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Anesthesia simulation

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https://www.readbyqxmd.com/read/29340856/core-point-of-care-ultrasound-curriculum-what-does-every-anesthesiologist-need-to-know
#1
REVIEW
Massimiliano Meineri, Gregory L Bryson, Ramiro Arellano, Nikolaos Skubas
Point-of-care ultrasound (POCUS) is becoming an integral part of anesthesia practice throughout the world. Despite the growing interest in POCUS among trainees and faculty, POCUS training is variable among universities across Canada. This suggests a need for curriculum development and standardization. International guidelines for Emergency Medicine and Critical Care have common frameworks and may be used as a reference to model anesthesia-specific curricula. The Royal College of Anaesthetists of the United Kingdom currently offers the only nationally approved POCUS curriculum for anesthesia and critical care trainees...
January 16, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#2
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29316070/incidence-and-risk-factors-of-severe-lacerations-during-forceps-delivery-in-a-single-teaching-hospital-where-simulation-training-is-held-annually
#3
Yasuko Sano, Chihiro Hirai, Shintaro Makino, Xianglan Li, Jun Takeda, Atsuo Itakura, Satoru Takeda
AIM: This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. METHODS: The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29314783/controlling-the-error-on-target-motion-through-real-time-mesh-adaptation-applications-to-deep-brain-stimulation
#4
Huu Phuoc Bui, Satyendra Tomar, Hadrien Courtecuisse, Michel Audette, Stéphane Cotin, Stéphane P A Bordas
An error-controlled mesh refinement procedure for needle insertion simulations is presented. As an example, the procedure is applied for simulations of electrode implantation for Deep Brain Stimulation. We take into account the brain shift phenomena occurring when a craniotomy is performed. We observe that the error in the computation of the displacement and stress fields is localised around the needle tip and the needle shaft during needle insertion simulation. By suitably and adaptively refining the mesh in this region, our approach enables to control, and thus to reduce, the error whilst maintaining a coarser mesh in other parts of the domain...
January 5, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29283921/a-simulation-study-to-evaluate-improvements-in-anesthesia-work-environment-contamination-after-implementation-of-an-infection-prevention-bundle
#5
Grete H Porteous, Helen A Bean, Crystal M Woodward, Ryan P Beecher, Jennifer R Bernstein, Sarah Wilkerson, Ian Porteous, Robert L Hsiung
BACKGROUND: Microbiological contamination of the anesthesia work environment (AWE) is a potential source of health care-associated infections. Medication syringes, stopcocks, and many other areas are routinely contaminated during anesthetic care, and adherence to hand hygiene recommendations is poor. Using a simulation model, we investigated whether AWE contamination could be reduced by implementing an intervention bundle focused on infection prevention. METHODS: Twenty-five anesthesia providers were enrolled in this nonrandomized simulation scenario crossover design study...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29261545/the-effect-of-high-frequency-structured-expert-feedback-on-the-learning-curves-of-basic-interventional-ultrasound-skills-applied-to-regional-anesthesia
#6
Getúlio Rodrigues de Oliveira Filho, Francisco de Assis Caire Mettrau
BACKGROUND: Proficiency in needle-to-ultrasound beam alignment and accurate approach to structures are pivotal for ultrasound-guided regional anesthesia. This study evaluated the effects of high-frequency, structured expert feedback on simulation training of such abilities. METHODS: Forty-two subjects randomly allocated as controls or intervention participated in two 25-trial experiments. Experiment 1 consisted of inserting a needle into a bovine muscular phantom parallel to the ultrasound beam while maintaining full imaging of the needle...
December 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29235453/potential-impact-of-thermal-effects-during-ultrasonic-neurostimulation-retrospective-numerical-estimation-of-temperature-elevation-in-seven-rodent-setups
#7
Charlotte Constans, Philippe Mateo, Mickael Tanter, Jean-Francois Aubry
In the past decade, a handful but growing number of groups have reported worldwide successful low intensity focused ultrasound induced neurostimulation trials on rodents with effects ranging from movement elicitations to reduction of anesthesia time or reduction of the duration of drug induced seizures. The mechanisms underlying ultrasonic neuromodulation are still not fully understood. Given the low intensities used in most of the studies, a mechanical effect is more likely to be responsible for the neuromodulation effect, but a clear description of the thermal and mechanical effects is necessary to optimize clinical applications...
December 13, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29225743/comparison-of-the-clinical-performance-of-the-modified-marsh-model-for-propofol-between-underweight-and-normal-weight-patients-with-crohn-s-disease
#8
Soo-Kyung Park, Ji Hyun Park, Hyun Uk Kang, Byung-Moon Choi, Gyu-Jeong Noh
Background: The aim of this retrospective study was to compare the clinical performance of the modified Marsh model for propofol between underweight and normal-weight patients with Crohn's disease. Methods: The medical records of 50 patients who underwent elective surgery for Crohn's disease were reviewed retrospectively. Propofol and remifentanil were administered using target effect-site concentration (Ce)-controlled infusion with the modified Marsh and Minto models...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29219894/crisis-management-simulation-establishing-a-dual-neurosurgery-and-anesthesia-training-experience
#9
Jeremy Ciporen, Haley Gillham, Michele Noles, Dawn Dillman, Mark Baskerville, Caleb Haley, Donn Spight, Ryan C Turner, Brandon P Lucke-Wold
BACKGROUND: Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. METHODS: Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique...
January 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29210892/physiologically-triggered-digital-cognitive-aid-facilitates-crisis-management-in-a-simulated-operating-room-a-randomized-controlled-study
#10
Jonathan Lipps, Lori Meyers, Scott Winfield, Michael Durda, Vedat Yildiz, Michael Kushelev
INTRODUCTION: Although the benefits of using cognitive aids in anesthesia care have previously been demonstrated, several challenges remain. It must be presented in a timely manner, and providers must be amenable to using the tool once it is available. We hypothesized that anesthesia residents would perform superiorly when presented with a digital cognitive aid (DCogA) that is automatically triggered by a set vital sign aberration. METHODS: Thirty anesthesia residents were randomized to either control (with access to hard copy of the cognitive aid) or receive a DCogA projected on their anesthesia information management system with the onset of heart block and associated hypotension...
November 28, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#11
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29197630/population-pharmacokinetics-of-articaine-with-1-200-000-epinephrine-during-third-molar-surgery-and-simulation-of-high-dose-regimens
#12
Yoann Cazaubon, Cédric Mauprivez, Catherine Feliu, Laurent Binet, Olivier Oget, Claire Gozalo, Zoubir Djerada
BACKGROUND AND OBJECTIVES: Articaine is more and more used in third molar surgery under local anesthesia (LA). The objectives of this analysis were to characterize the pharmacokinetics of articaine for this type of surgery and to simulate dosing regimens. METHODS: Non-linear mixed-effects modeling conducted in Monolix 4.4.0 was used to describe articaine plasma concentration-time data from 20 patients. Monte Carlo simulations were then performed to evaluate the probability of cardiotoxic target attainment (PCTA) of various dosage regimens...
November 29, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29182554/alcohol-interactions-with-lipid-bilayers
#13
Tomáš Kondela, Jana Gallová, Thomas Hauß, Jonathan Barnoud, Siewert-J Marrink, Norbert Kučerka
We investigate the structural changes to lipid membrane that ensue from the addition of aliphatic alcohols with various alkyl tail lengths. Small angle neutron diffraction from flat lipid bilayers that are hydrated through water vapor has been employed to eliminate possible artefacts of the membrane curvature and the alcohol's membrane-water partitioning. We have observed clear changes to membrane structure in both transversal and lateral directions. Most importantly, our results suggest the alteration of the membrane-water interface...
November 28, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29159491/-algorithm-for-securing-an-unexpected-difficult-airway-user-analysis-on-a-simulator
#14
T Ott, K Truschinski, M Kriege, M Naß, S Herrmann, V Ott, S Sellin
BACKGROUND: Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#15
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29123607/procedural-simulation-medical-student-preference-and-value-of-three-task-trainers-for-ultrasound-guided-regional-anesthesia
#16
Shadi Lahham, Taylaur Smith, Jessa Baker, Amanda Purdy, Erica Frumin, Bret Winners, Sean P Wilson, Abdulatif Gari, John C Fox
BACKGROUND: Ultrasound guided regional anesthesia is widely taught using task trainer models. Commercially available models are often used; however, they can be cost prohibitive. Therefore, alternative "homemade" models with similar fidelity are often used. We hypothesize that professional task trainers will be preferred over homemade models. The purpose of this study is to determine realism, durability and cleanliness of three different task trainers for ultrasound guided nerve blocks...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29112655/multiparous-ewe-as-a-model-for-teaching-vaginal-hysterectomy-techniques
#17
Yohan Kerbage, Michel Cosson, Thomas Hubert, Géraldine Giraudet
BACKGROUND: Despite being linked to improving patient outcomes and limiting costs, the use of vaginal hysterectomy is on the wane. Although a combination of reasons might explain this trend, one cause is a lack of practical training. An appropriate teaching model must therefore be devised. Currently, only low-fidelity simulators exist. Ewes provide an appropriate model for pelvic anatomy and are well-suited for testing vaginal mesh properties. This article sets out a vaginal hysterectomy procedure for use as an education and training model...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29079566/swine-atrioventricular-node-ablation-using-stereotactic-radiosurgery-methods-and-in-vivo-feasibility-investigation-for-catheter-free-ablation-of-cardiac-arrhythmias
#18
Marwan M Refaat, Jad A Ballout, Patrick Zakka, Mostafa Hotait, Karine A Al Feghali, Ibrahim Abu Gheida, Charbel Saade, Mukbil Hourani, Fady Geara, Malek Tabbal, Pierre Sfeir, Wassim Jalbout, Wael Al-Jaroudi, Abdo Jurjus, Bassem Youssef
BACKGROUND: Linear accelerator-based stereotactic radiosurgery delivered to cardiac arrhythmogenic foci could be a promising catheter-free ablation modality. We tested the feasibility of in vivo atrioventricular (AV) node ablation in swine using stereotactic radiosurgery. METHODS AND RESULTS: Five Large White breed swine (weight 40-75 kg; 4 females) were studied. Single-chamber St Jude pacemakers were implanted in each pig. The pigs were placed under general anesthesia, and coronary/cardiac computed tomography simulation scans were performed to localize the AV node...
October 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29060849/audible-capnometric-cues-with-end-tidal-carbon-dioxide-improve-the-quality-of-patient-monitoring
#19
Toshiki Aoki, Masayuki Inoue, Kiyoyuki Miyasaka
The importance of capnometry and end-tidal carbon dioxide (ETCO2) has been underscored in recent years by guidelines as a method to continuously monitor adequacy of ventilation during sedation and anesthesia. Guidelines for cardiopulmonary resuscitation (CPR) recommend attempts to improve CPR quality if ETCO2 is lower than 10 mmHg. ETCO2 is thus a time-critical parameter that may benefit from being delivered in real time to health care providers. We performed a pilot study to investigate whether the addition of audible capnometric cues after each breath enhanced providers' ability to maintain appropriate ventilation over conventional capnography...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059806/a-hybrid-low-cost-tissue-like-epidural-needle-insertion-simulator
#20
B Esterer, S Gabauer, R Pichler, D Wirthl, M Drack, M Hollensteiner, G Kettlgruber, M Kaltenbrunner, S Bauer, D Furst, R Merwa, J Meier, P Augat, A Schrempf
Epidural and spinal anesthesia are mostly performed "blind" without any medical imaging. Currently, training of these procedures is performed on human specimens, virtual reality systems, manikins and mostly in clinical practice supervised by a professional. In this study a novel hybrid, low-cost patient simulator for the training of needle insertion into the epidural space was designed. The patient phantom provides a realistic force feedback comparable with biological tissue and enables sensing of the needle tip position during insertion...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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