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Anesthesia and education

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https://www.readbyqxmd.com/read/29889973/ether-anesthesia-in-the-austere-environment-an-exposure-and-education
#1
L Brad Morgans, Nicholas Graham
Medical services in the austere and limited environment often require therapeutics and practices uncommon in modern times due to a lack of availability, affordability, or expertise in remote areas. In this setting, diethyl ether, or simply ether anesthesia, still serves a role today as an effective inhalation agent. An understanding of ether as an anesthetic not only illustrates the evolution in surgical anesthesia but also demonstrates ether's surviving function and durable use as a practical agent in developing nations...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889707/postoperative-cognitive-dysfunction-and-noncardiac-surgery
#2
Lisbeth A Evered, Brendan S Silbert
Postoperative cognitive dysfunction (POCD) is an objectively measured decline in cognition postoperatively compared with preoperative function. POCD has been considered in the anesthetic and surgical literature in isolation of cognitive decline which is common in the elderly within the community and where it is labeled as mild cognitive impairment, neurocognitive disorder, or dementia. This narrative review seeks to place POCD in the broad context of cognitive decline in the general population. Cognitive change after anesthesia and surgery was described over 100 years ago, initially as delirium and dementia...
June 8, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29875086/dental-home-visits-for-caries-prevention-among-preschool-children-protocol-for-a-cost-effectiveness-analysis-on-a-randomized-control-trial
#3
Niekla Survia Andiesta, Maimunah A Hamid, Kkc Lee, Allan Pau
BACKGROUND: In 2012, nearly 4000 children in Malaysia were referred to hospital pediatric dental services due to dental caries. Recent research has reported the effectiveness of dental home visits in preventing caries development in young children. Dental home visits (DHVs) are described as an ongoing relationship between the dentist and their patients, providing all aspects of a preventive oral health care program in the presence of the parents at home. OBJECTIVE: The objective of this study is to evaluate the cost-effectiveness of dental home visits and oral health information, in the form of educational leaflets, in preventing new caries development in young children, compared to those receiving only educational leaflets over a period of two years...
June 6, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29870136/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#4
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries are increasingly engaged in resource-limited areas, with short-term missions as the most common form of involvement. However, consensus recommendations currently do not exist for short-term missions in pediatric general surgery and associated perioperative care. The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
May 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29844009/workflow-and-efficiency-in-mri-based-high-dose-rate-brachytherapy-for-cervical-cancer-in-a-high-volume-brachytherapy-center
#5
Hayeon Kim, Christopher J Houser, Ronny Kalash, Carly A Maceil, Brett Palestra, Deborah Malush, Sushil Beriwal
PURPOSE: We report the clinical workflow and time required for MRI-based image-guided brachytherapy (MR-IGBT) of cervical cancer patients in a high-volume brachytherapy center with 10 years of experiences to provide a practical guideline for implementing MR-IGBT into clinical use. METHODS AND MATERIALS: We recorded the time and workflow of each procedure step within the 40 consecutive ring and tandem applicator fractions of MR-IGBT by our multidisciplinary team...
May 26, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29804407/-therapeutic-effect-of-ginkgo-biloba-extract-on-postoperative-delirium-in-aged-patients
#6
K J Xie, W Zhang, J B Yuan, J Zhou, Y Y Lian, J Fang
Objective: To observe whether Ginkgo biloba extract (EGb761) can improve postoperative delirium in elderly patients. Methods: Eighty elderly patients undergoing tumor surgery at Zhejiang Cancer Hospital and complicated with postoperative delirium(POD) between June 2013 and July 2016 were randomly divided into treatment group (group A) and control group (group B) according to the random number table method. Patients in group A received ginkgo biloba extract (EGb761) drops oral treatment (3 times/d, 80 mg each time) in addition to oxygen inhalation and appeasement treatment...
May 15, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29801659/process-measures-facilitate-maturation-of-pediatric-enhanced-recovery-protocols
#7
Ira L Leeds, Mitchell R Ladd, Margaret H Sundel, Melissa L Fannon, Jessica A George, Emily F Boss, Eric B Jelin
BACKGROUND/PURPOSE: The role of process measures used to predict quality in pediatric colorectal surgery enhanced recovery protocols has not been described. The purpose of this study was to demonstrate the feasibility of abstracting and monitoring process measures over protocol improvement iteration. METHODS: Patients enrolled in the Pediatric Colorectal Enhanced Recovery After Surgery pathway at our institution were grouped by stage of implementation. We used a quality improvement database to compare multistage enhanced recovery process measures and 30-day patient outcomes...
May 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29793471/surgical-informed-consent-in-obstetric-and-gynecologic-surgeries-experience-from-a-comprehensive-teaching-hospital-in-southern-ethiopia
#8
Million Teshome, Zenebe Wolde, Abel Gedefaw, Mequanent Tariku, Anteneh Asefa
BACKGROUND: Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries...
May 24, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29790369/an-innovative-perioperative-pain-program-for-chronic-opioid-users-an-academic-medical-center-s-response-to-the-opioid-crisis
#9
Marie N Hanna, Traci J Speed, Ronen Shechter, Michael C Grant, Rosanne Sheinberg, Elizabeth Goldberg, Claudia M Campbell, Nicholas Theodore, Colleen G Koch, Kayode Williams
Increased utilization of prescription opioids for pain management has led to a nationwide public health crisis with alarming rates of addiction and opioid-related deaths. In the surgical setting, opioid prescriptions have been implicated as a contributing factor to the opioid epidemic. The authors developed an innovative model to address aspects of pain management and opioid utilization during preoperative evaluation, acute surgical hospitalization, and postoperative follow-up for chronic opioid users. This program involves multidisciplinary teams that include acute and chronic pain specialists, psychiatrists, integrative medicine specialists, and physical medicine and rehabilitation services...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#10
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#11
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29766037/international-elective-opportunities-in-united-states-anesthesia-residency-programs
#12
Meghan Prin, Janey Phelps
Background: Global health is a recognized component of medical education and is increasingly included in residency programs. International electives have the potential to improve global health training by providing exposure to different populations and the challenges of health disparities. The objective of this study was to describe international elective opportunities in US anesthesiology residency training programs, including an assessment the types of programs offered and the obstacles to providing this type of training...
October 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29766033/use-of-key-performance-indicators-to-improve-milestone-assessment-in-semi-annual-clinical-competency-committee-meetings
#13
Fei Chen, Harendra Arora, Susan M Martinelli
Background: The Accreditation Council for Graduate Medical Education's Next Accreditation System requires residency programs to semiannually submit composite milestone data on each resident's performance. This report describes and evaluates a new assessment review procedure piloted in our departmental Clinical Competency Committee (CCC) semi-annual meeting in June 2016. Methods: A modified Delphi technique was utilized to develop key performance indicators (KPI) linking milestone descriptors to clinical practice...
October 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29760370/using-eye-tracking-technology-to-compare-the-effectiveness-of-malignant-hyperthermia-cognitive-aid-design
#14
Roderick King, Jaber Hanhan, T Kyle Harrison, Alex Kou, Steven K Howard, Lindsay K Borg, Cynthia Shum, Ankeet D Udani, Edward R Mariano
Background: Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology. Methods: With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants...
May 15, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#15
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750689/a-prospective-observational-study-of-technical-difficulty-with-glidescope-guided-tracheal-intubation-in-children
#16
Bin Zhang, Harshad G Gurnaney, Paul A Stricker, Jorge A Galvez, Rebecca S Isserman, John E Fiadjoe
BACKGROUND: The GlideScope Cobalt is one of the most commonly used videolaryngoscopes in pediatric anesthesia. Although visualization of the airway may be superior to direct laryngoscopy, users need to learn a new indirect way to insert the tracheal tube. Learning this indirect approach requires focused practice and instruction. Identifying the specific points during tube placement, during which clinicians struggle, would help with targeted education. We conducted this prospective observational study to determine the incidence and location of technical difficulties using the GlideScope, the success rates of various corrective maneuvers used, and the impact of technical difficulty on success rate...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29743181/evaluation-of-the-quality-of-transesophageal-echocardiography-images-and-verification-of-proficiency
#17
Robina Matyal, Faraz Mahmood, Ziyad Omar Knio, Stephanie Jones, Lu Yeh, Rabina Amir, Ruma Bose, John D Mitchell
Various metrics have been used in curriculum-based TEE training programs to evaluate acquisition of proficiency. However, the quality of task completion, i.e. the final image quality, was subjectively evaluated in these studies. Ideally, the end point metric should be an objective comparison of the trainee-acquired image with a reference ideal image. Therefore, we developed a simulator-based methodology of pre-clinical verification of proficiency (VOP) in trainees by tracking objective evaluation of the final acquired images...
May 9, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29739184/moving-anesthesiology-educational-resources-to-the-point-of-care-experience-with-a-pediatric-anesthesia-mobile-app
#18
Katherine S Monroe, Michael A Evans, Shivani G Mukkamala, Julie L Williamson, Craig S Jabaley, Edward R Mariano, Vikas N O'Reilly-Shah
Background: Educators in all disciplines recognize the need to update tools for the modern learner. Mobile applications (apps) may be useful, but real-time data is needed to demonstrate the patterns of utilization and engagement amongst learners. Methods: We examined the use of an anesthesia app by two groups of learners (residents and anesthesiologist assistant students [AAs]) during a pediatric anesthesiology rotation. The app calculates age and weight-based information for clinical decision support and contains didactic materials for self-directed learning...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29725565/the-use-of-simulation-to-improve-family-understanding-and-support-of-anesthesia-providers
#19
Susan M Martinelli, Fei Chen, Gene Hobbs, Brooke A Chidgey, Lacey E Straube, David Zvara, Robert Isaak
Introduction  Burnout in medical providers is associated with work dissatisfaction, reduction in patient safety, and provider depression. Simulation is a tool effectively used for specific task training but has not been broadly used as a means to combat medical professional stress and enhance wellness. The authors created a medical simulation program targeted at those involved in the social support of medical providers. The hypothesis was that education of non-medical persons involved in social support would translate into an enhanced understanding of the demands among medical providers in anesthesiology...
March 2, 2018: Curēus
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
#20
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
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