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https://www.readbyqxmd.com/read/27878890/a-qualitative-exploration-of-anesthesia-trainees-experiences-during-transition-to-a-children-s-hospital
#1
Peter W Howe, Koshila Kumar
BACKGROUND: The stresses of starting a new job can make anyone feel tired and inefficient. In health care, this may impair the ability to learn at a time when there is most to learn, and increase the risk of error in a context where errors may lead to patient harm. AIM: The aim of this study was to understand issues which influence anesthesia trainees' transition to a pediatric setting. METHODS: This qualitative study utilized in-depth semi-structured interviews to gather data from 31 anesthesia trainees who had commenced work at a tertiary children's hospital between 4 and 6 weeks previously...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27878131/extra-luminal-entrapment-of-guide-wire-a-rare-complication-of-central-venous-catheter-placement-in-right-internal-jugular-vein
#2
Md Abu Masud Ansari, Naveen Kumar, Shailesh Kumar, Sarita Kumari
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27871589/trainee-experience-and-success-of-urgent-airway-management
#3
Thomas E Schulte, Kyle J Ringenberg, Steven J Lisco, Harlan Sayles, Sasha K Shillcutt
BACKGROUND: There are limited data regarding emergent, non-operating room, intubations performed by all levels of anesthesia residents. This study was a large retrospective review of all non-operating room emergent intubations performed at a single tertiary medical center. The study evaluated the rate of difficult intubations by level of resident training, compared success rates for direct versus video laryngoscopy and evaluated the rate and success of rescue video laryngoscopy following failed direct laryngoscopy...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27705012/how-patient-controlled-sedation-is-adopted-in-clinical-practice-of-sedation-for-endoscopic-retrograde-cholangiopancreatography-a-prospective-study-of-1196-cases
#4
Jarno Jokelainen, Marianne Udd, Leena Kylänpää, Harri Mustonen, Jorma Halttunen, Outi Lindström, Reino Pöyhiä
OBJECTIVE: Patient controlled sedation (PCS) has been shown to be a valid choice for sedation during endoscopic retrograde cholangiopancreatography (ERCP) in randomized studies. However, large scale studies are lacking. MATERIAL AND METHODS: A single center, prospective observational study to determine how sedation for ERCP is administered in clinical setting. All 956 patients undergoing 1196 ERCPs in the endoscopy unit of Helsinki University Central Hospital 2012-2013, methods of sedation and adverse events associated with different sedations were recorded...
October 5, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27685347/a-randomized-controlled-trial-of-ultrasound-versus-nerve-stimulator-guidance-for-axillary-brachial-plexus-block
#5
Michael J Barrington, Samuel R Gledhill, Roman Kluger, Alexander L Clarke, Daniel M Wong, Henry Davidson, Rowan Thomas
BACKGROUND: Ultrasound-guided techniques improve outcomes in regional anesthesia when compared with traditional techniques; however, this assertion has not been studied with novices. The primary objective of this study was to compare sensory and motor block after axillary brachial plexus block when performed by novice trainees allocated to an ultrasound- or nerve-stimulator-guided group. A secondary objective was to compare the rates of skill acquisition between the 2 groups. METHODS: This study was a prospective, randomized, observer-blinded, 2-arm controlled trial...
September 28, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27663452/perceptions-of-purpose-value-and-process-of-the-mini-clinical-evaluation-exercise-in-anesthesia-training
#6
Damian J Castanelli, Tanisha Jowsey, Yan Chen, Jennifer M Weller
INTRODUCTION: Workplace-based assessment is integral to programmatic assessment in a competency-based curriculum. In 2013, one such assessment, a mini-Clinical Evaluation Exercise (mini-CEX) with a novel "entrustability scale", became compulsory for over 1,200 Australia and New Zealand College of Anaesthetists (ANZCA) trainees. We explored trainees' and supervisors' understanding of the mini-CEX, their experience with the assessment, and their perceptions of its influence on learning and supervision...
December 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27625481/reliability-and-validity-of-a-tool-to-assess-airway-management-skills-in-anesthesia-trainees
#7
Aliya Ahmed, Fauzia Anis Khan, Samina Ismail
BACKGROUND AND AIMS: Gaining expertise in procedural skills is essential for achieving clinical competence during anesthesia training. Supervisors have the important responsibility of deciding when the trainee can be allowed to perform various procedures without direct supervision while ensuring patient safety. This requires robust and reliable assessment techniques. Airway management with bag-mask ventilation and tracheal intubation are routinely performed by anesthesia trainees at induction of anesthesia and to save lives during a cardiorespiratory arrest...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27587344/simulation-based-training-in-echocardiography
#8
Monodeep Biswas, Rajendrakumar Patel, Charles German, Anant Kharod, Ahmed Mohamed, Harvinder S Dod, Poonam Malhotra Kapoor, Navin C Nanda
The knowledge gained from echocardiography is paramount for the clinician in diagnosing, interpreting, and treating various forms of disease. While cardiologists traditionally have undergone training in this imaging modality during their fellowship, many other specialties are beginning to show interest as well, including intensive care, anesthesia, and primary care trainees, in both transesophageal and transthoracic echocardiography. Advances in technology have led to the development of simulation programs accessible to trainees to help gain proficiency in the nuances of obtaining quality images, in a low stress, pressure free environment, often with a functioning ultrasound probe and mannequin that can mimic many of the pathologies seen in living patients...
September 1, 2016: Echocardiography
https://www.readbyqxmd.com/read/27466975/teaching-concepts-in-ultrasound-guided-regional-anesthesia
#9
Jens Kessler, Jessica T Wegener, Markus W Hollmann, Markus F Stevens
PURPOSE OF REVIEW: Ultrasound-guided regional anesthesia is a challenging, complex skill and requires competence in teaching. The aim of this study was to review current literature on identification of education and learning of ultrasound-guided regional anesthesia and to summarize recent findings on teaching concepts. RECENT FINDINGS: Several teaching programs have been described and implemented into daily routine. Factors relevant to current practice are the knowledge of sonoanatomy, the acquisition of manual skills, the teaching ability, and the feedback given to the trainee...
October 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27453703/oxymetazoline-metered-dose-spray-factors-affecting-delivery-volume
#10
Mumin Hakim, Hina Walia, Mahmood Rafiq, Timothy Grannell, Richard S Cartabuke, Joseph D Tobias
OBJECTIVES: The current study compared the amount of oxymetazoline delivered by various anesthesia providers when holding the bottle in the upright and inverted position. Additionally, the amount delivered from a full bottle and a half-full bottle was also investigated. METHODS: Using an analytical balance that was calibrated to zero, we evaluated the impact the position of the bottle and the volume of oxymetazoline in the bottle had on the amount being delivered by both anesthesia staff and trainees...
May 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27390576/spinal-anesthesia-facilitates-the-early-recognition-of-tur-syndrome
#11
REVIEW
Sam McGowan-Smyth, Nikhil Vasdev, Shan Gowrie-Mohan
OBJECTIVES: To investigate what clinical features typically present in transurethral resection (TUR) syndrome and to see which classically present first. The purpose of the study was to establish whether or not a particular method of anesthesia is preferred in detecting this syndrome in its early stages. METHODS: A total of 1,502 transurethral resection of the prostate (TURP) over a 15 year period were reviewed to see which, if any, went on to experience this complication...
May 2016: Current Urology
https://www.readbyqxmd.com/read/27382808/comparison-of-indirect-video-laryngoscopes-in-children-younger-than-two-years-of-age-a-randomized-trainee-evaluation-study
#12
RANDOMIZED CONTROLLED TRIAL
Marissa G Vadi, Elizabeth A Ghazal, Bryan Halverson, Richard L Applegate
BACKGROUND: Gaining proficiency with various airway management tools is an important goal for anesthesiology training. Indirect video laryngoscopes facilitate tracheal intubation in adults, but it is not clear whether these findings translate to children. This study evaluates the total time to successful intubation when performed by anesthesiology trainees using GlideScope Cobalt® video laryngoscopy (GlideScope), Storz DCI® video laryngoscopy (Storz), or direct laryngoscopy (Direct) in children <2 years old with normal airway anatomy...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27375380/inaccurate-level-of-intervertebral-space-estimated-by-palpation-the-ultrasonic-revelation
#13
L H Parate, B Manjunath, C A Tejesh, V Pujari
BACKGROUND: Spinal cord injury resulting from spinal anesthesia is a rare, but an alarming scenario. The most likely cause is believed to be misjudged level of intervertebral space (IVS). We evaluated the accuracy of palpation method to locate IVS with the ultrasonography. MATERIALS AND METHODS: A total of 109 patients undergoing spinal anesthesia were included in this observational, double-blind study. First anesthesiologist was asked to mark IVS using palpation method...
July 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27350541/current-practice-patterns-of-rectal-suction-biopsy-in-the-diagnostic-work-up-of-hirschsprung-s-disease-results-from-an-international-survey
#14
Florian Friedmacher, Prem Puri
PURPOSE: The diagnosis of Hirschsprung's disease (HD) was revolutionized by the introduction of rectal suction biopsy (RSB), allowing specimens to be taken without general anesthesia on the ward or as an out-patient procedure. However, insufficient tissue samples are not uncommon, and subsequently histopathologists often remain reluctant to confirm the presence or absence of enteric ganglion cells merely on the basis of submucosal RSBs. The aim of this study was to evaluate the current usage of RSB in the diagnostic work-up of HD based on an international survey...
August 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27246662/a-randomized-double-blinded-trial-on-the-effects-of-ultrasound-transducer-orientation-on-teaching-and-learning-ultrasound-guided-regional-anesthesia
#15
Nicholas C K Lam, Elizabeth B Baker, Steven J Fishburn, Angie R Hammer, Timothy R Petersen, Edward R Mariano
OBJECTIVES: Learning ultrasound-guided regional anesthesia skills, especially needle/ beam alignment, can be especially difficulty for trainees, who can often become frustrated. We hypothesized that teaching novices to orient the transducer and needle perpendicular to their shoulders will improve performance on a standardized task, compared to holding the transducer and needle parallel to the shoulders. METHODS: This study compared the effects of transducer orientation on trainees' ability to complete a standardized ultrasound-guided nerve block simulation...
July 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27193185/a-proposal-of-a-simple-epidural-simulator-for-training-novice-anesthesiologists
#16
Sung-Moon Jeong, Jae Moon Choi, Ji Hyun Kim, Hwanhee Yoo, Sukyung Lee, Hyungseok Seo, Sooyoung Kim, Sung-Hoon Kim
PURPOSE: Confirming the epidural space during epidural anesthesia relies mainly on feel and experience, which are difficult techniques for a trainee to learn. We designed an epidural simulator for trainees to experience loss of resistance (LOR) and various degrees of pressure resistance. METHODS: The simulator consists of a Perifix(®) LOR syringe and 1-, 5-, 10- and 50-mL syringes assembled by three-way stopcocks. A total of 89 anesthesiologists evaluated the simulator, given the choice of either the intermittent technique with air or continuous technique with saline...
August 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27185683/incidence-and-risk-factors-for-early-postoperative-reintubations
#17
Margaret N Tillquist, Rodney A Gabriel, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: Reintubations are associated with significantly increased morbidity and mortality, increased hospital length of stay, and increased cost. Our aim was to assess the national incidence and associated risk factors for unanticipated early postoperative reintubations. DESIGN: Using the National Anesthesia Clinical Outcomes Registry (NACOR) from 2010 to 2014, multivariate logistic regression was fitted to determine if various patient, surgical, intraoperative, or provider data were associated with unanticipated early postoperative reintubations...
June 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27175421/a-workshop-in-physician-patient-communication-for-anesthesiology-trainees
#18
Susan Eggly, Elie Joseph Chidiac, Maria Zestos
BACKGROUND: Although abundant literature demonstrates the importance of effective physician-patient communication, most research and teaching models in this area are based on a primary care setting, and may not apply to procedural specialties. Some research demonstrates that patients perceive their surgeons' and anesthesiologists' communication skills to be less effective than those of primary care specialists. In order to improve the effectiveness of anesthesiology trainee communication skills and simultaneously address the new ACGME general competency requirements pertaining to such skills, faculty from the Departments of Anesthesiology and Internal Medicine collaborated in the development of a workshop tailored to the needs of this group...
July 2003: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/27175414/a-comparison-of-internet-usage-between-two-residency-programs-in-the-united-kingdom-and-the-united-states
#19
John C Sanders
BACKGROUND: The Internet is a potentially useful tool in medical education. The patterns of its usage and availability among anesthesia residents have not been surveyed. This survey, conducted in 2000, attempts to gain insight into and quantify its usage. METHODS: After ethics committee approval, a postal questionnaire of attitudes and usage was sent to trainees in Anesthesiology in two training programs: the University of New Mexico, USA (UNM) and the North West Regional Health Authority, UK (NWR)...
January 2002: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/27175397/predicting-success-does-performance-on-the-anesthesia-knowledge-test-6-akt-6-correlate-with-the-american-board-of-anesthesiology-aba-licensing-exam-first-time-pass-rate
#20
Mark A Cheney, Michael A Dimeola, Christopher J Nagy
BACKGROUND: We sought to determine the relationship between residents' Anesthesia Knowledge Test 6 (AKT-6) scores and their first-time success/failure on the American Board of Anesthesiology written licensing examination. Reliable early identification of residents at risk for failing the ABA exam would be an invaluable screening tool for program leadership and facilitate timely remediation for struggling residents. METHODS: Program directors were invited to submit anonymous data regarding their residents' performance on the AKT-6 and their subsequent first-time success/failure on the American Board of Anesthesiology written licensing examination...
January 2014: Journal of Education in Perioperative Medicine: JEPM
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