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Intubation is a standard part of airway management in the O.R., ICU and other settings. At some point, every intubation will be followed by an extubation. But what if the extubation has complications? Few anesthesiologists think about strategies for reintubation until problems have already begun to escalate. “Extubation has percolated into most airway guidelines at […]
Read MoreAuthors: Andrew S. Huhn, Ph.D. et al Anesthesiology November 5, 2018. What We Already Know about This Topic: The prevalence of patients prescribed buprenorphine for treatment of opioid use disorder is increasing Managing acute pain in buprenorphine-maintained individuals can be challenging What This Article Tells Us That Is New: Large doses of intravenous hydromorphone can provide […]
Read MoreBy Maggie Fox American hospitals may have made a little progress in fighting one of the biggest problems threatening patients: infections they get while in the hospital. A new survey by the Centers for Disease Control and Prevention shows that the rate of hospital acquired infections has gone down a little bit. “We see things going […]
Read MoreDorsal root ganglion stimulation provides long-term relief, research shows AMERICAN SOCIETY OF ANESTHESIOLOGISTS People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting. Chronic pain – pain that lasts three months or more […]
Read MoreAuthors: Laurent Brochard, M.D. et al Anesthesiology October 2018. “How can we determine when mechanical ventilation is harming the lung…?” VENTILATOR-INDUCED lung injury is a multifaceted problem that has progressively become a preoccupation for intensivists and anesthesiologists. It has taken many years to realize that mechanical ventilation, a life-saving technique, could also induce harm. The first […]
Read MoreASA Monitor 11 2018, Vol.82, 52-55. A 48-year-old man with a history of severe depression, former heroin use and chronic low back pain presents for elective minor scar revision surgery. He is taking 8 mg of buprenorphine sublingually daily, and a recent urine screen was negative for illicit substances. Which of the following is the best course of […]
Read MoreASA Monitor 11 2018, Vol.82, 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 MoreASA Monitor 11 2018, Vol.82, 44. Which of the following characteristics is most likely in a neonate with a gastroschisis rather than an omphalocele? (A) Congenital heart disease (B) Inborn errors of metabolism (C) Absence of coverage with a membranous sac (D) Urologic abnormalities Omphalocele (Figure 1) and gastroschisis (Figure 2) represent two of the more common neonatal […]
Read MoreAuthors: Stephen H. Jackson, M.D. ASA Monitor 11 2018, Vol.82, 24-27. Ethical Principles and Informed Consent1-3 The ethical implications of routine (“screening,” non-con-sented) preoperative pregnancy testing often are obscured by scientific and legal misinformation that creates unfounded uncertainty. The process of informed consent honors what the patient wants through respecting the ethical principle of patient autonomy (self-determination). Ethically, a woman has the right to be offered pregnancy […]
Read MoreAuthors: Michael Souter, M.B., Ch.B., FRCA, FNCS ASA Monitor 11 2018, Vol.82, 20-22. Michael Souter, M.B., Ch.B., FRCA, FNCS, is Professor of Anesthesiology and Pain Medicine and Neurological Surgery/Chief of Anesthesia Services (HMC), Harborview Medical Center, University of Washington, and Medical Director, LifeCenter Northwest (Organ Procurement Organization), Seattle. Prior to a consensus on the definition of […]
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