The Ochsner journal
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The Ochsner journal · Jan 2012
All the World's a Stage: Integrating Theater and Medicine for Interprofessional Team Building in Physician and Nurse Residency Programs.
To facilitate the delivery of excellent patient care, physician-nurse teams must work in a collaborative manner. We found that venues for the joint training of physician-nurse teams to foster collaboration are insufficient. ⋯ The learners felt the physician-nurse team training experience was exceptionally valuable for its authenticity.
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The Jehovah's Witnesses, a religious group of 7 million people in more than 200 countries, teaches its followers to not accept blood, resulting in potentially challenging and ethical dilemmas for anesthesiologists. In recent years, Jehovah's Witnesses changed certain elements of their approach to blood transfusion practice, including accepting autologous transfusions in certain circumstances. We examine mechanisms to resolve ethical conflicts, such as additional medical consultations with other involved physicians, surgeons, and anesthesiologists; short-term counseling or psychiatric consultation for patient and family; case management conferences; consultation with individuals trained in clinical ethics or a hospital-based ethics committee; and discussions with hospital administration. We also discuss treatment options, including certain blood products, anesthetic techniques, and pharmacological interventions.
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The Ochsner journal · Jan 2012
Presence of anesthesia resident trainees in day surgery unit has mixed effects on operating room efficiency measures.
Three competing goals at academic medical centers are to increase efficiency, to optimize clinical care, and to train residents. The goal of this project was to compare day surgery operating room (OR) efficiency measures for anesthesiologists working alone, working with residents, and working with certified nurse anesthetists in a tertiary multisubspecialty teaching hospital to determine if trainees significantly impact OR efficiency. ⋯ The pairing of anesthesiology residents with anesthesia staff has mixed effects on OR efficiency measures in a day surgery unit.
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The Ochsner journal · Jan 2012
Acute respiratory distress following ultrasound-guided supraclavicular block.
Brachial plexus blocks have become very common for patients undergoing upper extremity surgery. We report a case in which the patient developed ipsilateral phrenic nerve paralysis and acute respiratory failure following supraclavicular nerve block. ⋯ Phrenic nerve injury leading to respiratory distress is a rare complication of supraclavicular brachial plexus block. Anesthesiologists should be ready for emergency intubation when performing this kind of block.
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The Ochsner journal · Jan 2012
Epidural anesthesia for cesarean delivery in a morbidly obese parturient with spinal meningioma.
We report our experience with epidural anesthesia for cesarean section in a morbidly obese parturient with progressive paraplegia from a spinal meningioma. Epidural anesthesia may represent a safe anesthetic choice in such clinical situations.