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Anesthesia trainees

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
Joel Bierer, Eustatiu Memu, Robert Leeper, Dalilah Fortin, Eric Fréchette, Richard Inculet, Richard Malthaner
BACKGROUND: Our vision was to develop an inexpensive training simulation in a functional operating room (in-situ) that included surgical trainees, nursing and anesthesia staff to focus on effective interprofessional communication and teamwork skills. METHODS: The simulation scenario revolved around a post-pneumonectomy airway obstruction by residual tumor. This model included our thoracic operating room with patient status displayed by an open access vital sign simulator and a reversibly modified Laerdal® airway mannequin...
February 27, 2018: Annals of Thoracic Surgery
N'Diris Barry, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Kamlesh Kumari, Tanvir Samra, B Naveen Naik, Vikas Saini
Background: To ensure patient safety, it is important to regularly assess the knowledge and practical skills of anesthesia trainees. This study was conducted to evaluate the competency of the residents and the impact of various corrective measures in the form of didactic lectures and clinical skill demonstrations on the conduct of various procedural skills by the residents. Materials and Methods: Ninety-five junior residents were enrolled in this study. Assessment of competency of 1st, 2nd, and 3rd year residents in performing various procedure skills of anesthesia was done in two stages using procedure specific checklist (PSC) and Global Rating Scales (GRSs)...
January 2018: Saudi Journal of Anaesthesia
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
Massimiliano Meineri, Gregory L Bryson, Ramiro Arellano, Nikolaos Skubas
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees...
January 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
M Portas, M I Canal, M Barrio, M Alonso, P Cabrerizo, M López-Gil, M Zaballos
INTRODUCTION: Airway management is still a major cause of anesthesia-associated morbidity and mortality. Supraglottic devices are recommended in difficult airway management guidelines. The aim of this study was to compare the performance of the Air-Q® and the LMA Fastrach™ for fiberoptic guided tracheal intubation. METHODS: Thirty-three anesthesia trainees participated in this randomized crossover study. Time to insert the dedicated airways (insertion of the airway into the manikin and delivery of two breaths), time to tracheal intubation (fiberoptic-guided tracheal intubation), time to remove the dedicated airway (removal of the Air-Q® /LMA Fastrach™ over the tracheal tube) and the opinion of the ease of use of the anesthesia trainees were measured...
March 2018: Revista Española de Anestesiología y Reanimación
Roy K Kiberenge, Kenichi Ueda, Brett Rosauer
BACKGROUND: Radial arterial cannulation is most commonly done using palpation, but the use of ultrasound has increased the cannulation success rate. This improvement, albeit significant, has not led to a very high success rate especially in trainees. A modified ultrasound technique for vascular cannulation (dynamic needle tip positioning) has been described for peripheral venous cannulation. We therefore assessed the success rate of this technique compared to the palpation technique for radial artery cannulation in adult surgical patients...
January 2018: Anesthesia and Analgesia
Stephen C Haskins, Jinhui Zhao, Jemiel A Nejim, Kara Fields, Sean Garvin, Sumudu Dehipawala, James D Beckman, Angie Zhang, James A Osorio, Christopher Tanaka
At our institution, implementation of a formal training course in Basic Focus Assessed Transthoracic Echocardiography (FATE) was associated with an improvement in anesthesia trainees' ability to obtain transthoracic echocardiography (TTE) images. Total image acquisition scores improved by a median (Q1, Q3) 9.1 (2.9,14.7) percentage points from pre-to post-hands-on FATE course (n=20; p=0.001). Participants who returned for a subsequent assessment 5 months following the course demonstrated a median (Q1, Q3) 18...
September 2017: Journal of Anesthesia & Clinical Research
James A O'Neill
The traditional model for humanitarian work for surgeons has been a few long-term people and a larger number of volunteers on short-term missions to needy places for one or two weeks with limited opportunity for follow-up. While a great deal of good has resulted from these efforts, in the long term not much has changed. Recent studies like the U.N. Millennium Development Goals and the Lancet Commission Report, Surgery 2030, have pointed out that the burden of surgical disease is the major public health issue in the world, such that an estimated five billion people worldwide do not have access to safe surgery and anesthesia, with the largest number being in Africa where almost half of the population is less than age 18years...
October 10, 2017: Journal of Pediatric Surgery
Hiroyuki Oizumi, Hirohisa Kato, Makoto Endoh, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Kenta Nakahashi, Mitsuaki Sadahiro
BACKGROUND: Despite the increasing demand for thoracoscopic lung segmentectomy, the appropriate training method is not well established. Therefore, we developed a swine model for anatomical thoracoscopic lung segmentectomy training. METHODS: Three-month-old pigs, weighing 40 to 45 kg, were used in this model. Anterior segmentectomy of the left cranial lobe and segmentectomy of the most anterior left caudal lobe were performed under general anesthesia and differential ventilation...
2017: Journal of Visualized Surgery
Yihan Lin, John W Scott, Sojung Yi, Kathryn K Taylor, Georges Ntakiyiruta, Faustin Ntirenganya, Paulin Banguti, Steven Yule, Robert Riviello
OBJECTIVE: A substantial proportion of adverse intraoperative events are attributed to failures in nontechnical skills. To strengthen these skills and improve surgical safety, the Non-Technical Skills for Surgeons (NOTSS) taxonomy was developed as a common framework. The NOTSS taxonomy was adapted for low- and middle-income countries, where variable resources pose a significant challenge to safe surgery. The NOTSS for variable-resource contexts (VRC) curriculum was developed and implemented in Rwanda, with the aim of enhancing knowledge and attitudes about nontechnical skills and promoting surgical safety...
October 23, 2017: Journal of Surgical Education
K Gandhi, N Sahni, S K Padhy, P J Mathew
OBJECTIVE: The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. MATERIALS AND METHODS: A comparative, observational study was conducted in a tertiary care teaching hospital in North India...
October 23, 2017: Journal of Postgraduate Medicine
B Esterer, S Gabauer, R Pichler, D Wirthl, M Drack, M Hollensteiner, G Kettlgruber, M Kaltenbrunner, S Bauer, D Furst, R Merwa, J Meier, P Augat, A Schrempf
Epidural and spinal anesthesia are mostly performed "blind" without any medical imaging. Currently, training of these procedures is performed on human specimens, virtual reality systems, manikins and mostly in clinical practice supervised by a professional. In this study a novel hybrid, low-cost patient simulator for the training of needle insertion into the epidural space was designed. The patient phantom provides a realistic force feedback comparable with biological tissue and enables sensing of the needle tip position during insertion...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Charlotte B Winder, Stephen J LeBlanc, Derek B Haley, Kerry D Lissemore, M Ann Godkin, Todd F Duffield
The use of pain control for disbudding and dehorning is important from both an animal and industry perspective. Best practices include the use of local anesthetic, commonly given as a cornual nerve block (CNB), and a nonsteroidal anti-inflammatory drug. The proportion is decreasing, but many dairy producers do not use local anesthesia, perhaps in part due to lack of knowledge of the CNB technique. Although this skill is typically learned in person from a veterinarian, alternative methods may be useful. The objective of this trial was to determine if there were differences in the efficacy of online training (n = 23), hands-on training (n = 20), and a combined approach (n = 23) for teaching producers to successfully administer a CNB and disbud a calf...
October 18, 2017: Journal of Dairy Science
Ryan M Chadha, Cara Crouch, Jeron Zerillo, Ernesto A Pretto, Raymond Planinsic, Sang Kim, Ramona Nicolau-Raducu, Dieter Adelmann, Elia Elia, Christopher L Wray, Coimbatore Srinivas, M Susan Mandell
The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers...
December 2017: Seminars in Cardiothoracic and Vascular Anesthesia
M St Pierre, C Gall, G Breuer, J Schüttler
BACKGROUND: Simulation-based training with a focus on non-technical skills can have a positive influence on safety relevant attitudes of participants. If an organization succeeds in training sufficient staff, it may experience a positive change in the safety climate. As the effects of a single training are of a transient nature, annual training sessions may lead to an incremental improvement of safety relevant attitudes of employees over time. In spring 2012 the Department of Anesthesia at the University Hospital of Erlangen established an annual simulation-based training for staff members (e...
December 2017: Der Anaesthesist
Leslie A Schornack, Curtis L Baysinger, May C M Pian-Smith
PURPOSE OF REVIEW: Simulation training in obstetric anesthesia has become widespread in recent years. Simulations are used to train staff and trainees, assess and improve team performance, and evaluate the work environment. This review summarizes current research in these categories. RECENT FINDINGS: Simulation to improve individual technical skills has focused on induction of general anesthesia for emergent cesarean delivery, an infrequently encountered scenario by anesthesia trainees...
December 2017: Current Opinion in Anaesthesiology
Gilles Guerrier, Pierre-Raphaël Rothschild, Mathieu Lehmann, Frédéric Azan, Christophe Baillard
BACKGROUND AND OBJECTIVES: Efficient learning of regional anesthesia in ophthalmology remains challenging because trainees are afforded limited opportunity to practice ocular anesthesia. The aim of this prospective, randomized, blinded study was to determine whether teaching with video improves regional anesthesia skills of residents in ophthalmology. METHODS: From January to October 2016, 32 novice anesthesiology residents were evaluated while performing medial canthus episcleral procedures during a 5-day rotation...
November 2017: Regional Anesthesia and Pain Medicine
Laura Maria Cacioppa, Rodolfo Pini, Matteo Longhi, Andrea Vacirca, Enrico Gallitto, Gianluca Faggioli, Mauro Gargiulo, Andrea Stella
BACKGROUND: Carotid endarterectomy (CEA) intervention needs a specific training and a sufficient learning curve to obtain optimal results in terms of outcome. A formative program was settled up in a single academic center to optimize training of standard CEA procedures. This study aims to evaluate the 11-year results of the teaching CEA program. METHODS: The trainees CEA teaching program is carried on during the 5-year vascular surgery residency period, and it is stratified as follows: learning theory and intervention assistance (minimum 50 procedures per year) in the first and second residency year; performing CEA as second operator in the third and fourth residency year (minimum 50 procedures per year); CEA execution as first operator with attending supervision in the last residency year...
September 7, 2017: Annals of Vascular Surgery
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