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Simulation anesthesia

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https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-paediatric-anaesthesia-mepa-course
#1
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#2
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#3
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28791331/temporal-processing-in-the-visual-cortex-of-the-awake-and-anesthetized-rat
#4
Ida E J Aasebø, Mikkel E Lepperød, Maria Stavrinou, Sandra Nøkkevangen, Gaute Einevoll, Torkel Hafting, Marianne Fyhn
The activity pattern and temporal dynamics within and between neuron ensembles are essential features of information processing and believed to be profoundly affected by anesthesia. Much of our general understanding of sensory information processing, including computational models aimed at mathematically simulating sensory information processing, rely on parameters derived from recordings conducted on animals under anesthesia. Due to the high variety of neuronal subtypes in the brain, population-based estimates of the impact of anesthesia may conceal unit- or ensemble-specific effects of the transition between states...
July 2017: ENeuro
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#5
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28759501/ultrasound-guided-regional-anesthesia-simulation-training-a-systematic-review
#6
Xiao Xu Chen, Vatsal Trivedi, AbdulHadi A AlSaflan, Suzanne Clare Todd, Andrea C Tricco, Colin J L McCartney, Sylvain Boet
BACKGROUND AND OBJECTIVES: Ultrasound-guided regional anesthesia (UGRA) has become the criterion standard of regional anesthesia practice. Ultrasound-guided regional anesthesia teaching programs often use simulation, and guidelines have been published to help guide URGA education. This systematic review aimed to examine the effectiveness of simulation-based education for the acquisition and maintenance of competence in UGRA. METHODS: Studies identified in MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were included if they assessed simulation-based UGRA teaching with outcomes measured at Kirkpatrick level 2 (knowledge and skills), 3 (transfer of learning to the workplace), or 4 (patient outcomes)...
July 28, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#7
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28734531/event-based-control-of-depth-of-hypnosis-in-anesthesia
#8
Luca Merigo, Manuel Beschi, Fabrizio Padula, Nicola Latronico, Massimiliano Paltenghi, Antonio Visioli
BACKGROUND AND OBJECTIVE: In this paper, we propose the use of an event-based control strategy for the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. METHODS: A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The tuning of the parameters is performed off-line by using genetic algorithms by considering a given data set of patients...
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28713258/relationship-of-topology-multiscale-phase-synchronization-and-state-transitions-in-human-brain-networks
#9
Minkyung Kim, Seunghwan Kim, George A Mashour, UnCheol Lee
How the brain reconstitutes consciousness and cognition after a major perturbation like general anesthesia is an important question with significant neuroscientific and clinical implications. Recent empirical studies in animals and humans suggest that the recovery of consciousness after anesthesia is not random but ordered. Emergence patterns have been classified as progressive and abrupt transitions from anesthesia to consciousness, with associated differences in duration and electroencephalogram (EEG) properties...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#10
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28704284/evaluation-of-a-simpler-tool-to-assess-nontechnical-skills-during-simulated-critical-events
#11
Scott C Watkins, David A Roberts, John R Boulet, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Management of critical events requires teams to employ nontechnical skills (NTS), such as teamwork, communication, decision making, and vigilance. We sought to estimate the reliability and provide evidence for the validity of the ratings gathered using a new tool for assessing the NTS of anesthesia providers, the behaviorally anchored rating scale (BARS), and compare its scores with those of an established NTS tool, the Anaesthetists' Nontechnical Skills (ANTS) scale. METHODS: Six previously trained raters (4 novices and 2 experts) reviewed and scored 18 recorded simulated pediatric crisis management scenarios using a modified ANTS and a BARS tool...
April 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28695248/divergent-effects-of-anesthetics-on-lipid-bilayer-properties-and-sodium-channel-function
#12
REVIEW
Karl F Herold, Olaf S Andersen, Hugh C Hemmings
General anesthetics revolutionized medicine by allowing surgeons to perform more complex and much longer procedures. This widely used class of drugs is essential to patient care, yet their exact molecular mechanism(s) are incompletely understood. One early hypothesis over a century ago proposed that nonspecific interactions of anesthetics with the lipid bilayer lead to changes in neuronal function via effects on membrane properties. This model was supported by the Meyer-Overton correlation between anesthetic potency and lipid solubility and despite more recent evidence for specific protein targets, in particular ion-channels, lipid bilayer-mediated effects of anesthetics is still under debate...
July 10, 2017: European Biophysics Journal: EBJ
https://www.readbyqxmd.com/read/28678068/anesthesia-adverse-events-voluntarily-reported-in-the-veterans-health-administration-and-lessons-learned
#13
Julia Neily, Elda S Silla, Sam John T Sum-Ping, Roberta Reedy, Douglas E Paull, Lisa Mazzia, Peter D Mills, Robin R Hemphill
BACKGROUND: Anesthesia providers have long been pioneers in patient safety. Despite remarkable efforts, anesthesia errors still occur, resulting in complications, injuries, and even death. The Veterans Health Administration (VHA) National Center of Patient Safety uses root cause analysis (RCA) to examine why system-related adverse events occur and how to prevent future similar events. This study describes the types of anesthesia adverse events reported in VHA hospitals and their root causes and preventative actions...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#14
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28648752/physiological-and-self-assessed-psychological-stress-induced-by-a-high-fidelity-simulation-course-among-third-year-anaesthesia-and-critical-care-residents-an-observational-study
#15
Pr Thomas Geeraerts
INTRODUCTION: The use of high-fidelity simulators in Medicine can improve knowledge, behavior and practice but may be associated with significant stress. Our objective was to measure physiological and psychological self-assessed intensity of stress before and after a planned simulation training session among third year anesthesia and critical care residents. METHODS: A convenience sample of 27 residents participating in a simulation training course was studied. Stress was evaluated by self-assessment using a numerical scale and by salivary amylase concentration before and after the session...
June 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28641713/assessment-tools-for-use-during-anesthesia-centric-pediatric-advanced-life-support-training-and-evaluation
#16
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
#17
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
#18
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...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#19
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
#20
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
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