Month: June 2016

Uncategorized Published - 7 June, 2016    By - Dr Clemens
Analgesia in Intensive Care

Authors: M Narayanan MB BS MD FRCA FCARCSI EDIC EDRA et al BJA Education. 2016;16(2):72-78. Introduction Patients in intensive care experience distress because of a multitude of factors and a significant proportion is attributable to pain.[1] A vast majority of patients report moderate to severe pain at some point during their intensive care stay. Pain can be […]

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Uncategorized Published - 6 June, 2016    By - Dr Clemens
Fentanyl Patches Overused in Vulnerable Populations

Study finds fentanyl transdermal patches are too often prescribed to opioid-naïve and elderly patients, raising their risks of fatal adverse drug events. Interview with Caleb Alexander, MD Fentanyl patches are a highly potent options for cancer and non-cancer pain patients, but are contraindicated in opioid naïve patients. However, new research indicates that physicians may be […]

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Uncategorized Published - 6 June, 2016    By - Dr Clemens
Hemostatic Therapy Using Tranexamic Acid and Coagulation Factor Concentrates in a Model of Traumatic Liver Injury

Anesthesia & Analgesia: May 17, 2016 AUTHORS: Zentai, Christian MD et al BACKGROUND: The potential clinical benefits of targeted therapy with coagulation factor concentrates (e.g., fibrinogen) and antifibrinolytic agents (e.g., tranexamic acid [TXA]) for the treatment of trauma-induced coagulopathy are increasingly recognized. We hypothesized that human fibrinogen concentrate (FC) and prothrombin complex concentrate (PCC), administered […]

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Uncategorized Published - 6 June, 2016    By - Dr Clemens
Study: Outpatient Staff Neglect Hand Hygiene 37% of the Time

By now, one would think that all health care workers know the importance of washing their hands, yet a recent study found that staff at outpatient care facilities fail to follow recommendations for hand hygiene 37% of the time, and for safe injection practices 33% of the time, even after having policies in place about […]

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Uncategorized Published - 6 June, 2016    By - Dr Clemens
QZ Modifier Found Not Representative of CRNA-Only Care

In stark contrast to a 2010 investigation suggesting that nurse anesthetists frequently provide care unsupervised by physician anesthesiologists, researchers at the University of Texas Medical Branch and the American Society of Anesthesiology’s (ASA) Department of Health Policy have found that the Medicare billing code at the center of that trial—modifier QZ—does not seem to be […]

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Uncategorized Published - 6 June, 2016    By - Dr Clemens
Evidence-Based Guidelines for Management of Post-Op Pain Issued Jointly by APS, ASA and ASRA

The American Pain Society, for the first time, has released a clinical practice guideline on managing postoperative pain. The guideline was created with input from the American Society of Anesthesiologists (ASA) and was subsequently approved by the American Society for Regional Anesthesia and Pain Medicine (ASRA), and was based on the 23-member panel’s review of […]

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Uncategorized Published - 3 June, 2016    By - Dr Clemens
Prince Dies of Fentanyl Overdose

Autopsy confirms that the pop star died of an accidental overdose of fentanyl. But questions remain regarding his pain treatment and recovery plans. Interview with Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHPThe autopsy report confirms fentanyl in Prince’s system at the time of death. Since his death, news coverage has speculated about what caused Prince to […]

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Uncategorized Published - 3 June, 2016    By - Dr Clemens
Predicting the Best Fit: A Comparison of Response Surface Models for Midazolam and Alfentanil Sedation in Procedures with Varying Stimulation

Anesthesia & Analgesia: May 17, 2016 AUTHORS: Liou, Jing-Yang MD et al BACKGROUND: Selecting an effective dose of sedative drugs in combined upper and lower gastrointestinal endoscopy is complicated by varying degrees of pain stimulation. We tested the ability of 5 response surface models to predict depth of sedation after administration of midazolam and alfentanil […]

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Uncategorized Published - 3 June, 2016    By - Dr Clemens
Does Preprocedural Ultrasound Increase the First-Pass Success Rate of Epidural Catheterization Before Cesarean Delivery? A Randomized Controlled Trial

Anesthesia & Analgesia: May 13, 2016 AUTHORS: Tawfik, Mohamed Mohamed MD et al BACKGROUND: Preprocedural ultrasound may improve the efficacy and safety of epidural catheterization, especially in difficult cases. Most studies of ultrasound-assisted epidural catheterization in the obstetric population are dated and nonblinded with inconsistent designs. This double-blind, randomized controlled study aimed to compare the […]

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Uncategorized Published - 3 June, 2016    By - Dr Clemens
Advanced Uses of Pulse Oximetry for Monitoring Mechanically Ventilated Patients.

Anesthesia & Analgesia: May 13, 2016 Authors: Tusman, Gerardo MD et al Pulse oximetry is an undisputable standard of care in clinical monitoring. It combines a spectrometer to detect hypoxemia with a plethysmograph for the diagnosis, monitoring, and follow-up of cardiovascular diseases. These pulse oximetry capabilities are extremely useful for assessing the respiratory and circulatory […]

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