Task Sharing in Global Anesthesia and Surgery: Workforce Concerns
AbstractPurpose of ReviewThis review highlights the role of task sharing in temporarily solving the human resource crisis in anesthesia and surgery in low- and middle-income countries (LMICs) while emphasizing the need for these countries to increase the workforce of anesthesiologists and surgeons as a permanent solution.Recent FindingsDespite the obvious need for specialists to provide safe anesthesia and surgery in the LMICs, there is still a critical shortage of skilled personnel to fill this gap. Task sharing and task shifting are temporary solutions to this crisis but continue to be a challenge. Even with such measures in place, the current specialist workforce density is a far cry from the recommended safe anesthesia and surgical workforce density.SummaryTask sharing is crucial to the future of anesthesia and surgery in LMICs, but it must be balanced with quality patient care. Upscaling of the current specialized surgical workforce in LMICs must be both qualitative and quantitative.
Dr. Laura Esserman answers the door of her bright yellow Victorian home in San Francisco’s Ashbury neighborhood with a phone at her ear. She’s wrapping up one of several meetings that day with her research team at University of California, San Francisco, where she heads the Carol Franc Buck Breast Care Center. She motions me in and reseats herself at a makeshift home office desk in her living room, sandwiched between a grand piano and set of enormous windows overlooking her front yard’s flower garden. It’s her remote base of operations when she’s not seeing patients or operating at the hospita...
Seventy percent of the global population do not have access to safe and affordable surgical and anaesthesia care, and 90% of them are found in the low-and-middle income countries. The WHO considers perioperative mortality rate (POMR) as a gross indicator for safe surgical practice. We aimed to descriptively assess the POMR of our low resource non-governmental organization (NGO) hospital in India.
Surgery has formerly been called the ‘neglected stepchild of global health.’ Although significant progress has been achieved in bringing surgical care to the forefront of global health discussions, the state of surgery in many Low- and Middle- Income Countries remains unchanged. A number of these countries are in the process of dev eloping National Surgical (including trauma), Obstetric, and Anesthesia plans (NSOAP), the vehicle that will be used to scale up surgical capacity. We aimed to describe the initial steps towards the development of the Kenya NSOAP and the development of the Kenya National Hospital Ass...
Frail patients have an increased risk of postoperative morbidity and mortality, and there is an urgent need for interventions to improve outcomes in this vulnerable group. We hypothesized that using locoregional rather than general anesthesia would significantly reduce morbidity and mortality for frail patients having complex surgery.
This study evaluates outcomes in patients undergoing urgent surgery with GET unrelated to their asymptomatic COVID-19 infection.
Triage of indeterminate pulmonary nodules to biopsy, resection, observation or ablative therapy is an essential component of comprehensive oncology care. Early NSCLC detection improves 5 year survival. Characterization of contralateral nodules enhances surgical staging in new lung cancers. Tissue diagnosis of pulmonary nodules may prevent unnecessary resection; series have reported up to 40% benign diagnosis in surgically resected nodules. We are evaluating the utility of the robotic navigational bronchoscope (Ion) in a community academic oncology program including: safety, diagnostic yield, localization efficacy, and valu...
As body temperature influences haemodynamics through a variety of autonomous mechanisms, temperature alterations may influence tissue perfusion during reconstructive- or micro-surgery. Anesthesia centrally impairs the ability to thermoregulate. We sought to describe the influence of anesthesia-induced-hypothermia on cutaneous perfusion in mice, alongside correction with active warming.
This study aimed to evaluate the effectiveness of V2 nerve blocking with bupivacaine and dexmedetomidine in decreasing postoperative pain following bimaxillary osteotomy.
Conditions: Uterine Bleeding; Atony, Uterine; Cesarean Section Complications Intervention: Sponsor: Gazi University Enrolling by invitation
Conditions: Pain, Postoperative; Pain, Acute; Pain, Chronic; Cholecystectomy; Ketamine; Dexmedetomidine; Lidocaine; Central Nervous System Depressants; Analgesia; Analgesics; Analgesic Non-narcotic Interventions: Drug: ketamine-lidocaine-dexmedetomidine; Drug: fentanyl Sponsor: Aretaieion University Hospital Not yet recruiting