Current opinion in anaesthesiology
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Although recent census demonstrates that women comprise 50.8% and ethnic minority groups collectively consist of 42.1% of the US population, the field of anesthesiology still demonstrates disparity in representation and health outcomes across race, ethnicity, and gender. In addition, the growing percentage of people that identify as lesbian, gay, bisexual, transgender, and queer (LGBTQ) compounded with limited representation among providers of their care can augment existing disparate outcomes within this community. ⋯ To achieve an optimized quality of healthcare, anesthesiologists and other providers should be a reflection of the communities they serve, including women, people of color, and LGBTQ. In this way, there is an increased likelihood of empathy, effective communication, and insightful perspectives on how to bridge the gap in health equity. A diverse lens is essential to ensure grassroots efforts lead to lasting transformational change.
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Curr Opin Anaesthesiol · Apr 2022
ReviewAirway management in the critically ill patient with COVID-19.
Critically ill Coronavirus disease 2019 (COVID-19) patients needing endotracheal intubation are on the verge of rapid decompensation. The aims of this review were to assess the risks, the preoxygenation, the device and the hemodynamic management of a patient with COVID-19. ⋯ Future trials will better define the role of videolaryngoscopy, apneic oxygenation and mask ventilation during apnea for intubation of COVID-19 patients in ICU. The use of fluid loading and vasopressors remains to be investigated in large randomized controlled studies. Choosing the right time for intubation remains uncertain in clinical practice, and future works will probably help to identify earlier the patients who will need intubation.
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Curr Opin Anaesthesiol · Apr 2022
ReviewSurgical rib fixation in traumatic rib fractures: is it warranted?
Traumatic chest wall injuries and rib fractures remain a prevalent injury. Despite many advances, these injuries result in high morbidity and mortality. Surgical stabilization of rib fractures (SSRF) is increasing in utilization with expanding indications. Recent studies have demonstrated that many patients may benefit from surgical intervention. ⋯ SSRF has become more prevalent with improving outcomes for patients. Understanding the indications will help expand utilization and improve patient outcomes.
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The relationship between trauma and the ongoing global coronavirus 2019 (COVID-19) pandemic is still largely unclear. This comprehensive review of recent studies examining overall trauma volumes, mechanisms of injury, and outcomes after trauma during the COVID-19 pandemic was performed to better understand the impact of the pandemic on trauma patients. ⋯ Consequences of the COVID-19 pandemic include increased financial stressors, job loss, mental illness, and illegal drug use, all of which are known risk factors for trauma. This is particularly true among vulnerable patient populations such as racial minority groups and low socioeconomic status patients. To lessen the impact of COVID-19 on trauma patients, increased awareness of the problem and heightened emphasis on injury prevention must be made.
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Curr Opin Anaesthesiol · Apr 2022
ReviewAirway misadventures in adult critical care: a concise narrative review of managing lost or compromised artificial airways.
Loss or compromise of artificial airways in critically ill adults can lead to serious adverse events, including death. In contrast to primary emergency airway management, the optimal management of such scenarios may not be well defined or appreciated. ⋯ Management of lost or otherwise compromised artificial airways is a key skill set for adult critical care clinicians alongside primary emergency airway management.