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Simulation anaesthesia

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https://www.readbyqxmd.com/read/28044328/an-introduction-to-predictive-modelling-of-drug-concentration-in-anaesthesia-monitors
#1
REVIEW
J DeCou, K Johnson
A significant amount of anaesthetists' work involves the prediction of drug effects and interactions to produce a smooth general anaesthetic that minimises drug side effects and promotes rapid emergence. Successfully managing this process requires a basic understanding of drug effects, experience and inevitably some guesswork, since it is difficult (and in some cases impossible) to anticipate all relevant patient and surgical factors. Although data are generally available to allow calculation of plasma drug and effect site concentrations, this is often difficult to apply in complex clinical contexts, particularly when multiple drug types are used...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28028288/a-cost-effectiveness-analysis-of-self-debriefing-versus-instructor-debriefing-for-simulated-crises-in-perioperative-medicine-in-canada
#2
Wanrudee Isaranuwatchai, Fahad Alam, Jeffrey Hoch, Sylvain Boet
PURPOSE: High-fidelity simulation training is effective for learning crisis resource management (CRM) skills, but cost is a major barrier to implementing high-fidelity simulation training into the curriculum. The aim of this study was to examine the cost-effectiveness of self-debriefing and traditional instructor debriefing in CRM training programs and to calculate the minimum willingness-to-pay (WTP) value when one debriefing type becomes more cost-effective than the other. METHODS: This study used previous data from a randomized controlled trial involving 50 anesthesiology residents in Canada...
2017: Journal of Educational Evaluation for Health Professions
https://www.readbyqxmd.com/read/27995430/eeg-artifacts-reduction-by-multivariate-empirical-mode-decomposition-and-multiscale-entropy-for-monitoring-depth-of-anaesthesia-during-surgery
#3
Quan Liu, Yi-Feng Chen, Shou-Zen Fan, Maysam F Abbod, Jiann-Shing Shieh
Electroencephalography (EEG) has been widely utilized to measure the depth of anaesthesia (DOA) during operation. However, the EEG signals are usually contaminated by artifacts which have a consequence on the measured DOA accuracy. In this study, an effective and useful filtering algorithm based on multivariate empirical mode decomposition and multiscale entropy (MSE) is proposed to measure DOA. Mean entropy of MSE is used as an index to find artifacts-free intrinsic mode functions. The effect of different levels of artifacts on the performances of the proposed filtering is analysed using simulated data...
December 19, 2016: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#4
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27930962/aiming-for-excellence-a-simulation-based-study-on-adapting-and-testing-an-instrument-for-developing-non-technical-skills-in-norwegian-student-nurse-anaesthetists
#5
Fiona M Flynn, Kjersti Sandaker, Randi Ballangrud
There is increasing focus on building safety into anaesthesia practice, with excellence in anaesthesia as an aspirational goal. Non-technical skills are an important factor in excellence and improved patient safety, though there have been few systematic attempts at integrating them into anaesthesia nursing education. This study aimed to test the reliability of NANTS-no, a specially adapted behavioural marker system for nurse anaesthetists in Norway, and explore the development of non-technical skills in student nurse anaesthetists...
November 29, 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27844477/videolaryngoscopy-versus-direct-laryngoscopy-for-adult-patients-requiring-tracheal-intubation
#6
REVIEW
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...
15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27832555/driving-impairment-due-to-propofol-at-effect-site-concentrations-relevant-after-short-propofol-only-sedation
#7
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
https://www.readbyqxmd.com/read/27807487/tibiofibula-transposition-in-high-energy-fractures
#8
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
https://www.readbyqxmd.com/read/27734483/speak-up-barriers-to-challenging-erroneous-decisions-of-seniors-in-anaesthesia
#9
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
https://www.readbyqxmd.com/read/27679989/high-correlation-between-performance-on-a-virtual-reality-simulator-and-real-life-cataract-surgery
#10
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
https://www.readbyqxmd.com/read/27666546/-localizating-and-extracting-small-peripheral-nodules-of-lung-with-simulating-%C3%A2-radiaotherapy-combining-methylene-blue-staining
#11
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
https://www.readbyqxmd.com/read/27647659/positive-influence-of-a-dental-anaesthesia-simulation-model-on-the-perception-of-learning-by-mexican-dental-students
#12
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
https://www.readbyqxmd.com/read/27635955/impact-of-age-on-anaesthesiologists-competence-a-narrative-review
#13
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
https://www.readbyqxmd.com/read/27635951/modelling-of-the-optimal-bupivacaine-dose-for-spinal-anaesthesia-in-ambulatory-surgery-based-on-data-from-systematic-review
#14
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
https://www.readbyqxmd.com/read/27581377/assessing-the-similarity-of-mental-models-of-operating-room-team-members-and-implications-for-patient-safety-a-prospective-replicated-study
#15
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...
August 31, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27565996/-briefing-improves-the-management-of-a-difficult-mask-ventilation-in-infants-simulator-study-using-web-based-decision-support
#16
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
https://www.readbyqxmd.com/read/27512572/transperineal-implantation-of-gold-fiducial-markers-gold%C3%A2-seeds-for-prostate-image-guided-radiation-therapy-a%C3%A2-feasible-technique-associated-with-a-low-risk-of-complications
#17
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
https://www.readbyqxmd.com/read/27501409/simulator-evaluation-of-a-prototype-device-to-reduce-medication-errors-in-anaesthesia
#18
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
https://www.readbyqxmd.com/read/27465063/end-task-versus-in-task-feedback-to-increase-procedural-learning-retention-during-spinal-anaesthesia-training-of-novices
#19
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
https://www.readbyqxmd.com/read/27338521/evolution-of-stress-in-anaesthesia-registrars-with-repeated-simulated-courses-an-observational-study
#20
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
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