Scaling Up Surgical Capacity in Kenya: The Kenya Hospital Assessment Tool (K-HAT)
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 Assessment Tool (K- HAT), by a group of local stakeholders, led by the Ministry of Health.
Wasting another holiday away from family and friends in the call room, I thought of the adam Sandler movie click. Essentially he gets a remote control that lets him fast forward parts of life. If you had such a remote, would you just fast forward your call shifts and move life along?
Conclusion: In the acutely ill patients with DFNFs, “damage control” fixation with CRPP can be safely performed in lieu of HA to stabilize the fracture in those unable to tolerate anesthesia or the sequelae of major surgery. Patients should be followed closely to evaluate the need for secondary surgery. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.
An obese patient goes under anesthesia for knee arthroscopy. What led to his fatal complication?The Doctors Company
Veterinary practices should consider designing and equipping a dedicated space to provide companion animal dental and oral surgical care. A single or multi-table dental suite design will allow organized and efficient delivery of dental care. Each workstation should be equipped with a procedural table that will allow for drainage, shadow-free procedural lighting, an anesthetic machine with monitoring, thermal support, anesthetic scavenger system, dental radiographic equipment, and an air-driven dental delivery system. Lift tables, dental-specific seating, swivel handpieces, and headlamp/surgical loupe lighting should also b...
We report on the realignment of the anesthesia seminar in an online flipped classroom and the development towards a hybrid model. As such, an adequate transfer of knowledge could take place under difficult conditions and at the same time the teaching concept could be further developed.PMID:34820816 | DOI:10.1055/a-1543-2913
This article shows how to interpret the raw EEG, spectrograms and processed indices for different age groups and anaesthetics and summarizes the resulting clinical benefits. While propofol and volatile anesthetics produce characteristic frontal EEG signatures with a high activity of coherent α- and δ-waves, ketamine triggers an increase in rapid γ-waves, which leads to incorrectly high indices (BIS, PSI, NI) despite deep anaesthetic levels.In children, frontal α-waves do not appear until the age of approx. 6 months and valid indices (BIS, PSI, NI) can only be derived starting at an age of approx. 12...
J Perianesth Nurs. 2021 Nov 21:S1089-9472(21)00083-6. doi: 10.1016/j.jopan.2021.04.008. Online ahead of print.ABSTRACTPURPOSE: To examine the key factors impacting surgical team performance in a military medical center.DESIGN: A retrospective, exploratory, cross-sectional design.METHODS: We reviewed 751 orthopedic surgical cases to determine the association of surgical team familiarity, surgical complexity, team size, and the presence of student registered nurse anesthetists (SRNAs) with the surgical performance measures of total operative time, turnover time, and on-time surgical start.FINDINGS: We found increases in surg...
Hoping for some honest advice here: For reasons I won't get into, my employer is asking me to perform upcoming phaco cases under "nurse anesthesia" while we look into replacing our CRNA. Employer also owns the ASC and a few of us operate there. I have serious hesitations about letting the nurses administer fentanyl without a CRNA present. Versed, fine. Propofol, obviously not. Am I crazy to put my foot down on this? I'm not comfortable with recussitation and my patients are often elderly... Read more
Conclusion: Dexmedetomidine was slightly better drug for post Bronchoscopy cough scoring whereas propofol is preferred anesthetic agent by the patient. Low dose Propofol and Dexmedetomidine both seems to be safe and effective when given as premedication during flexible Bronchoscopy.
Conclusion: EI appears to be an attactive option for TSTB patients. We postulate that EI might produce more sustainable benefits in those with pure short membranous concentric stenosis without adverse airway features. Future studies are needed to define the exact role of EI for TSTB patients.