Operating room management

Galenic dural arteriovenous fistulas account for 1 of the 6 types of tentorial dural arteriovenous fistulas (type I). These fistulas are located around the great cerebral vein of Galen, with dural arterial supply through the tentorial arteries of Bernasconi and Cassinari or other posterior fossa branches, such as the posterior meningeal artery. In this case, a man in his 60s presented with a headache and was found to have this high-risk lesion, which was Borden grade III and Cognard grade IV. The lesion persisted despite embolization through the middle meningeal artery...

BACKGROUND: The operating theatre (OT) complex of hospitals represents areas of considerable expenditure with regard to costs and requires maximum use to ensure optimum cost benefit for both patients and the hospital. Inefficient use of an operating theatre room (OTR) may result in hospital wasteful expenditure and frustrations for patients owing to surgery delays, cancellations and prolonged hospitalisation while waiting. AIM: The aim of the study was to explore and describe using a consensus method, factors impacting the use of an emergency orthopaedic theatre that can be optimised in a selected public hospital in Gauteng province...

OBJECTIVE: To assess the intraoperative use of 3-dimensional transesophageal echocardiography (3D TEE) in cardiac surgical centers, the authors created a survey aimed at evaluating the availability of equipment and the use of 3D TEE for specific surgical and interventional procedures and single-image modalities. The respondents were asked to identify the perceived impact on patient management and current limitations to its routine use. DESIGN: A multiple choice 25-question online survey submitted to the members of the European Association of Cardiothoracic Anesthesia and Intensive Care (EACTAIC) on December 6, 2021, and closed on January 31, 2022...

BACKGROUND: Reported drug allergies are commonly encountered by surgeons and can lead to uncertainty in selecting an appropriate agent due to concerns of associated risks with related and cross-reactive drugs. This uncertainty can ultimately lead to increased infection rates. METHODS: A literature review was conducted in PubMed using a combination of the terms "allergy," "allergic reaction," "anaphylaxis," and "surgery," "surgical," or "operating room" for articles published within the last 10 years...

PURPOSE: Few guidelines exist for the perioperative management (PM) of neonates with surgical conditions (SC). This study examined the current neonatal PM in Italy. METHODS: We invited 51 neonatal intensive care units with pediatric surgery in their institution to participate in a web-based survey. The themes included (1) the involvement of the neonatologist during the PM; (2) the spread of bedside surgery (BS); (3) the critical issues concerning the neonatal PM in operating rooms (OR) and the actions aimed at improving the PM...

INTRODUCTION/BACKGROUND: Safe and quality surgery is crucial for child health. In Rwanda, district hospitals serve as primary entry points for pediatric patients needing surgical care. This paper reports on the organizational readiness and facility capacity to provide pediatric surgery in three district hospitals in rural Rwanda. METHODS: We administered the Children's Surgical Assessment Tool (CSAT), adapted for a Rwandan district hospital, to assess facility readiness across 5 domains (infrastructure, workforce, service delivery, financing, and training) at three Partners in Health supported district hospitals (Kirehe, Rwinkwavu, and Butaro District Hospitals)...

In recent years, the landscape of computer-assisted interventions and post-operative surgical video analysis has been dramatically reshaped by deep-learning techniques, resulting in significant advancements in surgeons' skills, operation room management, and overall surgical outcomes. However, the progression of deep-learning-powered surgical technologies is profoundly reliant on large-scale datasets and annotations. In particular, surgical scene understanding and phase recognition stand as pivotal pillars within the realm of computer-assisted surgery and post-operative assessment of cataract surgery videos...

INTRODUCTION: Pupillary block, a concerning complication of cataract surgery, is heightened when a single-piece acrylic (SPA) intraocular lens (IOL) is implanted in the ciliary sulcus. We report an unusual occurrence of relative pupillary block and chronic angle-closure glaucoma (ACG) identified in the late postoperative period due to unintentional SPA IOL implantation in the sulcus. CASE PRESENTATION: An 82-year-old woman presented with a history of chronic ACG 5 years after bilateral cataract extraction...

BACKGROUND: Operating rooms are complex working environments with high workloads and high levels of cognitive demand. The first surgical count which occurs during the chaotic preoperative stage and is considered a critical phase, is a routine task in ORs. Interruptions often occur during the first surgical count; however, little is known about the first surgical counting interruptions. This study aimed to observe and analyse the sources, outcomes, frequency of the first surgical counting interruptions and responses to interruptions...

Background: The timely initiation of extracorporeal membrane oxygenation (ECMO) is crucial for providing life support. However, delays can occur when perfusionists are not readily available. The Jena Method aims to address this issue by offering a wet-primed ECMO system that can be rapidly established without the perfusionist's presence. Methods: The goal was to ensure prompt ECMO initiation while maintaining patient safety. The method focuses on meeting hygienic standards, safe primed storage of the circuit, staff training, and providing clear step-by-step instructions for the ECMO unit...

BACKGROUND: Anesthesia is required for endoscopic removal of esophageal foreign bodies (EFBs) in children. Historically, endotracheal intubation has been the de facto gold standard for airway management in these cases. However, as more elective endoscopic procedures are now performed under propofol sedation with natural airway, there has been a move toward using similar Monitored Anesthesia Care (MAC) for select patients who require endoscopic removal of an EFB. METHODS: In this single-center retrospective cohort study, we compared endoscopic EFB removal with either MAC or endotracheal intubation...

The operational building data presented in this paper has been collected from six office rooms located in an office building (research and educational purposes) located on the main campus of Aalborg University in Denmark. The dataset consists of measurements of occupancy, indoor environmental quality, room-level and system-level heating, ventilation and lighting operation at a 5 min resolution. The indoor environmental quality and building system data were collected from the building management system. The occupancy level in each monitored room is established from the computer vision-based analysis of wall-mounted camera footage of each office...

Post-traumatic compartment syndrome in the lower extremity has been commonly associated with fractures of the tibia. Only in rare cases, this critical condition might be related to isolated fibular fractures. We present a rare case of delayed onset of acute compartment syndrome after a solitary fracture of the fibula. A 40-year-old man with a history of coagulation disorders due to hepatic cirrhosis was admitted to a neighboring hospital after a car accident with left-sided fractures to ribs 9 and 10 and a transverse fracture in the mid-shaft of the left fibula...

This review article provides a comprehensive examination of the evolution of cardiac anesthesia, emphasizing contemporary approaches beyond the traditional operating room (OR) setting. Tracing the historical roots of cardiac anesthesia from its inception in the mid-20th century, the narrative explores the significant paradigm shift driven by technological advancements and changing procedural approaches. The review highlights the emergence of non-OR environments, such as hybrid operating rooms, catheterization laboratories, and electrophysiology labs, as integral spaces for cardiac interventions...

Hypothermia in a trauma patient has been associated with increased morbidity and mortality and is more frequently seen in those sustaining traumatic brain injuries (TBIs). Acidosis is an important consequence of hypothermia that leads to derangements across the spectrum of the coagulation cascade. Here, we present a case of a 31-year-old male presented after suffering a right parietal penetrating ballistic injury with an associated subdural hematoma and 7 mm midline shift requiring decompressive craniectomy and external ventricular drain (EVD) placement in the setting of severe hypothermia (28°C) and acidosis (pH 7...

PURPOSE: Management of high-grade pediatric and adolescent liver trauma can be complex. Studies suggest that variation exists at adult (ATC) vs pediatric trauma centers (PTC); however, there is limited granular comparative data. We sought to describe and compare the management and outcomes of complex pediatric and adolescent liver trauma between a level 1 ATC and two PTCs in a large metropolitan city. METHODS: A retrospective review of pediatric and adolescent (age < 21 years) patients with American Association for the Surgery of Trauma (AAST) Grade 4 and 5 liver injuries managed at an ATC and PTCs between 2016 and 2022 was performed...

OBJECTIVE: This case series seeks to describe three specific airway complications following vocal fold injection augmentation procedures, involving carboxymethylcellulose gel. The literature review focused on adverse events linked to carboxymethylcellulose within the field of otolaryngology as well as beyond. STUDY DESIGN: Case series. METHODS: This series reviews the management of three patients who suffered severe airway complications following vocal fold injection augmentations from December 2020 to August 2021 RESULTS: All three of these patients received the RENÚ brand carboxymethylcellulose injection material...

CASE: A 54-year-old male with osteoarthritis of the right long finger metacarpophalangeal joint underwent Pyrocarbon joint arthroplasty. Seven years later the patient presented for metacarpophalangeal joint swelling and pain. The workup was benign, without signs of implant complication or osseous abnormality. He underwent washout and two-stage revision, where gross implant wear and debris not demonstrated by radiograph were found. He then returned to the operating room for reimplantation of a PyroCarbon implant...

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been often used in place of open aortic occlusion for management of hemorrhagic shock in trauma. There is a paucity of data evaluating REBOA usage in military settings. STUDY DESIGN AND METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all cases with at least one intervention or assessment available within the first 72 h after injury between 2007 and 2023...

BACKGROUND: This study describes the presentation and initial management of anorectal malformation (ARM); evaluating the frequency, causes and consequences of late diagnosis. METHODS: A prospective, population cohort study was undertaken for newly diagnosed ARMs in the UK and Ireland from 01/10/2015 and 30/09/2016. Follow-up was completed at one year. Data are presented as n (%), appropriate statistical methods used. Factors associated with late diagnosis; defined as: detection of ARM either following discharge or more than 72 h after birth were assessed with univariable logistic regression...