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https://www.readbyqxmd.com/read/29218778/examination-of-sacral-tissue-oxygen-saturation-among-immobile-patients
#1
Burcu Ceylan, Ulku Yapucu Gunes, Mehmet Uyar
AIMS AND OBJECTIVES: This research was conducted to explore the effect of immobility on sacral tissue oxygen saturation in patients lying on a supporting surface in supine position. BACKGROUND: Guidelines in regard to preventing pressure ulcers recommend that patients lying on a standard bed should change their positions every two hours and that patients on a supporting surface should change their positions every four hours. But there is no strong evidence that justifies this practice...
December 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29209789/-novel-aspects-of-the-guidelines-for-hemotherapy-2017-implications-for-anesthesiology
#2
REVIEW
I Pekrul, G Wittmann, P Möhnle
Based on the German Transfusion Law, the periodically updated guidelines "Richtlinien zur Gewinnung von Blut und Blutbestandteilen und zur Anwendung von Blutprodukten" ("Hämotherapierichtlinien") are intended to provide the current knowledge and state of the art of blood transfusion practice in Germany. The novel update 2017 contains relevant changes for blood donation, especially the extension of the exclusion period of persons at risk for sexually transmitted HBV, HCV and HIV diseases to 12 months. Moreover, the guidelines provide several changes relevant to blood transfusion practice in anesthesiology, such as: all autologous hemotherapy procedures including normovolemic hemodilution, cell saver, and autologous blood donation and transfusion require formal registration at the regulatory authority...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29204875/focused-assessment-with-sonography-in-trauma-a-review-of-concepts-and-considerations-for-anesthesiology
#3
Jacob Pace, Robert Arntfield
The use of point-of-care ultrasound in trauma provides diagnostic clarity and routinely influences management. A scanning protocol known as the Focused Assessment with Sonography in Trauma (FAST) has been widely adopted by trauma providers of all specialties. The FAST exam addresses a broad array of pathologic conditions capable of causing instability, including hemoperitoneum, hemopericardium, hemothorax, and pneumothorax. The exam is an integral component to the primary assessment of injured patients and an iconic application of point-of-care ultrasound...
December 4, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29200062/is-compliance-with-surgical-care-improvement-project-cardiac-scip-card-2-measures-for-perioperative-%C3%AE-blockers-associated-with-reduced-incidence-of-mortality-and-cardiovascular-related-critical-quality-indicators-after-noncardiac-surgery
#4
Miklos D Kertai, Mary Cooter, Richard J Pollard, William Buhrman, Solomon Aronson, Joseph P Mathew, Mark Stafford-Smith
BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. METHODS: For this retrospective study, the quality assurance database of a large community-based anesthesiology group practice was used to identify 410,288 surgical cases, 18 years of age or older, who underwent elective or emergent noncardiac surgical procedures between January 1, 2009, and December 31, 2014...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29190178/transanal-total-mesorectal-excision-in-lower-rectal-cancer-comparison-of-short-term-outcomes-with-conventional-laparoscopic-total-mesorectal-excision
#5
Tung-Cheng Chang, Kee-Thai Kiu
BACKGROUND: Transanal total mesorectal excision (TaTME) is a novel technique to treat rectal cancer and also to obtain good-quality specimens. This study investigated the clinical results and perioperative and pathological outcomes of TaTME in lower rectal cancer treatment in comparison with laparoscopic total mesorectal excision (LaTME). METHODS: During January 2014 to May 2017, all consecutive patients with lower rectal cancer who underwent TaTME were identified...
November 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29174119/engaging-the-front-line-tapping-into-hospital-wide-quality-and-safety-initiatives
#6
Jed Wolpaw, Deborah Schwengel, Nadia Hensley, Bommy Hong Mershon, Tracey Stierer, Anne Steele, Alexandra Hansen, Colleen G Koch
Healthcare increasingly is moving from volume- to value-based care, with an emphasis on linking a larger percentage of payments to the quality of care provided. There is a renewed interest in designing a focused, strategic approach to quality and safety education and engagement of trainees in hospital-wide quality, safety, and patient experience initiatives. Hospitals, trainees, and patients benefit as a result of engaging frontline learners in these activities. Hospitals can leverage the intelligence from the front line to contribute to improved hospital safety, increased employee and patient engagement, and better identification of vulnerable areas of safety risks...
May 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#7
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#8
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29116968/antiemetic-prophylaxis-as-a-marker-of-health-care-disparities-in-the-national-anesthesia-clinical-outcomes-registry
#9
Michael H Andreae, Jonah S Gabry, Ben Goodrich, Robert S White, Charles Hall
BACKGROUND: US health care disparities persist despite repeated countermeasures. Research identified race, ethnicity, gender, and socioeconomic status as factors, mediated through individual provider and/or systemic biases; little research exists in anesthesiology. We investigated antiemetic prophylaxis as a surrogate marker for anesthesia quality by individual providers because antiemetics are universally available, indicated contingent on patient characteristics (gender, age, etc), but independent of comorbidities and not yet impacted by regulatory or financial constraints...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29112023/behavior-of-anesthesiology-residents-in-a-situation-of-intravenous-route-occlusion-during-syringe-pump-use-in-a-simulated-intensive-care-unit
#10
Takayuki Kariya, Tetsuya Miyashita, Hitoshi Sato, Hiromasa Kawakami, Takahisa Goto
INTRODUCTION: Unintentional catecholamine flush caused by inappropriate release of an intravenous occlusion during use of a syringe pump in the intensive care unit (ICU) can have dangerous consequences in patients receiving critical care. We investigated whether anesthesiology residents understood how to deal with syringe pump occlusion in a simulated ICU setting. METHODS: We set up a mannequin that virtually simulated a sedated patient under mechanical ventilation after cardiac surgery, with epinephrine and dopamine being infused by syringe pumps to maintain blood pressure at 100/50 mm Hg...
November 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29100739/selected-highlights-in-clinical-anesthesia-research
#11
REVIEW
Mark C Kendall, Zachary M Robbins, Alexander Cohen, Mary Minn, Scott E Benzuly, Andrew S Triebwasser, Zachary L McCormick, Michelle Gorgone
STUDY OBJECTIVE: To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. DESIGN: Narrative review. SETTING: N/A. MATERIALS: The major themes address broad categories of general anesthesia including airway management, abdominal surgery, and obstetrical and gynaecological anesthesia. In addition, recent advancements in specialties of anesthesiology including regional anesthesia are reviewed...
October 31, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29099845/real-time-endoscopic-image-orientation-correction-system-using-an-accelerometer-and-gyrosensor
#12
Hyung-Chul Lee, Chul-Woo Jung, Hee Chan Kim
The discrepancy between spatial orientations of an endoscopic image and a physician's working environment can make it difficult to interpret endoscopic images. In this study, we developed and evaluated a device that corrects the endoscopic image orientation using an accelerometer and gyrosensor. The acceleration of gravity and angular velocity were retrieved from the accelerometer and gyrosensor attached to the handle of the endoscope. The rotational angle of the endoscope handle was calculated using a Kalman filter with transmission delay compensation...
2017: PloS One
https://www.readbyqxmd.com/read/29075381/a-checklist-to-help-faculty-assess-acgme-milestones-in-a-video-recorded-osce
#13
L Jane Easdown, Marsha L Wakefield, Matthew S Shotwell, Michael R Sandison
BACKGROUND : Faculty members need to assess resident performance using the Accreditation Council for Graduate Medical Education Milestones. OBJECTIVE : In this randomized study we used an objective structured clinical examination (OSCE) around the disclosure of an adverse event to determine whether use of a checklist improved the quality of milestone assessments by faculty. METHODS : In 2013, a total of 20 anesthesiology faculty members from 3 institutions were randomized to 2 groups to assess 5 videos of trainees demonstrating advancing levels of competency on the OSCE...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29064863/the-influence-of-collaboration-ralph-waters-friendship-with-john-lundy-and-the-spread-of-regional-anesthesia
#14
Shelly B Borden, Colby L Parks
Ralph Waters, the founder of the anesthesiology department and residency program at the University of Wisconsin-Madison, and John Lundy, the chair at the Mayo Clinic beginning in 1924, collaborated to expand regional anesthetic techniques and knowledge not only at their institutions, but also at institutions around the country through correspondence, meetings, and hosting of other anesthesiologists. The Ralph Waters Collection at the University of Wisconsin Archives was searched for information on Waters' and Lundy's involvement in regional anesthesia...
October 23, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29060733/development-of-a-thermal-associated-pain-index-score-using-infrared-thermography-for-objective-pain-assessment
#15
M Czaplik, N Hochhausen, H Dohmeier, C Barbosa Pereira, R Rossaint
Without any doubt, research in biomedical engineering and anesthesiology achieved diverse ground-breaking successes for the sake of patient safety and for optimization of medical treatment in the last decades. Particularly anesthesia has become increasingly comfortable and safer due to new monitoring devices and further techniques. However, assessment of pain still relies on self-reporting of the patient using a Numeric Rating Scale ranging from 0 to 10. Obviously, this method suffers from severe restraints when unconscious, anesthetized or uncooperative subjects or children are involved as patients...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29052742/-triple-arthrodesis-for-correction-of-cavovarus-deformity
#16
REVIEW
A Barg, R Ruiz, B Hintermann
OBJECTIVE: The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot. INDICATIONS: Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking...
October 20, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29051136/using-google-glass-in-nonsurgical-medical-settings-systematic-review
#17
Bryn Dougherty, Sherif M Badawy
BACKGROUND: Wearable technologies provide users hands-free access to computer functions and are becoming increasingly popular on both the consumer market and in various industries. The medical industry has pioneered research and implementation of head-mounted wearable devices, such as Google Glass. Most of this research has focused on surgical interventions; however, other medical fields have begun to explore the potential of this technology to support both patients and clinicians. OBJECTIVE: Our aim was to systematically evaluate the feasibility, usability, and acceptability of using Google Glass in nonsurgical medical settings and to determine the benefits, limitations, and future directions of its application...
October 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29049076/fatigue-risk-management-the-impact-of-anesthesiology-residents-work-schedules-on-job-performance-and-a-review-of-potential-countermeasures
#18
Lily R Wong, Erin Flynn-Evans, Keith J Ruskin
Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29029012/heterogeneity-of-studies-in-anesthesiology-systematic-reviews-a-meta-epidemiological-review-and-proposal-for-evidence-mapping
#19
B Umberham, R Hedin, B Detweiler, L Kollmorgen, C Hicks, M Vassar
Heterogeneity among the primary studies included in a systematic review (SR) is one of the most challenging considerations for systematic reviewers. Current practices in anaesthesiology SRs have not been evaluated, but traditional methods may not provide sufficient information to evaluate the true nature of these differences. We address these issues by examining the practices for evaluating heterogeneity in anesthesiology reviews. Also, we propose a mapping method for presenting heterogeneous aspects of the primary studies in SRs...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28943117/lack-of-methemoglobin-elevations-after-topical-applications-of-benzocaine-alone-or-benzocaine-plus-tetracaine-to-the-oral-mucosa
#20
Steven Wang, Helen Giannakopoulos, Jamie Lowstetter, Laura Kaye, Catherine Lee, Stacey Secreto, Vanessa Ho, Matthew C Hutcheson, John T Farrar, Ping Wang, Geraldine Doyle, Stephen A Cooper, Elliot V Hersh
PURPOSE: This study evaluated changes in methemoglobin and oxygen saturation concentrations after the administration of recommended doses of 14% benzocaine alone or 14% benzocaine combined with 2% tetracaine. METHODS: American Society of Anesthesiology class 1 and 2 subjects (n = 40) were enrolled in this modified crossover study. Subjects were administered 0.2 mL of 14% benzocaine alone, 0.2 mL of 14% benzocaine plus 2% tetracaine, or 0.4 mL of 14% benzocaine plus 0...
September 21, 2017: Clinical Therapeutics
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