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Researchers are developing a tool they hope will quickly identify surgery patients at greatest risk for opioid-induced respiratory depression (OIRD). With this tool, hospital staff will be better equipped to more closely monitor at-risk patients, which should reduce adverse events, increase patient safety, and improve patient satisfaction, said lead author Nicole Humbert, PharmD, Trinity Hospital, […]
Read MoreOne of strongest testaments to the effect of the prescription drug abuse epidemic on clinical practice is the increase in state mandates for opioid or controlled substance agreements that clinicians are required to have patients sign when receiving opioid prescriptions. But such agreements are not without significant controversy, raising a host of ethical issues, said […]
Read MoreAuthors: Shopp JD et al. Acad Emerg Med 2015 Sep 22. A meta-analysis found that a Daniel Score >5 is associated with a higher probability of shock from PE. Treatments for hemodynamically stable patients with confirmed pulmonary embolism (PE) vary from outpatient anticoagulation to systemic fibrinolysis. Guidelines recommend that the choice of treatment be based on risk […]
Read MoreAuthors: Wallace CD et al. Anaesthesia 2015 Sep 4. When used to obtain a direct view — for which it was not designed — the McGrath was associated with more difficult intubation and worse glottic views than a conventional Macintosh laryngoscope. Video laryngoscopes improve glottic view and first-attempt intubation success compared with direct laryngoscopes. Curved blade designs […]
Read MoreAuthors: Drake-Brockman TF et al., Anaesthesia 2015 Sep 10; In anesthetized spontaneously breathing children, leakage volume was greater, device dislodgement was more common, and first-attempt insertion success was lower with the i-gel. The i-gel is an extraglottic device with a noninflatable cuff made of a flexible gelatinous material. The PRO-Breathe is a silicone-based standard laryngeal mask airway […]
Read MoreA noninvasive wearable nerve stimulator improves pain to the point of needing less analgesia in patients with neuropathy, arthritis, and other common forms of chronic pain, a new study shows. “Our data suggest, and this is mimicked anecdotally, that this device works for about eight out of 10 people,” said Shai Gozani, MD, PhD, president […]
Read MoreAuthors: Le Manach Y et al. JAMA 2015 Sep 15. More than just age and medical comorbidity seem to be at work. Excess mortality among hip fracture–surgery patients above that seen in total hip–replacement patients has been ascribed largely to age and medical comorbidities. This French study was designed to explore potentially modifiable risk factors that contribute […]
Read MoreAuthors: Lomonte AB et al. J Rheumatol 2015 Sep. Triamcinolone and methylprednisolone worked equally well in a double-blind trial. Symptomatic knee osteoarthritis (OA) occurs in as many as 6% of adults older than 30, and the prevalence of OA rises with increasing age. Treatment of patients with symptomatic knee OA includes physical therapy, analgesics (including nonsteroidal anti-inflammatory […]
Read MoreAuthors: Angela K.M. Lipshutz et al BMC Anesthesiol. 2015;15(93) Background: Learning from adverse events and near misses may reduce the incidence of preventable errors. Current literature on adverse events and near misses in the ICU focuses on errors reported by nurses and intensivists. ICU near misses identified by anesthesia providers may reveal critical events, causal mechanisms and […]
Read MoreAn intensive biopsychosocial chronic pain and recovery program shows significant reductions in opiate use along with pain reduction, researchers report. “We have found that 63% of our chronic pain patients who come in on opiates are leaving without opiates and with a 25% reduction in pain,” lead author Bruce Singer, PsyD, director of the Chronic […]
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