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https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#1
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#2
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28501071/in-patients-with-symptomatic-irreversible-pulpitis-articaine-is-3-6-times-more-efficacious-than-lidocaine-in-achieving-anesthetic-success-when-used-for-supplementary-infiltration-after-mandibular-block-anesthesia
#3
Mathilde C Peters, Tatiana M Botero
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Does articaine provide an advantage over lidocaine in patients with symptomatic irreversible pulpitis? A systematic review and meta-analysis. Kung J, McDonagh M, Sedgley CM. J Endod 2015; 41(11):1784-94. SOURCE OF FUNDING: The study was supported by the OHSU Department of Endodontology Les Morgan Endowment Fund and a resident research grant from the American Association of Endodontists Foundation TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data...
June 2017: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/28496077/-surgical-training-utilizing-swine-under-general-anesthesia-and-animal-ethics
#4
Yuko Iki, Masafumi Noda, Katsuyoshi Kudoh, Teruko Sueta, Masahiko Kanehira, Takuya Ito, Yasushi Matsuda, Yoshinori Okada, Michiaki Unno
A cross-sectional study is conducted with primary residents attended wet labs at Tohoku University Hospital Advanced Medical Training Center in order to investigate the efficacy of the training, especially focused on the animal ethics. The 41 participants answered questionnaires in regard to non-technical skills, technical skills and ethics before and after the practice. To identify differences in each ethical question between 2 time points, Wilcoxon signed ranks test was used because the data was not normally distributed...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28494890/the-predictive-value-of-pre-recruitment-achievement-on-resident-performance-in-anesthesiology
#5
Fei Chen, Harendra Arora, Susan M Martinelli, Emily Teeter, David Mayer, David A Zvara, Anthony Passannante, Kathleen A Smith
STUDY OBJECTIVE: Selecting candidates for residency positions is challenging and there is little research on the correlation between commonly used selection criteria and subsequent performance in anesthesiology. This study examined the association between the selection measures and post-recruitment performance in residency. DESIGN: Retrospective review of archival data. SETTING: Anesthesiology residency program at a large academic anesthesiology department...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28474273/outpatient-appendectomy-in-an-emergency-outpatient-surgery-unit-24%C3%A2-h-a-day-an-intention-to-treat-analysis-of-194-patients
#6
Adeline Aubry, Arnaud Saget, Gilles Manceau, Matthieu Faron, Mathilde Wagner, Christophe Tresallet, Bruno Riou, Olivier Lucidarme, Frédéric le Saché, Mehdi Karoui
OBJECTIVE: To evaluate the feasibility and outcomes of patients operated on for uncomplicated acute appendicitis (UAA) in our 24-h emergency outpatient surgery unit. METHODS: This was a prospective observational study with intention-to-treat (ITT) analysis. From 12/2013 to 03/2015, all consecutive patients admitted for acute appendicitis (AA) were prospectively screened. A computed tomography or abdominal ultrasound confirmed the diagnosis of AA. Eligibility criteria for outpatient appendectomy were: UAA, no comorbidity, no physical or mental condition preventing participation in the study, absence of pregnancy, age older than 15 years, an accompanying adult person available for the hospital discharge and place of residence within 1 h of our hospital...
May 4, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28463875/training-anesthesiologists-in-out-of-operating-room-anesthesia
#7
Karen J Souter, Wil Van Cleve
PURPOSE OF REVIEW: The purpose of this review is to describe recent developments and current trends in training anesthesiologists in out-of-operating room anesthesia (OORA). RECENT FINDINGS: In the United States, the Accreditation Council for Graduate Medical Education recently updated its training requirements to include a mandatory 2-week rotation in OORA for anesthesiology residents. This likely reflects the continuing expansion of anesthesia services in the out-of-operating room (OOR) environment as well as the increasing complexity of OOR procedures and medical acuity of patients in these settings...
April 29, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28448197/surgical-site-infections-and-associated-operative-characteristics
#8
Paul K Waltz, Brian S Zuckerbraun
Surgical site infection (SSI) contributes significantly to surgical morbidity. Patient factors and operative factors contribute to the risk of development of SSI. This review focuses on understanding operative characteristics that are associated with an increased risk of SSI. Much attention has been given to protocol care to reduce SSI, such as hair removal, skin preparation, and pre-operative antibiotic agents. Even with this, the appropriate antibiotic and re-dosing regimens often remain a challenge. Other operative factors such as blood loss/transfusion, emergency/urgent cases, duration of the operation, type of anesthesia, and resident involvement are also potentially modifiable to reduce the risk of SSI...
April 27, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#9
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#10
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#11
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28419841/buffered-1-lidocaine-with-epinephrine-can-be-as-effective-as-nonbuffered-2-lidocaine-with-epinephrine-for-maxillary-field-block
#12
James A Phero, Victor T Warren, Anson G Fisher, Eric M Rivera, Pooja T Saha, Glenn Reside, Ceib Phillips, Raymond P White
PURPOSE: Buffering local anesthetics with epinephrine (Epi) offers clinicians options not often considered. This study assessed outcomes for pulpal anesthesia, pain on injection, and time to midface numbness for buffered 1% lidocaine with 1:100,000 Epi versus nonbuffered 2% lidocaine with 1:100,000 Epi. MATERIALS AND METHODS: In this trial with a randomized, crossover design, buffered 1% lidocaine was compared with nonbuffered 2% lidocaine. Subjects were adult volunteers who served as their own controls...
March 25, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28416593/two-components-of-aversive-memory-in-drosophila-anesthesia-sensitive-and-anesthesia-resistant-memory-require-distinct-domains-within-the-rgk1-small-gtpase
#13
Satoshi Murakami, Maki Minami-Ohtsubo, Ryuichiro Nakato, Katsuhiko Shirahige, Tetsuya Tabata
For aversive olfactory memory in Drosophila, multiple components have been identified that exhibit different stabilities. These components have been defined by behavioral and genetic studies, and genes specifically required for a specific component have also been identified. Intermediate-term memory generated after single cycle conditioning is divided into anesthesia-sensitive memory (ASM) and anesthesia-resistant memory (ARM), with the latter being more stable. We determined that the ASM and ARM pathways converged on the Rgk1 small GTPase and that the N-terminal domain-deleted Rgk1 was sufficient for ASM formation, whereas the full-length form was required for ARM formation...
April 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28410834/wearing-id-badges-in-the-operating-room-environment-is-reconsideration-warranted
#14
Matthew H Hogue, Kris P Heilmann, John J Callaghan
BACKGROUND: Surgical site infection and nosocomial infections in general have appropriately undergone increased scrutiny over the last decade. Numerous studies have documented pathogenic bacterial contamination of personal items such as cell phones, pagers, ties, and pens in the hospital setting. It is our understanding that Joint Commission on Accreditation of Healthcare Organizations requires all personnel to wear an identification badge at all times, which includes the operating room environment...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28377944/are-prior-experience-and-subspecialty-training-time-predictive-of-pediatric-anesthesia-exit-exam-scores-for-rotating-ca-2-residents
#15
Jonathon H Nelson, Nina Deutsch, Ira T Cohen, Srijaya K Reddy
BACKGROUND: Anesthesiology residency programs commonly have rotations at free-standing children's hospitals to provide and/or supplement their residents' training in pediatric anesthesia. Length and timing of these rotations differ from program to program as can their residents' existing medical knowledge and clinical skills. We predicted that residents with prior pediatric anesthesia experience, who rotate at our pediatric institution for two consecutive months, will score higher on an exit exam compared to residents without prior pediatric experience or those that only rotate for one month...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28377942/an-evaluation-of-ca-1-residents-adherence-to-a-standardized-handoff-checklist
#16
Madeline C Heck, Peter Huges, Mojca Konia
BACKGROUND: Poor-quality handoffs are a significant cause of preventable medical errors and adverse events. Handoff checklists improve handoffs but adherence to these tools is often inconsistent. In our study we aimed to investigate the effects of simulated handoff workshop and clinical instruction on resident handoff quality. METHODS: A three-week pre-education intervention observation period of handoffs was conducted to assess the deficits, variability, and common practice in handoffs at the University of Minnesota Fairview Hospital...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28372650/asa-physical-status-assignment-by-non-anesthesia-providers-do-surgeons-consistently-downgrade-the-asa-score-preoperatively
#17
Christopher Curatolo, Andrew Goldberg, David Maerz, Hung-Mo Lin, Hardikkumar Shah, Muoi Trinh
OBJECTIVE: The American Society of Anesthesiologists physical status (ASA-PS) is associated with increased morbidity and mortality in the perioperative period. When surgeries are scheduled by surgeons and their staff at our large institution a presumed ASA-PS is chosen. This is because our institution (and, anecdotally, others in our hospital system and elsewhere), recognizing the relationship between higher ASA-PS and poorer postoperative outcomes, requires all patients with higher ASA-PS levels (≥3) to undergo enhanced preoperative workup...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28372645/anesthesiologists-perceptions-of-minimum-acceptable-work-habits-of-nurse-anesthetists
#18
Ilana I Logvinov, Franklin Dexter, Bradley J Hindman, Sorin J Brull
STUDY OBJECTIVE: Work habits are non-technical skills that are an important part of job performance. Although non-technical skills are usually evaluated on a relative basis (i.e., "grading on a curve"), validity of evaluation on an absolute basis (i.e., "minimum passing score") needs to be determined. DESIGN: Survey and observational study. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: The theme of "work habits" was assessed using a modification of Dannefer et al...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28367396/comparing-anesthesiology-residency-training-structure-and-requirements-in-seven-different-countries-on-three-continents
#19
Satoshi Yamamoto, Pedro Tanaka, Matias V Madsen, Alex Macario
Little has been published comparing the graduate medical education training structure and requirements across multiple countries. The goal of this study was to summarize and compare the characteristics of anesthesiology training programs in the USA, UK, Canada, Japan, Brazil, Denmark, and Switzerland as a way to better understand efforts to train anesthesiologists in different countries. Two physicians trained in each of the seven countries (convenience sample) were interviewed using a semi-structured approach...
February 26, 2017: Curēus
https://www.readbyqxmd.com/read/28367291/learning-curves-for-three-specific-procedures-by-anesthesiology-residents-using-the-learning-curve-cumulative-sum-lc-cusum-test
#20
Gregoire Weil, Cyrus Motamed, David J Biau, Marie Laurence Guye
BACKGROUND: The learning curve cumulative sum (LC-CUSUM) test is an innovative tool that allows quantitative monitoring of individual medical performance during the learning process by determining when a predefined acceptable level of performance is reached. This study used the LC-CUSUM test to monitor the learning process and failure rate of anesthesia residents training for specific subspecialty anesthesia procedures. METHODS: The study included 490 tracheal punctures (TP) for jet ventilation, 340 thoracic epidural analgesia (TEA) procedures, and 246 fiberoptic nasal intubations (FONI) performed by 18 residents during their single 6-month rotation...
April 2017: Korean Journal of Anesthesiology
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