Author: Dr Clemens

Uncategorized Published - 7 November, 2017    By - Dr Clemens
A Case Report From the Anesthesia Incident Reporting System

ASA Monitor 10 2017, Vol.81, 50-51. Review of unusual patient care experiences is a cornerstone of medical education. Each month, the AQI-AIRS Steering Committee abstracts a patient history submitted to the Anesthesia Incident Reporting System (AIRS) and authors a discussion of the safety and human factors challenges involved. Real-life case histories often include multiple clinical decisions, […]

Read More
Uncategorized Published - 7 November, 2017    By - Dr Clemens
Should Anesthesiologists Care About the Latest Member of the CAHPS Surveys?

Author: Zeev N. Kain, M.D., M.B.A., FAAP ASA Monitor 10 2017, Vol.81, 18-20. Zeev N. Kain, M.D., M.B.A., FAAP, is Chancellor’s Professor of Anesthesiology and Medicine, Director, Stress and Health, University of California, Irvine, Adjutant Professor, Yale University, New Haven. The American medical environment is currently experiencing a dramatic transformation, and much of that relies on […]

Read More
Uncategorized Published - 7 November, 2017    By - Dr Clemens
Nuss procedure poses potential for complications

How to Get an A for a Nuss Procedure: Management of Arrhythmias, Arrests, Allergies and Analgesia! By Lauren M. Lobaugh, M.D. A Nuss procedure is a surgical correction of a pectus excavatum chest wall deformity. It is not a common procedure, so many anesthesiologists are not familiar with it and its possible complications. A Problem-Based […]

Read More
Uncategorized Published - 7 November, 2017    By - Dr Clemens
Preventing Retained Central Venous Catheter Guidewires: A Randomized Controlled Simulation Study Using a Human Factors Approach

Authors: Maryanne Z. A. Mariyaselvam, M.B.B.S. et al Anesthesiology 10 2017, Vol.127, 658-665 Background: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for […]

Read More
Uncategorized Published - 6 November, 2017    By - Dr Clemens
Prevalence of Potentially Distracting Noncare Activities and Their Effects on Vigilance, Workload, and Nonroutine Events during Anesthesia Care

Authors: Jason M. Slagle, Ph.D. et al Anesthesiology published on October 19, 2017. Background: When workload is low, anesthesia providers may perform non–patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on […]

Read More
Uncategorized Published - 6 November, 2017    By - Dr Clemens
An International, Multicenter, Observational Study of Cerebral Oxygenation during Infant and Neonatal Anesthesia

Authors: Vanessa A. Olbrecht, M.D., M.B.A. et al Anesthesiology published on October 19, 2017. Background: General anesthesia during infancy is associated with neurocognitive abnormalities. Potential mechanisms include anesthetic neurotoxicity, surgical disease, and cerebral hypoxia–ischemia. This study aimed to determine the incidence of low cerebral oxygenation and associated factors during general anesthesia in infants. Methods: This multicenter study enrolled […]

Read More
Uncategorized Published - 6 November, 2017    By - Dr Clemens
Lying Down in Second Stage of Labor After Low-Dose Epidural Tied to Higher Odds of Spontaneous Delivery

Having women lie down during the second stage of labor after an epidural is associated with increased rates of spontaneous vaginal birth without an increase in complications, according to a randomized trial in The BMJ. Roughly 3200 nulliparous U.K. women who received low-dose epidurals were assigned to undergo the second stage of labor (after the cervix […]

Read More
Uncategorized Published - 6 November, 2017    By - Dr Clemens
Extended-Release Naltrexone Seems as Effective as Standard Treatment for Opioid Dependence

Injectable extended-release naltrexone (Vivitrol) appears to be as safe and effective as daily oral buprenorphine-naloxone for treating opioid dependence, according to a Norway-based, noninferiority trial in JAMA Psychiatry. Roughly 160 opioid-dependent adults who were discharged from addiction treatment programs were randomized to receive either oral buprenorphine-naloxone daily or extended-release intramuscular naltrexone every 4 weeks for 12 […]

Read More
Uncategorized Published - 6 November, 2017    By - Dr Clemens
Ibutilide for Conversion of Atrial Fibrillation or Flutter in Community Emergency Departments

Daniel J. Pallin, MD, MPH reviewing Vinson DR et al. Ann Emerg Med 2017 Sep 29. Ibutilide successfully cardioverted 55% of patients within 4 hours in a multicenter retrospective cohort study. Ibutilide is a class III antiarrhythmic drug that is effective for cardioverting atrial fibrillation or flutter (AF/F). However, reported rates of induced ventricular tachycardia of around 1% may […]

Read More
Uncategorized Published - 3 November, 2017    By - Dr Clemens
Are Anesthesia and Surgery during Infancy Associated with Decreased White Matter Integrity and Volume during Childhood?

Authors: Robert I. Block, Ph.D. et al Anesthesiology 11 2017, Vol.127, 788-799. Background: Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. Methods: Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy […]

Read More