Current opinion in anaesthesiology
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Simulation is frequently cited as the ideal method to improve the training of health care professionals. Studies from specialties such as anesthesia and intensive care report that life-sized mannequins reliably measure acute care skills. Task trainers, such as laparoscopic simulators, effectively improve participants' ability to perform minimally invasive surgery. This review will chart the progress made in defining the role of simulation training in medical education. ⋯ Task trainers are recommended for training physicians for a number of minimally invasive procedures. Life-sized mannequins can be used to train residents to manage a range of critical events in a simulated setting. These exercises train residents to conduct a sequential, logical examination, perform various tasks, interpret clinical findings and use clinical reasoning to resolve the simulated crisis.
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Closed system anaesthesia allows economic use of medical gases and volatile anaesthetics, maintenance of airway climatization and reduction of anaesthetic gas loss into the environment. In this context we reviewed papers addressing recent technical and clinical advances of closed system anaesthesia. ⋯ Modern feedback controlled ventilators allow the application of closed system anaesthesia as a safe and economic technique for routine clinical practice.
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In this review, the most recent and relevant developments in the field of emergence agitation in children, as related to its assessment, etiology, and management, are discussed. ⋯ It is recommended that children at high risk are identified in order to decrease their level of preoperative anxiety, to supplement low-solubility inhalational agents with adjuvant drugs, to prevent postoperative pain and to allow parents to be with their children during recovery from anesthesia.