University of Nebraska Medical Center.
Children's Hospital and Medical Center, Omaha, NE.
J Pediatr Orthop. 2022;42(5):289-292. doi: 10.1097/BPO.0000000000002092.
To determine the effectiveness of a novel cast-saw alarm system in minimizing the number and duration of cast-saw blade-to-skin contacts.
Twenty orthopaedic residents removed a pair of long-arm casts applied to instrumented pediatric upper extremity models. The model and cast-saw were instrumented to detect blade to "skin" contact at a rate of 600 Hz. Each resident performed cast removal with and without the use of a cast-saw alarm, the order of which was randomized. Eleven additional "new" cast-saw users then removed pairs of casts, without and then with the cast alarm, to evaluate what effect the alarm would have on preventing blade-to-skin contact in users with no previous cast-saw experience. The number and duration of cast-saw touches were then evaluated. Statistical significance was determined paired 1-sided students t tests (number of touches).
For the residents (n=20), the total number of blade-to-skin contacts was 233. One hundred eighty-one blade-to-skin contacts without the alarm and 52 with the alarm (71% reduction) (t(19)=-3.42, P=0.001), averaging 6.45 more blade-to-skin contacts per cast without the alarm. The median blade-to-skin contact duration was 0.166 seconds without the alarm and 0.087 seconds with the alarm. This was a 48% reduction in contact time (P=0.073). For the inexperienced users (n=11), the total number of blade-to-skin contacts was 356, 324 blade-to-skin contacts without the alarm and 32 with the alarm (90% reduction) (t(10)=-2.78, P=0.009), averaging 26.5 more blade-to-skin contacts without the alarm. The median blade-to-skin contact duration for the novice was 0.313 seconds without the alarm and 0.1 seconds with the alarm (68% reduction). Contact time was reduced in both groups but failed to reach statistical significance. However, alarm use significantly reduced the number of touches of >0.5 seconds duration (62 vs. 3) in the novice group, P=0.0176. Blade-to-skin contact of >0.5 seconds were felt to represent touches that were more likely to result in thermal injury to a living patient.
Blade-to-skin contact can be reduced with the use of a cast-saw alarm. These effects appear most amplified in users with little prior cast-saw experience.
Not applicable.
确定一种新型的石膏锯报警系统在最大限度地减少石膏锯刀片与皮肤接触的次数和时间方面的有效性。
20 名骨科住院医师移除了一对应用于仪器化儿科上肢模型的长臂石膏。模型和石膏锯以 600Hz 的速率检测刀片与“皮肤”的接触。每位住院医师在使用和不使用石膏锯报警的情况下进行石膏去除，顺序随机。然后，另外 11 名“新”使用石膏锯的用户在没有和使用报警的情况下移除了一对石膏，以评估报警对防止没有先前使用石膏锯经验的用户刀片与皮肤接触的效果。然后评估石膏锯接触的次数和持续时间。使用配对单边学生 t 检验（接触次数）确定统计学意义。
对于住院医师（n=20），总共有 233 次刀片与皮肤接触。在没有报警的情况下有 181 次刀片与皮肤接触，而在有报警的情况下有 52 次（减少 71%）（t(19)=-3.42，P=0.001），平均每次去除石膏时没有报警的刀片与皮肤接触次数多 6.45 次。没有报警时刀片与皮肤接触的中位数持续时间为 0.166 秒，有报警时为 0.087 秒。接触时间减少了 48%（P=0.073）。对于没有经验的用户（n=11），总共有 356 次刀片与皮肤接触，没有报警的情况下有 324 次刀片与皮肤接触，而有报警的情况下有 32 次（减少 90%）（t(10)=-2.78，P=0.009），平均每次去除石膏时没有报警的刀片与皮肤接触次数多 26.5 次。新手的刀片与皮肤接触中位数持续时间没有报警时为 0.313 秒，有报警时为 0.1 秒（减少 68%）。两组的接触时间都减少了，但没有达到统计学意义。然而，报警的使用显著减少了接触时间超过 0.5 秒的次数（62 次比 3 次），在新手组中，P=0.0176。接触时间超过 0.5 秒被认为是更有可能对活体患者造成热损伤的接触。
使用石膏锯报警可以减少刀片与皮肤的接触。这些效果在以前使用石膏锯经验较少的用户中似乎更为明显。
不适用。
