...Complications rates are reported to be 2.1-20% and include the potential for airway loss and extratracheal tube placement resulting in subcutaneous emphysema, pneumomediastinum, and cardiac arrest or death. (Schmidt, Hess, Kwo, Lagambina, Gettings, Khandwala, 2008; Fikkers, Briede, Verwiel, Van Den Hoogen, 2002; Ritter, Lakshmanan, Sakabu, Troop, Trottier, 2002). Premature changing a TT tube prior to maturation of the tract increases the potential for complications (Deutsch, 1998). Our findings indicated the TT change procedure were completed a mean of 13 days post tracheotomy which is consistent with The American Academy of Otolaryngology-Head and Neck Surgery Foundation (White, Kher, & O'Connor, H. 2010) and other publications (Resp care 2013). No loss of airway, death, malpositioned tube was reported with any of the TT changes, completed by the SLPs, we retrospectovely reviewed. All TT were positioned correctly following the completionon of the procedure and were verified by passing a suction catheter to ensure no distal TT obstruction or by observing the subglottal anatomy through fiberoptic...
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...How to Clean a Tracheostomy Tube, Adult A tracheostomy tube, or trach tube, allows a person to breath without using his or her nose or mouth. A trach tube may be made up of one tube called an outer cannula. Or, it may be made up of an outer cannula and a second tube called an inner cannula. Keeping a trach tube clean helps prevent infection and helps make breathing easier. SUPPLIES NEEDED Towel. Suction supplies. Sterile trach care kit. The kit should contain: 4 x 4 inch (10 x 10 cm) gauze pads. Cotton-tipped swabs. Trach bandage (dressing). Container. 0.9% saline solution. Small trach brush or disposable inner cannula. Roll of twill tape, trach ties, or a velcro trach holder. Scissors. Clean gloves. HOW TO CLEAN A TRACH TUBE Have all supplies ready and available. Suction the trach tube as needed. Wash your hands well. Put on a pair of clean gloves. Fill a sterile container with 0.9% saline solution. Give oxygen as needed. If you have a nondisposable inner cannula: While only touching the outer part of the trach tube, unlock and remove the inner cannula. Drop the inner cannula into 0.9% saline solution. Use a small brush to clean the inside and outside of the inner cannula. Hold the inner cannula over the container, and rinse the cannula with 0.9% saline solution. Pat the inner cannula with gauze to help dry it. Replace...
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...Background: Nasoenteric tube insertion is a common procedure used in the clinical setting. Often viewed as a safe bedside procedure, there are risks for numerous complications including tracheobronchial insertion, which could lead to deleterious consequences. We present the first case of bilateral pneumothorax caused by the insertion of mal-positioned nasoenteric tube and discuss common pitfalls for diagnostic positioning as well as risk factors that can predispose a patient to improper placement. Case Report: In this case report, we demonstrate a 74-year-old male patient who presents with multiple orthopedic injuries following an auto-pedestrian collision. During his hospital stay, a routine nasoenteric tube was inserted for the purposes of enteral nutrition. Follow up abdominal X-ray revealed the nasoenteric tube misplaced in the left pleural space. After removal of the nasoenteric tube, a follow up chest X-ray revealed bilateral pneumothorax. The patient fell into respiratory distress and subsequent bilateral chest tubes were placed. Over the course of the next three weeks the patient improved, both chest tubes were removed, and the patient made a full recovery. Conclusion: Improper placement of nasoenteric tubes are can lead to complications such as bilateral pneumothorax. This unique case report of bilateral pneumothorax after mal-positioned nasoenteric tube emphasizes the necessity of understanding risk factors, and proper diagnostic techniques of nasoenteric...
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...This report provides an in-depth analysis of the two Everest Simulations conducted by Group 10 of MGMT1001 Thursday Tutorial. This task required students to form teams consisting of five to six members whose goals were to summit Mount Everest. While it provided us with a rich experience in team dynamics and collaboration, it also enabled us to explore key managerial concepts taught in the course, consisting of: • Communication • Groups and Teams • Leadership In this report, we examine the effectiveness of Face to Face Communication (FTFC) versus Computer Mediated Communication (CMC), and the problems encountered through the utilisation of the virtual medium including efficiency of the feedback system, loss of personal focus and other emergent issues. It includes personal reflections on attitudes and perceptions, as well as group performance and strategies adopted in the second Simulation in order to create a more positive team experience. Theories which relate to interpersonal communication have also been integrated in the report to illustrate its relation to certain situations encountered during the Simulation. Additionally, we provide a multifaceted analysis on the notion of team cohesiveness and how it attributes to better performance outcomes. An overview on the different intragroup conflicts encountered in the Simulation has been included, examining the positive and negative impact that conflict had on team experience and performance, and how mutual agreements were reached...
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...is a computer necessary in conducting a realworld simulation? Answer It is important because there are many different types of outcomes that comes in with simulation. Computers are used in daily life activities and it is necessary. 14-11 What is operational gaming? What is systems simulation? Give examples of how each may be applied. Answer Operational gaming is the use of simulation in competitive situations such as military games and business or management. System simulation ls that deal with the dynamics of large organizational or governmental systems. Validation The process of comparing a model to the real system that it represents to make sure that it is accurate. 14-17 (a) Resimulate the number of stockouts incurred over a 20-week period (assuming Higgins maintains a constant supply of 8 heaters). (b) Conduct this 20-week simulation two more times and compare your answers with those in part (a). Did they change significantly? Why or why not? (c) What is the new expected number of sales per week? Answer A. The number of stockouts incurred over a 20 week period is HOT WATER NUMBER OF HEATER SALES WEEKS THIS PER WEEK NUMBER WAS SOLD 3 2 4 9 5 10 6 15 7 25 8 12 9 12 10 10 B, Two more times would give us the value of a multiplied by 2. c. 25 14-18 A. 15 days of barge uploadings and average number of barges delayed B, They both are probabilistic simulations. Chapter 5 HW 5-14 Using MAD, determine whether...
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...A SYSTEM SIMULATION STUDY ON THE THREE FAST MOVING PRODUCTS (MARLBORO, C2, VIVA) OF THE COLLEGE VARIETY SHOPPE USING THE MONTE CARLO SIMULATION IN INVENTORY MANAGEMENT EXECUTIVE SUMMARY This study shows how the selected three fast moving products (Marlboro cigarettes, C2, Viva mineral water) move from the current Inventory Management technique of the College Variety Shoppe from its distributors to its warehouse storage to the end user or customer. An excel program and a simulation model was made to observed its current performance. After the observation, the group performs an experimentation that will improve the current technique of the College Variety Shoppe. After simulating the experimentation, the group then give conclusions and recommendations on how to improve the College Variety Shoppe’s current Inventory Management. TABLE OF CONTENTS Title Page ........................................................ 1 Executive Summary ........................................................ 2 Table of Contents ........................................................ 3 Introduction ........................................................ 4 Methodology ........................................................ 6 Model Development ........................................................ 7 Model Validation ........................................................ 11 Experimentation, Results .......
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...Initial operations strategy Prior to the commencement of the simulation, we examined the 50 days of historical data to glean as much information as we could about the operations. We performed some analysis in Excel and created a dashboard to illustrate various data. Specifically, we regressed the prior 50 days of jobs accepted to forecast demand over the next 2 - 3 months within a 95% confidence interval. The yellow and grey lines represent the maximum and minimum variability, respectively, based on two standard deviations (95%). Exhibit 1: Forecasted and actual demand by Day 50 and Day 270 Our two primary goals at the beginning of the simulation were as follows: 1) Eliminate bottlenecks and increase capacity in order to meet forecasted demand 2) Decrease lead time to 0.25 days in order to satisfy Contract 2 and maximize revenue In order to achieve these goals, we would need to know the capacity and throughput time of the entire system. We used the time required by each machine to process a lot to calculate capacity per station and then capacity of the entire production line (380 kits/day or 6 orders/day). In Exhibit 2 we can observe that the capacity of the production line is given by the station that produces the least number of units per day. Exhibit 2: Capacity of the production line The Decisions We decided to work with the maximum variability of demand because there was a penalty for late jobs and because there was no revenue for orders that took more than “x”...
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...Monte Carlo Statistical Analysis Name Course Instructor Date The Monte Carlo method is a mathematical method used for problem solving through the generation of random numbers and then observing a fraction of these numbers and the properties they obey. It is useful in obtaining numerical solutions to problems that are too complicated for analytical solutions. It is a form of probability used to understand the impact of risk and uncertainty in various areas such as financial and cost forecasting. It involves computation of the likelihood of given events occurring or not occurring, without taking into account the interaction of the elements involved in influencing the occurrence. The mathematical method was invented by Stanislaw Ulam in 1946 and named by Nicholas Metropolis after a classy gambling resort in Monaco, where a relative of Ulam frequently gambled [ (Fishman, 1996) ]. Concepts of the Monte Carlo method Uncertainty Being a forecasting model, there are assumptions that need to be made due to the uncertainty of various factors. One therefore needs to be able to make estimations of the expected results as they cannot predict with certainty what the end value will be. Important factors such as historical data and past experiences in the field can be helpful in making an accurate estimate. Estimation In some cases, estimation may be possible but in others it is not. In situations where estimation is possible, it is wise to use a wide range of possible values instead...
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...materials such as Ultra/Advanced High Strength Steels (U/AHSS), aluminum alloys, magnesium alloys and boron steels in automotive industry is increasing to reduce vehicle weight and increase crash performance. The use of these relatively new materials requires advanced and reliable techniques to a) obtain data on material properties and flow stress, b) predicting springback and fracture in bending and flanging, c) selecting lubricants and die materials/coatings for stamping and forging and d) designing tools for blanking and shearing. In addition, designing the process and tooling for a) hot stamping of boron steels, b) warm forming of Al and Mg alloys, and c) optimizing the use of servo-drive presses require advanced Finite Element based simulation methods. CPF is conducting R&D in most of these topics and also in many hot and cold forging related topics. This paper gives an overview of this research and discusses how the research results are applied in cooperation with industry. Keywords: Metal Forming, Sheet metal, Forging, FEM 1 INTRODUCTION The Center for Precision Forming (CPF) has been established with funding from the National Science Foundation (NSF) and a number of companies (www.cpforming.org). CPF is an outgrowth of the Engineering Research Center for Net Shape Manufacturing (ERC/NSM – www.ercnsm.org) and conducts research in sheet metal forming while ERC/NSM focuses on cold and hot forging related R&D projects. Both Centers work closely with industry under contract....
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...Introduction This chapter describes our work in evolution of buildable designs using miniature plastic bricks as modular components. Lego 1 bricks are well known for their flexibility when it comes to creating low cost, handy designs of vehicles and structures. Their simple modular concept make toy bricks a good ground for doing evolution of computer simulated structures which can be built and deployed. Instead of incorporating an expert system of engineering knowledge into the program, which would result in more familiar structures, we combined an evolutionary algorithm with a model of the physical reality and a purely utilitarian fitness function, providing measures of feasibility and functionality. Our algorithms integrate a model of the physical properties of Lego structures with an evolutionary process that freely combines bricks of different shape and size into structures that are evaluated by how well they perform a desired function. The evolutionary process runs in an environment that has not been unnecessarily constrained by our own preconceptions on how to solve the problem. The results are encouraging. The evolved structures have a surprisingly alien look: they are not based in common knowledge on how to build with brick toys; instead, the computer found ways of its own through the evolutionary search process. We were able to assemble the final designs manually and confirm that they accomplish the objectives introduced with our fitness functions. This chapter...
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...developed, operated and maintained the Concept Simulator since 1998. The Concept Simulator models the functional operation and inter-operation of key components of train control system architecture and the external systems to which the system interfaces. The simulator is valuable in the development and analysis of operational principles, and in assessing design trade-offs. The SEA-designed facility simulates operation at ERTMS Levels 1, 2, and 3. Components include a Communications Network, a Network Management Centre, a generic Interlocking, a Radio Block Centre, a Track Simulator including both conventional and TCS equipment, a Driver Desk, a European Vital Computer and a Driver MMI. The components are modelled using software-based simulations hosted on networked PCs. The simulator has been valuable in the engineering evaluation and validation of emergent system architectures, and enables system constraints to be explored and defined. ERTMS operational modes and the transitions between them are simulated and ERTMS principles and procedures are followed. Innovative Customer Information System (ICIS) SEA's Innovative Customer Information System (ICIS) is capable of managing and displaying customer information, including real time information, in a visually dynamic manner. The system utilises intelligent screens and wireless technology to distribute data, thus minimising installation and commissioning efforts. The system will be suitable for any transport environment, mobile...
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...Brooklyn Warren Chapter 10 Simulation Modeling What is Simulation? * To try to duplicate the features, appearance, and characteristics of a real system. * Imitate a real-world situation mathematically. * Study its properties and operating characteristics. * Draw conclusions and make action decisions based on the results. Processes of Simulation: 1. Define Problem 2. Introduce Important Variables 3. Construct Simulation Model 4. Specify Values of Variables to Be Tested 5. Conduct the Simulation 6. Examine the Results 7. Select Best Course of Action Advantages of Simulation: * Straightforward and flexible. * Can handle large and complex systems. * Allows "what-if" questions. * Does not interfere with real-world systems. * Study interactions among variable. * "Time comparison" is possible. * Handles complications that other methods can't. Disadvantages of Simulation: * Can be expensive and time consuming. * Does not generate optimal solutions. * Managers must generate all conditions and constraints. * Each model is unique. Monte Carlo Simulation: Can be used with variables that are probabilistic. Steps: * Establish the probability distribution for each random variable. * Use random numbers to generate random values. * Repeat for some number of replications. Probability Distributions: Historical data Goodness-of-fit tests for common distributions: ...
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...678-679 of the text. Using simulation estimate the loss of revenue due to copier breakdown for one year, as follows: 1. In Excel, use a suitable method for generating the number of days needed to repair the copier, when it is out of service, according to the discrete distribution shown. 2. In Excel, use a suitable method for simulating the interval between successive breakdowns, according to the continuous distribution shown. 3. In Excel, use a suitable method for simulating the lost revenue for each day the copier is out of service. 4. Put all of this together to simulate the lost revenue due to copier breakdowns over 1 year to answer the question asked in the case study. 5. In a word processing program, write a brief description/explanation of how you implemented each component of the model. Write 1-2 paragraphs for each component of the model (days-to-repair; interval between breakdowns; lost revenue; putting it together). 6. Answer the question posed in the case study. How confident are you that this answer is a good one? What are the limits of the study? Write at least one paragraph. There are two deliverables for this Case Problem, the Excel spreadsheet and the written description/explanation. Please submit both of them electronically via the dropbox. The assignment will be graded using the associated rubric. |Outcome Assessed: |Create statistical analysis of simulation results. ...
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...Jet Copy Simulation Prepared by Joe Miller Prepared for February 7th 2013 TABLE OF CONTENTS INTRODUCTION SUMMARY JET COPY SIMILATION CONCLUSION AND RECOMMENDATIONS APPENDIX INTRODUCTION The purpose of this report is to examine the feasibility to for Jet Copy to purchase a second copy machine. Based on copies produced and lost with only the use of one copier. In this report I will use data from a simulation to assist in the determination of an additional copier for Jet Copy. As a reminder that this is a random simulation and the information in the simulation will only assist between when the test stop and 52 week will not have great affect on the outcome of the in the decision making. The simulation that was run was base on a 52 week scenario. The actual results are based on 51 week trial. The difference between the 51 week test and the actual 52 weeks will not have any great impact on the recommendation. ------------------------------------------------- SUMMARY This report creates a simulation that shows one possible outcome for Jet Copier when there one copier is out for repair for up to 4 days. It will also aid in the decision to ad d or not to add a second copier. This report will answer the following questions: 1. Using Excel to generate the number of days needed to repair the copier. 2. Using Excel to generate the interval between successive breakdowns according to continuous distribution. 3. Using Excel, use a suitable method to...
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...Class: Seminar in Organizational Theory & Behavior Professor :Dr. Dyck's Bio Name: Zhihui Dai Change Management Simulation: Power and Influence Abstract Within this program Change Management Simulation: Power and Influence, I am a Director Product Innovation manager in Spectrum Sunglass Company, which is a private company that designs, manufactures, and sells sunglasses. What I need do is convince people adapt my proposal. I should choose method from 18 change levers that attempt to convince workers to adapt my new proposal that will change their attitude from awareness, interest, trial, to adoption. I must decide the proper method and use the time wisely. Be able to increase credibility and achieve the greatest percentage of adopters. Key words: Convince percentage of adoption credibility limited time This Management Simulation Project from Harvard provides students a virtual experience to convince people in start-up companies. When I started the first test run of the simulation there are various decisions, However, if an administrator make the wrong move, then I lose credibility and set the proposal is a backwards. On the other hand, if I decide on a correct decision, then not only will I get the workers are more interested in my proposal, but it also increases the credibility of the workers. When I was implementing change behavior, building a coalition of support is a important tool to get satisfied from people. When I simulate this behavior, I can have more...
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