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Anesthesia and education

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https://www.readbyqxmd.com/read/29680811/does-the-age-of-acute-care-physicians-impact-their-1-crisis-management-performance-and-2-learning-after-simulation-based-education-a-protocol-for-a-multicentre-prospective-cohort-study-in-toronto-and-ottawa-canada
#1
Fahad Alam, Vicki R LeBlanc, Alan Baxter, Jordan Tarshis, Dominique Piquette, Yuqi Gu, Caroline Filipkowska, Ashley Krywenky, Nicole Kester-Greene, Pierre Cardinal, Shelly Au, Sandy Lam, Sylvain Boet, Perioperative Anesthesia Clinical Trials Group
INTRODUCTION: The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29680176/perianesthesia-nurses-survey-of-their-knowledge-and-practice-with-obstructive-sleep-apnea
#2
Andrea M Erwin, Kim A Noble, June Marshall, Susan Cooper
PURPOSE: Anesthesia, sedation, and analgesia can negatively impact adult patients with obstructive sleep apnea (OSA). Despite known risks, current evidence, and practice guidelines, insufficient evidence exists that standardization and clinical application of OSA screening tools, problem identification, and perioperative nursing intervention and management strategies are consistently implemented for OSA patients across perianesthesia settings. The purpose of this study was to conduct a knowledge and practice assessment of perianesthesia nurses who care for adult patients with diagnosed or undiagnosed OSA...
April 18, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29671090/postoperative-cognitive-dysfunction-after-cochlear-implantation
#3
Annes J Claes, Suzanne de Backer, Paul Van de Heyning, Annick Gilles, Vincent Van Rompaey, Griet Mertens
PURPOSE: Postoperative cognitive dysfunction (PCD) is a subtle, prolonged deterioration in cognition after surgery. This complication has been frequently investigated, mainly after major (cardiac) surgery. However, the incidence after cochlear implantation is unknown. Therefore, the aim of the study was to investigate the incidence and possible risk factors of PCD in severely hearing-impaired older adults after cochlear implantation. METHODS: In a prospective cohort study, 26 older participants (age: M = 70, SD = 8 years), scheduled for cochlear implantation, were assessed prior to and 1 week after implantation by means of the Montreal Cognitive Assessment (MoCA)...
April 18, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29628544/anesthetic-considerations-for-carotid-endarterectomy-a-postgraduate-educational-review
#4
REVIEW
Ahmed Yousef A Al Sultan, Abdulrahman Mawadh A Alsubhi
Carotid endarterectomy (CEA) has shown a significant benefit in preventing ipsilateral stroke when it is compared to conservative management. Surgical morbidity and mortality must be kept to a minimum to achieve this benefit. Neurological status of the CEA patients can be monitored easily during regional anesthesia depending on the awake testing (neurocognitive assessment) method of the CEA patients. In addition, specific parameters can help us to monitor and to predict the neurological status of the CEA patients during the procedures such as regional cerebral oxygen saturation (rSO2 ) and middle cerebral artery velocity (MCAv) changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29624526/american-society-for-enhanced-recovery-advancing-enhanced-recovery-and-perioperative-medicine
#5
Tong J Gan, Michael Scott, Julie Thacker, Traci Hedrick, Robert H Thiele, Timothy E Miller
As the population ages, the increasing surgical volume and complexity of care are expected to place additional care delivery burdens in the perioperative setting. In this age of integrated multidisciplinary care of the surgical patients, there is increasing recognition that an evidence-based perioperative pathway is associated with the optimal outcomes. These pathways, collectively referred to as Enhanced Recovery Pathways, have resulted in shortened length of hospital stay, reduced complications, and variance in outcomes, as well as earlier return to baseline activities...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29624026/preoperative-anxiety-and-implications-on-postoperative-recovery-what-we-can-do-to-change-our-history
#6
Dusica M Stamenkovic, Nemanja K Rancic, Milan B Latas, Vojislava Neskovic, Goran M Rondovic, Jennifer D Wu, Davide Cattano
Preoperative anxiety can influence the intensity of postoperative pain and anesthesia and analgesia requirement. In certain types of surgery, anxiety may even increase postoperative morbidity and mortality. The goal of this narrative review is to remind anesthesiologists that anxiety measurement using specific tools can be done in clinical practice, to present the implications of preoperative anxiety on postoperative patient recovery, and to acknowledge the importance of a dedicated anesthesia plan in the management of anxious adult patients...
April 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29622308/oral-and-maxillofacial-surgery-team-anesthesia-model-and-anesthesia-assistant-training
#7
REVIEW
Stephanie J Drew
The model for oral and maxillofacial surgery (OMFS) delivery of office-based, open airway anesthesia has morphed from the operator-anesthetist to the delivery of team anesthesia, supporting a widespread focus on organizational aspects of the delivery of care. The training, continuing education, and coordination of a diverse anesthesia team provides a system to improve the safety and efficacy of anesthesia delivery. The hallmarks of this system include communication, checks and balances, monitoring, team dynamics, protocols, emergency scenario preparation and rehearsal, and crisis resource management during an emergent situation...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29588995/the-adjunctive-application-of-transcranial-direct-current-stimulation-in-the-management-of-de-novo-refractory-epilepsia-partialis-continua-in-adolescent-onset-polg-related-mitochondrial-disease
#8
Yi Shiau Ng, Henriette van Ruiten, H Ming Lai, Rebecca Scott, Venkateswaran Ramesh, Karen Horridge, Robert W Taylor, Doug M Turnbull, Gráinne S Gorman, Robert McFarland, Mark R Baker
Focal status epilepticus in POLG -related mitochondrial disease is highly refractory to pharmacological agents, including general anesthesia. We report the challenges in managing a previously healthy teenager who presented with de novo epilepsia partialis continua and metabolic stroke resulting from the homozygous p.Ala467Thr POLG mutation, the most common pathogenic variant identified in the Caucasian population. We applied transcranial direct current stimulation (tDCS; 2 mA; 20 min) daily as an adjunctive therapy because her focal seizures failed to respond to five antiepileptic drugs at maximal doses...
March 2018: Epilepsia Open
https://www.readbyqxmd.com/read/29580593/multimodal-perioperative-analgesia-regimen-to-improve-patient-outcomes-after-total-knee-arthroplasty-a-multidisciplinary-quality-improvement-project
#9
Rebecca E Donahue, George R Bradbury, Michael E Zychowicz, Virginia C Muckler
PURPOSE: The primary aim of this quality improvement project was to improve mobilization for patients after total knee arthroscopy by developing and implementing a standardized, evidence-based, multimodal analgesia regimen and patient-educational video. Secondary outcomes included opioid consumption, pain, and length of stay. DESIGN: A pre-post implementation design was used to compare two independent samples. METHODS: Patients were screened based on inclusion and exclusion criteria 1-2 weeks before surgery...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29580444/medical-simulation-as-a-vital-adjunct-to-identifying-clinical-life-threatening-gaps-in-austere-environments
#10
Adaora M Chima, Rahul Koka, Benjamin Lee, Tina Tran, Onyebuchi U Ogbuagu, Howard Nelson-Williams, Michael Rosen, Michael Koroma, John B Sampson
BACKGROUND: Maternal mortality and morbidity are major causes of death in low-resource countries, especially those in Sub-Saharan Africa. Healthcare workforce scarcities present in these locations result in poor perioperative care access and quality. These scarcities also limit the capacity for progressive development and enhancement of workforce training, and skills through continuing medical education. Newly available low-cost, in-situ simulation systems make it possible for a small cadre of trainers to use simulation to identify areas needing improvement and to rehearse best practice approaches, relevant to the context of target environments...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29559262/integration-of-simulation-components-enhances-team-training-in-cardiac-surgery
#11
David L Joyce, Brian D Lahr, Simon Maltais, Sameh M Said, John M Stulak, Gregory A Nuttall, Lyle D Joyce
OBJECTIVES: Simulation in resident medical education has traditionally focused on isolated components of a surgical procedure. We hypothesized that incorporating an interdisciplinary team into a high-fidelity simulation laboratory would enhance the modeling of real-world challenges during cardiac surgery. METHODS: Simulation exercises were performed with staffing by surgeons, anesthesiologists, perfusionists, surgical assistants, and operating room technicians. Twelve accredited cardiothoracic surgical residents were divided into 3 teams...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29548007/plastic-surgery-resident-run-cosmetic-clinics-a-survey-of-current-practices
#12
Michael J Ingargiola, Felipe Molina Burbano, Amy Yao, Saba Motakef, Paymon Sanati-Mehrizy, Nikki M Burish, Lisa R David, Peter J Taub
Background: The recently increased minimum aesthetic surgery requirements set by the Plastic Surgery Residency Review Committee of the ACGME highlight the importance of aesthetic surgery training for plastic surgery residents. Participation in resident aesthetic surgery clinics has become an important tool to achieve this goal. Yet, there is little literature on the current structure of these clinics. Objectives: The authors sought to evaluate current practices of aesthetic resident-run clinics in the United States...
March 14, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29547920/nicotine-addiction-management-following-surgery-a-quality-improvement-approach-in-the-post-anesthesia-care-unit
#13
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29547425/are-short-subspecialty-courses-the-educational-answer
#14
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29547424/education-the-heart-of-the-matter
#15
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29547422/anesthesia-development-in-mongolia-strengthening-anesthesia-practice-in-mongolia-through-education-and-continuing-professional-development
#16
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29543613/peer-support-in-anesthesia-turning-war-stories-into-wellness
#17
Amy E Vinson, Gail Randel
PURPOSE OF REVIEW: Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. RECENT FINDINGS: As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery...
March 14, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29532559/epidemiology-of-general-anesthesia-prior-to-age-3-in-a-population-based-birth-cohort
#18
Yu Shi, Danqing Hu, Erin L Rodgers, Slavica K Katusic, Stephen J Gleich, Andrew C Hanson, Darrell R Schroeder, Randall P Flick, David O Warner
BACKGROUND: Utilization of general anesthesia in children has important policy, economic, and healthcare delivery implications, yet there is little information regarding the epidemiology of these procedures in the United States. AIMS: The primary objective of this study was to describe in a geographically defined population the incidence of procedures requiring general anesthesia up to the child's third birthday, and the patient characteristics associated with receiving these procedures...
March 13, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29513208/use-of-and-access-to-deep-sedation-and-general-anesthesia-for-dental-patients-a-survey-of-ontario-dentists
#19
Andrew Adams, Carilynne Yarascavitch, Carlos Quiñonez, Amir Azarpazhooh
OBJECTIVE: This study aims to assess barriers to the use of deep sedation/general anesthesia (DS/GA) identified by dentists in Ontario. METHODS: An email invitation to a web-based survey was distributed to all licensed dentists and specialists who have provided an email address to the provincial regulator (n = 5507). Descriptive and regression analyses were performed to explore practice and demographic factors associated with the use of DS/GA. RESULTS: The response rate was 18...
July 2017: Journal—Canadian Dental Association, Journal de L'Association Dentaire Canadienne
https://www.readbyqxmd.com/read/29508477/understanding-cardiac-shunts
#20
REVIEW
Denise C Joffe, Mark R Shi, Carson C Welker
Most patients with congenital heart disease have a cardiac shunt whose direction and magnitude can have a major impact on cardiorespiratory physiology and function. The dynamics of the shunt can be significantly altered by anesthetic management and must be understood in order to provide optimal anesthetic care. Given that there are now more adults than children with congenital heart disease and that the majority of nonpediatric patients are cared for in centers without special expertise in congenital heart disease, it is imperative that all anesthesia providers have a general understanding of the subject...
March 6, 2018: Paediatric Anaesthesia
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