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81 papers 25 to 100 followers
Rhona Flin, Nikki Maran
In this paper, we explain the conceptual background to non-technical skills and show how they can influence job performance in anaesthesia. We then describe the taxonomy of anaesthetists' non-technical skills (ANTS) and related systems, such as ANTS-AP for anaesthetic practitioners. We discuss the training courses that have been designed to teach these non-technical skills, which are called crew resource management (CRM), crisis resource management (CRM) or crisis avoidance resource management (CARMA). Finally, we discuss the application of non-technical skills assessment systems...
March 2015: Best Practice & Research. Clinical Anaesthesiology
Jonathan Ilicki
BACKGROUND: Digital nerve blocks are commonly performed in emergency departments. Health care practitioners are often taught to avoid performing blocks with epinephrine due to a risk of digital necrosis. OBJECTIVE: To review the literature on the safety of epinephrine 1:100,000-200,000 (5-10 μg/mL) with local anesthetics in digital nerve blocks in healthy patients and in patients with risk for poor peripheral circulation. METHODS: PubMed, Web of Science, and the Cochrane Library were searched in June 2014 using the query "digital block AND epinephrine OR digital block AND adrenaline"...
November 2015: Journal of Emergency Medicine
Koen G Lapage, Patrick F Wouters
PURPOSE OF REVIEW: General recommendations for the perioperative management of patients with hypertensive disease have not evolved much over the past 20 years, yet new pathophysiological concepts have emerged and new monitoring techniques are available today. In this review, we will discuss their significance and potential role in the modern perioperative care of hypertensive patients. RECENT FINDINGS: For hypertensive patients, total cardiovascular risk rather than blood pressure (BP) alone should determine the preoperative strategy...
June 2016: Current Opinion in Anaesthesiology
M Soledad Cepeda, Aikaterini Tzortzopoulou, Michael Thackrey, Jana Hudcova, Preeti Arora Gandhi, Roman Schumann
BACKGROUND: Lidocaine administration produces pain due to its acidic pH. OBJECTIVES: The objective of this review was to determine if adjusting the pH of lidocaine had any effect on pain resulting from non-intravascular injections in adults and children. We tested the hypothesis that adjusting the pH of lidocaine solution to a level closer to the physiologic pH reduces this pain. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, to June 2010); Ovid MEDLINE (1966 to June 2010); EMBASE (1988 to June 2010); LILACS (1982 to June 2010); CINAHL (1982 to June 2010); ISI Web of Science (1999 to June 2010); and abstracts of the meetings of the American Society of Anesthesiologists (ASA)...
December 8, 2010: Cochrane Database of Systematic Reviews
W J Stept, P Safar
No abstract text is available yet for this article.
July 1970: Anesthesia and Analgesia
James H Abernathy, Scott T Reeves
PURPOSE OF REVIEW: The article reviews the epidemiology of airway injuries, airway anatomy, techniques for airway management, helpful pharmacologic adjuncts and finally alternatives to airway manipulation. RECENT FINDINGS: Principles of airway management including the maintenance of spontaneous ventilation and careful and adequate preparation for an alternative plan will always be important. Advances in pharmacologic agents provide a safer, more controlled environment through which the patient's compromised airway can be controlled...
February 2010: Current Opinion in Anaesthesiology
Ivan S Y Chua, S L Chong, Gene Y K Ong
STUDY OBJECTIVES: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. METHODS: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block...
October 16, 2017: Injury
Victoria A Bennett, Maurizio Cecconi
Perioperative fluid management is a key component in the care of the surgical patient. It is an area that has seen significant changes and developments, however there remains a wide disparity in practice between clinicians. Historically, patients received large volumes of intravenous fluids perioperatively. The concept of goal directed therapy was then introduced, with the early studies showing significant improvements in morbidity and mortality. The current focus is on fluid therapy guided by an individual patient's physiology...
August 2017: Indian Journal of Anaesthesia
Guy A Dumont, J Mark Ansermino
Feedback control is ubiquitous in nature and engineering and has revolutionized safety in fields from space travel to the automobile. In anesthesia, automated feedback control holds the promise of limiting the effects on performance of individual patient variability, optimizing the workload of the anesthesiologist, increasing the time spent in a more desirable clinical state, and ultimately improving the safety and quality of anesthesia care. The benefits of control systems will not be realized without widespread support from the health care team in close collaboration with industrial partners...
November 2013: Anesthesia and Analgesia
C G Sheahan, D M Mathews
Sedation for medical procedures is provided in a variety of clinical settings by medical personnel with differing levels of education and training. Although generally a safe practice, there is a degree of morbidity and mortality associated with sedation practice. Monitoring standards continue to be refined by professional societies with the goal of improving care. The depth of sedation should be monitored with clinical criteria. Processed electroencephalographic monitors currently do not contribute significantly to sedation care...
December 2014: British Journal of Anaesthesia
Ki Jinn Chin, John G McDonnell, Brendan Carvalho, Aidan Sharkey, Amit Pawa, Jeffrey Gadsden
Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings...
March 2017: Regional Anesthesia and Pain Medicine
Pamela J Lyons, Ryan M Rivosecchi, Jose P Nery, Sandra L Kane-Gill
There are safety concerns with the use of fentanyl, including respiratory depression, nausea, constipation, and possibly opioid-induced hyperalgesia (OIH). The purpose of this review is to evaluate the occurrence and significance of opioid-induced hyperalgesia (OIH) after acute fentanyl exposure. A literature search was conducted from October 1995 through January 2015 using MEDLINE, Embase, and Scopus with the terms hyperalgesia, fentanyl, pronociceptive, acute tolerance, and acute. Published articles evaluating the adverse effects of fentanyl during acute pain management (≤96 hours) in humans were included...
June 2015: Journal of Pain & Palliative Care Pharmacotherapy
Steffen T Simon, Peyla Köskeroglu, Jan Gaertner, Raymond Voltz
CONTEXT: Fentanyl is a potent opioid that has been proven to provide effective treatment for breakthrough cancer pain. Although opioids are the only drug group with evidence for the symptomatic treatment of breathlessness, evidence about the efficacy of fentanyl for the relief of breathlessness is unknown. OBJECTIVES: We performed a systematic review to evaluate the current evidence for the use of fentanyl for the relief of breathlessness. METHODS: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendation for systematic reviews...
December 2013: Journal of Pain and Symptom Management
Ki Jinn Chin, Natalie W Y Wong, Alan James Robert Macfarlane, Vincent W S Chan
BACKGROUND AND OBJECTIVES: Ultrasound-guided (USG) ankle block has been described; however, its clinical efficacy compared with conventional anatomic landmark-guided (ALG) techniques remains undetermined. METHODS: We performed a 6-year retrospective cohort study of all ankle blocks performed for foot surgery and extracted demographic, intraoperative, and postoperative outcome data. We divided blocks into 2 groups for comparison, depending on whether they were performed using an ALG technique or a USG technique...
November 2011: Regional Anesthesia and Pain Medicine
Sheridan M Hoy, Gillian M Keating
Dexmedetomidine (Precedex®), a pharmacologically active dextroisomer of medetomidine, is a selective α(2)-adrenergic receptor agonist. It is indicated in the US for the sedation of mechanically ventilated adult patients in an intensive care setting and in non-intubated adult patients prior to and/or during surgical and other procedures. This article reviews the pharmacological properties, therapeutic efficacy and tolerability of dexmedetomidine in randomized, double-blind, placebo-controlled, multicentre studies in these indications...
July 30, 2011: Drugs
Brett Doleman, Matthew Sherwin, Jonathan N Lund, John P Williams
PURPOSE: Endotracheal intubation is the gold standard for securing the airway before surgery. Nevertheless, this procedure can produce an activation of the sympathetic nervous system and result in a hemodynamic response which, in high-risk patients, may lead to cardiovascular instability and myocardial ischemia. The aim of this review was to evaluate whether gabapentin can attenuate this response and whether such an attenuation could translate into reduced myocardial ischemia and mortality...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Joanna L Stollings, Daniel A Diedrich, Lance J Oyen, Daniel R Brown
OBJECTIVE: To summarize published data regarding the steps of rapid-sequence intubation (RSI); review premedications, induction agents, neuromuscular blockers (NMB), and studies supporting use or avoidance; and discuss the benefits and deficits of combinations of induction agents and NMBs used when drug shortages occur. DATA SOURCE: A search of Medline databases (1966-October 2013) was conducted. STUDY SELECTION AND DATA EXTRACTION: Databases were searched using the terms rapid-sequence intubation, fentanyl, midazolam, atropine, lidocaine, phenylephrine, ketamine, propofol, etomidate thiopental, succinylcholine, vecuronium, atracurium, and rocuronium...
January 2014: Annals of Pharmacotherapy
W C Bowman
Descriptions of the South American arrow poisons known as curares were reported by explorers in the 16th century, and their site of action in producing neuromuscular block was determined by Claude Bernard in the mid-19th century. Tubocurarine, the most important curare alkaloid, played a large part in experiments to determine the role of acetylcholine in neuromuscular transmission, but it was not until after 1943 that neuromuscular blocking drugs became established as muscle relaxants for use during surgical anaesthesia...
January 2006: British Journal of Pharmacology
Scott D Weingart
No abstract text is available yet for this article.
November 2016: Annals of Emergency Medicine
Jarrod M Mosier, Cameron D Hypes, John C Sakles
No abstract text is available yet for this article.
February 2017: Intensive Care Medicine
2017-08-20 03:59:58
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