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https://www.readbyqxmd.com/read/28336015/ten-years-of-en-route-critical-care-training
#1
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28259354/-comparison-of-waste-anesthetic-gases-in-operating-rooms-with-or-without-an-scavenging-system-in-a-brazilian-university-hospital
#2
Leandro Gobbo Braz, José Reinaldo Cerqueira Braz, Guilherme Aparecido Silva Cavalcante, Kátina Meneghetti Souza, Lorena Mendes de Carvalho Lucio, Mariana Gobbo Braz
BACKGROUND AND OBJECTIVES: Occupational exposure to waste anesthetic gases in operating room (OR) without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhaled anesthetics isoflurane and sevoflurane in OR with and without central scavenging system. METHOD: Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station) and at two times (30 and 120minutes after the start of surgery) in both OR types...
March 2, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28257153/assessment-of-continuous-pain-in-newborns-admitted-to-nicus-in-18-european-countries
#3
Kanwaljeet J S Anand, Mats Eriksson, Elaine M Boyle, Alejandro Avila-Alvarez, Randi Dovland Andersen, Kosmas Sarafidis, Tarja Polkki, Cristina Matos, Paola Lago, Thalia Papadouri, Simon Attard-Montalto, Mari-Liis Ilmoja, Sinno Simons, Rasa Tameliene, Bart van Overmeire, Angelika Berger, Anna Dobrzanska, Michael Schroth, Lena Bergqvist, Emilie Courtois, Jessica Rousseau, Ricardo Carbajal
AIM: Continuous pain occurs routinely, even after invasive procedures, or inflammation and surgery, but clinical practices associated with assessments of continuous pain remain unknown. METHODS: A prospective cohort study in 243 Neonatal Intensive Care Units (NICUs) from 18 European countries recorded frequency of pain assessments, use of mechanical ventilation, sedation, analgesia, or neuromuscular blockade for each neonate upto 28 days after NICU admission. RESULTS: Only 2113/6648 (31·8%) of neonates received assessments of continuous pain, occurring variably among tracheal ventilation (TrV, 46·0%), noninvasive ventilation (NiV, 35·0%), and no ventilation (NoV, 20·1%) groups (p<0·001)...
March 3, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28098571/operating-room-anesthesia-subspecialization-is-not-associated-with-significantly-greater-quality-of-supervision-of-anesthesia-residents-and-nurse-anesthetists
#4
Franklin Dexter, Johannes Ledolter, Richard H Epstein, Bradley J Hindman
BACKGROUND: Supervision of anesthesia residents and nurse anesthetists is a major responsibility of faculty anesthesiologists. The quality of their supervision can be assessed quantitatively by the anesthesia residents and nurse anesthetists. Supervision scores are an independent measure of the contribution of the anesthesiologist to patient care. We evaluated the association between quality of supervision and level of specialization of anesthesiologists. METHODS: We used two 6-month periods, one with no feedback to anesthesiologists of the residents' and nurse anesthetists' evaluations, and the other with feedback...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28095834/barriers-to-venipuncture-induced-pain-prevention-in-cancer-patients-a-qualitative-study
#5
Marilène Filbet, Philip Larkin, Claire Chabloz, Anne Chirac, Léa Monsarrat, Murielle Ruer, Wadih Rhondali, Cyrille Collin
BACKGROUND: Procedural pain reduces the quality of life of cancer patients. Although there are recommendations for its prevention, there are some obstacles for its management. The purpose of this study was to analyze the barriers to procedural pain prophylaxis in cancer patients reflecting the views of the nurses. METHODS: We used qualitative methodology based on semi-structured interviews conducted with nurses, focusing on practices of venipuncture-induced and needle change for implantable central venous access port (ICVAP) pain management in cancer patients...
January 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#6
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27990376/management-of-glaucoma-in-pregnancy-risks-or-choices-a-dilemma
#7
REVIEW
Harinder Singh Sethi, Mayuresh Naik, Vishnu Swarup Gupta
The treatment of glaucoma in and around pregnancy offers the unique challenge of balancing the risk of vision loss to the mother as against the potential harm to the fetus or newborn. Most anti-glaucoma drugs (i.e. beta-blockers, prostaglandin analogues, carbonic anhydrase inhibitors topical and systemic, cholinergics, anticholinesterases, and apraclonidine) are considered category C agents and ophthalmologists are usually limited to treating patients with the category B drugs of brimonidine and dipivefrin...
2016: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/27935772/anesthetic-implications-of-obesity-and-obstructive-sleep-apnea
#8
Jennifer Greenwood
The incidence of morbid obesity has tripled within the past 25 years in developed countries, with the highest rate of growth noted among people with body mass index (BMI) greater than 50. The physiologic derangements that accompany obesity affect almost every organ system leading to a vast array of comorbid conditions including obstructive sleep apnea (OSA). This review focuses on the unique perioperative management considerations that the nurse anesthetist must address when caring for these patients as well as the impact of obesity and OSA on postoperative complications and mortality rates...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27931710/anesthetic-nursing-keep-in-touch-watch-over-and-be-one-step-ahead
#9
Ulrica Nilsson, Maria Jaensson
No abstract text is available yet for this article.
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27918405/certified-registered-nurse-anesthetist-perceptions-of-factors-impacting-patient-safety
#10
Susan P McMullan, Charlotte Thomas-Hawkins, Maria R Shirey
Certified registered nurse anesthetists (CRNAs) provide more than 40 million anesthetics each year in the United States. This article describes a study that investigates relationships among CRNA organizational structures (CRNA practice models, work setting, workload, level of education, work experience), CRNA ratings of patient safety culture, and CRNA adverse anesthesia-related event (ARE) reporting. This is a cross-sectional survey study of 336 CRNAs randomly selected from American Association of Nurse Anesthetists database...
January 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/27903850/nurse-performed-local-anesthetic-insertions-of-pd-catheters-one-unit-s-experience
#11
Elaine Bowes, Bhezad Ansari, Hugh Cairns
No abstract text is available yet for this article.
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27893511/continuous-infusion-antiepileptic-medications-for-refractory-status-epilepticus-a-review-for-nurses
#12
Adam L Wiss, Michael Samarin, Jacob Marler, G Morgan Jones
Status epilepticus requires treatment with emergent initial therapy with a benzodiazepine and urgent control therapy with an additional antiepileptic drug (AED) to terminate clinical and/or electrographic seizure activity. However, nearly one-third of patients will prove refractory to the aforementioned therapies and are prone to a higher degree of neuronal injury, resistance to pharmacotherapy, and death. Current guidelines for refractory status epilepticus (RSE) recommend initiating a continuous intravenous (CIV) anesthetic over bolus dosing with a different AED...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#13
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27863620/paediatric-airway-foreign-body-the-human-factors-influencing-patient-safety-in-our-hospitals
#14
MULTICENTER STUDY
O C Okonkwo, A Simons, J Nichani
Foreign bodies in the pediatric airway are an uncommon emergency with a high morbidity and mortality rate. Morbidity ranges from 10 to 20% worldwide and this pathology accounts for up to 7% of accidental deaths in children under 4. Dealing with this emergency safely and effectively is complex, requiring a tight coupling of procedures and processes and optimal anesthetic and operating conditions to prevent errors. These factors are recognized by the World Health Organization as 'Human Factors'. We perform a multi-center assessment of human factors pertinent to this emergency...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27798810/emergence-delirium-in-pediatric-anesthesia
#15
REVIEW
Arthura D Moore, Doralina L Anghelescu
Emergence delirium (ED) is a complex of perceptual disturbances and psychomotor agitation that occurs most commonly in preschool-aged children in the early postanesthetic period. The incidence of ED varies between 10 and 80% in children and is perceived as a troublesome clinical situation by 42% of pediatric anesthesiologists. Although these events are often short lived, they increase the risk of self-injury and delayed discharge, require additional nursing staff and can increase medical care costs, all of which are causes for concern...
February 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/27637824/transformation-of-anesthesia-for-ambulatory-orthopedic-surgery-a-mixed-methods-study-of-a-diffusion-of-innovation-in-healthcare
#16
Kyle T Leggott, Matthew Martin, David Sklar, Deborah Helitzer, Randy Rosett, Cameron Crandall, Firoz Vagh, Deana Mercer
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27606558/sedation-and-analgesia-for-dressing-change-a-survey-of-american-burn-association-burn-centers
#17
Rachel Myers, Jeanette Lozenski, Matthew Wyatt, Maria Peña, Kayla Northrop, Dhaval Bhavsar, Anthony Kovac
Pain and sedation management for patients undergoing burn dressing change can be challenging. Variations appear to exist in the selection of medications before and during burn dressing change. To determine if institutional variations exist in pain and sedation management for burn dressing change, an online survey was sent to ABA Burn Center nurses and physicians. Three hundred seventy-eight anonymous responses were received from nurses (72%), nurse practitioners (10%), and physicians (18%). Burn centers had adult (22%), pediatric (12%), or pediatric and adult (66%) patients...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27542098/precautionary-practices-for-administering-anesthetic-gases-a-survey-of-physician-anesthesiologists-nurse-anesthetists-and-anesthesiologist-assistants
#18
James M Boiano, Andrea L Steege
Scavenging systems and administrative and work practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants...
October 2, 2016: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/27537538/intraperitoneal-local-anesthetic-for-laparoscopic-appendectomy-in-children-a-randomized-controlled-trial
#19
James K Hamill, Andrew Liley, Andrew G Hill
OBJECTIVE: The aim of this study was to investigate the efficacy of intraperitoneal local anesthetic (IPLA) on pain after acute laparoscopic appendectomy in children. SUMMARY OF BACKGROUND: IPLA reduces pain in adult elective surgery. It has not been well studied in acute peritoneal inflammatory conditions. We hypothesized that IPLA would improve recovery in pediatric acute laparoscopic appendectomy. METHODS: This randomized controlled trial in acute laparoscopic appendectomy recruited children aged 8 to 14 years to receive 20 mL 0...
August 17, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27501656/tranexamic-acid-in-anesthetic-management-of-surgical-procedures
#20
Jessica Mayeux, Kathy Alwon, Shawn Collins, Ian Hewer
Blood loss during surgical procedures poses a grave risk to the patient, but transfusion is costly and associated with adverse outcomes. Antifibrinolytics, however, offer an economical and effective means of decreasing blood loss associated with surgical procedures. Tranexamic acid (TXA) is an antifibrinolytic that blocks lysine-binding sites of fibrinogen and fibrin, preventing the breakdown of existing clots. This journal course reviews extensive research demonstrating that antifibrinolytics such as TXA decrease blood loss and in some studies reduce allogeneic transfusion requirements...
June 2016: AANA Journal
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