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https://www.readbyqxmd.com/read/29159000/umbilical-cord-prolapse-in-a-labouring-patient-a-multidisciplinary-and-interprofessional-simulation-scenario
#1
Chandrew Rajakumar, Adam Garber, Purnima M Rao, Genevieve Rousseau, George A Dumitrascu, Glenn D Posner
This case is one of an eight-case multidisciplinary curriculum designed and implemented at the University of Ottawa by simulation educators with specialty training in obstetrics and gynecology (OB/GYN) and anesthesiology. Consultation from a nurse educator maintained quality and relevance of objectives for nursing participants. The curriculum was prepared to train OB/GYN and anesthesiology residents and nurses to hone crisis resource management skills and to recognize and manage rare/critical medical events in an obstetrical setting...
September 16, 2017: Curēus
https://www.readbyqxmd.com/read/29158865/-anesthesiological-aspects-and-complications-of-intracranial-meningiomas-operated-at-the-sylvanus-olympio-university-hospital-center-lom%C3%A3-about-21-cases
#2
Pilakimwé Egbohou, Tabana Mouzou, Kadanga Beketi, Essossinam Kpelao, Abdel Kader Moumouni, Hamza Doles Sama, Sarakawabalo Assénouwé, Gnimdou Akala-Yoba, Kadjika Tomta
This study aimed to point to both the anesthesiological aspects and the perioperative complications of intracranial meningiomas operated at the Sylvanus Olympio University Hospital Center, Lomé. We conducted a retrospective study by reviewing the medical records of patients with intracranial meningiomas undergoing surgery over the period December 2010-December 2015 (5 years) at the Sylvanus Olympio University Hospital Center, Lomé. Out of 46 patients operated fo brain tumors, 21 (45.6%) had meningioma. The average age was 49 ±20 years, with a male predominance (52...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29157768/identifying-nurse-anesthetists-professional-identity
#3
Karin Aagaard, Erik Elgaard Sørensen, Bodil Steen Rasmussen, Birgitte Schantz Laursen
PURPOSE: To explore professional identity of registered nurse anesthetists (RNAs) and RNAs' expectations of their professional self and the expectations RNAs meet from interdisciplinary team members when preparing patients for general anesthesia. DESIGN: Focused ethnography was used for data collection. METHODS: Participant observations and interviews were conducted with patients scheduled for surgery and with RNAs in charge of the patients during the anesthetic procedures...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#4
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#5
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29149145/endoscopic-epidural-laser-decompression-versus-transforaminal-epiduroscopic-laser-annuloplasty-for-lumbar-disc-herniation-a-prospective-randomized-trial
#6
Chang Hong Park, Sang Ho Lee
BACKGROUND: Lumbar radicular pain often results from lumbar disc herniation, spinal stenosis, or degenerative spondylolisthesis. Minimally invasive disc decompression procedures, such as nucleo-annuloplasty or epiduroscopic neural decompression by laser, have been devised to treat such pain. OBJECTIVE: The short-term outcomes of disc decompression by endoscopic epidural laser decompression (EELD) or transforaminal epiduroscopic laser annuloplasty (TELA) were compared in patients with lumbar radicular pain due to disc herniation...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#7
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/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#8
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29145835/global-health-education-in-united-states-anesthesiology-residency-programs-a-survey-of-resident-opportunities-and-program-director-attitudes
#9
Gunisha Kaur, Sheida Tabaie, Jasmit Brar, Virginia Tangel, Kane O Pryor
BACKGROUND: Interest in global health during postgraduate residency training is increasing across medical specialties, and multiple disciplines have categorized global health training opportunities in their arena. No such cataloging exists for anesthesiology residency programs. The aim of this study was to assess and characterize global health opportunities and the attitudes of program directors (PDs) in U.S. anesthesiology residency programs towards this training. METHODS: A cross-sectional 20-question survey on global health opportunities was distributed to 128 ACGME accredited anesthesiology residency program directors via email between October 2015 and January 2016...
November 16, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#10
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29116973/the-pediatric-anesthesiology-workforce-projecting-supply-and-trends-2015-2035
#11
Matthew K Muffly, Mark Singleton, Rita Agarwal, David Scheinker, Daniel Miller, Tyler M Muffly, Anita Honkanen
BACKGROUND: A workforce analysis was conducted to predict whether the projected future supply of pediatric anesthesiologists is balanced with the requirements of the inpatient pediatric population. The specific aims of our analysis were to (1) project the number of pediatric anesthesiologists in the future workforce; (2) project pediatric anesthesiologist-to-pediatric population ratios (0-17 years); (3) project the mean number of inpatient pediatric procedures per pediatric anesthesiologist; and (4) evaluate the effect of alternative projections of individual variables on the model projections through 2035...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29116968/antiemetic-prophylaxis-as-a-marker-of-health-care-disparities-in-the-national-anesthesia-clinical-outcomes-registry
#12
Michael H Andreae, Jonah S Gabry, Ben Goodrich, Robert S White, Charles Hall
BACKGROUND: US health care disparities persist despite repeated countermeasures. Research identified race, ethnicity, gender, and socioeconomic status as factors, mediated through individual provider and/or systemic biases; little research exists in anesthesiology. We investigated antiemetic prophylaxis as a surrogate marker for anesthesia quality by individual providers because antiemetics are universally available, indicated contingent on patient characteristics (gender, age, etc), but independent of comorbidities and not yet impacted by regulatory or financial constraints...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29115945/mechanical-strain-to-maxillary-incisors-during-direct-laryngoscopy
#13
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/29112023/behavior-of-anesthesiology-residents-in-a-situation-of-intravenous-route-occlusion-during-syringe-pump-use-in-a-simulated-intensive-care-unit
#14
Takayuki Kariya, Tetsuya Miyashita, Hitoshi Sato, Hiromasa Kawakami, Takahisa Goto
INTRODUCTION: Unintentional catecholamine flush caused by inappropriate release of an intravenous occlusion during use of a syringe pump in the intensive care unit (ICU) can have dangerous consequences in patients receiving critical care. We investigated whether anesthesiology residents understood how to deal with syringe pump occlusion in a simulated ICU setting. METHODS: We set up a mannequin that virtually simulated a sedated patient under mechanical ventilation after cardiac surgery, with epinephrine and dopamine being infused by syringe pumps to maintain blood pressure at 100/50 mm Hg...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29109642/comparison-of-intra-articular-analgesics-in-arthroscopic-anterior-cruciate-ligament-reconstruction-surgeries-a-randomized-controlled-trial
#15
Vijayalakshmi Sivapurapu, Shishir Suranigi Murugharaj, Sai Saran Panathula Venkata
Background and Aims: Arthroscopic anterior cruciate ligament reconstruction (ACLR) is one of the most common knee surgeries done worldwide today. It involves immense pain at sites of graft harvest, tibial, and femoral tunnels, thereby delaying recovery and increased patient morbidity, and delayed rehabilitation. Various drugs and combination of drugs administered intra-articularly have been studied for analgesic efficacy. Our study gives an insight if there is any added advantage of additives morphine or clonidine to bupivacaine when compared to administering bupivacaine alone...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29101950/use-of-anesthesiology-services-in-radiology
#16
REVIEW
Hansol Kim, Jason Lane, Rolf Schlichter, Michael S Stecker, Richard Taus
In the setting of technological advancements in imaging and intervention with concomitant rise in the use of non-operating room anesthesia (NORA) care, it has become even more critical for anesthesiologists to be aware of the needs and limitations of interventional procedures performed outside of the operating room. This article addresses the use of NORA services from the interventional radiologist's point of view and provides specific examples of preprocedural, intraprocedural, and postprocedural care patients may need for optimal outcome...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29101945/demands-of-integrated-care-delivery-in-interventional-medicine-and-anesthesiology-interdisciplinary-teamwork-and-strategy
#17
REVIEW
Wendy L Gross, Lebron Cooper, Steven Boggs
Evolving financial and medical constraints fueled by the increasing repertoire of nonoperating room cases and widening scope of patient comorbidities are discussed. The need to integrate finances and care approaches is detailed, and strategic suggestions for broader collaborative practice are suggested.
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29100739/selected-highlights-in-clinical-anesthesia-research
#18
REVIEW
Mark C Kendall, Zachary M Robbins, Alexander Cohen, Mary Minn, Scott E Benzuly, Andrew S Triebwasser, Zachary L McCormick, Michelle Gorgone
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes address broad categories of general anesthesia including airway management, abdominal surgery, and obstetrical and gynaecological anesthesia. In addition, recent advancements in specialties of anesthesiology including regional anesthesia are reviewed...
October 31, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29099845/real-time-endoscopic-image-orientation-correction-system-using-an-accelerometer-and-gyrosensor
#19
Hyung-Chul Lee, Chul-Woo Jung, Hee Chan Kim
The discrepancy between spatial orientations of an endoscopic image and a physician's working environment can make it difficult to interpret endoscopic images. In this study, we developed and evaluated a device that corrects the endoscopic image orientation using an accelerometer and gyrosensor. The acceleration of gravity and angular velocity were retrieved from the accelerometer and gyrosensor attached to the handle of the endoscope. The rotational angle of the endoscope handle was calculated using a Kalman filter with transmission delay compensation...
2017: PloS One
https://www.readbyqxmd.com/read/29098342/preoperative-evaluation-of-adult-patients-before-elective-noncardiothoracic-surgery-joint-recommendation-of-the-german-society-of-anesthesiology-and-intensive-care-medicine-the-german-society-of-surgery-and-the-german-society-of-internal-medicine
#20
REVIEW
B Zwissler
Evaluation of the patient's medical history and a physical examination are the cornerstones of risk assessment prior to elective surgery, and may help to optimize the patient's preoperative medical condition and guide perioperative management. Whether performance of additional technical tests (e. g., blood chemistry, electrocardiography, spirometry, chest x‑ray) can contribute to reduction of the perioperative risk is often not well known or controversial. Similarly, there is considerable uncertainty among anesthesiologists, internists, and surgeons with respect to perioperative management of the patient's long-term medication...
November 2, 2017: Der Anaesthesist
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