Anesthesia and analgesia
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Anesthesia and analgesia · Nov 2012
ReviewWhat's new in obstetric anesthesia in 2011? Reducing maternal adverse outcomes and improving obstetric anesthesia quality of care.
This article accompanied the "What's New in Obstetric Anesthesia?" lecture presented at the Society for Obstetric Anesthesia and Perinatology Annual Meeting in May 2012. The invited lecturer reviewed the obstetric, obstetric anesthesiology, perinatology, and key medical literature published in 2011. This review identifies key topics and themes from the 2011 literature relevant to the science and clinical practice of obstetric anesthesiology and the interdisciplinary care of obstetric patients. Specific topics include health care policy issues that affect pregnant women, updated information on maternal mortality and morbidity, and clinical and outcomes-based research related to anesthetic practices for women undergoing cesarean delivery.
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Anesthesia and analgesia · Nov 2012
Randomized Controlled TrialLocal insufflation of warm humidified CO₂increases open wound and core temperature during open colon surgery: a randomized clinical trial.
The open surgical wound is exposed to cold and dry ambient air resulting in heat loss through radiation, evaporation, and convection. Also, general and neuraxial anesthesia decrease the patient's core temperature. Despite routine preventive measures mild intraoperative hypothermia is still common and contributes to postoperative morbidity and mortality. We hypothesized that local insufflation of warm fully humidified CO(2) would increase both the open surgical wound and core temperature. ⋯ Insufflation of warm fully humidified CO(2) in an open surgical wound cavity increases surgical wound and core temperatures and helps to maintain normothermia.
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Anesthesia and analgesia · Nov 2012
Clinical TrialSpeaking up is related to better team performance in simulated anesthesia inductions: an observational study.
Our goal in this study was to test the relationship between speaking up--i.e., questioning, correcting, or clarifying a current procedure--and technical team performance in anesthesia. Hypothesis 1: team members' higher levels of speaking up are related to higher levels of technical team performance. Hypothesis 2: team members will react to speaking up by either clarifying their procedure or initiating a procedural change. Hypothesis 3: higher levels of speaking up during an earlier phase of teamwork will be related to higher levels of speaking up during a later phase. ⋯ This study provides empirical evidence and shows mechanisms for the positive relationship between speaking-up behavior and technical team performance.
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Anesthesia and analgesia · Nov 2012
ReviewCore review: physician-performed ultrasound: the time has come for routine use in acute care medicine.
The use of ultrasound in the acute care specialties of anesthesiology, intensive care, emergency medicine, and surgery has evolved from discrete, office-based echocardiographic examinations to the real-time or point-of-care clinical assessment and interventions. "Goal-focused" transthoracic echocardiography is a limited scope (as compared with comprehensive examination) echocardiographic examination, performed by the treating clinician in acute care medical practice, and is aimed at addressing specific clinical concerns. In the future, the practice of surface ultrasound will be integrated into the everyday clinical practice as ultrasound-assisted examination and ultrasound-guided procedures. ⋯ The key to making ultrasound available to every physician is through education programs designed to facilitate uptake, rather than to prevent access to this technology and education by specialist craft groups. There is evidence that diagnosis is improved with ultrasound examination, yet data showing change in management and improvement in patient outcome are few and an important area for future research.