Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To compare the self-perceived sleepiness of Canadian anesthesia residents providing modified on-call duties (12-16 h) vs. traditional on-call duties (24 h). ⋯ Many anesthesia residents do exhibit excessive daytime sleepiness, with a similar incidence for those working within either modified or traditional call systems. Our study suggests that sleepiness may be reduced by scheduling on-call duties no more frequently than one in every five nights and by ensuring that residents sleep more than 2 h while on call.
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Review
An evidence-based review of parental presence during anesthesia induction and parent/child anxiety.
The purpose of this evidence-based review was to examine the effect of parental presence during anesthesia induction on parents' and children's anxiety. ⋯ Contrary to popular belief, in most cases parental presence does not appear to alleviate parents' or children's anxiety. In the rare instances when it does seem to diminish parents' or children's anxiety, premedicating children with midazolam has shown to be a viable alternative. Other anxiety-reducing solutions, such as distracting children with video games, should also be considered.
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The success of any research process relies, in part, on how well investigators are able to translate a clinical problem into a research question-a task that is not so simple for novice investigators. The PICOT approach requires that the framing of the research question specify the target Population, the Intervention of interest, the Comparator intervention, key Outcomes, and the Time frame over which the outcomes are assessed. This paper describes the use of the PICOT structure in framing research questions and examines PICOT criteria as applied to the anesthesia literature. We also provide a roadmap for applying the PICOT format in identifying and framing clear research questions. ⋯ The PICOT approach may be helpful in defining and clearly stating the research question. It remains to be determined whether or not compliance with the PICOT style, or any other format for framing research questions, is associated with a higher quality of research reporting.
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Randomized Controlled Trial
Knowledge-based errors in anesthesia: a paired, controlled trial of learning and retention.
Optimizing patient safety by improving the training of physicians is a major challenge of medical education. In this pilot study, we hypothesized that a brief lecture, targeted to rare but potentially dangerous situations, could improve anesthesia practitioners' knowledge levels with significant retention of learning at six months. ⋯ A brief lecture improved knowledge, and the subjects retained a significant amount of this learning at six months. Exposing residents or other practitioners to this type of inexpensive teaching intervention may help them to avoid preventable uncommon errors that are rooted in unfamiliarity with the situation or the equipment. The methods used for this study may also be applied to compare the effect of various other teaching modalities while, at the same time, preserving participant anonymity and making adjustments for ongoing learning.
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To report our experiences regarding the implementation of a combined ultrasound and nerve stimulation guidance technique for supraclavicular blockade in day-case hand surgery patients at our institution. ⋯ We report our successful experience using ultrasound guidance and nerve stimulation during supraclavicular blockade. The curvilinear probe enables a large field of view, adequate resolution in larger patients, and excellent needle visibility that allows access to the plexus while avoiding the pleura and subclavian artery.