The Role of Technology Advancement in Improving the Current Practice of Ambulance Decontamination in Malaysia: A Scoping Review

Abstract In Malaysia, the current methodology for decontaminating ambulances is by manually cleaning surfaces with Environmental Protection Agency (EPA) approved disinfecting solutions as contrast to previous practice using water and soap. The solutions used are registered with National Pharmaceutical Regulatory Agency (NPRA) Ministry of Health Malaysia (NPRA) to ensure adherence to international standard of practice.  The manual decontamination practices are effective if strictly conducted following guidelines. However, the proper cleaning and decontamination of an ambulance is an important task that frequently overlooked. It creates a risk to healthcare providers and their patients for subsequent ambulance trip. To ensure the patient compartment is absent from multitudes of infectious pathogen especially Covid-19, is not only an escalating challenge for healthcare providers as it is an unseen, but also poses a real threat to them and their patient. The healthcare managers should consider technologies that can provide a safer, effective and more efficient cleaning and decontamination of an ambulances. We proposed to adapt a new approach of decontamination by using a vapour based disinfection method coupled with germicidal enhancement using ultra violet. It utilizes an EPA-approved hospital disinfectant to decontaminate surfaces in the patient care compartment after every patient transport. A nozzle, placed inside the patient care compartment, disperses a mist of disinfectant solution that designed to meet standard requirement. The enhancement of germicidal effect using an ultra violet ray will disinfect and ensure a free patient compartment from an infectious organism. This decontamination system directly integrated into a new or existing ambulance. It is convenient, timesaving, hands-off solution for decontaminating of an ambulance and importantly creates a safer practice. Keywords: Ambulance service, decontamination, Vapour-based, safe practice

A Narrative Review on Disinfection Tunnel for Covid-19: A Friend or Foe?

Abstract T The use of a disinfection tunnel has become increasingly popular to eliminate the Covid-19 on the body particularly during the pandemic, however insufficient attention paid to its effectiveness and safety. We undertake a narrative review on the disinfection tunnel and evaluate their effectiveness and safety. The keyword searches of Medline, EMBASE, PubMed, EBM reviews database and manual searches of Google Scholar and US Food and Drug Administration (USFDA) was used. An analysis of the papers reviewed were categorized into three main themes: technical design of disinfection tunnel; effectiveness of disinfectant used; and safety or harmful effect. To date, no relevant specific scientific studies or evidence retrieved about disinfection tunnel for public usage including effectiveness and safety. We found a various designs of disinfection in the market today. It mainly originated from an innovative idea to assist in limiting the spread of Covid-19. However, current available evidence does not support its effectiveness and safety. Although it may lead to a false sense of security, this potential approach appears attractive thus creates an opportunity for further research

A Potentially Disastrous Life -Threatening Complication of Emergency Tube Thoracostomy in A Simple Case of Spontaneous Pneumothorax

Emergency tube thoracostomy carries risks of infective and technical complications. The aseptic technique is essential to prevent infections, while blunt dissection method can minimise the associated technical complications. Preparation and adherence to protocols as well as appropriate knowledge and skills, however, are of utmost importance to reduce risks of complications. Physicians must have adequate knowledge of anatomy and the procedure to ensure for accurate site tube placement without any complication. This case illustrates how a failure to appropriately use the instrument resulted in a displaced scalpel blade inside the thoracic cavity. It caused an unnecessary thoracotomy for blade retrieval. The mishap escalated a simple procedure to the potentially disastrous life-threatening event

Tualang honey supplementation as cognitive enhancer in patients with schizophrenia

Schizophrenia is a chronic mental illness with major clusters of symptoms, including positive symptoms, negative symptoms and cognitive impairment. It is debilitating and common. It occurs in approximately 1% or nearly 21 millions of world population (WHO, 2018). Locally, the National Mental Health Registry (NMHR) at the Ministry of Health Malaysia reported an incidence rate of between 7.3 to 43.0 per 100 000 population (Malaysia, 2005). A weakening in at least one of the cognitive function domain occurred in 80% of schizophrenia patients (R. S. E. Keefe and Fenton, 2007) and cognitive impairment is a core feature. Cognitive impairment is both predictive for functional outcomes and a treatment target (Green et al., 2004)

The Beautiful Mind : A Case Report

Caring for a family member diagnosed with schizophrenia will not only impart a lifetime of emotional distress but also social and financial challenges. Failure to anticipate and cope with the burden of care responsibilities will add unnecessary risk to permanent injury resulting in substandard management of the patient and even death. We describe a case of successful removal of nine (9) constricting rings from the finger of both hands in a poorly taken care of an abusive relapse schizophrenia patient using an oscillating saw and ring cutter under procedural sedation combined with wrist block in the emergency department (ED). Early recognition and definitive treatment are of paramount importance to avoid irreversible ischemia and gangrene. The possible risk of negligence should be kept in mind bearing a link with depression among members caring for schizophrenia. Keywords: Schizophrenia, Emergency Department, Negligence, Early recognitio

A case report: The beautiful mind

Caring for a family member diagnosed with schizophrenia will not only impart a lifetime emotional distress but also social and financial challenge. Failure to anticipate and cope with the burden of care responsibilities will add an unnecessary risk to permanent injury resulting in a substandard management of the patient and even death. We describe a case of successful removal of nine (9) constricting rings from the finger of both hands in a poorly taken care of an abusive relapse schizophrenia patient using an oscillating saw and ring cutter under prosedural sedation combined with wrist block in emergency department (ED). Early recognition and a definitive treatment are of paramount importance in order to avoid irreversible ischemia and gangrene. The possible risk of negligence should be kept in mind bearing a link with depression among members caring for schizophrenia