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https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#1
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
#2
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
#3
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
#4
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. Participants 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28349314/measurement-of-faculty-anesthesiologists-quality-of-clinical-supervision-has-greater-reliability-when-controlling-for-the-leniency-of-the-rating-anesthesia-resident-a-retrospective-cohort-study
#13
Franklin Dexter, Johannes Ledolter, Bradley J Hindman
BACKGROUND: Our department monitors the quality of anesthesiologists' clinical supervision and provides each anesthesiologist with periodic feedback. We hypothesized that greater differentiation among anesthesiologists' supervision scores could be obtained by adjusting for leniency of the rating resident. METHODS: From July 1, 2013 to December 31, 2015, our department has utilized the de Oliveira Filho unidimensional nine-item supervision scale to assess the quality of clinical supervision provided by faculty as rated by residents...
March 27, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28348895/in-flight-hypoxemia-in-a-tracheostomy-dependent-infant
#14
Jason Quevreaux, Christopher Cropsey
Millions of passengers board commercial flights every year. Healthcare providers are often called upon to treat other passengers during in-flight emergencies. The case presented involves an anesthesia resident treating a tracheostomy-dependent infant who developed hypoxemia on a domestic flight. The patient had an underlying congenital muscular disorder and was mechanically ventilated while at altitude. Although pressurized, cabin barometric pressure while at altitude is less than at sea level. Due to this environment patients with underlying pulmonary or cardiac pathology might not be able to tolerate commercial flight...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28346035/one-needle-is-better-than-two-the-philosophy-surrounding-use-of-local-anesthesia-in-northern-india
#15
Maria Story
The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28339766/higher-bioavailability-of-doxycycline-in-broiler-chickens-with-a-novel-in-feed-pharmaceutical-formulation
#16
Lilia Gutiérrez, Juan Zermeño, Yazmín Alcalá, Héctor Sumano
Bioavailability of a new, long-acting (LA) pharmaceutical preparation for administering doxycycline as in-feed medication to broiler chickens was compared to the standard in-feed administration of doxycycline. A commercial poultry house harboring Ross-308 broiler chickens, weighing 450 g, was divided into 7 sections as follows: doxy-FOLA group (n = 6,000 chickens divided into 3 replicates) medicated with 10% doxycyline, long-acting pellets at a dose of 400 g of doxycycline HCl/ton of food, resulting in a calculated dose of 48 mg/kg for 5 d; doxy-ref group (n = 6,000, divided into 3 replicates) medicated as for doxy-FOLA, but using a 20% commercial preparation of doxycycline...
February 23, 2017: Poultry Science
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#17
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28291057/mild-cognitive-impairment-and-exposure-to-general-anesthesia-for-surgeries-and-procedures-a-population-based-case-control-study
#18
Juraj Sprung, Rosebud O Roberts, David S Knopman, Lauren L Price, Hunter P Schulz, Christie L Tatsuyama, Toby N Weingarten, Darrell R Schroeder, Andrew C Hanson, Ronald C Petersen, David O Warner
BACKGROUND: To examine whether exposure to general anesthesia for procedures at age ≥40 years is associated with prevalent mild cognitive impairment (MCI) in the elderly. METHODS: A case-control study nested within a population-based cohort. Olmsted County, Minnesota, residents, aged 70-91 years, underwent baseline evaluations that included the Clinical Dementia Rating scale, a neurologic evaluation, and neuropsychologic testing. Individuals identified with MCI (cases) at enrollment were matched 1:2 on age, sex, education, and apolipoprotein genotype with participants who were cognitively normal at the time of the index visit...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#19
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28283998/anesthesia-residents-preferentially-request-operating-room-case-assignments-with-complex-cases
#20
Peggy Y Kim, Jonathan P Wanderer, David W Allbritton, Matthias Eikermann, Keith Baker
Self-directed learning is associated with knowledge and performance improvements, increased identification and amelioration of knowledge gaps, and heightened critical appraisal of available evidence. We developed and implemented a decision support system that could support self-directed learning for anesthesia residents by soliciting resident input in case selection. We hypothesized that residents would utilize this system to request complex cases, and that more advanced residents would request more complex cases...
April 2017: Journal of Medical Systems
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