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Emergency medicine and anesthesia

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https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#1
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
November 10, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29016368/perioperative-point-of-care-ultrasound-in-ambulatory-anesthesia-thinking-beyond-nerve-blocks
#2
Ranjit Deshpande, Davinder Ramsingh
PURPOSE OF REVIEW: Ultrasound has become readily available in the perioperative area. In this review, we aim to bring forth some uses of ultrasound beyond that in regional anesthesia. RECENT FINDINGS: Critical care and emergency physicians have embraced ultrasound in their respective fields. We as anesthesiologists and practitioners of acute care medicine are not immune to this penetration. There is been a lot of recent literature on the various uses of perioperative point of care ultrasound...
October 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28922229/micrornas-as-clinical-biomarkers-and-therapeutic-tools-in-perioperative-medicine
#3
Simone Kreth, Max Hübner, Ludwig Christian Hinske
Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28891406/clinical-practice-guideline-evaluation-of-the-neck-mass-in-adults
#4
Melissa A Pynnonen, M Boyd Gillespie, Benjamin Roman, Richard M Rosenfeld, David E Tunkel, Laura Bontempo, Itzhak Brook, Davoren Ann Chick, Maria Colandrea, Sandra A Finestone, Jason C Fowler, Christopher C Griffith, Zeb Henson, Corinna Levine, Vikas Mehta, Andrew Salama, Joseph Scharpf, Deborah R Shatzkes, Wendy B Stern, Jay S Youngerman, Maureen D Corrigan
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28744243/the-odyssey-of-dental-anxiety-from-prehistory-to-the-present-a-narrative-review
#5
REVIEW
Enrico Facco, Gastone Zanette
Dental anxiety (DA) can be considered as a universal phenomenon with a high prevalence worldwide; DA and pain are also the main causes for medical emergencies in the dental office, so their prevention is an essential part of patient safety and overall quality of care. Being DA and its consequences closely related to the fight-or-flight reaction, it seems reasonable to argue that the odyssey of DA began way back in the distant past, and has since probably evolved in parallel with the development of fight-or-flight reactions, implicit memory and knowledge, and ultimately consciousness...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#6
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#7
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#8
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#9
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28441505/error-detection-based-model-to-assess-educational-outcomes-in-crisis-resource-management-training-a-pilot-study
#10
Sarah Bouhabel, Emily Kay-Rivest, Carol Nhan, Ilana Bank, Peter Nugus, Rachel Fisher, Lily Hp Nguyen
Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors...
June 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#11
MULTICENTER STUDY
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28377943/expert-evaluation-of-a-chicken-tissue-based-model-for-teaching-ultrasound-guided-central-venous-catheter-insertion
#12
Akiva Nachshon, John D Mitchell, Ariel Mueller, Valerie M Banner-Goodspeed, Jakob I McSparron
BACKGROUND: Ultrasound-guided central venous catheterization (CVC) is a commonly performed procedure which carries significant risks for complications. Current models used for simulation-based teaching are expensive and may not replicate tissue feel and ultrasound qualities of human tissues. We aimed to evaluate a tissue model composed of chicken breast and balloons and compare it to a commercially available mannequin. METHODS: Forty attending physicians from four departments with extensive CVC experience were enrolled...
January 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#13
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286528/evaluation-of-a-pilot-project-to-introduce-simulation-based-team-training-to-pediatric-surgery-trauma-room-care
#14
Markus Lehner, Ellen Heimberg, Florian Hoffmann, Oliver Heinzel, Hans-Joachim Kirschner, Martina Heinrich
Introduction. Several studies in pediatric trauma care have demonstrated substantial deficits in both prehospital and emergency department management. Methods. In February 2015 the PAEDSIM collaborative conducted a one and a half day interdisciplinary, simulation based team-training course in a simulated pediatric emergency department. 14 physicians from the medical fields of pediatric surgery, pediatric intensive care and emergency medicine, and anesthesia participated, as well as four pediatric nurses. After a theoretical introduction and familiarization with the simulator, course attendees alternately participated in six simulation scenarios and debriefings...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/28270765/cafedrine-theodrenaline-20-1-is-an-established-alternative-for-the-management-of-arterial-hypotension-in-germany-a-review-based-on-a-systematic-literature-search
#15
REVIEW
Berthold Bein, Torsten Christ, Leopold H J Eberhart
A 20:1 combination of cafedrine:theodrenaline (Akrinor®) is widely used in Germany for the treatment of hypotensive states during anesthesia and in emergency medicine. Although this drug formulation has been available since 1963, there are few studies relating to its use and many of the data are only available in German. In this article, we summarize the available data and propose mechanisms for the effects of cafedrine/theodrenaline on cardiac muscle cells and vascular smooth muscle cells. Cafedrine/theodrenaline leads to a rapid increase in mean arterial pressure that is characterized by increased cardiac preload, stroke volume, and cardiac output...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28042430/experimental-protocol-of-dental-procedures-in-patients-with-hereditary-angioedema-the-role-of-anxiety-and-the-use-of-nitrogen-oxide
#16
A Rosa, M Miranda, R Franco, M G Guarino, A Barlattani, P Bollero
Hereditary angioedema (HAE) is a rare disease, little known to the medical and dental community, but with a growing rate of hospitalization over the years. HAE is due to a deficit/dysfunction of C1 esterase inhibitor which leads to an increase in vascular permeability and the appearance of edemas widespread in all body areas. The airways are the most affected and laryngeal swelling, which can occur, it is dangerous for the patient's life, is also a sensitive spot in our daily practice, therefore, it is also important to be aware of all the signs of this disease...
April 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28017173/femoral-nerve-block-versus-intravenous-fentanyl-in-adult-patients-with-hip-fractures-a-systematic-review
#17
REVIEW
Flávia Vieira Guimarães Hartmann, Maria Rita Carvalho Garbi Novaes, Marta Rodrigues de Carvalho
BACKGROUND: Hip fractures configure an important public health issue and are associated with high mortality taxes and lose of functionality. Hip fractures refer to a fracture occurring between the edge of the femoral head and 5cm below the lesser trochanter. They are common in orthopedic emergencies. The number of proximal femoral fractures is likely to increase as the population ages. The average cost of care during the initial hospitalization for hip fracture can be estimated about US$ 7,000 per patient...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27965560/ketamine-50-years-of-modulating-the-mind
#18
REVIEW
Linda Li, Phillip E Vlisides
Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine's effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal ("top down") distribution...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27896148/plasma-lyte-148-a-clinical-review
#19
Laurence Weinberg, Neil Collins, Kiara Van Mourik, Chong Tan, Rinaldo Bellomo
AIM: To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine. METHODS: We performed an electronic literature search from Medline and PubMed (via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: "surgery", "anaesthesia", "anesthesia", "anesthesiology", "anaesthesiology", "fluids", "fluid therapy", "crystalloid", "saline", "plasma-Lyte", "plasmalyte", "hartmann's", "ringers" "acetate", "gluconate", "malate", "lactate"...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#20
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
February 2017: Journal of Emergency Medicine
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