi.org/10.1097/sih.0000000000000395.

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Skube, Mariya E., Seth Witthuhn, Kristine Mulier, Bonnie Boucher, Elizabeth Lusczek, and Greg J. Beilman. "Assessment of prehospital hemorrhage and airway care using a simulation model." Journal of Trauma and Acute Care Surgery 85 (July 2018): S27—S32. http://dx.doi.org/10.1097/ta.0000000000001800.

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Troyan, Pattie, Tara Fernandez Bertulfo, and Fran Kamp. "Postpartum Hemorrhage: A Novel Approach to Large Classroom Simulation and Debriefing." Clinical Simulation in Nursing 48 (November 2020): 59–63. http://dx.doi.org/10.1016/j.ecns.2020.08.008.

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Hargaden, Maureen, Stuart H. Goldberg, Denise Cunningham, Michael E. Breton, James W. Griffith, and C. Max Lang. "Optic Neuropathy Following Simulation of Orbital Hemorrhage in the Nonhuman Primate." Ophthalmic Plastic & Reconstructive Surgery 12, no. 4 (December 1996): 264–72. http://dx.doi.org/10.1097/00002341-199612000-00009.

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Joseph, Naima T., Nikkia H. Worrell, Janice Collins, Melanie Schmidt, Grace Sobers, Kathlyn Hutchins, E. Britton Chahine, et al. "Implementation of a Postpartum Hemorrhage Safety Bundle at an Urban Safety-Net Hospital." American Journal of Perinatology Reports 10, no. 03 (July 2020): e255-e261. http://dx.doi.org/10.1055/s-0040-1714713.

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Abstract Background Postpartum hemorrhage (PPH) is a leading cause of preventable maternal morbidity and mortality. Standardized response to obstetric hemorrhage is associated with significant improvement in maternal outcomes, yet implementation can be challenging. Objective The primary objective is to describe the methodology for program implementation of the Alliance for Innovation on Maternal Health Safety Bundle on PPH at an urban safety-net hospital. Methods Over an 18-month period, interventions geared toward (1) risk assessment and stratification, (2) hemorrhage identification and management, (3) team communication and simulation, and (4) debriefs and case review were implemented. Hemorrhage risk assessment stratification rates were tracked overtime as an early measure of bundle compliance. Results Hemorrhage risk assessment stratification rates improved to >90% during bundle implementation. Conclusion Keys to implementation included multidisciplinary stakeholder commitment, stepwise and iterative approach, and parallel systems for monitoring and evaluation Implementation of a PPH safety bundle is feasible in a resource-constrained setting.

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Santhoshkumar, Sundar, Vijayakumar Varadarajan, S. Gavaskar, J. Jegathesh Amalraj, and A. Sumathi. "Machine Learning Model for Intracranial Hemorrhage Diagnosis and Classification." Electronics 10, no. 21 (October 21, 2021): 2574. http://dx.doi.org/10.3390/electronics10212574.

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Intracranial hemorrhage (ICH) is a pathological disorder that necessitates quick diagnosis and decision making. Computed tomography (CT) is a precise and highly reliable diagnosis model to detect hemorrhages. Automated detection of ICH from CT scans with a computer-aided diagnosis (CAD) model is useful to detect and classify the different grades of ICH. Because of the latest advancement of deep learning (DL) models on image processing applications, several medical imaging techniques utilize it. This study develops a new densely connected convolutional network (DenseNet) with extreme learning machine (ELM)) for ICH diagnosis and classification, called DN-ELM. The presented DL-ELM model utilizes Tsallis entropy with a grasshopper optimization algorithm (GOA), named TEGOA, for image segmentation and DenseNet for feature extraction. Finally, an extreme learning machine (ELM) is exploited for image classification purposes. To examine the effective classification outcome of the proposed method, a wide range of experiments were performed, and the results are determined using several performance measures. The simulation results ensured that the DL-ELM model has reached a proficient diagnostic performance with the maximum accuracy of 96.34%.

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Carvalho, Valério S., Miguel R. Picanço, André Volschan, and Daniel C. Bezerra. "Impact of simulation training on a telestroke network." International Journal of Stroke 14, no. 5 (July 24, 2018): 500–507. http://dx.doi.org/10.1177/1747493018791030.

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Background Stroke is a leading cause of morbidity and mortality in Brazil, where there are significant imbalances in access to specialized stroke care. Telemedicine networks allow patients to receive neurological evaluation and intravenous thrombolysis in underserved areas, where performance measures are challenging. Aims To describe the impact caused by adequate stroke care training, using realistic simulation, in a developing country telestroke network. Methods Retrospective observational study comparing the number of all stroke diagnoses, thrombolysis rate, door-to-needle time and symptomatic intracranial hemorrhage after intravenous thrombolysis, during one year providing just algorithms and orientation in stroke care to spoke facilities (phase 1), with the results achieved along one year after the beginning of ongoing live training sessions (phase 2). Results The mean number of patients diagnosed with stroke increased from 7.5 to 16.58 per month ( P = 0.019) rising from 90 patients during phase 1 to 199 in phase 2. There was a reduction in the mean door-to-needle time from 137.1 to 95.5 min (−41.58; 95% CI −62.77 to −20.40). The thrombolysis and symptomatic intracranial hemorrhage rates had a non-significant decrease from 21.31% to 18.18% (OR 0.82; 95% CI 0.39 to 1.71) and 12.5% to 7.69% (OR 0.58; 95% CI 0.046 to 7.425), respectively. Conclusions Realistic simulation stroke care training provided by stroke centers to spoke facilities seems to significantly reduce door-to-needle time and enhance adherence in a telestroke network.

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Zhang, Yanling, Jinyan Hu, Lingling Li, and Yunpeng Zhao. "Application of Computer-Based Simulation Teaching Combined with PBL in Colorectal Tumor Hemorrhage." Emergency Medicine International 2022 (September 9, 2022): 1–10. http://dx.doi.org/10.1155/2022/1251388.

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Objective. This paper aims to explore the use of computer-based simulation teaching combined with PBL in colorectal tumor bleeding. Methods. The outpatient department organized 21 nursing staffs to conduct computer simulation combined with PBL teaching, compared emergency theory and skill scores, and investigated the recognition of computer simulation teaching combined with PBL. Results. The scores of theoretical knowledge examination before training were (84.31 ± 6.39) and (92.59 ± 2.93) after training; the scores of treatment skills examination were (85.69 ± 6.15) and (95.43 ± 2.88) after training; the scores of comprehensive treatment skills before training were (76.6 ± 6.31) and (91.43 ± 2.3) after training. The results of the questionnaires showed that the nurses were more agreeable to the new teaching methods and were able to complete the tasks in strict accordance with the requirements, ultimately achieving a level of satisfaction with their progress. Conclusion. Computer simulation teaching combined with PBL can deepen general practitioners’ understanding of knowledge, improve practical ability, and provide a clinical basis for improving patient resuscitation in specialized oncology hospitals.

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Lapcharoensap, Wannasiri, Allison Cong, Jules Sherman, Doug Schwandt, Susan Crowe, Kay Daniels, and Henry C. Lee. "Safety and Ergonomic Challenges of Ventilating a Premature Infant During Delayed Cord Clamping." Children 6, no. 4 (April 13, 2019): 59. http://dx.doi.org/10.3390/children6040059.

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Delayed cord clamping (DCC) is endorsed by multiple professional organizations for both term and preterm infants. In preterm infants, DCC has been shown to reduce intraventricular hemorrhage, lower incidence of necrotizing enterocolitis, and reduce the need for transfusions. Furthermore, in preterm animal models, ventilation during DCC leads to improved hemodynamics. While providing ventilation and continuous positive airway pressure (CPAP) during DCC may benefit infants, the logistics of performing such a maneuver can be complicated. In this simulation-based study, we sought to explore attitudes of providers along with the safety and ergonomic challenges involved with safely resuscitating a newborn infant while attached to the placenta. Multidisciplinary workshops were held simulating vaginal and Caesarean deliveries, during which providers started positive pressure ventilation and transitioned to holding CPAP on a preterm manikin. Review of videos identified 5 themes of concerns: sterility, equipment, mobility, space and workflow, and communication. In this study, simulation was a key methodology for safe identification of various safety and ergonomic issues related to implementation of ventilation during DCC. Centers interested in implementing DCC with ventilation are encouraged to form multidisciplinary work groups and utilize simulations prior to performing care on infants.

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Lampe, Renée, Varvara Turova, Tobias Blumenstein, and Ana Alves-Pinto. "Towards simulation of germinal matrix hemorrhage as a complication of premature birth." Open Journal of Obstetrics and Gynecology 03, no. 09 (2013): 61–63. http://dx.doi.org/10.4236/ojog.2013.39a008.

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Ings, Jeanne L. "Simulation Education to Enhance Nurse Knowledge and Improve Response to Postpartum Hemorrhage." Journal of Obstetric, Gynecologic & Neonatal Nursing 46, no. 3 (June 2017): S17. http://dx.doi.org/10.1016/j.jogn.2017.04.028.

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Marcus, Jessica, and Jacqueline Bempah. "Use of Quick Response Codes for Postpartum Hemorrhage Simulation in Nursing Education." Journal of Obstetric, Gynecologic & Neonatal Nursing 48, no. 3 (June 2019): S57. http://dx.doi.org/10.1016/j.jogn.2019.04.098.

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Kikura, Mutsuhito, Junko Nishino, and Masahiro Uraoka. "Clinical Simulation Model of Fibrinogen Decline During Hemorrhage in Major Noncardiac Surgery." Journal of Surgical Research 261 (May 2021): 43–50. http://dx.doi.org/10.1016/j.jss.2020.12.008.

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Al-Saeed, Tarek A. "Modeling of fundus imaging distortion under vitreous hemorrhage by Monte Carlo simulation." Optik 207 (April 2020): 163872. http://dx.doi.org/10.1016/j.ijleo.2019.163872.

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Al-Saeed, Tarek A., and Sayed Y. El-Zaiat. "Modeling of vision loss due to vitreous hemorrhage by Monte Carlo simulation." Journal of Biomedical Optics 19, no. 8 (August 28, 2014): 085009. http://dx.doi.org/10.1117/1.jbo.19.8.085009.

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de Melo, Brena Carvalho Pinto, Ana Rodrigues Falbo, Jette Led Sorensen, Jeroen J. G. van Merriënboer, and Cees van der Vleuten. "Self-perceived long-term transfer of learning after postpartum hemorrhage simulation training." International Journal of Gynecology & Obstetrics 141, no. 2 (February 6, 2018): 261–67. http://dx.doi.org/10.1002/ijgo.12442.

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He, Ling Na, and Jian Wei Pan. "The Construction of Cerebrovascular Model and Numerical Simulation." Advanced Materials Research 562-564 (August 2012): 1382–85. http://dx.doi.org/10.4028/www.scientific.net/amr.562-564.1382.

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Medical image reconstruction technique has been an important research topic. Based on cerebrovascular CT image of actual victims, through extracting the contour of image, dividing the nodes and defining boundary, the paper reconstructed 2D grid model of blood vessel of brain. Using the finite element method to simulate and analyze the dynamics features of the medical image mesh model. Through experiment, the paper mainly compared the value of blood velocity and dynamics pressure, and analyzed the difference of hemodynamic parameters in different models. Finally, It found that the model I artery more easily alter form and induce arterial hemorrhage. This will provide the theoretical basis for analyzing the mechanism of Cerebrovascular diseases.

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Davuluri, Pavani, Jie Wu, Yang Tang, Charles H. Cockrell, Kevin R. Ward, Kayvan Najarian, and Rosalyn H. Hargraves. "Hemorrhage Detection and Segmentation in Traumatic Pelvic Injuries." Computational and Mathematical Methods in Medicine 2012 (2012): 1–12. http://dx.doi.org/10.1155/2012/898430.

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Automated hemorrhage detection and segmentation in traumatic pelvic injuries is vital for fast and accurate treatment decision making. Hemorrhage is the main cause of deaths in patients within first 24 hours after the injury. It is very time consuming for physicians to analyze all Computed Tomography (CT) images manually. As time is crucial in emergence medicine, analyzing medical images manually delays the decision-making process. Automated hemorrhage detection and segmentation can significantly help physicians to analyze these images and make fast and accurate decisions. Hemorrhage segmentation is a crucial step in the accurate diagnosis and treatment decision-making process. This paper presents a novel rule-based hemorrhage segmentation technique that utilizes pelvic anatomical information to segment hemorrhage accurately. An evaluation measure is used to quantify the accuracy of hemorrhage segmentation. The results show that the proposed method is able to segment hemorrhage very well, and the results are promising.

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Wang, Changbin, Zudong Yin, Xinyi Zhang, and Xiumin Zhao. "Clinical Significance of Hyperdense Lesions on Non-enhanced Brain CT Obtained Immediately after Arterial Revascularization in Acute Ischemic Stroke Patients." Computational and Mathematical Methods in Medicine 2021 (September 3, 2021): 1–8. http://dx.doi.org/10.1155/2021/1562502.

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Purpose. To analyze the characteristics of hyperdense lesions on brain CT conducted immediately after arterial revascularization (AR) in patients with acute ischemic stroke (AIS), track the outcome of those lesions and investigate their clinical significance. Materials and Methods. 97 AIS patients were enrolled in our study. Among them, 52 patients showed hyperdense lesions and were divided into three categories: type I, type II and type III according to the morphologic characteristics of hyperdense lesions. All patients underwent several follow-up CT/MR examinations to visualize the outcomes of the lesions. Results. Among the 52 patients, 22 showed contrast extravasation, 23 displayed contrast extravasation combined with hemorrhagic transformation (HT) and 7 confirmed symptomatic intracranial hemorrhage (SICH) in follow-up CT/MR. Among the without hyperdense lesions group, only 7 converted to hemorrhage, and no SICH occurred. All type I lesions showed contrast extravasation; 23 type II lesions turned to hemorrhage, 2 revealed SICH and 6 were pure contrast extravasation; all of the type III developed into SICH. Conclusion. Hyperdense lesions on non-enhanced brain CT obtained immediately after arterial revascularization (AR) exhibited varying features. Type I indicated a pure contrast extravasation. Type II and type III hyperdense lesions suggested higher incidence of HT, the presence of type III lesions indicated an ominous outcome.

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Barré, Jessy, Daphné Michelet, Anais Job, Jennifer Truchot, Philippe Cabon, Catherine Delgoulet, and Antoine Tesnière. "Does Repeated Exposure to Critical Situations in a Screen-Based Simulation Improve the Self-Assessment of Non-Technical Skills in Postpartum Hemorrhage Management?" Simulation & Gaming 50, no. 2 (February 20, 2019): 102–23. http://dx.doi.org/10.1177/1046878119827324.

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Background. Postpartum hemorrhage (PPH) is the leading cause of maternal death in the world. Non-technical skills (e.g. communication) are now recognized as a contributing factor to medical safety. In the field of simulation, screen-based simulations are currently very popular with computer/technological development. This study evaluates a screen-based simulation device, PerinatSims, developed to improve technical and non-technical skills in PPH situation. This experiment hypothesized that exposure and repetition of training with PerinatSims would improve the self-assessment of non-technical skills, and therefore increase the ability to manage PPH. Methods. The primary endpoint was a self-assessment of non-technical skills during simulation session of PPH on a digital simulator. Twenty French midwives performed three of nine 25 minutes sessions of PPH screen-based simulation. Four self-assessment questionnaires were administered at the end of each simulation session: a leadership/team working questionnaire (BAT), a negative feelings/emotional questionnaire (DASS-21), a Flow questionnaire and a mental load questionnaire (NASA-TLX). Results between sessions were compared using a repeated measures ANOVA followed by a Bonferroni post hoc test. Results. The study showed a positive evolution during the three screen-based simulation sessions: an increase of leadership and team working self-assessment, an increase of Flow sense, and a decrease of negative emotions (anxiety and depression in the DASS-21 score). Significant decrease of stress was found only between the second and the third sessions, and significant differences in the NASA-TLX were observed only in two dimensions, Performance and Frustration. Conclusion. A repeated exposure to PPH situations with a screen-based simulation tool improved the midwives’ self-assessment, especially for leadership, team working, emotion management and Flow sense. Furthermore, midwives had a very positive feedback on the device. They highlighted the desire to use PerinatSims more often to be trained to PPH management, for technical as well as non-technical skills.

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Pergakis, Melissa B., Wan-Tsu W. Chang, Ali Tabatabai, Michael S. Phipps, Benjamin Neustein, Jamie E. Podell, Gunjan Parikh, et al. "Simulation-Based Assessment of Graduate Neurology Trainees' Performance Managing Acute Ischemic Stroke." Neurology 97, no. 24 (October 27, 2021): e2414-e2422. http://dx.doi.org/10.1212/wnl.0000000000012972.

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Background and ObjectivesMultidisciplinary acute stroke teams improve acute ischemic stroke management but may hinder trainees' education, which in turn may contribute to poorer outcomes in community hospitals on graduation. Our goal was to assess graduate neurology trainee performance independently of a multidisciplinary stroke team in the management of acute ischemic stroke, tissue plasminogen activator (tPA)–related hemorrhage, and cerebral herniation syndrome.MethodsIn this prospective, observational, single-center simulation-based study, participants (subinterns to attending physicians) managed a patient with acute ischemic stroke followed by tPA-related hemorrhagic conversion leading to cerebral herniation. Critical actions were developed by a modified Delphi approach based on relevant American Heart Association guidelines and the Neurocritical Care Society's Emergency Neurologic Life Support protocols. The primary outcome measure was graduate neurology trainees' critical action item sum score. We sought validity evidence to support our findings by comparing performance across 4 levels of training.ResultsFifty-three trainees (including 31 graduate neurology trainees) and 5 attending physicians completed the simulation. The mean sum of critical actions completed by graduate neurology trainees was 15 of 22 (68%). Ninety percent of graduate neurology trainees properly administered tPA; 84% immediately stopped tPA infusion after patient deterioration; but only 55% reversed tPA according to guidelines. There was a moderately strong effect of level of training on critical action sum score (level 1 mean [SD] score 7.2 [2.8] vs level 2 mean [SD] score 12.3 [2.6] vs level 3 mean [SD] score 13.3 [2.2] vs level 4 mean [SD] score 16.3 [2.4], p < 0.001, R2 = 0.54).DiscussionGraduate neurology trainees reassuringly perform well in initial management of acute ischemic stroke but frequently make errors in the treatment of hemorrhagic transformation after thrombolysis, suggesting the need for more education surrounding this low-frequency, high-acuity event. High-fidelity simulation holds promise as an assessment tool for acute stroke management performance.

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Levit, Elizabeth, and Emily K. Marko. "Improving Postpartum Hemorrhage Outcomes With Team-Based Simulation of Operating Room Transfers [A339]." Obstetrics & Gynecology 139, no. 1 (May 2022): 98S. http://dx.doi.org/10.1097/01.aog.0000825472.30484.01.

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Lutgendorf, Monica A., Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O. Heaton, and Kristina V. Morocco. "Multidisciplinary In Situ Simulation-Based Training as a Postpartum Hemorrhage Quality Improvement Project." Military Medicine 182, no. 3 (March 2017): e1762-e1766. http://dx.doi.org/10.7205/milmed-d-16-00030.

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Kato, Chiho, and Yaeko Kataoka. "Simulation training program for midwives to manage postpartum hemorrhage: A randomized controlled trial." Nurse Education Today 51 (April 2017): 88–95. http://dx.doi.org/10.1016/j.nedt.2017.01.005.

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Deering, Shad, Michael Chinn, Jonathan Hodor, Thomas Benedetti, Peter Nielsen, and Barbara Goff. "Validation and Testing of A Postpartum Hemorrhage Simulator." Simulation In Healthcare: The Journal of the Society for Simulation in Healthcare 2, no. 1 (2007): 80. http://dx.doi.org/10.1097/01266021-200700210-00077.

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Stief, Thomas W. "In Vitro Simulation of Extremely Activated Thrombolysis." Clinical and Applied Thrombosis/Hemostasis 14, no. 2 (April 2008): 238–40. http://dx.doi.org/10.1177/1076029607308038.

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A life-threatening thrombus in massive pulmonary embolism has to be eliminated within minutes. Extremely activated plasmatic fibrinolysis destroys such thrombi in time: 50 µL plasma clots were incubated with urokinase or tissue-type plasminogen activator and 50 µL pooled normal plasma. The microtiter plate clot lysis assay was performed. The time point at which 50% of the clot has been lysed is 4 minutes for 8333 IU/mL urokinase or an equimolar concentration of tissue-type plasminogen activator (52498 IU/mL = 105 µg/mL). The effective dose 50% at 5 minutes lysis time is about 800 nM (4320 IU/mL) urokinase or (27220 IU/mL = 54 µg/mL) tissue-type plasminogen activator. Addition of plasminogen to the plasmatic clot supernatant improves thrombolysis if 65 IU/mL of urokinase acts for 10 minutes. The risk for severe intracranial hemorrhage in massive thrombolysis might be much lower than the lethality of a massive pulmonary embolism. Extremely activated plasmatic thrombolysis could be clinically indicated.

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Yang, Qian, Yuedong Yang, and Xiaoting Li. "Related Factors of Cerebral Hemorrhage after Cerebral Infarction and the Effect of Atorvastatin Combined with Intensive Nursing Care." Computational and Mathematical Methods in Medicine 2022 (July 31, 2022): 1–7. http://dx.doi.org/10.1155/2022/9546006.

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Background. Cerebral infarction is a common neurological disease with high incidence, which is the main factor causing death and disability in adults in China. Cerebral hemorrhage transformation is a common clinical complication. High NIHSS score at admission, atrial fibrillation, and small artery occlusion cerebral infarction can increase the risk of cerebral infarction complicated with hemorrhage transformation. Aim. To explore the related factors of cerebral hemorrhage transformation after cerebral infarction and the value of atorvastatin calcium tablets combined with early intensive care measures. Methods. In this study, a case-control study was conducted. Sixty patients with hemorrhagic transformation after cerebral infarction admitted to the Department of Neurology of our hospital from January 2017 to June 2021 were selected as the observation group, and 90 patients with cerebral infarction without hemorrhagic transformation during the same period were selected as the control group. The risk factors of hemorrhagic transformation after cerebral infarction were analyzed. Results. The results of logistic regression model showed that the increased National Institutes of Health Stroke Scale (NIHSS) score at admission, hypertension, atrial fibrillation, TOAST classification of small artery occlusion, and large infarction lesions were the risk factors for hemorrhagic transformation in patients with cerebral infarction ( P < 0.05 ). After 2 weeks and 4 weeks of treatment, the NIHSS scores of the intervention group were lower than those of the conventional group ( P < 0.05 ). NIHSS scores of the two groups after treatment were significantly lower than those before treatment ( P < 0.05 ). After three months of treatment, the patients in the intervention group with GOS score of 5 points accounted for 16.67%, and the patients with GOS score of 4 points accounted for 56.67%. The patients in the conventional group with GOS score of 5 points accounted for 6.67%, and the patients with GOS score of 4 points accounted for 33.33%. The prognosis of the intervention group was better than that of the conventional group on the whole ( P < 0.05 ). Conclusion. Patients with hypertension, large infarction lesions, high NIHSS score at admission, atrial fibrillation, and small artery occlusion cerebral infarction can increase the risk of bleeding transformation in patients with cerebral infarction. For patients with bleeding transformation, atorvastatin calcium tablets combined with early intensive nursing intervention has a certain value for improving the prognosis of patients.

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Ghosh, Rakesh, Susanna Cohen, Hilary Spindler, Divya Vincent, Mona Sterling, Aritra Das, Aboli Gore, Tanmay Mahapatra, and Dilys Walker. "Simulation and nurse-mentoring in a statewide nurse mentoring program in Bihar, India: diagnosis of postpartum hemorrhage and intrapartum asphyxia." Gates Open Research 6 (June 13, 2022): 70. http://dx.doi.org/10.12688/gatesopenres.13490.1.

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Background: Mentoring programs that include simulation, bedside mentoring, and didactic components are becoming increasingly popular to improve quality. These programs are designed with little evidence to inform the optimal composition of mentoring activities that would yield the greatest impact on provider skills and patient outcomes. We examined the association of number of maternal and neonatal emergency simulations performed in trainings with the diagnosis of postpartum hemorrhage (PPH) and intrapartum asphyxia in real patients. Methods: We used a prospective cohort and births were compared between- and within-facility over time. Setting included 320 public facilities in the state of Bihar, India May 2015 – 2017. The participants were Deliveries and livebirths. The interventions carried out were mobile nurse-mentoring program with simulations, teamwork and communication activities, didactic teaching, demonstrations of clinical procedures and bedside mentoring including conducting deliveries. Nurse mentor pairs visited each facility for one week, covering four facilities over a four-week period, for seven to nine consecutive months. The outcome measures were diagnosis of PPH and intrapartum asphyxia. Results: Relative to the bottom one-third facilities that performed the fewest maternal simulations, facilities in the middle one-third group diagnosed 26% (incidence rate ratio [IRR] = 1.26, 95% confidence interval [CI]: 1.00, 1.59) more cases of PPH in real patients. Similarly, facilities in the middle one-third group, diagnosed 25% (IRR = 1.25, 95% CI: 1.04, 1.50) more cases of intrapartum asphyxia relative to the bottom third group that did the fewest neonatal simulations. Facilities in the top one-third group (i.e., performed the most simulations) did not have a significant difference in diagnosis relative the bottom one-third group. Conclusions: Findings suggest a complex relationship between performing simulations and opportunities for direct practice with patients, and there may be an optimal balance in performing the two that would maximize diagnosis of PPH and intrapartum asphyxia.

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