We develop the theory behind and a prototype of a 0.3-12 GHz ground-penetrating radar (GPR) system foruse in imaging the subsurface environment. Experimental results show that the prototype GPR system is likely able to perform in field applications including buried utility detection and humanitarian demining operations. First, we present two antenna designs – the resistively loaded vee dipole (RLVD) and elliptical RLVD based on a Guanella balun structure. However, we found a disconnect between the performance of these antennas in simulation and the real-world system performance. Therefore, we have developed a theory of how the less-often-considered aspects of antennas including coupling, distortion, beamwidth, and radar cross section dramatically affect the overall imaging performance. We perform a deep-dive into the causes, solutions, and design decisions that each aspect of the antenna requires in order to make it more likely that an antenna will perform well in the niche application of GPR. In order to validate and apply these principles in the real world, we present the creation of a 0.3-12 GHz GPR system in both the lab and outside environments. We show the entire build of the custom FPGA-based sampling receiver, examine the VHDL backend for data offloading, and describe the real-time visualization system. Next, we show in depth the signal-processing pipeline required to take raw data to a pre-processed image: de-glitching, de-jittering, and background removal algorithms, among others. The Kirchhoff-Migration imaging algorithms used to transform the pre-processed data into human-readable images are presented in detail. Finally, lab-based and real-world underground imaging results are presented as validation of the operation of the GPR system. We demonstrate the detection of steel rebar in a laboratory sandbox imaging test and portions of the underground structure around Kemper Hall at UC Davis.

Introduction: Intubation and mechanical ventilation are common interventions performed in the emergency department (ED). These interventions cause pain and discomfort to patients and necessitate analgesia and sedation. Recent trends in the ED and intensive care unit focus on an analgesia-first model to improve patient outcomes. Initial data from our institution demonstrated an over-emphasis on sedation and an opportunity to improve analgesic administration. As a result of these findings, the ED undertook a quality improvement (QI) project aimed at improving analgesia administration and time to analgesia post-intubation.

Methods: We performed a pre-post study between January 2017–February 2019 in the ED. Patients over the age of 18 who were intubated using rapid sequence intubation (RSI) were included in the study. The primary outcome was the rate of analgesia administration; a secondary outcome was time to analgesia administration. Quality improvement interventions occurred in two phases: an initial intervention focused on nursing education only, and a subsequent intervention that included nursing and physician education.

Results: During the study period, 460 patients were intubated in the ED and met inclusion/exclusion criteria. Prior to the first intervention, the average rate of analgesia administration was 57.3%; after the second intervention, the rate was 94.9% (P <0.01). Prior to the first intervention, average time to analgesia administration was 36.0 minutes; after the second intervention, the time was 16.6 minutes (P value <0.01).

Conclusion: This QI intervention demonstrates the ability of education interventions alone to increase the rate of analgesia administration and reduce the time to analgesia in post-intubation patients.