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Anesthesia simulation

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https://www.readbyqxmd.com/read/29771811/use-of-emergency-manuals-during-actual-critical-events-in-china-a-multi-institutional-study
#1
Jeffrey Huang, Jiayan Wu, Christina Dai, Xianwei Zhang, Hui Ju, Yiqi Chen, Chunyuan Zhang, Fan Ye, Yi Tan, Yongbo Zong, Telong Liu
INTRODUCTION: Emergency manuals (EMs) can help healthcare providers respond to crises more efficiently. Three anesthesia EMs have been translated into Chinese. These EMs have been made publicly available as a free document downloadable in China. A year after these Chinese versions of EMs were published, we conducted a multi-institutional survey in China to assess the progress of how well EM had been adapted and used in the setting of critical events. METHODS: Our study used a multi-institutional, anonymous electronic survey...
May 16, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29767569/teaching-tip-development-of-veterinary-anesthesia-simulations-for-pre-clinical-training-design-implementation-and-evaluation-based-on-student-perspectives
#2
Jana L Jones, Jim Rinehart, Jacqueline Jordan Spiegel, Ryane E Englar, Brian K Sidaway, Joie Rowles
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access...
2018: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#3
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29749993/central-acinic-cell-carcinoma-of-the-mandible-simulating-as-benign-odontogenic-lesion-a-case-report
#4
Manas Bajpai, Nilesh Pardhe, Betina Chandolia, Manika Arora
Centrally occurring salivary gland tumors are rare. Because of a considerable overlap between the clinical and histopathological features, this group of tumors often produces a diagnostic difficulty to the clinicians and oral pathologists. Acinic cell carcinoma (ACC) is an unusual, low-grade, malignant salivary gland tumor that represents approximately 2% of the salivary gland tumors with almost 90% arising in the parotid gland. The rest involve the submandibular and the minor salivary gland. ACC of the jaw is extremely rare and, to our knowledge, only 8 cases have been reported in the English literature...
March 2018: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29743181/evaluation-of-the-quality-of-transesophageal-echocardiography-images-and-verification-of-proficiency
#5
Robina Matyal, Faraz Mahmood, Ziyad Omar Knio, Stephanie Jones, Lu Yeh, Rabina Amir, Ruma Bose, John D Mitchell
Various metrics have been used in curriculum-based TEE training programs to evaluate acquisition of proficiency. However, the quality of task completion, i.e. the final image quality, was subjectively evaluated in these studies. Ideally, the end point metric should be an objective comparison of the trainee-acquired image with a reference ideal image. Therefore, we developed a simulator-based methodology of pre-clinical verification of proficiency (VOP) in trainees by tracking objective evaluation of the final acquired images...
May 9, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29727758/deliberate-practice-using-validated-metrics-improves-skill-acquisition-in-performance-of-ultrasound-guided-peripheral-nerve-block-in-a-simulated-setting
#6
Osman M A Ahmed, Imran Azher, Anthony G Gallagher, Dara S Breslin, Brian D O'Donnell, George D Shorten
STUDY OBJECTIVES: The aim of this study was to compare the effects of deliberate vs. self-guided practices (both using validated metrics) on the acquisition of needling skills by novice learners. DESIGN: Randomized Controlled Study. SETTING: Simulation lab, Department of Anesthesia, St.Vincent's Hospital, Dublin. SUBJECTS: Eighteen medical students. INTERVENTIONS: Students were assigned to either (i) deliberate practice (n = 10) or (ii) self-guided practice (n = 8) groups...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29725565/the-use-of-simulation-to-improve-family-understanding-and-support-of-anesthesia-providers
#7
Susan M Martinelli, Fei Chen, Gene Hobbs, Brooke A Chidgey, Lacey E Straube, David Zvara, Robert Isaak
Introduction  Burnout in medical providers is associated with work dissatisfaction, reduction in patient safety, and provider depression. Simulation is a tool effectively used for specific task training but has not been broadly used as a means to combat medical professional stress and enhance wellness. The authors created a medical simulation program targeted at those involved in the social support of medical providers. The hypothesis was that education of non-medical persons involved in social support would translate into an enhanced understanding of the demands among medical providers in anesthesiology...
March 2, 2018: Curēus
https://www.readbyqxmd.com/read/29721547/evaluation-of-the-pharyngeal-airway-using-computational-fluid-dynamics-in-patients-with-acromegaly
#8
Keika Mukaihara, Maiko Hasegawa-Moriyama, Tomonori Iwasaki, Youichi Yamasaki, Yuichi Kanmura
Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans-sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS. Methods: CT images of the nasopharyngeal airways of patients with acromegaly (n = 5) or nonfunctional pituitary adenoma (n = 6) undergoing TSS from April 2012 to January 2017 were used to construct these airways in three dimensions...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29698253/auditory-icon-alarms-are-more-accurately-and-quickly-identified-than-current-standard-melodic-alarms-in-a-simulated-clinical-setting
#9
Richard R McNeer, Danielle Bodzin Horn, Christopher L Bennett, Judy Reed Edworthy, Roman Dudaryk
BACKGROUND: Current standard audible medical alarms are difficult to learn and distinguish from one another. Auditory icons represent a new type of alarm that has been shown to be easier to learn and identify in laboratory settings by lay subjects. In this study, we test the hypothesis that icon alarms are easier to learn and identify than standard alarms by anesthesia providers in a simulated clinical setting. METHODS: Twenty anesthesia providers were assigned to standard or icon groups...
April 26, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29680811/does-the-age-of-acute-care-physicians-impact-their-1-crisis-management-performance-and-2-learning-after-simulation-based-education-a-protocol-for-a-multicentre-prospective-cohort-study-in-toronto-and-ottawa-canada
#10
Fahad Alam, Vicki R LeBlanc, Alan Baxter, Jordan Tarshis, Dominique Piquette, Yuqi Gu, Caroline Filipkowska, Ashley Krywenky, Nicole Kester-Greene, Pierre Cardinal, Shelly Au, Sandy Lam, Sylvain Boet, Perioperative Anesthesia Clinical Trials Group
INTRODUCTION: The proportion of older acute care physicians (ACPs) has been steadily increasing. Ageing is associated with physiological changes and prospective research investigating how such age-related physiological changes affect clinical performance, including crisis resource management (CRM) skills, is lacking. There is a gap in the literature on whether physician's age influences baseline CRM performance and also learning from simulation. We aim to investigate whether ageing is associated with baseline CRM skills of ACPs (emergency, critical care and anaesthesia) using simulated crisis scenarios and to assess whether ageing influences learning from simulation-based education...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29677389/population-pharmacokinetics-of-intramuscular-and-intravenous-ketamine-in-children
#11
Christoph P Hornik, Daniel Gonzalez, John van den Anker, Andrew M Atz, Ram Yogev, Brenda B Poindexter, Kee Chong Ng, Paula Delmore, Barrie L Harper, Chiara Melloni, Andrew Lewandowski, Casey Gelber, Michael Cohen-Wolkowiez, Jan Hau Lee
Ketamine is an N-methyl D-aspartate receptor antagonist used off-label to facilitate dissociative anesthesia in children undergoing invasive procedures. Available for both intravenous and intramuscular administration, ketamine is commonly used when vascular access is limited. Pharmacokinetic (PK) data in children are sparse, and the bioavailability of intramuscular ketamine in children is unknown. We performed 2 prospective PK studies of ketamine in children receiving either intramuscular or intravenous ketamine and combined the data to develop a pediatric population PK model using nonlinear mixed-effects methods...
April 20, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29677057/newborn-resuscitation-skills-in-health-care-providers-at-a-zambian-tertiary-center-and-comparison-to-world-health-organization-standards
#12
Sara C Mistry, Richard Lin, Hazel Mumphansha, Laura C Kettley, Janaki A Pearson, Sonia Akrimi, David J Mayne, Wonder Hangoma, M Dylan Bould
BACKGROUND: Birth asphyxia is a leading cause of early neonatal death. In 2013, 32% of neonatal deaths in Zambia were attributable to birth asphyxia and trauma. Basic, timely interventions are key to improving outcomes. However, data from the World Health Organization suggest that resuscitation is often not initiated, or is conducted suboptimally. Currently, there are little data on the quality of newborn resuscitation in the context of a tertiary center in a lower-middle income country...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29674729/in-vitro-cortical-network-firing-is-homeostatically-regulated-a-model-for-sleep-regulation
#13
Sohrab Saberi-Moghadam, Alessandro Simi, Hesam Setareh, Cyril Mikhail, Mehdi Tafti
Prolonged wakefulness leads to a homeostatic response manifested in increased amplitude and number of electroencephalogram (EEG) slow waves during recovery sleep. Cortical networks show a slow oscillation when the excitatory inputs are reduced (during slow wave sleep, anesthesia), or absent (in vitro preparations). It was recently shown that a homeostatic response to electrical stimulation can be induced in cortical cultures. Here we used cortical cultures grown on microelectrode arrays and stimulated them with a cocktail of waking neuromodulators...
April 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29662089/time-rescaling-reproduces-eeg-behavior-during-transition-from-propofol-anesthesia-induced-unconsciousness-to-consciousness
#14
S Boussen, A Spiegler, C Benar, M Carrère, F Bartolomei, P Metellus, R Voituriez, L Velly, N Bruder, A Trébuchon
General anesthesia (GA) is a reversible manipulation of consciousness whose mechanism is mysterious at the level of neural networks leaving space for several competing hypotheses. We recorded electrocorticography (ECoG) signals in patients who underwent intracranial monitoring during awake surgery for the treatment of cerebral tumors in functional areas of the brain. Therefore, we recorded the transition from unconsciousness to consciousness directly on the brain surface. Using frequency resolved interferometry; we studied the intermediate ECoG frequencies (4-40 Hz)...
April 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29661451/ischemia-with-preconditioning-in-wistar-rats-maintains-mitochondrial-respiration-even-with-mild-hepatocellular-disturbance
#15
R R Tártaro, G L Jorge, A H Dianin, C A F Escanhoela, I F S F Boin
INTRODUCTION: In hepatectomy or liver transplantation, preconditioning is a procedure indicated to protect the organ from ischemia-reperfusion injury (I-R). OBJECTIVE: Evaluate the effect of preconditioning after hepatic I-R in Wistar rats, through mitochondrial respiration, liver histology, and profile. METHOD: Twenty male Wistar rats, weighing on average 307.1 g, were anesthetized with sodium thiopental (25 mg/kg) intravenously and xylazine hydrochloride (30 mg/kg) intramuscularly...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29661286/comparison-of-zone-3-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-abdominal-aortic-and-junctional-tourniquet-in-a-model-of-junctional-hemorrhage-in-swine
#16
Jason M Rall, Theodore T Redman, Elliot M Ross, Jonathan J Morrison, Joseph K Maddry
BACKGROUND: Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. METHODS: Yorkshire swine (n = 10, 70-90 kg) underwent general anesthesia, instrumentation, and surgical isolation of the femoral artery...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29628666/cardiopulmonary-resuscitation-unusual-techniques-for-unusual-situations
#17
Vidhu Bhatnagar, Kavitha Jinjil, Deepak Dwivedi, Rohit Verma, Urvashi Tandon
Background: The cardiopulmonary resuscitation (CPR) in prone position has been dealt with in 2010 American Heart Association (AHA) guidelines but have not been reviewed in 2015 guidelines. The guidelines for patients presenting with cardiac arrest under general anesthesia in lateral decubitus position and regarding resuscitation in confined spaces like airplanes are also not available in AHA guidelines. This article is an attempt to highlight the techniques adopted for resuscitation in these unusual situations...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29622313/the-american-association-of-oral-and-maxillofacial-surgeons-simulation-program
#18
REVIEW
David W Todd, John J Schaefer
Patient safety in dental anesthesia has been called into question in recent years. Simulation training has been proposed and developed as one possibility for increasing preparedness and training in cases of adverse events in dental anesthesia. This article presents an overview of the challenges of patient safety in dental anesthesia and how to address them with simulation training. The American Association of Oral and Maxillofacial Surgeons simulation program is unique in its potential to become a standardized, validated competency course with objective grading criteria, mastery-based cooperative learning model, and low facilitator-to-participant ratio, leading to a practical delivery cost structure...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29622312/oral-surgery-patient-safety-concepts-in-anesthesia
#19
REVIEW
Richard C Robert, Chirag M Patel
An effective office emergency preparedness plan for the oral and maxillofacial surgery office can be developed through the use of well-designed checklists, cognitive aids, and regularly scheduled in situ simulations with debriefings. In order to achieve this goal, the hierarchal culture of medicine and dentistry must be overcome, and an inclusive team concept embraced by all members of the staff. Technologic advancements in office automation now make it possible to create interactive cognitive aids. These enhance office emergency training and provide a means for more rapid retrieval of essential information and guidance during both simulations and a real crisis...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29621098/comparison-of-the-efficacy-and-efficiency-of-the-use-of-virtual-reality-simulation-with-high-fidelity-mannequins-for-simulation-based-training-of-fiberoptic-bronchoscope-manipulation
#20
Bailin Jiang, Hui Ju, Ying Zhao, Lan Yao, Yi Feng
INTRODUCTION: This study compared the efficacy and efficiency of virtual reality simulation (VRS) with high-fidelity mannequin in the simulation-based training of fiberoptic bronchoscope manipulation in novices. METHODS: Forty-six anesthesia residents with no experience in fiberoptic intubation were divided into two groups: VRS (group VRS) and mannequin (group M). After a standard didactic teaching session, group VRS trained 25 times on VRS, whereas group M performed the same process on a mannequin...
April 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
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