Conventional emergency front of neck airway training manikins mimic slim patients and are associated with unrealistic procedural ease. We have described previously a pork belly-modified manikin that more realistically simulated an obese patient's neck. In this study, we compared a novel obese-synthetic manikin (obese-synthetic manikin) with a pork belly-modified manikin (obese-meat manikin) and a conventional slim manikin (slim manikin). Thirty-three experienced anaesthetists undertook simulated emergency front of neck airway procedures on each manikin (total 99 procedures). Time to ventilation was longer on both obese manikins compared with the slim manikin (median (IQR [range]) time to intubation 159 (126-243 [73-647]) s in the obese-synthetic, 105 (72-138 [43-279]) s in the obese-meat and 58 (47-74 [30-370]) s in the slim manikin; p < 0.001 between each manikin). Cricothyroidotomy success rate was similar in the both obese manikins but lower when compared with the slim manikin (15/33 obese-synthetic vs. 14/33 obese-meat vs. 27/33 slim manikin). Participant feedback indicated performance difficulty was similar between both obese manikins, which were both more difficult than the slim manikin. The tissues of the obese-meat manikin were judged more realistic than those of either other manikin. Overall, the obese-synthetic manikin performed broadly similarly to the obese-meat manikin and was technically more difficult than the conventional slim manikin. The novel obese-synthetic manikin maybe useful for training and research in front of neck airway procedures.
Amitriptyline and propranolol are life threatening in overdose. The efficacy of intravenous lipid emulsion (ILE) in tricyclic antidepressant and propranolol overdose is unclear. We report a dramatic response to ILE following pulseless electrical activity arrest due to mixed amitriptyline and propranolol overdose.
peripheral oxygen saturation (SpO 2) before intubation, and patient comfort to the interface. Results are shown as mean (standard deviation, SD) or median (25th percentile; 75th percentile). The average BMI was 40.6 (SD, 3.79) kg m e2. The normalised
This paper presents an investigation work about the bond wire electrical performances, with the aim of designing an integrated time base using the bond wire inductance. Our work was focused on the characterization of single and double gold bond wire, and multi bond wire length for the frequency range from 500 MHz to 5 GHz. A lumped П-model is used for the modeling and the electrical parameters are extracted thanks to the measured S-parameters. A de-embedding procedure is performed to characterize the bond wire. Finally, a structure is proposed to employ the bond wire into an integrated time base.
This paper presents a simple architecture for clock-fault detection in high-speed applications. The overall principle consists in converting a possible error of time to a logic voltage level. When a high voltage level is present at the output, a reliable clock is detected whereas a low voltage level implies a clock error. This detection system is intended for all System-on-Chip such as microcontrollers which use external clock from 4 MHz to 50 MHz. The proposed circuit is realized in CMOS 40 nm process technology. Simulation results prove the suitability of the structure and its integration on silicon is strongly considered by clock error detection in integrated circuits.
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