Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Jun 2017
ReviewCurrent applications of big data in obstetric anesthesiology.
The narrative review aims to highlight several recently published 'big data' studies pertinent to the field of obstetric anesthesiology. ⋯ 'Big data' research has important implications for obstetric anesthesia care and warrants continued study. Real-time electronic surveillance is a potentially useful application of big data technology on the labor and delivery unit.
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Curr Opin Anaesthesiol · Jun 2017
ReviewAnesthesia in patients with infectious disease caused by multi-drug resistant bacteria.
Up to 50% of specific bacterial strains in healthcare admission facilities are multi-drug resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). ⋯ Discussions regarding the management of potential MDRO carriers must include anesthesia providers to optimize infection control interventions as well as the anesthesia method, the location of surgery and recovery and the details of patient transport. Anesthesia staff must learn to identify patients at risk for MDRO infection. Antibiotic prophylaxis, although not evidence based, should adhere to known best practices. Adjuvant therapies (e.g. intranasal Mupirocin and bathing with antiseptics) should be considered. Addition of nonmanual OR cleaning methods such as ultraviolet irradiation or gaseous decontamination is encouraged. Anesthesiologists must undergo formal training in sterile drug preparation and administration.
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Curr Opin Anaesthesiol · Jun 2017
ReviewMaking the pediatric perioperative surgical home come to life by leveraging existing health information technology.
To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. ⋯ The experience with the PPSH dashboard provides solid evidence for the use of integrated Electronic Health Record to improve patient outcomes and decrease cost.
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The care administered on air ambulances has become increasing complex. This has led to a discussion among experts as to whether air ambulance travel should be manned by physicians. This review provides evidence in support of anaesthesiologists being the physician-leaders in air ambulance medicine, because of their training in advanced airway management, critical care, and resuscitation. ⋯ There are few studies investigating the specific benefit of anaesthesiologists in air ambulance medicine. However, current evidence indicates that their presence does improve patient care and safety. Future studies on this topic should use evidence-based quality indicators and standardized data sets to seek answers to optimal staffing of air ambulance teams.
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There is ongoing controversy surrounding the use of glucose monitoring in the perioperative setting. It is an important aspect of patient care, but the best way to go about monitoring this parameter is still up for debate. This article will review previously established data and new developments in this field. ⋯ The monitoring of blood glucose levels in the perioperative patient remains an important part of patient care; however, debate still exist on how best to reliably measure blood glucose levels in the most effective manner.