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https://www.readbyqxmd.com/read/28087958/the-teaching-of-trauma-management-in-undergraduate-medical-education
#1
S K Lum, T Subramaniam
BACKGROUND: The teaching of trauma in medical schools faces many educational and logistic challenges. Issues on what to teach, how to teach, when to teach, who will teach and whether medical students with insufficient exposure to clinical medicine can benefit from a trauma course are unclear. MATERIALS AND METHODS: A well-designed one day intensive trauma course concentrating on the primary survey was taught to semester seven and semester eight students by a multi-disciplinary team comprising of surgeons, anaesthetists, emergency physicians and trained medical officers...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28078374/-anaesthesia-procedures-and-invasive-vascular-access-in-severely-injured-patients-at-trauma-room-admission-in-germany-an-online-survey
#2
M F Struck, P Hilbert-Carius, B Hossfeld, J Hinkelbein, M Bernhard, T Wurmb
BACKGROUND: The continuous monitoring of vital parameters and subsequent therapy belong to the core duties of anaesthetists during acute trauma resuscitation in the trauma room. Important procedures may include placement of arterial lines and central venous catheters (CVCs). Knowledge of indication, performance and localization of invasive catheterisation of trauma care in Germany is scarce. METHODS: After approval of the German Society of Anaesthesiology and Intensive Care Medicine we conducted an online survey about arterial and central venous catheterisation of severely injured patients with consideration of common practice used by anaesthetists in German trauma rooms...
January 11, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28074295/-neuraxial-anaesthesia-and-noacs
#3
T Standl
BACKGROUND: Cardiovascular comorbidities in surgical patients are frequent and have a substantial impact on the postoperative outcome. Neuraxial blockades are able to reduce perioperative morbidity and mortality. The increasing use of new oral anticoagulants (NOAC) requires a high level of attention, especially in patients undergoing neuraxial blockades or requiring postoperative analgesia. OBJECTIVE: The goal of this article is to present the benefit of neuraxial anaesthesia and analgesia in patients with cardiovascular risks and perioperative management of NOAC in this setting...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28072938/welfare-of-anaesthesia-trainees-survey
#4
G B Downey, J M McDonald, R G Downey
This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072935/the-addition-of-tick-boxes-related-to-tobacco-cessation-improves-smoking-related-documentation-in-the-anaesthesia-chart
#5
A Webb, A C Wilson
The Australian and New Zealand College of Anaesthetists (ANZCA) 'Guidelines on Smoking as Related to the Perioperative Period (PS12)' recommends that anaesthetists should always ask about smoking, advise quitting and refer patients to their general practitioner (GP) or a telephone quit-line for quit support. In this study we evaluated the effect of adding tick-boxes for 'quit advice given' and 'referral to GP/Quitline' to anaesthesia charts of elective surgical patients to assess whether this intervention changed documentation of compliance with the ANZCA guideline...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28051046/typhoid-perforation-post-operative-intensive-care-unit-care-and-outcome
#6
Mukaila Oyegbade Akinwale, Arinola A Sanusi, Oluwaseun K Adebayo
BACKGROUND: Typhoid perforation ileitis is a serious complication of typhoid fever, a common and unfortunate health problem in a resource-poor country like Nigeria. Following bowel perforation, treatment is usually by simple closure or bowel resection and anastomosis after adequate aggressive fluid resuscitation and electrolyte correction. Postoperatively, some of these patients do require management in Intensive Care Unit (ICU) on account of sepsis or septic shock and to improve survival...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28044334/monitoring-the-anaesthetist-in-the-operating-theatre-professional-competence-and-patient-safety
#7
REVIEW
J Larsson
This article about competence and patient safety in anaesthesia was inspired by a statement in the 2015 AAGBI guidelines on monitoring during anaesthesia: 'the presence of an appropriately trained and experienced anaesthetist is important for patient safety during anaesthesia'. The review starts with a structured description of competence, presenting five dimensions of it; the first two dimensions are identical with the two classical attributes of competence, practical skills and theoretical knowledge. Concerning skills, the value of aiming for a high level of proficiency early in a traning programme is pointed out, and deliberate practice is given as an example of a pedagogical model where aiming for excellence is a core idea...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28044332/monitoring-teamwork-a-narrative-review
#8
REVIEW
J S Rutherford
A narrative review was carried out to identify articles on monitoring of teamwork, with particular relevance to anaesthetists. The papers reviewed showed that team monitoring takes place both implicitly and explicitly in the anaesthetic environment. No single optimal model of teamwork monitoring for all situations was identified. Most of the studies identified were of a pre-intervention, post-intervention design, without randomisation or control group. Information shared during a formal briefing is more likely to be recalled, and provides a basis for a shared team mental model...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28044328/an-introduction-to-predictive-modelling-of-drug-concentration-in-anaesthesia-monitors
#9
REVIEW
J DeCou, K Johnson
A significant amount of anaesthetists' work involves the prediction of drug effects and interactions to produce a smooth general anaesthetic that minimises drug side effects and promotes rapid emergence. Successfully managing this process requires a basic understanding of drug effects, experience and inevitably some guesswork, since it is difficult (and in some cases impossible) to anticipate all relevant patient and surgical factors. Although data are generally available to allow calculation of plasma drug and effect site concentrations, this is often difficult to apply in complex clinical contexts, particularly when multiple drug types are used...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28039246/safety-of-sedation-for-gastrointestinal-endoscopy-in-a-group-of-university-affiliated-hospitals-a-prospective-cohort-study
#10
K Leslie, M L Allen, E C Hessian, P J Peyton, J Kasza, A Courtney, P A Dhar, J Briedis, S Lee, A R Beeton, D Sayakkarage, S Palanivel, J K Taylor, A J Haughton, C X O'Kane
BACKGROUND: Service models for gastrointestinal endoscopy sedation must be safe, as endoscopy is the most common procedure performed under sedation in many countries. The aim of this prospective cohort study was to determine the patient risk profile, and incidence of and risk factors for significant unplanned events, in adult patients presenting for gastrointestinal endoscopy in a group of university-affiliated hospitals where most sedation is managed by anaesthetists. METHODS: Patients aged ≥18 yr presenting for elective and emergency gastrointestinal endoscopy under anaesthetist-managed sedation at nine hospitals affiliated with the University of Melbourne, Australia, were included...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28039245/chewing-gum-for-the-treatment-of-postoperative-nausea-and-vomiting-a-pilot-randomized-controlled-trial
#11
J N Darvall, M Handscombe, K Leslie
BACKGROUND: A novel treatment, chewing gum, may be non-inferior to ondansetron in inhibiting postoperative nausea and vomiting (PONV) in female patients after laparoscopic or breast surgery. In this pilot study, we tested the feasibility of a large randomized controlled trial. METHODS: We randomized 94 female patients undergoing laparoscopic or breast surgery to ondansetron 4 mg i.v. or chewing gum if PONV was experienced in the postanaesthesia care unit (PACU)...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28032332/deprescribing-implications-for-the-anaesthetist
#12
EDITORIAL
J Hermanowski, N Levy, P Mills, N Penfold
No abstract text is available yet for this article.
December 29, 2016: Anaesthesia
https://www.readbyqxmd.com/read/28030444/impact-of-reversal-strategies-on-the-incidence-of-postoperative-residual-paralysis-after-rocuronium-relaxation-without-neuromuscular-monitoring-a-partially-randomised-placebo-controlled-trial
#13
Réka Nemes, Béla Fülesdi, Adrienn Pongrácz, László Asztalos, Zoltán Szabó-Maák, Szabolcs Lengyel, Edömér Tassonyi
BACKGROUND: Electronic neuromuscular monitoring is not widely used to determine either the reversal requirements for neuromuscular block before extubation of the trachea, or to determine if there is any subsequent postoperative residual neuromuscular block (PORNB). OBJECTIVES: To investigate the incidence of PORNB using acceleromyography after spontaneous recovery of rocuronium-induced block and to compare this with the administration of sugammadex, neostigmine or a placebo...
December 26, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28009731/combining-systems-and-teamwork-approaches-to-enhance-the-effectiveness-of-safety-improvement-interventions-in-surgery-the-safer-delivery-of-surgical-services-s3-program
#14
Peter McCulloch, Lauren Morgan, Steve New, Ken Catchpole, Eleanor Roberston, Mohammed Hadi, Sharon Pickering, Gary Collins, Damian Griffin
IMPORTANCE: Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. OBJECTIVE: To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. DESIGN: Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28007520/spinal-anaesthesia-in-outpatient-and-conventional-surgery-a-point-of-view-from-experienced-french-anaesthetists
#15
Régis Fuzier, Christophe Aveline, Paul Zetlaoui, Olivier Choquet, Hervé Bouaziz
INTRODUCTION: The objective of this investigation was to evaluate the practice of spinal anaesthesia among French anaesthetists in inpatient and outpatient settings. METHODS AND MATERIALS: A questionnaire was sent to members of the French Association of Anaesthetists involved in regional anaesthesia during the first 4 months of 2015. The questionnaire included items on the practice of spinal anaesthesia (type of needle, local anaesthetic available, puncture and disinfection techniques, etc...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27996086/international-consensus-statement-on-the-peri-operative-management-of-anaemia-and-iron-deficiency
#16
M Muñoz, A G Acheson, M Auerbach, M Besser, O Habler, H Kehlet, G M Liumbruno, S Lasocki, P Meybohm, R Rao Baikady, T Richards, A Shander, C So-Osman, D R Spahn, A A Klein
Despite current recommendations on the management of pre-operative anaemia, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in surgical patients. A number of experienced researchers and clinicians took part in an expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the peri-operative period...
December 20, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27981565/a-multicentre-snapshot-study-of-the-incidence-of-serious-procedural-complications-secondary-to-central-venous-catheterisation
#17
R K Lathey, R E Jackson, A Bodenham, D Harper, V Patle
Despite the high number of central venous access devices inserted annually, there are limited data on the incidence of the associated procedural complications, many of which carry substantial clinical risk. This point was highlighted in the recently published Association of Anaesthetists of Great Britain and Ireland 'Safe vascular access 2016' guidelines. This trainee-led snapshot study aimed to identify the number of central venous catheter insertions and the incidence of serious complications across multiple hospital sites within a fixed two-week period...
December 16, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27974973/day-of-surgery-admission-in-total-joint-arthroplasty-why-are-surgeries-cancelled-an-analysis-of-3195-planned-procedures-and-114-cancellations
#18
David M Dalton, Enda G Kelly, Terence P Murphy, Gerry F McCoy, Aaron A Glynn
Background. Day of surgery admission (DOSA) is becoming standard practice as a means of reducing cost in total joint arthroplasty. Aims. The aim of our study was to audit the use of DOSA in a specialty hospital and identify reasons for cancellation. Methods. A retrospective study of patients presenting for hip or knee arthroplasty between 2008 and 2013 was performed. All patients were assessed at the preoperative assessment clinic (PAC). Results. Of 3195 patients deemed fit for surgery, 114 patients (3.5%) had their surgery cancelled...
2016: Advances in Orthopedics
https://www.readbyqxmd.com/read/27974889/regional-anaesthesia-is-associated-with-shorter-postanaesthetic-care-and-less-pain-than-general-anaesthesia-after-upper-extremity-surgery
#19
Sven Grauman, Jakob Boethius, Joakim Johansson
Introduction. For surgery on the upper extremity, the anaesthetist often has a choice between regional anaesthesia (RA) and general anaesthesia (GA). We sought to investigate the possible differences between RA and GA after upper extremity surgery with regard to postoperative patient comfort. Methods. This is a retrospective observational study that was performed at an acute care secondary referral centre. One hundred and eighty-seven procedures involving orthopaedic surgery on the upper extremity were included...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27956679/chronic-postsurgical-pain-in-the-evaluation-of-nitrous-oxide-in-the-gas-mixture-for-anaesthesia-enigma-ii-trial
#20
M T V Chan, P J Peyton, P S Myles, K Leslie, N Buckley, J Kasza, M J Paech, W S Beattie, D I Sessler, A Forbes, S Wallace, Y Chen, Y Tian, W K K Wu
BACKGROUND: Previous animal and clinical studies showed that nitrous oxide may produce long-term analgesia. The aim of this study was to evaluate the effect of nitrous oxide in preventing chronic postsurgical pain. We also explored whether methylenetetrahydrofolate reductase gene polymorphisms (1298A>C, 667C>T) would enhance nitrous oxide analgesia. METHODS: We conducted a telephone interview at 12 months after surgery on 2924 (41.1%) patients enrolled in the Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia-II trial...
December 2016: British Journal of Anaesthesia
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