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Anesth Analg ; 129(5): 1197-1198, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31613808
A A Pract ; 12(10): 378-381, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31091201


Although rare, cannot intubate and cannot oxygenate situations are challenging acute events. The development of management algorithms, standardized equipment provisions, and appropriate clinical training in the application of front-of-neck access techniques are necessary to optimize procedural success to ensure adequate oxygenation. The OxyTain algorithm is an institutionally developed protocol to manage cannot intubate and cannot oxygenate events. With proper implementation, this unique process aligning the cannula cricothyroidotomy and scalpel bougie as primary and secondary techniques, respectively, can potentially optimize procedural success. This algorithmic approach is trained routinely among our anesthesia providers, while the equipment is standardized throughout our anesthetizing locations.

Manuseio das Vias Aéreas/métodos , Educação Médica Continuada/métodos , Manuseio das Vias Aéreas/instrumentação , Algoritmos , Cânula , Competência Clínica , Humanos , Intubação Intratraqueal/efeitos adversos
Pain Pract ; 18(6): 698-708, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29080245


OBJECTIVE: The objective of this study was to develop a child-friendly biofeedback-mediated relaxation device called BrightHearts. METHODS: Qualitative data were collected at a tertiary pediatric hospital to inform an iterative design process. Clinicians participated in expert group interviews to identify practical considerations that would facilitate the use of BrightHearts during procedures and provide feedback on prototype designs. Children 7 to 18 years of age participated in interactive exhibitions of the prototypes and were interviewed about their experiences using BrightHearts. RESULTS: Twenty-four clinicians participated in 6 group interviews. Thirty-nine children participated in interactive exhibitions, and 21 were interviewed. Clinicians placed high value on the following factors in the management of procedural pain: providing children with an element of control, the use of relaxation techniques, and the use of portable electronic devices such as iPads. They highlighted the need for BrightHearts to be cost effective, portable, and capable of engaging children's interest. They confirmed the utility of developing a biofeedback-assisted relaxation device for children. Based on the factors identified by clinicians, BrightHearts was developed as an iPad application (app) paired with a wireless heart rate monitor. The BrightHearts heart rate biofeedback app displays digital geometric artwork that responds to changes in heart rate. Children 7 to 17 years of age understood the concept of biofeedback and operated the app by slowing their heart rates. CONCLUSION: The BrightHearts app can be used to teach children biofeedback-assisted relaxation. Ongoing studies are evaluating its efficacy for the management of procedural pain in children.

Biorretroalimentação Psicológica/métodos , Aplicativos Móveis , Dor Processual/prevenção & controle , Terapia de Relaxamento/métodos , Adolescente , Ansiedade/prevenção & controle , Criança , Feminino , Frequência Cardíaca , Humanos , Masculino