Care Intensity During Transport to the Critical Care Resuscitation Unit: Transport Clinician's Role.

OBJECTIVE: Patients are often transferred between hospitals for a higher level of care. Critically ill patients require high-intensity care after transfer, but their care intensity during transport is unknown. We studied transport clinicians' management for patients who had time-sensitive or critical illnesses and were transferred to a critical care resuscitation unit (CCRU) at a quaternary academic center. METHODS: We prospectively surveyed transport clinicians who brought interhospital transport patients to the CCRU between March 1, 2019, and January 8, 2020. The primary outcome was care intensity during transport, which was defined as new interventions rendered by transport clinicians. RESULTS: We analyzed 852 surveys. Seventy-four percent of transports occurred by ground, and 54% originated from emergency departments. Up to 19% of patients received 2 or more interventions, whereas 29% received at least 1 intervention during transport. Ventilator management occurred in 25% of cases. When adjusting for known confounders, respiratory failure or acute respiratory distress syndrome, air transport, and contacting the CCRU attending physicians en route were associated with a higher likelihood of an intervention during transport. CONCLUSION: Transport clinicians provided new interventions in 48% of patients being transferred to the CCRU. Patients with respiratory failure or acute respiratory distress syndrome and those transported by helicopter emergency medical services were more likely to receive interventions en route.

A broadband ultraviolet light source using GaN quantum dots formed on hexagonal truncated pyramid structures.

Group III-nitride semiconductor-based ultraviolet (UV) light emitting diodes have been suggested as a substitute for conventional arc-lamps such as mercury, xenon and deuterium arc-lamps, since they are compact, efficient and have a long lifetime. However, in previously reported studies, group III-nitride UV light emitting diodes did not show a broad UV spectrum range as conventional arc-lamps, which restricts their application in fields such as medical therapy and UV spectrophotometry. Here, we propose GaN quantum dots (QDs) grown on different facets of hexagonal truncated pyramid structures formed on a conventional (0001) sapphire substrate. A hexagonal truncated GaN pyramid structure includes {101̄1} semipolar facets as well as a (0001) polar facet, which have intrinsically different piezoelectric fields and growth rates of GaN QDs. Consequently, we successfully demonstrated a plateau-like broadband UV spectrum ranging from ∼400 nm (UV-A) to ∼270 nm (UV-C) from the GaN QDs. In addition, at the top-edge of the truncated pyramid structure, a strain was locally suppressed compared to the center of the truncated pyramid structure. As a result, various emission wavelengths in the UV range were achieved from the GaN QDs grown on the sidewall, top-edge and top-center of hexagonal truncated pyramid structures, which ultimately provide a broadband UV spectrum with high efficiency.