Variability and Costs of Low-Value Preoperative Testing for Carpal Tunnel Release Surgery.

CONCLUSIONS: Counter to guidance from the ASA, we found that almost half of CTRs performed on ASA class I-II VHA patients were preceded by ≥1 LVT. Although the total cost of these tests is relatively modest, CTR is just one of many low-risk procedures (eg, trigger finger release, cataract surgery) that may involve similar preoperative testing practices. These results will inform site selection for qualitative investigation of the drivers of low-value testing and the development of interventions to improve preoperative testing practice, especially in locations where rates of LVT are high. PMID: 31425223 [PubMed - in process]
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research

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CONCLUSION: Lean Six Sigma methodology is a new business management strategy in the health area. It is perfectly inserted in the current context of quality and safety to the patient; therefore, relevant in the practice of anesthesiology. PMID: 31522741 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Back in May, Bruce Schoneboom wrapped up his appointment to the HHS Pain Management Best Practices Inter-Agency Task Force. The group determined best practices for managing chronic and acute pain—and addressed judicious prescribing of opioids. If you didn’t know: The CDC reports there are 192 overdose deaths in the U.S. every day. Forty percent of The post Dr. Bruce Schoneboom and the HHS Pain Task Force appeared first on Johns Hopkins Nursing Magazine.
Source: Nursing Blogs at Johns Hopkins University - Category: Nursing Authors: Tags: New On the Pulse DNP nurse anesthesiology nurse anesthetist pain month Source Type: blogs
Background: The correlation between cardiac output (CO) evaluated by echocardiography and CO measured by thermodilution (COth) varies according to different studies. A new transthoracic echocardiography (TTE) tool allows automatic calculation of the subaortic velocity time index (VTIauto) and CO (COauto). The main objective was to evaluate the correlation between COth and COauto in an anesthetized, ventilated piglet hemorrhagic shock (HS) model. The secondary objectives were to evaluate the correlation between COth and CO evaluated by manual measurements of VTI, and the preload-dependency of VTIvaresp. Methods: Eighte...
Source: Shock - Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research
Hyperoxia (ventilation with FIO2 = 1.0) has vasoconstrictor properties, in particular in the coronary vascular bed, and, hence, may promote cardiac dysfunction. However, we previously showed that hyperoxia attenuated myocardial injury during resuscitation from hemorrhage in swine with coronary artery disease. Therefore, we tested the hypothesis whether hyperoxia would also mitigate myocardial injury and improve heart function in the absence of chronic cardiovascular comorbidity. After 3 h of hemorrhage (removal of 30% of the calculated blood volume and subsequent titration of mean arterial pressure to 40 mm Hg) 19 a...
Source: Shock - Category: Emergency Medicine Tags: Online Articles Source Type: research
Background Males represent a significant portion of patients undergoing abdominal contouring. Despite this, there are few studies examining the implication of gender on complications. Objective The aim of this study was to examine the association between gender and early postoperative outcomes in patients undergoing abdominal contouring procedures. Methods The American College of Surgeons National Surgical Quality Improvement Program database (2006–2016) was queried to identify subjects undergoing panniculectomy or abdominoplasty. Minor and major complications were identified. Operative time and length of hos...
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Review Paper Source Type: research
Throughout the last decade, aesthetic breast surgery has enormously spread in the outpatient clinic setting where plastic surgeons perform the vast majority of procedures under local anesthesia as day-case operations. The “tumescent anesthesia” is defined as the injection of a dilute solution of local anesthetic combined with epinephrine and sodium bicarbonate into subcutaneous tissue until it becomes firm and tense, which is “tumescent.” The “cold tumescent anesthesia” (CTA) derives from Klein's solution with the introduction of a new concept, which is the low temperature (4°C) of t...
Source: Annals of Plastic Surgery - Category: Cosmetic Surgery Tags: Aesthetic Surgery Source Type: research
Publication date: Available online 17 September 2019Source: Advances in AnesthesiaAuthor(s): Jennifer L. Fichter, Kenneth E. Nelson
Source: Advances in Anesthesia - Category: Anesthesiology Source Type: research
Publication date: Available online 17 September 2019Source: Anesthesiology ClinicsAuthor(s): Sreekanth Cheruku, Norman Huang, Kyle Meinhardt, Marco Aguirre
Source: Anesthesiology Clinics - Category: Anesthesiology Source Type: research
Editor ’s PerspectiveWhat We Already Know about This TopicSuccessful tracheal intubation of an infant may be a challenging skill to acquire due to differing anatomy and physiology compared to older children and adultsMultiple intubation attempts may be associated with increased complicationsWhat This Article Tells Us That Is NewIn a quaternary pediatric academic center, 16% of healthy infants undergoing routine tracheal intubations had multiple laryngoscopiesThere was also a 35% incidence of hypoxemia, defined as an oxygen saturation measurement less than 90%, during induction of anesthesiaThere was evidence for an a...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
The future of surgery offers an amazing cooperation between humans and technology, which could elevate the level of precision and efficiency of surgeries so high we have never seen before. Will we have Matrix-like small surgical robots? Will they pull in and out organs from patients’ bodies? The scene is not impossible. It looks like we have come a long way from ancient Egypt, where doctors performed invasive surgeries as far back as 3,500 years ago. Only two years ago, Nasa teamed up with American medical company Virtual Incision to develop a robot that can be placed inside a patient’s body and then controlled...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Medical Augmented Reality Medical Robotics Virtual Reality in Medicine 3d printing AI artificial intelligence diagnostics gc4 Surgery surgical robot technology Source Type: blogs
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