A coordinated response and collaboration between law enforcement, the local public health, emergency medical services and Health Center staff, were all key interventions in preventing a more substantial public health outbreak resulting from use of a novel synthetic cannabinoid compound. Real time collaborations between toxicology laboratories, suppliers of analytical standards and the public health system may be useful in the face of future novel chemical exposures.
IntroductionUltrasound is a technique that can be utilised to augment procedures to increase their safety and efficacy, but requires that health professionals be trained to use this imaging modality before it can be implemented. With the extremely high cost of manufactured phantoms, homemade alternatives are popular substitutes. Gelatine is commonly used as a matrix to suspend analogues and mimic tissue, but other substrates like ground meat can also be used. Both of these substrates require refrigeration and are subject to spoiling. Our research was designed to evaluate whether agar models would be superior to traditional Gelatine models in their sustainability and whether they would produce ultrasound images adequate for training.MethodsAgar models of varying formulas (percent agar by weight with certain additives varied) were tested for acceptable fidelity to real tissue, ultrasound image quality, and durability compared to gelatine models and human tissue.ResultsA five percent by-mass agar model augmented with small amounts of suspended wheat flour presented as a model that could generate an ultrasound image that remarkably resembled that of real tissue. This agar model does not require refrigeration, is resistant to spoiling and desiccation, mimics tissue texture well, is durable enough to withstand high-volume training, and can be recycled to make new models.ConclusionAgar phantoms are easy to make, do not require refrigeration, and have multiple distinct advantages over gelatine models for ultrasound training in austere conditions.
Objective: To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities. Background: Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers. Methods: We conducted electronic database searches of PubMed and CINAHL through November 2018. Result: Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories. Conclusion: This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.
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