Equipment and Supplies Commons^™

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Telerehabilitation: An Updated View Of Practices, Cost Analysis, And Client Perceptions, Gokcen Akyurek, Selen Aydoner

Internet Journal of Allied Health Sciences and Practice

Telerehabilitation is an alternative and complementary rehabilitation method in which information and communication technologies are used to remove the distance between healthcare professionals and clients. The COVID-19 pandemic has led to the rapid adoption of telerehabilitation services, limiting the in-person rehabilitation services available all over the world. The restrictions that started with the COVID-19 pandemic also negatively affected rehabilitation services, clients, and healthcare professionals, and it was considered essential to provide services using telerehabilitation technology. Therefore, this review aimed to examine and inform health professionals' telerehabilitation practices such as remote assessment, evaluation, intervention, monitoring, supervision, education, and follow-up during the …

Algorithmic Bias: Causes And Effects On Marginalized Communities, Katrina M. Baha

Undergraduate Honors Theses

Individuals from marginalized backgrounds face different healthcare outcomes due to algorithmic bias in the technological healthcare industry. Algorithmic biases, which are the biases that arise from the set of steps used to solve or analyze a problem, are evident when people from marginalized communities use healthcare technology. For example, many pulse oximeters, which are the medical devices used to measure oxygen saturation in the blood, are not able to accurately read people who have darker skin tones. Thus, people with darker skin tones are not able to receive proper health care due to their pulse oximetry data being inaccurate. This …

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

Redesigning Nasogastric Feeding Tubes To Prevent Dislodgement, Sydney Ruth Rester, Shelby Lynn Berry

Honors Theses

Seniors at the University of Mississippi studying biomedical engineering complete a senior project that seeks to solve a problem in healthcare. Our team, composed of Sydney Rester, Shelby Berry, Andrew Ulmer, and Alex Bromley, sought to improve care associated with nasogastric feeding tubes. We identified two major problems: clogging and tube dislodgement. To address the problem of dislodgement, the team crafted a new feeding tube design with a balloon attachment. The attachment prevents a patient from pulling the feeding tube out and keeps the tube from dislodging due to normal patient movement. We further determined that our tube should be …

Redesigning Nasogastric Feeding Tubes To Prevent Dislodgement, Shelby Lynn Berry, Sydney Ruth Rester

Honors Theses

Seniors at the University of Mississippi studying biomedical engineering complete a senior project that seeks to solve a problem in healthcare. Our team, composed of Sydney Rester, Shelby Berry, Andrew Ulmer, and Alex Bromley, sought to improve care associated with nasogastric feeding tubes. We identified two major problems: clogging and tube dislodgement. To address the problem of dislodgement, the team crafted a new feeding tube design with a balloon attachment. The attachment prevents a patient from pulling the feeding tube out and keeps the tube from dislodging due to normal patient movement. We further determined that our tube should be …

Handheld Bedside Pocus In The Evaluation Of Neck Swelling: A Case Of Ludwig's Angina, Alex Gechlik, Frank Wheeler, James Espinosa, Alan Lucerna, Henry Schuitema

Stratford Campus Research Day

Ludwig's angina is a rare and life threatening cellulitic infection, first described by German physician, Wilhelm Frederick Von Ludwig in 1836, as a gangrenous infection of the soft tissue floor of the mouth and neck. The potential to spread rapidly to contiguous tissues surrounding the upper airways, notably the glottis, resulted in Ludwig's angina carrying a high mortality rate near 50% in the pre- antibiotic era. It necessitates rapid detection and management to assure respiratory compromise does not occur. This case study is novel as it illustrates handheld bedside POCUS utilization in diagnosing Ludwig’s Angina.

The Angiovac® Device Limits Lethal Complications Of Sepsis And Severe Infective Endocarditis With A Large Tricuspid Valve Vegetation: A Case Report, Dua Xiao, Raeann Dalton, Adam Fineman, Michael Benz, Antonios Tsompanidis

Stratford Campus Research Day

Introduction: Infectious endocarditis of the tricuspid valve is a common complication of intravenous drug use. Endocarditis caused by viridans streptococci can lead to heart valve vegetations which may be life threatening due to the potential for embolism and obstruction. Management of large valvular vegetations is often difficult due to the risks involved with open heart surgery, especially in patients with comorbid conditions. The AngioVac® device has been shown in rare cases to be effective at debulking vegetations without the need for invasive surgery.

Case Presentation: We present a patient with a history of intravenous heroin use disorder, hepatitis C, spinal …

Human Airway Mucociliary Tissue Cultures Chronically Exposed To E-Cigarette Vapors Exhibit Altered Cell Populations And Increased Secretion Of Immunomodulatory Cytokines, Vanessa Pizutelli, Vincent Manna, Shannon Dwyer, Salvatore Caradonna

Stratford Campus Research Day

Vape-pens or electronic cigarettes (e-cigarettes) are handheld battery powered devices that use a vape-liquid to produce a vapor that is inhaled by the user. The active ingredients in commercial vape-liquids are commonly nicotine, tetrahydrocannabinol or cannabidiol. A consequence of the rise in e-cigarette usage was the 2019 emergence of a vaping-induced respiratory disease denoted ‘e-cigarette or vaping use-associated lung injury’ (EVALI). One of the suspected causes of EVALI is Vitamin E Acetate (VEA), which was found to be a diluent in certain illicit tetrahydrocannabinol vape-pens, whereas nicotine is commonly diluted in equal parts propylene glycol and vegetable glycerin (PG:VG). The …

Purple Urine Bag Syndrome (Pubs) In A Patient With A Chronic Indwelling Foley, Kelsey Murray, Kishan Patel

Stratford Campus Research Day

Purple urine bag syndrome (PUBS) is a rare medical condition characterized by the appearance of purple discoloration in the urine collection bag of patients who use catheters for urinary drainage. PUBS is primarily seen in elderly, female, and institutionalized patients who have chronic indwelling catheters. The discoloration occurs due to the presence of certain bacteria that produce pigments, which react with the plastic materials of the catheter and urine collection bag, leading to the formation of a purple color. In addition to the aesthetic concerns, PUBS may also indicate an underlying urinary tract infection or other medical conditions that require …

Brief Review: Iv Fluid Choice In The Emergency Department, Kaywan Saed, James Espinosa, Alan Lucerna

Stratford Campus Research Day

Normal saline and balanced crystalloids, such as lactated Ringer's (LR) and Plasma-Lyte A, are commonly used in the emergency setting for fluid resuscitation. However, there has been growing interest in recent years in whether balanced crystalloids may be superior to normal saline, particularly in critically ill patients.

Normal saline has been the traditional fluid of choice for decades due to its widespread availability, low cost, and presumed safety. However, normal saline has a high chloride concentration (154 mmol/L), which can lead to hyperchloremic metabolic acidosis and other adverse effects, such as renal vasoconstriction and reduced renal blood flow.

In contrast, …

Importance Of Serial Ekgs In The Emergency Room Setting, Swet Patel, James Espinosa, Alan Lucerna

Stratford Campus Research Day

Chest pain is one of the most common chief complaints that presents to the emergency department. More than 8 million patients with chest related complaints present each year with about 10% of all ED visits comprise of cardiovascular emergencies. Immediate evaluation is the standard of care to differentiate between life threatening conditions and non-life threatening ones with the use of 12-lead electrocardiograph (EKG) and bedside monitors. The 12 lead EKG remains gold standard for initial screening and evaluating patients with chest pain and angina equivalents. The test is fairly inexpensive and noninvasive with providing vital information about cardiac rhythm. The …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Stratford Campus Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Practicality In Pocus: Benefits Of Ultrasound Training In Medical Education, Robert Martin, Ho An Lau, Ryan Morrison, Kate Deiling

Stratford Campus Research Day

As point-of-care ultrasound (POCUS) becomes an integral component of healthcare, both undergraduate and graduate medical POCUS education is urgently necessary in curricula. Despite the apparent need of POCUS curricula, there remains a lingering question: Are there evidence-based benefits to POCUS training in undergraduate and/or graduate medical education settings? This systematic review utilized PubMed, Google Scholar, and Scopus to identify articles of interest that met the inclusion criteria and relevance to undergraduate and/or graduate medical education. Qualitative evaluation of research was conducted to identify common themes for benefits of POCUS and the requirements or characteristics for effective POCUS educational curricula. Results …

Case Report: Anaphylactic Reaction To Magnesium Sulfate, Nicholas Coan, Kelly Schiers, James Espinosa, Alan Lucerna

Stratford Campus Research Day

We report a case of a 65-year-old female who prior to being discharged from the hospital developed an anaphylactic reaction after receiving an intravenous magnesium sulfate infusion. After extensive literature review, there are few documented hypersensitivity reactions documented. This case report is to highlight a known human response, anaphylaxis, but in response to the repletion of an essential electrolyte to human life, magnesium.

Infective Endocarditis Secondary To Needle Embolization To The Heart, Tony Elias, David Barsoum, Robert Malak, Veyola Rezkalla, Maziyar Daneshvar, Howard Weinberg, Rafail Beshai

Stratford Campus Research Day

Needle embolisms in the heart are very rare, even though the number of intravenous drug users (IVDUs) has increased over the past 10 years.Due to varied symptomology-chest pain, dyspnoea, fever, or asymptomatic, this remains a complex and likely underdiagnosed condition. We describe a 31-year-old female with past medical history of IV drug use who presented to the emergency room with heart palpitations and described it as her “heart feels funny” and shortness of breath. She acknowledged intravenous (IV) heroin use and stated that the last time to use IV drugs was 2 days before coming to the hospital.

To our …

Design And Preliminary Testing Of A Multi-Use 3d-Printed Splint For Wilderness Medicine, Ryan Desrochers, John Desrochers

Stratford Campus Research Day

Splinting devices are commonplace in emergency medicine, as musculoskeletal and soft tissue injuries account for a majority of nonfatal events in wilderness medicine. Current splint designs, such as the SAM splint, sacrifice site-specific stability for their portability. This leads to the need for a similarly portable, but more securely fitting splint device. This design aims to provide a lightweight, multi-use, reusable, biodegradable, and inexpensive solution for splinting in wilderness medicine. A thin plate constructed of polylactic acid extruded from a 3D printer becomes easily malleable after submersion in hot water and can be form fitted to almost any location on …

Risk Assessment Framework For Evaluation Of Cybersecurity Threats And Vulnerabilities In Medical Devices, Maureen S. Van Devender

Theses and Dissertations

Medical devices are vulnerable to cybersecurity exploitation and, while they can provide improvements to clinical care, they can put healthcare organizations and their patients at risk of adverse impacts. Evidence has shown that the proliferation of devices on medical networks present cybersecurity challenges for healthcare organizations due to their lack of built-in cybersecurity controls and the inability for organizations to implement security controls on them. The negative impacts of cybersecurity exploitation in healthcare can include the loss of patient confidentiality, risk to patient safety, negative financial consequences for the organization, and loss of business reputation. Assessing the risk of vulnerabilities …

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …

Combination Thromboembolism Prevention Prophylaxis, Karma Davis

MSN Capstone Projects

Venous thromboembolism (VTE) is a leading cause of preventable hospital death in the United States (Centers for Disease Control and Prevention, 2022). The correct selection of VTE prophylaxis in hospitalized patients is critical in stopping increased length of stays, incurring extra costs, and preventing deaths. Currently, the single modality of pneumatic compression sleeves (ICD) are often utilized for inpatient deep vein thrombosis prevention. ICDs are an easy, quick way for physicians to meet the requirement for VTE prevention in both general medical patients and those in the critical care unit. However, patients may remove or refuse this type of prevention …