Current opinion in anaesthesiology
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To explore the collaboration between human factors (HFs) experts and clinicians in order to improve perioperative patient safety. ⋯ Human factors engineering is underutilized worldwide. Patient safety would benefit from collaboration with HF experts to design resilient systems. Healthcare organizations must consider HF to develop and implement user-centered solutions to improve safety for patients and professionals.
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Curr Opin Anaesthesiol · Dec 2024
ReviewMore than pacemakers and defibrillators: perioperative management of implantable devices for patient safety.
The use of implantable medical devices (IMDs) continues to increase with estimates that 10% of the American population will have an IMD in their lifetime. IMDs require special considerations for management in the perioperative period to ensure optimal patient care and patient safety. This review summarizes the current perioperative considerations for IMDs. ⋯ There are very few guidelines regarding the perioperative management of IMDs. Given the significant impact that these devices have on patient care and safety, evidence-based guidelines should be established.
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To assess current practice in the use of spinal anesthesia in major ambulatory surgery, highlighting its advantages over general anesthesia and identifying potential areas for improvement to facilitate a transition to a sustainable healthcare system. ⋯ Spinal anesthesia is an appropriate method for anesthesia in ambulatory patients, offering advantages over general anesthesia in selected populations.The use of spinal anesthesia is expanding to meet surgical needs. Therefore, it is crucial to plan ahead and anticipate organizational failures in the ambulatory setting to maintain safety and efficiency during outpatient procedures and surgeries.
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Curr Opin Anaesthesiol · Dec 2024
ReviewMitigating and preventing perioperative opioid-related harm.
Although necessary for treatment of acute pain, opioids are associated with significant harm in the perioperative period and further intervention is necessary perioperatively to mitigate opioid-related harm. ⋯ We will review policy and guidelines regarding perioperative opioid management and identify challenges and future directions to mitigate opioid-related harm.
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This article explores the unique intersection of the challenges confronting ambulatory anesthesiology education and charts a trajectory forward. The proportion of ambulatory, nonoperating room (NORA), and office-based surgical cases continues to rise; however, the requirements for trainees in these settings have remained static. The rapid evolution of the field combined with a limited workforce also makes continuing education essential, and we discuss the current and future states of ambulatory anesthesia education. ⋯ We begin with an appraisal of the current state of ambulatory anesthesiology training and evaluate the gap between current graduate medical education and trends in ambulatory surgery. We then develop a vision for an ideal state of future ambulatory education for residents as well as anesthesiologists in practice and highlight the priorities necessary to reach this vision.