Fire in the Operating Room During Hypospadias Repair

Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery

Understanding Stress In The Operating Room: A Step Toward Improving The Work Environment

Job-related stress is an important factor predicting staff satisfaction and position turnover among nursing staff, particularly in the operating room. The purpose of this study was to examine the perceived amount of stress elicited by events in the perioperative environment, the frequency of those events, and the impact of those events on the perceived stress of operating room nurses (ORNs) and operating room technologists (ORTs). The Survey on Stress in the OR instrument, which was used to query the subjects, exhibited high internal consistency of all items. The findings indicated that the ORNs and the ORTs exhibited remarkable similarities between stressful events perceived as high and low impact. The two groups agreed that the highest impact stressful event was pressure to work more quickly. Using the results of this study, OR administrators may be able to redesign the OR environment to minimize the impact of stressful events and thereby improve job satisfaction and minimize nursing staff turnover

Liquid cryogenic lubricant

Fluorinated polyethers are suitable lubricants for rolling-element bearings in cryogenic systems. Lubrication effectiveness is comparable to that of super-refined mineral oil lubricants operating at room temperature

Emergency Undocking Curriculum in Robotic Surgery

Introduction Traditional instruction for robotic surgery is typically devoid of training that addresses the delineation of interprofessional roles for operating room personnel. An emergency undocking scenario was developed for robotic surgeons with the objectives of improving time to access the patient, provider knowledge of and confidence in emergency undocking, completion of predetermined critical actions, and delineation of operating room personnel roles. Methods Over one month, participants joined in three sessions: Session 1 - formative, Session 2 - review, and Session 3 - summative. Embedded standardized participants (ESPs) represented members of the interprofessional team. Prior to entering the operating room for Sessions 1 and 3, trainees were asked to complete a confidence survey and multiple choice questionnaire (MCQ) for knowledge assessment. Participants were randomized to one of two cases and participated in the reciprocal case for the final session four weeks later. Following Session 1, participants underwent an educational intervention, including the proper technique for emergency undocking, emphasis on operating room personnel roles, and hands-on practice. Obstetrics and Gynecology (OBGYN) residents in post-graduate Years 2-4 and attending physicians with robotics privileges at Summa Health Akron Campus or Cleveland Clinic Akron General Medical Center were invited to participate. A total of 21 participants enrolled and finished the study. Results Among the 21 participants, there was a significant increase in the baseline level of knowledge (p-value=0.001) and in the confidence of surgeons when faced with an emergency undocking after the completion of our curriculum (p-value=0.003). Additionally, an improvement in the undocking times (p-value<0.001) and an increase in the critical actions performed (p-value=0.002) were observed. Conclusion The results of this study demonstrate that incorporating this curriculum into the training programs of robotic surgeons is an effective way to improve the surgical skill of emergency undocking

Articulated Clinician Detection Using 3D Pictorial Structures on RGB-D Data

Reliable human pose estimation (HPE) is essential to many clinical applications, such as surgical workflow analysis, radiation safety monitoring and human-robot cooperation. Proposed methods for the operating room (OR) rely either on foreground estimation using a multi-camera system, which is a challenge in real ORs due to color similarities and frequent illumination changes, or on wearable sensors or markers, which are invasive and therefore difficult to introduce in the room. Instead, we propose a novel approach based on Pictorial Structures (PS) and on RGB-D data, which can be easily deployed in real ORs. We extend the PS framework in two ways. First, we build robust and discriminative part detectors using both color and depth images. We also present a novel descriptor for depth images, called histogram of depth differences (HDD). Second, we extend PS to 3D by proposing 3D pairwise constraints and a new method that makes exact inference tractable. Our approach is evaluated for pose estimation and clinician detection on a challenging RGB-D dataset recorded in a busy operating room during live surgeries. We conduct series of experiments to study the different part detectors in conjunction with the various 2D or 3D pairwise constraints. Our comparisons demonstrate that 3D PS with RGB-D part detectors significantly improves the results in a visually challenging operating environment.Comment: The supplementary video is available at https://youtu.be/iabbGSqRSg

Sub-picotesla widely tunable atomic magnetometer operating at room-temperature in unshielded environments

We report on a single-channel rubidium radio-frequency atomic magnetometer operating in un-shielded environments and near room temperature with a measured sensitivity of 130 fT/\sqrt{Hz}. We demonstrate consistent, narrow-bandwidth operation across the kHz - MHz band, corresponding to three orders of magnitude of magnetic field amplitude. A compensation coil system controlled by a feedback loop actively and automatically stabilizes the magnetic field around the sensor. We measure a reduction of the 50 Hz noise contribution by an order of magnitude. The small effective sensor volume, 57 mm^3, increases the spatial resolution of the measurements. Low temperature operation, without any magnetic shielding, coupled with the broad tunability, and low beam power, dramatically extends the range of potential field applications for our device.Comment: Main text: 6 pages, 9 figures. Supplementary material: 3 pages, 3 figures. Published version can be found at https://aip.scitation.org/doi/full/10.1063/1.5026769 . V2: Added journal layout, minor typos fixed. Content unchange

Modeling and Experimental Investigation of Laminar Ceiling Air Distribution System for Operating Room in Merjan Teaching Hospital

Room air distribution in operating rooms is critical to successful surgical treatment. The present study investigated the effects of the location of the air supply and exhaust grills on the air movement and air parameters inside an operating room. This paper presents an experimental and numerical analysis of air distribution in the operating room. The experimental work was conducted in an operating room in Merjan Teaching Hospital in the city of Babylon. Air was supplied from one square plenum box located in the middle of the ceiling, while air was exhausted through eight grills: large exhaust grills in the four upper corners and small exhaust grills in the four lower corners. In the theoretical work, a model of the operating room was developed and two cases were analyzed using the FLUEN 6.3.26 software program. The first case included all eight exhaust grills, while the second case included only the four lower exhaust grills. The ceiling system gave good ventilation for air distribution inside the operating room. There was no clear effect of the small exhaust grills located in the upper corners of the operating room. The height of the ceiling room is an effective factor in air distribution

Air handling system optimisation

Often each floor of a building has an air handling system consisting of a plant room, ducting and equipment such as fans and heaters. The cost of the system consists of the capital cost of the equipment and the operating cost to satisfy the thermal loads. An efficient method is required for evaluating the operating costs when the configuration of the system is specified and the thermal loads are known. The operating cost of a particular configuration are obtained by solving a nonlinear program. The method is efficient since it consists of solving a sequence of single period models