Rising patient numbers and limited resources are creating a challenging environment for healthcare providers recently. Anaesthesiologists are also increasingly faced with complex situations, requiring high adaptability in the operating room. To enhance team adaptability during emergencies, effective communication methods are essential. This study aimed to compare the impact of mobile phones and intercoms on the response time and effectiveness of anaesthesiologist teams in emergency situations. Prospective, observational and simulation study. Anaesthesiology and Critical Care, Yokohama City University Medical Center, Yokohama, Japan. This study, conducted at Yokohama City University Medical Center (Yokohama, Japan), evaluated how communication methods (intercoms vs mobile phones) impact the efficiency of anaesthesiologists in the simulation setting. Two scenarios were tested: (1) retrieving a video laryngoscope during a difficult intubation and (2) gathering support during cardiac arrest. Outcomes measured included time to secure equipment, time for assistance to arrive and staff numbers gathered. The Wilcoxon signed-rank test was used to compare the outcomes between the intercom and mobile phone groups. In scenario 1, the time to secure the video laryngoscope was significantly shorter with intercom use compared with mobile phones (intercom vs mobile phone, median (IQR): 29 (25-33) s vs 50 (39-62) s; p=0.013, effect size 20 (95% CI 7 to 31)). In scenario 2, the time from the request for assistance until the first supporting staff member reached the operating room was significantly shorter in using the intercoms (intercom vs mobile phone, median (IQR): 16 (14-18) s vs 35 (31-38) s; p=0.04, effect size 17 (95% CI 6 to 24)), and more personnel were available in the intercom group (intercom vs mobile phone, median (IQR): 3 (3-3.5) persons vs 2 (1-2) persons; p=0.04, effect size 1.5 (95% CI 1 to 3)). Real-time information sharing through intercoms improved the ability of the anaesthesiologist team to respond more rapidly and effectively in emergency situations, enhancing overall team adaptability. This approach may improve patients' outcomes by shortening response times and increasing team coordination.
Scholarship on security technologies has focused on states and infrastructures, but this article shows how security logics reshaped everyday manners inside the home. Introducing the concept of "securitized etiquette," the article examines how video intercoms transformed domestic interaction in modern Japan. Situating contemporary practices within a longer history from the Meiji period to the present, it traces a shift from a "voice-calling culture" (koe o kakeru bunka) to technologically mediated interaction governed by logics of security and risk. By focusing on the materiality of manners, the article highlights domestic technologies as active participants in the reconfiguration of social relations and everyday governance.
The study aimed to estimate the cost-effectiveness of interdisciplinary community-based chronic obstructive pulmonary disease (COPD) management in patients with COPD. We conducted a cost-effectiveness analysis alongside a 2-yr randomised controlled trial, in which 199 patients with less advanced airflow obstruction and impaired exercise capacity were assigned to the INTERCOM programme or usual care. The INTERCOM programme consisted of exercise training, education, nutritional therapy and smoking cessation counselling offered by community-based physiotherapists and dieticians and hospital-based respiratory nurses. All-cause resource use during 2 yrs was obtained by self-report and from hospital and pharmacy records. Health outcomes were the St George's Respiratory Questionnaire (SGRQ), exacerbations and quality-adjusted life years (QALYs). The INTERCOM group had 30% (95% CI 3-56%) more patients with a clinically relevant improvement in SGRQ total score, 0.08 (95% CI -0.01-0.18) more QALYs per patient, but a higher mean number of exacerbations, 0.84 (95% CI -0.07-1.78). Mean total 2-yr costs were euro2,751 (95% CI -euro632-euro6,372) higher for INTERCOM than for usual care, which resulted in an incremental cost-effectiveness ratio of euro9,078 per additional patient with a relevant improvement in SGRQ or euro32,425 per QALY. INTERCOM significantly improved disease-specific quality of life, but did not affect exacerbation rate. The cost per QALY ratio was moderate, but within the range of that generally considered to be acceptable.
When this study began in 2018, I sought to determine the extent to which the top 50 schools of nursing were using hashtags that could attract attention from journalists on Twitter. In December 2020, the timeframe was expanded to encompass 2 more years of data, and an analysis was conducted of the types of hashtags used. The study attempted to answer the following question: to what extent are top-ranked schools of nursing using hashtags that could attract attention from journalists, policy makers, and the public on Twitter? In February 2018, 47 of the top 50 schools of nursing had public Twitter accounts. The most recent 3200 tweets were extracted from each account and analyzed. There were 31,762 tweets in the time period covered (September 29, 2016, through February 22, 2018). After 13,429 retweets were excluded, 18,333 tweets remained. In December 2020, 44 of the original 47 schools of nursing still had public Twitter accounts under the same name used in the first phase of the study. Three accounts that were no longer active were removed from the 2016-2018 data set, resulting in 16,939 tweets from 44 schools of nursing. The Twitter data for the 44 schools of nursing were obtained for the time period covered in the second phase of the study (February 23, 2018, through December 13, 2020), and the most recent 3200 tweets were extracted from each of the accounts. On excluding retweets, there were 40,368 tweets in the 2018-2020 data set. The 2016-2018 data set containing 16,939 tweets was merged with the 2018-2020 data set containing 40,368 tweets, resulting in 57,307 tweets in the 2016-2020 data set. Each hashtag used 100 times or more in the 2016-2020 data set was categorized as one of the following seven types: nursing, school, conference or tweet chat, health, illness/disease/condition, population, and something else. These types were then broken down into the following two categories: intercom hashtags and megaphone hashtags. Approximately 83% of the time, schools of nursing used intercom hashtags (inward-facing hashtags focused on in-group discussion within and about the profession). Schools of nursing rarely used outward-facing megaphone hashtags. There was no discernible shift in the way that schools of nursing used hashtags after the publication of The Woodhull Study Revisited. Top schools of nursing use hashtags more like intercoms to communicate with other nurses rather than megaphones to invite attention from journalists, policy makers, and the public. If schools of nursing want the media to showcase their faculty members as experts, they need to increase their use of megaphone hashtags to connect the work of their faculty with topics of interest to the public.
In a reference set of 403 kidney transplant biopsies, we recently developed a microarray-based test that diagnoses antibody-mediated rejection (ABMR) by assigning an ABMR score. To validate the ABMR score and assess its potential impact on practice, we performed the present prospective INTERCOM study (clinicaltrials.gov NCT01299168) in 300 new biopsies (264 patients) from six centers: Baltimore, Barcelona, Edmonton, Hannover, Manchester and Minneapolis. We assigned ABMR scores using the classifier created in the reference set and compared it to conventional assessment as documented in the pathology reports. INTERCOM documented uncertainty in conventional assessment: In 41% of biopsies where ABMR features were noted, the recorded diagnoses did not mention ABMR. The ABMR score correlated with ABMR histologic lesions and donor-specific antibodies, but not with T cell-mediated rejection lesions. The agreement between ABMR scores and conventional assessment was identical to that in the reference set (accuracy 85%). The ABMR score was more strongly associated with failure than conventional assessment, and when the ABMR score and conventional assessment disagreed, only the ABMR score was associated with early progression to failure. INTERCOM confirms the need to reduce uncertainty in the diagnosis of ABMR, and demonstrates the potential of the ABMR score to impact practice.
Limited data are available on effectiveness and costs of nutritional rehabilitation for patients with COPD in community care. In a 2-year RCT, 199 COPD patients (FEV(1)%pred. 60% [SD 16%]) and impaired exercise capacity were randomized to the interdisciplinary community-based COPD management program (INTERCOM) or usual care (UC). A prescheduled subgroup analysis was performed on 39 of 199 patients who were muscle wasted and received UC or nutritional therapy in combination with exercise training. Body composition, muscle strength, and exercise capacity were assessed at baseline and 4, 12, and 24 months. Between group differences after 4 months in favor of the intervention group: fat free mass index (FFMI 0.9 kg/m(2) [SE = 0.2, P < .001]), body mass index (BMI 1.0 kg/m(2) [SE = 0.4, P = .009]), maximum inspiratory mouth pressure (Pimax 1.4 kPa [SE = 0.5, P = .011]), quadriceps average power (QAP 13.1 Watt [SE=5.8, P = .036]), 6-minute walking distance (6MWD 27 m, [SE = 11.5, P = .028]), cycle endurance time (CET 525 seconds [SE=195, P = .013]), and peak exercise capacity (Wmax 12 Watt [SE = 5, P = .036]). Between group difference over 24 months in favor of the intervention group: Pimax 1.7 kPa (SE = 0.53, P = .004), QAP 19 Watt (SE = 6, P = .005), 6MWD 57 (SE = 19, P = .006), and CET 485 seconds (SE = 159, P = .006). After 4 months total costs were Euro 1501 higher in the intervention group than in the UC group (P < .05), but not significantly different after 24 months. Hospital admission costs were significantly lower in the intervention group -euro 4724 (95% CI -7704, -1734). This study in muscle-wasted COPD patients with moderate airflow obstruction shows a prolonged positive response to nutritional support integrated in a community-based rehabilitation program.
In contrast with the frequency distribution of chronic obstructive pulmonary disease (COPD) stages in the population, in which the majority of the patients is classified as GOLD 2, much less information is available on the prevalence and implications of systemic manifestations in less severe patients relative to GOLD 3 and 4. To characterize local and systemic impairment in relation to disease burden in a group of GOLD 2 COPD patients (n = 127, forced expiratory volume in one second (SD): 67 (11)% pred) that were eligible for the Interdisciplinary Community-based COPD management (INTERCOM) trial. Patients were included for this lifestyle program based on a peak exercise capacity (Wmax) < 70% of predicted. Metabolic and ventilatory response to incremental cycle ergometry, 6 minute walking distance (6MWD), constant work rate test (CWR), lung function, maximal inspiratory pressure (Pimax), quadriceps force (QF), quadriceps average power (QP) (isokinetic dynamometry), handgrip force (HGF) and body composition were measured. Quality of life (QoL) was assessed by the St. George's Respiratory Questionnaire (SGRQ) and dyspnea by the modified Medical Research Council (MRC) dyspnea scale. Exacerbations and COPD-associated hospital admissions in 12 months prior to the start of the study were recorded. Burden of disease was defined in terms of exercise capacity, QoL, hospitalization, and exacerbation frequency. GOLD 2 patients were compared with reference values and with GOLD 3 patients who were also included in the trial. HGF (77.7 (18.8) % pred) and Pimax (67.1 (22.5)% pred) were impaired in GOLD 2, while QF (93.5 (22.5)% pred) was only modestly decreased. Depletion of FFM was present in 15% of weight stable GOLD 2 patients while only 2% had experienced recent involuntary weight loss. In contrast to Wmax, submaximal exercise capacity, muscle function, and body composition were not significantly different between GOLD 2 and 3 subgroups. Body mass index and fat-free mass index were significantly lower in smokers compared to ex-smokers. In multivariate analysis, QF and diffusing capacity (DLco) were independently associated with Wmax and 6 MWD in GOLD 2 while only 6 MWD was identified as an independent determinant of health-related QoL. HGF was an independent predictor of hospitalization. This study shows that also in patients with moderate COPD, eligible for a lifestyle program based on a decreased exercise capacity, systemic impairment is an important determinant of disease burden and that smoking affects body composition.
We previously developed a microarray-based test for T cell-mediated rejection (TCMR) in a reference set of 403 biopsies. To determine the potential impact of this test in clinical practice, we undertook INTERCOM, a prospective international study of 300 indication biopsies from 264 patients (ClinicalTrials.gov NCT01299168). Biopsies from six centers-Baltimore, Barcelona, Edmonton, Hannover, Manchester and Minneapolis-were analyzed by microarrays, assigning TCMR scores by an algorithm developed in the reference set and comparing TCMR scores to local histology assessment. The TCMR score correlated with histologic TCMR lesions-tubulitis and interstitial infiltration. The accuracy for primary histologic diagnoses (0.87) was similar to the reference set (0.89). The TCMR scores reclassified 77/300 biopsies (26%): 16 histologic TCMR were molecularly non-TCMR; 15 histologic non-TCMR were molecularly TCMR, including 6 with polyoma virus nephropathy; and all 46 "borderline" biopsies were reclassified as TCMR (8) or non-TCMR (38). Like the reference set, discrepancies were primarily in situations where histology has known limitations, for example, in biopsies with scarring and inflammation/tubulitis potentially from other diseases. Neither the TCMR score nor histologic TCMR was associated with graft loss. Thus the molecular TCMR score has potential to add new insight, particularly in situations where histology is ambiguous or potentially misleading.
[This corrects the article DOI: 10.2196/25114.].
This prospective interventional study aimed at increasing knowledge and adherence to 4 infection control standards by visitors to a neonatal intensive care unit. Visitors were interviewed and observed for knowledge of and adherence to the standards pre- and postinstallation of an audiovisual display monitor, which demonstrates handwashing and delivers an auditory and written list of the standards. Handwashing adherence and watch removal improved from 79.2% to 100% and 67% to 89.7%, respectively. Recall of the standards increased from 19% to 81%.
Conventional manual visitor screening via intercom systems at the pediatric ward frequently disrupted the workflow of nurses. To address this, we introduced an automated access control system that incorporated facial recognition and body surface temperature monitoring, integrated with the existing intercom system. The guardians of long-term hospitalized children were authorized to use the new system. After implementation, the number of intercom calls significantly decreased from 139 [134, 145] to 120 [96, 129] (p=0.004).
Gastrointestinal hormones such as glucagon-like peptide-1 (GLP-1), gastric inhibitory peptide (GIP), glucagon, and glicentin are important regulators of appetite and glucose homeostasis. While agonists of GLP-1 and GIP receptors are approved treatments for type 2 diabetes and obesity, their role in anorexia nervosa (AN) remains largely unknown. In this study, we measured fasting serum levels of GLP-1, GIP, glucagon, and glicentin in 80 female patients with AN before (acAN-T1) and after short-term weight restoration (acAN-T2) compared to 80 age-matched female healthy controls (HC). GIP levels were higher (42.9%) in acAN-T1 than in HC, while GLP-1, glicentin, and glucagon showed no group differences. Additionally, acAN-T1 patients exhibited lower fasting glucose (-8.4%) and insulin (-42.6%) levels than HC. In acAN-T2, GIP, GLP-1, and glicentin levels decreased (-30.4%, -9.7%, -15.7 %, respectively), with only GIP normalizing. Glucose and insulin levels increased (4.5% and 41.4%, respectively), although they remained lower than in HC. Importantly, changes in GIP levels after short-term weight restoration negatively correlated (r = -0.279) with changes in glucose levels. Furthermore, GIP levels in acAN-T1 were positively associated with disordered eating and depressive symptoms, independent of BMI-SDS. These results reveal that GIP shows a distinct pattern of dysregulation and normalization in AN and link GIP levels to both glucose metabolism and symptom severity in AN. Thus, our findings support the rationale for investigating GIP receptor-targeted therapies in AN.
Operating room (OR) noise commonly originates from drills, suction devices, and intercom operations, which may interfere with the staff's emotional regulation. This study investigates the influence of OR noise on occupational burnout, perceived stress, and life satisfaction of OR nurses. A cross-sectional analysis was conducted on 80 OR nurses from Wuxi Ninth People's Hospital. The average OR noise level from January 2022 to December 2024 was 50.47 ± 14.52 dB. Nurses were categorized into a low-noise group (n = 37, noise exposure level ≤50 dB) and a high-noise group (n = 43, noise exposure level >50 dB) based on their average noise exposure levels. Occupational burnout level was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), perceived stress levels using the Perceived Stress Scale (PSS), and life satisfaction using the Life Satisfaction Scale (SWLS). Compared with those in the low-noise group, nurses in the high-noise group exhibited significantly higher MBI-HSS scores on the emotional exhaustion (P = 0.019) and depersonalization (P = 0.001) subscales, and significantly higher PSS scores on value strain (P = 0.048), aspiration strain (P = 0.014), deprivation strain (P = 0.020), and coping strain (P = 0.021) dimensions. The high-noise group reported lower SWLS scores compared with the low-noise group (χ2 = 16.681, P = 0.011), suggesting that noise can reduce nurses' life satisfaction. OR noise was correlated with heightened occupational burnout, stress, and reduced life satisfaction among nurses. Future research could explore the potential benefits of reducing OR noise levels for improving nurses' job satisfaction and indirectly enhancing the quality of patient care.
Androgen deprivation therapy (ADT) for prostate cancer is carried out in a palliative approach in symptomatic geriatric patients. Testosterone synthesis is suppressed using a dual therapy principle with luteinising hormone-releasing hormone (LH-RH) analogues or antagonists of LH-RH, in addition to modern antiandrogens. Additional administration of taxanes is initially possible in cases of high tumor burden and aggressive tumor biology, which is otherwise reserved for castration-resistant prostate cancer. The ADT is a systemic therapy for all testosterone-dependent processes and can lead to hot flushes, gynecomastia, osteoporosis, sarcopenia, anemia, falls, cognitive decline, depression, metabolic syndrome, increased cardiovascular events and many drug interactions. In patients identified as geriatric, ADT should therefore only be used after a thorough risk-benefit analysis. Eine androgendeprivative Therapie (ADT) des Prostatakarzinoms (PCA) erfolgt beim symptomatischen geriatrischen Patienten im palliativen Ansatz. Die Testosteronsynthese wird mithilfe eines dualen Therapieprinzips mit Luteinisierendes-Hormon-Releasing-Hormon(LH-RH)-Analoga oder Antagonisten des LH-RH unterdrückt; zusätzlich wird mit modernen Antiandrogenen therapiert. Prinzipiell ist initial bei hoher Tumorlast und aggressiven Tumoren die additive Gabe von Taxanen möglich; diese bleibt sonst dem kastrationsresistenten Prostatakarzinom vorbehalten. Eine ADT stellt eine Systemtherapie aller testosteronabhängigen Prozesse dar und kann zu Hitzewallungen, Gynäkomastie, Osteoporose, Sarkopenie, Anämie, Stürzen, kognitivem Abbau, Depression, metabolischem Syndrom, vermehrten kardiovaskulären Ereignissen und einer Fülle von Medikamenteninteraktionen führen. Sie sollte bei einem als geriatrisch identifizierten Patienten nur nach sorgfältiger Risiko-Nutzen-Analyse angewendet werden.
In Canada, healthcare professionals often rely on ad hoc interpreters, who are untrained volunteers recruited via intercom hospital announcements to interpret for patients with language barriers. This study analyzed the frequency of ad hoc interpreter requests via intercom announcements to estimate hospital interpretation needs. A retrospective cohort analysis from intercom requests for medical interpretation collected from five hospitals of the McGill University Health Center. Requests included date, time, language requested, hospital location, and extension for who placed the request. A total of 1265 intercom requests were placed for 48 languages, with the top five languages being Mandarin (17.8%), Punjabi (10.1%), Inuktitut (9.8%), Arabic (7.3%), and Cantonese (6.4%). Almost 69.8% of requests were made during working hours, 13.2% on workday evenings, and 14.8% on weekends. Requests came from urgent care (42.3%), outpatient (29.5%), and inpatient (23.3%) settings. This is the first published study that measures interpretation needs via intercom requests. We propose that our method can be replicated to inform implementation of professional medical interpretation services. We conclude that linguistic interpretation needs are significant in the Montreal area, and likely in Canada in general and pose a barrier to effective medical care.
The study purpose was to identify associations between assault deterrent presence in kindergarten through 12th (K-12) grade schools and physical assaults (PAs) against educators. Data collected through a two-phase study identified physical and nonphysical violent events and utilized a nested case-control study to identify PA risk/protective factors. Analyses included multivariable modeling. Adjusted analyses demonstrated a significant decreased risk of PA with routine locker searches (odds ratio [OR] = 0.49, 95% confidence interval [CI] [0.29, 0.82]). Also important, although not statistically significant, were presence of video monitors (OR = 0.72, 95% CI [0.50, 1.03]), intercoms (OR = 0.77, 95% CI [0.55, 1.06]), and required school uniforms/dress codes (OR = 0.74, 95% CI [0.52, 1.07]). These findings are integral to school nursing practice in which there is opportunity to influence application of relevant pilot intervention efforts as a first step in determining the potential efficacy of broad-based interventions that can positively impact the problem of school-related violence.
Complementary and integrative health approaches with a focus on relieving side effects of cancer treatment are popular among cancer patients. Previous studies have investigated the combined effects of yoga postures, breathing, and meditation, but the specific effects of the breathing component are under-reported. Our previous studies indicate that yogic breathing can improve salivary biomarker expression related to stress, immune response, and tumor suppression. We aim to assess the acceptability and feasibility of a yogic breathing program in cancer patients and caregivers during the treatment period. In this quality improvement study, we designed a 20-minute yogic breathing regimen and introduced them to all-site cancer patients and their caregivers during the cancer treatment period at a lodging facility, Hope Lodge in Charleston, SC. All interested participants were included as there were no eligibility criteria set for the study. The availability of the class was advertised via intercom, displays, and word of mouth. Participants were taught five different breathing exercises, and after completion of the exercises in a single session, a self-reported quality improvement questionnaire was administered assessing sociodemographic/clinical factors, expectations about the session, and ratings of satisfaction with the session. During the nine months of the data collection period, 52 participants provided feedback of which patients and caregivers were almost equal numbers. Participants' perception of intervention acceptance, symptom management, satisfaction with the sessions, and future needs for practice indicate that the yogic breathing sessions help improve some of the key symptoms of cancer experience such as stress. Findings indicate that yogic breathing is acceptable to patients and caregivers and may help alleviate some of the side effects resulting from cancer treatment, and the intervention is feasible at lodging facilities during treatment. Currently, the yogic breathing sessions are conducted on a weekly basis by Hope Lodge volunteers trained by the study team.
An active shooter in a hospital is an emergency extraordinaire. We report a single institution's response to the largest active shooter mass casualty event in American History. Review of notification, flow of prioritized patients, and key elements of the day's dynamic after a hospital attack by a lone gunman were commenced. The review includes outcomes on seven victims and assailants. "Code Silver" announced: open display of a weapon. Concise, known, and published chain of command implemented. All house staff to the Emergency Department (ED) via text blast. Operating room (OR) notified. Injured to ED, then triaged to OR. Armed NYPD stationed throughout OR. Senior surgeons controlled key triage during attack with flow controlled from the ED and OR control desk. One fatality plus shooter. Success favors the prepared. The response to attack, readiness of medical personnel, mitigation, and recovery have brought the following recommendations: (1) single entrance access; (2) armed, professional guards at all entrances; (3) camouflage metal detectors; (4) mandatory, recurrent hospital-wide active shooter training, mock, and table top; (5) published physician chain of command; (6) intercom code system known to all hospital personnel indicating a weapon is openly displayed; (7) a "no fly" list of former employees who are prohibited on premises; (8) stop the bleed training with kits on every floor; (9) one voice, one face to disseminate information. Prognostic and Epidemiological; Level I.
Geant4 is a versatile Monte Carlo radiation transport simulation toolkit with a steep learning curve. This work introduces a user-code called M-TAG (Modular Radiation Teaching-Aid for Geant4), built on top of Geant4. M-TAG is designed to help gradually introduce the Geant4 toolkit to new users. The goal of Geant4 is to record quantities from the simulated radiation as it is transported through geometries. M-TAG simplifies the inclusion of new geometric elements and detector components in the simulation by including new classes. M-TAG also provides basic validated examples for some common detector development tasks. Geant4 intercom modules, called messenger classes, manage these classes. To validate M-TAG, simulations were performed to calculate the range of positrons in water. One hundred million decays at the center of a water-filled sphere with a radius of 1 m were allowed for fluorine-18, carbon-11, oxygen-15 and gallium-68. These results were compared to literature values. An inexperienced Geant4 user was tasked with creating a simulation model for a plastic scintillator-based detector and conducting basic tests to assess the effectiveness of M-TAG as a teaching tool. The simulation involved calculating the dose to the detector's sensitive volume using a 2x2 cm planar monoenergetic photon source spanning energies from 20 to 100 keV. One billion particles were simulated twice: once with the actual detector geometry and once with the sensitive volume replaced by water. The validity of M-TAG was also verified by computing dose ratios and comparing them with mass-attenuation ratios obtained from NIST XCOM data sets. The mean positron travel distances were within the distribution of literature values. Simulated positron energy spectra means were within 1.8% of literature means. Simulated dose ratios agreed with literature values within uncertainties. We have developed and verified a modular Geant4 teaching aid called M-TAG. It was used to introduce a new user to Geant4, who used it to perform further validation simulations.
The Committee on En Route Combat Casualty Care recently ranked the patient handoff as their fourth research priority. Bluetooth technology has been introduced to the battlefield and has the potential to improve the tactical patient handoff. The purpose of this study is to compare the traditional methods of communication used in tactical medical evacuation by Special Operations medical personnel (radio push-to-talk [PTT] and Tactical Medic Intercom System [TM-ICS]) to Bluetooth communication. Twenty-four simulated tactical patient handoffs were performed to compare Bluetooth and traditional methods of communication used in tactical medical evacuation. Patient scenario order and method of communication were randomized. Accuracy and time required to complete the patient handoff were determined. The study took place using a rotary-wing aircraft kept at level 2 to simulate real-world background noise. Preferred method of communication for each study participant was determined. There were no differences in accuracy of the received patient handoffs between groups or patient handoff transmission times at the ramp of the aircraft. However, when comparing patient handoff times to the medical team within the aircraft, Bluetooth communication was significantly faster than both TM-ICS and radio PTT, while Bluetooth PTT and radio PTT were also significantly faster than TM-ICS. Bluetooth communication was ranked as the preferred method of handoff by all study participants. The study demonstrated that utilization of Bluetooth technology for patient handover results in faster handoffs compared with traditional methods without sacrificing any accuracy in a scenario with high levels of noise.