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https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#1
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#2
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29147790/-etomidate-for-intravenous-induction-of-anaesthesia
#3
C Dumps, D Bolkenius, E Halbeck
The pharmacological and historical knowledge about the currently available intravenous induction hypnotics form the basis for the daily work of anesthetists. Side effects of using hypnotic induction agents must be anticipated and adequately treated. Decades of experience with using intravenous induction hypnotics have led to theoretical requirements for an ideal narcotic agent with a best possible side effect profile. In the absence of this optimal hypnotic induction agent, a careful selection of one or a combination of narcotic drugs is necessary to meet the needs of the respective risk constellation of the patient...
November 16, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29145989/pain-management-strategies-in-shoulder-arthroplasty
#4
REVIEW
Jason L Codding, Charles L Getz
Pain control in total shoulder arthroplasty demands a multidisciplinary approach with collaboration between patients, surgeon, and anesthetist. A multimodal approach with preemptive medication, regional blockade, local anesthetics, and a combination of acetaminophen, nonsteroidal antiinflammatory drugs, tramadol, and gabapentinoids postoperatively leads to pain control and patient satisfaction. Assessment of patients' expectations constitutes a vital aspect of the preoperative patient evaluation. Educating and psychologically preparing patients reduces postoperative pain...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145331/severe-hemodynamic-instability-after-indocyanine-green-injection-during-off-pump-coronary-artery-bypass-grafting-a-case-report
#5
Qing Zhai, Yun Wang, Ayong Tian
RATIONALE: The increasingly intraoperative use of indocyanine green (ICG) means that it is necessary to be aware of both its advantages and potential adverse effects. PATIENT CONCERNS: A 76-year-old woman developed symptoms of sudden severe hemodynamic instability while undergoing coronary artery bypass grafting with ICG injection to detect the patency of the graft. The main clinical manifestations were a sudden drop in blood pressure and increased heart rate. DIAGNOSES: Severe side effects or allergic reaction of ICG...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29122393/how-do-professional-relationships-influence-surgical-antibiotic-prophylaxis-decision-making-a-qualitative-study
#6
Jennifer K Broom, Alex F Broom, Emma R Kirby, Jeffrey J Post
BACKGROUND: Surgical antibiotic prophylaxis (SAP) is a critical area to optimize to reduce the escalation of antimicrobial resistance. This article explores the ways by which interpersonal relationships influence SAP decision making. METHODS: Twenty surgeons and anesthetists participated in in-depth semistructured interviews on SAP prescribing. Results were analyzed using the framework approach. RESULTS: Analysis revealed 3 ways by which interpersonal relationships influence SAP: relationship dynamics between the surgeon and the anesthetist determine appropriateness of SAP, particularly operative risk ownership; perceived hierarchies within, and between, surgical and anesthetist specialties influence antibiotic prescribing decisions; and surgical distance from the antimicrobial stewardship team, which influences use of antimicrobial stewardship principles...
November 7, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29117089/simulation-in-interprofessional-clinical-education-exploring-validated-nontechnical-skills-measurement-tools
#7
Carl Eugene Alexander von Wendt, Leila Niemi-Murola
The research literature regarding interprofessional simulation-based medical education has grown substantially and continues to explore new aspects of this educational modality. The aim of this study was to explore the validation evidence of tools used to assess teamwork and nontechnical skills in interprofessional simulation-based clinical education. This systematic review included original studies that assessed participants' teamwork and nontechnical skills, using a measurement tool, in an interprofessional simulated setting...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29115945/mechanical-strain-to-maxillary-incisors-during-direct-laryngoscopy
#8
Milo Engoren, Lauryn R Rochlen, Matthew V Diehl, Sarah S Sherman, Elizabeth Jewell, Mary Golinski, Paul Begeman, John M Cavanaugh
BACKGROUND: While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP)...
November 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29110158/factors-predicting-ethiopian-anesthetists-intention-to-leave-their-job
#9
Adrienne Kols, Sharon Kibwana, Yohannes Molla, Firew Ayalew, Mihereteab Teshome, Jos van Roosmalen, Jelle Stekelenburg
BACKGROUND: Ethiopia has rapidly expanded training programs for associate clinician anesthetists in order to address shortages of anesthesia providers. However, retaining them in the public health sector has proven challenging. This study aimed to determine anesthetists' intentions to leave their jobs and identify factors that predict turnover intentions. METHODS: A nationally representative, cross-sectional survey of 251 anesthetists working in public-sector hospitals in Ethiopia was conducted in 2014...
November 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29109634/accuracy-of-ultrasound-imaging-versus-manual-palpation-for-locating-the-intervertebral-level
#10
Reshma Ambulkar, Vijaya Patil, Jeson R Doctor, Madhavi Desai, Nitin Shetty, Vandana Agarwal
Background and Aims: Efficacy of epidural analgesia depends on placement of the epidural catheter at the appropriate level. Manual palpation using surface landmarks to identify the desired intervertebral level may not be a reliable method. Ultrasonography (USG) is an alternative technique but requires training and may increase procedure time. The objective of this study was to compare the accuracy of ultrasound (US) imaging with manual palpation for locating the intervertebral level. Material and Methods: We included postoperative adult patients without an epidural catheter who were scheduled to have a chest radiograph in the recovery room...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29099473/a-study-of-interpersonal-conflict-among-operating-room-nurses
#11
Tsui-Fen Chang, Chung-Kuang Chen, Ming-Jia Chen
BACKGROUND: Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important. PURPOSE: The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict...
December 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29090036/the-autoimmunity-s-footprint-in-pediatrics-type-1-diabetes-coeliac-disease-thyroiditis
#12
Anca Orzan, Carmen Novac, Mihaela Mihu, Constantin Ionescu Tirgoviste, Mihaela Balgradean
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
https://www.readbyqxmd.com/read/29090034/endotracheal-intubation-in-a-down-syndrome-adult-undergoing-cataract-surgery-a-multidisciplinary-approach
#13
George Gabriel Moldoveanu, Emilia Severin, Andreea Paun
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
https://www.readbyqxmd.com/read/29089740/awareness-and-use-of-surgical-checklist-among-theatre-users-at-ekiti-state-university-teaching-hospital-ado-ekiti-nigeria
#14
Johnson Dare Ogunlusi, Moruf Babatunde Yusuf, Popoola Sunday Ogunsuyi, Obafemi K Wuraola, Waheed O Babalola, Kehinde Sunday Oluwadiya, Oduwole Olayemi Ajogbasile
BACKGROUND: Surgical checklist was introduced by the World Health Organization to reduce the number of surgical deaths and complications. During a surgical conference on "safety in surgical practice," it was noticed that the awareness and the use of surgical checklist are poor in Nigerian hospitals. This study was aimed at determining the awareness and use of surgical checklist among the theater users in our hospital, factors militating against its implementation, and make recommendations...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29083331/the-effect-of-remifentanil-on-succinylcholine-induced-changes-in-serum-potassium-and-creatine-kinase-a-prospective-randomized-double-blind-study
#15
Karim Nasseri, Shoaleh Shami, Mousa Shirmohammadi, Farzad Sarshivi, Negin Ghadami
BACKGROUND AND AIM OF THE WORK: Succinylcholine is still included as drugs favored by anesthetists because of its rapid onset and short duration of action. However, it can bring about complications such as hyperkalemia and increased serum creatine phosphokinase (CPK). This study aims at evaluating the effects of remifentanil on succinylcholine-induced postoperative changes in serum potassium and CPK. METHODS: In this study, 59 patients with short term lower abdominal surgery were randomly divided into two groups...
October 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29068081/a-new-pressure-guided-management-tool-for-epidural-space-detection-feasibility-assessment-on-a-simulator
#16
Massimiliano Carassiti, Alessia Mattei, Rossella Quarta, Carlo Massaroni, Paola Saccomandi, Marco Tesei, Roberto Setola, Emiliano Schena
The detection of epidural space is usually performed by the technique of loss of resistance (LOR) without technological support, although there are few commercial options. We sought to design and develop a new noninvasive system able to detect the LOR without any changes to the conventional procedure. It allows detecting the LOR by a custom made algorithm. The system provides a visual and acoustic feedback when the LOR is detected. We optimized the detection algorithm and investigated the performance of the system during experiments on a custom simulator...
October 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29063228/safety-and-feasibility-of-a-ketamine-package-to-support-emergency-and-essential-surgery-in-kenya-when-no-anesthetist-is-available-an-analysis-of-1216-consecutive-operative-procedures
#17
Thomas F Burke, Sebastian Suarez, Daniel I Sessler, Ayla Senay, Taha Yusufali, Charles Masaki, Moytrayee Guha, Debora Rogo, Pankaj Jani, Brett D Nelson, Khama Rogo
BACKGROUND: Lack of access to emergency and essential surgery is widespread in low- and middle-income countries. Scarce anesthesia services contribute to this unmet need. The aim of this study was to evaluate the safety and feasibility of the Every Second Matters for Emergency and Essential Surgery-Ketamine (ESM-Ketamine) package for emergency and essential procedures when no anesthetist was available. METHODS: From November 2013 to September 2017, the ESM-Ketamine package was used for patients requiring emergency or life-improving surgeries in fifteen selected facilities across Kenya when no anesthetist was available...
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29060565/gabor-based-automatic-spinal-level-identification-in-ultrasound
#18
Mohammad Ikhsan, Kok Kiong Tan, Ting Ting Oh, John Paul Lew, Ban Leong Sng
This paper presents an automatic lumbar spine level identification system based on image processing of ultrasound images. The goal is to aid anesthetists in identifying the correct spinal level during epidural anesthesia. Spine level identification is initiated by detecting the location of the sacrum using a classifier based on a support vector machine. Image stitching is then conducted to produce a panorama image of the spinal area. During this process, the location of spinal processes are enhanced using a Gabor filter and detected through template matching...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29053033/hyaluronidase-allergy-mimicking-orbital-cellulitis
#19
Nirav D Raichura, Md Shahid Alam, V V Jaichandran, Saurabh Mistry, Bipasha Mukherjee
PURPOSE: Hyaluronidase enzyme is a common additive with local anesthetic agent to facilitate faster permeation of the anesthetic in periocular tissues during ophthalmic surgery. We report a series of five subjects presenting with clinical features mimicking orbital cellulitis following peribulbar anesthesia and consequently diagnosed with hyaluronidase hypersensitivity. SETTING: The study was conducted at a tertiary eye care center in Southern India. DESIGN: It was a retrospective interventional case series...
October 20, 2017: Orbit
https://www.readbyqxmd.com/read/29051871/bilateral-divergent-shoulder-s-fracture-dislocation-case-in-an-ischemic-stroke-patient
#20
Atchi Walla, Faré Gnandi-Piou, Pilakimwé Egbohou, Komi Assogba, Mawuko Quacoe
INTRODUCTION: The literature review revealed that nowadays only about 15 cases of bilateral shoulder dislocation associated with the fracture of the upper end of the humerus have been published. The triad of lesional mechanism designated by the triple syndrome E composed of epilepsy, electrocution, and external trauma was the circumstances noted in which these fractures dislocations occur with migration of the two humeral heads either forward or backward. CASE REPORT: An architect of 36-year-old, right-handed, was admitted in emergency department for loss of knowledge of progressive installation...
May 2017: Journal of Orthopaedic Case Reports
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