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Defining and developing expertise in tracheal intubation using a GlideScope® for anaesthetists with expertise in Macintosh direct laryngoscopy: An in-vivo longitudinal study | Although videolaryngoscopy can provide excellent views of the laryngeal structures as both the primary method of tracheal intubation and as a rescue technique for difficult direct laryngoscopy, the existing literature is inadequate to define expertise or even competence. We observed the performance of nine trainees dur... |
America's Opioid Epidemic: Supply and Demand Considerations | America is in the midst of an opioid epidemic characterized by aggressive prescribing practices, highly prevalent opioid misuse, and rising rates of prescription and illicit opioid overdose-related deaths. Medical and lay public sentiment have become more cautious with respect to prescription opioid use in the past few... |
Mothers of Africa - An anaesthesia charity | An anaesthetic charity 'Mothers of Africa' has been established as a link between the academic departments of anaesthesia in Togo and Benin and the University Hospital of Wales. Visits by UK consultant anaesthetists have identified a number of clinical areas where collaborative working in both classroom and theatre has... |
Learning to apply effective cricoid pressure using a part task trainer | An anatomically-correct model of a larynx inside a head and neck model was constructed so that the location, direction and amount of force applied to the neck could be measured. Fifty trained staff from three general hospitals were then asked to apply cricoid pressure on the model. None was able to state the force that... |
Remote monitoring using an induction loop | An electromagnetic induction loop is used to transmit signals from a pulse and respiration monitor to a standard National Health Service hearing aid to facilitate remote monitoring Copyright © 1986, Wiley Blackwell. All rights reserved |
The perioperative care of the transgender patient | An estimated 25 million people identify as transgender worldwide, approximately 1 million of whom reside in the United States. The increasing visibility and acceptance of transgender people makes it likely that they will present in general surgical settings; therefore, perioperative health care providers must develop t... |
Endotracheal intubation training using a simulator: An evaluation of the laerdal adult intubation model in the teaching of endotracheal intubation | An evaluation of a human adult simulator for teaching endotracheal intubation is described. An observation study on the training of medical students is presented which shows that while the simulator is not ideally representative of the human anatomy, it is nevertheless a useful device for the teaching of this vital man... |
Morbidity and early retirement among anaesthetists and other specialists | An historically prospective study of the rates of early retirement due to permanent ill health, early retirement between 60 and 64 years of age for other reasons, and deaths while in post, among consultant anaesthetists in England was carried out. The control group comprised consultants in four other hospital specialty... |
Anesthesia for cardiac surgery in patients receiving monoamine oxidase inhibitors | An increase in the number of patients receiving MAOI is likely to be seen in the clinical practice of anesthesiology. This report suggests that patients receiving MAOI may be safely anesthetized for major surgical procedures. Appropriate monitoring and preparation may obviate the need for withdrawal of MAOI prior to su... |
Fostering belonging in academic anaesthesiology: faculty and department chair perspectives on supporting women anaesthesiologists | An increasing number of global initiatives aim to address the disconnection between the increasing number of women entering medicine and the persistence of gender imbalance in the physician anaesthesiologist workforce. This commentary complements the global movement's efforts to increase women's representation in acade... |
Assessment of an interactive learning system with 'sensorized' manikin head for airway management instruction | An interactive, self-study learning system for airway management instruction that utilizes a 'sensorized' manikin head (Actronics Inc., Pittsburgh, PA) was compared to didactic instruction from anesthesiologists during third-year medical student anesthesia rotations. Before students were allowed to participate in airwa... |
Handover of responsibility for the anaesthetised patient - Opinion and practice | Anaesthesia is a critical and complex process that extends from the pre-operative assessment through to the postoperative management of patients. Handover of responsibility for logistical as opposed to patient-orientated reasons may compromise that process of care. If such handover becomes inevitable with shift-based p... |
Critical incident reports concerning anaesthetic equipment: Analysis of the UK National Reporting and Learning System (NRLS) data from 2006-2008 | Anaesthetic equipment plays a central role in anaesthetic practice but brings the potential for malfunction or misuse. We aimed to explore the national picture by reviewing patient safety incidents relating to anaesthetic equipment from the National Reporting and Learning System for England and Wales between 2006 and 2... |
Anaesthesia equipment malfunction | Anaesthetic equipment was studied to determine whether the accuracy was improved and failure rate decreased by routine maintenance and calibration by a biomedical technician. Each piece was evaluated, and then repaired and rechecked at intervals by the same technician. Equipment failures were divided into three types: ... |
Age‐dependent haematological disturbances in anaesthetic personnel chronically exposed to high occupational concentrations of halothane and nitrous oxide | Anaesthetic staff chronically exposed to high occupational concentrations of halothane and nitrous oxide were tested for numerous haematological and cellular function parameters at the peak of the working season and after 3 weeks vacation. The analysis of data was performed to compare differences in subjects younger an... |
Magnetic resonance for the anaesthetist: Part I: physical principles, applications, safety aspects | Anaesthetists are being increasingly involved in magnetic resonance (MR) procedures, both in patient care and as a research tool. This paper outlines the physical basis of nuclear magnetic resonance and describes its application in magnetic resonance imaging and spectroscopy. Principles of magnet design and safety rele... |
Magnetic resonance for the anaesthetist: Part II: anaesthesia and monitoring in MR units | Anaesthetists are increasingly involved in patient care during magnetic resonance imaging and spectroscopy. This paper describes a system which has been developed for the management of critically ill patients and the conduct of anaesthesia in a magnetic resonance unit with a 1.6 tesla whole body magnet. Difficulties wh... |
Substance use disorder in the anaesthetist: Guidelines from the Association of Anaesthetists | Anaesthetists have a higher incidence of substance use disorder when compared with other doctors. This might be due to the ease of access to intravenous opioids, propofol, midazolam, inhalational agents and other anaesthetic drugs. Alcohol use disorder continues to be the most common problem. Unfortunately, the first s... |
The impact of continuous pulse oximetry monitoring on intensive care unit admissions from a postsurgical care floor | Anesthesia and Cardiopulmonary Services, University Health Systems East; Department of Anesthesiology, University of Pennsylvania, Philadelphia, Pennsylvania Continuous pulse oximetry (CPOX) has the potential to increase vigilance and decrease pulmonary complications and thus decrease intensive care unit (ICU) admissio... |
Radiation exposure to anesthesia personnel: The impact of an electrophysiology laboratory | Anesthesia care providers are vulnerable to radiation exposure during a number of diagnostic and therapeutic procedures. In this study I examined the radiation exposure to members of a small department of anesthesiology. The aggregate radiation exposure to all members of the department doubled subsequent to the introdu... |
Anesthesia development in Mongolia: Strengthening anesthesia practice in Mongolia through education and continuing professional development | Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances ... |
Anesthesia information management system implementation: A practical guide | Anesthesia Information Management Systems (AIMS) display and archive perioperative physiological data and patient information. Although currently in limited use, the potential benefits of an AIMS with regard to enhancement of patient safety, clinical effectiveness and quality improvement, charge capture and professiona... |
Anesthesia information management systems | Anesthesia information management systems (AIMS) have evolved from simple, automated intraoperative record keepers in a select few institutions to widely adopted, sophisticated hardware and software solutions that are integrated into a hospital's electronic health record system and used to manage and document a patient... |
Percutaneous injuries in anesthesia personnel | Anesthesia personnel are at risk for occupationally acquired blood- borne infections from human immunodeficiency virus, hepatitis viruses, and others after percutaneous exposures to infected blood or body fluids. The risk is greater after an infected, blood-contaminated, percutaneous injury, especially from a hollow-bo... |
The use of needles in the practice of anesthesiology and the effect of a needleless intravenous administration system | Anesthesia personnel are at risk for occupationally acquired blood-borne infections transmitted through needlestick injuries. To formulate strategies for the prevention of needlestick injuries, it is necessary to identify the types of needles used by anesthesia personnel and the devices associated with injuries. The in... |
Teaching neuraxial anesthesia techniques for obstetric care in a ghanaian referral hospital: Achievements and obstacles | Anesthesia providers in low-income countries may infrequently provide regional anesthesia techniques for obstetrics due to insufficient training and supplies, limited manpower, and a lack of perceived need. In 2007, Kybele, Inc. began a 5-year collaboration in Ghana to improve obstetric anesthesia services. A program w... |
Repeated measures designs and analysis of longitudinal data: If at first you do not succeed-try, try again | Anesthesia, critical care, perioperative, and pain research often involves study designs in which the same outcome variable is repeatedly measured or observed over time on the same patients. Such repeatedly measured data are referred to as longitudinal data, and longitudinal study designs are commonly used to investiga... |
Should we reevaluate the variables for predicting the difficult airway in anesthesiology? | Anesthesiologists have often been confronted with the difficult question of determining which patient will present an increased difficulty for endotracheal intubation. The limits of the previously reported morphometric airway measurements for predicting difficult intubation have inadequately addressed the normal patien... |
Analysis of variance of communication latencies in anesthesia: Comparing means of multiple log-normal distributions | Anesthesiologists rely on communication over periods of minutes. The analysis of latencies between when messages are sent and responses obtained is an essential component of practical and regulatory assessment of clinical and managerial decision-support systems. Latency data including times for anesthesia providers to ... |
'Do Not Resuscitate' (DNR) orders and the anesthesiologist: A survey | Anesthesiologists were surveyed to determine their experience and opinions regarding 'Do Not Resuscitate' (DNR) orders in the perioperative period. Four hundred fifteen questionnaires were mailed and 193 (47%) were returned. One hundred sixty-one (87%) of 186 respondents had been requested to provide (and more than two... |
Achieving Greater Health Equity: An Opportunity for Anesthesiology | Anesthesiology and anesthesiologists have a tremendous opportunity and responsibility to eliminate health disparities and to achieve health equity. We thus examine health disparity and health equity through the lens of anesthesiology and the perspective of anesthesiologists. In this paper, we define health disparity an... |
Anesthesiology critical care medicine fellowship training | Anesthesiology critical care medicine (ACCM) fellowship training was accredited in 1989, and a small number of graduating anesthesiology residents pursue this additional training. Considering the flexible program guidelines of the American Board of Anesthesiology (ABA), we hypothesized that ACCM fellowship training pro... |
Increasing the value of time reduces the lost economic opportunity of caring for surgeries of longer-than-average times | Anesthesiology groups that provide care for surgical procedures of longer-than-average duration are economically disadvantaged by both increased staffing costs and reduced revenue. Under the current billing system, anesthesia time is valued the same regardless of the total case duration. In this study, we evaluated the... |
Outpatient evaluation: a new role for the anesthesiologist | Anesthesiology, although still a relatively young specialty, is expanding beyond the operating room. The author reports material savings in many areas through presurgical interviews in the outpatient department by anesthesiologists. |
Provider Education and Vaporizer Labeling Lead to Reduced Anesthetic Agent Purchasing with Cost Savings and Reduced Greenhouse Gas Emissions | Anesthetic agents are known greenhouse gases with hundreds to thousands of times the global warming impact compared with carbon dioxide. We sought to mitigate the negative environmental and financial impacts of our practice in the perioperative setting through multidisciplinary staff engagement and provider education o... |
Preoperative pregnancy testing in adolescents | Anesthetics and other drugs used during the perioperative period may have teratogenic or abortive effects. The pregnancy status of surgical patients is often unknown. This investigation examined retrospectively the results of 2 yr of mandatory pregnancy testing in 412 adolescent surgical patients. The overall incidence... |
Multicentre randomised trials in anaesthesia: an analysis using Bayesian metrics | Are the results of randomised trials reliable and are p values and confidence intervals the best way of quantifying efficacy? Low power is common in medical research, which reduces the probability of obtaining a ‘significant result’ and declaring the intervention had an effect. Metrics derived from Bayesian methods may... |
Science Without Conscience Is but the Ruin of the Soul: The Ethics of Big Data and Artificial Intelligence in Perioperative Medicine | Artificial intelligence-driven anesthesiology and perioperative care may just be around the corner. However, its promises of improved safety and patient outcomes can only become a reality if we take the time to examine its technical, ethical, and moral implications. The aim of perioperative medicine is to diagnose, tre... |
A national survey (NAP5-Ireland baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in Ireland | As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant anaesthetist in each of 46 public hospitals in Ireland, represented ... |
A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK | As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant and staff and associate specialist anaesthetist in the UK. The surve... |
100 Years of Pediatric Anesthesia With Anesthesia & Analgesia: Growing Together | As the practice of pediatric anesthesiology grew in the early 20th century, Anesthesia & Analgesia (A&A) became the most important practical resource of pediatric fundamentals for general anesthesiologists. With continued growth in the mid-20th century, focus then shifted to complex cases performed by dedicated pediatr... |
Teaching anesthesia motor skills by review of videotaped performances | As with various areas of training, from sports to surgery, anesthesia motor skills are being taught by films and videotapes. Group comparisons and critiques stimulate interest and enthusiastic acceptance by trainees. |
Assessing the learning needs of college tutors in anaesthesia: Proposals for an introductory learning package | At present there is no nationwide formal training course at which college tutors in anaesthesia can develop the specific skills required to perform their important role effectively. The purpose of this study was to ascertain whether there is a need for an introductory learning package for college tutors and if so, what... |
Anesthesia and World War II: When the Battlefield Becomes a Research Field - A Bibliometric Analysis of the Influence of World War II on the Development of Anesthesiology | At the outbreak of World War II (WWII), anesthesiology was struggling to establish itself as a medical specialty. The battlefield abruptly exposed this young specialty to the formidable challenge of mass casualties, with an urgent need to provide proper fluid resuscitation, airway management, mechanical ventilation, an... |
Anaesthetists' attitudes to parental presence at induction of general anaesthesia in children | Attitudes of anaesthetists of various grades working in different types of hospital in England and Wales, to parental presence in the anaesthetic room during induction of anaesthesia in children were assessed by means of a postal questionnaire. Of the 300 questionnaires sent out, 244 (82%) were completed. The majority ... |
Availability of anesthesia equipment in Chinese hospitals: Is the safety of anesthesia patient care assured? | Availability of physiologic monitoring equipment to ensure the safe administration of anesthesia is an expected standard in many parts of the world. Many hospitals in China may not have an adequate quantity and variety of anesthesia delivery and patient monitoring equipment to assure safe administration of anesthesia p... |
Surgicric 2: A comparative bench study with two established emergency cricothyroidotomy techniques in a porcine model | Background 'Can't Intubate, Can't Oxygenate' is a rare but life threatening event. Anaesthetists must be trained and have appropriate equipment available for this. The ideal equipment is a topic of ongoing debate. To date cricothyroidotomy training for anaesthetists has concentrated on cannula techniques. However cases... |
Teicoplanin allergy - An emerging problem in the anaesthetic allergy clinic | Background Anaphylaxis to teicoplanin appears to be extremely rare, with only one confirmed case report worldwide. Two anaesthetic allergy clinics in the UK have received a number of suspected cases referred for investigation, and we present here the first case series of teicoplanin allergy. Methods We investigated 20 ... |
An instrument designed for faculty supervision evaluation by anesthesia residents and its psychometric properties | BACKGROUND AND OBJECTIVES:: We aimed 1) to develop a valid and reliable instrument for faculty supervision evaluation by anesthesia residents and 2) to disclose the sources of error in residents' ratings. METHODS:: A qualitative study involving residents and faculty identified constructs of supervisory ability, which w... |
Intraoperative arterial blood pressure lability is associated with improved 30 day survival | Background Arterial blood pressure lability, defined as rapid changes in arterial blood pressure, occurs commonly during anaesthesia. It is believed that hypertensive patients exhibit more lability during surgery and that lability is associated with poorer outcomes. Neither association has been rigorously tested. We hy... |
Using educational video to enhance protocol adherence for medical procedures | Background Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an inst... |
SmartPilot ® view-guided anaesthesia improves postoperative outcomes in hip fracture surgery: A randomized blinded controlled study | Background Both under-dosage and over-dosage of general anaesthetics can harm frail patients. We hypothesised that computer-Assisted anaesthesia using pharmacokinetic/pharmacodynamic models guided by SmartPilot ® View (SPV) software could optimise depth of anaesthesia and improve outcomes in patients undergoing hip fra... |
Use of a hand-held digital cognitive aid in simulated crises: The MAX randomized controlled trial | Background Cognitive AIDS improve the technical performance of individuals and teams dealing with high-stakes crises. Hand-held electronic cognitive AIDS have rarely been investigated. A randomized controlled trial was conducted to investigate the effects of a smartphone application, named MAX (for Medical Assistance e... |
Evaluating the ORSIM® simulator for assessment of anaesthetists' skills in flexible bronchoscopy: Aspects of validity and reliability | Background Developing expertise in flexible bronchoscopy is limited by inadequate opportunities to train on difficult airways. The new ORSIM bronchoscopy simulator aims to address this by creating virtual patients with difficult airways. This study aims to provide evidence on the validity and reliability of the ORSIM f... |
Sufentanil administration guided by surgical pleth index vs standard practice during sevoflurane anaesthesia: A randomized controlled pilot study | Background Evaluation of analgesia and antinociception during anaesthesia is still a challenging issue and routinely based on indirect and non-specific signs such as movement, tachycardia, or lacrimation. Recently, the surgical pleth index (SPI) derived by finger plethysmography was introduced to detect nociceptive sti... |
Simulation as a set-up for technical proficiency: Can a virtual warm-up improve live fibre-optic intubation? | Background Fibre-optic intubation (FOI) is an advanced technical skill, which anaesthesia residents must frequently perform under pressure. In surgical subspecialties, a virtual 'warm-up' has been used to prime a practitioner's skill set immediately before performance of challenging procedures. This study examined whet... |
Team-based model for non-operating room airway management: Validation using a simulation-based study | Background Non-operating room (non-OR) airway management has previously been identified as an area of concern because it carries a significant risk for complications. One reason for this could be attributed to the independent practice of residents in these situations. The aim of the present study was to ascertain wheth... |
Tracheal intubation by trainees does not alter the incidence or duration of postoperative sore throat and hoarseness: A teaching hospital-based propensity score analysis | Background Postoperative throat complications, such as sore throat and hoarseness, are frequent complications of tracheal intubation. To assess whether severity of throat complications is related to the experience of physicians performing tracheal intubation, we compared the incidence and duration of postoperative sore... |
Improving team information sharing with a structured call-out in anaesthetic emergencies: A randomized controlled trial | Background Sharing information with the team is critical in developing a shared mental model in an emergency, and fundamental to effective teamwork. We developed a structured call-out tool, encapsulated in the acronym 'SNAPPI': Stop; Notify; Assessment; Plan; Priorities; Invite ideas. We explored whether a video-based ... |
Use of the NexfinTM device to detect acute arterial pressure variations during anaesthesia induction | Background Standard non-invasive arterial pressure (AP) measurements are discontinuous. By providing non-invasive beat-to-beat AP measurements, Nexfin™ might limit duration of intraoperative hypotension and hypertension. We assessed the ability of Nexfin™ to detect AP variations by comparing its trending ability with i... |
A national survey of the impact of NAP4 on airway management practice in United Kingdom hospitals: Closing the safety gap in anaesthesia, intensive care and the emergency department | Background The 4th National Audit Project of the Royal College of Anaesthetists' and Difficult Airway Society (NAP4) made recommendations to improve reliability and safety of airway management in hospitals. This survey examines its impact. Methods A survey was sent to all UK National Health Service hospitals to examine... |
Can i leave the theatre? A key to more reliable workplace-based assessment | Background The value of workplace-based assessments such as the mini-clinical evaluation exercise (mini-CEX), and clinicians' confidence and engagement in the process, has been constrained by low reliability and limited capacity to identify underperforming trainees. We proposed that changing the way supervisors make ju... |
Physical properties and functional alignment of soft-embalmed Thiel human cadaver when used as a simulator for ultrasound-guided regional anaesthesia | Background We evaluated the physical properties and functional alignment of the soft-embalmed Thiel cadaver as follows: by assessing tissue visibility; by measuring its acoustic, mechanical and elastic properties; by evaluating its durability in response to repeated injection; and by aligning images with humans. Method... |
Teaching lifesaving procedures: The impact of model fidelity on acquisition and transfer of cricothyrotomy skills to performance on cadavers | BACKGROUND: A decline in emergency surgical airway procedures in recent years has resulted in a decreased exposure to cricothyrotomy. Consequently, residents have very little experience or confidence in performing this intervention. In this study, we compared cricothyrotomy skills acquired on a simple inexpensive model... |
Anesthesia Care Transitions and Risk of Postoperative Complications | BACKGROUND: A patient undergoing surgery may receive anesthesia care from several anesthesia providers. The safety of anesthesia care transitions has not been evaluated. Using unconditional and conditional multivariable logistic regression models, we tested whether the number of attending anesthesiologists involved in ... |
Determinants, associations, and psychometric properties of resident assessments of anesthesiologist operating room supervision | Background: A study by de Oliveira Filho et al. reported a validated set of 9 questions by which Brazilian anesthesia residents assessed faculty supervision in the operating room. The aim of this study was to use this question set to determine whether faculty operating room supervision scores were associated with resid... |
Demographic Trends from 2005 to 2015 among Physicians with Accreditation Council for Graduate Medical Education-Accredited Anesthesiology Training and Active Medical Licenses | BACKGROUND: A temporary decrease in anesthesiology residency graduates that occurred around the turn of the millennium may have workforce implications. The aims of this study are to describe, between 2005 and 2015, (1) demographic changes in the workforce of physicians trained as anesthesiologists; (2) national and sta... |
Determinants of a subject's decision to participate in clinical anesthesia research | BACKGROUND: A top priority for research studies is to ensure that potential participants receive adequate information to make a truly informed decision. Understanding patient experiences with the recruitment process may identify areas for improvement in the consent process. We examined which factors were associated wit... |
Discrepancies in medication entries between anesthetic and pharmacy records using electronic databases | BACKGROUND: Accurate recording of disposition of controlled substances is required by regulatory agencies. Linking anesthesia information management systems (AIMS) with medication dispensing systems may facilitate automated reconciliation of medication discrepancies. METHODS: In this retrospective investigation at a la... |
Leaving More Than Your Fingerprint on the Intravenous Line: A Prospective Study on Propofol Anesthesia and Implications of Stopcock Contamination | BACKGROUND: Acute care handling of IV stopcocks during anesthesia and surgery may result in contaminated IV tubing sets. In the context of widespread propofol use, a nutrient-rich hypnotic drug, we hypothesized that propofol anesthesia increases bacterial contamination of IV stopcocks and may compromise safety of IV tu... |
Digital Quality Improvement Approach Reduces the Need for Rescue Antiemetics in High-Risk Patients: A Comparative Effectiveness Study Using Interrupted Time Series and Propensity Score Matching Analysis | BACKGROUND: Affecting nearly 30% of all surgical patients, postoperative nausea and vomiting (PONV) can lead to patient dissatisfaction, prolonged recovery times, and unanticipated hospital admissions. There are well-established, evidence-based guidelines for the prevention of PONV; yet physicians inconsistently adhere... |
High-fidelity simulation demonstrates the influence of anesthesiologists' age and years from residency on emergency cricothyroidotomy skills | BACKGROUND: Age-related deterioration in both cognitive function and the capacity to control fine motor movements has been demonstrated in numerous studies. However, this decline has not been described with respect to complex clinical anesthesia skills. Cricothyroidotomy is an example of a complex, lifesaving procedure... |
Airway management practice in adults with an unstable cervical spine: The harborview medical center experience | Background: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the wid... |
Barriers to adverse event and error reporting in anesthesia | BACKGROUND: Although anesthesiologists are leaders in patient safety, there has been little research on factors affecting their reporting of adverse events and errors. First, we explored the attitudinal/emotional factors influencing reporting of an unspecified adverse event caused by error. Second, we used a between-gr... |
A prospective study on anesthesia machine fault identification | BACKGROUND: Although few studies have been performed recently, several have suggested that some practitioners are not well able to detect preset anesthesia machine faults. METHODS: We performed a prospective study to determine whether there is a correlation between duration of anesthesia practice and the ability to det... |
In the Aftermath: Attitudes of Anesthesiologists to Supportive Strategies after an Unexpected Intraoperative Patient Death | Background: Although most anesthesiologists will have 1 catastrophic perioperative event or more during their careers, there has been little research on their attitudes to assistive strategies after the event. There are wide-ranging emotional consequences for anesthesiologists involved in an unexpected intraoperative p... |
A survey of obstetric perianesthesia care unit standards | BACKGROUND: Although obstetric patients are generally healthy, population risk is increasing because of increases in maternal age, obesity, and rates of multifetal pregnancies, and complications may occur in the immediate postoperative period. In this study, we sought to identify the current level of recovery care for ... |
Growth of nonoperating room anesthesia care in the United States: A contemporary trends analysis | Background: Although previous publications suggest an increasing demand and volume of nonoperating room anesthesia (NORA) cases in the United States, there is little factual information on either volume or characteristics of NORA cases at a national level. Our goal was to assess the available data using the National An... |
A survey of propofol abuse in academic anesthesia programs | BACKGROUND: Although propofol has not traditionally been considered a drug of abuse, subanesthetic doses may have an abuse potential. We used this survey to assess prevalence and outcome of propofol abuse in academic anesthesiology programs. METHODS: E-mail surveys were sent to the 126 academic anesthesiology training ... |
National survey on sedation for gastrointestinal endoscopy in 2758 Chinese hospitals | Background: Although sedation during gastrointestinal endoscopy is widely used in China, the characteristics of sedation use, including regional distribution, personnel composition, equipment used, and drug selection, remain unclear. The present study aimed to provide insights into the current practice and regional dis... |
Occupational chronic sevoflurane exposure in the everyday reality of the anesthesia workplace | BACKGROUND: Although sevoflurane is one of the most commonly used volatile anesthetics in clinical practice, anesthesiologists are hardly aware of their individual occupational chronic sevoflurane exposure. Therefore, we studied sevoflurane concentrations in the anesthesiologists' breathing zones, depending on the kind... |
Quality of supervision as an independent contributor to an anesthesiologist's individual clinical value | BACKGROUND: Although the clinical (operating room) production of individual anesthesiologists has been measured in multiple related ways (e.g., hours of direct clinical care), the same is not true for the quality of that effort. In our study, we consider the quality of clinical supervision provided by anesthesiologists... |
Optimal nasopharyngeal temperature probe placement | Background: Although the nasopharynx is a commonly used temperature-monitoring site during general anesthesia, it is unknown whether the position of nasopharyngeal temperature probes placed blindly by anesthesia practitioners is optimal. The purposes of this study were (1) to determine where the nasopharyngeal mucosa i... |
Representation of Women as Editors in Anesthesiology Journals | BACKGROUND: Although there has been a considerable increase in the representation of women in medicine, a gender gap still exists with regard to leadership positions. This gender discrepancy has been identified in the field of anesthesiology, in terms of first and senior authorship, as well as in general composition of... |
Coordination of appointments for anesthesia care outside of operating rooms using an enterprise-wide scheduling system | BACKGROUND: An anesthesia department implemented scheduling of anesthetics outside of operating rooms (non-OR) by clerks and nurses from other departments using its hospital's enterprise-wide scheduling system. METHODS: Observational studies chronicled the change over 2 yr as non-OR time was allocated by specialty, and... |
Humanistic medicine in anaesthesiology: development and assessment of a curriculum in humanism for postgraduate anaesthesiology trainees | Background: An unintended consequence of medical technologies is loss of personal interactions and humanism between patients and their healthcare providers, leading to depersonalisation of medicine. As humanism is not integrated as part of formal postgraduate anaesthesiology education curricula, our goal was to design,... |
Learning through simulated independent practice leads to better future performance in a simulated crisis than learning through simulated supervised practice | Background: Anaesthetists may fail to recognize and manage certain rare intraoperative events. Simulation has been shown to be an effective educational adjunct to typical operating room-based education to train for these events. It is yet unclear, however, why simulation has any benefit. We hypothesize that learners wh... |
Written comments made by anesthesia residents when providing below average scores for the supervision provided by the faculty anesthesiologist | BACKGROUND: Anesthesia residents in our department evaluate the supervision provided by the faculty anesthesiologist with whom they worked the previous day. What advice managers can best provide to the faculty who receive below-average supervision scores is unknown. METHODS: The residents provided numerical answers (1 ... |
Incentive payments to academic anesthesiologists for late afternoon work did not influence turnover times | Background: Anesthesiologists are often paid extra for hours worked in the late afternoon and evening. Although anesthesiologists have little influence on their operating room (OR) assignments and workloads late in the afternoon, they can influence turnover times. Methods: OR turnover times on workdays were reviewed fo... |
Anesthesiologists with substance use disorders: A 5-year outcome study from 16 state physician health programs | BACKGROUND: Anesthesiologists have a higher rate of substance use disorders than other physicians, and their prognoses and advisability to return to anesthesiology practice after treatment remain controversial. Over the past 25 yr, physician health program (PHPs), created under authority of state medical regulatory boa... |
A new approach to pathogen containment in the operating room: Sheathing the laryngoscope after intubation | BACKGROUND: Anesthesiologists may contribute to postoperative infections by means of the transmission of blood and pathogens to the patient and the environment in the operating room (OR). Our primary aims were to determine whether contamination of the IV hub, the anesthesia work area, and the patient could be reduced a... |
Anesthesiologists and disaster medicine: A needs assessment for education and training and reported willingness to respond | BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were a... |
Diversity and similarity of anesthesia procedures in the United States during and among regular work hours, evenings, and weekends | BACKGROUND: Anesthesiologists providing care during off hours (ie, weekends or holidays, or cases started during the evening or late afternoon) are more likely to care for patients at greater risk of sustaining major adverse events than when they work during regular hours (eg, Monday through Friday, from 7:00 am to 2:5... |
An analysis of risk factors for patient complaints about ambulatory anesthesiology care | Background: Anesthesiology groups continually seek data sources and evaluation metrics for ongoing professional practice evaluation, credentialing, and other quality initiatives. The analysis of patient complaints associated with physicians has been previously shown to be a marker for patient dissatisfaction and a pred... |
Contemporary Academic Contributions From Anesthesiologists in Adult Critical Care Medicine | BACKGROUND: Anesthesiology has a long relationship with critical care medicine (CCM). However, US anesthesiologists are less likely to practice CCM than non-US anesthesiologists. To date, no studies have compared academic contributions in CCM between US anesthesiologists and non-US anesthesiologists. The objective of o... |
Resident Physicians Improve Nontechnical Skills When on Operating Room Management and Leadership Rotation | BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive s... |
A Descriptive Survey of Anesthesiology Residency Simulation Programs: How Are Programs Preparing Residents for the New American Board of Anesthesiology APPLIED Certification Examination? | BACKGROUND: Anesthesiology residency programs may need new simulation-based programs to prepare residents for the new Objective Structured Clinical Examination (OSCE) component of the American Board of Anesthesiology (ABA) Primary Certification process. The design of such programs may require significant resources, inc... |
Anesthesiology Residents' Experiences and Perspectives of Residency Training | BACKGROUND: Anesthesiology residents' experiences and perspectives about their programs may be helpful in improving training. The goals of this repeated cross-sectional survey study are to determine: (1) the most important factors residents consider in choosing an anesthesiology residency, (2) the aspects of the clinic... |
Reliability and validity of performance evaluations of pain medicine clinical faculty by residents and fellows using a supervision scale | BACKGROUND: Annual and/or semiannual evaluations of pain medicine clinical faculty are mandatory for multiple organizations in the United States. We evaluated the validity and psychometric reliability of a modified version of de Oliveira Filho et al clinical supervision scale for this purpose. METHODS: Six years of wee... |
Computational modeling and prototyping of a pediatric airway management instrument | BACKGROUND: Anterior retraction of the tongue is used to enhance upper airway patency during pediatric fiberoptic intubation. This can be achieved by the use of Magill forceps as a tongue retractor, but lingual grip can become unsteady and traumatic. Our objective was to modify this instrument using computer-aided engi... |
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