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Anesthesia education

Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
Yu Shi, Danqing Hu, Erin L Rodgers, Slavica K Katusic, Stephen J Gleich, Andrew C Hanson, Darrell R Schroeder, Randall P Flick, David O Warner
BACKGROUND: Utilization of general anesthesia in children has important policy, economic, and healthcare delivery implications, yet there is little information regarding the epidemiology of these procedures in the United States. AIMS: The primary objective of this study was to describe in a geographically defined population the incidence of procedures requiring general anesthesia up to the child's third birthday, and the patient characteristics associated with receiving these procedures...
March 13, 2018: Paediatric Anaesthesia
Andrew Adams, Carilynne Yarascavitch, Carlos Quiñonez, Amir Azarpazhooh
OBJECTIVE: This study aims to assess barriers to the use of deep sedation/general anesthesia (DS/GA) identified by dentists in Ontario. METHODS: An email invitation to a web-based survey was distributed to all licensed dentists and specialists who have provided an email address to the provincial regulator (n = 5507). Descriptive and regression analyses were performed to explore practice and demographic factors associated with the use of DS/GA. RESULTS: The response rate was 18...
July 2017: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
Denise C Joffe, Mark R Shi, Carson C Welker
Most patients with congenital heart disease have a cardiac shunt whose direction and magnitude can have a major impact on cardiorespiratory physiology and function. The dynamics of the shunt can be significantly altered by anesthetic management and must be understood in order to provide optimal anesthetic care. Given that there are now more adults than children with congenital heart disease and that the majority of nonpediatric patients are cared for in centers without special expertise in congenital heart disease, it is imperative that all anesthesia providers have a general understanding of the subject...
March 6, 2018: Paediatric Anaesthesia
Rosalie T Trevejo, Sandra L Lefebvre, Mingyin Yang, Catherine Rhoads, Gary Goldstein, Elizabeth M Lund
OBJECTIVE To examine potential associations between periodontal disease (PD) and the risk of development of chronic azotemic kidney disease (CKD) among cats and determine whether the risk of CKD increases with severity of PD. DESIGN Retrospective cohort study. ANIMALS 169, 242 cats. PROCEDURES Cats were evaluated ≥ 3 times at any of 829 hospitals from January 1, 2002, through June 30, 2013. Cats with an initial diagnosis of PD of any stage (n = 56,414) were frequency matched with cats that had no history or evidence of PD (112,828) by age and year of study entry...
March 15, 2018: Journal of the American Veterinary Medical Association
Zhi-Peng Wang, Jue Ma, Sheng Wang, Li-Na Yu, Jin-Feng Wei, Jin-Dong Xu
OBJECTIVE: To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. METHODS: Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
J Breckwoldt, S K Beckers, G Breuer, A Marty
Entrustable professional activities (EPAs) are characterized as self-contained units of work in a given typical clinical context, which may be entrusted to a trainee for independent execution at a certain point of training. An example could be the intraoperative anesthesia management of an ASA 1 patient for an uncomplicated surgical intervention as an EPA in early postgraduate anesthesia training. The EPAs can be described as an evolution of a competency-based medical educational concept, applying the concept of the competencies of a person to specific workplace contexts...
March 2, 2018: Der Anaesthesist
Kaitlen O Woodfin, Corey Johnson, Renee Parker, Caroline Mikach, Molly Johnson, Susan P McMullan
Interdisciplinary collaboration is key to safe surgical positioning. Although the surgical procedure dictates the patient's position, surgeons, anesthesia care providers, intraoperative nurses, and ancillary staff members must work together to achieve the goal of safe positioning. Correct patient positioning includes the provision of adequate access to the surgical site for the surgeon and surgical assistants. Surgical positions may put the patient at risk of injury. Understanding human anatomy, including the nerves commonly affected by each surgical position, can help the surgical team prevent accidental and irreversible patient injury...
March 2018: AORN Journal
Ethan O Bryson
PURPOSE OF REVIEW: There has been a substantial increase in prescription and illicit opioid abuse in the general population observed over the last two decades. Initially fueled by an influx of prescription opioid medications, the opioid epidemic now includes increasingly potent heroin and illicit fentanyl. Younger anesthesiologists, those currently in training or recent graduates, have come of age in a society where opioid abuse is much more prevalent. RECENT FINDINGS: The current prevalence of substance use disorder (SUD) in the physician population is slightly higher than in the general population and appears to be increasing...
February 22, 2018: Current Opinion in Anaesthesiology
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
Yang Wang, Zejun Liu, Shuanghong Chen, Xiaoxuan Ye, Wenyi Xie, Chunrong Hu, Tony Iezzi, Todd Jackson
BACKGROUND: chronic pain post-surgical pain (CPSP) is common and has far-reaching negative consequences for patients, yet relatively few studies have evaluated the impact of both deficit- and resource-based beliefs about pain and surgery on subjective intensities of acute and chronic post-surgical pain. METHOD: To address this issue, a prospective cohort study was performed. 259 consecutive surgery patients from general surgery, gynecology, and thoracic departments completed a self-report battery of demographics, pain experiences, and psychological factors 24 h before surgery (T1) and provided follow-up pain intensity ratings 48 h-72 h after surgery (T2), and at a 4-month follow-up (T3)...
February 17, 2018: International Journal of Surgery
Paul Abraham, Franck Verdonk, Clement Buleon, Antoine Tesniere, Marc Lilot
Integration of simulation in educational curricula for anesthesia and intensive care residents is a hot topic. There is a great interest for simulation centers to share their experiences through multi-site synchronous simulation sessions. The present study results from an experience conducted at three sites in France (Paris, Lyon, and Caen), which involved 16 instructors and 25 residents facing the same scenario across 1 day. Synchronous simulations were performed at each site with local and shared debriefing via teleconference...
2018: Advances in Simulation
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
Haiqing Huang, Jared Tanner, Hari Parvataneni, Mark Rice, Ann Horgas, Mingzhou Ding, Catherine Price
 Using resting state functional magnetic resonance imaging (RS-fMRI), we explored: 1) pre- to post-operative changes in functional connectivity in default mode, salience, and central executive networks after total knee arthroplasty (TKA) with general anesthesia, and 2) the contribution of cognitive/brain reserve metrics these resting state functional declines. Individuals age 60 and older electing unilateral total knee arthroplasty (TKA; n = 48) and non-surgery peers with osteoarthritis (n = 45) completed baseline cognitive testing and baseline and post-surgery (post-baseline, 48-h post-surgery) brain MRI...
2018: Journal of Alzheimer's Disease: JAD
Tulika Singh, Sanju Sharma, Bratati Banerjee, Suneela Garg
INTRODUCTION: Anesthesia has become one of the most advanced specialties in modern medicine with tremendous growth in knowledge and substances available for use. However, public awareness toward anesthesiologist and anesthesiology is limited. It is important for us to make people aware about the role played by an anesthesiologist in medical setup. The present study was conducted among patients and attendants to assess the knowledge regarding the anesthesiologist and anesthesiology. MATERIALS AND METHODS: The study was carried out at a rural hospital of New Delhi, on 250 adult patients and attendants visiting outpatient departments to assess their knowledge regarding anesthesiologists and anesthesiology...
2018: Journal of Education and Health Promotion
Hugo Paquin, Ilana Bank, Meredith Young, Lily H P Nguyen, Rachel Fisher, Peter Nugus
Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education...
February 5, 2018: Leadership in Health Services
Saundra E Curry
There are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. A survey was conducted among US anesthesiology teaching programs regarding the teaching content and approaches currently used to teach US medical students clinical anesthesia...
February 2, 2018: Anesthesia and Analgesia
Jeron Zerillo, Natalie K Smith, Tetsuro Sakai
In 2017, we identified more than 400 peer reviewed publications on the topic of pancreas transplantation, more than 500 on intestinal transplantation, more than 4000 on renal transplantation, and more than 4700 on liver transplantation. This annual review highlights the most pertinent literature for anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a wide range of topics, including risk for and prediction of perioperative complications, recommendations on perioperative management, economic analyses, and education of the trainees in abdominal transplantation anesthesia and critical care...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
A Antoniou, K Marmai, F Qasem, R Cherry, P M Jones, S Singh
BACKGROUND: Informed consent is required before placing an epidural. At our hospital, teaching of residents about this is done informally at the bedside. This study aimed to assess the ability of anesthesia residents to acquire and retain knowledge required when seeking informed consent for epidural labor analgesia. It assessed how well this knowledge was translated to clinical ability, by assessing the verbal consent process during an interaction with a standardized patient. METHODS: Twenty anesthesia residents were randomized to a 'didactic group' or a 'simulation group'...
December 29, 2017: International Journal of Obstetric Anesthesia
Richard H Blum, Sharon L Muret-Wagstaff, John R Boulet, Jeffrey B Cooper, Emil R Petrusa, Keith H Baker, Galina Davidyuk, Jennifer L Dearden, David M Feinstein, Stephanie B Jones, William R Kimball, John D Mitchell, Robert L Nadelberg, Sarah H Wiser, Meredith A Albrecht, Amanda K Anastasi, Ruma R Bose, Laura Y Chang, Deborah J Culley, Lauren J Fisher, Meera Grover, Suzanne B Klainer, Rikante Kveraga, Jeffrey P Martel, Shannon S McKenna, Rebecca D Minehart, John D Mitchell, Jeremi R Mountjoy, John B Pawlowski, Robert N Pilon, Douglas C Shook, David A Silver, Carol A Warfield, Katherine L Zaleski
BACKGROUND: Obtaining reliable and valid information on resident performance is critical to patient safety and training program improvement. The goals were to characterize important anesthesia resident performance gaps that are not typically evaluated, and to further validate scores from a multiscenario simulation-based assessment. METHODS: Seven high-fidelity scenarios reflecting core anesthesiology skills were administered to 51 first-year residents (CA-1s) and 16 third-year residents (CA-3s) from three residency programs...
January 24, 2018: Anesthesiology
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