One Doctor 's Hope for Better Patient Monitoring

Anyone who has ever been a hospital patient on a general care floor should be familiar with the standard vital check routine in which a nurse enters the room every four- to six-hours to chart your blood pressure and other vital signs to monitor your condition. But what if your condition suddenly deteriorates in between those routine checks? Is there a better way to monitor these patients? Ashish Khanna, MD, an anesthesiologist and researcher at the Cleveland Clinic believes there is. "The problem with that approach is that we are essentially seeing our patients at a snapshot of time and ignoring large chunks of time where they are possibly showing signs of deterioration," Khanna told MD+DI. In a manuscript recently published by the Journal of Critical Care, Khanna described how challenging it is to predict episodes or severity of cardiorespiratory decompression in patients who appear to be in stable condition and staying on the general care floor. The paper also describes the protocol for an ongoing global trial that could go a long way toward better monitoring protocols to detect signs of deterioration earlier. The PRODIGY trial builds on an earlier study at Cleveland Clinic that Khanna was involved with. The investigators put all of the institution's post-surgical patients who were recovering on the general care floor on continuous monitoring but blinded the clinicians to the monitoring by covering up the device and silencing the monitor's alarms. &...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Tubing Source Type: news

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(American Society of Anesthesiologists) While childbirth pain has been linked to postpartum depression, the culprit may be the pain experienced by the mother following childbirth, rather than during the labor and delivery process, suggests new research presented at the ANESTHESIOLOGY ® 2018 annual meeting.
Source: EurekAlert! - Social and Behavioral Science - Category: International Medicine & Public Health Source Type: news
Conclusion: Dexmedetomidine is effective and comparably better than tramadol or ketamine in preventing shivering after spinal anesthesia. Dexmedetomidine also provides sedation without respiratory depression and favorable surgical conditions. However, with its use a fall in blood pressure and heart rate is anticipated.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
PMID: 30303866 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Abstract BACKGROUND: The aim of this systematic review was to compare the effects of regional analgesic (RA) techniques with systemic analgesia on postoperative pain, nausea and vomiting, resources utilization, reoperation, death, and complications of the analgesic techniques in children undergoing cardiac surgery. METHODS: A search was done in May 2018 in PubMed, Embase, and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing RA techniques with systemic analgesia. Risks of bias of included trials were judged with the Cochrane tool. Data were analyzed with fixed- (I
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
Authors: Dutta A, Sethi N, Choudhary P, Sood J, Panday BC, Chugh PT Abstract OBJECTIVE: Postoperative nausea and vomiting (PONV) is commonly attributed to opioid analgesics; consequently, perioperative opioid dosage reduction is a common practice. However, inadequate fentanyl analgesia may have adverse implications (sympathetic activation, pain). We conducted this randomized clinical study to analyze whether preinduction fentanyl 3 µg kg-1 administered by different techniques increases incidence of PONV. DESIGN: Randomized-control, prospective, investigator and observer blinded, two-arm, single-center com...
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
As we follow the national opioid epidemic, with its greater than five deaths per hour from opioid overdoses, the focus is shifting to methods for limiting an individual’s exposure to these drugs. For most of us, our first contact with these highly addictive medications is after surgery. Studies now reveal that 60 percent of pills prescribed for pain after surgery go unused. These opioids often make their way to other family members, are kept for continued use by the surgical patient to maintain a feeling of euphoria, or even find their way out into the community. Limiting the number of pills and refills prescribed is...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Surgery Source Type: blogs
CONCLUSIONS: Patients with poor quality of recovery had the worst health status at D0. Evaluation at 3 months indicated similar rates of problems in EuroQol (except for pain/discomfort) and World Health Organization Disability Assessment Schedule 2.0 scores were similar. PMID: 30197270 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
8.8 percent of suicide decedents have evidence of chronic pain; percentage increased from 2003 to 2014
Source: The Doctors Lounge - Psychiatry - Category: Psychiatry Tags: Family Medicine, Internal Medicine, Neurology, Oncology, Orthopedics, Psychiatry, Rheumatology, Anesthesiology & amp; Pain, Journal, Source Type: news
Purpose of review Electroconvulsive therapy (ECT) is a well established and effective therapy in treatment-resistant depression. It is performed under general anesthesia, but no consensus exists regarding the optimal anesthetic drugs. A growing interest in optimizing adjunctive medication regimes in ECT anesthesia has emerged in recent years. Moreover different methods of seizure induction have been evaluated. Recent findings Pretreatment with dexmedetomidine eased the propofol injection pain and reduced the hyperdynamic response to ECT, but prolonged recovery. Remifentanil exhibited no proconvulsive effect and had no...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Federico Bilotta Source Type: research
Ketamine, once known primarily as a club drug, has in recent years gained legitimacy among some scientific experts as potential therapy for hard-to-treat depression. It works faster than antidepressants but wears off fairly quickly, and the health consequences of taking ketamine over months and years is so far unknown. The drug is FDA-approved as an anesthetic, and several academic centers across the U.S. run ketamine clinics; private ketamine clinics run by doctors have also sprung up. But new research points to what could be a major drawback of the drug. It seems to behave like an opioid in the brain, which experts worry...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Drugs healthytime onetime Source Type: news
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