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Anaesthesia training

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https://www.readbyqxmd.com/read/28342526/use-of-the-cumulative-sum-method-cusum-to-assess-the-learning-curves-of-ultrasound-guided-continuous-femoral-nerve-block
#1
A Kollmann-Camaiora, N Brogly, E Alsina, F Gilsanz
BACKGROUND: Although ultrasound is a basic competence for anaesthesia residents (AR) there is few data available on the learning process. This prospective observational study aims to assess the learning process of ultrasound-guided continuous femoral nerve block and to determine the number of procedures that a resident would need to perform in order to reach proficiency using the cumulative sum (CUSUM) method. METHODS: We recruited 19 AR without previous experience...
March 22, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28321296/improving-surgical-and-anaesthesia-practice-review-of-the-use-of-the-who-safe-surgery-checklist-in-felege-hiwot-referral-hospital-ethiopia
#2
Ryan Ellis, Ahmad Izzuddin Mohamad Nor, Iona Pimentil, Zebenaye Bitew, Jolene Moore
Development of surgical and anaesthetic care globally has been consistently reported as being inadequate. The Lancet Commission on Global Surgery highlights the need for action to address this deficit. One such action to improve global surgical safety is the introduction of the WHO Surgical Checklist to Operating Rooms (OR) around the world. The checklist has a growing body of evidence supporting its ability to assist in the delivery of safe anaesthesia and surgical care. Here we report the introduction of the Checklist to a major Ethiopian referral hospital and low-resource setting and highlight the success and challenges of its implementation over a one year period...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28293789/development-of-an-ovine-model-for-training-in-vaginal-surgery-for-pelvic-organ-prolapse
#3
A Mansoor, S Curinier, S Campagne-Loiseau, L Platteeuw, B Jacquetin, B Rabischong
INTRODUCTION AND HYPOTHESIS: This aim of this study was to evaluate the feasibility and usefulness of an ovine model for training in vaginal surgery. METHODS: Four senior urogynaecological surgeons and five residents attended five sessions of vaginal surgery for pelvic organ prolapse (POP) in five old multiparous female sheep. Urogynaecological examinations were performed and measurements similar to the POP-Q classification in humans were obtained. Standard POP surgical procedures with and without mesh were performed...
March 14, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28267945/validation-of-a-difficult-endotracheal-intubation-simulator-designed-for-use-in-anaesthesia-training
#4
S Brettig, M Shurgott, S J Quinn, H Owen
There is a need for a validated endotracheal intubation trainer that has variable difficulty settings for the training and assessment of medical practitioners. In this study three anatomical modifications were retrofitted to a commercial manikin and then validated. These modifications included restricted movements of the mandible as well as changes to the upper incisors. A total of 130 participants comprising specialists, trainees and medical students volunteered for this study. Validity was tested using randomised between-groups comparison of the time taken to intubate the manikin on all settings...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28249993/moderate-sedation-in-cardiac-electrophysiology-laboratory-a-retrospective-safety-analysis
#5
V Sawhney, E Bacuetes, M Wray, M Dhinoja, M J Earley, R J Schilling, S Sporton
OBJECTIVE: Cardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study examines the use of a standardised nurse-led physician-directed sedation protocol for EP procedures to determine the safety of moderate sedation administered by non-anaesthesia personnel who have been trained in sedation techniques. METHODS AND RESULTS: Consecutive EP procedures done under moderate sedation over 12 years at our institution were evaluated...
March 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#6
Deep Shah, Aynkaran Dharmarajah
BACKGROUND: Myaesthenia Gravis is an autoimmune disorder that results in increased sensitivity to neuromuscular blockers. Anaesthesia and surgery in patients with Myaesthenia Gravis is associated with an increased incidence of complications, including post operative ventilation. We report the successful use of intra-operative train of four ratio monitoring and Sugammadex to reverse rocuronium induced neuromuscular blockade in an elderly octagenarian with Myaesthenia Gravis undergoing an emergency laporotomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28216703/effects-of-avoiding-neuromuscular-blocking-agents-during-maintenance-of-anaesthesia-on-recovery-characteristics-in-patients-undergoing-craniotomy-for-supratentorial-lesions-a-randomised-controlled-study
#7
Ruchi A Jain, Anita N Shetty, Shrikanta P Oak, Anjana S Wajekar, Madhu B Garasia
BACKGROUND AND AIMS: Neuromuscular blocking agents have been one of the cornerstones of anaesthesia. With the advent of newer surgical, anaesthetic and neurological monitoring techniques, their utility in neuroanaesthesia practice seems dispensable. The aim of this prospective, comparative, randomised study was to determine whether neuromuscular blocking agents are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28205226/an-investigation-into-the-effects-of-real-vs-stimulated-cases-and-level-of-experience-on-the-distribution-of-visual-attention-during-induction-of-general-anaesthesia
#8
T Grundgeiger, C Klöffel, S Mohme, T Wurmb, O Happel
In anaesthesia, patient simulators have been used for training and research. However, insights from simulator-based research may only translate to real settings if the simulation elicits the same behaviour as the real setting. To this end, we investigated the effects of the case (simulated case vs. real case) and experience level (junior vs. senior) on the distribution of visual attention during the induction of general anaesthesia. We recorded eye-tracking data from 12 junior and 12 senior anaesthetists inducing general anaesthesia in a simulation room and in an actual operating room (48 recordings)...
February 16, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28194274/moderate-to-deep-sedation-technique-using-propofol-and-ketamine-allowing-synchronised-breathing-for-magnetic-resonance-high-intensity-focused-ultrasound-mr-hifu-treatment-for-uterine-fibroids-a-pilot-study
#9
Hermanus H B Vaessen, F M Knuttel, J M M van Breugel, M E Ikink, J M Dieleman, M A A J van den Bosch, J T A Knape
BACKGROUND: Magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids is rapidly gaining popularity as a treatment modality. This procedure is generally uncomfortable, painful, and requires minimal or absence of movement and an MR-HIFU synchronised breathing pattern of the patient. Procedural sedation and analgesia protocols have become the standard practice in interventional radiology departments worldwide. The aim of this study was to explore if a sedation regimen with low-dose propofol and ketamine performed by trained non-medical sedation practitioners could result in relief of discomfort for the patient and in adequate working conditions for MR-HIFU treatment for uterine fibroids...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28185260/a-comparison-of-sugammadex-and-neostigmine-for-reversal-of-rocuronium-induced-neuromuscular-blockade-in-children
#10
RANDOMIZED CONTROLLED TRIAL
A S Ammar, K M Mahmoud, Z A Kasemy
BACKGROUND: Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine. METHODS: Sixty paediatric patients aged 2-10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28171853/assessing-nursing-students-knowledge-and-skills-in-performing-venepuncture-and-inserting-peripheral-venous-catheters
#11
C Ahlin, B Klang-Söderkvist, E Johansson, M Björkholm, A Löfmark
Venepuncture and the insertion of peripheral venous catheters are common tasks in health care, and training in these procedures is included in nursing programmes. Evidence of nursing students' knowledge and skills in these procedures is limited. The main aim of this study was to assess nursing students' knowledge and skills when performing venepuncture and inserting peripheral venous catheters. Potential associations between level of knowledge and skills, self-training, self-efficacy, and demographic characteristics were also investigated...
January 27, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28170398/emergency-obstetric-care-in-a-rural-district-of-burundi-what-are-the-surgical-needs
#12
E De Plecker, R Zachariah, A M V Kumar, M Trelles, S Caluwaerts, W van den Boogaard, J Manirampa, K Tayler-Smith, M Manzi, K Nanan-N'zeth, B Duchenne, B Ndelema, W Etienne, P Alders, R Veerman, R Van den Bergh
OBJECTIVES: In a rural district hospital in Burundi offering Emergency Obstetric care-(EmOC), we assessed the a) characteristics of women at risk of, or with an obstetric complication and their types b) the number and type of obstetric surgical procedures and anaesthesia performed c) human resource cadres who performed surgery and anaesthesia and d) hospital exit outcomes. METHODS: A retrospective analysis of EmOC data (2011 and 2012). RESULTS: A total of 6084 women were referred for EmOC of whom 2534(42%) underwent a major surgical procedure while 1345(22%) required a minor procedure (36% women did not require any surgical procedure)...
2017: PloS One
https://www.readbyqxmd.com/read/28159844/military-anaesthesia-in-contingencies-what-skill-sets-are-required-and-how-will-we-prepare-our-trainees
#13
EDITORIAL
Simon J Mercer, C L Jones, J Round, D Parkhouse
The Defence Medical Services are now in an established period of contingency operations. In 2008, the Royal College of Anaesthetists approved a Military Anaesthesia Higher Training Module which could be easily achieved by deploying to the field hospital in Camp Bastion, Afghanistan, for two months under the supervision of a consultant anaesthetist. This opportunity no longer exists but the need to assure quality training and to demonstrate military skill sets is still essential. This article discusses the revised Military Higher Module and how it will be implemented in the future either during deployment or during times of peace...
February 3, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28148321/training-residents-and-fellows-in-paediatric-cardiac-anaesthesia
#14
Dean B Andropoulos
The significant increase in complex anaesthetic care for infants, children, adolescents, and adults with CHD has given rise to specialized fellowship training programs. Specialized paediatric cardiac anaesthesia training for residents and fellows has advanced significantly since the 1970's, when there a handful of programs. With the advent of formal paediatric anaesthesia fellowship programs in the U.S., more specialized training became available in the 1990's and early 2000's. In the past decade, increasing numbers of second year advanced fellowships in paediatric cardiac anaesthesia have been organized; today in North America there are 18 programs with 25 positions...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28148256/defining-reasonable-patient-standard-and-preference-for-shared-decision-making-among-patients-undergoing-anaesthesia-in-singapore
#15
J L J Yek, A K Y Lee, J A D Tan, G Y Lin, T Thamotharampillai, H R Abdullah
BACKGROUND: A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. METHODS: A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28138164/comparison-of-preventive-analgesia-techniques-in-circumcision-cases-dorsal-penile-nerve-block-caudal-block-or-subcutaneous-morphine
#16
Ebru Canakci, Ozgur Yagan, Nilay Tas, Tugce Mutlu, Abdullah Cirakoglu, Erdal Benli
OBJECTIVE: To compare 3 different techniques of preventive analgesia before circumcision operations in male children between 6-12 years of age. Our objective was to investigate the duration and quality of postoperative analgesia in patients, who were subject to caudal block technique, dorsal penile nerve block or who were administered subcutaneous morphine. METHODS: The prospective, randomised, single-blind study was conducted at Ordu University Training and Research Hospital, Ordu, Turkey, from January 1 to June 30, 2015, and comprised boys aged 6-12 years, who were scheduled to undergo circumcision operation...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28125185/knowledge-skills-and-experience-managing-tracheostomy-emergencies-a-survey-of-critical-care-medicine-trainees
#17
A A Nizam, S C Ng, M Kelleher, N Hayes, E Carton
Since the development of percutaneous tracheostomy, the number of tracheostomy patients on hospital wards has increased. Problems associated with adequate tracheostomy care on the wards are well documented, particularly the management of tracheostomy-related emergencies. A survey was conducted among non-consultant hospital doctors (NCHDs) starting their Critical Care Medicine training rotation in a university affiliated teaching hospital to determine their basic knowledge and skills in dealing with tracheostomy emergencies...
October 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28100524/making-robust-assessments-of-specialist-trainees-workplace-performance
#18
J M Weller, D J Castanelli, Y Chen, B Jolly
BACKGROUND: Workplace-based assessments should provide a reliable measure of trainee performance, but have met with mixed success. We proposed that using an entrustability scale, where supervisors scored trainees on the level of supervision required for the case would improve the utility of compulsory mini-clinical evaluation exercise (CEX) assessments in a large anaesthesia training program. METHODS: We analysed mini-CEX scores from all Australian and New Zealand College of Anaesthetists trainees submitted to an online database over a 12-month period...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28072938/welfare-of-anaesthesia-trainees-survey
#19
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/28044334/monitoring-the-anaesthetist-in-the-operating-theatre-professional-competence-and-patient-safety
#20
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
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