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Anesthesia emergency care

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https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#1
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28291658/how-do-they-get-here-does-the-method-of-transportation-impact-salvage-for-patients-with-testicular-torsion
#2
D A Weiss, N Tsarouhas, M C Carr, A Kalmus, S A Zderic
INTRODUCTION: A growing number of patients are arriving at our tertiary care center for evaluation of possible testicular torsion using ambulance or helicopter transport. In many cases the parents arrive by car before the patient arrives. Are these advanced methods of medical transport worth the expense and risk in the case of suspected testicular torsion? OBJECTIVE: We evaluated the total number of patients presenting to our emergency room for suspected testicular torsion to see if the means of transport affected testicular survival...
January 23, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#3
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#4
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#5
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28283018/tramadol-vs-dexmedetomidine-for-emergence-agitation-control-in-pediatric-patients-undergoing-adenotonsillectomy-with-sevoflurane-anesthesia-prospective-randomized-controlled-clinical-study
#6
Nurdan Bedirli, Mehmet Akçabay, Ulku Emik
BACKGROUND: This study was designed to compare the efficacy of an intraoperative single dose administration of tramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation, emerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. METHODS: Seventy-seven patient, aged 2-12, undergoing adenotonsillectomy with sevoflurane anesthesia was enrolled in this study. Patients were randomly assigned to receive either intravenous 2 mg/kg tramadol (Group T; n = 39) or 1 μg/kg dexmedetomidine (Group D; n = 38) after intubation...
March 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28260430/anesthetic-and-perioperative-management-of-nontransplant-surgery-in-patients-after-liver-transplant
#7
Zeynep Ersoy, Asude Ayhan, Aycan Ozdemirkan, Gulsi Gulsah Polat, Pinar Zeyneloglu, Gulnaz Arslan, Mehmet Haberal
OBJECTIVES: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. MATERIALS AND METHODS: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Başkent University Hospital. RESULTS: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28252543/anesthetic-management-of-a-patient-with-multiple-previous-episodes-of-postanesthesia-care-unit-delirium-a-case-report
#8
Matthias Kreuzer, Matthew K Whalin, September D W Hesse, Margaret A Riso, Paul S García
We report the case of a 37-year-old female patient who required 22 surgeries following a pedestrian versus car accident. She was enrolled in a clinical study investigating emergence from anesthesia. In 10 of her 22 surgeries, we assessed her cognitive status in the postanesthesia care unit (PACU) using the Confusion Assessment Method. We observed PACU delirium in all 4 cases in which the patient received sevoflurane, but only in 1 of 6 cases in which she received propofol. The patient showed EEG α-band activity similar to that of an elderly patient who may reflect a greater risk of PACU delirium...
March 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28244911/effects-of-the-length-of-stay-on-the-cost-of-total-knee-and-total-hip-arthroplasty-from-2002-to-2013
#9
Ilda B Molloy, Brook I Martin, Wayne E Moschetti, David S Jevsevar
BACKGROUND: Utilization of total knee and hip arthroplasty has greatly increased in the past decade in the United States; these are among the most expensive procedures in patients with Medicare. Advances in surgical techniques, anesthesia, and care pathways decrease hospital length of stay. We examined how trends in hospital cost were altered by decreases in length of stay. METHODS: Procedure, demographic, and economic data were collected on 6.4 million admissions for total knee arthroplasty and 2...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28243856/predictors-of-intraoperative-testing-in-adults-undergoing-noncardiac-surgery-within-a-regional-hospital-system
#10
Jessica Spence, Michael Troncone, Steven Long, Velina Tzankova, Susan Tran, Joshua Peachey, Yannick LeManach, James Paul
BACKGROUND: The use of intraoperative testing is central to anesthesia practice, and point-of-care testing (POCT) is often used. Nevertheless, POCT is costly and its contribution to patient outcome is unknown. There is a lack of guidelines to describe which patients should undergo intraoperative testing or how results should be applied. As such, we undertook a historical cohort study evaluating intraoperative testing practices within our region where POCT is not used. METHODS: In 2012, we obtained a random sample of 1,000 adult patients undergoing noncardiac surgery in three of our health system hospitals...
February 27, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28243008/a-descriptive-study-of-hand-injuries-presenting-to-the-adult-emergency-department-of-a-tertiary-care-center-in-urban-india
#11
Murtuza N Ghiya, Shakuntala Murty, Naren Shetty, Rodney D'Cunha
BACKGROUND: Despite having a dedicated Plastic Surgery Unit, emergency physicians (EPs) manage many of the acute, traumatic hand injuries. Further very minimal information exists about the extent to which tetanus recommendations as per Advisory Committee on Immunization Practices are followed in emergency departments (EDs). Furthermore, the management of pain is often neglected. OBJECTIVES: To provide a clinical description of hand injuries with etiology and mechanism; and describe the trends of ED management, including analgesia and tetanus prophylaxis...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28223831/cost-analysis-of-facial-injury-treatment-in-two-university-hospitals-in-malaysia-a-prospective-study
#12
Bin Sulong Saperi, Roszalina Ramli, Zafar Ahmed, Amrizal Muhd Nur, Mohd Ismail Ibrahim, Muhd Fazlynizam Rashdi, Rifqah Nordin, Normastura Abd Rahman, Azizah Yusoff, Abd Jabar Nazimi, Roselinda Abdul Rahman, Noorhayati Abdul Razak, Norlen Mohamed
OBJECTIVE: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. MATERIALS AND METHODS: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#13
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28217058/sub-tenon-s-injection-versus-paracetamol-in-pediatric-strabismus-surgery
#14
A N Ibrahim, T Shabana
BACKGROUND: Emergence agitation, vomiting, and oculocardiac reflex (OCR) in children undergoing strabismus surgery under general anesthesia are common problems. The purpose of this study was to determine whether the effect of analgesia can reduce the incidence of these problems. We compared the effects of sub-Tenon's injection versus intravenous (IV) and rectal paracetamol in this surgery. METHODS: In a prospective, randomized, double-blind study, ninety patients ranging in age from 4 to 8 years scheduled for extraocular muscle surgery for strabismus were included in this study...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28207547/planning-for-operating-room-efficiency-and-faster-anesthesia-wake-up-time-in-open-major-upper-abdominal-surgery
#15
Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chih-Shung Wong, Chen-Hwan Cherng, Zhi-Fu Wu
Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28180984/beyond-a-moral-obligation-a-legal-framework-for-emergency-and-essential-surgical-care-and-anesthesia
#16
Kashmira S Chawla, Lainie Rutkow, Kent Garber, Adam L Kushner, Barclay T Stewart
BACKGROUND: Access to quality and timely emergency and essential surgical care and anesthesia (EESCA) is an integral component of the right to health as reinforced by the ratification of the World Health Assembly Resolution 68.15. However, this resolution is merely a guideline and has not been able to bolster the necessary political will to promote EESCA. Our objective was to evaluate international treaties, which carry legal obligations, for EESCA-related text, and develop a human rights-based framework to support EESCA advancement and advocacy...
February 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28166099/pediatric-cardiopulmonary-arrest-in-the-postanesthesia-care-unit-rare-but-preventable-analysis-of-data-from-wake-up-safe-the-pediatric-anesthesia-quality-improvement-initiative
#17
Robert E Christensen, Bishr Haydar, Terri D Voepel-Lewis
BACKGROUND: Nearly 20% of anesthesia-related pediatric cardiac arrests (CAs) occur during emergence or recovery. The aims of this case series were to use the Wake Up Safe database to describe the following: (1) the nature of pediatric postanesthesia care unit (PACU) CA and subsequent outcomes and (2) factors associated with harm after pediatric PACU CA. METHODS: Pediatric CAs in the PACU were identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28144270/a-clinical-trial-evaluating-the-laryngeal-mask-airway-supreme-in-obese-children-during-general-anesthesia
#18
Yue Tian, Xiu-Ying Wu, Lu Li, Ling Ma, Yun-Feng Li
INTRODUCTION: The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure. MATERIAL AND METHODS: After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28097415/anesthesia-practices-for-interventional-radiology-in-europe
#19
Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#20
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
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