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https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#1
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28520886/use-of-an-anaesthesia-workstation-barrier-device-to-decrease-contamination-in-a-simulated-operating-room
#2
S Hunter, D Katz, A Goldberg, H-M Lin, R Pasricha, G Benesh, B Le Grand, S DeMaria
Background.: Strategies to achieve reductions in perioperative infections have focused on hand hygiene among anaesthestists but have been of limited efficacy. We performed a study in a simulated operating room to determine whether a barrier covering the anaesthesia workstation during induction and intubation might reduce the risk of contamination of the area and possibly, by extension, the patient. Methods.: Forty-two attending and resident anaesthetists unaware of the study design were enrolled in individual simulation sessions in which they were asked to induce and intubate a human simulator that had been prepared with fluorescent marker in its oropharynx as a marker of potentially pathogenic bacteria...
May 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510742/drug-safety-in-paediatric-anaesthesia
#3
J Kaufmann, A R Wolf, K Becke, M Laschat, F Wappler, T Engelhardt
Life-threatening drug errors are more common in children than in adults. This is likely to be because of their variations in age and weight, combined with the occasional exposure of most anaesthetists to paediatric patients. Drug administration in anaesthesia is mostly undertaken by a single operator and thus represents a potentially greater risk compared with other areas of medicine. This increased risk is believed to be offset by anaesthetists working with only a limited number of drugs on a very frequent and repetitive basis...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510736/go-no-go-decision-in-anaesthesia-wide-variation-in-risk-tolerance-amongst-anaesthetists
#4
P R Greig, H E Higham, J L Darbyshire, C Vincent
Background: The variability in risk tolerance in medicine is not well understood. Parallels are often drawn between aviation and anaesthesia. The aviation industry is perceived as culturally risk averse, and part of preflight checks involves a decision on whether the flight can operate. This is sometimes termed a go/no-go decision. This questionnaire study was undertaken to explore the equivalent go/no-go decision in anaesthesia. We presented anaesthetists with a range of situations in which additional risk might be expected and asked them to decide whether they would proceed with the case...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey%C3%A2
#5
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
May 12, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28486899/a-survey-of-australian-and-new-zealand-anaesthetists-attitudes-towards-resuscitation-orders-in-the-perioperative-setting
#6
Z Keon-Cohen, P S Myles, D A Story
Not for resuscitation (NFR) orders are often suspended during anaesthesia, as perioperative care is believed to inherently involve the need for resuscitation including ventilation support. Recent legislative changes in Australia, New Zealand and the UK have enacted the binding nature of advance care directives (ACDs) in healthcare. National guidelines regarding codes of practice and government strategic plans for implementing advance care planning have reinforced the role for advance care planning in modern healthcare...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28479877/laparoscopic-uterovaginal-prolapse-surgery-in-the-elderly-feasibility-and-outcomes
#7
Samuel W King, Helen Jefferis, Simon Jackson, Alexander G Marfin, Natalia Price
BACKGROUND: Uterovaginal prolapse in very elderly women is a growing problem due to increased life expectancy. Surgeons and anaesthetists may be wary of performing quality of life surgery on this higher risk group. Where surgery is undertaken, it is commonly performed vaginally; there is a perception that this is better tolerated than abdominal surgery. Little data is published about laparoscopic prolapse surgery tolerability in this population, and laparoscopic surgery is perceived within the urogynaecological community as complex and lengthy and hence inherently unsuitable for the very elderly...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28463875/training-anesthesiologists-in-out-of-operating-room-anesthesia
#8
Karen J Souter, Wil Van Cleve
PURPOSE OF REVIEW: The purpose of this review is to describe recent developments and current trends in training anesthesiologists in out-of-operating room anesthesia (OORA). RECENT FINDINGS: In the United States, the Accreditation Council for Graduate Medical Education recently updated its training requirements to include a mandatory 2-week rotation in OORA for anesthesiology residents. This likely reflects the continuing expansion of anesthesia services in the out-of-operating room (OOR) environment as well as the increasing complexity of OOR procedures and medical acuity of patients in these settings...
April 29, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28439886/lifebox-pulse-oximeter-implementation-in-malawi-evaluation-of-educational-outcomes-and-impact-on-oxygen-desaturation-episodes-during-anaesthesia
#9
V Albert, S Mndolo, E M Harrison, E O'Sullivan, I H Wilson, I A Walker
Pulse oximetry is an essential monitor for safe anaesthesia but is often not available in low-income countries. The aim of this study was to determine whether the introduction of pulse oximetry with training was feasible and could reduce the incidence of oxygen desaturation during anaesthesia in a low-income country. Pulse oximeters were donated, with training, to 83 non-physician anaesthetists in Malawi. Knowledge was tested immediately before and after training and at follow-up. Providers were asked to record the lowest peripheral oxygen saturation (SpO2 ) for the first 100 cases anaesthetised after training...
April 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28437261/training-in-intraoperative-handover-and-display-of-a-checklist-improve-communication-during-transfer-of-care-an-interventional-cohort-study-of-anaesthesia-residents-and-nurse-anaesthetists
#10
Marion Jullia, Anaïs Tronet, Fabiola Fraumar, Vincent Minville, Olivier Fourcade, Xavier Alacoque, Yannick LeManach, Matt M Kurrek
BACKGROUND: Handovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality. OBJECTIVES: We hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room. DESIGN: Interventional cohort study. SETTING: Single-centre tertiary care university hospital. PARTICIPANTS: A total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28429173/a-new-approach-to-local-dco-in-ankle-fracture-dislocations-external-fixation-with-diaphyseal-unicortical-screws-applied-by-local-anaesthesia
#11
F Lavini, T Maluta, G Carpeggiani, C Dall'Oca, E Samaila, G Marconato, B Magnan
PURPOSE: Ankle fracture dislocations represent a great threat for soft tissue viability and articular instability. The use of a temporary ankle bridging ExFix plays a fundamental role in the local damage control orthopaedics while waiting for definitive synthesis. METHODS: For this prospective research, we have developed a full application protocol of innovative diaphyseal monocortical screws fixator (Unyco-Orthofix(TM)) exclusively under local anaesthesia. Rigid selection criteria allowed us to collect nine patients during a period of almost 2 years...
April 20, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28419420/reliability-of-pressure-waveform-analysis-to-determine-correct-epidural-needle-placement-in-labouring-women
#12
I Al-Aamri, S H Derzi, A Moore, M F Elgueta, M Moustafa, T Schricker, D Q Tran
Pressure waveform analysis provides a reliable confirmatory adjunct to the loss-of-resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss-of-resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss-of-resistance)...
April 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28410880/the-effect-of-user-experience-and-inflation-technique-on-endotracheal-tube-cuff-pressure-using-a-feline-airway-simulator
#13
Donna M White, José I Redondo, Alastair R Mair, Fernando Martinez-Taboada
OBJECTIVE: The effect of user experience and inflation technique on endotracheal tube cuff pressure using a feline airway simulator. STUDY DESIGN: Prospective, experimental clinical study. METHODS: Participants included veterinary students at the beginning (group S1) and end (group S2) of their 2-week anaesthesia rotation and veterinary anaesthetists (group A). The feline airway simulator was designed to simulate an average size feline trachea, intubated with a 4...
February 24, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28403414/a-national-survey-of-videolaryngoscopy-in-the-united-kingdom
#14
T M Cook, F E Kelly
Background.: There are increasing numbers of videolaryngoscopes marketed and increasing interest in the technology. The Difficult Airway Society's 2015 guidelines recommend that videolaryngoscopes should be immediately available at all times and that all anaesthetists should be trained and skilled in their use. Methods.: An electronic survey was sent to all UK National Health Service hospitals to examine availability, use, and attitudes to videolaryngoscopy, and closed in January 2014...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28389221/welfare-law-and-ethics-in-the-veterinary-intensive-care-unit-a-discussion-of-the-different-types-of-suffering-that-patients-may-endure-in-the-veterinary-intensive-care-unit-the-legal-limits-to-that-suffering-and-the-ethics-underpinning-at-what-point-that-suffering
#15
REVIEW
Peter S Fordyce
OBJECTIVES: In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28385614/review-of-hypoxaemia-in-anaesthetized-horses-predisposing-factors-consequences-and-management
#16
REVIEW
Adam Auckburally, Görel Nyman
OBJECTIVE: To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. DATABASES USED: Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28384846/absence-of-posterior-triangle-clinical-and-embryological-perspective
#17
Shikha Singh, Puja Chauhan, Hitendra Kumar Loh, Vandana Mehta, Rajesh Kumar Suri
Sternocleidomastoid (SCM) and Trapezius (TM) muscle present in the cervical region serves as an important landmark in forming boundaries of posterior triangle of neck. This case reports a continuous muscle sheet obscuring the left posterior triangle in the neck of a 60-year-old Indian male cadaver. An unfamiliar oval gap was observed in its posterosuperior portion. Description of such a variant in anatomical literature is rare and is scarcely reported. An attempt has been made to portray its embryological and phylogenetic basis...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28376246/non-technical-skills-of-surgeons-and-anaesthetists-in-simulated-operating-theatre-crises
#18
A G Doumouras, M Hamidi, K Lung, C L Tarola, M W Tsao, J W Scott, D S Smink, S Yule
BACKGROUND: Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. METHODS: Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses...
April 4, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28371312/intraoperative-and-postoperative-hyperkalaemia-after-total-parathyroidectomy-following-exposure-to-cinacalcet-in-sixteen-patients-for-renal-hyperparathyroidism
#19
LETTER
G C Chong, J D W Choi, T T Lee, G Carney
No abstract text is available yet for this article.
April 1, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28362426/bispectral-index-monitoring-in-vitrectomy-surgery-under-local-anaesthetic-block-with-sedation-a-single-surgeon-single-anaesthetist-review
#20
A J Porter, L Lee, C Bradshaw
No abstract text is available yet for this article.
March 31, 2017: Eye
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