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Simulation anaesthesia

Sharon R Lewis, Andrew R Butler, Joshua Parker, Tim M Cook, Andrew F Smith
BACKGROUND: Successful tracheal intubation during general anaesthesia traditionally requires a line of sight to the larynx attained by positioning the head and neck and using a laryngoscope to retract the tongue and soft tissues of the floor of the mouth. Difficulties with intubation commonly arise, and alternative laryngoscopes that use digital and/or fibreoptic technology have been designed to improve visibility when airway difficulty is predicted or encountered. Among these devices, a rigid videolaryngoscope (VLS) uses a blade to retract the soft tissues and transmits a lighted video image to a screen...
November 15, 2016: Cochrane Database of Systematic Reviews
J L Telles, S Agarwal, J Monagle, C Stough, R King, L Downey
Australian guidelines state "Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more". The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms...
November 2016: Anaesthesia and Intensive Care
Peter R Loughenbury, Rebecca A Gledhill, Nick Evans
We report two cases of failed attempts at closed reduction of high-energy tibial fractures with an associated fibula fracture. The first case was a 39-year-old male involved in high-speed motorbike collision, while the second was a 14-year-old male who injured his leg following a fall of three metres. Emergency medical services at the scenes of the accidents reported a 90-degree valgus deformity of the injured limb and both limbs were realigned on scene and stabilized. Adequate alignment of the tibia could not be achieved by manipulation under sedation or anaesthesia...
2016: Case Reports in Emergency Medicine
T Beament, S J Mercer
'Speaking up' or the ability to effectively challenge erroneous decisions is essential to preventing harm. This mixed-methods study in two parts explores the concept of 'barriers to challenging seniors' for anaesthetic trainees, and proposes a conceptual framework. Using a fully immersive simulation scenario with unanticipated airway difficulty, we investigated how junior anaesthetists (one to two years of training) challenged a scripted error. We also conducted focus groups with senior trainees (three to seven years of training) and undertook a 'thematic network analysis' of responses...
November 2016: Anaesthesia
Ann Sofia Skou Thomsen, Phillip Smith, Yousif Subhi, Morten la Cour, Lilian Tang, George M Saleh, Lars Konge
PURPOSE: To investigate the correlation in performance of cataract surgery between a virtual-reality simulator and real-life surgery using two objective assessment tools with evidence of validity. METHODS: Cataract surgeons with varying levels of experience were included in the study. All participants performed and videorecorded three standard cataract surgeries before completing a proficiency-based test on the EyeSi virtual-reality simulator. Standard cataract surgeries were defined as: (1) surgery performed under local anaesthesia, (2) patient age >60 years, and (3) visual acuity >1/60 preoperatively...
September 29, 2016: Acta Ophthalmologica
Feng Mao, Liang Zhang, Hengle Gu, Hui Zhang, Changxing Lv, Yang Shen-Tu
BACKGROUND: With the extensively application of HRCT (high resolution CT) and the popularization of early lung cancer screening, the proportion of small nodullar lung cancer to be operated increases rapidly. Identifying the focus lesions quickly and accurately in operation has shown to be a challenge. We carried out this research trying to make use of and evaluate a new method that localizaes and extracts small peripheral pulmonary nodules by way of simulating radiaotherapy combining methylene blue staining...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
C López-Cabrera, E J Hernández-Rivas, T Komabayashi, E L Galindo-Reyes, D Tallabs-López, B I Cerda-Cristerna
INTRODUCTION: This study evaluated the influence of three-repetition training with a dental anaesthesia simulation model (DASM) on the perception of learning by dental students. MATERIALS AND METHODS: Dental students who had never used a dental anaesthesia technique were randomly divided into two groups that were taught the anterior superior alveolar nerve infiltrative anaesthesia technique. Group 1 (G1; N = 10) followed a three-stage learning method: (i) theoretical lecture, (ii) clinical demonstration and (iii) DASM training, including three repetitions of the anaesthesia technique...
September 19, 2016: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
Marilù Giacalone, Cédrick Zaouter, Stefano Mion, Thomas M Hemmerling
The international anaesthesia community is getting older, in line with trends worldwide, and as men and women age there is the risk that psychophysiological decline could have an impact on clinical practice. Impairment of technical and nontechnical skills could have a negative impact on patients' safety and outcomes. The ageing process may not necessarily go hand-in-hand with a predictable pattern of decreased competence as not all aspects of functional decline are affected at the same rate and to the same extent...
November 2016: European Journal of Anaesthesiology
Adrien Lemoine, Jean X Mazoit, Francis Bonnet
BACKGROUND: Spinal bupivacaine is used for day-case surgery but the appropriate dose that guarantees hospital discharge is unknown. OBJECTIVE: We sought to determine the spinal bupivacaine dose that prevents delayed hospital discharge in ambulatory surgery. DESIGN: Systematic review of clinical trials. DATA SOURCES: Comprehensive search in electronic databases of studies published between 1996 and 2014 reporting the use of spinal bupivacaine in ambulatory patients...
November 2016: European Journal of Anaesthesiology
Ivana Nakarada-Kordic, Jennifer M Weller, Craig S Webster, David Cumin, Christopher Frampton, Matt Boyd, Alan F Merry
BACKGROUND: Patient safety depends on effective teamwork. The similarity of team members' mental models - or their shared understanding-regarding clinical tasks is likely to influence the effectiveness of teamwork. Mental models have not been measured in the complex, high-acuity environment of the operating room (OR), where professionals of different backgrounds must work together to achieve the best surgical outcome for each patient. Therefore, we aimed to explore the similarity of mental models of task sequence and of responsibility for task within multidisciplinary OR teams...
2016: BMC Medical Education
M St Pierre, G Breuer, D Strembski, C Schmitt, B Lütcke
BACKGROUND: Unanticipated airway problems in infants can rapidly develop into severe hypoxemia. Team members can provide support and suggest steps of action if a shared mental model of the next steps exists. Briefing prior to induction of anaesthesia may create such a shared mental model among all team members. OBJECTIVES: The aim of the study was to assess whether a short briefing on the recommendations for an unexpected difficult airway, developed by the Working Group on Paediatric Anaesthesia of the German Society for Anaesthesiology and Intensive Care Medicine, would influence the management of an unexpected difficult mask ventilation in an infant...
September 2016: Der Anaesthesist
Akram Saad, Jeffrey Goldstein, Yaacov Richard Lawrence, Ilana Weiss, Rasha Saad, Benjamin Spieler, Zvi Symon
INTRODUCTION: The purpose is to describe the method, safety and efficacy of transperineal gold seed placement for image-guided radiation therapy. METHODS: An ethics committee approved database was used to review records of consecutive patients from October 2008 through December 2013, who underwent transperineal implantation of three gold markers into the prostate using staged local anaesthesia and transrectal ultrasound. Seeds were counted on radiographs from CT simulation, first treatment and last treatment...
December 2015: Journal of Medical Radiation Sciences
S A Khan, S Khan, H Kothandan
We undertook a randomised control led trial to evaluate the effect of a prototype device which attaches to the intravenous drug administration port, and allows injection of intravenous drugs only after the user scans the barcode on the syringe label. This requires two steps: first, that the correct drug label is generated; and second, that the syringe-with-label is scanned before administration. Ten anaesthetists, who were unaware of the primary outcome being measured, administered general anaesthesia for two simulated standardised cases each without and with our prototype (control and intervention, respectively)...
October 2016: Anaesthesia
Lyn Li Lean, Ryan Yee Shiun Hong, Lian Kah Ti
Communication of feedback during teaching of practical procedures is a fine balance of structure and timing. We investigate if continuous in-task (IT) or end-task feedback (ET) is more effective in teaching spinal anaesthesia to medical students. End-task feedback was hypothesized to improve both short-term and long-term procedural learning retention as experiential learning promotes active learning after encountering errors during practice. Upon exposure to a 5-min instructional video, students randomized to IT or ET feedbacks were trained using a spinal simulator mannequin...
July 27, 2016: Advances in Health Sciences Education: Theory and Practice
Antoine Gouin, Cédric Damm, Grégory Wood, Sébastien Cartier, Marie Borel, Karen Villette-Baron, Sylvain Boet, Vincent Compère, Bertrand Dureuil
BACKGROUND AND OBJECTIVE: High-fidelity medical simulation is a source of stress for participants. The aim of this study was to assess if repeated simulated courses decrease perceived stress and/or physiological stress level and increase performance in anaesthesiology registrars. METHOD: Fourteen anaesthesiology specialty registrars participated individually in three successive sessions of crisis simulation in the operating room. Participants' perceived stress levels were measured by self-assessment (simple numerical scale from 0 to 10 [0=no stress, 10=maximum stress]) and physiological stress was estimated via the maximal heart rate measured by a Holter system)...
June 23, 2016: Anaesthesia, Critical Care & Pain Medicine
S DeMaria, D J Berman, A Goldberg, H-M Lin, Y Khelemsky, A I Levine
BACKGROUND: Non-operating room (non-OR) airway management has previously been identified as an area of concern because it carries a significant risk for complications. One reason for this could be attributed to the independent practice of residents in these situations. The aim of the present study was to ascertain whether differences in performance exist between residents working alone vs with a resident partner when encountering simulated non-OR airway management scenarios. METHODS: Thirty-six anaesthesia residents were randomized into two groups...
July 2016: British Journal of Anaesthesia
Sylvain Boet, Ashlee-Ann Pigford, Amber Fitzsimmons, Scott Reeves, Emmanuel Triby, M Dylan Bould
The value of debriefing after an interprofessional simulated crisis is widely recognised; however, little is known about the content of debriefings and topics that prompt reflection. This study aimed to describe the content and topics that facilitate reflection among learners in two types of interprofessional team debriefings (with or without an instructor) following simulated practice. Interprofessional operating room (OR) teams (one anaesthesia trainee, one surgical trainee, and one staff circulating OR nurse) managed a simulated crisis scenario and were randomised to one of two debriefing groups...
June 16, 2016: Journal of Interprofessional Care
E Hoerner, K Schebesta, M Hüpfl, O Kimberger, B Roessler
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
E H Liu, Y Tan, N H W Loh, C Siau
Anaesthesia machine failure requires rapid solutions to maintain ventilation and anaesthesia. During procedures with poor access to the patient's airway, it may not be possible to use a self-inflating mechanical ventilation device (SIMVD) for emergency ventilation, and alternative solutions are needed. We evaluated five methods for rescue ventilation using a patient simulator. In Method 1, we used the inspiratory and expiratory tubes and the alternative common gas outlet (ACGO) on the anaesthesia machine to produce a Mapleson E system...
May 2016: Anaesthesia and Intensive Care
Juan A Juanes, Pablo Alonso, Felipe Hernández, Pablo Ruisoto, Clemente Muriel
INTRODUCTION: Regions considered optimal for performing peripheral nerve blocking have been well documented. However identify and perform regional anesthesia in those regions from ultrasound images remains a challenge. AIM: This study aims to develop a virtual environment for the simulation of ultrasound exploration of the neck nerves and both the upper and lower limbs for regional anesthesia. METHOD: Cross-sectional images were obtained from Magnetic Resonance Imaging for puncture regions involved in ultrasound-guided nerve block...
July 2016: Journal of Medical Systems
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