Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), 2024 Otterbein University
Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson
Doctor of Nursing Practice Scholarly Projects
When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …
The New Era Of Aspiration Risk: The Dilemma Of Glp-1 Receptor Agonists, 2024 ANZCA
The New Era Of Aspiration Risk: The Dilemma Of Glp-1 Receptor Agonists, Jack D. Madden Fanzca, Andrew K. Goyen
Journal of Perioperative Nursing
There is a new wave of aspiration risk heading towards our operating theatres in the coming years. The popular weight loss drugs, glucagon-like peptide (GLP-1) receptor agonists, are providing us with new dilemmas in fasting guidelines and airway management. What does the anaesthetic team need to know?
Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), 2024 Wayne State University
Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), Olivia Heppell, Carlos Guerra Londono, Nilesh Gupta
Medical Student Research Symposium
Introduction: Upregulation of hypoxia-inducible factors (HIF) is an important pathological feature shared by clear cell renal cell carcinoma (ccRCC) and obstructive sleep apnea (OSA). However, it is unclear whether OSA alters the pathogenesis of ccRCC via HIF expression.
Methods: A retrospective cohort of adults undergoing nephrectomy for ccRCC was identified electronically (IRB#16040-1). The diagnosis of OSA was established with preoperative STOP-BANG scores or polysomnography. A consecutive sample of 20 individuals with and 20 without OSA was selected. Clinical characteristics and pathology results were reviewed. Resected tumor sections were immunohistochemically stained for HIF-1& HIF-2 at antibody dilutions of 1:150. Intensity and …
Variation In Transcript Reports Among Residency Applicants: An Anesthesia Program’S Perspective, 2024 HCA Florida Westside Hospital
Variation In Transcript Reports Among Residency Applicants: An Anesthesia Program’S Perspective, Alex M. Hendon, Imani Thornton
HCA Healthcare Journal of Medicine
Background
With recent changes made to move USMLE Step 1 and COMLEX Level 1 scores to Pass/Fail, it becomes necessary to find other metrics to evaluate residency candidates. One conserved metric included in all residency applications is medical school transcripts. This study aims to highlight the highly varied transcript reporting in a new era of holistic applicant review.
Methods
Medical school transcripts were extracted from the Electronic Residency Application Service applications to our anesthesiology residency program for the 2021-2022 application cycle. All personally identifiable information was removed. Results were categorized and tallied by 2 independent reviewers. Overall, we assessed transcript …
Evaluation Of Nursing Approach To Assessment Of Post-Operative Respiratory Depression Using A Simulation Model, 2024 Mayo Clinic
Evaluation Of Nursing Approach To Assessment Of Post-Operative Respiratory Depression Using A Simulation Model, Natalia Tarasova, Usha Asirvatham, Robin D. Goetz, Mariela Riveria, Juraj Sprung, Toby N. Weingarten
Journal of Perioperative Nursing
Introduction: Assessments of post-operative patients that have been carried out by health care providers before critical opioid-induced respiratory events often do not detect respiratory depression. We hypothesise that opioidinduced respiratory patterns present during sleep may not be properly recognised as providers typically awaken patients for vital sign checks, and awake state assessment is recorded. We used a simulation manikin model to test this hypothesis.
Methods: Nurses who work on a standard post-operative hospital ward volunteered to participate in a study designed to record vital signs on an adult male manikin. None of the nurses had formal critical care or postoperative …
A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, 2024 University of South Dakota, Sanford School of Medicine
A Case Report And Review On The Anesthetic Considerations Of Anterior Mediastinal Masses, Carter A. Schulz, Joshua D. Mohs, Andrew M. Reuter
Aesculapius Journal (Health Sciences & Medicine)
Case summary: A 15-year-old female presented with chest pain, dyspnea, and weight loss. A chest X-ray and subsequent CT scan revealed a large anterior mediastinal mass with cervical lymphadenopathy and pericardial effusion. Two biopsies under general anesthesia were performed, with the latter confirming classic Hodgkin lymphoma, nodular sclerosis subtype.
Discussion: This case underscores the significant clinical challenges posed by anterior mediastinal masses due to their proximity to vital cardiovascular and respiratory structures. Physiologic changes during general anesthesia can exacerbate these challenges. Preoperative assessment, including imaging and symptom evaluation, is crucial to guide operative planning. It is key to individualize the …
Drug-Free Noninvasive Thermal Nerve Block: Validation Of Sham Devices, 2023 Thomas Jefferson University
Drug-Free Noninvasive Thermal Nerve Block: Validation Of Sham Devices, Michael Fishman, Ahish Chitneni, Alaa Abd-Elsayed, Samuel Grodofsky, Ashley Scherer, Brendan Schetzner, Malvina Klusek, Stephen Popielarski, Stephen Meloni, Steven Falowski, Philip Kim, Konstantin Slavin, Stephen Silberstein
Department of Jefferson Headache Center papers and presentations
Headache is a leading cause of disability and suffering. One major challenge in developing device treatments is demonstrating their efficacy given devices' often-high placebo rate. This paper reviews the importance of validating sham devices as part of finalizing the design for larger-scale prospective randomized controlled trials in patients with chronic headache as well as the results of a prospective, single-blind trial to validate two potential sham noninvasive thermal nerve block devices. Study participants were trained to self-administer thermal nerve block treatment using sham devices in an office visit. Two different sham systems with different temperature profiles were assessed. Devices were …
Perioperative Chest X-Ray Interpretation For Anesthesia Providers, 2023 The University of Southern Mississippi
Perioperative Chest X-Ray Interpretation For Anesthesia Providers, Kaitlyn Brown, Jessica Parsons
Doctoral Projects
Currently, a knowledge gap exists among anesthesia providers regarding perioperative chest x-ray (CXR) appropriateness and interpretation (Collins, 2022). The Council on Accreditation (COA) requires that students graduating from a nurse anesthesia program (NAP) interpret a minimum of five CXRs before program completion (Council on Accreditation [COA], 2020). This DNP project aimed to address the knowledge gap by offering an easily accessible online forum that guides anesthesia providers on CXR indications in surgical patients, and in identifying pathologies and invasive line and tube placement using CXR.
The authors created four learning modules regarding perioperative CXRs using Microsoft PowerPoint presentations with animation …
The Analgesic Efficacy Of Ultrasound-Guided Transversus Abdominis Plane Block Vs. Local Anesthetic Infiltration Technique In Major Gynecologic Surgery: A Randomized Controlled Trial, 2023 Aga Khan University
The Analgesic Efficacy Of Ultrasound-Guided Transversus Abdominis Plane Block Vs. Local Anesthetic Infiltration Technique In Major Gynecologic Surgery: A Randomized Controlled Trial, Samina Ismail, Akbar A. Mistry, Ali S. Siddiqui, Aliya Aziz, Nadeem Zuberi
Department of Anaesthesia
Background and aim: Transversus abdominis plane (TAP) block and local anesthetic infiltration (LAI) technique are used as part of the multimodal analgesic regimen after abdominal surgery. Postoperative opioid consumption and analgesic efficacy was compared using TAP and LAI techniques in patients undergoing gynecologic surgery in a randomized, controlled clinical trial.
Material and methods: Total of 135 patients scheduled for major gynecological surgeries were allocated into three groups: group T received bilateral TAP block with bupivacaine 0.25%; group I received LAI with 0.25% bupivacaine with epinephrine 5 μ/mL in the peritoneum and abdominal wall, and group C was control group. Anesthesia …
Angiotensin Ii In Liver Transplantation (Anglt-1): Protocol Of A Randomised, Double-Blind, Placebo-Controlled Trial., 2023 Thomas Jefferson University
Angiotensin Ii In Liver Transplantation (Anglt-1): Protocol Of A Randomised, Double-Blind, Placebo-Controlled Trial., Michael Bokoch, Amy Tran, Erika Brinson, Sivan Marcus, Meghana Reddy, Elizabeth Sun, Garrett Roll, Manuel Pardo, Scott Fields, Dieter Adelmann, Rishi Kothari, Matthieu Legrand
Department of Anesthesiology Faculty Papers
INTRODUCTION: Catecholamine vasopressors such as norepinephrine are the standard drugs used to maintain mean arterial pressure during liver transplantation. At high doses, catecholamines may impair organ perfusion. Angiotensin II is a peptide vasoconstrictor that may improve renal perfusion pressure and glomerular filtration rate, a haemodynamic profile that could reduce acute kidney injury. Angiotensin II is approved for vasodilatory shock but has not been rigorously evaluated for treatment of hypotension during liver transplantation. The objective is to assess the efficacy of angiotensin II as a second-line vasopressor infusion during liver transplantation. This trial will establish the efficacy of angiotensin II in …
Decreasing Perioperative Medication Errors With Standardized Labeling Education, 2023 University of Tennessee, Knoxville
Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).
LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.
METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …
Early Goal-Directed Hemostatic Therapy For Severe Acute Bleeding Management In The Intensive Care Unit: A Narrative Review, 2023 Hospital Vila Nova Star, Brazil
Early Goal-Directed Hemostatic Therapy For Severe Acute Bleeding Management In The Intensive Care Unit: A Narrative Review, Tomaz Crochemore, Görlinger Klaus, Marcus Lance
Anaesthesiology, East Africa
This is a narrative review of the published evidence for bleeding management in critically ill patients in different clinical settings in the intensive care unit (ICU). We aimed to describe “The Ten Steps” approach to early goal-directed hemostatic therapy (EGDHT) using point-of-care testing (POCT), coagulation factor concentrates, and hemostatic drugs, according to the individual needs of each patient. We searched National Library of Medicine, MEDLINE for publications relevant to management of critical ill bleeding patients in different settings in the ICU. Bibliographies of included articles were also searched to identify additional relevant studies. English-language systematic reviews, meta-analyses, randomized trials, observational …
Implementation Of A Single-Patient-Use Airway Taping Product In The Operating Room, 2023 University of Tennessee, Knoxville
Implementation Of A Single-Patient-Use Airway Taping Product In The Operating Room, Savannah Sierra Nicole Craig, Kaitlin D. Burrell, Jennifer Patrick
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
BACKGROUND: Anesthesia providers use adhesive tape to secure advanced airway devices. Rolls of adhesive tape serve as reservoirs for pathogens. Rolls of tape do not have instructions on how they are to be reused, cannot be disinfected, and should not be repurposed. The re-use of rolls of tape poses a risk to patient safety.
LOCAL PROBLEM: The project facility was an academic medical center in the Southeast region of the United States. The facility does not have taping practice guidelines in place. Rolls of tape are handled without gloves, used by several providers, placed on multiple patients’ faces, and stored …
Implementation Of Standardized Handoff Report In The Post Anesthesia Care Unit, 2023 University of Tennessee, Knoxville
Implementation Of Standardized Handoff Report In The Post Anesthesia Care Unit, Christie Faye Cox, Godsy Raju, Alyssa Garcia, Nicole Odom, Jennifer Patrick
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
BACKGROUND: Handoff communication is a critical event as it involves the transfer of patient details, authority, and responsibility from one clinician to another. The variations in handoff can lead to increased opportunities for clinician error due to the distinct possibility of the anesthesia providers omitting critical patient information.
LOCAL PROBLEM: The site for this quality improvement project is an academic medical center in the Southeastern region. The purpose of this quality improvement project was to implement a standardized anesthesia handoff tool for anesthesia providers. The aim of this project was after one month of implementation, the mean anesthesia …
Anesthetic Management Of Clamshell Thoracotomy For Large Tumor, 2023 Children's Mercy Kansas City
Anesthetic Management Of Clamshell Thoracotomy For Large Tumor, Kasey Brooks, Nathaniel Lata
Posters
No abstract provided.
The Implementation Of A Pectus Bar Insertion Eras Pathway, 2023 Children's Mercy Hospital
The Implementation Of A Pectus Bar Insertion Eras Pathway, Todd A. Glenski, Emily Weisberg, Christian M. Taylor, Brandon Layton, Andrea Melanson, Sameer Lalani
Posters
No abstract provided.
Role Of A Multidisciplinary Pulmonary Embolism Response Team And Impact Of Interventional Therapy In The Management Of Patients With Intermediate-High Risk Pulmonary Embolism, 2023 Cardiovascular Intensive Care Unit, Department of Cardiothoracic Anesthesiology and Critical Care Medicine, Swedish Heart and Vascular Institute, Swedish Medical Center, US Anesthesia Partners Washington, Seattle, Wash.
Role Of A Multidisciplinary Pulmonary Embolism Response Team And Impact Of Interventional Therapy In The Management Of Patients With Intermediate-High Risk Pulmonary Embolism, Juan N Pulido, Robert Fletcher, Michelle A. Poitevin, Kristina Pratt, Paul P Huang, Eric J Lehr, George P Pappas
Articles, Abstracts, and Reports
Background: Despite emerging interventional options for pulmonary embolism (PE), the mortality rate for intermediate high-risk PE (IHR-PE) remains high and the optimal therapeutic approach unclear due to a lack of robust outcomes data. We describe the outcomes of patients presenting with IHR-PE managed by a multidisciplinary PERT program with all available reperfusion options.
Methods: This single center retrospective study included EMR data from patients that were a part of the multidisciplinary PERT program from January 2012 to June 2023. PERT was activated if risk of death was intermediate or higher. The simplified pulmonary embolism severity index (sPESI) and Bova score …
Peripheral Nerve Catheter Securement: A Narrative Literature Review, 2023 The University of Notre Dame Australia
Peripheral Nerve Catheter Securement: A Narrative Literature Review, Joshua M. Wiesel, Bernadette R. Findlay, Li Ching Ooi, Jennifer A. Stevens, Renata Hadzic
Journal of Perioperative Nursing
Peripheral nerve catheters are commonly used to provide analgaesia and improve patient outcomes. Catheter dislodgment, displacement or leakage can result in premature cessation of analgaesic effect. There are currently no published guidelines for how to secure peripheral nerve catheters.
This narrative review explores and integrates the available research into the efficacy of peripheral nerve catheter securement products and techniques to reduce catheter dislodgement and displacement.
All studies looking at peripheral nerve catheter securement methods were included from inception until 19 October 2022 across PUBMED, Scopus, Ovid, Google Scholar, EMBASE and The Cochrane Library. The Jadad scale and Newcastle–Ottawa scale were …
Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness In Non-Intubated Septic Patients A Prospective Observational Study, 2023 Aga Khan University
Inferior Vena Cava Collapsibility Index Versus Passive Leg Raise To Assess Fluid Responsiveness In Non-Intubated Septic Patients A Prospective Observational Study, Anne Githaiga, Wangari Siika, Jeilan Mohamed, Vitalis Mung’Ayi, Idris Chikophe
Anaesthesiology, East Africa
Background: Rapid fluid loading at diagnosis of sepsis is part of standard treatment. Predictive tools of fluid responsiveness are required to guide fluid resuscitation. The Passive Leg Raise [PLR] manoeuvre can predict fluid responsiveness in non-intubated patients with sepsis. The Inferior Vena Cava Collapsibility Index [IVCCI] can also be utilised but is not routinely performed.
Aim: To investigate the correlation between Inferior Vena Cava Collapsibility Index [IVCCI] and a Passive Leg Raise [PLR] manoeuvre for the assessment of fluid responsiveness in non-intubated septic patients in a tertiary referral hospital in Sub-Saharan Africa.
Methodology: A prospective observational study which recruited non-intubated …
Who O2cov2: Oxygen Requirements And Respiratory Support In Patients With Covid-19 In Low-And-Middle Income Countries—Protocol For A Multicountry, Prospective, Observational Cohort Study, 2023 World health organization, Switzerland
Who O2cov2: Oxygen Requirements And Respiratory Support In Patients With Covid-19 In Low-And-Middle Income Countries—Protocol For A Multicountry, Prospective, Observational Cohort Study, Pryanka Relan, Srinivas Murthy, John Marshall, Djillali Annane, Sylvie Chevret, Yaseen Arabi, Wangari Siika, Sara Dominguez Rodriguez, Pauline Convocar, Janet Diaz
Anaesthesiology, East Africa
Introduction: SARS-CoV-2 has been identified as the cause of the disease officially named COVID-19, primarily a respiratory illness. COVID-19 was characterised as a pandemic on 11 March 2020. It has been estimated that approximately 20% of people with COVID-19 require oxygen therapy. Oxygen has been listed on the WHO Model List of Essential Medicines List and Essential Medicines List for Children for almost two decades. The COVID-19 pandemic has highlighted, more than ever, the acute need for scale-up of oxygen therapy. Detailed data on the use of oxygen therapy in low-and-middle income countries at the patient and facility level are …