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Anesthesia simulation

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https://www.readbyqxmd.com/read/28641713/assessment-tools-for-use-during-anesthesia-centric-pediatric-advanced-life-support-training-and-evaluation
#1
Scott C Watkins, Paul J Nietert, Elisabeth Hughes, Eric T Stickles, Tracy E Wester, Matthew D McEvoy
BACKGROUND: Pediatric perioperative cardiac arrests are rare events that require rapid, skilled and coordinated efforts to optimize outcomes. We developed an assessment tool for assessing clinician performance during perioperative critical events termed Anesthesia-centric Pediatric Advanced Life Support (A-PALS). Here, we describe the development and evaluation of the A-PALS scoring instrument. METHODS: A group of raters scored videos of a perioperative team managing simulated events representing a range of scenarios and competency...
June 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28638983/treatment-of-benign-thyroid-nodules-by-high-intensity-focused-ultrasound-hifu-at-different-acoustic-powers-a-study-on-in-silico-phantom
#2
Fabiano Bini, Pierpaolo Trimboli, Franco Marinozzi, Luca Giovanella
BACKGROUND: The non-surgical therapies of benign thyroid nodules are gaining momentum due to the possibility to reduce the nodule's volume and avoid surgery. As the last technique introduced, high intensity focused ultrasound allows the thermal tissue treatment by directing energy inside the targeted nodule with no invasive instruments. In the present study we applied the Food and Drug Administration high intensity focused ultrasound simulator to in-silico phantom to evaluate the effects obtained by different acoustic powers...
June 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28632531/a-descriptive-survey-of-anesthesiology-residency-simulation-programs-how-are-programs-preparing-residents-for-the-new-american-board-of-anesthesiology-applied-certification-examination
#3
Robert S Isaak, Fei Chen, Harendra Arora, Susan M Martinelli, David A Zvara, Marjorie P Stiegler
BACKGROUND: Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, including faculty time, expertise, and funding, as are currently needed for structured oral examination (SOE) preparation. This survey analyzed the current state of US-based anesthesiology residency programs regarding simulation-based educational programming for SOE and OSCE preparation...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#4
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28582277/simulation-based-assessment-identifies-longitudinal-changes-in-cognitive-skills-in-an-anesthesiology-residency-training-program
#5
Avner Sidi, Nikolaus Gravenstein, Terrie Vasilopoulos, Samsun Lampotang
OBJECTIVES: We describe observed improvements in nontechnical or "higher-order" deficiencies and cognitive performance skills in an anesthesia residency cohort for a 1-year time interval. Our main objectives were to evaluate higher-order, cognitive performance and to demonstrate that simulation can effectively serve as an assessment of cognitive skills and can help detect "higher-order" deficiencies, which are not as well identified through more traditional assessment tools. We hypothesized that simulation can identify longitudinal changes in cognitive skills and that cognitive performance deficiencies can then be remediated over time...
June 2, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28580083/implementation-of-clinical-practice-changes-by-experienced-anesthesiologists-after-simulation-based-ultrasound-guided-regional-anesthesia-training
#6
T Edward Kim, Toni Ganaway, T Kyle Harrison, Steven K Howard, Cynthia Shum, Alex Kuo, Edward R Mariano
BACKGROUND: Anesthesiologists who have finished formal training and want to learn ultrasound-guided regional anesthesia (UGRA) commonly attend 1 day workshops. However, it is unclear whether participation actually changes clinical practice. We assessed change implementation after completion of a 1 day simulation-based UGRA workshop. METHODS: Practicing anesthesiologists who participated in a 1 day UGRA course from January 2012 through May 2014 were surveyed. The course consisted of clinical observation of UGRA procedures, didactic lectures, ultrasound scanning, hands-on perineural catheter placement, and mannequin simulation...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28566223/oxidative-and-biochemical-responses-in-brycon-amazonicus-anesthetized-and-sedated-with-myrcia-sylvatica-g-mey-dc-and-curcuma-longa-l-essential-oils
#7
Etiane M H Saccol, Érika P Londero, Caroline A Bressan, Joseânia Salbego, Luciane T Gressler, Lenise V F Silva, Rosa H V Mourão, Ricardo B Oliveira, Susana F Llesuy, Bernardo Baldisserotto, Maria A Pavanato
OBJECTIVE: To investigate the effects of rapid anesthesia and long-term sedation with the essential oils (EOs) of Myrcia sylvatica (EOMS) and Curcuma longa (EOCL) on biochemical and oxidative parameters in matrinxã. STUDY DESIGN: Prospective, randomized, laboratory experiment. ANIMALS: A total of 72 matrinxã (Brycon amazonicus) adults weighing 404.8 ± 27.9 g were divided into eight groups of nine fish. METHODS: Biochemical and oxidative effects were investigated in plasma and tissues of matrinxã subjected to rapid anesthesia (5 minutes) or long-term sedation (360 minutes, simulating the practice of transport) with EOMS (200 μL L(-1) and 10 μL L(-1), respectively) and EOCL (500 μL L(-1) and 40 μL L(-1), respectively)...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#8
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28518117/simultaneous-evaluation-of-cerebral-hemodynamics-and-light-scattering-properties-of-the-in-vivo-rat-brain-using-multispectral-diffuse-reflectance-imaging
#9
Izumi Nishidate, Afrina Mustari, Satoko Kawauchi, Shunichi Sato, Manabu Sato
The simultaneous evaluation of cerebral hemodynamics and the light scattering properties of in vivo rat brain tissue is demonstrated using a conventional multispectral diffuse reflectance imaging system. This system is constructed from a broadband white light source, a motorized filter wheel with a set of narrowband interference filters, a light guide, a collecting lens, a video zoom lens, and a monochromatic charged-coupled device (CCD) camera. An ellipsoidal cranial window is made in the skull bone of a rat under isoflurane anesthesia to capture in vivo multispectral diffuse reflectance images of the cortical surface...
May 7, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28484741/effects-of-clove-oil-and-lidocaine-hcl-anesthesia-on-water-parameter-during-simulated-transportation-in-the-marine-medaka-oryzias-dancena
#10
In-Seok Park, Hyun Woo Gil, Tae Ho Lee, Yoon Kwon Nam, Sang Gu Lim, Dong Soo Kim
Optimum concentrations of anesthetic clove oil and anesthetic lidocaine-HCl were determined for a species of adult marine medaka, Oryzias dancena, over a range of salinity conditions, and investigated in a transport simulation experiment by analyzing various water and physiological parameters. Research indicated that the higher the concentration of anesthetic at each salinity, the shorter the anesthesia time at each salinity. At each concentration, fish were anesthetized slower at water salinities over 10 ppt (P<0...
March 2017: Balsaeng'gwa Saengsig
https://www.readbyqxmd.com/read/28457421/later-evaluation-of-ischemia-and-reperfusion-by-the-pringle-maneuver-in-wistar-rats-demonstrating-that-hepatic-lesions-can-be-reversible
#11
G de Lourdes Jorge, R Dos Reis Tártaro, C A Fazzio Escanhoela, I F S F Boin
OBJECTIVE: There has been much research on hepatic ischemia and reperfusion by means of short or longer interruption of the portal triad. The aim of this work was to evaluate the mitochondrial respiratory activity and liver histology at 2 different times after the Pringle maneuver. METHODS: Twenty-eight male Wistar rats, weighing ∼308 g, with histologic and mitochondrial study: immediate ischemic group (IIG; 40 minutes; 9 animals) and late ischemic group (LIG; 28 days; 9 animals)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28456368/bone-penetrance-of-locally-administered-vancomycin-powder-in-a-rat-femur-fracture-model
#12
Zachary M Working, Hunter Frederiksen, Alex Drew, Catherine Loc-Carrillo, Erik N Kubiak
INTRODUCTION: Locally delivered, crystalline vancomycin has been suggested as a potential prophylactic measure against the development of deep and superficial surgical site infection. Clinical expectations regarding the duration and peak of drug concentration in local tissues following administration are unknown. Our goal was to develop concentration vs time curves for locally administered vancomycin powder in a high-energy, open femur fracture rat model in local tissues and to compare that data to two well performed similar, systemic administration studies...
April 21, 2017: Injury
https://www.readbyqxmd.com/read/28452823/arterial-pressure-and-the-rate-of-elimination-of-crystalloid-fluid
#13
Robert G Hahn
Excretion of crystalloid fluid is slow during general anesthesia. The distribution and elimination of buffered Ringer's solution were analyzed to determine whether the rate of elimination correlates with a hemodynamic factor, consciousness, patient posture, or the type of general anesthesia. Data were derived from 4 separately published studies in which 30 volunteers and 48 anesthetized patients had received 0.833 (1 series 0.667) mL/kg/min of lactated or acetated Ringer's solution over 30 minutes. Frequent measurements of the blood hemoglobin and mean urinary excretion were used as input in a kinetic analysis according to a 2-volume model and covariates, using microconstants and mixed-effects modeling software...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28442961/integration-of-simulation-in-postgraduate-studies-in-saudi-arabia-the-current-practice-in-anesthesia-training-program
#14
REVIEW
Abeer Arab, Abdulaleem Alatassi, Elias Alattas, Usamah Alzoraigi, Zaki AlZaher, Abdulaziz Ahmad, Hesham Albabtain, Abdulaziz Boker
The educational programs in the Saudi Commission for Health Specialties are developing rapidly in the fields of technical development. Such development is witnessed, particularly in the scientific areas related to what is commonly known as evidence-based medicine. This review highlights the critical need and importance of integrating simulation into anesthesia training and assessment. Furthermore, it describes the current utilization of simulation in anesthesia and critical care assessment process.
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#15
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28433802/role-of-environmental-stressors-in-determining-the-developmental-outcome-of-neonatal-anesthesia
#16
Ling-Sha Ju, Jiao-Jiao Yang, Nikolaus Gravenstein, Christoph N Seubert, Timothy E Morey, Colin Sumners, Terrie Vasilopoulos, Jian-Jun Yang, Anatoly E Martynyuk
BACKGROUND: The majority of studies evaluating neurocognition in humans who had procedures under anesthesia early in life found long-term deficits even though the typical anesthesia duration normalized to the human life span is much shorter than that shown to induce developmental abnormalities in rodents. Therefore, we studied whether subsequent environmental stressors contribute to deficiencies programmed by a brief neonatal etomidate exposure. METHODS: Postnatal days (P) 4, 5, or 6, Sprague-Dawley rats, pretreated with vehicle or the Na(+)-K(+)-2Cl(-) (NKCC1) inhibitor, bumetanide, received two injections of etomidate resulting in anesthesia for 2h...
April 7, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28395952/a-novel-methodology-for-assessing-laryngeal-and-vagus-nerve-integrity-in-patients-under-general-anesthesia
#17
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan, Vedran Deletis
OBJECTIVE: To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR). METHODS: Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode...
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28386360/neuroprotective-effect-of-mir-665-against-sevoflurane-anesthesia-induced-cognitive-dysfunction-in-rats-through-pi3k-akt-signaling-pathway-by-targeting-insulin-like-growth-factor-2
#18
Xihua Lu, Shuaiguo Lv, Yan Mi, Lei Wang, Gensheng Wang
The aim of this study was to investigate the in vivo and in vitro effects of miR-665 on sevoflurane anesthesia-induced cognitive dysfunction. SH-SY5Y cells and male SD rats were treated with sevoflurane to simulate anesthesia-induced cognitive dysfunction. The cells and rats both were transfected with a miR-665 mimic, inhibitor, scramble, IGF-2 siRNA, or treated with P13K/Akt inhibitor LY294002. The cell apoptosis, autophagy, growth related proteins, and mRNA levels were measured using different methods. The motor performance was assessed using the Morris water maze (MWM) test...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28377943/expert-evaluation-of-a-chicken-tissue-based-model-for-teaching-ultrasound-guided-central-venous-catheter-insertion
#19
Akiva Nachshon, John D Mitchell, Ariel Mueller, Valerie M Banner-Goodspeed, Jakob I McSparron
BACKGROUND: Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin. METHODS: Forty attending physicians from four departments with extensive CVC experience were enrolled...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28377942/an-evaluation-of-ca-1-residents-adherence-to-a-standardized-handoff-checklist
#20
Madeline C Heck, Peter Huges, Mojca Konia
BACKGROUND: Poor-quality handoffs are a significant cause of preventable medical errors and adverse events. Handoff checklists improve handoffs but adherence to these tools is often inconsistent. In our study we aimed to investigate the effects of simulated handoff workshop and clinical instruction on resident handoff quality. METHODS: A three-week pre-education intervention observation period of handoffs was conducted to assess the deficits, variability, and common practice in handoffs at the University of Minnesota Fairview Hospital...
January 2017: Journal of Education in Perioperative Medicine: JEPM
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