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Anesthesia information management systems

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https://www.readbyqxmd.com/read/28938302/anesthesia-information-management-clinical-decision-support
#1
Robert E Freundlich, Jesse M Ehrenfeld
PURPOSE OF REVIEW: Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. RECENT FINDINGS: Clinical decision support tools become more timely, accurate, and, in some instances, have been shown to improve patient outcomes...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28858900/trends-in-the-prevalence-of-intraoperative-adverse-events-at-2-academic-hospitals-after-implementation-of-a-mandatory-reporting-system
#2
Jonathan P Wanderer, David M Gratch, Paul St Jacques, Luis I Rodriquez, Richard H Epstein
BACKGROUND: Anesthesia information management systems (AIMSs) have been effectively used to improve quality in anesthesia care, and have enabled the development of mandatory quality assurance (QA) reporting systems for adverse events (AEs). While this approach has been shown to increase event reporting over time, the long-term effect of such a system on quality is unknown. We investigated the trends in AE reporting over time after implementing AIMS-based mandatory reporting systems at 2 academic medical centers...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28836540/gingival-fibromatosis-with-hypertrichosis-syndrome-case-series-of-rare-syndrome
#3
Preetha Balaji, S M Balaji
Gingival fibromatosis with hypertrichosis syndrome is an extremely rare genetic condition characterized by profound overgrowth of hair and gums, as well as other variable features. Gingival fibromatosis is characterized by a large increase in the gingival dimension which extends above the dental crowns, covering them partially or completely. They were found to have a genetic origin, may also occur in isolation or be part of a syndrome, or acquired origin, due to specific drugs administered systemically. Congenital generalized hypertrichosis is a heterogeneous group of diseases with continuing excessive growth of terminal hair without androgenic stimulation...
July 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/28738985/intraoperative-handoffs-among-anesthesia-providers-increase-the-incidence-of-documentation-errors-for-controlled-drugs
#4
Richard H Epstein, Franklin Dexter, David M Gratch, David A Lubarsky
BACKGROUND: When electronic anesthesia records are compared to pharmacy transactions, discrepancies in total doses of controlled drugs are commonly found (≈16% of cases), potentially affecting patient safety and placing hospitals at risk for regulatory action. Errors (≈5%) persisted even with near real-time drug reconciliation feedback to providers. A study was conducted to test the hypothesis of greater risks of discrepancy for longer-duration cases and for intraoperative handoff involving a permanent handoff of care...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#5
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation after cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series. If there is a threshold below which survival was extremely unlikely, it might be useful in guiding decision-making in the early termination of futile resuscitative efforts...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28619774/protocol-for-a-multicentre-multistage-prospective-study-in-china-using-system-based-approaches-for-consistent-improvement-in-surgical-safety
#6
Xiaochu Yu, Jingmei Jiang, Changwei Liu, Keng Shen, Zixing Wang, Wei Han, Xingrong Liu, Guole Lin, Ye Zhang, Ying Zhang, Yufen Ma, Haixin Bo, Yupei Zhao
INTRODUCTION: Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28598914/perioperative-temperature-measurement-considerations-relevant-to-reporting-requirements-for-national-quality-programs-using-data-from-anesthesia-information-management-systems
#7
Richard H Epstein, Franklin Dexter, Ira S Hofer, Luis I Rodriguez, Eric S Schwenk, Joni M Maga, Bradley J Hindman
BACKGROUND: Perioperative hypothermia may increase the incidences of wound infection, blood loss, transfusion, and cardiac morbidity. U.S. national quality programs for perioperative normothermia specify the presence of at least 1 "body temperature" ≥35.5°C during the interval from 30 minutes before to 15 minutes after the anesthesia end time. Using data from 4 academic hospitals, we evaluated timing and measurement considerations relevant to the current requirements to guide hospitals wishing to report perioperative temperature measures using electronic data sources...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504990/a-structured-transfer-of-care-process-reduces-perioperative-complications-in-cardiac-surgery-patients
#8
Michael Hall, Jamie Robertson, Matthias Merkel, Michael Aziz, Michael Hutchens
INTRODUCTION: Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. METHODS: We hypothesized that a collaborative, comprehensive, structured handover of care from the intraoperative team to the ICU team would reduce a specific set of postoperative complications...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28269717/assessment-of-sedation-analgesia-by-means-of-poincare%C3%AC-analysis-of-the-electroencephalogram
#9
Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia
Monitoring the levels of sedation-analgesia may be helpful for managing patient stress on minimally invasive medical procedures. Monitors based on EEG analysis and designed to assess general anesthesia cannot distinguish reliably between a light and deep sedation. In this work, the Poincaré plot is used as a nonlinear technique applied to EEG signals in order to characterize the levels of sedation-analgesia, according to observed categorical responses that were evaluated by means of Ramsay Sedation Scale (RSS)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227981/assessment-of-sedation-analgesia-by-means-of-poincare%C3%AC-analysis-of-the-electroencephalogram
#10
Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Xavi Borrat, Jose F Valencia, Montserrat Vallverdu, Pere Caminal, Pedro L Gambus, Daniel F Valencia
Monitoring the levels of sedation-analgesia may be helpful for managing patient stress on minimally invasive medical procedures. Monitors based on EEG analysis and designed to assess general anesthesia cannot distinguish reliably between a light and deep sedation. In this work, the Poincaré plot is used as a nonlinear technique applied to EEG signals in order to characterize the levels of sedation-analgesia, according to observed categorical responses that were evaluated by means of Ramsay Sedation Scale (RSS)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28207594/using-high-technology-simulators-to-prepare-anesthesia-providers-before-implementation-of-a-new-electronic-health-record-module-a-technical-report
#11
Ari Y Weintraub, Ellen S Deutsch, Roberta L Hales, Newton A Buchanan, Whitney L Rock, Mohamed A Rehman
Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28183549/hypocapnia-measured-by-end-tidal-carbon-dioxide-tension-during-anesthesia-is-associated-with-increased-30-day-mortality-rate
#12
Philippe Dony, Michele Dramaix, Jean G Boogaerts
STUDY OBJECTIVE: To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS). DESIGN: Retrospective, observational study. SETTING: Surgical theaters of the University Hospital Center of Charleroi. PATIENTS: Five thousand three hundred seventeen patients ASA I-IV undergoing various surgical procedures (except pediatric and cardiac surgery) under general anesthesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#13
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28119992/development-and-feasibility-of-a-real-time-clinical-decision-support-system-for-traumatic-brain-injury-anesthesia-care
#14
Taniga Kiatchai, Ashley A Colletti, Vivian H Lyons, Rosemary M Grant, Monica S Vavilala, Bala G Nair
BACKGROUND: Real-time clinical decision support (CDS) integrated with anesthesia information management systems (AIMS) can generate point of care reminders to improve quality of care. OBJECTIVE: To develop, implement and evaluate a real-time clinical decision support system for anesthetic management of pediatric traumatic brain injury (TBI) patients undergoing urgent neurosurgery. METHODS: We iteratively developed a CDS system for pediatric TBI patients undergoing urgent neurosurgery...
January 25, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28099325/intraoperative-clinical-decision-support-for-anesthesia-a-narrative-review-of-available-systems
#15
REVIEW
Bala G Nair, Eilon Gabel, Ira Hofer, Howard A Schwid, Maxime Cannesson
With increasing adoption of anesthesia information management systems (AIMS), there is growing interest in utilizing AIMS data for intraoperative clinical decision support (CDS). CDS for anesthesia has the potential for improving quality of care, patient safety, billing, and compliance. Intraoperative CDS can range from passive and post hoc systems to active real-time systems that can detect ongoing clinical issues and deviations from best practice care. Real-time CDS holds the most promise because real-time alerts and guidance can drive provider behavior toward evidence-based standardized care during the ongoing case...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#16
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28089598/impact-of-focused-intraoperative-transthoracic-echocardiography-by-anesthesiologists-on-management-in-hemodynamically-unstable-high-risk-noncardiac-surgery-patients
#17
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28079663/general-anesthesia-and-fabry-disease-a-case-report
#18
Stefan Krüger, Albina Nowak, Torben Christoph Müller
Fabry disease is an inherited X-linked disorder characterized by the absence (in men) or deficiency (in women) in α-galactosidase A activity that causes a progressive accumulation of glycosphingolipids within lysosomes of cells of all the major organ systems. The subsequent organ damage that manifests in childhood and early adulthood presents a widely variable clinical picture of pain, hypertension, and cardiac, renal, nervous system, and lung dysfunction. We present 2 female patients with Fabry disease who required general anesthesia twice for gynecological and trauma surgery, respectively, and discuss their perioperative management based on new information in the medical literature...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#19
REVIEW
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27935775/anesthesia-information-management-systems
#20
Thomas Corey Davis
Anesthesia information management systems (AIMS) are rapidly gaining widespread acceptance. Aggressively promoted as an improvement to manual-entry recordkeeping systems in the areas of accuracy, completeness, quality improvement, billing, and vigilance, these systems record all patient vital signs and parameters, providing a legible hard copy and permanent electronic record. With well-documented financial incentives, as well as government subsidies, AIMS are becoming adopted at an unprecedented rate. With the goals of the federal government to enhance the use of the electronic medical record, there is an emerging belief that AIMS may soon be mandated, with more limited choices than currently available...
January 2017: Annual Review of Nursing Research
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