scholarly journals A Survey of Regional Anesthesia Use In Greece And The Impact of A Structured Regional Anesthesia Course On Regional Techniques Knowledge And Practice

2021 ◽  
Author(s):  
Kassiani Theodoraki ◽  
Eleni Moka ◽  
Alexandros Makris ◽  
Evmorfia Stavropoulou
Keyword(s):  
Regional Anesthesia ◽  
Ultrasound Guidance ◽  
Electronic Database ◽  
Nerve Blocks ◽  
Training Course ◽  
Hands On ◽  
Lower Limb Surgery ◽  
Knowledge And Attitude ◽  
Ra Training ◽  
The Impact

Abstract Background: Due to the growing interest in regional anesthesia (RA) techniques and the realization of the need for formalized education in them, the Greek Chapter of the European Society of Regional Anesthesia and Pain Therapy (ESRA-Hellas) has established a structured hands-on training Course held annually since 2009, which is quite popular in the community of Greek anesthesiologists. The aim of the current survey was two-fold: first to provide an overview about the current practice of RA in Greece and secondly to evaluate the effect the aforementioned training Course has on participants’ knowledge and attitude towards RA.Methods: An electronic questionnaire was uploaded on SurveyMonkey and a link giving access to the questionnaire was forwarded via email to an electronic database of 825 practicing Greek anesthesiologists held in the electronic database of ESRA Hellas. The survey was totally anonymous and no identifying information was collected throughout. It contained questions relating to the anesthesiologists’ demographic characteristics, their RA practice and information pertaining to the RA training Course.Results: A total of 424 fully completed questionnaires were received, representing an overall response rate of 51.4%. Attendants of the Course are more familiar with the performance of peripheral nerve blocks with neurostimulation and/or ultrasound guidance as compared to non-attendants (p<0.001). Attendants are also less likely to practice exclusively general anesthesia, more likely to use peripheral blocks for lower limb surgery and more likely to consider taking the European Diploma of RA in comparison to non-attendants (p<0.001, p=0.018 and p=0,002, respectively). Both cohorts consider the Course of value and agree that the main reason to use regional techniques is to ensure optimal postoperative analgesia while the main hindrance to RA practice is the lack of relevant education in the techniques, especially those under ultrasound guidance. Regarding improvement of the Course, most participants suggested devoting ampler time in ultrasound hands-on practice and application.Conclusion: Greek anesthesiologists seek educational activities in the field of RA and the Course seems to fulfil the majority of attendants’ expectations. There will be further effort by the organizers to improve weaknesses of the current Course and undertake further educational initiatives in the field of RA according to international recommendations.

Effectiveness of an Advanced Airway Training “Boot Camp” for Family Medicine Physician Trainees

2020 ◽  
Vol 163 (2) ◽  
pp. 204-208 ◽  
Author(s):  
Kastley Marvin ◽  
Paige Bowman ◽  
Matthew W. Keller ◽  
Art A. Ambrosio
Keyword(s):  
Family Medicine ◽  
Airway Management ◽  
Family Medicine Residency ◽  
Training Course ◽  
Intubation Difficulty ◽  
Advanced Airway ◽  
Medicine Physician ◽  
Hands On ◽  
Difficulty Scale ◽  
The Impact

Objective This course was designed to characterize the impact of a curriculum for training family medicine physicians in advanced airway techniques with respect to intubation performance and learner confidence. Methods A training course was introduced into the curriculum in a single-group pretest-posttest model at a community family medicine residency program. Training consisted of a didactic teaching session on airway management and hands-on skill session with direct laryngoscopy (DL) and video-assisted laryngoscopy (VAL) on normal and difficult airway simulators. Participants were scored with the Intubation Difficulty Scale and completed surveys before and after the training. Results Twenty-eight residents of all levels participated. The mean time to successful intubation was significantly decreased after training from 51.96 to 23.71 seconds for DL and from 27.89 to 17.07 seconds for VAL. Participant scores with the Intubation Difficulty Scale were also significantly improved for DL and VAL. All participants rated their comfort levels with both techniques as high following training. Discussion Advanced airway management is a critical skill for any physician involved in caring for critically ill patients, though few trainees receive formal training. Addition of an airway training course with simulation and hands-on experience can improve trainee proficiency and comfort with advanced airway techniques. Implications for Practice Training on airway management should be included in the curriculum for trainees who require the requisite skills and knowledge necessary for advanced airway interventions. This introductory project demonstrates the efficacy and feasibility of a relatively brief training as part of a family medicine residency curriculum.

scholarly journals Evaluation of a Point-of-Care Ultrasound (POCUS) training course for Regional Anesthesiologists – A Single Institution’s Experience

2020 ◽  
Vol 1 (2) ◽  
pp. 1-7
Author(s):  
Alex K. Saltzman ◽  
Thuyvan H. Luu ◽  
Nicole Brunetti ◽  
James D. Beckman ◽  
Mary J. Hargett ◽  
...  
Keyword(s):  
Decision Making ◽  
Regional Anesthesia ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Clinical Decision ◽  
Left Ventricular ◽  
P Value ◽  
Point Of Care Ultrasound ◽  
Training Course ◽  
The Impact

Background and Objectives: Point-of-care ultrasound (POCUS) in the form of focused cardiac ultrasound (FOCUS) is a powerful clinical tool for anesthesiologists to supplement bedside evaluation and optimize cardiopulmonary resuscitation in the perioperative setting. However, few courses are available to train physicians. At Hospital for Special Surgery (HSS), from March of 2013 to May of 2016, nine basic Focused Assessed Transthoracic Echocardiography (FATE) training courses were held. A large percentage of the participants were practicing regional anesthesiologists or trainees in fellowship for regional anesthesia and acute pain. In this study, a survey was used to assess clinical utilization as well as potential barriers to use for regional anesthesiologists. Methods: Following IRB approval, 183 past participants of the basic FATE training course were contacted weekly from November 22nd, 2016, through January 3rd, 2017, via email and sent a maximum 40-item electronic survey hosted on REDCap. Responses were analyzed by a blinded statistician. Results: 92 participants responded (50%), and 65 of the 92 (70.7%) indicated they had regional anesthesiology training or practice regional anesthesia regularly. Of the total number of respondents, 50% (95% CI: 40.3%, 59.8%; P-value = 0.001) have used FOCUS to guide clinical decision making. Of the regional anesthesiologists, 27 (45.8%) have used FOCUS to guide clinical decision making with left ventricular function assessment (40.7%) and hypovolemia (39.0%) being the most common reasons. Regional anesthesiologists utilized FOCUS in the following settings: preoperatively (44.6%), intraoperatively (41.5%), postoperatively (41.5%), and in the Intensive Care Unit (40.0%). Limitations were due to lack of opportunities (52.3%), resources (36.9%), and comfort with performance (30.8%). 84.4% agreed that basic FOCUS training should be a required part of anesthesia residents or fellows’ curriculum. Conclusions: This study is the first formal evaluation of the impact of the implementation of a FOCUS training course on regional anesthesiologists’ current practice. Nearly 50% of regional anesthesiologists used FOCUS to guide clinical decision-making following formal training. The limitations to the use of FOCUS were a lack of relevant opportunities and resources. This evaluation of clinical use following training provides insight into how FOCUS is used by regional anesthesiologists and the limitations to implementation in the perioperative setting.

scholarly journals Does Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review

2019 ◽  
Vol 16 (18) ◽  
pp. 3257 ◽  
Author(s):  
Olufunke Dada ◽  
Alicia Gonzalez Zacarias ◽  
Corinna Ongaigui ◽  
Marco Echeverria-Villalobos ◽  
Michael Kushelev ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Nerve Block ◽  
Peripheral Nerve Block ◽  
Opioid Consumption ◽  
Orthopedic Procedures ◽  
Negative Consequences ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
The Impact

Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. A search of relevant keywords was performed using PubMed, EMBASE, and Web of Science. Twenty-eight articles (n = 28) were included in our review. Perioperative considerations for peripheral nerve blocks and other alternatives used for postoperative pain management in patients undergoing orthopedic surgeries were discussed. Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.

scholarly journals Lower extremity regional anesthesia: essentials of our current understanding

2019 ◽  
Vol 44 (2) ◽  
pp. 143-180 ◽  
Author(s):  
De Q Tran ◽  
Francis V Salinas ◽  
Honorio T Benzon ◽  
Joseph M Neal
Keyword(s):  
Lower Extremity ◽  
Regional Anesthesia ◽  
Lower Limb ◽  
Ultrasound Guidance ◽  
Evidence Based ◽  
Nerve Blocks ◽  
Pharmacological Agents ◽  
Current Review ◽  
American Society ◽  
Selection Of

The advent of ultrasound guidance has led to a renewed interest in regional anesthesia of the lower limb. In keeping with the American Society of Regional Anesthesia and Pain Medicine’s ongoing commitment to provide intensive evidence-based education, this article presents a complete update of the 2005 comprehensive review on lower extremity peripheral nerve blocks. The current review article strives to (1) summarize the pertinent anatomy of the lumbar and sacral plexuses, (2) discuss the optimal approaches and techniques for lower limb regional anesthesia, (3) present evidence to guide the selection of pharmacological agents and adjuvants, (4) describe potential complications associated with lower extremity nerve blocks, and (5) identify informational gaps pertaining to outcomes, which warrant further investigation.

Awareness and perception of precautionary measures against Covid 19 exposure among dental practitioners- A questionnaire based study

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 550-557
Author(s):  
Harini P ◽  
Abilasha R
Keyword(s):  
Statistical Analysis ◽  
Aerosol Formation ◽  
Dental Clinic ◽  
Attitude And Practice ◽  
Dental Practitioners ◽  
Hands On ◽  
The World ◽  
Spss Software ◽  
Precautionary Measures ◽  
Knowledge And Attitude

The most unexpected pandemic global outbreak is COVID 19 which is a newly discovered viral infection which originated in Wuhan, China and it caused the outbreak of pneumonia in the rest of the world. Dental practitioners are more susceptible to COVID 19 infection as their work is related to the aerosol formation during various procedures through which the virus spreads. The aim of the study is to create awareness about precautionary measures against COVID- 19 exposure among dental practitioners in Tamilnadu. A Survey based questionnaire was formulated with questions related to the various precautionary measures to be adopted by dental practitioners which would be effective to prevent Covid-19 exposure. A questionnaire with a total of 20 questions was circulated among dental practitioners and the responses were collected by google forms SPSS software statistical analysis was done. The overall awareness of dental practitioners against Covid-19 was above average. The dental practitioners were relatively well aware of the precautions to be adopted while treating the patients, but the implementation in practice is lacking due absence of hands-on experience in using various kinds of PPE. There is a gap between knowledge and attitude and practice among the participants of this survey. It is therefore essential to plan for organising training sessions and hands-on workshops for the use of PPE and public training of the general population regarding Covid-19 to improve the knowledge among the patients visiting the dental clinic as well.

An improved de Laval nozzle experiment

2021 ◽  
pp. 030641902110341
Author(s):  
Nicholas Goodman ◽  
Brian J Leege ◽  
Peter E Johnson
Keyword(s):  
Data Acquisition ◽  
Laval Nozzle ◽  
Flow Characteristics ◽  
Data Acquisition System ◽  
Isentropic Flow ◽  
Hands On ◽  
De Laval Nozzle ◽  
Physical Phenomena ◽  
The Impact ◽  
The Relationship

Exposing students to hands-on experiments has been a common approach to illustrating complex physical phenomena that have been otherwise modelled solely mathematically. Compressible, isentropic flow in a duct is an example of such a phenomenon, and it is often demonstrated via a de Laval nozzle experiment. We have improved an existing converging/diverging nozzle experiment so that students can modify the location of the normal shock that develops in the diverging portion to better understand the relationship between the shock and the pressure. We have also improved the data acquisition system for this experiment and explained how visualisation of the standing shock is now possible. The results of the updated system demonstrate that the accuracy of the isentropic flow characteristics has not been lost. Through pre- and post-laboratory quizzes, we show the impact on student learning as well.

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