Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. The original treatment plan did not include a contour of the device. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The total dose was 50.4 Gy delivered over 40 elapsed days. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up betweenmore » the device, a lower-density alternative device, and an open field. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Yu, SuhongĪmerican Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. Radiation dermatitis caused by a bolus effect from an abdominal compression deviceĭOE Office of Scientific and Technical Information (OSTI.GOV)Ĭonnor, Michael Wei, Randy L. A programmable logic controller is provided for controlling the rotational speed of the feed and compression auger-screws for selectively varying the compression of the waste material and for overcoming jamming conditions within either the supply tube or the compression tube. The compression tube is sloped downwardly towards the reactor to drain fluid from the waste material to the reactor and is oriented at generally right angle to the supply tube such that the feed-outlet end of the supply tube is adjacent to the feed-inlet end of the compression tube. A compression auger-screw extends axially in the compression tube between the feed-inlet and feed-outlet ends thereof. A feed auger-screw extends axially in the supply tube between the feed-inlet and feed-outlet ends thereof. A feed-discharge valve assembly is located between the feed-outlet end of the compression tube and the reactor. Each of the supply and compression tubes includes feed-inlet and feed-outlet ends. Bauer, Edward J.Ī compression device for feeding a waste material to a reactor includes a waste material feed assembly having a hopper, a supply tube and a compression tube. Method for preventing jamming conditions in a compression device The use of a sequential compression mechanical pump that detects venous refilling and cycles accordingly, reduced the incidence and severity of hypotension after spinal anesthesia for cesarean section. There was no difference between groups in the time to onset of hypotension. The median ephedrine dose was greater in Group C (12 mg) compared to Group M (0 mg) (P<0.001). Hypotension occurred in 12 of 47 (25.5%) patients in Group M compared to 27 of 45 (60%) in Group C (P=0.001). Median ephedrine requirement was taken as a measure of the severity of hypotension. The incidence of hypotension was defined as the primary outcome. With the addition of a simple flyer and a single in-service on the importance of mechanical compression in the surgical patient, a significant improvement in compliance was documented at the authors' institution from 28% to 59% (p 20% from baseline, was treated with 6-mg boluses of intravenous ephedrine. Patients were then monitored, again at random, and compliance was recorded. Following a 2-week period of data collection, an educational flyer was displayed in every patient's room and nursing staff held an in-service training event focusing on the importance of sequential compression device use in the surgical patient. All non-intensive care unit orthopaedic primary patients were evaluated at random times and their compliance with sequential compression devices was monitored and recorded. This process improvement study sought to evaluate the compliance in orthopaedic patients with sequential compression devices and to monitor any improvement in compliance following an educational intervention. A Process Improvement Evaluation of Sequential Compression Device Compliance and Effects of Provider Intervention.īeachler, Jason A Krueger, Chad A Johnson, Anthony E
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