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Biomedical subjects

Henry Shih

Publications and source records attributed to Henry Shih.

3 recordsLinked to original sources
PubMed2006

A video based training program improves defibrillator inspection compliance.

Improperly maintained defibrillators are an important cause of defibrillation delay or failure during in-hospital cardiac arrest. This study investigated whether a brief training video of how to properly inspect crash carts and defibrillators would improve the quality and frequency of these inspections. The study was a before-after cohort design. Crash cart inspection logs were explicitly examined, and the electronic archive records of the defibrillators were interrogated. The compliance and quality of inspections were compared before and after the implementation of the training video program. The missed-inspection rate for defibrillators significantly improved from 8.9% to 6.9% (p= 0.037) after video training program implementation. The missed-inspection rate for crash carts, however, actually worsened from 2.7% before to 8.0% (p = 0.0001). The introduction of a new crash cart inspection training video program improved the frequency and quality of defibrillator inspections but not crash cart inspections. The inspection of crash carts and defibrillators is a vital hospital task. Because available training time for clinical personnel is limited, our 15-minute video can be viewed on a ward computer workstation at the most convenient time.

Cardiopulmonary Resuscitation↗
PubMedDate not supplied

Injection pressures by anesthesiologists during simulated peripheral nerve block.

BACKGROUND AND OBJECTIVES: Anesthesiologists typically rely on a subjective evaluation ("syringe feel") of possible abnormal resistance to injection while performing a peripheral nerve block (PNB). A greater force required to perform the injection is believed to be associated with intraneural injection. The hypothesis of this study is that anesthesiologists vary in their perception of "normal" injection force, that the syringe feel method is inconsistent in estimating resistance, and that needle design may affect the injection force. METHODS: Thirty anesthesiologists were asked to inject a local anesthetic, as they would in their everyday practice, through a commonly used syringe and needle assembly. Injection force was measured using an in-line manometer coupled to a computer via an analog-to-digital conversion board. In addition, injection force at clinically relevant injection speeds was determined using 3 differently sized needles from 4 different manufacturers. RESULTS: During a steady injection rate, all anesthesiologists perceived an increase in the force required to inject, even with minor pressures changes (0.6 +/- 0.3 psi). However, the 30 anesthesiologists, 21 (70%) initiated injection using a force that resulted in pressures greater than 20 psi; 15 (50%) used a force greater than 25 psi, and 3 (10%) exerted pressures greater than 30 psi. Pressures varied as much as 20-fold among needles of the same gauge/length from different manufacturers (P <.01). CONCLUSIONS: Anesthesiologists vary widely in their perception of appropriate force and rate of injection during PNB. The syringe-feel method of assessing injection force is inconsistent and may be further affected by variability in needle design.

Analysis of Variance↗