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Operating room management

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https://www.readbyqxmd.com/read/28926391/medical-team-training-improves-team-performance-aoa-critical-issues
#1
James E Carpenter, James P Bagian, Rebecca G Snider, Kyle J Jeray
Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#2
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28916849/1000-consecutive-cases-of-laser-assisted-liposuction-utilizing-the-1440%C3%A2-nm-wavelength-nd-yag-laser-assessing-the-safety-and-efficacy
#3
Christopher T Chia, Mark G Albert, Sharon Del Vecchio, Spero J Theodorou
BACKGROUND: Liposuction remains one of the most popular aesthetic surgery procedures performed today, and it has undergone continuous refinements over the past four decades. Advancements in anesthesia, improvements in instrumentation, better understanding of fluid dynamics and the addition of energy to liposuction have led to better outcomes with improved safety and efficacy. OBJECTIVES: The purpose of this study is to review 1000 consecutive laser-assisted liposuction (LAL) cases utilizing the 1440 nm wavelength...
September 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28914176/intraoperative-gutter-leaks-that-merit-our-attention
#4
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Martin R Back, Murray L Shames
INTRODUCTION: The natural history and potential morbidity of gutter endoleaks are unclear. We present our experience with intraoperative gutter endoleaks and strategies to determine which of these require intervention. METHODS: This is a retrospective review of all patients treated with parallel stent grafts from January 2010 to September 2015. We reviewed all operative records and intraoperative angiograms as well as all postoperative imaging and secondary interventions...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28913494/the-public-perception-of-the-anaesthesiologist-in-romania-a-survey
#5
Adela Hilda Onutu, Cristina Rus, Iurie Acalovschi
BACKGROUND: Previous studies have shown that the public perception of anaesthesiologists' duties regarding perioperative management lacks a good understanding. The aim of this study was to assess the public perception of the anaesthesiologist's role before, during and after surgery, in Romania. METHOD: The prospective cross-sectional study was undertaken between January 2015 and August 2016. A questionnaire that comprised 23 questions was uploaded on Google at https://docs...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28900481/routine-pre-treatment-mri-for-breast-cancer-in-a-single-payer-medical-center-effects-on-surgical-choices-timing-and-outcomes
#6
Timothy J Vreeland, John S Berry Iv, Erika Schneble, Doreen O Jackson, Garth S Herbert, Diane F Hale, Jonathon M Martin, Madeline Flores, Adam R Pattyn, Kai Hata, Guy T Clifton, Aaron D Kirkpatrick, George E Peoples
Introduction: Pre-operative MRI is being used with increasing frequency to evaluate breast cancer patients, but the debate surrounding risks and benefits of this use continues. At our institution, we instituted a standardized protocol for pre-operative MRI. Here, we compare patients seen prior to routine use of MRI to those seen after and examine effects on surgical choices, timing and outcomes. Methods: This is a retrospective review of a prospectively collected database of all new invasive breast cancers seen from January 2007 to December 2012...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28895383/robotic-assisted-thoracoscopic-lung-surgery-anesthetic-impact-and-perioperative-experience
#7
Joshua A Heller, Fraiz Y Bhora, Benjamin J Heller, Edmond Cohen
Anesthesiologists and the perioperative team have a tremendous impact upon clinical outcomes in robotic-assisted thoracoscopic surgery. As anesthesiology is developing its role outside the operating room, the patient population benefits from an expanded focus on perioperative critical care and pain management. This review focuses upon the preoperative optimization, unique intraoperative considerations for surgeons and anesthesiologists, and postoperative management of patients undergoing robotic-assisted thoracoscopic surgery...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28894837/dental-occlusion-ties-a-rapid-safe-and-non-invasive-maxillo-mandibular-fixation-technology
#8
Alan W Johnson
OBJECTIVES: For decades, Erich arch bars have been a standard in establishing maxillo-mandibular fixation (MMF). While reliable, the approach risks sharps injury, consumes operating room time, and inflicts gingival trauma. Newer technologies including screw-based techniques and "hybrid" techniques have improved MMF by reducing sharps injuries and operating room time, but risk injury to tooth roots, nerves, and gingiva. This study aims to establish the application, strengths, and limitations of dental occlusion ties as a novel alternative in maxillo-mandibular fixation...
August 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28893445/cost-benefit-analysis-of-different-air-change-rates-in-an-operating-room-environment
#9
Thomas Gormley, Troy A Markel, Howard Jones, Damon Greeley, John Ostojic, James H Clarke, Mark Abkowitz, Jennifer Wagner
BACKGROUND: Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. METHODS: The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry...
September 8, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28893218/contributing-factors-of-elective-surgical-case-cancellation-a-retrospective-cross-sectional-study-at-a-single-site-hospital
#10
Kaiye Yu, Xiaolei Xie, Li Luo, Renrong Gong
BACKGROUND: Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention. METHOD: We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories...
September 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28890060/transverse-versus-longitudinal-incisions-for-femoral-artery-exposure-in-treating-patients-with-peripheral-vascular-disease
#11
Punam P Parikh, Gustavo A Rubio, Kunal Patel, Kapil Gupta, Keith Jones, Jorge Rey, Handel Robinson
OBJECTIVE: This study evaluates differences in wound complication rate when transverse versus longitudinal incision is utilized to expose femoral vessels in managing patients with peripheral vascular disease. METHODS: A retrospective review from 2013-2015 was conducted of 150 patients undergoing 156 lower extremity revascularizations with femoral artery exposure through a groin incision. Patients were stratified into two groups, transverse versus longitudinal groin incision...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28877801/using-electromagnetic-navigation-bronchoscopy-and-dye-injection-to-aid-in-video-assisted-lung-resection
#12
Jordan Brown, Thomas J Lee, Theresa Joiner, William Wrightson
Small (2 cm) peripheral lung lesions and ground glass opacities remain a difficult subset of lung lesions for the diagnosis and management of lung cancer. Surgical biopsy is more difficult for these lesions because intraoperative localization has to be made without the aid of direct visualization or manual palpation. Electromagnetic navigation bronchoscopy can be used in the operating room to identify a small peripheral lesion and marked using an injection of methylene blue, which can be seen on the visceral pleura of the lung...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28873028/randomized-prospective-evaluation-of-intraoperative-intravenous-acetaminophen-in-pediatric-adenotonsillectomy
#13
Christopher A Roberts, Shivani Shah-Becker, Ashley O'Connell Ferster, Aaron Baker, Lauren E Stahl, Khaled Sedeek, Michele M Carr
Objective To establish the safety and efficacy of single-dose intraoperative intravenous (IV) acetaminophen in postoperative pain management following adenotonsillectomy in addition to a standardized regimen of oral pain medication. Study Design Randomized, controlled prospective clinical trial. Setting Single academic medical center. Subjects and Methods Patients between the ages of 3 and 17 years scheduled for tonsillectomy or adenotonsillectomy by a single surgeon between December 2014 and November 2016 were recruited...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28867583/-hybrid-operating-room-for-what
#14
M Benoit, A Bouvier, P Bigot
Hybrid operating rooms (HOR) are rooms that mix interventional radiology and surgical equipments. They are usually used in heart, vascular, orthopedic and neurosurgery, and make it possible to consider new minimally invasive procedures in urology. Thanks to these, we developed a new partial nephrectomy technique without renal pedicle clamping and without ischemia. Renal cancer is now diagnosed at localized stage in most of the cases, and its treatment is mostly based on nephron sparing surgery. However, the hemorrhagic character of this intervention requires a renal pedicle clamping whose long-term consequences on renal function are discussed...
August 31, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28867046/peritoneal-dialysis-catheter-placement-as-a-mode-of-renal-replacement-therapy-long-term-results-from-a-tertiary-academic-institution
#15
Ivy N Haskins, Martin Schreiber, Ajita S Prabhu, David M Krpata, Arielle J Perez, Luciano Tastaldi, Chao Tu, Michael J Rosen, Steven Rosenblatt
BACKGROUND: Peritoneal dialysis as a mode of renal replacement therapy still has not been embraced widely as an alternative to hemodialysis. Furthermore, there is marked variability in peritoneal dialysis catheter insertion techniques and perioperative management within the United States. After the publication of best-demonstrated practices for peritoneal dialysis catheter placement, the utilization of peritoneal dialysis has increased significantly at our institution. We detail the long-term success of peritoneal dialysis catheter placement after the adoption of best-demonstrated practices...
August 31, 2017: Surgery
https://www.readbyqxmd.com/read/28864690/interprofessional-team-assessments-of-the-patient-safety-climate-in-swedish-operating-rooms-a-cross-sectional-survey
#16
Camilla Göras, Maria Unbeck, Ulrica Nilsson, Anna Ehrenberg
BACKGROUND: A positive patient safety climate within teams has been associated with higher safety performance. The aim of this study was to describe and compare attitudes to patient safety among the various professionals in surgical teams in Swedish operating room (OR) departments. A further aim was to study nurse managers in the OR and medical directors' estimations of their staffs' attitudes to patient safety. METHODS: A cross-sectional survey with the Safety Attitudes Questionnaire (SAQ) was used to elicit estimations from surgical teams...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862030/eliminating-critical-incident-tracking-network-patient-safety-events-at-a-veterans-affairs-institution-through-crew-resource-management-training
#17
SreyRam Kuy, Ramon A L Romero
The objective of this study was to determine whether rates of Critical Incident Tracking Network (CITN) patient safety adverse events change after implementation of crew resource management (CRM) training at a Veterans Affairs (VA) hospital. CRM training was conducted for all surgical staff at a VA hospital. Compliance with briefing and debriefing checklists was assessed for all operating room procedures. Tracking of adverse patient safety events utilizing the VA CITN events was performed. There was 100% adherence to performance of briefings and debriefings after initiation of CRM training...
September 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28858895/current-review-of-prepubertal-vaginal-bleeding
#18
Maggie Dwiggins, Veronica Gomez-Lobo
PURPOSE OF REVIEW: Prepubertal vaginal bleeding raises many concerns and evaluation and diagnosis may prove difficult for many providers. We aim to provide a comprehensive review and recent updates for those practitioners who care for these patients. RECENT FINDINGS: Prompt management in the case of prepubertal vaginal bleeding is indicated, especially to rule out malignancy or abuse. If a child is reluctant to undergo examination, or if the extent of injury or source of bleeding cannot be determined, examination under anesthesia and vaginoscopy is recommended...
October 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28846795/neonatal-nasal-septal-deviation-two-cases-of-successful-early-surgical-intervention
#19
Claire M Lawlor, Maria Grant, Joshua Levy, Ashwin Ananth, J Lindhe Guarisco
Neonatal nasal septal deviations can occur as a result of trauma in utero or during birth. They are associated with significant clinical implications, including respiratory distress and failure to thrive. The incidence and classification of these deformities are varied in the otolaryngology literature. Some authors advocate conservative observation, but no consensus on management has been reached. We present 2 cases of neonatal septal deviation that occurred during difficult deliveries. We repaired the defects with closed reduction in the operating room within the first 2 weeks of life to good effect...
August 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28845456/outcome-analysis-of-congenital-diaphragmatic-hernia-cohort-before-and-after-implementation-of-standardized-protocol-in-a-tertiary-neonatal-unit
#20
Amitava Sur, Adjemoke Awoseliya, Alok Sharma
Despite evolving evidence and increased understanding, there is a strong argument that best outcomes in managing congenital diaphragmatic hernia (CDH) patients are achieved in centers which have a high admission rate of such patients and follow standardized operating protocols of management. Pneumothorax and air leak syndromes are one of the main causes of pre- and postoperative morbidity in these patients and experts believe that delivery room sedation and gentle ventilation strategies can minimize this. We observed a significant drop in incidence of pneumothorax and reduction of mortality following implementation of standardized guidelines at the neonatal unit at Southampton which is a tertiary-level neonatal care in the southern United Kingdom and a regional referral center for CDH patients...
July 2017: Surg J (N Y)
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