The Use of Negative Inspiratory Force by ED Personnel to Monitor Respiratory Deterioration in the Event of a Botulism-induced MCI

Rynen, John L. Van; Rega, Paul P.; Budd, Churton; Burkholder-Allen, Kelly

doi:10.1016/j.jen.2007.12.010

Cited by 5 publications

(4 citation statements)

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“…The instrument used was a questionnaire developed by the authors based upon information available on the Centers for Disease Control and Prevention (CDC) website as well as from peer‐reviewed publications. (Arnon et al., ; Dembek, Smith, & Rusnak, ; Rega, Bork, Burkholder‐Allen, Bisesi, & Gold, ; Rega et al., ; Sobel, ; Van Rynen, Rega, Budd, & Burkholder‐Allen, ) The information was distilled into 11 multiple choice items that addressed key areas including types of botulism, pathophysiology, clinical signs and symptoms, and treatment. Demographic items about professional preparation, clinical experience, area of practice, perceived knowledge of botulism and attendance at disaster medicine classes were also included.…”

Section: Methodsmentioning

confidence: 99%

An Assessment of Nurses’ Knowledge of Botulism

Bork

Rega

2011

Public Health Nursing

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Section: Methodsmentioning

confidence: 99%

An Assessment of Nurses’ Knowledge of Botulism

Bork

Rega

2011

Public Health Nursing

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“…Each participant was given a handheld NIF device that he/she would use at home. A step-by-step written instruction was also provided on how to perform a NIF reading (Van Rynen et al, 2009). Using a demonstration NIF device, the PI showed each participant how to calibrate the instrument, perform the NIF measurement, and record the reading in the diary; further instructions were given when appropriate.…”

Section: Methodsmentioning

confidence: 99%

Feasibility study of respiratory function home monitoring for patients with Myasthenia Gravis

Deters

Bluhm²

2021

J Am Assoc Nurse Pract

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Background: Myasthenia gravis (MG) is a rare and chronic autoimmune neuromuscular disease that causes weakness among skeletal muscles responsible for mobility and breathing. Individuals with MG who have difficulty breathing may need to schedule an emergent provider visit where a negative inspiratory force (NIF) measurement test is performed to measure respiratory strength. Purpose: Examine the feasibility of individuals with MG to perform NIF respiratory function monitoring in the home setting and determine its impact on their perceived quality of life. Methods: This is a quantitative one-group pretest-posttest study of 30 individuals (18–75 years old) who carry the diagnosis of MG and have been stable with treatment for at least 30 days. Participants completed the Brunnsviken Brief Quality of Life Scale (BBQ-LS) and the System Usability Scale (SUS) prestudy. Participants were required to independently perform and record their NIF measurements twice daily for 14 days. After completing the 14 days, participants completed the BBQ-LS, SUS, and an end-of-study survey. Results: There was a significant difference in BBQ-LS scores at baseline (M = 62.97, SD = 17.84) and poststudy (M = 98.2, SD = 13.63) (t[29] = −5.39, p <.000). System Usability Scale scores were significantly different at baseline (M = 77.25, SD = 11.05) than at study completion (M = 94.42, SD = 5.64) (t[29], = −8.04, p = .000). Conclusion: Study results indicate that it is feasible for individuals with MG to perform NIF readings in the home setting and demonstrated an increase in the perceived quality of life. Implications: Future large-scale studies can help determine the adoption of handheld NIF monitoring at home for individuals with MG.

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“…11 An objective evaluation of ventilatory status is even more critical for this disease, since visual cues may be lacking due to the progressive paralysis of the muscles of facial expression. 12 As previously mentioned, the commonly-used vital signs, plus SaO 2 are part of the patient assessment paradigm but are neither sensitive nor specific enough to evaluate impending failure of the ventilatory system.…”

Section: Improving the Triage Of Presumed Botulism Patientsmentioning

confidence: 99%

“…Negative Inspiratory Force (NIF) measures the inspiratory muscular strength upon deep inspiration. 12 Unfortunately, these tools are neither typically taught to nor employed by prehospital or emergency department personnel. Since specialized training is required, they are not appropriate for just-in-time training should a botulism mass-casualty incident occur.…”

Section: Improving the Triage Of Presumed Botulism Patientsmentioning

confidence: 99%

Single-Breath-Count Test: An Important Adjunct in the Triaging of Patients in a Mass-Casualty Incident Due to Botulism

Rega

Bork

Burkholder-Allen

et al. 2010

Prehosp. Disaster med.

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Clostridium botulinum toxins, the most poisonous substance known to humankind, are considered to be a [US] Centers for Disease Control and Prevention Category A bioterrorist agent. Despite this concern, little has been published with regard to the tactical aspects of triaging a mass-casualty event involving botulism victims arriving at an emergency department. Because neuromuscular-ventilatory failure is a principal reason for botulism's early morbidity and mortality, using a quick and sensitive test to evaluate this possibility is imperative. The purpose of this article is to propose the adoption of the Single-Breath-Count Test (SBCT). The ease and validity of the use of the SBCT in evaluating complications associated with various neuromuscular disorders make it an attractive adjunct for triage during a mass-casualty incident due to botulism. While education, immune globulin, antitoxin, and invasive airway techniques are well-recognized steps in treating botulism, incorporating a time-honored technique such as the SBCT, will be an important addition to the triage process.

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The Use of Negative Inspiratory Force by ED Personnel to Monitor Respiratory Deterioration in the Event of a Botulism-induced MCI

Cited by 5 publications

References 10 publications

An Assessment of Nurses’ Knowledge of Botulism

An Assessment of Nurses’ Knowledge of Botulism

Feasibility study of respiratory function home monitoring for patients with Myasthenia Gravis

Single-Breath-Count Test: An Important Adjunct in the Triaging of Patients in a Mass-Casualty Incident Due to Botulism

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