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Measuring the anaesthesia clinical learning environment at the department level is feasible and reliable | Background: The learning environment describes the context and culture in which trainees learn. In order to establish the feasibility and reliability of measuring the anaesthetic learning environment in individual departments we implemented a previously developed instrument in hospitals across New South Wales. Methods:... |
Mini-clinical evaluation exercise in anaesthesia training | Background: The Mini-Clinical Evaluation Exercise (Mini-CEX) is a workplace-based assessment tool of potential value in anaesthesia to assess and improve clinical performance. Its reliability and positive educational impact have been reported in other specialities, but not, to date, in anaesthesia. In this study, we ev... |
Trends in gender distribution among anesthesiology residents: Do they matter? | BACKGROUND: The number of women graduating from United States medical schools progressively increased during the 26 yr period from 1978 to 2004. This change was associated with shifts in the gender distribution of residents training in Accreditation Council for Graduate Medical Education-accredited residency programs. ... |
The status of women in academic anesthesiology: A progress report | BACKGROUND: The number of women in medicine has increased steadily in the last half century. In this study, we reassessed the status of women in academic anesthesiology departments in the United States in 2006. METHODS: Medical student, resident, and faculty rank gender data were obtained from the Association of Americ... |
Cardiac Output Assessments in Anesthetized Children: Dynamic Capnography Versus Esophageal Doppler | BACKGROUND: The objective of this study was to compare esophageal Doppler cardiac output (COEDM) against the reference method effective pulmonary blood flow cardiac output (COEPBF), for agreement of absolute values and ability to detect change in cardiac output (CO) in pediatric surgical patients. Furthermore, the rela... |
Scientific publications in anesthesiology journals from Mainland China, Taiwan, and Hong Kong: A 10-year survey of the literature | Background: The past 20 yr have seen significant growth in China's role in the international community. This same growth and international presence is occurring in the field of anesthesiology. The research status in anesthesiology among Chinese individuals in the 3 major regions of China-mainland China, Hong Kong, and ... |
Development, Validation, and Results of a Survey of Personal Electronic Device Use Among 299 Anesthesia Providers From a Single Institution | BACKGROUND: The pattern of perioperative use of personal electronic devices (PEDs) among anesthesia providers in the United States is unknown. METHODS: We developed a 31-question anonymous survey of perioperative PED use that was sent to 813 anesthesiologists, anesthesiology residents, and certified registered nurse an... |
Implementation of a total joint replacement-focused | BACKGROUND: The perioperative setting in the United States is noted for variable and fragmented care that increases the chance for errors and adverse outcomes as well as the overall cost of perioperative care. Recently, the American Society of Anesthesiologists put forward the Perioperative Surgical Home (PSH) concept ... |
The Specialist Anesthesiology Workforce in East, Central, and Southern Africa: A Cross-Sectional Study | BACKGROUND: The populations of the East, Central, and Southern African regions receive only a fraction of the surgical procedures they require, and patients are more likely to die after surgery than the global average. An insufficient anesthetic workforce is a key barrier to safe surgery. The anesthetic workforce in th... |
Identifying and managing technical faults in the anesthesia machine: Lessons learned from the Israeli board of anesthesiologists | Background: The potential for catastrophe resulting from anesthetic equipment failure and the failure of training programs to adequately prepare residents to detect and manage equipment failure prompted the Israel Board of Anesthesiologists to include simulation-based testing in the Objective Structured Clinical Evalua... |
Motherhood and Anesthesiology: A Survey of the American Society of Anesthesiologists | BACKGROUND: The proportion of women medical school graduates in the United States has grown substantially; however, representation of women in anesthesiology lags behind. We sought to investigate factors associated with women recommending against a career in anesthesiology due to obstacles related to motherhood. METHOD... |
Gender Gap: A Qualitative Study of Women and Leadership Acquisition in Anesthesiology | BACKGROUND: The representation of women among leaders in the field of anesthesia continues to trail that of their male counterparts. This qualitative study was conducted to understand the pathway of leadership acquisition among women in the field of anesthesiology. METHODS: Using constructivist grounded theory, we soug... |
The utility of pre-residency standardized tests for anesthesiology resident selection: The place of united states medical licensing examination scores | BACKGROUND: The resident selection process could be improved if United States Medical Licensing Examination (USMLE) scores obtained during residency application were found to predict success on the American Board of Anesthesiology (ABA) written examination (part 1). In this study, we compared USMLE performance during m... |
The impact of a perceptual and adaptive learning module on transoesophageal echocardiography interpretation by anaesthesiology residents | Background: The role of transoesophageal echocardiography (TOE) in anaesthetic practice is expanding. We evaluated the effect of a TOE perceptual and adaptive learning module (PALM) on first-yr anaesthesiology residents' performance, in diagnosing cardiac pathology by TOE. Methods: First-yr residents were assigned to a... |
Observational study of anaesthesia workflow to evaluate physical workspace design and layout | Background: The safety and efficiency of anaesthesia care depend on the design of the physical workspace. However, little is known about the influence that workspace design has on the ability to perform complex operating theatre (OT) work. The aim of this study was to observe the relationship between task switching and... |
A Remote Surveillance Platform to Monitor General Care Ward Surgical Patients for Acute Physiologic Deterioration | BACKGROUND: The traditional paradigm of hospital surgical ward care consists of episodic bedside visits by providers with periodic perusals of the patient's electronic health record (EHR). Vital signs and laboratory results are directly pushed to the EHR but not to providers themselves. Results that require interventio... |
Interview Data Highlight Importance of "same-State" on Anesthesiology Residency Match | Background: The US residency application, interview, and match processes are costly and time-intensive. We sought to quantify the importance of an applicant being from the same-state as a residency program in terms of how this impacted the number of interviews needed to match. METHODS: We examined data from interview s... |
Emergency Manual Implementation in a Large Academic Anesthesia Practice: Strategy and Improvement in Performance on Critical Steps | BACKGROUND: The use of cognitive aids, such as emergency manuals (EMs), improves team performance on critical steps during crisis events. In our large academic anesthesia practice, we sought to broadly implement an EM and subsequently evaluate team member performance on critical steps. METHODS: We observed the phases o... |
Anesthetic Care in Mozambique | Background: The World Bank and Lancet Commission in 2015 have prioritized surgery in Low-Income Countries (LIC) and Lower-Middle Income Countries (LMICs). This is consistent with the shift in the global burden of disease from communicable to noncommunicable diseases over the past 20 years. Essential surgery must be per... |
Role of communication systems in coordinating supervising anesthesiologists' activities outside of operating rooms | BACKGROUND: Theoretically, communication systems have the potential to increase the productivity of anesthesiologists supervising anesthesia providers. We evaluated the maximal potential of communication systems to increase the productivity of anesthesia care by enhancing anesthesiologists' coordination of care (activi... |
The making of an anesthesia historian: Lessons from a worldwide biographical survey | BACKGROUND: There are few, if any, training opportunities for individuals wishing to pursue a career as an anesthesia historian. We surveyed anesthesia historians to learn about their training and experience, with an emphasis on mentoring, obstacles faced, and opportunities for improvement. METHODS: Questionnaires were... |
The Most Influential Publications in Obstetric Anesthesiology, 1998-2017: Utilizing the Delphi Method for Expert Consensus | BACKGROUND: There have been many advances in obstetric anesthesiology in the past 2 decades. We sought to create a list of highly influential publications in the field using the Delphi method among a group of obstetric anesthesiology experts to create an important educational, clinical, and research resource. METHODS: ... |
New teaching model for practicing ultrasound-guided regional anesthesia techniques: No perishable food products! | Background: There is a pronounced learning curve for the technique of ultrasound-guided regional anesthesia. Practicing with a simulator model has been shown to speed the acquisition of these skills for various ultrasound-guided procedures. However, commercial models for ultrasound-guided regional anesthesia may be too... |
Prior Podcast Experience Moderates Improvement in Electroencephalography Evaluation after Educational Podcast Module | BACKGROUND: There is continued interest in using technology to enhance medical education and the variables that may affect its success. METHODS: Anesthesiology residents and fourth-year medical students participated in an electroencephalography (EEG) educational video podcast module. A 25-item evaluation tool was admin... |
Multicentre analysis of practice patterns regarding benzodiazepine use in cardiac surgery | Background: There is controversy regarding optimal use of benzodiazepines during cardiac surgery, and it is unknown whether and to what extent there is variation in practice. We sought to describe benzodiazepine use and sources of variation during cardiac surgeries across patients, clinicians, and institutions. Methods... |
The Current Landscape of US Pediatric Anesthesiologists: Demographic Characteristics and Geographic Distribution | BACKGROUND: There is no comprehensive database of pediatric anesthesiologists, their demographic characteristics, or geographic location in the United States. METHODS: We endeavored to create a comprehensive database of pediatric anesthesiologists by merging individuals identified as US pediatric anesthesiologists by t... |
Critical Care Medicine Practice: A Pilot Survey of US Anesthesia Critical Care Medicine-Trained Physicians | BACKGROUND: This survey assessed satisfaction with the practice environment among physicians who have completed fellowship training in critical care medicine (CCM) as recognized by the American Board of Anesthesiology (and are members of the American Society of Anesthesiology) and evaluated the perceived effectiveness ... |
What will anesthesiologists be anesthetizing? trends in neurosurgical procedure usage | BACKGROUND: To anticipate future changes to the practice of neuroanesthesia, we examined the nationwide trends in frequently performed operative neurosurgery. METHODS: We used the Nationwide Inpatient Sample, a random sampling of approximately 20% of United States hospitals from 1993 to 2007. Eight categories of operat... |
Hypercapnic hyperventilation shortens emergence time from isoflurane anesthesia | BACKGROUND: To shorten emergence time after a procedure using volatile anesthesia, 78% of anesthesiologists recently surveyed used hyperventilation to rapidly clear the anesthetic from the lungs. Hyperventilation has not been universally adapted into clinical practice because it also decreases the Paco2, which decrease... |
Conventional versus video laryngoscopy for tracheal tube exchange: Glottic visualization, success rates, complications, and rescue alternatives in the high-risk difficult airway patient | BACKGROUND: Tracheal tube exchange is a simple concept but not a simple procedure because hypoxemia, esophageal intubation, and loss of airway may occur with life-threatening ramifications. Combining laryngoscopy with an airway exchange catheter (AEC) may lessen the exchange risk. Laryngoscopy is useful for a pre-excha... |
Generative retrieval improves learning and retention of cardiac anatomy using transesophageal echocardiography | BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in t... |
Intraoperative transfusion practices in Europe | Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transf... |
I Tweet, Therefore I Learn: An Analysis of Twitter Use Across Anesthesiology Conferences | BACKGROUND: Twitter in anesthesiology conferences promotes rapid science dissemination, global audience participation, and real-time updates of simultaneous sessions. We designed this study to determine if an association exists between conference attendance/registration and 4 defined Twitter metrics. METHODS: Using pub... |
Dissemination of Anesthesia Information during the Coronavirus Disease 2019 Pandemic Through Twitter: An Infodemiology Study | BACKGROUND: Twitter is a web-based social media platform that allows instantaneous sharing of user-generated messages (tweets). We performed an infodemiology study of the coronavirus disease 2019 (COVID-19) Twitter conversation related to anesthesiology to describe how Twitter has been used during the pandemic and ways... |
A prospective observational study of anesthesia- related adverse events and postoperative complications occurring during a surgical mission in Madagascar | BACKGROUND: Two-thirds of the world's population lack access to safe anesthesia and surgical care. Nongovernmental organizations (NGOs) play an important role in bridging the gap, but surgical outcomes vary. After complex surgeries, up to 20-fold higher postoperative complication rates are reported and the reasons for ... |
Practice of ultrasound-guided palpation of neck landmarks improves accuracy of external palpation of the cricothyroid membrane | BACKGROUND: Ultrasonography can accurately identify the cricothyroid membrane; however, its impact on the subsequent accuracy of external palpation is not known. In this study, we tested the ability of anesthesia participants to identify the midpoint of the cricothyroid membrane using external palpation with and withou... |
Adultification of Black Children in Pediatric Anesthesia | BACKGROUND: Unconscious racial bias in anesthesia care has been shown to exist. We hypothesized that black children may undergo inhalation induction less often, receive less support from child life, have fewer opportunities to have a family member present for induction, and receive premedication with oral midazolam les... |
Antiemetic prophylaxis as a marker of health care disparities in the national anesthesia clinical outcomes registry | BACKGROUND: US health care disparities persist despite repeated countermeasures. Research identified race, ethnicity, gender, and socioeconomic status as factors, mediated through individual provider and/or systemic biases; little research exists in anesthesiology. We investigated antiemetic prophylaxis as a surrogate ... |
Coronavirus Disease 2019: Anesthesia Machine Circuit Pressure during Use as an Improvised Intensive Care Unit Ventilator | BACKGROUND: Use of anesthesia machines as improvised intensive care unit (ICU) ventilators may occur in locations where waste anesthesia gas suction (WAGS) is unavailable. Anecdotal reports suggest as much as 18 cm H2O positive end-expiratory pressure (PEEP) being inadvertently applied under these circumstances, accomp... |
Large heterogeneity in mean durations of labor Analgesia among hospitals reporting to the American Society of anesthesiologists' anesthesia quality Institute | BACKGROUND: Variability in the mean durations of labor analgesia for vaginal delivery among hospitals is unknown. Such differences in means among hospitals would influence appropriate equitable fee-for-service payment to US anesthesia groups. Equitable payment is the foundational principle of relative value unit paymen... |
Physician-directed versus computerized closed-loop control of blood pressure using phenylephrine in a swine model | BACKGROUND: Vasopressors provide a rapid and effective approach to correct hypotension in the perioperative setting. Our group developed a closed-loop control (CLC) system that titrates phenylephrine (PHP) based on the mean arterial pressure (MAP) during general anesthesia. As a means of evaluating system competence, w... |
A vibro-tactile display for clinical monitoring: Real-time evaluation | Background: Vibro-tactile displays use human skin to convey information from physiological monitors to anesthesiologists, providing cues about changes in the status of the patient. In this investigation, we evaluated, in a real-time clinical environment, the usability and wearability of a novel vibro-tactile display be... |
Universal videolaryngoscopy: a structured approach to conversion to videolaryngoscopy for all intubations in an anaesthetic and intensive care department | Background: Videolaryngoscopy (VL) is increasingly used, but not yet routine practice, for tracheal intubation. Few departments formally trial equipment before adopting it into practice. We describe the decision-making and implementation processes that our department used when introducing universal VL, with the C-MAC© ... |
Frequency of Operative Anesthesia Care after Traumatic Injury | BACKGROUND: Virtually all anesthesiologists care for patients who sustain traumatic injuries; however, the frequency with which operative anesthesia care is provided to this specific patient population is unclear. We sought to better understand the degree to which anesthesia providers participate in operative trauma ca... |
Visual Analytics to Leverage Anesthesia Electronic Health Record | BACKGROUND: Visual analytics is the science of analytical reasoning supported by interactive visual interfaces called dashboards. In this report, we describe our experience addressing the challenges in visual analytics of anesthesia electronic health record (EHR) data using a commercially available business intelligenc... |
Assessing the association between blood loss and postoperative hemoglobin after cesarean delivery: A prospective study of 4 blood loss measurement modalities | BACKGROUND: Visual estimation and gravimetric methods are commonly used to quantify the volume of blood loss during cesarean delivery (CD). However, the correlation between blood loss and post-CD hemoglobin (Hb) is poorly studied, and it is unclear whether the correlation varies according to how blood loss is measured.... |
Interprofessional handover and patient safety in anaesthesia: Observational study of handovers in the recovery room | Background: We aimed to describe how anaesthetists hand over information and professional responsibility to nurses in the operating theatre recovery room. Methods: We carried out non-participant practice observation and in-depth interviews with practitioners working in the recovery room of an English hospital and used ... |
The relationship of learning environment, quality of life, and study strategies measures to anesthesiology resident academic performance | BACKGROUND: We designed this study to determine the academic performance of anesthesia residents as related to their differential characteristics on some affective-motivational variables, represented by perceptions about their educational environment, subjective quality of life, and learning and study strategies. METHO... |
Analgesic effects of oxycodone relative to those of sufentanil, in the presence of midazolam, during endoscopic injection sclerotherapy for patients with cirrhosis and esophageal varices | BACKGROUND: We evaluated the efficacy and gastroenterologist/patient satisfaction of midazolam combined with oxycodone, relative to that of midazolam combined with sufentanil, for anesthesia during endoscopic injection sclerotherapy (EIS) in patients with cirrhosis and esophageal varices. METHODS: Patients with cirrhos... |
Supraglottic airway device versus tracheal intubation and the risk of emergent postoperative intubation after general anaesthesia in adults: a retrospective cohort study | Background: We examined the association between emergent postoperative tracheal intubation and the use of supraglottic airway devices (SGAs) vs tracheal tubes. Methods: We included data from adult noncardiac surgical cases under general anaesthesia between 2008 and 2018. We only included cases (n=59 991) in which both ... |
Visualization improves supraclavicular access to the subclavian vein in a mixed reality simulator | BACKGROUND: We investigated whether visual augmentation (3D, real-time, color visualization) of a procedural simulator improved performance during training in the supraclavicular approach to the subclavian vein, not as widely known or used as its infraclavicular counterpart. METHODS: To train anesthesiology residents t... |
A psychological basis for anesthesiologists' operating room managerial decision-making on the day of surgery | BACKGROUND: We investigated whether, without prompting, anesthesiologists tend to make managerial decisions to increase the clinical work per unit time of the sites to which they are assigned during their scheduled time present. Although a sound basis for decision-making involving individual ORs, the heuristic is often... |
Improvement in the quality of randomized controlled trials among general anesthesiology journals 2000 to 2006: A 6-year follow-up | BACKGROUND: We previously assessed all randomized controlled trials (RCTs) from four anesthesiology journals from January 2000 to December 2000. We identified key areas for improvement in the study protocol design and implementation and in data analyses. This study was repeated for the year 2006 to determine if improve... |
Forecasting and perception of average and latest hours worked by on-call anesthesiologists | BACKGROUND: We studied the value of providing information to anesthesia providers about the length of time typically worked during on-call shifts. The mean time at which a shift ends can be used for purposes of trades, payments, or reverse auctions, because the mean is proportional to the total time. The 80th percentil... |
The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study | BACKGROUND: When applied to the pediatric population, the American Society of Anesthesiologists physical status (ASA-PS) classification has exhibited poor reliability due to its subjective and adult-focused definitions. This study was done to measure interrater agreement of a pediatric-adapted ASA-PS classification and... |
Is compliance with surgical care improvement project cardiac (SCIP-Card-2) measures for perioperative β-blockers associated with reduced incidence of mortality and cardiovascular-related critical quality indicators after noncardiac surgery? | BACKGROUND: While continuation of β-blockers (BBs) perioperatively has become a national quality improvement measure, the relationship between BB withdrawal and mortality and cardiovascular-related critical quality indicators has not been studied in a contemporary cohort of patients undergoing noncardiac surgery. METHO... |
Anaesthesia provider volume and perioperative outcomes in total joint arthroplasty surgery | Background: While increased surgical-provider volume has been associated with improved outcomes, research regarding volume–outcome relationships within high-volume institutions and the role of anaesthesiologists is limited. Further, the effect of anaesthesia-care-team composition remains understudied. This analysis aim... |
Evaluation of Open Access Websites for Anesthesia Education | BACKGROUND: While the prevalence of free, open access medical education resources for health professionals has expanded over the past 10 years, many educational resources for health care professionals are not publicly available or require fees for access. This lack of open access creates global inequities in the availa... |
The Practice of Pediatric Cardiac Anesthesiology in the United States | BACKGROUND: With advances in surgical and catheter-based interventions and technologies in patients with congenital heart disease (CHD), the practice of pediatric cardiac anesthesiology has evolved in parallel with pediatric cardiac surgery and pediatric cardiology as a distinct subspecialty over the past 80 years. To ... |
Should Objective Structured Clinical Examinations Assist the Clinical Competency Committee in Assigning Anesthesiology Milestones Competency? | BACKGROUND: With the integration of Objective Structured Clinical Examinations into the Anesthesiology primary board certification process, residency programs may choose to implement Objective Structured Clinical Examinations for resident skill assessment. The aim of this study was to evaluate Objective Structured Clin... |
Gender effects in anaesthesia training in Australia and New Zealand | Background: Women face gender-based challenges in their medical education and career. Inequitable access to procedural training, a confidence gap, and professional identity deficit have been shown. We made a gender comparison of procedural case volume, confidence for independent practice, perceived gender and ethnic bi... |
Perceptions of gender equity in departmental leadership, research opportunities, and clinical work attitudes: an international survey of 11 781 anaesthesiologists | Background: Women make up an increasing proportion of the physician workforce in anaesthesia, but they are consistently under-represented in leadership and governance. Methods: We performed an internet-based survey to investigate career opportunities in leadership and research amongst anaesthesiologists. We also explor... |
Eye tracking for assessment of workload: a pilot study in an anaesthesia simulator environment | Background: Workload assessment is an important tool for improving patient safety in anaesthesia. We tested the hypothesis that heart rate, pupil size, and duration of fixation increase, whereas saccade amplitude decreases with increased workload during simulated critical incidents. Methods: Fifteen trainee anaesthetis... |
Validity evidence for the Anesthesia Clinical Encounter Assessment (ACEA) tool to support competency-based medical education | Background: Workplace-based assessment (WBA) is key to a competency-based assessment strategy. Concomitantly with our programme's launch of competency-based medical education, we developed an entrustment-based WBA, the Anesthesia Clinical Encounter Assessment (ACEA), to assess readiness for independent practice of comp... |
Closed-circuit xenon delivery using a standard anesthesia workstation | Background: Xenon (Xe) is an anesthetic with minimal side effects, now also showing promise as a neuroprotectant both in vitro and in vivo. Although scarce and expensive, Xe is insoluble and patient uptake is low, making closed circuits the optimum delivery method. Although the future of Xe anesthesia is uncertain, eff... |
Perceptions about blood transfusion: A survey of surgical patients and their anesthesiologists and surgeons | BACKGROUND:: Although blood transfusion is a common therapeutic intervention and a mainstay of treating surgical blood loss, it may be perceived by patients and their physicians as having associated risk of adverse events. Practicing patient-centered care necessitates that clinicians have an understanding of an individ... |
Automated correction of room location errors in anesthesia information management systems | BACKGROUND:: Anesthesia information management systems (AIMS) and operating room information management systems (ORIMS) are both used in operating rooms (OR). Anesthesia providers use AIMS to document their care in near real-time, including milestone events, and these systems automatically record vital signs from patie... |
Technology diffusion of anesthesia information management systems into Academic Anesthesia Departments in the United States | BACKGROUND:: Anesthesia information management systems (AIMS) are electronic health records that automatically import vital signs from patient monitors and allow for computer-assisted creation of the anesthesia record. When most recently surveyed in 2007, it was estimated that at least 16% of U.S. academic hospitals (i... |
Preparation of the Dräger Fabius anesthesia machine for the malignant-hyperthermia susceptible patient | BACKGROUND:: Anesthesia machines must be flushed of halogenated anesthetics before use in patients susceptible to malignant hyperthermia. We studied the kinetics of sevoflurane clearance in the Dräger Fabius anesthesia machine and compared them to a conventional anesthesia machine (Dräger Narkomed GS). METHODS:: Before... |
Performance of certified registered nurse anesthetists and anesthesiologists in a simulation-based skills assessment | BACKGROUND:: Anesthesiologists and certified registered nurse anesthetists (CRNAs) must acquire the skills to recognize and manage a variety of acute intraoperative emergencies. A simulation-based assessment provides a useful and efficient means to evaluate these skills. In this study, we evaluated and compared the per... |
What can the national quality forum tell us about performance measurement in anesthesiology? | BACKGROUND:: Anesthesiologists face increasing pressure to demonstrate the value of the care they provide, whether locally or nationally through public reporting and payor requirements. In this article, we describe the current state of performance measurement in anesthesia care at the national level and highlight gaps ... |
Anesthetic agent-specific effects on synaptic inhibition | BACKGROUND:: Anesthetics enhance γ-aminobutyric acid (GABA)-mediated inhibition in the central nervous system. Different agents have been shown to act on tonic versus synaptic GABA receptors to different degrees, but it remains unknown whether different forms of synaptic inhibition are also differentially engaged. With... |
Influence of provider type (Nurse Anesthetist or Resident Physician), staff assignments, and other covariates on daily evaluations of anesthesiologists' quality of supervision | BACKGROUND:: At many U.S. healthcare facilities, supervision of anesthesiology residents and/or Certified Registered Nurse Anesthetists (CRNAs) is a major daily responsibility of anesthesiologists. Our department implemented a daily process by which the supervision provided by each anesthesiologist working in operating... |
Deficits in the provision of cardiopulmonary resuscitation during simulated obstetric crises: Results from the israeli board of anesthesiologists | BACKGROUND:: Cardiac arrest in the parturient is often fatal, but appropriate resuscitation in this special situation may save the lives of the mother and/or unborn baby. Concern has arisen as to application of recommended techniques for resuscitation in the obstetric patient. The Israel Board of Anesthesiology has inc... |
Evaluating the long-term retention of a multidisciplinary electroencephalography instructional model | BACKGROUND:: Clinical decision making and problem solving require a core of basic factual knowledge that must be accessed sometimes months or years after it has been learned. We examined whether 10 compared with 20 total electroencephalogram (EEG) interpretations impacted scores for long-term retention with the residen... |
Rescheduling of previously cancelled surgical cases does not increase variability in operating room workload when cases are scheduled based on maximizing efficiency of use of operating room time | BACKGROUND:: Conceptually, cancelling a case close to the scheduled day of surgery increases variability in operating room (OR) workload (i.e., total hours of scheduled cases plus turnovers), creating managerial problems. However, in our recent study of an OR scheduling office, cancellations (slightly) reduced variabil... |
Oxygen consumption of a pneumatically controlled ventilator in a field anesthesia machine | BACKGROUND:: Field anesthesia machines (FAM) have been developed for remote locations where reliable supplies of compressed medical gases or electricity may be absent. In place of electricity, pneumatically controlled ventilators use compressed gas to power timing circuitry and actuate valves. We sought to determine th... |
Operating room nursing directors' influence on anesthesia group operating room productivity | BACKGROUND:: Implementation of initiatives to increase anesthesia group productivity depends not just on anesthesia groups, but on operating room (OR) nursing administration. OR nursing directors may encourage organizational change based on the needs of their hospitals and nurses. These changes may differ from those th... |
Six-year follow-up on work force and finances of the United States anesthesiology training programs: 2000 to 2006 | BACKGROUND:: In the mid 1990s, interest in the field of anesthesiology decreased significantly among medical students, resulting in a decreasing resident class size and, subsequently, fewer anesthesiologists entering the United States workforce. This apparent practitioner shortage was associated with increased salary d... |
Adoption of anesthesia information management systems by academic departments in the United States | BACKGROUND:: Information technology has been promoted as a way to improve patient care and outcomes. Whereas information technology systems for ancillary hospital services (e.g., radiology, pharmacy) are deployed commonly, it has been estimated that anesthesia information management systems (AIMS) are only installed in... |
Examination of publications from academic anesthesiology faculty in the United States | BACKGROUND:: Leaders in academic anesthesiology in the United States have called for an examination of the state of scholarship within anesthesiology departments. National Institutes of Health funding and publication quality of subsets of U.S anesthesiologists have been examined; however, the publication output of and ... |
Noble gas binding to human serum albumin using docking simulation: Nonimmobilizers and anesthetics bind to different sites | BACKGROUND:: Nonimmobilizers are structurally similar to anesthetics, but do not produce anesthesia at clinically relevant concentrations. Xenon, krypton, and argon are anesthetics, whereas neon and helium are nonimmobilizers. The structures of noble gases with anesthetics or nonimmobilizers are similar and their inter... |
The importance of subjective facial appearance on the ability of anesthesiologists to predict difficult intubation | BACKGROUND:: Previously we demonstrated that a computer algorithm based on bedside airway examinations and facial photographs accurately classified easy and difficult airways. The extent of the ability of anesthesiologists to perform the same task is unknown. We hypothesized that providing photographs would add to the ... |
Academic productivity of directors of ACGME-Accredited residency programs in surgery and anesthesiology | BACKGROUND:: Scholarly activity is expected of program directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs. Anesthesiology residency programs are cited more often than surgical programs for deficiencies in academic productivity. We hypothesized that this may ... |
The ability of anesthesia providers to visually estimate systolic pressure variability using the "eyeball" technique | BACKGROUND:: Systemic arterial respiratory variation has been shown to be a reliable predictor of changes in cardiac output after fluid administration. Arterial respiratory variation is often estimated from visual examination of the arterial waveform tracing. Our goal in this study was to assess the ability of anesthes... |
Transthoracic echocardiography simulation is an efficient method to train anesthesiologists in basic transthoracic echocardiography skills | BACKGROUND:: The clinical utility of focused transthoracic echocardiography (TTE) is increasingly recognized in perioperative medicine. However its use is limited among anesthesiologists because of a lack of training. The most efficient training methods have not been determined. We hypothesized that simulation-based TT... |
Status of anesthesiology resident research education in the United States: Structured education programs increase resident research productivity | BACKGROUND:: The enhancement of resident research education has been proposed to increase the number of academic anesthesiologists with the skills and knowledge to conduct meaningful research. Program directors (PDs) of the U.S. anesthesiology residency programs were surveyed to evaluate the status of research educatio... |
The learning curve associated with the epidural technique using the Episure™ AutoDetect™ versus conventional glass syringe: An open-label, randomized, controlled, crossover trial of experienced anesthesiologists in obstetric patients | BACKGROUND:: The Episure™ AutoDetect™ (spring-loaded) syringe has been observed to successfully identify the epidural space in 2 pilot studies. In this study we evaluated the impact of the spring-loaded syringe on the establishment of successful epidural labor analgesia (primary outcome), elapsed time for catheter plac... |
Subspecialty impact factors: The contribution of pediatric anesthesia and pain articles | BACKGROUND:: The Science Citation Index "Journal Impact Factor" (JIF) is widely used to assess journal quality and prestige. The JIFs for the specialty anesthesia are reported annually, however, the impact factors (IFs) for subspecialties in those journals have not been reported. Therefore, we compared the IFs of pedia... |
The influence of head and neck position on the oropharyngeal leak pressure and cuff position of three supraglottic airway devices | BACKGROUND:: With supraglottic airway devices, such as the laryngeal tube suction (LTS), ProSeal laryngeal mask airway (PLMA) and Cobra perilaryngeal airway (CobraPLA), oropharyngeal leak pressure or cuff position may vary according to changes in the position of the head and neck. We evaluated oropharyngeal leak pressu... |
Financial and environmental costs of reusable and single-use anaesthetic equipment | Background. An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. Methods. We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use varia... |
Failure mode and effects analysis of the universal anaesthesia machine in two tertiary care hospitals in Sierra Leone | Background. Anaesthesia care in developed countries involves sophisticated technology and experienced providers. However, advanced machines may be inoperable or fail frequently when placed into the austere medical environment of a developing country. Failure mode and effects analysis (FMEA) is a method for engaging loc... |
Predictive validity of a selection centre testing non-technical skills for recruitment to training in anaesthesia | Background. Assessment centres are an accepted method of recruitment in industry and are gaining popularity within medicine. We describe the development and validation of a selection centre for recruitment to speciality training in anaesthesia based on an assessment centre model incorporating the rating of candidate's ... |
National survey of College Tutors in the UK regarding training in medical education | Background. College Tutors are responsible for the organization of training and should possess the pre-requisite knowledge and skills to facilitate this. Methods. An anonymized survey of anaesthetic College Tutors in the UK was conducted with regard to training in medical education. Results. A response rate of 65.54% w... |
National critical incident reporting systems relevant to anaesthesia: A European survey | Background. Critical incident reporting is a key tool in the promotion of patient safety in anaesthesia. Methods. We surveyed representatives of national incident reporting systems in six European countries, inviting information on scope and organization, and intelligence on factors determining success and failure. Res... |
Comparative effectiveness and safety of physician and nurse anaesthetists: A narrative systematic review | Background. Despite widespread debate on the merits of different models of anaesthesia care delivery, there are few published data on the relative safety and effectiveness of different anaesthesia providers. Method. We conducted a systematic search for, and critical appraisal of, primary research comparing safety and e... |
The State of UK anaesthesia: A survey of National Health Service activity in 2013 | Background. Details of current UK anaesthetic practice are unknown and were needed for interpretation of reports of accidental awareness during general anaesthesia (GA) within the 5th National Audit Project. Methods.We surveyed NHS anaesthetic activity to determine numbers of patients managed by anaesthetists and detai... |
Expertise in practice: An ethnographic study exploring acquisition and use of knowledge in anaesthesia | Background. Expert professional practice in any field is known to rely on both explicit (formal) and tacit (personal) forms of knowledge. Current anaesthetic training programmes appear to favour explicit knowledge and measurable competencies. We aimed to describe and explore the way different types of knowledge are lea... |
Misuse of standard error of the mean (SEM) when reporting variability of a sample. A critical evaluation of four anaesthesia journals | Background. In biomedical research papers, authors often use descriptive statistics to describe the study sample. The standard deviation (SD) describes the variability between individuals in a sample; the standard error of the mean (SEM) describes the uncertainty of how the sample mean represents the population mean. A... |
What information do anesthetics provide for patients? | Background. Information on anaesthesia interventions, plans and risks is needed by patients and carers alike and is a key component of the Good Practice In Consent initiative. Existing information materials may under-represent what patients are able to contribute. Method. UK anaesthetic departments were surveyed on pro... |
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