自引率: 9%
被引量: 2866
通过率: 暂无数据
审稿周期: 12
版面费用: 暂无数据
国人发稿量: 1
投稿须知/期刊简介:
Published by Lippincott Williams and Wilkins. ISSN (printed): 0952-7907. ISSN (electronic): 1473-6500.<br> This reader-friendly, bimonthly resource provides a powerful, b
期刊描述简介:
Published by Lippincott Williams and Wilkins. ISSN (printed): 0952-7907. ISSN (electronic): 1473-6500.
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Critical care innovations: navigating pain relief in intensive care: the role of regional anesthesia.
The purpose of this article is to provide an update of regional anesthesia and its applications in the critical care patient population. Regional anesthesia including blocks of the abdomen and thorax, head and neck, as well as upper and lower extremities can be used to alleviate pain and assist in managing life-threatening conditions such as cerebral vasospasm and ventricular storm in the ICU population. There have been many advances in these techniques including ultrasound-guidance with innovative approaches that allow for more superficial procedures that are safer for critically ill patients. Regional anesthesia can decrease hospital length of stay (LOS), prevent ICU admission, shorten ICU LOS, and increase ventilator free days and may have mortality benefits. Pain management in the ICU is an important and sometimes challenging aspect of patient care. Regional anesthetic techniques have more indications and are safe, versatile tools that should be incorporated into care of critically ill patients.
被引量：- 发表：1970
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Chronic consequences of accidental dural puncture and postdural puncture headache in obstetric anaesthesia - sieving through the evidence.
Accidental dural puncture (ADP) and postdural puncture headache (PDPH) are relatively common complications of neuraxial anaesthesia and analgesia in obstetrics. Both may result in acute and chronic morbidity. This review intends to discuss the chronic implications of ADP and PDPH and raise awareness of severe and potentially life-threatening conditions associated with them. ADP may be associated with a high rate of PDPH, prolonged hospitalization and increased readmissions. Studies have shown that PDPH may lead to chronic complications such as post-partum depression (PPD), post-traumatic stress disorder (PTSD), chronic headache, backache and reduced breastfeeding rates. There are many case reports indicating that major, severe, life-threatening neurologic complications may follow PDPH in obstetric patients including subdural haematoma and cerebral venous thrombosis. Many clinicians still believe that ADP and PDPH are benign and self-limiting conditions whereas there may be serious and devastating consequences of both. It is imperative that all women with ADP and PDPH are appropriately diagnosed and treated.
被引量：- 发表：1970
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The electronic health record: does it enhance or distract from patient safety?
The electronic health record (EHR) is an invaluable tool that may be used to improve patient safety. With a variety of different features, such as clinical decision support and computerized physician order entry, it has enabled improvement of patient care throughout medicine. EHR allows for built-in reminders for such items as antibiotic dosing and venous thromboembolism prophylaxis. In anesthesiology, EHR often improves patient safety by eliminating the need for reliance on manual documentation, by facilitating information transfer and incorporating predictive models for such items as postoperative nausea and vomiting. The use of EHR has been shown to improve patient safety in specific metrics such as using checklists or information transfer amongst clinicians; however, limited data supports that it reduces morbidity and mortality. There are numerous potential pitfalls associated with EHR use to improve patient safety, as well as great potential for future improvement.
被引量：- 发表：1970
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Safety amid the scalpels: creating psychological safety in the operating room.
We briefly review the concept of psychological safety and discuss the actions that can create it in the anesthesiologist's work environment. The interest in psychological safety has grown in popularity since the publication of Amy Edmondson's book The Fearless Organization in 2018. While the concept and its benefits are described in the healthcare literature, the specific actions necessary to create it are often not. To ensure patient safety, we want members of the teams we lead to be comfortable sharing emerging problems that they see before we become aware of them. As educators, we want trainees to approach us when they do not understand something and openly participate and contribute without the fear of how others will perceive them. These scenarios require an environment of psychological safety - the ability to ask for help, admit mistakes, and be respectfully forthright with unpopular beliefs without the fear of being ostracized or ignored. Methods for creating an environment of psychological safety will be discussed.
被引量：- 发表：1970
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Beyond adverse events in anesthesiology: 'unanticipated events' and strategies for improved reporting.
Patient safety in anesthesiology has advanced significantly over the past several decades. The current process of improving care is often based on studying adverse events (AEs) and near misses. However, there is a wealth of information not captured by focusing solely on these events, potentially resulting in missed opportunities for care improvements. We review terms such as AEs and nonroutine events (NREs), and introduce the concept of unanticipated events (UEs), defined as events that deviate from intended care that may/may not have been caused by error, may/may not be preventable, and may/may not have caused injury to a patient. UEs incorporate AEs in addition to many other anesthetic events not routinely tracked, allowing for trend analysis over time and the identification of additional opportunities for quality improvement. We review both automated and self-reporting tools that currently exist to capture this often-neglected wealth of data. Finally, we discuss the responsibility of quality/safety leaders for data monitoring. Consistent reporting and monitoring for trends related to UEs could allow departments to identify risks and mitigate harm before it occurs. We review various proposed methods to expand data collection, and recommend anesthesia practices pursue UE tracking through department-specific reporting interfaces.
被引量：- 发表：1970
