Characteristics of intraoperative emergencies and perspectives on operating room emergency responses in a large Academic Medical Center: A case series

2021 ◽  
Vol 72 ◽  
pp. 110264
Author(s):  
Caoimhe C. Duffy ◽  
Joshua H. Atkins
2019 ◽  
Vol 161 (1) ◽  
pp. 164-170 ◽  
Author(s):  
Lyndy J. Wilcox ◽  
Claudia Schweiger ◽  
Catherine K. Hart ◽  
Alessandro de Alarcon ◽  
Nithin S. Peddireddy ◽  
...  

ObjectiveThis study documents the growth and course of repaired complete tracheal rings over time after slide tracheoplasty.Study DesignCase series with review.SettingTertiary pediatric academic medical center.Subjects/MethodsMedical records of pediatric patients with confirmed tracheal rings on bronchoscopy who underwent slide tracheoplasty between January 2001 and December 2015 were reviewed. Patients who had operative notes documenting tracheal sizing over time were included. Exclusion criteria included tracheal stenosis not caused by complete tracheal rings, surgical repair prior to presentation at our institution, or lack of adequate sizing information. The postoperative follow-up was examined and airway growth over time documented.ResultsOf 197 slide tracheoplasties performed during the study time period, 139 were for complete tracheal rings, and 40 of those children met inclusion criteria. The median age at time of surgery was 7 months, and the median initial airway size was 3.9 mm (n = 34). The median growth postoperatively was 1.9 mm over a median follow-up period of 57 months (0.42 mm/year), which is similar to growth rates of unrepaired complete tracheal rings ( P = .53). Children underwent a median of 10 postoperative endoscopies, with time between endoscopies increasing further out from surgery. The most commonly performed adjunctive procedure was balloon dilation.ConclusionsThis is the first study documenting continued growth of repaired complete tracheal rings after slide tracheoplasty. Postoperative endoscopic surveillance ensures adequate growth. Intervals between airway endoscopies can be increased as the child gets older, as the airway increases in size, and as long as symptoms are minimal.


2020 ◽  
Author(s):  
Michael P. Perisa ◽  
Keri Streby ◽  
Mark Ranalli ◽  
Micah A. Skeens ◽  
Nilay Shah

2016 ◽  
Vol 5 ◽  
pp. 7-12 ◽  
Author(s):  
Pedro Ramos ◽  
Eloisa Bonfá ◽  
Patrícia Goulart ◽  
Marion Medeiros ◽  
Nélson Cruz ◽  
...  

2011 ◽  
Vol 32 (11) ◽  
pp. 1127-1129 ◽  
Author(s):  
Robert Chang ◽  
M. Todd Greene ◽  
Carol E. Chenoweth ◽  
Latoya Kuhn ◽  
Emily Shuman ◽  
...  

Little is known about the epidemiology of nosocomial urinary tract-related bloodstream infection. In a case series from an academic medical center, Enterococcus (28.7%) and Candida (19.6%) species were the predominant microorganisms, which suggests a potential shift from gram-negative microorganisms. A case-fatality rate of 32.8% highlights the severity of this condition.


Neurosurgery ◽  
2018 ◽  
Vol 84 (6) ◽  
pp. E392-E401
Author(s):  
Panagiotis Kerezoudis ◽  
Amy E Glasgow ◽  
Mohammed Ali Alvi ◽  
Robert J Spinner ◽  
Fredric B Meyer ◽  
...  

2020 ◽  
Author(s):  
James Andrew McCracken ◽  
Mohamed Nakeshbandi ◽  
Jeffrey Arace ◽  
Wayne J Riley ◽  
Roopali Sharma

Abstract Background Available studies are lacking in analysis of baseline demographics and hospital presentation of patients at risk of expiring due to coronavirus disease 2019 (COVID-19), particularly Black American patients. We conducted a retrospective chart review to determine similarities in demographics and hospital presentation among patients who expired due to COVID-19 at an academic medical center in Brooklyn, New York.Study design and methods This is a retrospective observational study of 200 patients who expired due to complications of COVID-19. Patients were included in this study if they had laboratory-confirmed SARS-CoV-2 infection and expired during their admission. Data were collected on patients who expired between March 17 and April 16, 2020. Results A vast majority of patients were Black Americans (89%) with no history of international travel who had more than one comorbidity (81%), with the most common comorbidities being hypertension (84·5%), diabetes mellitus (57·5%), and obesity (41·5%). Fifty-five percent of our patient population had three or more comorbidities. Among patients with available data, C-reactive protein, lactate dehydrogenase, and ferritin values were elevated above normal limits at admission. Dyspnea was the most common presenting symptom (92·5%). Most (90·5%) presented within the first week of symptoms, with a median time of symptoms prior to expiration being 8·42 days (IQR 5·57 – 12·72). Interpretation Socioeconomic status and healthcare inequalities have greatly affected the Black population of Brooklyn, New York, and these disparities become even more apparent in COVID-19 infection. Patients presenting with numerous comorbidities and elevated inflammatory markers represent a population at high risk of in-hospital mortality.


2019 ◽  
Vol 76 (3) ◽  
pp. 644-651
Author(s):  
Pedro Tanaka ◽  
Natalya Hasan ◽  
Anita Tseng ◽  
Chinh Tran ◽  
Alex Macario ◽  
...  

2020 ◽  
pp. 000313482095143
Author(s):  
Melissa M. J. Chua ◽  
Keith Lewis ◽  
Yi-An Huang ◽  
Mary Fingliss ◽  
Alik Farber

Background Operating room (OR) inefficiency drives up cost, decreases revenue, and leads to surgeon, staff, and patient dissatisfaction. Given a low mean first-case start rate in our tertiary academic medical center, we developed a process to improve first-case start rates in an effort to increase OR efficiency. Methods A working group of the OR Executive Committee was constituted to develop and implement a multistep operational plan. This plan was predicated on a sensible staggered start framework, coordination of stakeholder responsibilities, a visual preoperative Stop/Go checklist tool, real-time measurement, and feedback. Results Within 11 days of implementation, 95% of first-start OR cases were tracked to start on time. Throughout the observation period (May 2015-July 2016), the goal of a daily mean 80% on-time start rate was either met or exceeded. Conclusions Implementation of an organized collaborative effort led to dramatic improvements in first OR case on-time rates. Such improvement in OR utilization may lead to an increase in staff and patient satisfaction and cost reduction.


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