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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/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#2
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/29200073/decreased-parasympathetic-activity-of-heart-rate-variability-during-anticipation-of-night-duty-in-anesthesiology-residents
#3
Man-Ling Wang, Pei-Lin Lin, Chi-Hsiang Huang, Hui-Hsun Huang
BACKGROUND: In residency programs, it is well known that autonomic regulation is influenced by night duty due to workload stress and sleep deprivation. A less investigated question is the impact on the autonomic nervous system of residents before or when anticipating a night duty shift. In this study, heart rate variability (HRV) was evaluated as a measure of autonomic nervous system regulation. METHODS: Eight residents in the Department of Anesthesiology were recruited, and 5 minutes of electrocardiography were recorded under 3 different conditions: (1) the morning of a regular work day (baseline); (2) the morning before a night duty shift (anticipating the night duty); and (3) the morning after a night duty shift...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29195847/trochanteric-bursitis-following-primary-total-hip-arthroplasty-incidence-predictors-and-treatment
#4
Shai S Shemesh, Calin S Moucha, Aakash Keswani, Nolan A Maher, Darwin Chen, Michael J Bronson
BACKGROUND: Trochanteric bursitis (TB) remains a common complication after total hip arthroplasty (THA), with an incidence between 3% and 17%, depending on the surgical approach, with the posterior approach (PA) being relatively protective compared to the lateral approach. The purposes of this study were to determine the incidence of TB after primary THA, identify potential risk factors for TB, and examine the utility of different modes of treatment. METHODS: Retrospective cohort data of 990 primary THAs performed in a single institution, including 613 PAs and 377 direct anterior approaches (DAAs), were analyzed...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#5
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#6
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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
#7
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/29109642/comparison-of-intra-articular-analgesics-in-arthroscopic-anterior-cruciate-ligament-reconstruction-surgeries-a-randomized-controlled-trial
#8
Vijayalakshmi Sivapurapu, Shishir Suranigi Murugharaj, Sai Saran Panathula Venkata
Background and Aims: Arthroscopic anterior cruciate ligament reconstruction (ACLR) is one of the most common knee surgeries done worldwide today. It involves immense pain at sites of graft harvest, tibial, and femoral tunnels, thereby delaying recovery and increased patient morbidity, and delayed rehabilitation. Various drugs and combination of drugs administered intra-articularly have been studied for analgesic efficacy. Our study gives an insight if there is any added advantage of additives morphine or clonidine to bupivacaine when compared to administering bupivacaine alone...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29101950/use-of-anesthesiology-services-in-radiology
#9
REVIEW
Hansol Kim, Jason Lane, Rolf Schlichter, Michael S Stecker, Richard Taus
In the setting of technological advancements in imaging and intervention with concomitant rise in the use of non-operating room anesthesia (NORA) care, it has become even more critical for anesthesiologists to be aware of the needs and limitations of interventional procedures performed outside of the operating room. This article addresses the use of NORA services from the interventional radiologist's point of view and provides specific examples of preprocedural, intraprocedural, and postprocedural care patients may need for optimal outcome...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29099845/real-time-endoscopic-image-orientation-correction-system-using-an-accelerometer-and-gyrosensor
#10
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/29076431/pharmacology-and-perioperative-considerations-of-pain-medications
#11
Ryan M Chadha, Stephen Aniskevich, Brian J Egan
BACKGROUND: Pain continues to be the most common medical concern, and perioperative health care providers are encountering increasing numbers of patients with chronic pain conditions. It is important to have a clear understanding of how long-term use of pain medications impacts anesthesia during the intraoperative and postoperative periods. OBJECTIVE: To review common medications used to treat chronic pain and summarize current recommendations regarding perioperative care...
October 27, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29076261/informed-consent-in-pediatric-anesthesiology
#12
Katherine R Gentry, Katherine Lepere, Douglas J Opel
BACKGROUND: Informed consent for pediatric anesthesia is unique because it is (1) obtained from surrogates (ie, parents) rather than from the patient and (2) sought after parents have authorized the surgical intervention. There are limited data on how pediatric anesthesia informed and consent discussions are conducted. The purpose of this study was to characterize the content of preanesthesia informed consent discussions and assess their impact on parent recall and understanding. METHODS: We conducted a cross-sectional observational study at a tertiary pediatric hospital...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#13
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29046791/evaluation-of-safety-feasibility-and-the-long-term-outcomes-of-colorectomy-for-colorectal-adenocarcinoma-in-patients-older-than-80-years-of-age
#14
Norio Yukawa, Toru Aoyama, Tsutomu Sato, Takashi Oshima, Takaki Yoshikawa, Yasushi Rino, Munetaka Masuda
The short- and long-term outcomes of colorectomy for colorectal adenocarcinoma have not been fully evaluated in elderly patients. The present retrospective study investigated patients who underwent curative surgery for colorectal cancer at the Department of Surgery, Yokohama City University (Yokohoma, Japan). The patients were categorized into two groups: Elderly patients (70-79 years of age; group A) and extremely elderly patients (≥80 years of age; group B). The rates of surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) in the two groups were compared...
October 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28991114/a-survey-evaluating-burnout-health-status-depression-reported-alcohol-and-substance-use-and-social-support-of-anesthesiologists
#15
Steve Alan Hyman, Matthew S Shotwell, Damon R Michaels, Xue Han, Elizabeth Borg Card, Jennifer L Morse, Matthew B Weinger
BACKGROUND: Burnout affects all medical specialists, and concern about it has become common in today's health care environment. The gold standard of burnout measurement in health care professionals is the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures emotional exhaustion, depersonalization (DP), and personal accomplishment. Besides affecting work quality, burnout is thought to affect health problems, mental health issues, and substance use negatively, although confirmatory data are lacking...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28975073/usefulness-of-ultrasound-view-of-larynx-in-pre-anesthetic-airway-assessment-a-comparison-with-cormack-lehane-classification-during-direct-laryngoscopy
#16
Sussan Soltani Mohammadi, Alireza Saliminia, Nasim Nejatifard, Roxana Azma
BACKGROUND: One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic airway assessments in patients with no prior history of tracheal intubation. Recently, ultrasound has been successfully used for several airway-related applications...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28932497/evaluation-of-amiodarone-versus-metoprolol-in-treating-atrial-fibrillation-after-coronary-artery-bypass-grafting
#17
Alireza Kamali, Amir Sanatkar, Mehrzad Sharifi, Esmaeil Moshir
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia affecting patients in open heart ICU after coronary artery bypass grafting (CABG). Most cardiac surgery textbooks recommend beta blockers as the drug of choice for treating such a condition while many experienced physicians and a number of anesthesiology references offer amiodarone as the drug of choice. Therefore, because of insufficient evidence and the aforementioned controversy, we decided to conduct a study evaluating these two antiarrhythmic medicines...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28930765/encouraging-reflexivity-in-a-residency-leadership-development-program-expanding-outside-the-competency-approach
#18
Justin T Clapp, Emily K B Gordon, Dimitry J Baranov, Beulah Trey, Felice Y Tilin, Lee A Fleisher
PROBLEM: While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28928550/evaluating-the-efficacy-of-tramadol-as-an-adjuvant-to-intrathecal-isobaric-levobupivacaine-for-elective-infraumbilical-surgeries
#19
Dewan Roshan Singh, Hajer Mohamed, N Krishnaveni, Kusha Nag
BACKGROUND: Long-acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia. SETTINGS: Randomized controlled trial was conducted in the Department of Anesthesiology in a tertiary care hospital. AIMS AND OBJECTIVES: The objective of this study was to evaluate the efficacy of low-dose tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28924502/factors-influencing-healthcare-provider-respondent-fatigue-answering-a-globally-administered-in-app-survey
#20
Vikas N O'Reilly-Shah
BACKGROUND: Respondent fatigue, also known as survey fatigue, is a common problem in the collection of survey data. Factors that are known to influence respondent fatigue include survey length, survey topic, question complexity, and open-ended question type. There is a great deal of interest in understanding the drivers of physician survey responsiveness due to the value of information received from these practitioners. With the recent explosion of mobile smartphone technology, it has been possible to obtain survey data from users of mobile applications (apps) on a question-by-question basis...
2017: PeerJ
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