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Full-Text Articles in Medicine and Health Sciences
Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda
Implementation Of Guidelines For Preprocedural Ultrasound In Neuraxial Placement For Obstetric Patients With Scoliosis, Luther Nyirenda
Doctor of Nursing Practice Scholarly Projects
Neuraxial anesthesia including epidural, spinal, and combined spinal-epidural, is used with 65% of parturients in the United States for the management of pain and discomfort. Conventional landmark palpation has been the mainstay technique for neuraxial anesthesia, but unfamiliar spinal anatomy can lead to incomplete blockade or an increased incidence of complications. Scoliosis causes lateral curvature and rotation of the spine leading to arthritis and soft tissue changes that can present obscure anatomical landmarks, cause difficulty in needle passage, and result in inadequacy of local anesthetic efficacy. The literature illustrates that preprocedural ultrasound is recommended for needle placement in parturients with …
Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison
Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison
Doctor of Nursing Practice Scholarly Projects
Thoracic surgery is considered one of the most painful surgical procedures due to its severity and the duration of the procedure. Pain is detrimental to the patient experience, and poor patient satisfaction results in revenue loss for hospitals. Maintaining adequate pain control after surgery is crucial in preventing pulmonary complications such as atelectasis and respiratory failure that prolong patient recovery. It is the responsibility of the anesthesia provider to ensure adequate pain control throughout the perioperative experience. Although current evidence-based data shows that regional anesthesia provides superior thoracic postoperative pain control, the current practice continues to be the utilization of …
Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson
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 …
Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson
Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson
Doctor of Nursing Practice Scholarly Projects
Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to …
Final Scholarly Project: Implementation Guidelines Of Ultrasound-Guided Regional Anesthesia In Pediatric Cardiac Surgical Patients, Matthew Hall
Doctor of Nursing Practice Scholarly Projects
In the United States, around 40,000 surgeries are conducted on pediatric patients yearly to address congenital heart disease. These surgeries involve a variety of complications beyond cardiovascular problems, including pain management. Traditional pain management involving intravenous opioids has drawbacks such as sedation, respiratory depression, and prolonged recovery times. As the healthcare industry moves away from opioid-centric pain management, the use of multimodal analgesia, including ultrasound-guided regional anesthesia, is being utilized. Regional anesthesia techniques, such as the transversus thoracis muscle plane block and the thoracic erector spinae block, are being considered for the ability to provide adequate pain relief while reducing …
Guidelines For Non-Anesthesia Providers Performing Point Of Care Ultrasound (Pocus) For Airway Assessment In The Emergency Room, Shannen Steinbrunner
Guidelines For Non-Anesthesia Providers Performing Point Of Care Ultrasound (Pocus) For Airway Assessment In The Emergency Room, Shannen Steinbrunner
Doctor of Nursing Practice Scholarly Projects
Effective airway management is critical for nurse anesthetists, encompassing tasks such as anesthesia administration, airway establishment, and patient safety, particularly in challenging cases where airway difficulties may arise. The subjectivity in airway assessments poses challenges for clinicians when accurately predicting difficult cases. Point-of-care ultrasound (POCUS) has emerged as a valuable tool for quantifying airway parameters, providing objective data to guide decision-making. This project aims to establish evidence-based guidelines for managing the airway in unconscious trauma patients requiring intubation using POCUS. By quantifying parameters such as PEP/E-VC ratios, hyomental distance, thyrohyoid membrane thickness, and anterior neck thickness, healthcare providers can make …
Development And Implementation Of An Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Program For Student Registered Nurse Anesthetists, Nicholas Colangelo, Zachary Wise
Development And Implementation Of An Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Program For Student Registered Nurse Anesthetists, Nicholas Colangelo, Zachary Wise
Doctor of Nursing Practice Scholarly Projects
The American Association of Nurse Anesthetists (AANA) has defined the scope of nurse anesthesia practice to include services in acute, chronic, and interventional pain management, as well as the use of ultrasound (U/S) and other diagnostic technologies. However, there are no standard curriculum requirements in place that mandate graduate programs to educate student nurse anesthetists in U/S-related modalities. In addition to the AANA, the use of U/S in nurse anesthesia practice has recently been adopted by The Council on Accreditation of Nurse Anesthesia Educational Programs (COA), which characterizes U/S use by its clinical impact on the reduction in complications, increased …
Evidence-Based Practice Guidelines For The Optimal Assessment Of The Airway In Predicting Difficult Intubation, Meredith Louden
Evidence-Based Practice Guidelines For The Optimal Assessment Of The Airway In Predicting Difficult Intubation, Meredith Louden
Doctor of Nursing Practice Scholarly Projects
Adverse respiratory events are the most common injuries in anesthesia; difficult intubation and ventilation contribute to most cases. Injuries following inadequate airway management include cerebral hypoxia, aspiration, and cardiac arrest. Despite the risk and consequences following inadequate airway management, most medical facilities lack standardized airway assessments for anesthesia providers. Current evidence implicates that ultrasound measurement of the hyomental distance demonstrates the highest specificity and accuracy in predicting difficult intubation. The traditional approach to conducting airway assessments includes Mallampati classification, which shows high specificity for predicting difficult airways only when combined with other airway assessments. The purpose of this evidence-based project …
Development Of Guidelines For Early Implementation Of Regional Anesthesia In United States Personnel With Peripheral Injuries, Matthew Baker
Development Of Guidelines For Early Implementation Of Regional Anesthesia In United States Personnel With Peripheral Injuries, Matthew Baker
Doctor of Nursing Practice Scholarly Projects
Dating back to 3200 BC, military personnel routinely experience peripheral extremity wounds during combat. Traditionally, military anesthesia providers utilized general anesthesia and opioids to treat acute pain in the combat setting. Opioids can cause adverse effects such as respiratory depression, delirium, hemodynamic instability, nausea & vomiting, and addiction, which causes delays in care and requires more resources. Regional anesthesia is gaining favor during military operations due to its safety profile and effectiveness in controlling acute pain. Regional anesthesia is safer and more effective than opioids in the trauma/combat setting. Guidelines were provided based on current evidence in the literature and …