It’s In The Bag: Tidal Volumes in Adult and Pediatric Bag Valve Masks

Introduction: A bag valve mask (BVM) is a life saving device used by all levels of health care professionals during resuscitative care. We focus most of our time optimizing the patient’s position, firmly securing the mask, and frequency of ventilations. However, despite our best efforts to control these factors, we may still be precipitating harm to the patient. Multiple studies have shown the tidal volumes typically delivered by the adult BVM are often higher than recommended for lung-protective ventilation protocols. In this study we measure and compare the ventilation parameters delivered by the adult and pediatric BVM ventilators.Methods: A RespiTrainer Advance® adult mannequin was used to simulate a patient. Healthcare providers were directed to manually ventilate an intubated mannequin for two minutes using adult and pediatric sized BVMs. Tidal volume, minute ventilation, peak pressure, and respiration rate was recorded.Results: The adult BVM provided a mean tidal volume of 807.7mL versus the pediatric BVM providing 630.7mL, both of which exceeded the upper threshold of 560mL of tidal volume necessary for lung protective ventilation of an adult male with an ideal body weight of 70kg. The adult BVM exceeded this threshold by 44.2% versus the pediatric BVM’s 12.6% with 93% of participants exceeding the maximum threshold with the adult BVM and 82.3% exceeding it with the pediatric BVM.Conclusion: The pediatric BVM in our study provided far more consistent and appropriate ventilation parameters for adult patients compared to an adult BVM, but still exceeded the upper limits of lung protective ventilation parameters. The results of this study highlight the potential dangers in using an adult BVM due to increased risk of pulmonary barotrauma. These higher tidal volumes can contribute to lung injury. This study confirms that smaller BVMs may provide safer ventilatory parameters. Future studies should focus on patient-centered outcomes with BVM

Jefferson Digital Commons quarterly report: January-March 2020

This quarterly report includes: New Look for the Jefferson Digital Commons Articles COVID-19 Working Papers Educational Materials From the Archives Grand Rounds and Lectures JeffMD Scholarly Inquiry Abstracts Journals and Newsletters Master of Public Health Capstones Oral Histories Posters and Conference Presentations What People are Saying About the Jefferson the Digital Common

Carbon Free Boston: Buildings Technical Report

Part of a series of reports that includes: Carbon Free Boston: Summary Report; Carbon Free Boston: Social Equity Report; Carbon Free Boston: Technical Summary; Carbon Free Boston: Transportation Technical Report; Carbon Free Boston: Waste Technical Report; Carbon Free Boston: Energy Technical Report; Carbon Free Boston: Offsets Technical Report; Available at http://sites.bu.edu/cfb/OVERVIEW: Boston is known for its historic iconic buildings, from the Paul Revere House in the North End, to City Hall in Government Center, to the Old South Meeting House in Downtown Crossing, to the African Meeting House on Beacon Hill, to 200 Clarendon (the Hancock Tower) in Back Bay, to Abbotsford in Roxbury. In total, there are over 86,000 buildings that comprise more than 647 million square feet of area. Most of these buildings will still be in use in 2050. Floorspace (square footage) is almost evenly split between residential and non-residential uses, but residential buildings account for nearly 80,000 (93 percent) of the 86,000 buildings. Boston’s buildings are used for a diverse range of activities that include homes, offices, hospitals, factories, laboratories, schools, public service, retail, hotels, restaurants, and convention space. Building type strongly influences energy use; for example, restaurants, hospitals, and laboratories have high energy demands compared to other commercial uses. Boston’s building stock is characterized by thousands of turn-of-the-20th century homes and a postWorld War II building boom that expanded both residential buildings and commercial space. Boston is in the midst of another boom in building construction that is transforming neighborhoods across the city. [TRUNCATED]Published versio

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 192

This bibliography lists 247 reports, articles, and other documents introduced into the NASA scientific and technical information system in March 1979

User-centered visual analysis using a hybrid reasoning architecture for intensive care units

One problem pertaining to Intensive Care Unit information systems is that, in some cases, a very dense display of data can result. To ensure the overview and readability of the increasing volumes of data, some special features are required (e.g., data prioritization, clustering, and selection mechanisms) with the application of analytical methods (e.g., temporal data abstraction, principal component analysis, and detection of events). This paper addresses the problem of improving the integration of the visual and analytical methods applied to medical monitoring systems. We present a knowledge- and machine learning-based approach to support the knowledge discovery process with appropriate analytical and visual methods. Its potential benefit to the development of user interfaces for intelligent monitors that can assist with the detection and explanation of new, potentially threatening medical events. The proposed hybrid reasoning architecture provides an interactive graphical user interface to adjust the parameters of the analytical methods based on the users' task at hand. The action sequences performed on the graphical user interface by the user are consolidated in a dynamic knowledge base with specific hybrid reasoning that integrates symbolic and connectionist approaches. These sequences of expert knowledge acquisition can be very efficient for making easier knowledge emergence during a similar experience and positively impact the monitoring of critical situations. The provided graphical user interface incorporating a user-centered visual analysis is exploited to facilitate the natural and effective representation of clinical information for patient care

Toxic Hazards Research Unit annual technical report, 1969 Final report, Jun. 1968 - May 1969

Apollo materials toxicity screening tests and effects of ethylene glycol, monomethylhydrazine, NF3, OF2, and ClF

Characterization of non-intentional emissions from distributed energy resources up to 500 kHz: A case study in Spain

Narrow Band Power Line Communications (NB-PLC) systems are currently used for smart metering and power quality monitoring as a part of the Smart Grid (SG) concept. However, non-intentional emissions generated by the devices connected to the grid may sometimes disturb the communications and isolate metering equipment. Though some research works have been recently developed to characterize these emissions, most of them have been limited to frequencies below 150 kHz and they are mainly focused on in-house electronic appliances and lightning devices. As NB-PLC can also be allocated in higher frequencies up to 500 kHz, there is still a lack of analysis in this frequency range, especially for emissions from Distributed Energy Resources (DERs). The identification and characterization of the emissions is essential to develop solutions that avoid a negative impact on the proper performance of NB-PLC. In this work, the non-intentional emissions of different types of DERs composing a representative microgrid have been measured in the 35–500 kHz frequency range and analyzed both in time and frequency domains. Different working conditions and coupling and commutation procedures to mains are considered in the analysis. Results are then compared to the limits recommended by regulatory bodies for spurious emissions from communication systems in this frequency band, as no specific limits for DERs have been established. Field measurements show clear differences in the characteristics of non-intentional emissions for different devices, working conditions and coupling procedures and for frequencies below and above 150 kHz. Results of this study demonstrate that a further characterization of the potential emissions from the different types of DERs connected to the grid is required in order to guarantee current and future applications based on NB-PLC.This work has been financially supported in part by the Basque Government (Elkartek program)