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Korean Journal of Anesthesiology Feb 2021
Topics: Anesthesiology; Bibliometrics; Humans; Republic of Korea
PubMed: 33535726
DOI: 10.4097/kja.21015 -
Anesthesiology Jul 2023
Topics: Brain; Anesthesia; Anesthesiology
PubMed: 37279104
DOI: 10.1097/ALN.0000000000004571 -
British Journal of Anaesthesia Oct 2020Coronavirus disease 2019 (COVID-19; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] has dislocated clinical services and postgraduate training. To better... (Review)
Review
Coronavirus disease 2019 (COVID-19; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] has dislocated clinical services and postgraduate training. To better understand and to document these impacts, we contacted anaesthesia trainees and trainers across six continents and collated their experiences during the pandemic. All aspects of training programmes have been affected. Trainees report that reduced caseload, sub-specialty experience, and supervised procedures are impairing learning. Cancelled educational activities, postponed examinations, and altered rotations threaten progression through training. Job prospects and international opportunities are downgraded. Work-related anxieties about provision of personal protective equipment, and risks to self and to colleagues are superimposed on concerns for family and friends and domestic disruption. These seismic changes have had consequences for well-being and mental health. In response, anaesthetists have developed innovations in teaching and trainee support. New technologies support trainer-trainee interactions, with a focus on e-learning. National training bodies and medical regulators that specify training and oversee assessment of trainees and their progression have provided flexibility in their requirements. Within anaesthesia departments, support transcends grades and job titles with lessons for the future. Attention to wellness, awareness of mental health issues and multimodal support can attenuate but not eliminate trainee distress.
Topics: Anesthesiology; Anesthetists; Attitude of Health Personnel; COVID-19; Coronavirus Infections; Curriculum; Diagnosis-Related Groups; Education, Medical, Graduate; Humans; Mental Health; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Students, Medical; Teaching
PubMed: 32773215
DOI: 10.1016/j.bja.2020.07.011 -
Anesthesiology Clinics Dec 2021Simulation has played a critical role in medicine for decades as a pedagogical and assessment tool. The labor and delivery unit provides an ideal setting for the use of... (Review)
Review
Simulation has played a critical role in medicine for decades as a pedagogical and assessment tool. The labor and delivery unit provides an ideal setting for the use of simulation technology. Prior reviews of this topic have focused on simulation for individual and team training and assessment. The COVID-19 pandemic has provided an opportunity for educators and leaders in obstetric anesthesiology to rapidly train health care providers and develop new protocols for patient care with simulation. This review surveys new developments in simulation for obstetric anesthesiology with an emphasis on simulation use during the COVID-19 pandemic.
Topics: Anesthesiology; COVID-19; Clinical Competence; Female; Humans; Obstetrics; Pandemics; Patient Simulation; Pregnancy; SARS-CoV-2; Simulation Training
PubMed: 34776102
DOI: 10.1016/j.anclin.2021.08.001 -
Anaesthesiology Intensive Therapy 2023Heart rate variability (HRV) is a measure that shows the variation in time between consecutive heartbeats - a physiological phenomenon controlled by the autonomic... (Review)
Review
Heart rate variability (HRV) is a measure that shows the variation in time between consecutive heartbeats - a physiological phenomenon controlled by the autonomic nervous system. Over the years the analysis of this parameter has been used in many fields of medicine, including anaesthesiology, for scientific and research purposes. We carried out a review of the available literature on the applicability of HRV assessment in anaesthesiology. Several potential applications of HRV in clinical anaesthesia have been identified and proven feasible. As a non-invasive and relatively easy method to gauge the autonomic nervous system, HRV analysis can provide the anaesthesiologist with additional datapoints, potentially useful in assessing efficacy of a blockade and adequacy of analgesia, and in predicting adverse events. However, interpretation of HRV and generalizability of research findings can be problematic due to the multiplicity of factors that influence this parameter and bias in methods introduced by the researchers.
Topics: Humans; Anesthesiology; Heart Rate; Anesthesiologists; Anesthesia; Analgesia
PubMed: 37306266
DOI: 10.5114/ait.2023.126309 -
European Journal of Trauma and... Oct 2023Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and...
Cardiac arrest in the perioperative period: a consensus guideline for identification, treatment, and prevention from the European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery.
INTRODUCTION
Cardiac arrest in the operating room is a rare but potentially life-threatening event with mortality rates of more than 50%. Contributing factors are often known, and the event is recognised rapidly as patients are usually under full monitoring. This guideline covers the perioperative period and is complementary to the European Resuscitation Council guidelines.
MATERIAL AND METHODS
The European Society of Anaesthesiology and Intensive Care and the European Society for Trauma and Emergency Surgery jointly nominated a panel of experts to develop guidelines for the recognition, treatment, and prevention of cardiac arrest in the perioperative period. A literature search was conducted in MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. All searches were restricted to publications from 1980 to 2019 inclusive and to the English, French, Italian and Spanish languages. The authors also contributed individual, independent literature searches.
RESULTS
This guideline contains background information and recommendation for the treatment of cardiac arrest in the operating room environment, and addresses controversial topics such as open chest cardiac massage, resuscitative endovascular balloon occlusion and resuscitative thoracotomy, pericardiocentesis, needle decompression, and thoracostomy.
CONCLUSIONS
Successful prevention and management of cardiac arrest during anaesthesia and surgery requires anticipation, early recognition, and a clear treatment plan. The ready availability of expert staff and equipment must also be taken into consideration. Success not only depends on medical knowledge, technical skills and a well-organised team using crew resource management, but also on an institutional safety culture embedded in everyday practice through continuous education, training, and multidisciplinary co-operation.
Topics: Humans; Anesthesiology; Critical Care; Heart Arrest; Resuscitation; Thoracotomy
PubMed: 37430174
DOI: 10.1007/s00068-023-02271-3 -
BMC Medical Education Apr 2023Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all"...
BACKGROUND
Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all" approach to this problem which involves monetary incentives to lure students to these specialties. Instead, we used the marketing principle the "consumer knows best" to explore ways of elucidating the reasons and proposing solutions for such shortages.
METHODS
A convenience sample of Israeli 6th-year medical students and interns completed questionnaires to determine why they thought three specialties (geriatrics, anesthesiology, emergency medicine) were unpopular and their ideas on increasing their appeal.
RESULTS
119 6th-year students and 84 interns completed questionnaires. Geriatrics was reported having a problematic patient population; not being interesting and challenging; and not considered prestigious by colleagues and the populace. This contrasts with emergency medicine which, although considered prestigious, has difficult working conditions both during and after residency accompanied by much pressure at work. Although, improvements in lifestyle and remuneration were thought by students and interns as possibly making these specialties more attractive, reducing the pressure at work and decreasing on-call obligations were designated by the students/interns as ways to increase emergency medicine's and anesthesiology's appeal. Half the students replied that anesthesiology would be more appealing if work was in shifts (< 16 h), while 60% replied so for emergency medicine and only 18% for geriatrics. 90% of students reported that control over lifestyle would make emergency medicine more attractive while 55% and 48% replied positively for anesthesiology and geriatrics, respectively.
CONCLUSIONS
Using the concept "consumer knows best" provided additional insight into the specialty selection process. Students/interns have specialty-specific opinions as to why some specialties are unpopular. Their ideas about attracting more students to these specialties were also specialty-dependent, i.e. "one solution does not fit all". These observations render problematic a single solution aimed at ameliorating the workforce shortages of multiple specialties. Instead, these results advocate a differential approach wherein the lack of appeal of each unpopular specialty is analyzed individually and the students'/interns' (the "consumers") ideas sought resulting in solutions tailored to address each specialty's lack of attractiveness.
TRIAL REGISTRATION
None.
Topics: Humans; Career Choice; Anesthesiology; Emergency Medicine; Surveys and Questionnaires; Students, Medical; Internship and Residency
PubMed: 37081461
DOI: 10.1186/s12909-023-04241-0 -
Journal of Cardiothoracic and Vascular... Dec 2021
Review
Topics: Female; Humans; Pregnancy; Anesthesiologists; Anesthesiology; Heart; Obstetrics; Pregnancy Complications, Cardiovascular
PubMed: 34253444
DOI: 10.1053/j.jvca.2021.06.012 -
Annals of Cardiac Anaesthesia 2022
Topics: Anesthesiology; Cardiology; Heart; Humans
PubMed: 35799550
DOI: 10.4103/aca.aca_103_22 -
Anesthesiology Nov 2020
Topics: Anesthesia; Anesthesiology; Humans
PubMed: 32936864
DOI: 10.1097/ALN.0000000000003551