This is what to remember in health reform: We are all one patient
As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine. I think it is important to know all that goes into the complex care of one patient. I am an anesthesiologist, but there is no way I could do my job without a large team. Each of us plays a role in the care of one patient. I am part of a team of people whose sole job every day is to care for you, our patient. In surgery, we start preparing well in advance, from the people who prepare the proper instruments and stock the drawers so in a second’s notice I have what I need to save your life, to the schedulers who triage add-on cases and bump elective cases to take care of life-threatening events. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
High-risk patients receiving either a self-expandable CoreValve Evolut R or a balloon-expandable SAPIEN 3 valve under either local or general anesthesia had similar outcomes in SOLVE-TAVI.Medscape Medical News
PMID: 30247867 [PubMed - as supplied by publisher]
PMID: 30247866 [PubMed - as supplied by publisher]
I was called to your room in the middle of an overnight shift. There you were, breathing quickly, neck veins bulging and oxygen levels hovering despite the mask on your face. I placed my stethoscope on your back and listened to the cacophony of air struggling to make its way through your worsening pneumonia. “We’re going to place a tube down your throat to help you breathe,” I told you. Your eyes were pleading, scared. “We’ll put you to sleep. It’ll help you breathe more comfortably. Okay?” You nodded. You had already told the doctors who cared for you during the day that if your b...
In conclusion, the collateral pathway did not appear to be only for temporary use to compensate for drainage from the edematous limb but appears more stable as a component of a compensating lymphatic system. These new dilated vessels, although functional at this point, may still be susceptible to disturbance by further alteration to the lymph vessels. PMID: 30234249 [PubMed]
The procedure, which can be carried out without an anaesthetic, uses a machine that directs blasts of ultrasound energy at the kidneys. The waves break up troublesome crystals which are passed through urine.
CONCLUSIONS: No definitive conclusion can be drawn about the type of anesthetic used and its relation to occurrence of POCD. However, the information presented is crucial, which can help to improve anesthetic usage and patient safety. PMID: 30236581 [PubMed - in process]
We report a case of an 85-year-old chronic smoker with controlled diabetes mellitus who needed an emergency laparotomy for a perforated gastric ulcer. Unfortunately, there was a shortage of ICU backup. With the successful conduct of an early surgery using combined general and regional anesthesia, the use of sugammadex (Bridion, Merck Sharp &Dohme Corp, Oss, the Netherlands) as a reversal agent, a skilled surgeon, and good postanesthesia care, the patient did not require ICU admission. He recovered fast and was discharged home 4 days after surgery. This case study aims to contribute to the literature on experience ...
CONCLUSIONS: Study results can be used as a basis to provide patients with clarifications about surgeries during the presurgery period and as a means of decreasing their anxiety about surgery and anesthesia. PMID: 30236573 [PubMed - in process]
CONCLUSION: The use of a simple rehydration protocol reduced the incidence of PONV in patients with prolonged fasting times. Time and personnel constraints were identified as barriers that prevented full compliance with the protocol. PMID: 30236569 [PubMed - in process]