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https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#1
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29606090/application-of-intraoperative-lung-protective-ventilation-varies-in-accordance-with-the-knowledge-of-anaesthesiologists-a-single-centre-questionnaire-study-and-a-retrospective-observational-study
#2
Seung Hyun Kim, Sungwon Na, Woo Kyung Lee, Hyunwoo Choi, Jeongmin Kim
BACKGROUND: The benefits of lung-protective ventilation (LPV) with a low tidal volume (6 mL/kg of ideal body weight [IBW]), limited plateau pressure (< 28-30 cm H2 O), and appropriate positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome have become apparent and it is now widely adopted in intensive care units. Recently evidence for LPV in general anaesthesia has been accumulated, but it is not yet generally applied by anaesthesiologists in the operating room...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29599968/partial-avulsion-of-the-ulnaris-lateralis-and-enthesiopathy-of-the-lateral-epicondyle-of-the-humerus-in-a-thoroughbred-race-horse
#3
Neal Ashton
Background: There is relatively little literature on elbow disease in the horse. The only published reports on soft tissue conditions describe collateral ligament and biceps brachii injuries. Case presentation: A three-year old Thoroughbred gelding presented with a history of acute onset right forelimb lameness of less than one week duration, one month after commencing training in a National Hunt racing yard. Physical examination and peri-neural anaesthesia failed to localise the lesion...
2018: Irish Veterinary Journal
https://www.readbyqxmd.com/read/29587754/retrograde-intubation-in-a-dog-with-severe-temporomandibular-joint-ankylosis-case-report
#4
Verónica Vieitez, Luis Javier Ezquerra, Víctor López Rámis, Massimo Santella, Ignacio Álvarez Gómez de Segura
BACKGROUND: Orotracheal intubation in dogs is a common and easily-performed procedure that provides a patent airway during anaesthesia. In dogs with temporomandibular joint ankylosis or pseudo-ankylosis, airway management can be a challenging procedure since these dogs have a limited ability to open their mouth. Methods to provide safe, uneventful intubation in such patients may include minimally invasive techniques such as retrograde intubation using a guide wire and fibre-optic-aided laryngoscopy...
March 27, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29557527/the-college-of-anaesthetists-of-ireland-simulation-training-programme-a-descriptive-report-and-analysis-of-course-participants-feedback
#5
Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29547425/are-short-subspecialty-courses-the-educational-answer
#6
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29519263/-handovers-during-anaesthetic-care-can-be-further-improved
#7
A Dahan, L P H J Aarts
In 2005, the Dutch Society of Anaesthesiologists showed that handovers during anaesthetic care increase complication and mortality rates, an observation that has recently been confirmed by a Canadian study. In contrast to surgical care, handovers in anaesthetic care are quite common for various reasons including end of shift, tiredness after night duty, and activities outside the operating centre. The quality of handovers could be improved by training on an anaesthesia simulator, with emphasis on communication, reduction of information loss and using checklists...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29519222/should-ongoing-airway-education-be-a-mandatory-component-of-continuing-professional-development-for-college-of-intensive-care-medicine-fellows
#8
D J Brewster, C P Nickson, J J Gatward, M Staples, F Hawker
This study aimed to determine whether airway education should be introduced to the continuing professional development (CPD) program for College of Intensive Care Medicine (CICM) Fellows. A random representative sample of 11 tertiary intensive care units (ICUs) was chosen from the list of 56 units accredited for 12 or 24 months of CICM training. All specialist intensive care Fellows (n=140) currently practising at the eleven ICUs were sent the questionnaire via email. Questionnaire data collection and post-collection data analysis was used to determine basic respondent demographics, frequency of certain airway procedures in the past 12 months, confidence with advanced airway practices in ICU, participation in airway education in the past three years, knowledge of can't intubate, can't oxygenate (CICO) algorithms, preference for certain airway equipment/techniques, and support for required airway education as a component of the CICM CPD program...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29507873/anaesthesia-in-austere-environments-literature-review-and-considerations-for-future-space-exploration-missions
#9
REVIEW
Matthieu Komorowski, Sarah Fleming, Mala Mawkin, Jochen Hinkelbein
Future space exploration missions will take humans far beyond low Earth orbit and require complete crew autonomy. The ability to provide anaesthesia will be important given the expected risk of severe medical events requiring surgery. Knowledge and experience of such procedures during space missions is currently extremely limited. Austere and isolated environments (such as polar bases or submarines) have been used extensively as test beds for spaceflight to probe hazards, train crews, develop clinical protocols and countermeasures for prospective space missions...
2018: NPJ Microgravity
https://www.readbyqxmd.com/read/29452814/deep-or-awake-removal-of-laryngeal-mask-airway-in-children-at-risk-of-respiratory-adverse-events-undergoing-tonsillectomy-a-randomised-controlled-trial
#10
A Ramgolam, G L Hall, G Zhang, M Hegarty, B S von Ungern-Sternberg
BACKGROUND: Laryngeal mask airways (LMA) are widely used during tonsillectomies. Contrasting evidence exists regarding the timing of the removal and the risk of perioperative respiratory adverse events. We assessed whether the likelihood of perioperative respiratory adverse events is influenced by the timing of LMA removal in children with at least one risk factor for these events. METHODS: Participants (n=290, 0-16 yr) were randomised to have their LMA removed either deep (in theatre by anaesthetist at end-tidal sevoflurane >1 minimum alveolar concentration) or awake (in theatre by anaesthetist or in postanaesthesia care unit by anaesthetist or trained nurse)...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29447711/no-355-physiologic-basis-of-pain-in-labour-and-delivery-an-evidence-based-approach-to-its-management
#11
Julie Bonapace, Guy-Paul Gagné, Nils Chaillet, Raymonde Gagnon, Emmanuelle Hébert, Sarah Buckley
OBJECTIVE: To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. OPTIONS: Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. EVIDENCE: PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29443725/pediatric-anesthesia-after-the-anaesthesia-practice-in-children-observational-trial-study-who-should-do-it
#12
Walid Habre
PURPOSE OF REVIEW: This review highlights the requirements for harmonization of training, certification and continuous professional development and discusses the implications for anesthesia management of children in Europe. RECENT FINDINGS: A large prospective cohort study, Anaesthesia PRactice In Children Observational Trial (APRICOT), revealed a high incidence of perioperative severe critical events and a large variability of anesthesia practice across 33 European countries...
February 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29440478/career-specialty-choices-of-uk-medical-graduates-of-2015-compared-with-earlier-cohorts-questionnaire-surveys
#13
Trevor William Lambert, Fay Smith, Michael J Goldacre
OBJECTIVE: To report the career specialty choices of UK medical graduates of 2015 one year after graduation and to compare these with the choices made at the same postgraduate stage by previous cohorts. DESIGN: National survey using online and postal questionnaires. SETTING: UK. PARTICIPANTS: UK-trained medical graduates. MAIN OUTCOME MEASURES: Grouped and individual specialty choices. RESULTS: The response rate was 41...
February 12, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29437211/an-observational-feasibility-study-of-a-new-anaesthesia-drug-storage-tray
#14
D S Almghairbi, L Sharp, R Griffiths, R Evley, S Gupta, I K Moppett
Drug errors in the anaesthetic domain remain a serious cause of iatrogenic harm. To help reduce this issue, we explored the potential safety impact of using a simple colour-coded tray for anaesthetic drug preparation and storage. Over a six-month period, three different trained researchers observed 30 cases at three NHS Trusts. Ten observations involved standard drug trays in 'normal' practice, and 20 observations, involved 'Rainbow trays' before and after their introduction. We conducted 20 semi-structured interviews immediately after completing the Rainbow tray observation with the anaesthetists involved...
March 2018: Anaesthesia
https://www.readbyqxmd.com/read/29417547/a-mixed-methods-evaluation-of-the-association-of-anaesthetists-of-great-britain-and-ireland-uganda-fellowship-scheme
#15
A Hewitt-Smith, F Bulamba, S Ttendo, K Pappenheim, I A Walker, A F Smith
The Association of Anaesthetists of Great Britain and Ireland and the then Uganda Society of Anaesthesia established the Uganda Fellowship Scheme in 2006, to provide scholarships to encourage doctors to train in anaesthesia in Uganda. We conducted an evaluation of this programme using online questionnaires and face-to-face semi-structured interviews with trainees who received scholarships, as well as with senior surgeons and anaesthetists. Focus group discussions were held to assess changes in attitudes towards anaesthesia over the last 10 years...
February 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29399858/pharmacological-behaviour-support-for-adults-with-intellectual-disabilities-frequency-and-predictors-in-a-national-cross-sectional-survey
#16
C Mac Giolla Phadraig, C Griffiths, P McCallion, M McCarron, E Donnelly-Swift, J Nunn
OBJECTIVE: To report frequency and predictors of reported pharmacological behaviour support use among older adults with intellectual disabilities (ID) accessing dental care in Ireland. METHODS: Data from a nationally representative cross-sectional survey of adults with ID over 40 years of age allowed identification of the reported frequency of pharmacological behaviour support use. Predictors of pharmacological support were identified using multiple logistic regression...
February 5, 2018: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/29397126/universal-videolaryngoscopy-a-structured-approach-to-conversion-to-videolaryngoscopy-for-all-intubations-in-an-anaesthetic-and-intensive-care-department
#17
T M Cook, N J Boniface, C Seller, J Hughes, C Damen, L MacDonald, F E Kelly
BACKGROUND: Videolaryngoscopy (VL) is increasingly used, but not yet routine practice, for tracheal intubation. Few departments formally trial equipment before adopting it into practice. We describe the decision-making and implementation processes that our department used when introducing universal VL, with the C-MAC© (Karl Storz, Germany), throughout our anaesthesia and intensive care departments. METHODS: We used a structured process to assess the feasibility of a change to universal VL...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29392357/thyromental-distance-patil-revisited-knowledge-and-performance-of-a%C3%A2-basic-airway-screening-tool-among-european-anesthetists
#18
H Ilper, A Grossbach, C Franz-Jäger, C Byhahn, M Klages, H H Ackermann, K Zacharowski, T Kunz
Predicting and managing the difficult airway is a lifesaving and vital basic task for the anesthetist. Current guidelines of all important societies include thyromental distance (TMD, "Patil") as a possible predictor for a difficult airway and includes two important aspects for airway management: the mandibular space and the flexibility of the cervical spine. We evaluated knowledge and execution regarding TMD for predicting a difficult airway on participants at the Euroanaesthesia (ESA) congress and German Anaesthesia Congress (DAC) in 2014...
February 1, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29389819/for-beginners-in-anaesthesia-self-training-with-an-audiovisual-checklist-improves-safety-during-anaesthesia-induction-a-prospective-randomised-controlled-two-centre-study
#19
Stefanie Beck, Christian Reich, Dorothea Krause, Bjarne Ruhnke, Anne Daubmann, Jörg Weimann, Christian Zöllner, Jens Kubitz
BACKGROUND: Beginners in residency programmes in anaesthesia are challenged because working environment is complex, and they cannot rely on experience to meet challenges. During this early stage, residents need rules and structures to guide their actions and ensure patient safety. OBJECTIVE: We investigated whether self-training with an electronic audiovisual checklist app on a mobile phone would produce a long-term improvement in the safety-relevant actions during induction of general anaesthesia...
January 31, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29374637/emergency-percutaneous-transtracheal-jet-ventilation-in-a-hypoxic-cardiopulmonary-resuscitation-setting-a-life-saving-rescue-technique
#20
Phi-Vu Dong, Leontien Ter Horst, Ralf Krage
(Un)anticipated difficult airway remains a challenge in anaesthesia. Percutaneous transtracheal jet ventilation has been shown to be an adequate technique for temporary oxygenation and ventilation and has been described as an acknowledged method in emergency settings of an unanticipated difficult airway. These emergency settings can be considered as low incidence high-risk situations. Both technical and non-technical skills should be trained regularly as education and simulation continues to play an important factor in patient safety...
January 26, 2018: BMJ Case Reports
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