Proceedings of Singapore Healthcare最新文献

Hyperbaric oxygen therapy for sudden hearing loss in enlarged vestibular aqueduct syndrome: A case report and review of literature 高压氧疗法治疗前庭导水管扩大综合征突发性听力损失：病例报告和文献综述

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241230181

Genevieve Min Lee, Soo Joang Kim, James Wei Ming Kwek, Ching Yee Chan

引用次数: 0

Quality improvement project to improve inhaler delivery in the intensive care unit 改善重症监护室吸入器配送的质量改进项目

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241241915

QinHao Jonathan Ye, Ganesh Kalyanasundaram, Hsiao Peng Toh, Qian Wen Leo, Linda Marie Nathan, Aubrey Cunanan, Han Ying Jessica Tan, Kiran Sharma

{"title":"Quality improvement project to improve inhaler delivery in the intensive care unit","authors":"QinHao Jonathan Ye, Ganesh Kalyanasundaram, Hsiao Peng Toh, Qian Wen Leo, Linda Marie Nathan, Aubrey Cunanan, Han Ying Jessica Tan, Kiran Sharma","doi":"10.1177/20101058241241915","DOIUrl":"https://doi.org/10.1177/20101058241241915","url":null,"abstract":"Late 2022, an ICU nurse discovered that Seretide™ (salmeterol/Fluticasone) Evohaler, a commonly used inhaler, did not change its dose counter when used with the inhaler connector 22M-22F. This was identified as a medication safety issue. Knowledge gaps of inhaler use in mechanically ventilated patients were identified as well. To effectively administer metered dose inhalers to ventilated patients and increase its accuracy and safety. We instituted education programs for healthcare professional in the ICU and introduced a new inhaler connector RTC 24-V. This was compared with the existing 22M-22F connector in a comparative study. The dose counter of Seretide™ recorded prior to initiation and extubation showed an obvious drop in doses ranging from 15 to 63 in patients randomized to use RTC 24-V, compared to 0 to 2 drop in doses for patients using 22M-22F. A total of 51 pre study and 33 post study questionnaires were completed. Confidence that the accurate dose of medications was administered rose from 58.8% to 84.8% after using the RTC 24-V. Responses that there was no issue compromising patient safety rose from 0% to 51.5% and fewer staff expressed concern about disconnections causing infections, dropping from 51% to 9.1%. 93.9% of respondents chose the new RTC 24-V as the preferred inhaler connector. The new inhaler connector RTC 24-V was assessed to have less medication errors. ICU healthcare professionals expressed greater confidence in its safety and accuracy. We will implement the use of this connector with continued medical education.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140524402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessment and evaluation of nutrition education among physicians in a tertiary paediatric specialist hospital: The need for improved clinical nutrition teaching 一家三级儿科专科医院医生营养教育的评估与评价：改进临床营养教学的必要性

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241236988

Sudipta Roy Chowdhury, M. Chia, Christopher Ho Wen Wei

{"title":"Assessment and evaluation of nutrition education among physicians in a tertiary paediatric specialist hospital: The need for improved clinical nutrition teaching","authors":"Sudipta Roy Chowdhury, M. Chia, Christopher Ho Wen Wei","doi":"10.1177/20101058241236988","DOIUrl":"https://doi.org/10.1177/20101058241236988","url":null,"abstract":"Nutrition education is one the essential components of any paediatric residency training. However, many paediatricians world-wide have suboptimal knowledge in core clinical nutritional topics. The purpose of our study is to assess the perceived effectiveness of nutrition training among physicians, including paediatric residents, paediatric trainees and paediatricians; identify areas of need for additional education resources and the preferred method of teaching for nutritional topics for medical education. A survey-questionnaire was sent to our physicians in our centre to assess general nutrition education via self-assessment of current nutritional knowledge across 12 distinct topics; importance of teaching amongst these topics and the preferred method of teaching. A total of 64 physicians completed the survey with an overall response rate of 88%. Most responders reported having average or above-average knowledge base in all nutritional topics except for nutritional aspects of special diets. Poorest knowledge base (either below average or poor) was reported in special diet ( n = 38, 59.4%), inflammatory bowel disease ( n = 17, 26.6%) and gastrointestinal allergy ( n = 16, 25.0%). There was strong interest in additional teaching needs for the topics of failure to thrive ( n = 38, 59.4%), nutritional assessment ( n = 34, 53.1%) and infant feeding ( n = 31, 48.4%). Most popular teaching methods were clinical case review (31.7%) followed by didactic lectures (29.8%) for overall clinical nutritional education. Physicians identified gaps in their nutrition knowledge base and multiple topics were identified for additional nutrition education. Preferred methods of teaching for nutritional education were clinical case reviews and didactic lectures.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140517733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A review on cytomegalovirus in patients with autoimmune inflammatory rheumatic diseases: Prevalence, clinical spectrum, treatment, and antiviral prophylaxis 自身免疫性炎症性风湿病患者巨细胞病毒综述：发病率、临床表现、治疗和抗病毒预防措施

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241241914

Brianna Brianna, A. Masnammany, Yuan Seng Wu

{"title":"A review on cytomegalovirus in patients with autoimmune inflammatory rheumatic diseases: Prevalence, clinical spectrum, treatment, and antiviral prophylaxis","authors":"Brianna Brianna, A. Masnammany, Yuan Seng Wu","doi":"10.1177/20101058241241914","DOIUrl":"https://doi.org/10.1177/20101058241241914","url":null,"abstract":"Human cytomegalovirus (CMV) is a highly infectious virus that is prevalent among adults worldwide. In immunocompetent individuals, CMV infection rarely causes complications. Following initial infection, however, CMV remains latent in the body and can be reactivated especially in immunocompromised patients, such as those with autoimmune inflammatory rheumatic diseases (AIIRDs), leading to tissue-invasive, life-threatening diseases, such as colitis, vascular thrombosis, and pneumonitis. Although there are standard treatment recommendations for symptomatic CMV disease, there is paucity of consensus in the role of primary and secondary antiviral prophylaxis to prevent CMV reactivation, especially in AIIRDs patients undergoing immunosuppressive therapy. Therein, this review aimed to provide an overview of the prevalence, clinical disease, risk factors, and treatment for CMV infection, as well as on the role of primary and secondary antiviral prophylaxis in AIIRDs patients. The emerging novel techniques that measure CMV-specific T-cell immunity as a guide to initiate prophylaxis in high-risk patients were also discussed.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140518655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241232182

Y. Okada, Joel Aik, A. Ho, Yilin Ning, M. Ong

{"title":"Heat-related illness in Singapore: Descriptive analysis of a tertiary care center from 2008 to 2020","authors":"Y. Okada, Joel Aik, A. Ho, Yilin Ning, M. Ong","doi":"10.1177/20101058241232182","DOIUrl":"https://doi.org/10.1177/20101058241232182","url":null,"abstract":"This study aimed to describe the clinical characteristics and epidemiology of heat-related illnesses presented at a tertiary hospital in Singapore. This retrospective observational study utilized electronic health records from the emergency department (ED) of Singapore General Hospital. Patients primarily diagnosed with heat-related illnesses from 2008 to 2020, were analyzed. The annual number of cases and the temporal trend of heat-related illnesses were described, along with the characteristics of patients. Among the 1,833,908 patients registered at the ED, 426 patients had diagnoses of heat-related illnesses. The median age (interquartile range [IQR]) was 32 (22, 43) years, with 303 (71%) being male and 201 (47%) not being Singapore citizens. The annual number of cases ranged from a minimum of 21 in 2019 to a maximum of 49 cases in 2015, except for four cases in 2020. Heat-related illnesses occurred most commonly on Sundays (233, 55%) and in December (97, 23%). A significant number of cases in December coincided with the day of an annually organized marathon (91, 21%). Approximately half of the total cases required hospitalization, with 183 (43%) admitted to the general ward and 31 (7%) admitted to the intensive care unit. The 30-day mortality was 2 (0.5%). This descriptive study indicated the unique characteristics of heat-related illness in a tertiary care hospital in Singapore. These local contexts may be valuable to consider preventative measures for heat-related illness, in preparation for future extreme weather events related to climate change.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140518485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nitrous oxide-induced subacute combined degeneration of the spinal cord 氧化亚氮诱发的脊髓亚急性联合变性

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241236987

Georgina Kwek, Zi Yang Wong, P. Salkade, J. Pek, Chinmaya Shrikant Joshi

引用次数: 0

Caudal epidural, pericapsular nerve group block and lateral femoral cutaneous nerve block in hip fracture surgery: A case report 髋部骨折手术中的尾硬膜外、包膜神经群阻滞和股外侧皮神经阻滞：病例报告

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241230182

Natesha Eusoof Angullia, Elizabeth Sein Jieh Tan

引用次数: 0

The correlation of Rotational Thromboelastometry (ROTEM) derived parameters with severe obstetric haemorrhage 旋转血栓弹性测量法（ROTEM）得出的参数与严重产科出血的相关性

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241245239

H. Tan, J. Yek, Terrence K Allen, R. Sultana, C. Tan, B. Sng

{"title":"The correlation of Rotational Thromboelastometry (ROTEM) derived parameters with severe obstetric haemorrhage","authors":"H. Tan, J. Yek, Terrence K Allen, R. Sultana, C. Tan, B. Sng","doi":"10.1177/20101058241245239","DOIUrl":"https://doi.org/10.1177/20101058241245239","url":null,"abstract":"Prediction of severe obstetric haemorrhage may facilitate timely interventions and reduce maternal morbidity and mortality. Rotational thromboelastometry (ROTEM) provides point-of-care coagulation parameters that may identify patients at risk of severe haemorrhage. Our aim was to determine the correlation of ROTEM-derived parameters at early stages of postpartum haemorrhage. Retrospective cohort study. Patients who utilised ROTEM during postpartum haemorrhage from 2013 to 2021. Severe harmorrhage was defined as: (1) decrease in haemogoblin concentration >4g.dL-1 within 48 h; (2) packed red blood cell transfusion of >1000 mL; (3) haemostatic intervention such as angiographic embolisation, arterial ligration, or hysterectomy; or (4) death. ROTEM-derived parameters were collected accordingly. Data from 36 patients were analysed, of whom 29 (80.6%) developed severe haemorrhage. FIBTEM A5, A10, and A20 were highly correlated (r > +/−0.7) with severe haemorrhage. There were moderate correlations (r = +/− 0.5 to 0.7) between EXTEM A5, A10, A20, maximum clot firmness, maximum lysis, and lysis index-30 with severe haemorrhage. These findings are consistent with prior studies reporting associations between fibrinogen concentration, EXTEM A10, and FIBTEM A10 with severe haemorrhage. In conjunction with these studies, our results support the use of FIBTEM A5 and A10 as early biomarkers to predict progression to severe haemorrhage and facilitate timely implementation of appropriate medical or surgical interventions.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140523703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and outcomes of cardiac arrest patients with prolonged resuscitation 长时间复苏的心脏骤停患者的特征和预后

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241236991

Abhay Kant, Yi-En Clara Seah

{"title":"Characteristics and outcomes of cardiac arrest patients with prolonged resuscitation","authors":"Abhay Kant, Yi-En Clara Seah","doi":"10.1177/20101058241236991","DOIUrl":"https://doi.org/10.1177/20101058241236991","url":null,"abstract":"Background: There is lack of uniformity and consensus amongst the emergency physicians about an appropriate duration of cardiopulmonary resuscitation (CPR) and resuscitative efforts before deciding about termination of resuscitation (TOR) in patients with either out-of-hospital or in the emergency department (ED) non-traumatic cardiac arrests. An ideal duration of resuscitation for those with persistent cardiac arrest has not been determined yet. This study aims to evaluate the resuscitative interventions, patient factors and outcomes associated with prolonged duration of resuscitation in these patients. Methods: A retrospective study conducted in the Emergency Department (ED) of Changi General Hospital, Singapore and included 15 non-consecutive and randomly selected adult patients who either had an out-hospital cardiac arrest (OHCA) or suffered a witnessed cardiac arrest soon after arrival in the ED and were resuscitated further. Results: The median age was 58 years (IQR 51.5–70.5 years), and the median total CPR and resuscitation duration was 46 min (IQR 40–62.5 min). 12 patients sustained ROSC and one had transient ROSC. Ten (10) patients survived to hospital admission from ED and 5 of them underwent emergency angiography from ED. Three patients were discharged from hospital eventually with mRS scores of 0–1. Conclusion: Patients with sustained ROSC were older, had more prevalence of co-morbidities and lesser prevalence of shockable rhythms, received bystander CPR and pre-hospital adrenaline more frequently, had longer total duration of CPR and a larger proportion were administered intravenous calcium gluconate during ED resuscitation.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140521890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ophthalmic primary care in Singapore: Considerations for review 新加坡的眼科初级保健：审查考虑因素

IF 0.5

Proceedings of Singapore Healthcare Pub Date : 2024-01-01 DOI: 10.1177/20101058241239442

Hou Boon Lim, Tin Aung

引用次数: 0