Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device-related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device-related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January–December 2013, 254 trauma patients were visited every 2 days for skin assessment. The overall incidence of PUs was 28⋅3% (n = 72/254 patients). The incidence of device-related PUs was 20⋅1% (n = 51), and 13% (n = 33) developed solely device-related PUs. We observed 145 PUs in total of which 60⋅7% were related to devices (88/145). Device-related PUs were detected 16 different locations on the front and back of the body. These results show that the incidence of PUs and the proportion of device-related PUs is very high in trauma patients
Objectives To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries. Design Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries. Methods Between January and December 2013, 254 trauma patients were included. The following dependent variables were collected: Age, Skin color and Body Mass Index, and Time in Emergency Department, Injury Severity Score, Mean Arterial Pressure, hemoglobin level, Glasgow Coma Score, and admission ward after Emergency Department. Results Pressure ulcer development during admission was associated with a higher age (p 0.00, OR 1.05) and a lower Glasgow Coma Scale score (p 0.00, OR 1.21) and higher Injury Severity Scores (p 0.03, OR 1.05). Extra nutrition decreases the probability of PU development during admission (p 0.04, OR 0.20). Pressure ulcer development within the first 48 h of admission was positively associated with a higher age (p 0.01, OR 1.03) and a lower Glasgow Coma Scale score (p 0.01, OR 1.16). The proportion of patients admitted to the Intensive Care Unit and Medium Care Unit was higher in patients with pressure ulcers. Conclusions The pressure ulcer risk during admission is high in patients with an increased age, lower Glasgow Coma Scale and higher Injury Severity Score in the Emergency Department. Pressure ulcer risk should be assessed in the Emergency Department to apply preventive interventions in time.
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The Co-Design Pressure Cooker was set up to gather knowledge on co-design in product development activities of Small-to-Medium Enterprises(SMEs). This booklet gives an impression of ten projects conducted in the Province of Utrecht, the Netherlands. In these ten projects, a total of 22 companies were involved. 5000 booklets have already been printed in Dutch and handed out to SMEs for knowledge dissemination. We have received ample requests from the international community, which leads us to believe that there is an international audience for the cases conducted and knowledge gathered. This is why we decided to publish an English version of this booklet. The booklet will be followed by a scientific publication on the knowledge gathered for the academic community. Feel free to contact us for more information on this project
In Gelderland at industriepark Kleefsewaard, a prominent knowledge hub for hydrogen technology has been developed, featuring key industry players and research groups contributing to innovative and cost-effective hydrogen technologies. However, the region faces a challenge in the lack of available test equipment for hydrogen innovations. In Anion Exchange Membrane (AEM) technology, a route to follow is to create hydrogen more efficiently with stacks that can operate under high pressure (50 bar – 200 bar). This results in compact hydrogen storage. Research must be done to understand crossover effects which become more apparent at these high pressure conditions. The overall goal is to design a Balanced of Plant (BOP) system, incorporating Process Flow Diagram (PFD) and Piping & Instrumentation Diagram (P&ID) elements, alongside hydrogen purification systems and gas-liquid separators, for a test setup operating AEM stacks at 200 bar. De Nooij Stainless contributes by designing and fabricating a gas liquid separator, addressing challenges such as compatibility, elevated temperatures, and hydrogen safety. ON2Quest collaborates in supporting the design of a hydrogen purification system and the Balance of Plant (BoP), ensuring flexibility for testing future stacks and hydrogen purification components. HyET E-Trol specializes in high pressure (up to 200 bar) AEM electrolyser stacks and is responsible for providing problem statements and engineering challenges related to the (Balanced of Plant) BoP of AEM systems, and contributes in solving them. Subsequent projects will feature test sequences centered on other stacks, allowing for testing stacks from other companies. The resulting framework will provide a foundation for ongoing advancements, with contributions from each partner playing a crucial role in achieving the project's goals.
