Anesthesia and analgesia
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The Anesthesia Quality Institute (AQI) was chartered in 2008 by the American Society of Anesthesiologists to develop the National Anesthesia Clinical Outcomes Registry (NACOR). In this Technical Communication, we will describe how data enter NACOR, how they are authenticated, and how they are analyzed and reported. NACOR accepts case-level administrative, clinical, and quality capture data from voluntarily participating anesthesia practices and health care facilities in the United States. ⋯ The database server of AQI, which houses the NACOR database, is protected by 2 firewalls within the American Society of Anesthesiologists' network infrastructure; this system has not been breached. The NACOR Participant User File, a deidentified case-level dataset of information from NACOR, is available to researchers at participating institutions. NACOR architecture and the nature of the Participant User File include both strengths and weaknesses.
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Anesthesia and analgesia · Dec 2015
ReviewThe Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner.
Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remain up-to-date in their clinical realm. ⋯ Cognitive load theory, constructivism, and analogical transfer are concepts particularly beneficial to educators. An understanding of goal orientation, metacognition, retrieval, spaced learning, and deliberate practice will primarily benefit the learner. When these concepts are understood and incorporated into education and study, the effectiveness of learning is significantly improved.
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Anesthesia and analgesia · Dec 2015
Occupational Chronic Sevoflurane Exposure in the Everyday Reality of the Anesthesia Workplace.
Although sevoflurane is one of the most commonly used volatile anesthetics in clinical practice, anesthesiologists are hardly aware of their individual occupational chronic sevoflurane exposure. Therefore, we studied sevoflurane concentrations in the anesthesiologists' breathing zones, depending on the kind of induction for general anesthesia, the used airway device, and the type of airflow system in the operating room. Furthermore, sevoflurane baselines and typical peaks during general anesthesia were determined. ⋯ Anesthesiologists are chronically exposed to trace concentrations of sevoflurane during work. Inhalational inductions, LMA™, and TF air-conditioning systems in particular are associated with higher sevoflurane exposure. However, the amount of inhaled sevoflurane per day was lower than expected, perhaps because concentrations in previous measurements could be overestimated (10%-15%) because of the cross-sensitivity reaction.
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Anesthesia and analgesia · Dec 2015
Editorial CommentCardiac Bulldozers, Backhoes, and Blood Pressure.