Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Dec 2013
ReviewThe changing landscape of anesthesia education: is Flipped Classroom the answer?
Educators in the specialty of anesthesiology are facing a number of challenges. A new generation of residents are entering the specialty and they have unique learning styles and expectations. The new duty hour regulations also encroach on the time available to the residents for education. In the last decade, a number of models for teaching and learning have been proposed to tackle these issues. ⋯ The 'Flipped Classroom' model seems to combine the best of both worlds. It allows the learner to assimilate basic information (lower order cognitive skills) from material that is placed online, allowing asynchronous learning. It frees up the teacher to use the face-to-face interaction time in the operating room and classroom for training the student in advanced concepts (higher order cognitive skills). This model allows efficient and effective use of time and technology, but involves the redesign of how in person time between faculty and residents are spent, along with the faculty development to effectively engage this new type of curriculum.
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Curr Opin Anaesthesiol · Dec 2013
Administrative issues to ensure safe anesthesia care in the office-based setting.
Office-based practice is distinct from other ambulatory practices and has unique considerations for an effective administrative structure to support its operations. ⋯ Office-based practice will continue to evolve with the national emphasis on patient safety, cost reduction, value-based care, and outcomes measurement and reporting. Each practice must comply with the state and national regulations that could limit the types of procedures being performed and who can administer sedation or anesthesia, and require the facility to be accredited by a nationally recognized accrediting agency.
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Curr Opin Anaesthesiol · Dec 2013
ReviewThe patient with a history of congenital heart disease who is to undergo ambulatory surgery.
There is a strong pressure to widen the indications of ambulatory anaesthesia in children. Making a decision concerning a child with a history of cardiac disease is often difficult. The aim of this review is to give practical recommendations to help the anaesthesiologist recognize potentially dangerous situations in children with a history of cardiac disease. ⋯ A child whose cardiac disease has been corrected, who is developing well, has no exercise restriction and undergoes regular cardiologic follow-up does not present more risks than any normal American Society of Anesthesiologists physical status 1-2 child. Any other situation requires close communication with the child's paediatric cardiologist to evaluate the risks of both anaesthesia and outpatient care, and make an individualized decision accordingly.
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Curr Opin Anaesthesiol · Oct 2013
ReviewAssessment and management of rib fracture pain in geriatric population: an ode to old age.
Pain management for traumatic rib fractures has been described in literature, but there is paucity of data when it comes to acute pain management in the elderly, let alone pain resulting from traumatic rib fractures. ⋯ The goal is to devise a proper pain management regimen for geriatric patients with rib fractures to decrease the morbidity and mortality associated with it. Developing institutional protocols is one step forward towards quality care for such patients.