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Anesthesia simulation

Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Junichi Tokuda, Laurent Chauvin, Brian Ninni, Takahisa Kato, Franklin King, Kemal Tuncali, Nobuhiko Hata
Patient-mounted needle guide devices for
 percutaneous ablations are vulnerable to patient motion. The objective of this study is to develop and evaluate a software system for MRI-compatible patient-mounted needle guide device that can adaptively compensate for the displacement of the device due to the patient motion using a novel image-based automatic device-to-image registration.
 Materials and Methods. We developed a software system for an MRI-compatible patient-mounted needle guide device for percutaneous ablations...
March 16, 2018: Physics in Medicine and Biology
Kazuchika Suzuki, Hiroaki Sakai, Kenji Takahashi
We herein report anesthetic management during aortic valve replacement for aortic valve regurgitation in a patient with adult mucopolysaccharidosis type II (MPS type 2) (Hunter syndrome). This disorder is rare and related to the accumulation of a mucopolysaccharide in lysosomes. It affects various organs, including the airways, heart, and central nerves. In children with MPS type 2, the risk of airway obstruction during anesthesia/sedation is high, and the degree of difficulty increases with aging. The patient described herein was a 33-year-old male without mental retardation...
2018: JA Clin Rep
Laurence C Torsher
No abstract text is available yet for this article.
2018: International Anesthesiology Clinics
Ji Young Yoo, Sung Yong Park, Jong Yeop Kim, Myungseob Kim, Seok Jin Haam, Dae Hee Kim
BACKGROUND: Double lumen endobronchial tube (DLT) intubation is commonly used for one-lung ventilation in thoracic surgery. However, because of its large size and shape, it is difficult to perform intubation compared with a single lumen tube. The aim of this randomized controlled trial was to determine whether the McGrath videolaryngoscope has any advantage over the direct Macintosh laryngoscope for DLT intubation in patients with a simulated difficult airway. METHODS: Forty-four patients (19-60 years of age); scheduled to undergo general anesthesia with one-lung ventilation were assigned to 1 of 2 groups: DLT intubation with the McGrath videolaryngoscope (ML group [n = 22]); or conventional Macintosh laryngoscope (DL group [n = 22])...
March 2018: Medicine (Baltimore)
Joel Bierer, Eustatiu Memu, Robert Leeper, Dalilah Fortin, Eric Fréchette, Richard Inculet, Richard Malthaner
BACKGROUND: Our vision was to develop an inexpensive training simulation in a functional operating room (in-situ) that included surgical trainees, nursing and anesthesia staff to focus on effective interprofessional communication and teamwork skills. METHODS: The simulation scenario revolved around a post-pneumonectomy airway obstruction by residual tumor. This model included our thoracic operating room with patient status displayed by an open access vital sign simulator and a reversibly modified Laerdal® airway mannequin...
February 27, 2018: Annals of Thoracic Surgery
Josh D Kaullen, Joel S Owen, Kim L R Brouwer, Paul M Heerdt, Cynthia A Lien, John J Savarese, Virginia D Schmith
BACKGROUND: CW002 is an investigational nondepolarizing, neuromuscular blocking agent with a rapid onset and intermediate duration of action in animals. This is a single ascending dose, healthy subject study exploring tolerability, pharmacokinetics, and potency. METHODS: Population pharmacokinetic and pharmacokinetic/pharmacodynamic models were developed using plasma drug concentration data from a previously published dose-response study in 28 healthy subjects receiving single doses of CW002 during sevoflurane anesthesia...
March 1, 2018: Anesthesiology
Torsten Birkholz, Christian Leuthold, Joachim Schmidt, Harald Ihmsen, Jürgen Schüttler, Christian Jeleazcov
BACKGROUND: Sufentanil is used for general anesthesia and analgesia. The study aim was to determine the effect of pharmacologically induced changes in cardiac output on the pharmacokinetics of sufentanil in anesthetized pigs. METHODS: Twenty-four pigs were randomly assigned to low, high, and control cardiac output groups. Cardiac output was decreased or increased from baseline by at least 40%, or maintained within ± 10% of baseline, respectively. Sufentanil was administered as a bolus followed by a continuous infusion for 120 min...
March 1, 2018: Anesthesiology
Daniel E Callan, Thibault Gateau, Gautier Durantin, Nicolas Gonthier, Frédéric Dehais
Individuals often have reduced ability to hear alarms in real world situations (e.g., anesthesia monitoring, flying airplanes) when attention is focused on another task, sometimes with devastating consequences. This phenomenon is called inattentional deafness and usually occurs under critical high workload conditions. It is difficult to simulate the critical nature of these tasks in the laboratory. In this study, dry electroencephalography is used to investigate inattentional deafness in real flight while piloting an airplane...
February 26, 2018: Human Brain Mapping
Arlyne Thung, Dmitry Tumin, Joshua C Uffman, Joseph D Tobias, Tricia Buskirk, Whitney Garrett, Arleen Karczewski, Haleh Saadat
PURPOSE: MRI is a common modality for diagnostic imaging. In children, general anesthesia is often required to complete MRI examinations. Simulation training can reduce the need for anesthesia in some children. Reliable screening tools to select who could benefit from practice MRI sessions are lacking. This study evaluates the use of the modified Yale Preoperative Anxiety Scale (mYPAS) in effectively identifying patients who may benefit from simulation-based training. METHODS: Children aged 5 and older who were originally scheduled for MRI with anesthesia in 2015 to 2016 were prospectively recruited for simulation-based training...
February 24, 2018: Journal of the American College of Radiology: JACR
Sean S Li, Libby R Copeland-Halperin, Alexander J Kaminsky, Jihui Li, Fahad K Lodhi, Reza Miraliakbari
BACKGROUND:  Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction. METHODS:  The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA)...
February 20, 2018: Journal of Reconstructive Microsurgery
Handan Guler, Perihan Cetin, Zeliha Burcu Yurtsal, Busra Cesur, Mine Bekar, Tuba Uçar, Funda Evcili, Ali Cetin
This study assesses the efficacy of simulation-based episiotomy training (SBET) with beef tongue and sponge models in terms of the self confidence of midwifery students while performing episiotomy. Third-year midwifery students from Cumhuriyet University in the fall semesters of 2011 and 2012 were enrolled in the sponge and beef tongue model groups (n = 36 and n = 37, respectively). A checklist was prepared on the required skills for performing episiotomy which can be broken into three main parts, namely preparation, cutting and repairing and completion...
February 9, 2018: Nurse Education in Practice
Paul Abraham, Franck Verdonk, Clement Buleon, Antoine Tesniere, Marc Lilot
Integration of simulation in educational curricula for anesthesia and intensive care residents is a hot topic. There is a great interest for simulation centers to share their experiences through multi-site synchronous simulation sessions. The present study results from an experience conducted at three sites in France (Paris, Lyon, and Caen), which involved 16 instructors and 25 residents facing the same scenario across 1 day. Synchronous simulations were performed at each site with local and shared debriefing via teleconference...
2018: Advances in Simulation
Hugo Paquin, Ilana Bank, Meredith Young, Lily H P Nguyen, Rachel Fisher, Peter Nugus
Purpose Complex clinical situations, involving multiple medical specialists, create potential for tension or lack of clarity over leadership roles and may result in miscommunication, errors and poor patient outcomes. Even though copresence has been shown to overcome some differences among team members, the coordination literature provides little guidance on the relationship between coordination and leadership in highly specialized health settings. The purpose of this paper is to determine how different specialties involved in critical medical situations perceive the role of a leader and its contribution to effective crisis management, to better define leadership and improve interdisciplinary leadership and education...
February 5, 2018: Leadership in Health Services
Saundra E Curry
There are many reasons for evaluating our approach and improving our teaching of America's future doctors, whether they become anesthesiologists (recruitment) or participate in patient management in the perioperative period (general patient care). Teaching medical students the seminal aspects of any medical specialty is a continual challenge. Although no definitive curricula or single clinical approach has been defined, certain key features can be ascertained from clinical experience and the literature. A survey was conducted among US anesthesiology teaching programs regarding the teaching content and approaches currently used to teach US medical students clinical anesthesia...
February 2, 2018: Anesthesia and Analgesia
A Antoniou, K Marmai, F Qasem, R Cherry, P M Jones, S Singh
BACKGROUND: Informed consent is required before placing an epidural. At our hospital, teaching of residents about this is done informally at the bedside. This study aimed to assess the ability of anesthesia residents to acquire and retain knowledge required when seeking informed consent for epidural labor analgesia. It assessed how well this knowledge was translated to clinical ability, by assessing the verbal consent process during an interaction with a standardized patient. METHODS: Twenty anesthesia residents were randomized to a 'didactic group' or a 'simulation group'...
December 29, 2017: International Journal of Obstetric Anesthesia
Melissa N Hempstead, Joseph R Waas, Mairi Stewart, Suzanne K Dowling, Vanessa M Cave, Gemma L Lowe, Mhairi A Sutherland
Cautery disbudding of goat kids is painful, but may be alleviated with pain mitigation. We therefore evaluated the effect of administering general anesthesia (isoflurane) or a nonsteroidal anti-inflammatory drug (meloxicam) on goat kid behavior and physiology following cautery disbudding. Trial 1 (n = 12/treatment) evaluated behavioral responses in 72 female Saanen dairy goat kids (mean ± standard error of the mean; 3.9 ± 0.15 d old) and trial 2 (n = 10/treatment) evaluated physiological responses in 60 female Saanen dairy goat kids (4...
January 31, 2018: Journal of Dairy Science
Nibardo Lopez Rios, Philippe Pouliot, Konstantinos Papoutsis, Alexandru Foias, Nikola Stikov, Frédéric Lesage, Mathieu Dehaes, Julien Cohen-Adad
The purpose of this work was to develop an optimized transmit/receive birdcage coil to extend the possibilities of a 7T preclinical MRI system to conduct improved full body imaging in medium-sized animals, such as large New Zealand rabbits. The coil was designed by combining calculation and electromagnetic simulation tools. The construction was based on precise mechanical design and careful building practice. A 16-leg, 20 cm long, 16 cm inner diameter, shielded quadrature hybrid structure was selected. Coil parameters were assessed on the bench and images were acquired on phantoms and rabbits...
2018: PloS One
John D Mitchell, Rabia Amir, Mario Montealegre-Gallegos, Feroze Mahmood, Marc Shnider, Azad Mashari, Lu Yeh, Ruma Bose, Vanessa Wong, Philip Hess, Yannis Amador, Jelliffe Jeganathan, Stephanie B Jones, Robina Matyal
While standardized examinations and data from simulators and phantom models can assess knowledge and manual skills for ultrasound, an Objective Structured Clinical Examination (OSCE) could assess workflow understanding. We recruited 8 experts to develop an OSCE to assess workflow understanding in perioperative ultrasound. The experts used a binary grading system to score 19 graduating anesthesia residents at 6 stations. Overall average performance was 86.2%, and 3 stations had an acceptable internal reliability (Kuder-Richardson formula 20 coefficient >0...
January 29, 2018: Anesthesia and Analgesia
Richard H Blum, Sharon L Muret-Wagstaff, John R Boulet, Jeffrey B Cooper, Emil R Petrusa, Keith H Baker, Galina Davidyuk, Jennifer L Dearden, David M Feinstein, Stephanie B Jones, William R Kimball, John D Mitchell, Robert L Nadelberg, Sarah H Wiser, Meredith A Albrecht, Amanda K Anastasi, Ruma R Bose, Laura Y Chang, Deborah J Culley, Lauren J Fisher, Meera Grover, Suzanne B Klainer, Rikante Kveraga, Jeffrey P Martel, Shannon S McKenna, Rebecca D Minehart, John D Mitchell, Jeremi R Mountjoy, John B Pawlowski, Robert N Pilon, Douglas C Shook, David A Silver, Carol A Warfield, Katherine L Zaleski
BACKGROUND: Obtaining reliable and valid information on resident performance is critical to patient safety and training program improvement. The goals were to characterize important anesthesia resident performance gaps that are not typically evaluated, and to further validate scores from a multiscenario simulation-based assessment. METHODS: Seven high-fidelity scenarios reflecting core anesthesiology skills were administered to 51 first-year residents (CA-1s) and 16 third-year residents (CA-3s) from three residency programs...
January 24, 2018: Anesthesiology
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