Prescription Analgesia And Adjuvant Use By Pain Severity At Admission Among Nursing Home Residents With Non-Malignant Pain, 2020 University of Massachusetts Medical School
Prescription Analgesia And Adjuvant Use By Pain Severity At Admission Among Nursing Home Residents With Non-Malignant Pain, Kate L. Lapane, Anne L. Hume, Reynolds A. Morrison, William M. Jesdale
Population and Quantitative Health Sciences Publications
OBJECTIVE: We estimated the use of prescribed analgesics and adjuvants among nursing home residents without cancer who reported pain at their admission assessment, in relation to resident-reported pain severity.
METHODS: Medicare Part D claims were used to define 3 classes of analgesics and 7 classes of potential adjuvants on the 21st day after nursing home admission (or the day of discharge for residents discharged before that date) among 180,780 residents with complete information admitted between January 1, 2011 and December 9, 2016, with no cancer diagnosis.
RESULTS: Of these residents, 27.9% reported mild pain, 46.6% moderate pain ...
Managing Chronic Pain Through Advancements In Transcranial Brain Stimulation Technology Currently Used For Depression, 2020 University of South Dakota
Managing Chronic Pain Through Advancements In Transcranial Brain Stimulation Technology Currently Used For Depression, Ashley N. Skinner
The purpose of this thesis is to bring attention to alternatives to using analgesics or painkillers and potentially addictive opioid analgesics. Transcranial Magnetic Stimulation (TMS) has been proven successful in treating medication-resistant depression. This literature review will look at the links between pain and depression and examine adaptations to TMS coils in hopes of being able to stimulate the regions of the brain that interpret pain. By looking at current advancements in TMS, we can work towards adapting TMS to stimulate deeper regions. The final section of this thesis will examine how making these alternatives more popular will impact pain ...
Innovative Treatment Of Burn Wounds With Banana Leaf Dressing: A Case Report, 2020 HCA Healthcare
Innovative Treatment Of Burn Wounds With Banana Leaf Dressing: A Case Report, Kanakadurga Poduri, Brian Tucker, Pritesh Patel
Physical Medicine & Rehabilitation
No abstract provided.
Availability Of Pain Medications For Npo Patients, 2019 HCA Healthcare
Availability Of Pain Medications For Npo Patients, Anna Augustin Do, Kyle Borodunovich Do, Sean Quinonez Do, Furqan Haq, My Myers Md
In recent years, the opioid epidemic has been a key catalyst in changing the medical standards for treating both acute and chronic pain. Instead of relying heavily on narcotics for pain management, practitioners are not encouraged to adapt a non-pharmacologic, non-opioid approach to analgesia. While many guidelines have been set to standardize outpatient pain management, the rules surrounding inpatient analgesia are limited or lacking.
A Case Of Cannot Intubate, Cannot Ventilate, 2019 HCA Healthcare
A Case Of Cannot Intubate, Cannot Ventilate, Evan Davidson Md, Su Min Oon
69M with a PMH of parotid gland carcinoma status post resection and radiation therapy with extensive reconstruction, G-tube placement, COPD, multiple tracheostomies with takedowns (with refusal permanent tracheostomy over objections of family members) presented for CTR and ulnar tunnel exploration. With plans of MAC, an axillary block was placed and maintained on minimal propofol infusion. After administration of 50 mcg fentanyl due to pain, he was noted to be apnic. Ventilation via mask and #3 LMA failed, as well as placement of an 6 mm ET tube. Eventually, patient was ventilated via emergency surgical cricothyroidotomy. He was discharged on POD4.
Efficacy And Tolerability Of Adjunctive Intravenous Sodium Nitroprusside Treatment For Outpatients With Schizophrenia: A Randomized Clinical Trial, Hannah E. Brown, Oliver Freudenreich, Xiaoduo Fan, Stephen O. Heard, Donald Goff, George Petrides, Amy Harrington, John M. Kane, Heidi Judge, Bettina Hoeppner, Maurizio Fava, Roy H. Perlis
Importance: Antipsychotic medications for the treatment of schizophrenia have limitations, and new treatments are needed. A prior pilot investigation suggested that adjunctive sodium nitroprusside (SNP) administered intravenously had rapid efficacy in the treatment of patients with schizophrenia.
Objective: To determine the efficacy and tolerability of intravenous SNP infused at a rate of 0.5 mug/kg/min for 4 hours in patients with schizophrenia with some degree of treatment resistance.
Design, Setting, and Participants: Multicenter, randomized, double-blind acute treatment study using a sequential parallel comparison design conducted in two 2-week phases at 4 academic medical centers beginning May 20, 2015 ...
Comparison Of Post-Operative Pain Control Modalities For Pectus Excavatum Repair, 2019 Children's Mercy Hospital
Comparison Of Post-Operative Pain Control Modalities For Pectus Excavatum Repair, Charlene Dekonenko
This study compares patient outcomes following pectus excavatum repair using cryoablation, epidural, or patient-controlled analgesia for post-operative pain control. Primary outcome: length of stay
Secondary outcomes: operative time, pain scores, time to only oral analgesics.
Conclusion: Intercostal cryoablation during minimally invasive pectus excavatum repair significantly reduces length of stay and time to oral analgesics alone.
The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava
Evidence-Based Practice Project Reports
The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient ...
Utilizing Simulation To Implement Cognitive Aids In The Operating Room, 2019 Southern Illinois University Edwardsville
Utilizing Simulation To Implement Cognitive Aids In The Operating Room, Kaitlyn Brown
Doctor of Nursing Practice Projects
Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events.
Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education.
Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education ...
Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, 2019 University of California, Irvine
Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain
Psychology Faculty Articles and Research
The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.
This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain Scale-Revised, children; Numeric Rating Scale, parents) on postoperative recovery days 1, 2, and 3, reflecting an overall pain level for the past 24 h. Parents also completed a log of analgesic administration. Based on postoperative pain scores, parent-child dyads were classified as overestimators (i.e., parents rated their child's pain higher than children rated their own pain), in agreement (i.e., rating in agreement), or underestimators (i.e., parents rated their child's pain lower than children rated their own pain).
Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, 2019 Valparaiso University
Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll
Evidence-Based Practice Project Reports
Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine ...
Changing Healthcare Provider And Parent Behaviors In The Pediatric Post‐Anesthesia‐Care‐Unit To Reduce Child Pain: Nurse And Parent Training In Postoperative Stress (Np‐Tips), Brooke N. Jenkins, Michelle Fortier, Robert S. Stevenson, Mai Makhlouf, Paulina Lim, Remy Converse, Zeev N. Kain
Psychology Faculty Articles and Research
Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain.
In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents (N ...
Low Back Pain, A Comprehensive Review: Pathophysiology, Diagnosis, And Treatment (Poster), 2019 Harvard Medical School
Low Back Pain, A Comprehensive Review: Pathophysiology, Diagnosis, And Treatment (Poster), Ivan Urits, Aaron Burshtein, Medha Sharma, Lauren Testa, Peter A. Gold, Vwaire Orhurhu, Omar Viswanath, Mark R. Jones, Moises A. Sidransky, Alan D. Kaye
Senior Scholars Program
Purpose of Review: Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general U.S. adult population is 10-30%, and the lifetime prevalence of U.S. adults is as high as 65-80%.
Recent Findings: Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology. Etiologies of low back pain include myofascial pain, facet joint pain, sacroiliac joint pain, discogenic pain, and spinal stenosis, and failed back surgery. In chronic back pain patients, a multidisciplinary, logical approach to treatment is ...
Npo Or Ama? Patients Allowed Clear Liquids Up To 2 Hours Pre-Procedure Have Equivalent Aspiration Risk And Increased Patient Satisfaction, 2019 University of Wayne State Medical School
Npo Or Ama? Patients Allowed Clear Liquids Up To 2 Hours Pre-Procedure Have Equivalent Aspiration Risk And Increased Patient Satisfaction, Erich Smith
Clinical Research in Practice: The Journal of Team Hippocrates
A critical appraisal and clinical application of Itou K, Fukuyama T, Sasabuchi Y, et al. Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. Journal of Anesthesia. 2012;26(1):20-27. doi: 10.1007/s00540-011-1261-x.
Development Of A Descriptive Model Of Flow Disruption Effect On Bypass Time In A Cardiovascular Operating Room, 2019 Embry-Riddle Aeronautical University
Development Of A Descriptive Model Of Flow Disruption Effect On Bypass Time In A Cardiovascular Operating Room, Timothy J. Disher
Dissertations and Theses
The current paper proposes utilizing extant flow disruption data, collected from two cardiovascular operating rooms, and utilizing that to develop a mathematical model. Of particular interest is bypass time which is a critical surgical phase, the length of which has been linked to post-operation complications such as hospital-borne infections and readmission. By developing a model that predicts bypass time, the present research can determine the impact by types of flow disruptions – coded based on the RIPCHORD-TWA taxonomy, team member disrupted, and where in the surgery the FD occurs.
After a review of literature, a variety of models were explored to ...
Protecting Patients Who Lack A Voice, 2019 University of Tuebingen (Germany), BG Trauma Hospital Tuebingen
Protecting Patients Who Lack A Voice, Rainer Spiegel
Neither human young today nor future human generations nor non-human species have a voice in protecting the biosphere. Treves et al. propose courts and trustees for defending their interests. I describe an analogy with attempts to represent the interests of children and comatose patients in medicine.
Non-Human Animals Providing Rescue In Medical Emergencies, 2019 University of Tuebingen (Germany), BG Trauma Hospital Tuebingen
Non-Human Animals Providing Rescue In Medical Emergencies, Rainer Spiegel
In their target article, Chapman & Huffman challenge the quotation of Sir William Osler that the desire to take medication distinguishes humans from non-human animals. They provide examples of self-medication in non-human animals. Based on these examples, it can be inferred that non-human animals practice at least some form of medicine for symptom control. I would like to extend this view by showing that non-human animals not only provide self-medication, but also rescue others facing emergencies.
Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, 2018 The University of Southern Mississippi
Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, Madison Nowell
Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at ...
The Impact Of Joint Commission International Accreditation On Time Periods In The Operating Room: A Retrospective Observational Study, Takenori Inomata, Ju Mizuno, Masao Iwagami, Shiori Kawasaki, Akie Shimada, Eiichi Inada, Tina Shiang, Atsushi Amano
Open Access Articles
The Joint Commission International (JCI) is responsible for upholding standards in healthcare and organizations in compliance receive accreditation. JCI requires quality improvement on patient safety goals, but requirements may prolong the total procedure/surgery time and reduce efficiency. Here, we evaluate the impact of JCI requirements on time periods in the operating room. We included patients who received elective and emergency surgeries under general anesthesia at Juntendo University Hospital between December 2014 and June 2016. Patients were classified as before and after JCI accreditation on December 12, 2015. The primary outcome was total procedure/surgery time. Secondary outcomes include five ...
A Chronology For The Identification And Disclosure Of Adverse Effects Of Succinylcholine, 2018 University of Massachusetts Medical School
A Chronology For The Identification And Disclosure Of Adverse Effects Of Succinylcholine, Lisa Huang, Christine N. Sang, Manisha S. Desai
Anesthesiology and Perioperative Medicine Publications
Background: New therapies are created to address specific problems and enjoy popularity as they enter widespread clinical use. Broader use can reveal unknown adverse effects and impact the life cycle significantly. Succinylcholine, a depolarizing neuromuscular blocker, was the product of decades of research surrounding the ancient compound, curare. It was introduced into practice in the 1940s by Burroughs Wellcome and Company (BW Co.) and was welcomed due to its rapidly acting muscle relaxation effects. Global clinical use revealed adverse effects, both minor and major, in particular, hyperkalemia and malignant hyperthermia. We investigated when practitioners and the manufacturer became aware of ...