The telecom industry is moving towards a "greener" supply chain for manufacturing. As part of this greening, more emphasis is being placed on logistics management, remanufacturing and recycling of e-waste. There has been much publicity concerning the environmental benefits of remanufacturing electronic equipment and reselling it to customers in lieu of manufacturing new like-kind equipment. This paper will provide an assessment of the environmental benefits associated with remanufacturing network telecommunications equipment by employing lifecycle assessment (LCA) methodology and commercially available LCA software / database information on these products. The results will demonstrate the significant environmental benefits of remanufacturing network telecommunications equipment as an "eco-sustainable" alternative to manufacturing new equipment.
Extubation of appropriate patients in the emergency department (ED) may be a strategy to avoid preventable or short-stay intensive care unit (ICU) admissions, and could allow for increased ventilator and ICU bed availability when demand outweighs supply. Extubation is infrequently performed in the ED, and a paucity of outcome data exists. Our objective was to descriptively analyze characteristics and outcomes of patients extubated in an ED-ICU setting. Methods: We conducted a retrospective observational study at an academic medical center in the United States. Adult ED patients extubated in the ED-ICU from 2015-2019 were retrospectively included and analyzed. Results: We identified 202 patients extubated in the ED-ICU; 42% were female and median age was 60.86 years. Locations of endotracheal intubation included the ED (68.3%), outside hospital ED (23.8%), and emergency medical services/prehospital (7.9%). Intubations were performed for airway protection (30.2%), esophagogastroduodenoscopy (27.7%), intoxication/ingestion (17.3%), respiratory failure (13.9%), seizure (7.4%), and other (3.5%). The median interval from ED arrival to extubation was 9.0 hours (interquartile range 6.2-13.6). One patient (0.5%) required unplanned re-intubation within 24 hours of extubation. The attending emergency physician (EP) at the time of extubation was not critical care fellowship trained in the majority (55.9%) of cases. Sixty patients (29.7%) were extubated compassionately; 80% of these died in the ED-ICU, 18.3% were admitted to medical-surgical units, and 1.7% were admitted to intensive care. Of the remaining patients extubated in the ED-ICU (n = 142, 70.3%), zero died in the ED-ICU, 61.3% were admitted to medical-surgical units, 9.9% were admitted to intensive care, and 28.2% were discharged home from the ED-ICU. Conclusion: Select ED patients were safely extubated in an ED-ICU by EPs. Only 7.4% required ICU admission, whereas if ED extubation had not been pursued most or all patients would have required ICU admission. Extubation by EPs of appropriately screened patients may help decrease ICU utilization, including when demand for ventilators or ICU beds is greater than supply. Future research is needed to prospectively study patients appropriate for ED extubation.
As the information and communications technology (ICT) packaging: a novel Static Intercept* bag which is recyclable, offers 20 years of corrosion protection in Class 2 environments, and has permanent ESD protection; and traditional metalized shield bags, a common packaging option that is not recyclable (due to its aluminum content), must be landfilled, and offers time-limited ESD protection. The analysis was performed on the basis of several environmental impact criteria (e.g., greenhouse gas [GHG] emissions) in order to assess an overall "greener" and reliable solution due to packaging.The Static Intercept bag consists of a novel blend of polymers covalently bonded with a complementary
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