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https://www.readbyqxmd.com/read/29135593/ultrasound-guided-dynamic-needle-tip-positioning-technique-versus-palpation-technique-for-radial-arterial-cannulation-in-adult-surgical-patients-a-randomized-controlled-trial
#1
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...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#2
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29111084/a-model-for-humanitarian-outreach-in-today-s-world
#3
REVIEW
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
https://www.readbyqxmd.com/read/29101946/building-and-maintaining-organizational-infrastructure-to-attain-clinical-excellence
#4
REVIEW
Kelly Lebak, Jason Lane, Richard Taus, Hansol Kim, Michael S Stecker, Michael Hall, Meghan B Lane-Fall, Mark S Weiss
Active maintenance of highly functional teams is critical to ensuring safe, efficient patient care in the non-operating room anesthesia (NORA) suite. In addition to developing collaborative relationships and patient care protocols, individual and team training is needed. For anesthesiologists, this training must begin during residency. The training should be supplemented with continuing education in this field for providers who find themselves working in the NORA space. As NORA continues to grow, robust NORA-specific quality assurance and improvement programs will empower anesthesiologists with the tools they need to best care for these patients...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29084068/can-providers-use-clinical-skills-to-assess-the-adequacy-of-ventilation-in-children-during-bag-valve-mask-ventilation
#5
Heather J Becker, Melissa L Langhan
OBJECTIVE: Bag-valve mask (BVM) ventilation requires both manual skill and clinical assessment of minute ventilation. Subjective factors can make supplying appropriate ventilation difficult. Capnography is not routinely used when ventilating nonintubated patients. Our objective was to determine if providers were able to maintain normal capnography values with BVM ventilation in pediatric patients based on clinical skills alone. METHODS: Providers (nurses, residents, and fellows) delivered 2 minutes of BVM respiratory support to healthy children during induction of anesthesia for elective surgery...
October 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29078911/resident-postgraduate-year-does-not-influence-rate-of-complications-following-inguinal-herniorrhaphy
#6
Oswaldo Renteria, Ali A Mokdad, Jonathan Imran, Sergio Huerta
BACKGROUND: Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. MATERIALS AND METHODS: A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29075412/low-cost-method-for-obtaining-medical-rapid-prototyping-using-desktop-3d-printing-a-novel-technique-for-mandibular-reconstruction-planning
#7
Ignacio Velasco, Soheil Vahdani, Hector Ramos
BACKGROUND: Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries...
September 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/29074364/improving-surgical-safety-and-nontechnical-skills-in-variable-resource-contexts-a-novel-educational-curriculum
#8
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
https://www.readbyqxmd.com/read/29070163/dental-caries-experience-in-texan-children-with-cleft-lip-and-palate
#9
Sabrina Sunderji, Bhavini Acharya, Catherine Flaitz, Brett Chiquet
PURPOSE: The purpose of this study was to assess the caries experience in the primary dentition of children born with cleft lip and palate (CLP). METHODS: A retrospective chart review was conducted on subjects between two and six years old recruited from a university-based pediatric dentistry residency clinic. The number of dental visits and professional fluoride applications, the plaque index and treatment modality, and the presence/location of caries, white spot lesions, and enamel hypoplastic lesions were compared between CLP patients and healthy age- and gender-matched controls...
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29067929/comparison-of-stress-and-burnout-among-anesthesia-and-surgical-residents-in-a-tertiary-care-teaching-hospital-in-north-india
#10
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
https://www.readbyqxmd.com/read/29064863/the-influence-of-collaboration-ralph-waters-friendship-with-john-lundy-and-the-spread-of-regional-anesthesia
#11
Shelly B Borden, Colby L Parks
Ralph Waters, the founder of the anesthesiology department and residency program at the University of Wisconsin-Madison, and John Lundy, the chair at the Mayo Clinic beginning in 1924, collaborated to expand regional anesthetic techniques and knowledge not only at their institutions, but also at institutions around the country through correspondence, meetings, and hosting of other anesthesiologists. The Ralph Waters Collection at the University of Wisconsin Archives was searched for information on Waters' and Lundy's involvement in regional anesthesia...
October 23, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29063598/insertion-methods-comparison-for-the-streamlined-liner-of-the-pharynx-airway-in-children-by-novice
#12
Y Chen, J Bai, R Wang
BACKGROUND: The Streamlined Liner of the Pharynx Airway (SLIPA™) is a popular supraglottic airway device used for pediatric anesthesia. However, based on the anatomical features of pediatric patients, novice residents are expected to have difficulties inserting the device. The objective of this work was to improve the SLIPA insertion by modifying the device. METHODS: A total of 134 children were randomized into two groups. Anesthesia was standardized among all patients except for the way in which the SLIPA was inserted...
October 23, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29051898/accuracy-of-the-lever-sign-test-in-the-diagnosis-of-anterior-cruciate-ligament-injuries
#13
Keith A Jarbo, David E Hartigan, Kelly L Scott, Karan A Patel, Anikar Chhabra
BACKGROUND: The lever sign test is a new physical examination tool to diagnose anterior cruciate ligament (ACL) tears. Preliminary results suggest almost 100% sensitivity and specificity to diagnose acute and chronic complete ACL tears and clinically significant partial tears as compared with magnetic resonance imaging (MRI). PURPOSE: To assess the sensitivity and specificity of the lever sign test for the diagnosis of acute ACL injuries, as compared to MRI. We also aimed to determine the accuracy of the lever sign test compared with 3 other tests (anterior drawer, Lachman, and pivot shift) when performed by providers of various training levels, and with the patient awake or under anesthesia...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29046774/role-of-whatsapp-based-discussions-in-improving-residents-knowledge-of-post-operative-pain-management-a-pilot-study
#14
Sumitra G Bakshi, Pranay Bhawalkar
BACKGROUND: To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. METHODS: This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29035894/prevalence-of-potentially-distracting-noncare-activities-and-their-effects-on-vigilance-workload-and-nonroutine-events-during-anesthesia-care
#15
Jason M Slagle, Eric S Porterfield, Amanda N Lorinc, David Afshartous, Matthew S Shotwell, Matthew B Weinger
BACKGROUND: When workload is low, anesthesia providers may perform non-patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. METHODS: In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis...
October 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29030927/suitability-of-the-forearm-for-non-invasive-blood-pressure-measurement-in-children
#16
David Greaney, Solmaz Nakhjavani, Fiona Desmond, Mark Tormey, Ian Dawkins, Brendan O'Hare
BACKGROUND: Measurement of forearm blood pressure (BP) in pediatric patients during general anesthesia is periodically employed despite a lack of evidence for this practice. Upper arm BP measurement may be impossible to perform for either patient or surgical reasons, and the forearm has theoretical benefits over the lower leg when an alternate site is required. We hypothesize that forearm BP measurement provides an accurate and reliable alternative to the upper arm. Published adult data do not support this hypothesis, and the little pediatric data published contain methodological shortcomings...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29029588/society-for-the-advancement-of-transplant-anesthesia-liver-transplant-anesthesia-fellowship-white-paper-advocating-measurable-proficiency-in-transplant-specialties-training
#17
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
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#18
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28993991/pocus-in-perioperative-medicine-a-north-american-perspective
#19
Lorenzo De Marchi, Massimiliano Meineri
Ultrasound (US) performed at the point of care has found fertile ground in perioperative medicine. In the hands of anesthesiologists, transesophageal echocardiography (TEE) has become established as a powerful diagnostic and monitoring tool in the perioperative care of cardiac and non-cardiac patients. A number of point-of-care US (POCUS) applications are relevant to perioperative care, including airway, cardiac, lung and gastric US. Although guidelines exist to define the scope of practice for basic and advanced TEE, there remains a lack of such guidelines for perioperative point-of-care ultrasound (POCUS), despite a number of recent calls for action in the academic anesthesia community...
October 9, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28987231/controversies-in-anesthesia-for-oral-and-maxillofacial-surgery
#20
REVIEW
Brett J King, Adam Levine
The future of office-based anesthesia for oral and maxillofacial surgery is at risk. Oral and maxillofacial surgeons have been on the forefront of providing safe and effective outpatient anesthesia for decades. Recent changes in Medicare policies have had, and will continue to have, a significant effect on the training of oral and maxillofacial surgery residents regarding anesthesia. The outcome of these changes can have a major effect on the specialty of oral and maxillofacial surgery and a cornerstone of the profession...
November 2017: Oral and Maxillofacial Surgery Clinics of North America
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