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1.
Rev. colomb. anestesiol ; 49(4): e600, Oct.-Dec. 2021.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341248

RESUMO

Malignant hyperthermia (MH) is often neglected in anesthesia because of its rare incidence (around 1:100,000 general anesthetics). However, when it occurs, it becomes the anesthesiologist's nightmare. In the United States, Canada, and in most European countries, it is mandatory to store dantrolene wherever halogenated agents and/or succinylcholine are used by anesthesia providers (including sites that use only succinylcholine and no volatiles for electroconvulsive therapies). Unfortunately, its availability in Colombia is not mandatory or universal


La hipertermia maligna (HM) es algo a menudo se descuida durante el acto anestésico debido a su muy baja incidencia (aproximadamente 1:100.000 anestesias generales). Sin embargo, cuando se presenta, se convierte en una pesadilla para el anestesiólogo. En los Estados Unidos, Canadá y la mayoría de los países de Europa es obligatorio contar con dantroleno siempre que los anestesiólogos administran agentes halogenados y/o succinilcolina (incluidos los centros que utilizan succinilcolina sola sin agentes volátiles para terapias electroconvulsivas). En Colombia, infortunadamente, su disponibilidad no es obligatoria ni universal


Assuntos
Humanos , Hipertermia Maligna , Bicarbonato de Sódio , Dantroleno , Anestesiologia
2.
Rev. colomb. anestesiol ; 49(4): e700, Oct.-Dec. 2021.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341250

RESUMO

According to Professor Alejandro Jadad in his article "Toward the 'next normal': An opportunity to unlearn and reflect about life, death, and our mental health during the pandemic," 1 Which of the following feelings is perhaps the most important source of unhappiness at the end of life?


Según el profesor Alejandro Jadad en su artículo "Hacia la 'próxima normalidad': una oportunidad para desaprender y reflexionar sobre la vida, la muerte y nuestra salud mental durante la pandemia" 1 ¿Cuál de los siguientes sentimientos es quizás la fuente más importante? de la infelicidad al final de la vida?


Assuntos
Humanos , Questões de Prova , Comunicação Acadêmica , Pandemias , Anestesiologistas , Anestesiologia
3.
Rev. colomb. anestesiol ; 49(4): e100, Oct.-Dec. 2021.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1341235

RESUMO

The S.C.A.R.E. members assembly held on March 3ist, 2021, was quite revealing: its leitmotiv was the challenging work situation experienced by the colleagues across the country. The similarity with the very first assembly meeting I attended in Pasto in 1990 as a young anesthetist, invited by the tireless of doctor Jorge Osorio, was mystifying. It is rather striking to see how history repeats itself after 31 years, bringing back times that we thought were something of the past.


La asamblea de socios de la S.C.A.R.E. celebrada el 3 de marzo de 2021 fue bastante reveladora: su leitmotiv fue la desafiante situación laboral que viven los colegas de todo el país. La similitud con la primera asamblea a la que asistí en Pasto en 1990 como joven anestesista, invitado por el incansable del doctor Jorge Osorio, fue desconcertante. Es bastante llamativo ver cómo la historia se repite después de 31 años, trayendo de vuelta tiempos que creíamos que eran cosa del pasado.


Assuntos
Humanos , Anestesistas , Anestesiologia , Associação , Pensamento , Colômbia , História
4.
BMC Med Educ ; 21(1): 569, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758815

RESUMO

BACKGROUND: Competency-based medical education (CBME) has revolutionized approaches to training by making expectations more concrete, visible, and relevant for trainees. Designing, applying, and updating CBME requirements challenges residency programs, which must address many aspects of training simultaneously. This challenge also exists for educational regulatory bodies in creating and adjusting national competencies to standardize training expectations. We propose that an international approach for mapping residency training requirements may provide a baseline for assessing commonalities and differences. This approach allows us to take our first steps towards creating international competency goals to enhance sharing of best practices in education and clinical work. METHODS: We chose anesthesiology residency training as our example discipline. Using two rounds of content analysis, we qualitatively compared published anesthesiology residency competencies for the European Union (The European Training Requirement), United States (ACGME Milestones), and Canada (CanMEDS Competence By Design), focusing on similarities and differences in representation (round one) and emphasis (round two) to generate hypotheses on practical solutions regarding international educational standards. RESULTS: We mapped the similarities and discrepancies between the three repositories. Round one revealed that 93% of competencies were common between the three repositories. Major differences between European Training Requirement, US Milestones, and Competence by Design competencies involved critical emergency medicine. Round two showed that over 30% of competencies were emphasized equally, with notable exceptions that European Training Requirement emphasized Anaesthesia Non-Technical Skills, Competence by Design highlighted more granular competencies within specific anesthesiology situations, and US Milestones emphasized professionalism and behavioral practices. CONCLUSIONS: This qualitative comparison has identified commonalities and differences in anesthesiology training which may facilitate sharing broader perspectives on diverse high-quality educational, clinical, and research practices to enhance innovative approaches. Determining these overlaps in residency training can prompt international educational societies responsible for creating competencies to collaborate to design future training programs. This approach may be considered as a feasible method to build an international core of residency competency requirements for other disciplines.


Assuntos
Anestesiologia , Internato e Residência , Anestesiologia/educação , Competência Clínica , Educação Baseada em Competências , Currículo , Educação de Pós-Graduação em Medicina , Objetivos , Humanos , Estados Unidos
5.
Br J Hosp Med (Lond) ; 82(10): 1-2, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34726939

RESUMO

Airway management is fundamental to anaesthesia, and technology may help with the safety of this procedure. Videolaryngoscopy is a developing area, which is becoming commonplace in anaesthesia practice.


Assuntos
Anestesia , Anestesiologia , Laringoscópios , Manuseio das Vias Aéreas , Humanos , Intubação Intratraqueal , Laringoscopia
6.
J Hist Dent ; 69(2): 94-98, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34734789

RESUMO

For decades dentists have faced the challenge of achieving profound anesthesia in the presence of a severe tooth ache. Frequently this challenge was more acute when the tooth or teeth in question were mandibular molars. Over a 125 years ago this clinical dilemma was managed by using cocaine, both directly on an exposed dental pulp and often times using a solution of such injected directly into the pulp. Both clinical applications were considered as achieving "pressure anesthesia" sufficient to permit pulp extirpation. This historical perspective will focus on both the origins of this approach and its contemporary counterparts.


Assuntos
Anestesia Dentária , Anestesiologia , Cocaína , Dente Molar , Pulpectomia
7.
J Hist Dent ; 69(2): 104-113, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34734791

RESUMO

Henry Jacob Bigelow (1818-1890) qualified in Medicine at Harvard and was appointed Surgeon at Massachusetts General Hospital (MGH) in 1847 and to the Chair of Surgery at Harvard Medical School in 1849. His international reputation was earned by two operations he developed, namely the treatment of hip dislocation and litholapaxy. Perhaps even more important to the practice of surgery was his role in facilitating the introduction of ether anesthesia. A dentist, William Morton (1819-1868), had used ether for the painless extraction of teeth. Through Bigelow's influence, Morton was given the opportunity to use ether for more advanced surgery at Massachusetts General Hospital. There, the leg of a patient was successfully amputated on November 7, 1846. Henry Bigelow published the first full account of ether in major surgery on November 18, 1846, while not even being in the surgical team and before his own Professor, John Collins Warren. Despite the slowness of others, he ensured that ether was used continuously in Massachusetts General Hospital, championing its use and supporting the claim of William Morton as the discoverer of anesthesia.


Assuntos
Anestesia Dentária , Anestesiologia , Anestesia Geral , Éter , História do Século XIX , Humanos , Massachusetts
8.
Pan Afr Med J ; 40: 21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34733389

RESUMO

Introduction: the blended SORT-IT model uses a combination of online modules and teleconferences with local and international mentors to teach operational research. We modified SORT-IT to create the Acute Care Operational Research (ACOR) course directed to anesthesiology residents in Kigali, Rwanda. This course takes students from an initial research idea through submitting a paper for publication. Our viewpoint on entering this study was that ACOR participants would have adequate resources to complete the course, but be hampered by cultural unfamiliarity with the blended teaching approach. Methods: we conducted a qualitative analysis of the experiences of all those who participated in the ACOR course to understand obstacles and improve future course iterations. Six anesthesiology residents participated in the first iteration of the course, with 4 local mentors and 2 secondary mentors, one of whom was based at the University of Virginia, with a total of 12 participants. Semi-structured interviews were conducted with all participants and mentors, which were independently coded for topics by two reviewers. Results: there was a 50% publication rate for those enrolled in the course and an expected 100% acceptance rate for those who completed the course. Some reported benefits to the course included improved research knowledge, societal improvements, and knowledge exchange. Some reported obstacles to successful course completion included time limitations, background knowledge, and communication. Of note, only 4 out of 12 participants recognized cultural barriers. Conclusion: although successful in the sense that all participants completed their research project, ACOR did not fully solve the main issues hindering research training. Our results show that research training in low-resource settings needs a continuing and formal focus on the factors that hinder participants´ success: mentorship and time.


Assuntos
Anestesiologia/educação , Internato e Residência , Mentores , Pesquisa Operacional , Humanos , Cooperação Internacional , Ruanda , Estudantes de Medicina
10.
A A Pract ; 15(10): e01536, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34673666

RESUMO

Increasing medical student enrollment creates challenges for clinical course directors to accommodate students and to provide consistency in clinical experiences. We discuss curricular modifications addressing these challenges specific to anesthesiology electives through the creation of 2-week anesthesiology electives to provide scheduling flexibility in the clinical years. We also incorporated curricular enhancements as a consistent didactic framework congruent with the clinical experience. Since initiating these electives in 2017, annual student enrollment increased >33%. More fourth-year students have enrolled in these courses. The annual number of students matching anesthesiology has maintained ≥8% graduating class. Our highest has been 15% in 2020.


Assuntos
Anestesiologia , Educação de Graduação em Medicina , Estudantes de Medicina , Currículo , Humanos
13.
J Med Syst ; 45(12): 101, 2021 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-34661760

RESUMO

Anesthesia Information Management Systems are specialized forms of electronic medical records used by anesthesiologists to automatically and reliably collect, store, and present perioperative patient data. There are no recent academic publications that outline the names and features of AIMS in the current American and Canadian marketplace. An environmental scan was performed to first identify existing AIMS in this marketplace, and then describe and compare these AIMS. We found 13 commercially available AIMS but were able to describe in detail the features and functionalities of only 10 of these systems, as three vendors did not participate in the study. While all AIMS have certain key features, other features and functionalities are only offered by some of the AIMS. Features less commonly offered included patient portals for pre-operative questionnaires, clinical decision support systems, and voice-to-text capability for documentation. The findings of this study can inform AIMS procurement efforts by enabling anesthesia departments to compare features across AIMS and find an AIMS whose features best fit their needs and priorities. Future studies are needed to describe the features and functionalities of these AIMS at a more granular level, and also assess the usability and costs of these systems.


Assuntos
Anestesia , Anestesiologia , Sistemas de Informação Administrativa , Canadá , Humanos , Gestão da Informação , Estados Unidos
14.
A A Pract ; 15(10): e01524, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606483

RESUMO

Effective communication and conflict management are important skills for anesthesiologists and are designated by the Accreditation Council for Graduate Medical Education (ACGME) as elements of the "interpersonal and communication skill" competency (ACGME Anesthesiology Milestone Project 2020). However, structured conflict management education for anesthesiology residents remains limited. To address this gap, we developed and implemented a conflict management session incorporating didactics and application exercises using role-play and high-fidelity simulation (SIM) for anesthesiology residents (postgraduate years 3 and 4) at a tertiary academic medical institution. These sessions were well-received, and both role-play and SIM appear to help residents learn conflict management skills.


Assuntos
Anestesiologia , Internato e Residência , Anestesiologia/educação , Competência Clínica , Comunicação , Educação de Pós-Graduação em Medicina , Humanos
16.
Anesth Prog ; 68(3): 154-157, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606573

RESUMO

Leaks involving the anesthesia circuit can cause significant complications including hypoxia and hypoventilation. We present a case of a circuit leak caused by damage to the corrugated tubing attributed to improper use of the tube holder. A 58-year-old male was scheduled for resection of a palatal tumor under an intubated general anesthetic. After successful nasotracheal intubation, the anesthesiologist inserted the corrugated tubing of the anesthetic circuit into the tube holder. A leaking sound was heard and a tear in the corrugated tubing was promptly discovered. The corrugated tubing of the anesthetic circuit presumably tore because it was inserted into the groove of the tube holder at an inappropriate angle with excessive force. Anesthesiologists should be aware of potential leaks if the anesthesia circuit is damaged, which may be caused by improper use of tube holders.


Assuntos
Anestesiologia , Anestésicos , Anestesia Geral/efeitos adversos , Anestesiologistas , Humanos , Intubação Intratraqueal/efeitos adversos , Masculino , Pessoa de Meia-Idade
17.
Can J Anaesth ; 68(12): 1811-1821, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34608588

RESUMO

PURPOSE: Qualitative research (QR) take advantage of a wide range of methods and theoretical frameworks to explore people's beliefs, perspectives, experiences, and behaviours and has been applied to many areas of healthcare. The aim of this review was to explore how QR has contributed to the field of perioperative anesthesiology. SOURCE: We performed a systematic scoping review of published QR studies pertaining to the field of perioperative anesthesiology in three databases (CINAHL, Pubmed, and Embase), published between January 2000 and June 2018. We extracted data regarding publication and researchers' characteristics, main study objectives, and methodological details. Descriptive statistics were generated for each data extraction category. PRINCIPAL FINDINGS: A total of 107 articles fulfilled our inclusion criteria. We identified 13 main research topics addressed by the included studies. Topics such as "patient safety," "barriers to evidence-base medicine," "patient experiences under local/regional anesthesia," "training in practice," "experiences of care," and "implementation of changes in clinical practice" were commonly tackled. Others, such as "interprofessional communication", "work environment," and "patients'/healthcare professionals' interactions" were less common. Qualitative research was often poorly reported and methodological details were frequently missing. CONCLUSION: Qualitative research has been used to explore an array of issues in perioperative anesthesiology. Some areas may benefit from further primary research, such as interprofessional communication or patient-centred care, while other areas may deserve a detailed systematic knowledge synthesis. We identified suboptimal reporting of qualitative methods and their link to study findings. Increased attention to quality criteria and reporting standards in QR is called for.


Assuntos
Anestesiologia , Atenção à Saúde , Pessoal de Saúde , Humanos , Pesquisa Qualitativa , Local de Trabalho
20.
AORN J ; 114(4): 350-360, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34586675

RESUMO

An intraoperative power failure (IOPF) is a complete or partial absence of the electrical power supply with or without the availability of a backup generator system during an operative or other invasive procedure. An IOPF can be stressful for the OR team and puts surgical patients at risk for adverse outcomes. To prepare providers for an IOPF, a CRNA piloted a project to create an evidence-based, facility-specific cognitive aid (CA) to guide decision making and enhance patient management and outcomes during an IOPF. The project team tested the battery-power capabilities of essential anesthesia equipment, including anesthesia gas machines, IV pumps, and vital sign monitors, and included the results in the CA. A needs assessment survey was sent to the anesthesia professionals at the facility to promote clinician buy-in and solicit feedback for creating the CA.


Assuntos
Anestesia , Anestesiologia , Cognição , Fontes de Energia Elétrica , Humanos , Determinação de Necessidades de Cuidados de Saúde
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