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Authors: Neumann JT et al. JAMA Cardiol 2016 Jun 1. Carlton E et al. JAMA Cardiol 2016 Jun 1. Two large studies show that troponin levels that are normal at presentation and not increased 1 hour later can rule out myocardial infarction. Prior research has suggested that negative and nonincreasing high-sensitivity cardiac troponin (hsTn) levels measured at emergency department (ED) presentation […]
Read MoreAuthors: Girardis M et al. JAMA 2016 Oct 18. Ferguson ND.JAMA 2016 Oct 18. Outcomes were worse with a conventional high-oxygenation goal than with a conservative moderate-oxygenation goal. Increasingly, excess oxygen administration is recognized as a risk factor for adverse outcomes when used perioperatively (NEJM JW Infect Dis Nov 2009 and JAMA 2009; 302:1543) or after myocardial infarction (NEJM JW Hosp Med […]
Read MoreAuthors: Jaber S et al. JAMA 2016 Mar 15. Hernández G et al. JAMA 2016 Mar 15.Spoletini G et al. JAMA 2016 Mar 15. High-flow oxygen and noninvasive positive pressure ventilation lowered reintubation rates in selected patient populations. During the past few years, interest has grown in using high-flow oxygen (HFO) and noninvasive positive pressure ventilation (NPPV) in lieu of intubation and […]
Read MoreToday is the official New Year Holiday so there is no post so enjoy the family.
Read MoreCMS recently issued an interim final rule with comment period that exempts MIPS-eligible clinicians in disaster areas from submitting data for the quality, improvement activities and advancing care information performance categories. The interim final rule includes the Extreme and Uncontrollable Circumstances policy, which applies to MIPS clinicians who have been affected by the Northern California wildfires and Hurricanes […]
Read MoreIf there were any doubts about the efficacy of the STOP-Bang questionnaire to predict perioperative complications, they can be put to rest, thanks to a meta-analysis by a group of Ontario researchers. The investigators found that patients who score high on the obstructive sleep apnea (OSA) STOP-Bang questionnaire are at higher risk for perioperative complications, […]
Read MoreStudy Summary A team of investigators retrospectively analyzed 346,861 anesthesia cases that involved attempted tracheal intubation from 2004 to 2013 at seven academic centers. Of these, 1427 patients (0.41%) had a failed direct laryngoscopy, leading to 1619 subsequent intubation attempts. The majority of these rescue attempts (69%) were managed with video laryngoscopy, followed in frequency […]
Read MorePatients need only half of the opioids they’re prescribed after surgery and take only a fraction of the opioids they receive, according to new research published in the Annals of Surgery, which suggests overprescribing the painkillers increases the risk of abuse. Researchers at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., assessed the post-op opioid prescription fill […]
Read MoreThe interscalene and supraclavicular nerves may be the blocks of choice in shoulder surgery, but both present the risk for respiratory distress. Ultrasound guidance provides a third option: the suprascapular block. Indeed, the suprascapular block provides analgesia similar to the other two blocks, but without compromise in pulmonary function. “For years, the standard for shoulder […]
Read MoreThe patient’s physical status, the duration of surgery and the surgical specialty are all factors affecting the likelihood of unplanned hospital admission after ambulatory surgery. “Ambulatory surgery patients with higher ASA [American Society of Anesthesiologists] physical status scores coming in for longer procedures are at greatest risk for needing an unplanned admission to the hospital,” […]
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