Author: Dr Clemens

Uncategorized Published - 17 November, 2017    By - Dr Clemens
High Wastage of Infused Medications Found, But Fix Not Difficult

If the experience of researchers at Duke University Medical Center is indicative of the nation as a whole, then infused medications are being wasted throughout the perioperative process. This is the product of preparing and priming standard infusions regardless of patient and procedural characteristics. The good news is that such practices seem to be easily […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
Pain Control After Liver Transplant Inadequate for Most Patients

Better pain management protocols are needed for patients who undergo orthotopic liver transplantation, according to research presented here at the 2017 Annual Meeting of the Canadian Anesthesiologists Society (CAS). “Liver transplantation is very painful surgery,” said Hussein Sadkhan, MD, London Health Sciences Center/Western University, London, Ontario. “We conducted a retrospective study to assess pain control […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
General Anesthesia No Safer Than Sedation for TAVR

Although general anesthesia is preferred by many anesthesiologists because of a perceived superior safety profile, a study has found that it is no safer than sedation in patients undergoing transcatheter aortic valve replacement (TAVR). The retrospective trial concluded that compared with sedation, TAVR patients who receive general anesthesia do not have smaller volume requirements, fewer […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
PCT Biomarker Can Help Assess Sepsis Risk

Using biomarkers such as procalcitonin (PCT) in the ER can help physicians assess the risk for sepsis before patients are admitted to the ICU. The Society of Critical Care Medicine recently updated its sepsis guidelines, recommending early empirical broad-spectrum antibiotics that are then adjusted or de-escalated as more information becomes available. “The early identification of sepsis […]

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Uncategorized Published - 17 November, 2017    By - Dr Clemens
Pediatric Appendicitis Can Be Safely Managed as an Urgent, Rather than Emergent, Procedure

Author: Landisch RM et al., JAMA Pediatr 2017 Jun 19; The time to appendectomy, if performed within 24 hours of presentation, was not associated with perforation or other complications. Although studies are inconclusive, many physicians feel that a delay in appendectomy may result in complications (perforation) and prolonged hospital stay. Using the Pediatric National Surgical Quality Improvement […]

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Uncategorized Published - 16 November, 2017    By - Dr Clemens
Morbidity and Mortality Associated With ECMO Studied

Although extracorporeal membrane oxygenation (ECMO) continues to grow in use for patients with fulminant cardiac or respiratory failure unresponsive to conventional treatment, the rescue therapy is still associated with significant morbidity and mortality, according to a team of University of Chicago Hospitals researchers. Their national database study described the characteristics of patients undergoing the procedure, […]

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Uncategorized Published - 16 November, 2017    By - Dr Clemens
Neurologic Complications More Likely With Epidural Particulate Steroid Injections

Epidural steroid injections resulted in nearly twice the incidence of serious neurologic complications as epidural injections without steroids, according to a retrospective study, which also found soluble steroid injections to be just as safe as nonsteroid injections. Since 2012, when the FDA issued a letter of warning, “steroids have not been approved for epidural injections,” […]

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Uncategorized Published - 16 November, 2017    By - Dr Clemens
Burnout at work isn’t just about exhaustion it’s also about loneness

Authors: Emma Seppala et al Harvard Busienss Review JUNE 29, 2017 More and more people are feeling tired and lonely at work. In analyzing the General Social Survey of 2016, we found that, compared with roughly 20 years ago, people are twice as likely to report that they are always exhausted. Close to 50% of people […]

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Uncategorized Published - 16 November, 2017    By - Dr Clemens
While Imperfect, Anesthesia Guidelines Help Busy Clinicians

Karen B. Domino, MD, MPH Professor of Anesthesiology & Pain Medicine University of Washington, Seattle Martin J. London, MD Professor of Clinical Anesthesia University of California, San Francisco Avery Tung, MD Professor of Anesthesiology & Critical Care University of Chicago In an issue of Anesthesiology News, Robert E. Johnstone, MD, criticized anesthesia practice guidelines, citing “practice […]

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Uncategorized Published - 16 November, 2017    By - Dr Clemens
I’m your anesthesiologist. Let me explain what that means.

SASHA K. SHILLCUTT, MD  It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I walk in, I grab my patient’s hand, smile and say, “Hello. […]

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